The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective To investigate the efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) previously treated with tyrosine kinase inhibitor (TKI). Methods A retrospective analysis was performed for the clinical data of 76 patients with unresectable HCC who were treated with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 2019 to January 2020, and according to the treatment method, they were divided into TKI previously untreated group with 49 patients and TKI treatment-experienced group with 27 patients. The patients were observed till one year after enrollment, adjustment of treatment regimen, tumor progression, or death. The two groups were compared in terms of progression-free survival (PFS) time, objective response rate (ORR), disease control rate (DCR), and incidence rate of adverse events. The t -test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test or the Wilcoxon rank-sum test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison between groups. Results There were no significant differences between the TKI previously untreated group and the TKI treatment-experienced group in median PFS time (115 days vs 72 days, P =0.148), ORR (36.7% vs 18.5%, P =0.098), DCR (65.3% vs 55.6%, P =0.402), and incidence rates of grade ≥3 adverse events (24.5% vs 18.5%, P =0.550). Conclusion Patients with unresectable HCC previously treated with TKI can benefit from lenvatinib and have good safety, with similar results to those treated with TKI for the first time.

Objective:To investigate the measurement of small airways by high-resolution CT and image post-processing software. Screen and analyze the reconstructed airway parameters in order to find the best imaging biomarker parameters of small airway changes and calculate the reference value range; meanwhile, explore its influencing factors.Methods:From a water plant and a medical school, 169 cases of the general population aged 20 to 60 were selected as research objects, and questionnaire surveys and CT tests were performed, and CT data were reconstructed with image post-processing software. The reference value range of the general population was evaluated, and a linear mixed effect model was used to adjust the age, gender, height, BMI, and smoking status, and analyze the influencing factors of airway parameters.Results:The ratio of sixth-grade tracheal wall area to total tracheal area in the Left B1+2 to carina was (53.01±13.35) %, Left B9 to carina was (50.44±12.98) %, Right B1 to carina was (52.73±12.22) %, and Right B9 to carina was (52.93±11.85) %. The ratio of nineth-grade tracheal wall area to total tracheal area in the Left B1+2 to carina was (44.08±14.66) %, Left B9 to carina was (42.44±15.89) %, Right B1 to carina was (46.51±14.03) %, and Right B9 to carina is (43.54±15.87) %. BMI affect the area of the tracheal wall, all p value<0.05.Conclusion:High-resolution CT small airway morphology can make a preliminary assessment of the susceptible population of small airway-related diseases based on a range of reference values, and prevent and control it in combination with influencing factors.

Objective:To investigate the measurement of small airways by high-resolution CT and image post-processing software. Screen and analyze the reconstructed airway parameters in order to find the best imaging biomarker parameters of small airway changes and calculate the reference value range; meanwhile, explore its influencing factors.Methods:From a water plant and a medical school, 169 cases of the general population aged 20 to 60 were selected as research objects, and questionnaire surveys and CT tests were performed, and CT data were reconstructed with image post-processing software. The reference value range of the general population was evaluated, and a linear mixed effect model was used to adjust the age, gender, height, BMI, and smoking status, and analyze the influencing factors of airway parameters.Results:The ratio of sixth-grade tracheal wall area to total tracheal area in the Left B1+2 to carina was (53.01±13.35) %, Left B9 to carina was (50.44±12.98) %, Right B1 to carina was (52.73±12.22) %, and Right B9 to carina was (52.93±11.85) %. The ratio of nineth-grade tracheal wall area to total tracheal area in the Left B1+2 to carina was (44.08±14.66) %, Left B9 to carina was (42.44±15.89) %, Right B1 to carina was (46.51±14.03) %, and Right B9 to carina is (43.54±15.87) %. BMI affect the area of the tracheal wall, all p value<0.05.Conclusion:High-resolution CT small airway morphology can make a preliminary assessment of the susceptible population of small airway-related diseases based on a range of reference values, and prevent and control it in combination with influencing factors.

Objective: To explore the clinical application effect of the orbital periorbital perforator flap pedicled with zygomatic artery to repair the defect of eyelid ectropion and the defect after tumor resection. Methods: (1)Perfused 10 fresh cadavers gelatin lead oxidate with one-time arteriography and CT spiral scanning, and imported DICOM data into Mimics 17.0 for rapid body mapping and three-dimensional reconstruction, and observed the source of zygomatic orbital artery and distribution rules of perforating branches. (2)From July 2012 to July 2017, 18 clinical cases were repaired by orbital periorbital perforator flap pedicled with zygomatic artery, the flap was cut with the same width as the defect width, and the length of the flap was 2 to 3 times the defect length, with an area of 0.3 cm × 1.5 cm to 2.0 cm × 3.0 cm. Results: The zygomatic orbital artery originated from the superficial temporal artery, extending up to about the midpoint of the line between the anterior ear and the lateral canthus.The clinical application of the orbital periorbital flap with the perforating branch of the zygomatic orbital artery in 18 cases survived and healed well. After 1 month to 2 years of follow-up, the color, texture and shape function recovered well. Conclusions The orbital periorbital flap with the perforating branch of the zygomatic orbital artery is a good method for reconstruction of ectropion and palpebral defect due to its reliable movement and the arterial arch connected with the orbicularis suborbicularis.

The purpose is to establish an emergency medical system that covers a certain region, responds quickly, operates efficiently, functions perfectly and develops sustainably. Such a system leverages the potential social functions of research disciplines, and is guided by the concept of " expanding the emergency system of comprehensive emergency medicine". The authors identified the problems and shortcomings of the existing system and proposed to build a regional emergency medical system led by research disciplines. The path, system layout and functions are stated explicitly, while the system construction strategy is proposed by taking emergency treatment of myocardial infarction patients as an example. The system will be the pivotal support for integrating effectively regional emergency medical resources, improving the ability and level of emergency and first aid in medical institutions at various levels and of different types, promoting the formation of a new pattern of regional emergency medical service and achieving homogenized emergency medical services that everyone enjoy.

Precision medicine is an emerging approach for disease treatment and prevention , which attempts to explore the effective means for protecting human health by synthetical consideration of individual variability in genes , environment and life style.Precision medicine has the prominent property of multidisciplinary intercrossing and fusion , the development of which claims rapid clinical application of advanced technology in the research of basic medical science.What kind of development opportunities are laboratory medicine confronted with under the novel medical mode? How can laboratory medicine and its researchers do to seize these opportunities and meet the challenges of precision medicine ? These questions are preliminary discussed in this paper.

The aim of this study is to identify the express specificity of bone morphogenetic protein 15 (Bmp15) in porcine. The pBMP15-EGFP reporter vector was constructed from the 2.2 kb fragment of porcine bmp15 promoter to trace the differentiation process of stem cells into oocyte-like cells. We used porcine ovary and Chinese Hamster Ovary cell line (CHO), mouse myoblast cell line (C2C12) and porcine amniotic fluid stem cell (pAFSC) to investigate the expression and regulation of this gene via RT-PCR, immunofluorescence, cell transfection, and microinjection methods. We also used single layer cell differentiation to detect the application potential of bmp15. The results show that bmp15 gene was specifically expressed in the porcine ovary and CHO rather than in C2C12 and pAFSC. In addition, the characteristic of tissue-specific of Bmp15 was detected on CHO instead of other cell lines by transient transfection. We also detected the expression of Bmp15 in oocyte at different development stages by immunofluorescence of fixed paraffin-embedded ovary sections. Furthermore, microinjection results show that bmp15 expressed in oocytes at 18 h of maturation in vitro, and continued up to 4-cell stage embryos. Most importantly, we found that the expression of Bmp15 started at day 12 after inducing pAFSC into oocyte-like cells by transfection; green fluorescent was visible in round cell masses. It indicated that bmp15 has the expression specificity and the pBMP15-EGFP reporter vector can be used to trace Bmp15 action in the differentiation of stem cells into germ cells.
Animals ; Bone Morphogenetic Protein 15 ; genetics ; CHO Cells ; Cell Differentiation ; Cricetinae ; Cricetulus ; Female ; Genes, Reporter ; Genetic Vectors ; Mice ; Microinjections ; Myoblasts ; cytology ; Oocytes ; metabolism ; Ovary ; metabolism ; Stem Cells ; cytology ; Swine

Objective To evaluate the effects of botulinum toxin type A (BTX-A) on spasticity of wrist and hand post stroke. Methods 36 patients accepted BTX-A injection were assessed with modified Ashworth scale (MAS), Upper Extremities Functional Test (UEFT), limbs position at rest, Visual Analogous Scale (VAS) for pain, modified Barthel Index (MBI), and difficulties encountered during 3 upper limb motor tasks: cleaning the affected palm, cutting the affected fingernails, putting the affected arm into the sleeve, before and 2, 4, and 12 weeks after treatment. Results The scores of MAS, VAS, UEFT and accomplishment of those tasks improved after treatment (P<0.05), from 1 week to 12 weeks. No significant improvement was observed in MBI (P>0.05). Conclusion Local BTX-A injection can reduce the spasticity and pain, and improve function of upper limbs for stroke patients.