In recent years, with the continuous progress of medical technology, the survival rate of cancer patients after treatment has been continuously improved, and more and more young cancer patients begin to pay attention to the fertility problem after survival. For prepubertal or adolescent cancer patients who require urgent chemoradiotherapy, and for reproductive female patients, ovarian tissue cryopreservation (OTC) follows by transplantation is the only option to preserve their fertility at present. Although the OTC technology has been carried out as a routine clinical project in a few medical institutions in China, it is still in the stage of clinical trial research in majority medical institutions. There are still many technical and ethical challenges in clinical practice of OTC technology. Therefore, this paper discussed the ethical principles that should be followed in clinical practice of human OTC and transplantation, and briefly analyzed the corresponding ethical issues. When implementing this technology, the indications should be followed strictly, the wishes of patients should be respected and true and full informed consent should be obtained while ensuring that the cancer treatment of patients is not delayed. Besides, it is significants to accumulate enough experience for minor patients to fully protect their rights and interests and promote the construction of relevant national laws and regulations.

The discussion and research on the clinical dominant diseases of traditional Chinese medicine （TCM） have attracted increasing attention. Through approaches including modern technology， evidence-based medical methods， and multi-disciplinary treatment， we should construct a sound TCM inheritance and innovation system， establish a collaborative innovation mechanism， and integrate major research projects， striving to make breakthroughs in TCM theory， methodology， standards， and regulation system， promoting the scientific and technological progress of TCM， and thereby improving its curative effect. The China Association of Chinese Medicine （CACM） carried out a series of youth salon seminars for clinical dominant diseases in TCM， discussing and sorting out the advantages of the dominant diseases in clinical diagnosis and treatment of TCM and integrated traditional Chinese and western medicine in specific diseases or fields. Authoritative experts in the industry were invited to give comment and guidance to form a report. Centering on clinical research of dominant diseases， thematic research was carried out in the aspects of practice， human experience-based evidence， and transformation path. Through the systematic study of the dominant diseases， the advantages of TCM in different stages of disease treatment were excavated to constantly improve the prevention and treatment ability of TCM and carry forward the advancement of TCM theory and practice. At the same time， the communication and understanding between traditional Chinese and western medicine were improved， laying the foundation for the further formation of industry guidelines or consensus and comprehensive promotion. These seminars are expected to provide references for the development of policy planning， clinical diagnosis and treatment， health economy， and social services in TCM and lay the foundation for the formation of a new modern diagnosis and treatment system with Chinese characteristics.

Objective:To compare the clinical efficacies of O-arm combined with CT three-dimensional navigation system assisted screw placement versus manual screw placement in treating lower cervical fracture and dislocation.Methods:A retrospective cohort study was used to analyze the clinical data of 41 patients with lower cervical fracture and dislocation, who were treated in Honghui Hospital, Xi′an Jiaotong University from May 2021 to February 2022. The patients included 26 males and 15 females, aged 31.5-48.6 years [(41.5±15.0)years]. The injured segments were C 3 in 3 patients, C 4 in 12, C 5 in 13, C 6 in 10 and C 7 in 3. Nineteen patients were treated with cervical pedicle screws by O-shaped arm combined with CT three-dimensional navigation system (navigation group, 76 screws) and 22 by bare hands (traditional group, 88 screws). The total operation time, effective operation time, single nail placement time, single screw correction times, screw distance from anterior cortex, intraoperative blood loss, intraoperative fluoroscopic radiation dose, incision length and length of hospital stay were compared between the two groups, and the height of intervertebral space, Cobb angle, interbody slip distance and American Spinal injury Association (ASIA) grade were compared before operation and at 3 days after operation. Visual analogue score (VAS), Japanese Orthopedic Association (JOA) score, and neck dysfunction index (NDI) were evaluated before operation, at 3 days, 3 months after operation and at the last follow-up. Accuracy of screw placement and incidence of complications (adjacent facet joint invasion, infection, screw loosening) were detected as well. Results:All the patients were followed up for 11.1-13.9 months [(12.5±1.4)months]. The total operation time, intraoperative blood loss, intraoperative fluoroscopic radiation dose and incision length in the navigation group were more or longer than those in the traditional group (all P<0.05). The effective operation time, single nail placement time, single nail correction times and screw distance from anterior cortex in the navigation group were markedly less or smaller than those in the traditional group (all P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). There were significant improvements in the height of intervertebral space, Cobb angle and interbody slip distance between the two groups at 3 days after operation (all P<0.05). There was no significant difference in the height of intervertebral space, Cobb angle, interbody slip distance or ASIA grade between the two groups before operation or at 3 days after operation (all P>0.05). Compared with pre-operation, the VAS, JOA score and NDI were significantly improved in both groups at 3 days, 3 months after operation and at the last follow-up (all P<0.05), with further improvement with time. There was no significant difference in VAS between the two groups before operation or at 3 months after operation (all P>0.05), but it was markedly lower in the navigation group compared with the traditional group at 3 days after operation and at the last follow-up (all P<0.05). There were no significant differences in JOA score or NDI between the two groups before operation or at 3 days and 3 months after operation (all P>0.05), but both were lower in the navigation group compared with the traditional group at the last follow-up (all P<0.05). The accuracies of placement of grade 0 and grade 0+1 screws were 92.0% (70/76) and 96.6% (73/76) in the navigation group, respectively, which were markedly higher than 88.7% (78/88) and 93.5% (82/88) in the traditional group (all P<0.05). The rates of adjacent facet joint invasion of A, B, and C degrees were 71.2% (54/76), 28.8% (22/76) and 0% (0/76) in the navigation group, respectively, while the invasion rates were 60.5% (53/88), 32.3% (28/88) and 7.3% (7/88) in the traditional group ( P<0.05). No screw loosening was noted in the navigation group, but the screw loosening rate was 9.1% (8/88) in the traditional group ( P<0.01). Conclusion:Compared with manual screw placement, O-arm combined with CT three-dimensional navigation system assisted screw placement for lower cervical fracture and dislocation has the advantages of shorter effective operation time, quicker screw placement, stronger screw holding force, better cervical stability, slighter postoperative pain, higher screw placement accuracy, and lower facet joint invasion and screw loosening rates.

Objective:To compare the efficacy of cervical decompression performed at different times in the treatment of incomplete cervical spinal cord injury.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 96 patients with incomplete cervical spinal cord injury admitted to six hospitals including Honghui Hospital affiliated to Xi'an Jiaotong University, etc, from May 2018 to May 2021. There were 36 females and 60 males, aged 28-42 years [(35.2±6.7)years]. The injured segments were at C 3 in 7 patients, C 4 in 15, C 5 in 20, C 6 in 23 and C 7 in 31. According to the American Spinal Injury Association (ASIA) scale, there were 59 patients with grade B, 27 grade C, and 10 grade D. A total of 36 patients underwent cervical decompression within 24 hours after injury (early group), 33 patients within 24-72 hours after injury (late group), and 27 patients within 4-14 days after injury (delayed group). The operation time, intraoperative blood loss, postoperative drainage, length of hospital stay, Cobb angle, height of intervertebral space and space occupation of the spinal canal before surgery and at postoperative 3 days, and ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, visual analog scale (VAS) score, Japanese Orthopedic Association (JOA) score, neck dysfunction index (NDI) before surgery and at postoperative 3 months, 1 year and at the last follow-up and incidence of complications were compared among the three groups. Results:All the patients were followed up for 12-21 months [(16.4±4.2)months]. There was no significant difference in the operation time among the three groups (all P>0.05). The intraoperative blood loss and postoperative drainage volume in the early group were (312.5±5.2)ml and (165.3±45.8)ml, which were higher than those in the late group [(253.5±40.0)ml, (120.4±60.6)ml] and the delayed group [(267.3±36.8)ml and (130.4±38.6)ml] (all P<0.01). There was no significant difference between the late group and the delayed group (all P>0.05). The length of hospital stay in the early group was (5.2±1.6)days, which was shorter than that in the late group [(7.6±2.3)days] and the delayed group [(8.0±1.3)days] (all P<0.05), but there was no significant difference between the late group and the delayed group ( P>0.05). There was no significant difference in the Cobb angle, height of intervertebral space and space occupation of the spinal canal among the three groups before and at postoperative 3 days (all P>0.05). There was no significant difference in the ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, VAS score, JOA score and NDI among the three groups before surgery (all P>0.05). At postoperative 3 months, 1 year and at the last follow-up, the ASIA grading of the early group was better than that of the late group and the delayed group ( P<0.05 or 0.01), but there was no statistically significant difference between the late group and the delayed group (all P>0.05). The ASIA motor scores of the early group were (56.4±4.5)points, (76.3±3.6)points and (85.4±6.5)points at postoperative 3 months, postoperative 1 year and the last follow-up, respectively, which were higher than those in the late group [(52.3±2.4)points, (60.3±8.6)points and (72.3±2.4)points] and the delayed group [(51.9±2.3)points, (62.8±4.6)points and (71.9±1.3)points]; the ASIA light tactile scores of the early group were (70.2±2.9)points, (72.6±4.3)points and (78.3±2.3)points, which were higher than those in the late group [(66.2±3.7)points, (68.3±1.6)points and (73.3±1.6)points] and the delayed group [(65.2±2.1)points, (67.8±1.9)points and (72.3±2.5)points]; acupuncture sensation scores of the early group were (71.9±3.1)points, (80.1±3.8)points and (89.1±7.6)points, which were higher than those in the late group [(67.4±2.7)points, (72.6±3.7)points and (77.9±1.8)points] and the delayed group [(68.3±2.2)points, (72.6±3.1)points and (77.2±1.9)points] (all P<0.05). VAS scores of the early group at postoperative 3 months, 1 year and at the last follow-up were (4.3±0.6)points, (2.4±0.3)points and (1.6±0.2)points, which were lower than those in the late group [(5.1±1.3)points, (4.1±0.6)points and (3.0±0.6)points] and the delayed group [(5.0±1.7)points, (4.0±0.8)points and (3.1±0.2)points]; JOA scores of the early group were (12.8±1.6)points, (14.4±2.6)points and (17.9±3.3)points, which were higher than those in the late group [(11.9±1.9)points, (13.3±1.6)points and (8.9±1.3)points] and the delayed group [(11.6±1.8)points, (13.2±1.4)points and (9.3±2.1)points]; NDI scores of the early group were 12.1±3.3, 10.1±2.1 and 7.3±1.4, which were lower than those in the late group (14.4±3.1, 12.3±1.6 and 8.9±1.3) and the delayed group (14.1±2.3, 12.9±1.9 and 9.5±2.1) (all P<0.05). There was no significant difference in all the above-mentioned scores at postoperative 3 months, 1 year and at the last follow-up between the late group and the delayed group (all P>0.05). The incidence of complications was 25.0% (9/36) in the early group, 27.3% (9/33) in the late group and 37.0% (10/27) in the delayed group (all P>0.05). Conclusion:Compared with within 24-72 hours and 4-14 days after injury, cervical decompression performed within 24 hours after injury for patients with incomplete cervical spinal cord injury can shorten the length of hospital stay, improve the function of the spinal cord nerves and relieve pain, with no increase of the incidence of complications.

Objective:To evaluate the efficacy of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of type IIIA acute symptomatic osteoporotic lumbar fracture (ASOLF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 117 patients with type IIIA ASOLF admitted to Honghui Hospital of Xi′an Jiaotong University from April 2016 to February 2018, including 32 males and 85 females, aged 60 to 88 years [(68.3±5.7)years]. Injury segments were located at L 1 in 35 patients, at L 2 in 38, at L 3 in 26 and at L 4 in 18. All patients were treated with PKP. A total of 61 patients were treated using the midpoint of the transverse process-articular process displacement as the puncture point (unilateral puncture group) and 56 patients were treated using the traditional "2" point and "10" point as the puncture point (bilateral puncture group). The operation time, amount of radiation exposure of patients and surgeons and bone cement injection volume were compared between the two groups. The Cobb angle, height of anterior edge of injured vertebrae, visual analogue scale (VAS) and Oswestry disability index (ODI) were compared before operation, at day 1 after operation and at the final follow-up. Intraoperative and postoperative complications were observed. Results:All patients were followed up for 24-35 months [(26.3±4.7)months]. The operation time and amount of radiation exposure of patients were (20.4±5.6)minutes and (1.08±0.44)mSv in unilateral puncture group, significantly different from (37.5±9.2)minutes and (2.24±0.58)mSv in bilateral puncture group (all P<0.01). There were no significant differences in amount of radiation exposure of surgeons and bone cement injection volume between the two groups (all P>0.05). In unilateral puncture group and bilateral puncture group, the Cobb angle of fractured vertebrae at day 1 after operation [(22.4±10.7)°, (23.4±11.1)°] and at the final follow-up [(24.3±8.3)°, (23.5±9.5)°] was significantly decreased from that before operation [(29.6±9.7)°, (30.6±12.9)°] (all P<0.01); the height of anterior edge of injured vertebrae at day 1 after operation [(80.4±12.6)%, (78.8±11.9)%] and at the final follow-up [(79.3±10.7)%, (77.4±11.2)%] was significantly increased from that before operation [(65.7±6.3)%, (66.4±9.7)%] (all P<0.01); the VAS at day 1 after operation [(2.1±0.5)points, (2.3±1.1)points] and at the final follow-up [(1.9±0.8)points, (2.0±0.6)points] was significantly decreased from that before operation [(7.1±0.7)points, (7.2±0.9)points] (all P<0.01); the ODI at day 1 after operation (21.1±9.7, 22.9±7.9) and at the final follow-up (18.5±4.6, 19.8±9.4) was significantly decreased from that before operation (72.7±4.5, 73.1±3.7) (all P<0.01). While the above four parameters between the two groups had no significant differences at each time point, with no significant differences within each group at day 1 after operation and at the final follow-up (all P>0.05). There were 13 patients [21% (13/61)] with cement leakage in unilateral puncture group as compared to 18 patients [29% (18/56)] in bilateral puncture group ( P<0.05). There were 4 patients [7% (4/61)] with adjacent vertebral fracture in unilateral puncture group, similar to 5 patients [9% (5/56)] in bilateral puncture group ( P>0.05). The lower back pain caused by facet injury were noted in 8 patients [14% (8/56)] in bilateral puncture group who were relieved after 1 month of non-surgical treatment, but none occurred in unilateral puncture group ( P<0.01). Conclusions:Unilateral and bilateral PKP can obtain satisfactory clinical efficacy in the treatment of type IIIA ASOLF, but the former has advantages of shorter operation time, less radiation exposure and lower incidence of bone cement leakage and facet injury.

In recent years, with the continuous progress of medical technology, the survival rate of cancer patients after treatment has been continuously improved, and more and more young cancer patients begin to pay attention to the fertility problem after survival. For prepubertal or adolescent cancer patients who require urgent chemoradiotherapy, and for reproductive female patients, ovarian tissue cryopreservation (OTC) follows by transplantation is the only option to preserve their fertility at present. Although the OTC technology has been carried out as a routine clinical project in a few medical institutions in China, it is still in the stage of clinical trial research in majority medical institutions. There are still many technical and ethical challenges in clinical practice of OTC technology. Therefore, this paper discussed the ethical principles that should be followed in clinical practice of human OTC and transplantation, and briefly analyzed the corresponding ethical issues. When implementing this technology, the indications should be followed strictly, the wishes of patients should be respected and true and full informed consent should be obtained while ensuring that the cancer treatment of patients is not delayed. Besides, it is significants to accumulate enough experience for minor patients to fully protect their rights and interests and promote the construction of relevant national laws and regulations.

Objective To explore the effect of EZH2 on Hcy-induced cholesterol accumulation of foam cells. Methods THP-1 foam cells were divided into control group ,100 μmol/L Hcy group and folic acid group. Lipid droplet in foam cells was tested by Oil red O. TC and TG contents in cells were determined by enzymic meth od. H3K27me3 level and EZH2 protein expression were detected by Western-blot. EZH2 mRNA expression was assayed by q-PCR. H3K27me3 level and TC and TG contents were examined followed by overexpression or knock- down of EZH2. Results After administration of Hcy,TC and TG contents in foam cells were increased (P <0.05). H3K27me3 level and EZH2 expression were also increased(P<0.05). Overexpression of EZH2 caused the expansion of H3K27me3 level,and the TC and TC contents were also increased(P<0.05). Conclusion Regula-tion of H3K27me3 by EZH2 might be involved in Hcy-induced accumulation of cholesterol in foam cells.

To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.

To establish diagnostic criteria for common traditional Chinese medicine (TCM) syndromes in osteoporosis.

Objective: To establish a quantitative model for evaluating the degree of traditional Chinese medicine (TCM) syndromes often seen in patients with coronary heart disease (CHD). Methods: Medical literature concerning clinical investigation of TCM syndromes of CHD was collected and organized, and the "Hall for Workshop of Metasynthetic Engineering" expert symposium method was applied. First, the 100 millimeter scaling was used for combining with scoring on degree of symptoms to establish a quantitative criterion for classification of symptom degree in CHD patients, and the model was established by using comprehensive analytic hierarchy process as the mathematical tool to estimate the weight of the criterion for evaluating qualitative syndromes in various layers by specialists. Then the model was verified in clinical practice and the outcomes were compared with fuzzy evaluation from the specialists. Results: A total of 287 clinical observation forms on CHD cases were collected, and 167 forms were available after excluding any irregular forms. The results showed that basic coincidence rate between the outcomes derived from specialists and those from the model was 68.26% (114/167), and part coincidence rate was 88.62%(148/167). Conclusion: This model, with good rationality and feasibility, has a high coincidence rate with fuzzy evaluation from specialists, and can be promoted in clinical practice. It is a good quantitative model for evaluating the degree of TCM syndromes of CHD.