In recent years,there has been a consensus regarding the enhancement of prognosis in patients with ad-vanced non-small cell lung cancer(NSCLC)through the utilization of immune checkpoint inhibitors(ICIs).Numerous clini-cal studies have also demonstrated the substantial value of immunotherapy for resectable NSCLC patients.Nevertheless,there remain controversies surrounding the exploration of immune combination strategies,treatment-related side effects,prognostic biomarkers,as well as other issues in the neoadjuvant therapy setting.Consequently,this article presents a comprehensive overview of the recent advancements in neoadjuvant immunotherapy for resectable NSCLC,stimulating fresh perspectives and delving into its merits and challenges in clinical application.

Large cell neuroendocrine carcinoma(LCNEC)of lung is a rare neuroendocrine carcinoma subtype with difficulty in early diagnosis and poor prognosis which is treated with standard strategies of small cell lung cancer and non-small cell lung cancer.In recent years,the precise types of LCNEC and its response to therapy have been identified by next-generation sequencing.Some researches have also found the correlation between different subtypes of LCNEC and the efficacy of chemotherapy regimens.However,there is no consensual agreement of its therapy.Recently,immune checkpoint inhibitors(ICIs)has provided a new option for LCNEC patients based on some retrospective research data and case reports.In this review,we aimed to summarize the epidemiological characteristics,standard therapy,the advances of molecular subtypes and clinical applications of ICIs of LCNEC,so as to provide optimal systemic clinical decision-making for LCNEC patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Central nervous system （CNS） is a sophisticated system subject to complex regulation， which dominates the high-level neural activities of the human body. Due to its complex physiological structure and refined regulatory mechanism covering a variety of diseases， CNS is the place where many chronic， refractory and rare diseases occur. Nerve cell is the basic unit of CNS， and its dysfunction and death is the root cause of CNS diseases. Ferroptosis is a new form of programmed cell death proposed in recent years， and has been proved to be closely related to the production and development of multiple CNS diseases. Traditional Chinese medicine （TCM）， including Chinese herbs， acupuncture and moxibustion， and massage， has shown unique advantages in the treatment of CNS diseases for a long time. A large number of studies have demonstrated that TCM participates in the regulation of CNS diseases via regulating ferroptosis and shows a good research prospect. This paper summarized the characteristics of ferroptosis and discussed the association between ferroptosis and CNS diseases in pathological mechanism. We also reviewed the regulation of various CNS diseases by different TCM interventions through ferroptosis， providing references for TCM to participate in the treatment of CNS diseases properly in the future.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Humans ; COVID-19 ; Epidemics ; Respiratory Tract Diseases ; Hospitalization

Lung cancer is the malignancy with the highest mortality rate worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer severely affects the quality of life and prognosis of patients. Tumor-associated genetic testing is the basis for making precise treatment decisions. There are some risks of tissue biopsy, and it is difficult to sample repeatedly. Due to its non-invasive and can reflect the full profile of tumor gene characteristics, liquid biopsy is increasingly used in the diagnosis and treatment of lung cancer. Because of the extremely low DNA level of circulating tumor, the sensitivity and specificity of liquid biopsy based on blood samples are limited. Tumor cells is enriched in MPE. The detection of cell-free DNA, extracellular vesicles and microRNA in MPE will be helpful to the diagnose, treatment and assess prognosis of patients with lung cancer. This review aims to discuss the research progress of liquid biopsy based on MPE in the diagnosis and treatment of lung cancer patients.
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Objective:To investigate the clinical effects of robot-assisted minimally invasive percutaneous pedicle screwing in the treatment of multi-segmental thoracolumbar burst fractures without neurological dysfunction.Methods:A retrospective analysis was conducted of the 24 patients who had been treated at Department of Orthopaedics, Hospital Affiliated to Inner Mongolia Medical University for multi-segmental thoracolumbar fractures from January 2019 to December 2020. They were randomly divided into a robot group ( n=12) in which the minimally invasive percutaneous pedicle screwing was assisted by a surgical robot and a manual group ( n=12) in which the minimally invasive percutaneous pedicle screwing was performed manually. There were 8 males and 4 females in the robot group, aged from 35 to 74 years; there were 7 males and 5 females in the manual group, aged from 36 to 69 years. The clinical effects were evaluated by comparing the 2 groups in terms of operation time, fluoroscopy frequency, fluoroscopy time, intra-operative needle adjustments, intra-operative blood loss, screwing accuracy, and visual analogue scale (VAS) scores, anterior vertebral height ratios and sagittal cobb angles at preoperation, postoperative 3 days and the last follow-up. Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). A total of 128 screws were implanted in the robot group and 126 ones in the manual group. In the robotic group, operation time [(129.2±10.5) min], fluoroscopy frequency [(8.5±2.1) times], fluoroscopy time [(9.8±1.9) s], guide needle adjustments [(2.3±1.4) times], and intraoperative blood loss [(65.3±9.8) mL] were significantly less than those in the manual group [(153.8±18.1) min, (39.8±5.1) times, (43.9±4.8) s, (18.6±2.6) times and (96.8±10.9) mL] (all P<0.05). Regarding the screwing accuracy evaluated using CT scanning, the robot group was significantly higher (93.75%, 120/128) than the manual group (84.92%, 107/126) ( P<0.05). There was no significant difference between the 2 groups in VAS score, anterior vertebral height ratio or sagittal cobb angle at postoperative 3 days or the last follow-up ( P>0.05). The VAS scores, anterior vertebral height ratios and sagittal cobb angles at postoperative 3 days and the last follow-up were significantly improved than the preoperative values in all patients ( P<0.05). There was no supplementary surgery or screw loosening in either of the 2 groups. Conclusion:In the treatment of multi-segmental thoracolumbar fractures, robot-assisted percutaneous pedicle screwing can achieve satisfactory clinical effects, because, compared with traditional open surgery, it has exhibited advantages of less operation time, lower radiation exposure, less intraoperative blood loss, and higher screwing accuracy.

Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.

Objective To observe the Leu72Met single nucleotide polymorphism (SNP)of ghrelin gene and the relationship with essential hypertension (EH).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to detect the Leu72Met SNP of ghrelin gene in 210 EH patients and 220 healthy controls.The plasma ghrelin was detected by radioimmunoassay method collected from all subjects. Results There were three types of polymorphism of ghrelin gene at the base site Leu72Met.There were significant differences in the genotypes (CC,CA,AA)and alleles (C,A)between the EH patients and the controls (χ2 =6.054,P =0.048;χ2 =5.866,P =0.015).In EH group,the plasma ghrelin level in subjects who were homozygous CC without mutant was not only significantly lower than those who were heterozygous CA,but also lower than those who were nucleotide homozygous mutant AA (t =-8.738,P =0.000;t =-5.103,P =0.000).The patients with CC genotype had higher SBP (t =4.298,P =0.000;t =2.236,P =0.019)and lower HDL -C (t =-11.682,P =0.000;t =-7.872,P =0.000).The patients with A allele had lower plasma ghrelin (t =-16.264,P =0.000), HDL -C (t =-15.332,P =0.000)and higher SBP(t =3.800,P =0.000),DBP(t =11.895,P =0.000),and LDL -C (t =38.401,P =0.000).Conclusion The Leu72Met SNP of ghrelin gene is significantly related to the susceptibility of EH.Base mutation C to A reduced the incidence of EH.The Leu72Met polymorphism of ghrelin gene is related to the plasma ghrelin,blood pressure and blood lipid metabolism.Base mutation C to A elevated plasma ghrelin,and lowered blood pressure and blood lipid.