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.

Objective:To retrieve, evaluate, and integrate the best evidence for enteral nutrition management in children with prone position ventilation, providing a basis for constructing clinical nursing practice programs for enteral nutrition management in children with prone position ventilation.Methods:Evidence on the management of enteral nutrition in children with prone position ventilation, including clinical decisions, guidelines, expert consensus, systematic reviews, and original studies, was electronically retrieved on UpToDate, BMJ Best Practice, Joanna Briggs Institute Evidence-Based Health Care Center Database in Australia, Cochrane Library, CINAHL, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Data, Chinese Medical Journal Full-text Database, China Biology Medicine disc, Medlive, Guidelines International Network, National Institute for Health and Clinical Excellence, European Society for Parenteral and Enteral Nutrition, American Society for Parenteral and Enteral Nutrition and British Dietetic Association. The search period was from the establishment of the database until June 30, 2023. Two researchers independently screened literature, and extracted and summarized evidence from literature that met quality standards.Results:A total of 17 articles were included, including three clinical decisions, 7 guidelines, three expert consensus, two systematic reviews, one cross-sectional study, and one cohort study. Twenty-six pieces of evidence were summarized from 7 themes of preparation before prone position operation, post operation organization, timing of enteral nutrition restart in prone position, management of prone position, selection of feeding methods, management of feeding intolerance, and prevention of aspiration.Conclusions:The best evidence for enteral nutrition management in children with prone position ventilation covers the entire process of enteral nutrition management in prone position children, with strong guidance and operability, which can provide a basis for enteral nutrition management in children with prone position ventilation. Medical and nursing staff should further refine evidence-based nursing practice programs based on the characteristics of children of different age groups, standardize the operation process of enteral nutrition in children with prone position ventilation, ensure the target feeding amount, and reduce the occurrence of complications.

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.

cFos is one of the most widely-studied genes in the field of neuroscience. Currently, there is no systematic database focusing on cFos in neuroscience. We developed a curated database—cFos-ANAB—a cFos-based web tool for exploring activated neurons and associated behaviors in rats and mice, comprising 398 brain nuclei and sub-nuclei, and five associated behaviors: pain, fear, feeding, aggression, and sexual behavior. Direct relationships among behaviors and nuclei (even cell types) under specific stimulating conditions were constructed based on cFos expression profiles extracted from original publications. Moreover, overlapping nuclei and sub-nuclei with potentially complex functions among different associated behaviors were emphasized, leading to results serving as important clues to the development of valid hypotheses for exploring as yet unknown circuits. Using the analysis function of cFos-ANAB, multi-layered pictures of networks and their relationships can quickly be explored depending on users’ purposes. These features provide a useful tool and good reference for early exploration in neuroscience. The cFos-ANAB database is available at www.cfos-db.net.

cFos is one of the most widely-studied genes in the field of neuroscience. Currently, there is no systematic database focusing on cFos in neuroscience. We developed a curated database-cFos-ANAB-a cFos-based web tool for exploring activated neurons and associated behaviors in rats and mice, comprising 398 brain nuclei and sub-nuclei, and five associated behaviors: pain, fear, feeding, aggression, and sexual behavior. Direct relationships among behaviors and nuclei (even cell types) under specific stimulating conditions were constructed based on cFos expression profiles extracted from original publications. Moreover, overlapping nuclei and sub-nuclei with potentially complex functions among different associated behaviors were emphasized, leading to results serving as important clues to the development of valid hypotheses for exploring as yet unknown circuits. Using the analysis function of cFos-ANAB, multi-layered pictures of networks and their relationships can quickly be explored depending on users' purposes. These features provide a useful tool and good reference for early exploration in neuroscience. The cFos-ANAB database is available at www.cfos-db.net .
Animals ; Fear ; Mice ; Neurons ; Proto-Oncogene Proteins c-fos ; Rats

Objective To evaluate the safety and efficacy of botulinum toxin type A for injection in the treatment of post-stroke upper limb spasticity (dosage was 200 U,or 240 U if combined with thumb spasticity).Methods The study was a multi-center,stratified block randomized,double-blind,placebocontrolled trial.All the qualificd subjects were from 15 clinical centers from September 2014 to February 2016.They were randomized (2∶1) to injections of botulinum toxin type A made in China (200-240 U;n =118) or placebo (n =60) in pivotal phase after informed consent signed.The study was divided into two stages.The pivotal trial phase included a one-week screening,12-week double-blind treatment,followed by an expanded phase which included six-week open-label treatment.The tone of the wrist,finger,thumb flexors was assessed at baseline and at weeks 0,1,4,6,8,12,16 and 18 using Modified Ashworth Scale (MAS),disability in activities of daily living was rated using the Disability Assessment Scale and impaction on pain,muscle tone and deformity was assessed using the Global Assessment Scale.The primary endpoint was the score difference between botulinum toxin type A and placebo groups in the tone of the wrist flexor using MAS at six weeks compared to baseline.Results Muscle tone MAS score in the wrist flexor of botulinum toxin type A and placebo groups at six weeks changed-1.00 (-2.00,-1.00) and 0.00 (-0.50,0.00) respectively from baseline.Botulinum toxin type A was significantly superior to placebo for the primary endpoint (Z =6.618,P ＜ 0.01).The safety measurement showed 10 subjects who received botulinum toxin type A had 13 adverse reactions,with an incidence of 8.47％ (10/118),and three subjects who received placebo had three adverse reactions,with an incidence of 5.00％ (3/60) during the pivotal trial phase.All adverse reactions were mild to moderate,none serious.There was no significant difference in adverse reactions incidence between the botulinum toxin type A and the placebo groups.During the expanded phase three subjects had four adverse reactions and the incidence was 1.95％.All adverse reactions were mild,none serious.Conclusion Botulinum toxin type A was found to be safe and efficacious for the treatment of post-stroke upper limb spasticity.Clinical Trial Registration:China Drug Trials,CTR20131191

Objective To evaluate the system measurement procedure effects on the analytic precision of clinical chemistry analytes.Methods In June 2009, June 2010 and September 2010 respectively,the National Center for Clinical Laboratories of China and the Organization of Five Hospitals in Fukuoka Japan organized comparison activities of 26 clinical chemistry analytes which were ALT,AST,GGT, ALP,CK,LDH,AMY,ChE,TG,TC,HDL-C,LDL-C,Glu,Cr,BUN,UA,K,Na,Cl,Ca,TP,Alb,TBil,DBil, P,Fe.In this paper, we investigated 26 analytes of three sets in Beijing Aerospace General Hospital as follows.(1)The precision of different reconstitution methods was observed by using three kinds of pipetting tools, such as measuring pipette, pipette and dispenser.(2)The experiments were carried out in three stages by testing the dried powder control samples of two concentration levels(101-Ⅰ,101-Ⅱ)provided by Hitachi Japan.They were measured on 28 consecutive days at each stage in order to observe the precision of 26 clinical chemistry analytes.In the first stage,we used the former measurement procedure to measure the control samples;in the second stage we added three conditions of the measurement procedure.The first was two calibration modes,which were once-a--day calibration and twice-a--day calibration.The second was the calibration standard and the last was the conditions of the freeze-thaw samples.In the third stage, we used the twice-a-day calibration only for GGT,ALP,ChE,TG,Cr,Na,K,CL,ALB.(3)JSCC and Health Industry Standard quality objectives were implemented to evaluate whether the precision of the improved measurement procedure met the requirements.(4)Paired T test were used to compare the precision of measurement between the second stage and the first stage, and between the third stage and the second stage of the measurement procedure.Results (1)The precision of three kinds of pipetting tools were 0.56%,0.10%, 0.01%.(2)The ranges of precision of ALT,AST,GGT,ALP,CK,LDH,AMY,ChE,TG,TC,HDL-C,LDL-C,Glu,Cr,BUN,UA,K,Na,Cl,Ca,TP,Alb,TBil,DBil,P,Fe were 0.99%-10.5% about 101-Ⅰ and 0.91%-7.03%about 101-Ⅱin the first stage.The ranges of precision were 0.66%-8.81%of 101-Ⅰand 0.66%-4.28%of 101-Ⅱin the second stage.The ranges of precisions were 0.60%-3.91%of 101-Ⅰand 0.73%-3.39%of 101-Ⅱin the third stage.(3)73%/80%of the samples met the standard of JSCC about 101-Ⅰand 101-Ⅱand 80%/88%of the samples met the standard of Health Industry Standard in the first stage.88%/100% of the samples met the standard of JSCC about 101-Ⅰand 101-Ⅱ and 100%/100%samples met the standard of Health Industry Standard in the second stage.The ratio of samples meeting the standard of JSCC about 101-Ⅰand 101-Ⅱwere 96%/100% and that of Health Industry Standard were 100%/100%in the third stage.(4)Precision of 101-Ⅰand 101-Ⅱwas statistically significant between the measurement procedures of second stage and the first stage,and there was no significant difference between the third stage and the second stage.Conclusion (1)The precision of samples using dispenser to reconstitute is higher than that of the other two pipetting methods.(2)Improving the calibration mode and reconstitution of samples increase the precision of 26 clinical chemistry analytes by over 50%.

Objective To investigate the effect of measuring value transfer for human serum samples assigned by the reference laboratory network on improving the trueness of seven enzyme activities in clinical laboratories,such as ALT,AST,GGT,LDH,CK,AMY and ALP.Methods Depending on the medical imtitutions at all levels contacted by 5 reference laboratories in North China,South China,East China and Southwest China,the corresponding clinical laboratory measuring value transfer/traceability network was established.The frozen human serum samples with good interehangeability and standard material characteristics,including calibrator,sample 1 and sample 2,were provided by Beijing Aerospace General Hospital,and were assigned by 5 reference labotatories in four regiom.These samples were sent to 48 clinical laboratories.These clinical laboratories measured sample 1 and sample 2 according to their standard operating procedures,and then measured.the two samples again after adjusting their measurement system by using the supplied calibrator.The changes of trueness of detection results in these laboratories were evaluated according to the WS/T 403-2012 standard,and the changes of consistency for ALT and AST before and after measuring value tramfer were investigated.Results The results of AMY,ALP,GGT,CK and LDH calibrator,sample 1 and sample 2 assigned by the established network were 138.7 U/L,278.5 U/L and 68.3 U/L,265.3 U/L,94.5 U/L and 134.4 U/L,195.8 U/L,89.0 U/L and 158.9 U/L,393.7 U/L,260.0 U/L and 645.3 U/L,and 302.0 U/L,250.0 U/L and 452.7 U/L,respectively.The percentages of sample 1 and sample 2 which met the bias requirements of the WS/T 403-2012 standard before measuring value transfer for AMY,ALP and GGT were 65.9％ and 61.0％,76.6％ and 78.7％,and 66.7％ and 70.8％,respectively,while after measuring value transfer,they were 89.2％ and 83.8％,86.7％ and 80.0％,and 85.4％ and 91.7％,respectively.The percentages of sample 2 which met the bias requirements of the WS/T 403-2012 standard before measuring value transfer for CK and LDH were 64.6％ and 58.3％,respectively,while after measuring value trander,they were 93.5％ and 84.8％,respectively.The coefficients of variation (consistency) of sample 1 and sample 2 for ALT and AST before measuring value tramfer were 12.9％ and 11.3％,and 10.2％ and 8.9％,respectively,while after measuring value transfer,they were 9.3％ and 8.2％,and 5.6％ and 5.9％,respectively.Conclusion The calibration of routine measurement systems based on the measuring value transfer for human serum samples assigned by the reference laboratory network may improve the comparability of 7 enzyme actvities measurement results in chnical laboratories at all levels obviously,which deserves to be further spread.

Objective To investigate the routine methods of α-amylase (AMY) test in scrum which meets the requirements of ISO 15189.Methods Fifty human serum samples with different concentrations of AMY (40- 750 U/L) were collected from March to December in 2008,to form the patients' frozen serum group.Four AMY measurement systems including Roche,Wako,MINDRAY and MAKER were used.The frozen standard materials with concentrations of ( 70.1 ± 3.7 ) U/L and ( 418.3 ± 22.1 ) U/L and the patients' frozen serum group were measured simultaneously by using IFCC reference method and 4 AMY measurement systcms based on 7170A automatic biochemistry analyzer.Thc linear regression analysis was made between the measurement results of each system and IFCC reference method.The equivalence,agreement and trueness were also evaluated by using the file EP9-A2 method.Bland-Altman GraphicalAnalysis and the improved Bland-Altman Graphical-Analysis of MVS1.80 software.Results Judging by the standards of IFCC reference method,the measurement results of 4 measurement systems were obviously different. ( 1 ) When measuring standard materials the results were 66.4,70.6,69.4 and 49.2 U/L respectively and 394.0,456.4,406.7,302.4 U/L respectively.The measurement results of MINDRAY were in agreement with that of IFCC reference method.( 2 ) When mcasuring the patients' scrum group by 4 measurement systems and IFCC reference method,the slopes of the linear regression equations were 0.934,1.070,0.930 and 0.731.respectively.And the intercepts were 0.886,6.249,5.388 and 3.574,respectively.According to the EP9-A2 method,the measurement results of Roche Wako,MINDRAY were equivalent to that of IFCC reference method.According to Bland-Altman Graphical-Analysis, the measurement results of Roche and MINDRAY were in agreement with that of IFCC reference method.The average biases of each measurement system were - 6.11％ ( Average bias ± 2s were 2.81％ and -9.40％ ),1.99％ ( Average bias ± 2s were 10.35％ and - 6.36％ ),- 2.70％ (Average bias ± 2s were 2.37％ and -7.77％ ) and -34.72％ ( Average hias ±2s were -24.20％ and -45.24％ ),respectively.According to the improved Bland-Altman Graphical-Analysis, the measurement results of MINDRAY are correct.The average biases of each measurement system were - 5.92％ (Average bias ± 2s were -2.81％ and -9.03％),2.10％ (Average bias ±2s were 10.74％ and -6.53％),-2.64％ ( Average bias ± 2s were2.24％ and -7.51％ ) and - 29.51％ ( Average bias ± 2s were 21.82％ and - 37.21％ ),respectively.Conclusions ( 1 ) The measurement results of different measurement systems do not necessarily have crreet results though they have claimed to have traceability.(2) The trueness of measurement results using the same system may not come to the same conclusion when evaluated by different methods.So laboratories should select and establish a procedure to evaluate trueness of routine methods and adopt those meeting the trueness requirements of ISO 15189.