Objective To explore and verify the protective and therapeutic effects and possible mechanisms of Zukamu granules on hypoxia alone and hypoxia+Su5416-induced hypoxic pulmonary hypertension(HPH)in mice.Methods Multiple databases and related literature were used to collect the active ingredients data in Zukamu granules and the HPH-related targets were predicted and obtained.The network construction and enrichment analysis were performed.The HPH mouse models were es-tablished by two-week hypoxia and four-week hypoxia+Su5416 induction,and the relevant indicators and the main pharmacodyna-mic indexes such as right ventricular pressure were tested.Masson staining was used to observe the pathological changes in lung tissues,and Western blotting was used to detect the expression levels of bax,bcl-2,PI3K,p-PI3K,eNOS,and HIF-1α in lung tis-sues.Results A total of 167 active ingredients of Zukamu granules were screened,with 179 intersecting targets with HPH,in-cluding targets like PIK3CA and HIF-1.The validation experimental results showed that Zukamu granules could significantly re-duce right ventricular systolic pressure and right ventricular hypertrophy in HPH mice,and down-regulate the expression of bcl-2 and HIF-1α and up-regulate the expression of bax,PI3K,p-PI3K and eNOS in mice lung tissues.Conclusion Zukamu gran-ules may act against HPH by modulating bax/bcl and PI3K-eNOS/HIF-1α signaling pathways.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To investigate the influences of sufentanil(Suf)on the inflammatory response and chondrocyte apopto-sis in rats with osteoarthritis(OA)by modulating Ras/Raf/mitogen-activated protein kinase kinase(MEK)/extracellular signal-regulated kinase(ERK)signaling pathway.Methods:SD rats were grouped into normal control group(NC group),blank control group(Blank group),low-dose Suf group(Suf-L group,1 μg/kg),high-dose Suf group(Suf-H group,5 μg/kg),Diacerein group(DC group,54 mg/kg),and Suf-H+ML-099(Ras/Raf/MEK/ERK pathway activator)group(5 μg/kg Suf+11.7 mg/kg ML-099),with 12 rats in each group.Except for the NC group,the other groups were all constructed OA rat models by transection of the medial meniscus tibial ligament of the right knee joint.After the modeling was successful,the corresponding drug treatment was carried out,and the rats in the NC group and the Blank group were intraperitoneally injected and gavaged with the same amount of normal saline,administer once a day for 3 weeks.Twenty-four hours after the last administration,the changes of tenderness threshold and thermal pain threshold of rats were monitored;serum levels of TNF-α,IL-1β and IL-6 were detected by ELISA;Safranin O-Fast green staining was used to detect the pathological changes of cartilage tissue;TUNEL staining was used to detect chondrocyte apoptosis;Western blot was used to detect the expressions of Ras/Raf/MEK/ERK signaling pathway protein and matrix metalloproteinase 13(MMP-13)protein in carti-lage tissue.Results:Compared with NC group,the tenderness threshold and heat pain threshold of rats in Blank group were decreased(P<0.05),and the pathological injury of cartilage tissue was serious,TNF-α,IL-1β,IL-6 levels,Mankin score,chondrocyte apopto-sis rate,Ras,Raf,MEK,p-ERK1/2,MMP-13 protein expressions were increased(P<0.05);compared with the Blank group,the change trends of the corresponding indicators in Suf-L group,Suf-H group and DC group were opposite to the above(P<0.05);ML-099 attenuated the effect of high dose Suf on OA rats.Conclusion:Suf may attenuate the inflammatory response and chondrocyte apoptosis in OA rats by inhibiting the Ras/Raf/MEK/ERK signaling pathway.

[摘 要] 目的：探讨布托啡诺（BPH）对骨肉瘤（OS）细胞增殖、迁移和侵袭的影响及其相关的作用机制。方法：将MG-63细胞分为对照组、YAP抑制剂组（维替泊芬组）和BPH低、中、高浓度组，MTT法、克隆形成实验、FCM术、划痕愈合实验、Transwell实验、qPCR法、WB法和移植瘤实验分别检测处理后各组细胞的增殖活性、克隆形成数、细胞凋亡率、划痕愈合率，以及上皮钙黏蛋白（E-cadherin）、神经钙黏蛋白（N-cadherin）、波形蛋白（vimentin）mRNA的表达和YAP、TAZ蛋白的表达，同时观察BPH和维替泊芬对移植瘤生长的影响。结果：与对照组相比，维替泊芬组和BPH低、中、高浓度组细胞增殖活性、克隆数、划痕愈合率、侵袭细胞数，以及N-cadherin和vimentin mRNA水平、YAP和TAZ蛋白表达及移植瘤体积均显著降低（均P<0.05），细胞凋亡率、E-cadherin mRNA水平及对移植瘤的抑瘤率均升高（均P<0.05），且BPH高浓度组与维替泊芬组之间各项指标均无明显差异（均P>0.05）。结论：BPH可能通过抑制Hippo/YAP信号通路来抑制OS细胞MG-63增殖、迁移和侵袭。

  Objective  Different from other etiologies of early-onset scoliosis (EOS), congenital early-onset scoliosis (CEOS) is mainly linked to vertebral anomalies, such as formation failures and segmentation failures at the apex segments. So far, there is little research on CEOS patients who have completed traditional growing rods (TGR) treatment, and the initial outcomes of TGR with or without apical control technique (ACT) are different. Therefore, we compared the "final" results of CEOS patients who completed TGR treatment with or without ACT.  Methods  We conducted a retrospective study of CEOS patients who completed TGR treatment from 2007—2020. They either had final fusion or were followed up after reaching skeletal maturity. We split the patients into two groups based on whether they had ACT with TGR or not. The ACT-TGR group had apical vertebrectomy/hemivertebrectomy with short fusion and TGR. The TGR-only group had only TGR. We looked at their demographic features, radiographic measurements, and complications.  Results  This study enrolled 46 CEOS patients, of which 13 patients were in the ACT-TGR group and 33 patients in the TGR group. The ACT-TGR group had a longer distraction interval (1.17 years vs. 0.75 years). The ACT-TGR group had a larger preoperative main curve [87.00(63.50, 98.00)], but the residual curve degrees were comparable between the two groups at the last follow-up (P=0.354). At the last follow-up, the T1-12 and T1-S1 heights were similar between the two groups. The ACT-TGR group had a lower number of implant-related complications per patient (0.77 vs. 1.48). Three patients in the ACT-TGR group underwent final fusion, while 17 patients in the TGR group underwent final fusion (P=0.060).  Conclusions  Both ACT-TGR and traditional TGR coud effectively correct deformity and preserve spinal growth in CEOS patients. ACT-TGR had a better corrective effect on patients with severe deformity and did not have a significant impact on spinal height. For patients with acceptable correction, spontaneous fusion and without implant failure, retaining the implant and continuing observation could be a strategy for graduating from growing rod treatment.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Oral microbial community, as an important part of human microbial community, is closely related to oral and general health. Oral microbiological research has become the forefront of international microbiological research. Standardized and unified nomenclature for oral microorganisms in Chinese is of great significance to support the development of oral medicine research. Standardized translation of microbial names is the basis for writing canonical and authoritative professional textbooks and reference books, which helps students to accurately acquire the characteristics and classifications of oral microbes. Unified translation of oral microorganisms is also conducive to academic communication and cooperation, and plays an important role in oral health education and science popularization, which enables oral microbiology knowledge to be accurately disseminated to the public. Therefore, in order to standardize the words in scientific research, funding application, publications, academic exchanges and science popularization within the field of oral medicine, we have fully discussed and revised the Chinese names of oral microorganisms in 2017 edition and ones of newly discovered oral microbes, finally reaching a consensus to form the 2023 edition of Chinese names of oral microorganisms.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objective:To investigate the clinical efficacy of finasteride combined with 5% minoxidil in the treatment of male androgenetic alopecia.Methods:A total of 102 males with androgenetic alopecia diagnosed and treated in Shaoxing Hospital of China Medical University during 2018-2019 were selected in the study and divided into two groups by random number table method.The control group (50 cases) was only given finasteride, and the treatment group(52 cases) was given finasteride combined with minoxidil.All the patients were treated for 6 months.The therapeutic effects and adverse reactions during the treatment were compared between the two groups.Results:The effective rate of the treatment group was 86.5%(45/52), which was significantly higher than 66.0%(33/50) of the control group(χ 2=4.93, P<0.05). The incidence of adverse reactions in the treatment group was 3.8%(2/52), which was significantly lower than 18.0%(9/50) in the control group(χ 2=5.22, P<0.05). Conclusion:Finasteride combined with 5% minoxidil is safe and effective in the treatment of male androgenetic alopecia, which is worthy of clinical promotion.

Objective:To study the effect of Buzhong Yiqi Recipe on the use time of ventilator in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:From July 2017 to February 2019, 64 patients with AECOPD and respiratory failure treated in People's Hospital of Gaomi were divided into two groups according the random digital table method, with 32 cases in each group.The control group was treated with routine therapy, and the treatment group was treated with Buzhong Yiqi formula on the basis of routine therapy.The arterial blood gas index and ventilator time before and after treatment were compared between the two groups.Results:The mechanical ventilation time, intensive care unit hospitalization time of the treatment group was (14.56±3.52)d, (17.58±4.95)d, which were shorter than that those of the control group [(16.59±2.89)d, (20.37±5.62)d], and the differences were statistically significant( t=4.76, 5.04, all P<0.05). There were no statistically significant differences in arterial blood gas between the two groups after treatment(all P>0.05). Conclusion:Buzhong Yiqi Recipe can shorten the use time of ventilator in AECOPD patients with respiratory failure.