Objective To verify the mechanism of Buyang Huanwu decoction in the treatment of spinal cord injury based on network pharmacology and molecular docking.Methods The active ingredients and targets of Buyang Huanwu decoction were screened out by TCMSP,SymMap,PubChem and Swiss Target Prediction databases.Spinal cord injury targets were retrieved from OMIM,GeneCards,TTD,and DrugBank databases.Through venny software,the intersection target of Buyang Huanwu decoction and spinal cord injury was obtained.The active ingredient-target network for the treatment of spinal cord injury was constructed with Cytoscape software.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of common targets were carried out by DAVID,and the binding ability of drugs and targets was analyzed by molecular docking technology.Results A total of 106 active ingredients and 225 targets of Buyang Huanwu decoction,1315 targets of spinal cord injury and 112 targets of drug-disease intersection were obtained.The active ingredients of Buyang Huanwu decoction were quercetin,kaempferol,ellagic acid,luteolin and hederagenin in the treatment of spinal cord injury.Conclusion Buyang Huanwu decoction can achieve the purpose of treating spinal cord injury through various signal pathways.

BACKGROUND:Finite element analysis is a commonly used mathematical modeling method to analyze the biomechanics of the lumbar spine.By constructing finite element models of the complex tissues such as muscles,blood vessels,and nerves in the lumbar region,mechanical analysis is performed to elucidate the pathogenesis of lumbar spine disorders and the mechanical mechanisms of treatment approaches. OBJECTIVE:To review the progress of finite element analysis in understanding the pathogenesis and treatment modalities of lumbar spine disorders,and to propose a new clinical workflow for the implementation of finite element analysis,aiming to provide a reference for future studies and promote the widespread utilization of finite element analysis in clinical diagnosis and treatment. METHODS:The PubMed database was searched using English keywords"finite element analysis,lumbar vertebra",while the WanFang and China National Knowledge Infrastructure(CNKI)databases were searched using Chinese keywords"finite element analysis,lumbar vertebra".A total of 73 articles were included for review. RESULTS AND CONCLUSION:(1)Lumbar spine degeneration in non-slipped patients typically originates from the posterior annulus fibrosus,while in patients with lumbar spine spondylolisthesis,degeneration starts from the lumbar facet joints due to abnormal mechanical mechanisms.(2)Restoring vertebral body height can prevent adjacent-level degeneration,and finite element analysis-measured vertebral compression strength can serve as an effective predictor of fracture risk,replacing bone density measurements.(3)In lumbar spine fusion surgery,selecting fusion devices of appropriate height and placing them transversely can prevent device subsidence.Increased intervertebral strain,circumferential stress,and intervertebral pressure in adjacent segments after fusion surgery may contribute to the occurrence of degenerative changes in neighboring segments.(4)Finite element analysis results suggest that preoperative planning for transforaminal endoscopic surgery should include considerations for osteotomy size to avoid excessive destruction of the articular process,and intraoperatively,preferential selection of a technique that traverses the superior articular process for foraminal dilatation.(5)In percutaneous kyphoplasty,bilateral pedicle screw augmentation should be performed,distributing bone cement on both sides of the pedicle.More advanced non-aluminum glass polyalkenoate cement materials should be selected.(6)Traction therapy should be personalized based on individual patient characteristics,including customized traction angles and forces,to achieve optimal therapeutic effects.(7)Manual therapy can induce relative displacement between the herniated intervertebral disc and the nerve root,thereby reducing compression.(8)The workflow involving CT/MR-AI Plus FEA-AI Plus Surgical robots can enable more precise diagnosis and treatment.

Objective To explore the effect of exercise combined with dieting on chronic inflamma-tion based on fatty acids and peripheral blood mononuclear cell(PBMC)immunophenotypes.Methods Thirty-one obese volunteers(age:30.1±5.5 years,height:170.1±8.1 cm,weight:101.13±21.40 kg,BMI:34.66±5.01 kg/m2)were recruited and given a 5-week program of exercise combined with diet-ing.The exercise regimen consisted of daily 3-hour training at 60%-75%HRmax intensity,while the di-eting regimen was a moderate to high energy restriction model,with a daily reduction of 250 kcal in the 1st week and 600 kcal from the 2nd to 5th weeks.Before and after the intervention,all volunteers were measured morphological indicators(body weight,BMI,fat-free mass,body fat percentage,waist-to-hip ratio and visceral fat index),blood lipids(total cholesterol,triglycerides,high-density lipopro-tein cholesterol and low-density lipoprotein cholesterol),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),visfatin(VF),and the content of fatty acids in the blood.Moreover,the expression of cell surface receptors CD36,TLR4,and nuclear factor-κB(NF-κB)on PBMC sub-sets was tested before and after intervention.Results After intervention,a significant decrease was ob-served in the body composition indices,as well as in the four major blood lipid parameters.Levels of chronic inflammatory markers,including hs-CRP,VF and TNF-α,decreased significantly(P<0.01).Except for C6:0,C11:0,C12:0,C23:0,and C24:0,the levels of other fatty acids also decreased sig-nificantly(P<0.05,P<0.01).Among the measured fatty acids,13,31,and 15 were found to be signif-icantly and positively correlated with hs-CRP,VF,and TNF-α,respectively(P<0.05,P<0.01).More-over,the expression of monocyte cluster of differentiation 36(CD36),Toll-like receptor 4(TLR4),and nuclear factor-κB(NF-κB)in PBMC subsets decreased significantly after the intervention(P<0.05).In lymphocytes,CD36 and TLR4 expression lowered significantly after intervention(P<0.05 and P<0.01),while in granulocytes,CD36 and NF-κB expression decreased significantly(P<0.01 and P<0.05).Conclusion Exercise combined with dietary intervention can better body composition and physi-cal function in obese individuals,alleviating their chronic inflammation.The reduction in chronic in-flammation is closely related to the decrease in circulating fatty acid levels,which results in the re-duced expression of CD36 and TLR4 receptors on the surface of PBMC and the inhibition of the NF-κB signaling pathway.

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.

Objective: To investigate the effects of physical activity (PA) intensity and sedentary behavior (SB) on calcanues bone mineral density (BMD) in preschool children, so as to provide a basis for rationalizing the daily physical activity of preschool children to promote bone health. Methods: A total of 673 pre school children aged 3-6 years from nine kindergartens in Pingxiang City, Ganzhou City and Yingtan City of Jiangxi Province, were selected from September to December 2021 by using the whole stratified cluster random sampling method. The PA levels and SB were measured by using a three axis acceleration sensor, and left calcanues BMD was measured by an ultrasound bone densitometer. Multiple linear regression was used to explore the effects of changes in PA on calcanues BMD in pre school children of all ages. Results: Of the 673 preschoolers surveyed, 498 (74.0%) achieved an average of ≥60 min of moderate to vigorous physical activity (MVPA) per day, there were 265 boys (71.2%), and 233 girls ( 77.4 %). The difference between genders was not statistically significant ( χ 2=2.77, P >0.05). There was no statistically significant difference in the BMD test of the calcaneus bones of preschoolers by gender ( Z=0.42, P >0.05). The difference in BMD results of pre school children with 3, 4, 5 to 6 years was statistically significant ( H=2.65, P <0.05). Correlation analysis revealed a negative correlation between SB duration and calcaneus BMD ( r =-0.13), and a positive correlation between low intensity physical activity (LPA) duration, MVPA duration, and calcaneus BMD ( r =0.14, 0.25 ) ( P <0.05). Multivariate linear regression analysis showed that SB duration negatively correlated with calcaneus BMD, whereas LPA and MVPA duration positively correlated with calcaneus BMD ( P <0.05). Conclusions MVPA duration is positively correlated with the growth of BMD in the heel bone and negatively correlated with SB. The kindergartens can adjust their curricula according to the physical and mental developmental characteristics, gender and age differences of pre school children, increase the time of outdoor activities, and reduce the sedentary time to promote the bone health of young children.

Objective: Based on physical activity (PA) and sedentary behavior (SB) variables on weekdays and weekends, the study aims to cluster the physical activities inside and outside kindergartens and to explore the cluster characteristics of different children using physical fitness indicators, so as to provide new strategies and methods for early childhood education and health. Methods: From March to June 2019, 291 children aged 3-6 years from 6 kindergartens in Nanchang were recruited by a stratified cluster random sampling method. The ActiGraph GT3X-BT triaxial accelerometer was used to measure and analyze the PA and SB levels inside and outside the kindergarten. A twostep clustering algorithm model was employed for cluster analysis. Physical fitness were measured and evaluated according to the "National Physical Fitness Measurement Standard Manual (Preschool Section)". Differences in physical fitness among different clusters of children were compared, and the cluster characteristics of different children were analyzed. Results: The clustering algorithm model indicated that based on six indicators, including PA and SB inside the kindergarten on weekdays, and PA and SB outside the kindergarten on both weekdays and weekends, children could be divided into three categories:active inside (high PA, low SB inside), active outside (high PA outside), and inactive (low PA, high SB both inside and outside). The average silhouette coefficient of the model was 0.3, indicating good clustering results. Both the active inside and active outside children showed significantly higher PA inside on weekdays, PA outside on weekdays and weekends, daily low intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) than the inactive children ( F=157.91, 80.79 , 95.86, 95.52, 124.74, P <0.05). After adjusting for gender and age, the physical fitness scores of both active outside ( 19.03 ±0.47) and active inside (19.11±0.40) were significantly higher than those of the inactive children (17.94±0.31). Additionally, active inside children (3.91±0.14) also showed significantly better performance in continuous double-leg jumps, compared to inactive children (3.45±0.11) ( P <0.05). Conclusion Children active inside and those active outside perform well in PA. Future research should focus on the proportion of structured and unstructured PA time to enhance the overall physical fitness of children.

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

Objective:To explore the safety and efficacy of serial expansion without delay for the treatment of giant congenital melanocytic nevi (GCMN) on the back.Methods:The clinical date of children with GCMN on the back admitted to the Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from February 2017 to March 2019 were retrospectively analyzed. In stage Ⅰ, an expander was placed on each side of the back to laterally expand the skin on the back, as a whole. In stage Ⅱ, after the expanders were removed and part of the nevus was removed, the expanded flaps were advanced integrally across the back with additional incisions on both sides of the trunk. The new expanders were then placed under the expanded flaps simultaneously for serial expansion. In stage Ⅲ, the expanded flaps were used to reconstruct the wound after resection of GCMN. The color, texture of the flaps and the postoperative scar on the back were observed.Results:Ten patients were enrolled, including 4 males and 6 females, with an average age of 3.4 years (ranged between 2-6 years). All patients completed three stages of treatment. In the second stage, new expanders were placed under the expanded flap for serial expansion simultaneously. The three-stage operation took a total of 6.80 to 11.77 months, and all the nevus on the back were removed. The mean follow-up time was 16.6 months (ranged between 12-24 months). In one case, the skin flap necrosis (1.5 cm × 1.2 cm) was caused by abrasion at the end of stage Ⅱ when the inflation of the expander was nearly completed, without exposure of the dilator. After the expanders were removed in stage Ⅲ, the flap survived well. In the other children, no wound dehiscence, infection, dilator exposure and other complications occurred. The back was maintained as a whole aesthetic unit without conspicuous scars and the postoperative scars were located on the sides of the trunk. The color and texture of the flap were similar to its surrounding tissue.Conclusions:Serial expansion without delay is safe and efficient in the treatment of GCMN on the back. It not only eliminates the need to wait 4 to 15 months for the expander implantation, but also saves one operation and anesthesia. During the treatment, additional incisions are only made on both sides of the trunk, which could maintain the back as a whole aesthetic unit and obtain a better postoperative appearance.

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

Objective:To explore the safety and efficacy of serial expansion without delay for the treatment of giant congenital melanocytic nevi (GCMN) on the back.Methods:The clinical date of children with GCMN on the back admitted to the Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from February 2017 to March 2019 were retrospectively analyzed. In stage Ⅰ, an expander was placed on each side of the back to laterally expand the skin on the back, as a whole. In stage Ⅱ, after the expanders were removed and part of the nevus was removed, the expanded flaps were advanced integrally across the back with additional incisions on both sides of the trunk. The new expanders were then placed under the expanded flaps simultaneously for serial expansion. In stage Ⅲ, the expanded flaps were used to reconstruct the wound after resection of GCMN. The color, texture of the flaps and the postoperative scar on the back were observed.Results:Ten patients were enrolled, including 4 males and 6 females, with an average age of 3.4 years (ranged between 2-6 years). All patients completed three stages of treatment. In the second stage, new expanders were placed under the expanded flap for serial expansion simultaneously. The three-stage operation took a total of 6.80 to 11.77 months, and all the nevus on the back were removed. The mean follow-up time was 16.6 months (ranged between 12-24 months). In one case, the skin flap necrosis (1.5 cm × 1.2 cm) was caused by abrasion at the end of stage Ⅱ when the inflation of the expander was nearly completed, without exposure of the dilator. After the expanders were removed in stage Ⅲ, the flap survived well. In the other children, no wound dehiscence, infection, dilator exposure and other complications occurred. The back was maintained as a whole aesthetic unit without conspicuous scars and the postoperative scars were located on the sides of the trunk. The color and texture of the flap were similar to its surrounding tissue.Conclusions:Serial expansion without delay is safe and efficient in the treatment of GCMN on the back. It not only eliminates the need to wait 4 to 15 months for the expander implantation, but also saves one operation and anesthesia. During the treatment, additional incisions are only made on both sides of the trunk, which could maintain the back as a whole aesthetic unit and obtain a better postoperative appearance.