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 explore the association between aldehyde dehydrogenase 2 (ALDH2) gene polymorphisms and abnormal liver function-induced by acetaminophen (APAP) drugs.Methods:An ALDH2 gene knockout mouse model was constructed using CRISPR/Cas9 gene editing technology. The obtained heterozygous mice were mated with opposite sex of heterozygotes. Genomic DNA was extracted from the tail of the offspring mouse. The polymerase chain reaction (PCR) method was used to determine the ALDH2 genotype. APAP was further used to induce acute drug-induced liver injury models in wild-type and ALDH2 knockout mice. Blood and liver tissues of mice were collected for liver function index, HE staining, F4/80 immunohistochemistry, and other detections. The intergroup mean was compared using a one-way ANOVA. The LSD-? t test was used for pairwise comparison. Results:ALDH2 knockout mice were bred successfully. The genotyping of the offspring was segregated into the wild-type (ALDH2 +/+), heterozygous mutant (ALDH2 +/-), and homozygous mutant (ALDH2 -/-), respectively. Biochemical and histological results after APAP modeling showed that the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil) was not significantly increased in the blank control group ( P ?

Purpose/Significance To study the typical characteristics of urban residents when they choose internet medical services,and to establish patient behavior portraits,so as to provide decision-making basis for improving internet medical services.Method/Process Taking patients in Beijing as the research object,patient group portraits are constructed from three dimensions:individual attrib-ute characteristics,online consultation behavior and medical demand preference,and online patient groups are classified by the clustering method.Result/Conclusion Online patients are classified into five distinct groups:value potential,platform loyalty,potential conver-sion,strong demand,and service transfer.Overall,online patients from major cities tend to have lower case severity and lower levels of activity.They typically prefer lower-cost text-based consultations and show a preference for doctors from top-tier hospitals with higher professional titles and superior online service quality.These five different patient groups possess their own typical characteristics,and specific measures need to be taken to meet their personalized medical needs.

Humans ; Arthroplasty, Replacement, Knee/adverse effects* ; Surgical Wound Infection/etiology* ; Retrospective Studies ; Risk Factors ; Arthroplasty, Replacement, Hip/adverse effects* ; Prosthesis-Related Infections/etiology*

Purpose/Significance User portraits of doctors offering free medical advice in online live streaming are constructed and further used to analyze the behavioral characteristics of various types of doctors,so as to provide references for improving the effect of live streaming and their influence.Method/Process A sample of 1 816 doctors who offer free medical advice on the Haodf.com platform is used for clustering analysis to generate different doctor group portraits by using the two-step clustering algorithm.Then an evaluation system for live streaming influence is constructed to explore the differences in online influence among doctors with different styles of live streaming.Result/Conclusion Three types of doctor group portraits are identified,including knowledge-sharing,self-promotional and sociable.There are significant differences in their online influence and three dimensions of live streaming effects including activeness,reputation,and hotness among different doctor groups.Comparative analysis is further performed to find potential solutions for enhancing their live streaming influence.

Abstract OBJECTIVE To explore the material basis and mechanism of Crataegi Fructus in improving metabolic hypertension(MH) by using network pharmacology and molecular docking technique.METHODS The components of Crataegi Fructus were collected by HERB, ETCM database and literature survey; screening all ingredients of Crataegi Fructus to improve MH targets through databases such as SwissTargetPrediction and GeneCards; build "active ingredient-target-disease" network of Crataegi Fructus with Cytoscape software; DAVID was used to analyze GO enrichment and KEGG pathway. The core components and core targets were verified by molecular docking with Autodock software. RESULTS The total of 89 active components were screened from Crataegi Fructus and acted on 84 targets. Among them, the core active components of Crataegi Fructus to improve MH were maslinic acid, fomefficinic acid B, linolenic acid, linoleic acid, methyl-n-nonylketone, apigenin, ursolic acid, etc. The core targets were CYP19A1, PPARA, ESR1, PTGS2, PPARG, NR3C1, MMP9, TNF, etc. The mechanism of action mainly involved multiple signaling pathways such as inflammation, glycolipid metabolism, and vascular endothelial function. Molecular docking showed that the core active ingredients of Crataegi Fructus had high affinity with core targets. CONCLUSION Crataegi Fructus may regulate multiple signaling pathways such as TNF, IL-17, AGE-RAGE, HIF-1, cGMP-PKG through multi-component regulation, thereby inhibiting inflammatory response, improving glucose and lipid metabolism abnormalities, and improving vascular endothelial function, so as to comprehensively exert the role of improving MH in various aspects.

Objective: To evaluate the effectiveness of the SHARP intervention model for increasing students’ moderate to vigorous physical activity (MVPA) levels,and to provide a reference for physical activity enriching intervention among middle schools students’. Methods: One-year interventional teaching was carried out in 6 schools selected in the terms of scale and demographics from Nanjing City, Jiangsu Province. Data were collected during physical education (intervention group 105, control group 113; pre-intervention 119, post-intervention 99) data for 218 students. MVPA was assessed at baseline and post-intervention using the Observed Health and Coaching Time System(SOFIT). Interviews with 19 teachers were conducted with intervention schools to explore teachers’ views on interventions. Results: The two-way analysis of variance showed that the intervention of the SHARP model had a significant impact on MVPA, VPA, and motor skills of middle school students. Proportion of the average MVPA class time of the intervention school students(62.80±9.11), and the average proportion of the VPA class time of the intervention school(24.33±12.55), the average class time for intervention in the school’s mastery of skills(32.34±11.78)(t=-7.46, -4.82, -12.08, P<0.01). The MVPA of students in control school remained relatively constant while the VPA decreased. Classroom teaching capability improved significantly in intervention schools, which was further confirmed by teacher interviews. Conclusion The SHARP intervention model can effectively increase the MVPA level of middle school students.

Objective:To evaluate the clinical efficacy of Sini-Jia-Huanglian Decoction on chronic heart failure (CHF) with qi deficiency and blood stasis syndrome. Methods:A total of 100 patients with CHF and qi deficiency and blood stasis syndrome in Handan Mingren hospital from January 2018 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, 50 cases in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with Sini-Jia-Huanglian Decoction on the basis of the control group. Both groups were treated for 30 days. TCM syndrome score was performed before and after treatment. The level of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) was detected by radioimmunoassay. The levels of peptide and galectin 3 (Gal-3) were detected by ELISA. The exercise tolerance was measured by 6-minute walking test, the clinical efficacy was tevaluated. Results:The total effective rate of the treatment group was 92.0% (46/50), and the control group was 76.0% (38/50), there was significant difference between the two groups ( χ2=4.762, P=0.029). After treatment, the scores of shortness of breath, palpitation, dyspnea, dizziness, chest pain and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.257, 8.493, 8.211, 4.481, 5.500, 6.977, respectively, all Ps<0.01). After treatment, the levels of NT-proBNP (2 349.61 ± 683.50 ng/L vs. 3 026.27 ± 714.35 ng/L, t=4.840), and peptide (12.16 ± 3.43 ng/L vs. 17.52 ± 3.98 ng/L, t=7.214) and Gal-3 (3.01 ± 0.82 μg/L vs. 3.94 ± 0.93 μg/L, t=5.304) in the treatment group were significantly lower than those in the control group ( P<0.01), and the walking distance of 6 minutes (450.66 ± 79.25 m vs. 384.49 ± 70.16 m, t=4.421) was significantly longer than that of the control group ( P<0.01). Conclusions:The Sini-Jia-Huanglian Decoction can improve the heart function and clinical symptoms of CHF patients with qi deficiency and blood stasis syndrome, and improve the clinical efficacy.

Under the limitation of cross-sectional studies, more researchers are turning their attention to maternal and child cohort studies. However, some problems do exist in the traditional maternal and child cohort studies, if data is only gathered from the hospitals. The limitation would include the contents of research and the high rate of loss to follow-up. With the integration of different medical traits and the progress in big data, the development of maternal and child related cohorts, with characteristics of dynamic follow-up and data sharing, through combining the information and health service systems of different institutions, seem in urgent need. This paper aims to provide some basic achievements in conducting maternal and child cohorts that can serve the related health problems through full-life cycle, and provide new references on conducting cohort studies, aiming at special population or diseases.

Objective:To prospectively explore the associations between total and different types of physical activities and gestational diabetes mellitus (GDM) in the first trimester of pregnant women, in Beijing.Methods:Data of 909 participants from the Chinese Pregnant Women Cohort study were extracted and studied. Four types of physical activities, including household/care-giving, occupational, sports/exercise and outdoor ways of transportation (walking/cycling/E-biking) in early pregnancy were studied by using the pregnancy physical activity questionnaire (PPAQ). All the participants were followed up and related data on GDM collected. Logistic regressions were conducted for data analysis on the associations of interests.Results:A total of 206 pregnant women (22.7 %) were diagnosed with GDM. After adjusting for age, pre-pregnancy BMI, family history of diabetes and other types of physical activities, results from the logistic regression showed that women with moderate level of household/care-giving activities were with the lower odds on GDM ( OR=0.654, 95 %CI: 0.436-0.980). Women who had met the guideline of exercise were less likely to have GDM ( OR=0.518, 95 %CI: 0.287-0.934). There was no significant association appeared between total physical, occupational and outdoor ways of transportation (walking/cycling/E-biking) activities with GDM. Conclusions:Sports/exercise and household/care-giving activities in early pregnancy appeared important on GDM prevention. Pregnant women are encouraged to wisely arranging their sports/exercise activities and engaging in moderate household/care-giving activities in the first trimester of pregnancy, to prevent GDM.