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.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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With the spread of novel coronavirus pneumonia (NCP) in December 2019, the management and rehabilitation of elderly patients with hip fractures and protection of medical staff face new challenges, and need to be adjusted appropriately under this very circumstances. Hip fractures in the elderly account for more than half of osteoporotic fractures. Expert group formulate this consensus so as to make better decision against this epidemic and protect patients' families and medical staff. This consensus elaborates not only epidemic condition of NCP, but also general principles of medical admission, treatment and protection for both medical staff and patients, in order to provide some reference and promote the standardization of clinical diagnosis and treatment of elderly patients with hip fractures under the condition of NCP.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To establish the musculoskeletal multi-body dynamic foot-ground contact model and explore its applicability at different speed. Methods The gait data of the subjects at different speed were collected, and the foot-ground contact model was established based on the full body model from the musculoskeletal multibody dynamic software AnyBody. Then the calculated ground reaction forces (GRFs) and ground reaction moments (GRMs) at different speed (slow walking, normal walking, fast walking and jogging) were compared with the measurements from the force plates. Results The predicted GRFs and GRMs correlated well with the experimental measurements at slow, normal and fast speed (stride speed ranged from 0.69 to 1.68 m/s). The correlation coefficients between predicted and measured GRFs were greater than 0.875 and the correlation coefficients for GRMs were greater than 0.9. Conclusions The developed foot-ground contact model could simultaneously predict GRFs and GRMs with good accuracy, thus eliminating the dependency on force plates. The model could be applied to low-speed gait conditions, such as the elderly and pathological gait.

Objective To investigate the renoprotective effect of aspirin-triggered lipoxins(ATL)on kidney of mice with acute kidney injury(AKI).Methods Eighty-eight male specific pathogen-free(SPF)C57BL/6J mice were randomly divided into lipopolysaccharide(LPS)groups(including 2 h group,4 h group,8 h group,12 h group, 24 h group),ATL+LPS(including 2 h group,4 h group,8 h group,12 h group,24 h group)and normal control group according to random numble table,and each group had 8 mice.The mice in LPS groups were given LPS intraperitoneal injection to establish AKI animal models,while the mice in ATL+LPS groups were given ATL intraperitoneal injection 30 minutes before LPS intraperitoneal injection.The enzyme linked immunosorbent assay was used to test the serum creatinine(Scr),serum urea nitrogen(BUN),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and urine neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),cysteine-rich protein-61 (Cyr61)and netrin-1 levels of mice.Results The kidney tissue injury scores of mice of ATL+LPS group[4 h:(22.32 ± 1.04)scores,8 h:(31.11 ± 1.86)scores,12 h:(18.22 ± 0.92)scores,24 h:(20.87 ± 3.18)scores] were lower than those of LPS group at the corresponding time points[4 h:(35.47 ± 2.27)scores,8 h:(52.28 ± 2.82) scores,12 h:(54.99 ± 4.56)scores,24 h:(53.41 ± 4.76)scores],and the differences were statistically significant(all P<0.01).The values of Scr,BUN,TNF-α and IL-1β in ATL+LPS group[Scr 8 h:(143.07 ± 5.02)μmol/L, BUN 12 h:(33.07 ± 3.52)mmol/L,TNF-α 4 h:(196.33 ± 14.181)ng/L and 8 h:(221.77 ± 10.11)ng/L,IL-1β 4 h:(50.25 ± 2.67 ng/L)]were lower than those in LPS group at the corresponding time points[Scr 8 h:(227.43 ± 11.17)μmol/L,BUN 12 h:(59.68 ± 3.84)mmol/L,TNF-α 4 h:(267.87 ± 26.48)ng/L and 8 h:(334.78 ± 21.08)ng/L,IL-1β 4 h:(89.45 ± 5.87)ng/L],and the differences were statistically significant(all P<0.01). The urine NGAL[4 h:(56.76 ± 4.01)μg/L,8 h:(65.44 ± 7.81)μg/L],KIM-1[8 h:(78.19 ± 9.48)μg/L] and netrin-1[8 h:(40.12 ± 2.01)ng/L,12 h:(36.87 ± 2.87)ng/L]of mice in ATL+LPS group were lower than those in LPS group at the corresponding time points[NGAL 4 h:(168.77 ± 10.77)μg/L,8 h:(155.33 ± 8.26) μg/L;KIM-1 8 h:(124.73 ± 13.47)μg/L;netrin-1 8 h:(89.17 ± 2.74)ng/L,12 h:(81.11 ± 3.88)ng/L],and the differences were statistically significant(all P<0.01).Conclusions ATL can treat LPS-induced AKI and play a renoprotective role in the kidney.

Background and objective With the popularization of high-resolution computed tomography (HRCT), there is a rising trend of the detection of multiple primary lung cancers (MPLC). Adenocarcinomas is the major pathological type of MPLC. At present, reports on MPLC are relatively common, but few study focused on synchronous multiple primary lung adenocarcinomas (SMPLA). We carried out this study in an attempt to enhance our understanding about SMPLA.Meth-ods Data from 38 patients undergoing surgery for SMPLA in our institution frrom December 2012 and July 2016 were retro-spectively collected.Results Among the 38 patients, 12 patients were male, 26 patients were female, with a median age of 58 (ranging from 39 to 73). Surgical outcomes verified 29 patients with 2 tumors and 9 patients with more than 2 tumors. There were 26 patients with tumors in ipsilateral lung while 12 patients in contralateral lung. Eight patients underwent one-stage surgical treatment for contralateral tumors with mean postoperative hospitalization of 10 days. The gene detection results of 5 patients showed different epidermal growth factor receptor (EGFR) mutations can be found in one patient's different tumors. The 1-year and 3-year overall survival (OS) rate were 96.6% and 74.2%. Larger maximal tumor dimension (P<0.001), advanced pT stage (P=0.003), lymph nodes metastases positive (P=0.001), advanced TNM stage (P=0.022) and postoperative adjuvant chemoradiotherapy (P=0.009) were correlated with poor OS.Conclusion Multiple lung malignant lesions should not be taken as metastasis for granted and the possibility of MPLC also should be considered. Mutational status ofEGFR could be used as a clinical reference to diagnose patients with SMPLA.

Objective To evaluate the expression levels of peptidylarginine deiminase 4 (PADI4)and B-cells pecific Moloney leukemia virus insert site-1 (BMI-1 )in esophageal squamous cell carcinoma (ESCC) tissues and pericarcinous tissues.To explore the function and clinical significance in the development of ESCC and their association.Methods The expression levels of PADI4 and BMI-1 were measured by immunohisto-chemistry,Western blotting and quantitative real time PCR in ESCC tissues and pericarcinous tissues from 86 patients.The relationships between the expressions of PADI4 and BMI-1 and the clinicopathologic characte-ristics were analyzed.Results The immunohistochemistry showed that the expressions of PADI4 and BMI-1 in ESCC tissues (68.6% and 73.3%)were significantly higher than those in pericarcinous tissues (37.2% and 30.2%,χ2 =1 7.01 1 ,P =0.000;χ2 =31 .876,P =0.000).Western blotting indicated that the levels of PADI4 and BMI-1 were higher than those in pericarcinous tissues (0.91 9 ±0.098 vs.0.71 8 ±0.1 03,t =2.462,P =0.021 ;0.975 ±0.074 vs.0.71 7 ±0.071 ,t =2.640,P =0.01 4).The expressions of BMI-1 and PADI4 mRNA in ESCC tissues were higher than those in pericarcinous tissues,but the differences were not sta-tistically significant (0.091 ±0.005 vs.0.038 ±0.002,t =1 .701 ,P =0.1 01 ;0.1 1 4 ±0.075 vs.0.048 ± 0.003,t =1 .499,P =0.1 46)by the quantitative real time PCR.The expression of PADI4 was correlated with lymph node metastasis (χ2 =5.771 ,P =0.01 6),depth of invasion (χ2 =6.672,P =0.01 0)and clinical stage (χ2 =5.771 ,P =0.01 6).The BMI-1 gene expression had a correlation with lymph node metastasis (χ2 =7.1 76,P =0.007),the differentiation degree (χ2 =1 3.787,P =0.001 )and clinical stage (χ2 =7.1 76,P =0.007).In addition,there was a positive correlation between PADI4 and BMI-1 expression in ESCC by immunohistochemistry and quantitative real time PCR (r =0.21 4,P =0.047;r =0.534,P =0.005).Conclusion The expression levels of PADI4 and BMI-1 are significantly higher in ESCC compared to pericarcinous tissues.PADI4 and BMI-1 are positively correlated and may contribute to the diagnosis and prog-nosis of the ESCC.