Search

Lumbar spinal stenosis is one of the most common causes of low back and leg pain. However, there is a lack of evidence-based guidelines for the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine. To standardize the diagnosis and treatment of lumbar spinal stenosis with a combination of traditional Chinese medicine and western medicine, this guideline strictly followed the relevant guiding principles for the development of guidelines both domestically and internationally. A multidisciplinary working group was established. We adopted the GRADE approach to grade the quality of evidence and the strength of recommendation. Finally recommendations on the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine were formed, aiming to standardize clinical practice. This guideline is for patients with all degrees of lumbar spinal stenosis.

Lumbar spinal stenosis (LSS) is a common disease in orthopedics. The American Society of Pain and Neuroscience (ASPN) published a new version of minimally invasive treatment practice guidelines in 2022 to improve the clinical efficacy of LSS. A total of seven treatments for LSS were included in the guidelines, including percutaneous image-guided lumbar decompression (PILD), interspinous spacers (ISP), interspinous fusion (ISF), intrathecal drug delivery systems (IDDS), spinal cord stimulation (SCS), epidural steroid injections (ESI) and open decompression. Based on the guidelines, this paper summarizes and discusses the research progress of minimally invasive treatment of LSS in the context of the clinical situation, aiming to provide a reference for clinicians and further related researches.

Comorbidities are highly prevalent in osteoporosis patients, including endocrine, circulatory, respiratory, urinary, immune, musculoskeletal, and neurological diseases, which may aggravate osteoporosis, increase the risk of osteoporotic fracture, and seriously affect the quality of patient's life, bringing more challenges to associated clinical management, and imposing a heavy burden on the families and society. There is still a lack of studies on comorbidities of osteoporosis, and the existing research strategies are inadequate to support clinicians to carry out comorbidity management in terms of understanding the causes of osteoporosis and associated comorbidities, and delivering interventions for prevention and treatment of both of them. In view of this, it is suggested to use multidisciplinary integrated treatment, and strengthen the understanding of osteoporosis related comorbidities and their pathogenesis. Moreover, the screening for osteoporosis in people with possible osteoporosis risk should be performed as early as possible, and actions should be taken actively to reduce the risk of fracture in those who are found with osteopenia or osteoporosis. Early screening, diagnosis and treatment are necessary to realize the prevention and treatment of osteoporosis and associated comorbidities.

Background Vitamin D levels decrease with age and are associated with the occurrence of osteoporosis, fractures, falls and muscle weakness that are common in older adults. In addition, its association with quality of life in the elderly has also been increasingly paid attention. Objective To investigate the vitamin D level and its correlation with health-related quality of life in the elderly population dwelling in community in Beijing, and to provide decision-making reference for improving the full life-cycle quality of life of this population. Methods The data of this study were obtained from the BEYOND research database carried out in Chaoyang District and Fengtai District of Beijing from November 2017 to July 2018. A total of 1 066 elderly people aged ≥ 60 were included for analysis. Clinical information including demographic and socioeconomic characteristics, biochemical markers of bone metabolism, bone mineral density, left and right hand grip strength, sitting test, and history of falls and fractures during 2-year follow-up was collected. According to the level of 25-hydroxyvitamin D〔25 (OH) D〕, the subjects were divided into vitamin D deficient group, vitamin D insufficient group and vitamin D sufficient group, and the EuroQol Five-dimensional Questionnaire (EQ-5D) was used to evaluate the quality of life of the subjects. Results Among the 1 066 subjects, 729 (68.39%) were in the vitamin D deficient group, 291 (27.30%) were in the vitamin D insufficient group, and 46 (4.32%) were in the vitamin D sufficient group. Serum levels of procollagen type 1 N-terminal propeptide (P1NP) , alkaline phosphatase (ALP) , parathyroid hormone (PTH) , osteocalcin (OST) , and cross-linked type I collagen carboxyl-terminal peptide (β-CTX) , left hip overall T value, right hip overall T value, and left hand grip strength were statistically significant among three groups (P

Aims: The basolateral amygdala (BLA) plays an integral role in anxiety disorders (such as post traumatic stress disorder) stem from dysregulated fear memory. The excitability of glutamatergic neurons in the BLA correlates with fear memory, and the afterhyperpolarization current (IAHP) mediated by small‐conductance calcium‐activated potassium channel subtype 2 (SK2) dominates the excitability of glutamatergicneurons. This study aimed to explore the effect of MPP2 interacts with SK2 in the excitability of glutamatergic neurons in the BLA and the extinction of conditioned fear in mice. Methods: Fear memory was analyzed via freezing percentage. Western blotting and fluorescence quantitative PCR were used to determine the expression of protein and mRNA respectively. Electrophysiology was employed to measure the excitability of glutamatergic neurons and IAHP. Results: Fear conditioning decreased the levels of synaptic SK2 channels in the BLA, which were restored following fear extinction. Notably, reduced expression of synaptic SK2 channels in the BLA during fear conditioning was caused by the increased activity of protein kinase A (PKA), while increased levels of synaptic SK2 channels in the BLA during fear extinction were mediated by interactions with membrane‐palmitoylated protein 2 (MPP2). Conclusions: Our results revealed that MPP2 interacts with the SK2 channels and rescues the excitability of glutamatergic neurons by increasing the expression of synaptic SK2 channels in the BLA to promote the normalization of anxiety disorders and provide a new direction for the treatment. [ABSTRACT FROM AUTHOR]

The experiences and lessons of China's response to COVID-19 have been described in several studies, but the mechanisms of the Chinese government's efforts to fight COVID-19 have not been well characterized. Despite strong policy directives and orders from the central government, the response and handling of the epidemic also reflected distinctive characteristics of local governments in terms of their governance systems and capacities. In this article, we analyze public health policies and mechanisms of the Chinese government's response to COVID-19 based on the integration of top-down and local governance. A compendium of key events and measures provides the foundation for our analysis. Mechanisms related to leadership, emergency response, centralized mobilization, and accountability fully reflect the decisive measures for top-down interventions in the face of emergencies. China's policies and mechanisms to address the COVID-19 pandemic are consistent with its party-state bureaucracy and socioeconomic context. However, lower levels of government have used "repeated increments" and "one-size-fits-all" practices in the implementation of antiepidemic policies. Conservative local officials are more averse to social innovation and favor strict controls to manage the pandemic. Moreover, even under a unified system, there are substantial differences in the capacity and level of crisis management among local governments, especially in the mobilization of nonprofit organizations and volunteers. In this case study, we aim to expand the existing understanding of the tension between top-down interventions and local governance innovations. [ABSTRACT FROM AUTHOR]