Epigenetic modifications include DNA methylation, RNA methylation, histone methylation, histone acetylation, and noncoding RNA. This article elucidates the molecular mechanisms by which histone modifications regulate key proteins associated with neurological disorders, focusing on how the dynamic balance between histone acetyltransferase (HAT) and histone deacetylase (HDAC) serves as an epigenetic regulatory hub, influencing disease progression through acetylation coding. It also summarizes how fluctuations in acetyl coenzyme A/nicotinamide adenine dinucleotide levels regulate cell death networks via HAT and the silence information regulator family, as well as multi-target therapeutic strategies combining HDAC inhibitors, iron chelators, and receptor-interacting protein kinase 1 inhibitors to achieve precise neuroprotection.
Lumbar disc herniation (LDH) is one of the most important causes of back and leg pain, which seriously affects the quality of life of patients. As the first-line treatment for LDH, non-operative treatment can relieve 80% to 90% of symptoms among the patients with LDH. This guideline followed Guidelines for the Formulation/Revision of Clinical Treatment Guidelines in China (2022 edition) and WHO handbook for guideline development (2014 edition) to set up guideline working group. This guideline identified fourteen clinical questions through the literature review and clinical experts’ consensus. We drafted the recommendations after systematically searching and evaluating the evidence; delphi method was adopted for expert consensus on the preliminary recommendations, finally, 19 recommendations were made to guide non-operative treatments for LDH. This guideline can provide guidance for the clinical practice of Chinese and western orthopedics practitioners.