[Objective]To evaluate the surgical results of posterior hemivertebra resection in the treatment of congenital kyphoscoliosis caused by hemivertebra.[Method]From May 2000 to November 2005,14 cases with hemivertebra treated with one stage posterior hemivertebra resection were reviewed,which included males and females.All the cases underwent one stage posterior hemivertebra resection,fusion and correction with instrumentation.The mean age at time of surgery was 7.4 years old.Location of the hemivertebra included 7 cases at thoracic spine and 7 cases at lumbar spine.[Result]The mean operation time was 4.7 hours,the mean blood loss and blood transfusion during operation was 500 ml and 560 ml respectively.The fusion level was 2 to 8 segments,average 3.5 segments.Scoliosis was corrected from 46.2? to 17.3?with a correction rate of 62.6%.Kyphosis was corrected from 48.3? to 16.2? with a correction rate of 68.7%.At the final follow-up,the coronal Cobb's angle was 21.7? with a 4.4? loss of correction;the sagittal Cobb's angle was 18.7 with a 2.50 loss.Peri-operative complication included two of implant malposion,delayed wound healing.No reoperation due to the progressive deformititie was need.[Conclusion]One stage posterior hemivertebra resection has a good capability of correcting congenital kyphoscoliosis caused by a singe hemivertebra.It can save operation time and is less invasive compared to combined approach,and is indicated to thoracic and lumbar hemi-vertebra with fewer complications.

BACKGROUND:Previous clinical fol ow-up study showed that disc degeneration of adjacent segment after anterior cervical discectomy and fusion was faster than that of artificial cervical disc replacement. Compared with the anterior cervical discectomy and fusion, artificial cervical disc replacement can maintain a good range of motion of replacement segment. Further investigation should be taken to compare the difference between stress and fusion after replacement. OBJECTIVE:To compare the adjacent level discs loads between artificial cervical disc replacement and anterior cervical discectomy and fusion. METHODS:A healthy 30-year-old male volunteer was scanned with CT at the artificial cervical intervertebral disc and anterior cervical plate. Three-dimensional images were reconstructed with Mimics 10.01 and Geomagic Studio.v11 software. Above three-dimensional data were input into the Abaqus6.9 finite element analysis software for meshing, assignment, and stress analysis. Finite element method was used to simulate the stress changes of the adjacent segments after artificial cervical disc replacement and anterior cervical discectomy and fusion. RESULTS AND CONCLUSION:(1) Under the same preload, during anteflexion, posterior extension, and lateroflexion, the disc stress at adjacent segment was significantly larger after anterior cervical discectomy and fusion than normal disc. Compared with normal persons, no significant difference was detected in stress of adjacent segment at anteflexion, posterior extension, and lateroflexion after artificial cervical disc replacement. (2) Compared with artificial cervical disc replacement group, the stress of adjacent segment increased 10.3%-51.6%in the anterior cervical discectomy and fusion group. (3) Finite element analysis showed that the stress was larger in the anterior cervical discectomy and fusion group than in the artificial cervical disc replacement group. With prolonged fol ow-up, compared with the conventional anterior decompression and fusion, artificial cervical disc replacement can better play its protective effect on the adjacent intervertebral disc.

Objective To explore the diagnosis and treatment of biotinase deficiency (BTD) manifested as encephalomyelopathy.Methods The clinical data of one child with BTD were retrospectively analyzed.The pertinent literatures were reviewed.Results A six-year-old male child suffered from progressive spastic paralysis of lower limbs for 3 months before admission.A similar symptoms occurred after a cold in 3-year-old.It was easy to peel skin on her hands and she had angular stomatitis.Audio visual evoked potential was detected to be abnormal in other hospital.After hospitalizion,the cerebrospinal fluid examination was normal,and MRI showed long T1 long T2 signals bilateral occipital lobe and basal ganglia region.Because the child represented medulla palsy,and so the tracheal intubation ventilator was administrated to assist ventilation.Urine gas chromatography/mass spectrometry (GC/MS) analysis showed increases of lactic acid,3-hydroxy acid,3-tiglyl glycine,methylcitric acid,and ethylene lactic acid.Serum MS/MS analysis showed that the concentrations of propionyl camitine and 3-hydroxyisovaleryl carnitine were increase obviously.The serum biotinase level was significantly decrease to 0.076 pmol/(min·mm3).The diagnosis of BTD was confirmed.After supplementation biotin,40 mg/d,the ventilator was successfully weaned on the third day,the child walked again after 2 weeks,and the rash was vanished.After 3 weeks,the head MRI showed disappearance of the original lesion,and there was no abnormal in spinal cord.The BTD gene detected by PCR direct sequencing showed a heterozygosis mutation of T172T/C in the second exon and a homozygous mutation of T1413C in the fourth exon,which was confirmed as a pathogenic mutation by pedigree verification and database query.After discharge,the oral administration of biotin 20 mg/d continued,and no abnormality was found in 2 years of follow-up.Conclusions The manifestations of BTD are complex and diverse.The analysis of urine GC/MS and serum MS/MS can assist the diagnosis.The determination of biotinase activity and gene detection of BTD can further confirm the diagnosis.Timely biotin supplementation has significant treatment efficacy.

Objective:To analyze the spatial distribution characteristics and spatial aggregation of the epidemic of severe fever with thrombocytopenia syndrome(SFTS) in Yantai City of Shandong Province, and to provide basis for formulating effective SFTS prevention and control measures.Methods:The epidemic data of SFTS confirmed cases in each township (street) in Yantai City, Shandong Province from 2015 to 2020 were collected from the "China Disease Prevention and Control Information System Infectious Disease Monitoring and Reporting System", and ArcGIS 10.2 software was used for spatial autocorrelation analysis.Results:From 2015 to 2020, a total of 839 SFTS cases were reported in Yantai City, including 124 deaths; with an average annual incidence rate of 2.14/100 000, and a total case fatality rate of 14.78%. Global spatial autocorrelation analysis showed that the distribution of SFTS cases in Yantai City from 2015 to 2020 showed a positive spatial correlation, with the highest spatial correlation in 2015 (Moran's I = 0.25, Z = 5.66, P < 0.001), and the lowest in 2018 (Moran's I = 0.16, Z = 3.69, P < 0.001). Local spatial autocorrelation and hotspot analysis showed that the epidemic areas of SFTS were mainly in some mountainous and hilly townships (streets) of Laizhou City, Penglai District, Qixia City, Zhaoyuan City, and Haiyang City. Conclusions:The distribution of SFTS epidemic in Yantai City has obvious regional clustering. Intervention measures such as publicity, education and monitoring should be strengthened in high-incidence areas to reduce the incidence of the disease.

Objective:To understand the epidemic characteristics and influential factors of brucellosis patients in Laizhou, Shandong Province, and to provide scientific basis for prevention and control of brucellosis.Methods:Retrospective analysis was conducted to collect the surveillance data and epidemiological investigation results of confirmed cases of brucellosis in Laizhou from 2016 to 2019 through the "Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System". The general situation, epidemiological characteristics, and clinical characteristics of brucellosis were analyzed by descriptive epidemiology. Using the case-control study method, 81 confirmed cases of brucellosis and 162 healthy people in the same area, same gender and same age as confirmed cases were selected to analyze the influential factors of brucellosis.Results:Totally 222 cases of brucellosis had been reported in Laizhou, with an average annual incidence of 6.57/100 000. The onset age of brucellosis was mainly from 45 to 59 years old, accounting for 46.40% (103/222); male-to-female ratio was 2.42 ∶ 1.00 (157 ∶ 65); the occupation distribution was mainly farmer, accounting for 95.95% (213/222). The onset time of brucellosis was mainly from March to July, accounting for 58.11% (129/222). Cases of brucellosis were reported in 17 townships (streets) of Laizhou, and the top five townships were Zhuqiao, Shahe, Tushan, Chengguo and Yidao towns in order of incidence. Among 222 cases of brucellosis, the shortest interval from onset to diagnosis was 5 d, the longest was 36 d, and the median was 11 d. The main clinical manifestations of the patients were fever (89.19%, 198/222), fatigue (80.63%, 179/222), joint muscle soreness (72.97%, 162/222), and a few accompanied by liver, spleen and testis enlargement. The logistic regression analysis showed that contact with urine, feces and other excrements of diseased animals [odds ratio ( OR) = 6.244, 95% confidence interval ( CI): 1.609 - 24.231] and family members suffering from brucellosis ( OR = 16.363, 95% CI: 2.250 - 119.023) were risk factors of brucellosis. Conclusions:The incidence of brucellosis is mainly among 45 - 59 middle-aged farmers in Laizhou and the incidence peaks in spring and summer. Direct contact with excrements of diseased animals and family members suffering from brucellosis are the risk factors of brucellosis. Health departments should carry out health education and behavioral intervention for farmers in the season and areas with high incidence of brucellosis, so as to improve personal awareness of protection.