BACKGROUND:Because of complicated biomechanics of lumbar vertebra, mast facet osteoarthritis, degenerative joint disease and vertebral subluxation usual y occur fol owing lumbar fusion. To avoid adjacent segment disease, researchers have transformed strong internal fixation into elastic fixation, but the treatment outcomes are barely satisfactory. Furthermore, factors involving adjacent segment disease remain unclear. OBJECTIVE:To explore the relationship between L3-4 segment disease fol owing lumbar fusion and gender. METHODS:200 patients undergoing lumbar fusion of L4-5 and L5-S1 in the First Hospital of Shijiazhuang ranging from 2007 to 2016 were enrol ed, and then al otted into male and female groups (n=100 per group) for retrospective analysis. The incidence of L3-4 segment disease was compared between two groups. RESULTS AND CONCLUSION:Compared with the male group, in the female group, the incidence of L3-4 segment diseases at different fusion locations and ranges, the Oswestry disability index and visual analogue scale and each migration range were significantly higher. Logistic regression analysis showed that gender was one of the independent factors of L3-4 segment disease following lumbar fusion of L3-4 and L5-S1. These findings suggest that gender is one of the influencing factors of L3-4 segment disease after instrumented lumbar;thereby, adjacent segment disease occurs frequently in female patients.

Objective: Explore the method for volumetric measurement of alveolar bone defect. Methods: This study applied 2 advanced preoperative volume measurement methods: three-dimensional (3D) printing and computer-aided engineering (CAE). Twenty-six unilateral alveolar cleft patients were enrolled in this study from April 2015 to December 2016. Their computed tomographic data were sent to 3D printing and CAE software. A simulated graft was used on the 3D-printed model, and the graft volume was measured by water displacement. The volume calculated by CAE software used mirror-reverses technique. Results: The volume of alveolar bone defect could be detected by both methods. The average volume of the simulated bone grafts by 3D-printed models was 1.61 ml, a little higher than the mean volume of 1.60 ml calculated by CAE software. The difference between the 2 volumes was from -0.34 ml to 0.54 ml. The paired Student t test showed no statistically significant difference between the volumes derived from the 2 methods. Conclusions This study demonstrated that the volume of alveolar bone defect is about 1.6ml in unilateral alveolar cleft patients aged 9-12 years. The mirror-reversed technique by CAE software is as accurate as the simulated operation on 3D-printed models. These findings further validate the use of 3D printing and CAE technique in alveolar defect repairing.

Facial change is an important clinical manifestation of endocrine system diseases and genetic syndromes. The use of traditional photography and three-dimensional imaging techniques to collect patients’ facial images to analyze changes in patients’ face has become a hot topic. This article reviews the application of facial analysis in endocrine diseases, such as acromegaly, Cushing’s syndrome, hyperthyroidism, and genetic syndromes, and provide a new perspective for early diagnosis and prognosis of disease.

Facial change is an important clinical manifestation of endocrine system diseases and genetic syndromes. The use of traditional photography and three-dimensional imaging techniques to collect patients’ facial images to analyze changes in patients’ face has become a hot topic. This article reviews the application of facial analysis in endocrine diseases, such as acromegaly, Cushing’s syndrome, hyperthyroidism, and genetic syndromes, and provide a new perspective for early diagnosis and prognosis of disease.

Objective:To construct a whole course management and follow-up platform, named Care Plan, for patients undergoing breast reconstruction surgery, and to evaluate its initial clinical applications.Methods:From June 2023 to January 2024, patients who underwent breast reconstruction surgery at Peking Union Medical College Hospital were selected as the study subjects and enrolled in the Care Plan platform for whole course management. The platform comprised five modules: patient education, self-assessment, medical assessment, medical follow-up, and doctor-patient dialogue, each with corresponding sub-modules and specific components. Each patient was assigned to a case manager who provided one-on-one assessment, sent patient education materials, and conducted follow-ups. The preliminary application of the Care Plan platform was evaluated based on the completeness of patient data, patient education material reading status, doctor-patient dialogue topics, and follow-up responses. At 3 months postoperatively, patients were followed up and further divided into patient education group(reading at least an article on patient educational materials) and control group based on their reading status of educational materials. Patients rated their satisfaction with the surgery using a 5-point questionnaire, including five indicators: expected breast reconstruction outcome, expected surgical type, completeness of information acquisition, breast symmetry, and breast softness. Statistical analysis was performed using SPSS 27.0.1 software, with count data expressed as frequencies and (or) percentages, normally distributed measurement data expressed as Mean±SD, intergroup comparisons conducted using t-test, and P<0.05 indicating statistical significance. Results:A total of 147 female patients aged 16 to 63 years with a body mass index of 16.6 to 31.3 kg/m 2 were ultimately included. All 147 patients completed the content of the self-assessment and medical assessment modules, with relatively complete data. Of the 133 patients who received patient education materials sent through the platform, 38 (28.6%) read the materials, with the sub-module on the introduction and choices of the reconstruction surgery (37.3%, 94/252 ) being the most frequently viewed. A total of 24 patients (16.3%, 24/147 ) raised 45 questions using the doctor-patient dialogue module, with the highest proportion related to consultation issues and complications, each accounting for 22.2% (10/45). Twenty-three patients completed the 3-month follow-up, with 12 in the patient education group and 11 in the control group. The patient education group scored higher than the control group in terms of completeness of information acquisition [(4.58±0.51) points vs. (3.91±0.70) points, t=-2.65, P=0.015], while scoring lower in breast symmetry [(3.92±0.79) points vs. (4.63±0.67) points, t=2.33, P=0.030]. There was no significant difference between the two groups in terms of expected breast reconstruction outcome, expected surgical type, and breast softness scores ( P>0.05 for all). Conclusion:The Care Plan platform for whole course management and follow-up of breast reconstruction can assist medical staff in formulating patient-centered management plans, improve patients’ understanding of surgical information, and aid patients in making decisions regarding breast reconstruction methods.

Objective:To construct a whole course management and follow-up platform, named Care Plan, for patients undergoing breast reconstruction surgery, and to evaluate its initial clinical applications.Methods:From June 2023 to January 2024, patients who underwent breast reconstruction surgery at Peking Union Medical College Hospital were selected as the study subjects and enrolled in the Care Plan platform for whole course management. The platform comprised five modules: patient education, self-assessment, medical assessment, medical follow-up, and doctor-patient dialogue, each with corresponding sub-modules and specific components. Each patient was assigned to a case manager who provided one-on-one assessment, sent patient education materials, and conducted follow-ups. The preliminary application of the Care Plan platform was evaluated based on the completeness of patient data, patient education material reading status, doctor-patient dialogue topics, and follow-up responses. At 3 months postoperatively, patients were followed up and further divided into patient education group(reading at least an article on patient educational materials) and control group based on their reading status of educational materials. Patients rated their satisfaction with the surgery using a 5-point questionnaire, including five indicators: expected breast reconstruction outcome, expected surgical type, completeness of information acquisition, breast symmetry, and breast softness. Statistical analysis was performed using SPSS 27.0.1 software, with count data expressed as frequencies and (or) percentages, normally distributed measurement data expressed as Mean±SD, intergroup comparisons conducted using t-test, and P<0.05 indicating statistical significance. Results:A total of 147 female patients aged 16 to 63 years with a body mass index of 16.6 to 31.3 kg/m 2 were ultimately included. All 147 patients completed the content of the self-assessment and medical assessment modules, with relatively complete data. Of the 133 patients who received patient education materials sent through the platform, 38 (28.6%) read the materials, with the sub-module on the introduction and choices of the reconstruction surgery (37.3%, 94/252 ) being the most frequently viewed. A total of 24 patients (16.3%, 24/147 ) raised 45 questions using the doctor-patient dialogue module, with the highest proportion related to consultation issues and complications, each accounting for 22.2% (10/45). Twenty-three patients completed the 3-month follow-up, with 12 in the patient education group and 11 in the control group. The patient education group scored higher than the control group in terms of completeness of information acquisition [(4.58±0.51) points vs. (3.91±0.70) points, t=-2.65, P=0.015], while scoring lower in breast symmetry [(3.92±0.79) points vs. (4.63±0.67) points, t=2.33, P=0.030]. There was no significant difference between the two groups in terms of expected breast reconstruction outcome, expected surgical type, and breast softness scores ( P>0.05 for all). Conclusion:The Care Plan platform for whole course management and follow-up of breast reconstruction can assist medical staff in formulating patient-centered management plans, improve patients’ understanding of surgical information, and aid patients in making decisions regarding breast reconstruction methods.