Adolescent ; Adult ; Ear, Middle ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mastoid ; diagnostic imaging ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Objective To analyze the application of multi‐slice spiral CT and 3D airway reconstruction technique on obstruc‐tive sleep apnea syndrome (OSAS) of pharyngeal soft tissue and upper airway stenosis .Methods Selected 92 patients with OSAS in our hospital as the observation group and another 92 healthy persons were selected as control group ,all patients achieved multi‐slice CT and 3D airway reconstruction technical inspections ,counted and compared their pharyngeal soft tissue and upper airway stenosis .Results Airway stenosis of tongue back ,and hypopharynx retro‐palatal of control group were more narrow compared with the control group(P<0 .05);the observation group′s pharyngeal soft tissue was more thick than the control group ,so as the length and width(P< 0 .05) .Conclusion Multi‐slice spiral CT and 3D airway reconstruction technique can effectively share pharyngeal soft tissue and upper airway stenosis of patients with OSAS .

Objective To evaluate the value of postmastectomy radiotherapy (PMRT) in locally advanced breast cancer patients treated with neoadjuvant chemotherapy (neoCT) and modified radical mastectomy, and to investigate the possibility of individualized radiotherapy according to the response to neoCT.Methods We analyzed 523 patients with stage ⅢA and ⅢB breast cancer who received neoCT and modified radical mastectomy in our hospital from 1999 to 2013.Of all patients, 404 received PMRT, and 119 did not.The locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method, survival difference analysis and univariate prognostic analysis were performed using the log-rank test, and multivariate prognostic analysis was performed using the Cox regression model.Results Compared with those not treated with PMRT, the patients treated with PMRT had a significantly lower 5-year LRR rate (13.9% vs.24.8%, P=0.013), a significantly higher DFS rate (64.1% vs.53.9%, P=0.048), and an insignificantly higher OS rate (83.2% vs.78.2%, P=0.389).In the patients with ypT3-T4, ypN2-N3, or pathologic stage Ⅲ disease, those treated with PMRT had a significantly reduced 5-year LRR rate (P<0.05) and a significantly increased 5-year OS rate (P<0.05), as compared with those not treated with PMRT.Among the 158 patients with ypN0 disease, the 5-year LRR rate was significantly lower in those treated with PMRT than in those not treated with PMRT (P=0.004).Of 41 patients who achieved a pathologic complete response, 2 patients, who did not receive PMRT, developed LRR.The multivariate prognostic analysis indicated that PMRT was an independent prognostic factor associated with reduced LRR in all patients and ypN0 patients.Conclusions In patients with stage ⅢA and ⅢB breast cancer treated with neoCT and modified radical mastectomy, PMRT can significantly reduce LRR for all patients and can reduce both recurrence and mortality for those with ypT3-T4, ypN2-N3, or pathologic stage Ⅲ disease.There is no sufficient evidence that PMRT can be omitted safely for ypN0 or pCR patients according to their response to neoCT.

This paper first summarizes the cognition and understanding of online teaching, then introduces the active design and practice of online teaching in Harbin Medical University, and fully comprehends the quality of online teaching through the feedback to teachers and students. Through the investigation, the research group found that there are problems in online teaching, including teachers' difficulty in applying the teaching platform efficiently, limited Internet speed and hardware equipment, insufficient understanding and attention of individual teachers to online teaching, insufficient interaction between teachers and students, and difficulty in carrying out experiments and practical teaching. In this regard, the research group proposed countermeasures to change online teaching concept, reform online teaching methods, improve the function of online teaching platform, and optimize online course resources in order to timely summarize the online teaching situation, improve the shortcomings and promote advanced experience, and ensure the quality of follow-up online teaching.

Objective: To evaluate efficacy of the BiRd regimen, a combination of clarithromycin, lenalidomide, and dexamethasone, in the treatment of patients with relapsed/refractory multiple myeloma (RRMM) . Methods: Patients with RRMM treated with BiRd between September 11, 2013 and August 1, 2016 at six centers were included to evaluate overall survival rate (ORR) , clinical benefit rate (CBR) , progression-free survival (PFS) , overall survival (OS) , as well as adverse events. Results: Of 30 patients with RRMM, 27 patients were evaluable, and ORR and CBR were 51.9% (14/27) and 66.7% (18/27) respectively, including 1 sCR (3.7%) , 3 CR (11.1%) , 3 VGPR (11.1%) , and 7 PR (25.6%) . In 13 patients with prior Rd, ORR and CBR were 38.5% (5/13) and 61.5% (8/13) respectively, of which 5 patients with ≥MR carried high-risk cytogenetic[ (e.g.17p- or t (4;14) ] together with at least one of other adverse-prognostic cytogenetic (e.g.13q- and/or 1q21+) . In 24 patients with prior bortezomib-based therapy, ORR and CBR were 45.8 and 62.5%, respectively. With a median follow-up time of 14.9 (range 1.0-33.8) months, the median PFS and OS were 12.0 (95%CI 11.6-12.4) and 27.6 (95%CI 15.1-40.1) months, respectively. The BiRd regimen was well tolerated. Conclusion The BiRd regimen is an effective and safety protocol for RRMM, including those carrying high-risk cytogenetic markers.

Medical curriculum integration is of great significance for reforming traditional medical education models and cultivating new medical talents with competency. On the basis of reviewing the concepts and development history of medical curriculum integration in China, this article sorts out three relatively mature medical curriculum integration models based on the practice of medical education reform in China, namely, organ-system-based curriculum model, and problem-based curriculum model and modular curriculum integration model. It also points out the difficulties of the current curriculum integration reform in medical colleges and universities from the aspects of the construction of teaching staff, the construction of integrated curriculum teaching materials, the design and connection of curriculum, and the assessment and evaluation. Finally, we should deeply analyze the concept of curriculum integration and create a curriculum model suitable for the reality of China's medical education in practice, hoping to provide reference for the practice of medical curriculum integration reform in China.