Objective:To investigate the risk factors of musculoskeletal disorders(MSDs)in dental postgraduates.Methods:271 dental postgraduates majoring in five different specialties(orthodontics,prosthodontics,endodontics,periodontics and alveolar surgery) with average (2.78 ±1 .57)years of clinical practice were recruited.254 age-matched non-dental postgraduates were served as the controls.The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors were answered. Reliability of the responses was assessed by applying test-retest method.Results:The test-retest method revealed a high reliability of participants'answers with the intraclass correlation coefficient ranging from 0.89 to 0.96.Dental postgraduates had significantly higher incidence (85.6%)of MSDs than the controls(70.4%).In all included dental specialties,high prevalence of MSDs was reported at neck (47.5%-69.8%),followed by shoulders (50.8%-65.1 %),lowerback (27.1 %-51 .2%)and upper back (25.6%-46.5%).Meanwhile,the high prevalence of MSD varied in different specialties.Year of clinical work,clinical hours per week and desk hours per week were found to be the risk factors for MSDs,whereas physical exercise and rest were protective factors.Conclu-sion:MSDs with high prevelence and distinct specialty-related characteristics initiate at the early stage of dental career.Relevant measures to prevent and protect against MSDs should be taken during school-days.

Objective To investigate the correlation among mammographic features、pathology and molecu-lar biology markers of breast infitrating ductal carcinoma(IDC) tissues.Methods The mammographic features of 93 cases with IDC confirmed by surgery and histopathology were analyzed retrospectively.The mastectomy specimens of the IDC were stained with immunohistochemistry,and the expression of ER、PR、C-erbB-2 were measured.The rela-tionship between the immunohistochemical pathologic results and mammographic features was analyzed.Results A-mong the 93 cases of IDC,ER positive expression was positively correlated with the spiculate margin of breast cancer (P<0.05);C-erbB-2 positive expression was positively correlated(P<0.05).Moreover,ER and PR positive expres-sion showed a significant inverse correlation with the calcifying of breast cancer(P>0.05);ER and PR positive ex-pression was positively correlated with the transfer of lymph(P<0.05);there existed correlation between the positive expression of C-erbB-2 and lymphatic metastasis and pathohistology grade(P<0.05).Conclusion There was a pos-itive correlation among IDC mammography、pathology and the abnormal value of ER、PR and C-erbB-2.The X-ray mammography could reflect the diagnosis value of ER、PR and C-erbB-2 roughly,and thadpractical value in determi-ning prognoses and endocrinotherapy.

The morbidity of scoliosis in adolescents in China is about 3%-5%, 80%-85% of the patients are adolescent idiopathic scoliosis (AIS), whose etiology is unknown. Scoliosis is a structural spine disease occurring during puberty or before skeletal maturation. Scoliosis has a greatly negative impacton not only the growth and development of adolescent spine, but also the mental health of adolescents. Ocular disease is a common clinical disease in which the eye ball and its accessory structures have structural abnormalitiesordys function. Ocular disease snotonly bring in convenience to patients's life, but also may induce diseases in other organs. Recent studies have shown that various ocular diseases may have a potential impact on scoliosis, and quite a fewof patients with certain ocular diseases have higher incidence rate of scoliosis. Therefore, in this article, the etiological relationship between eye diseases and scoliosis will be summarized, which provides guidance and direction for the etiological research of scoliosis and eye diseases. After sorting out, we found that the relationship between ophthalmic diseases and scoliosis mainly concentrated in the following four aspects: choroidal thickness and scoliosis, Goldenhar syndrome, gene level and strabismus. Among them, the genetic relationship is the most complex, about 40 kinds of gene or chromosome abnormalities have been found to cause ocular diseases and scoliosis; Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, first revealed the relationship between ocular diseases and scoliosis, but the current statistical relationship is still very vague. There are few studies on choroidal thickness and strabismus at home and abroad, which are statistical studies, only revealing the relationship between choroidal thickness and scoliosis, and there are many defects in the study of choroidal thickness, which need further research.

Artificial intelligence (AI), a branch of computer science, is an emerging science used to develop theories, methods, technologies and application systems that can simulate human intelligence. The goal is to enable machines to solve some complex tasks that require human intelligence. With the era of big data coming, AI has been widely used in multitudinous professional fields, including machine vision, speech recognition, image understanding, genetic programming, intelligent factory and expert systems. As the most common three-dimensional deformity of the spine, scoliosis not only changes patients' appearance and body shape but also affects their mental health. Some challenges have to be solved in diagnosis and treatment of scoliosis, such as the complexity of the anatomical structure of the spine, the importance of maintaining the posture, and the long learning-curve of spine specialty. Additionally, some aspects, such as heavy workload, fatigue, high misdiagnosis rate and missed diagnosis rate, are prone to occur in large-scale scoliosis screening and diagnosis. Researchers have discovered that AI can learn inherent laws and representation of sample data in recent years. AI technology has been used in clinical practice, such as screening, diagnosis, surgical decision-making, intraoperative operation, prognosis prediction and conservative interventions. However, AI technology has serious limitations currently. There are many disadvantages in diagnosis and treatment of scoliosis, including irregular data collection, technical difficulty, inherent defects of AI, overdependency on AI, legal and ethics issues. Thus, summarizing the relevant trends and application of AI in the diagnosis and treatment of scoliosis is still required by using the literature database and data-sharing network. The aim of the present review is to provide a glimpse into the future applications of AI.

Objective To evaluate the effect of preoperative oral rehydration on postoperative recovery in patients undergoing laparoscopic radical resection of colorectal cancer.Methods Eighty patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of colorectal cancer,were randomly divided into either routine fluid replacement group (group R) or oral rehydration group (group O) with 40 patients in each group.Fasting for solid food was performed at 8 h before surgery and for water at 6 h before surgery,and fluid was replaced according to the volume expansion during induction and 4-2-1 formula in group R.In group O,multivitamin drinks containing sugar and electrolyte was given orally according to the fasting time:12-15 ml/kg at 8 h of fasting,15-20 ml/kg at 8-12 h of fasting,with the total volume not exceeding 1 200 ml,300 ml at 3 h before surgery,and the rest of fluid was given at different times the night before surgery,and fluid replacement 1 200 ml was performed according to the basic requirement of patients and intraoperative fluid loss.Fluid replacement was maintained at a rate of 1.5 ml · kg-1 · h-1 on the day of surgery in two groups.The volume of oral fluid intake,intraoperative net volume of fluid intake and volume of intravenously given fluid on the day of surgery were recorded.The time of surgery,emergence time,time to first flatus,time to first liquid diet,first ambulation time and length of postoperative hospital stay were recorded.The development of postoperative nausea and vomiting and hypotension was recorded.Peripheral venous blood samples were collected on the morning of day 2 after admission to hospital,the day of surgery and day 1 after surgery (T0-2) for determination of the fasting blood glucose and insulin concentrations,and insulin resistance index was calculated.Results Thirty-seven and 35 patients were included in R and O groups,respectively.Compared with group R,the intraoperative net volume of fluid intake and volume of intravenously given fluid on the day of surgery were significantly decreased,fasting blood glucose and insulin concentrations and insulin resistance index were decreased,and the time to first flatus,time to first liquid diet and length of postoperative hospital stay were shortened in group O (P＜0.05).Conclusion Preoperative oral rehydration can promote postoperative recovery,which may be related to mitigating insulin resistance in patients undergoing laparoscopic radical resection of colorectal cancer.

Scoliosis is characterized by one or several segments of the spine bending sideways, accompanied by vertebral rotation and sagittal imbalance with complex etiology. Scoliosis can be caused by congenital vertebral abnormalities, asymmetry of the paraspinal muscles due to neurological lesions, and malnutrition or metabolic disorders of bone tissue. Growth hormone is a peptide hormone that plays a key role in promoting human growth and development, especially in bone growth. When the secretion of growth hormone in children or adolescents in the rapid growth stage is insufficient, it may lead to the occurrence of idiopathic short stature (ISS) and growth hormone deficiency (GHD). In clinic, ISS and GHD are mainly treated by recombinant human growth hormone (rhGH). According to some early clinical reports, in the process of rhGH treatment, many patients occur scoliosis or the original scoliosis progression is aggravated. Therefore, many scholars conclude that rhGH treatment of ISS or GHD will lead to the occurrence or development of scoliosis. However, with the increase of clinical statistics and the further progress of research, many scholars found that rhGH treatment of ISS or GHD will only increase the Cobb angle of patients with scoliosis, but will not lead to the occurrence of scoliosis, that is, rhGH treatment of ISS or GHD will not increase the prevalence of scoliosis. At present, whether rhGH treatment of ISS and GHD can lead to scoliosis and aggravation of scoliosis remains controversial. Therefore, this paper summarizes and analyzes the correlation research on the risk of scoliosis complications in children treated with rhGH, and concludes that age, gender, body mass index, and growth potential are risk factors for the development or progression of scoliosis during treatment, and discusses the balance of advantages and disadvantages of using rhGH for ISS or GHD to provide a direction for future clinical guidance.

Objective:To introduce a novel technique note about anterior decompression through transoral axis slide and rotation osteotomy (ASRO) and identify its imaging parameters related to osteotomy, and to explore its clinical application value.Methods:CT data of cervical spine of 90 subjects were collected, including 54 males and 36 females. The age ranged from 26 to 72 years, with an average age of 48.7 years. The Mimics software was used to reconstruct the atlantoaxial three-dimensional model. We plan to perform osteotomy on both sides of the axis of the vertebral body in the anteroposterior direction and the ASRO related anatomical parameters were measured, including the minimum osteotomy angle, the maximum osteotomy angle, the minimum and maximumdistance between the osteotomy trajectory and the inner side of the articular surface, the length of the upper articular surface of the axis side mass, the depth of osteotomy at the highest point and lowest point of the axial osteotomy surface and the minimum osteotomy depth. A 56-year-old female patient was admitted to the hospital due to atlantoaxial dislocation with failure of occipital-cervical fusion, difficulty walking, weakness and hypoaesthesia in four limbs. Imaging revealed that narrow space between the transversal walking wire and upper-posterior of the odontoid process, compressing the spinal cord from the front and the back respectively. The ASRO technique was performed on the patient under neuro-electrophysiological monitoring, and the osteotomy angle, osteotomy depth, narrowest width of the upper cervical spinal canal, the medullary, spinal cord angle were measured and Japanese Orthopaedic Association Scores (JOA) cervical myelopathy evaluation were performed after the operation to evaluate the surgical treatment effect.Results:The minimum osteotomy angle and the maximum osteotomy angle was 14.7°± 4.36° and 33.0°± 8.67°. The minimum and maximumdistance between the osteotomy trajectory and the inner side of the articular surface, and the length of the upper articular surface of the axis side mass was 6.0±1.80 mm, 12.2±3.17 mm, and 17.2±1.90 mm, the ratio of the former two to the latter was 34%±8.7% and 70%± 15.0%. The depth of osteotomy at the upper edge, lower edge and narrowest place of the axial osteotomy surface were 6.0±1.80 mm, 12.2±3.17 mm and 17.2±1.90 mm. The postoperative imaging of the patient showed that the osteotomy angle was 17.1° on left side and 16.5° on right side, and the depth of osteotomy at the upper edge, lower edge and narrowest place of the axial osteotomy surface were 17.1 mm, 13.2 mm, and 9.1 mm on left side, and 17.4 mm, 11.8 mm, 8.46 mm on right side. All measured values met the ranges which were shown in the imaging anatomical study. The narrowest width of the upper cervical spinal canal increased from 6.58 mm to 15.28 mm, the medullary spinal cord angle increased from 131.7° to 153.8°postoperatively, and the cervical spine JOA score recovered from 6 points to 14 points, suggesting that the postoperative spinal canal space is obvious increased, the compression on the front of the spinal cord was significantly reduced. The patient's symptoms improved significantly.Conclusion:ASRO technique is a good choice for salvage of failed posterior occipitocervical fusion and some irreducible atlantoaxial dislocation because of the anterior bony fusion. It could direct decompress the spinal cord anteriorly, avoid the odontoid resection, which is a safe and feasible new technique.