Objective To investigate the clinical outcome and complications of different types of expansive open door laminoplasty in cervical spondylotic myelopathy.Methods From December 2008 to June 2012,221 patients with cervical spondylotic myelopathy treated with expansive open-door laminoplasty were divided into micro-titanium plate fixed group (96 cases),wire hanging fixed group(66 cases),anchor suspension fixed group (59 cases).The clinical outcome was evaluated including JOA score,operation time,bleeding volume,spinal cord pressure (a/M),cervical range of motion (ROM),open door angle,posterior shift distance of spinal cord and postoperative complications.Results All patients were followed up for more than 2 years.There were no significant differences in general condition,operation time,intraoperative blood loss,preoperative and postoperative 2 years JOA score,JOA score improvement rate,spinal cord shift distance,spinal cord compression among three groups;In the incidence of C5 nerve root paralysis,there was no significant difference between the silk suspension fixation group (12.1％) and the anchored suspension group (11.9％).The incidence of C5 nerve root paralysis for microplate fixation group (2.1％) was significantly lower than that of the silk suspension fixation group and anchored suspension fixation group,and the difference was statistically significant.There was no significant difference in the fusion rate between the 3-month and 6-month portal arteries in the group of silk suspension fixation group(65％,82％) and anchor fixation group(61％,82％).The fusion rate of the microtiter plate fixation group(90％,98％) was significantly higher than that of the silk suspension group and the anchorage group at 3 months and 6 months after operation.There were no significant differences in the incidence of recurrence,the total amount of cervical spine loss and the incidence of axial symptoms after 6 months of operation in the suspension group and the anchor suspension group.The incidence of occlusion,the total amount of cervical spine loss and the incidence of axial symptoms were significantly lower in the micro titanium plate fixation group than those in the silk suspension group and the anchorage fixation group,the difference was statistically significant.Conclusion Using micro-titanium plate to fix the side of open door could achieve full spinal cord decompression and access to satisfactory neurological improvement rate.At the same time,compared with the traditional silk or anchor suspension,the use of micro-titanium plate is more conducive to the door axis bone healing,prevent the occurrence of reclosing,significantly reduce the loss of postoperative cervical range of motion,and reduce the incidence of axial symptoms with the satisfaction of the clinical outcome.

Objective:To investigate the etiology of pleural effusion in hospitalized children in Beijing Children′s Hospital.Methods:Clinical information of children with pleural effusion admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from January 2016 to December 2018 was retrospectively analyzed.According to the etiology, the children were divided into infection group (parapneumonic pleural effusion, tuberculous pleurisy and empyema) and non infection group.According to the age, the children were further divided into ≤ 3 years old, >3-7 years old and > 7 years old groups.Classification of statistics was performed, and the etiology of pleural effusion were retrospectively analyzed.Results:Among the 1 165 children with pleural effusion, 746 cases(64.0%) were infected with pleural effusion, 697 cases (697/746, 93.4%) of who were parapneumonic effusion.In patients with parapneumonic effusion, 457 cases (61.3%) had Mycoplasma pneumonia (MP) infection.Infectious pleural effusion was more common in children >7 years old(339/479 cases, 70.8%), while non-infectious pleural effusion was prevalent in children under 3 years old(188/324 cases, 58.0%). The difference was statistically significant ( χ2=96.33, P<0.05). Among the patients with non-infectious pleural effusion, 239 cases (239/419 cases, 57.0%) had multi-system diseases and 97 cases (97/419 cases, 23.2%) had malignant pleural effusion.All the 18 deaths were non-infectious pleural effusion. Conclusions:The leading reason for pleural effusion in children is infection.The most prevalent symptom is parapneumonic effusion, which is mainly caused by MP.