Interspinous process device is a kind of non-fusion implant for posterior spinal surgery.It is classified by static system and dynamic system according to its characteristics.With rapid development of internal fixator manufacture,materials for interspinous process device become increasing,such as bone allograft,titanium,poly(ether-ether-ketone) and lactoprene composite.A large number of experimental and clinical researches reveal the advantages of this technology in degenerative spinal stenosis,intervertebral original lower back pain,facet syndrome,protrusion of intervertebral disk,and lumbar instability.However,there are still many problems such as the influence on the lumbar posterior column,the mechanism to lumbar disc and the effect on the stability of spine etc.In addition,the clinical indications need to validate by long-term follow up.

20?) or vertebral semiluxation and vertebral pathological fracture group (n=14),which was treated with full laminectomy and limited correction with pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract; mild coronal plane deformity (Cobb’s angle

Objective To compare the efficacy and safety between mono-chemotherapy and targeted therapy as first-line regimen for patients over 80 years old with advanced non-small cell lung cancer (NSCLC).Methods 108 NSCLC patients aged ≥80 years in our hospital were divided into two groups according to the therapeutic program,of which group A was mono-chemotherapy group (n =60) and group B was targeted therapy group (n =48).The primary endpoint was overall survival (OS) and progression free survival (PFS),while secondary endpoint was objective response rate (RR),disease control rate (DCR) and safety.Results The median PFS,and median OS in group B were significantly longer than those in group A (P =0.013,0.025).The 1-year survival rate of group B was significantly higher than that of group A (P =0.001),and there was no significant difference between the two groups (P =0.605).There was also no statistically significant difference in RR between the two groups (P =O.408).DCR in Group B was significantly higher than that in group A (P =0.043).The incidence of skin rash in group B was significantly higher than that in group A,and the incidence of adverse reactions and hematological toxicity in group A was significantly higher than that in group B.Conclusions Compared with single-agent chemotherapy,epithelial growth factor receptor-tyrosinekinase (EGFR-TKI) targeted therapy has longer PFS and OS benefits for patients ≥ 80 years with advanced NSCLC,and was well tolerated by patients.

Objective:To compare the clinical outcomes and correction effects of kyphosis between Zero-profile device (Zero-p) and plate/cage structures (PCC) in treating cervical spondylotic myelopathy (CSM) patients with cervical kyphosis.Methods:From August 2016 to July 2018, a total of 54 cases of cervical spondylotic myelopathy patients with cervical kyphosis were analyzed retrospectively, including 26 cases treated with Zero-p and 28 cases treated with PCC system. There was no significant difference between the two groups in gender, age, body mass index (BMI) and operative segment. The operation duration and the blood loss were recorded. The clinical outcomes of the patients were measured by visual analogue score (VAS) for neck pain and Japanese Orthopedic Association (JOA) score for neurological function. Moreover, JOA recovery rate was obtained to assess the surgical results. The cervical lordosis (C 2-C 7 Cobb angle), the Cobb angle of the operation segment, the C 2-C 7 vertical axis (C 2 SVA) and the cervical range of motion (ROM) were measured on the lateral and dynamic radiographs of the cervical spine, respectively. Results:In the Zero-p group, the operation duration was 83.0±14.9 (range 60-120) min, intraoperative blood loss was 70.5±27.3 (range 30-150) ml. In PCC group, the operation duration was 100.0±23.9 (range 65-145) min, intraoperative blood loss was 104.2±38.8 (range 30-250) ml. There were significant difference in above parameters between two groups ( t=3.40, 2.06; P=0.00, 0.04). The follow-up duration in Zero-p group was 30.4±5.8 (range 24-36) months and 31.2±4.9 (range 24-36) months in PCC group without significant difference ( t=1.061, P=0.291). The VAS/JOA score of the Zero-p group was improved from (5.9±1.0)/(9.2±1.7) preoperatively to (2.1±0.8)/(14.9±1.0) at 1 month postoperatively, and to (3.4±1.0)/(15.1±0.9) at the last follow-up. The difference between them was statistically significant ( F=130.96, 221.40, P=0.00). The VAS/JOA score of the PCC group was improved from (5.9±1.1)/(8.7±1.6) preoperatively to (2.3±0.9)/(14.9±1.0) at 1 month after surgery, and to (2.6±0.9)/(15.6±1.1) at the last follow-up. The difference between them was statistically significant ( F=303.35, 126.64, P=0.00). However, the VAS score of neck pain in the Zero-p group at the last follow-up was significantly deteriorated, which was significantly higher than that in PCC group ( P<0.05). The cervical lordosis/operative segment Cobb angle in the Zero-p group was improved from preoperative (-6.7°±2.7°)/(-6.5°±3.2°) preoperatively to (14.2°±4.9°)/(12.9°±4.9°) at 1 month postoperatively, and to (5.9°±4.7°)/(5.0°±4.0°) at the last follow-up with statistical significance ( F=196.98, 179.97, P=0.00). The cervical lordosis/operative segment Cobb angle in the PCC group was improved from (-5.7°±3.5°)/(-6.1°±4.0°) preoperatively to (13.9°±6.9°)/(13.0°±6.4°) 1 month after surgery, and to (11.0°±5.5°)/(10.4°±5.6°) at the last follow-up with statistical significance ( F=127.27, 119.98, P=0.00). However, the cervical lordosis and operative segment Cobb angle at the last follow-up in the Zero-p group were significantly lost compared with those at 1 month after surgery, which were significantly smaller than those in the PCC group ( P<0.05). The incidence of dysphagia after operation was 7.7% (2/26) in the Zero-p group and 28.6% (8/28) in the PCC group (χ 2=5.11, P=0.02). Conclusion:For CSM patients with cervical kyphosis, PCC could achieve much better mid-term kyphotic correction and clinical outcomes. However, Zero-p should be avoided as much as possible.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.