Adolescent idiopathic scoliosis(AIS)is a complex three-dimensional deformity involving coronal,sagittal,and axial planes,with a prevalence that should not be overlooked.With advancements in technology and in-depth research,an increasing number of hospitals and physicians are exploring standardized diagnostic and treatment approaches for AIS.Comprehensive and in-depth understanding is required for AIS,including its etiology,screening and diagnosis,classification,assessment and examination,treatment options,exploration of current focus,and evaluation of quality of life.Such understanding ensures that the diagnostic and treatment are scientific,standardized,and timely.Based on the principles of evidence-based medicine,a consensus on the diagnosis and treatment of AIS is reached after multiple discussions among spinal surgery experts,aiming to provide reference and guidance for clinical practice.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Objective To identify the pathogenic gene and variant for a family with branchio-otic syndrome.Methods The clinical data of this family were collected,and the peripheral blood was extracted for deafness gene NGS panel analysis.Pathogenic variation detected was verified by Sanger sequencing.Results The family contained 17 members in three-generations,3 of whom exhibited autosomal dominant,hearing loss,preauricular fistula and branchial cleft fistula,which were in accordance with the clinical diagnosis criteria of branchio-otic syndrome.A no-vel heterozygous variant c.963dupT(p.E322X)in EYA1 gene was identified,which co-segregated with the branchi-o-otic syndrome phenotype in the family.The variant was a nonsense variant resulting in the premature appearance of the stop codon.According to the American College of Medical Genetics and Genomics(ACMG)guidelines and the criteria,the variant was classified as pathogenic.Conclusion We identified a novel pathogenic variant EYA1:c.963dupT(p.E322X)in a family with branchio-otic syndrome.

Objective To identify the pathogenic gene and variant for a family with branchio-otic syndrome.Methods The clinical data of this family were collected,and the peripheral blood was extracted for deafness gene NGS panel analysis.Pathogenic variation detected was verified by Sanger sequencing.Results The family contained 17 members in three-generations,3 of whom exhibited autosomal dominant,hearing loss,preauricular fistula and branchial cleft fistula,which were in accordance with the clinical diagnosis criteria of branchio-otic syndrome.A no-vel heterozygous variant c.963dupT(p.E322X)in EYA1 gene was identified,which co-segregated with the branchi-o-otic syndrome phenotype in the family.The variant was a nonsense variant resulting in the premature appearance of the stop codon.According to the American College of Medical Genetics and Genomics(ACMG)guidelines and the criteria,the variant was classified as pathogenic.Conclusion We identified a novel pathogenic variant EYA1:c.963dupT(p.E322X)in a family with branchio-otic syndrome.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Objective To observe the impact of semi-solidification enteral nutrition on feeding tolerance,nutritional and infection related indicators,and prognosis in neurocritical patients.Methods Adopting the prospective research method,the neurocritical patients who were admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Ningbo University from December 2021 to May 2022 and had to stay in the nasogastric tube for enteral nutrition were selected as the study subjects,pectin was added to achieve the semi-solidification of enteral nutrition,and the patients were divided into pectin group and control group according to the principle of randomized control,with 25 cases in each group.Enteral nutrition was started within 24-48 hours of admission to the ICU in all patients,and pectin plus continuously pumped enteral nutrition preparation was given in the pectin group and continuously pumped enteral nutrition preparation in the control group,all of which was used continuously for more than 7 days.Differences in albumin,prealbumin,Glasgow coma scale(GCS),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),sequential organ failure assessment(SOFA),procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)were compared between the two groups before and after 7 days of treatment,and enteral nutrition compliance rates at 3 days and 7 days of treatment,as well as the incidence of enteral nutrition intolerance(including vomiting,diarrhea,constipation,aspiration and bloating),along with the length of ICU stay and 28 days prognosis were observed.Results There were no statistically significant differences between the two groups in general clinical data[including gender,age and body mass index(BMI)]and pre-treatment GCS score,APACHEⅡ score,SOFA score,albumin,prealbumin,PCT,IL-6 and CRP levels.The incidence of vomiting,diarrhea,constipation,and bloating during enteral nutrition was significantly lower in the pectin group than those in the control group[vomiting:4.0％(1/25)vs.24.0％(6/25),diarrhea:8.0％(2/25)vs.32.0％(8/25),constipation:20.0％(5/25)vs.65.0％(13/25),bloating:12.0％(3/25)vs.36.0％(9/25),all P<0.05],but the difference in the incidence of aspiration compared with the control group was not statistically significant[4.0％(1/25)vs.16.0％(4/25),P>0.05].Caloric compliance with enteral nutrition was significantly higher in the pectin group than in the control group at both 3 days and 7 days of treatment[3 days of treatment:48.0％(12/25)vs.20.0％(5/25),7 days of treatment:88.0％(22/25)vs.60.0％(15/25),both P<0.05],and the prealbumin level was significantly higher in the pectin group than in the control group at the end of 7 days treatment(mg/L:248.08±43.99 vs.221.64±33.95,P<0.05).There was no statistically significant difference in the comparison of GCS score,APACHEⅡ score,SOFA score,PCT,IL-6,CRP,length of ICU stay,and 28 days mortality between the two groups after treatment.Conclusion The administration of semi-solidification enteral nutrition reduces the incidence of enteral nutrition intolerance,improves caloric intake and nutritional status in neurocritical patients,but has no significant effect on infection indicators and prognosis.

Objective:To compare the efficacy of percutaneous vertebroplasty (PVP) under enhanced regional and conventional anesthesia for multisegmental acute symptomatic osteoporotic thoracolumbar fractures (m-ASOTLF).Methods:A retrospective cohort study was conducted to analyze the data of 91 patients with m-ASOTLF who were admitted to Honghui Hospital of Xi′an Jiaotong University from January 2021 to December 2022, including 36 males and 55 females, aged 55-80 years [(67.4±7.3)years]. According to American Society of Anesthesiologists (ASA) classification system, 18 patients were classified as grade I, 52 grade II, and 21 grade III. Injured segments included T 6-T 10 in 23 patients, T 11-L 2 in 47 and L 3-L 5 in 21. All the patients were treated with PVP, among whom 45 were given enhanced regional anesthesia (enhanced anesthesia group) and 46 regional conventional anesthesia (conventional anesthesia group). The following indicators were compared between the two groups: the operation time, intraoperative bleeding, intraoperative heart rate, intraoperative mean arterial pressure (MAP), number of intraoperative fluoroscopies, and total amount of bone cement injected; the visual analogue scale (VAS) and Oswestry dysfunction index (ODI) before surgery, at 1 day, 1 month after surgery and at the last follow-up; the mini-mental state examination (MMSE) before surgery, at 1, 6, and 12 hours after surgery; the anterior vertebrae height (AVH), middle vertebrae height (MVH), and vertebral kyphosis angle (VKA) before and at 1 day after surgery; the incidence of complications such as bone cement leakage. Results:All the patients were followed up for 12-20 months [(15.8±2.6)months]. There were no significant differences between the two groups in the operation time, intraoperative bleeding, intraoperative heart rate, intraoperative MAP, number of intraoperative fluoroscopies or total amount of bone cement injected ( P>0.05). No significant differences were found between the two groups in VAS or ODI before surgery and at the last follow-up ( P>0.05). The VAS scores in the enhanced anesthesia group were (2.5±0.4)points and (1.8±0.3)points at 1 day and 1 month postoperatively respectively, which were both lower than (3.5±0.4)points and (2.0±0.5)points in the conventional anesthesia group ( P<0.01). The ODI values in the enhanced anesthesia group were 39.8±3.3 and 26.5±5.0 at 1 day and 1 month postoperatively respectively, which were both lower than 43.8±7.5 and 30.3±6.4 in the conventional anesthesia group ( P<0.01). The VAS and ODI at all postoperative time points decreased in both groups compared with those before surgery, with significant differences among those at all postoperative time points ( P<0.05). There was no significant difference between the two groups in the MMSE scores before, at 1, 6, and 12 hours after surgery ( P>0.05). The MMSE scores at 1 and 6 hours postoperatively were lower than that preoperatively in both groups ( P<0.05), and it was increased at 6 hours compared with that at 1 hour postoperatively ( P<0.05). There was no significant difference between the MMSE scores at 12 hours postoperatively and preoperatively in both groups ( P>0.05). The differences between the two groups in AVH, MVH, or VKA preoperatively were not statistically significant ( P>0.05). The AVH and MVH at 1 day postoperatively in the enhanced anesthesia group were (22.4±4.2)mm and (22.7±3.7)mm respectively, which were both higher than those in the conventional anesthesia group [(19.3±3.7)mm and (20.1±6.3)mm] ( P<0.05 or 0.01); the VKA at 1 day postoperatively in the enhanced anesthesia group was (13.9±3.7)°, which was lower than that in the conventional anesthesia group (15.8±4.1)° ( P<0.05). The AVH, MVH, and VKA in both groups were all improved at 1 day postoperatively compared with those preoperatively ( P<0.05). The incidence of bone cement leakage in the enhanced anesthesia group was 6.7% (3/45), which was lower than 21.7% (10/46) in the conventional anesthesia group ( P<0.05). Conclusion:Compared with conventional regional anesthesia, PVP under enhanced regional anesthesia for m-ASOTLF has more advantages in early postoperative pain relief, improvement of spinal function, restoration of vertebral height and reduction of bone cement leakage.