Objective:To examine the clinical effect of the enlarged anterior cervical intervertebral cone-shape decompression and fusion(EACDF) for treating degenerative cervical kyphosis (DCK).Methods:This study is a retrospective case series research. From September 2018 to September 2023, the data of 51 patients with DCK who underwent EACDF at Department of Orthopaedics, the Second Affiliated Hospital, Naval Medical University were analyzed retrospectively. Among the 51 patients, there were 28 males and 23 females, with an age of (61.6±9.8) years old (range:39 to 74 years), and an body mass index of (25.9±2.7) kg/m 2 (range:20.7 to 31.7 kg/m 2). Patients underwent EACDF with expanded decompression by distracted intervertebral space, partial resections of posterior edge of vertebral body and uncinate vertebral joint. The operation duration, blood loss and length of hospital stay were recorded. The visual analog scale (VAS) of neck pain and arm pain, cervical disability index (NDI), and modified Japanese Orthopaedic Association (mJOA) score were recorded in patients before and immediately after surgery, as well as at follow-up. Imaging parameters such as C 2-7 Cobb angle of cervical global curvature, Cobb angle at the operative segment, C 2-7 sagittal vertical axis (C 2-7 SVA), T 1 slope and the height of operative segment were measured. The fusion rate and surgical complications of two groups were recorded. Fourty-five patients who underwent anterior cervical corpectomy with fusion (ACCF) during the same period were included to compare the effectiveness of deformity correction between the two groups. Repeated measures ANOVA was used for intra group data comparison and Dunnett- t test was used for pairwise comparison, and mixed design ANOVA was used for inter group data comparison. Results:All patients were successfully completed the operation. The follow-up period after surgery was (40.4±13.4) months (range:12 to 72 months). The neck pain and arm pain VAS, NDI and JOA in the two groups immediately after surgery, at 2 months, 12 months after surgery, and the final follow-up were significantly improved compared with those before operation (all P<0.05). In both groups, postoperative the C 2-7 Cobb angle, Cobb angle at the operative segment, C 2-7 SVA, T 1 slope, and height of operative segment were significantly improved immediately after surgery, at 2 months, 12 months, and the final follow-up (all P<0.05). The C 2-7 Cobb angle, Cobb angle at the operative segment, and height of operative segment immediately after surgery, at 2 months, 12 months, and the final follow-up in the EACDF group were significantly higher than those in the ACCF group (all P<0.05). There were no significant differences in C 2-7 SVA and T 1 slope between the two groups(all P>0.05). At the final follow-up, the angle of every intervertebral space correction in the EACDF group was (9.3±1.6) °(range:6.5° to 12.3°), while in the ACCF group was (3.1±1.8) °(range:1.2° to 5.6°), with a significant difference between the two groups ( P<0.05). Patients at the both groups got bone graft fusion at the final follow-up. Conclusions:The clinical effect of EACDF for treating DCK is satisfactory. EACDF maybe superior to ACCF in restoring intervertebral height, correcting and maintaining cervical curvature.

Artificial intelligence(AI) is increasingly being utilized in the research of cervical spine diseases, encompassing areas such as image analysis, assisted diagnosis, clinical treatment decision support, surgical assistance, and postoperative rehabilitation, thereby demonstrating significant clinical value. However, many existing studies primarily focus on evaluating model performance and often lack clear indicators of clinical utility. Additionally, these studies face challenges such as heterogeneity in research design and reporting, low transparency of algorithms and dataset quality. As AI continues to advance rapidly, future efforts should prioritize the establishment of standardized databases, the enhancement of algorithm reliability, the minimization of data bias, and the achievement of comprehensive AI assistant management throughout the cervical spine surgery process.

Objective:To examine the clinical effect of the enlarged anterior cervical intervertebral cone-shape decompression and fusion(EACDF) for treating degenerative cervical kyphosis (DCK).Methods:This study is a retrospective case series research. From September 2018 to September 2023, the data of 51 patients with DCK who underwent EACDF at Department of Orthopaedics, the Second Affiliated Hospital, Naval Medical University were analyzed retrospectively. Among the 51 patients, there were 28 males and 23 females, with an age of (61.6±9.8) years old (range:39 to 74 years), and an body mass index of (25.9±2.7) kg/m 2 (range:20.7 to 31.7 kg/m 2). Patients underwent EACDF with expanded decompression by distracted intervertebral space, partial resections of posterior edge of vertebral body and uncinate vertebral joint. The operation duration, blood loss and length of hospital stay were recorded. The visual analog scale (VAS) of neck pain and arm pain, cervical disability index (NDI), and modified Japanese Orthopaedic Association (mJOA) score were recorded in patients before and immediately after surgery, as well as at follow-up. Imaging parameters such as C 2-7 Cobb angle of cervical global curvature, Cobb angle at the operative segment, C 2-7 sagittal vertical axis (C 2-7 SVA), T 1 slope and the height of operative segment were measured. The fusion rate and surgical complications of two groups were recorded. Fourty-five patients who underwent anterior cervical corpectomy with fusion (ACCF) during the same period were included to compare the effectiveness of deformity correction between the two groups. Repeated measures ANOVA was used for intra group data comparison and Dunnett- t test was used for pairwise comparison, and mixed design ANOVA was used for inter group data comparison. Results:All patients were successfully completed the operation. The follow-up period after surgery was (40.4±13.4) months (range:12 to 72 months). The neck pain and arm pain VAS, NDI and JOA in the two groups immediately after surgery, at 2 months, 12 months after surgery, and the final follow-up were significantly improved compared with those before operation (all P<0.05). In both groups, postoperative the C 2-7 Cobb angle, Cobb angle at the operative segment, C 2-7 SVA, T 1 slope, and height of operative segment were significantly improved immediately after surgery, at 2 months, 12 months, and the final follow-up (all P<0.05). The C 2-7 Cobb angle, Cobb angle at the operative segment, and height of operative segment immediately after surgery, at 2 months, 12 months, and the final follow-up in the EACDF group were significantly higher than those in the ACCF group (all P<0.05). There were no significant differences in C 2-7 SVA and T 1 slope between the two groups(all P>0.05). At the final follow-up, the angle of every intervertebral space correction in the EACDF group was (9.3±1.6) °(range:6.5° to 12.3°), while in the ACCF group was (3.1±1.8) °(range:1.2° to 5.6°), with a significant difference between the two groups ( P<0.05). Patients at the both groups got bone graft fusion at the final follow-up. Conclusions:The clinical effect of EACDF for treating DCK is satisfactory. EACDF maybe superior to ACCF in restoring intervertebral height, correcting and maintaining cervical curvature.

Artificial intelligence(AI) is increasingly being utilized in the research of cervical spine diseases, encompassing areas such as image analysis, assisted diagnosis, clinical treatment decision support, surgical assistance, and postoperative rehabilitation, thereby demonstrating significant clinical value. However, many existing studies primarily focus on evaluating model performance and often lack clear indicators of clinical utility. Additionally, these studies face challenges such as heterogeneity in research design and reporting, low transparency of algorithms and dataset quality. As AI continues to advance rapidly, future efforts should prioritize the establishment of standardized databases, the enhancement of algorithm reliability, the minimization of data bias, and the achievement of comprehensive AI assistant management throughout the cervical spine surgery process.

The matrix metalloproteinases family (MMPs) are proteins related to tumor formation and metastasis that have attracted the attention of scholars in recent years. Tumor cells can secrete MMPs during malignant transformation, and the expression of MMPs in different malignant tumors is diverse, and different members of MMPs do not have exactly the same biological properties. Matrix metalloproteinase-19 (MMP-19) is a new member of MMPs whose secretion increases rapidly during the malignant transformation of cells and is released into the extracellular space to participate in biological processes such as proliferation, adhesion, invasion, migration, and angiogenesis of tumor cells. In this paper, the progress of research on the biological properties of MMP-19 in tumors was reviewed to provide a theoretical basis for exploring the development of tumors, especially for studying the invasion and metastasis of tumor cells.

Objective:To analyze the clinical characteristics and treatment of patients with serious interstitial lung diseases (SILD).Methods:The clinical data of 43 patients with SILD hospitalized in the respiratory intensive care unit of the Characteristic Medical Center of The Chinese People's Armed Police Force from January 2010 to December 2020 were retrospectively reviewed. According to the prognosis, the patients were divided into the death group and non-death group.Results:The included 43 patients include 31 cases of acute exacerbation of idiopathic interstitial pneumonia (AE-IIP), 18 cases of usual interstitial pneumonia (UIP) and 16 cases of nonspecific interstitial pneumonia (NSIP), in which 40% were aggravated due to co-infection and 33 patients were dead. The results showed that there was no significant difference between death and non-death patients in age, gender, smoking, hospitalization time, duration, clinical symptoms and signs, blood T lymphocyte subsets, co-infection, mechanical ventilation and glucocorticoid dose (all P>0.05), and there were significant differences in arterial partial pressure of oxygen to the fraction of inspired oxygen (PaO 2/FiO 2) and arterial partial pressure of carbon dioxide (PaCO 2) (all P<0.05). The PaO 2/FiO 2 level in the dead patients was lower, who often accompanied by type Ⅱ respiratory failure. Conclusions:AE-IIP was more common in patients with SILD, and most of their chest images were consistent with UIP and NSIP. Pulmonary infection is a common cause of acute exacerbation of SILD, and type II respiratory failure in the progress of the disease is a sign of poor prognosis.

Objective: To investigate the clinical application value of using laminoplasty combine with short-segment pedicle screw fixation in the treatment of cervical spine trauma patients with ossification of posterior longitudinal ligament (OPLL). Methods: Fifty-four cervical spine trauma patients with OPLL from June 2014 to June 2016 were retrospectively analyzed of Department of Spine Surgery, Changzheng Hospital, Naval Military Medical University. There were 31 males and 23 females, aging (68.4±4.3) years (rang: 46 to 82 years). All patients had a history of cervical spine trauma, confirmed by imaging examination of OPLL, and there are signs and symptoms related to cervical spinal cord compression. Eighteen patients underwent one-stage laminoplasty combine with short-segment pedicle screw fixation(group A), and 15 patients underwent posterior cervical laminectomy and pedicle screw fixation (group B). Twenty-one patients underwent posterior laminoplasty (C group). According to the range of OPLL and the compression of the spinal cord, the range of laminoplasty was selected. MRI scan was used to evaluated the compression condition of cervical spine and the injury condition of anterior longitudinal ligament injury and other factors that can cause local instability of the cervical spine. Posterior unilateral pedicle screw fixation (two pedicles) were performed in the instability segment. The neurological function of the patients was assessed by the Japanese Orthopedic Association (JOA) Score before surgery, the second day after surgery, 3 months, 1 year and the last follow-up. The cervical spine X-ray films were used to evaluate cervical curvature, cervical spine activity and internal fixation-related complications. Results: The average follow-up time was 18 months (6-30 months). Satisfactory neurological improvement was achieved in all three groups, and no internal fixation-related complications occurred during follow-up. The range of laminoplasty was 22 cases in 4 segments (C₃-C₆, C₄-C₇) and 17 cases in 5 segments (C₃-C₇). Unilateral pedicle screw fixation was performed in 11 patients with C_3-4 fixation and 7 patients with C_4-5 fixation. Cervical curvature was basically the same in the three groups after operation and at the last follow-up. No significant changes in cervical curvature and kyphosis were observed during the follow-up period. The overall cervical mobility (C₂-C₇) in group A and group C had no significant difference compared with preoperative (P=0.077). The overall mobility of cervical vertebrae in group B was significantly lower than that before surgery (P=0.013). Conclusions For cervical spine trauma patients with OPLL, laminoplasty combined short-segment pedicle screw fixation can increase cervical segmental stability while extensive decompression of cervical spinal cord compression. At the same time, to some extent, the complications of postoperative axial symptoms caused by posterior cervical laminectomy and pedicle screw fixation were avoided.

Objective To analyze cervical sagittal parameters change after anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF) in cervical myelopathy.Methods 80 patients with cervical myelopathy who underwent anterior cervical surgery between March 2013 and October 2014 were analyzed in this study.44 patients (24 males,20 females) were operated by ACDF,with an average age of 59.5±4.26 years old and 36 patients (20 males,16 females) were operated by ACCF,with an average age of 62.5±3.85 years old.Japanese Orthopaedic Association (JOA) scores,visual analogue scale (VAS) and neck disability index (NDI) were obtained in all patients preoperatively,6 months after surgery and at the latest follow-up.Standing radiographs of cervical spine,CT (3D) and MR were obtained preoperatively,6 months after surgery and at the latest follow-up.Cervical sagittal parameters were assessed with the following 3 parameters:C2-7 Cobb angle,C2-7 sagittal vertical axis (C2-7 SVA) and T1-Slope.Results All the patients were followed up from 18 to 26 months,with the average time of 22 months.The group of ACDF:JOA scores,VAS scores and NDI scores changed from 8.1±1.4,5.8±1.2,22.2±5.9 to 13.2±1.8,1.5±1.4,10.5± 4.8.The group of ACCF:JOA scores,VAS scores and NDI scores changed from 7.3±1.6,4.9±1.5,24.2±4.3 to 13.9±1.1,1.7±1.2,11.3±4.2.There was no significant difference of JOA scores,VAS scores and NDI scoresbetween two group (t=1.544,0.887,1.666;P=0.134,0.382,0.107).The group of ACDF:C2-7 Cobb angle,C2-7 SVA and T1-Slope angle changed from 17.5°±4.7°,20.3±9.3 mm,35.2°±8.6° to 29.5°±5.2°,11.2±8.6 mm,28.7°±8.2°.The group of ACCF:C2-7 Cobb angle,C2-7 SVA and T1-Slope angle changed from 16.8°±5.1°,19.5±8.6 mm,34.6°±9.1° to 25.3°±4.2°,15.7±9.2 mm,30.3°±7.9°,with significant difference between the two group (t=2.75,2.45,2.34;P=0.039,0.045,0.043).The changes of T1-Slope angle in ACDF group were more significantly (P＜ 0.05).In each group,compared with patients who had low T1-Slope (＜ 25°) preoperatively,the C2-7 SVA in the patients with high T1-Slope (＞25°) was decreased significantly.Compared with patients who had high T1-Slope preoperatively,the C2-7 Cobb in the patients with low T1-Slope was increased significantly.Conclusion Good curative effect could be achieved by ACDF and ACCF in cervical myelopathy.Both surgical methods can maintain the curvature of the cervical alignment and improve the sagittal balance parameters of the cervical alignment.Consideringthe cervical sagittal balance,the ACDF is more suitable for the patient with high T1-Slope angle preoperatively.

Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.

Objective To investigate the short-term clinical outcome and radiographic assessment of Oblique Lateral Interbody Fusion to indirectly decompress for the degenerative lumbar spinal stenosis with or without lumbar spine instability.Methods All of 15 patients with diagnosis of degenerative lumbar spinal stenosis with or without lumbar spine instability (7 males and 8 females,age from 36y to 86,mean age 53.5± 15.2 y) were treated with OLIF surgery in our spine surgery center.The main symptoms included lumbar pain with unilateral or bilateral leg pain or intermittent claudication.The Visual analogue scale (VAS),Oswestry disability index (ODI),Japanese Orthopaedic Association (JOA) and SF-36 scores were used to assess the clinical effect pre and post-operatively while radiographic assessments were compared as well as comprehensive evaluation of the radiography,MRI,and CT images.Results All patients were followed up for an average of 12.5 (6-21) months.And all the patients enjoyed alleviation of symptoms although varying in extent.The radiographic results showed satisfactory indirect decompression of the neuro-elements,as well as reduction of the lumbar spine.The DH,VH and FH increased by 3.6mm,4.8mm and 5.7mm respectively.The foraminal area (FA) and canal area (CA) enlarged by 44.2mm2 and 24.8mm2.The canal diameters (CD) and disk-flavum ligamentum space (DLFS) increased by 2.5mm and 2mm respectively.The foraminal diameters (FD) increased by 0.3mm,but there was not significantly different.The segment angle and lumbar lordosis angle were partially restored after operation,and the angle increased by 14 ° and 13.6 °respectively.One of the patients had a transient paresthesia and mild weakness of muscle when hip flexor and recovered within 3 months.Another one case encountered serious back pain after a month and alleviated after reoperation with PPF.Conclusion OLIF can provide a satisfactory outcome for the patients with degenerative lumbar spinal stenosis through indirectly decompression,which can increase the disc height,foramen height,canal diameter and disk-flavum ligamentum space.