BACKGROUND:With the development of the concept of minimally invasive surgery,lumbar posterior dynamic internal fixation has become the mainstream operation for the treatment of diseases caused by intervertebral disc degeneration.OBJECTIVE:To review the latest progress of lumbar posterior dynamic internal fixation in the treatment of lumbar degenerative diseases and postoperative intervertebral disc rehydration.METHODS:The relevant literature published in CNKI,WanFang,and PubMed databases from 2010 to 2025 was searched with the Chinese and English search terms"lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys system,In-space system,PercuDyn system,intervertebral disc rehydration,crushing stress."By reading the articles,we eliminated the literature with little relevance to the article topic,poor quality and outdated content,and finally 65 articles were included for summary.RESULTS AND CONCLUSION:(1)Although the main surgical method for the treatment of disc degeneration is still the traditional open surgical method of implantation,posterior lumbar dynamic internal fixation has made great progress.(2)Posterior lumbar dynamic fixation can be divided into open dynamic fixation system and percutaneous dynamic fixation system.Each system can be divided into interspinous dynamic internal fixation system and pedicle dynamic internal fixation system according to the different fixation positions.According to the design of specific instruments and the differences of operation methods in the surgery,different operation methods have been derived.At present,the focus of research at home and abroad is on open dynamic internal fixation system.(3)Under the premise that the clinical effect of posterior lumbar dynamic internal fixation is better than that of traditional interbody fusion surgery,it can cause the rehydration phenomenon of postoperative lumbar intervertebral disc,and further improve the long-term postoperative efficacy of patients.

BACKGROUND:With the development of the concept of minimally invasive surgery,lumbar posterior dynamic internal fixation has become the mainstream operation for the treatment of diseases caused by intervertebral disc degeneration.OBJECTIVE:To review the latest progress of lumbar posterior dynamic internal fixation in the treatment of lumbar degenerative diseases and postoperative intervertebral disc rehydration.METHODS:The relevant literature published in CNKI,WanFang,and PubMed databases from 2010 to 2025 was searched with the Chinese and English search terms"lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys system,In-space system,PercuDyn system,intervertebral disc rehydration,crushing stress."By reading the articles,we eliminated the literature with little relevance to the article topic,poor quality and outdated content,and finally 65 articles were included for summary.RESULTS AND CONCLUSION:(1)Although the main surgical method for the treatment of disc degeneration is still the traditional open surgical method of implantation,posterior lumbar dynamic internal fixation has made great progress.(2)Posterior lumbar dynamic fixation can be divided into open dynamic fixation system and percutaneous dynamic fixation system.Each system can be divided into interspinous dynamic internal fixation system and pedicle dynamic internal fixation system according to the different fixation positions.According to the design of specific instruments and the differences of operation methods in the surgery,different operation methods have been derived.At present,the focus of research at home and abroad is on open dynamic internal fixation system.(3)Under the premise that the clinical effect of posterior lumbar dynamic internal fixation is better than that of traditional interbody fusion surgery,it can cause the rehydration phenomenon of postoperative lumbar intervertebral disc,and further improve the long-term postoperative efficacy of patients.

BACKGROUND:It has been proved clinically that adhesion of fibrous scar with the dura mater or nerve root after lumbar operation is an important factor for postoperative symptoms,such as postoperative pain and numbness. OBJECTIVE:To verify the inhibitory effect of autologous ligamentum flavum on the formation of epidural fibrous scar after lumbar surgery and explore the possible molecular biological mechanism. METHODS:Forty-eight Japanese white rabbits(6-8 months old)were randomly divided into three groups:a ligamentum flavum preservation group,a ligamentum flavum non-preservation group,and an autologous fat reposition group.A lumbar laminectomy model was established in all the three groups of rabbits,and rabbit epidural tissues were collected at 3 and 6 weeks after modeling.Hematoxylin-eosin staining was used to observe histological changes and the number and density of fibroblasts,VG staining was used to observe the percentage of collagen fiber area,and immunohistochemistry was used to observe the expression of transforming growth factor β1 and Smad3 proteins. RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that fibroblasts in the ligamentum flavum preservation group were few and loosely arranged,while the cells in the ligamentum flavum non-preservation and autologous fat reposition groups were more numerous and closely arranged.The number density of fibroblasts in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05);however,there was no significant difference between the latter two groups.VG staining results showed that the collagen fibers in the ligamentum flavum preservation group were sparse and distributed unevenly,while a lot of red collagen fibers were gathered in the ligamentum flavum non-preservation and autologous fat reposition groups.The area percentage of collagen fibers in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.The results of immunohistochemistry showed that the degree of positive staining of retained histone the ligamentum flavum preservation group was significantly lower than that of the other two groups.The absorbance value of transforming growth factor β1 and Smad3 in the ligamentum flavum preservation group was significantly lower than that in the other two groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.To conclude,there are different degrees of epidural fibrous scar formation after lumbar surgery.If the ligamentum flavum is preserved,it can help to reduce the number of epidural fibroblasts as well as the formation of collagen fibers,thus reducing the adhesion of the fibrous scar tissue to the dural sac and nerve root.The mechanism is not only a purely mechanical blockade,but also to reduce the formation of epidural fibrous scar by interfering with the transforming growth factor β1/Smad3 signaling pathway.

BACKGROUND:Currently,there have been studies on three-dimensional digitalization and visualization systems for adult acupoints,but there are not many reports on the visualization of pediatric acupoints based on real pediatric digital sectional anatomical datasets. OBJECTIVE:To design and develop a digital three-dimensional visualization system for children's neck acupoints,to provide a basis for acupuncture and moxibustion,meridian and acupoint science teaching,clinical practice,acupuncture manipulation practice,and acupuncture safety research,and to provide a basis for the development of children's acupoint simulation system. METHODS:Based on a real cross-sectional anatomical dataset of pre-school boys,a three-dimensional digital virtual anatomical model of the neck region of children and internal multi-organ three-dimensional reconstruction were completed using PhotoShop 2021 and Digihuman Reconstruction System software.A database of 11 acupoints was compiled,including Fengfu and Fengchi,using the Unity database language.A three-dimensional model of children's neck anatomy,acupoint database,and writing acupuncture operation codes were integrated in Unity3D software.A three-dimensional digital visualization system for children's neck acupoints was successfully created,which integrated simulation acupoint positioning,three-dimensional acupoint anatomy,acupuncture training,clinical teaching,and acupuncture safety research. RESULTS AND CONCLUSION:(1)This study was based on real child specimens.Manual layer by layer segmentation of cross-sectional images was used to ensure the accuracy of the three-dimensional model to the greatest extent possible.The 3D software Digihuman Reconstruction System was utilized to extract and save independent segmentation data.PhotoShop 2021 software was collaborated with to complete dozens of three-dimensional reconstruction anatomical models of the outer skin of the neck and its internal bone structure,cervical spinal cord,blood vessels and nerves,muscles,and ligaments in children.The basic morphology and overall contour integrity verification of each independent structure were completed in MeshLab software.The 3-material research 13.0 software was applied for final fine tuning and anatomical position confirmation,successfully simulating and restoring the true anatomical morphology of the neck of preschool children.(2)Based on and referring to the national standards of the People's Republic of China,a database of commonly used acupoints in children's neck region was collected and organized,including their names,meridians,positioning,local anatomy,needle insertion levels,acupuncture methods,acupuncture accidents and prevention,acupoint indications,and two-dimensional anatomical sectional images.(3)Unity3D software was employed to integrate the three-dimensional model of children's neck,acupuncture simulation operation,and acupoint database,and a three-dimensional digital children's neck acupoint acupuncture visualization system was successfully constructed.The system displayed information on children's neck acupoints,two-dimensional and three-dimensional anatomical structures,and achieved two-dimensional and three-dimensional acupuncture simulation functions and acupuncture safety research functions for children's neck acupoints.Based on the ultra-thin sectional anatomical dataset of real child specimens,the first three-dimensional digital and visualization system for acupoints in the neck region of children had been constructed.Compared with previous acupoint acupuncture systems,it is more in line with the anatomical and morphological development characteristics of Asian children and has high application value in the fields of acupuncture safety research,clinical teaching,and acupuncture simulation training.

ObjectiveTo analyze the hygienic status of tableware cleaning and disinfection in 41 catering facilities of Shanghai in 2020, to identify its influencing factors, so as to propose evidence-based improvements for future scientific supervision. MethodsA field survey was conducted on the cleaning and disinfection methods of tableware in 41 catering establishments in Shanghai. A total of 180 tableware samples were collected and tested for four indicators, including free residual chlorine, anionic synthetic detergent residues, coliforms, and total number of bacterial colonies. The results were classified and statistically analyzed based on the type of catering establishment, tableware material, tableware function, and cleaning and disinfection methods. ResultsThe tableware passed the tests for coliforms and free residual chlorine. The qualification rate for anionic synthetic detergent residues was 48.89% (88/180), with an average of 0.02 mg per 100 cm² and a maximum of0.25 mg per 100 cm² (This unit complied with the requirements of national standardard: GB 14934—2016). Based on the type of catering enterprises, large restaurants had the lowest qualification rate for anionic synthetic detergent residues in tableware at 46.15%. In terms of the function of tableware, chopsticks had the lowest qualification rate for anionic synthetic detergent residues at 26.32%. The detection rate of total number of bacterial colonies in tableware was 42.22% (76/180), with an average of 0.5 log₁₀ (CFU·mL⁻¹) and a maximum of 3.4 log₁₀ (CFU·mL⁻¹). Among them, medium-sized restaurants had the highest detection rate of total number of bacterial colonies in tableware at 47.73% (21/44). ConclusionThe qualification rate of anionic synthetic detergent residues in tableware is relatively low.It is recommended to strengthen research on the occurrence patterns of unqualified tableware and establish early warning values for the qualification rate of anionic synthetic detergent residues, enhance law enforcement inspections on relevant catering establishments, guide enterprises to fulfill their main responsibilities, and improve the quality and safety of tableware.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Modern abdominal wall hernia repair has evolved into a systematic engineering project aimed at "functional abdominal wall reconstruction", the success of which largely depends on the deep integration of autologous tissue reconstruction and mesh reinforcement. As the foundation of repair, autologous tissue reconstruction involves meticulous anatomical restoration, tension-control techniques (e.g., component separation technique, transversus abdominis release), and neurovascular protection to restore the integrity of the abdominal wall's layered structures, thereby creating optimal conditions for mesh reinforcement. The selection of mesh materials should follow individualized principles: large-pore lightweight polypropylene mesh is preferred in clean surgeries to achieve a balance between mechanical support and biocompatibility; in contaminated or infected environments, biological meshes, owing to their inherent anti-infection properties and regenerative potential, become the optimal choice for such patients; and for massive defects, a combination of tissue separation techniques and composite mesh strategies is required to balance mechanical demands and biological infection risks. A well-designed repair plan should comprehensively consider patient factors (comorbidities, age), characteristics (size of defect, contamination level, abdominal wall condition), and surgical approach (mesh placement layer), achieving synergistic restoration of anatomical structure, mechanical force distribution, and physiological function, ultimately improving long-term patient outcomes.

Diabetic retinopathy(DR)is a common ocular complication in patients with diabetes and one of the leading causes of blindness in adults.Due to the complex pathological mechanism of DR and its close relationship with other meta-bolic disorders,it has become an urgent need in the field of public health to explore its etiology and develop effective pre-vention and treatment methods.As a new causal inference method,Mendelian randomization(MR)can effectively control the influence of confounding factors and inverse causality by using genetic variations to infer the causal relationship between exposure and diseases.The purpose of this paper is to introduce the application and research progress of MR in the investi-gation of the etiology of DR and analyze the limitations of current research and the future development direction.

BACKGROUND:With the increasing attention of scholars at home and abroad to children's cervical spine-related diseases,the demand for exploring the anatomical indicators and changes of cervical spine morphology and development in children of different ages is increasing.OBJECTIVE:To explore and analyze the morphological changes of children with different ages and vertebral sequences by measuring the anatomical position indexes of C2-C7 neurocentral synchondrosis in children aged 1-6 years.METHODS:Normal cervical spine CT images were retrospectively collected from 160 children aged 1-6 years at provincial tertiary hospitals.They were divided into six groups according to an age group of 1 year.The raw data of consecutively scanned cervical spine tomography images were imported into Mimics 16.0 software.The positional anatomical indexes of cervical spine segments C2-C7 in coronal and transverse planes were measured and analyzed under the two-dimensional image window by choosing the measurement tools under the toolbar of Measurements.RESULTS AND CONCLUSION:(1)The distance between the two sides of C2-C7 neurocentral synchondrosis and the distance between the left and right sides of neurocentral synchondrosis and the transverse process gradually increased with age.The overall development of vertebrae in each cervical vertebral segment was faster than the ossification of the neurocentral synchondrosis.(2)The cross-sectional angles on both sides of C2-C7 neurocentral synchondrosis gradually increased with age,and the angles between the left and right sides of neurocentral synchondrosis and the anterior and posterior edges of the vertebral body gradually decreased.Both sides of the neurocentral synchondrosis in cervical vertebral segments tended to grow toward the arch site,which mainly promoted the growth and development of the arch.(3)Except for C7,the angle between the coronal planes on both sides of the cervical spine changed little with the descending neurocentral synchondrosis of the cervical spine,and the neurocentral synchondrosis of the cervical spine was more inclined to longitudinal growth and ossification.(4)The neurocentral synchondrosis position changes in C7 were significantly different from those in the rest of the cervical vertebrae.(5)The anatomical indexes of C2-C7 neurocentral synchondrosis position in children have obvious development rules among different ages and vertebral bodies,and these rules are helpful for the clinical diagnosis and treatment of cervical spine diseases in children.