Objective To evaluate the effect of exercise on freezing of gait in Parkinson's disease.Methods After constructing a PICO framework,randomized controlled trials(RCTs)about exercise for freezing of gait in Parkinson's disease were systematically retrieved from Web of Science,PubMed,Cochrane Library,Embase,CNKI,VIP and Wanfang Data,from the establishment of the databases to March,2025.The PEDro scale was used to evaluate the quality of literature,Stata 17.0 was used for meta-analysis,and GRADE was used to assess the evidence quality.Results A total of twelve RCTs involving 463 patients were included,with PEDro scale scores of five to eight.Exercise improved the scores of Freezing of Gait Questionnaire(FOGQ)(SMD=-0.61,95%CI-0.85～-0.36,P<0.001)and Unified Parkinson's Disease Rating Scale Ⅲ(UPDRSⅢ)(SMD=-0.84,95%CI-1.27～-0.41,P<0.001).Subgroup analysis revealed that the patients aged 59 to 68 years,the course of disease

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To evaluate the effect of exercise on freezing of gait in Parkinson's disease.Methods After constructing a PICO framework,randomized controlled trials(RCTs)about exercise for freezing of gait in Parkinson's disease were systematically retrieved from Web of Science,PubMed,Cochrane Library,Embase,CNKI,VIP and Wanfang Data,from the establishment of the databases to March,2025.The PEDro scale was used to evaluate the quality of literature,Stata 17.0 was used for meta-analysis,and GRADE was used to assess the evidence quality.Results A total of twelve RCTs involving 463 patients were included,with PEDro scale scores of five to eight.Exercise improved the scores of Freezing of Gait Questionnaire(FOGQ)(SMD=-0.61,95%CI-0.85～-0.36,P<0.001)and Unified Parkinson's Disease Rating Scale Ⅲ(UPDRSⅢ)(SMD=-0.84,95%CI-1.27～-0.41,P<0.001).Subgroup analysis revealed that the patients aged 59 to 68 years,the course of disease

Objective:To investigate the relationship between the Palatopharyngeal Arch Staging System（PASS） and the severity of Obstructive Sleep Apnea（OSA）, as well as the patterns of airway collapse, while further assessing its clinical applicability. Methods:A total of 98 patients diagnosed with OSA at the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University Affiliated Shenzhen Hospital, were recruited for this study. Data collected included basic demographic information, oropharyngeal laryngoscopy videos, results from awake laryngoscopy Muller tests, and indicators from sleep respiratory monitoring. The distribution of each PASS stage among patients with varying severities of OSA was compared. Additionally, both objective and subjective sleep indicators along with occurrences of airway collapse in OSA patients across different PASS stages were analyzed. Results:In total, 98 patients participated in this study. Statistically significant differences were observed in neck circumference, weight, Body Mass Index（BMI）, tongue position, and PASS stage when comparing mild-to-moderate OSA patients to those with severe OSA（P<0.05）. Furthermore, there were statistically significant variations in Apnea-Hypopnea Index（AHI）, minimum blood oxygen saturation levels, average blood oxygen saturation levels, oxygen desaturation index values, and total oxygen desaturation indices among OSA patients categorized by different PASS stages. Multiple comparisons revealed statistically significant differences in AHI as well as minimum and average blood oxygen saturation levels between patients at PASS 1 versus those at PASS 3（P<0.05）. Additionally, notable differences regarding oropharyngeal collapse rates among OSA patients across various PASS stages were identified; specifically between those at PASS stage 1 and those at PASS stage 3. Conclusion:The proportion of PASS stages for OSA varies across different severity levels. The severity of OSA and the degree of airway collapse in patients with varying PASS stages also exhibit significant differences. Patients classified as PASS 3 demonstrate a more severe form of OSA compared to those at PASS 1, with stage 3 being more susceptible to oropharyngeal collapse than its stage 1 counterpart. This assessment system is anticipated to address the current limitations in evaluating the lateral pharyngeal wall within the oropharynx.
Humans ; Sleep Apnea, Obstructive/pathology* ; Male ; Severity of Illness Index ; Female ; Middle Aged ; Polysomnography ; Adult ; Pharynx/physiopathology* ; Aged

The Department of Plastic and Reconstructive Surgery of the Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medical, has witnessed and propelled the remarkable evolution of China’s plastic and reconstructive surgery over the past sixty years. Established in 1961 under the leadership of its founding father, Professor Ti-sheng Chang, the department was built on the mission of "Preventing the injured from disabled, the disabled from incapable". It pioneered groundbreaking advancements in flap microsurgery, craniofacial surgery, and lymphatic medicine. Entering the 21st century, guided by its motto of "Openness, Innovation, Excellence, and Dedication", the department has developed a comprehensive, full-cycle diagnostic and treatment system covering all disease spectrums. With seven major specialties and 24 subspecialty divisions, it has achieved continuous breakthroughs in surface organ reconstruction, hemangioma and neurofibroma treatment, fat transplantation, and craniomaxillofacial surgery. These innovations have yielded landmark achievements, with multiple technologies receiving National Science and Technology Progress Awards, significantly advancing the field of reconstructive surgery in China. Committed to talent development, the department, as one of China’s first doctoral training centers and a national standardized training base for resident and specialist physicians, has trained over 750 postgraduate students, more than 240 resident and specialist trainees, and over 2 000 clinic fellow. It has also led the compilation of multiple national standardized textbooks in plastic surgery, making substantial contributions to professional education and training standardization. Through administration innovation, the department has established a "bed-bench-bed" closed-loop model, driving technological advancements and facilitating major translational achievements, including Class 1.1 new drugs and stem cell therapies. It pioneered a structured multi-site practice platform for surgeons, optimizing the allocation of medical resources. Now, the department is focusing on high-quality patient cohort and biobank development while exploring cutting-edge fields such as AI-assisted diagnostics, gene therapy, and brain-computer interfaces, striving to build a world-class discipline at the forefront of global reconstructive surgery.

Objective To observe the value of deep progressive reconstruction(DPR)algorithm for reconstructing whole-body 18 F-FDG PET images.Methods Totally 67 patients who underwent whole-body 18 F-FDG PET/CT were retrospectively enrolled.PET data of 30 s,60 s,90 s and 120 s per bed in equipment list were reconstructed using ordered subset expectation maximization(OSEM)and DPR algorithms,respectively.Finally 7 groups of reconstructed images were obtained,including OSEM_30,OSEM_60 and OSEM_120,also DPR_30,DPR_60,DPR_90 and DPR_120 groups.The subjective scores,also objective evaluation indexes,i.e.the maximum and mean standard uptake values(SUV)of lesions and livers,namely SUVmax and SUVmean,were compared,and target-to-background ratio(TBR),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and coefficient of liver variation(CVliver)were calculated.Taken results based in OSEM_120 group as references,Bland-Altman plot was drawn to explore the consistency of SUV of lesions and livers obtained based on DPR_30,DPR_60 and DPR_90 groups with those in OSEM_120 group.Results Under the same acquisition time,subjective scores,SUVmax and SUVmean of lesions,TBR,SNR,CNR and CVliver in DPR_30,DPR_60 and DPR_120 groups were superior to those in corresponding OSEM_30,OSEM_60 and OSEM_120 groups(all P＜0.001).Compared with OSEM_120 group,subjective scores and SNR decreased but TBR and CVliver increased in DPR_30 group,while subjective and objective evaluation results in DPR_60 group and DPR_90 group increased(all P＜0.05)or being not significantly different from those in OSEM_120 group(all P＞0.05).No significant difference of liver SUV mean was found among 7 groups(P=0.955).SUVmax and SUVmean of lesions and livers obtained based on DPR_30,DPR_60 and DPR_90 groups were in good agreement with those oibtained based on OSEM_120 group.Conclusion Using DPR algorithm to reconstruct whole-body 18 F-FDG PET image could shorten acquisition time under the premise of ensuring image quality.

The Department of Plastic and Reconstructive Surgery of the Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medical, has witnessed and propelled the remarkable evolution of China’s plastic and reconstructive surgery over the past sixty years. Established in 1961 under the leadership of its founding father, Professor Ti-sheng Chang, the department was built on the mission of "Preventing the injured from disabled, the disabled from incapable". It pioneered groundbreaking advancements in flap microsurgery, craniofacial surgery, and lymphatic medicine. Entering the 21st century, guided by its motto of "Openness, Innovation, Excellence, and Dedication", the department has developed a comprehensive, full-cycle diagnostic and treatment system covering all disease spectrums. With seven major specialties and 24 subspecialty divisions, it has achieved continuous breakthroughs in surface organ reconstruction, hemangioma and neurofibroma treatment, fat transplantation, and craniomaxillofacial surgery. These innovations have yielded landmark achievements, with multiple technologies receiving National Science and Technology Progress Awards, significantly advancing the field of reconstructive surgery in China. Committed to talent development, the department, as one of China’s first doctoral training centers and a national standardized training base for resident and specialist physicians, has trained over 750 postgraduate students, more than 240 resident and specialist trainees, and over 2 000 clinic fellow. It has also led the compilation of multiple national standardized textbooks in plastic surgery, making substantial contributions to professional education and training standardization. Through administration innovation, the department has established a "bed-bench-bed" closed-loop model, driving technological advancements and facilitating major translational achievements, including Class 1.1 new drugs and stem cell therapies. It pioneered a structured multi-site practice platform for surgeons, optimizing the allocation of medical resources. Now, the department is focusing on high-quality patient cohort and biobank development while exploring cutting-edge fields such as AI-assisted diagnostics, gene therapy, and brain-computer interfaces, striving to build a world-class discipline at the forefront of global reconstructive surgery.

Objective To observe the value of deep progressive reconstruction(DPR)algorithm for reconstructing whole-body 18 F-FDG PET images.Methods Totally 67 patients who underwent whole-body 18 F-FDG PET/CT were retrospectively enrolled.PET data of 30 s,60 s,90 s and 120 s per bed in equipment list were reconstructed using ordered subset expectation maximization(OSEM)and DPR algorithms,respectively.Finally 7 groups of reconstructed images were obtained,including OSEM_30,OSEM_60 and OSEM_120,also DPR_30,DPR_60,DPR_90 and DPR_120 groups.The subjective scores,also objective evaluation indexes,i.e.the maximum and mean standard uptake values(SUV)of lesions and livers,namely SUVmax and SUVmean,were compared,and target-to-background ratio(TBR),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and coefficient of liver variation(CVliver)were calculated.Taken results based in OSEM_120 group as references,Bland-Altman plot was drawn to explore the consistency of SUV of lesions and livers obtained based on DPR_30,DPR_60 and DPR_90 groups with those in OSEM_120 group.Results Under the same acquisition time,subjective scores,SUVmax and SUVmean of lesions,TBR,SNR,CNR and CVliver in DPR_30,DPR_60 and DPR_120 groups were superior to those in corresponding OSEM_30,OSEM_60 and OSEM_120 groups(all P＜0.001).Compared with OSEM_120 group,subjective scores and SNR decreased but TBR and CVliver increased in DPR_30 group,while subjective and objective evaluation results in DPR_60 group and DPR_90 group increased(all P＜0.05)or being not significantly different from those in OSEM_120 group(all P＞0.05).No significant difference of liver SUV mean was found among 7 groups(P=0.955).SUVmax and SUVmean of lesions and livers obtained based on DPR_30,DPR_60 and DPR_90 groups were in good agreement with those oibtained based on OSEM_120 group.Conclusion Using DPR algorithm to reconstruct whole-body 18 F-FDG PET image could shorten acquisition time under the premise of ensuring image quality.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:Exploring the clinical characteristics and treatment outcomes of tailgut cysts, and improving the understanding of this disease.Methods:A retrospective analysis of 42 patients with tailgut cyst surgically treated from Jan 2012 to Mar 2024 was conducted.Results:This study included 42 patients (28 females,14 males) with a median age of 51 (23-76)years old. Nineteen cases of perineal/abdominal pain, 13 cases of perianal swelling, 10 cases of perianal abscess, 7 cases of sacrococcygeal sinus, and 4 cases of anal mass were observed. These symptoms often occurred simultaneously. All 42 patients had lesions located behind the rectum, with a relative position to the coccyx (7 above the coccyx, 17 below the coccyx, 11 above and between the coccyx levels, and 7 horizontally).Tailgut cysts were located in the pelvic floor, with 3 cases above the levator ani muscle, 17 cases below the levator ani muscle, and 22 cases between the levator ani muscle levels. Forty-one cases were treated with posterior approach, and 1 case was treated with combined approach. Thirty-two were unilocular and 10 multilocular. Female patients with multiple compartments were significantly more common than males ( P<0.05), while tumor location, tumor size, recurrence, and malignancy were all independent of gender. After surgery, 8 cases (19％) experienced recurrences and 5 cases of malignant transformation patients had a long term multiple relapses. Conclusions:Tailgut cysts are rare,while women were common seen.Non-specific symptoms of pain in the perineum or abdomen, perianal swelling or abscess, are usually observed. In addition, multiple relapses could have malignant transformation. Surgical complete resection is the most reasonable treatment method and the appropriate surgical path should be selected based on the size, location, and relationship with adjacent tissues of the tumor.