Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective:To investigate the feasibility of establishing a canine model of lumbar intervertebral disc degeneration through the application of cumulative axial load and a six-phase combined motion on the vertical sitting dog's lumbar spine.Methods:Twenty adult female grass dogs, each weighing 10.0±0.5 kg, were randomly divided into two groups, with 10 dogs in each group. In the model group, dogs were secured to an exercise machine in a vertical position, and six phases of lumbar spine movement (flexion and extension, left and right lateral flexion, left and right rotation, 45° each) were combined with a specific number of cycles under continuous axial load (245 N). In the control group, dogs were secured to the exercise machine in a vertical position without any intervention. Radiographic examinations were performed before and after 20,000, 50,000, 100,000, and 150,000 compound exercises in the model group. The disc height index (DHI) was measured through lateral X-ray, and MRI T2-mapping was used for quantitative analysis of intervertebral disc degeneration. When intervertebral disc degeneration was evident on MRI T2-weighted imaging (modified Pfirrmann system > Grade V), the combined motion was halted. Micro-CT quantitative analysis of bone mineral density (BMD) in the upper and lower endplates, trabecular bone structure, and histological staining (HE staining, "O" staining, Sirius red staining) were employed to verify and assess the degree of intervertebral disc degeneration.Results:After 50,000 compound exercises, mild degeneration of the intervertebral discs at L 6-7 and L 7S 1 was observed on T2-weighted imaging. With the accumulation of exercise load, the degree of degeneration progressively increased, reaching a moderate degree of degeneration after 100,000 composite exercises, and DHI began to decrease. Mild degeneration was also observed in the upper L 5-6 intervertebral disc. When the cumulative exercise volume reached 150,000 repetitions, the height of intervertebral spaces in the L 5-6, L 6-7, and L 7S 1 segments further decreased, and the intervertebral discs exhibited severe degeneration (improved Pfirrmann grading system Grades IV-VI). The upper L 4-5 intervertebral discs also displayed mild degeneration. Histological scores were as follows: L 5-6 (8.2±0.8), L 6-7 (9.5±0.7), and L 7S 1 (10.3±0.5), indicating a degree of degeneration in the order of L 5-6

Objective To compare the effects of preserving the posterior ligament complex (PLC) with torque loading and displacement loading on the biomechanical properties of the adjacent segments after lumbar decompression and fusion. Methods Six fresh male cadaver lumbar specimens of T12-S2 were tested in the sequence of intact, L4-5 laminotomy (preserving the PLC) with fixation and L4-5 laminectomy (destructing the PLC) with fixation, by applying both displacement loading and torque loading, respectively. Ranges-of-motions (ROMs) of the adjacent segments were measured under a noncontact photographic recording system. Results In displacement-loading mode, the flexion ROM in laminectomy group was significantly higher than that in laminotomy group, and no obvious ROM differences were found in the laminectomy and laminotomy groups under extension, lateral bending, and rotation movement. Conclusions Torque loading and displacement loading have different biomechanical effects on the adjacent segments after lumbar decompression and fusion. Compared with the laminotomy method, in which the PLC is preserved, the laminectomy method in which PLC structures are damaged can obviously lead to an increment of flexion ROMs at the adjacent segments, and also increase the ROMs of the adjacent segments under extension, lateral bending, and rotation movements, which might increase the risk of further instability of the fused adjacent segments.

Objective To observe the effect of different explosion impulse on rabbit lung injury and decide the death curve,so as to provide a reference for the prediction of lung injury.Methods Six healthy male New Zealand white rabbits with weight of 2.0-2.5 kg and age of (6 ± 1)months were selected.The rabbits were put 0.5 m,0.6 m,0.7 m,0.9 m,1.0 m,and 1.2 m away from 90 g TNT to carry out the blast injury experiment.The characteristic parameters of blast shock wave and general lung injury were recorded.Based on the experimental results combined with theoretical analysis,the changes of rabbit lung injury depending on the explosion distance as well as the rabbit death curve were determined.Results After the 90 g TNT explosion,the peak overpressure of shock wave and the corresponding specific impulse decreased quickly with the increase of explosion distance.The peak overpressure was 0.79 MPa and the specific impulse was 82 Pa · s at the explosion distance of 0.5 m.The peak overpressure was 0.1 MPa and the specific impulse was 34 Pa · s at the explosion distance of 1.2 m.The rabbits at 0.5 m and 0.6 m died,the rabbit at 0.7 m was severely injured,and the rabbits at 0.9 m,1.0 m,and 1.2 m were slightly injured.The dependence of lung injury degree on the explosion distance under 90 g TNT explosion was established based on dimensional analysis theory.The lung injury degree was exponentially attenuated with the explosion distance:φ =(R/0.6)-5.64(φ represented lung injury degree,and R represented the explosion distance).Considering the combined injury effects of peak overpressure of shock wave and its specific impulse on rabbit lung,the death curve of rabbit was determined:(p-0.1) (I-59) =2.6 (p represented peak overpressure,and I represented specific impulse).The criterion of "overpressure-specific impulse" was used to estimate the death of rabbit,and the death curve of rabbit was determined as (p-0.1)(I-59) =2.6(p represented peak overpressure and I represented specific impulse).The critical overpressure was 0.1 MPa and the critical specific impulse was 59 Pa · s.Conclusions Under the explosion condition of 90 g TNT,the relationship between degree of lung injury in rabbits and explosion distance is established.Death curve of rabbits is determined based on the damage effect of shock wave peak overpressure and specific impulse on the lungs of rabbits,which is significant for predicting the blast injury.

Intervertebral disc degeneration (IVDD) takes great affection on people health all over the world.With the extension of human life and aging,the number of sick people will grow rapidly.At present,both conservative and surgical treatment can only alleviate the symptoms,rather than the fundamental treatment for the process of degeneration.Therefore,the application of cell therapy in the treatment of degenerative disc regeneration is an innovative treatment.However,it's a great bottleneck for exogenous transplanted stem cells to survive in degenerated intervertebral disc with harsh environment containing strong force,acidic pH,hypoxia,hyperosmolarity and limited nutrition.In recent years,tissue endogenous repair has been demonstrated to be present in almost all human tissues,and endogenous stem cell play an important role in the process.Similarly,nucleus pulposus was also confirmed the existence of such a kind of tissue specific stem cells-nucleus pulposus derived stem cells (NPSCs)-a new promising candidate for the treatment of IVDD.NPSCs,as a new kind of stem cells,hold either the characteristic of stem cell and the special potential of themselves,such as the nice adaption of the environment in intervertebral disc and the superior potential of cartilage differentiation.Nonetheless,the isolations of NPSCs were different;cell phenotypes were lack of wildly acceptable standard and the biological characteristics were various among different NP sources.In addition,whether the application of NPSCs could be used in nucleus pulposus tissue engineering still calls for further research.Due to the unclear in degeneration mechanism of IVDD,the study on degeneration mechanism of NPSCs may play a great important role in clarifying this issue.

Objective To investigate the main features and distribution pattern of blast injury in animals in close cabins of the ship.Methods The multi-cabin ship model was built by scale of 1:1 and typical internal structures were simulated as the practical ship.Seventy-six experimental rabbits were placed in the cabins.The animals were divided into 4 groups,by the sequence of live ammunition the first,rude ammunition the second,small caliber ammunition the first,large caliber ammunition the second.Then,the animals were randomly designated into 5 sub-groups,by the way of their positions in different cabins,and their positions in front of cabinets or behind cabinets.Two types of caliber live and rude ammunitions were exploded in the cabin.Then close observations were made on the death and injury of the animals.Results Total mortality rate of the animals was 59.2％,and the mortality rate of the live ammunition group was 63.2％,and there was no statistical significance,as compared with that of the nude ammunition group(55.3％) (P =0.05).The mortality rate of the large caliber group was.73.7％,which was higher than that of the small caliber group(44.7％),and statistical significance could be seen when comparisons were made between the 2 groups (P =0.010).There was no statistical significance in the mortality rates of various cabins in the explosions of small caliber ammunition (P =0.128).The mortality rates of various cabins in the explosions of large caliber ammunition were not identical (P =0.000),with the mortality rate of the explosion cabin being the highest,the neighboring cabin and the next-door cabin came the next.The main culprits for the mortalities were shock wave and blast fragments which caused severe injury to important organs of the body.Conclusion In the multi-cabin configuration of the ship,the integrated cabin structure and inboard cabinets could offer significant protection to personnel inside.The mortality rate caused by large caliber ammunition was significantly larger than that of the rate caused by small caliber ammunition.However,there was no statistical significance in the mortality rates caused by live ammunition and nude ammunition.The above casualty features provided a new research orientation in the protection and medical care of personnel onboard,when explosions occurred in the close cabins of the ship.

A finite element model of cervical spine was three-dimensionally reconstructed through computed tomography (CT) scan, recording the edges of image using Snigraphics V18.0 software, and calibrating in sequence of point, line, area, and solid. The stress distribution of cervical C_(3-4) was analyzed using compute aided design to validate the availability of reconstructed models. Results showed that the three-dimensional finite element cervical C_(3-4) was feasible in simulation analysis. These indicate that the established three-dimensional finite element models can simulate biomechanical experiments, providing foundations for analyzing biomechanical performance of local structure of this finite element model under various pressure conditions.

Objective To analyze the reasons and therapeutic effects for revision of spinal fractures.Method Ninteen patients with revised internal fixation on spinal fractures were reviewed in average of 3.5 years follow-up. Neurological function, pain and daily life quality of patients with revision surgery were evaluated by questionnaire.ResultIncomplete spinal canal decompression as well as improper application of instrumentation were the main reasons of failed internal fixation for spinal fractures.All patients with incomplete spinal cord injury had improvement on neurological function to some extent after re-operation, and 17 of 19 patients (89%) indicated improved daily life quality. However, revision surgery failed to have motor recovery in patients with complete spinal cord injury.ConclusionCorrect surgical technique and selection of internal fixation are very important in the treatment of spinal cord injury.

[Objective]To investigate the clinical and histopathological characteristics of myofibrosarcoma,and study its treatment and prognosis.[Method]The clinical features,histopathological characteristics,diagnosis,treatment and prognosis of two rare myofibrosarcoma patients were observed,and relative literatures were reviewed.[Result]After biopsy,the frist patient was treated with amputation in her middle thigh.postoperative chemotherapy was performed in the local hospital,but the drug and its dose didn't know in detail.one year latter,the patient died because of lung metastasis.The second patient was treated with tumor resection,but three months latter,the tumor recurred and was resected again,and the patient accepted chemotherapy,eleven nonthns latter,lung metastasis was found.then the patient died.About 54 patients with myofibrosarcoma were found in the literatures published in recent years.This neoplasms often involved the head and neck region,trunk and extremities in male patient A expandable and painless mass is the chief clinical features.Myofibrosarcoma can be identified by its specific morphologic features and positive myoid markers.[Conclusion]Myofibrosarcoma is a rare spindle cell neoplasm,Its morbidity dosen't know in detail.When making diagnisis,it is important to distinguished from synovial sarcoma,fibrosarcoma and leiomyosarcoma et al,Surgical resection is the mainstay of therapy,but the result of chemotherapy is not affirmed,The tumor is lower grade malignant one,and is invadable.The rate of local recurrence is high,and distant metastasis could be found.Its prognosis is not affirmed.