Objective:To explore the method of CT quantitative evaluation of silicosis fibrosis in artificial stone and analyze its correlation with the stage of chest X-ray and lung function impairment.Methods:The clinical data of 142 patients with artificial stone silicosis who were treated at Shanghai Pulmonary Hospital from January 2018 to December 2022 were collected. These patients were diagnosed based on GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis and underwent chest X-rays, chest CT scans, and lung function tests within a two-month period. The chest CT scoring method is based on the CT characteristics of silicosis, including ground-glass shadows, small nodule shadows, point-line shadows/cord-line shadows, emphysema/pulmonary bullae and patch shadows/mass shadows, with a scoring range of 0 to 25 points. Lung function indicators included FVC, FEV 1 and DLco. For inter-group comparisons of normally distributed quantitative data, one-way ANOVA was employed with LSD post-hoc test for multiple comparisons. Chi-square test was used for multi-group ratio comparisons. Kruskal-Wallis H test was applied to non-normally distributed quantitative data, followed by LSD post-hoc test. Spearman's rank correlation was used to analyze the relationship between pulmonary function indicators and CT fibrosis scores, Trend test was conducted using the Pearson test. Results:As the silicosis stage progressed, both the CT fibrosis score ( R=0.87, Ptrend<0.001) and the degree of lung function impairment (FVC: R=-0.41, Ptrend<0.001; FEV 1: R=-0.52, Ptrend<0.001) ; DLco: R=-0.38, Ptrend<0.001) showed an increasing trend. The CT fibrosis Score demonstrated a strong positive correlation with silicosis stage ( rs=0.85, Ptrend<0.001) and a moderate negative correlation with FVC, FEV 1, and DLco ( rs=-0.48, -0.56, and -0.45, respectively, with all P<0.05) . Over an average follow-up period of 14 months, it was observed that changes in the CT score had a strong to moderate negative correlation with variations in FVC and FEV 1 ( rs=-0.63 and -0.52, P<0.05) . Additionally, there was a moderate negative correlation between ground glass opacity and DLco ( rs=-0.52, P<0.001) . Conclusion:The CT fibrosis score not only reflects pathological changes associated with artificial stone-related silicosis but also provides a more precise representation of lung function injury.

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.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective:To explore the method of CT quantitative evaluation of silicosis fibrosis in artificial stone and analyze its correlation with the stage of chest X-ray and lung function impairment.Methods:The clinical data of 142 patients with artificial stone silicosis who were treated at Shanghai Pulmonary Hospital from January 2018 to December 2022 were collected. These patients were diagnosed based on GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis and underwent chest X-rays, chest CT scans, and lung function tests within a two-month period. The chest CT scoring method is based on the CT characteristics of silicosis, including ground-glass shadows, small nodule shadows, point-line shadows/cord-line shadows, emphysema/pulmonary bullae and patch shadows/mass shadows, with a scoring range of 0 to 25 points. Lung function indicators included FVC, FEV 1 and DLco. For inter-group comparisons of normally distributed quantitative data, one-way ANOVA was employed with LSD post-hoc test for multiple comparisons. Chi-square test was used for multi-group ratio comparisons. Kruskal-Wallis H test was applied to non-normally distributed quantitative data, followed by LSD post-hoc test. Spearman's rank correlation was used to analyze the relationship between pulmonary function indicators and CT fibrosis scores, Trend test was conducted using the Pearson test. Results:As the silicosis stage progressed, both the CT fibrosis score ( R=0.87, Ptrend<0.001) and the degree of lung function impairment (FVC: R=-0.41, Ptrend<0.001; FEV 1: R=-0.52, Ptrend<0.001) ; DLco: R=-0.38, Ptrend<0.001) showed an increasing trend. The CT fibrosis Score demonstrated a strong positive correlation with silicosis stage ( rs=0.85, Ptrend<0.001) and a moderate negative correlation with FVC, FEV 1, and DLco ( rs=-0.48, -0.56, and -0.45, respectively, with all P<0.05) . Over an average follow-up period of 14 months, it was observed that changes in the CT score had a strong to moderate negative correlation with variations in FVC and FEV 1 ( rs=-0.63 and -0.52, P<0.05) . Additionally, there was a moderate negative correlation between ground glass opacity and DLco ( rs=-0.52, P<0.001) . Conclusion:The CT fibrosis score not only reflects pathological changes associated with artificial stone-related silicosis but also provides a more precise representation of lung function injury.

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.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective:To improve the longevity genetic research study design by applying self-organizing maps to select a control group for longevity study.Methods:This study included the Han population aged 90 years and above or less than 80 years who have died (control group) from the natural population-based cohort formed by the fusion of the Chinese Chronic Diseases and Risk Factors Surveillance in 2013 and the China Death Surveillance System. The subjects who died of injury, infectious diseases, parasitic diseases, and malignant tumors were excluded. The self-organizing maps method, with multiple iterations and self-organizing clustering, was used to select similar factors among the population aged 90 years and above and the control group, including demographic characteristics, diseases, living habits, social behaviors, and mental and psychological factors. The study used PLINK 1.9 software to evaluate the quality of whole genome sequencing and to conduct logistic regression of single nucleotide polymorphisms (SNPs) and longevity on autosomes. Q-Q plots were used to visualize the P value associated with SNPs and longevity. Results:There were 1 019 samples selected from the baseline of 177 099 survey participants for genome sequencing, including 517 in the longevity group and 502 in the control group. The longevity and the control groups are generally similar in smoking, drinking, diet, sleep duration, blood lipid level, and self-assessment oral health status but differ significantly in socio-economic status, physical activity time, BMI, and self-assessment health status. The whole genome sequencing results were controlled, and 4 618 216 SNPs were involved in association analysis. The Q-Q plot of longevity-related SNPs analysis results showed that the enrichment of P value 1e-4 was significantly lower than the expected P value, and significant signals were also detected among P<1e-7 regions. Conclusions:The self-organizing maps can comprehensively consider the influence of socioeconomic and behavioral risk factors and select longevity control samples among samples with actual age and cause of death in a large-scale natural population cohort to improve the efficiency of longevity genome association analysis. This study provides a methodological reference for nested case-control study sample selection from the large-scale natural population cohort.

Objective: Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods: This survey adopted the stratified cluster sampling method for school selection. The full automatic computer optometry (TOPCON RM800) was used to track myopia related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results: The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively( χ 2=53.59, 49.63, 32.52, P <0.01). The mean diopter of right eye and left eye after mydriasis were ( 0.30± 1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age ( HR =1.21, 95% CI =1.09-1.34), naked eye vision ( HR =0.08, 95% CI =0.07-0.11), height ( HR =0.98, 95% CI =0.97-0.99) showed a strong correlation with the incidence and progression of myopia( P <0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.