Objective: To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications. Methods: Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model. Results: The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%). Conclusion Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

Objective: To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications. Methods: Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model. Results: The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%). Conclusion Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

Objective: To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications. Methods: Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model. Results: The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%). Conclusion Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

Objective: To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications. Methods: Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model. Results: The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%). Conclusion Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

Objective: To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications. Methods: Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model. Results: The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%). Conclusion Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

OBJECTIVES: To evaluate the application value of genetic newborn screening (gNBS) in the Yunnan region. METHODS: A prospective study was conducted with a random selection of 3 001 newborns born in the Yunnan region from February to December 2021. Traditional newborn screening (tNBS) was used to test biochemical indicators, and targeted next-generation sequencing was employed to screen 159 genes related to 156 diseases. Positive-screened newborns underwent validation and confirmation tests, and confirmed cases received standardized treatment and long-term follow-up. RESULTS: Among the 3 001 newborns, 166 (5.53%) were initially positive for genetic screening, and 1 435 (47.82%) were genetic carriers. The top ten genes with the highest variation frequency were GJB2 (21.29%), DUOX2 (7.27%), HBA (6.14%), GALC (3.63%), SLC12A3 (3.33%), HBB (3.03%), G6PD (2.94%), SLC25A13 (2.90%), PAH (2.73%), and UNC13D (2.68%). Among the initially positive newborns from tNBS and gNBS, 33 (1.10%) and 47 (1.57%) cases were confirmed, respectively. A total of 48 (1.60%) cases were confirmed using gNBS+tNBS. The receiver operating characteristic curve analysis demonstrated that the areas under the curve for tNBS, gNBS, and gNBS+tNBS in diagnosing diseases were 0.866, 0.982, and 0.968, respectively (P<0.05). DeLong's test showed that the area under the curve for gNBS and gNBS+tNBS was higher than that for tNBS (P<0.05). CONCLUSIONS gNBS can expand the range of disease detection, and its combined use with tNBS can significantly shorten diagnosis time, enabling early intervention and treatment.
Humans ; Infant, Newborn ; Neonatal Screening ; Genetic Testing ; Female ; Male ; Follow-Up Studies ; Prospective Studies ; China

Objective To investigate clinical effect of tendons pulling,poking and kneading for the treatment of external humeral epicondylitis.Metods From January 2018 to December 2021,a multicenter randomized controlled study was per-formed to collect 192 patients with external humeral epicondylitis in Wangjing Hospital,Beijing Dianli Hospital,and Beijing Fengsheng Osteotraumatology Hospital,respectively,and they were divided into treatment group and control group by random number table method.There were 96 patients in treatment group,including 36 males and 60 females,aged from 28 to 60 years old with an average of(41.20±5.50)years old;the course of disease ranged from 1 to 14 days with an average of(5.24±1.35)days;they were treated once every other day for 2 weeks.There were 96 patients in control group,including 33 males and 63 females,aged from 26 to 60 years old with an average of(43.35±7.75)years old;the course of disease ranged from 1 to 14 days with an average of(5.86±1.48)days;they were treated with topical voltaalin combined with elbow joint fixation for 2 weeks.Visual analogue scale(VAS)and Hospital for Surgery Scoring System(HSS)elbow pronation and supination angles,wrist metacarpal flexion and dorsal extension angles,elbow tenderness between two groups were compared before treatment and at 1,3,5,7,11 and 13 days after treatment;Hospital for Surgery Scoring System 2(HSS2)was compared before treatment and the final treatment.Results All patients were followed up for 10 to 14 days with an average of(12±1.6)days.VAS between treatment group and control group before treatment were 6.83±1.36 and 6.79±1.58,respectively,and decreased to 1.49±1.09 and 2.11±1.81 after the final treatment.VAS of treatment group were significantly lower than those of control group at 1,3,5,7,9,11 and 13 days after treatment(P＜0.05).HSS between two groups were 61.73±11.00 and 36.47±12.45 before treatment,respectively,and increased to 94.42±5.9 and 91.44±9.11 at the final treatment.HSS of treatment group were signifi-cantly higher than those of control group at 1,3,5,7,9,11 and 13 days after treatment(P＜0.05).On the 5th day after treat-ment,the external and internal rotation angles of elbow in treatment group were(66.41±12.69)° and(66.35±13.54)°,while those in control group were(62.08±16.03)° and(61.77±16.35)°.On the 7th day after treatment,the external and internal ro-tation angles of elbow were(69.79±12.64)° and(70.02±13.55)° in treatment group,and(65.28±15.86)° and(65.09± 16.67)° in control group.Elbow joint motion in treatment group was higher than that in control group(P＜0.05).On the 5th day after treatment,angles of wrist dorsiflexion and palm flexion were(39.43±15.94)°and(46.68±11.10)° in treatment group,and(38.51±18.49)° and(44.27±13.58)° in control group.On the 7th day after treatment,angles of wrist dorsiflexion and palm flexion were(42.52±16.50)° and(49.23±10.96)° in treatment group,and(41.18±20.09)° and(46.64±14.63)° in control group.The motion of wrist joint in treatment group was higher than that in control group(P＜0.05).On the 13th day after treatment,HSS2 in treatment group 93.61±6.32 were higher than those in control group 92.06±7.94(P＜0.05).There was no significant difference in elbow tenderness between two groups at each time point(P＞0.05).Conclusion Voltaren external treatment combined with elbow fixation and tendons pulling,poking and kneading could effectively improve symptoms of exter-nal humeral epicondylitis.Compared with voltaren external treatment,tendons pulling,poking and kneading has advantages of longer analgesic time and better elbow function recovery.

Background/Aims: Hepatitis B surface antigen (HBsAg) seroclearance remains uncommon in chronic hepatitis B (CHB) infection. During acute flares of CHB (AFOCHB), alanine aminotransferase elevation reflects a mounting immune response toward viral clearance. We hypothesized that severe AFOCHB is associated with a greater quantitative HBsAg (qHBsAg) decline and HBsAg seroclearance rate. Methods: A total of 75 patients with severe AFOCHB with alanine aminotransferase 10× the upper limit of normal were matched to a control group by age and sex in a 1:2 ratio. qHBsAg levels were measured at the time of flare and annually (for both cases and controls) until the last follow-up. Results: The median follow-up times for patients with severe AFOCHB and controls were 8.8 and 10.5 years, respectively. The cumulative rate of HBsAg seroclearance was higher in the severe AFOCHB group than in the control group (11.8% vs 5.0%, p=0.04) despite the former group having a trend of a higher baseline median qHBsAg (3,127 IU/mL vs 1,178 IU/mL, p=0.076). Compared with the control group, the severe AFOCHB group had a greater annual qHBsAg reduction (–242.4 IU/mL/yr vs –47.3 IU/mL/yr, p=0.002). Increasing age (p=0.049), lower baseline qHBsAg (p=0.002), and severe AFOCHB (p=0.014) were independently associated with HBsAg seroclearance. However, the cumulative rate of hepatocellular carcinoma was significantly higher in the severe AFOCHB group than in the control group (15.8% vs 1.9%, p<0.001). Conclusions Severe AFOCHB was associated with a greater incidence of HBsAg seroclearance and qHBsAg decline. However, it was associated with a higher incidence of hepatocellular carcinoma.

Objective: To describe fertility and explore factors associated with it among pre-conception couples of childbearing age. Methods: Based on the pre-conceptional offspring trajectory study of the School of Public Health of Fudan University, couples of childbearing age who participated in the pre-conception physical examination in Shanghai Jiading District from 2016 to 2021 were recruited and followed up. Couples' time to pregnancy (TTP) was analyzed and Cox proportional hazards regression model was used to explore the factors associated with TTP. Kaplan-Meier was used to calculate each menstrual cycle's cumulative pregnancy rate. Results: A total of 1 095 preconception couples were included in the analysis, the M(Q₁,Q₃)of TTP was 4.33 (2.41, 9.78) menstrual cycles. Age of women (FR=0.90, 95%CI: 0.85-0.95, P<0.001), women who were overweight or obese before pregnancy (FR=0.36, 95%CI: 0.24-0.55, P<0.001), women who were exposed to second-hand smoking (FR=0.63, 95%CI: 0.44-0.92, P=0.016), women whose home or office had been renovated in the past 2 years and had a particular smell (FR=0.46, 95%CI: 0.26-0.81, P=0.008) were risk factors for impaired fertility. Regular menstrual cycles (FR=1.64, 95%CI: 1.16-2.31, P=0.005), females who often drank tea/coffee (FR=1.55, 95%CI: 1.11-2.17, P=0.011) and males who took folic acid before conception (FR=2.35, 95%CI: 1.38-4.23, P=0.002) were associated with better fertility. The cumulative pregnancy rate of 3, 6, and 12 menstrual cycles was 37.6%, 64.4%, and 78.4%, respectively. Conclusion: Older couples, overweight or obesity before pregnancy, irregular menstruation, exposure to secondhand smoke and decoration pollutants in females are associated with impaired fertility. Frequent tea/coffee drinking before pregnancy in females and taking folic acid before pregnancy in males are associated with shortened conception time.
Pregnancy ; Male ; Humans ; Female ; Cohort Studies ; Overweight/complications* ; Coffee ; Intention ; China/epidemiology* ; Fertility ; Obesity/complications* ; Tea