Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Background: En bloc resection is recommended for the treatment of malignant and aggressive benign spinal tumors; however, it often requires a combined anterior-posterior approach, which is usually accompanied by longer surgical duration, increased blood loss, larger trauma, and surgical complexity. The present study describes a novel rotation-reversion technique for en bloc resection of the thoracic and upper lumbar spinal tumors using a posterior-only approach and evaluate its safety and efficacy. Methods: Thirteen patients with thoracic and upper lumbar (L1-L3) spinal tumors were treated with en bloc resection using the rotation-reversion technique through a posterior-only approach at our institution between 2015 and 2023. The clinical characteristics and surgical results of the patients were reviewed and analyzed. Results: Posterior-only en bloc resection was performed successfully in all 13 patients using the rotation-reversion technique, with a median follow-up of 30.4 months (range, 6–74 months). The average maximum size of these 13 tumors was 5.7 × 5.8 × 4.8 cm.The mean operation time and blood loss were 458.5 minutes (range, 220–880 minutes) and 3,146.2 mL (range, 1,000–6,000 mL), respectively, with 4 of the 13 patients (30.8%) experiencing perioperative complications. Negative margins were achieved in all the 13 patients (100%). One patient experienced local recurrence (7.7%) and 1 patient experienced instrumentation failures. Interbody fusion was confirmed in 11 of the 13 patients (84.6%), with a median fusion time of 6.9 months. All of the 13 patients experienced varying degrees of mild postoperative neurological deficits owing to resection of the nerve roots affected by tumor invasion of the vertebrae. No vessel injury or postoperative neurological paralysis occurred, except 1 patient who had been completely paralyzed before surgery. Conclusions The rotation-reversion technique is an effective procedure for en bloc resection of selected thoracic and upper lumbar spinal tumors through the posterior-only approach.

Objective To explore the clinical value of models based on clinical features and enhanced MRI radiomics for predicting the occurrence of post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A retrospective selection of 161 acute pancreatitis(AP)patients was conducted,comprising 99 in the non-PPDM-A group and 62 in the PPDM-A group.They were randomly divided into training set and test set in a ratio of 7∶3.Region of interest(ROI)were delineated and radiomics features were extracted on the late arterial phase MRI images.Optimal radiomics features were selected by maximum relevance and minimum redundancy(mRMR)and least absolute shrinkage and selection operator(LASSO).Support vector machine(SVM)was used to develop three predictive models.The efficacy of the models in predicting PPDM-A was evaluated,the receiver operating characteristic(ROC)curve was drawn,and the DeLong test was employed to assess the difference in predictive capability among the models.Results In the training set,the area under the curve(AUC)of the clinical model,radiomics model,and combined model were 0.702,0.810 and 0.901,respectively,and in the test set were 0.678,0.797 and 0.830,respectively.The DeLong test revealed a statistically significant difference in the predictive capability of the combined model compared to the clinical model both in the training and test sets(training set:P＜0.001;test set:P=0.019).Conclusion The combined model based on clinical features and enhanced MRI radiomics features demonstrates good predictive effi-cacy and can provide valuable insights for clinical interventions aimed at preventing PPDM-A.

Objective To explore the value of dual-phase enhanced CT radiomics in predicting post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A total of 145 patients with acute pancreatitis(AP)were retrospectively collected,including 62 patients in PPDM-A group and 83 patients in non-PPDM-A group.The patients were randomly divided into training set and test set at a ratio of 7︰3,the pancreatic parenchyma in arterial phase and venous phase was delineated and the radiomics features were extracted.Vari-ance threshold method,univariate selection method and least absolute shrinkage and selection operator(LASSO)were used to screen radiomics features.The prediction performance of the model was evaluated by the area under the curve(AUC).The DeLong test was used to compare the prediction efficiency between the models,and the calibration curve and decision curve were used to evaluate the prediction efficiency of the model.Results The AUC of arterial phase model,venous phase model,combined arterial venous phase model,clinical model and radiomics combined clinical model in the training set were 0.845,0.792,0.829,0.656 and 0.862,respec-tively.The DeLong test results showed that only the difference between the radiomics combined clinical model and the clinical model in the training set and the test set was statistically significant(P<0.05).The decision curve showed that the radiomics combined clinical model had high clinical practicability in a certain range,and the calibration curve showed that the radiomics combined clinical model had the best fitting degree with the actual observation value.Conclusion Based on the dual-phase enhanced CT radiomics combined clinical model,PPDM-A can be predicted more accurately,and it can provide a certain reference value for the clinical development of per-sonalized treatment programs.

Objective:To summarize the clinical characteristics of neonatal Ureaplasma parvum (Up) infection.Methods:From June 2021 to July 2023, a total of 2 890 neonates were admitted to the Neonatal Intensive Care Unit of the Children's Hospital Capital Institute of Pediatrics. Metagenomic next generation sequencing (mNGS) was performed on 373 specimens from 157 infants, detecting Up sequences in 12 specimens from ten infants, with no detection of Ureaplasma urealyticum sequences. All ten infants with detected Up were included in a retrospective analysis. Descriptive statistical analysis was used to summarize the clinical characteristics of Up-infected neonates.Results:All ten Up-infected neonates were preterm infants with a gestational age of (28.3±2.6) weeks (25 +3-33 +1 weeks). Seven were delivered vaginally; eight had mothers with premature rupture of membranes; seven had mothers with elevated white blood cell counts and/or C-reactive protein levels prenatally; one had a mother with Ureaplasma Urealyticum vaginitis. All ten infants experienced clinical deterioration after initial stabilization of their underlying conditions, primarily presenting with respiratory symptoms, including decreased blood oxygen saturation, diffuse reticular changes on chest X-rays by the second day of life, pneumonia, and atelectasis. Some also had fever, decreased heart rate, poor skin perfusion, and scattered bruises, with two cases of heart failure. Despite empirical antibiotic treatment, nine infants continued to have significantly elevated white blood cell counts, with only mildly elevated or normal C-reactive protein levels. Seven developed bronchopulmonary dysplasia, including four moderate to severe cases. After mNGS confirmed Up infection, all infants received macrolide antibiotics and symptomatic treatment, with individualized treatment courses. All were discharged after recovery with a median hospital stay of 58.5 d (range 26-100 d), though three had respiratory sequelae on follow-up. Conclusions:In preterm infants, clinical deterioration after initial stabilization, primarily with respiratory symptoms and persistent leukocytosis despite routine antibiotic treatment, should raise suspicion for Up infection. And mNGS aids in definitive diagnosis, and early initiation of macrolide antibiotics can improve clinical outcomes and long-term prognosis.

Objective:To explore the method of repairing huge bone and soft tissue defects in clavicle area after en bloc resection of primary malignant tumor of clavicle and the effect of shoulder joint function.Methods:Data of 3 patients with primary malignant tumors of clavicle who underwent en bloc resection (total or subtotal clavicle resection) and individualized repair of bone and soft tissue defects in clavicular region from January 2018 to December 2021 were retrospectively analyzed. All patients were female aged 45, 57 and 14 years old, respectively. Tumor types were osteosarcoma, solitary plasmacytoma and pleomorphic undifferentiated sarcoma. Postoperative adjuvant chemotherapy, shoulder rehabilitation training were performed. Oncological assessment and shoulder joint activity assessment were regularly performed. Musculoskeletal Tumor Society score (MSTS), Constant-Murley scoring and University of California, Los Angeles (UCLA) scoring system were used for functional assessment of shoulder joint.Results:All 3 cases were followed up with follow-up period of 33, 23 and 8 months respectively. No tumor recurrence or metastasis was detected at the last follow up. After tumor resection, one patient with osteosarcoma and one patient with pleomorphic undifferentiated sarcoma underwent reconstruction with clavicular plate and ligament advanced reinforcement system (LARS) ligament. One patient with solitary plasmacytoma underwent LARS ligament reconstruction only after tumor resection. At the latest follow-up, MSTS scores were 28, 30 and 28, Constant-Murley scores were 80, 90 and 84, and UCLA scores were 29, 33 and 30, respectively. No complications occurred during perioperative and postoperative follow-up period.Conclusion:Reconstruction of clavicle and surrounding important ligaments after en bloc resection of primary clavicle malignant tumor is of great significance to the recovery of postoperative shoulder joint function. Satisfactory stability and good shoulder joint function could be obtained after reconstruction of clavicle and sternoclavicular joint.

Objective:To review the research methods, contents and research results of spatial disorientation (SD) accident analysis system, and point out the problems in the research and the future research direction. Literature sources and selection Relevant articles and reviews published in China and abroad. Literature quotation Thirty-six published papers and reviews were cited. Literature synthesis The development history of SD accident analysis system were reviewed, and the characteristics, advantages and disadvantages of 3 common spatial disorientation accident analysis systems were analyzed. The paper briefly introduced the application of the spatial disorientation accident analysis system on aviation accidents analysis by taking the American International Aerospace Training and Research Center developed system as an example. Finally, the paper prospected the direction and trend of the development. Conclusion:The SD accident analysis system visualizes the causal relationship of SD accidents and further analyzes and studies SD accidents so as to reduce the occurrence of SD accidents.

Objective:To review the research methods, contents and research results of spatial disorientation (SD) accident analysis system, and point out the problems in the research and the future research direction. Literature sources and selection Relevant articles and reviews published in China and abroad. Literature quotation Thirty-six published papers and reviews were cited. Literature synthesis The development history of SD accident analysis system were reviewed, and the characteristics, advantages and disadvantages of 3 common spatial disorientation accident analysis systems were analyzed. The paper briefly introduced the application of the spatial disorientation accident analysis system on aviation accidents analysis by taking the American International Aerospace Training and Research Center developed system as an example. Finally, the paper prospected the direction and trend of the development. Conclusion:The SD accident analysis system visualizes the causal relationship of SD accidents and further analyzes and studies SD accidents so as to reduce the occurrence of SD accidents.