Objective To evaluate the clinical efficacy of robot-assisted navigation with percutaneous lag screw treatment for Hangman's fracture.Methods We retrospectively analyzed the clinical data of 5 patients treated with robot-assisted C2 percutaneous lag screw for Hangman's fracture in our hospital from September 2021 to August 2023.Patients were positioned with moderate head-neck flexion in a Mayfield head clamp.After closed reduction with manual traction under general anesthesia,the C2 percutaneous lag screws were implanted under TINAVI orthopedic surgical robot assistance.Postoperative cervical CT scans were used to assess screw placement accuracy and fracture healing quality.Clinical efficacy was evaluated by the Odom grading system.Results All the 5 patients were operated successfully without vertebral artery injury or neurological complications.A total of 10 screws were implanted.According to the Gertzbein-Robbins standard,9 screws belonged to the grade A,and 1 belonged to the grade B,with an accuracy of 90％(9/10)and an excellent rate of 100％(10/10).The neck incision length ranged 20-30 mm(mean,27 mm).The operation time was 86-160 min(mean,112.8 min).The intraoperative blood loss was 10-50 ml(mean,30 ml).The postoperative hospitalization was5-18 d(mean,8 d).The patients were followed up for 12-34 months(mean,23.6 months).All fractures healed without screw breakage or loosening.According to the Odom grading,4 cases were excellent,and 1 case was good.Conclusion Robot-assisted navigation C2 percutaneous lag screw treatment for Hangman's fracture is accurate and minimally invasive,safe and effective.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.

Objective To evaluate the clinical efficacy of robot-assisted navigation with percutaneous lag screw treatment for Hangman's fracture.Methods We retrospectively analyzed the clinical data of 5 patients treated with robot-assisted C2 percutaneous lag screw for Hangman's fracture in our hospital from September 2021 to August 2023.Patients were positioned with moderate head-neck flexion in a Mayfield head clamp.After closed reduction with manual traction under general anesthesia,the C2 percutaneous lag screws were implanted under TINAVI orthopedic surgical robot assistance.Postoperative cervical CT scans were used to assess screw placement accuracy and fracture healing quality.Clinical efficacy was evaluated by the Odom grading system.Results All the 5 patients were operated successfully without vertebral artery injury or neurological complications.A total of 10 screws were implanted.According to the Gertzbein-Robbins standard,9 screws belonged to the grade A,and 1 belonged to the grade B,with an accuracy of 90％(9/10)and an excellent rate of 100％(10/10).The neck incision length ranged 20-30 mm(mean,27 mm).The operation time was 86-160 min(mean,112.8 min).The intraoperative blood loss was 10-50 ml(mean,30 ml).The postoperative hospitalization was5-18 d(mean,8 d).The patients were followed up for 12-34 months(mean,23.6 months).All fractures healed without screw breakage or loosening.According to the Odom grading,4 cases were excellent,and 1 case was good.Conclusion Robot-assisted navigation C2 percutaneous lag screw treatment for Hangman's fracture is accurate and minimally invasive,safe and effective.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To investigate the compliance with early Warfarin anticoagulation therapy after cardiac mechanical valve replacement(MHVR)and its related factors in elderly patients.Methods:The convenience sampling method was used to prospectively recruit 210 patients undergone MHVR at the Ningbo Medical Center of Lihuili Hospital from January 2017 to October 2019.Six months after discharge, face-to-face interviews or telephone follow-ups were conducted to assess general information, warfarin anticoagulation knowledge, anticoagulant treatment compliance and social support.Results:The overall compliance of early Warfarin anticoagulation therapy was excellent, with 99.5% of patients compliant with medication and 99.0% compliant with INR monitoring, both higher than the rate of compliance with advised lifestyle adjustment(92.1%). Anticoagulation knowledge and age were the main influencing factors for compliance in elderly patients after MHVR.Conclusions:The compliance with early Warfarin anticoagulation therapy after MHVR is good in elderly patients in the Ningbo area.The correlation analysis suggests that medical professionals need to promote education on anticoagulation knowledge and pay more attention to anticoagulation compliance in elderly people.

Objective:To explore the genetic characteristics and evolution of hantavirus carried by rodents in port area of Ningde in Fujian province in the summer of 2020.Methods:Rodents were captured in the port area of Ningde, the RNA was extracted from rodent lung tissues and detected by using specific kit. The positive samples were used for whole-genome sequencing of the virus. Bioinformatics software was used for the analysis on the similarity and genetic variation of the sequences.Results:A total of 112 rodents were captured, including 5 Rattus norvegicus and 2 Rattus flavipectus, the positive rate of hantavirus was 6.25% (7/112). By virus gene sequencing, two hantavirus complete genome sequences were obtained (named as FJ35 and FJ36, GenBank accession numbers: MW449188-MW449193). The genetic analysis results showed that the hantavirus detected in positive samples were SEOV and shared 99% nucleotide similarity with hantavirus strains LZSF21 and JX20140581 isolated from Shandong province. Phylogenetic analysis using the maximum likelihood method showed that the hantavirus detected in positive samples belonged to S3 subtype, sharing the same subtype with hantavirus strains Z37 from Zhejiang province, LZSF21 from Shandong province, and zy27 and Gongzhuling 415 from northeastern China. Compared with FJ372, the amino acid variation of N259S was observed at sites 251-264 of nucleoprotein, which might be related to antigenicity. Another variation of Q81R was observed in glycoprotein compared with SEOV 80-39 segment of coded amino acid of international reference strain, which might also cause the change in antigenicity. Conclusion:The high positive rate of hantavirus in rodents in the port area of Ningde- would increase the risk of natural human infection and epidemic in local area. The hantavirus positive rodents in this focus might be from an endemic area in Shandong. It is necessary to strengthen the imported rodent control in the port area of Ningde. The virus detected in 2 positive samples belonged to SEOV subtype Ⅲ and shared high homologies of nucleotides and amino acid sequences with the hantavirus strains in surrounding area. However, some slight variations occurred in glycoprotein and nucleoprotein amino acid sequences, which might cause changes in its antigeniity.

With the aging of the Chinese society and the population, the incidence of hip fractures in the elderly is increasing significantly. Elderly patients have various basic diseases and decreased organ compensatory capacity, which increase the risks related to surgery and anesthesia, increase the incidence of postoperative complications and mortality, and affect the recovery process of patients. Malnutrition is one of the main causes of hip fractures in elderly patients, and it is also a major factor predicting the prognosis of patients. Elderly patients with hip fractures are considered at high risk of malnutrition. Malnutrition can lead to adverse clinical outcomes, such as increased mortality and complications, prolonged hospital stays, and increased hospital costs. Elderly patients with hip fracture should be routinely screened for nutritional risk. Those with malnutrition or nutritional risk, should be given nutritional support treatment. And conduct assessments and optimizations of nutritional support treatmentby observing the prognosis indicators such as complication rate, mortality, and rehabilitation status. At present, orthopedic surgeons who are the main body of elderly hip fracture treatment do not pay enough attention to the nutritional status of patients. Many elderly hip fracture patients undergo surgery while their malnutrition status has not improved. Therefore, it is important to improve their prognosis that strengthen the perioperative nutritional management of elderly patients with hip fracture. Domestic research on the nutritional status of elderly hip fracture patients started late. Many medical institutions have not carried out routine nutritional screening and active nutritional support treatment for elderly hip fracture patients, and there is also a lack of relevant clinical research and data statistics in the nutritional support and treatment of elderly patients with hip fractures. This article describes the current research status of nutritional risk screening and nutritional support treatment for elderly patients with hip fracture at home and abroad. However, due to differences in ethnicity, lifestyle, religious culture, and eating habits in various regions, foreign research data may not be suitable for domestic patients. Therefore, this article provides a reference for the research on perioperative nutritional screening and nutritional treatment of elderly hip fracture patients, and establishes a nutritional management plan suitable for elderly hip fracture patients in China.

Objective: To explore the relationship between the tumor necrosis factor receptor superfamily members 11A (TNFRSF11A) and 11B (TNFRSF11B) gene polymorphisms and the outcome of hepatitis C virus (HCV) infection. Methods: In this case-control study, 749 cases of persistent HCV infection, 494 cases of spontaneous clearance and 1 486 control subjects were included from 2008 to 2016. TaqMan-MGB probe method was used to detect the genotype of TNFRSF11A rs1805034 and TNFRSF11B rs2073617. The genotypes distribution of the two single nucleotide polymorphisms (SNP) were analyzed in different populations. Results: Co-dominant model showed that individuals carrying the rs2073617 CC genotype were prone to have chronic HCV infection, compared with individuals carrying the rs2073617 TT genotype (OR=1.517, 95%CI: 1.055-2.181, P=0.024). Recessive model results showed that individuals carrying rs2073617 CC genotype were more likely to develop chronic HCV infection compared with individuals carrying rs2073617 TT or TC genotype (OR=1.435, 95%CI: 1.033-1.996, P=0.032). Additive model showed that the risk for chronic HCV infection increased with the increase of the number of rs2073617 C alleles (OR=1.204, 95%CI: 1.013-1.431, P=0.035). Conclusion The genetic polymorphism of TNFRSF11B rs2073617 might be related with the chronicity of HCV infection.

Objective: To understand the serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), and thyroxine (T4) and identify the related influencing factors of thyroid dysfunction in drug users. Methods: From June to August 2018, a face-to-face questionnaire survey was conducted in 788 male drug users in a drug rehabilitation center in Jiangsu province to collect their socio-demographic information. Then, venous blood sample was collected from each participant for the detection of various hematological indicators, such as thyroid hormones. Results: The abnormal rates of T3, T4, FT3, FT4 and TSH were 4.57%, 1.27%, 0.51%, 0.38% and 0.89%, respectively, in the male drug users. HCV infection was an influencing factor for abnormal T3 level in the male drug users (OR=8.52, 95%CI: 2.36-30.74, P=0.001). And serum T3 (P<0.001) and T4 (P=0.048) levels increased with increasing HCV viral load. Conclusions HCV infection was an influencing factor for the abnormality of serum T3 level in drug users. Therefore, thyroid-related knowledge should be added in the health education for drug users, and the monitoring of thyroid function should be strengthened for drug users infected with HCV.