Objective:To analyze the selection of internal fixation methods, surgical outcomes, and complications in patients with Neurofibromatosis Type 1 (NF1) accompanied by dystrophic lumbosacral deformities, and to evaluate the indications for pelvic fixation.Methods:A retrospective analysis was conducted on 21 patients with NF1 and associated dystrophic lumbosacral malformations (L 4 to sacrum) who underwent spinal deformity correction surgery at Nanjing Drum Tower Hospital from January 2009 to November 2022. The cohort included 11 males and 10 females, with a mean surgical age of 15.4±4.7 years (range, 7-24 years). Patients were divided into two groups based on whether pelvic fixation was performed: 10 patients in the non-pelvic fixation group (NP group) and 11 in the pelvic fixation group (P group), where fixation involved second sacral alar-iliac (S 2AI) screws or iliac screws. Radiographic parameters, including the Cobb angle of the lumbosacral fractional curve, main curve, and focal kyphosis, were compared preoperatively, postoperatively, and at the last follow-up. Results:The NP group had a significantly lower mean age (13.2±4.9 years) compared to the P group (17.5±3.5 years; t=2.287, P=0.034). Spinal instability (rotational subluxation or spondylolisthesis) due to dystrophic changes was observed in 2 patients in the NP group and 8 in the P group, a statistically significant difference (χ 2=5.838, P=0.030). In the P group, five patients underwent unilateral fixation and six underwent bilateral fixation. Implant types included 2 cases with iliac screws, 1 case with iliac screws plus S 2AI, and 8 cases with S 2AI screws alone. The utilization rate of hooks was significantly higher in the NP group (12.6%±11.5%) compared to the P group (3.5%±6.9%; t=2.230, P=0.038). The preoperative Cobb angle of the lumbosacral fractional curve was significantly smaller in the NP group (13.8°±9.0°) than in the P group (25.5°±13.9°; t=2.228, P=0.039). Postoperatively, the angles were corrected to 6.3°±6.1° and 6.4°±5.3°, respectively ( t=0.901, P=0.969), with correction rates of 57.3%±13.6% and 74.1%±17.8% ( t=2.369, P=0.029). At final follow-up, the angles remained stable (6.6°±6.6° vs. 6.3°±4.8°; t=0.116, P=0.909). For the main curve, preoperative Cobb angles were 52.5°±15.1° (NP) and 61.1°±16.9° (P; t=1.200, P=0.246), corrected to 31.3°±13.8° and 28.0°±8.4°, respectively ( t=0.646, P=0.526). Correction rates were 41.3%±13.0% in the NP group and 53.2%±11.6% in the P group ( t=2.206, P=0.037). At the final follow-up, these values were 32.4°±14.2° and 31.7°±10.3° ( t=0.133, P=0.896). Focal kyphosis, seen in 9 patients, was corrected from 19.7°±10.9° preoperatively to -13.6°±9.5° postoperatively, and remained at -14.1°±9.6° at the final follow-up ( F=33.547, P<0.001). Multi-rod systems were used in 6 cases (NP group) and 7 cases (P group), with no significant difference (χ 2=0.153, P=0.926). Two patients in the NP group developed coronal decompensation three years postoperatively, and one required revision surgery. In the P group, rod breakage occurred in 3 patients, two of whom underwent revision. Conclusions:Dystrophic rotational subluxation or spondylolisthesis of the lumbosacral spine is a primary indication for pelvic fixation in patients with NF1-associated deformities. However, complications related to internal fixation remain common. The combined use of a multi-rod screw-hook hybrid system, particularly when extending across the lumbosacral region, may reduce the risk of instrumentation failure.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Objective:To analyze the selection of internal fixation methods, surgical outcomes, and complications in patients with Neurofibromatosis Type 1 (NF1) accompanied by dystrophic lumbosacral deformities, and to evaluate the indications for pelvic fixation.Methods:A retrospective analysis was conducted on 21 patients with NF1 and associated dystrophic lumbosacral malformations (L 4 to sacrum) who underwent spinal deformity correction surgery at Nanjing Drum Tower Hospital from January 2009 to November 2022. The cohort included 11 males and 10 females, with a mean surgical age of 15.4±4.7 years (range, 7-24 years). Patients were divided into two groups based on whether pelvic fixation was performed: 10 patients in the non-pelvic fixation group (NP group) and 11 in the pelvic fixation group (P group), where fixation involved second sacral alar-iliac (S 2AI) screws or iliac screws. Radiographic parameters, including the Cobb angle of the lumbosacral fractional curve, main curve, and focal kyphosis, were compared preoperatively, postoperatively, and at the last follow-up. Results:The NP group had a significantly lower mean age (13.2±4.9 years) compared to the P group (17.5±3.5 years; t=2.287, P=0.034). Spinal instability (rotational subluxation or spondylolisthesis) due to dystrophic changes was observed in 2 patients in the NP group and 8 in the P group, a statistically significant difference (χ 2=5.838, P=0.030). In the P group, five patients underwent unilateral fixation and six underwent bilateral fixation. Implant types included 2 cases with iliac screws, 1 case with iliac screws plus S 2AI, and 8 cases with S 2AI screws alone. The utilization rate of hooks was significantly higher in the NP group (12.6%±11.5%) compared to the P group (3.5%±6.9%; t=2.230, P=0.038). The preoperative Cobb angle of the lumbosacral fractional curve was significantly smaller in the NP group (13.8°±9.0°) than in the P group (25.5°±13.9°; t=2.228, P=0.039). Postoperatively, the angles were corrected to 6.3°±6.1° and 6.4°±5.3°, respectively ( t=0.901, P=0.969), with correction rates of 57.3%±13.6% and 74.1%±17.8% ( t=2.369, P=0.029). At final follow-up, the angles remained stable (6.6°±6.6° vs. 6.3°±4.8°; t=0.116, P=0.909). For the main curve, preoperative Cobb angles were 52.5°±15.1° (NP) and 61.1°±16.9° (P; t=1.200, P=0.246), corrected to 31.3°±13.8° and 28.0°±8.4°, respectively ( t=0.646, P=0.526). Correction rates were 41.3%±13.0% in the NP group and 53.2%±11.6% in the P group ( t=2.206, P=0.037). At the final follow-up, these values were 32.4°±14.2° and 31.7°±10.3° ( t=0.133, P=0.896). Focal kyphosis, seen in 9 patients, was corrected from 19.7°±10.9° preoperatively to -13.6°±9.5° postoperatively, and remained at -14.1°±9.6° at the final follow-up ( F=33.547, P<0.001). Multi-rod systems were used in 6 cases (NP group) and 7 cases (P group), with no significant difference (χ 2=0.153, P=0.926). Two patients in the NP group developed coronal decompensation three years postoperatively, and one required revision surgery. In the P group, rod breakage occurred in 3 patients, two of whom underwent revision. Conclusions:Dystrophic rotational subluxation or spondylolisthesis of the lumbosacral spine is a primary indication for pelvic fixation in patients with NF1-associated deformities. However, complications related to internal fixation remain common. The combined use of a multi-rod screw-hook hybrid system, particularly when extending across the lumbosacral region, may reduce the risk of instrumentation failure.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Objective To explore the predictive value of CT radiomics and morphological features for the prognosis and survival in non-small cell lung cancer(NSCLC)patients.Methods The clinic data of 300 NSCLC patients(300 lesions)were downloaded from the Cancer Imaging Archive,with 210 randomly selected as the training set and 90 as the test set.According to the prognosis and survival,the patients were divided into two groups with survival period≤3 and＞3 years.3D Slicer software was used to delineate the regions of interest layer by layer in CT images,and the radiomics features were extracted from each region of interest.Both t-test and least absolute shrinkage and selection operator were utilized for radiomics feature screening.Three types of prediction models,namely radiomics model,morphological model and combined model,were constructed with Logistic regression,whose performances were evaluated using the receiver operating characteristic(ROC)curve.Results The differences in radiomics labels and mediastinal lymph node metastasis between the training set and the test set were statistically significant.For radiomics model,morphological model and combined model,the area under the ROC curve was 0.784(95%CI:0.722-0.847),0.734(95%CI:0.664-0.804)and 0.748(95%CI:0.680-0.815)in the training set,and 0.737(95%CI:0.630-0.844),0.665(95%CI:0.554-0.777)and 0.687(95%CI:0.578-0.797)in the test set,which demonstrated that radiomics model had the best diagnostic performance.Conclusion The CT radiomics model can effectively predict the prognosis and survival in NSCLC patients.

OBJECTIVE：To establish the HPLC fingerprints of ethanol extracts of Dendrobium nobile from different habitats ， and to study spectrum effect relationship of its anti-inflammatory effect. METHODS ：The ethanol extracts from 12 batches of D. nobile from different habitats （S1-S12）were prepared. The fingerprints of ethanol extracts from 12 batches of D. nobile were established by HPLC and TCM Fingerprint Similarity Evaluation System （version 2012）. Common peaks were identified and the similarity was evaluated. Using the contents of inflammatory factors （IL-4，IL-6）as anti-inflammatory indexes ，ELISA was used to investigate the effects of ethanol extracts from 12 batches of D. nobile on RAW 264.7 macrophages in inflammatory model induced by lipopolysaccharide. Grey correlation analysis was used to analyze the correlation between common peaks and anti-inflammatory indexes in the fingerprint of ethanol extract from D. nobile . RESULTS ：There were 18 common peaks in ethanol extracts from 12 batches of D. nobile ，and No. 12 peak was identified as dendrophenol. The similarity of each sample was 0.911-0.996. The content of IL- 4 in cell culture medium was significantly reduced by ethanol extracts of D. nobile S1-S12（P＜0.05 or P＜0.01）；the content of IL- 6 in cell culture was significantly reduced by ethanol extracts of D. nobile S1-S8，S10（P＜0.05 or P＜0.01）. Grey correlation analysis found that except for peaks 4 and 18，the correlation degree between the other common peaks and the content of IL- 4 was greater than 0.6，and the correlation degree between peaks 5 and 7 and the content of IL- 4 was greater than 0.8；except for peaks 9，14，4，3 and 18，the correlation degree between the other common peaks and the content of IL- 6 was greater than 0.6，and the correlation degree between peaks 1，12 and 13 and the content of IL- 6 was greater than 0.8. CONCLUSIONS ：HPLC fingerprints of ethanol extracts from 12 batches of D. nobile ； from different habitats have high similarity and good consistency in composition ； the chemical constituents represented by peaks 1，5，7，12（dendrophenol）and 13 may 769096783@qq.com be potential anti-inflammatory components of D. nobile .

OBJECTIVE To study the anatomic relationship of the divus region and provide the anatomical basis for the extended endoscopic endonasal approach to clivus region.METHODS 10 cadaveric heads were dissected using the surgical microscope and endoscope.RESULTS 1.With the extended endoscopic endonasal approach,we can expose the ventral side of brain stem from interpeduncal fossa to the foramen magnum and upper,middle,and lower neurovascular complexes.2.The clivus region,formed by the sphenoid body and the clival part of occipital bone,is situated between the dorsum sellae and the anterior margin of the foramen magnum.Occipital bone and the petrous part of the temporal bone were separated by the petroclival fissure.CONCLUSION 1.The extended endoscopic endonasal approach can be tailored to deal with the local lesions involving the clivus and adjacent posterior cranial fossa structures.2.Full andcomprehensive understanding of the anatomy around the clivus region can help surgeons to improve accuracy and safety of procedures in this region.

Objective To investigate the characteristics of ocular movement disorders in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO), and explore the clinical application of videonystagmograph (VNG) exami?nation in the diagnosis and differential diagnosis of MS. Methods Sixteen MS ,10 NMO and 30 control ( sudden deafness ) patients were enrolled prospectively. Ocular movement disorders including saccades, gaze fixation, smooth pursuits, opto?kinetic nystagmus and spontaneous nystagmus were evaluated by using VNG. Results The positive rate of ocular motility disorders in MS patients detected by VGN was 68.75%. The incidences of abnormalities in saccades, smooth pursuits and optokinetic nystagmus were significantly higher in MS than in control groups (P= 0.000, 0.001 and 0.001, respectively). The positive rate of ocular motility disorders in NMO patients detected by VGN was 80.00%. The incidences of abnormal?ities in saccades, gaze fixation, smooth pursuits and optokinetic nystagmus were significantly higher in NMO than control groups (P=0.000, 0.012, 0.000 and 0.002, respectively). The positive rate of ocular motility disorders was not significant? ly different in MS and MS patients (68.5%vs. 80%,P>0.05). Compared with bedside physical examination, VNG showed a notable higher sensitivity in the detection of ocular motility disorders(68.75% vs. 37.50%). Furthermore, VNG disor?ders might indicate brain lesions undetected by MRI. Conclusion This small sample research indicates that VNG is a valuable tool in the detection of ocular motility disorders as well as brain lesions in MS and NMO patients. However, its role in the differential diagnosis between MS and NMO is not confirmed.

The clival region refers to the skull base between dorsum sellae and anterior border of foramen magnum. It is located in central area of skull base and is in close proximity to pons, medulla oblongata, basilar artery and other crucial intracranial structures. Although there are various microsurgical approaches using craniotomy to reach this region, there are still a lot of difficulty in exposure of clivus. With the increasing development in extended endoscopic endonasal approach, a new route to clivus, as well as meticulous endoscopic anatomy studies is emerging. This article reviewed related researches progress of the detailed anatomical studies from endoscopic perspective.
Cranial Fossa, Posterior ; anatomy & histology ; Craniotomy ; Endoscopy ; methods ; Humans ; Nasal Surgical Procedures ; methods ; Nose ; anatomy & histology ; Skull Base ; anatomy & histology

OBJECTIVE: To observe the CT three-dimensional imaging features of the frontal recess region with advanced three-dimensional reconstruction, and develop the real image of the important anatomical structures around the region to conduct surgery. METHOD: Thirty patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard three-dimensional reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. RESULT: After the reconstruction, we get the three-dimensional model very close to the true state of the nasal cavity-sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important structures. In these patients, the height, width and depth of the agger nasi and frontal sinus were (9.45 ± 3.60)mm, (8.08 ± 3.37)mm, (26.98 ± 6.82)mm and (26.86 ± 9.45)mm, respectively. CONCLUSION This study tried to develop the standardized techniques and measurements from three-dimensional reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The project results in better preoperative patient counselling and in predicting postoperative improvement in clinical status.
Ethmoid Sinus ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Nasal Cavity ; Paranasal Sinuses ; diagnostic imaging ; Tomography, Spiral Computed ; methods