BACKGROUND:With the development of the concept of minimally invasive surgery,lumbar posterior dynamic internal fixation has become the mainstream operation for the treatment of diseases caused by intervertebral disc degeneration.OBJECTIVE:To review the latest progress of lumbar posterior dynamic internal fixation in the treatment of lumbar degenerative diseases and postoperative intervertebral disc rehydration.METHODS:The relevant literature published in CNKI,WanFang,and PubMed databases from 2010 to 2025 was searched with the Chinese and English search terms"lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys system,In-space system,PercuDyn system,intervertebral disc rehydration,crushing stress."By reading the articles,we eliminated the literature with little relevance to the article topic,poor quality and outdated content,and finally 65 articles were included for summary.RESULTS AND CONCLUSION:(1)Although the main surgical method for the treatment of disc degeneration is still the traditional open surgical method of implantation,posterior lumbar dynamic internal fixation has made great progress.(2)Posterior lumbar dynamic fixation can be divided into open dynamic fixation system and percutaneous dynamic fixation system.Each system can be divided into interspinous dynamic internal fixation system and pedicle dynamic internal fixation system according to the different fixation positions.According to the design of specific instruments and the differences of operation methods in the surgery,different operation methods have been derived.At present,the focus of research at home and abroad is on open dynamic internal fixation system.(3)Under the premise that the clinical effect of posterior lumbar dynamic internal fixation is better than that of traditional interbody fusion surgery,it can cause the rehydration phenomenon of postoperative lumbar intervertebral disc,and further improve the long-term postoperative efficacy of patients.

BACKGROUND:With the development of the concept of minimally invasive surgery,lumbar posterior dynamic internal fixation has become the mainstream operation for the treatment of diseases caused by intervertebral disc degeneration.OBJECTIVE:To review the latest progress of lumbar posterior dynamic internal fixation in the treatment of lumbar degenerative diseases and postoperative intervertebral disc rehydration.METHODS:The relevant literature published in CNKI,WanFang,and PubMed databases from 2010 to 2025 was searched with the Chinese and English search terms"lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys system,In-space system,PercuDyn system,intervertebral disc rehydration,crushing stress."By reading the articles,we eliminated the literature with little relevance to the article topic,poor quality and outdated content,and finally 65 articles were included for summary.RESULTS AND CONCLUSION:(1)Although the main surgical method for the treatment of disc degeneration is still the traditional open surgical method of implantation,posterior lumbar dynamic internal fixation has made great progress.(2)Posterior lumbar dynamic fixation can be divided into open dynamic fixation system and percutaneous dynamic fixation system.Each system can be divided into interspinous dynamic internal fixation system and pedicle dynamic internal fixation system according to the different fixation positions.According to the design of specific instruments and the differences of operation methods in the surgery,different operation methods have been derived.At present,the focus of research at home and abroad is on open dynamic internal fixation system.(3)Under the premise that the clinical effect of posterior lumbar dynamic internal fixation is better than that of traditional interbody fusion surgery,it can cause the rehydration phenomenon of postoperative lumbar intervertebral disc,and further improve the long-term postoperative efficacy of patients.

Objective To construct a model that can predict the risk of diagnosing ABO-blood group sys-tem hemolytic disease of the newborn(ABO-HDN)and to verify its effectiveness.Methods A total of 446 children with neonatal hyperbilirubinemia who met the inclusion criteria and were first diagnosed in this hos-pital from January 2022 to March 2023 were selected as the modeling group,and were divided into the develo-ping group(200 cases)and the non-developing group(246 cases)according to whether ABO-HDN was diag-nosed.Totally 17 potential influencing factors were included for univariate analysis and multi-factor analysis,and independent risk factors were included in R software to establish a Nomogram model to predict the risk of ABO-HDN.Another 105 cases of neonatal hyperbilirubinemia in the hospital from April to September 2023 were selected as the verification group.Results In the modeling group,Logistic regression analysis showed that maternal pregnancy number,prenatal serum titer,hemoglobin level,white blood cell count,creatine ki-nase level and neonatal Apgar 1 min score were all independent risk factors for ABO-HDN(P＜0.05).Multi-variate Logistic regression analysis showed that the area under receiver operating characteristic(ROC)curve of the modeling group was 0.819(95％CI:0.779-0.859),sensitivity was 0.655,specificity was 0.878.In the verification group,the area under ROC curve was 0.867(95％CI:0.800-0.933),the sensitivity was 0.803,and the specificity was 0.773.Conclusion The established predictive model scoring system can effec-tively predict the risk of ABO-HDN.

BACKGROUND:It has been proved clinically that adhesion of fibrous scar with the dura mater or nerve root after lumbar operation is an important factor for postoperative symptoms,such as postoperative pain and numbness. OBJECTIVE:To verify the inhibitory effect of autologous ligamentum flavum on the formation of epidural fibrous scar after lumbar surgery and explore the possible molecular biological mechanism. METHODS:Forty-eight Japanese white rabbits(6-8 months old)were randomly divided into three groups:a ligamentum flavum preservation group,a ligamentum flavum non-preservation group,and an autologous fat reposition group.A lumbar laminectomy model was established in all the three groups of rabbits,and rabbit epidural tissues were collected at 3 and 6 weeks after modeling.Hematoxylin-eosin staining was used to observe histological changes and the number and density of fibroblasts,VG staining was used to observe the percentage of collagen fiber area,and immunohistochemistry was used to observe the expression of transforming growth factor β1 and Smad3 proteins. RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that fibroblasts in the ligamentum flavum preservation group were few and loosely arranged,while the cells in the ligamentum flavum non-preservation and autologous fat reposition groups were more numerous and closely arranged.The number density of fibroblasts in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05);however,there was no significant difference between the latter two groups.VG staining results showed that the collagen fibers in the ligamentum flavum preservation group were sparse and distributed unevenly,while a lot of red collagen fibers were gathered in the ligamentum flavum non-preservation and autologous fat reposition groups.The area percentage of collagen fibers in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.The results of immunohistochemistry showed that the degree of positive staining of retained histone the ligamentum flavum preservation group was significantly lower than that of the other two groups.The absorbance value of transforming growth factor β1 and Smad3 in the ligamentum flavum preservation group was significantly lower than that in the other two groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.To conclude,there are different degrees of epidural fibrous scar formation after lumbar surgery.If the ligamentum flavum is preserved,it can help to reduce the number of epidural fibroblasts as well as the formation of collagen fibers,thus reducing the adhesion of the fibrous scar tissue to the dural sac and nerve root.The mechanism is not only a purely mechanical blockade,but also to reduce the formation of epidural fibrous scar by interfering with the transforming growth factor β1/Smad3 signaling pathway.

Both the incidence and mortality of primary liver cancer in China rank first globally. Stereotactic body radiotherapy (SBRT) is valued for its ability to significantly enhance the irradiation precision of target volumes while reducing the radiation doses to surrounding normal tissues. Respiratory motion management represents a critical SBRT technology. Meanwhile, abdominal compression has been extensively applied as a critical approach to respiratory motion management thanks to its convenient operation and high applicability. Furthermore, applying abdominal compression to the liver can effectively reduce the extent of motion of the gross target volumes, thus reducing the expanding ranges of the internal target volumes (ITVs). This further contributes to increased radiation dose to target volumes and decreased radiation dose to surrounding normal tissues. Focusing on respiratory motion management for the liver, the application of abdominal compression, improvements in abdominal compression devices, and method for assessing the abdominal compression effects, this study presents a review of advances in research on the application of abdominal compression in SBRT for liver cancer, aiming to provide a valuable reference for clinical practice.

Objective:To assess the feasibility and security the orientation of foreign bodies using a portable X-ray machine in computer-aided navigation surgery.Methods:A model with a metallic foreign body was constructed.Under the fluoroscopy of a portable X-ray machine,4 points on 2 straight lines passing through the tip of the foreign body were recorded by the navigation e-quipment,and subsequently,the midpoints of the common perpendicular segments of the 2 lines were calculated as the coordinates of the foreign body(Bilinear Method).2 operators measured the coordinates of the foreign body 10 times and compared the measured coordinates of the foreign body with the actual coordinates of the foreign body in order to analyze the accuracy of the Bilinear Method.Radiation doses to model area and operators at different locations were measured using ionizing radiation detectors.Results:The ac-curacy of the Bilinear Method for measuring foreign body coordinates was(1.98±0.77)mm,and that of the 2 operators was 1.55±0.68 and 2.40±0.36 respectively(P=0.02).The radiation dose was(221.45±50.15)μSv in the model and(4.44±1.35)μSv in the operator's chest.Conclusion:The accuracy of the coordinates of the foreign body intraoperation measured by Bilinear Method meets general clinical needs,and different operators may produce different accuracy.The radiation dose is small.

Objective:The impact of bystander CD8 + T cells (CD8 + Tbys) within the tumor microenvironment on the prognosis of early-stage non-small cell lung cancer (NSCLC) remains unclear, particularly concerning their infiltration differences at the invasive margin (IM) and tumor center (TC). Methods:We retrospectively collected postoperative specimens from 173 patients with primary early-stage NSCLC who underwent radical surgery at the Affiliated Tumor Hospital of Shandong First Medical University from 2014 to 2018. Tissue microarrays encompassing IM and TC regions were prepared and subjected to multicolor immunofluorescence staining (CK/CD8/CD103/DAPI). Image processing and phenotype recognition (CD8 + T cells, CK -CD8 +; CD8 + T bys, CK -CD8 +CD103 -) were performed using inFrom software, and automatic quantitative cell density analysis was conducted using R language. Differences in CD8 + T and CD8 + T bys densities at IM and TC were analyzed using the Mann-Whitney U test. The relationship between CD8 + T, CD8 + T bys and clinicopathological features was examined using the Kruskal-Wallis H test. The impact of CD8 + T and CD8 + T bys on recurrence-free survival (RFS) was evaluated using Kaplan-Meier, log-rank, and Cox proportional hazards models. Results:A total of 173 patients with stage ⅠA-ⅡA NSCLC were included, with a recurrence rate of 26.6% (46/173) and a median RFS of 62.3 months (range: 44.7-71.9 months). CD8 + T and CD8 + T bys densities (1/1 000) were significantly higher in the IM region than in the TC region [70(32, 155) vs. 37(18, 88), P＜0.001; 25(11, 46) vs. 18(7, 34), P=0.002]. No significant association was found between CD8 + T, CD8 + T bys and age, gender, smoking history, histological type, or pathological stage (all P＞0.05). Patients with low-density IM CD8 + T cells had lower RFS compared to those with high-density IM CD8 + T cells ( P=0.021; median RFS not reached), Further analysis revealed that patients with low-density IM CD8 + T bys cell had lower RFS compared to those with high-density IM CD8 + T bys ( P=0.047; median RFS not reached), and low-density IM CD8 + T cell was an independent risk factor for postoperative recurrence ( HR=1.836, 95% CI:1.007-3.347, P=0.048). Joint analysis of IM and TC revealed that patients with low IM CD8 + T bys and high TC CD8 + T bys had significantly lower RFS compared to the other three groups ( P=0.006), and this combination was an independent risk factor for postoperative recurrence in early-stage NSCLC ( HR=2.090, 95% CI:1.162-3.760, P=0.014). Conclusions:The spatial distribution of bystander CD8 + T cells within the primary tumor influences the prognosis of patients with early-stage NSCLC. Patients with low-density IM CD8 + T bys and high-density TC CD8 + T bys are more prone to recurrence after radical surgery.

Objective:To investigate the clinical value of the Nomogram model based on two-dimensional shear wave elastography(2D-SWE)combined with biochemical indicators in the diagnosis of moderate and severe metabolic-associated fatty liver disease(MAFLD).Methods:A total of 170 patients with MAFLD diagnosed by ultrosound image in the health management center of the Second People's Hospital of Wuhu from Jan 2023 to Dec 2023 were divided into mild,moderate and severe groups according to two-dimensional ultrasound images,and 111 healthy volunteers were recruited as control group in the same period.Multivariate logistic regression analysis was used to screen independent risk factors for moderate and severe MAFLD and construct a predictive model.The diagnostic efficacy of the ROC model was plotted,and the Nomogram model was used to conduct internal verification.Results:Multivariate logistic regression analysis showed that liver stiffness measurement(LSM),platelet count(PLT)and hepatic steatosis index(HSI)were the independent risk factors for the diagnosis of moderate and severe MAFLD.The area under the curve(AUC)of LSM,PLT and HSI was 0.940(95%CI:0.911-0.969),with a sensitivity was 87.5%and a specificity was 88.1%.The internal validation showed that the model had high accuracy and stability.Conclusion:The Nomogram model based on LSM combined with PLT and HSI can effectively diagnose moderate and severe MAFLD,providing a reliable evidence for early clinical intervention and adjustment of therapeutic measures.

This study innovatively incorporates on-site teaching with the International Museum of Stomatology into the curriculum to establish an immersive and intuitive teaching mode,promoting education from both theoretical and practical dimensions.The teaching effect is comprehensively evaluated to explore the pathway to optimization.Multi-dimensional questionnaires are designed to collect feedback data from students on teaching satisfaction,knowledge mastery,professional identity,and humanistic literacy perception,fol-lowed by in-depth quantitative and qualitative analyses.The results demonstrate that this teaching mode significantly enhances literacy,playing a critical role in helping stomatological students fully understand professional knowledge and humanistic connotations while sub-stantially improving their professional identity.This teaching mode gives a direction for innovative stomatological education,holds sig-nificant importance for cultivating stomatological professionals with both clinical skills and humanistic literacy,possessing substantial potential for promotion,application,and further refinement.

Objectives:To investigate the mid-term outcomes of percutaneous cement discoplasty(PCD)in the treatment of lumbar axial instability,and analyze its technical keypoints and indications.Methods:A retrospective analysis was conducted on 9 patients with axial lumbar instability treated with PCD from January 2018 to December 2019.There were 5 males and 4 females,aged 62-87 years(75.7±8.2 years),with a follow-up period of 0.5-3 years,averaged 2.3±1.0 years.Three cases had three-disc operation at the same time,three had double-space operation and three had single-space operation,involving L2/3 disc in 3 cases,L3/4 disc in 3 cases,L4/5 disc in 4 cases,and L5/S1 disc in 3 cases.Lumbar anteroposterior and lateral ra-diographs in supine and standing positions were performed before operation,at postoperative 1d,3,6,12 months and final follow-up to measure the height of intervertebral space of responsible level,as well as the sagittal area of intervertebral foramen at responsible level.Visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the pain and function before surgery,at 1d,3 months,6 months,12 months and final follow-up after operation to assess the clinical efficacy.The amount of bone cement injected in each intervertebral disc,the time of operation and the amount of blood loss were recorded respectively.Results:All the patients successfully completed the operation,no bone cement leakage occurred.The VAS score and ODI after operation were significantly improved compared with those before operation(P＜0.05).The injection volume of bone cement per intervertebral disc was 3.50±0.73mL.The operative time of each disc was 16.33±1.28min,and the blood loss of each disc was 3.83±0.71mL.The height of intervertebral space of responsible level at various time points after operation was different from that before operation(P＜0.05),and there was no difference in any two time points after operation.The sagittal area of intervertebral foramen at each time point after operation was different from that before operation(P＜0.05),and there was difference be-tween postoperative 1d and the final follow-up values(P＜0.05).Conclusions:PCD can increase the height of the intervertebral space after surgery,relieve lumbar pain,and have a lasting effect in the treatment of lum-bar instability,which is safe with satisfactory mid-term effect,and not prone to bone cement leakage,but long-term large-sample follow-up is still needed.