Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Purpose To analyze the imaging features of juvenile xanthogranuloma (JXG) in children and to improve the diagnostic level of JXG. Materials and Methods The clinical and imaging data of 15 children with JXG confirmed by menstrual biopsy or surgical pathology from January 2011 to December 2023 in Hunan Children's Hospital were retrospectively analyzed. 13 cases underwent CT examinations and 7 cases underwent MRI examinations,of which 5 underwent both MRI and CT examinations. The type,number,involved site,lesion signal,density and enhancement characteristics of JXG were observed and analyzed. Results Of the 15 children with JXG,7 cases were systemic. It involves the central nervous system (5 cases,including pineal region,choroid plexus,cranial sublamina,middle cranial fossa and spinal canal),mastoid process (1 case),liver (3 cases),kidney (3 cases),pancreas (1 case) and lung (2 cases),mainly manifested as single or multiple nodular,mass or patchy lesions in different organs. On MRI,the lesions showed slightly higher or lower or mixed signals on T1WI,low/slightly lower or higher or mixed signals on T2WI,unrestricted or limited diffusion,and significantly enhanced or slightly enhanced enhancement. On CT,the lesions showed patchy,clumpy or nodular low-density or high-density shadows,and the enhancement was mild to moderate uneven enhancement or obvious enhancement. 8 patients with simple skin type showed nodular shadow of subcutaneous soft tissue,equal or slightly low signal on T1WI,slightly low/low signal on T2WI and obvious enhancement. CT showed a slightly low/equal/slightly high density image,and the enhancement showed a slightly enhanced/significantly enhanced image. Conclusion JXG mainly presents as single or multiple nodules and clumps in subcutaneous soft tissues and/or various organs,with increased signal on T1WI,decreased signal on T2WI,decreased or increased diffusion and obvious enhancement. The CT and MRI manifestations of JXG have certain characteristics.

Objective To explore the correlation between the diameter of patients'autologous tendon and the prognosis of anterior cruciate ligament(ACL)reconstruction surgery.Methods From October 2018 to October 2023,82 patients who underwent anterior cruciate ligament reconstruction surgery at Wuxi No.904 Hospital were selected.Based on whether complications occurred after the anterior cruciate ligament reconstruction surgery,they were divided into a group with good prognosis(n=64)and a group with poor prognosis(n=18).Performing univariate analysis on the prognosis of anterior cruciate ligament reconstruction surgery.Pearson correlation analysis was used to analyze the relationship between tendon diameter and prognosis.A multifactorial Logistic regression model was applied to analyze the factors influencing the prognosis of ACL reconstruction and construct a nomogram.The diagnostic efficacy of tendon diameter on the prognosis of ACL reconstruction was analyzed using the receiver operating characteristic(ROC)curve.Results The results of the univariate analysis showed that there were statistically significant differences in gender and age between the two groups(P＜0.05).The tendon diameter and cross-sectional area in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Post-treatment,the Lysholm,Tegner,and IKDC scores in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Pearson correlation analysis showed a significant positive correlation between the patient's tendon diameter and Lysholm,Tegner,and IKDC scores(r=0.417,0.411、0.446,P＜0.05).Logistic analysis indicated that gender,age,tendon diameter,and tendon cross-sectional area are factors affecting the prognosis of ACL reconstruction(P＜0.05).The ROC curve results showed that the combined diagnostic effect of gender,age,tendon diameter,and cross-sectional area is significantly better than any single factor alone.Conclusion There is a significant correlation between the patient's autologous tendon diameter and the prognosis of ACL reconstruction surgery.An increase in autologous tendon diameter enhances knee joint function and improves patient prognosis.

Objective To observe the value of morphological features of mass-like non-special type of invasive breast cancer(IBC-NST)based on dynamic contrast-enhanced MRI(DCE-MRI)radiomics alone and their combinations for identifying ductal carcinoma in situ(DCIS)components.Methods Sixty-seven patients with mass-like IBC-NST were retrospectively collected.According to postoperative pathological findings,28 patients with 34 lesions were clustered into ductal carcinoma in situ component(DCISC)group,while the other 39 patients with 40 lesions were clustered into non-DCISC group.Fourteen parameters of morphological features within mass-like IBC-NST lesions were extracted from the 2nd phase axial images of breast DCE-MRI using radiomics analysis,and then MRI characteristics and morphological feature parameters were compared between groups.Multivariate logistic regression models were constructed under different combinations of morphological feature parameters being significantly different between groups.The performance of each parameter alone and logistic regression models for identifying mass-like IBC-NST with DCIS component were evaluated using receiver operating characteristic(ROC)curves and the area under the curve(AUC),and DeLong tests were conducted for comparisons.Results The proportion of irregularly shaped mass-like IBC-NST in DCISC group(64.71％)was significantly higher than in non-DCISC group(25.00％,P＜0.05).In DCISC group,the elongation,flatness,least axis length,mesh volume,sphericity and voxel volume were all lower,while surface area to volume ratio was higher than those in non-DCISC group(all P＜0.05).AUC of flatness and sphericity for identifying mass-like IBC-NST with DCIS component(0.812 and 0.793,respectively)were both higher than that of lesions shape(AUC=0.659,Z=2.451,2.447,both P＜0.05).Logistic regression models(Model 1,2 and 3)were established through combining sphericity+least axis length,flatness+least axis length+surface area to volume ratio,and the former three+elongation,with AUC of 0.836,0.849 and 0.857,respectively.AUC of Model 3 was not statistically different with that of flatness nor sphericity(both P＞0.05)but higher than that of other morphological feature parameters alone(all P＜0.05).Conclusion Radiomics morphological features of mass-like IBC-NST on DCE-MRI alone or in combinations could effectively identify DCIS component,with performance superior to that of lesion'MRI shape alone.Combining parameters model could improve diagnostic efficacy when compared to several norphological features alone.

Objective To observe the value of morphological features of mass-like non-special type of invasive breast cancer(IBC-NST)based on dynamic contrast-enhanced MRI(DCE-MRI)radiomics alone and their combinations for identifying ductal carcinoma in situ(DCIS)components.Methods Sixty-seven patients with mass-like IBC-NST were retrospectively collected.According to postoperative pathological findings,28 patients with 34 lesions were clustered into ductal carcinoma in situ component(DCISC)group,while the other 39 patients with 40 lesions were clustered into non-DCISC group.Fourteen parameters of morphological features within mass-like IBC-NST lesions were extracted from the 2nd phase axial images of breast DCE-MRI using radiomics analysis,and then MRI characteristics and morphological feature parameters were compared between groups.Multivariate logistic regression models were constructed under different combinations of morphological feature parameters being significantly different between groups.The performance of each parameter alone and logistic regression models for identifying mass-like IBC-NST with DCIS component were evaluated using receiver operating characteristic(ROC)curves and the area under the curve(AUC),and DeLong tests were conducted for comparisons.Results The proportion of irregularly shaped mass-like IBC-NST in DCISC group(64.71％)was significantly higher than in non-DCISC group(25.00％,P＜0.05).In DCISC group,the elongation,flatness,least axis length,mesh volume,sphericity and voxel volume were all lower,while surface area to volume ratio was higher than those in non-DCISC group(all P＜0.05).AUC of flatness and sphericity for identifying mass-like IBC-NST with DCIS component(0.812 and 0.793,respectively)were both higher than that of lesions shape(AUC=0.659,Z=2.451,2.447,both P＜0.05).Logistic regression models(Model 1,2 and 3)were established through combining sphericity+least axis length,flatness+least axis length+surface area to volume ratio,and the former three+elongation,with AUC of 0.836,0.849 and 0.857,respectively.AUC of Model 3 was not statistically different with that of flatness nor sphericity(both P＞0.05)but higher than that of other morphological feature parameters alone(all P＜0.05).Conclusion Radiomics morphological features of mass-like IBC-NST on DCE-MRI alone or in combinations could effectively identify DCIS component,with performance superior to that of lesion'MRI shape alone.Combining parameters model could improve diagnostic efficacy when compared to several norphological features alone.

Objective To explore the correlation between the diameter of patients'autologous tendon and the prognosis of anterior cruciate ligament(ACL)reconstruction surgery.Methods From October 2018 to October 2023,82 patients who underwent anterior cruciate ligament reconstruction surgery at Wuxi No.904 Hospital were selected.Based on whether complications occurred after the anterior cruciate ligament reconstruction surgery,they were divided into a group with good prognosis(n=64)and a group with poor prognosis(n=18).Performing univariate analysis on the prognosis of anterior cruciate ligament reconstruction surgery.Pearson correlation analysis was used to analyze the relationship between tendon diameter and prognosis.A multifactorial Logistic regression model was applied to analyze the factors influencing the prognosis of ACL reconstruction and construct a nomogram.The diagnostic efficacy of tendon diameter on the prognosis of ACL reconstruction was analyzed using the receiver operating characteristic(ROC)curve.Results The results of the univariate analysis showed that there were statistically significant differences in gender and age between the two groups(P＜0.05).The tendon diameter and cross-sectional area in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Post-treatment,the Lysholm,Tegner,and IKDC scores in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Pearson correlation analysis showed a significant positive correlation between the patient's tendon diameter and Lysholm,Tegner,and IKDC scores(r=0.417,0.411、0.446,P＜0.05).Logistic analysis indicated that gender,age,tendon diameter,and tendon cross-sectional area are factors affecting the prognosis of ACL reconstruction(P＜0.05).The ROC curve results showed that the combined diagnostic effect of gender,age,tendon diameter,and cross-sectional area is significantly better than any single factor alone.Conclusion There is a significant correlation between the patient's autologous tendon diameter and the prognosis of ACL reconstruction surgery.An increase in autologous tendon diameter enhances knee joint function and improves patient prognosis.

Purpose To analyze the imaging features of juvenile xanthogranuloma (JXG) in children and to improve the diagnostic level of JXG. Materials and Methods The clinical and imaging data of 15 children with JXG confirmed by menstrual biopsy or surgical pathology from January 2011 to December 2023 in Hunan Children's Hospital were retrospectively analyzed. 13 cases underwent CT examinations and 7 cases underwent MRI examinations,of which 5 underwent both MRI and CT examinations. The type,number,involved site,lesion signal,density and enhancement characteristics of JXG were observed and analyzed. Results Of the 15 children with JXG,7 cases were systemic. It involves the central nervous system (5 cases,including pineal region,choroid plexus,cranial sublamina,middle cranial fossa and spinal canal),mastoid process (1 case),liver (3 cases),kidney (3 cases),pancreas (1 case) and lung (2 cases),mainly manifested as single or multiple nodular,mass or patchy lesions in different organs. On MRI,the lesions showed slightly higher or lower or mixed signals on T1WI,low/slightly lower or higher or mixed signals on T2WI,unrestricted or limited diffusion,and significantly enhanced or slightly enhanced enhancement. On CT,the lesions showed patchy,clumpy or nodular low-density or high-density shadows,and the enhancement was mild to moderate uneven enhancement or obvious enhancement. 8 patients with simple skin type showed nodular shadow of subcutaneous soft tissue,equal or slightly low signal on T1WI,slightly low/low signal on T2WI and obvious enhancement. CT showed a slightly low/equal/slightly high density image,and the enhancement showed a slightly enhanced/significantly enhanced image. Conclusion JXG mainly presents as single or multiple nodules and clumps in subcutaneous soft tissues and/or various organs,with increased signal on T1WI,decreased signal on T2WI,decreased or increased diffusion and obvious enhancement. The CT and MRI manifestations of JXG have certain characteristics.

Induction of cancer cell ferroptosis has been proposed as a potential treatment in several cancer types. Tumor-associated macrophages (TAMs) play a key role in promoting tumor malignant progression and therapy resistance. However, the roles and mechanisms of TAMs in regulating tumor ferroptosis is still unexplored and remains enigmatic. This study shows ferroptosis inducers has shown therapeutic outcomes in cervical cancer in vitro and in vivo. TAMs have been found to suppress cervical cancer cells ferroptosis. Mechanistically, macrophage-derived miRNA-660-5p packaged into exosomes are transported into cancer cells. In cancer cells, miRNA-660-5p attenuates ALOX15 expression to inhibit ferroptosis. Moreover, the upregulation of miRNA-660-5p in macrophages depends on autocrine IL4/IL13-activated STAT6 pathway. Importantly, in clinical cervical cancer cases, ALOX15 is negatively associated with macrophages infiltration, which also raises the possibility that macrophages reduce ALOX15 levels in cervical cancer. Moreover, both univariate and multivariate Cox analyses show ALOX15 expression is independent prognostic factor and positively associated with good prognosis in cervical cancer. Altogether, this study reveals the potential utility of targeting TAMs in ferroptosis-based treatment and ALOX15 as prognosis indicators for cervical cancer.

Next-generation sequencing has revolutionized family-based association tests for rare variants. As the lower power of genome wide association study for detecting casual rare variants, methods aggregating effects of multiple variants have been proposed, such as burden tests and variance component tests. This paper summarizes the methods of rare variants association test that can be applied for family data, introduces their principles, characteristics and applicable conditions and discusses the shortcomings and the improvement of the present methods.
Computer Simulation ; Family Relations ; Genetic Association Studies ; Genetic Variation ; Genome-Wide Association Study/methods* ; Humans