BACKGROUND:With the increasing attention of scholars at home and abroad to children's cervical spine-related diseases,the demand for exploring the anatomical indicators and changes of cervical spine morphology and development in children of different ages is increasing.OBJECTIVE:To explore and analyze the morphological changes of children with different ages and vertebral sequences by measuring the anatomical position indexes of C2-C7 neurocentral synchondrosis in children aged 1-6 years.METHODS:Normal cervical spine CT images were retrospectively collected from 160 children aged 1-6 years at provincial tertiary hospitals.They were divided into six groups according to an age group of 1 year.The raw data of consecutively scanned cervical spine tomography images were imported into Mimics 16.0 software.The positional anatomical indexes of cervical spine segments C2-C7 in coronal and transverse planes were measured and analyzed under the two-dimensional image window by choosing the measurement tools under the toolbar of Measurements.RESULTS AND CONCLUSION:(1)The distance between the two sides of C2-C7 neurocentral synchondrosis and the distance between the left and right sides of neurocentral synchondrosis and the transverse process gradually increased with age.The overall development of vertebrae in each cervical vertebral segment was faster than the ossification of the neurocentral synchondrosis.(2)The cross-sectional angles on both sides of C2-C7 neurocentral synchondrosis gradually increased with age,and the angles between the left and right sides of neurocentral synchondrosis and the anterior and posterior edges of the vertebral body gradually decreased.Both sides of the neurocentral synchondrosis in cervical vertebral segments tended to grow toward the arch site,which mainly promoted the growth and development of the arch.(3)Except for C7,the angle between the coronal planes on both sides of the cervical spine changed little with the descending neurocentral synchondrosis of the cervical spine,and the neurocentral synchondrosis of the cervical spine was more inclined to longitudinal growth and ossification.(4)The neurocentral synchondrosis position changes in C7 were significantly different from those in the rest of the cervical vertebrae.(5)The anatomical indexes of C2-C7 neurocentral synchondrosis position in children have obvious development rules among different ages and vertebral bodies,and these rules are helpful for the clinical diagnosis and treatment of cervical spine diseases in children.

Interleukin- (IL) 23 drives pathogenic differentiation of Th17 cells via the JAK2-STAT3 signaling pathway, upregulates IL-17A/IL-22 expression, and disrupts intestinal barrier integrity, thereby playing a pivotal role in the pathogenesis of Crohn's disease (CD). IL-23p19 inhibitors—exemplified by risankizumab, mirikizumab, and guselkumab—precisely block this pathway. Key phase 3 trials have demonstrated their efficacy in CD, showing significant clinical benefits in patients refractory to conventional therapies or biologics, with no new safety signals identified. The ultimate treatment goal for CD is deep healing (mucosal-transmural-biochemical composite remission) as defined by STRIDE II. However, current evidence exhibits critical limitations: absence of head-to-head drug comparisons, insufficient data on biologic-experienced subpopulations, and heterogeneous follow-up durations leading to uncertainties in long-term safety. Future studies require standardized head-to-head trials with enhanced subgroup analyses to optimize precision therapeutics.

Interleukin- (IL) 23 drives pathogenic differentiation of Th17 cells via the JAK2-STAT3 signaling pathway, upregulates IL-17A/IL-22 expression, and disrupts intestinal barrier integrity, thereby playing a pivotal role in the pathogenesis of Crohn's disease (CD). IL-23p19 inhibitors—exemplified by risankizumab, mirikizumab, and guselkumab—precisely block this pathway. Key phase 3 trials have demonstrated their efficacy in CD, showing significant clinical benefits in patients refractory to conventional therapies or biologics, with no new safety signals identified. The ultimate treatment goal for CD is deep healing (mucosal-transmural-biochemical composite remission) as defined by STRIDE II. However, current evidence exhibits critical limitations: absence of head-to-head drug comparisons, insufficient data on biologic-experienced subpopulations, and heterogeneous follow-up durations leading to uncertainties in long-term safety. Future studies require standardized head-to-head trials with enhanced subgroup analyses to optimize precision therapeutics.

BACKGROUND:With the increasing attention of scholars at home and abroad to children's cervical spine-related diseases,the demand for exploring the anatomical indicators and changes of cervical spine morphology and development in children of different ages is increasing.OBJECTIVE:To explore and analyze the morphological changes of children with different ages and vertebral sequences by measuring the anatomical position indexes of C2-C7 neurocentral synchondrosis in children aged 1-6 years.METHODS:Normal cervical spine CT images were retrospectively collected from 160 children aged 1-6 years at provincial tertiary hospitals.They were divided into six groups according to an age group of 1 year.The raw data of consecutively scanned cervical spine tomography images were imported into Mimics 16.0 software.The positional anatomical indexes of cervical spine segments C2-C7 in coronal and transverse planes were measured and analyzed under the two-dimensional image window by choosing the measurement tools under the toolbar of Measurements.RESULTS AND CONCLUSION:(1)The distance between the two sides of C2-C7 neurocentral synchondrosis and the distance between the left and right sides of neurocentral synchondrosis and the transverse process gradually increased with age.The overall development of vertebrae in each cervical vertebral segment was faster than the ossification of the neurocentral synchondrosis.(2)The cross-sectional angles on both sides of C2-C7 neurocentral synchondrosis gradually increased with age,and the angles between the left and right sides of neurocentral synchondrosis and the anterior and posterior edges of the vertebral body gradually decreased.Both sides of the neurocentral synchondrosis in cervical vertebral segments tended to grow toward the arch site,which mainly promoted the growth and development of the arch.(3)Except for C7,the angle between the coronal planes on both sides of the cervical spine changed little with the descending neurocentral synchondrosis of the cervical spine,and the neurocentral synchondrosis of the cervical spine was more inclined to longitudinal growth and ossification.(4)The neurocentral synchondrosis position changes in C7 were significantly different from those in the rest of the cervical vertebrae.(5)The anatomical indexes of C2-C7 neurocentral synchondrosis position in children have obvious development rules among different ages and vertebral bodies,and these rules are helpful for the clinical diagnosis and treatment of cervical spine diseases in children.

Objective:To analyze the levels of inflammatory indicators of fistula tissue and blood of Crohn′s disease (CD) patients with perianal fistula and the clinical significance.Methods:A cross-sectional study was conducted. Clinical data of 60 CD patients with perianal fistula (CD fistula group) admitted to the Department of Anorectum, Suzhou Hospital of Traditional Chinese Medicine from May 2022 to May 2023 were collected, and 50 non-CD patients with perianal fistula were selected as non-CD fistula group. The level differences of tumor necrosis factor-α (TNF-α) , interleukin (IL) -12, IL-23, IL-17A, and IL-6 in fistula tissue, and the level differences of white blood cell (WBC) , C-reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , platelet (PLT) , and fecal calprotectin (FC) were compared between the two groups. Pearson or Spearman rank correlation analysis was used to analyze the correlation of various indicators between fistula tissue and blood in CD fistula group.Results:In CD fistula group, there were 47 males and 13 females, with a mean age of (28.9 ± 8.5) years. In non-CD fistula group, there were 40 males and 10 females, with a mean age of (31.3 ± 5.9) years. There were no significant differences in age, gender, Park′s classification, perianal disease activity index and Wexner score between the two groups (all P>0.05) . Compared with the non-CD fistula group, the levels of TNF-α, IL-12, IL-23, IL-17A and IL-6 in fistula tissue were higher in CD fistula group, and the levels of CRP, PLT, FC and ESR were higher, with statistically significant differences (all P<0.05) . IL-12 was positively correlated with CRP ( r = 0.451, P<0.05) and WBC ( r = 0.414, P<0.05) in CD fistula group. Conclusion:Fistula inflammatory factors levels in CD patients with perianal fistula are higher than patients with non-CD fistula, and positively correlate with the levels of blood inflammatory indicators, which may serve as a reference for targeted precision treatment of perianal fistula CD.

Perianal lesions are characteristic manifestations of Crohn's disease (CD) at the same time often herald the progression of the disease. CD fistula is one of the most common lesions, and the commonly used medications and biologics are unable to cure CD fistula. In recent years, new technology therapies have been widely used by clinicians to treat CD fistula, including platelet-rich plasma, mesenchymal stem cells, haematopoietic stem-cell transplantation and hyperbaric oxygen therapy. This article provides an overview of the progress of these non-pharmacological therapies.

Objective:To analyze the levels of inflammatory indicators of fistula tissue and blood of Crohn′s disease (CD) patients with perianal fistula and the clinical significance.Methods:A cross-sectional study was conducted. Clinical data of 60 CD patients with perianal fistula (CD fistula group) admitted to the Department of Anorectum, Suzhou Hospital of Traditional Chinese Medicine from May 2022 to May 2023 were collected, and 50 non-CD patients with perianal fistula were selected as non-CD fistula group. The level differences of tumor necrosis factor-α (TNF-α) , interleukin (IL) -12, IL-23, IL-17A, and IL-6 in fistula tissue, and the level differences of white blood cell (WBC) , C-reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , platelet (PLT) , and fecal calprotectin (FC) were compared between the two groups. Pearson or Spearman rank correlation analysis was used to analyze the correlation of various indicators between fistula tissue and blood in CD fistula group.Results:In CD fistula group, there were 47 males and 13 females, with a mean age of (28.9 ± 8.5) years. In non-CD fistula group, there were 40 males and 10 females, with a mean age of (31.3 ± 5.9) years. There were no significant differences in age, gender, Park′s classification, perianal disease activity index and Wexner score between the two groups (all P>0.05) . Compared with the non-CD fistula group, the levels of TNF-α, IL-12, IL-23, IL-17A and IL-6 in fistula tissue were higher in CD fistula group, and the levels of CRP, PLT, FC and ESR were higher, with statistically significant differences (all P<0.05) . IL-12 was positively correlated with CRP ( r = 0.451, P<0.05) and WBC ( r = 0.414, P<0.05) in CD fistula group. Conclusion:Fistula inflammatory factors levels in CD patients with perianal fistula are higher than patients with non-CD fistula, and positively correlate with the levels of blood inflammatory indicators, which may serve as a reference for targeted precision treatment of perianal fistula CD.

Perianal lesions are characteristic manifestations of Crohn's disease (CD) at the same time often herald the progression of the disease. CD fistula is one of the most common lesions, and the commonly used medications and biologics are unable to cure CD fistula. In recent years, new technology therapies have been widely used by clinicians to treat CD fistula, including platelet-rich plasma, mesenchymal stem cells, haematopoietic stem-cell transplantation and hyperbaric oxygen therapy. This article provides an overview of the progress of these non-pharmacological therapies.

Objective:To report our experience in diagnosis and treatment of posterior atlantoaxial dislocation with odontoid retrolisthesis.Methods:A retrospective study was conducted of the 5 patients who had been treated from July 2012 to August 2018 at Department of Orthopaedics, General Hospital of Southern Theater Command for posterior atlantoaxial dislocation. They were 4 men and one woman, aged from 34 to 67 years (average, 47 years). All of them had a history of trauma. Of them, 4 were complicated with odontoid fracture and one with congenital free os odontoideum. Their posterior atlantoaxial dislocation ranged from 3 to 9 mm (average, 6 mm). By the American Spinal Injury Association (ASIA) grading system, their preoperative spinal injury was rated as grade B in one, as grade C in 3 cases and as grade D in one. All the 5 patients underwent skull traction at 10° flexion. Surgical trans-oralpharyngeal atlantoaxial reduction and internal fixation was performed for the one patient whose reduction had not been achieved by traction while posterior atlantoaxial screw-rod fixation or anterior odontoid screwing was conducted for the 4 patients whose reduction had been achieved by traction. The distance of posterior atlantoaxial dislocation was measured to evaluate their reduction and ASIA grade system was used to assess their spinal function after operation.Results:The postoperative distance of posterior atlantoaxial dislocation was 0 mm, showing a reduction rate of 100%. The 5 patients were followed up for 6 to 36 months (average, 15 months). By the ASIA grade system, the postoperative functional recovery of the spine was grade D in 4 cases and grade C in one. No implant loosening or breakage occurred.Conclusion:As a kind of high-energy hyperextension injury, posterior atlantoaxial dislocation is rare in clinic, but an appropriate treatment can be adopted to deal with its different clinical types to achieve good outcomes.