BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.

OBJECTIVE To explore the therapeutic effect of modified Yupingfeng powder combined with Yougui pill on patients with chronic obstructive pulmonary disease （COPD）with deficiency of lung and kidney in remission period . METHODS Ninety-two patients ，who were in remission of COPD and whose traditional Chinese medical syndromes belonged to deficiency of lung and kidney from Fuzhou Hospital of Traditional Chinese Medicine in Jiangxi province during May 2018-January 2020，were divided into control group and observation group according to random number table method ，with 46 patients in each group . Control group was treated with conventional western medicine （given Tiotropium bromide powder spray ，18 μg/inhalation，one dose per day ）；observation group was additionally treated with modified Yupingfeng powder decoction combined with Yougui pill （decocting one dose per day ，filtering 300 mL per time ，150 mL in the morning and afternoon ）on the basis of control group . After 8 weeks of treatment ，the clinical efficacy ，serum inflammatory factors and fibrosis indexes ，T cell subsets and lung function indexes，and the occurrence of adverse drug reactions were compared between 2 groups. RESULTS After treatment ，the total clinical effective rate of treatment （91.30%）in observation group was significantly higher than that of the control group （71.74%）； the levels of serum chemokine C -X3-C motif ligand 1，transforming growth factor β1，interleukin-6，matrix metalloproteinase -2 and tissue inhibitor of metalloproteinase -2 in observation group were significantly lower than control group ；there was statistical significance in CD 4+，CD3+，CD4+/CD8+，forced vital capacity ，the ratio of forced expiratory volume in the one second to forced vital capital （FEV1/FVC%）（P＜0.05）. The adverse drug reactions of the two groups were mainly gastrointestinal reactions and rashes. The incidence of adverse drug reactions in the observation group was 13.04%，and there was no statistical difference compared with control group （10.86%） （P＞0.05）. CONCLUSIONS Modified Yupingfeng powder combined with Yougui pill can reduce airway inflammation ， improve immunity and improve lung function of COPD patients with deficiency of lung and kidney in remission period ，and have good safety .

BACKGROUND: Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia. METHODS: This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years. RESULTS: A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group. CONCLUSIONS In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
Child, Preschool ; Exchange Transfusion, Whole Blood/adverse effects* ; Humans ; Hyperbilirubinemia, Neonatal/therapy* ; Infant ; Infant, Newborn ; Kernicterus/therapy* ; Phototherapy/methods* ; Retrospective Studies

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.

Infants suffering from angiostrongylus eosinophilic meningitis (AEM) is rare, while AEM can cause severe consequences.The diagnostic value of high-throughput sequencing for AEM was studied by analyzing 2 AEM children (< 2 years old) in the Department of Neurology, Shenzhen Children′s Hospital in 2019.Case 1 mainly pre-sented intermittent fever, vomiting, mental fatigue and bregma bulge.Case 2 mainly manifested intermittent fever, cough, vomiting and convulsion.Due to hypereosinophils in patients′ peripheral blood and cerebrospinal fluid (CSF), and abundant DNA sequences from a cantonensis in CSF and positive antibody test, the patients were diagnosed with AEM.The patients were treated with albendazole to deworm, and small doses of methylprednisolone to reduce inflammation.The clinical characteristics of AEM infant are not typical, and high-throughput sequencing technology can assist the diagnosis of AEM.

OBJECTIVE: To explore the clinical effects and short-term complications of using free jejunum graft (FJG) to reconstruct the defects by resections of pharyngeal, laryngeal or cervical esophageal cancers. METHOD: Fifty-eight cases of pharyngeal, laryngeal or cervical esophageal cancers were reconstructed with FJG. All cases were analyzed retrospectively. RESULT: The success rate of FJG transplantations was 91.4% (53/58). The incidence of post-operative short-term complication was 43.1% (25/58), which was not related to age or BMI. The most common complication was anastomotic leakage (18.9%), which was not related to per-operative radiation therapy. However, BMI > 25 cases had significantly higher incidence of anastomotic leakage than BMI ≤ 25 cases (P = 0.009). The second and third most common complications were respiratory system complications (10. 3%) and FJG necrosis (8. 6%). Para-operative death rate was 3.4% (2/58). Two-year overall survival rates of hypopharyngeal cancer and cervical esophageal cancer were 49% and 67% respectively. The group with no short-term complications had a slightly better survival rate than the group with short-term complications from the Kaplan-Meier curve, but there was no significant difference (P = 0.103). CONCLUSION FJG is ideal to reconstruct cervical digestive tract circumferential defects with a high success rate and a low mortality. However, the post-operative complication rate is high. Intensive observation, early detection and timely treatment of complications are crucial.
Esophageal Neoplasms ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Jejunum ; transplantation ; Laryngeal Neoplasms ; surgery ; Pharyngeal Neoplasms ; surgery ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate

Objective To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap ( FJF ) to repair the defects following tumor resection, and to analyze the effect of multi?disciplinary treatment on their survival. Methods Fifty?eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap ( FJF ) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed. Results The success rate of flap transplantation was 91.4% (53/58). The 2?year overall survival rates ( OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67. 5% and 49. 3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short?term complications had a better two?year OSR (59.0%) than the group with short?term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2?year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi?disciplinary treatment group had a significantly better 2?year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016). Conclusions Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi?disciplinary treatment can significantly improve the survival rate of late?stage hypopharyngeal and cervical esophageal cancer patients.

Objective To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap ( FJF ) to repair the defects following tumor resection, and to analyze the effect of multi?disciplinary treatment on their survival. Methods Fifty?eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap ( FJF ) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed. Results The success rate of flap transplantation was 91.4% (53/58). The 2?year overall survival rates ( OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67. 5% and 49. 3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short?term complications had a better two?year OSR (59.0%) than the group with short?term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2?year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi?disciplinary treatment group had a significantly better 2?year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016). Conclusions Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi?disciplinary treatment can significantly improve the survival rate of late?stage hypopharyngeal and cervical esophageal cancer patients.

Objective To explore the effect of transplanting poly (lactic-co-glycolic acid) (PLGA) scaffolds seeded with neural stemcells (NSCs) and Schwann cells (SCs) on spinal cord injured rats and the mechanism. Methods NSCs and SCs were cultured in vitro andthen seeded into the directional PLGA scaffolds. Then PLGA-cell complexes were implanted into the spinal cord hemisected rats, whichwere divided into PLGA group, PLGA+NSCs group and PLGA+ NSC+SCs group. The rats were tested with cortical motor evoked potentials(CMEPs) and Basso-Beattle-Bresnahan (BBB) score. Then, the rats were further ipsilaterally or contralateral hemisected at T6 and testedwith CMEPs and BBB score again. Results The incidence of recovery and the amplitudes of CMEPs were the highest in PLGA+NSCs+SCs group. The rats exhibited a gradual improvement in hindlimb locomotor function in score. The BBB score was the least in the PLGAgroup in the 2nd week or later. After retransected ipsilaterally, the CMEPs disappeared again and the BBB score improved quickly. But afterretransected contralaterally, the rats were completely paraplegia. Conclusion The directional PLGA scaffolds seeded with NSCs and SCs facilitatethe recovery in spinal cord injured rats, which may associate with axonal regeneration and functional connections, but play a limitedrole.

Objective To analyze the severe extracranial internal carotid artery (EICA)stenosis and occlusion caused the distribution patterns of cerebral infarction lesion and then to investigate the differences of stenosis and occlusion caused mechanisms of cerebral infarction in order to provide the basis for individual prevention and treatment strategies. Methods The clinical and imaging data of 61 patients with atherosclerotic severe EICA stenosis (70-99%) or occlusion caused acute cerebral infarction were analyzed retrospectively. They were divided into stenosis group (n =31) and occlusion group (n =30) according to the degree of stenosis. The distribution pattems of infarct lesion of both groups were compared. They were divided into good (n =31) and poor (n = 26) collateral flow compensation groups according to the middle cerebral artery (MCA) and magnetic resonance angiography (MRA) on the lesion sides of EICA.The distribution patterns of the infarct lesion in both groups were compared. Results The proportion of the patients with hypertension in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (22/26 vs.18/31, P = 0. 042). The proportion of the patients with multiple cerebral infarction in the occlusion group was significantly higher than thai in the stenosis group (15/30 vs. 24/31, P =0. 026),and the proportion of the patients with single cerebral infarction was significantly lower than that in the stenosis group (15/30 vs. 7/31, P =0. 026). The proportion of the patients with large cortical infarction was significantly higher than that in the stenosis group (7/30 vs. 1/31, P=0. 026). Among the patients with single cerebral infarction, the proportion of the patients with border-zone infarct (BZI) in the occlusion group was significantly higher than that in thestenosis group (8/15 vs. 5/24, P = 0. 036), and the proportion of the patients with cortical infarct (CI) was significantly lower than that in the stenosis group (15/24 vs. 4/15, P =0. 048).The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (8/15vs. 4/22, P =0. 036), and the proportion of the patients with CI was significantly lower than that in the good collateral flow compensation group (4/15 vs. 14/22, P =0. 045). The proportions of the patients with large perforating artery infarct (11/30 vs. 3/31, P=0. 016) and BZI (20/30 vs. 10/31, P =0. 010) in the occlusion group were significantly higher than those in the stenosis group, and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the stenosis group (15/30 vs. 6/31, P =0. 016). The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs.9/31, P =0. 001), and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the good collateral flow compensation group (14/26 vs. 6/31, P =0. 011). The proportion of the patients with incomplete anterior circle of Willis in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs. 8/31,P =0. 001).Conclusions The lesion distribution patterns of cerebral infarction caused by severe EICA stenosis and occlusion are different, and it suggests that the cerebral infarction mechanisms caused by both are different. In patients with severe EICA occlusive disease, MRA showed that the developing signal change at the lesion sides of MCA may be a potential surrogate index for identifying the state of collateral circulation, but it needs to use the research means of quantitative determination of blood perfusion to verify.