BACKGROUND:At present,the incidence of scoliosis is increasing year by year,especially in adolescent idiopathic scoliosis.Therefore,it is more and more important to strengthen the research on the treatment of adolescent scoliosis. OBJECTIVE:To summarize the current status,hotspots,emerging trends,and frontiers of global research on the treatment of adolescent idiopathic scoliosis to provide reference and guidance for future related research. METHODS:The literature related to the treatment of adolescent idiopathic scoliosis was retrieved on the Web of Science Core Collection(WOSCC)database from 2013 to 2023.CiteSpace 6.2.R1 software was used for visual analysis of countries,institutions,authors,and keywords. RESULTS AND CONCLUSION:(1)A total of 561 English articles were included in this study.Among countries,institutions,and authors,the United States has contributed the most.Nanjing University and Qiu,Yong(Affiliated Drum Tower Hospital,Nanjing University School of Medicine)are the most published institution and author.The academic journal with the largest number of articles is the European Spine Journal.(2)In the analysis of cited literature,the top 10 most cited articles mainly describe the effects of surgical treatment and conservative treatment on improving adolescent idiopathic scoliosis,especially improving the curvature of patients.(3)Through the summary of highly cited articles and the keyword clustering,keyword prominence in-depth mining,the research hotspots are currently the relationship between Cobb angle and treatment choice,the therapeutic effect of exercise therapy and the therapeutic effect of posterior vertebral fusion.(4)The prognosis of patients with different curvatures has not been studied in depth,and the etiology of adolescent idiopathic scoliosis has not been clarified,so the relationship between curvature and prognosis and the etiology of adolescent idiopathic scoliosis may be a new research trend in the future.

Objective : To explore the main points of clinical treatment of fourth branchial cleft deformity in special positions and to provide a reference for clinical practice. Methods: The clinical data of one case of a fourth branchial cleft deformity that occurred in the left anterior chest wall with a fistula below the clavicle are summarized and combined with a literature review. Results: The patient complained of repeated swelling and pain under the left anterior chest wall for 2 months. A 10 mm×10 mm fistula with yellow clear liquid exudate from the fistula was observed on the left side below the clavicle. A 20 mm×20 mm×10 mm swelling was immediately adjacent at the superficial cervicothoracic junction of the upper sternoclavicular joint, with no fluctuation and poor activity; this swelling produced slight pain upon pressing. Imaging examinations pointed to cystic lesions. The primary diagnosis was a fourth branchial deformity. A small amount of methylene blue was injected into the patient's subclavian fistula, and a supraclavicular T-shaped incision was made where the cyst contacted the fistula. By turning the flap, all the methylene blue-stained areas and adjacent submucosal tissues were exposed. During the operation, a mass was found on the sternum. The platysma was found deep in the notch, which was incised before excising the surrounding area. The pathological result is the fourth branchial cleft deformity. After 1 week and 3 months of follow-up, the patients had no discomfort and no recurrence. A review of the relevant literature shows that the fourth branchial cleft deformity is a congenital developmental abnormality that occurs in 1% of all branchial cleft deformity. It often presents as a fistula, cyst, or sinus tract and is anatomically located at the neck root and supravicular region. The fistula is close to the medial lower boundary of the sternocleidomastoid muscle. The diagnosis is often made based on its anatomical location, imaging examinations and, ultimately, pathology. The differential diagnoses include other cervical swellings, such as hemangioma and a thyroglossal duct cyst. Surgical resection is a commonly used treatment method. In recent years, endoscopic positioning and internal fistula burning have had good curative effects for recurrent fourth branchial cleft deformity, with a small chance of recurrence or cancer. Conclusion Given its unique position, clinicians should make full use of imaging methods to determine the size, anatomical location and course of the lesion when treating the fourth branchial cleft deformity to ensure the complete and safe surgical resection of the lesion and prevent recurrence.

Objective:To evaluate the ultrasound diagnostic value of portal vein complications after liver transplantation by monitoring changes in portal vein hemodynamic parameters using the color Doppler ultrasound technology and to determine its clinical significance.Methods:The clinical data of 99 patients who underwent liver transplantation at the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from July 2015 to December 2018 were analyzed retrospectively. There were 81 males and 18 females, aged (51±9) years old. These patients were divided into the portal vein complication ( n=23) and the non-portal vein complication ( n=76) groups, based on whether portal vein complications had developed within 2 years after surgery. In addition, 30 healthy volunteers at the Affiliated Hospital of Qingdao University, including 16 males and 14 females, aged (40±14) years old were selected to form the control group. The patients’ morphology of liver was studied using color Doppler ultrasound at days 1, 7, 14, 30, 180, 365 and 730 after liver transplantation, and the maximum portal vein blood flow velocity and portal blood flow were recorded. Results:Compared with the control group, the maximum portal venous flow velocity and portal venous blood flow significantly increased on days 1, 7, 14, 30, and 180 after liver transplantation in the non-portal complication group (all P<0.05). With time, these changes showed a decreasing trend. By day 365 after surgery, the differences between the maximum portal venous flow velocity and the portal venous blood flow between the two groups became not significant ( P>0.05). Of the 23 patients in the portal vein complication group, 9 developed portal vein stenosis (PVS) and 14 portal vein embolism. The 9 patients with PVS had a maximum portal flow velocity of 63.8 (46.0, 78.6) cm/s at 1 month after surgery, and this flow velocity was significantly higher than that in the non-portal complication group [35.0(29.6, 41.8) cm/s, Z=-3.35, P<0.001]. The portal blood flow was 993 (887, 1168) ml/min in the 9 patients with portal vein stenosis at 1 month after surgery, and it was significantly higher than those in the non-portal complication group [811(682, 1 018) ml/min, Z=-2.37, P=0.020]. Conclusions:After liver transplantation, both the portal venous blood flow velocity and the blood flow were at high levels in the early postoperative period and they returned to normal levels with time. Ultrasound dynamic monitoring of portal venous blood flow changes was of clinical significance in diagnosing portal vein stenosis and portal vein embolism after liver transplantation.

Objective    To analyze the surgical results of patients with supracardiac total anomalous pulmonary venous connection (TAPVC) in a single pediatric cardiac center. Methods    A retrospective study was conducted on 98 pediatric patients with supracardiac TAPVC receiving surgical repair from 2014 to 2019 in our center. There were 64 males and 34 females with a median surgical age of 3.0 (1.5, 7.0) months and a median weight of 5.0 (4.0, 6.0) kg. Twenty-three (23.5%) patients had preoperative pulmonary vein obstruction. Ninety-two (93.9%) patients received conventional surgical repair, while six (6.1%) patients were treated with the sutureless technique. The Cox regression model was used to analyze the data. Results    The median follow-up time was 26.50 (5.75, 44.25) months. There were 9 (9.2%) deaths. Lower weight at the time of repair (P=0.013) and prolonged cardiopulmonary bypass time (P=0.007) were associated with mortality. Postoperative pulmonary vein obstruction was observed in 8 (8.2%) patients. Associated risk factors for postoperative pulmonary vein obstruction included lower weight at the time of repair (P=0.042) and prolonged cardiopulmonary bypass time (P=0.002). Conclusion    Surgical repair of supracardiac TAPVC has achieved satisfactory results in our center. Risk factors such as lower weight at the time of repair and prolonged cardiopulmonary bypass time are associated with a poor prognosis.

Objective    To introduce a modified sutureless technique and its surgical results in the treatment of total anomalous pulmonary venous connection (TAPVC). Methods    Clinical data of 11 patients with TAPVC who underwent the modified sutureless technique treatment from 2014 to 2019 in our center were retrospectively analyzed, including 4 males and 7 females. The median surgical age was 1.4 (0.3, 27.0) months. The median weight was 4.3 (3.5, 8.5) kg. Six (54.5%) patients were of supracardiac subtype, and five (45.5%) patients were of infracardiac subtype. Five (45.5%) patients had preoperative severe pulmonary hypertension, and three (27.3%) patients had preoperative pulmonary vein obstruction. The surgical results were compared with those of 10 patients treated with conventional surgical technique. Results    The median follow-up was 12 (range, 1-65) months. During the follow-up, no death or postoperative pulmonary vein obstruction occurred in the modified sutureless technique group. The perioperative data and relief of re-obstruction were superior in the modified sutureless technique group, but the difference was not statistically significant (P>0.05). The postoperative survival of the the modified sutureless technique group was better than that of the traditional surgery group (P=0.049). Conclusion    The modified sutureless technique which includes partial suture and then incising, and eversion of pulmonary vein incision, is a safe and reliable method for the treatment of TAPVC with satisfactory short-term results.

Objective:To investigate the clinical efficacy of laparoscopic sleeve gastrectomy in obese adolescents.Methods:The retrospective and descriptive study was conducted. The clinical data of 37 obese adolescents who were admitted to Drum Tower Hospital Affiliated to Nanjing University Medical School between July 2016 and August 2020 were collected. There were 18 males and 19 females, aged 18(range, 13?19)years. All patients underwent laparoscopic sleeve gastrec-tomy. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. The patients were followed up by outpatient review to detect body weight, blood glucose, blood lipid, blood pressure, nutrition situation and related complications at 3, 6 and 12 months after operation. The follow-up was up to August 2021. Measurement data with normal distribution were represented as Mean± SD. Repeated measurement data were analyzed by Repeated Measures Anova. Measurement data with skewed distribution were represented by M(range). Count data were expressed as absolute numbers or percentages. Results:(1) Surgical and postoperative situations. All 37 patients under-went laparoscopic sleeve gastrectomy successfully, the operative time was (50±7)minutes, the volume of intraoperative blood loss was (53±17)mL, and the duration of postoperative hospital stay was (3.0±0.5)days. Of the 37 patients, 2 cases had puncture infection. There was no complication such as bleeding occurred. (2) Follow-up. Of the 37 patients, 35, 31 and 22 cases were followed up at postoperative 3, 6 and 12 months, respectively. There was no anemia, malnutrition, trace element deficiency or other nutrition-related complications during the follow-up, and there was no death. The body mass, body mass index, homeostasis model assessment-insulin resistance, triglyceride, total cholesterol, systolic pressure, diastolic pressure, vitamin D, folate of the 37 patients were (117±19)kg, (40±5)kg/m 2, 6.59(range, 2.84?28.02), (1.6±0.7)mmol/L, (4.5±0.7)mmol/L, (141±22)mmHg (1 mmHg=0.133 kpa), (84±18)mmHg,(14±5)μg/L, (10±5)μg/L before the surgery, and (81±15)kg, (27±4)kg/m 2, 2.69(range, 1.08?9.71), (0.9±0.5)mmol/L, (4.5±0.7)mmol/L, (115±15)mmHg, (70±11)mmHg, (23±10)μg/L, (9±5)μg/L at postoperative 12 months. There were significant differences in the time effect of above indicators ( Ftime=214.14, 160.37, 12.66, 11.77, 2.90, 18.08, 11.32, 8.61, 5.04, P<0.05). The percentages of excess of body mass index lost of the 37 patients were 48%±19%, 77%±28% and 89%±24% at postoperative 3, 6 and 12 months, the percentages of excess weight loss were 42%±13%, 63%±17% and 75%±18%, the percentages of total body weight loss were 18%±5%, 26%±6% and 34%±7%, respectively. There were significant differences in the time effect of above indicators ( Ftime=83.96, 107.24, 109.06, P<0.05). The hemoglobin A1c was 4.8%, 5.0%, 5.1% and 4.9%, 5.2%, 5.2% in the 2 patients with type 2 diabetes at postoperative 3, 6 and 12 months, respectively, and they were relieved without drug treatment. Conclusion:Laparoscopic sleeve gastrectomy has definite short-term clinical efficacy in the treatment of adolescent obesity, which can effectively reduce excess body weight and improve the metabolic complications of insulin resis-tance, dyslipidemia and hypertension.

Objective:To observe the clinical characteristics of esophageal reflux after total gastrectomy (ERATG), and to explore the mechanism of occurrence.Methods:Fourteen gastric cancer patients who underwent total gastrectomy were prospectively enrolled in this study. The postoperative symptoms were observed and recorded and 24 h MII-pH with pH monitoring was performed to investigate the characteristics of postoperative reflux.Results:After total gastrectomy patients were with different degrees of ERATG as heartburn, appetite loss, chest tightness and belching. The overall nature of ERATG is mainly weak acid, with a pH between 4 and 7. ERATG involved esophageal-jejunal anastomosis and a length of esophagus 7 cm above the anastomosis. Patients with typical reflux symptoms had a lower pH minimum in the upright position than those without typical symptoms[(4.76±0.71) vs.(5.68±0.37), t=2.866, P<0.05]. Patients with typical reflux symptoms had a higher frequency of reflux of mixed liquid and liquid-air reflux than those without typical symptoms[liquid(31.25±29.76) vs.(4.50±9.14), t=0.011, P<0.05; liquid-air(19.50±12.99) vs.(2.00±2.61), t=0.004, P<0.05]. Conclusion:ERATG is mainly a upward reflux of weakly acidic gas, with typical symptoms of heartburn, appetite loss, chest tightness and belching. Patients with typical symptoms usually have lower pH in the upright position.

Objective:To analyze characteristics of and distribution of pathogenic fungi in patients with tinea capitis in the First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018.Methods:Clinical data were collected from 122 tinea capitis patients with positive fungal culture results in Department of Dermatology, First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018, and retrospectively analyzed. Fungal culture was carried out, and lactophenol cotton blue staining was performed for morphological identification of the fungal isolates.Results:Of the 122 patients with tinea capitis, 112 (91.8%) were children, including 70 (62.5%) males and 42 (37.5%) females, and there were 58 (51.79%) preschool children and 37 (33.04%) school-age children; 9 (7.38%) were adults, including 7 females and 2 males; 66 (54.1%) were of Uygur nationality, 46 (37.7%) of Han nationality, 5 (4.1%) of Kazakh nationality, 3 (2.46%) of Hui nationality, 1 (0.82%) of Mongolian nationality, and 1 of unknown nationality. The annual number of cases of tinea capitis was more than 20 from 2011 to 2013, and gradually decreased year by year from 2014 (≤ 13 cases/year) . All the patients were infected with a single fungal strain, and a total of 122 strains were identified, including 46 (37.7%) strains of Microsporum ferrugineum, 44 (36.07%) strains of Microsporum canis, 10 (8.2%) strains of Trichophyton violaceum, 9 (7.38%) strains of Trichophyton schoenleini, 6 (4.91%) strains of Trichophyton tonsurans, 4 (3.28%) strains of Trichophyton mentagrophytes, 3 (2.46%) strains of Trichophyton verrucosum. Microsporum ferrugineum (anthropophilic species) mostly affected patients of Uygur nationality (34 cases, 73.91%) , and Microsporum canis (zoophilic species) mostly affected patients of Han nationality (26 cases, 59.09%) . Conclusion:In the Department of Dermatology, First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018, tinea capitis commonly affected male children of Uygur nationality, and Microsporum ferrugineum and Microsporum canis were the dominant pathogenic species.

Objective:To determine the diagnostic value of tumor markers in peritoneal lavage fluid from colorectal cancer patients for tumor peritoneal metastasis.Methods:A total of 227 colorectal cancer patients who undergoing surgical treatment were included. 300 ml of peritoneal lavage fluid was irrigated immediately upon laparotomy for traditional cytology (PLC) testing, 134 patients were tested for tumor marker of peritoneal lavage fluid (pTM). Univariate analysis was performed to determine the risk factors for peritoneal metastasis; pTM ROC curve was used to determine the best cutoff value; paired chi-square test was used to compare the difference between PLC and pTM detection.Results:The positive rate of PLC was 12.3% (28/227). Age>65, stage T3 + , lymph node metastasis, mucinous adenocarcinoma and increased serum CA125, CA19-9 are related to peritoneal metastasis; The best cutoff value of pTM for peritoneal metastasis : pCEA 17.095 ng/dl, sensitivity 58.3%, specificity 93.9%; pCA19-9 4.515 U/ml, sensitivity 83.3%, specificity 80.0%; pCA125 303.2 U/ml, sensitivity 58.3%, specificity 95.7%; pCA-724 3.01 U/ml, sensitivity 66.7%, specificity 95.7%; The best cutoff value of pTM for peritoneal micrometastasis: pCA19-9 3.43 U/ml, sensitivity 100%, specificity 72.2%. The positive rate of pCA19-9 was 29.85%, which was higher than that of PLC (χ 2=2.00, P<0.05). Conclusion:Peritoneal metastasis of colorectal cancer is related to tumor T stage, lymph node metastasis, tumor pathological type, and increased serum CA125 and CA19-9; pTM has diagnostic value for peritoneal metastasis of colorectal cancer.

Objective:To investigate the role of indocyanine green(ICG) fluorescence imaging in laparoscopic anterior resection for rectal cancer.Methods:A retrospective analysis was performed on 7 patients who had undergone laparoscopic anterior resection with the use of ICG fluorescence imaging at Peking University People′s Hospital between Oct 2018 and Mar 2019. The clinicopathological variables, surgical factors, short-term outcome and complications were analyzed.Results:The median operation time was 185 min. The median estimated blood loss was 50 ml. The median time from ICG injection to anastomotic perfusion was 45 s. One patient received extended proximal resection of bowel due to poor perfusion as suggested by ICG imaging. The median time to soft diet was 4 days, and the median hospital stay was 8 days. The median number of lymph nodes harvested was 16. There were no major complications in all these patients. No adverse events related to ICG were recorded.Conclusions:ICG fluorescence imaging was safe and effective in detecting insufficient blood supply around newly established bowel anastomsis, hence potentially reducing the anastomotic leakage rate.