1.Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery.
Y ZHAO ; B Y XU ; L T QI ; L YUE ; R L ZHU ; Z R YU ; X D YI ; C D LI
Chinese Journal of Surgery 2023;61(8):656-665
		                        		
		                        			
		                        			Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,P<0.01). There were no significant differences in coronal, sagittal parameters, VAS and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2(t=-3.203, P=0.046). PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.
		                        		
		                        		
		                        		
		                        			Male
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		                        			Female
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		                        			Animals
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		                        			Humans
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		                        			Adult
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		                        			Retrospective Studies
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		                        			Titanium
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		                        			Kyphosis/etiology*
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		                        			Sacrum
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		                        			Osteotomy/adverse effects*
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		                        			Spinal Fusion/methods*
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		                        			Lumbar Vertebrae
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		                        			Treatment Outcome
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		                        			Postoperative Complications/epidemiology*
		                        			
		                        		
		                        	
4.Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment
Jeremy T. HINES ; Woo-Lam JO ; Quanjun CUI ; Michael A. MONT ; Kyung-Hoi KOO ; Edward Y. CHENG ; Stuart B. GOODMAN ; Yong-Chan HA ; Phillippe HERNIGOU ; Lynne C. JONES ; Shin-Yoon KIM ; Takashi SAKAI ; Nobuhiko SUGANO ; Takuaki YAMAMOTO ; Mel S. LEE ; Dewei ZHAO ; Wolf DRESCHER ; Tae-Young KIM ; Young-Kyun LEE ; Byung-Ho YOON ; Seung-Hoon BAEK ; Wataru ANDO ; Hong-Seok KIM ; Jung-Wee PARK
Journal of Korean Medical Science 2021;36(24):e177-
		                        		
		                        			
		                        			Non-traumatic osteonecrosis of the femoral head (ONFH) usually affects adults younger than 50 years and frequently leads to femoral head collapse and subsequent arthritis of the hip.It is becoming more prevalent along with increasing use of corticosteroids for the adjuvant therapy of leukemia and other myelogenous diseases as well as management of organ transplantation. This review updated knowledge on the pathogenesis, classification criteria, staging system, and treatment of ONFH.
		                        		
		                        		
		                        		
		                        	
5.Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment
Jeremy T. HINES ; Woo-Lam JO ; Quanjun CUI ; Michael A. MONT ; Kyung-Hoi KOO ; Edward Y. CHENG ; Stuart B. GOODMAN ; Yong-Chan HA ; Phillippe HERNIGOU ; Lynne C. JONES ; Shin-Yoon KIM ; Takashi SAKAI ; Nobuhiko SUGANO ; Takuaki YAMAMOTO ; Mel S. LEE ; Dewei ZHAO ; Wolf DRESCHER ; Tae-Young KIM ; Young-Kyun LEE ; Byung-Ho YOON ; Seung-Hoon BAEK ; Wataru ANDO ; Hong-Seok KIM ; Jung-Wee PARK
Journal of Korean Medical Science 2021;36(24):e177-
		                        		
		                        			
		                        			Non-traumatic osteonecrosis of the femoral head (ONFH) usually affects adults younger than 50 years and frequently leads to femoral head collapse and subsequent arthritis of the hip.It is becoming more prevalent along with increasing use of corticosteroids for the adjuvant therapy of leukemia and other myelogenous diseases as well as management of organ transplantation. This review updated knowledge on the pathogenesis, classification criteria, staging system, and treatment of ONFH.
		                        		
		                        		
		                        		
		                        	
6.Prevalence and characteristics of overweight and obesity in Chinese children aged 0-5 years.
D M YU ; L H JU ; L Y ZHAO ; H Y FANG ; Z Y YANG ; H J GUO ; W T YU ; F M JIA ; W H ZHAO
Chinese Journal of Epidemiology 2018;39(6):710-714
		                        		
		                        			
		                        			Objective: To study the prevalence and characteristics of overweight and obesity among Chinese children aged 0-5 years, in 2010-2013. Methods: Data was from the'China Nutrition and Health Surveillance-0-5-Years-Old Children and Lactating Women'project in 2013. Stratified multistage cluster sampling method was used to select 55 districts/counties from 30 provinces (autonomous regions, municipalities) with the sample size of children as 32 862. Definition of overweight and obesity were according to both the WHO 2006 growth standard in children less than 5-year-old and the WHO 2007 growth reference in children of 5-years-old. Results: were calculated by complex weight based on national census from the National Bureau of Statistics in 2010. Results The overall prevalence of overweight was 8.4% among the 0-5-year-old in 2013, with 9.4% in boys and 7.2% in girls. Both of the rates from urban and rural areas were the same, as 8.4%. The prevalence rates of overweight in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups appeared as 13.0%, 11.1%, 8.3%, 6.0%, 4.8%, 3.9% and 15.9%, respectively. The rates of overweight in low, medium and high income families were 8.0%, 8.8% and 8.9%, respectively. The prevalence of obesity was 3.1% among the 0-5-year-old, with 3.6% in boys and 2.5% in girls. There was no significant difference seen in urban (3.3%) and rural areas (2.9%). The prevalence rates for obesity in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups were 5.8%, 3.8%, 2.5%, 1.6%, 1.2%, 1.3% and 7.8%, respectively. The rates of obesity in low, medium and high income families were 2.8%, 3.3% and 3.5%, respectively. Conclusion: The prevalence rates of both overweight and obesity were increasing among the 0-5-year-olds in China, suggesting that it is necessary to timely conduct the surveillance and intervention programs on overweight and obesity in this target population.
		                        		
		                        		
		                        		
		                        			Adolescent
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		                        			Asian People/statistics & numerical data*
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		                        			Body Mass Index
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		                        			Body Weight
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		                        			Child
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		                        			Child, Preschool
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		                        			China/epidemiology*
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		                        			Female
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		                        			Humans
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		                        			Income
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		                        			Infant
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		                        			Infant, Newborn
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		                        			Lactation
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		                        			Male
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		                        			Nutritional Status
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		                        			Obesity/ethnology*
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		                        			Overweight/ethnology*
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		                        			Prevalence
		                        			
		                        		
		                        	
7.Epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years.
H Y FANG ; D LIU ; L Y ZHAO ; D M YU ; Q ZHANG ; W T YU ; Y ZHAI ; W H ZHAO
Chinese Journal of Epidemiology 2018;39(6):715-719
		                        		
		                        			
		                        			Objective: To analyze the epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Methods: Data was from the samples of aged 6-17 years in the China National Nutrition and Health Surveillance program in 2010-2012. P(90) (the same age, the same sex) was used as the diagnostic value for abdominal obesity. Results: The overall waist circumference of children and adolescents in all the age groups appeared higher in males than that in females (P<0.000 1), higher in cities than that in the rural areas (P<0.05), and higher in children with high family income than those with middle or low family incomes (P=0.000 3). The rate of abdominal obesity in children and adolescents aged 6-17 years appeared as 11.2% on average and 10.7% and 11.8% for boys and girls, respectively but with no significant difference (P>0.05). Rates on abdominal obesity appeared as 13.2% and 8.5% for boys while as 12.3% and 11.2% for girls respectively, in urban or rural areas. As for the levels of family income, the abdominal obesity rates appeared as 15.8%, 11.5% and 8.8% respectively for boys while 13.5%, 11.9% and 11.6% respectively for girls, under high, middle and low levels of family income. Conclusion: The rate of abdominal obesity in boys seemed more responsive to the impact of income in urban or rural areas.
		                        		
		                        		
		                        		
		                        			Adolescent
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		                        			Asian People/statistics & numerical data*
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		                        			Child
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		                        			China/epidemiology*
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		                        			Cities
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		                        			Female
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		                        			Humans
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		                        			Male
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		                        			Obesity, Abdominal/ethnology*
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		                        			Prevalence
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		                        			Waist Circumference
		                        			
		                        		
		                        	
8.Epidemiological characteristics of overweight and obesity in Chinese children and adolescents aged 6-17 years.
H Y FANG ; Y ZHAI ; L Y ZHAO ; D M YU ; Q ZHANG ; L H JU ; W T YU ; W H ZHAO
Chinese Journal of Epidemiology 2018;39(6):724-727
		                        		
		                        			
		                        			Objective: To analyze the prevalence rates of overweight and obesity in Chinese children and adolescents aged 6-17 years, and to provide scientific basis for the development of prevention strategies on obesity. Methods: Data was from children and adolescents aged 6-17 years in the China National Nutrition and Health Surveillance 2010-2012 program. In children aged 6 years, criteria of overweight and obesity were followed the WHO growth reference for school-aged children and adolescents. In children and adolescents aged 7-17 years, overweight and obesity were defined by sex and age specific BMI, recommended by Guidelines for prevention and control of overweight and obesity among school-age children and adolescents according to the Chinese guidelines. Results: The overall rates on overweight and obesity were 9.6% and 6.4% among the Chinese children and adolescents aged 6-17 years, with 11.0% (12.8% for boys and 9.0% for girls) in urban and 7.7% (boys 9.7%, girls 5.5%) in rural areas. The rates of overweight and obesity among children and adolescents were 8.4% (boys 9.3%, girls 7.4%) and 5.2% (boys 6.2%, girls 4.1%) in the rural areas. According to the levels of household income, the overweight rates of children in high, middle and low incomes were 12.3%, 10.7% and 8.2%, with obesity as 8.6%, 7.2% and 5.7% respectively. Conclusions: In 2012, the prevalence rates of overweight and obese were 9.6% and 6.4% among children and adolescents aged 6-17 years, respectively, higher in urban than in rural areas and higher boys than in girls. The prevalence rates of overweight and obesity seemed to be related to the levels of household income.
		                        		
		                        		
		                        		
		                        			Adolescent
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		                        			Asian People/statistics & numerical data*
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		                        			Body Mass Index
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		                        			Child
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		                        			China/epidemiology*
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		                        			Female
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		                        			Health Promotion
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		                        			Humans
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		                        			Male
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		                        			Nutritional Status
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		                        			Obesity/ethnology*
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		                        			Overweight/ethnology*
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		                        			Prevalence
		                        			
		                        		
		                        	
9.Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017.
J YU ; T ZHANG ; Y WANG ; J M GAO ; J HUA ; J M TIAN ; Y F DING ; J ZHANG ; L L CHEN ; J Q LI ; G M ZHAO
Chinese Journal of Epidemiology 2018;39(6):847-851
		                        		
		                        			
		                        			Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.
		                        		
		                        		
		                        		
		                        			Ambulatory Care/statistics & numerical data*
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		                        			Child
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		                        			Child, Preschool
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		                        			China/epidemiology*
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		                        			Cost of Illness
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		                        			Cough/virology*
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		                        			Female
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		                        			Fever/virology*
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		                        			Humans
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		                        			Infant
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		                        			Infant, Newborn
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		                        			Influenza A Virus, H1N1 Subtype
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		                        			Influenza A Virus, H3N2 Subtype
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		                        			Influenza, Human/epidemiology*
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		                        			Outpatient Clinics, Hospital/statistics & numerical data*
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		                        			Outpatients/statistics & numerical data*
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		                        			Prospective Studies
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		                        			Socioeconomic Factors
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		                        			Surveys and Questionnaires
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		                        			Virus Diseases
		                        			
		                        		
		                        	
10.Prevalence of drug resistance in treatment-naive HIV infected men who have sex with men in Guangzhou, 2008-2015.
Z G HAN ; Y L ZHANG ; H WU ; K GAO ; Y T ZHAO ; Y Z GU ; Y C CHEN
Chinese Journal of Epidemiology 2018;39(7):977-982
		                        		
		                        			
		                        			Objective: To understand the prevalence of drug resistance in treatment-naive HIV infected men who have sex with (MSM) in Guangzhou. Methods: HIV-1 RNA were extracted from the serum specimens of the MSM newly confirmed to be HIV-1 positive, living in Guangzhou and receiving no anti-viral therapy from 2008 to 2015. HIV-1 pol gene segments, including full protease and part reverse transcriptase, were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced by Sanger. Subsequently, the sequence data were submitted to Stanford University HIV Drug Resistance Database for drug resistance analysis. Results: Among 2 283 HIV infected MSM, HIV-1 pol gene segments were obtained from the serum samples of 1 986 HIV infected MSM aged 16-84 (30.18±8.24) years. Among them, the unmarried accounted for 74.17% (1 473/1 986), those of Han ethnic group accounted for 90.64% (1 800/1 986), those with education level of college or above accounted for 49.65% (986/1 986), those with education level of senior high school or secondary school accounted for 27.14% (539/1 986), those with education level of junior high school or below accounted for 20.89% (415/1 986). The distribution of subtypes was predominated by CRF07_BC (38.22%, 759/1 986) and CRF01_AE (34.49%, 685/1 986). The overall prevalence of drug resistance was 3.32% (66/1 986). The prevalence of resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 1.36%(27/1 986), 0.65% (13/1 986) and 1.61% (32/1 986), respectively. Subtype B had higher resistance to PIs, NRTIs and NNRTIs and subtype CRF55_01B had highest resistance to NNRTIs compared with other subtypes. In subtype B, the resistant rates to D4T, EFV and NVP were highest (all 4.17%, 5/120), followed by those to NFV, AZT and RPV (all 3.33%, 4/120). In subtype CRF55_01B, the resistant rates to EFV and NVP were highest (all 5.50%, 16/291), followed by those to ETR and RPV (all 5.15%, 15/291). Conclusions: The prevalence of drug resistance in treatment-naive HIV infected MSM in Guangzhou remained at low level and current antiretroviral drugs are generally effective. However, subtype B and CRF55_01B have higher drug resistance.
		                        		
		                        		
		                        		
		                        			Adolescent
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		                        			Adult
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		                        			Child
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		                        			Drug Resistance, Viral
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		                        			Genotype
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		                        			HIV Infections/ethnology*
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		                        			Homosexuality, Male/statistics & numerical data*
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		                        			Humans
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		                        			Male
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		                        			Phylogeny
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		                        			Prevalence
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		                        			RNA, Viral/genetics*
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		                        			Sexual and Gender Minorities
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		                        			Young Adult
		                        			
		                        		
		                        	
            
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