Guidelines for management of pediatric acute hyperextension spinal cord injury

Pediatric acute hyperextension spinal cord injury(SCI)named as PAHSCI by us,is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training,which has been increasingly reported.At present,it has become the leading cause of SCI in children,and brings a heavy social and economic burden.Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards,specifications or guidelines.In order to provide standardized guidance,the expert team formulated this guideline based on the principles of science and practicability,starting from the diagnosis,differential diagnosis,etiology,admission evaluation,treatment,complications and prevention.This guideline puts forward 23 recommendations for 14 related issues.

Outcomes of mobile bearing unicompartmental knee arthroplasty in medial osteoarthritis knee with and without preoperative genu recurvatum

AIM To compare clinical outcomes of patients with and without preoperative genu recurvatum(GR) following mobile bearing unicompartmental knee arthroplasty(UKA). METHODS We prospectively followed 176 patients for at least 24 mo who had been treated by unilateral, minimally invasive, Oxford UKA. Patients with medial osteoarthritis(OA) knee and preoperative GR(Group Ⅰ) accounted for 18%(n = 32) and patients without preoperative GR(Group Ⅱ) accounted for the remaining 82%(n = 144). Knee score, pain scores, and functional scores were assessed for each patient and compared between the two groups. The incidence of postoperative GRand the postoperative hyperextension angles also were recorded and analyzed. RESULTS The pain score, knee score and functional score were not significantly different between the two groups. Similarly, the incidence of postoperative GR and the measured hyperextension angles were not significantly different between the two groups. The incidence of postoperative GR was 1/32(3.12%) in Group Ⅰ and 1/144(0.69%) in Group Ⅱ(P = 0.34). The mean postoperative hyperextension angles were 2.40°± 2.19°(range: 1°-7°) for Group Ⅰ and 1.57°± 3.51°(range: 1°-6°) for Group Ⅱ(P = 0.65).CONCLUSION Medial OA of the knee and concomitant GR is not a contraindication for the mobile bearing UKA.

Hyperextended crustal structure of the Qiongdongnan Basin and subsequent magmatic influence from the Hainan mantle plume

The Qiongdongnan Basin(QDNB)is a rift basin located in the extension direction of the oceanic ridge of the Northwest Subbasin of the South China Sea.This basin is surrounded by Late Cenozoic Ocean Island Basalts(OIBs)magmatism associated with the putative Hainan mantle plume.However,how the Hainan mantle plume has affected the QDNB has not been studied in detail.To reveal the crustal structure of the QDNB and the possible influence of the Hainan mantle plume,we conducted a wide-angle seismic exploration from Hainan Island across the QDNB to the Xisha Block,and obtained the crustal structure by travel-time tomography.The results show that the crustal stretching factors of the Northern and Southern Rises of the QDNB are estimated to be 1.3-2.0,indicating slight or moderate crustal thinning.Whereas,the crustal stretching factor in the Central Depression of the QDNB is estimated to be more than 3.0,which means that the crust has been hyperextended.Controlled by two detachment faults(F2 and F11),the upper and lower crust show brittle and ductile thinning,respectively.Three anomalous low-velocity conduits penetrating the crystalline crust are developed in the Songnan Uplift and the Southern Rise of the QDNB.Their P-wave velocities are 5.5-6.0 km s^(−1),which are significantly lower than those of the surrounding crust(6.0-6.8 km s^(−1)).The Late Cenozoic magmatic intrusions(e.g.,sills and dikes)and hydrothermal activities can be observed in the sedimentary strata above these low-velocity conduits.We interpret that the low-velocity conduits might be the crustal magmatic footprints of the Hainan mantle plume,due to the correlated distributions of OIB-type magmatism,the magmatic intrusion patterns,the deep structure of the Hainan mantle plume and the high heat flow of 95 mW m^(−2).Thus,we propose that the crustal structure of the QDNB is the product of crustal hyperextension in the rifting stage and subsequently affected by the Hainan mantle plume magmatism.This study provides a typical case for understanding the influence of a mantle plume on the continental crust with pre-existing rift structures.