Symposium 4 - Striving for Clinical Excellence in HKU-Shenzhen Hospital

As a flagship institution of Hong Kong-Shenzhen collaboration, HKU Shenzhen Hospital (HKU-SZH) has pioneered clinical excellence and healthcare innovation in the Greater Bay Area (GBA). Since its establishment, the hospital has integrated Hong Kong's advanced medical expertise with Mainland China's healthcare system, setting new benchmarks in quality, safety, and patient-centered care.


HKU-SZH has led transformative reforms in governance, adopting a Hong Kong-style hospital management model to enhance efficiency and accountability. Our commitment to quality and safety is demonstrated by achieving mainland and international accreditation, including ACHS and China's AAA recognition, ensuring world-class standards. The hospital has also implemented groundbreaking salary reforms, experimenting with incentives to drive professionalism.


As part of the Green Healthcare reform, HKU-SZH has incorporated sustainable practices into operations. Our patient-centered approach prioritizes holistic care, with multidisciplinary teams delivering seamless, compassionate services. Additionally, together with Shenzhen Health Commission and the Hong Kong Academy of Medicine, the hospital has played a pivotal role in specialist training, fostering the next generation of medical specialist in Shenzhen to an international standard through structured programs and cross-border collaborations.


HKU-SZH's strategic location in Shenzhen enables it to serve as a bridge between Hong Kong and the GBA, facilitating medical exchanges, research partnerships, and integrated healthcare solutions. Looking ahead, the hospital will continue to leverage its unique position to drive innovation, improve healthcare accessibility, and contribute to the GBA's vision of a world-class medical hub.

Background
Spinal deformity represents one of the most challenging and complex domains in spinal surgery. Over recent decades, substantial progress has been achieved through advancements in internal fixation systems, osteotomy techniques, and navigation technologies, significantly extending the boundaries of spinal deformity management. In the current era, the rapid development of artificial intelligence (AI) holds great promise in further transforming the diagnosis and treatment of spinal deformities.


Objective
This study aims to present the staged surgical management of a rare and extreme case of "3-on" folded man, which is a spinal kyphosis deformity secondary to ankylosing spondylitis (AS), highlighting the current development in managing severe spinal deformities. Furthermore, the study discusses future perspectives on the integration of AI and robotics in spinal deformity correction.


Methodology
A 40-year-old male presented with a severe kyphosis deformity due to advanced AS. His face was on femur, chin on chest, and the sternum on the pubis. The entire spine and both hips were fused, and the patient exhibited severe osteoporosis. A four-stage surgical plan was implemented, consisting of bilateral femoral neck osteotomies, cervical osteotomy, thoracolumbar osteotomy, and bilateral total hip arthroplasty. The deformity was ultimately corrected, enabling the patient to stand and walk independently.


Results
The surgical strategy was meticulously designed based on cumulative experience and literature evidence. However, a misjudgment in the outcome of the first-stage procedure necessitated a cervical osteotomy in an abnormal position during the second stage. Additionally, postoperative hip mobility remained suboptimal. Looking forward, the establishment of comprehensive spinal deformity databases combined with deep learning algorithms and intelligent surgical planning systems may provide surgeons with more intuitive and evidence-based decision-making tools. The application of orthopedic robots and intelligent positioning/reduction platforms can further enhance the safety and accuracy of correction procedures. Moreover, emerging technologies such as osteotomy robots and virtual reality systems are expected to reduce the risks associated with complex osteotomies and deformity corrections.


Conclusion
The ongoing advancement of AI and robotic technologies is anticipated to significantly reduce the technical barriers to routine spinal deformity correction and expand the frontier of surgical capability. Nevertheless, the treatment of extremely severe spinal deformities remains highly individualized and continues to depend heavily on the surgical team's expertise and multidisciplinary collaboration.

Since the birth of the worlds first IVF baby in 1978, assisted reproductive technologies have advanced dramatically. The following are now well-established clinical standards:   Conventional IVF，Intracytoplasmic Sperm Injection (ICSI) ，Preimplantation Genetic Testing (PGT), Oocyte and Embryo Cryopreservation.  
While these innovations address many challenges, three emerging frontiers hold transformative potential for future IVF practices and live birth outcomes:  
1. Artificial Intelligence (AI) in IVF: Enhancing Diagnostic and Therapeutic Efficacy 
-Optimized Ovarian Stimulation: Machine learning algorithms tailor protocols using pharmacogenomic and follicular growth data.  
- Automated Embryo Selection: AI-powered time-lapse imaging systems achieve better accuracy in predicting viable blastocysts.  
- Live Birth Prediction Models: Multivariable algorithms improve cumulative live birth rate predictions.  
- Smart Laboratory Systems: Automated incubator monitoring and robotic ICSI reduce human error.  
2. Breakthroughs in PGT: Precision and Scope  
- Non-invasive PGT (niPGT): Blastocyst fluid/spent medium analysis matches traditional biopsy accuracy while eliminating embryo manipulation risks.  
- Single-cell Multi-omics: Integrates genomic, transcriptomic, and mitochondrial profiling to detect mosaicism (<5%) and polygenic risks.  
- Polygenic Disease Screening: Embryonic polygenic risk scores (ePRS) now cover more and more conditions, including cardiovascular and metabolic disorders.  
- CRISPR-based Editing: Preclinical correction of monogenic defects (e.g., β-thalassemia) 
3. Stem Cell Innovations in Reproductive Aging
- Ovarian Rejuvenation: MSC-derived exosomes restore ovarian reserve in POI patients (32% AMH increase in early trials).  
- Spermatogenesis Restoration: 3D bioprinted testicular niches regenerate functional sperm in azoospermic models.  
- Mitochondrial Replacement: Oocyte rejuvenation via mitochondrial transplantation improves embryo quality.  
While these advancements promise revolutionary progress, they necessitate rigorous ethical oversight and safeguards to prevent misuse of emerging technologies, for example standardization of AI decision-making transparency, regulatory frameworks for gene-edited embryos and long-term safety monitoring of stem cell therapies and so on. Under scientifically grounded ethical governance, these technologies are poised to redefine IVF success metrics, offering hope to millions facing complex infertility challenges.