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26 February 2010, Volume 14 Issue 9 Previous Issue    Next Issue

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Ultrastructural changes in distal femur cancellous bone in glucocorticoid-treated rats under scanning electron microscope Li Jie, Liu Ling-ping, Chen Hong, Huang Zhen 2010, 14 (9):  1521-1524.  doi: 10.3969/j.issn.1673-8225.2010.09.001 Abstract ( 297 )   PDF (591KB) ( 402 )   Save BACKGROUND: Bone ultrastructural destruction is an important cause for bone strength decrease, bone friability and bone fracture incidence increase in osteoporosis. OBJECTIVE: To observe the ultrastructural changes of distal femur cancellous bone in glucocorticoid (GC)-treated rats by scanning electron microscopy (SEM). METHODS: A total of 32 female Sprague-Dawley rats, aged 3.5 months old, were respectively treated with methylprednisolone 3.5 mg/kg per day by subcutaneous injection to induce osteoporosis and normal saline. At 4 and 9 weeks, the distal femurs were coronary sectioned and rinsed with distilled water, dehydrated in graded ethanol, coated with gold, and observed by SEM. RESULTS AND CONCLUSION: Compared to the control, the number of bone trabeculae in the GC group was significantly decreased, and the bone trabeculae became thin, fragile, discontinuous; network structures of bone trabeculae were destroyed, and bone resorption surface increased, with disorderly arranged collagenous fibers and increased micro-damage. Rats treated with GC for 4 weeks maintained better bone ultrastructure compared with rats treated with GC for 9 weeks. Results show that GC can induce bone mass lost, destroy network structures of bone trabeculae, accelerate bone resorption in rat cancellous bone, and accordingly lead to increased bone brittleness and decreased bone functional of biodynamics. Related Articles | Metrics

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Application of improved shape-based interpolation algorithm in substantia nigra slices of rhesus monkeys Zhu Liu-hong, Luo Shu-qian 2010, 14 (9):  1525-1530.  doi: 10.3969/j.issn.1673-8225.2010.09.002 Abstract ( 397 )   PDF (461KB) ( 442 )   Save BACKGROUND: Studies have shown that pathological change of substantia nigra (SN) is the main reason for Parkinson's disease (PD). From the medical imaging, spatial location, size and 3D morphology analysis of the tiny SN structure are very important to PD’s diagnosis and treatment evaluation. As the physiology of rhesus monkey is much similar to human’s, it has been used as an ideal experiment subject in many scientific researches. OBJECTIVE: To modify traditional shape-based interpolation method for SN structure of the rhesus monkey brain slices. METHODS: To gain the middle layers between two slices, traditional shape-based interpolation used linear weighted mean algorithm. However, considering the impact of adjacent multi-layer to the image, the middle layers were obtained by non-linear weight. RESULTS AND CONCLUSION: The new interpolation algorithm was assessed with a favorable results. Also, this method was applied to the 3D reconstruction of SN structure. The results show that the new interpolation method can be used in nucleus group interpolation with sparse slices and tiny structures, and offer reference to the related disease research. Related Articles | Metrics

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Three dimensional reconstruction of craniofacial vascularity based on the data of CT strengthening scanning Gu Fang, Cui Yi-qun, Zeng Bing, Shen Ruo-wu, Shao Gang 2010, 14 (9):  1531-1534.  doi: 10.3969/j.issn.1673-8225.2010.09.003 Abstract ( 473 )   PDF (423KB) ( 515 )   Save BACKGROUND: Using three dimensional (3D) reconstruction techniques, any part of body is accessible to visual observation. However, reports concerning 3D reconstruction of craniofacial vascularity based on PC are few in China. OBJECTIVE: To explore the method and the application values of reconstructing a digital 3D model of craniofacial vascularity based on the data of CT strengthening scanning.  METHODS: CT strengthening scan images from a healthy volunteer in DICOM format were imported into Mimics10.01 software and craniofacial blood vessels were reconstructed with the technique of thresholding, editing and 3D region growing. RESULTS AND CONCLUSION: The 3D digital model of craniofacial blood vessels was obtained. This model could be zoomed and rotated randomly and displayed the spatial positions and adjacent relationships of different anatomical structures, also the reconstructed structures could be measured in 3D space. The 3D digital model of craniofacial blood vessels can be reconstructed conveniently and quickly with Mimics software on PC, and also it can bring morphological reference to human anatomy teaching, clinical neurosurgery, oral and maxillofacial surgery, as well as image diagnosis, and will be helpful to generate a virtual plateform in craniofacial surgery Related Articles | Metrics

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Medical image segmentation based on multifractal theory Jin Chun-lan, Huang Hua, Liu Kuang-bin 2010, 14 (9):  1535-1538.  doi: 10.3969/j.issn.1673-8225.2010.09.004 Abstract ( 591 )   PDF (493KB) ( 494 )   Save BACKGROUND: As the complexity of human anatomic structure, the abnormity of tissue shape and the difference among individuals, the structure of multifractal is adapted. OBJECTIVE: To investigate medical image segmentation based on multifractal. METHODS: Image segmentation was performed by algorithm based on capacity measurement and probability measure. The experimental images were segmented using traditional region growing, max capacity measurement, sum capacity measurement, and probability measure. Following adding noise, the images were identically segmented and compared. RESULTS AND CONCLUSION: In the two algorithms based on multifractal, the key of the algorithm based on capacity measurement is that appropriate measure μα is defined, and the key of the algorithm based on probability measure is that appropriate normalized probability Pi is defined. The different measures (probability) and thresholds bring greater effect. The method based on probability measure is sensitive to noises, but after filtration noise, segmentation effect is greater for the images whose pixels vary comparatively great and very complicated. The results show that it is feasible that appropriate measure (probability) and threshold is chosen based on medical image segmentation. Especially greater advantage exists for the distinction of texture and edge in the complicated image processing, which can reserve details while precisely dividing. It has very significant practical significance. At the same time, multifractal can also be characteristics of images, which provide powerful data for feature extraction Related Articles | Metrics

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Measurement of bone density based on three-dimensional reconstruction and finite element analysis Zhang Guo-dong, Tao Sheng-xiang, Mao Wen-yu, Chen Jian-qiao, Luan Xia-gang, Zheng Xiao-hui, Liao Wei-jing 2010, 14 (9):  1539-1544.  doi: 10.3969/j.issn.1673-8225.2010.09.005 Abstract ( 333 )   PDF (417KB) ( 573 )   Save BACKGROUND: To decrease operation amount of finite element analysis and increase its clinical practice, previous studies explored the material properties and 10 kinds of material attributes were assigned, which met the requirements of finite element analysis. Moreover, it can be used to calculate bone density. OBJECTIVE: To explore a method for measurement of bone density based on three-dimensional reconstruction and finite element analysis. METHODS: A total of 11 specimens of femoral superior segment were selected. The mass of control group was firstly measured. The experimental groups were treated with thin-slice high resolution CT scan and three-dimensional reconstruction in Mimics 10.0, volume meshing in Ansys, assigned with 10, 100 and 400 kinds of material attributes Mimics, exported to Ansys to calculat the volumes of the block elements of every types of material attributes. The mass and the density of the specimens was harvested according to the empirical formula concerning the gray value and the bone density. All results were treated with one-way ANOVA. RESULTS AND CONCLUSION: One-way ANOVA showed that there were no significant differences between control group and experimental groups assigned with 10, 100 and 400 kinds of material attributes (P > 0.28), and there were no significantly among the experimental groups (P > 0.8). Results show that the method was able to measure the mass and the density of bone quantitatively, as well as the proportion between compact bone and cancellous bone; to assign 10 kinds of material attributes to three-dimensional model of femur could match the needs for measurements. The results can be used as an initial preparation for the unification of bone density and finite element analysis for osteoporosis. Related Articles | Metrics

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Establishment of a three-dimensional finite element model of osteoporotic femur Peng Li-hua, Chen Shi-rong, Tang Jin, Huang Liang-ku, Xiong Fei-long 2010, 14 (9):  1545-1548.  doi: 10.3969/j.issn.1673-8225.2010.09.006 Abstract ( 317 )   PDF (472KB) ( 532 )   Save BACKGROUND: Usual mechanics experiment approach cannot be applied directly to human body and the inter-comparability of models is low. Therefore finite element numerical simulation to mechanical behavior of human body has become an effective method for better understanding of the human body. OBJECTIVE: To establish a three-dimensional finite element model of femoral osteoporosis. METHODS: According to the average Chinese femur parameters, 1 male patient with severe osteoporosis, aged 86 years, with no hip joint diseases, was selected. The data of femoral osteoporosis was obtained by means of spiral CT scanning. The graphical data were processed by the Mimics11.1 (a graph processing software), and the outline curve data of femoral bone cortex inside and outside surface were obtained. The curve data were imported into the Unigraphic NX4.0 for solid modeling. The femur three-dimensional model composed of the cortical bone, cancellous bone and medullary canal was obtained. The model data were imported into the Ansys11.0 for operations such as assigning, meshing, and contact interactions to establish three-dimensional finite element model of osteoporotic femur. RESULTS AND CONCLUSION: Three-dimensional finite element model of femur of osteoporosis was successfully established, which provides a reliable method for the construction of finite element model of femoral osteoporosis, and creates conditions for investigating femoral osteoporosis fracture fixation method and joint replacement. Related Articles | Metrics

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Finite element analysis of the grafts used for acetabular revision in the presence of bone loss Ma Wen-hui, Zhang Xue-min, Wang Ji-fang, Shi Shu-shan 2010, 14 (9):  1549-1554.  doi: 10.3969/j.issn.1673-8225.2010.09.007 Abstract ( 232 )   PDF (394KB) ( 461 )   Save BACKGROUND: Alternative implants affect stability of prostheses, and freeze-dried bone allografts are most selected as implants. The crack between grafts and host bone is unavoidable, which would weaken the bone integration. Bone cement can fill the cracks quickly and completely, however, the effects of bone cement on the stress of prostheses and its own remains poorly understood.  OBJECTIVE: To evaluate the effect of the different grafting for bone loss in the presence of the new acetabular component with wings at the time of acetabular revision. METHODS: The finite-element models of acetabular component with three wings and acetabulum with bone loss were established. Following prostheses implantation, the gaps were filled with bone cement and freeze-dried bone allograft, respectively, stress of the graft and its effect on prostheses were analyzed under 2 158 N and 426 N acetabular loads. RESULTS AND CONCLUSION: The finite-element analysis demonstrated that stress and strain at the interfaces of bone-shell and metal-polyethylene liner had the same direction of change but no significant difference between them. In the study, the result indicated increased contact stresses with an increased hip force and orientation. The stress of wings increased gradually from rim to root. Its peak stress was at the joint between the wing and the shell. The different grafts did not affect the stress of the acetabular component. But the stress of bone cement was significantly higher than that of particulate bone. The study demonstrated that change of the graft could not make remarkable effect on the stress of the acetabular component. But the stress of bone cement increased significantly. The result of the finite-element analysis indicated that particulate bone graft is benefit to improving its stability and to minimize aseptic loosening rate of acetabular component. Related Articles | Metrics

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Parameters of inserting pedicle screws in the cervical vertebrae with CT three-dimensional technique Pang Xiao-ping, Yu Hai-long, Li Xiao-long, Wu Nan-zhou, Yang Li 2010, 14 (9):  1555-1558.  doi: 10.3969/j.issn.1673-8225.2010.09.008 Abstract ( 275 )   PDF (445KB) ( 426 )   Save BACKGROUND: The cervical pedicle screws mistakenly inverted the cervical pedicle could lead to the many complications such as spinal cord, vertebral arteries and nerve root damage. If the parameter of inserting pedicle screws were measured accuracy, the rate of inserting pedicle screws successfully could be improved. OBJECTIVE: To get 3D anatomic parameter of inserting pedicle screws in the cervical vertebrae with the CT three-dimensional recontruction.  METHODS: The Dicom data that the cervical vertebrae had been scanned by SIEMENS EMOTION 16 CT were converted into the soft Mimics 8.1, GE workstation and three-dimensional cervical vertebrae were reconstructed. The parameters of inserting cervical pedicle screws were measured with the consideration of the diameter of pedicle screw.  RESULTS AND CONCLUSION: The cervical three-dimension images were reconstructed clearly with the CT three-dimensional reconstruction techniques. The cervical pedicular width, the axial length, α and β angles were measured by the soft measure function. The average inserting angular safe range of α angle was gained with the consideration of the diameter of pedicle screw. This method can mimic the operation and it is significant way in measuring the three-dimension anatomic parameter of the cervical vertebrae. The method is a good way that how to insert the cervical pedicle screw safely. Related Articles | Metrics

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Three-dimensional finite element analysis of stress on connector of CAD/CAM fixed bridge Li Xiao-meng, Gao Ping, Wang Yong-xian, Li Jia 2010, 14 (9):  1559-1562.  doi: 10.3969/j.issn.1673-8225.2010.09.009 Abstract ( 336 )   PDF (426KB) ( 412 )   Save BACKGROUND: Artificial teeth computer aided design and computer aided manufacture (CAD/CAM) is a high technology involving various subjects. Many CAD/CAM systems have designed. However, they have some disavantages and a high cost. Therefore, only the system with proprietary intellectual property can solve this problem.  OBJECTIVE: To optimize the connector of the CAD/CAM fixed bridge. METHODS: Three-dimensional finite element models of the connector were established which was used to design different styles of connectors. Stress under different vertical loading conditions was compared. RESULTS AND CONCLUSION: The connectors with different appearances displayed varying stress. Stress on the connector with arc transition was less than connector without arc transition. Connector was supposed to design to style with arc transition. Related Articles | Metrics

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Fixed-point measurement of ANB angle, AXB angle, Beta angle and APDI value: To evaluate sagittal discrepancy between mandible and maxilla in transitional dentition cases with Angle’s class Ⅲ malocclusion Liu Hong, Mi Cong-bo, Ayiguli•Tuerdi, Pan Xu, Zhu Ting-ting, Chen Liang 2010, 14 (9):  1563-1566.  doi: 10.3969/j.issn.1673-8225.2010.09.010 Abstract ( 334 )   PDF (346KB) ( 870 )   Save BACKGROUND: It is very important to appreciate the Sagittal discrepancy during the diagnosis and therapy in orthodontics patients. At present, ANB angle, AXB angle, Beta angle and APDI value were often used to evaluate the mandible and maxilla relationships in orthodontic clinic. Correlation and variance degree among these parameters were analyzed to judge the reliability. OBJECTIVE: To compare the reliability of ANB angle, AXB angle, Beta angle and APDI value in assessing sagittal discrepancy between mandible and maxilla in transitional dentition cases with Angle’s class Ⅲ malocclusion. METHODS: Totally 56 patients of Angle’s class Ⅲ malocclusion in transitional dentition at the Department of Orthodontics, First Affiliated Hospital of Xinjiang Medical University, between January 2004 and June 2009, were selected. ANB angle, AXB angle, Beta angle and APDI value of Angle’s class Ⅲ malocclusion in transitional dentition were measured on the cephalometric radiographs. The radiographs were scanned by Microtek Phantom 9800 XL scanner at proportion of 1:1 with 300 dpi pixels, and saved as JPG format. The JPG pictures were fixed-point using Photoshop 8.0 to measure ANB angle, AXB angle, Beta angle and APDI value, the mean value was obtained after 3 times measurement. The correlation and variance degree among these parameters were analyzed. RESULTS AND CONCLUSION: Significant correlation was found among ANB angle, AXB angle, Beta angle and APDI value (P < 0.05). The coefficients of variation for the 4 indexes were 1.35, 0.75, 0.07 and 0.04, respectively. The results demonstrated that, it is accurate to use ANB angle, AXB angle, Beta angle and APDI value as cephalometric norm to evaluate sagittal discrepancy of maxmandibul in transitional dentition cases with Angle’s class Ⅲ malocclusion. However, the APDI value is more reliable as cephalometric norm. Related Articles | Metrics

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An experimental study on static and dynamic friction of XH1-type self-ligating bracket GaoYu-li, Hou Lu, Xu Shi-qian 2010, 14 (9):  1567-1571.  doi: 10.3969/j.issn.1673-8225.2010.09.011 Abstract ( 324 )   PDF (429KB) ( 374 )   Save BACKGROUND: XH1 type self-ligating bracket is a novel appliance of straight wire appliance. Currently, the majority of clinically applied self-ligating brackets are imported, which has low friction, short course of treatment, simple and efficient clinical practice. However, its cost is also very high. Therefore, we designed and developed the bracket. OBJECTIVE: Through the scanning electron microscopy (SEM) observation of XH1-type self-ligating bracket grooves, to perform the energy spectrum analysis of bracket, compare with the other bracket, and test the static and dynamic friction of this bracket. METHODS: A total of 4 kinds of upper right canine brackets, XH1-type self-ligating brackets, 2E1 brackets (Shanghai), TP Straight Wire Bracket (USA), and AO self-ligating bracket (USA) were used. Brackets and arch wire were combined, respectively and tested on the XF-1-type friction tester. The friction mv-ms change marked and saved by Fluke190-type oscilloscope was recorded. The compile software graphics Matlab2007 was used to smooth the graph to remove abnormal data. The maximum static friction and a corresponding voltage (mV) value dynamic friction were obtained, and converted into force values, followed by statistical analysis. RESULTS AND CONCLUSION: Different brackets had different static and dynamic frictions. The static and dynamic friction TP-type bracket was higher than XH1-type bracket's. There was no difference between 2E1 and TP bracket, AO and XH1 bracket. This XH1-type self-ligating brackets is a self-developed product, with small static and dynamic friction, simple sterilization, and low cost, which allow widely clinical application. Related Articles | Metrics

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Hard-soft tissue changes with the Twinblock appliance in Class Ⅱ malocclusion patients Cui Li-juan, Liu Ya-fei, Zuo Yan-ping, Lü Tong, Liu Xin, Liu Xue-cong, Chen Wen-jing 2010, 14 (9):  1572-1576.  doi: 10.3969/j.issn.1673-8225.2010.09.012 Abstract ( 337 )   PDF (428KB) ( 591 )   Save BACKGROUND: Twin block appliance has been shown to effectively promote mandibular bone growth of Class Ⅱ malocclusion patients and improve lateral appearance of mandibular retrusion. The other improvement of Twin block appliance on hard-soft tissues remains unclear. OBJECTIVE: To assess the hard-soft tissue changes following Twinblock appliance treatment. METHODS: A total of 48 adolescent patients, 30 males and 18 females, aged 11.6 years (range 9.58-12.37) with Class Ⅱ malocclusion were selected from Department of Orthodontics, Affiliated Stomatology Hospital of Hebei Medical University. Of them, 27 were treated with Twinblock appliance as the treatment group, and 21 adolescent patients without treatments were selected as the control group. Cephalonetric analysis was used to compare the changes before and after treatment. RESULTS AND CONCLUSLON: Comparative analysis showed that Twinblock could effectively adjust or improve the effect of the natural growth, reduced upper lip convexity and mentolabial furrow angle. Moreover, Twinblock inhibited facial vertical distance reduction and facial convexity increase to decrease the potential differences between maxillary and mandibular bones in sagittal plance. Results show that Twinblock could effectively improve the profile of soft-tissues of Class Ⅱ malocclusion cases. Related Articles | Metrics

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Evaluation of micro-implant transition mesially molar by implant anchorage Guo Jun, Fa Yong-hong, Cai Xing-wei, Huang Chang-cheng 2010, 14 (9):  1577-1580.  doi: 10.3969/j.issn.1673-8225.2010.09.013 Abstract ( 274 )   PDF (373KB) ( 419 )   Save BACKGROUND: It needs strong anchorage for shifting mandibular molar in orthodontics, which is a difficult problem to clinical orthodontic doctors. OBJECTIVE: To evaluate clinical effects and the characters by micro-implant anchorage during mandibular molars mesialization in Class I malocclusal patients. METHODS: A total of 24 micro-implants were embedded mandibular bones between mandibular second premolar and mandibular first premolar of 15 Angle I malocclusal patients as clinical anchorages for mesializing mandibular molars. The position changes of mandibular molars were measured from mesiodistal direction and vertical direction, and the implant anchorage loss was evaluated by maxillary central incisor. RESULTS AND CONCLUSION: The course of treatment was 10.4 months, and the velocity of mandibular second molar mesializing was 0.8 mm per month, with 8.5 mm in mesiodistal direction, there was no changes in the vertical direction. The distal tipping angle of molar was 2.5°, and the mandibular central incisor did not move. The method successfully mesialized mandibular molars to appropriate positions. No anchorage loss was found. The implant plays absolute anchorage during mandibular molar mesialization. Related Articles | Metrics

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Effects of pelvic orientation on the anteveration measurement of simulated acetabular cup Du Xue-jun, Liao Wei-ming, Fu Ming, He Ai-shan, Yang Zi-bo, Kang Yan, Wu Pei-hui, Zhang Hao, Zhang Zi-ji 2010, 14 (9):  1581-1585.  doi: 10.3969/j.issn.1673-8225.2010.09.014 Abstract ( 328 )   PDF (434KB) ( 481 )   Save BACKGROUND: Acetabular cup orientation using a standard radiograph of the pelvis is quite common method to assess artificial hip replacement nowadays. Non-standardization of pelvic orientation affected accuracy of measurement results, and it is difficult to compare. OBJECTIVE: To make sure how pelvis tilting affect the anteveration of the cup and to elevate clinical accuracy and compare study comparability. METHODS: Designed a simulated acetabular cup with serial concentric circles which pass through the same polars and represent anteveration of 0°, 10°, 20°, 30°, 40°. Loaded the simulated acetabular cup at an inclination of 35°, 40°, 45°, 50°, 55° to 6 cadaver pelves. Made the pelves tilt around the frontal axis and sagittal axis with 5° each time in a scope of ± 30°. Take standard radiograph of the pelvis accordingly. Radiograph was photographed and frontal angle of dip was measured. RESULTS AND CONCLUSION: Pelvic tilt of about 1° causes measuring errors of anteveration 0.61°-0.73°. The anteveration decreased at both acetabular cups when pelvic posterior tilt and at the acetabular cup that near the X-ray source as pelvic lateral tilt. The anteveration rose at both acetabular cups when pelvic anterior tilt and at the acetabular cup that away from the X-ray source as pelvic lateral tilt. During clinical evaluation, pelvic orientation effects on measurement results should be considered Related Articles | Metrics

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Effects of femoral isthmus on cementless total hip replacement Li Yi-zhong, Li Jian-long, Lin Jin-kuang, Yao Xue-dong 2010, 14 (9):  1586-1590.  doi: 10.3969/j.issn.1673-8225.2010.09.015 Abstract ( 329 )   PDF (407KB) ( 425 )   Save BACKGROUND: The template method used in cementless total hip arthroplasty is influenced by many factors, so the accuracy is poor. Studies demonstrated that femoral isthmus plays an important role in total hip arthroplasty, which affect femoral prosthesis. OBJECTIVE: To discuss the effects of femoral isthmus on cementless total hip arthroplasty. METHODS: The images of 4 cadaver femoral isthmus were obtained by computer tomography. The relations between femoral component and cortical bone contact were observed on coronal slices by sawing manully. The longest and the smallest medullary canal dimensions and the cortical thickness of femoral isthmus were measured by CT films from 50 patients (55 hips) prepared for primary total hip arthroplasty. The size of prosthesis was predicted based on the smallest medullary canal dimension of isthmus. And the conventional preoperative template was served as control. RESULTS AND CONCLUSION: There were a press fit and good contact between the femoral component and cortical bone of isthmus in 3 cadaver femoral bones. In 50 patients, the longest medullary canal dimensions of femoral isthmus were 8.2-22.4 mm (mean 14.2±3.1 mm). The smallest medullary canal dimensions of femoral isthmus were 6.1-17.9 mm [mean (10.2±2.9) mm], and the cortical thickness of femoral isthmus were 2.7-12.7 mm [mean (7.5±1.8) mm]. The results of CT-isthmus measurement method predicted sizes were excellence in the 50.9% cases. There was statistically significant difference of predicted sizes between the excellence rate of CT-isthmus measurement method and the rate of control (P < 0.05). Particularly, the excellence rate of CT-isthmus measurement method was 63.9% in the group aged below or equal to 65 years. When the ratio of the longest medullary canal dimensions and the smallest medullary canal dimensions of femoral isthmus was large than or equal to 1.4, the excellence rate of CT-isthmus measurement method was 70%. The press fit and good contact between the femoral component and femoral isthmus plays a very important role in stabilizing of femoral prosthesis in total hip arthroplasty. The predicted sizes of femoral prosthesis depending on the medullary canal dimensions of femoral isthmus measured by CT film has better accuracy than the conventional preoperative template. Related Articles | Metrics

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Technical points of an anterolateral minimally invasive total hip replacement Geng De-chun, Xu Yao-zeng, Huang Li-xin, Li Rong-qun, Zhou Feng, Yang Hui-lin 2010, 14 (9):  1591-1594.  doi: 10.3969/j.issn.1673-8225.2010.09.016 Abstract ( 314 )   PDF (378KB) ( 329 )   Save BACKGROUND: There are a variety of surgical approaches for minimally invasive total hip replacement, such as anterolateral, posterolateral and two-incision. However, it is unknown which one is more in line with the concept of minimally invasive and easy to carry out. OBJECTIVE: To observe the clinical application effect of total hip replacement using anterlateral modified Watson-Jones approach. METHODS: From January 2005 to December 2006, 35 patients were performed total hip replacement with the new anterlateral approach at the Department of Orthopaedics, the First Affiliated Hospital of Soochow University, including 16 males and 19 females, aged 52-78 years, mean aged 65.9 years; the average body mass index was 24.4 kg/m2 (19.3-30.1 kg/m2). The length of incision, operative duration, transfusion, complications, postoperative movement, postoperative hospital stay, prosthesis position and Harris score after operation were observed. RESULTS AND CONCLUSION: The patients were followed up 6-24 months, with an average of 17.3 months. The average length of incision was 8.3 cm (7-12 cm). The mean operative duration was 92.1 minutes (70-120 minutes). The average blood transfusion was 300 mL (0-800 mL). All the patients were practice their limb muscles immediately after the operation and they were activity the day after operation under the guidance of doctor. The average postoperative hospital stay was 7.9 days (5-15 days). Eleven hip pains occurred at 3 months, 9 cases at 6 months and 5 cases at 12 months, the Harris scores were (79.5±4.4) points, (84.0±3.6) points, and (85.4±3.0) points, respectively. No infection, dislocation, vessel or nerve injury happened. From the follow up, all of the patients had good prosthesis position and rang of hip motion. The results revealed that the new anterolateral approach is minimally invasive total hip replacement, and the patients can recover faster via some proper exercise. Related Articles | Metrics

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Shear mechanical properties of lumbar trabecular bone in aged people Lü Ya-ping, Li Yun-he, Liu Yi-fan, Ma Hong-shun 2010, 14 (9):  1595-1598.  doi: 10.3969/j.issn.1673-8225.2010.09.017 Abstract ( 275 )   PDF (355KB) ( 402 )   Save BACKGROUND: Shear mechanical properties of lumbar trabecular bone should be understood in treating osteoporosis, bone remodeling, bone reconstruction, as well as the choice of fracture fixed equipment. OBJECTIVE: To explore whether the shear mechanical properties of lumbar trabecular bone is different in young and aged normal fresh cadavers. METHODS: Experimental samples were from 4 normal fresh corpse, aged 22, 28, 70 and 75 years, were provided by Department of Anatomy, Norman Bethune Medical University. Spinal column thoracic vertebra L2-L5 specimen were obtained from corpse within 1 hour and cut into 40 mm×5 mm×5 mm pieces. The specimen were tested on electronic universal testing machine with speed of 5 mm/min, the shear load, stress, strain and other data would be printed automatically, and the morphology of fracture surface was observed. RESULTS AND CONCLUSION: Majority of the fracture surfaces were comminuted, minority were transverse or oblique fracture. The macroscopic observation showed that trabecular arranged compact in the thoracic vertebra cancellous bone of the youth group, which was sparse arrangement and presented with senile osteoporosis in the aged group. The shear force, shear stress and strain of the youth group was greater than that of the aged group [(37.19±3.25), (28.34±3.42) N; (1.49±0.13), (1.13±0.14) MPa; (1.40±0.50)%, (0.90±0.20)%, P < 0.05]. It demonstrated that the impact mechanics properties of thoracic vertebra cancellous bone are different between the youth and aged groups. Related Articles | Metrics

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Impact mechanics properties of T3-12 thoracic vertebra cancellous bone: Comparison between the youth and elderly people Zang Hu, Zhang Qiao, Ma Hong-shun 2010, 14 (9):  1599-1602.  doi: 10.3969/j.issn.1673-8225.2010.09.018 Abstract ( 301 )   PDF (353KB) ( 391 )   Save BACKGROUND: Impact mechanics properties of thoracic vertebra cancellous bone should be understood in treating osteoporosis, bone remodeling, bone reconstruction, as well as fixator selection for thoracic vertebral fracture. Most of previous studies concerning youth and the elderly bodies alone, reports regarding impact of thoracic vertebra cancellous bone mechanical properties are few. OBJECTIVE: To perform impact experiment to the normal people youth and the elderly fresh corpse thoracic vertebra cancellous bone to survey the impact mechanical properties, and to definite whether the impact mechanical properties of thoracic vertebra trabecular bone have difference between youth and the elderly people. METHODS: Experimental samples were from 4 normal fresh corpse, aged 20, 25, 70 and 75 years, were provided by Department of Anatomy, Norman Bethune Medical University. Spinal column thoracic vertebra T3-12 specimen were obtained from corpse within 1 hours and cut into 40 mm×6 mm×6 mm pieces, with 20 test pieces in each group. The impact experiment was performed using energy liberation method at room temperature under 28 ℃. After experiment, the impact energy was displayed automatic on testing machine, and the impact toughness was calculated by mechanical formula, and the morphology of fracture surface was observed. RESULTS AND CONCLUSION: The impact energy and impact toughness of the youth group was obviously greater than that of the elderly group (P < 0.05). Majority of the fracture surfaces were comminuted, minority were transverse or oblique fracture. The macroscopic observation showed that trabecular arranged compact in the thoracic vertebra cancellous bone of the youth group, which was sparse arrangement and presented with senile osteoporosis in the elderly group. It demonstrated that the impact mechanics properties of thoracic vertebra cancellous bone are different between the youth and elderly groups, and osteoporosis changes impact mechanics properties in the elderly people. Related Articles | Metrics

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Intensity-time curve for diagnosis and prognostic evaluation of lumbar disc herniation Bai Ling, Zhang An-ren, Sun Yan, Wang Wen-chun, Pang Ri-zhao, Guo Xiao-yan, Zhao Juan-ni, Sheng Jie-ting 2010, 14 (9):  1603-1606.  doi: 10.3969/j.issn.1673-8225.2010.09.019 Abstract ( 397 )   PDF (295KB) ( 378 )   Save BACKGROUND: Intensity-time (I/T) curve examination is a monitoring technology used for diagnosis of nerve damage, muscle disease and prognostic evaluation using current stimulation and qualitative or quantitative analysis. It also has significance to the diagnosis of lumbar disc herniation (LDH). Whether it can be used in LDH prognostic evaluation is poorly understood. OBJECTIVE: To explore the effectiveness of I/T curve in diagnosis and prognostic evaluation of LDH.  METHODS: I/T curves of 113 LDH patients were measured by CX-3 electrodiagnostic equipment, and the results were compared with their unaffected sides and analyzed after physiotherapy. A total of 253 curves were measured, including 107 biceps femoris, 101 gastrocnemius and 45 tibialis anterior muscle curves. All patients were sequential treated by traction, medium frequency, ultrashort wave, electric acupuncture as well as infrared radiation following I/T diagnosis, once a day, 10 days for a course, with 10 days interval in 3 courses. I/T curves were performed after 3 courses. The therapeutic effect was evaluated by using I/T results combined with clinical symptom and physical signs. RESULTS AND CONCLUSION: The first estimated percentage by I/T curved line were 36.36% (controlled by normal nerve), 62.85% (controlled by part of the denervated), 0.79% (controlled by the completely denervated) and 63.64% (controlled by total abnormal nerve). After the physiotherapy, the effectiveness of the complete recovery was 92.86% by the normal nerve as well as 58.82% by the abnormal nerve. Above all, the practical value could be concluded from the diagnosis, evaluation and effectiveness of LDH used by I/T curve line. The therapeutic effectiveness controlled by the normal nerve is much better than that controlled by the abnormal. Related Articles | Metrics

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Correlation between type Ⅰ collagen gene polymorphism and spinal fusion rate following autologous bone transplantation Hu Ming-tao, Chen Xiao-liang, Zhou Chuan-li, Wang De-chun, Liu Tao 2010, 14 (9):  1607-1611.  doi: 10.3969/j.issn.1673-8225.2010.09.020 Abstract ( 288 )   PDF (403KB) ( 413 )   Save BACKGROUND: Basic research demonstrated that type I collagen exhibited prominent effect on osteogenesis, bone mass and bone fracture, which also participated in the bone fusion. However, few reports concerning the polymorphism of type I collagen gene and spinal fusion. OBJECTIVE: To investigate the polymorphism of type I collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation. METHODS: A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected, including 102 cases received anterior cervical subcorpectomy combined with iliac bone implantation fusion following decompression, and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion. Meantime, 223 normal adults were served as the control group. The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells. The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR), with length of 293 bp. The genotypes of Pcol2 site in type I collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method. The PCR product was digested with restriction endonuclease Eco31I and the result was observed by agarose gel electrophoresis. The G gene represented for the presence of the restriction endonuclease site, while the T gene for the absence of the restriction endonuclease site. The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3, 6 and 12 after operation, and the results were compared by stages including quick (<3 months), middle (3-6 months) and slow (6-12 months). RESULT AND CONCLUSION: There were the -1997G/T polymorphisms of the type I collagen gene in 423 cases, including 166 cases with GG, 232 cases with GT, and 25 cases with TT, in addition, there was some correlation between the GG genotype and the iliac bone implantation fusion (P =0.004). The GG genotype accounted for 50% in the fast group, which was obviously greater than that of the middle and slow groups (33.3% and 16.7%, respectively). However, the -1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831). The GG genotype in the -1997G/T polymophsim of the type I collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion Related Articles | Metrics

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Treatment of type Rockwood Ⅲ acromioclavicular joint dislocation with clavicular hook plate implantation in 56 cases Wang Guang-yong, Zhang Jian-hua, Dun Xian-li, Li You-fang, Zhou Ting-yu, Zhong Bin 2010, 14 (9):  1612-1616.  doi: 10.3969/j.issn.1673-8225.2010.09.021 Abstract ( 264 )   PDF (468KB) ( 415 )   Save BACKGROUND: Which an ideal method to treat type Rockwood Ⅲ acromioclavicular joint dislocation is, traditional or surgical therapy, is still controversial. OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on type Rockwood Ⅲ acromioclavicular joint dislocation. METHODS: A total of 56 patients with type Rockwood Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008. There were 42 males and 14 females, aged 16-65 years and mean age of 32 years. All patients were treated with clavicular hook plate implantation. Indicators including visual analogue scale (VAS), the United States shoulder and elbow surgeon score (ASES), and Constant and Murley scoring system were tested pre-operatively, one year postoperatively, before internal fixation, and 3 months after internal fixation; additionally, functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation. RESULTS AND CONCLUSION: The surgery and following-up were successfully achieved in 56 cases. The following-up lasted for 15-30 months, with the mean time of 20 months. The internal fixation was taken out at about 1 year after implantation. Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases. Two patients with acromioclavicular joint dislocation recurrence were excluded, and coracoclavicular ligament therapy was not performed. Shoulder pain, foreign body sensation, and internal fixation failure occurred in two cases. One year after operation, VAS was decreased compared with that before operation, but ASES and Constant and Murley score were significantly increased (P < 0.01). At three months after internal fixation, VAS was decreased compared with that at 1 year after operation, but ASES and Constant and Murley score were increased (P < 0.05). The results demonstrated that clavicular hook plate implantation for treating type Rockwood Ⅲ acromioclavicular joint dislocation is simple and less invasive, thus it is an ideal internal fixation. Related Articles | Metrics

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Bone grafting related complications in 92 patients undergoing different kinds of anterior cervical surgeries: Entire autogenous bone versus Pyramesh bone graft Ye Yong-ping, Chen Dan, Fu Chen-xue, Yin Cheng-hui, Xu Hao 2010, 14 (9):  1617-1620.  doi: 10.3969/j.issn.1673-8225.2010.09.022 Abstract ( 265 )   PDF (318KB) ( 479 )   Save BACKGROUND: Anterior cervical plate can maximize the intervertebral space height, expand intervertebral foramen, restore cervical physiological antecurvature, prevent instability due to implant micromovement, and increase graft fusion. However, the selection of entire autologous bone or Ti-mesh bone graft remains uncertain in application of anterior cervical plate.  OBJECTIVE: To compare the complications of three different intervertebral fusion methods in anterior cervical decompression surgery. METHODS: A total of 92 cases of cervical spondylotic myelopathy were treated by anterior cervical decompression and three different intervertebral fusion methods. They were followed up for at least 3 months. Of them, 6 underwent bone grafting alone, 21 underwent autogenous bone graft with cervical plate-screw fixation, and 65 underwent pyramesh with anterior cervical plate-screw fixation. Complications were observed in all cases. RESULTS AND CONCLUSLON: A total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation, 1 suffered from pseudoarthrosis formation, and 1 suffered from donated ilium. Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height, and 3 suffered from pain of donated ilium. Eleven of 65 pyramesh with anterior cervical plate-screw fixation suffered from titanium mesh subsidence, 1 case suffered from breakage of fixation screw. Simple autogenous bone grafting surgery was rarely used due to long duration of external fixation and too much complications. Autogenous bone grafting with anterior cervical plate-screw fixation surgery has shortage of grafted bone absorption and pain of donated ilium. Pyramesh with anterior cervical plate-screw fixation surgery overcomes the shortage of donated iliac pain, but remains the shortage of titanium mesh subsidence and lose of intervertebral height Related Articles | Metrics

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Injured lateral ligaments in 17 cases: Reconstruction of the ankle with allogeneic tendon and anchors Wang Pei, Yan Hong-wei, Li Zhe, Yang Dong-rui, Li Zhi-huai 2010, 14 (9):  1621-1624.  doi: 10.3969/j.issn.1673-8225.2010.09.023 Abstract ( 338 )   PDF (361KB) ( 468 )   Save BACKGROUND: Obsolete lateral ankle ligament injury is frequently treated by Chrisman-Snook operation. However, this operation destructs some peroneus brevis tendon, and affects the function of peroneus brevis tendon for foot valgus. OBJECTIVE: Based on previous research, to investigate the effect of allogeneic tendon for reconstruction of ankle lateral ligaments. METHODS: A total of 17 cases of ankle lateral ligament injured were selected, with a course of disease from 3 to 6 months. All lateral ligaments were reconstructed by allogeneic tendon & anchors. During the operation, a drill, 4.5 mm diameter, was used to drill a hole on the lateral ankle; one anchor was drilled into the talus at the end of anterior talofibular ligament, another one was threaded on the calcaneus; the allogeneic tendon was permeated through the hole on the lateral ankle, maintaining ankle neutral and moderate valgus position. The allogeneic tendon was sutured with the thread of the anchors. Following operation, the ankle was fixed in neutral position and slightly valgus position; wound healing, AOFAS score and stress radiograph were observed. RESULTS AND CONCLUSION: All 17 patients showed no rejection, and the wound healing well at the primary stage. At 6, 12, 24 after operation, all patients were followed-up. According to AOFAS criteria, function of ankle in all patients was significantly improved. No patients complained of instability of the ankle, and stress radiograph confirmed this improvement. Reconstruction of lateral ligaments of the ankle with allogeneic tendon and anchors is a practical treatment, which restores stability and function of ankle without long incision or damaging normal tendons. Related Articles | Metrics

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Extracorporeal shock wave therapy for nonunion or delayed osseous union: Animal experiment and clinical follow-up Xing Xing, Feng Pei 2010, 14 (9):  1625-1628.  doi: 10.3969/j.issn.1673-8225.2010.09.024 Abstract ( 304 )   PDF (520KB) ( 728 )   Save BACKGROUND: Extracorporeal shock wave (ESW) therapy is using principles of liquid-electric conversion and transfer to produce energy gradient difference and torsional tension in tissues with varied density. It is a matured technique in treating urinary and digestive system calculosis. However, the applications of ESW in treating nonunion or delayed osseous union are few.      OBJECTIVE: To explore the therapeutic effects of ESW in treating nonunion or delayed osseous union by animal experiment and clinical verification. METHODS: The effect of ESW on periosteal metabolism was explored by focusing extracorporeal wave on bone tissues, and the autoradiography of H3-TdR labeling rate was observed by animal experiment. ESW was used to treat nonunion patients (n=16) or delayed osseous union patients (n=16), and the follow-up results were evaluated.   RESULTS AND CONCLUSION: By autoradiography, the H3-TdR labeling rate was greater in the experimental sides than that of the control sides at 1 and 2 weeks after operation (P < 0.05-0.01), which confirmed that the mitotic activity of periosteal osteoblasts was increased, namely, endosteal osteogenesis was enhanced. Clinical verification results demonstrated that, at 16 weeks after operation, 16 patients with delayed union were all cured, 13 were cured among the 16 cases of nonunion, and the remained 3 cases had notably callus formation. No adverse events occurred in all cases. The results suggested that it is reliable to treat nonunion or delayed osseous union using ESW therapy. Related Articles | Metrics

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Simulation of extracellular electrical stimulation of rat optic nerve fiber based on experimental data Gao Jie, Qiao Qing-li, Xie Nan 2010, 14 (9):  1629-1633.  doi: 10.3969/j.issn.1673-8225.2010.09.025 Abstract ( 363 )   PDF (520KB) ( 432 )   Save BACKGROUND: Currently, there are three types of visual prosthesis: retinal prosthesis, optic nerve prosthesis and visual cortical prosthesis. Normal optic nerve fiber is the basis to apply visual prosthesis. Extracellular stimulation of myelinated optic nerve fiber is developed from intracellular stimulation, with feasible selection of stimulation locations and low requirements for operation. OBJECTIVE：Using computer to simulate the response of myelinated rat optic nerve fiber to extracellular point current source and to analyze the effect of the position of the point source on the response of the optic nerve fiber. METHODS: The experiment data of ion channels of rat optic nerve fiber and the characteristic of common ion channels were summarized, and the existing Hodgkin-Huxley like optic nerve fiber models were analyzed. The response of the optic nerve fiber model was simulated by computer, and the differences of action potentials of Ranvier node were compared by changing the position of point source. RESULTS AND CONCLUSION：Simulated models showed that the response of optic nerve is affected by the position of extracellular exciting electrode. The myelinated rat optic nerve fiber is easier to activate when the distance between point source and the Ranvier node center of the optic nerve fiber is short. Related Articles | Metrics

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Application of wavelet transform in quatum dot barcodes identification Yang Jiu-min, Gong Xiao-qun, Zhang Qi, Song Tao, Liu Tie-gen, Li Ying-xin, Chang Jin 2010, 14 (9):  1634-1637.  doi: 10.3969/j.issn.1673-8225.2010.09.026 Abstract ( 324 )   PDF (379KB) ( 402 )   Save BACKGROUND: To obtain more quantum dot (QD) barcodes, the overlay peaks of fluorescence occur, leading to difficulties in identifying QD barcodes.  OBJECTIVE: To identify QD barcodes of two adjacent wave length using wavelet transform technique. METHODS: Through the microscopy, the spectrum of fluorescence induced by 375 nm light was captured by spectroscopy. The spectral signal was split into multi-scale components by wavelet transform. After transformed by spline function, every component constructed a new spectrum with peaks expanded by inverse wavelet transform. RESULTS AND CONCLUSION: Interpolation operation was performed on original data to control the data length to 2n. Following wavelet transform, peak location remained unchanged, so the eigenvalue of spectrum of coding fluorescence was extracted. The spectrum of fluorescence mixed with microspheres was split, and two QD barcodes were identified. The improved barcodes identification of adjacent spectrum increase color of QD barcodes, thereby enhancing code information volume. Results show that following spectrum was processed by wavelet transform, overlay peaks of fluorescence has be expanded, and enhanced the efficiency of recognition, which lays a foundation for detecting tumor markers. Related Articles | Metrics

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Tongue-image segmentation based on gray projection and threshold-adaptive method Zhang Ling, Qin Jian 2010, 14 (9):  1638-1641.  doi: 10.3969/j.issn.1673-8225.2010.09.027 Abstract ( 423 )   PDF (437KB) ( 650 )   Save BACKGROUND: Traditional Chinese medicine glossoscopy observes tongue image by vision, and to diagnose diseases by physicians’ clinical experiences, which lacks of objective diagnostic methods and criteria, finally resulting in affecting the effectiveness of this diagnostic method. Therefore, it is necessary to realize quantitive and objective glossoscopy using techniques such as computer vision. Tongue body segmentation is the premise of the tongue image recognition diagnostic system. The quality of segmentation directly affects the sequent work. At present, there are many methods of tongue body segmentation, but obtained results cannot ensure the accuracy, and the anti-interference ability is poor. OBJECTIVE: To design a new method of tongue image segmentation, and effectively isolate tongue body. METHODS: According to tongue-images gray and color’s features, a segmentation method of combining gray projection and threshold-adaptive way is presented in this paper. By this method, the intensity image of a colorful tongue-image is firstly projected at horizontal and vertical direction to locate the tongue-body area, and then threshold-adaptive way Otsu is used to segment the located area. RESULTS AND CONCLUSION: Tongue-body segmentation is the basis of automatic tongue-images analysis. The following 281 tongue-images segmentation experiments show the efficiency of this method Related Articles | Metrics

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Feature extraction of electroencephalogram based on data reduction Mu Zhen-dong, Xiao Dan 2010, 14 (9):  1642-1645.  doi: 10.3969/j.issn.1673-8225.2010.09.028 Abstract ( 403 )   PDF (341KB) ( 437 )   Save BACKGROUND: Reaction velocity for brain imagination is a major criterion in measuring quality of brain computer interface (BCI) system. Therefore, electroencephalogram (EGG) analysis, especially the feature extraction screening, is very important. Reduction the number of features is an important way to improve the speed. OBJECTIVE: To screen EGG features using reduction algorithm, and to decrease the number of EGG features.  METHODS: Firstly, by various analytical methods, the EGG features were extracted and classified; then, discreting the continuous EGG to establish an EGG information table; At last, reduction theory was used to reduce EGG features, and to sort the data according to reduced attributes, the accuracy of sorting was validated. RESULTS AND CONCLUSION: Using reduction algorithm and feature marking, discreting the continuous EGG to establish an EGG information table, and then choose the features from the discrete data. The results show that classification accuracy has not been reduced but the number of features was reduced. However, this method can be used marking features in two sorts, how to marking features of multi-sorts and to perform data reduction is a key point in further study. Related Articles | Metrics

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Poincare mapping method for T-wave alternans using a nonlinear dynamic system Xu Fang-zhou, Zhao Jie, Wang Ji-kui1, Li Qun, Tian Jie, Tang Wen-tao 2010, 14 (9):  1645-1648.  doi: 10.3969/j.issn.1673-8225.2010.09.029 Abstract ( 392 )   PDF (706KB) ( 562 )   Save BACKGROUND: The microvolt T-wave alternans (MTWA) is an important index for ventricular arrhythmias prediction and is a promising tool to evaluate non-invasively malignant ventricular arrhythmia and risk of sudden death. OBJECTIVE: To introduce a algorithm for detecting TWA using Poincare mapping method (PM), which is a technique for dynamics systems to display periodic behavior. METHODS: Samples series of beat to beat cycles were selected to prepare Poincare mapping to describe TWA distribution.  , which denoted the sum distances between the origin to even and odd series, was used to present the presence and absence of TWA. RESULTS AND CONCLUSION: This algorithm was applied in MIT/BIH Arrhythmia database and European ECG ST-T database, and  was used for correlation analysis with , which denoted TWA amplitude of Spectrum Method. The cross-correlation coefficient was . The algorithm can identify the absence and presence of TWA accurately and provide idea for further study of TWA-PM. Related Articles | Metrics

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Expression of serum endothelial nitric oxide synthase in pigs following acute myocardial infarction: Influencing ways of extracorporeal cardiac shock wave therapy Sun Shuai, Guo Tao 2010, 14 (9):  1649-1652.  doi: 10.3969/j.issn.1673-8225.2010.09.030 Abstract ( 308 )   PDF (363KB) ( 452 )   Save BACKGROUND: Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors, promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium, however, the specific mechanisms remain unclearly. OBJECTIVE: To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI). METHODS: Pig AMI model was established by embolizing the distal of left anterior coronary artery. Following model preparation, pigs were randomly divided into 2 groups. In the experimental group received three CSWT at days 1, 3 and 5, 200 hits per point, totally 12 points, with 0.09 mJ/mm2 energy. Pigs with simple AMI were served as the control group. The serum eNOS level was detected by ELISA method before, immediate postoperative, and at days, 1, 3, 5, and weeks 1, 2, 3, and 4 after operation.  RESULTS AND CONCLUSION: The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation. At day 1 after CSWT, eNOS level was increased in the experimental group, which was still decreased in the control group. It revealed that CSWT play a positive effect on ischemia myocardium. The eNOS level reached a peak in the experimental group after 3 times of CSWT, lasted for 2-3 weeks, and began to decrease at week 4. The difference between the experimental group and control group had significance (P < 0.01). The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.  Related Articles | Metrics

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Noninvasive gastric motility measurement and evaluation by bioimpedance Ren Chao-shi, Li Zhang-yong, Wang Wei, Zhao Shu, Deng Juan 2010, 14 (9):  1653-1657.  doi: 10.3969/j.issn.1673-8225.2010.09.031 Abstract ( 285 )   PDF (596KB) ( 451 )   Save BACKGROUND: Bioimpedance method can be used to extract physiology and pathology information relative to the gastric motility states, to investigate the courses of contraction, peristalsis, transmission and emptying of the stomach, to measure and evaluate gastric motility function. However, early studies mainly focused on the emptying of the stomach, and few studies on evaluation of gastric motility by extracting gastric motility information. OBJECTIVE: To understand the gastric motility from electricity-mechanism composite concept and to establish a noninvasive, convenience measurement method of gastric motility impedance. METHODS: Based on the characters of gastric motility impedance signal, a measurement method of impedance gastric motility is introduced. Some foundation experiments about the gastric emptying measurement, the gastric motility compare between fasting and repast, the gastric motility comparison of healthy volunteers during different periods and some medicine effects on gastric motility have carried out. The gastric motility measurement of the patients with functional dyspepsia and gastric motility evaluation for the patients with erosive gastritis had been reported. RESULTS AND CONCLUSION: Using electrical bioimpedance method, according to the electrical property of the stomach tissue or the food in stomach and the change rules of the property, the physiology and pathology information relative to the gastric motility states can be extracted, the courses of contraction, peristalsis, transmission and emptying of the stomach can be investigated and noninvasive measure and evaluation of gastric motility function can be realized. Related Articles | Metrics

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Metal implants for treatment of unstable pelvic fracture Lin Zhi-jin, Cao Lie-hu, Shen Feng, Huang Jian-ming, Kang Yi-fan 2010, 14 (9):  1655-1658.  doi: 10.3969/j.issn.1673-8225.2010.09.034 Abstract ( 337 )   PDF (440KB) ( 627 )   Save BACKGROUND: It is controversial to treat sacroiliac joint fracture. Some scholars advocated expectant treatment, and some others advocated surgery therapy. Pelvic stability was responsible for the scheme selection. Sacroiliac joint fracture-dislocation destroys pelvic stability, which easily induces instability and bone nonunion, resulting in sacroiliac joint pain, unequal size of lower limbs, sitting pain and dysfunction. Thus, prognosis of mental implant is significantly better than expectant treatment in treatment of unstable pelvic fracture. OBJECTIVE: To summarize the treatment of unstable pelvic fractures and their clinical application using various internal and external fixation of metal implants. METHODS: The computer-based research was done in Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) for articles published from January 1991 to December 2009 with the key words of “Pelvic fractures, instability, surgical treatment” by the first author. A total of 115 articles were retrieved, and those concerning characteristics and clinical application of implants in the treatment of unstable pelvic fracture. Articles addressing old and repetitive contents were excluded. Literatures of the same fields published in recent years or in authorized journals were selected. Finally, 30 articles were included. RESULTS AND CONCLUSION: Sacroiliac joint fracture-dislocation is a severe, high-energy trauma, has been paid great attention in the therapy, particularly in unstable sacroiliac joint fracture-dislocation. A stable type of fracture and dislocation of the sacroiliac joint received a conservative treatment of unstable sacroiliac joint fracture-dislocation appropriate line of external fixation, internal fixation for reconstruction of pelvic stability and internal fixation treatment varied, but the therapeutic effect of internal fixation needs to be improved. What are bio-mechanical characteristics of various internal fixation methods, and how the timing of weight-bearing activities following various internal fixations require further basic and clinical studies. An unstable sacroiliac joint fracture-dislocation fixation has many ways, including the anterior and posterior fixed-fixed. Minimally invasive therapy such as posterior CT guided sacroiliac joint lag screw is the developmental trend. Related Articles | Metrics

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Clinical contents of artificial knee prosthetic replacement: Application and problems Zhang Wen-qing, Wan Chun-ying, Yu Tun-de 2010, 14 (9):  1661-1664.  doi: 10.3969/j.issn.1673-8225.2010.09.033 Abstract ( 318 )   PDF (483KB) ( 380 )   Save BACKGROUND: Knee osteoarthritis and rheumatoid arthritis are common arthritis in the knee. In late stage of arthritis, severe deformation and activity obstacle are found, which require total knee replacement. The total knee replacement not only can significantly relieve symptom, but also correct deformation and improve joint function. OBJECTIVE: To summarize classification of knee joint, techniques of knee replacement surgery and complications following replacement. METHODS: We retrieved Vip Database (http://www.cqvip.com) for titles and abstracts with the key words of “knee replacement, prosthesis, complication”. Articles concerning clinical application of knee prosthesis were included. Articles in the same field that published recently or in authorized journals were included. A total of 20 literatures were included for review according to inclusion criteria. RESULTS AND CONCLUSION: Various artificial total knee prostheses were used in different patients in accordance with patients’ condition, joint limitation degree, fixation method and meniscus function. Indication of different knee prostheses depends on bone and soft tissue of the knee, and quality and status of knee ligament, joint deformation and destruction degree of articular cartilage are responsible for the choice of prosthesis. Thrombosis of deep veins of the lower limb, pulmonary embolism, infection surrounding the prosthesis and prosthesis loose are common complications in joint replacement. Related Articles | Metrics

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Reasons for restenosis and treatment progress of biliary metal stent implantation Tan Zhi-gang, Guo Yi-tong 2010, 14 (9):  1669-1672.  doi: 10.3969/j.issn.1673-8225.2010.09.035 Abstract ( 319 )   PDF (458KB) ( 695 )   Save BACKGROUND: Biliary stent restenosis is one of the main long-term complications following biliary stent restenosis implantation, which affects its application.  OBJECTIVE: To evaluate the reasons for the biliary stent restenosis and to explore corresponding prevention methods.  METHODS: A computer-based online search of MEDLINE, Cochrane library, CNKI and VIP between January 1989 and August 2009 was performed to search related articles with the key words of “biliary metal stent, reobstruction, and interventional therapy”. Literatures related to biliary stent restenosis were selected, in the same field, the articles published lately or published by authoritative journals were preferred. A total of 171 articles were searched and 22 documents were included according to inclusion and exclusion criteria.  RESULTS AND CONCLUSION: Tumor growth, gallstone formation and inflammatory hyperplasia are the main reasons for restenosis following biliary metal stent implantation. The interventional therapy is an effective way for the patients of stent restenosis. Simultaneously, the therapeutic efficacy and living quality of patients can be improved by noticing preoperative conditions, in-time detecting and controlling biliary infection, reducing complications as well as strengthening postoperative combined therapy. Related Articles | Metrics

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Shear resistance, stability and plasticity of reconstructed plate implantation in treating acetabular fractures complicated by free bone blocks Tang Guo-liang, Chen Tao, Chen Shun-bao, Han Li-feng, Huang Xie-zan 2010, 14 (9):  1673-1676.  doi: 10.3969/j.issn.1673-8225.2010.09.036 Abstract ( 271 )   PDF (496KB) ( 390 )   Save OBJECTIVE: To explore the anti-shear force, stability and plasticity of reconstruction plate implantation, and to investigate its role in treating acetabular fractures complicated by free bone graft in the joint. METHODS: A computer-based online search of Science Direct and Ei databases (1960-01/2009-10) was performed for related English articles with the keywords of “acetabular fractures, modified ilioinguinal approach, reconstruction plate”. In addition, CNKI and CBM database (1994-01/2009-10) were searched for related Chinese articles with the same key words in Chinese. Moreover, related works were manually searched. Studies regarding reconstruction plate implantation in treating acetabular fractures were included, including basic and clinical experiments. RESULTS: Acetabular top is weight loading region of human body, and the fracture should be reducted by the operation. Prior to reconstruction plate for acetabular fracture fixation, bone hook, and Kirschner wire can be used for temporary fixation, and the plate bending angle should be adjusted to accordant with lateral posterior wall or medial anterior wall of the acetabular top, followed by screw threading for fracture fixation. In addition, the screw entrance angle is very important. If the fixation of one plate is not satisfactory, one or two cancellous bone screw or Kirschner wire can be used to enhance the fixation. But the Kirschner wire tail should be bended to prevent dislocation into the pelvic cavity. Moreover, additional plate can be used for further fixation. Reconstruction plate fixation has advantages of anti-shear force, high stability and plasticity, which fully adapt the special appearance of acetabulum. Moreover, the incidence of postoperative plate loosening and breakage is low, and the satisfaction is high. Free bone blocks can be temporarily fixed by Kirschner wire, followed by reconstruction plate fixation. CONCLUSION: Reconstruction plate fixation has good clinical effect and few complications in treating acetabular fractures complicated by free bone blocks in the joint. Related Articles | Metrics

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Occurrence factor and preventive strategy for deep venous thrombosis following artificial hip replacement Ma Li, Wang Xin, Jiang Li-hua 2010, 14 (9):  1677-1680.  doi: 10.3969/j.issn.1673-8225.2010.09.037 Abstract ( 273 )   PDF (443KB) ( 575 )   Save OBJECTIVE: A series of studies has been reported concerning deep venous thrombosis following artificial hip replacement. This paper is aimed to summarize the occurrence factor and preventive measures for deep venous thrombosis following artificial hip replacement. METHODS: A computer-based online search of VIP database was undertaken by the first author to identify the articles about the deep venous thrombosis following artificial hip replacement published in between January 1994 and October 2009 with the key words of “artificial hip replacement and deep venous thrombosis”. Inclusive criteria: ①Occurrence factor of deep venous thrombosis following artificial hip replacement. ②Diagnostic criteria and diagnostic methods of deep venous thrombosis following artificial hip replacement. ③Preventive strategy for deep venous thrombosis following artificial hip replacement. Inclusive criteria: repetitive research or obsolete documents. Totally 25 literatures were included in this paper. RESULTS: The agreement has been basically achieved for pathogenesis and risk factor of deep venous thrombosis following artificial hip replacement. The pathogenesis included blood hypercoagulable state, slow blood flow (or stasis), and vessel wall damage. Meanwhile, elderly, cerebrovascular disease, varicose vein or intravenous surgery, were the risk factors of deep venous thrombosis. Mechanical therapy or medication could be selected for preventing patients against deep venous thrombosis following artificial hip replacement with different features. It was an acceptable method for most patients using mechanical therapy, which could not induce drug adverse reaction, but the clinical efficacy remained uncertain for high-risk patient population, thus, medication should be combined. Low molecular heparin was considered first-choice drugs for preventing deep venous thrombosis following artificial hip replacement, which was characterized by common uses and reliable effects. CONCLUSION: Studies on influencing factor and preventive treatment of deep venous thrombosis following artificial hip replacement has arisen more attention in medical circles. The understanding of pathogenesis, correlation factors and preventive measures plays an important role in decreasing incidence deep venous thrombosis. Related Articles | Metrics

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Prevention of complications following cerebrovascular stent implantation Guan Chang-lun, Shi Guo-xian, Li Qin, Luo Yong-mei, Zeng You-chao 2010, 14 (9):  1681-1684.  doi: 10.3969/j.issn.1673-8225.2010.09.038 Abstract ( 370 )   PDF (456KB) ( 363 )   Save OBJECTIVE: To explore the reasons, occurrence mechanisms, as well as prevention methods for complications following cerebrovascular stent implantation. METHODS: A computer-based online search was performed by the first author. The databases of Medline and CNKI were searched with year’s limitation of 1989-2009. According to the inclusive and exclusive criteria, the documents were screened, collected and evaluated from the following aspects: treating progress of cerebrovascular stent implantation; category and biocompatibility of cerebrovascular stent; as well as occurrence and prevention methods for complication following cerebrovascular stent implantation. RESULTS: A series of complications, such as carotid sinus response, hyper-perfusion syndrome, cerebral angio spasm, bleeding at puncture locus, thrombosis, restenosis, as well as cerebral ischemia, would occur following cerebrovascular stent implantation. The complications were difficult to eliminate, but should be avoided by selecting correct implanting cases, elevating operator’s proficiency, enhancing understanding of complications, obeying perioperative management, as well as correctly and in-time treatment. Polymer stent, coating stent, and drug eluting stent presented superior biocompatibility to metal stent, which could prevent restenosis following implantation.     CONCLUSION: Cerebrovascular stent implantation is one of the main treatments for cerebrovascular disease. Polymer stent, coating stent, and drug eluting stent exhibit excellent biocompatibility. The complications associate to stent implantation are preventable and remediable via sufficient preoperatively preparation, exactly operation and perioperative management. Related Articles | Metrics

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Various stent materials for intracranial arteriostenosis: Complication prevention and application development Yang Lei, Huang Bin 2010, 14 (9):  1685-1688.  doi: 10.3969/j.issn.1673-8225.2010.09.039 Abstract ( 311 )   PDF (449KB) ( 370 )   Save OBJECTIVE: To explore the treatment effect and complication prevention of various stent materials for intracranial arteriostenosis. METHODS: A computer-based online search of Science Direct and Ei database (1998-01/2009-10) was performed for English articles with the key words of “intracranial arteriostenosis, stent placement”. In addition, CNKI and CBM database (1998-01/2009-10) were searched for related Chinese articles with the same key words in Chinese. Moreover, related works were manually searched. Studies regarding various stent materials for intracranial arteriostenosis were included, including basic and clinical experiments. RESULTS: Multicenter studies of worldwide show that stent implantation displays obvious advantages in treating carotid artery stenosis compared with carotid endarterectomy. Recently, with developing of balloon and stent compliance, as well as stent technology, and application of various novel materials and cerebral protection device, stent has become a safe and effective therapy for intracranial arteriostenosis. However, complications following stent implantation, such as restenosis, ischemic stroke, cerebral hemorrhage hypertransfusion syndrome, and cerebral angiospasm, limit its application. CONCLUSION: The safety and efficacy of intracranial stent implantation remains validation of multicenter and perspective studies. High incidence of restenosis following stent implantation requires further improvement. Related Articles | Metrics

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In-stent thrombus problems following coronary artery stent implantation: Factors for its formation as well as its prevention and treatment Liu Ming-xin, Wang Shou-li, Tao Gui-zhou 2010, 14 (9):  1689-1692.  doi: 10.3969/j.issn.1673-8225.2010.09.040 Abstract ( 500 )   PDF (449KB) ( 397 )   Save OBJECTIVE: To explore mechanism, prevention and treatment of thrombosis following implantation of coronary artery stent. METHODS: The first author used computer to retrieve Vip Database (http://www.cqvip.com/) for articles concerning thrombosis following implantation of coronary artery stent published from January 2000 to October 2009. The key words included “coronary artery, stent implantation, thrombus”. The data were primarily screened, and references of each article were checked. Inclusion criteria: mechanism and risk factor of thrombosis in stent; prevention and treatment of thrombosis in stent. Exclusion criteria: articles addressing duplicated or old contents. Finally, 28 articles were included. RESULTS: Thrombosis in stent was a severe complication in interventional therapy of coronary artery disease, could induce severe outcomes for the body. Compared with common mental stent, drug eluting stents can significantly reduce restenosis rate and revascularization rate of target lesions. Following stent implantation, thrombosis in stent can occur in early, late and extremely late phases. The mechanisms are different. Antiplatelet, anticoagulation and lipid-lowering therapy can diminish the occurrence rate of thrombosis in stent. Individual surgery and individual drug therapy not only can solve revascularization in the coronary artery, but also decrease restenosis rate and occurrence rate of thrombosis in stent. CONCLUSION: With the expectation of novel stents, various risk factors for thrombosis in stent should be assessed in detail to achieve individual surgery and individual drug therapy. During revascularization in the coronary artery, restenosis rate and occurrence rate of thrombosis in stent should be reduced. Related Articles | Metrics

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Clinical application and complications of esophageal stent implantation Li Feng, Yu Li-chao, Cheng Zhao-ming 2010, 14 (9):  1693-1696.  doi: 10.3969/j.issn.1673-8225.2010.09.041 Abstract ( 421 )   PDF (443KB) ( 625 )   Save OBJECTIVE: To summarize the types of esophageal stent implantation and explore the clinical application and complications following esophageal stent implantation. METHODS: A computer-based online search of VIP database (http://www.cqvip.com/) was performed for articles about clinical application of esophageal stent implantation, published between January 1998 and October 2009, with the key words “esophageal stent, indication, complication”. The data were collected. and the references were reviewed. Inclusion criteria: Type of esophageal stent; clinical application and complications following esophageal stent implantation. Exclusion criteria: repetitive studies. A total of 22 articles were finally included. RESULTS: Esophageal stent implantation as a novel technique has become an important approach for innocent or malignant esophageal stenosis, as well as orificium fistulae. The metal stent with no cover, partially covered stent and fully-covered stent have effectively cure esophageal diseases. However, patients suffer from the complications, such as chest pain, bleeding and perforation, gastroesophageal reflux, stent dislocation or shedding, and restenosis. Reduction of complications can improve quality of life of the patients. CONCLUSION: There are various types of esophageal stents. Therefore, appropriate selection of type, size, and characteristics of stent according to different disease condition, and accurate operation may minimize incidence of complications. Related Articles | Metrics

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Safety and efficacy of interventional occlusion for patients with multiple outlets sac-type membranous ventricular septal defection Xie Dong-ming, Liao Xiang-zhong, Yang Yi-hong, Zhou Ai-qin, Liao Yong-ling, Xie Dong-yang 2010, 14 (9):  1697-1779.  doi: 10.3969/j.issn.1673-8225.2010.09.042 Abstract ( 297 )   PDF (309KB) ( 397 )   Save OBJECTIVE: To investigate the feasibility, safety and efficacy of domestic small waist big edge-type occluder for patients with multiple outlets sac-type membranous ventricular septal defection (VSD), and summarize its technical problems and the choice of treatment strategies. METHODS: A total of 20 patients with sac-type membranous VSD, underwent left ventricular angiography at left anterior oblique 45°-60° plus CAOD 20°-25°; the left ventricular entrance diameters were 7-21 (10.9 ± 5.2) mm, more than 2 outlets in the right ventricular surfaces, and the largest outlet diameters were 3-10 (4.8 ± 2.9) mm. According to the result from transthoracic echocardiography (TTE) and angiography, the sac-bag size, shape, location, extent of tissue adhesion, and stability were determined. Different types of small waist big edge-type occluder were implanted, and the occluder diameter was 5-14 (4.6±   2.8) mm. Following 15 minutes of blocking, the immediate effects of occlusion were observed through repeating left ventricular angiography and TTE. All patients rechecked ultrasonic cardiography and electrocardiogram at 5-7 days of hospital stay, and 1, 3, 6 and 12 months following surgery. All patients took aspirin tablets for 6 months. RESULTS: Of 20 patients, 17 cases underwent domestic small waist big edge occluder, blocked successfully through left ventricular entrance, 2 cases were successful using symmetry block, and 1 case was failed. Intraoperative occlusion did not affect the aortic valve and tricuspid valve function. There were 1 case with left bundle branch block and 1 case with right bundle branch block during the operation, and all recovered within a week by using hormone therapy. After 6 months, the cardiac sizes were reduced to different degrees. CONCLUSION: It is safe and effective to treat multiple outlets sac-shaped membranous VSD with domestic small waist big edge-type occluder. The key technology, according to the sac size, shape, firmness, outlet orientation, import size, and the size of aortic stump, is to determine the block site and to select a suitable occluder. Related Articles | Metrics

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Effects of obstructive sleep apnea on restenosis following coronary artery stent implantation Yao Li-mei 2010, 14 (9):  1700-1702.  doi: 10.3969/j.issn.1673-8225.2010.09.043 Abstract ( 368 )   PDF (310KB) ( 573 )   Save BACKGROUND: Multiple studies have shown that obstructive sleep apnea is correlated with cardiovascular diseases, and plays an important role in occurrence and development of cardiovascular diseases. Nevertheless, we have little knowledge about effects of obstructive sleep apnea on results and prognosis of coronary artery interventional therapy. OBJECTIVE: To investigate the effect of obstructive sleep apnea on restenosis in patients undergoing successful coronary artery stent implantation. METHODS: A total of 76 patients with acute coronary syndrome (ACS) were selected, including 59 males and 17 females, with an average age of (67±10) years, at the Department of Cardiology, Xingtai Municipal People’s Hospital from January 2005 to December 2008. There were 45 patients with acute myocardial infarction and 31 patients with unstable angina pectoris. All patients were subjected to coronary artery stent implantation, coronary angiography. The coronary lesion cases and Gensini grades were recorded. Of them, 63 patients received coronary artery interventional therapy. All patients underwent polysomnography. The results of quantitative coronary angiography were analyzed in the course of operation and at 6-months following-up. RESULTS AND CONCLUSION: A total of 37 of the 76 patients had obstructive sleep apnea. The prevalence of multivessel disease was 51% and Gensini grades was 23.6±20.7, which was higher than patients without obstructive sleep apnea (P = 0.004). There were no significant differences between the two groups for median reference vascular diameter, median lesion length before operation, acute gain besides minimum lumen diameter after operation (P > 0.05). The rate of coronary artery in stent restenosis in patients with obstructive sleep apnea was 37%, which was higher than patients without obstructive sleep apnea over a 6-month follow-up (P = 0.021). Related Articles | Metrics

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Mental health states of patients with recurrent chest pain after percutaneous coronary intervention and coronary artery bypass grafting Liu Wei-fang, Liang Jin-rui, Wang Li 2010, 14 (9):  1703-1706.  doi: 10.3969/j.issn.1673-8225.2010.09.044 Abstract ( 353 )   PDF (368KB) ( 394 )   Save BACKGROUND: Many researchers appealed that coronary atherosclerotic heart disease patients were medical treated while special psychological intervention should be integrated into the rehabilitation plans (biology-psychology-social treatment) for coronary atherosclerotic heart disease patients. Pertinence psychological intervention would be processed after finding out mental health state of coronary atherosclerotic heart disease patients. OBJECTIVE: To make principal component analysis for mental health state of coronary atherosclerotic heart disease patients with relapsing pain in chest after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) by questionnaire investigation, and to find out the primary factors.  METHODS: A total of 40 coronary atherosclerotic heart disease patients with relapsing pain in chest after PCI and CABG were selected, (25 males and 15 females), mean age of (60±10) years old. It was used that the mental health section of the integrative system for diagnosing and assessing health state in Chinese population, including body symptoms, positive emotion, negative emotion, cognitive ability, behavior trouble, self-evaluation and social adapting problem. RESULTS AND CONCLUSION: Totally 4 principle component factors which the accumulative contribution rate reached to 83.89% were extracted. The first principle component factors which the contribution rate reached to 40% mainly demonstrated behavior trouble and social adapting problem. The second one mainly demonstrated positive emotion and negative emotion, the third for cognitive ability and self-evaluation, and the fourth for body symptoms. The behavior trouble and social adapting problem of coronary atheroscleroticheart disease patients with relapsing pain in chest after PCI and CABG must be paid great attention, and positive emotion would be leaded, negative emotion would be lowered. Related Articles | Metrics

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Endovascular stent implantation for symptomatic cerebral artery stenosis in 20 cases Zhou Zhu-qian, Li Gui-jie, Li Yan-bin, Han Ju, Wang Zi-bin 2010, 14 (9):  1707-1710.  doi: 10.3969/j.issn.1673-8225.2010.09.045 Abstract ( 328 )   PDF (336KB) ( 449 )   Save BACKGROUND: Cerebrovascular stent may destroy the vessel walls, which can lead to vascular restenosis. There are different versions about the safety, pathologic pharmacology reasons and clinical effect. OBJECTIVE: To evaluate the safety and short-term effect of endovascular stent implantation for symptomatic artery stenosis. METHODS: Totally 20 patients with total 22 lesions diagnosed symptomatic artery stenosis were treated with endovascular stenting. The vascular stenotic lesions involved middle cerebral artery in 6 cases, internal carotid artery in 6 cases, vertebral artery in 4 cases, basilar artery in 3 cases and vertebro-basilar artery in 3 cases. The length of vascular stenotic lesions was 3-10 mm with the average of 7 mm. Both balloon and self-expandable stents were used in 12 cases with embolus protection device. RESULTS AND CONCLUSION: All of the 22 stents in 20 patients were placed successfully in one time. After stent implantation, the vascular angiography showed that the vessels were reformed obviously with the degree of stenosis no more than 20%. The perfusion in cerebrum was improved in parenchymal phase and the symptom was also improved clearly. At 6-24 months follow-up, 20 patients never had cerebral ischemia. With follow-up for 12-24 months in 7 patients, digital subtraction angiography displayed that intima hyperplasia was occurred in stent in one patient with no symptom. The stenotic vascular were unobstructed and no intima hyperplasia by transcranial Doppler examinations. The results demonstrated that endovascular stent implantation is a safe and effective treatment for intracranial symptomatic artery stenosis, while its long-term effect needs further study. Related Articles | Metrics