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26 February 2011, Volume 15 Issue 9 Previous Issue    Next Issue

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Tagged cardiac MR image segmentation based on texture analysis Li Zhen-li, Yang Xiao-mei 2011, 15 (9):  1521-1524.  doi: 10.3969/j.issn.1673-8225.2011.09.001 Abstract ( 466 )   PDF (1383KB) ( 509 )   Save BACKGROUND: Analysis of the left ventricle motion and deformation is based on accurate segmentation of the left ventricle boundaries. However, affected by the strong gradient from tagged lines in tagged cardiac MR images, extracting endocardium boundaries makes itself very difficult. OBJECTIVE: A new texture analysis method is proposed, based on a minimum-variance energy map, to suppress the effect of tag lines on image segmentation. METHODS: Firstly, weighted sums of the local minimum and variance were computed, generating a minimum-variance map; Secondly, some block-like artifacts in the map were filtered off, as well as the boundaries were preserved by using median filter; Finally, GVF-snake model was applied to detect the endocardial contour. RESULTS AND CONCLUSION: According to the distribution characteristics of tag lines in tagged cardiac MR images, a new texture analysis method based on a minimum-variance energy map is proposed, which can effectively remove tag lines. Experimental results proved that the application of GVF-snake model in the energy map generated by the proposed method can well extract the endocardium boundary of the left ventricle in tagged cardiac MR image. Related Articles | Metrics

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Receptor pathway of lumbar facet joint and lamina muscle attachment points  Zhang Yun-hai, Geng Zhu-sheng, Lei Ling, Cui Ji-zheng, Zhang Xiao-bao, Yang Cong-ying, Li Yu, Xu Xin-tang 2011, 15 (9):  1527-1530.  doi: 10.3969/j.issn.1673-8225.2011.09.003 Abstract ( 453 )   PDF (1412KB) ( 513 )   Save BACKGROUND: Drug administration and silver needle heat conductive treatment through receptor pathway of lumbar facet joint and lamina muscle attachment points can achieve good effect in the treatment of discogenic low back pain, but the pathway remains unclear. OBJECTIVE: To observe the receptor pathway of lumbar facet joint and lamina muscle attachment points morphologically in the rabbits. METHODS: A total of eight rabbits were randomly divided into 2 groups. Fluorescent riboflavin was injected into the bilateral lumbar facet and lamina muscle attachment points under CT guidance. At 18 and 36 hours after injection, consecutive frozen sections were made in T1-L5 spinal ganglia, cervical, thoracic sympathetic ganglion, inferior mesenteric ganglion, brain, cerebellum, thalamus, brain stem, spinal cord, internal organs, blood vessels, skin, synovial membrane of lumbar facet joint, tendon of lamina muscle attachment, disc, testes and ovaries, etc. Nerve cells and nerve endings labeled by fluorescence were observed under fluorescence microscope and hematoxylin-eosin staining. The exposure time was recorded. RESULTS AND CONCLUSION: Nerve cells labeled by fluorescence were observed in hypothalamus, neck, thoracic sympathetic ganglion, T12-L5 spinal ganglia, gastric mucosa, the intestinal mucosa and submucosa and the inferior mesenteric ganglion 18 hours after injection. Fluorescent-intensive area was observed in frontal horn and posterior horn of spinal cord, brain, cerebellum, annulus fibrosus disci intervertebralis, nucleus pulposus of lumbar intervertebral disc, lumbar synovial membrane between the skeletal muscle membrane, inside and outside membrane of trachea, inside membrane of lung, internal and external membrane of cardiac muscle, glomeruli, tubules, wall of gallbladder, inside and outside membrane of fallopian tube, ovary, inside and outside membrane of uterus, testis, capillary loops of skin and wall of mesenteric artery. Lots of lymphocyte were seen in the spinal ganglia under hematoxylin-eosin staining, fluorescent-intensive areas were similar to fluorescence microscope, but the exposure time was significantly reduced (P < 0.01). At 36 hours after injection, labeled cells in spinal ganglion were significantly reduced, and exposure time was significantly lengthened (P < 0.01). Fluorescence-intensive areas were the same, but the exposure time in some sites was significantly lengthened (P < 0.01), significantly decreased at some sites (P < 0.01). Receptor pathway network of lumbar facet joint and lamina muscle attachment points in the rabbit were composed by sympathetic ganglia and postganglionic neurons, intestinal ganglion cells, spinal ganglia, parasympathetic neuron in peripheral and part neurons in the hypothalamus. Related Articles | Metrics

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Histological changes of tooth root and periodontal tissue during mini-implant anchorage for incisor intrusion in dogs Ge Zhen-lin, Lu Jia-jing, Qi Tao, Tian Jia-ling, Yang Cai-xia 2011, 15 (9):  1531-1535.  doi: 10.3969/j.issn.1673-8225.2011.09.004 Abstract ( 313 )   PDF (575KB) ( 487 )   Save BACKGROUND: Tooth intrusion easily leads to root resorption. Previous studies regarding orthodontic treatment-caused tooth root resorption or retrospective clinical studies based on X-ray films have great errors in outcome evaluation because of intrusion force which cannot be precisely controlled. OBJECTIVE: This study established dog models of mini-implant anchorage for incisor intrusion to observe the histological changes of tooth root and periodontal tissue and to evaluate the feasibility and safety of mini-implant anchorage for incisor intrusion. METHODS: Nine dogs were assigned to one control group (n = 1) and four experimental groups per time to sacrifice (1, 2, 4 and 12 weeks; n = 2 dogs for each experimental group). No force was added to the control group. In the experimental groups, mini-implant as an anchorage was placed in the buccal alveoli between maxillary second and third incisors on each side. A traction force of 100 g was imposed to each side to intrude the maxillary first and second incisors on each side. At 1, 2, 3, and 4 weeks (traction force was imposed for 4 weeks and after withdrawal of extraction force, mini-implant was retained in place for 8 weeks), dogs were sacrificed. The first and second incisors together with gingival and alveolar bone were completely resected to prepare histological specimens. Following hematoxylin-eosin staining, histological changes of tooth root and periodontal tissue were observed. RESULTS AND CONCLUSION: Compared with the control group, in the 1-week group, histological changes were primarily at the root tip and alveolar ridge crest, alveolar bone and cementum were absorbed and peridental membrane presented glassy degeneration in local region; in the 2-week group, bone resorption degree and range were obviously enlarged, and bone resorption developed from root tip, root middle part to cervical part; in the 4-week group, bone resorption was still active and the glassy degeneration of peridental membrane disappeared; in the 12-week group, significant improvement in alveolar bone and cemental surface was observed, bone lacuna had deposition of newly formed bone, and peridental membrane was orderly arranged. These findings reveal that in the mini-implant anchorage for dog incisor intrusion, early histological changes primarily appear in the root tip and alveolar ridge crest, presenting as alveolar bone and cemental resorption and the glassy degeneration of the peridental membrane. Bone resorption extent and range expand with the persistence of traction force. After withdrawal of traction force, tooth root and periodontal tissue were gradually repaired.  Related Articles | Metrics

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CT scan of proximal femur in preoperative plan of total hip arthroplasty Li Yi-zhong, Li Jian-long, Lin Jin-kuang, Yao Xue-dong, Zhuang Hua-feng, Jiang Zhi-zhao 2011, 15 (9):  1536-1540.  doi: 10.3969/j.issn.1673-8225.2011.09.005 Abstract ( 306 )   PDF (1386KB) ( 420 )   Save BACKGROUND: The premise of model prediction of prosthesis is the full understanding and accurate measurement on proximal femur before total hip arthroplasty, but X-ray film only can provides a ground-plan, cannot understand the cross-sectional of proximal femur. However, the CT scan of the proximal femur can provide more information. OBJECTIVE: To observe the effect of CT scan of proximal femur in the preoperative plan of total hip arthroplasty. METHODS: A total of 61 patients with primary total hip arthroplasty underwent CT scan of proximal femur. The parameters were defined from the CT films taken at T20 (the neck at 20 mm higher than the apex of lesser trochanter), T0 (the level of the apex of lesser trochanter), and N level (the level of femoral isthmus). The length-diameter, wide diameter, medial diameter of plane medullary cavity in neck of femur, the length-diameter, medial diameter of plane medullary cavity in lesser trochanter, the length-diameter, wide diameter, cortical thickness of plane medullary cavity in femoral isthmus was measured. RESULTS AND CONCLUSION: The length-diameter of the neck of femur at T20 level was 40.8-63.3, average (49.6±5.1) mm, wide diameter of the neck of femur at T20 level was 13.3-29.1, average (22.4±3.4) mm and medial diameter of the neck of femur at T20 level was 7.2-14.6, average (10.6±1.6) mm; the length-diameter of the intertrochanter region at T0 level was 20.5-40.2 mm, average (28.7±4.4) mm, medial diameter of intertrochanter region at T0 level was 4.3-13.0, average (8.1±1.7) mm; the length-diameter of femoral isthmus at N level was 8.2-22.4, average (14.1±3.1) mm, wide diameter of femoral isthmus at N level was 6.1-17.9, average (10.2±2.9) mm and cortical thickness on wide diameter at N level was 2.7-12.7, average (7.5±1.8) mm. The CT scan of proximal femur can provide more image information and more accurate measured data, which is helpful to the preoperative plan of total hip arthroplasty. Related Articles | Metrics

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Relationship between pneumatic tourniquet application in total knee arthroplasty and hypercoagulability Zhou Wei, Liu Dong-hai, Ma Guo-tao, Gong Yue-kun, Liu Jin-song 2011, 15 (9):  1541-1544.  doi: 10.3969/j.issn.1673-8225.2011.09.006 Abstract ( 319 )   PDF (991KB) ( 655 )   Save BACKGROUND: Numerous studies show the pneumatic tourniquet on hemodynamics during total knee arthroplasty (TKA) can lead to hypercoagulability or deep vein thrombosis. OBJECTIVE: To investigate correlation between tourniquet and hypercoagulability during TKA. METHODS: The 39 cases undergoing TKA were randomly divided into two groups: tourniquet group (n=20) and non-tourniquet group (n=19). Hemorheology, D-dimer, fibrinogen degradation products (FDP) and antithrombin-Ⅲ (AT-Ⅲ) were measured pre-, 5 minutes after of the first tourniquet deflation in the tourniquet group and post-operation in the non-tourniquet group. RESULTS AND CONCLUSION: The indexes of two groups had no differences before operation (P > 0.05). After operation, red blood cell deformability index TK and AT-Ⅲ were significantly reduced than that before surgery, while erythrocyte aggregation index, erythrocyte rigidity index, D-dimer and FDP were significantly greater than that before surgery (P < 0.05). Erythrocyte aggregation index, erythrocyte rigidity index, D-dimer and FDP were significantly increased, while red blood cell deformability index TK and AT-Ⅲ were significantly decreased in tourniquet group compared with non-tourniquet group (P < 0.05). Results show that trauma of TKA and the application of tourniquet during surgery can lead to hypercoagulable state. The use of pneumatic tourniquet during TKA exacerbated hypercoagulable state, which prone to deep venous thrombosis. Related Articles | Metrics

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Gait analysis after total knee arthroplasty with cemented versus cementless type Zhang Min, Jiang Lan, Shen Xiao-yan 2011, 15 (9):  1545-1548.  doi: 10.3969/j.issn.1673-8225.2011.09.007 Abstract ( 305 )   PDF (545KB) ( 490 )   Save BACKGROUND: Total knee arthroplasty (TKA) has been proved to be a very effective method for patients with knee osteoarthritis. But the biomedical changes at knee joint between two different types of TKA (cemented and cementless) after operation remain not clear. OBJECTIVE: To explore the different biomechanical changes between the cemented and cementless TKA through three-dimensional gait analysis. METHODS: A total of 16 knee osteoarthritis patients treated with cemented TKA and 16 with cementless TKA were included. Force plates and three-dimensional gait analysis system were used to compare differences in biomechanics before and 3 months after operations.   RESULTS AND CONCLUSION: Both groups showed significant increased walking speed and stride length, but decreased percentage of stance phase in gait cycle after operation, significant increased knee flexion angle in stance phase and swing phase and knee valgus degrees. In addition, both groups showed significant decreased knee varus degrees and knee adduction moments. Results indicated that both types of TKA can help to improve the joint function, walking ability and reduce the pressure of the knee in the patients with knee osteoarthritis, but there were no significant biomechanical changes between cemented TKA and cementless TKA on the operated side. Related Articles | Metrics

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Early functional recovery following bilateral total knee replacement versus selective unilateral total knee replacement  Fang Rui, Liang Zhi-quan, Meng Qing-cai 2011, 15 (9):  1549-1552.  doi: 10.3969/j.issn.1673-8225.2011.09.008 Abstract ( 337 )   PDF (543KB) ( 548 )   Save BACKGROUND: Early functional recovery following bilateral total knee replacement or selective unilateral after total knee arthroplasty are still controversial. OBJECTIVE: To evaluate the function recovery differences of patients with osteoarthritis knees after bilateral total knee replacement or selective unilateral total knee replacement. METHODS: 86 cases with osteoarthritis (116 knees) performed first line total knee replacement were divided into the bilateral total knee replacement group (n=29, 58 knees), and unilateral total knee replacement group (n=57, 57 knees). Preoperative and postoperative range of motion (ROM), flexion contracture, muscle strength, pain score, leg-length discrepancy and HSS ratings were compared, and the incidence of complications were recorded. RESULTS AND CONCLUSION: There were no significances between two groups in ROM and muscle strength at 1 year follow-up (P=0.171, 0.418); Postoperative flexion contracture, pain score, and leg-length discrepancy of the bilateral total knee replacement group were obviously lower than those of the unilateral total knee replacement group (P=0.026, 0.0013, 0.026); meanwhile, the postoperative HSS score of the bilateral total knee replacement group was superior to the unilateral total knee replacement group (P=0.003). It is suggested that bilateral total knee replacement is superior to the unilateral total knee replacement in flexion contracture, pain score, leg-length discrepancy and HSS ratings, but there is no obviously difference in ROM and muscle strength. Related Articles | Metrics

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Analgesics-assisted early functional exercise following minimally invasive total hip arthroplasty Li Lu-huan, Pan Qing, Cao Yong-zhi, Gao Hui, Xu Su-fei, Cong Xiao-ling, Yang Yi, Wu Li-rong 2011, 15 (9):  1553-1556.  doi: 10.3969/j.issn.1673-8225.2011.09.009 Abstract ( 449 )   PDF (624KB) ( 617 )   Save BACKGROUND: The hip function after the minimally invasive total hip arthroplasty (MIS-THA) is associated with surgical techniques and post-operation functional exercise as well.  OBJECTIVE: To observe the role of adjuvant analgesia in functional exercise after MIS-THA. METHODS: Forty-two patients treated with MIS-THA were randomly assigned to two groups. Analgesics-assisted group orally administrated celecoxib and did early functional exercise, and the control was not treated with analgesics. Visual analog scale (VAS) scores, Harris scores and satisfaction to the operation in two groups were compared. RESULTS AND CONCLUSION: The VAS scores of analgesics-assisted group were significantly lower than the control in 7 days after operation (P < 0.05); the Harris scores and the satisfaction rate of the analgesics group were higher than the control at 6 months after operation (P < 0.05). Celecoxib has the positive effect on the functional exercise after MISTHA and improved hip function in a short period of time. Related Articles | Metrics

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Construction of a three-dimensional finite element model of lower lumbar spine based on computed tomography images and computer aided design  Fu Yu, Ruan Di-ke2, Huo Hong-jun, Yang Xue-jun, Li Chen-guang 2011, 15 (9):  1557-1561.  doi: 10.3969/j.issn.1673-8225.2011.09.010 Abstract ( 339 )   PDF (778KB) ( 533 )   Save BACKGROUND: Currently, the rapid developments of computer technology and finite element theory provide technical supports for construction of lumbar spine models. The finite element model with high accuracy and reliability provides better platform for clinical biomechanics, such as intervertebral discs, lamina excision, lumbar fusion, and spinal internal fixation materials. OBJECTIVE: To construct a lumber spine (L3-5) biomechanical model using three-dimensional finite element method. METHODS: Reconstructing the skeleton through CT scan, recording the edges of image, calibrating in sequence of point, line, face and solid. Mapped-mesh technique was used to obtain the finite element, adopt finite element commercial software package Unigraphics V18.0 was used to study the response of the disc model. RESULTS AND CONCLUSION: The finite element model of lower lumbar spine (L3-5) was reconstructed, which can simulate biomechanical experiment. There were 6 482 nodes and 31 326 units in the model. Based on geometrical shape of model, the mesh generation was reduced minimum utilizing mesh generator, which can not only ensure model accuracy and calculation feasibility, but also meet needs of biomechanical studies.  Related Articles | Metrics

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Construction of cyno-mandibular condyle models using three-dimensional imaging and rapid prototyping technology Han Dong, Xu Hua, Dong Jia-sheng, Shen Guo-xiong, Yu Zhe-yuan, Chai Gang, Ai Song-tao 2011, 15 (9):  1562-1565.  doi: 10.3969/j.issn.1673-8225.2011.09.011 Abstract ( 298 )   PDF (509KB) ( 444 )   Save BACKGROUND: Craniomaxillofacial bone is irregular and has a subtle three-dimensional (3D) structure, and individualized repair of bone defects is very important. Computer-aided design (CAD), computer-aided manufacturing (CAM), rapid prototyping, as well as laser scanning have therefore been applied in craniomaxillofacial surgery. OBJECTIVE: To develop a novel digital medical support system that enables us to custom-make scaffolds to repair craniomaxillofacial bone defects using CAD/CAM and rapid-prototyping technology. METHODS: We created positive molds using CT data, CAD/CAM and a rapid prototyping method using 3D printing. Custom-made poly (glycolic acid) (PGA) and polymers poly (lactic acid) (PLA) scaffolds were prefabricated by a positive-negative mold interchange technique. A laser scanning system was used to evaluate the accuracy of the PGA/PLA scaffold. RESULTS AND CONCLUSION：The mean error was smaller than 0.3 mm and confidence was greater than 95% when the error was smaller than 1 mm. This pilot study suggests that custom-made PGA/PLA scaffolds could accurately reconstruct craniomaxillofacial bone injuries by our digital medical support system. Related Articles | Metrics

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Three-dimensional finite element analysis of stress distribution of mandible angle under forces Wu Ling-Li, Chen Jun, Li Zhi-jie, He Xiang-yi 2011, 15 (9):  1566-1569.  doi: 10.3969/j.issn.1673-8225.2011.09.012 Abstract ( 364 )   PDF (561KB) ( 624 )   Save BACKGROUND: The studies regarding fracture risk in different parts of the mandible after impact are few.  OBJECTIVE: To study the condition and characteristics of stress distribution in the mandible, of which forces are applied on mandibular angle by using 3D finite element analysis. METHODS: The electronic CT images of mandible were scanned and then imported to the Amira software for the fabrication of 3D mandible model. At the angle of 90°, 0° to the middle sagittal plane, 1 000 N forces were applied on the left side of mandibular angle in Ansys software. Thereafter, the condition of stress distribution and Von Mises stress of the weak parts of the mandible were expressed in the 3D mandible model. RESULTS AND CONCLUSION: 3D model of mandible was established. When force was applied on the left side of mandibular angle in 90° angle, both sides of mandibular angles and condylar necks were easily fractured. The inside surface of central symphysis and the left of mental foramen of mandible may show fissures, while the right of mental foramen was slightly damaged. When force was applied on the left side of inferior border of mandibular angle in 0° angle, both sides of mandibular angles and condylar necks were easily fractured. The inside of central symphysis and the left of mental foramen may showed fissures, while the right of mental foramen slightly damaged. It is revealed that, while forces were applied on the left side of mandibular angle, Von Mises stress mainly concentrated on the weak parts of mandible, which provides theoretical basis for preliminary clinical diagnosis and treatment of mandibular fractures. Related Articles | Metrics

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Preparation accuracy and in vitro cytotoxicity of models prepared by rapid prototyping Zhou Ye, Zhao Hua-fu, Zhou Xia, Wu Xiao-li, Zhang Hong-bin, Wang Jie 2011, 15 (9):  1570-1574.  doi: 10.3969/j.issn.1673-8225.2011.09.013 Abstract ( 305 )   PDF (711KB) ( 448 )   Save BACKGROUND: Rapid prototyping technology has been widely used in surgery simulation and tissue engineering research. However, spot surgical stimulation and preoperative instruction on accuracy of model is very high, and the model in the operation should require its avirulence to humans. OBJECTIVE: To evaluate the accuracy and cytotoxicity of the rapid prototyping models with different post treatment. METHODS: Standard cylindrical models were prepared by selective laser sintering method, followed by paraffin or resin treatment, the height and bottom diameter of the models was measured and its accuracy was assessed. Then, MTT method was used to study the cytotoxicity of model on mouse fibroblast L929 and mouse preosteoblast MC3T3-E1. The experiment was divided into five groups: paraffin-treatment group, resin-treatment group, negative control group (non-treatment sample), blank group (flesh DMEM medium), and positive control group (5% (v/v) DMSO). After 2 days culturing, the absorbance of cells at 490 nm was tested, the relative growth rate was calculated and the cytotoxicity grade of models was evaluated. RESULTS AND CONCLUSION: The accuracy and error of models treated by paraffin, resin and the original model was 95%-97% and 0.5-1 mm respectively. After 2 days L929 and MC3T3-E1 cells cultured by leaching liquor of models, the relative growth rates of cells were more than 80% in each group. Moreover, rapid prototyping models treated by paraffin had low cytotoxicity on L929 and MC3T3-E1 cells, while resin-treatment and non-treatment models had no cytotoxicity on L929 and MC3T3-E1 cells, the grade of cytotoxicity was 0-1. Related Articles | Metrics

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Coflex interspinous process dynamic internal fixation for the treatment of middle-aged lumbar rotation instability: Short-term lumbar stability evaluation Guan Hua-qing, Yang Hui-lin, Xu Yao-zeng, Yang Tong-qi 2011, 15 (9):  1575-1578.  doi: 10.3969/j.issn.1673-8225.2011.09.014 Abstract ( 276 )   PDF (518KB) ( 447 )   Save BACKGROUND: Coflex interspinous dynamic internal fixation is mainly applied for degenerative lumbar spinal stenosis patients. It remains unclear whether the indication of Coflex can be enlarged. OBJECTIVE: To evaluate the early clinical results of Coflex interspinous dynamic internal fixation for middle-aged lumbar rotation instability. METHODS: A total of 11 middle-aged patients with lumbar rotation instability were treated with Coflex interspinous dynamic internal fixation. The operation levels were all at L4-5 segments. The Japanese Orthopaedic Association (JOA) questionnaires were assessed before and after operation. The radiological measurement included segmental intervertebral angles including neutral angle, flexion angle, extension angle and the range of motion (ROM) of L4-5 segments. The operating time and the blood loss during operation were also observed. RESULTS AND CONCLUSION: All the patients were followed up for 6 months. The average operating time was 72.6 minutes, and blood loss during operation was 85.7 mL. Compared with pre-operation, the JOA score of 6 months after operation were raised from 14.45±2.42 to 21.00±2.24 (P < 0.05), and the ROM of L4-5 segment decreased from (13.18±2.04)° to (8.09±0.94)° (P < 0.05). Coflex device shows a good early result for the treatment of middle-aged lumbar rotation instability and improved intervertebral rotation instability, but the long-term outcomes and complications need further evaluation. Related Articles | Metrics

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Coflex interspinous process dynamic reconstruction system for treatment of lumbar degenerative diseases in 18 cases Liu Jin, Liu Hao, Li Tao, Zeng Jian-cheng, Li Guang-hui 2011, 15 (9):  1579-1582.  doi: 10.3969/j.issn.1673-8225.2011.09.015 Abstract ( 322 )   PDF (652KB) ( 625 )   Save BACKGROUND: In recent years, the technique of the spinal nonfusion is the focus for researching and debating in the filed of spinal surgery. Coflex interspinous process dynamic reconstruction system is a posterior nonfusion equipment, despite of used for a long time abroad, but in China is still in a trail stage.  OBJECTIVE: To explore the indications of Coflex interspinous process dynamic reconstruction system in the treatment of lumbar degenerative diseases and its early clinical efficacy.  METHODS: From October 2008 to September 2010, 31 patients with lumbar degenerative diseases were treated by Coflex interspinous process dynamic reconstruction system, of which 18 cases were followed up more than 1 year, and we analyzed and summarized their clinical data. Surgical procedures were posterior resection of nucleus pulposus, decompression of spinal canal and implantation Coflex interspinous dynamic reconstruction system, only 1 patient was implanted 2 Coflexes in surgery. The patients' JOA, VAS, and ODI scores, the intervertebral height of the implanted segment and the range of motion (ROM) of adjacent segments, and the angle of the upper and lower plates of the Coflex in each position were evaluated before and after the operation, and at every follow-up.  RESULTS AND CONCLUSION: All cases were followed up for 15.4 (12-20) months. The patients' JOA, VAS, ODI scores have been significantly improved at the last follow-up. The intervertebral height of the implanted segment and the ROM of adjacent segments had no significant change (P > 0.05), the angle of the upper and lower plates of the Coflex in the hyperextension position is significantly increased than in the neutral position at the last follow-up (P < 0.05). Coflex interspinous process dynamic reconstruction system is a safe and effective technique for treatment lumbar degenerative diseases ,such as lumbar disc herniation, spinal stenosis and lumbar instability, and it not only have little impact on physical function of lumbar but also effectively share the load when the lumbar spine extend backward, so its early clinical efficacy is positive. Related Articles | Metrics

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Matching between intergrated anterior cervical plate cage benezech implant and biomechanical environment Yang Yue-zhou, Xu Yao-zeng, Du Xing-ye, Geng De-chun, Yang Hui-lin 2011, 15 (9):  1583-1587.  doi: 10.3969/j.issn.1673-8225.2011.09.016 Abstract ( 293 )   PDF (565KB) ( 400 )   Save BACKGROUND: Studies demonstrated that intergrated anterior cervical plate cage benezech implant (PCB) superior to used plates and fusion cage theoretically. However, reports concerning biomechanical analysis of the PCB are few. OBJECTIVE: To investigate biomechanical characteristics of the PCB. METHODS: Five types were made in 6 adult cadaveric cervical spines: normal, simulated vertebral disc removal, PCB fixation, CBK fusion cage fixation, CBK fusion cage and Secuplate titanium plate conjoined fixation. Their stability was tested by experimental stress analysis at C5-6. RESULTS AND CONCLUSION: The cervical spine became unstable and the range of motion increased significantly after the removal of vertebral disc. Compared with simulated vertebral disc removal group, after instrumentation of cervical PCB fixation, the strength increased 24%, the flexibility decreased 31%, the stiffness increased 14.3%, and the migration decreased 15% (P < 0.05). There was significant difference between the PCB fixation group and simulated vertebral disc removal one (P  < 0.05). And the range of motion of the cervical spine after the insertion of correct size of PCB was similar to that of intact condition. The CBK fusion cage group was unsatisfied under extension and torsion tests, but there was significant difference between CBK fusion cage fixation group and simulated vertebral disc removal one (P  < 0.05). Compared with simulated vertebral disc removal group, after instrumentation of cervical CBK fusion cage and Secuplate titanium plate conjoined fixation, the strength increased 27%, the flexibility decreased 38%, the stiffness increased 17%, and the migration decreased 17% (P  < 0.05). But the motion of the segment following insertion of CBK fusion cage and Secuplate titanium plate conjoined fixation almost lost and the range of motion of the adjacent segment increased. PCB has occupied advantages of both secuplate titanium plate fixation and CBK fusion cage fixation which could match the biomechanical environment. Related Articles | Metrics

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Posterior vertebral column resection and titanium mesh implantation for the treatment of severe spinal angular deformity Wang Ying-song, Li Shi-he, Zhang Ying, Zhao Zhi, Yang Zhen-dong, Liu Lu-ping, Zhao Wei 2011, 15 (9):  1588-1593.  doi: 10.3969/j.issn.1673-8225.2011.09.017 Abstract ( 402 )   PDF (635KB) ( 514 )   Save BACKGROUND: No matter anterior strut-grafting, anterior release combined with posterior correction or posterior wedge osteotomy, can not treat severe spinal angular deformity effectively. OBJECTIVE: To summarize the clinical experience of the posterior vertebral column resection (PVCR) in the treatment of angular scoliosis and kyphosis, and to discuss the influence about spinal cord. METHODS: From 2004 October to 2008 December, 15 patients with severe rigid angular kyphosis and scoliosis treated by PVCR were retrospective analyzed. The major curve of all cases in the coronal or/and sagittal plane > 100°, and flexibility less than 10%. There were 2 patients with spinal cord injury and Frankel grade D. Other cases was E. A thorough rib and transverse process resection of the exposed posterior vertebral column was performed. The top segments vessel was ligated and completely resection with the apex to correction. The temporary rods were exchanged alternately. In the process, somatosensory-evoked potentials and eurogenic mixed-evoked potentials (NMEPs) were not used. The Cobb angle correction and neural function changes were compared.  RESULTS AND CONCLUSION: Average (3.8±1.4) segment vessels were cut in the operation. Deformity correction was 60.8% in the coronal plane and72.9% in the sagital plane. Patients were follow-up for 6-48 months, and all patients Frankel grade was E. Part of patients had muscle tension and anal sphincter muscle relaxation recovered to normal. No grafting shedding or loosening occurred. PVCR is an effective alternative and can obtain good correction for severe rigid angular kyphoscoliosis patients. In the stable mechanical and look, spinal cord can tolerate appropriate short, angles and displacement. Through circumferential decompression, and keep spinal cord isotonic and appropriate short, spinal cord function will recover. Related Articles | Metrics

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Effect of cobra internal fixation system combined with halo-vest on treatment of the craniocervical malformation Guo Liang-bing, Liao Wen-sheng, Wang Li-min, Wang Wei-dong, Tan Hong-yu, Bao Heng, Liu Yi-lin, Dong Xiao-tong 2011, 15 (9):  1594-1598.  doi: 10.3969/j.issn.1673-8225.2011.09.018 Abstract ( 362 )   PDF (679KB) ( 579 )   Save BACKGROUND: Craniocervical posterior fusion can decompress the spinal cord and obtain the early stability for the instability occipitocervical fusion. The anatomic design of Cobra system can provid strongly internal fixation for this instability fusion and it is beneficial for fixation, reduction and bone graft fusion with the Halo-vest external fixation. OBJECTIVE: To evaluate the clinical application of Cobra internal fixation system with Halo-vest in craniocervical fusion surgery for craniocervical region malformation patients. METHODS: Thirty-four cases of craniocervical region malformation underwent craniocervical fusion using Cobra internal fixation system and with a specific therapy used Halo-vest according to the actual situation. The JOA17 spinal cord function evaluation standard was used for evaluation of the treatment effect. The neurologic recovery rate was calculated by the method established by Yin Qing-shui. At 3, 6, 12, and 24 months after the internal fixation, two-plane roentgenograms, CT and 3D reconstruction could be made to judge the internal fixation and bone grafting fusion situation, some patient also did MRI to clarify the spinal cord decompression. RESULT AND CONCLUSION: All of the patients were followed up for 7-29 months. There were no aggravations of the symptoms of spinal cord compression. The preoperative average spinal function was 8.2 and postoperative average was 14.8, respectively. The overall mean improvement was 75%. One patient died of cerebral infarction postoperatively. At the sixth month of follow-up, there were two cases with bone graft nonunions and absorption, two cases with the loosed occiput plate bolt, one case with the pulled out screws, one case with a nonhealing incision. The Halo-vest was used in ten cases for 3 to 4 months postoperatively. Other cases wore a cervical collar until the bone grafts were fused completely. It is suggested that Cobra internal fixation system offers a good biomechanical stability for craniocervical region fixation. It’s convenient for reduction and fixation during the operation along with the Halo-vest, and suitable for the treatment of craniocervical region malformation. Related Articles | Metrics

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Meta analysis of computer navigation in total hip arthroplasty Liao Liang, Zhao Jin-min, Su Wei, Sha Ke, Tan Zhen 2011, 15 (9):  1599-1602.  doi: 10.3969/j.issn.1673-8225.2011.09.019 Abstract ( 330 )   PDF (540KB) ( 467 )   Save BACKGROUND: Traditional operation frequently depends on experience of doctors and anatomic landmark visual observation, which often leads to deviation in acetabular prosthesis implantation. Computer navigation technique greatly improves accuracy of prosthesis implantation. OBJECTIVE: To assess the accuracy and clinical significance of computer navigation for acetabular implantation in total hip arthroplasty. METHODS: A computer-based online search of Cochrane Library, Medline, Embase, CBM, and CNKI was performed, and related Chinese journals were manually searched. Clinical trials were selected and analyzed using RevMan5.0.18 software. RESULTS AND CONCLUSION: A total of 9 clinical trials were included, involving 695 cases. Meta analysis showed that compared with traditional surgery, acetabular component of computer navigation technology in total hip arthroplasty was more accurate in prosthesis position [RR=0.22, 95%CI(0.14-0.34), P < 0.000 01], the degree of inclination angles [RR=-1.76, 95%CI (-5.02 to 1.50), P=0.29], but no differences in the degree of anteversion angles [RR=-1.28, 95%CI (-5.68 to 3.12), P=0.57], and postoperative dislocation rate [RR = 1.25, 95%CI (0.05-31.66), P = 0.89]. There was no statistical difference between navigation applications and traditional surgery in the accuracy of acetabular position. Related Articles | Metrics

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A systematic review of osteogenesis induced by recombinant human bone morphogenetic protein-2/absorbable collagen sponge for maxillary sinus floor augmentation Ning Jing, Liu Ya-li, Yang Ke-hu, Wang Lin, Ma Peng, Liu Bin 2011, 15 (9):  1603-1606.  doi: 10.3969/j.issn.1673-8225.2011.09.020 Abstract ( 387 )   PDF (533KB) ( 354 )   Save BACKGROUND: Maxillary antrum limits the application of implant in maxillary molar region; the application of guided bone regeneration (GBR) provides chance and security for the elevation maxillary sinus floor. Although pharmacology, animal experiment, and some clinical research have verified the osteoinductive of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS), the existence of the limitations of the study, cases of self-limiting, the reliability of the results is not very clear. OBJECTIVE: To systematically evaluate curative effect and safety of rhBMP-2/ ACS on the incrementation of alveolar crest in process of maxillary sinus floor augmentation. METHODS: A computer based online search of PubMed database (1996/2009-12), Embase database (1974/2009-12), Cochrane Library database (the 4th period, 2009), CBM database (1978/2009-12), and CNKI database (1994/2009-12), VIP database (1989/2009-12) was performed with the key words “rhBMP-2, ACS, autogenous bone graft” in English, and “rhBMP-2, ACS, autogenous bone graft” in Chinese. The literatures were retrieved by the way of free words combined with key words. The studies of randomized controlled trials (RCTs) which addressed the efficiency of rhBMP-2/ACS compared with an autogenous bone graft were selected and reviewed. And RevMan 5 software was used for Meta-analysis. RESULTS AND CONCLUSION: Three RCTs was finally included, a total of 288 patients. Meta-analysis results showed that there was significant difference between 1.5 g/L rhBMP-2/ACS and autogenous bone graft in height changes and width changes of alveolar ridge. While for 0.75 g/L rhBMP-2/ACS group, there was no significant difference in height changes of alveolar ridge. There was significant difference in width changes of alveolar ridge. After 6 months rhBMP-2/ACS, the bone density can be improved in implant region, no reports of untoward reaction. 1.5 g/L rhBMP-2/ACS, 0.75 g/L rhBMP-2/ACS and autogenous bone graft had good effects for the bone induction, and the effect of rhBMP-2/ACS was superior to autogenous bone. Related Articles | Metrics

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Influence of leg length discrepancy following total hip replacement on hip function: A Meta analysis Xu Jie, Liang Guo-yan, Prakash-Raj Bhandari, Ma Ruo-fan 2011, 15 (9):  1607-1610.  doi: 10.3969/j.issn.1673-8225.2011.09.021 Abstract ( 367 )   PDF (454KB) ( 495 )   Save BACKGROUND: It remains controversial whether leg length discrepancy (LLD) after hip replacement (THR) affects hip function. Several randomized controlled studies have been conducted to evaluate the influence of length discrepancy on function after hip replacement. System review of these studies could be more objective to evaluate the influence and provide evidence for clinical decision. OBJECTIVE: To assess the influence of LLD on the function of the operated hip after THR. METHODS: Randomized controlled trials and clinical controlled trials of functional evaluation of LLD after THR were identified from Cochrane Back Group, Cochrane Library, additional electronic search (including MEDLINE (1950-2010), EMBASE (1979-2010) and CBM (1978-2010), hand searching for Chinese journals). Two reviewers assessed the quality of the trials and extracted data independently. Meta analysis was conducted using RevMan 5.  RESULTS AND CONCLUSION: A total of 6 clinical controlled trials involving 1 304 patients were included. Four trials with data integrity were reviewed with Meta analysis. LLD after THA can influence the function of hip joints. It is essential to balance the leg length for better outcomes and less limp. Functional disorder in LLD group can be relieved over time, even it was worse than that in non-LLD group. As very few studies and patients were included in the review, further trials with high quality on methodology are needed to identify complications in LLD, such as dislocation, nerve injury, wearing and loosening. Related Articles | Metrics

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Dynamic contrast-enhanced scanning of nucleus pulposus of adult goat: Quantitative observation of enhancement degree and nutrition state of intervertebral discs Du Heng, Guan Min, Ma Shao-hui, Han Bo, Yang Guang-fu, Zhang Ming, Liu Miao 2011, 15 (9):  1611-1614.  doi: 10.3969/j.issn.1673-8225.2011.09.022 Abstract ( 349 )   PDF (527KB) ( 394 )   Save BACKGROUND: The reduction of nutrient substances has been considered to be the main factor, which leads to the ultimate way to disc degeneration. Numerous studies have shown that nutrition of intervertebral disc is mainly obtained through endplate, and there is close relationship between the cataplasia of endplate and that of intervertebral disc. Dynamic contrast-enhanced MRI scans as a non-invasive, repeatable method that has been used to study nutrition mechanism disc. OBJECTIVE: To quantitatively analyze the characteristics of enhancement of nucleus pulpous of adult goat lumbar discs. METHODS: Eight 24-month-old goats, weighing 38 kg and 50 kg, were selected, a total of 32 lumbar inter-vertebral discs were included. After anesthesia for goats, we observed the signal changes of regions of interest by using T1-TSE-SPIR, T2WI-TSE-SPAIR and dynamic enhanced magnetic resonance scan. On the point of time before enhancement and 0 minute, 5 minutes, 10 minutes, 30 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 3.5 hours and 4 hours after enhancement, the enhancement of nucleus pulposus was calculated and the time-enhancement ratio curve was used to analyze the perfusion characteristics. RESULTS AND CONCLUSION: The nucleus pulposus exhibited no obvious increase within 10 minutes and began to increase quickly at 30 minutes and achieved its peak enhancement at 3.5 hours, after which was the plateau stage. The time-enhancement ratio curve of nucleus pulposus is distinctive, which encourages more researches to explore the mechanism of nutrition. Related Articles | Metrics

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The relationship between ligamentum flavum thickening and degenerative intervertebral discs of lumbar spine by MRI image measurement Cui Tao, Li Shu-zhong, Zhang Xiu-gong, Liu Hao 2011, 15 (9):  1615-1618.  doi: 10.3969/j.issn.1673-8225.2011.09.023 Abstract ( 306 )   PDF (615KB) ( 319 )   Save BACKGROUND: Lumbar disc degeneration and thickening of ligamentum flavum (LF) are considered to be associated with changes in aging. However, the natural course of disease of LF thickening evaluated by MRI is poorly understood. OBJECTIVE: To evaluate the relationships among thickness, age, intervertebral space level and degeneration of intervertebral disc by MRI. METHODS: The thickness of LF was measured at L2/3, L3/4, L4/5 and L5S1 levels (n = 712) using MRI in 178 patients with low back pain and/or leg pain. The relationships among thickness, age, intervertebral space level and degeneration of intervertebral disc were detected. RESULTS AND CONCLUSION: The thickness LF increased with age; however, the increments at L4/5 and L5S1 levels were larger than that at L2/3 and L3/4 levels. At L4/5 level, the thickness of LF was over 3.0 mm in patients in the 20–29 age brackets. If all patients with a thickened LF at L2/3 (>3.0 mm), then the remaining levels of LF were thickened. In elderly patients, there was no correlation between the thickness of LF and the degeneration of intervertebral disc. The results show that thickening of LF at L4/5 had already thickened in patients in the 20–29 age bracket. However, the thickening of LF was not the buckling of the LF into the spinal canal with degeneration of intervertebral disc. The thickness of LF at L2/3 can serve as an indicator of lumbar spinal canal stenosis at multiple levels. Related Articles | Metrics

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Computer-assisted three-dimensional CT angiography for reconstruction of course and variations of the second segment of vertebral artery Zhang Xiu-gong, Wang Ting, Gao Jia-ke, Cui Tao, Li Shu-zhong 2011, 15 (9):  1619-1622.  doi: 10.3969/j.issn.1673-8225.2011.09.024 Abstract ( 365 )   PDF (542KB) ( 539 )   Save BACKGROUND: Different imaging detections for vertebral artery are still varied and controversial. The development of CT angiography has provided a new method for the anatomic observation and disease diagnosis about vessels and joints. OBJECTIVE: To evaluate the three-dimensional CT angiography (3DCTA) in displaying the second (V2) segment of the vertebral artery, and to identify its course and variation. METHODS: Totally 250 cases without obvious pathological lesions were selected from the 3D data of head-neck CT angiography examination. On the 3D images, the courses of the V2 segment of the vertebral artery and the variations of the vascular diameter were observed. RESULTS AND CONCLUSION: The vertebral artery entered the C6 transverse foramen in 92.6% of all specimens. An abnormal level of entrance was observed in 7.4% of specimens (37 courses), with a level of entrance into the C4, C5, or C7 transverse foramen, respectively, in 2.2% (n=11; 29.7% of all anomalies), 4.6% (n=23; 62.2% of all anomalies) and 0.6% (n =3; 8.1% of all anomalies) of all specimens. 20 (54.1%) abnormalities were right-sided and 17 (45.9%) were left-sided. 27 out of 250 patients (10.8%) had a unilateral anomaly and 5 had a bilateral anomaly (2%). To compare the vascular diameter of the vertebral artery, the size in the left were larger than that in the right in 53 cases, and the size in the right were larger than in the left in 30 cases, which was of significant difference between left and right (P < 0.01). The incidence of anatomic variations of the vertebral artery V2 segment is high. 3D-CTA, which can objectively reflect the pathology of the vertebral artery, has important clinical value. Related Articles | Metrics

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Application of support vector machines and fuzzy clustering algorithm in gait classification Lu Qiang, Feng Min, Ma Hua, Zhang Xi-xue 2011, 15 (9):  1623-1626.  doi: 10.3969/j.issn.1673-8225.2011.09.025 Abstract ( 480 )   PDF (581KB) ( 430 )   Save BACKGROUND: The gait data is an objective parameter to patients who have musculoskeletal disorders or nervous system diseases. It can evaluate recovery of illness and set up treatment method. How to classify the gait data effectively has become an important research topic. OBJECTIVE: In order to diagnosis illness effectively and provide scientific basis for setting up treatment method, using the modified support vector machines algorithm to classify gait data. METHODS: Modified Support Vector Machines algorithm was proposed, and 720 samples were selected from 6 group data aged 40-59 years from Gait Dynamics in Neuro-degenerative Disease Data Base. Gait data models were established using left swing interval and left stance interval. After normalization, data were preprocessed with Fuzzy C-Mean algorithm, and then classified gait data utilizing support vector machines. The classification ability was verified by support vector machines algorithm with various kernel functions. RESULTS AND CONCLUSION: By comparing classifiers using different kernel function, the result is that the classifier with modified support vector machines algorithm can classify small sample size gait data and set up treatment method effectively. Related Articles | Metrics

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Excitation source design for endocardial three-dimensional mapping based on direct digital synthesis Chen Zhong-zhong, Tian Guo-qiang, Su Zhi-jian, Zheng Wei 2011, 15 (9):  1627-1630.  doi: 10.3969/j.issn.1673-8225.2011.09.026 Abstract ( 259 )   PDF (658KB) ( 425 )   Save BACKGROUND: The excitation source’s design is precondition of detecting the catheter’s position in endocardial three-dimensional (3D) mapping by low-frequency electric field. OBJECTIVE: To design an excitation source for endocardial 3D mapping with simple structure and high integration, furthermore, to test the performance of the excitation source through animal experiments. METHODS: Three channel different frequencies (28, 30, 32 kHz) sine voltage signals were generated based on the direct digital synthesis (DDS) technology and modularization design through three AD9851 chip controlled by single-chip microcomputer STC89C52. The excitation source's performance is analyzed by acquisition and processing the localization signal in animal right atrium. RESOULTS AND CONCLUSION: The animal experimental results show that three signals' current value can be stable at 1mA and the frequency errors are 0.054%, 0.097%, 0.056%, respectively, furthermore, voltage signals in three directions can be extracted from the mapping catheter's sampling data. The excitation source has little frequency error and higher constant-current performance, and therefore can satisfy the endocardial mapping requirements. Related Articles | Metrics

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Effects of rotary speed and pressure changes of blood pump on flow rate base on two cascaded neural networks Xuan Yan-jiao, Chang Yu 2011, 15 (9):  1631-1634.  doi: 10.3969/j.issn.1673-8225.2011.09.027 Abstract ( 350 )   PDF (825KB) ( 776 )   Save BACKGROUND: In clinical applications, the timely and accurate detection of the output flow of artificial heart is very necessary, as it is directly related to the effects of zoopery and clinical application. However, it is difficult to achieve. OBJECTIVE: To explore how cardiovascular hemodynamic parameters reflect the blood pump’s working status during the process of assist circulation and obtain the neural network results which grasp the characteristics of the output flow of blood pump by experiments and theoretical analysis. METHODS: In order to estimate and test the working condition of the blood pump in ventricular assist device correctly, two types of neural networks were established, and the effects of changing rotary speed and pressure on flow rate of the pump were estimated. In the first order, the flow rate affected by continuously changing blood pressure at different rotational speed was estimated by the BP neural network. In the second order, radial basis function neural network was applied to estimate the flow rate of the pump at different rotational speed of the blood pump. RESULTS AND CONCLUSION: This method showed a better estimation ability to estimate the flow rate according to?different rotational speed and blood pressure compared with previous methods. Related Articles | Metrics

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Control mode of a new gas-cooled controlled radio frequency ablation system Wang Yu-kai, Gu Xue-lian, Chang Zhao-hua, Zhao Qing-xiao 2011, 15 (9):  1635-1638.  doi: 10.3969/j.issn.1673-8225.2011.09.028 Abstract ( 347 )   PDF (676KB) ( 413 )   Save BACKGROUND: Radio frequency ablation (RFA) has widely utilized in the treatment for tumor with minimally invasion. However, the current RFA has disadvantages of little volume of coagulation. OBJECTIVE: To design a new gas-cooled RFA controlled mode to increase the extent of coagulation. METHODS: A new gas-cooled RFA controlled mode was researched based on existing gas-cooled RFA system and characteristics of gas-cooled electrode. That is, the new mode was by freeing power of gas-cooled to control the range of RFA under temperature-controlled. The control system adopted master machine and slave machine architecture, and the temperature controlling used improved PID control algorithm. RESULTS AND CONCLUSION: The temperature control results showed that improved PID control algorithm could control temperature precisely, with a fast reaction velocity. Gas-cooled radio frequency power and cooling power showed that, freeing power of gas-cooled can better regulate the output power of RFA to achieve aim of controlling RFA range. Related Articles | Metrics

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Characteristic components and source localization of electroencephalogram signals evoked by magnetic stimulation at acupoints Yu Hong-li, Xu Gui-zhi, Yang Shuo, Li Wen-wen, Xie Xue 2011, 15 (9):  1639-1642.  doi: 10.3969/j.issn.1673-8225.2011.09.029 Abstract ( 318 )   PDF (741KB) ( 545 )   Save BACKGROUND: Acupuncture is an important part of traditional Chinese medicine. Whether acupuncture analgesia has a physiological basis or other psychological effects has long been a focus of argument. Manual manipulation and electrical acupuncture manipulations are clinically used. There are few published on the electroencephalogram (EEG) changes during magnetic stimulation at an acupuncture site. OBJECTIVE: EEG data in response to magnetic stimulation at Hegu (LI4) acupoint were measured to determine whether magnetic acupoint stimulation might modulate cortex function or not. The mechanism of analgesic effect induced by magnetic stimulation at acupoint was discussed. METHODS: Eighteen healthy volunteers (13 male, 5 female) were chosen in this experiment, with consent obtained before the study. LI4 acupoint lying at right were selected. The distance between mock point and LI4 was 3 cm. The frequency of stimulation was 1 Hz, and the intensity was 1.76T. EEG data were recorded before, during and after stimulation. RESULTS AND CONCLUSION: Evoked potential was recorded in F3, F1, FZ, F2, F4, FC3, FC1, FCZ, FC2, FC4 electrodes, at about 140-170 ms (P150) after acupoint stimulation. With regard to the location of P150 in the human brain, it was located to the contralateral anterior cingulated cortex (ACC). Previous research has shown that ACC was not only involved in cognition of pain, but also modulated by analgesics. The result suggests the potential mechanism of analgesic effect induced by magnetic stimulation at acupoint. Related Articles | Metrics

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Clinical manifestation and influence factors in patients with knee osteoarthritis Shen Yan-qing, Liu Feng-xia, Cao Hong, Ma Ai-guo 2011, 15 (9):  1643-1646.  doi: 10.3969/j.issn.1673-8225.2011.09.030 Abstract ( 949 )   PDF (516KB) ( 1183 )   Save BACKGROUND: The precisely etiological factors and pathogenesis of knee osteoarthritis remain unclear. OBJECTIVE: To analyze clinical manifestations of patients with knee osteoarthritis and to explore the influence factors of knee osteoarthritis. METHODS: The general information, such as present illness, past history, physical examination, X-ray film inspection, disease diagnosis and laboratory tests were collected for 315 patients with knee osteoarthritis who were hospitalized in a hospital in Qingdao from July 2007 to November 2009. Statistical comparisons were performed Using SPSS 13.0 software with the χ2 test to analyze influence factors in patients with knee osteoarthritis. RESULTS AND CONCLUSION: ①The percentage of left knee joint pain in patients with knee osteoarthritis was 21.6% and in right knee was 29.5%. The percentage of right knee pain was higher than in left knee (P < 0.01). The percentage of one knee joint pain in patients with knee osteoarthritis was 51.1% and in double knees was 48.9%. There were no statistically significant differences (P > 0.01). ②The detection rate of knee osteoarthritis in women was higher than in men (P< 0.01). The disease incidence was related to age in an increasing tendency with age. ③Compared with non-obesity population, the obesity population suffered a higher incidence of knee osteoarthritis (P< 0.01). There were no statistically significant differences in gender. ④A higher labor intensity in patient means more incidence of knee osteoarthritis. ⑤The detection rate of knee osteoarthritis in postmenopausal women was higher than pre-menopausal women (P < 0.05). The postmenopausal ages were 45-60-year (All subjects over 60 years had menopause). The results demonstrated that gender, age, body mass index, occupation (worker, housework), as well as genetic results are risk factors that cause knee osteoarthritis in the elderly, especially age, which is the highest risk factor. Related Articles | Metrics

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Effect of vertical dimension determined by functional view on occlusal relationship satisfaction of reconstruction of complete denture Zhang Jing-lin, Bai Yue-ying, Wang Wen 2011, 15 (9):  1647-1649.  doi: 10.3969/j.issn.1673-8225.2011.09.031 Abstract ( 293 )   PDF (450KB) ( 425 )   Save BACKGROUND: At present, for the determination of vertical dimension, vertical dimension of rest position is mostly used to reduce mean rest position gap, and combined with experience of physician, finally determine the vertical dimension of complete denture, this dimension is not necessarily maybe the optimal vertical dimension of patients. OBJECTIVE: To investigate the effect of vertical dimension determined by functional view on repair satisfaction of complete dentures in patients with edentulous jaw, according to self-control functional and traditional approach. METHODS: A total of 40 patients were treated with the repairs of complete dentures, the vertical dimension was determined by functional and traditional approach to manufacture complete dentures, respectively. The dentural satisfaction of patients with edentulous jaw was tested, after the patients wore their dentures 3 months. RESULTS AND CONCLUSION: The satisfaction of complete dentures manufactured by functional approach was superior to that by traditional approach (P < 0.05). Functional approach can determine the vertical dimension of the repair of complete dentures. Related Articles | Metrics

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Value of ultrasonometry of acetabular cartilage thickness in the evaluation of infant developmental dysplasia of the hip Li Na 2011, 15 (9):  1650-1653.  doi: 10.3969/j.issn.1673-8225.2011.09.032 Abstract ( 351 )   PDF (534KB) ( 733 )   Save BACKGROUND: A better understanding of classification and features of developmental dysplasia of the hip (DDH), as well as the advantages of early screening and diagnosis, are necessary for correct selection of ultrasonic diagnosis. OBJECTIVE: To summary the classification, features of DDH, and the combination of ultrasonic inspection, clinical examination and radiography in early diagnosis and treatment for DDH. METHODS: A computer-based online search was performed on PubMed and CNKI with search words of “developmental dysplasia of the hip and uhrasonography” both in English and Chinese. Articles addressing classification and features of DDH or the clinical outcomes of ultrasonic inspection in the treatment of DDH were selected. Literatures about the same circle published in the near future or on the authoritative journals were included. Totally 28 papers were selected in this review. RESULTS AND CONCLUSION: Ultrasound can display the cartilage and soft tissue structures surrounding hip joint clearly, present the relative position of femoral head and acetabulum, as well as the morphology and structure changes of femoral head cartilage and glenoid labrum, in addition, it can show parts of soft tissues within acetabulum and supplement information that cannot be displayed by X-ray film or CT. Ultrasonic image is sectional view, compared with X-ray film, it can avoid missed diagnosis or diagnostic errors that caused by structure overlapping or projection angles. On the whole, ultrasonometry possesses highly clinical value in diagnosing infant DDH, which can be used a conventional examination method. Related Articles | Metrics

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Effect size selection of Meta-analysis based on different structural response variable: A comparative study Shen Xu-hui, Wang Zhen 2011, 15 (9):  1654-1658.  doi: 10.3969/j.issn.1673-8225.2011.09.033 Abstract ( 284 )   PDF (761KB) ( 522 )   Save BACKGROUND: The comparative study of groups design data is to compare the difference of response variable measurements on two or more groups of respondents. The Meta-analysis on the studies of this kind of design information is theoretically comparative maturity and consummate, but the researchers and system evaluators still face many difficulties during the Meta-analysis of groups design data. The Meta-analysis on group comparison study requires selecting carefully different effect sizes based on the structure of response variable. OBJECTIVE: To explore the effect size selection and announcements of response variable of different structure in Meta-analysis of groups design data. METHODS: Articles related to Meta-analysis or systematic review methodology literature about group comparison studies for the continuous, dichotomous, and combined outcomes in CNKI database, VIP database, Wanfang Chinese Doctoral database (1990/2009), and Pubmed database (1979/2009) were retrieved by computer. Outdated and repetitive researches were excluded. RESULTS AND CONCLUSION: Totally 30 literatures were involved for summarization according to inclusion criteria. It is relatively common that outcome variables were presented in continuous or dichotomous forms in the research literature, in some situations, it may be more applicable, but when continuous outcome variables were converted to percentage, the determination of cut points may be too arbitrary after converted to percentage analysis, and some information were lost after the treatment of continuous variable dichotomy. It is still facing a huge methodological challenge for meta-analysis. In this review, we introduced a approach based on several treatments commonly used, namely, bayesian reconstruction method, which is based on bayesian model class (Hierarchical Bayesian Models) will overcome the shortcomings of arbitrary determination of cut points and information default. Related Articles | Metrics

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Estimation of effect-size after dichotomized continuous variables in Meta-analysis Zhang Hong, Wang Zhen 2011, 15 (9):  1659-1662.  doi: 10.3969/j.issn.1673-8225.2011.09.034 Abstract ( 568 )   PDF (575KB) ( 690 )   Save BACKGROUND: Both in the field of medical research and behavioral science or psychology in research, even if the type of design is a comparative study of the two samples; for the same outcome variable, there are dichotomized variables and continuous variables, especially for the continuous variables in the dichotomized treatment analysis. Therefore, it also faces enormous challenges in the meta-analysis. OBJECTIVE: To explore 7 different effect-size indices for estimating the population standardized mean difference (δ) based on a 2 × 2 contingency table in terms of bias and sampling variance. METHODS: The literatures related to the outcome variable of intragroup comparative study for the continuous, dichotomous, and continuous combined with dichotomous meta-analysis or systematic review methodology in CNKI database, VIP full text database, Wanfang Chinese Doctoral database (1990/2009), Pubmed database (1979/2009) were retrieved, with key words of “group comparison study, continuous outcomes, dichotomous outcomes, combining continuous and dichotomous outcomes, meta-analysis, effect size” in Chinese, and the same key words in English. Non-comparative studies and relative meta-analysis and systematic evaluation literatures were excluded. RESULTS AND CONCLUSION: A total of 23 documents were included, and which focus on the problems of outcome variables are the continuous variable’s effect-size selection and 7 effect-size selections of dichotomized variables in comparative studies of two groups. In the field of sociology and ethology, essentially as a continuous outcome variables in order to explain and easy to use in the analysis, the dichotomized treatment of continuous variables was widely applied, but it brought challenge for systemic evaluation and meta-analysis. For the dichotomized treatment of continuous variables, 7 kinds of commonly used effect-size was performed comparative analysis. The results showed good performance for 2 indices, one based on the probit transformation and the other based on the logistic distribution. Related Articles | Metrics

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Application of tumor-type prosthesis and reconstruction of bone defects following treatment of giant cell tumor of bone Liu Wei, Zhang Shao-kun, Yan Ming, Niu Feng 2011, 15 (9):  1663-1666.  doi: 10.3969/j.issn.1673-8225.2011.09.035 Abstract ( 370 )   PDF (585KB) ( 349 )   Save BACKGROUND: The giant cell tumor of bone has a high recurrence rate after traditional treatment; however, with better understanding of its mechanism and the successful application of tumor-type prosthesis, the therapeutic efficacy will be better. OBJECTIVE: To summarize the application and pathogenesis of tumor-type prosthesis in the treatment of giant cell tumor of bone. METHODS: A computer-based online search was performed on PubMed and CNKI databases with key words of “giant cell tumor of bone, tumor-type prosthesis, therapy research” from January 2000 to October 2010. Totally 475 documents were initially searched, and 35 papers were included in this review.  RESULTS AND CONCLUSION: The traditional way to cure giant cell tumor of bone is surgery and the reconstruction work was operated based on the diverse situations of damages of bone caused by surgery. It can be seen that choosing tumor-type prosthesis to cure the giant cell tumor of bone is a better approach, according to the comparision of various bone reconstruction ways. It can not only enable the patients to acquire the instant stability of affected limbs or spines, also has less complication. Compared to other reconstruction ways, it apparently lowers rate of after-surgical recurrence, and makes the tumor be removed extensively. However, the application of tumor-type prosthesis does not implicate the disappearence of the recurrence of after-surgical tumor. Recently, the research of signal path from giant cell tumor of bone has made progress, providing a new therapy for lowering the rate of after-surgical recurrence and inoperable patients, which maybe increase the outcome of the therapy. Related Articles | Metrics

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Metallic implant internal fixation for the treatment of nonunion following extremity fracture Wang Cheng-wei, Aierken?Amudong, Li Lu-bing, A Man, Paerhati, Shu Li, Wang Xue 2011, 15 (9):  1667-1670.  doi: 10.3969/j.issn.1673-8225.2011.09.036 Abstract ( 301 )   PDF (738KB) ( 706 )   Save BACKGROUND: Besides fracture pattern, local blood supply and infections, selection, utilization, as well as standard operation of internal fixation also affect bone union. OBJECTIVE: To analyze the causes of nonunion following internal fixation for the treatment of extremity fracture, and to explore the effective treat methods and selection of suitable internal fixation. METHODS: Wangfang data was retrieved by the first author using key words of “bone fracture, internal fixation, nonunion” for papers addressing bone nonunion after internal fixation and treatment methods published between January 2000 and May 2010. Totally 25 documents were analyzed after removing repetitive studies or Meta analysis.   RESULTS AND CONCLUSION: Incidence of nonunion after extremity fracture is related to operation technique except fracture pattern, local blood supply and infections, especially, has directly association with selection and utilization of internal fixation. How to select pertinent internal fixation and accurate fix it is an important factor affects long-term efficacy of fixation and promote bone union. Extremity fractures are complex due to various injury mechanisms and have effect on bone union. Accordingly, matched internal fixations are designed for different fractures types and positions. The selection and utilization of internal fixation affect bone union greatly.   Related Articles | Metrics

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Research progress of the pathogenesis, diagnosis and treatment of infections following total knee replacement Yi Ming, Huang Rong, Li Shu-zhong 2011, 15 (9):  1671-1674.  doi: 10.3969/j.issn.1673-8225.2011.09.037 Abstract ( 436 )   PDF (596KB) ( 404 )   Save BACKGROUND: Periprosthetic infection remains one of the most devastating and costly complications after total knee replacement. It is very important for the prognosis of total knee replacement that understanding its pathogenesis, make an accurate diagnosis timely, and to develop the appropriate treatment. OBJECTIVE: To summarize the research progress regarding pathogenesis, diagnosis and treatment of infections after total knee replacement. METHODS: A computer-based online search of CNKI between January 1982 and December 2009 and PUBMED database was performed to search related articles with the key words of “total knee arthroplasty; infection”. A total of 2 673 articles were retrieved. Moreover, related works were manually searched. Totally 34 articles were included.  RESULTS AND CONCLUSION: The biofilm on phantom surface protects the microbiologic not eradicated by antibiotics. Blood tests, bacteriological culture and imaging are effective procedures for the diagnosis of total knee replacement. But they all have disadvantages, which should be considered. Currently, the treatment modalities of total knee replacement are antibiotics, debridement and prosthesis retention, thorough debridement and one or two-stage reimplantation, arthrodesis, disarticulation and other treatments. The orthopaedic surgeon uses an essential armamentarium of diagnostic and treatment options to determine the presence of infection and tailor the individual treatment for each patient. Related Articles | Metrics

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Biomechanics of acromioclavicular joint reduction using triple button plates Lü Shu-jun, Cao Yong, Zhou Guang-jian, Wang Yi-jin 2011, 15 (9):  1675-1679.  doi: 10.3969/j.issn.1673-8225.2011.09.038 Abstract ( 429 )   PDF (563KB) ( 574 )   Save BACKGROUND: Coracoclavicular ligament plays an important role in maintaining acromioclavicular joint (ACJ) stability, thus, ACJ reconstruction is necessary.  OBJECTIVE: To observe the biomechanics of acromioclavicular joint reduction using triple button plates.  METHODS: Fifteen fresh shoulders were collected, prepared for ACJ dislocation, and reconstructed using triple button plate or double Endobutton. Biomechanical stress analysis was used to compare performances and the effects of two methods. RESULTS AND CONCLUSION: The stress-strain relationship showed that, strength of triple button plate was 25% and 15% larger than the normal coracoclavicular ligament and double Endobutton plate, the elastic modulus was 17% and 14%, and the axial stiffness was 24% and 14%, respectively. There were significant differences between the two groups (P < 0.05). Triple button plates are superior to initial ACJ in strength and stiffness. Obviously, triple fixed-button reconstruction has mechanical advantage than reconstruction plate has much mechanical advantage than the double Endobutton plate. Related Articles | Metrics

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Minimally invasive Kirschner wire combined with external fixation for repair of unstable distal epiphyseal fracture of radius Ren Yi, Hu Jian-shan, Li Pu, Song Xi-lun, Tang Guang-ying, Cen Shi-qiang, Chen Qi-kuan, Cao Yang-bin, Feng Lin,Yu Xue-wen 2011, 15 (9):  1680-1685.  doi: 10.3969/j.issn.1673-8225.2011.09.039 Abstract ( 319 )   PDF (700KB) ( 762 )   Save BACKGROUND: Postoperative complications, such as radial shortening and displacement of fractures, still exist in the clinical practice of treatment of distal radius fracture with only Kirschner wire or external fixation, especially in the treatment of unstable epiphyseal fracture. Kirschner wire is mainly indicated in distal radius fracture and it is rarely applied on the treatment of epiphyseal fracture. OBJECTIVE: To explore the clinical curative effects of the minimally invasive treatment of unstable distal epiphyseal fracture of radius with the combination of external fixation and reduction and percutaneous Kirschner wire fixation. METHODS: Implement surgical treatment on 90 children having distal epiphyseal fractures of radius with no cut by minimally invasive closure and reduction of epiphyseal fractures. Two treatment methods were used: in control group, external fixation of only across carpal joint, external fixation of across carpal joint and percutaneous Kirschner wire fixation were used in the observation group. All cases were followed up at 9 weeks and 24 months after fixation. The long-dated clinical curative effects after surgical operation, functional recovery and the change of X-ray films were compared. RESULTS AND CONCLUSION: According to Cooney rating criteria, the good to excellent rate of the control group was 77%. According to X-ray evaluation, the good to excellent rate was 63.33%. The good to excellent rate of the observation group was 93% and 90 % according to Cooney rating criteria and X-ray evaluation. The difference was significant between two groups (P < 0.01). All the cases got the clinical healing of bones and recovery of wrist joint function. Studies show that: In the minimally invasive surgical treatment of unstable distal epiphyseal fracture of radius with the combination of external fixation and reduction and percutaneous Kirschner wire fixation, K-wire helps the reduction with appropriate palmar inclination and ulnar deviation. Cured by external fixation, static fixation of fractures with the help of K-wire and dynamic transarticular fixation, the patients have a simple postoperative treatment with reliable fixation, good shape, fair recovery of function and few complications of epiphysis malunion. The basic learning function returns to normal after surgical treatment and the curative effects are stable and satisfactory. Related Articles | Metrics

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Treatment of displaced intra-articular fracture of calcaneus using plastic titanic plates Fu Chang-ma, Yang Zu-hua, Qian Chun-sheng, Zhou Si-qi, Zhang You-cai 2011, 15 (9):  1686-1689.  doi: 10.3969/j.issn.1673-8225.2011.09.040 Abstract ( 298 )   PDF (574KB) ( 647 )   Save BACKGROUND: There are various open reduction internal fixation methods and materials, such as specific plate, type U fixation, quadruple-feet nails or tension band fixation. Due to the complex anatomic structures of calcaneus, how to select an internal material that both has good internal strength and can avoid long-term complications need to be explored.  OBJECTIVE: To evaluate the clinical value of plastic titanic plate for intra-articular fracture of calcaneus and its biocompatibility. METHODS: Plastic titanic plates were used in 30 cases (34 feet) with Sanders classificationⅡ-Ⅳ calcaneal fractures approached via lateral L and oblique incision. Autogenous iliac bone-grafting was used in all cases. Postoperative therapeutic effects were evaluated by X-ray film. Based on Maryland foot score, subjective pain assessment, functional recovery, and motion situations were observed. The healing conditions in two groups were compared.  RESULTS AND CONCLUSION: Totally 26 cases were followed up for 9-18 months, compared with the preoperative group, Bohler angle and Gissane angle were significantly satisfactorily after operation (P < 0.001). According to Maryland foot scores, the excellent and good rate was 88.5%, and the oblique lateral incision can be considered as a good alterative of lateral approach for intra-articular fracture of calcaneus. The open reduction and internal fixation with plastic titanic plate is reliable to treat displaced intra-articular fracture of calcaneus. Effective preparation before operation, surgery familiarity of fracture of calcaneus and basic anatomic of calcaneus are the key factors of successful operation. Related Articles | Metrics

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AO hook-plate implantation for Neer type Ⅱ distal clavicle fracture Wang Tian-bing, Yan Yong-qing, Bai Lu, Fu Zhong-guo, Zhang Dian-ying, Xu Hai-lin, Jiang Bao-guo 2011, 15 (9):  1690-1693.  doi: 10.3969/j.issn.1673-8225.2011.09.041 Abstract ( 369 )   PDF (579KB) ( 445 )   Save BACKGROUND: Kirschner wire tension band or common plate screw fixation is frequently used for distal clavicle fracture. However, tension band wire loosening, screw loosening, plate breakage, pin tract infection, even internal fixation failure frequently occur. Recently, AO clavicle hook-plate has been used to treat distal clavicle fracture and obtained favorable effect. However, it remains controversial whether hook can influence shoulder function. OBJECTIVE: To observe the outcome of Neer type Ⅱ distal clavicle fracture treated by AO clavicle hook-plate and coracoid-clavicular ligment repair or reconstruction. METHODS: From September 2002 to March 2008, 27 cases of Neer type Ⅱ unstable fractures of the distal clavicle were treated with AO clavicle hook-plates internal fixation and cocrcoid-clavicular ligment repair or reconstruction. Rehabilitative training began 2 weeks after operation. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was assessed using the Constant-Murley scoring system. RESULTS AND CONCLUSION: The 27 patients were followed up for more than 6 months. All fractures eventually achieved solid bony union within 3 months after surgery. The hook plates were removed at an average of 8.2 months after the first operation. Clinical results were satisfied with a mean Constant-Murley score of 87 points. Open reduction and internal fixation with AO clavicle hook-plates is a useful method for unstable fractures of the distal clavicle. The coracoid-clavicular ligment repair or reconstruction must be paid attention while internal fixation was performed. Related Articles | Metrics

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Change regularity of intervertebral contact areas during lumbar spondylolisthesis and its value in clinical application Shen Ai-dong, Xu Rui-sheng 2011, 15 (9):  1694-1697.  doi: 10.3969/j.issn.1673-8225.2011.09.042 Abstract ( 279 )   PDF (423KB) ( 466 )   Save BACKGROUND: Lumbar spondylolisthesis directly reduces contact areas between dislocated vertebral body and subjacent vertebral body, which is an important factor that decides intervertebral stress and lumbar degeneration. The cross section of lumbar is irregular reniform shaped and there is no mathematical formula to calculate changing regularity of intervertebral contact areas of lumbar spondylolisthesis directly. OBJECTIVE: To study changing regularity of intervertebral contact areas during lumbar spondylolisthesis and to analyze its clinical significance.  METHODS: Super-surface of L5 vertebra and sub-surface of L4 from 25 cases were taken by a digital camera and computer simulation spondylolisthesis process and every intervertebral contact areas (Sn) were measured by Image-Pro Plus software. The mean value was obtained and converted into percentage area according to Sn%=Sn/S×100%. The change rules of vertebral bodies were observed from 0 to 100% spondylolisthesis. Based on this regularity, a new clinical stage of lumbar spondylolisthesis was proposed and guided for treatment of 56 cases with lumbar spondylolisthesis. RESULTS AND CONCLUSION: During lumbar spondylolisthesis process, Sn% changes like a hyperbola. Sn% lost slowly during spondylolisthesis rate at 0-23% and quickly during 23%-44%, and then it become slowly once again after spondylolisthesis rate at 44%-100%, the inflection points appeared at (23±2)% and (44±2)%. Totally 48 patients were followed up, according to Staufee standard rate, the clinical curative effect reached approximately 90%. It suggests that the intervertebral contact areas present with a non-linear change, which is helpful to judge the stability of lumbar spine and guide the treatment of lumbar spondylolisthesis. Related Articles | Metrics

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Feasibility of manubrium sterni cancellous bone plus pyramesh in anterior cervical spinal fusion surgery Wang Gao-ju, Wang Qing, Wang Song, Zhong De-jun, Wang Zhuan, Wen Rui 2011, 15 (9):  1698-1701.  doi: 10.3969/j.issn.1673-8225.2011.09.043 Abstract ( 401 )   PDF (323KB) ( 680 )   Save BACKGROUND: Current commonly used bone graft materials include cancellous bone or bone blocks from ilium, tibia, fibula and others. There is no report of bone graft and fusion in cervical spine from manubrium sterni. OBJECTIVE: To measure lateral X-ray of cervical vertebrae with no degeneration and manubrium sterni samples to explore feasibility of autologous cancellous bone graft of manubrium sterni with pyramesh in anterior cervical spinal fusion surgery, so as to develop a new source of autogenous bone graft. METHODS: A total of 40 manubrium sterni specimens were selected and the length, maximum width and minimum width, thickness, anterior and posterior cortex thickness of manubrium sterni were measured. Manubrium sterni area was calculated: the length, maximum width and minimum width were 4 mm reduced from those of manubrium sterni, its thickness was 2 mm reduced from that of manubrium sterni. The formula of measuring the manubrium sterni volume is (maximum width of manubrium sterni + the minimum width of manubrium sterni)×length of manubrium sterni × thickness of manubrium sterni×1/2. Intervertebral height and vertebral height from C2 to C7 were measured from lateral cervical radiograph of 106 patients with cervical radiolopathy, and the length of pyramesh needed in anterior cervical spinal surgery for one, two, three discs resection, one vertebra plus two discs resection and two vertebrae plus three discs resection was calculated. RESULTS AND CONCLUSION: The manubrium sterni volume was (17 735.51±5 234.92) mm3 and the volume of bone-grafting area was (8 982.83±2 427.76) mm3. The length of pyramesh and volume of bone used in operation were minimal for one disc resection, and maximal for two vertebrae plus three discs resection. The volume of bone graft in the pyramesh was significantly less than the donor area in any anterior cervical spinal fusion operation. Results show that autologous cancellous graft of manubrium sterni combined with pyramesh supporting can be used in anterior cervical spinal fusion surgery. Compared with autologous iliac graft, this method is simpler and does not influence early functional exercise or walking bearing weight. Related Articles | Metrics

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BP neural network in analysis of disease influential factors Zhou Jin-hai, Shen Gang-lei, Ding Xiao-li, Yang Tao 2011, 15 (9):  1702-1705.  doi: 10.3969/j.issn.1673-8225.2011.09.044 Abstract ( 529 )   PDF (393KB) ( 583 )   Save BACKGROUND: Disease pathogenic factors are complicated. There is not an effective method to analyze large sample data mining, and application ability of information technology of clinical doctors needs to be improved.  OBJECTIVE: Using BP algorithm of artificial neural network to analyze large sample clinical cases, in order to explore inner relations between disease pathogenic factors and diseases. METHODS: Take hypertension for example, medical data of patients with hypertension in a traditional Chinese medical hospital served as experimental data, and the influence factors of the disease were simulated with Microsoft SQL Server 2005 Analysis Services, the mining data was analyzed, and a single query was used as prediction and decision support. RESULTS AND CONCLUSION: Analysis of effect of disease pathogenic factors on disease itself based on artificial neural network with BP algorithm has good predictive effect in clinical diagnosis, which is of benefit to enhance the diagnostic efficiency of medical personnel using information technology. Related Articles | Metrics

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Hip-preserving treatment for osteonecrosis of the femoral head Evaluation criteria of quality of life Zheng Zhi-hui, Zeng Yi-rong 2011, 15 (9):  1706-1710.  doi: 10.3969/j.issn.1673-8225.2011.09.045 Abstract ( 369 )   PDF (294KB) ( 392 )   Save BACKGROUND: There are many criteria used to evaluate the curative effects of hip-preserving treatment for osteonecrosis of the femoral head (ONFH), and there have been no consistent criteria, so the curative effects of hip-preserving treatment lack comparability to some extent. OBJECTIVE: To review and analyze a variety of criteria for evaluating the curative effects of hip-preserving treatment and to develop a specific quality of life scale of hip-preserving treatment. METHODS: A computer-based retrieval of Pubmed database using key words “osteonecrosis, femoral head, quality of life”, or “osteonecrosis, femoral head, curative effect” for manuscripts published from August 2000 to August 2010 and of CNKI database for manuscripts published from January 1994 to December 2009 using key words “femoral head necrosis, curative effect” or “femoral head necrosis, quality of life”. Manuscripts that address hip-preserving treatment of ONFH and related quality of life or manuscripts that were recently published or in the high-impact journals were included in this paper. Finally, 31 manuscripts were reviewed. RESULTS AND CONCLUSION: The current criteria for evaluating the curative effects of hip-preserving treatment focus on pain, function, and range of motion of hip joints, but do not lay emphasis on the local changes of hip joints or lower limbs, which can not sufficiently reflect the overall quality of life of patients. The SF-36 scale lack specificity to some extents and cannot be used to evaluate the curative effects of hip-preserving treatment systemically and specifically. Therefore, it is necessary to develop a specific quality of life scale for evaluating the curative effects of hip-preserving treatment of ONFH. Related Articles | Metrics