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26 March 2010, Volume 14 Issue 13 Previous Issue    Next Issue

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Mobile-bearing versus fixed-bearing in total knee arthroplasty: A systematic review Luo Shi-xing, Zhao Jin-min, Su Wei, Sha Ke, Wei Qing-jun, Li Xiao-feng 2010, 14 (13):  2281-2284.  doi: 10.3969/j.issn.1673-8225.2010.13.001 Abstract ( 110 )   PDF (733KB) ( 437 )   Save BACKGROUND: The question regarding whether mobile bearing prostheses has superiority over fixed-bearing prostheses remains controversial. Although some scholars believed that mobile bearing prostheses is better than fixed-bearing prostheses, other researchers argue no differences between both implant types. OBJECTIVE: To compare the clinical results of mobile bearing with fixed-bearing in total knee arthroplasty (TKA) and to assess the differences between two groups. METHODS: We conducted computer-aided searches of Medline (January 1966 to November 2009), Embase (January 1980 to November 2009), Cochrane library (November 2009), Chinese Biomedical Databases (CBM, January 1990 to November 2009) with references to mobile bearing versus fixed-bearing in TKA. Randomized controlled studies on TKA between mobile bearing and fixed-bearing prostheses were collected. The methodological quality of included studies was assessed by using of assessments of risk of bias in Cochrane handbook 5.0.1. RevMan 5.0.18 software was used for Meta-analysis. RESULTS AND CONCLUSION: A total of 11 randomized controlled trials were included with a total of 1 427 knees, 694 knees in mobile bearing and 723 knees in fixed-bearing. The bias in the studies was low. Postoperative outcomes were significantly elevated compared with preoperative outcomes. The outcomes of Meta-analysis showed that no statistical significance differences on Knee score range of motion (ROM), bearing dislocation, need for repeated surgery. But, 4 dislocation knees all occurred in four studies of mobile bearing TKA, the rate of dislocation was 1.8% (4/217). The results showed that no significant differences on clinical results and complications compared mobile bearing prosthesis with fixed-bearing prosthesis in TKA, we advise that more evidences should be needed for supporting the outcomes, and both types of prosthesis can get well results in clinical trial. Related Articles | Metrics

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Computer-assisted navigation system in midfacial fracture treatment Fu Jian-ming, Wang Jing, Yu Zheng-yu, Jia Liu-he, Gao Tao, Yang Guang 2010, 14 (13):  2287-2291.  doi: 10.3969/j.issn.1673-8225.2010.13.003 Abstract ( 88 )   PDF (818KB) ( 489 )   Save BACKGROUND: The spatial structure of midface leads to changeable in injury, and difficult to recover especialy for obsolete fracture. The application of computer-assisted navigation system provides a reliable basis for midfacial fracture treatment. OBJECTIVE: To explore the application result and precautions of computer-assisted navigation system in midfacial fracture treatment. METHODS: Totally 6 midfacial fracture cases received treatment at the Departments of Dentistry and Ophthalmography, Beijing Jishuitan Hospital were selected, including 4 cases with orbital-maxillary-zygomatic compound fracture and 2 cases with LeFortⅢ maxillary fracture. Computer-assisted navigation system was used in the treatment. Data were collected by CT, and navigation software was used for preoperative design. During the operation, the navigation workstation was used for guidance and open reduction and internal fixation was performed. RESULTS AND CONCLUSION: The computer-assisted navigation system could facilitate accurate preoperative design, precise surgical location, and satisfactory results were obtained in 6-12 months follow-up. It suggested that computer-assisted navigation system is a valuable technique, which could increase the reposition precision of midfacial fracture. Related Articles | Metrics

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Robotic assisted femoral shaft fracture reduction Ruan Zhi-yong, Tobias Huefner, Luo Cong-feng, Zhang Chang-qing 2010, 14 (13):  2292-2294.  doi: 10.3969/j.issn.1673-8225.2010.13.004 Abstract ( 134 )   PDF (394KB) ( 608 )   Save BACKGROUND: Robot-assisted surgery is the future of femoral fracture treatment. It coud create a real minimally invasive fracture manipulation, which is the one-time, single-way, fine-tune gentle reduction. It can greatly decrease the systemic and local damage of fracture manipulation. OBJECTIVE: To report a new system of robot-assisted surgery for femoral fracture and the preliminary experimental results. METHODS: The study was accomplished in Hannvoer Medical University in Germany. Human femoral cadavers and navigation system and Stäubli RX 90CR robot system were employed, dynamic reference bases (DRB) was mounted on the distal and proximal femur and the robotic arm as well to record the initial spatial relative relationship. The femur was fractured by Zwick/Roell machine, the 3D fluoroscopy imaging of the fracture area was created by three-dimensional fluoroscopy, and the fracture fragments were visualized on the screen, with the navigation system, the fracture was reduced by the robot arm based on the visual reality. The accuracy of the reduction result in terms of lateral displacement and angulation and malrotation were measured. RESULTS AND CONCLUSION: This robot-assisted fracture reduction system worked well. In simple fracture, the reduction time was 4 minutes and 34 seconds on the average, the mean lateral displacement was 1.61 mm, the mean angle error was 1.42°, and the rotation error was 1.37°. The rotation error was still below 4° for complex fractures. This solution of robotic fracture reduction is promising. It seems to be a universal platform in the research of robotic fracture treatment. Related Articles | Metrics

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Development of intelligent lower limb prostheses based on iterative learning control: A follow of normal walking speed Gong Si-yuan, Yang Peng, Song Liang, Liu Zuo-jun 2010, 14 (13):  2295-2298.  doi: 10.3969/j.issn.1673-8225.2010.13.005 Abstract ( 99 )   PDF (559KB) ( 670 )   Save BACKGROUND: Traditional lower limb prosthesis with hydraulic or pneumatic dampers only can be adjusted to a fixed damper. For a changing cadence, the traditional prosthesis with limited operating range cannot follow the sound leg. Intelligent prosthesis can adjust the knee moment to achieve a near-normal gait. Affordable intelligent lower limb prostheses can significantly improve the life quality of native amputees. OBJECTIVE: To develop a practical lower limb intelligent prosthesis which can follow the walking speed of sound leg. METHODS: Four-bar linkage with a fixed pneumatic cylinder was adopted as the mechanism of the prosthesis joint. The electronic goniometer measured the prosthesis knee angle to acquire the walking speed. To obtain a displacement of the conical valve corresponding to current speed, a knowledge base was established by ILC (Iterative Learning Control) algorithm. The prosthesis leg swing speed was regulated by a needle valve whose orifice opening was adjusted by a permanent magnet linear step motor. RESULTS AND CONCLUSION: Results indicate that potentiometer employed as local sensor can measure the walking speed, and distinguish stance phase and swing phase. Maximum knee joint angle of prosthesis varies in a limited range within 13 degree at different walking speeds. Intelligent lower limb prosthesis can identify the walking speed and follow the cadence of sound leg, which lays a experimental base for a practical product. Related Articles | Metrics

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Establishment and validation of a three-dimensional finite element model of the cervical spine Li Bin, Zhao Wen-zhi, Chen Bing-zhi, Su Jin, He Sheng-wei, Fang Xu 2010, 14 (13):  2299-2302.  doi: 10.3969/j.issn.1673-8225.2010.13.006 Abstract ( 109 )   PDF (692KB) ( 544 )   Save BACKGROUND: Finite element analysis, as a numerical calculation of a discrete method, is characterized by short experimental time, less cost, comprehensive mechanical performance test and repeatable experiments. But more focused on the lumbar spine model for the study, due to anatomy and injury mechanisms of cervical complex, poor stability, there are few studies on cervical spine finite element model, and research is limited to a single vertebra and the motion segment. OBJECTIVE: To establish the cervical three-dimensional finite element model and it will be used for clinical study. METHODS: A three dimensional finite element model of the cervical spine was established from the CT scan images of a cadaver cervical spin，Solid-Works2003, HyperMesh and ANSYS11.0. Different material was assigned different mechanical parameter, and we created a cervical three-dimensional finite element model．After setting the boundary, the model is loaded to simulate the flexion/extension, left/right bending and rotating. The relationship of movement and displacement will compare with the results of experiment in vitro. RESULTS AND CONCLUSION: The model has 372 896 solid elements and 97 705 points. Established model in flexion/extension, left/right lateral bending, left/right rotation range of motion in six directions, theoretical analysis results and measured data were highly consistent in biomechanics. Results of analysis of finite element and other experiment results have good coincidence and the method can be used to establish the model of the living cervical spine. Related Articles | Metrics

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Relationship between therapeutic effect of physical therapy on cervical rediculopathy patients and characteristics described by the LOGISTIC regression model Li Xue-ying, Wang Lin 2010, 14 (13):  2303-2306.  doi: 10.3969/j.issn.1673-8225.2010.13.007 Abstract ( 110 )   PDF (595KB) ( 387 )   Save BACKGROUND: In previous study, the LOGISTIC model has been established and showed its superiority in describing the physical therapy processes on cervical radiculopathy.  OBJECTIVE: To analysis relation between the therapeutic effects and the math characters given by the LOGISTIC model, and to demonstrate the effectiveness of LOGISTIC model in describing the physical therapy processes on cervical radiculopathy. METHODS: Multiple physical therapies were administered to 90 cervical radiculopathy patients with pain for 10 sessions. A visual analogue scale was used to measure the pain intensity before each time. Calculate the inflexion and the curvature extremum point of each patient from the LOGISTIC model. Statistical analysis was performed for demonstrating the relation between the therapeutic effects and the math characters. RESULTS AND CONCLUSION: The pain relief and location of inflection point was negatively correlated with the second extreme point of curvature (r=-0.460, P < 0.001; r=-0.598, P < 0.001); which had no significance with the first extreme point of curvature (r=0.075, P=0.481). It reveled that the earlier appearance of inflection point and the second extreme point of curvature, the most pain relief. There was no obvious correlation between the first extreme point of curvature location and the pain relief. The location of inflexion point and the curvature extremum point were different between the effective cases and the ineffective case, but the differences of the first extreme point of curvature had no significance between two groups. ROC analysis showed that using inflection point and the second extreme point of curvature as judgment indexes, greater area under curve could be obtained, and the Youden index was 0.54-0.64, which exhibited judgment capacity. The LOGISTIC model can describe the characters of physical therapy processes on cervical radiculopathy sufficiently. Related Articles | Metrics

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Three-dimensional forces of Buccal multiloop appliance in the mouth opening and closing movement Miao Nan, Hou Lu, Xu Shi-qian 2010, 14 (13):  2307-2310.  doi: 10.3969/j.issn.1673-8225.2010.13.008 Abstract ( 90 )   PDF (617KB) ( 375 )   Save BACKGROUND: Buccal multiloop removable appliance is a novel appliance. It is primarily used to treat Angle Ⅲ malocclusion at milk teeth and mixed dentition periods. In addition, it can promote maxilla development and inhibit mandible excessively forward development. OBJECTIVE: To observe the three-dimensional forces of Buccal multiloop appliance in the mouth opening and closing movement and analyze the changing regularity METHODS: Buccal Multiloop Resistance Tester was used to imitate and calculate the Buccal multiloop removable appliance three-dimensional forces in the mouth opening and closing movement and analyze the changing regularity. RESULTS AND CONCLUSION: The min force in the mouth opening movement was (64.96±48.47) g when 2 mm sagittal afterburner and 5 mm opening degree. The max force in the mouth opening movement was (285.47±14.44) g when 3 mm sagittal afterburner and 0 mm opening degree. The min force in the mouth closing movement was (79.31±19.94) g when 3 mm sagittal afterburner and 5 mm opening degree. The max force in the mouth closing movement was (285.47±14.44) g when 3 mm sagittal afterburner and 0 mm opening degree. The dimensional linear regression equation in the mouth opening movement was = -0.415 44 + 0.529 42 X1+0.803 64 X2 -0.004 17 X3. The dimensional linear regression equation in the mouth closing movement was = -0.426 5+ 0.559 4 X1+0.777 51 X2+0.005 16 X3 . The results showed the levels of the mouth opening and closing had significant effects on Buccal multiloop removable appliance forces, but the mandibular lateral movement had no effects. There was linear relationship among sagittal saw forces, the levels of the mouth opening and closing and the Buccal multiloop removable appliance forces. Related Articles | Metrics

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Finite element analysis of stress distribution of Spline implant-abutment joint with different number of projections Huang Qian, Li Su-ling, Wang Cong, Wang Shao-an, Wang Lu 2010, 14 (13):  2311-2314.  doi: 10.3969/j.issn.1673-8225.2010.13.009 Abstract ( 126 )   PDF (655KB) ( 297 )   Save BACKGROUND: Spline implant has been shown to have maximum stress at Spline projection root under different loading. OBJECTIVE: To find a way to strengthen the Spline projections from projection numbers, namely to reduce projection number but increase projection volume, and to verify the accuracy by three-dimensional finite element analysis. METHODS: Pro/Engineer Wildfire 2.0 software was used to establish Spline implant-abutment model with identical diameter and length but different projection numbers (4, 5, 6). The model interface was modified by two methods: by method A, the total volume of 4 or 5 projections was equal to Spline implant; by method B, the projection space of 4 or 5 projections was equal to Spline implant. Three-dimensional finite element analysis was used to determine stress distribution of the implant with different number of projections under vertical 200, 500 N, oblique 100 N (45°) by Ansys Workbench 9.0 software. RESULTS AND CONCLUSION: For method A, stress on projections of the implant increased with reducing number of projections. For method B, implant with 5 projections displayed greater stress compared with 6 projections, and 4 projections showed similar or a little lower stress compared with implant with 6 projections. Results show that it requires validation to strengthen the Spline projections by reducing projection numbers. Related Articles | Metrics

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Curve fitting of soft and hard tissue relation using mathematics models: Functional treatment and natural growth of Class II malocclusion Liu Ya-fei, Cui Li-juan, Zuo Yan-ping, Liu Xue-cong, Liu Xin 2010, 14 (13):  2315-2318.  doi: 10.3969/j.issn.1673-8225.2010.13.010 Abstract ( 72 )   PDF (658KB) ( 455 )   Save BACKGROUND: With development of the digitization in cephalometry and model, increasing mathematical methods are applied in studies of orthodontics. OBJECTIVE: To investigate whether the relationship between soft- and hard-tissue changed before and after the functional treatment and to build up mathematical models. METHODS: A total of 67 early permanent dentition Class II Division 1 malocclusion patients were selected, including 40 with functional treatment and 27 with no functional treatment. They were examined cephalometrially before and after treatment. Mathematical methods were used to evaluate effect of treatment, including 4 items, APDI, Ls-EP, U1-NA (mm) and U1-NA. To evaluate the relationship between soft- and hard-tissue movements, a linear function was initially fitted to the data. A quadratic function was fitted to the data when the linear term was not significant.  RESULTS AND CONCLUSION: Mathematical models confirmed that the association for the soft and hard tissues was quadratic, by using curve-fitting polynomial approach to the cephalometric data of 4 indicators before and after the functional treatment. The pre-treatment  functional formula were: U1–NAmm =-0.012 7 (APDI)2 +1.705 2 (APDI) -0.686 1; U1–NA =-0.025 5 (APDI)2 +3.234 3 (APDI) -67.831 8; Ls–EP =-0.003 7 (APDI)2 +0.380 2(APDI) -3.267 3. The post-treatment  functional formula were: U1–NAmm =-0.003 1(APDI)2 +0.495 8(APDI) -14.248 4; U1–NA =0.01 32 (APDI)2 -1.993 9 (APDI) +98.104 5; Ls–EP =0.007 4 (APDI)2 -1.264 7(APDI) + 55.412 4. The results showed obvious changed in the relationship between soft- to hard-tissue pre- and post the functional treatment. The functional treatment effectively improved the profile of soft-tissues of Class II malocclusion cases. Related Articles | Metrics

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Application of computer-aided design-rapid prototyping in intertrochanteric fracture: Compared to routine operation Xing Xiao-wei, Yin Qing-shui, Huang Shan-dong, Zhang Yu, Xu Kai, Zhang Hai-yan, Zhou Ye 2010, 14 (13):  2319-2323.  doi: 10.3969/j.issn.1673-8225.2010.13.011 Abstract ( 101 )   PDF (604KB) ( 575 )   Save BACKGROUND: Development of computer-aided design (CAD)-rapid prototyping implements planar image to three-dimensional solid digitization, thus, provides guidance for disease diagnosis, focus location, and operation project confirmation, which significantly enhance the security and quality of operation. OBJECTIVE: To evaluate the therapeutic effect of CAD-rapid prototyping on treating femoral intertrochanteric fracture. METHODS: A total of 30 cases of intertrochanteric fracture, aged 18-55 years, were selected from Department of Orthopaedics, General Hospital of Guangzhou Command. All cases were randomly divided into the routine operation and CAD groups. Traction on tibial tubercle was performed in the routine group; in the CAD group, exception of traction on tibial tubercle, CT data were extracted, intertrochanteric fracture mode was constructed by CAD, operation reposition on femoral intertrochanteric fracture was simulated, the module match with Greater trochanter of femur, as well as the screw patch was designed. Operation duration and bleeding amount were recorded in the operation. The therapeutic effect was evaluated by using Harris scores at 1 year follow-up. RESULTS AND CONCLUSION: Femoral intertrochanteric fracture 1:1 model and screw implanting platen could guide the operation accurately, which elevated operating security. Compared to the routine group, CAD decreased operation duration and bleeding amount, with excellent reposition. Harris scores for hip joint showed that the patients recovered well after operation. There was no deformity of coxa vara or shortened limb. All patients achieved the anticipation of clinic purpose. CAD-rapid prototyping overcome the disadvantages, such as inaccurately, great trauma, and repeated radiation exposure of routine operation, which is more safety to patients and doctors. Related Articles | Metrics

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Personalized prefabricated titanium template and tissue-engineered bone in reconstruction of maxillary alveolar defect in rabbits: Feasibility to maintain new bone shape Ge Yi-ming, Qi Feng, Wang Zhi-ying 2010, 14 (13):  2324-2428.  doi: 10.3969/j.issn.1673-8225.2010.13.012 Abstract ( 96 )   PDF (740KB) ( 371 )   Save BACKGROUND: In oral tissue engineering, appearance of maxillofacial bone is complex and irregular, and maxillofacial bone supports the face, and highly correlates to this appearance. Therefore, in addition to restoring the function, appearance restoration is also important. Precise appearance restoration would become developing trends. OBJECTIVE: To explore the effect of tissue-engineered bone constructed by hyaluronic acid in combination with recombinant bone morphogenetic protein (rhBMP-2)-induced bone marrow stromal stem cells (MSCs) in vitro on repairing maxillary alveolar ridge defect, and investigate the feasibility to maintain moulding by personalized template for the external fixation of titanium. METHODS: Rabbit MSCs were cultured in vitro for bone induction to construct tissue-engineered bone in combination with sodium hyaluronate and rhBMP-2. The bone was implanted into the autologous alveolar ridge defect, plus personalized titanium template. After 4, 8, 12 weeks, animals were sacrificed and respectively subjected to radiation, conventional histological examination to observe in vivo osteogenesis of this tissue-engineered bone. In addition, rats implanted with autogenous bone fragments served as control. RESULTS AND CONCLUSION: There were significant differences in gray scale between experimental and control groups at the first 4 weeks (P < 0.05). But at 8 and 12 weeks, no differences were observed (P > 0.05). In addition, there were significant differences in gray scale of newly-generated bone between 4 and 8 weeks and 8 and 12 weeks after operation (P < 0.05). Histological staining showed that osteogenesis of the experimental group was less than the control group at 4 weeks, and became similar at 8 weeks. Results show that the tissue-engineered bone constructed with hyaluronic acid sodium and rhBMP2F-induced MSCs displayed obvious osteogenesis, and personalized shaping titanium barriers play a role in the template to promote the new bone generated by a particular shape. Related Articles | Metrics

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Three-dimensional finite element analysis of screw-plate fixation and joint lag screws fixation for sacroiliac joint dislocation Zhang Jing-liao, Gu Li-qiang, Zhang Mei-chao, Liu Shi-Jing 2010, 14 (13):  2329-2332.  doi: 10.3969/j.issn.1673-8225.2010.13.013 Abstract ( 116 )   PDF (456KB) ( 513 )   Save BACKGROUND: Finite element analysis (FEA) can be applied to compare stress of complicated structure, morphology, load, and material property, and it is being considered as an important method in orthopaedic biomechanical research. OBJECTIVE: To prepare sacroiliac joint dislocation models by FEA, and to compare biomechanics stability of two internal fixation treatments for sacroiliac joint dislocation. METHODS: All the ligaments situated in half sacroiliac joint were cut on the normal three-dimensional finite element model of pelvis. These ligaments include anterior sacroiliac ligaments, posterior sacroiliac ligaments, interosseous sacroiliac ligaments, sacrotuberous ligaments and sacrospinous ligaments. Thus, the pelvic model of sacroiliac joint dislocation was established. In order to simulate the treatment with plates and screws on dislocation of pelvic sacroiliac joint via anterior path, the two reconstructive plates and the six standard screws were added into the model, as well as the two sacroiliac joint lag screws via posterior path. Then, the same load was exerted on different model respectively. At the end, the none-line solution was analyzed. MAIN OUTCOME MEASURES: The stress, strain and displacement nephograms were obtained under axial load. RESULTS AND CONCLUSIONS: The high-precision three dimensional finite element model of pelvic sacroiliac dislocation was established. The biomechanical stability and intensity of the two methods of internal fixations were analyzed and compared by the stress-strain nephogram. The consequences indicated that the fixation stability of two sacroiliac joint lag screws was larger than that of two reconstruction plates via anterior path. The total displacement of the former was less then that of the latter, and the stress of the former was not clearly concentrated on some sites. The fixation intensity of the former was larger, and the stability of fixed pelvis was better. The method on analyzing biomechanics stability of two internal fixation treatments on sacroiliac joint dislocation by the three-dimensional finite element analysis has the advantages of the higher authenticity, precision and repeatability. The result is identical to those of other experimental methods. Accordingly, this method can be applied to the research of pelvis injuries clinically. Related Articles | Metrics

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Biomechanical comparison between anterior and upper reconstruction plate internal fixation for middle clavicular fractures Shi Ji-xiang, Cao Cheng-fu, Shi Wen-jun, Ji Bin, Zhou Qiang, Zhou Jun-jie, Zhao Ying, Liu Fu-ying 2010, 14 (13):  2333-2336.  doi: 10.3969/j.issn.1673-8225.2010.13.014 Abstract ( 113 )   PDF (504KB) ( 431 )   Save BACKGROUND: It is dispute which placement methods are adaptable when repairing clavicle middle segment comminuted fractures using open reduction and internal fixation, therefore, the biomechanical difference between anterior and upper reconstruction plate internal fixation should be verified, which can provide guidance for clinical treatment. OBJECTIVE: To compare the biomechanical characteristics of upper and anterior reconstruction plate internal fixation for middle clavicular fractures. METHODS: Totally 12 adult clavicles (24 clavicles) were prepared for middle fractures models, fixed using 6 holes reconstruction plate, and randomly divided into 3 groups: in the upper plate group (n=9) and the anterior plate group (n=9), the reconstruction plates were fixed at the upper or anterior of the clavicle fracture specimen, there were 3 screws at the each end of fracture lines. In the normal specimen group (n=6), there was no treatment. The biomechanical characteristics of each specimen were tested and compared.  RESULTS AND CONCLUSION: Three-point bending test, torsional strength and stiffness measurement demonstrated that there were no significant difference between the upper plate, anterior plate and normal specimen groups (P < 0.05); the tension test showed that the tensile strength and stiffness of the anterior plate group were larger than that of the upper plate group (P < 0.05), with stronger pull-out resistance (P < 0.05). Simultaneously, the anti-putout power of the anterior plate group was less than the upper plate group (P < 0.05). It revealed that the anterior reconstruction plate internal fixation is an ideal method for treating middle clavicular fracture. Related Articles | Metrics

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MATLAB-based numerical conversion algorithm of cardiac electrophysiology image Hou Yuan-yuan, Han Yang, Zhou Ping, Ma Yu-jing 2010, 14 (13):  2337-2340.  doi: 10.3969/j.issn.1673-8225.2010.13.015 Abstract ( 156 )   PDF (543KB) ( 665 )   Save BACKGROUND: Original experiment record of cardiac electrophysiology is significant for further research. However, the original record is curve graphics. It is difficult to repeat this experiment because of the special cases or the restrictions of the experimental equipment and the cost of experiment. Therefore, it is necessary to convert the curve graphics to numerical value as a method of processing the original data in the medical signal area. OBJECTIVE: To convert various types of electrophysiology image into numerical value by the means of MATLAB for further analysis, comparison and research store. METHODS: Based on characteristic analysis of cardiac electrophysiology images, the cardiac electrophysiology images were subjected to numerical value, including signal extraction, noise extraction, and error correction. The last numerical values were converted matching to the actual size of the image. This algorithm was used for various types of heart electrophysiology image to prove its feasibility. Finally, the image of numerical value was compared with the original to check its accuracy. RESULTS AND CONCLUSION: Through a comparison with the original image, the result of this algorithm could mostly reflect the original information and had a high degree of accuracy. Almost every kind of electrophysiology image could be converted using this algorithm. This algorithm is a powerful tool in image conversion. Using this algorithm, electrophysiology image can be converted to numerical value accurately and stored for further research, which is an important preparation especially for the study of heart diseases. Related Articles | Metrics

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Hip replacement for senile unstable femoral interochanteric fractures: internal fixation following prosthesis implantation Chen Rong-bo, Fan Shao-di, Hu Wan-hua, Wang Ren, Yu Jie, Zhou Feng-jin, Liu Jian 2010, 14 (13):  2341-2344.  doi: 10.3969/j.issn.1673-8225.2010.13.016 Abstract ( 111 )   PDF (422KB) ( 551 )   Save BACKGROUND: In recent years artificial joint replacement surgery has become a new method for the treatment of intertrochanteric fractures of the elderly. In the traditional treatment of internal fixation of senile intertrochanteric fractures, the prosthesis is implanted following fracture treatment, or the small trochanter is treated and the prosthesis is implanted, followed by greater trochanter treatment. It remains controversial about the application of lengthened or standard length stem. OBJECTIVE: To evaluate the effect of artificial joint replacement on elderly patients with unstable intertrochanteric fracture, and observe the influence of the order of prosthesis implantation, small trochanter and greater trochanter treatment during the surgery. METHODS: The clinical data of 28 elderly patients with unstable femoral intertrochanteric fractures treated in Department of Orthopedics, the 451 Hospital of Chinese PLA from January 2006 to December 2008 were retrospectively analyzed, including 20 undergoing artificial joint replacement and 8 undergoing total hip replacement with cemented prosthesis. X-ray, Harris scores of hip joint and complications were observed postoperatively. RESULTS AND CONCLUSION: All patients were followed up for 1 to 4 years (average 2.8 years), with an excellent and good rate of 89.3%. No coxa vara, infection, loosening or dislocation was found. The surgery can quickly restore limb function and reduce complications. The treatment of greater and small tuberosity fracture and prosthesis is very important. The prosthesis is firstly implanted, followed by internal fixation with the prosthesis as the support. Tightly matching of the proximal femur and prosthesis is essential for the stability of postoperative prosthesis, and lengthened or standard length stem can be used. Related Articles | Metrics

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Effectiveness comparison between knee replacement and arthroscopic debridement combined sodium hyaluronate injection for knee osteoarthritis Huang Liang-ku, Chen Shi-rong, Tang Jin, Peng Li-hua, Xu Tao, Feng Qing-lin 2010, 14 (13):  2345-2348.  doi: 10.3969/j.issn.1673-8225.2010.13.017 Abstract ( 116 )   PDF (570KB) ( 504 )   Save BACKGROUND: Treatments for knee osteoarthritis (KOA) contain injecting sodium hyaluronate into the intra-articular or surgical arthroscopic debridement and artificial knee replacement. At present, most study concerning the treatment of osteoarthritis concentrates on effectiveness comparison between various individual therapies, which are few in combined therapy. OBJECTIVE: To investigate the efficacy of treating KOA using knee replacement and arthroscopic debridement with intra-articular injection of sodium hyaluronate. METHODS: Fifty-five KOA patients were collected, aged 50-83 years. The surgical methods were decided by patients following telling the advantages and disadvantages of each treatment. Patients in the joint group (n=23) were treated by arthroscopic debridement and intra-articular injection of sodium hyaluronate, once a week, for 5 successive weeks; those in the replacement group (n=32) received total knee replacement. All patients were followed-up for 6-30 months. The effectiveness of KOA treatment was evaluated by HSS knee scores prior to and after operation.  RESULTS AND CONCLUSION: The comprehensive assessment showed, in the joint group, there were 8 excellent cases and 8 good cases with 70 % good rate; in the replacement group, there were 23 excellent cases and 7 good cases, with 94 % good rate. The therapeutic effect of the replacement group was superior to the joint group (P < 0.05). The knee joint activity, pain, and joint functions were improved significantly after operation, in particular in the replacement group. Related Articles | Metrics

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Velocity factor of continuous passive motion following knee replacement: Differences between treatment and control groups Li Xiao-liu 2010, 14 (13):  2349-2352.  doi: 10.3969/j.issn.1673-8225.2010.13.018 Abstract ( 211 )   PDF (565KB) ( 412 )   Save BACKGROUND: At present, continuous passive motion therapeutic instrument for treatment of joint stiffness and contracture following total knee replacement has been widely applied in orthopedics field. The speed is seldom paid attention during continuous passive motion, and there are no relevant reports. OBJECTIVE: To explore the effects of continuous passive motion speed on postoperative joint functional rehabilitation following knee replacement. METHODS: A total of 60 patients undergoing artificial total knee replacement were selected at the Department of Orthopaedics, Minhang Central Hospital, Shanghai Ruijin Hospital Group from December 2007 to August 2009. The subjects were assigned to treatment and control groups (n = 30). The treatment group taken at the beginning of continuous passive motion machine maximum speed of 1/2 gradually from 2/3 of the transition to a maximum speed of treatment, the initial scope of activities for the 0°-45°, a day continuous use of 2 hours. Each treatment increased 5-15 minutes per 1°, range of activities every day for 10°, all patients prior to discharge to reach 90°. In the next day, the biggest point of view at day 1 of the end of treatment served as a starting point, and then a gradual increase. In the control group, velocity of continuous passive motion was determined in accordance with patient comfort. Continuous passive motion machine was used following artificial knee replacement to assess knee Hospital for Special Surgery (HSS) and activities of daily living Barthel index at 1 and 5 days following treatment. Affected limb underwent visual analogue scale (VAS) was detected at the same time at 1, 3 and 5 days following treatment. RESULTS AND CONCLUSION: VAS of affected limb was significantly decreased in both groups following continuous passive motion treatment. At 1 and 3 days following treatment, VAS was significantly lower in the treatment group compared with the control group (P < 0.01). No significant difference was determined between both groups at day 5 (P > 0.05). HSS was significantly greater in the treatment group compared with the control group at day 5, whereas Barthel index was significantly lower in the treatment group than in the control group (P < 0.01). Efficacy rate of knee joint range of motion was significantly greater in the treatment group compared with the control group before discharge. Above-mentioned results indicated that slow start to increase progressively continuous passive motion campaigns will obtain early rapid analgesia compared with the choices according to the patients’ wills, resulting in improving the ability of daily activities and knee stability enhancement. Related Articles | Metrics

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Subchondral fractures in adult femoral head necrosis: Comparison study of radiography, computer tomography, magnetic resonance imaging and pathological results  Liu Chun-hong, Du Tie-qiao, Dong Jie, Li Hai-mei, Zhang Yu 2010, 14 (13):  2353-2356.  doi: 10.3969/j.issn.1673-8225.2010.13.019 Abstract ( 182 )   PDF (756KB) ( 457 )   Save BACKGROUND: Subchondral fractures were identified as the most complication of the femoral head necrosis and had important influences on the treatment and prognosis. The pathological and radiological findings on subchondral fractures of the femoral head necrosis have rare deep investigation. OBJECTIVE: To compare the sensitivity of X-ray plain film, CT and magnetic resonance imaging (MRI) in revealing subchondral fractures. METHODS: A total of 82 patients (132 hips) with known osteonecrosis were examined consecutively with MRI, CT and plain film. Sixteen resected specimens were sliced, decalcified, stained with hematoxylin and eosin, and examined using microscopy. RESULTS AND CONCLUSION: Of 132 hips, 72 of the 132 hips with subchondral fractures were proved by radiography or CT, and 51 were detected on plain film, 60 on CT and 33 on MR images. Compared with CT, MR imaging has sensitivity and specificity of 36% and 100%. Radiography has sensitivity and specificity of 70% and 96% respectively. CT revealed more subchondral fractures in femoral head necrosis than MR imaging (χ2=10.95, P < 0.05). All histological sections in subchondral fractures area showed fluid accumulation and fibroblastic proliferation, which were corresponded slit-shaped radiolucent shadow on subchondral fractures using X-ray and CT, and consistent with above-described pathological processes. Results indicated that CT revealed more subchondral fractures in femoral head necrosis than radiography or MRI. MRI provided useful signs accompanied by subchondral fractures, especially T2WI+ fat-suppression, and evaluated liquid at fracture site. CT provided more detailed information than plain film. Related Articles | Metrics

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Effects of soft, hard cobalt-chromium casting alloy and gold alloy on magnetic resonance imaging artifacts Huang Chao, Li Zhi-gang, Ma Ke-ji, Wang Zhi-ying 2010, 14 (13):  2357-2360.  doi: 10.3969/j.issn.1673-8225.2010.13.020 Abstract ( 154 )   PDF (395KB) ( 584 )   Save BACKGROUND: Magnetic resonance imaging (MRI) with advantages of high contrast, no bone artifacts, and arbitrary fault orientation, are widely used in diagnosing head and neck surgery, neurosurgery and oral surgery collar surface diseases. However, artifacts formed by some metallic materials have seriously affected the image quality, and the use of these materials limits the application and accurate diagnosis of MRI in head and neck region. OBJECTIVE: To study the artifacts of hard cobalt-chromium (Co-Cr) casting alloy, soft Co-Cr casting alloy, gold alloy and 3 kinds of metallic materials in head and neck scan sequence. METHODS: Five kinds of head and neck of conventional and fast imaging sequences was performed axial scan respectively for three kinds of metal specimen placed in the center of cylindrical water phantom. Artifacts were measured, and the results were performed statistical analysis. RESULTS AND CONCLUSION: In 3 kinds of metals with the same MRI imaging sequence, gold alloy produced the smallest artifacts, which was largest in the hard cobalt-chromium, the difference between the two groups was significant (P < 0.05); for the same metal material, spin-echo sequences produced the smallest artifacts, gradient echo sequence produced larger artifacts, echo-planar sequences produced largest artifacts with image deformation. The results suggest that, compared with non-precious metal dental restoration materials, using precious metal as dental restoration materials, can produce the minimum artifacts in the head and neck MRI. Therefore, the optimal MRI can be received via rational selecting metal dental restoration materials and imaging technology. Related Articles | Metrics

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Encoding medical image based on embedded zero-tree wavelet Wang Shi-gang, You Min-juan 2010, 14 (13):  2361-2364.  doi: 10.3969/j.issn.1673-8225.2010.13.021 Abstract ( 133 )   PDF (470KB) ( 341 )   Save BACKGROUND: Medical digital image must be a high-quality, high resolution, large amounts of data. Such an enormous amount of data is not conducive to the operation of Picture Achieving and Communication System (PACS) and digital hospital, telemedicine implementation. Therefore, image compression becomes an important issue to PACS. OBJECTIVE: To analyze the zero-tree wavelet coding algorithm and program for the medical digital image compression, to enable it to meet the medical image transmission and diagnostic requirements. METHODS: Using embedded zero-tree wavelet coding algorithm, wavelets and the layers of wavelet transform were presented, and the medical digital image compression was achieved. RESULTS AND CONCLUSION: Choosing pairs of orthogonal wavelets for medical image compression four-layer wavelet transform obtained a higher PSNR, and achieved good compression. Related Articles | Metrics

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Medical image segmentation based on multi-fractal spectrum and self-organizing neural network Jin Chun-lan, Huang Hua, Zhang Guo-fang, Liu Kuang-bin 2010, 14 (13):  2365-2368.  doi: 10.3969/j.issn.1673-8225.2010.13.022 Abstract ( 161 )   PDF (660KB) ( 1885 )   Save BACKGROUND: Though the sole multi-fractal spectrum image segmentation has a great advantage when distinguishing edge texture, the results are influenced to be different when adopting different measures and thresholds when adopting different measures. So it is difficult to correctly adopt optimal measure. OBJECTIVE: Combing the multi-fractal spectrum image segmentation method and self-organizing feature map neural network to process the image. METHODS: The mean and variance of every pixel and others around were served as the basic characteristics. And the texture characteristics were combined with four different multi-fractal spectrums to realize self-organizing neural network. RESULTS AND CONCLUSION: The results were different when adopting different measures and thresholds, meantime, the results were different to the different image using the same measure. So the key was how to choose the suitable measure. The method of multi-fractal spectrum image segmentation method binding self-organizing feature map neural network was used. It omitted the steps of choosing measures, and immediately made four multi-fractal spectrums be characteristics combining the other two characteristics to be the input of self-organizing neural network. Then the net was studied, and the image was automatically segmented. The experiment results showed that this method can fulfill effective segmentation in the complicated image with automatic and adaptively. Related Articles | Metrics

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Interested area extraction of human brain MR image based on mathematical morphology Hou Hong-hua, Gui Zhi-guo 2010, 14 (13):  2369-2372.  doi: 10.3969/j.issn.1673-8225.2010.13.023 Abstract ( 122 )   Save BACKGROUND: The applying of mathematical morphological algorithm has achieved good result in extracting the interested area of the brain MR image. However, it is has limitation in anti-noise property and structuring element selection. OBJECTIVE: To extract the interested area of the brain MR image clearly and fully based on mathematical morphology, to provide accurate information for clinical medical diagnosis. METHODS: Firstly, a compound mathematical morphological algorithm was used to filter the pulse and gauss noise and a hip-top cap transform was used to buildup the image. Then, the brain compositions were extracted based on watershed threshold segmentation method. After morphological filter, tracking edge and filling in gray degree, the edge of the interested area was detected clearly by the anti-noise edge detectors. At last, in order to stand out the physician, interested area, it was demarcated colorful in original image. RESULTS AND CONCLUSION: It introduced a combination utilization of multi- mathematical morphology algorithms to realize the interested area extraction of brain clearly and fully. The experimental results show that the proposed algorithm is characterized by simple, fast, high precision and strong applicability. Related Articles | Metrics

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Changes of cephalofacial far infrared thermogram as an evaluating index for treatment of acute peripheral facial paralysis Gao Yu-hong, Xue Yi-long, Luo Yun, Zhou Zhang-ling, Cui Xin, Tian Lei, Pan Jing-kun 2010, 14 (13):  2373-2376.  doi: 10.3969/j.issn.1673-8225.2010.13.024 Abstract ( 160 )   PDF (660KB) ( 538 )   Save BACKGROUND: Previous experiments have demonstrated that acupuncture combined far infrared thermogram could be utilized in treating facial paralysis with short pathogenesis and high cure rate. However, studies underlying using changes of cephalofacial far infrared thermogram as evaluating index for acute peripheral facial paralysis are few.  OBJECTIVE: To dynamic monitoring the changes of cephalofacial far infrared thermogram before and after acupuncture therapies in patients with acute peripheral facial paralysis.   METHODS: A total of 40 healthy persons were served as the control group, and 40 persons who diagnosed peripheral facial paralysis were included in the case group. Non-refrigerated focal plane thermal imaging system (ATIR-M301B) was used, whose temperature sensitivity was 0.05 ℃ and working temperature was 20-25 ℃. After the checking spots were exposed, cephalic far infrared thermography data were collected and analyzed by software provided by the system. Temperature differences of both sides of cheeks, inner canthi, supraorbitals, forehead and tongue areas were compared with statistical methods in the same patient before and after acupuncture therapies.   RESULTS AND CONCLUSION: Far infrared thermography revealed that there were no obvious temperature differences between both sides of the cheeks, inner canthus, sup raorbitals, forehead and tongue areas in the healthy persons (P > 0.05). Far infrared thermography manifested that obvious temperature differences existed in both sides of the cheeks, inner canthi, sup raorbitals, forehead and tongue areas of patients before acupuncture therapies, and the temperature was higher on affected sides than unaffected ones (P < 0.05-0.001). Far infrared thermography revealed that there were no obvious temperature differences between both sides of the cheeks, inner canthi, sup raorbitals, forehead and tongue areas after acupuncture therapies (P > 0.05). Far infrared thermography can be utilized as a visualized index for diagnosis of acute peripheral facial paralysis. Related Articles | Metrics

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Analysis of gait signal based on wavelet packet decomposition in Parkinson’s disease patients Han Yang, Zhou Ping, Hou Yuan-yuan, Li Ning 2010, 14 (13):  2377-2380.  doi: 10.3969/j.issn.1673-8225.2010.13.025 Abstract ( 142 )   PDF (676KB) ( 511 )   Save BACKGROUND: Parkinson’s disease (PD) is a degenerative disease of the central nervous system. Disturbed gait is one of 3 features of PD. Therefore, it is widely to study Parkinson's foot pressure. Previous studies have focused on pressure distribution, but the gait signal research is little. OBJECTIVE: To find the difference of gait signal between PD patients and normal people. METHODS: Foot data of 93 PD patients and 72 normal controls were collected. Subjects walked for about 2 minutes as normal on the horizontal ground. The counteracting force on the foot sole from vertical direction was recorded. Sixteen transducers on the foot sole were used to record at 100 times/s. The data included the sum of 8 transducers on the foot sole. Sampling speed was 100 Hz. The sampling time of each subject was 121.1715 s. Gait data of PD patients and controls were analyzed using wavelet packet decomposition algorithm. RESULTS AND CONCLUSION: Entropy of signal of different transducers from foot sole was obtained by decomposition and calculation. D1 layer entropy value showed that P value from transducers L1, R1, L2, R2, L6 and R6 signal was significantly less than other transducers, and less than 0.05. DD2 layer entropy value showed that P value from transducers L1, R1, L6 and R6 signal was significantly less than other transducers, and less than 0.05. Statistical results demonstrated that there are significant differences in signal entropy value in foot sole between PD patients and normal controls. Foot sole pressure signal analysis can help physician diagnosis and PD treatment. Related Articles | Metrics

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Analytical system of extracting HIS-Bundle signals from surface electrocardiogram Zhou Ping, Han Yang, Hou Yuan-yuan, Li Ning 2010, 14 (13):  2381-2385.  doi: 10.3969/j.issn.1673-8225.2010.13.026 Abstract ( 229 )   PDF (984KB) ( 334 )   Save BACKGROUND: Traditional detection methods of HIS-Bundle are hundreds of nestification of surface electrocardiogram (ECG), via esophagus or via intracardiac catheter. Developing the analyzing system of extract HIS Bundle signals from surface ECG is not only beneficial to clinical diagnosis, but also beneficial to animal drug experiments. OBJECTIVE: To detect the HIS-Bundle signals from surface ECG, and to develope the surface HIS Bundle signal analysis system. METHODS: Surface ECG on rabbits served as the analyzed signal, and its intracardiac HIS-Bundle electrogram as the contrast signal. Stochastic resonance models, wavelet transform, the superposed average method and the coupling-adding method were used to analyze the surface ECG signals. RESULTS AND CONCLUSION: The wavelet transform method can detect the HIS-Bundle signals from surface ECG, but not all HIS-Bundle signals can be recognized, such as the intracardiac signals can not detect some HIS-Bundle signals by the wavelet transform method. The recognition rate of detecting the HIS-Bundle signals from surface ECG by Stochastic resonance method is higher than the wavelet analysis method, but they have one thing in common, some HIS-Bundle signals disappear after dealing with intracardiac signals. This paper put forward the coupling-adding method to detect the HIS-Bundle signals from surface ECG, compared with traditional adding method, the HIS-Bundle signals is more obvious and the stacking fold is far less. These indicated that it is effectively to restrain the noise signals and extract HIS Bundle signals using Stochastic resonance, wavelet transformation, superposed average, and coupling-adding methods. This HIS Bundle signals analyzing system has strong practical value. Related Articles | Metrics

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Development of an intelligent respiration and sanitarian chair based on HMI-3084 and incremental PID algorithm Zhu Qing-song, Xu Ji-ping, Ye Ru-yan 2010, 14 (13):  2386-2390.  doi: 10.3969/j.issn.1673-8225.2010.13.027 Abstract ( 121 )   PDF (739KB) ( 340 )   Save BACKGROUND: Nowadays positive pressure ventilation has been widely applied in breath prostrating and other diseases of lung. But its disadvantages, such as pneumonia relating to breathing machine, abnormally low blood pressure and difficulty in removing breathing machine, bring risks for patients while supplying breathing function. OBJECTIVE: To develop a new product to cure the disease of lung safely and intelligently. METHODS: Combined traditional rocking chair and the way of mechanical ventilation through changing posture, intelligent sanitarian chair based on HMI-3084 was designed innovatively using control algorithm of incremental PID. RESULTS AND CONCLUSION: This equipment has the function of traditional rocking chair and effect of auxiliary respiration. It can realize controlling mechanical ventilation and auxiliary ventilation through respiring synchronously. It aims at the chronic obstructive pneumonia and may become a new medical sanitarian facility. Related Articles | Metrics

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Development of a movement training machine with active and passive movement training function Wu Hong, Ran Chun-feng, Chen Wei 2010, 14 (13):  2391-2394.  doi: 10.3969/j.issn.1673-8225.2010.13.028 Abstract ( 191 )   PDF (651KB) ( 503 )   Save BACKGROUND: Development of automatized multifunctional movement training machine is very essential for patients with limbs disturbance. However, the foreign machine is expensive. Currently, there is no movement training machine with active movement training and passive movement training function. OBJECTIVE: To observe the effects of computer multifunctional movement training machine in the treatment of stroke patients. METHODS: A total of 60 stroke patients were randomly divided into therapeutic and control groups with 30 patients in each group. All patients were subjected to comprehensive rehabilitation therapy, such as Bobath handshake, bridge exercise, turning over training, Kabat-Knott-Voss program, seat and arise balance function training. The therapeutic group was trained using the computer multifunctional movement training machine in addition to comprehensive rehabilitation therapy. Movement function and activity of daily life of two group patients were assessed with Brunnstrom method and Barthel index of ability of daily life, respectively. RESULTS AND CONCLUSION: After 30 days of treatment, movement function score and activity of daily life of two groups patients were improved, in particular, the therapeutic group was significantly improved compared with the control group (P < 0.05). The computer multifunctional movement training machine and comprehensive rehabilitation treatment are effective for stroke patients, which benefits recovery of movement function to improve quality of life. Individualized rehabilitation protocol should be formulated and applied as early as possible for stroke patients. Related Articles | Metrics

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Changes in high order aberrations following myopia correction with monofocal soft contact lens Li Ying, Tang Xin, Li Li-hua 2010, 14 (13):  2395-2398.  doi: 10.3969/j.issn.1673-8225.2010.13.029 Abstract ( 156 )   PDF (562KB) ( 690 )   Save BACKGROUND: High order aberrations (HOA) are a key factor that influences vision quality following low order aberrations rectification. As a rectification of ametropia, corneal contact lens corrects low order aberrations, but the changes in HOA require exploration. OBJECTIVE: To evaluate the influence of hydrogel soft contact lenses (SCL) for correction of myopia on HOA.  METHODS: Monochromatic aberrations of the whole eye were measured with a COAS Shack-Hartmann wavefront analyzer before and after wearing SCL for myopia correction with a natural pupil. The fitted Zernike coefficients were calculated for each eye including 47 myopic eyes with fixed optical zones of 6.0 mm. Each order aberrations and total high order aberrations from 3rd to 6th before and after correcting the lower order aberrations in myopia were compared, and the relationship of changes in refraction, C20 and C40 was analyzed respectively. RESULTS AND CONCLUSION: SCL yielded larger high order aberrations (t =2.125, P=0.039) including more coma (t =3.843, P=0.000) and less spherical aberration (t =–8.319, P=0.000). The change in spherical aberration was highly positively correlated with the changes in negative power of the contact lens (r=0.536, P=0.000). Correcting myopia defocus affects HOA. SCL for myopia induced a significant increase in total HOA. The spherical aberration of myopia subject changes statistically with sphere trial SCL. Related Articles | Metrics

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Th1/Th2 immunological response expression in a patient of coronary arterial stent restenosis Lin Jin-zhao, Zhang Jun 2010, 14 (13):  2399-2402.  doi: 10.3969/j.issn.1673-8225.2010.13.030 Abstract ( 111 )   PDF (635KB) ( 345 )   Save BACKGROUND: Mechanism of restenosis remains unclear. Inflammatory unbalance plays an important role in various diseases, being related to stent restenosis. OBJECTIVE: To evaluate the distribution characteristics of Th1-type cytokines [interferon-γ (INF-r) and interleukin-2 (IL-2)] and Th2-type cytokines (IL-4 and IL-10) in the serum of the patients with the in-stent restenosis following coronary artery stent implantation. METHODS: The concentrations of INF-γ, IL-2, IL-4, and IL-10 in the serum of 32 patients with in-stent restenosis following coronary artery implantation (experimental 2 group) were measured with enzyme linked immuno-sorbent assay (ELISA). The serum levels of the four cytokines were compared with the subjects without stent implantation and coronary artery disease (n=30, control I group), the patients without stent implantation but with the coronary artery disease (n=30, control II group), and the patients with stent implantation but without in-stent restenosis (n=30, experimental I group). RESULTS AND CONCLUSION: There was no significant difference in the level of the INF-γ, IL-2, IL-4, and IL-10 between control 2 group and control 1 group (P > 0.05); while there was also no significant difference in those levels between experimental 1 group and control 1 group (P > 0.05). The levels of INF-γ and IL-2 in the experimental 2 group were significantly higher than other three groups (P < 0.01); but the levels of IL-4 and IL-10 in the experimental 2 group were significantly lower than control 1 and experimental 1 groups (P < 0.01). The results demonstrated that Th1 and Th2 inflammatory unbalances, i.e., up-regulation of Th1 and down-regulation of Th2, occurred in patients with in-stent restenosis, which might be the key factors for in-stent restenosis following coronary artery implantation. Related Articles | Metrics

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Serum cystatin C levels in patients with acute myocardial infarction following coronary artery drug stent implantation: Predictive value of cardiovascular events and target vessel lesion Zhang Liang, Zhou Sheng-hua, Liu Qi-ming, Zhou Tao, Lin Chu-wei 2010, 14 (13):  2403-2406.  doi: 10.3969/j.issn.1673-8225.2010.13.031 Abstract ( 147 )   PDF (463KB) ( 525 )   Save BACKGROUND: Previous studies have shown that cystatin C is a better endogenous marker of glomerular filtration rate, and is closely correlated with cardiovascular disease. OBJECTIVE: To evaluate the prognostic value of cystatin C on cardiovascular events and target vessel lesion restenosis in patients with ST elevated acute myocardial infarction (STEAMI) treated with primary percutaneous coronary intervention. METHODS: From October 2007 to October 2008, a total of 81 patients who underwent percutaneous coronary intervention for ST-segment elevation myocardial infarction < 12 hours from symptom onset were included at the Department of Cardiology, Second Xiangya Hospital, Central South University. According to cystatin C levels, patients were classified into 2 groups: group  A > 1.00 mg/L and group B ≤ 1.00 mg/L. The clinical data was collected during hospitalization and all patients were followed up for nearly 8 months. The relationship of cystatin C mass concentration to main adverse cardiovascular events and stent stenosis was analyzed in patients. RESULTS AND CONCLUSION: Mean duration of clinical follow-up was 8 months. There was no significant difference in death, reinfarction, stroke or revascularization between the two groups (P > 0.05). The death rate during hospitalization was higher in the group A than in the group B (χ2=2.50, P≈0.08). There were no significant differences in death, reinfarction, stroke, revascularization and thrombosis in stent in patients of both groups (P > 0.05). A higher incidence of rehospitalization for congestive heart failure was observed in patients of group A than in group B (P < 0.05). The ratio of in-stent restenosis and target vessel new lesion was significantly higher in group A than in group B (P < 0.05). These suggested that cystatin C plasma concentrations may be associated with target vessel lesion and cardiovascular events, mainly rehospitalization for congestive heart failure, after percutaneous coronary intervention in patients with ST-elevation myocardial infarction. Related Articles | Metrics

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Prolonged course of clopidogrel treatment following non-drug coronary artery stent implantation: Can it decrease the inflammatory reaction? Tang Ai-ming 2010, 14 (13):  2407-2410.  doi: 10.3969/j.issn.1673-8225.2010.13.032 Abstract ( 91 )   PDF (429KB) ( 299 )   Save BACKGROUND: Pretreatment of adenosine diphosphate receptor antagonists (clopidogrel) can reduce case fatality and incidence of myocardial infarction for patients receiving percutaneous coronary intervention (PCI). However, the course of clopidogrel needs to be discussed. OBJECTIVE: To observe the changes of C-reactive protein (CRP) in atherosclerotic heart disease patients after percutaneous transluminal coronary angioplasty followed by clopidogrel intervention. METHODS: Totally 48 atherosclerotic heart disease patients received antiplatelet therapy, including aspirin (300 mg) and clopidogrel (300 mg) at 1 day before PCI, followed by a daily dose of clopidogrel (75 mg/day) combined with aspirin (100 mg/d). The patients were followed up at 24 hours, 1 month and 6 months after operation. They were divided into 2 groups. Patients in the first group were received clopidogrel combined with aspirin for 12 months, and those in the second group received clopidogrel combined with aspirin for 3 months after PCI, and then aspirin alone. Blood was taken from all patients before intervention, immediately after intervention and in the follow-up. Serum CRP was measured by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION: Serum CRP level was increased after operation, reached a peak at 24 hours, and then gradually decreased. CRP level still increased in the patients receiving clopidogrel pretreatment, it showed the anti-inflammatory therapy is necessary after operation. Prolonged course of clopidogrel treatment could obviously decrease CRP levels, which may have roles on lower the risk of cardiovascular accident after operation.    Related Articles | Metrics

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Mechanical imbalances and abnormal stress in a goat model of cervical kyphosis Fang Jia-hu, Jia Lian-shun, Zhou Xu-hui, Song Li-jun, Li Xiang, Wang Yi-jin 2010, 14 (13):  2411-2415.  doi: 10.3969/j.issn.1673-8225.2010.13.033 Abstract ( 104 )   PDF (607KB) ( 326 )   Save BACKGROUND: The incidence of cervical kyphosis occurs with bio-mechanical behavior changes. However, bio-mechanics research of animal model of cervical kyphosis has been rarely reported. OBJECTIVE: To analyze biomechanical changes in a goat model of cervical kyphosis. METHODS: To simulate the formation of cervical kyphosis cause, a goat model of cervical kyphosis was made. Biomechanics of fresh cervical specimens of the cervical kyphosis goats and normal goats was compared to measure three-dimensional range of motion (ROM) and bending stiffness. REULTS AND CONCLUSION: Compared with normal specimens, the deformity range of cervical kyphosis goats was from C2 to C5, and their ROM in the C2/3 to C4/5 segment was obviously reduced. ROM differences between two groups in C5/6 segment was significantly reduced, similar in the C6/7 segment, even slight greater than normal specimens. The rotation motion was significantly reduced, nearly limited. The bending stiffness of the kyphosis group was increased significantly in the C2/3 to C4/5 segment, while almost the same as normal group in the C5/6 and C6/7 segments. With the formation of kyphosis, mechanical imbalances and the presence of abnormal stress in the deformity range resulted in abnormal cervical joint fusion, leading to cervical biomechanical changes. Related Articles | Metrics

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Gender differences in lumbar vertebral body in Chinese adults Lou Zhao-hui, Liang Bi-ling, Wu Zhuo, Ye Rui-xin 2010, 14 (13):  2416-2420.  doi: 10.3969/j.issn.1673-8225.2010.13.034 Abstract ( 132 )   PDF (588KB) ( 463 )   Save BACKGROUND: Recent studies have shown that there are gender differences in many organs and tissues, as well as bone and nerve growth in the bone of human body. Moreover, gender differences may exist in some operations, such as knee joint replacement and elbow fracture treatment. OBJECTIVE: To explore the gender differences in lumbar vertebral body. METHODS: A total of 67 normal adults, comprising 35 males aged 20-51(39.4±4.3) years, and 32 females aged 19-52(41.2±5.6) years. Morphometric analysis was performed on T2-weighted midsagittal and transverse digital images. For each vertebral level between L1 to L5, the superior sagittal diameter Dn, the middle sagittal diameter Dm, the inferior sagittal diameter Dd, the anterior height Ha, central height Hc, and posterior height Hp were measured from the sagittal images of the lumbar spine. Three new height ratios of vertebral body shape were derived from these measurements: anterior height ratio (Ha/Dm), middle height ratio (Hm/Dm) and posterior height ratio (Hp/Dm). The areas of lumbar vertebral bodies were measured from the superior transverse images of every vertebral body. RESULTS AND CONCLUSION: The gender differences were significant: From L1 to L5, the area (S), the Dn, Dm, Dd, Ha, Hm, and Hp of male vertebral body was respectively greater than the female’s. But the Ha/Dm, Hm/Dm, Hp/Dm of female vertebral body was greater than the male’s. Related Articles | Metrics

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Pedicle screw fixation with autogenous morselized bone graft impaction for senile lumbar degeneration Li Jian, Zhong Zhi-hong, Zhang Ping, Zhao Hong-pu, Yang Bo, Chen Ying-chao 2010, 14 (13):  2421-2424.  doi: 10.3969/j.issn.1673-8225.2010.13.035 Abstract ( 95 )   PDF (514KB) ( 417 )   Save BACKGROUND: It remains controversial about the source and shape of bone material, as well as the pattern of bone-grafting. As a new method, autogenous morselized bone graft impaction has some advantages, but there are few reports about the clinical application in lumbar interbody fusion. OBJECTIVE: To investigate the feasibility of pedicle screw fixation with autogenous morselized bone graft impaction in the posterior lumbar interbody fusion for senile lumbar degeneration. METHODS: A total of 21 senile lumbar degeneration cases (28 segments) underwent autogenous morselized bone graft impaction in the posterior lumbar interbody fusion, including 7 of lumbar disc herniation combined with segmental instability, 6 of lumbar spinal stenosis, and 8 of degenerative lumbar instability. Pedicle screw fixation with autogenous morselized bone graft impaction was performed in all patients. The fusion rate was evaluated according to the pre and post operative X-ray. The clinical outcomes were measured according to VAS scores, ODI scores as well as Macnab evaluation scale. RESULTS AND CONCLUSION: All patients were followed up for more than 12 months. The bony fusions were detected in 3-5 months postoperatively. No reduction or fixation failure was found. After operation, the lower back pain and leg pain was relieved in different levels. The VAS and ODI scores at the final follow up were significantly improved compared with preoperative scores (P < 0.01), and the fusion rate was 95%. There was 1 case whose CT scanning showed some morselized bone in the spinal canal on day 6 after operation, causing the nerve compressed, and 1 case whose soft tissue of the cut was infected post-discharge on day 5 after operation. The Macnab criteria revealed that 10 patients had excellent result, 9 had good, 0 had fair, and 2 had bad, with a excellent and good rate of 91%. Results show a good short-term clinical outcome of pedicle screw fixation with autogenous morselized bone graft impaction applying in posterior lumbar interbody fusion for senile lumbar degeneration with high interbody fusion rate and low complication rate. Related Articles | Metrics

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Transforaminal lumbar interbody fusion based on pedical fixation: Can it increase lumbar stability and fusion rate? Zhu Jian-wei, Liu Fan, Zhang Feng, Dong Qi-rong, Shi De 2010, 14 (13):  2425-2428.  doi: 10.3969/j.issn.1673-8225.2010.13.036 Abstract ( 102 )   PDF (471KB) ( 370 )   Save BACKGROUND: Lumbar spinal fusion has widely used in treating lumbar degenerative disease. However, the fusion rates of traditional posterior or posterolateral fusion are low, and companied by more complications, which affect adjacent segment stability and destroy distribution of mechanical loading in vertebral column. OBJECTIVE: To evaluate clinical efficacy for the treatment of lumbar degeneration with transforaminal lumbar interbody fusion (TLIF) based on pedical fixation. METHODS: A total of 68 patients with lumbar degeneration were treated with TLIF and pedical screw fixation，including 24 cases of isthmus spondylolisthesis, 16 cases of degenerative lumbar spondylolisthesis, 18 cases of degenerative lumbar spinal stenosis and 10 cases of lumbar intervertebral disc degeneration. RESULTS AND CONCLUSION: There were no complications of neurologic damage，infection of lumbar vertebrae interspace or cerebrospinal leakage. All patients were follow-up for 29 months (10-60 months). There were no inner fixation breakage and loosing, and no disc space height losing in all cases. Intervertebral fusion rate was 91%. Japanese Orthopaedic Association (JOA) score showed 35 cases were excellent, 26 good, 5 improved and 2 worse, with 89.71% excellent and good rate. TLIF based on pedical screw fixation is an effective method for the treatment of lumbar degeneration. The short-term results are satisfied. Related Articles | Metrics

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Treatment of spondylolisthesis using titanium posterior pedicle screw-rod fixation system combined with intervertebral bone grafting: A 5-year follow-up in the same institute for 36 cases Mo Chu-hong, Tan Jian-ji, Tang Can-rui 2010, 14 (13):  2429-2432.  doi: 10.3969/j.issn.1673-8225.2010.13.037 Abstract ( 149 )   PDF (559KB) ( 437 )   Save BACKGROUND: Clinical treatments for spondylolisthesis including simple decompression, anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF) or the 360° combination of ALIF and PLIF, which has its own characteristics. OBJECTIVE: To evaluate the effects of GSS II system combined with interbody graft in treating spondylolisthesis. METHODS: Totally 38 spondylolisthesis cases were selected. Firstly, 2 pedicle screws were inserted into both sides of vertebral slips, then additional 2 pedicle screws were inserted into subordinate vertebral of vertebral slips. The position of screws was confirmed by C-arm imaging machine. After that, the spinous process and vertebral plates were cut off, the bone bed was prepared, and vertebral slip was replaced. The bone fragments and ilium were grafted into intervertebral space. Finally, regulated GSS system, placed drainage, and closed the incision. X-ray changes, signs and symptoms changes, material biocompatibility, as well as bone fusion status was observed at 8 weeks after operation and in the follow-up.  RESULTS AND CONCLUSION: X-ray films showed that spondylolisthesis of 36 cases were improved, including 28 cases with completely reduction and 10 cases with I spondylolisthesis. The pedicle screw-rod fixation system showed good stability, no screw, rod loose or shedding could be seen at 8 weeks after operation. In the follow-up of 36 cases, no shedding status could be found, and the symptoms of spodylolisthesis were improved, and therapeutic effects evaluation revealed 33 cases were excellent, and 3 cases were good. All results demonstrated that GSS system is a good fixation system with sample operation and strong anti-pull-out strength, which can be used in treating spondylolisthesis. Related Articles | Metrics

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Evaluating the clinical efficacy of short-segment pedicle screws fixation for single segmental thoracolumbar fracture in 27 cases  Wu Huai-bao, Liu Zhi-fu, Wu Ye 2010, 14 (13):  2433-2436.  doi: 10.3969/j.issn.1673-8225.2010.13.038 Abstract ( 115 )   PDF (651KB) ( 393 )   Save BACKGROUND: Considerable debate exists whether long- or short-segment pedicle screws fixation is profitable for single segmental thoracolumbar fracture patients.  OBJECTIVE: To evaluate the clinical efficacy of segment pedicle screws fixation for single segmental thoracolumbar fracture. METHODS: Totally 27 patients suffered from single thoracolumbar fracture from June 2005 to June 2008 were selected, and the fracture vertebral was between T11 and L2. All patients were divided into 2 groups according to young or older. Young group comprised 12 cases, with mean follow up time of 28.7 months. Elder group consisted of 15 cases, with mean follow up time of 31.4 months. Pedicle screws were inserted in the pedicles of above and lower adjacent vertebral body of injured vertebral body. The operation time, volume of loss blood, complications, the compression vertebral height and kyphosis angle of the fracture vertebral prior to, 1 month and 1 year after fixation were compared between 2 groups.  RESULTS AND CONCLUSION: The kyphosis angles of all patients were obvious corrected, and the compression vertebral height was notably recovered after treatment. At 1 year of follow up, kyphosis angle was some loss in patients using short-segments pedicle screw fixation in two groups, but the difference had no significance (P > 0.05). There was some loss of kyphosis correction rate in patients received long- or short-segments pedicle screw fixation in the young group, and the difference had no significance (P > 0.05). In addition, in the elder group, compared with patients received short-segments pedicle screw fixation, the loss of kyphosis correction rate was smaller in patients received long-segment pedicle screw fixation (P < 0.05). All results suggested that it is better clinical efficacy of short-segments pedicle screws instrument for treating young thoracolumbar fracture, and long-segments pedicle screws are suitable for elder patients. Related Articles | Metrics

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Wallis interspinous dynamic stabilization in treating lumbar degenerative disease: A comparison with lumbar spinal canal decompression Xu Xi-qiang, Wu Hua, Li Guang-hui, Li Feng 2010, 14 (13):  2437-3440.  doi: 10.3969/j.issn.1673-8225.2010.13.039 Abstract ( 80 )   PDF (584KB) ( 351 )   Save BACKGROUND: Lumbar degenerative disease has been commonly treated with nucleus pulposus extirpation or nucleus pulposus extirpation combined with internal fixation; however, with the development of non-rigidity fixation, interspinous dynamic stabilization and intervertebral disk displacement attract more and more attention.  OBJECTIVE: To evaluate the therapeutic effect of Wallis interspinous dynamic stabilization on lumbar degenerative disease compared with lumbar spinal canal decompression. METHODS: A total of 40 patients with lumbar degenerative disease were selected from Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between December 2007 and December 2008. Twenty patients were treated with nucleus pulposus extirpation alone, considering as control group; while, other 20 patients were treated with nucleus pulposus extirpation combined with Wallis interspinous dynamic stabilization, considering as experimental group. JOA score and VAS score were made at 1 week and 1 year postoperatively for all the patients. RESULTS AND CONCLUSION: There was no significant difference in JOA score and VAS score between two groups at 1 week postoperatively (P > 0.05); but there was significant difference in both scores at 1 year postoperatively (P < 0.05). The results demonstrated that both methods achieved well therapeutic effects, which depended on effective decompression. The therapeutic effect of the first group was better than the second group, depending on the favourable biologic effect of the implantation of Wallis interspinous dynamic stabilization, which could effectively relieve the residual low back pain. Related Articles | Metrics

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Interlocking intramedullary nails for postoperative nonunion of femoral fractures in 20 cases: Effectiveness of plate combined with bone graft Hao Jian-xue, Zhang Jian-peng, Li Bing, Liu Yan-mei, Ren Kang, Liu Suo-li, Wan Jian-she, Ren Yong-min, Chen Mei-qing, Li Xue-bo 2010, 14 (13):  2441-2444.  doi: 10.3969/j.issn.1673-8225.2010.13.040 Abstract ( 128 )   PDF (556KB) ( 444 )   Save BACKGROUND: Interlocking intramedullary nail is the prior choice for femoral fractures. Previous studies have shown that treatments for nonunion of femoral fractures following intramedullary nail concentrate on replace nails or changed to plate fixation, which is unacceptable for patients due to great trauma and high cost. OBJECTIVE: To explore the effect of plate combined with bone graft on the postoperative femoral fractures nonunion treated by interlocking intramedullary nail. METHODS: Twenty cases of postoperative femoral fracture nonunion treated by interlocking intramedullary nail from February 2006 to December 2008 were entered in our surgery. They received operations to remove the fibrous tissue and sclerosis bone. Then anterolateral or posterolateral of femoral was fixed by 7-9-well forearm plates, and the fracture ends were fixed using 3 nails. After fixation, the autogenous iliac bone was grafted at fracture end. After treatment, patients receive functional exercise without weight-bearing or with weight-bearing, which turned to full weight-bearing when the fracture was united.  RESULTS AND CONCLUSION: All 20 cases were available for follow up. The follow-up lasted for 8-12 months. All cases achieved solid union within 3-10 months, averaged 5 months. There was no disorder of limb’s activity. Plate combined with bone graft is characterized by simple operation, reliable effect and early motion, which is an ideal method for treatment of postoperative femoral fractures nonunion treated by interlocking intramedullary nail. Related Articles | Metrics

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Platelet activation and biocompatibility following coronary artery stent implantation Duo Li-juan 2010, 14 (13):  2445-2448.  doi: 10.3969/j.issn.1673-8225.2010.13.041 Abstract ( 93 )   PDF (499KB) ( 438 )   Save OBJECTIVE:To evaluate the biocompatibility of coronary artery stent implantation and explore the relationship between platelet activation and stent restenosis following coronary artery stent implantation. METHODS: A computer-based online search of CNKI (1990/2009) and Pubmed database(1990/2009) was performed with the key words “coronary artery stent, platelet activation, biocompatibility” in Chinese and English. Articles related to biocompatibility and relationship between platelet activation and stent restenosis following coronary artery stent implantation were included. Meta analysis and repetitive studies were excluded. RESULTS:Coronary artery stent implantation damages vessel wall and activates body immune response process. Growth factors and cytokines released from endothelial cells, platelet and inflammatory leukocyte promotes vascular smooth muscle cell proliferation, which contributes to restenosis. This study explored the relationship of platelet activation and in-stent restenosis and biocompatibility following stenting and prospected development of biodegradable stents. CONCLUSION: Biodegradable stents could minimize possibility of restenosis, and protect from thrombosis, which bring hope for treating restenosis following stent implantation.on. Related Articles | Metrics

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Complication prevention and treatment following stent implantation for cerebrovascular diseases and its application progress Xing Yan-hui, Shi Wei 2010, 14 (13):  2449-2452.  doi: 10.3969/j.issn.1673-8225.2010.13.042 Abstract ( 87 )   PDF (576KB) ( 479 )   Save OBJECTIVE: To summarize and analyze the occurrence, prevention and treatment of complications of ischemic cerebrovascular disease following stent implantation. METHODS: We retrieved Science Direct database and Ei database for relevant articles published from January 1960 to October 2009. The key words included “cerebral disease, fracture, stenting” in English. Simultaneously, we retrieved Chinese Journal Full-text Database and Chinese Biomedical Literature Database for relevant articles published from January 1994 to October 2009, with the key words of “cerebrovascular disease, stent implantation, biomaterial” in Chinese. In addition, several relevant literatures were looked up by hand. Studies concerning treatment manners of stent implantation in treatment of cerebrovascular disease were included. RESULTS: Following stent implantation for cerebrovascular disease, common complications contained contrast medium-related complications, such as anaphylactoid reaction, nephrotoxicity, aggravated cardiac load and so on; puncture site complications, such as hematoma, tunica intima laceration-induced secret compartment isolation and severe pelvic cavity bleeding; carotid sinus reflex, such as blood pressure decrease, decreased heart rate, sudden cardiac arrest, even death, serious cardiac arrhythmias and acute myocardial infarction; ischemic stroke; luxury perfusion syndrome, which can induce fatal hemorrhage sometimes; long-term complications, such as restenosis, stent collapse, deformation, displacement and so on. Therefore, protective umbrella technique during surgery can significantly decrease the incidence rate of embolism induced by atherosclerotic plaque desquamation. Transcranial Doppler technique was used during the surgery to promptly find vessel spasm or occlusion. Early application of urokinase and papaverine can lead to complete remission in patients. Intramuscular atropine was utilized to elevate heart rate prior to stent implantation in patients with carotid sinus dysfunction and sinus bradycardia. Following stent implantation, blood volume was enlarged and appropriate pressor agents were taken according to blood pressure. CONCLUSION: During stent implantation for cerebrovascular disease, we can achieve prospective outcomes through making entire diagnostic regulation and operation pre-, in- and post-implantation, promptly finding abnormal condition and effectively managing. Related Articles | Metrics

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Tissue repair in femoral neck fracture: Biomechanics, digital technology and graft implantation Song Ya-wei, Wang Yu, Rong Ke, Li Guang-kai 2010, 14 (13):  2453-2456.  doi: 10.3969/j.issn.1673-8225.2009.13.043 Abstract ( 90 )   PDF (661KB) ( 446 )   Save BACKGROUND: With the faster development of biomechanics and computer simulation technique, treatments for femoral neck fracture main concentrate on internal fixation, muscle pedicle bone, bone flap, and periosteum implantation, as well as prosthetic replacement under the guidance of computer. OBJECTIVE: To analyze the stress distribution in the neck of femur through morphological, biomechanical analysis, and computer simulation technique of reviewed treatments for femoral neck fracture. METHODS: “Femoral neck fracture” in English was utilized as search terms to retrieve Pubmed database (1999-01/2009-06). Simultaneously, “femoral neck fracture” in Chinese was used to search Wanfang database (1999-01/2009-06). Literatures were limited to English and Chinese languages. The femoral neck research equipment and studies for cure of femoral neck fracture were included, while other outdated and repetitive researches were excluded. RESULTS AND CONCLUSION: Totally 667 literature were obtained from the computer screen, and 42 documents of them were involved for analysis according to the inclusion and exclusion criteria. In case of femoral neck fracture analysis method, scholars in China and abroad have carried out extensive studies, including: ①Using CT scan for the form of femoral neck to generate CT image, the study obtains Results Feature data with finite element analysis. Meanwhile, results Feature data could reconstruct a 3D body by the software. ②Biomechanical analysis for stress distribution about the femoral neck could obtain corresponding data. ③Conclusion of such analysis could be applied to the treatment of femoral neck fracture, especially for the aged Related Articles | Metrics

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Applied situation of finite element modeling method in foot Sun Wei-dong, Wen Jian-min 2010, 14 (13):  2457-2461.  doi: 10.3969/j.issn.1673-8225.2010.13.044 Abstract ( 124 )   PDF (624KB) ( 470 )   Save BACKGROUND: Finite element analysis is becoming a kind of strong tool in pathologies, treatment and manufacture of orthopedic brace in the research area of foot diseases because of its unique advantage in biomechanical research in recent years. OBJECTIVE: To review the applied situation of finite element modeling method in foot, consisting of scientific methods of data acquisition, reliable material characteristics and parameter definition, modeling method and the software of finite element. METHODS: To search the articles from January 1980 to May 2009 by computer in CNKI database, PubMed database, Wanfang database and Vip database. The index words were “finite element method, foot, finite element model”. The articles included the studies on methods of data acquisition, on material characteristics and parameter definition and on modeling method. The articles which to repeat the similar method, not to introduce the relative parameters in detail were deleted.                                    RESULTS AND CONCLUSION: It was the most popular method in current years to acquire the data of study object from CT and MR images. It will be the developing tendency of medical finite element modeling method to establish program interface between 3-D rebuilt technique of CT and finite element which finite element software can directly read 3-D model of CT. The material characteristics and parameter of foot finite element model mostly referred to the foreign data. The studies of material parameter test were not reported. In the field of material characteristics, the finite element model of foot with nonlinearity and tissue anisotropy will be the main stream. Related Articles | Metrics

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Finite element mechanical analysis on fracture hip supporting joint for treatment of femoral neck fracture Shi Zhen-man, Shi Jiang, Wang Xin, Guo Shu-zhang, Wu Yue, Peng Jiang 2010, 14 (13):  2462-2466.  doi: 10.3969/j.issn.1673-8225.2010.13.045 Abstract ( 118 )   PDF (350KB) ( 476 )   Save BACKGROUND: For treatment of femoral neck fracture, all therapies with the exception of joint replacement encounter the problems including slow healing, poor prognosis, various complications, and unable to bear weight for long time. Fracture hip supporting joint (FHSJ) is a novel unlimited hip support implement that possesses the double functions of fracture fixation and joint supporting and can be used to prevent and treat the complications of femoral neck fracture in young people. OBJECTIVE: To investigate the mechanical effects of FHSJ on treatment of femoral neck fracture. METHODS: Three types of two-dimensional finite element models were constructed by AutoCAD: normal hip (group A), femoral neck fracture fixed with two screws (group B), and femoral neck fracture fixed with two screws and FHSJ (group C). The grids of two-dimensional four nodal point elements were divided by ANSYS (PLANE82). Under the identical condition, the calculations were performed respectively. RESULTS AND CONCLUSION: The stress peak value of femoral head weight-bearing zone was 1.029 and 1.63 MPa in group A and group B, respectively, and that in the group C was 0.1-0.4 MPa. The stress peak value of the screws was 37.186 and 7.474 MPa in the group B and group C, respectively. These results indicate that FHSJ installation based on fixation of multiple screws could promote the recovery of femoral head and neck, which exhibits promising prospects in treatment of femoral neck fracture in young people. Related Articles | Metrics

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Danhong injection effects on vascular endothelial function in patients undergoing coronary artery stent implantation Liang Hong 2010, 14 (13):  2467-2470.  doi: 10.3969/j.issn.1673-8225.2010.13.046 Abstract ( 90 )   PDF (253KB) ( 355 )   Save BACKGROUND: Numerous studies have shown that Danshen Root can suppress adhesion and aggregation of neutrophils as well as production of oxygen free radical, can activate blood circulation to dissipate blood stasis. However, there are few studies about precise mechanisms underlying protection of vascular endothelium and anti-thrombosis, especially concerning the mechanism of action following coronary artery stent implantation. OBJECTIVE: To investigate the influence of Danhong injection on vascular endothelial function before and after coronary artery stent implantation in patients with acute coronary syndrome (ACS). METHODS: A total of 60 ACS patients were randomly assigned to two groups. The patients in the conventional treatment group were subjected to conventional drug treatment following coronary artery stent implantation. The patients in the Danhong injection group received conventional drug treatment and Danhong injection (20 mL/d) following coronary artery stent implantation. The treatment course was 10 days. Before and after implantation as well as before and after Danhong injection treatment, endothelium-derived blood flow-mediated vasodilation, plasma endothelin, thromboxane B2, 6-keto-prostaglandin levels were determined, and the vascular endothelial function were evaluated. Simultaneously, short-term prognosis was observed in patients of both groups. RESULTS AND CONCLUSION: Plasma endothelin and thromboxane B2 levels were significantly increased, but 6-keto-prostaglandin levels were significantly decreased following stent implantation in patients of both groups compared with that before implantation (P < 0.05). Plasma endothelin and thromboxane B2 levels were significantly reduced, but endothelium-derived blood flow-mediated vasodilation and 6-keto-prostaglandin levels were significantly increased in both groups following treatment compared with that following implantation (P < 0.05, P < 0.01), especially in the Danhong injection group (P < 0.05). During hospitalization, the incidences of cardiovascular events were diminished in the Danhong injection group compared with conventional drug treatment group (P > 0.05). Results suggested that Danhong injection significantly improves vascular endothelial function, induces vasodilatation, improves blood supply, inhibits platelet aggragation, and shows the tendency of ameliorating short-term prognosis. Related Articles | Metrics