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25 March 2012, Volume 16 Issue 13 Previous Issue    Next Issue

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Effect of hydrostatic pressure on the morphology and matrix expression in human nucleus pulposus cells Chen Jiang, Liu Gen-zhe, Xu Lin, Li Chun-gen, Sun Qi, Qiao Wei-ping, Zhu Zhi-qiang 2012, 16 (13):  2281-2286.  doi: 10.3969/j.issn.1673-8225.2012.13.001 Abstract ( 261 )   PDF (427KB) ( 358 )   Save BACKGROUND: Hydrostatic pressure stimulation caused by gravity is an important regulator of human nucleus pulposus cells metabolism. OBJECTIVE: To observe the effect of hydrostatic pressure on the morphology of monolayer cultured human nucleus pulposus cells and matrix expression in vitro. METHODS: In the hydrostatic pressure loading system, 0.3, 0.7, 3 MPa pressure were imposed on the passage 4 human nucleus pulposus cells in monolayer in vitro culture for 30, 60, 90, 120 minutes, and the atmospheric pressure 0.1 MPa group was as the control group. RESULTS AND CONCLUSION: ①Morphology: cell volume became small under hydrostatic pressure stimulation. Under 0.3 and 0.7 MPa hydrostatic pressure, cell volume shrinked slightly, and cell morphology were relatively complete. Under 3 MPa hydrostatic pressure, cell volume was significantly reduced, and cell morphology was not complete. ②Survival rate: after 30 minutes hydrostatic pressure stimulation, survival rate were relatively low in all groups, as time passed, the rate gradually increased or remained stably in 0.3, 0.7 MPa groups, and tended to decline in 3 MPa group.③ Proteoglycan expression: the expression were increasing with time in all groups, and when hydrostatic pressure sustained for 120 minutes, the strongest proteoglycan expression were detected in 0.3 and 0.7 MPa group which were significantly more than that in the 0.1 and 3 MPa group. The results show that hydrostatic pressure would affect nucleus pulposus cell morphology, viability and proteoglycan expression.   Related Articles | Metrics

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Finite element analysis of Wallis non-fusion system for human lumbar   Liu Rui1, Xu Lin2, Zhang Yuan-zhi1, Yu Xing2 2012, 16 (13):  2287-2291.  doi: 10.3969/j.issn.1673-8225.2012.13.002 Abstract ( 272 )   PDF (418KB) ( 344 )   Save BACKGROUND: At present, the clinical short-term effect of Wallis non-fusion system is obvious. OBJECTIVE: To establish the Wallis non-fusion system finite element model and to analyze the stress distribution under different physiological movement. METHODS: Eight volunteers with mild degeneration of the lumbar intervertebral disc were subjected to compute tomography (CT) scanner. CT scanning images were imported into Materialise Mimics 10.01 software. Three-dimensional models of L4-5 disc and its intervertebral disc were reconstructed, and then the results were compared with literature results to verify the model validity. Wallis system were established by using the AutoCAD 2009 software, and then transformed into Materialise 3-Matic 4.3 software for re-meshing, the reconstructed Wallis system was fitted with lumbar spine model according to the standard operation mode, and then transformed into Abaqus 6.9 software to form finite element model, then the stress changes of lumbar flexion, extension, lateral bending and rotation of lumbar Wallis non-fusion system were analyzed. RESULTS AND CONCLUSION: The three-dimensional finite element model of lumbar established in the experiment concluded 233 438 units and 48 174 nodes; the three-dimensional finite element model of Wallis system concluded 11 857 units and 3 398 nodes. After the two models were merged, it concluded 245 295 units and 51 572 nodes. The reconstructed three-dimensional model could accurately simulate the fixation of the Wallis non-fusion system. Then the stress changes of lumbar flexion, extension, lateral bending and rotation of lumbar Wallis non-fusion system were analyzed through stress contour. The stress contour showed that Wallis system was involved in the activities of lumbar spine in different directions and had a good match with the lumbar spine. Wallis system was conformed to the four movement conditions of lumbar spine, and the stress located between the upper and lower spinous part was more concentrated, and the stress contacted with the lower part of the vertebral spinous process was highest. Applications of sophisticated CT scanning technique and Mimics software could directly docking with Abaqus software which made the establishment of three-dimensional finite element model of Wallis non-fusion system more faster and accurate according to the direct assignment of the CT value. The implantation of the Wallis interspinous distraction device could share the stress of the disc and the small joints. The stresses of Wallis system and spinous processes were increased leading to the increasing possibility of spinous process fracture and implant fatigue rupture accordingly.   Related Articles | Metrics

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Three-dimensional digital measurement of fixed parameters of the less invasive stable system fixation  Hao Ting1, Yu Bin1, Hao Zeng-tao2, Feng Wei2 2012, 16 (13):  2292-2295.  doi: 10.3969/j.issn.1673-8225.2012.13.003 Abstract ( 271 )   PDF (283KB) ( 374 )   Save BACKGROUND: The research has shown that the less invasive stable system (LISS) fixation has good effect on the treatment of distal femoral fractures, but its parameter was according to westerner, and the specification of a manufactured item is limited.  OBJECTIVE: To digital measure the related anatomical CT data of LISS fixation in Chinese adults.  METHODS: Fifteen cases imaging samples with no disease or osteoporosis were selected from the Second Affiliated Hospital of Inner Mongolia Medical College. The MIMICS10.01 software was used to do the three-dimensional reconstruction, the width of distal femur, anteroposterior diameter of condylus lateralis femoris, basilar part width of condylus lateralis femoris and angle between condylus lateralis femoris and trunk were measured in the three-dimensional images. Every 5 cm was divided into a segment from the 5 cm to the lower edge of the greater trochanter to the lateral epicondyle, five segments in total. The width of internal and lateral cortex and medullary cavity diameter of the femur in the central part of each segments were measured.   RESULTS AND CONCLUSION: After LISS fixation in Chinese adults, the width and anteroposterior diameter of condylus lateralis femoris were (84.80±1.27) mm and (67.36±1.41) mm in the left and (84.60±1.40) mm and (66.27±1.42) mm in the right; the basilar part width of condylus lateralis femoris was (42.53±3.42) mm and (42.98±1.25) mm; the angle between condylus lateralis femoris and trunk was (7.58±0.69)° in the left and (7.66±0.79)° in the right, and there was no significant difference between two sides. Related Articles | Metrics

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Three-dimensional finite element analysis of ankle arthrodesis with fibular strut graft  Ouyang Han-bin, Xiong Jun, Xiang Peng, Cui Zhuang, Chen Li-guang, Yu Bin 2012, 16 (13):  2296-2299.  doi: 10.3969/j.issn.1673-8225.2012.13.004 Abstract ( 323 )   PDF (383KB) ( 374 )   Save BACKGROUND: Finite element modeling in biomechanical experiment has advantages in shorter experiment time, lower expense, simulation of complex boundary condition, full analysis of biomechanical characteristics and repeatability. OBJECTIVE: To establish a finite element model of ankle arthrodesis with fibular strut graft, to evaluate the biomechanical stability and safety, and to study the biomechanical characteristics of ankle arthrodesis with fibular strut graft. METHODS: A three-dimensional model of a healthy ankle was developed from computed tomography images. Ankle arthrodesis was simulated by Abaqus 6.9 software, and the model was submitted to mechanical analysis under four load procedures according to the postoperative activity pattern of ankle (neutral position, dorsiflexion, external rotation and internal rotation). RESULTS AND CONCLUSION: The model was successful established and had high geometric similarity. In dorsiflexion status, posterior-anterior screw yielded maximum stress concentration at middle part; meanwhile, maximum displacement occurred at the fusion site. Screw stress at posterolateral tibial was maximal. A high concentrated stress was found surrounding the screw hole. High stress was distributed between the screw holes of fibular strut. To avoid the high concentration of stress distribution, the crossed screws should be configured appropriately. And additional ante-dorsiflexion immobilization might lower the risk of screw implant failure. Shortening of distance between parallel screws and centralized drilling on fibula also tended to reduce the risk of strut failure. Related Articles | Metrics

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Biomechanical finite element analysis of the pelvic in a standing position following modular hemipelvic prosthesis replacement   Lian Shi-hai1, Tu Chong-qi2, Zhang Qiang1, Liang Lei1, Duan Hong2, Zhou Yong2 2012, 16 (13):  2300-2304.  doi: 10.3969/j.issn.1673-8225.2012.13.005 Abstract ( 312 )   PDF (563KB) ( 326 )   Save BACKGROUND: At present, the finite element analysis of the pelvic biomechanics is mainly on the normal and post-traumatic pelvis. However, the three-dimensional finite element analysis of the pelvic biomechanics following malignant tumor resection and reconstruction of pelvic ring defects with modular hemipelvic prosthesis replacement is rare. OBJECTIVE: To research and analyze the stress distribution in a standing position about the normal pelvis, postoperative contralateral pelvic and modular hemipelvic prosthesis replacement. METHODS: First, the original digital imaging and communications standard data of the pelvis in patients with hemipelvic resection and modular hemipelvic prosthesis replacement were obtained by thin-layer CT scanning, and then the data were transferred into the Mimics8.1 software to set up three-dimensional solid model. The solid model was established by Abaqus6.7-1 analysis software. By means of the normal pelvis and after modular hemipelvic prosthesis replacement, the three-dimensional finite element models of the pelvis were set up respectively. The stress in different standing positions, including two legs standing and one leg standing, was loaded in finite element models and the results in finite element models were analyzed. RESULTS AND CONCLUSION: In the kinds of models, the difference of contralateral pelvic stress value was small under the same load in different standing positions. The maximum stress of modular hemipelvic prosthesis in the ipsilateral pelvic at different standing positions appeared on the inner wall of connector bar between CS spinal fixation at the top of acetabular cup and acetabular cup. It is much lower than the fatigue strength of connector bar. The stress distribution of the pelvic at different standing positions after prosthesis replacement was basically consistent with the normal pelvis. ①It demonstrates that the effect of modular hemipelvic prosthesis replacement on contralateral pelvis is less. ②Modular hemipelvic prosthesis has good security at different standing positions. ③The pelvis after modular hemipelvic prosthesis reconstruction is consistent with the normal laws of human biomechanics, and has a good biomechanical compatibility.  Related Articles | Metrics

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Mimics software three-dimensional reconstruction for individual revision using total hip prosthesis Wang De-chun, Xiang Yu-cheng, Huang Shuai, Wei Xi-jiang, Pan Tao 2012, 16 (13):  2305-2308.  doi: 10.3969/j.issn.1673-8225.2012.13.006 Abstract ( 412 )   PDF (390KB) ( 363 )   Save BACKGROUND: Acetabular bone defects in hip arthroplasty are often difficult to locate and quantify, and therefore the use of computer-aided design and computer-aided processing technology for preoperative preparation can reduce the difficulty and risk of acetabular reconstruction. OBJECTIVE: To investigate the application and significance of Mimics software for individual revision of total hip prothesis.  METHODS: The hip CT scan image data of patients with total hip arthroplasty was input into Mimics software to reconstruct the three-dimensional hip joint model. The anteversion, valgus angle, neckshaft angle, femoral head diameter, acetabular wall thickness/diameter and loosening broken case of the hip prosthesis were measured; the range of acetabular bone defect was located and quantified. Meanwhile, through the simulation of the renovation, the range of bone and the implanted total hip prosthesis size were designed. RESULTS AND CONCLUSION: Mimics three-dimensional window was used to precisey locate the broken prosthesis; the maximum longitudinal diameter of the debris was forecasted to 33.68 mm, the distance from the debris to the femoral head prosthesis was 48.93 mm, the distance from the debris to the acetabular component was 20.14 mm. The average threshold of acetabular selected 130.47 mm2 viewable area was 339.98, the average threshold of 130.47 mm2 viewable area in bone defect area was -481.25, and the defect area was 21.41 mm×21.38 mm. The bone defects were evaluated according to three-dimensional model assessment and classified: American Academy of Orthopaedic Surgeons classification type ⅠB, Gross classification type ⅡA, Engh classification type Ⅰ. Results confirm that Mimics software can optimize solutions and ways of hip arthroplasty and reduce complications and the risk of surgery.  Related Articles | Metrics

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Effect of femoral offset on the occurrence of related complications after total hip arthroplasty Lü Zuo-gang, Kong Rong 2012, 16 (13):  2309-2312.  doi: 10.3969/j.issn.1673-8225.2012.13.007 Abstract ( 444 )   PDF (351KB) ( 305 )   Save BACKGROUND: As a test indicator of total hip arthroplasty (THA), femoral offset plays an important role in the efficiency of THA and the life expectancy of prosthesis. OBJECTIVE: To investigate the correlation between the femoral offset and the postoperative complications of THA. METHODS: The femoral offset between healthy side and affected side of patients with femoral neck fracture after THA was compared. Totally 61 patients who were treated with THA after femoral neck fracture were followed-up. According to the difference of femoral offset between the healthy and affected sides, cases were divided into D > 4 mm group (difference > 4 mm) and D≤4 mm group (difference ≤ 4 mm). RESULTS AND CONCLUSION: Totally 31 cases were in the D > 4 mm group: the complications of pain, dislocation, claudication and lower limb length discrepancy were 4, 0, 2 and 6 cases, respectively. And 30 cases were in the D≤4 mm group: the complications of pain, dislocation, claudication and lower limb length discrepancy were 1, 0, 0 and 1 case, respectively. There is a close relationship between the effective reconstruction of femoral offset and complications after THA, and a good recovery of femoral offset can significantly reduce the occurrence of related complications after THA. Related Articles | Metrics

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Instrumented fusion versus simple fenestration discectomy in treatment of bulged lumbar disc herniation  Chen Zhong1, Min Shao-xiong1, Jin An-min1, Zhang Ji-li2, Chen Ke1, Yang Shao-an1 2012, 16 (13):  2313-2317.  doi: 10.3969/j.issn.1673-8225.2012.13.008 Abstract ( 317 )   PDF (496KB) ( 336 )   Save BACKGROUND: There has been a controversy concerning whether fusion or not is applied in the treatment of lumbar disc herniation. OBJECTIVE: To compare the curative effects of instrumented fusion and simple fenestration discectomy in the treatment of bulged lumbar disc herniation. METHODS: Totally 152 patients with bulged lumbar disc herniation treated between December 2004 and December 2009 in Zhujiang Hospital were reviewed. Fifty-five cases underwent simple fenestration discectomy (simple fenestration group), 97 cases received nucleus pulposus annulus extraction, instrumented intervertebral fusion and pedicle screw fixation (fusion group). Follow-up was performed termly after operation. RESULTS AND CONCLUSION: X-rays showed that the intervertebral height of simple fenestration group was significantly reduced at 6 months and 6 years after operation whereas the intervertebral height of the fusion group was increased at these two time points (P < 0.05). There was no significant difference in visual analogue score and Oswestry score before and 6 months after operation between two groups (P > 0.05). However, 6 years later, the mean visual analogue score and Oswestry score in the fusion group were significantly lower than that in the simple fenestration group (P < 0.01). For bulged disc herniation, nucleus pulposus annulus extraction, instrumented intervertebral fusion and pedicle screw fixation have better long term results compared with simple fenestration discectomy.  Related Articles | Metrics

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The stress and strain distributions of periodontal ligament of maxillary canine under the orthodontics force  Ni Ling, Wu Yang, Dai Hong-wei 2012, 16 (13):  2318-2323.  doi: 10.3969/j.issn.1673-8225.2012.13.009 Abstract ( 265 )   PDF (292KB) ( 265 )   Save BACKGROUND: The stress-strain analysis of the periodontal ligament under the orthodontic force can provide theoretical basis for the orthodontics design. OBJECTIVE: To analyze the stress and strain distributions of periodontal ligament of maxillary canine under the orthodontics force. METHODS: The stress and strain distributions of periodontal ligament of maxillary canine were analyzed under the orthodontics force by assuming the root of maxillary canine to be paraboloidal shape model. The model was loaded and solved; the approximate shear force, axial force, bending moment and torque were loaded on the model in order to analyze the stress and strain distributions of the periodontal ligament.  RESULTS AND CONCLUSION: The results of theoretical analysis and numerical results of stress distribution in the periodontal ligament were very similar, the maximum difference value was 13.4%, and the largest Von misses stress of the periodontal ligament was in the alveolar crest. The results show that the stress and strain distributions of the periodontal ligament were complicated; they were not only related with the root length, but also related with different load power system. The dentist should rationally take all these parameters into account in the clinical treatment.  Related Articles | Metrics

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Effect of gait training and assessment system of Lokomat automatic robot on walking ability of  patients with incomplete spinal cord injury Guo Su-mei1, Li Jian-min1, Wu Qing-wen2, Shen Hai-tao2 2012, 16 (13):  2324-2327.  doi: 10.3969/j.issn.1673-8225.2012.13.010 Abstract ( 331 )   PDF (249KB) ( 517 )   Save BACKGROUND: Robotic devices can provide safe, repetitive, high-intensity and long time gait training for patients under precisely control. Application of robotic devices in the field of rehabilitation has obvious advantages. OBJECTIVE: To investigate the role of Lokomat-system in recovery of walking ability in people with incomplete spinal cord injury. METHODS: Two male patients with motor-incomplete spinal cord injury were selected to join in Lokomat gait training for 5.5 months. Lower extremity motor scores, 10-meter walk test, the 6-minute walk test, the Berg test were assessed prior to, at 6, 12 weeks and 5.5 months after training. RESULTS AND CONCLUSION: After finishing automatic gait training with Lokomat, although lower extremity motor scores was not improved apparently, the 10-meter walk test, the 6-minute and Berg test of the two patients were improved as compared with the pretraining. Automatic gait training with Lokomat is helpful to improve walking ability of patients with incomplete spinal cord injury. Related Articles | Metrics

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Design of a remote medical monitoring alarm system based on GPS and GPRS  Peng Sheng-hua1, Yu Xiao-e1, Lai Sheng-sheng2 2012, 16 (13):  2328-2331.  doi: 10.3969/j.issn.1673-8225.2012.13.011 Abstract ( 335 )   PDF (320KB) ( 359 )   Save BACKGROUND: Remote medical monitoring alarm system can transmit medical information and realize dynamic physiological monitoring. OBJECTIVE: To design a remote medical monitoring alarm system based on GPS and GPRS. METHODS: The system consisted of central station and multiple subscriber terminals. The real-time physiological and location information of patients were gathered by collection terminal and then sent by positioning transmission module to GSM mobile communication network by using medical monitoring technology, mobile communication technology, embedded technology and GPS technology, so a doctor could diagnose and deal with patients timely to realize the real-time remote monitoring and alarm of physiological parameters. RESULTS AND CONCLUSION: The system built a remote medical information transmission and medical treatment platform which was trinitarian for families, communities and hospitals, through which patient’s medical and position information were sent to a medical center immediately, then experts made a diagnosis and provided guidance and assistance. The system can be used in pre-hospital first aid, out-hospital care, and remote medical and emergency assistance. It is not only applicable to hospital and ambulance, but also to monitor and track chronic patients in family. Related Articles | Metrics

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Application of orthopantomography and cone beam computed tomography in dental implant: A comparative study   Zhang Yun-long, Li Chang-fu 2012, 16 (13):  2332-2335.  doi: 10.3969/j.issn.1673-8225.2012.13.012 Abstract ( 315 )   PDF (250KB) ( 426 )   Save BACKGROUND: Imaging studies can get the information of dental implants timely. However, there are errors in the height and width of the bone when determined by commonly used orthopantomography (OPG). OBJECTIVE: To compare the application of cone beam computed tomography (CBCT) and OPG in dental implants. METHODS: Fifty-three patients with missing teeth (n=65) and good periodontal status were assessed with CBCT and OPG before and after implant operation. Before operation, a steel ball with a diameter of 3 mm was fixed at the implanted area as a standard object for reference. Then, the diameter of the steel ball was measured by both CBCT and OPG. After operation, the rate of osseointegration was analyzed, and the difference was compared. RESULTS AND CONCLUSION: Compared with OPG, the difference between the real diameter and X-ray results by CBCT was smaller (P < 0.05). Three months later, the discovery rate of implant non-osseointegration measured by CBCT was similar to the result measured by OPG (P > 0.05). Compared with OPG, CBCT can evaluate the bone volume of pre-surgical alveolar bone more accurately, and can also indicate the peri-implant bone volume and quality much clearly. Related Articles | Metrics

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Implementation and animal experiment of an implantable artificial anal sphincter system Xu Qian-qian, Liu Hua, Yan Guo-zheng 2012, 16 (13):  2336-2341.  doi: 10.3969/j.issn.1673-8225.2012.13.013 Abstract ( 418 )   PDF (424KB) ( 530 )   Save BACKGROUND: It is important to develop a new kind of implantable artificial anal sphincter system to meet the physiological needs of the human body. OBJECTIVE: To design a new kind of implantable artificial anal sphincter system. METHODS: Wireless communication model and pressure sensors were used to rebuild the mechanism of defection, and the power was supplied with transcutaneous energy transmission model. The electro-mechanical system was adopted to simulate the human natural organ to achieve the control efforts of human anal sphincter finally. RESULTS AND CONCLUSION: A new kind of implantable artificial anal sphincter system was designed and accomplished. The bio-feedback control ability of anus incontinent patients could be recovered in some degree based on the reconstruction of defecation mechanism and model. The implantable artificial anal sphincter system had the module of transcutaneous energy transmission that could provide long-time wireless power for the internal system. The animal experiment was accomplished to verify the feasibility to implant the implantable artificial anal sphincter system and its basic function. Related Articles | Metrics

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Evaluation of intermuscular fat content in menopausal women by magnetic resonance imaging scanning and simple surface parameters  Yan Dan, Ruan Xiang-yan 2012, 16 (13):  2342-2345.  doi: 10.3969/j.issn.1673-8225.2012.13.014 Abstract ( 269 )   PDF (235KB) ( 322 )   Save BACKGROUND: Menopausal women often appear with the increase of intermuscular adipose tissue mass (IMAT) content. International methods that used to measure the IMAT content are CT and magnetic resonance imaging (MRI). Because the costs are more expensive and CT has disadvantages in radioactivity, so they are not suitable to be widely used in clinical. OBJECTIVE: To estimate the intermuscular fat content which measure by MRI from simple surface parameters (anthropometric and serological indicators) in menopausal women in order to improve the detection efficiency and save the health care costs. METHODS: A total of 60 naturally menopausal women were divided into metabolic syndrome group and non-metabolic syndrome group. The anthropometric indicators and serological indicators were measured. IMAT content was detected using bioelectrical impedance analyzer. According to previous research results, the middle leg area and IMAT content were measured by single cross-sectional MRI of the middle leg area. The multiple-regression analysis was conducted between measurement results of MRI and simple surface parameters. RESULTS AND CONCLUSION: ①IMAT content was excess (percentage of IMAT content > 30%). The incidence of metabolic syndrome was 88.3% and 28.3%. ②Middle leg IMAT area and total IMAT content had a positive correlation with triglyceride, systolic pressure, diastolic pressure and fasting plasma glucose, while a negative correlation with high density lipoprotein-cholesterol, when age, years since postmenopause and the level of estradiol were eliminated. ③Fat content of the whole body had a strongest relationship with the IMAT. ④The equation which was used to estimate IMAT from anthropometric simple surface parameters in menopausal women was initially established. It is indicated that the total IMAT content is a risk factor for metabolic syndrome in menopausal women. Related Articles | Metrics

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Expression of matrix metaloproteinases-1 in degenerative lumbar intervertebral disc in different degrees and fiber ring   Zhang Bo, Yang Shao-hua, Lin Shi-zhou, Chen Wei 2012, 16 (13):  2346-2349.  doi: 10.3969/j.issn.1673-8225.2012.13.015 Abstract ( 286 )   PDF (303KB) ( 333 )   Save BACKGROUND: Matrix metalloproteinases lead to matrix components disorders and change the function through the influence on matrix synthesis and degradation in the disc degeneration. OBJECTIVE: To observe the expression of matrix metalloproteinase-1 (MMP-1) in degenerative human intervertebral disc. METHODS: Thirty intervertebral disk samples were selected from the prolapse of lumbar intervertebral disc patients in surgery. Experimental group was made from 30 cases with lumbar disc protrusion disease and control group was made from 10 cases of lumbar spine fracture in traumatic. Experimental group included protrusion, extrusion and sequestration type, 10 samples in each type and the nucleus pulposus and annulus were separated. The immunohistochemistry was used to detect the expression of MMP-1 in nucleus cells and fiber ring. RESULTS AND CONCLUSION: ①Hematoxylin-eosin staining showed that intervertebral disc specimen fiber ring still maintained a dense lamellar structure in the control group and the intervertebral disc tissue present fibrotic changes in the experimental group. ②The expression of MMP-1 in nucleus cells of two groups were higher than those in the fibrous ring. ③The expression of MMP-1 in the protrusion specimen of experimental group was significantly higher than that of control group (P < 0.01), and MMP-1 expression in extrusion type and sequestration type specimen was significantly higher than that in the protrusion specimen (P < 0.01). Related Articles | Metrics

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An invasive telemetric pressure sensor for detecting endoleaks after endovascular abdominal aortic aneurysm stent repair   Weng Hai-bin1, Guo Xu-dong2, Wang Wen-xing3 2012, 16 (13):  2350-2353.  doi: 10.3969/j.issn.1673-8225.2012.13.016 Abstract ( 251 )   PDF (327KB) ( 378 )   Save BACKGROUND: To date, the method for detecting endoleaks after endovascular abdominal aortic aneurysm stent repair include spiral computed tomography (CT) scan, artery angiography, magnetic resonance imaging, or duplex ultrasound scanning. But all the results are judged by the image indirectly and cannot examine the endoleaks directly and efficiently. The shortages exist, such as miss diagnosis, complicate to operate, high cost and another disadvantages to patients. OBJECTIVE: To measure the pressure in cavity by using the implantable wireless invasive telemetric pressure sensor in order to diagnose the occurrence of endoleaks after endovascular abdominal aortic aneurysm stent repair METHODS: The implantable wireless pressure detection system consisted of an invasive telemetric pressure sensor, power transmitting coil, data recorder and data processing station. The implantable wireless invasive telemetric pressure sensor could detect the blood pressure in tumor cavity. The implantable wireless invasive telemetric pressure sensor was composed of the wireless energy receiving module, the power management module, the sensor module, the signal conditioning module, the microcontroller and the radio frequency communication module. RESULTS AND CONCLUSION: The prototype has been made and the in vitro blood test experiment has been carried out. Through the simulation test, the feasibility and effectiveness of the pressure telemetry for the wireless pressure sensors has been verified preliminary. Related Articles | Metrics

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Anatomy analysis and establishment of a three-dimensional visible model of the arteries in the sellar region  Wu Zhi-bing1, Guo Xing2, Li Fu-de1, Li He-ping1, Li Jian-bin1, Liu Xue-min1 2012, 16 (13):  2354-2357.  doi: 10.3969/j.issn.1673-8225.2012.13.017 Abstract ( 294 )   PDF (367KB) ( 347 )   Save BACKGROUND: A thorough anatomical knowledge of the arteries in the sellar region is important for the diagnosis and operation of cerebrovascular diseases. It is very important to develop a digitized visible model that can illustrate the complex anatomy of the arteries in the sellar region. OBJECTIVE: To develop a digitized visible model of the arteries in the sellar region for anatomy observation of the arteries in the sellar region. METHODS: According to CT data of one patient, a digitized visible model of the arteries in the sellar region was constructed by Mimics software, and the arteries in the sellar region were observed. RESULTS AND CONCLUSION: Three-dimensional model of the arteries in the sellar region was successfully constructed, which could observe the arterial distribution and branch artery at the sellar region from different angles and dimensions, and demonstrate the individual anatomic features of the arteries in the sellar region. The model allowed the user to interact with the data and manipulate, and observe anatomy in special visual field. The method for creating a digitized visible model using Mimics software is simple and feasible. Related Articles | Metrics

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Condylar volume and surface area in adults with unilateral scissors-bite assessed by cone-beam computed tomography Wang Mou, Zhang Ding-ming, Feng Gang, Zhou Xiao-feng, Dai Hong-wei 2012, 16 (13):  2358-2361.  doi: 10.3969/j.issn.1673-8225.2012.13.018 Abstract ( 321 )   PDF (337KB) ( 331 )   Save BACKGROUND: Condyle is the growth center of the mandibular, occlusal asymmetry can cause morphologic alterations in condylar. OBJECTIVE: To investigate condylar volume and surface area of patients with unilateral scissors-bite assessed by cone-beam computed tomography and to observe the effect of unilateral scissors-bite on the morphology of condylar. METHODS: Twenty-nine adults with unilateral scissors-bite were selected as experimental group from the Department of Orthodontics, Stomatology Hospital of Chongqing Medical University. Thirty-two adults with normal occlusion were selected as control group at the same time. All the objects had no orthodontic treatment history. The cone-beam computed tomography was taken before orthodontic treatment and the measurement of volume and surface area was taken by Mimics 10.0 software. RESULTS AND CONCLUSION: In the experimental group, the condylar volume and surface area on the noscissors-bite side were smaller than those on the scissors-bite side (P < 0.05). The condylar volume and surface asymmetry index of the experimental group were significantly bigger than those of the control group (P < 0.05). Subjects with unilateral scissors-bite have asymmetrical condyles. Related Articles | Metrics

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Effect of plaster external fixation on the histomorphological changes for bone-tendon junction healing Wang Jing1, Zhang Chao-yue2, Tan Cai-Fu3 2012, 16 (13):  2362-2365.  doi: 10.3969/j.issn.1673-8225.2012.13.019 Abstract ( 233 )   PDF (360KB) ( 408 )   Save BACKGROUND: Plaster external fixation has a positive effect on bone-tendon junction healing, but there is no in-depth study on the repair mechanism. OBJECTIVE: To investigate the effect of plaster external fixation on the histomorphological changes for bone-tendon junction healing. METHODS: The bone-tendon junction healing models were established by cutting off the junction between the patellar tip and the patellar tendon as well as the distal part of the patella. The models were divided into experimental group and model group. The models in the experimental group were performed with plaster external fixation and those in the model group were without fixation. Each group got the sample at 2, 4 and 8 weeks after operation. RESULTS AND CONCLUSION: Hematoxylin-eosin staining, Safranin’O staining, macrophages immunohistochemistry staining and integral absorbance showed that the tissue edema and adhesion at the bone-tendon junction in the experimental group were better than those in the model group, cartilage cells and bone tissue formation and differentiation in the experimental group were significantly better those those in the model group, and degree of the inflammation in the experimental group was light and disappeared quickly. External fixation can accelerate the process of bone-tendon repair and promote the healing.    Related Articles | Metrics

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Implantation of locking proximal humeral plate for osteoporotic fractures of the proximal humerus in the elderly: A 12 months follow-up Sun Guan-wen 2012, 16 (13):  2366-2369.  doi: 10.3969/j.issn.1673-8225.2012.13.020 Abstract ( 222 )   PDF (328KB) ( 368 )   Save BACKGROUND: Development of minimally invasive plate osteosynthesis (MIPO) and improvement of internal fixatior provides a reliable treatment for osteoporotic fractures of the proximal humerus in the elderly. OBJECTIVE: To apply locking proximal humeral plate (LPHP) implanted by MIPO for osteoporotic fractures of the proximal humerus in the elderly. METHODS: Totally 39 cases with proximal humeral fractures were observed. By the skill of MIPO, lateral shoulder horizon minor incision was made by the way of trigonal muscle, fractures reduction was made by extracapsular maneuver, then LPHP was planted into the incision above. After implantation, the shoulder function were evaluated by Neer scoring system. RESULTS AND CONCLUSION: All the cases were followed-up for over 12 months. Neither misplacement, mobilize and fracture of internal fixation material, nor screw in articular capsule, and caput femoris necrosis developed. All fractures healed at 10-16 weeks after implantation (averaged 12.3 weeks). The shoulder function was evaluated by Neer scoring system: excellent and good rate were 75.3%, and there were 29 cases for excellent and good, 8 cases for normal and 2 cases for poor. The skill of LPHP implanted by MIPO can treat the osteoporotic fractures of the proximal humerus in elderly, which has the characteristics of less blood circulation damage and stabilized fixation.  Related Articles | Metrics

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Effect of tibia slotting versus trephine for ankle fusion on the degeneration of the adjacent joint Zhu Fa-hao, Zhang Hong-tao,Yang Hui-lin, Ni Li, Cheng Yu, Hu Hai 2012, 16 (13):  2370-2373.  doi: 10.3969/j.issn.1673-8225.2012.13.021 Abstract ( 269 )   PDF (338KB) ( 240 )   Save BACKGROUND: Because of the special anatomy of the ankle joint, there are many methods in ankle fusion, and each has its own advantages. OBJECTIVE: To analyze and compare the effect of tibia slotting versus trephine for ankle fusion discuss the degeneration of adjacent joints. METHODS: A retrospective study was carried out in 35 patients with ankle from February 2002 to February 2011 in the First Affiliated People’s Hospital of Soochow University. We used trephine (n=16) and slotted (n=19) in the tibia to fuse the patients’ ankle joint, then the effect was analyzed and compared. RESULTS AND CONCLUSION: All the 35 patients were followed-up for 8-96 months. The duration of ankle arthrodesis by tibia slotting was longer than that by trephine (P < 0.05), and the intraoperative blood loose was more (P < 0.05). The average American College of Foot and Ankle Society score at the 8th month follow-up in the tibia slotting group was higher than that in the trephine group (P < 0.05). Eighteen of the 35 patients were followed-up for at least 5 years, 10 cases in the tibia slotting group and 8 cases in the trephine group. Over one third of the patients in both two groups occurred adjacent joint degeneration. Compared with slotting in the tibia, trephine for ankle arthrodesis was a simple operation with small wound, higher fusion rate and less complications. However, the degeneration of the near joint should not be ignored.   Related Articles | Metrics

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Effect of novel implant percutaneous compression plate implantation on the recovery of femoral neck fractures Wang Cheng-qing, Xu Yao-zeng, Geng De-chun, Chen Yi-nan, Li Rong-qun 2012, 16 (13):  2374-2377.  doi: 10.3969/j.issn.1673-8225.2012.13.022 Abstract ( 303 )   PDF (335KB) ( 425 )   Save BACKGROUND: Meta-analysis shows the high rate of nonunion, femoral head necrosis and operative revision in femooal neck fractures after internal fixation. OBJECTIVE: To explore the security and short-term therapeutic effect of novel implant percutaneous compression plate (PCCP) on the recovery of femoral neck fractures. METHODS: Twenty-four patients suffering from fresh femoral neck fractures were treated with PCCP. The postoperative pain score at 3 days, a Harris score of the last follow-up, union of fracture and complications were recorded. RESULTS AND CONCLUSION: The mean duration of follow-up was 6.2 months (2.5-11 months). There were 14 cases followed-up for more than half a year and all of them were healed. No fixation failure, re-fracture, hip varus or other complications were found. There was no blood transfusion preformed in any patient during and after operation. The mean time of partial weight-bearing was 4.8 days (2-14 days). Postoperative pain rank at 3 days showed: grade one in 10 cases, grade two in 12 cases and grade three in two cases. Cases in grade one and two accounted for 91%. According to Harris score, the postoperative excellent rate reached 87% after the final follow-up. It shows that the novel implant PCCP implantation is security to the recovery of femoral neck fractures. Stable fixation allows patients early weight-bearing rehabilitation which makes satisfactory short-term therapeutic outcomes. Related Articles | Metrics

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AF pedicle screw internal fixation system for thoracolumbar burst fractures: Medium- and long-term curative effects during 30 months follow-up Gu Hua, Fu Jian, Yi Nan, Zhang Bo-tao, Song Xiao-yong, Xu Li-bing 2012, 16 (13):  2378-2381.  doi: 10.3969/j.issn.1673-8225.2012.13.023 Abstract ( 294 )   PDF (256KB) ( 368 )   Save BACKGROUND: Previous studies have confirmed that posterior short-segment pedicle screw system for the treatment of thoracolumbar burst fractures with none-neurological symptoms can provide enough stability and restore vertebral body height, physiological curvature, spinal curvature and spinal canal volume efficiently. OBJECTIVE: To evaluate the clinical curative of AF pedicle screw internal fixation system for thoracolumbar fractures. METHODS: Fifty-one cases of thoracolumbar burst fractures treated with AF pedicle screw internal fixation system were included. The height of anterior and posterior vertebral border was measured by X-ray before and after operation, before and after the removal of internal fixation, respectively, and all corresponding Cobb angles were calculated. The extent of vertebral protrusion was examined by CT scan, neural function were measured by Frankel scoring. Christian grade and Denis pain grade were obtained respectively. RESULTS AND CONCLUSION: All the patients were all followed-up for over 30 months. Compared with before internal fixation, the height of anterior and posterior vertebral border and Cobb angle were significantly increased and CT scan detected vertebral protrusion was obviously restored after internal fixation, before removal of internal fixation and follow-up after removal of internal fixation (P < 0.01). A total of 24 cases had spinal cord dysfunction preoperatively, and 22 patients obtained complete recovery after the surgery. With respect to Christian grades: 3 points in 1 case, 4 points in 3 cases, 5 points in 15 patients, 6 points in 20 cases, 7 points in 12 cases. After the operation, Denis score system detected P1 (without pain) in 42 cases, P2 (between whiles minute pain, need not treatment) in 9 cases. Self-evaluation satisfaction, 35 patients were very satisfied and 16 cases were satisfied with this treatment. A pedicle screw was broken in one case. It is indicated that AF pedicle screw internal fixation system can treat thoracolumbar fractures effectively and achieve satisfactory reduction, reliable fixation and decompress spinal canal effectively.   Related Articles | Metrics

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Value of dynamic memorial force for holding bone of swan-like memorably-compressive connector Zheng Yi-hong1, Xia Yan2, Xu Shuo-gui2 2012, 16 (13):  2382-2383.  doi: 10.3969/j.issn.1673-8225.2012.13.024 Abstract ( 299 )   PDF (253KB) ( 226 )   Save BACKGROUND: Swan-like memorably-compressive connector (SMC) has received good efficiency in clinical application, and appears with new phenomenon of bone healing with no callus and no stress-shielding. OBJECTIVE: To electrometric analyze the clinical application of SMC. METHODS: Load-strain curve was obtained by sticking slice and standardization, then according to the strain value showed by strain gauge when the fresh humerus was fixated by SMC, the value of dynamic memorial force for holding bone was calculated. RESULTS AND CONCLUSION: The swan-neck compressive part, swan-body connective part, swan-wing holing part of the SMC were harmonized with each other, biological force values of the dynamic memorably holding the bone was 110.35 N. It is indicated that SMC has the dynamic memorably holding force providing guarantee for promoting external fixation removal, postoperative functional exercises and limb rehabilitation. Related Articles | Metrics

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Percutaneous screw insert fixation versus cast immobilization treatment for acute nondisplaced carpal scaphoid fracture: A systematic review    Liu Wei1, Zhao Jin-min1, Su Wei1, Tang Shi-ting2, Xiong Kai1 2012, 16 (13):  2384-2388.  doi: 10.3969/j.issn.1673-8225.2012.13.025 Abstract ( 256 )   PDF (245KB) ( 308 )   Save BACKGROUND: There are some clinical experiences for percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture. However, relevant evidence-based medicine studies are rare.  OBJECTIVE: To assess the effectiveness and safety of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture. METHODS: Relevant domestic and abroad published randomized controlled trials (RCTs) of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture were searched from Medline, EMBASE, Cochrane library, CNKI and CBM databases by computer. RESULTS AND CONCLUSION: Four randomized controlled trials (RCTs) involved 175 patients. The results of Meta-analysis showed that the fracture healing time (SMD=-8.83, 95%CI -10.45 to -7.21, P < 0.000 01) and off work time (MD=-6.86, 95%CI -7.17 to -6.56, P < 0.000 01) in the percutaneous screw insert fixation group were shorter than those in cast immobilization group; the wrist motion (SMD=1.79, 95%CI 1.23 to 2.36, P < 0.000 01) and grip strength (MD=3.53, 95%CI 2.52 to 4.54, P < 0.000 01) were better in the percutaneous screw insert fixation group; the differences of complications had no statistical significance (RR=0.50, 95%CI 0.22 to 1.14, P=0.10). It indicates that percutaneous screw insert fixation treatment for acute nondisplaced carpal scaphoid fracture is superior to cast immobilization treatment. Due to the small sample and limitation of quality in this review, the effectiveness and safety analysis are still needs more high quality and large scale samples of RCTs to get further confirm Related Articles | Metrics

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Research of hip replacement: Literature search and analysis based on Scopus database within 5 years Yao Jin, Zhao Yun, Zhong Cong-li 2012, 16 (13):  2389-2398.  doi: 10.3969/j.issn.1673-8225.2012.13.026 Abstract ( 316 )   PDF (624KB) ( 321 )   Save BACKGROUND: Hip replacement has been confirmed to be a reliable treatment for patients with hip diseases. The main outcomes of hip replacement are to relieve joint pain, correction of deformity and restoration and improvement of the movement function of the joint. OBJECTIVE: To provide the valuable bibliometric analytical data in hip replacement field. DESIGN: Bibliometric data analysis based on Scopus database within 5 years. DATA RETRIEVAL: ①A search of related literatures was performed in Scopus database using the key words of “hip arthroplasty or hip replacement, femoral head necrosis, femoral neck fracture and rheumatoid arthritis”. ②The data were analyzed. ③The data were output into pictures and tables to describe the results. SELECTION CRITERIA: Original researches, reviews and conference proceedings were selected. Letters, editorials, proofreading, essays, short messaging and unpublished articles were excluded. MAIN OUTCOME MEASUREMENTS: ①Numbers of the literatures; ②Publication year of the documents; ③Distribution of the countries; ④Distribution of the institutions; ⑤Document types; ⑥Analysis of source journals; ⑦Analysis of citation frequency; ⑧Patents information. RESULTS: The literatures associated with hip replacement in Scopus database from January 2007 to December 2011 were mainly related to femoral neck fracture, and followed by the femoral head necrosis and rheumatoid arthritis. The patents were mainly related to femoral head necrosis. The number of papers was gradually increasing. The USA published the most documents related to these three types of diseases, and the numbers were 58, 142 and 91 respectively. The Journal of Arthroplasty published the most papers, and the numbers were 47, 58 and 40 respectively. China had an important position in these fields and its numbers of literature were 42, 40 and 10, respectively.  CONCLUSION: Hip replacement used in femoral head necrosis and femoral neck fracture is the hot spot in recent years. Researches of China in this field are gradually mature and have an important position, and China is important in the number of literature in international database. Related Articles | Metrics

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Chinese medicine treatment of deep venous thrombosis of the lower extremity after artificial joint replacement Wu Zheng-lin 2012, 16 (13):  2399-2402.  doi: 10.3969/j.issn.1673-8225.2012.13.027 Abstract ( 316 )   PDF (382KB) ( 666 )   Save BACKGROUND: The incidence of lower extremity deep venous thrombosis is high after artificial joint replacement and mainly caused by intimal damage, slow blood flow velocity and blood hypercoagulable state. OBJECTIVE: To evaluate the preventive and therapeutic effects of Chinese medicine on the lower extremity deep venous thrombosis after artificial joint replacement. METHODS: A computer-based online search was performed for the articles from January 1989 to October 2011 with the key words of “Chinese medicine, lower extremity deep venous thrombosis, prevention and treatment, artificial joint replacement”. The articles that related with the Chinese medicine for the treatment of lower extremity deep venous thrombosis after artificial joint replacement were included; the repeat studies or Meta-analysis articles were excluded. A total of 26 articles were included to review.  RESULTS AND CONCLUSION: For the treatment of lower extremity deep venous thrombosis, the main treatment methods include functional exercise, the pressure gradient therapy, and the thrombolytic and anticoagulant therapy. In recent years, the Chinese medicine shows a good effect in the treatment of lower extremity deep venous thrombosis and the main Chinese medicine include salvia miltiorrhiza, ligustrazine and astragalus mongholicus. Some Chinese herbal compound with the effect of promoting blood circulation also has a role in the prevention of lower extremity deep venous thrombosis. It demonstrates that Chinese medicine shows a good effect both on the prevention and treatment of lower extremity deep venous thrombosis with less adverse reaction. Chinese and Western medicine combined with functional exercise is an effective means for the prevention and treatment of lower extremity deep venous thrombosis.    Related Articles | Metrics

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Artificial shoulder prosthesis for repair of shoulder joint injury Guo Yan-hua 2012, 16 (13):  2403-2406.  doi: 10.3969/j.issn.1673-8225.2012.13.028 Abstract ( 384 )   PDF (359KB) ( 361 )   Save BACKGROUND: Shoulder joint replacement is dependent on the reconstruction of the proximal humerus anatomical structure, at present, there are a wide variety of artificial shoulder prosthesis, which greatly vary in the efficacy. OBJECTIVE: To summarize the application progress of artificial shoulder prosthesis in the repair of shoulder joint injury. METHODS: A computer-based online retrieval was performed by the first author among Wanfang database, China National Knowledge Infrastructure (CNKI) database and PubMed database between 1999 and 2012, using the key words of “shoulder joint, prosthesis” in Chinese and “shoulder joint, artificial false body” in English. Articles addressing the type, design, application and complication of shoulder joint prosthesis were included, as well as those regarding the role of shoulder joint prosthesis in the repair of shoulder joint injury were selected. A total of 86 articles were screened out according to inclusion and exclusion criteria, and 25 articles of them were involved in the analysis. RESULTS AND CONCLUSION: UNIVERS3-D and Aequalis fracture shoulder prosthesis are the commonly used, because of good clinical efficacy, little complications and low revision rate after the replacement, and good biocompatibility. Delta reverse replacement of shoulder joint prosthesis shows a high revision rate and poor biocompatibility as a result of scapular notching and dislocation. Therefore, proper selection of cases, understanding of the anatomy of shoulder joint and the special reconstruction technology of shoulder joint, as well as a careful replacement scheme can reduce the replacement complications of artificial shoulder prosthesis, thereby improving the biocompatibility between the prosthesis and the host. Related Articles | Metrics

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Role of Wnt/beta-catenin signal pathway in the occurrence of osteoarthritis  Li Sheng-cun, Bao Jie, Wang Guo-xiang 2012, 16 (13):  2407-2410.  doi: 10.3969/j.issn.1673-8225.2012.13.029 Abstract ( 291 )   PDF (443KB) ( 521 )   Save BACKGROUND: Studies have shown that the classical Wnt/β-catenin signal pathway is closely related to the occurrence and development of osteoarthritis. Wnt protein family, β-catenin and related inhibitors can regulate the function and metabolism of chondrocytes. OBJECTIVE: To summarize the relationship between Wnt/β- catenin signal pathway and osteoarthritis. METHODS: A computer online search was performed to fine papers published between 2000 and 2011 in CNKI database and PubMed database. The key words of “Wnt/β-catenin, OA, osteoarthritis, cartilage cells” were used. Documents concerning the effects of Wnt/β- catenin signal pathway on osteoarthritis were included. RESULTS AND CONCLUSION: Currently, studies show that the Wnt/β- catenin signal pathway is one of the important way to restrain the integrity of joint and regulate the metabolism of bone joint, can influence the osteoarthritis. Wnt signal pathway and its downstream signal osteoprotegerin/receptor activator of nuclear factor kappa B ligand/receptor activator of nuclear factor kappa B can regulate and control the articular cartilage metabolism result in osteoarthritis. However, the specific mechanism is still unclear. The research of components and effect of Wnt signal pathway are important for the special treatment of osteoarthritis and the prevention of osteoporosis or other diseases. Related Articles | Metrics

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Application of posterior cervical lateral mass plates and screws for the treatment of multilevel cervical myelopathy   Wang Jing-xu, Yin Xi-meng, Gong Shu-yi, Wu Bo 2012, 16 (13):  2411-2414.  doi: 10.3969/j.issn.1673-8225.2012.13.030 Abstract ( 299 )   PDF (375KB) ( 431 )   Save BACKGROUND: Internal fixation of the lateral masses with plate and screw has been widely used to treat cervical instability, cervical spondylolisthesis, cervical reconstruction and other injuries caused by various reasons. OBJECTIVE: To discuss the therapeutic effect of posterior cervical mass fixation assisted with joint distraction in multilevel cervical myelopathy patients. METHODS: An online search of China Academic Journals Full-text Database was performed for the related articles with the key words of “cervical vertebrae”, “lateral mass”, “internal fixation” and “bone graft”. A total of 22 articles were retained after excluding meta-analysis and repetitive studies. These articles were analyzed from three following aspects mainly: the clinical anatomy of cervical lateral mass, the fixation technique of lateral mass screw and the efficacy of lateral mass screw fixation. RESULTS AND CONCLUSION: Lateral cervical mass screw fixation belongs to posterior cervical oligo-segmental fixation. It retains the maximum active degree of cervical vertebrate, adequately decompresses the cervical spinal cord, restores the intervertebral height, maintains the cervical physiological curvature and stabilizes the unstable cervical segments. In addition, it prevents the kyphosis deformity, nerve root palsy and the aggravation of cervical spinal instability. Therefore, lateral cervical mass screw fixation is an effective way to treat multilevel cervical myelopathy accompanied with cervical spinal instability. Related Articles | Metrics

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CT three-dimensional reconstruction and cervical pedicle measurement Yu Jian-hua, A Zha-ti, Liu Xiang-feng 2012, 16 (13):  2415-2418.  doi: 10.3969/j.issn.1673-8225.2012.13.031 Abstract ( 315 )   PDF (479KB) ( 267 )   Save BACKGROUND: Three-dimensional reconstruction technique can provide digital three-dimensional model of human internal structure. Surgery design and biomechanical analysis were conducted on the model using relevant software, which can provide reliable data for safe effective implantation of pedicle screw. OBJECTIVE: To review the application of CT three-dimensional reconstruction in cervical pedicle measurement. METHODS: We retrieved PubMed Database, Vip Database and Wanfang Database for literature regarding the application of CT three-dimensional reconstruction in cervical pedicle measurement published from 1990 to 2011. The English key words were “three dimensional reformations of multi-slice spiral CT, cervical pedicle”. The Chinese key words were “cervical pedicle, three-dimensional CT, computer-aided design, spinal surgery, digital orthopedics, medical image”. RESULTS AND CONCLUSION: Using CT three-dimensional reconstruction technique could obtain clear three-dimensional image of cervical vertebra. Due to the great variation of cervical pedicle and complicated anatomic structure, cervical pedicle screw implantation has been used in a few hospitals in China. However, three-dimensional CT reconstruction for measuring cervical pedicle simulated pedicle screw implantation, exactly observed and measured pedicle screw conditions in vivo, and obtained individual anatomic data, which provided guidance for clinical application of pedicle screw implantation. Related Articles | Metrics

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Relationship of shape and structure of internal fixation implant to biomechanics following bone injury Yang Jun-jian 2012, 16 (13):  2419-2422.  doi: 10.3969/j.issn.1673-8225.2012.13.032 Abstract ( 350 )   PDF (378KB) ( 351 )   Save BACKGROUND: Good biomechanical property of internal fixation material has great effects on therapeutic outcomes of damaged bone. Good mechanics outcomes can be obtained by improving the shape and structure of internal fixation material. OBJECTIVE: From the view angle of biomechanical feature of orthopedic implant internal fixation material, to analyze the correlation of shape and structure of orthopedic implant and internal fixation outcomes. METHODS: We retrieved PubMed, Vip and Wanfang Database for articles concerning bone injury treatment and internal fixation material published from January 1990 to December 2011. The key words were “bone, fixation, shape, material”, which were searched in titles and abstracts. The articles addressing repetitive studies, common reviews or Meta analysis were excluded. A total of 156 articles were primarily obtained, and 29 articles were included according to inclusion criteria. RESULTS AND CONCLUSION: Biomechanical property of orthopedic implants played an important inhibitory effect on bone fixation, bone blood supply, growth and regeneration of osteoblasts. Changes in material shape and structure would produce great effects on biomechanical property, and further affected therapeutic outcomes. How to use new technology to improve shape and structure of orthopedic implant material, and to perform physical modification and to reach ideal internal fixation therapeutic outcomes, has become a focused project by researchers. Related Articles | Metrics

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Application of finite-element analysis in dental biomechanics Huang Yu-wen 2012, 16 (13):  2423-2426.  doi: 10.3969/j.issn.1673-8225.2012.13.033 Abstract ( 361 )   PDF (420KB) ( 871 )   Save BACKGROUND: There are a lot of biomechanical problems in stomatology. Finite element method is an effective tool to numerically simulate the mechanical behavior of human; it has more wide application in the dental biomechanics. OBJECTIVE: To summarize the research progress in the application of finite element method to solve biomechanical problems in orthodontics, prosthodontics, oral implantology, oral and maxillofacial surgery and other fields. METHODS: A computer-based online search of PubMed and VIP databases was performed for articles related to the application of finite element method in dental biomechanics, published between January 1995 and October 2011, with the key words of “finite element analysis (FEA)”, “oral cavity” and “biomechanics” in English and Chinese. RESULTS AND CONCLUSION: The stress analysis of oral cavity structure, shape, load and mechanical properties of materials can be performed using finite element analysis; the stress value and displacement value of any part of the model can be gained and the solving process is rapid and accurate with the aid of a computer. The finite element analysis can reflect the stress distribution objectively, accurately and veritably; it provides the mechanical foundation for the research of relevant basic problems in the stomatology, the solution of clinical practical problems in the stomatology and the technical development of dental clinical practice; it provides reference for the further investigation of treatment of oral disease. Related Articles | Metrics

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Tissue engineering repair for femoral head necrosis Long Teng-he, Cui Hui-qin, Li Tao 2012, 16 (13):  2427-2430.  doi: 10.3969/j.issn.1673-8225.2012.13.034 Abstract ( 230 )   PDF (434KB) ( 349 )   Save BACKGROUND: The development of tissue engineering technique changed the manner for treating bone defect. Because bone tissues are reproducible, more and more medical investigators paid a great attention on application of tissue engineering in treatment of femoral head necrosis. OBJECTIVE: To summarize the tissue engineering repair manner of femoral head necrosis, and to explore the perspective of regenerative medicine in bone tissue engineering. METHODS: We retrieved articles regarding tissue engineering techniques in repair of femoral head necrosis from aspects of frontier fields of tissue engineering, including stem cells, tissue construction and biomechanics, orthopedics biomaterial, artificial prosthetic replacement, bone graft transplantation published from January 2000 to December 2011. Repetitive or Meta analysis articles were excluded. A total of 30 representative articles were analyzed. RESULTS AND CONCLUSION: With the progression of regenerative medicine, tissue engineering technique had been widely used in repair of femoral head necrosis, containing stem cells from different sources transplantation for treating femoral head necrosis, inflammatory factor and femora head necrosis, construction and biomechanical analysis of finite element model of femoral head necrosis, varied giant molecular organism bone scaffold in repair of femoral head necrosis, artificial bone implantation and artificial hip joint replacement. However, present tissue engineering in treatment of femoral head necrosis is still in animal experiment and empirical treatment levels. Related Articles | Metrics

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Absorbable screw implantation for humeral supracondylar fracture in children  Wang Min, Wu Shun-fen, Tang Guang-yao 2012, 16 (13):  2431-2434.  doi: 10.3969/j.issn.1673-8225.2012.13.035 Abstract ( 272 )   PDF (408KB) ( 410 )   Save BACKGROUND: Absorbable screw internal fixation is an ideal treatment for humeral lateral condyle fracture in children. OBJECTIVE: To summarize research advances in absorbable screw implantation for humeral supracondylar fracture in children. METHODS: A computer-based online search of Wanfang, VIP and PubMed database was performed for articles related to absorbable screw internal fixation for humeral supracondylar fracture in children, published between January 2000 and August 2011 with key words “absorbable screw, internal fixation, children, humeral supracondylar fracture” in Chinese and English. A total of 79 articles were selected and 20 were included. RESULTS AND CONCLUSION: Open reduction and internal fixation have been clinically used to treat humeral supracondylar fracture in children. And crossing Kirschner wire has been extensively used in the internal fixation. With developing internal fixation materials, absorbable screws exhibit advantages as internal fixtor. Absorbable screw has tenacity and precise fixation and compression effects, allowing pressure to the broken ends and tight end-to-end anastomosis for the fracture. Moreover, the blood supply of fracture site rapidly recovers following screw implantation, which reduces duration for clinical healing. Moreover, absorbable screw for humeral supracondylar fracture in children is simple and reliable in effects. It tightly fixes the fractured ends, shortens healing duration, with precise treatment effects. Therefore, it is a good option for internal fixation of humeral supracondylar fracture in children. Related Articles | Metrics

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Reconstruction of a three-dimensional model based on C-arm two-dimensional projections Hu Fang-qiu1, Li Zi-qiang2, Yan Shi-ju1 2012, 16 (13):  2435-2338.  doi: 10.3969/j.issn.1673-8225.2012.13.036 Abstract ( 328 )   PDF (342KB) ( 479 )   Save BACKGROUND: X-ray image intensifier images are the basement of three-dimensional (3D) model reconstruction based on C-arm two-dimensional (2D) projections. The 3D model reconstruction technology corrected with certain numerical functions can provide enough image information for surgeons during surgery to facilitate surgery. OBJECTIVE: To explore the 3D model reconstruction technology based on C-arm 2D projections. METHODS: PubMed database, CNKI database and Wanfang database were retrieved to search papers published between January 1990 to December 2010 about image-guided surgery technology, correction and reconstruction of C-arm 2D images, 3D model reconstruction based on C-arm 2D projections, as well as medical image registration. RESULTS AND CONCLUSION: 3D model reconstruction based on C-arm 2D projections refers to reconstructing 3D bone models on the basis of 2D projections acquired with a mobile C-arm X-ray machine. 3D reconstructed model contains not only more abundant information about the external anatomy structure of the bone, but also more useful multiple information internal the bone such as bone density and bone strength. The technology contains two main lines: synthetic limited angle X-ray photography of cone-beam; non-rigid registration based on statistical variable model. The technology can be combined with operation navigation technology to establish a surgical navigation system in the future research. Related Articles | Metrics

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The rehabilitation procedure following total hip arthroplasty Qin Xiao-yong1, Xiong Jie1, Zhan Xi-jing2 2012, 16 (13):  2439-2443.  doi: 10.3969/j.issn.1673-8225.2012.13.037 Abstract ( 322 )   PDF (431KB) ( 349 )   Save BACKGROUND: The rehabilitation training plays an important role in the physical rehabilitation of patients after total hip arthroplasty. OBJECTIVE: To take retrospective analysis of the articles about the composition, methods, outcome evaluation, development and problems of total hip arthroplasty rehabilitation procedure. METHODS: A computer-based online search of PubMed database and CNKI database was performed for articles regarding the rehabilitation training following total hip anthroplasty, with the key words of “total hip arthroplasty; total hip replacement; physical rehabilitation; rehabilitation trainning” in English and Chinese. RESULTS AND CONCLUSION: The rehabilitation training after total hip arthroplasty is mainly depend on posture nursing and physical therapy, combined with manual massage and magnetic therapy, electrotherapy and ultrasound therapy, etc. When using the exercise therapy, we should pay more attention to the proper sequence principle; the active exercise should be gradually transited from the initial passive exercise. The appropriate rehabilitation training program, which is selected according to the type of surgery, prosthesis and patients, can significantly improve the functional recovery of patients after total hip arthroplasty.   Related Articles | Metrics

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Research progress of cell apoptosis in the pathogenesis of steroid-induced necrosis of the femoral head Jia Yan-bo1, 2, Liu Wan-lin2, Ren Yi-zhong2 2012, 16 (13):  2444-2450.  doi: 10.3969/j.issn.1673-8225.2012.13.038 Abstract ( 423 )   PDF (454KB) ( 329 )   Save ACKGROUND: Clinical research indicates that the bone cell apoptosis has been involved in the pathogenesis process of steroid-induced necrosis of femoral head, is the cytological basis of genesis and evolution. OBJECTIVE: To summarize research progress of cell apoptosis in the pathogenesis of steroid-induced necrosis of femoral head. METHODS: The PubMed database, Springer Link database, Science Direct database and CNKI database were retrieved for papers published from October 1990 to October 2011 with the key words of “steroid, necrosis of the femoral head, cell apoptosis” in Chinese and English. The relevant articles concerning steroid-induced necrosis of femoral head and cell apoptosis were collected. The redundant researches or Meta analysis were removed. RESULTS AND CONCLUSION: This article summarizes the related apoptosis genes of steroid-induced necrosis of femoral head from the aspects of definition and measurement of cell apoptosis, histological and morphological changes of the cell apoptosis in the steroid-induced necrosis of femoral head and the pathogenesis of cell apoptosis in the steroid-induced necrosis of femoral head. The related genes include Fas and FasL Fas protein, Bcl-2 family, p53 gene, nitric oxide, Caspase and nuclear factor κβ. Hormone is one kind of cell apoptosis inducer. Steroid-induced necrosis of femoral head and cell apoptosis are closely related.   Related Articles | Metrics

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Development course of prosthetics at home and abroad  Shen Ling1, Yu Hong-liu2 2012, 16 (13):  2451-2454.  doi: 10.3969/j.issn.1673-8225.2012.13.039 Abstract ( 1027 )   PDF (373KB) ( 1165 )   Save BACKGROUND: Prosthetic is an important part of rehabilitation engineering research. OBJECTIVE: To summarize the development course of prosthetics at home and abroad. METHODS: CNKI database was retrieved for articles published from January 2001 to January 2011 with the key words of “prosthetics, prosthetic development, classification, product” in Chinese, at the same time IEEE/IET Electronic Library  database was also retrieved for articles published from January 1980 to January 2011 with the key words of “prosthetics, prosthetic development, product” in English. A total of 206 articles were obtained, and finally 16 articles were included for review. RESULTS AND CONCLUSION: The first half of the twentieth century, the United States as the representative of industrialized countries carried out large-scale studies on prosthetic technology, which caused the theory and practice of prosthesis have a significant progress. With the development of industry, using new material such as alloy, plastic and so on are successfully developed various modern prosthetics. Due to start later, China artificial limbs has some gap as compared with foreign products. And because of the particularity of prosthetic industry, artificial limbs personnel have to work in many disciplines in the group with the surgeon, physical therapists, homework therapists, psychotherapist, social workers and other professionals to work together, thus better services for patients. Related Articles | Metrics

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Basic and clinical research of artificial lamina Li Ling-jiang1, Chang Heng1, Shi Jian-gang2 2012, 16 (13):  2455-2458.  doi: 10.3969/j.issn.1673-8225.2012.13.040 Abstract ( 308 )   PDF (370KB) ( 270 )   Save BACKGROUND: Laminectomy can damage the spinal column structure, large scar tissue formation can be seen in some patients which adhere with the dura mater and nerve root that lead to the involve and compression of nerves, and finally, it can seriously affect the long-term effects of spinal surgery. OBJECTIVE: To comprehensive analysis the research progress and state of artificial lamina in the repair of lamina defect and the prevention of the occurrence of postoperative complications. METHODS: A computer-based online search of Chongqing Weipu database (1996-01/2009-01), Tsinghua Tong Fang database (2000-01/2009-01) and PubMed database (1996-01/2009-01) was preformed for the articles about the restenosis after laminectomy, postoperative adhesions, artificial lamina research and experiment with the key words of “artificial lamina, laminectomy, postoperative adhesions” in Chinese and “artificial vertebral lamina，laminectomy” in English. The repetitive researches were excluded and a total of 22 articles were included to review. RESULTS AND CONCLUSION: Artificial lamina has the preventive effect on the secondary scar adhesion after laminectomy, dural sac and nerve root, restenosis after laminectomy and spinal instability. But the artificial lamina needs further improvement in materials and design, as the ideal material can play the barriers and protective effect well with no adverse effect, and with the time prolonged, the ideal material can induce the bone regeneration in order to achieve bone fusion. The current technology and methods can not reach the effect above. Related Articles | Metrics

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Bacterial culture and treatment strategy of infection after total hip replacement: Review of the literature  Zhou Sheng-rui, Miao Sheng, Sha Guang-zhao 2012, 16 (13):  2459-2462.  doi: 10.3969/j.issn.1673-8225.2012.13.041 Abstract ( 310 )   PDF (281KB) ( 310 )   Save BACKGROUND: Periprosthetic infection after total hip replacement is one of the most serious complications. OBJECTIVE: To investigate the cause of infection after total hip replacement and to review the literature of treatment strategy.   METHODS: A retrospective analysis of pathogenic cultures on 18 infection cases after total hip replacement and review the treatment strategy. RESULTS AND CONCLUSION: Twenty-five (12-48) months follow-up of 18 patients after total hip replacement showed that there were six patients retained the prosthesis after debridement, five patients were preformed with one-stage revision, and among the five patients, only one case of recurrence after debridement and clear trauma again and finally the wound was healed; seven patients were preformed with two-stage revision using antibiotic bone cement and there was no recurrence in 25 months after total hip replacement; the wound of all the patients were healed completely and there was no recurrent infection in the final follow-up. The Harris score of the hip was changed from the 43.25 points preoperatively to 86.5 points postoperatively. The infected pathogenic bacteria of 18 patients after total hip replacement included six cases of staphylococcus epidermidis, four cases of staphylococcus aureus, three cases of enterobacter cloacae, two cases of pseudomonas aeruginosa, one case of hemolytic streptococcus and two cases of escherichia coli.  Related Articles | Metrics

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The treatment of bone tumour around the acetabulum by semi-pelvic prosthesis made in China Zhang Jing-dong, Zu Qi-ming, Liu Gui-tang, Han Wen-feng, Sun Rui, Xiang Liang-bi 2012, 16 (13):  2463-2466.  doi: 10.3969/j.issn.1673-8225.2012.13.042 Abstract ( 225 )   PDF (266KB) ( 250 )   Save BACKGROUND: The treatment of bone tumour around the acetabulum is a challenge of orthopedics, but the limb-sparing surgeries of bone tumour around the acetabulum become the main trend along with the development of the diagnosis techniques and the application of neoadjuvant chemotherapy and the establishment of the tumour excision principle. OBJECTIVE: To analyze the treatment effect semi-pelvic prosthesis made in China on bone tumour around the acetabulum. METHODS: From 2001 to 2010, 19 patients with bone tumour around the acetabulum were enrolled and six patients were cured by removing the tumour and assembling the semi-pelvic prosthesis made in China. All the patients were followed-up for 6-72 months (mean 50 months). RESULTS AND CONCLUSION: According to Enneking criteria, four cases were rated as good, two cases as fair. There was a good effect of semi-pelvic prosthesis made in China on the treatment of bone tumour around the acetabulum when the indications of resection and reconstruction of pelvic tumour were selected strictly. Related Articles | Metrics