【Abstract】 Objective To determine the three-dimensional stabil ity of atlantoaxial reconstruction withanterior approach screw fixation through C2 vertebral body to C1 lateral mass and Gall ie’s technique (ASMG) for C1,2instabil ity. Methods Twenty-five human cadaveric specimens (C0-3 ) were divided randomly into 5 groups (n=5). Thethree-dimensional ranges of motion C1 relative to C2 were measured under the five different conditions：the intact state group (group A), type II odontoid fracture group (group B), posterior C1,2 transarticular screw fixation group (group C), ASM group (group D) and ASMG group (group E). The three-dimensional ranges of motions C1 relative to C2 by loading ± 1.5 Nm were measured under the six conditions of flexion/extension, left/right lateral bending, and left/right axial rotation. The obtained data was statistically analyzed. Results In each group, the three-dimensional ranges of motion C1 relative to C2 under the six conditions of flexion/extension, left/right lateral bending, and left/right axial rotation were as follows: in group A (8.10 ± 1.08), (8.49 ± 0.82), (4.79 ± 0.47), (4.93 ± 0.34), (28.20 ± 0.64), (29.30 ± 0.84)°; in group B (13.60 ± 1.25), (13.80 ± 0.77), (9.64 ± 0.53), (9.23 ± 0.41), (34.90 ± 0.93), (34.90 ± 1.30)°; in group C (1.62 ± 0.10), (1.90 ± 0.34), (1.25 ± 0.13), (1.37 ± 0.28), (0.97 ± 0.14), (1.01 ± 0.17)°; in group D (2.03 ± 0.26), (2.34 ± 0.49), (1.54 ± 0.22), (1.53 ± 0.30), (0.80 ± 0.35), (0.76 ± 0.30)°; in group E (0.35 ± 0.12), (0.56 ± 0.34), (0.44 ± 0.15), (0.55 ± 0.16), (0.43 ± 0.07), (0.29 ± 0.06)°. Under the six conditions, there were generally significant differences between group A and other four groups, and between group B and groups C, D and E (P lt; 0.001), and between group E and groups C, D in flexion/ extension and left/right lateral bending (P lt; 0.05). There was no significant difference between group E and groups C, D in left/right axial rotation (P gt; 0.05). Conclusion In vivo biomechanical studies show that ASMG operation has unique superiority in the reconstruction of the atlantoaxial stabil ity, especially in controll ing stabil ity of flexion/extension and left/right lateral bending, and thus it ensures successful fusion of the implanted bone. It is arel iable surgical choice for the treatment of the obsolete instabil ity or dislocation of C1, 2 joint.
Abdominal imaging is one of the important clinical applications of magnetic resonance imagining, but image degradation due to respiratory motion remains a major problem. Retrospective respiratory navigator gating technique is an effective approach to alleviate such degradation but is subject to long scan time and low signal-to-noise ratio (SNR) efficiency. In this study, a modified retrospective navigator gating technique with variable over-sampling ratio acquisition and weighted average reconstruction algorithm is presented. Experiments in phantom and the imaging results of seven volunteers demonstrated that the proposed method provided an enhanced SNR and reduced ghost-to-image ratio compared to the conventional method. The proposed method can also be used to reduce imaging time while maintaining comparable image quality.
ObjectiveTo discuss application and research progress of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in liver and pancreas. MethodThe literatures about application and research progress of IVIM-DWI in liver and pancreas were researched and reviewed. ResultsWith the development of MRI, IVIM-DWI has become the hot research spot, and also has been widely used in liver and pancreas. It could make up the disadvantage of traditional DWI. IVIM-DWI holds an obvious value to assess the level of hepatic fibrosis or cirrhosis and differential diagnosis of liver tumors, diagnosis of pancreatic cancer and differential diagnosis of pancreatic cancers and mass type chronic pancreatitis. ConclusionIVIM-DWI has a great value in research of liver and pancreas, it is worth to be studied further.
ObjectiveTo explore the effect and safety of surgical treatment for hypertrophic obstructive cardiomyopathy (HOCM) with mitral regurgitation (MR) through right mini-thoracotomy.MethodsFrom January 2008 to June 2018, 54 patients with HOCM and moderate-to-severe MR underwent modified Morrow procedure and edge-to-edge mitral valvuloplasty through right mini-thoracotomy, including 31 males and 23 females, with an average age of 47.1±12.6 years. All patients had systolic anterior motion (SAM) phenomenon. Preoperative left ventricular outflow tract pressure gradient (LVOTPG) was 93.6±32.8 mm Hg, interventricular septum thickness (IVST) was 24.8±2.8 mm.ResultsSurgeries in all patients were completed successfully. No early death or interventricular septal perforation occurred. One (1.9%) patient received permanent pacemaker implantation due to the complete atrial-ventricular block. At discharge, postoperative LVOTPG (18.1±6.2 mm Hg) and IVST (14.5±2.1 mm) were significantly decreased compared with the preoperative values (P<0.05). No MR or SAM was observed in all patients. The follow-up time was 6-132 months, and during this period, no death, MR or SAM occurred. The average LVOTPG was 19.4±5.7 mm Hg, and the average IVST was 14.2±1.5 mm.ConclusionMorrow procedure and edge-to-edge mitral valvuloplasty through right mini-thoracotomy is a safe and effective method for treatment of HOCM with moderate-to-severe MR.
ObjectiveTo investigate the current status of the promotion of appropriate health technologies in Zhejiang province from 2009 to 2013, in order to provide baseline data for appropriate health technologies, application and research. MethodsThe status of promotion of appropriate health technologies in different regions of Zhejiang province were quantitatively described and compared according to the information in the websites of The Application and Promotion of Appropriate Techniques of Health, The Application and Promotion of Appropriate Techniques of Traditional Chinese Medicine as well as the Bank of Appropriate Technologies. Resultsa) A total of 127 Model Bases of Appropriate Health Technologies were set up, which were combined 127 leading institutions and 513 joint units, covering 11 cities, 40 counties, and 206 townships. b) The type of first aid base and chronic diseases base accounted for 33.0% and 25.3% of total types of model bases respectively; however, the number of bases dealing with rehabilitation care, public health and diseases referred to Ophthalmology & Otolaryngology and skin disease were very small. c) There were 486 appropriate health technologies promoted in Zhejiang province; appropriate technology about first aid, chronic diseases, women and children, rehabilitation care, public health, Ophthalmology & Otolaryngology and skin disease, traditional Chinese medicine and family planning accounted for 26.5%, 18.9%, 17.9%, 11.0%, 10.6%, 7.6%, 4.6% and 1.4%, respectively of total types of appropriate health technologies. d) The numbers of appropriate health technologies promoted in different regions were varied. Most of appropriate health technologies were promoted in more developed regions or more regions rich in health resources. Conclusiona) The model of "1+X" is used to promote the application of appropriate health technologies in Zhejiang province, and the prefecture-level regions of Zhejiang province have established the Model Bases of Appropriate Health Technologies in 11 cities. The promotion system of appropriate health technology is constructed and it achieves good results. b) In nine model bases, the most types of promotion bases are chronic diseases and first aid, and the technologies about first aid, chronic diseases, women and children are most promoted. c) The types of appropriate health technologies promoted in different areas are varied. d) It is necessary to evaluate and select appropriate health technology bases according to the burden of local disease and evidence.
To accurately capture and effectively integrate the spatiotemporal features of electroencephalogram (EEG) signals for the purpose of improving the accuracy of EEG-based emotion recognition, this paper proposes a new method combining independent component analysis-recurrence plot with an improved EfficientNet version 2 (EfficientNetV2). First, independent component analysis is used to extract independent components containing spatial information from key channels of the EEG signals. These components are then converted into two-dimensional images using recurrence plot to better extract emotional features from the temporal information. Finally, the two-dimensional images are input into an improved EfficientNetV2, which incorporates a global attention mechanism and a triplet attention mechanism, and the emotion classification is output by the fully connected layer. To validate the effectiveness of the proposed method, this study conducts comparative experiments, channel selection experiments and ablation experiments based on the Shanghai Jiao Tong University Emotion Electroencephalogram Dataset (SEED). The results demonstrate that the average recognition accuracy of our method is 96.77%, which is significantly superior to existing methods, offering a novel perspective for research on EEG-based emotion recognition.
Posterior-stabilized total knee prostheses have been widely used in orthopedic clinical treatment of knee osteoarthritis, but the patients and surgeons are still troubled by the complications, for example severe wear and fracture of the post, as well as prosthetic loosening. Understanding the in vivo biomechanics of knee prostheses will aid in the decrease of postoperative prosthetic revision and patient dissatisfaction. Therefore, six different designs of posterior-stabilized total knee prostheses were used to establish the musculoskeletal multibody dynamics models of total knee arthroplasty respectively, and the biomechanical differences of six posterior-stabilized total knee prostheses were investigated under three simulated physiological activities: walking, right turn and squatting. The results showed that the post contact forces of PFC Sigma and Scorpio NGR prostheses were larger during walking, turning right, and squatting, which may increase the risk of the fracture and wear as well as the early loosening. The post design of Gemini SL prosthesis was more conductive to the knee internal-external rotation and avoided the edge contact and wear. The lower conformity design in sagittal plane and the later post-cam engagement resulted in the larger anterior-posterior translation. This study provides a theoretical support for guiding surgeon selection, improving posterior-stabilized prosthetic design and reducing the prosthetic failure.
Objective To evaluate the short-term effectiveness of Kirschner wire (K-wire) elastic fixation in the treatment of Doyle type Ⅰ and Ⅱ mallet finger. Methods Between July 2016 and March 2017, 18 patients with Doyle type Ⅰ and Ⅱ mallet finger were treated. There were 12 males and 6 males, with an average age of 45 years (range, 16-61 years). The index finger was involved in 2 cases, the middle finger in 3 cases, the ring finger in 10 cases, and the little finger in 3 cases. The interval from injury to operation ranged from 2 hours to 45 days (median, 5.5 hours). There were 8 patients of closed wound and 10 patients of open wound. Fourteen patients were simply extensor tendon rupture and 4 were extensor tendon rupture complicated with avulsion fracture. The distal interphalangeal joints (DIPJ) of injured fingers were elastically fixed with the K-wire at mild dorsal extend position. The K-wire was removed after 6 weeks, and the functional training started. Results The operation time was 34-53 minutes (mean, 38.9 minutes). Patients were followed up 3-8 months (mean, 5 months). All incisions healed primarily and no K-wire loosening or infection happened during the period of fixation. All mallet fingers were corrected. The range of motion (ROM) in terms of active flexion of injured DIPJ was (75.83±11.15)° at 6 weeks after operation, showing significant difference when compared with the normal DIPJ of contralateral finger [(85.28±6.06)°] (t=3.158, P=0.003). The ROM in terms of active flexion was (82.67±6.78)° in 15 patients who were followed up at 8 months after operation, showing no significant difference when compared with the normal DIPJ of contralateral finger [(86.00±5.73)°] (t=1.454, P=0.157). After the removal of K-wire at 6 weeks, visual analogue scale (VAS) score of active flexion and of passive flexion to maximum angle were 1.78±0.88 and 3.06±1.06, respectively. According to the total active motion criteria, the effectiveness was rated as excellent in 10 cases, good in 5 cases, moderate in 2 cases, and poor in 1 case, and the excellent and good rate was 83.33%. The patients’ satisfaction were accessed by Likert scale, which were 3-5 (mean, 4.2). Conclusion K-wire elastic fixation in the treatment of Doyle typeⅠand Ⅱ mallet finger can repair the extensor effectively, correct the mallet finger deformity, and also be benefit for the flexion-extension function restoration of DIPJ.
In the process of positron emission tomography (PET) data acquiring, respiratory motion reduces the quality of PET imaging. In this paper, we present a correction method using three level grids B-spline elastic method to correct denoised and reorganized sinograms for respiratory motion correction. Using GATE simulates NCAT respiratory motion model to generate raw data which are used in experiment, the experiment results showed a significantly improved respiratory image with higher quality of PET, and the motion blur and structural information were fixed. The results proved the method of this paper would be effective for the elastic registration.