Objective To investigate a special optimized technique for computer aided measure,and provide an anatomical basis for the placement of lag screw in the posterior column of the acetabulum. Methods Eighty accurate hemi-pelvis models were reconstructed from 40 CT data sets.The optimization objective function,for improving the placement of lag screw,was built by adaptively sampling the weighted distance of screws to the acetabulum boundary according to surgical requirements,and the two end points of the screw were modified iteratively to reduce the objective value under constraints.The statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results The optimal entry point for lag screw fixation in the posterior column was located(18.90?1.19) mm above the line connecting the anterior borderline of the sacroiliac joint with the notch between the anterior superior iliac spine and the anterior inferior iliac spine,and the connecting line was divided by the perpendicular project point with a proportion of 2∶3.The mean inclination of the lag screw was(85.99?2.04)? for angle with the line connecting the entry point with the notch between the anterior superior iliac spine and the anterior inferior iliac spine,and(37.54?1.55)? for angle with the line connecting the entry point with the perpendicular project point;the mean length of the lag screws in the posterior column was(133.07?3.22)mm.Conclusion The automatic optimized technique for the computer aided measure is very efficient and has many advantages over the conventional manual dissection methods,and is convenient to design new anatomical reference landmark systems for clinical use.

Objective To investigate the stress changes of intervertebral disk of degenerative scoliosis (DS) after treatment with short-segment internal fixation and fusion.Methods Based on the DS patient's CT images of the successive spinal column from T12 to superior segment of S1,assigning special material attributes to the model and forming the integrated and effective three dimensional finite element model of DS.Treated with the short-segment (one-segment and two-segment) spinal canal decompression +intervertebral bone fusion+pedicle screw internal fixation.Loading the model on the following postures:anteflexion,postextension,left lateral inclination,right lateral incliniation,left rotation and right rotation.Calculating and analyzing the stress distribution of intervertebral disk and comparing to that of the preoperative normal DS model.Results The stress of intervertebral disk after the short-segment internal fixation and fusion was increased than that of preoperation.The rotation motion affected greater to the upper intervertebral disk of fixation segment and the extension motion affected greater to the inferior intervertebral disk of fixation segment.The increase of stress of upper and inferior intervertebral disk of fixation segment treated with one-segment fixation and fusion(average was 6.03,4.58 MPa,separately) was greater than that of the two-segment fixation and fusion (average was 5.24,4.47 MPa,separately),but there was no statisticdifference (P ＞ 0.05).Conclusions The short-segment intemal fixation can increase the intervertebral disk stress of adjacent segment fixation of DS.The effect on the stress of upper and inferior intervertebral disk of fixation segment of one-segment fixation and fusion is greater than that of two-segment fixation and fusion.And the patient should avoid the rotation and extension movements after treated with the short-segment internal fixation and fusion.

Objective To investigate the effect of doxapram on inhibition of medullary respiratory center excitability by sevoflurane in rats.Methods Neonatal Sprague-Dawley rats of both sexes,aged 1-4 days,were used in this study.Isolated medulla oblongata-spinal cord specimens were made according to the method described by Suzue and perfused with the artificial cerebrospinal fluid saturated with 95％O2-5％CO2.The specimens were randomly divided into 3 groups ( n =9 each):control group (group C),sevoflurane group (group S) and sevoflurane + doxapram group (group S + D).Respiratory rhythmical discharge activity of the hypoglossal nerve rootlets was recorded using suction electrode.After 10 min of equilibration,the specimens were perfused with the artificial cerebrospinal fluid,5％ sevoflurane and the mixture of 5％ sevoflurane and 5 μmol/L doxapram for 10 min in groups C,S,and S + D respectively.The respiratory cycle,inspiratory time and integral amplitude of inspiratory discharge were recorded.Results Compared with group C,the respiratory cycle was significantly prolonged,the inspiratory time was significantly shortened,and the integral amplitude of inspiratory discharge was significantly decreased in group S (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group S + D (P ＞ 0.05).Compared with group S,the respiratory cycle was significantly shortened,the inspiratory time was significantly prolonged,the integral amplitude of inspiratory discharge was significantly increased in group S + D ( P ＜ 0.05).Conclusion Doxapram antagonizes sevoflurane-induced inhibition of excitability of medullary respiratory center in rats.

BACKGROUND:Spine is relatively complex in structure, shape, material properties, and load bearing. The traditional biomechanical method cannot solve these problems. OBJECTIVE:To investigate the stress distribution of intervertebral disc, zygapophysial joints and vertebral body of degenerative scoliosis, and to provide accordance to the biomechanical mechanism of degenerative scoliosis occurrence and development. METHODS:Based on the successive CT images of spinal column from T12 to superior segment of S1 of degenerative scoliosis patients, the special material properties were attributed to the model to form the integrated and effective three-dimensional finite element model of degenerative scoliosis. The model was loaded on the anteflexion, extension, left lateral bending, right lateral bending, left rotation and right rotation conditons. Then the spinal activity and the stress distribution of intervertebral disc, vertebral body and articular cartilage of zygapophysial joints were calculated and analyzed. RESULTS AND CONCLUSION:The spinal activities of degenerative scoliosis finite element model were less than those of common lumbar spine. The stress distribution of intervertebral disc was inclined to the verge of it and the greatest stress was appeared on the extension motion. The apex of scoliosis was the place of stress concentration and the obvious stress concentration of articular cartilage of zygapophysial joints was appeared on the rotation motion, then fol owed by the extension motion, especial y that of articular cartilage of zygapophysial joints on the apex of scoliosis. Stress concentration is easily appeared on the apex of scoliosis, and the extension and rotation motion can aggravate the development of degenerative scoliosis.

With esoterica of Infantile Tuina by LI Dexiu and Infantile Tuina Therapy of LIU Kaiyun, the differences and similarities of manipulations, acupoints and the principles of treatment were studied so as to provide theoretical evidence to popularize tuina of LI Dexiu and LIU Kaiyun.
Acupuncture Points ; China ; Female ; History, 19th Century ; History, 20th Century ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Male ; Massage ; history ; manpower ; methods

Objective To establish a method for simultaneous determination of contents of schisandrin B, schisantherin A, lobetyolin and ruscogenin in Huangqi Shengmai Decoction with HPLC method. Methods The chromatographic column was an Agilent Eclipse C18 column (4.6 mm × 250 mm, 5 μm) that was maintained at a constant temperature of 30 ℃. The mobile phase was 0.1% acetic acid solution-acetonitrile, with gradient elution. The flow rate was 1.0 mL/min. The detection was at wavelength of 280 nm. Results The standard curves of schisandrin B, schisantherin A, lobetyolin and ruscogenin had good linearity in the ranges of 0.862 5-21.562 5μg (r 2=0.999 1), 0.737 5-18.437 5μg (r 2=0.999 4), 0.095 2-2.380 0 μg (r 2=0.999 6), and 0.810 0-20.250 0 μg (r 2=0.999 0), respectively. The average recoveries of the four components were 98.06%(RSD=1.64%), 99.61%(RSD=2.72%), 97.98%(RSD=1.45%), and 99.30%(RSD=1.25%), respectively. Conclusion This method is accurate, rapid and specific, achieving the stable results with high reproducibility.

BACKGROUND:Triggering receptor expressed on myeloid cel s 2 (TREM-2) is highly expressed throughout the synovial tissue in active rheumatoid arthritis patients, but the role of TREM-2 in the pathogenesis of rheumatoid arthritis stil remains unclear.
OBJECTIVE:To explore the TREM-2 expression in the synovial tissue of col agen type II-induced arthritis rats.
METHODS:The col agen-induced arthritis models were established in rats. The activity indicators and pathological changes of arthritis synovial were dynamical y observed. The mRNA levels of TREM-2, tumor necrosis factor-α, interleukin-1β, and interleukin-10 were detected in synovial tissue of rats by RT-PCR. The protein expression and location of TREM-2 were measured with western blot assay and immunohistochemistry, respectively.
RESULTS AND CONCLUSION:At day 13 after immunization, the paws of model rats appeared red and swel ing, the arthritis index scores were increased (P<0.01). At day 19-25 after immunization, the inflammation reached the peak. Hematoxylin-eosin staining showed that, the synovium of col agen-induced arthritis rats were proliferated and were infiltrated by inflammatory cel s, cartilage was destroyed. Compared with the control group, the expression of TREM-2 mRNA and protein, the mRNA levels of tumor necrosis factor-αand interleukin-1βin synovial tissue of the model rats were significantly increased (P<0.05 or P<0.01), while interleukin-10 mRNA expression was significantly decreased (P<0.05). Experimental findings indicate that, TREM-2 is a crucial inflammatory regulator and the increasing expression of TREM-2 plays an important role in the pathogenesis of col agen-induced arthritis.

Objective To compare the effects of preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine to prevent the hypotension after combined epiduralspinal anesthesia in parturient undergoing caesarean section.Methods Eighty patients with ASA class Ⅰ or Ⅱ[,were randomly divided into Dopamine group and Phenylephrine group,40 cases in each group.The 6％hydroxyethyl starch 500 ml was infused at the tate of 20 ml/(kg · h) after the intravenous catheterization was established and after the finishing of the infusion of 250 ml,the dopamine 5 mg (Dopamine group) or 200 ug phenylephrine (Phenylephrine group) were added respectively in residual liquid.After the bupivacaine was injected into the subarachnoid space,the intravenous infusion was continued at the same rate until the fetus was taken out and the blood pressure and heart rate were measured at intervals of 1 min.The blood sample of fetal cord was taken to measure ther troponin Ⅰ concentration.Results The incidence of hypotension after combined epidural-spinal anesthesia anesthesia in dopamine group (2/40) and in phenylephrine group (3/40) was with no statistical difference (P ＞ 0.05) ;The incidence of bradycardia in dopamine group (0/40) was significantly lower than that in phenylephrine group (6/40)) (P ＜0.05) ; The incidence of tachycardia in dopamine group (8/40) was significantly higher than that in phenylephrine group (1/40) (P ＜0.05) ; The troponin Ⅰ concentration of fetal cord blood in dopamine group [(0.21 ±0.07) ng/ml] and in phenylephrine group [(0.18 ±0.09)ng/ml]was with no statistical difference (P ＞0.05).Conclusion Preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine can effectively prevent the hypotension after combined epidural-spinal anesthesia in parturient undergoing caesarean section with no significant effect on the fetus and both can be chosen in terms of the heart rate of parturient before anesthesia.

Objective To study the effect of TCM five-tone therapy on chronic fatigue syndrome(CFS).Methods Fifty nine CFS patients were divided into the treatment group(n=30)and the control group(n=29),which received TCM five-tone therapy and common music therapy,respectively for 3 months.Both groups were assessed with fatigue Scale-14,depression status inventory and visual analogue scale.Result After treatment,the treatment group was scored lower than the control group in FS-14,DSI and VAS(all P<0.05).Conclusion TCM five-tone therapy may be more effective in decreasing the CFS patients with fatigue and depression and alleviating their pain symptoms.

Objective:To explore the clinical efficacy of dual-kidney transplantation from infant donors to adult recipients.Methods:From December 2012 to November 2020 in Organ Transplant Center First Affiliated Hospital Sun Yat-sen University, rertrospective reviews were conducted for clinical data of 25 pairs of infant donors and adult recipients. The survival rates were calculated for both recipients and transplanted kidneys at Year 1/3/5 post-transplantation. And the postoperative recovery status and the postoperative incidence of adverse events of recipients were observed.Results:The survival rates of recipients were all 95.8% at Year 1/3/5 and those of transplanted kidney and dealth-cancelling transplanted kidney all 87.2%. One case died due to acute inferior-wall cardiac infarction while three others lost renal functions for vascular thrombosis, ureteral stenosis and urinary fistula. Except for loss of renal function and death, the postoperative estimated golmerular fitration rate was (99.35±21.78), (103.11±29.20) and (114.99±28.55) ml/(min·1.73 m 2) at Year 1/2/3 respectively. Conclusions:Selecting proper recipients, standardizing donor acquisition and surgical procedures and strengthening perioperative managements may expand the donor pool. The overall outcomes are excellent for adult recipients with dual-kidney transplantation from donations after infants' death.