Objective To explore the correlation between CTvolume rendering (VR) statistics and living age and to build the mathematical models for skeletal age evaluation based on the grow th rules of medi-al clavicular epiphysis of teenagers in China. Methods The thin layer CTscan and VR3D imaging re-construction of both sides of sternal ends of clavicles were exam ined for 684 teenagers aged from 15 to 25 in East and South China. The parameters of sternal end of clavicle including the longest diameter of epiphysis, the longest diameter of metaphysis, their length radio, area of epiphysis, area of meta-physic, their area ratio, and other data were measured and calculated in order to establish mathematical models of skeletal age evaluation. Fifty trained subjects were tested to verify the accuracy of the math-ematical models. Results In the same age group, the length ratio and the area ratio had significant dif-ference in genders (P<0.05). The established mathematical models showed that the grow th rules of medial clavicular epiphysis were highly correlated with the living ages. The accuracies of these models were higher than 70.5% (±1.0 year) and 82.5% (±1.5 year). Conclusion The mathematical models have easy operability and high accuracy. It can be used to confirmand sustain the conclusion of atlas method. M eanw hile, it is of great significance to study the other single skeletal age evaluation in the future.

Objective To improve the quality,efficacy,and efficiency of health checkup by establishing and implementing total quality management system.Methods Routine physical examination data of 5955 individuals (from January 2007 to May 2007,when total quality management system was not implemented) were analyzed and compared with 7520 individuals (from January 2008 to May 2008.when the system was implemented).Results The report quality of routine physical examination was significantly improved,and the qualification rate was increased from 82.6% to 98.2%.The healthcare service procedure was optimized.The examination time for the essential items was shoaened from 51 to 35 minutes.The result report time was reduced from 5 to only 1 day.The customer satisfaction rate Was increased from 86.3% to 98.1%; however,the suing rate Was decreased from 0.05% to 0.01%.The examination efficiency was significantly improved.The growth rate of checkup recipients was increased from 7.22% to 26.38%.There Was statistical significance before and after the implementation of the total quality management system (P

BACKGROUND:Sagittal imbalance induced by vertebral osteoporotic fractures has not been paid enough attention in previous studies.
OBJECTIVE:To assess the correlation of osteoporotic vertebral compression fracture and spinal sagittal imbalance.
METHODS:Sixty patients with old osteoporotic vertebral compression fracture, who were treated in the Department of Spine Surgery, the Affiliated Hospital of Chengde Medical Colege from February 2013 to August 2015, were enroled in this study as the observation group. Sixty healthy old people from physical examination center were enroled as the control group. The whole-spine anteroposterior and lateral X-ray films were taken in both groups. The number and the location of fractured vertebrae were recorded. Sagittal parameters of both groups including thoracic kyphotic angle, lumbar lordotic angle, T1-spinopelvic inclination angle and the C7plumb line/sacro-femoral distance (PL/SFD) ratio were measured and compared among groups. The observation group was dividedinto three subgroups according to the number of fractured vertebrae,i.e., single-vertebrae fracture subgroup, double-vertebrae fracture subgroup and above triple-vertebrae fracture subgroup. The C7PL/SFD ratio of the three subgroups was compared. The correlation between the number of fractured vertebrae and the C7PL/SFD ratio was analyzed.
RESULTS AND CONCLUSION:(1) The thoracic kyphotic angle of the observation group was bigger than that of the control group (P< 0.05). The lumbar lordotic angle of the observation group was smaler than that of the control group (P< 0.05). The absolute value of the T1-spinopelvic inclination angle of the observation group (-1.81±1.48)° was smaler than that of the control group (-3.35±1.22)° (P< 0.05). The C7PL/SFDratio of the observation group was significantly bigger than that of the control group (P< 0.05). (2) In the observation group, there were 4 cases of single-vertebrae fracture, 25 cases of double-vertebrae fracture and 31 cases of above triple-vertebrae fracture. Significant differences in the C7PL/SFD ratio were determined among subgroups (P< 0.05). The number of fractured vertebrae was positively correlated with the C7PL/SFD ratio; the correlation coefficient was 0.747. (3) Results indicated that osteoporotic vertebral compression fracture can change spinal local sagittal alignment. Multiple compression fractures of vertebrae can cause spinal sagittal imbalance. The gravity center of human body shifts forward. The number of fractured vertebrae was positively correlated with the range of shift forward.

Objective To further improve the accuracy of bone age identification using the time of secondary ossification center appearance and epiphyseal fusion of 7 joints to estimate the age of living individuals.Methods DR films were taken from 7 parts including sternal end of clavical and the left side of shoulder,elbow,carpal,hip,knee and ankle joints of 1709 individuals who came from eastern China,central China and southern China,whose ages were between 11.0 and 20.0 years.From those 7 joints 24 osteal loci were selected as bone age indexes,which could better reflect age growth of teenagers.The characteristics of secondary ossification center appearance and epiphyseal fusion were observed,and the mean and age range of secondary ossification center appearance and epiphyseal fusion were calculated.Results The fusion time of the 24 epiphyses were advanced at different degrees,the most obvious epiphyses the sternal end of clavicle,scapular acromial end,distal end of the radius,distal end of the ulna,iliac crest,ischial tuberosity,the upper and lower end of tibia and fibula.The appearance time of sternal end of clavicle,scapular acromial end,iliac crest and ischial tuberosity epiphyses were all found to be after the age of 12,and the female's age,approximately 1year ahead of schedule in comparison with the male's.Conclusion The relevant forensic information and data for bone age identification should be updated every 10-15 years so as to provide accurate and objective evidence for court testimony,conviction and sentencing.

Objective To assess the correlation of newly fracture and spinal sagittal parameters.Methods From March 2011 to December 2014,80 patients of osteoporosis vertebral compression fracture treated by PVP as observation group were studied.The whole-spine anteroposterior view and lateral view XRay Photographes of the patients were taken,the sagittal parameters such as Pelvic index (PI),sacral slope (SS),pelvic tilt (PT),thoracic kyphotic angle(TK),lumbar lordotic angle(LL),the C7/SFD ratio were recorded.The whole cases were divided into two groups according to the presence of new fracture or not after the last followup of one year,the index of two groups were compared,and the risk factors of newly vertebral compression fractures were analysed.Results There were no statistically significant difference in gender,age,body mass index,BMD,PI,TK,LL between the two trea ted groups (P＞0.05);there were statistically significant difference in SS,PT and the C7/SFD between the new vertebral fracture group and the control group (P＜0.05).The analytic results of Logistic regression model showed that the smaller SS,larger TK and C7/SFD were risk factors of newly vertebral compression fractures.Conclusion The newly occurred vertebral compression fractures,after the primary treatment of PVP,are associated with changed spinal sagittal parameters.

BACKGROUND:Recent report addressing new vertebral fracture after vertebroplasty or bal oon kyphoplasty has increased gradual y. It remains controversial whether new vertebral fracture is induced by bone cement augmentation or osteoporosis.
OBJECTIVE:To observe new vertebral fracture after conservative treatment and bone cement augmentation for osteoporotic vertebral compression fractures, analyze the relationship between new vertebral fracture and spinal sagittal parameters, and explore the risk factors for new vertebral fracture.
METHODS:From June 2011 to December 2014, 160 patients with osteoporotic vertebral compression fractures in thoracic and lumbar vertebrae were selected from the Department of Spine Surgery, the Affiliated Hospital of Chengde Medical Col ege. According to therapeutic regimen, the patients were divided into two groups. The observation group (n=80) received vertebroplasty or kyphoplasty. The control group (n=80) underwent conservative treatment. At 1 day after surgery in the observation group and after walking in the control group, patients were subjected to anteroposterior and lateral X-ray in the entire length of the spine. Bone mineral density, number and location of new vertebral fractures and sagittal parameters during fol ow-up were recorded and compared between groups. After final fol ow-up, according to the appearance of new vertebral fracture, patients in both groups were assigned to two subgroups. The difference in above indicators was compared between the two subgroups. The relationship between new vertebral fracture and spinal sagittal parameters was analyzed.
RESULTS AND CONCLUSION:(1) There were no statistical y significant differences in gender, age, body mass index, bone mineral density, pelvic index, sacral slope, pelvic tilt, thoracic kyphotic angle, lumbar lordotic angle, C7/sacro-femoral distance ratio and occurrence rate of new fractures between the two treated groups (P>0.05). (2) There were no statistical y significant differences in gender, age, body mass index, pelvic index, and lumbar lordotic angle between new vertebral fracture group and non-fracture group. There were statistical y significant differences in bone mineral density, sacral slope, pelvic tilt, thoracic kyphotic angle and the C7/sacro-femoral distance between the new vertebral fracture group and the control group (P<0.05). (3) Results confirmed that new vertebral compression fractures after vertebroplasty, Kyphoplasty or conservative treatment for osteoporotic vertebral compression fractures were definitely associated with osteoporosis and spinal sagittal imbalance.

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Objective To realize the autom ated assessm ent of the levels of epiphysis of distal radius and ulna by support vector m achine (SVM). Methods The X-ray film s of the leftwrist jointswere taken from 140 teenagers aged from 11 to 19 years old as training sam ples. The levels of epiphysis of distal radius and ulnawere divided into five developm ental levels. Each level contained 28 sam ples. A nother 35 cas-eswere selected as independent verifying sam ples. SVM classification m odels of the five developm ental levels of epiphysis of distal radius and ulnawere established. The internal cross validationwas m ade by leave one out cross validation (LOOCV ),while the external validationwas m ade by histogram of orient-ed gradient (HOG), and then the accuracy (PA ) of testing resultswas calculated, respectively. Results The PA of SVM, LOOCV and HOG of distal radius epiphyseal levelwere 100%, 78.6%, and 82.8%, respec-tively;whereas the PA of SVM, LOOCV and HOGof distal ulna epiphyseal levelwere 100.0%, 80.0%and 88.6%, respectively. Conclusion The SVM -based autom atic m odels of the growth stage of distal ra-dius and ulna appear to have certain feasibility, and m ay provide a foundation for software developm ent of bone age assessm ent by forensic medicine.

The aim of the present study was to evaluate the effect of storage conditions,pretreatment,temperature,time and excystation solutions on in vitro excystation of Cryptosporidium oocyst.Cryptosporidium andersoni oocyst was used as a model and the results showed that 0.5% sodium hypochlorite could enhance the excystation rates.But there was no significant difference compared with oocysts untreated by sodium hypochlorite(P＞0.05).0.75% synthetic sodium taurocholate and 1% bile solution could urge the excystation of oocysts,which were significantly different compared with the excystation rate of oocysts in 0.25% trypsin solution or in PBS(P<0.05).The excystation rates of oocysts in acidic water (pH =3) were similar with the rates in PBS (pH =7.2) but significantly different from the rates in alkaline water (pH =9) (P<0.01).Additionally,the excystation rate of oocysts in water of 24℃ was significantly lower than in water of 37℃(P<0.01),and the excystation rate of oocysts raised gradually at 37℃ with the passage of time.It's concluded that temperature,acidity and excystation solution were vital factors for the in vitro excystation of Cryptosporidium oocyst.A higher excystation rate could be observed when oocysts were pretreated with 0.5% sodium hypochlorite and treated with 0.75% synthetic sodium taurocholate at 37℃ for 3 hours.

Objective:To explore the dance movement therapy on nutritional status and muscle strength in older patients with sarcopenia.Methods:A total of 35 older sarcopenia patients from May 2019 to April 2020 in Nanfang Hospital, Southern Medical University were enrolled as the intervention group with dance movement therapy; another 35 older sarcopenia patients from May 2018 to April 2019 were selected as control group with routine exercise intervention. Nutritional indicators and muscle strength were compared between two groups on admission, at 1, 3, 6 months after intervention.Results:At 3, 6 months after intervention, hemoglobin and body mass index were (124.10 ± 16.59) g/L, (128.33 ± 14.50) g/L and (21.40 ± 1.87) kg/m 2, (21.40 ± 1.87) kg/m 2 in the intervention group, higher than in the control group (116.03 ± 12.23) g/L, (120.09 ± 11.34) g/L and (20.03 ± 1.93) kg/m 2, (19.97 ± 1.99) kg/m 2. The differences were statistically significant ( t values were 2.17-2.84, all P<0.05). At 6 months after intervention, serum albumin was (33.73 ± 5.23) g/L in the intervention group, significantly higher than that in the control group (30.88 ± 5.17) g/L, the difference was statistically significant ( t=2.16, P<0.05). At 3, 6 months after intervention, muscle strength were (21.63 ± 1.54) kg, (23.17 ± 1.72) kg and short physical performance battery scores were 7.83 ± 1.56, 7.47 ± 1.59 in the intervention group, significantly higher than in the control group (19.66 ± 2.50) kg, (20.91 ± 2.83) kg and 6.59 ± 1.64, 5.97 ± 1.49, the differences were statistically significant ( t values were 3.05-3.83, all P<0.05). At 6 months after intervention, appendicular skeletal muscle mass index (ASMI) was (6.03 ± 1.47) kg/m 2 in the intervention group, significantly higher than (5.13 ± 1.36) kg/m 2 in the control group, the difference was statistically significant ( t=2.52, P<0.05). Conclusions:Dance movement therapy can improve the nutritional status and muscle strength of older patients with sarcopenia.