BACKGROUND: Artificial lumbar disc replacement is a novel approach to treat lumbar disc protrusion. But its theoreticalbasis needs further verification.OBJECTIVE:To establish finite element model of lumbar disc replacement for biomechanical studies.DESIGN: A single sample study taking the data of L4-5 three-dimensional infinite element model as object of research.SETTING: Orthopedic Department of Xiangya Hospital of SunYat-sen University.PARTICIPANTS: The trial was conducted in the Laboratory of the Orthopedic Department of Xiangya Hospital from December 2003 through August 2004. A healthy male volunteer served as simulation. His T12-S1 underwent continuous CT scanning. There were altogether 264 images with 2 mm inthickness each. Three-dimensional images were reconstructed every 15° in order to obtain the data for three-dimensional model.METHODS: The CT images and human anatomical data were processed by 3DSMAX software to establish three-dimensional L4-5 model of normal Chinese males. It was then transformed to finite element model after processed by SAP2000 software together with Charite SB Ⅲ disc prosthesis model.MAIN OUTCOME MEASURES: The three-dimensional model and finiteelement model of lumbar spine were successfully established.RESULTS: The finite element model of Charite SB Ⅲ disc replacement in L4_5 spine was established. The total nodes were 2542 and there were 1924Solid units, 592 Area units and 50 link units.CONCLUSION:The finite element model of artificial disc replacement can be established by CT scanning, digital processor and computer aideddesign,and used for further study on spinal biomechanics.

Objective To understand the job burnout status of bank staff and analyse the relationship between job burnout and self-efficacy,job satisfaction.Methods The job burnout,self-efficacy and job satisfaction of 8 942 bank staff was surveyed by Maslach burnout inventory-general survey(MBI-GS),general self-efficacy scale (GSES) and job satisfaction scale (JSS) respectively.Results A total of 8 942 questionnaires were issued and 7 486 valid questionnaires were returned.The score of self-efficacy in male was significantly higher than that in the female(P ＜0.05).There was no significant difference in job satisfaction score between male and female(P ＞ 0.05).The score of emotional exhaustion (EE) in female was significantly higher than that in male,while the score of reduced personal accomplishment(RPA) was significantly lower than that in male (P ＜ 0.05);there was no significant difference in depersonalization (DP) score between male and female (P ＞ 0.05).The EE,DP and PAL scores of bank staff with post-graduate education were significantly lower than those with high school/secondary school and junior college/undergraduate (P ＜ 0.05);the DP and PAL scores of bank staff with junior college/undergraduate were significantly lower than those with high school/secondary school(P ＜ 0.05);there was no significant difference in EE score of bank staff between junior college/undergraduate and high school/secondary school(P ＞ 0.05).The EE score of age ＞ 50 years old bank staff was significantly lower than that of age ＜ 30 years old,30-40 years old and 41-50 years old (P ＜0.05);there was no significant difference in EE score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).The DP score of 41-50 years old bank staff was significantly higher than that of age ＜ 30 years old (P ＜0.05);there was no significant difference in DP score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).There was no significant difference in PAL score among all age groups (P ＞ 0.05).The three dimensions of job burnout had significant negative correlation with self-efficacy and job satisfaction (P ＜ 0.05).Conclusion Bank staff have a certain degree of job burnout.Age,sex,and education level maybe the influence factors of job burnout.Improvement of self-efficacy and job satisfaction may help to reduce the job burnout.

ObjectiveTo determine the effect of total mesorectal excision with double anastomosis instruments(DAIs) in lower rectal carcinoma. MethodsFrom 1995 to 1998,57 cases of middle and lower segement rectal carcinoma were treated by total mesorectal excision with DAIs, and were followed for 3 years. Results No operative death and no anastomotic leakage were noted. Two patients suffered from anastomotic stenosis,but no dysuria and sexual dysfunction occurred. Local recurrence rate was 5.3%(3/57)in the follow-up period. ConclusionsTotal mesorectal excision with DAIs is not only an effective method to maintain pelvic organ function in lower rectal cancer, but also able to improve the living quality of patients and reduce local reccurence.

: Objective To analyse the characteristics of symptoms, signs and electrophysiology in Charcot-Marie-Tooth disease (CMT) with peripheral myelin protein 22 (PMP22) gene duplication abnormality.Methods 61 patients with CMT, 14 patients with family history and 47 sporadic patients were included. PMP22 gene duplication fragment was detected with PCR-double enzyme cutting assay. Medical history, signs were collected. Some of them received lumbar puncture and sural nerve pathological examination. Results The main clinical manifestation of the patients with PMP22 gene duplication abnormlity were asthenia of both lower extremities, especially dorsiflexion of foot, accompanied with distal atrophy (especially bilateral legs), some with upper extremity distal atrophy, ankle hyporeflexia or vanished and sensory disturbance. Protein in cerebrospinal fluid may increase, giant potential and conduction velocity of sensory and motor nerve decreased. Sural nerve biopsies revealed demyelination accompanied with axonal degeneration.Conclusion The main clinical manifestation of patients with PMP22 gene duplication abnormlity is charactered as the distal atrophy and asthenia of lower limbs, accompanied with sensory abnormlity. Myelin sheath and axonal alteration were found in electromyogram and peripheral nerve pathology.

Objective To investigate the feature brain damage and clinical manifestations in neuromyelitis optica (NMO) patients; To investigate the relationship between serum NMO-IgG antibody and NMO brain damage. Methods Clinical data of 37 NMO patients and their head and spinal cord MRI by 1.5T superconducting MR scanner, were analyzed; serum NMO-IgG antibody were measured by immunofluorescence. Results 17 cases were found to have abnormal signals on MRI, which were mainly in the white matter, pons, medulla, ventricle, aqueduct, and around the corpus callosum; According to pathological changes, brain damage can be divided into scattered irregularity (13 cases), fusion (3 cases),multiple sclerosis-like (1 case) ,with scattered irregularity more common,5 cases had clinical manifestations of brain damage: somnolence, vomiting, diplopia, visual rotation, 11 cases patients with brainstem damage show positive serum NMO-IgG antibodies. Conclusions Brain damage can be seen in half of NMO patients, they often located in the high expression area of AQP4: brain white matter, periventricular,brainstem and so on. Clinical symptoms has nothing to do with the size of lesions but the location, they often occur when brainstem was involved. Serum NMO-IgG is helpful in differentiating NMO with brain damage and MS.

Objective To explore the value of comprehensive biochemical and serological test in Salmonella clinical test .Methods A total of 95 cases of suspected salmonella infection with enteric fever were selected as subjects in this study from April 2013 to A‐pril 2014 ,and 48 cases randomly divided in research group ,47 cases in control group .Regular inspection was conducted in the con‐trol group ,comprehensive biochemical and serological test were conducted in the control group .Compared the results in the two groups .Results The salmonella detection rate in the research group was 93 .75% ,which was significant higher than 68 .09% in the control group (P< 0 .05) .Conclusion Combined detection of comprehensive biochemical and serology test could detect Salmonella effectively ,it is worthy of application and popularization in clinic .

BACKGROUND: With deepening of spinal biomechanics, artificial lumbar disc replacement is considered to be the optimal choice for treating degenerative lumbar disease. However, studies concerning biomechanics of artificial lumbar disc are insufficient. OBJECTIVE: To establish the three-dimensional (3-D) finite element model of artificial lumbar disc replacement and to explore the effects of artificial lumbar disc replacement on zygapophyseal joints using biomechanical analysis. METHODS: Based on normal 3-D finite element model of lumbar motion segment, L4-5 intervertebral disc, superior and inferior endplates were removed, and then, the model of SB-Charite Ⅲ disc prosthesis was added, which remained annular fibrosus and ligaments at L4-5 intervertebral space. Thus, 3-D finite element model of L4-5 segments artificial lumbar disc replacement was constructed. Biomechanical analysis of this model was processed under axial load, forward flexion, lateral bending or posterior extension moments. The stress data were contrasted with the normal 3-D finite element model of artificial disc replacement. RESULTS AND CONCLUSION: After artificial lumbar disc replacement, the data of biomechanical analysis indicated: ①There was no significant differences between the zygapophyseal joint and normal segment of stress under axial load (P > 0.01).②Compared with normal segment, the stress of anterior, posterior of upper and lower vertebral body and bilateral zygapophyseal joint had no obviously difference under forward flexion and posterior extension moments (P > 0.01). ③The stress differences between the both sides of upper and lower vertebral body and bilateral zygapophyseal joint were not significant under lateral bending moment (P > 0.01). Artificial lumbar disc replacement can keep the stress of motion segment at normal level, which can meet the needs of spinal functional reestablishment.

Objective To explore a variety of levels of serum marker test applications in the diagnosis of fatty liver .Methods Data were randomly selected from April 2013 to April 2014 for treatment of patients with fatty liver hospital 45 cases ,set the study group ,choose the same period in healthy volunteers to undergo a medical examination in our hospital 45 cases ,it was set to control group ,two groups of subjects were taking a variety of levels of serum markers tested .Comparison and analysis of two groups of subjects to detect a variety of levels of serum markers and positive case detection rate .Results The study group subjects ALT , AST ,TG ,TC index the average level of detection was higher than the control group ,statistically significant differences (P<0 .01);study group subjects ALT ,AST ,TG ,TC index the positive rates were 77 .78% ,93 .33% ,55 .56% ,46 .67% more than 8 .89% in the control group ,4 .44% ,15 .56% ,11 .11% higher ,statistically significant differences (P<0 .05);United biochemical indicator de‐tection of biochemical indicators of detection rate of fatty liver was obviously higher than that of single detection rate ,the difference was statistically significant (P<0 .05) .Conclusion Multiple levels of serum markers of fatty liver diagnostic test in higher detec‐tion rate .

ObjectiveTo evaluate three methods of detecting anti-aquaporin 4 (AQP4) antibody in neuromylitis optica (NMO),including indirect immunofluorescence assay organization(IIF),cell immunofluorescence method (CBA) and ELISA.MethodsThe patients were divided into NMO group (n =29), multiple sclerosis (MS) group (n = 23),and healthy controls group (n = 50).IIF, CBA and ELISA were used in 3 groups to detect serum anti-AQP4 antibody.The sensitivity and specificity as well as the consistency of positive results were compared.ResultsIn the aspect of the sensitivity of the three antiAQP4 antibody to diagnosis NMO, CBA (72.4％) ＞ IIF (62.1％) ＞ ELISA (51.7％) ; in the aspect of specificity, CBA (100.0％) ＞ ELISA (98.6％) ＞ IIF (97.3％).Kappa testing and evaluation method showed that the three detection methods were all in good consistency, particular in CBA and ELISA (P ＜0.01).ConclusionsCBA method showed a highest specificity and sensitivity in all these three anti-AQP4 antibody detection methods.CBA and ELISA are in better consistency of positive results.

OBJECTIVE: To determine the effectiveness of external fixator combined with limited internal fixation for Tile B pelvic fractures. METHODS: Fourteen patients with Tile B pelvic fracture were treated by external fixator combined with limited internal fixation between September 2004 and June 2009. RESULTS: All the patients were followed for 6-49 (20.2 +/- 10.2) months. According to the Matta standard, the outcome of 9 patients was excellent, 4 patients were good, while the other one patient was fair. CONCLUSION External fixator combined with limited internal fixation is effective for Tile B pelvic fracture. It can not only reduce the anatomic position of the pelvis, but also strengthen the stability of the pelvis as a whole. This method is less invasive and traumatic, which promotes the recovery of patients.
Adult ; External Fixators ; Female ; Fracture Fixation ; methods ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Young Adult