Objective To investigate the pathogenesis of cerebral infarction after non-cardiac surgeries according to imaging.Methods Retrospective analyses of clinical and imaging data of 17 patients with postoperative cerebral infarction(average 68 years old,total incidence 0.049％)from departments of orthopedics and general surgery were conducted during 52 months.Results Cerebral infarction occurred 39.1 hours after operation on average.Among the 17 patients,eight were detected with disturbance of consciousness,ten with hemiplegia,six with speech disorder and two with unilateral sensory disturbance.Six (35.3％)had blood lipids tests.Five(29.4％)had neck vascular ultrasound and one had intracranial magnetic resonance angiography(MRA).When discharged,one patient was declared death and ten had impaired neurological function in various degrees.Among six patients with previous stroke,one(16.7％)received neurological consultation before surgery.According to the image manifestation,ten cases were territory circulation infarcts,four centrum ovale infarcts and three watershed infarcts.Conclusions This study suggests that total incidence of cerebral infarction after non-cardiac surgeries is lower than previously reported and there is greater involvement of atherosclerosis.Patients' conditions should be closely observed within at least four days after surgeries.Preoperative assessment should be strengthened in order to avoid occurrence of postoperative cerebral infarction.

Amyotrophic lateral sclerosis is a rare but fatal neurodegenerative disorder.Riluzole remains the only available drug for slowing the progression of the disease.In the past few years,significant advances have been made in both our understanding of pathogenesis and the development of new therapeutic approaches.The authors review the current understanding of the pathogeneic mechanisms and drug therapy.The outcome of phase Ⅲ clinical trials will benefit the further investigation in ALS.

Objective To observe the characteristics of midbrain hyperechogenicity of amyotrophic lateral sclerosis (ALS) patients by transcranial sonography (TCS).Methods A total of 107 ALS patients,enrolled from January to July 2015 in Beijing University Third Hospital,with the diagnosis of possible or definite ALS according to revised E1 Escorial criteria were examined by transcrinal B-mode sonography.The area of midbrain and substantia nigra and the area ratio of hyper-substantia nigra/midbrain (S/M) were measured and compared between ALS and 40 age-and gender-matched controls.Results There were 29.0％ (31/107) of ALS patients and 7.5％ (3/40) of controls who displayed abnormal midbrain hyperechogenic areas for groups comparison (x2 =22.708,P ＜ 0.01).The hyperechogenic substantia nigra area and S/M were (0.40 ± 0.14) cm2 and 9.5％ (6.0％,13.0％) in ALS group,whereas (0.20 ± 0.06) cm2 and 5.0％ (2％,6.0％) in control group respectively,the difference between the two groups being statistically significant (t =12.727,Z =16.545,both P ＜0.01).No correlations of hyperechogenic area sizes in ALS patients were found in regard to age,gender,ALS duration or ALS Functional Rating Scale score (r=0.043,-0.088,0.018,0.202;P=0.251,0.512,0.894,0.190).However,there was significant correlation between TCS severity and ALS subtype (bulbar vs spinal form,r =0.386,P ＜ 0.01).Conclusion Hyperechogenicity of the substantia nigra was found in patients with sporadic ALS with a frequency higher than in controls.

Objective To evaluate the biomechanical effects of using a new injectable calcium phosphate cement to consolidate the fixation of osteoporotic intertrochanteric fracture.Method Five matchod pairs of human cadaver femora were used to produce the model of intertrochanteric fracture.All fractures were fixed with dynamic hip screws(DHS),and divided into two groups.In the CPC consolidation group of each pair,CPC was used to grout the hip screw and to fill the posteromedial defect.All femora were subjected to biomechanical test.Results Under the loading of 500 N,in the CPC consolidation group,the mean axial stiffness is(691.93±18.90)N/mm and the horizontal shear stiffness is(5553.84±27.47)N/mm.The mean lateral and medial strength is(5.15±0.35)MPa and(4.13±0.24)MPa.The torsion stiffness was 0.41 and the ultimate loading is(3580±286)N.In the control group,the mean axiak stiffness is(453.45±19.75)N/mm,the horizontal shear stiffness is(3848.87±22.63)N/mm,the mean lateral and medial strength is(3.12±0.37)MPa and(1.80±0.21)MPa,and,the torsion stiffness is 0.35 and the ultimate loading is(2512±189)N.Consolidation fixation with CPC increased each of the biomechanical efficiency(P＜0.05).Conclusions CPC consolidation of osteoprotic femoral head and the medial defect of intertrochanteric fracture can significantly improve the overall stability and decrease the rate of postoperative complication.

ObjectiveTo investigate the survival and migration of the neural stem cells(NSC) in the cerebrospinal fluid (CSF) circle of mice after ventricle transplantation. MethodsNSC labeled with green fluorescence protein (GFP) were implanted into the lateral cerebral ventricle of the mice. The mice were killed at time point of 24 h, 48 h, 2 weeks and 10 weeks after transplantation. The brain sections were observed and the behaviors of the mice were evaluated. ResultsGFP-positive cells were found in the lateral cerebral ventricle.Some of them migrated into the parenchyma and located in fibria-fornix, hippocampus,corpus callusum, septum,subventricle zone and beside the blood vessels at the time point of 2 weeks and 10 weeks. There were no obvious complications occured during operations which affected the outcome of growth and development. ConclusionNSC not only can survive, but also can migrate into the local parenchyma of the brain after ventricle transplantation. There were no obvious complications occured after the transplantation of NSC.

Abstract In recent years, mental health issues have gradually expanded from adults and professional groups to the primary and secondary school students, and are showing a trend of younger age. The article analyzes the "Special Action Plan for Comprehensively Strengthening and Improving the Mental Health Work of Students in the New Era (2023-2025)" jointly issued by 17 departments including the Ministry of Education. It explores the current situation, overall concept, key tasks, and other aspects to further improve the "four in one" student mental health work system of health education, monitoring and warning, consulting services, intervention disposal, and improve students mental health literacy.

Quite a few orthopedics experts have fabricated some novel bone scaffolds with nanotechnology and have carried out some researches on nano-biological effects. The study of the biological effects about nano-biomaterials can facilitate the understanding of the interaction between the biomaterials and the organism, and provide research ideas and direction to construct new biomaterials with physiological function. To better understand the interaction of nano biomaterials with protein, cells and bio-security, this review presents recent advances of biological effects about nano scaffold for bone tissue engineering.
Biocompatible Materials ; metabolism ; Bone Substitutes ; Bone and Bones ; Humans ; Nanostructures ; Nanotechnology ; Surface Properties ; Tissue Engineering ; methods ; Tissue Scaffolds

Based on the CT data, a medical treatment FE model of hip joint prosthesis with stepped stem was rebuilt according the anatomy of the hip joint. Under the loads of 1.5 times standard body weight (70kg), the mechanical behavior of the treatment model was calculated, and the influence of step structure and distribution for stepped stem on femur stress and stability of total hip replacement were analyzed by three-dimensional finite element analysis (3D-FEA). The results show that the step structure changs the bone stress transmission on the interface of stepped stem and femur, and benefits to reduce stress-shielding in the femur. For the same distribution of step, the reduction of stress-shielding for raised stepped stem is better than that for concave stepped stem. The raised stepped stem of which the steps is distributed one of third part of the stem is of the best effect of reduction of stress shielding in all of the analysis models, and is a beneficial mechanical design to relieves osteoporosis or osteopenia of femur caused by stress-shielding and improve the reliability of it in clinic.
Adult ; Arthroplasty, Replacement, Hip ; methods ; Biomechanical Phenomena ; Computer Simulation ; Equipment Failure Analysis ; Finite Element Analysis ; Hip Prosthesis ; Humans ; Imaging, Three-Dimensional ; Male ; Models, Biological ; Prosthesis Design ; Stress, Mechanical ; Tomography, Spiral Computed ; Weight-Bearing ; physiology

Objective To establish a method which could measure tongue muscle thickness and evaluate the fasciculation of the tongue muscle by submental way ultrasonic detection , and to obtain the reference values of tongue muscle thickness in healthy volunteers , exploring its clinical application in the patients with amyotrophic lateral sclerosis (ALS).Methods In two-hundred healthy volunteers who took physical examination at the Medical Examination Center of Peking University Third Hospital , the tongue thickness was determined by measuring the distance between the upper and lower surfaces of the lingual muscles in the center of the plane perpendicular to the Frankfurt horizontal plane of the frontal section with a 3.5 MHz convex array transducer .The fasciculation of tongue muscle was evaluated using a 7.5 MHz linear array transducer in the same position .This method was used to measure the thickness of tongue muscle and to evaluate tongue muscle fasciculation in 30 patients with ALS who visited neurological clinic with the diagnosis of possible or definite ALS according to revised El Escorial criteria during the same period .We compared the tongue muscle thickness between 30 ALS patients and the same number of age-and gender-matched healthy volunteers .Results The mean value of tongue muscle thickness of males was significantly higher than that of females ((4.09 ±0.52) cm vs (3.70 ±0.56) cm, t=5.108, P<0.01), but there was no significant difference in the tongue muscle thickness between the different age groups .The mean value of tongue muscle thickness was significantly correlated with the body mass index value in healthy subjects ( r=0.412, P<0.01).No tongue muscle fibrillation was detected in healthy volunteers .In ALS group, the tongue was significantly thinner than that in healthy subjects ((3.77 ±0.58) cm vs (4.05 ±0.49) cm, t=-0.253, P<0.05).Of the total 30 ALS patients, we recognized tongue muscle fasciculation in 12 (40%).Conclusion The method to measure tongue muscle thickness and evaluate tongue musclefibrillation is reliable , and has good clinical application value in related diseases such as ALS .

Objective To compare the clinical efficacy of posterior pedicle screw fixation through Wiltse paraspinal approach and posterior traditional open approach in the treatment of thoracolumbar fracture and dislocation.Methods A retrospective case control study was performed based on the clinical data of 40 patients with thoracolumbar fracture and dislocation admitted between January 2013 and January 2016.All the surgeries were performed through posterior midline incision,and they were divided into two groups according to different approaches.Patients in Group A received pedicle screw fixation through Wiltse paraspinal approach while Group B received fixed pedicle screw through open surgery.Group A was composed of 12 males and 8 females,aged 21-60 years [(41.5 ±9.6)years].Group B was composed of 13 males and 7 females,aged 18-58 years [(39.1 ± 13.1) years].The same surgical procedures were adopted in spinal decompression,reduction,and the spinal vertebral interbody bone graft and fusion surgery in the two groups.Operation duration,intraoperative blood loss,postoperative drainage volume,visual analogue scale (VAS),spinal canal patency at the last follow-up,percentage of postoperative injury of vertebral height recovery,and Cobb angle were compared.CT and MRI were used to evaluate postoperative paravertebral muscle atrophy,and American spinal injury association (ASIA) impairment scale was used to evaluate neurological function assessment.Results All patients were followed up for 9-33 months,with (19.3 ± 5.6) months for Group A and (22.5 ± 4.9) months for Group B (P ＞ 0.05).The operation duration was (240.5 ± 38.3) min in Group A and (258.5 ± 43.7) min in Group B (P ＞ 0.05).The intraoperative blood loss was (525.0 ± 168.2) ml in Group A,less than (770.0 ± 269.2) ml in Group B (P ＜ 0.05).Postoperative drainage volume was (190.1 ± 78.9) ml in Group A,less than (281.7 ± 122.3) ml in Group B (P ＜ 0.05).VAS score 24 hours after operation and at the last follow-up in Group A was (6.4 ± 1.0) points and (1.6 ± 0.5) points,respectively,better than those in Group B [(7.8 ± 0.7) points and (2.2 ± 0.4) points] (P ＜ 0.05).No significant differences were observed in terms of spinal canal patency at the last follow-up,percentage of postoperative injury of vertebral height recovery,and Cobb angle [Group A:(85.3 ± 3.7) ％,(85.5 ± 2.7) ％,and (4.7 ± 1.2)°;GroupB:(85.8±1.8)％,(88.8 ±1.3)％,and (5.3 ±1.5)°] (P＞0.05).In terms of MRI evaluation score of postoperative paravertebral muscle atrophy,Group A reported better results than Group B [(2.1 ± 0.6) points vs.(1.2 ± 0.6) points] (P ＜ 0.05).At the last follow-up,there were 7,5,6,1 and 1 patients in Group A,while 6,6,5,2 and 1 patients in Group B at ASIA grades A,B,C,D and E (P ＞ 0.05).Within the same group,significant difference was observed between the preoperative data and that at the last follow-up in terms of postoperative VAS score,spinal canal patency,percentage of injury of vertebral height,Cobb angle,and ASIA impairment scale (P ＜ 0.05).Conclusion For thoracolumbar fracture and dislocation,compared with traditional open approach,posterior pedicle screw fixation through Wiltse paraspinal approach can effectively restore the vertebral body height and spinal canal patency and can reduce the intraoperative bleeding,postoperative drainage,postoperative back pain,and paravertebral lesion.