BACKGROUND:The finite element model has been developed from two-dimensional model to three-dimensional model, from linear model to nonlinear model. As the advantage of this method in the analysis of mechanical characteristics of the irregular objects, the finite element model has been widely used in the research of orthopedic biomechanics, especial y in the research of hip joint. OBJECTIVE:To analyze the stress state of human femur with finite element analysis method and to investigate a method that can rapidly construct femoral finite element model and precisely analyze the biomechanics. METHODS:Normal male femur was used as specimen for CT scan to obtain cross-sectional images of femur in each slice. Three-dimensional reconstruction was performed with DICOM data and MIMICS software, then the femoral three-dimensional finite element model was established with the finite element analysis ABQUS 6.8 software, and the stress distribution of the model was analyzed under loading condition. RESULTS AND CONCLUSION:Based on DICOM data, three-dimensional finite element model of femur was constructed more quickly and precisely. The models were divided into 38 636 nodes and 201 422 units. The model included the parts of cortical and cancel ous bone. The biomechanical test results were accorded with the previous results, so the model could objectively reflect the real femur shape and biomechanical behavior with high precision. The Mimics software provided a simpler and effective method for the construction of femur model and improved the efficiency of modeling, and the three-dimensional finite element model based on DICOM data was accurate in shape and can be used for the normal research on biomechanical behavior of femur. The stress distribution analyzed with ABQUS 6.8 software is consistent with the clinical observation.

Cerebral small vessel disease is common and is gradually being understood,but it is difficult to visualize directly in the body.The retinal vessels share the similar anatomic,physiological,and embryological characteristics with the cerebral small vessels.Their changes may reflect the changes of cerebral small vessels in a certain extent.Studies in recent years have shown that retinal vascular abnormalities are associated with lacunar infarction and white matter lesions.This article summarizes the research evidence of the correlation of between retinal vascular abnormalities and cerebral small vessel disease.

Objective To study the effect of Simo Decoction on senile constipation. Methods A total of 109 cases with senile constipation were randomly recruited into a control group (49 case) and a treatment group (60 case). The control group was treated with Dangguihuilong pill, while the treatment group was additionally treated with Simo Decoction on that basis.Results The total effective rate was 93.33% and 79.59% in the treatment group and the control group respectively, showing statistical difference (x2=22.586, P＜0.01). Conclusion It was effective to treat senile constipation with Simo Decoction.

Objective To investigate the clinical features of spinal muscular atrophy type Ⅱ.Methods The data of clinical manifestation,laboratory data, onset, diagnosis, and rehabilitation of 53 outpatients suffering from spinal muscular atrophy type Ⅱ (SMA-Ⅱ) were analyzed. Results Among 53 patients with SMA-Ⅱ confirmed by molecular genetic tests, 27 patients were male while 26 were female. The mean age was 3.35 years (ranged 0.75~7.8 years), and the age receiving gene diagnosis was 17.27 months. Only 15% had a family history,and abnormalities were found in 23% patients' mothers during pregnancy. 83.4% of them had water choke cough, while 87% expectoration weakness. None of them had cough assist machines and had regular spirometry monitoring. 53% of the patients took semi-liquid diet, however,none of them used stomach tube. Symmetrical flaccid paralysis was so remarkable, even muscle strength of lower limbs in 87.7% of these patients were only grades 1-2. 92% had scoliosis, while 83% had tendon contracture. EMG showed extensive neurogenic changes. All children did not accept normal pre-school education, and 85% patients did not accept formal rehabilitation. Conclusion Most of phenotype of SMA-Ⅱ for the children was similar and more severe in China. Most of the patient didn't get formal education, rehabilitation and care.

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

Objective To explore the risk factors of ventilator-associated pneumonia(VAP)in neonatal patients.Methods A retrospective study was conducted on the 82 neonates who had ever received mechanical ventilation for more than 48 hours,non-conditional logistic regression analysis was performed to determine independent predictors for VAP.Results By logistic regression analysis,the following risk factors independently predicted VAP:gestational age(OR = 6.209,95%CI =2.112～16.835),duration of mechanical ventilation(OR =5.842,95%CI = 1.366～14.936),times of endotracheal suctioning(OR =4.764,95%CI = 1.416～14.736),re-intubation(OR = 6.190,95%CI = 1.669～16.019),gastric tubes retention(OR =6.794,95%CI = 1.928～19.160),treatment with CNS suppressant(OR = 4.297,95%CI = 1.002～15.216).Conclusion The neonatal VAP occoured for multiple facors,the rsik factors include gestational age,duration of mechanical ventilation,endotracheal suctioning,re-intubadon,gastric tubes retention and treatment with CNS suppressant.

Objective To explore clinical characteristics and the perinatal effects of multiple systems in pre-pregnancy obesity patients with early-onset preeclampsia. Methods A total of 111 cases with early-onset preeclampsia in our Inpatient Obstetric Department were reviewed in this study. According to pre-pregnancy body mass index (BMI), patients were divided into normal before pregnancy group (BMI<28 kg/m2, n=56) and obese before pregnancy group (BMI≥28 kg/m2, n=55) . The body weight, BMI, weight gain during pregnancy, risk factors, clinical features, and clinical features of neonatal index were compared between two groups. The correlation between maternal and neonatal indexes and glucose and lipid indexes were compared. Results Obese before pregnancy was more prone to blood concentration and disorders of lipid metabolism. The serum levels of lipid, glycosylated hemoglobin (HbA1c), hematocrit, platelet and fibrinogen were significantly higher in obese before pregnancy group than than those of normal group. The induced neonatal acidosis and other organ damage, newborn Apgar score, pH, glucose were significantly lower in obese before pregnancy group than those of normal group. The residual alkali (BE), lactic acid (LAC), creatine kinase (CK) and creatine kinase (CKMB) were higher in obese before pregnancy group than those of normal before pregnancy group. Correlation analysis showed that maternal low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), three acyl glycerol (TG) and HbA 1c were negatively correlated with neonatal Apgar score and pH, and which were positively correlated with neonatal LAC and CKMB. Both differences were significant (P<0.05 or P<0.01). Conclusion The dyslipidaemia in early onset preeclampsia in obesity patients before pregnancy is closely related with maternal and perinatal outcomes.

AIM:To compare the influence of anterior chamber maintainer and viscoelastic agent on corneal astigmatism and endothelial cells after phacoemulsification.METHODS:Totally 70 patients(70 eyes) of cataract from April 2013 to April 2015 were randomly divided into the study group and the control group, with 35 cases in each group.The study group were treated with anterior chamber maintainer during phacoemulsification with support system approach, and the control group were treated with phacoemulsification under viscoelastic agent.RESULTS:The age (t=0.215, P=0.831), the density of corneal endothelial cells (t=-0.352, P=0.726) and corneal luminosity (t=-0.162, P=0.872) of two groups had no significant difference before surgery;there were no significant difference in preoperative visual acuity (t=0.463, P=0.599) and visual acuity (t=1.616, P=0.124) at 1mo after operation.And patients in the study group (t=-21.129, P<0.01) and the control group (t=-12.780, P<0.01) before surgery and 1mo postoperative when compared with the naked eye eyesight showed significant difference.The visual acuity after operations improved significantly.There were significant differences of corneal endothelial cells density (t=8.489, P< 0.01) and corneal astigmatism (t=-2.032, P=0.046) in the study group before surgery and 1mo after surgery;corneal endothelial cell density (t=8.999, P<0.01) and corneal astigmatism (t=-2.167, P=0.034) in the control group before surgery and 1mo after surgery also had significant differences.There was no significant difference in the rate of corneal endothelial cell loss between the two groups (t=0.410, P=0.683).CONCLUSION:Compared with viscoelastic agent, anterior chamber maintainer during phacoemulsification in patients with cataract won't increase the damage of postoperative surgically induced astigmatism and corneal endothelial cells, which mean the method of anterior chamber maintainer during phacoemulsification in the treatment of cataract is safe and effective.

Objective To evaluate the effects of a health education project on prevention and control of iodine deficiency disorders.Methods From January to June 2011,an investigation was conducted using combined unified questionnaire in 9 counties on target population,and 3 townships were chosen in each project county.Health educational activities were carried out in grade 5 classes in the central primary school.In the meantime,3 villages were chosen in each selected township where the health educational activities in the community were carried out.Before and after the health educational activities,questionnaire surveys on knowledge of iodine deficiency disorders were conducted in each project county.Thirty students in one class of grade 5 in the central primary school were selected,and 15 women of childbearing age near the central primary school were selected too.The health education content included but not limited to:popular science films about the knowledge on endemic disease prevention and public-interest ads were broadcasted by radio,television,newspapers and other media in the project counties,aiming at spreading knowledge on prevention and treatment of endemic diseases.In each of the project township government and village committee locations,posters,banner pieces and slogan suspensions about knowledge on endemic disease prevention were posted or put up.In the project rural hospitals,a special bulletin boards was set up,and in the village clinics (rooms),posters were put up,to carry out a training program for women of childbearing age on endemic disease prevention.In primary schools,students in grades 4 to 6 were given a class about knowledge on prevention and treatment of iodine deficiency disorders,aiming at their transferring the learned knowledge to family members.Results A total of 2678 persons were investigated before and after the health education.After health education,the rate of knowledge(the correct answer rate) on iodine deficiency disorders increased from 69.04％ (1920/2781) to 94.08％ (2622/2787,x2 =580.63,P ＜ 0.05) among primary school students,and 74.76％(924/1236) to 92.60％(1139/1230,x2 =143.59,P ＜ 0.05) among women of childbearing age.Conclusions The rate of knowledge awareness in the students and the women of childbearing is increased significantly after the health educational activities.Systematic and targeted health education activities are effective measures in prevention and control of iodine deficiency disorders.