Objective:To simulate the placement of percutaneous cortical bone trajectory (CBT) screws on reconstructed CT images and three-dimensional lumbar model and to measure the morphometric parameters for guiding the placement of percutaneous CBT screws.Methods:The CT images of 100 adult patients with lumbar spine diseases were studied. The CT images were reconstructed using Mimics software. Taking the projection point on the lamina at the junction of the inner and lower edge of the smallest coronal section of lumbar pedicle as the entry point, the cephalad angle, lateral angle, maximum screw length, maximum screw diameter, distance between trajectory and spinous process were measured. At the same time, the relationship between the trajectory and spinous process was observed by using the reconstructed three-dimensional image.Results:The lateral angle of the trajectory from L 1 to L 5 were 9.3° (8.9°, 9.8°), 9.6° (8.9°, 9.8°), 10.4° (9.5°, 11.3°), 11.81°±1.24° and 13.6° (12.5°, 14.5°), respectively. The cephalad angle from L 1 to L 5 were 26.6° (26.0°, 27.0°), 26.2° (25.7°, 26.5°), 26.9° (26.5°, 27.4°), 25.94°±0.92° and 24.3° (22.7°, 25.4°), respectively. Significant statistic differences were found among all levels in the cephalad angles and lateral angles. The mean diameters of the trajectory from L 1 to L 5 were 5.65±0.49 mm, 6.38±0.60 mm, 6.91±0.67 mm, 7.42±0.76 mm and 8.33 (7.59, 9.01) mm, respectively. Except L 1 and L 5, there were significant differences among all levels in the maximum screw diameters. The mean length of the trajectory from L 1 to L 5 were 36.4 (35.4, 37.0) mm, 36.7 (35.8, 37.3) mm, 37.6 (37.1, 38.1) mm, 37.8 (37.3, 38.1) mm and 36.2 (35.2, 36.9) mm, respectively, and there were also significant differences among all levels. The ration in superior endplate for each segment were 41.08% (34.36%, 45.60%), 37.94% (32.97%, 43.63%), 40.18% (34.56%, 44.49%), 38.61% (34.80%, 46.24%) and 40.9% (35.32%, 46.02%), respectively and statistical differences were significant between L 1 and L 2 and L 2 and L 5. The mean distance between the trajectory and the spinous process from L 1 to L 5 were 7.27±1.23 mm, 7.19 (5.97, 8.28) mm, 7.32 (6.01, 8.28) mm, 7.31±1.36 mm and 7.45 (6.32, 8.23) mm, respectively. In the sagittal CT image, the tip of the trajectory located near the posterior two-fifths of the superior end plate, and the extended line of the trajectory located at the inferior edge of spinous process. In the three-dimensional reconstruction model, no obstruction was found between the simulated screws and the spinous process. Conclusion:Lumbar CBT screw can be implanted percutaneously, and spinous process will not hinder the implantation process. Spinous process and upper endplate can be used as a sign to guide the percutaneous CBT screw implantation. Digital analog screw placement can offer a useful reference for the clinical application of percutaneous cortical bone trajectory screw.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

OBJECTIVES: To investigate the genetic polymorphisms of 18 autosomal short tandem repeats （STR） loci in Changsha Han population, and explore the population genetic relationships and evaluate its application value in forensic medicine. METHODS: The DNA of 2 004 unrelated individuals in Changsha Han population were amplified using Goldeneye^®DNA ID System BASIC, and the PCR products were analyzed by electrophoresis using 3130xl genetic analyzer. The fragment sizes of alleles were analyzed subsequently by GeneMapper^® ID v3.2. The frequency data and forensic genetic parameters ［observed heterozygosity （Ho）, expected heterozygosity （He）, power of discrimination （DP） and polymorphic information content （PIC）］ of 18 STR loci were statistically analyzed. Total probability of discrimination （TDP）, probability of exclusion in trio cases （PE_trio） and probability of exclusion in duo cases （PE_duo） were calculated by Cervus 3.0. Hardy-Weinberg equilibrium and linkage disequilibrium of the loci were detected by Arlequin v3.5. The results were compared with the available data of other populations from different races and regions. RESULTS: The power of discrimination （DP）, and the polymorphic information content （PIC） of each locus of Changsha Han population ranged from 0.783 6 to 0.987 9 and 0.549 4 to 0.914 5, respectively. The TDP, cumulative probability of exclusion in trio cases （CPE_trio） and cumulative probability of exclusion in duo cases （CPE_duo） were 0.999 999 999 999 999 999 999 865 2, 0.999 999 979 and 0.999 988 325, respectively. According to the Nei's D_A genetic distance, the genetic distance between Changsha Han and Hunan Han populations was the smallest （0.014 1）, while it was the largest （0.041 8） between Changsha Han and Xinjiang Kazakh populations. CONCLUSIONS The 18 STR loci shows abundant genetic polymorphisms in Changsha Han population. The study of genetic diversity among different populations has an important meaning for the research of their origins, migrations and their relationships.
Alleles ; Asian People/genetics* ; China ; DNA/analysis* ; Gene Frequency ; Genetics, Population ; Humans ; Male ; Microsatellite Repeats ; Polymorphism, Genetic