[Objective]To investigate the effect of dermatomal somatosensory evoked potential(DSEP) in diagnosing the damage of nerve root in lumbar spinal stenosis. [Method]Diagnostic test was deployed in this reseach.All experiment objects were divided into the case group and the control group.There were 47 cases in the case group.There were 14 males and 33 females with the mean age of 52.6 and the mean stature was 1.64 m.In the control group,there were 50 cases which include 26 males and 24 females with the mean age of 50.4 and the mean stature of 1.65 m.The DSEP P40 latency and P1-N1 amplitude of cutis plate in L4、5 and S1 segment were determined.The data of the case group were compared with those of control group and analyzed statistically.[Result]In the case group,the P40 latency of 91 segments prolonged obviously and P40 wave of 103 segments disappeared.Comparing the P40 latency and P1-N1 amplitude of 3 segments(L3、4、L4、5and L5S1) in two groups,the change was remarkable(P

[Objective]To analyze the relation of age and sex with the incidence of physical examinees with osteoporosis and low bone mass of vertebras.[Method]Quantitative CT(QCT) was used to examine and analyze the lumbar bone mineral density in 575 physical examinees.The data was analyzed by statistical software SAS 9.0.[Result]Bone mineral density(BMD)decreased with age after 50 years old.The occurrence rates of osteoporosis were 56.34% for females at 50-59 years,87.80% at 60-69 years,97.22% at 70-79 years and 100% at 80-89 years,25.44% for males at 50-59 years,50.64% at 60-69 years,66.66% at 70-79 years,and 90.91% at 80-89 years.[Conclusion]The incidence of osteoporosis is positively related with the age.The occurrence rate of osteoporosis increases with increasing age.It is obviously higher in females than in males.

BACKGROUND: There are a lot of controversies regarding the choice of short versus long segment pedicle screw fixation for the treatment of isthmic spondylolisthesis and degenerative spondylolisthesis treatment. OBJECTIVE: To investigate clinical efficacy of short versus long segment pedicle screw fixation in treatment of lumbar spondylolisthesis.METHODS: A total of 146 spondylolisthesis patients were included in this study, 36 males and 110 females, aged 22-73 years at a mean of 53 years; disease duration was from 1 to 18 years at a mean of 5 years. These patients were treated with lumbar spinal window-opened decompression or laminectomy decompression, a short or long segment pedicle screw internal fixation, transverse interbody fusion.RESULTS AND CONCLUSION: Among 146 involved patients, 72 cases were treated with four pedicle screw fixation (short segments), while 74 cases with six pedicle screw fixation (long segments). Interbody graft was performed in 101 cases, while intertransverse fusion given in 45 cases. Totally 134 cases were followed up for postoperative 1.5-14 years. According to clinical grading standards of Steffee system, the clinical efficacy was assayed excellent in 74 cases, good in 41 cases, mild in 13 cases and poor in 6 cases, with good rate of 85.8%. 77 cases achieved a complete reduction, including 32 cases using a short segment fixation and 45 cases using a long segment fixation. 69 cases achieved partial reduction, including 40 cases using a short segment fixation and 29 cases using a long segment fixation. Pedicle screws ruptures were found in 13 screws of eight patients undergoing short segment fixation, while no pedicle screw fracture was found in long segment fixation. Choice of short or long segment for the fixation is based on the analysis of spondylolisthesis type, severity, duration of disease, emergence of adjacent segment disc degeneration and instability.

[Objective] To evaluate the clinical value of diagnosing osteoporosis with vertebra bone mineral density(BMD) by measurement with quantitative computed tomography (QCT) . [ Method] BMD in of lumbar vertebrae (L<,1～4>)were measured by QCT in 53 healthy middleaged persons or elderly persons (group A) and 68 osteoporosis patients ( groupB) . [Result] BMD in group A declined obviously as age increasing with significant differences (P<0. 01) . In group B,all 68 patients showed osteoporosis according to the diagnostic standard of BMD≤x -2. OSD. Sixty patients showed osteoporosis ifthe diagnostic standard was set to BMD ≤ x -2. 5SD. The BMD values of different age group was lower than the bone quantityblock values. [Conclusion] As a method for diagnosing osteoporosis, QCT has advantages of high sensitation, being precise,being reproducible and is easy for applying. It would be more practical and could decrease mis - diagnosing if the diagnosticstandard was BMD≤x-2.OSD.

A total of 64 patients with lumbar spondylolisthesis were enrolled from Department of Bone Surgery in the People's Hospital of Haian Province between January 2002 and December 2007, including 19 males and 45 females. They aged 26-73 years with a mean of 48.5 years. Their disease course was 1-15 years with a mean of 4 years. All patients complained about the repeated low back pain accompanied with lower limb radiating pain and intermittent claudication (50-300 m). Fifty-nine patients suffered from lumbar spondylolysis, including L3 Ⅰ degree in 3 cases, L4 Ⅰ degree in 31 cases,L4, Ⅱ degree in 13 cases, Ls Ⅰdegree in 9 cases and L5 Ⅱ degree in 3 cases. The remaining 5 cases were present with lumbar degenerative pseudo-spondylolysis. All patients were processed into whole laminectomy for decompression or vertebral canal decompression by fenestration, domestic vertebral internal fixation, reduction and interbody fusion. Fifty-five patients were followed up for an average of 3.1 years whereas 9 patients were lost. According to Steffee clinical effect grading, the curative effect was evaluated as excellent in 28 cases and good in 19 cases, the rate of excellence and good accounted for 85.5%. Within one week following bone graft, all patients were rechecked with X-ray plain film, 28 of them had shown complete reduction and 36 cases were present with part reduction. The fusion rate of interbody graft was 100%. These findings demonstrated that vertebral internal fixation system possesses a simple structure, convenient operation and solid fixation, resets the slipped vertebral body and significantly increases the fusion rate of vertebral graft.

Objective:To predict the financial impact of artificial intelligence (AI)-assisted community-based screening for primary angle-closure glaucoma (PACG) among the elderly on health expenses and medical insurance expenditures in remote areas of China.Methods:A total of 19 395 people aged more than 65 years old from Changjiang Li autonomous county, Hainan province were enrolled.A health economic model for glaucoma screening in Wenzhou, Zhejiang province was adopted.PACG was classified as suspected primary angle closure, primary angle closure, PACG, monocular blindness and binocular blindness according to its severity.The model was adjusted in combination with the epidemiology, metastasis probability and treatment compliance, screening and referral compliance, sensitivity and specificity of AI screening from glaucoma related literature and using data on local epidemiology and health costs of glaucoma from the Changjiang Hospital of Integrated Traditional Chinese and Western Medicine from 2016 to 2019.The health outcome, total health expenses and medical insurance expenditures of AI-assisted community-based screening and no screening for PACG in 15 years were compared and analyzed.Results:It is found that the AI-assisted community-based screening would prevent disease progression and reduce the number of PACG patients by 43% (134 cases) and blind patients by 50% (9 cases) in 15 years in comparison with no screening.Under the AI-assisted community-based screening system, the early diagnosis and intervention of positive PACG patients will cause the dramatic increase of both total health expenses and medical insurance expenditures compared with no screening in the short term.It was predicted that the increasing trend of medical insurance expenditure would turn to a downward trend and show cost saving advantage at the third year, whereas the declining trend of total health expense would not occur until 10 years later.Without screening, a large number of PACG patients would progress to advanced stages, so the medical costs would continue to rise and exceed the medical costs of the screening system at the 14th year.Conclusions:The AI-assisted community-based screening for PACG is cost-effective and can prevent disease progression, save health expenses and medical insurance expenditures in the long run in remote areas of China.