BACKGROUND:The surgical management to reconstruct the stability in lumbosacral region is very chal enging. There are many techniques to reconstruct the stability of the lumbosacral region, but the internal fixation loosening, fracture and pseudoarthosis are not uncommon. OBJECTIVE:Finite element analysis was used to analyze the stability of two types of reconstruction procedures and the stress of the internal fixation system. METHODS:A 64-slice spiral CT scan was used in a subject from L1 to pelvis. The scan data were imported into the Mimics 15.0 software to generate a three-dimensional surface model. The three-dimensional solid model was established using in the SolidWorks software. The solid geometry model of the L3, 4 pedicle screws combined with single iliac screw fixation and L3,4 pedicle screws combined with dual iliac screws and anterior titanium mesh cage support fixation were constructed by the Solidworks software. Two kinds of reconstruction procedures were simulated. The models were given material properties and analyzed by using the ABAQUS software. RESULTS AND CONCLUSION:(1) The maximum stress was 195.3 MPa in the complete model, 189.5 MPa in single iliac screw model, and 149.2 MPa in dual iliac screw+titanium cage model when constrained the roof of double acetabulum and applied a vertical load of 1 000 N. (2) The axial compression rigidity was 551.572 N/mm in the complete model, 613.87 N/mm in the single iliac screw model and 1 683.50 N/mm in the dual iliac screw+titanium cage model. (3) The bending rigidity of the dual iliac screw+titanium cage model was bigger than other models at 6 directions when applied 7 N?m bending loads. The maximum stress of single iliac screw model was bigger than other models. (4) The results suggest that the dual iliac screw+titanium mesh cage reconstruction can effectively restore the stability of the lumbosacral area. The stress of internal fixation system is smal er and more dispersed. There is obvious stress concentration in the connecting rod and the tail of the single iliac screw. The single iliac screw internal fixation system is easy to fatigue fracture and loosening.

BACKGROUND: The clinical application of one-level osteotomy and multilevel osteotomy has been well documented, but currently few studies were reported to compare their biomechanical characteristics.OBJECTIVE: To investigate the biomechanical characteristics of one-level osteotomy with Dick screw fixation and multilevel osteotomy with Luque instrumentation in the treatment of kyphosis.DESIGN: Randomized comparative experiment.SETTING: Laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: Fresh specimens of thoracic and lumbar spinal segments obtained from 12 3 or 4-year-old calves.METHODS: The experiment was conducted in the laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University between September 2002 and September 2003. Fresh spinal segments T8-L5 from 12 calves were randomized into an intact group, Dick screw group with one-level osteotomy with Dick screw fixation and Luque group with multilevel osteotomy with Luque instrumentation, with 4 spesimens in each group. Lateral bending test of the specimens was performed to examine the physiological overload using an Instron 5 500 universal material testing machine at the constant speed of 10 mm/minute until fracture or dislocation was induced. Changes in the loading were recorded and the induced injuries observed to obtain the load-displacement curve of the injury test.MAIN OUTCOME MEASURES: The load-displacement curve of the destructive right bending test in each group.RESULTS:All the data of 12 canines were involved in the result analysis.The spinal segments of the intact group yielded to the force of 3 600 N with a flat and smooth load-displacement curve, and those of Dick screw group yielded to a load of 2 800 N with also a relatively flat curve, while in Luque group, the segments did not yield until a load of 7 160 N, followed by drastic decrease of the resistance to less than 4 000 N, generating a flat and smooth curve afterwards.CONCLUSION: Luque instrumentation is a little more preferable than Dick screw in terms of the maximum resistance, but this difference does not justify the clinical decision of their superiority. Both techniques benefit postoperative recovery of spinal function with strong stability.

Objective: To explore the clinical, pathological and echocardiographic characteristics of rare primary non-mucinous cardiac tumor (PNCT) and to investigate the diagnostic value of echocardiography in benign and malignant PNCT with various pathological classiifcations. Methods: We retrospectively studied 32 PNCT patients including 21 benign and 11 malignant patients treated in our hospital from 2003-01 to 2013-02. There were 23 male and 9 female from 0.5 to 66 (36.92 ± 20.17) years of age. We analyzed the clinical information of echocardiography, CT, MRI and operation, and the ifndings were conifrmed by pathology. Results: Statistic analysis presented that there were more male PNCT patients than female, the ratio of male/female in benign patients was 16/5, in malignant patients was 7/4, P<0.05, the age was similar between 2 groups, (38.06 ± 21.68) years vs (35.72 ± 13.55) years,P>0.05, and either infant or adult could suffer from PNCT. Benign PNCT was more in left heart and malignant PNCT was more in right heart. Compared with benign PNCT, malignant lesions were usually no base, with irregular shape, pericardial effusion and surrounding tissue adhesion. Conclusion: Echocardiography was sensitive for diagnosing the patients with PNCT, it could preliminarily identify benign and malignant lesions with different ultrasonographic manifestation.

Objective:To investigate the effects of attention and interpretation therapy on fatigue and sleep quality in patients with gastrointestinal tumor during chemotherapy.Methods:From December 2018 to December 2019, eighty-four patients with gastrointestinal tumor hospitalized in two hospitals (third-grade class-A) in Ningxia were selected as the research objects. According to the random number table, they were divided into the control group and the observation group with 42 cases in each group. Patients in the two groups received routine care. On this basis, the observation group received 10 weeks of attention and interpretation therapy. Cancer patients fatigue scale and Pittsburgh sleep quality index(PSQI) scale were used to evaluate before intervention, 10 weeks after intervention and 3 months after intervention. SPSS 17.0 software was used for statistical analysis. Independent sample t-test and repeated measure analysis of variance were used for comparison between groups. Results:(1) The time effect, inter group effect and interaction effect of fatigue total scores and each dimension score of the two groups were significant (all P<0.01). Further simple effect analysis showed that there were significant differences in the total score and each dimension score of fatigue between the control group and the observation group at 10 weeks after intervention and 3 months after intervention (all P<0.01). (2) The time effect, inter group effect and interaction effect of PSQI total score, sleep quality, sleep time, sleep disorder score were significant (all P<0.01), but the time effect, inter group effect and interaction effect of sleep efficiency, daytime dysfunction and hypnotic drug use score were not significant (all P>0.05). Further simple effect analysis showed that there were significant differences in PSQI total score, sleep quality, sleep time, sleep time and sleep disorder scores between the control group and the observation group 10 weeks after the intervention(PSQI total score (6.83±2.46) vs (10.79±1.01); sleep quality (1.00±0.22) vs (1.24±0.82); sleep time (0.91±0.26) vs (1.40±0.86); sleep time (1.00±0.20) vs (2.02±0.72); sleep disorder (0.79±0.22) vs (1.60±0.59) and 3 months after the intervention(all P<0.01). Conclusion:Attention and interpretation therapy can effectively alleviate the fatigue of gastrointestinal tumor patients during chemotherapy, and improve sleep quality.