Pedicle screw fixation is biomechanically most reliable for reconstruction of the cervical spine, which can ef?fectively restore cervical sagittal profiles, provide rigid fixation and higher fusion rate. Because of the large individual differ?ences in cervical pedicle, vertebral artery and nerve root, preoperative evaluation should be individualized. Cervical pedicle screw techniques include freehand technique and the computer-assisted navigation technology developed recently. Although complications associated with cervical pedicle screw fixation cannot be completely obviated, they can be minimized by com?bination of sufficient preoperative imaging studies of the pedicles and meticulous surgical techniques of screw placement. Cervical pedicle screw fixation techniques have been used in the treatment of various cervical disorders, with fewer complica?tions and good clinical efficacy, and a wide range of clinical applications.

ObjectiveTo investigate the changes of serum growth hormone (GH)/insulin-like growth factor- Ⅰ ( IGF- Ⅰ ) in patients with traumatic long bone fractures and the related clinical significance.MethodsTwenty-one patients with traumatic long bone fractures from the same trauma care center treated between November 2009 and April 2010 were enrolled in the study..There were 14 males and 7 females,at age range of 22-60 years (mean 45.0 years).Seventeen patients (81％) were with closed trauma and four ( 19％ ) with open trauma.Enzyme Linked Immunoadsorbent Assay (ELISA) was used to determine the levels of serum GH and IGF- Ⅰ within 14 days after fractures and the relationship between changes of GH-IGF- Ⅰ axis and injury severity score (ISS) was further analyzed.Eight patients with normal GH/IGF- Ⅰ were set as control group.ResultsThe GH level in the peripheral blood was significantly higher at day 1 after fractures ( P ＜ 0.05 ),and rapidly declined and stabilized at day 5 compared with the control group.The GH level in the patients with ISS≥ 18 points was sigmficantly higher than that in those with ISS＜18 points at day 1 after fractures (P＜0.05).The IGF- Ⅰ level in the peripheral blood in the patients with 1SS≥ 18 points was significantly higher than that in those with ISS ＜ 18 points at days 5-10 after fractures ( P ＜ 0.05 ).ConclusionThe hypothalamus GH-IGF- Ⅰ axis plays an important role in early metabolism and fracture healing during the acute phase of traumatic long bone fractures.

Objective To treat complex fractures of the proximal tibia with the hybrid external fixation and internal fixation and to evaluate their efficiency. Methods During January 2000 to January 2005, 69 patients with complex proximal tibia fractures received operation in our hospital, which included Schatzker types Ⅳ(17 cases), Ⅴ(14 cases) and Ⅵ(9 cases) and AO A3 type 27 cases, and 2 amputation. The average age was 39 years(range from 18 to 74 years). Among them, 19 open fractures and 21 closed fractures were operated with hybrid external skeleton fixation(HESF) combined limited internal fixation, the others were treated by open reduction and internal fixation (ORIF). Results All the patients were followed from 6 months to 5 years(mean, 25 months), in the HESF group the average time of operation was 2.66 h, the bleeding in operation was 170.50 ml, while ORIF group was 3.33 h and 285.19 ml, the amount healing time of HESF group was 16.40 weeks, while the ORIF groups was 12.37 weeks; there were no deep infectious and skin necrosis patients in the HESF group. According to the HSS score system, there were excellent 31, good 5, fair 3 and bad 1 case, the rate of excellent and good was 90%. In the ORIF group, there were 1 deep infectious and 2 skin necrosis patients, 6 cases were malunion, 2 cases were nonunion. There were excellent 5, good 12, fair 7, bad 3 cases, the rate of excellent and good was 63%; and there were significantly difference between the two groups(u=219, P

0.05), but radioactivity counting ratio of before and 2 years after operation wassignificantly lower than operation after 1-12 months (P 0.05). CONCLUSION: Automated ROI setting findings show that moderate load-bearing for patients with femoral neck fracture is favor to femur neck fracture healing and bone reconstruction.

As the new development of scientometrics and informetrics, knowledge graph has infiltrated into the financial, industrial and medical fields, and become a hot issue in the real world research. In this article, the concept and features of knowledge graph, construction and the existing softwares, the application status and development prospect in the TCM field were reviewed, which may provide references for research on the knowledge graph in the TCM field.

BACKGROUND: Establishment of individual femoral model can describe the stereochemical structure of femoral accurately,which is conductive to measuring femoral anatomic forms. This model possesses unified standard, and removing the potential confounding factors, thus, it is more suitable for biomechanical test.OBJECTIVE: To explore a method for establishing an accurate individual femoral model.METHODS: A male, healthy, volunteer was selected from General Hospital of Tianjin Medical University, and the cross section of femur was successive scanned by 16 slice CT. In accordance with Dicom 3.0 standard, the CT image was reconstructed using Mimics software to establish the space model, and UG software was used to type on the workpiece, and cimatron software was used to sort, then set the coordinate system of computer numerical control machining, clamp and correct the workpiece to produce mold toolpath, so the mold was established. The femur model made by mould was compared with the femur by the method of point cloud.RESULTS AND CONCLUSION: An individual femur model was produced. The comparison results of point cloud showed that error was in allowing range. This is an advisable method to make a femoral model, which can achieve predetermined requirement.

BACKGROUND:At present,there are many established femoral finite element studies,but previous studies focused on femoral biomechanics of the outside are few.OBJECTIVE:To establish three-dimensional finite element model of structure of the proximal femur,and to analyze its biomechanics in normal standing position to provide reasonable evidence for clinical application.DESIGN,TIME AND SETTING:A three-dimensional finite element model analysis was performed in General Hospital of Tianjin Medical University from December 2008 to April 2009.PARTICIPANTS:One male volunteer aged 30 years was enrolled at General Hospital of Tianjin Medical University.Femur lesion or injury was excluded by means of X-ray.METHODS:The primitive femur CT data were adopted according to Dicom 3.0 standard in Mimics so as to obtain the primitive three-dimensional femur model which was established via threshold defining,region enlarging and morphological performing.The primitive model was remeshed and combined with ANSYS software to create a final finite-element model.The model obtained by using the Mimics was loaded with 200 N vertical loading to check out the difference of the stress distribution.MAIN OUTCOME MEASURES:Using 200 N as the external load in the vertical direction,the Vonmises stress distribution of the femur was detected.RESULTS:The applications of Mimics and Ansys software could create a finite element model of proximal femur.It was found that the correspondent relationship between stress and structure in proximal femur was verified.CONCLUSION:Mimics can build more three-dimensional finite element models in line with the proximal femoral mechanical structure and mechanical properties.The mechanical properties of the femur are more credible,and the results of the analysis support the clinical application of the guidance.

Objective To provide a theoretical basis for the pulmonary enteric therapy in treating intestinal dysbacteriosis complicating allergic asthma according to the traditional theory of Lung and Large intestine are interiorly-exteriorly.Methods The experiment included the blank group,model group,positive control group and three kinds of traditional Chinese medicine compound administration group;the intestinal dysbacteriosis in SD rats was duplicated by adopting cefoperazone and candida albicans gavage.On this basis ovalbumin injection sensitization and nebulization were applied to induce asthma.Meanwhile Jia-Wei-ShengJiang Powder(SJS),Guizhi-Jia-Houpu-Xingzi Decoction(GHX) and Zeng-Ye-Cheng-Qi Decoction(ZYCQ) were orally administered for treatment of lung-intestine combine therapy,lung therapy and intestine therapy.The respiratory function was analyzed by using the Buxco whole body plethysmography.The variety of intestinal flora were analyzed by using 16SrDNA.Results Analyzing the specieces composition of intestinal flora in each group by the OUT value found that the recovery of Lactobacillus in each group was close to that in the blank group and better than that in the positive group,meanwhile,3 treatment groups all could promote the recovery of Proteobacteria and bacteroidetes,but the lung-intestine combine therapy had optimal effect,the Alpha diversity analysis found that the intestinal microflora diversities from high to low were in turn the intestinal therapy group,lung therapy group,lungintestine combined therapy group and model group;the respiratory frequency and airway hyperreactivity in the model group was 260.56(1.28),which in the lung-intestine combined therapy group,lung therapy and intestine therapy after treatment were 141.79 (0.93),137.25 (1.30) and 203.16 (0.84) respectively,the rat respiratory frequency in each treatment group was lower than that in the model group,while the airway hyperreactivity only in the lung-intestine combined therapy group and intestinal therapy group was lower than that in the model group,moreover showing statistical significance.Conclusion The lung-intestine combine therapy method for treating rat intestinal dysbacteriosis complicating allergic asthma is superior to simple lung therapy method or intestine therapy method.

Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42％-57％.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.

Objective To investigate the relationship between the MR findings of lumbar elements and chronic low back pain(CLBP).Methods The patients underwent lumbar MRI examinations and sent for a questionnaires of low back pain (LBP).Among them,139 patients whose questionnaires illustrated with CLBP were enrolled.The enrolled patients included 68 patients with nerve roots compression and 71 patients without.Meanwhile,198 hospital staffs underwent lumbar MRI examinations and were sentfor a LBP questionnaire.Among them,62 patients without LBP and nerve roots compression were enrolled.Categorical regression was used to analyze the relationship between MR findings and CLBP.The MR findings iucluded nerve roots compression,average disk degeneration scores(ADD),high-intensity zones (HIZ),Schmorlnodes,Modic Ⅰ change,average facet joints degeneration scores(AZZ),facet joint effusion,high T2 signal in interspinous ligament and subcutaneousparaspinal muscles edema.The regression model was used to analyze the MR imaging and CLBP.Results The regression model was statistically significant (F=9.478,P＜0.01).All predictors yielded an adjusted value was 0.446.Among all predictors,nerve roots compression,ADD,AZZ,subcutaneous or paraspinal muscles edema were statistically associated with the VAS degree (P＜0.05).The sum of the importance of the four predictors above was 0.983.The quantification of predicted VAS degree increased as ADD level increased.The quantification of predicted VAS degree increased to the top at the 2 AZZ level and then decreased.Nerve roots compression and Subcutaneous or paraspinal muscles edema yielded higher quantification of predicted VAS degree level.Conclusion ADD,AZZ,subcutaneousparaspinal muscles edema were probably associated with CLBP degree after adjusting for nerve roots compression.