BACKGROUND:Transoral ventral release and posterior fusion have predominated in the treatment of irreducible atlantoaxial dislocation, but there is no consistent conclusion on the clinical efficacy.
OBJECTIVE:To explore the clinical outcomes of transoral ventral release and posterior fusion and screw/rod implantation in the treatment of irreducible atlantoaxial dislocation.
METHODS:A total of 32 patients with irreducible atlantoaxial dislocation undergoing thetransoral ventral release and posterior fusion were selected. After treatment, they received cervical anteroposterior and lateral digital DR and cervical MRI examinations to understand the conditions of nerve compression and bone fusion. The recovery of nerve function was evaluated using Japanese Orthopaedic Association before treatment, 6 months after treatment and during final fol ow-up.
RESULTS AND CONCLUSION:Post-treatment, 29 patients were fol owed-up for an average period of 12 months. (1) Al the patients obtained perfect atlantoaxial joint reduction and bone fusion. This achieved reduction and reconstruction of spinal column stability. (2) Spinal compression was obviously lessened after treatment in al patients, and nerve functions were improved to different degrees. Significant differences in Japanese Orthopaedic Association score were detected between 6 months post-treatment, final fol ow-up and pre-treatment (P<0.05). (3) There were no serious intraoperative complications such as spinal cord or vertebral artery injuries. Postoperative complications such as infection or burst were also not found. (4) Imaging evaluation revealed that transoral ventral release and posterior fusion is safe and effective for treatment of irreducible atlantoaxial dislocation.

Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.

Objective To provide a theoretical basis for radiation health supervision through an analysis of the situation of computed tomography (CT) equipment quality control and CT room radiological protection in Guangdong Province, China in recent years. Methods We collected the data of 392 times of CT quality control and radiological protection testing by a third-party radiological health technical service institution in Guangdong Province from 2019 to 2021. We analyzed the levels of CT-owning hospitals, CT manufacturers, CT quality control test results, and the pass rate of radiation protection tests. Results The examined CT scanners were from different levels of hospitals in Guangdong Province, and were manufactured by nine major CT equipment manufacturers at home and abroad. The pass rate of CT room radiological protection was 99.88%, and the ambient dose equivalent rates of five monitoring points exceeded the limit, with four at the control room door and one at the shield wall of the room. The overall pass rate of CT equipment quality control was 99.49%, and the non-conforming parameters were the accuracy of positioning light and the deviation of reconstructed slice thickness. Conclusion In recent years, CT equipment quality control and room radiation protection in Guangdong Province have been at a high level.

Objective: To construct and confirm a predictive model for the risks of cardiovascular diseases (CVD) with metabolic syndrome (MS) and its factors in Xinjiang Kazakh population. Methods: A total of 2 286 Kazakh individuals were followed for 5 years from 2010 to 2012 as baseline survey. They were recruited in Xinyuan county, Yili city, Xinjiang. CVD cases were identified via medical records of the local hospitals in 2013, 2016 and 2017, respectively. Factor analysis was performed on 706 MS patients at baseline, and main factors, age, and sex were extracted from 18 medical examination indexs to construct a predictive model of CVD risk. After excluding the subjects with CVD at baseline and incomplete data, 2007 were used as internal validation, and 219 Kazakhs in Halabra Township were used as external validation. Logistic regression discriminations were used for internal validation and external validation, as well as to calculate the probability of CVD for each participant and receiver operating characteristic curves. Results: The prevalence of MS in Kazakh was 30.88%. Seven main factors were extracted from the Kazakh MS population, namely obesity factor, blood lipid and blood glucose factor, liver function factor, blood lipid factor, renal metabolic factor, blood pressure factor, and liver enzyme factor. The area under the curve (AUC) for predicting CVD in the internal validation was 0.773 (95%CI 0.754-0.792). In the external validation, the AUC for predicting CVD was 0.858 (95%CI 0.805-0.901). Conclusions The CVD risk prediction model constructed by 7 main factors extracted from Kazakh MS patients has high validation efficiency and can be used for risk assessment of CVD in Xinjiang Kazakh population.