Objective:To investigate the efficacy of a 3D printed guide plate in the placement of a hinged external fixator for treatment of elbow terror triad.Methods:A retrospective study was conducted to analyze the data of 10 patients with elbow terror triad who had been treated at Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University from July 2021 to July 2023 by the hinged external fixator placement assisted by a 3D printed guide plate. There were 6 males and 4 females, aged (48.2±19.7) years. The range of elbow motion and visual analogue scale (VAS) pain score in the patients were recorded and compared between preoperation and the last follow-up. Mayo elbow performance score (MEPS) and complications were also recorded at the last follow-up.Results:The central axis of the elbow rotation was successfully located at one time under the assistance of the 3D printed guide plate in the 10 patients. Intraoperative fluoroscopy and postoperative CT computer simulation verified that the rotation center of the hinged external fixator was consistent with that of the elbow joint. All patients were followed up for 12.0 (5.5, 13.5) months. The elbow flexion and extension at the last follow-up in the 10 patients were 126.2°±6.1° and 153.2°±5.9°, respectively, significantly better than those before operation (23.3°±6.7° and 121.2°±5.7°) ( P<0.05). Their VAS pain score was 1 (0, 1) point at the last follow-up, significantly lower than that before operation [3 (2, 3) points] ( P<0.05). Their MEPS score at the last follow-up was (88.0±6.8) points, giving 6 excellent and 4 good cases. No patient experienced such complications as pin tract infection, loosening or breakage of fixation needles, or radial nerve injury. Ectopic ossification occurred in 2 patients, and 1 patient underwent a secondary nerve release due to ulnar nerve symptoms. Conclusion:In the surgical treatment of elbow terror triad, application of a 3D printed guide plate to assist the placement of an external fixator can quickly and accurately locate the central axis of the elbow rotation, which promotes the early functional exercise of the patients to obtain a satisfactory functional prognosis.

Objective:To investigate the effect of nourishing yin and tonifying yang method on inflammatory response and bone metabolism in patients with T2DM complicated with osteoporosis (OP).Methods:A randomized controlled trial. From January 2022 to December 2023,80 patients with T2DM and OP in our hospital were selected as the observation objects, and they were divided into two groups by random number table method, with 40 cases in each group.On the basis of conventional treatment, the control group chewed vitamin D calcium chewable tablets, and the observation group added nourishing yin and tonifying yang Chinese medicine.Both groups were treated for 6 months. TCM syndrome scores were performed before and after treatment ;the levels of fasting blood glucose (FPG), 2 hPG and HbA1c were detected by intelligent blood glucose monitor;the levels of serum neutrophils and lymphocytes were detected by automatic blood analyzer, and the neutrophil/lymphocyte ratio (NLR) was calculated;the levels of serum IL-1β and TNF-α were detected by automatic chemiluminescence analyzer, the levels of type I procollagen amino terminal propeptide (PINP), type I collagen carboxy terminal peptide β special sequence (β-CTX) and 25-hydroxy vitamin D3 [25-(OH)D3] were detected by ELISA;Bone mineral density (BMD) was detected by bone mineral density detector. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 92.5 %(37/40) in the observation group and 75.0 % (30/40) in the control group,the difference between the two groups was statistically significant ( χ2=4.50, P=0.034).After treatment, the scores of soreness and weakness of waist and knees, soreness and pain of waist and back, clear and long urine, pale tongue and white coating in the observation group were lower than those in the control group ( t=3.11, 3.75, 3.51, 3.74, P<0.01);the levels of serum FPG, 2 hPG and HbA1c in the observation group were lower than those in the control group ( t=3.11,3.20,3.39, P<0.01).The levels of serum NLR (2.63 ± 0.68 vs. 3.24 ± 0.79, t=3.70), IL-1β [(81.65 ± 8.30) ng/L vs. (89.03 ± 8.98) ng/L, t=3.82] and TNF-α [(35.14 ± 5.11) μg/L vs. (39.96 ± 5.38) μg/L, t=4.11] in the observation group were lower than those in the control group ( P<0.01). After treatment, the levels of PINP [(29.83 ± 3.92) ng/L vs. (34.02 ± 4.03) ng/L, t=4.71] and β-CTX [(21.30 ± 3.95 ) ng/L vs. (25.32 ± 4.18) ng/L, t=4.42] in the observation group were lower than those in the control group ( P<0.01), the levels of 25-(OH)D3 [(42.86 ± 5.12) μg/L vs. (38.08 ± 4.55) μg/L, t=4.41] and BMD [(0.90 ± 0.18) g/cm 3vs. (0.78 ± 0.16) g/cm 3, t=3.15] were higher than those in the control group ( P<0.01).During the treatment, the incidence of adverse reactions was 12.5% (5/40) in the observation group and 10.0 % (4/40) in the control group,there was no significant difference between the two groups ( χ2=0.13, P=0.723). Conclusion:The method of nourishing yin and tonifying yang can effectively improve the TCM syndromes of T2DM patients with OP, reduce the levels of blood glucose and inflammatory factors, improve bone metabolism, improve clinical efficacy and have good treatment safety.

Objective:To investigate the efficacy of a 3D printed guide plate in the placement of a hinged external fixator for treatment of elbow terror triad.Methods:A retrospective study was conducted to analyze the data of 10 patients with elbow terror triad who had been treated at Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University from July 2021 to July 2023 by the hinged external fixator placement assisted by a 3D printed guide plate. There were 6 males and 4 females, aged (48.2±19.7) years. The range of elbow motion and visual analogue scale (VAS) pain score in the patients were recorded and compared between preoperation and the last follow-up. Mayo elbow performance score (MEPS) and complications were also recorded at the last follow-up.Results:The central axis of the elbow rotation was successfully located at one time under the assistance of the 3D printed guide plate in the 10 patients. Intraoperative fluoroscopy and postoperative CT computer simulation verified that the rotation center of the hinged external fixator was consistent with that of the elbow joint. All patients were followed up for 12.0 (5.5, 13.5) months. The elbow flexion and extension at the last follow-up in the 10 patients were 126.2°±6.1° and 153.2°±5.9°, respectively, significantly better than those before operation (23.3°±6.7° and 121.2°±5.7°) ( P<0.05). Their VAS pain score was 1 (0, 1) point at the last follow-up, significantly lower than that before operation [3 (2, 3) points] ( P<0.05). Their MEPS score at the last follow-up was (88.0±6.8) points, giving 6 excellent and 4 good cases. No patient experienced such complications as pin tract infection, loosening or breakage of fixation needles, or radial nerve injury. Ectopic ossification occurred in 2 patients, and 1 patient underwent a secondary nerve release due to ulnar nerve symptoms. Conclusion:In the surgical treatment of elbow terror triad, application of a 3D printed guide plate to assist the placement of an external fixator can quickly and accurately locate the central axis of the elbow rotation, which promotes the early functional exercise of the patients to obtain a satisfactory functional prognosis.

Objective:To explore the role of static posturography in the assessment of fatigue due to flight tasks.Methods:Thirtymale college students were asked to perform simulated flight tasks consecutively forfour hours.Meanwhile their statie posturography and tasks performance would be repeatedly measured during the task-load at end of every hour.Based on the changed significantly parameters,the static balance index would be built by principle component analysis.Then its correlation with task-load level would be further analyzed by curve estimation.Results:Static postural control declined significantly under effect of simulated flight tasks.With task load sustaining,static balance index increased significantly and correlated linearly with duration of task load (R2=0.949).Besides,there was quadratic relationship between the change of multi-tasks performance and duration of task load (R2=0.968).And correlation of multi-tasks performance with static standing balance level also had been proved to be quadratic (R2=0.976).Conclusions:Static posturography correlated linearly with flight task-load level,which could reflect fatigue level caused by task load.

Objective To apply Windows presentation foundation (WPF) to rapid access and report printing of medical data.Methods Data access was realized by abstracting database to form data structure through entity framework (EF) and mapping datasheet as attribute.Multipage printing was executed by using Flow Document Scroll Viewer as the container and putting contents into different paragraphs with the block element.Results EF of WPF decreased the frequency of database access by the program greatly,and the reaction speed of the program was increased significantly.Flow document could be used for data printing.Conclusion WPF enhances the efficiency of system development and the beauty of man-machine interface,and thus is worthy promoting for medical system and software development.

Objective To verify the simulation effect by the performance of pedal and reaction tasks in aviation emergency simulation on ground and to evaluate the subjects' psychological stress response by heart rate variability (HRV).Methods Twenty-seven male subjects participated in the reaction task,the pedal task and the comprehensive tasks.In pedal task,subjects applied force on pedals with the feedback of force indication and the force curves were recorded.Subjects were asked to respond colored lights of reaction task in defined time (1 s) in reaction task.A safe-level current stimulus was applied on subject's wrist in case of wrong or prolonged response happened.Comprehensive task was the integration of pedal and reaction tasks.ECG signals were recorded at pre-task baselines before the task and in the tasks.The reaction rate,reaction accuracy and the performance of pedal task were all calculated.Results The subjects' reaction rate in the comprehensive tasks was faster than that in the reaction task (t=5.16,P＜0.05),while the accuracy was lower than that in the reaction task (t=1.97,P＜0.05).The performance of pedal force in the comprehensive task was the lowest (t=2.43,P＜0.05).Subjects' heart rate was significantly different among the pre-task,pedal task and comprehensive task (F=42.33,P＜0.05).HR was the lowest in the pre-task and the highest in comprehensive task.Standard deviation of the NN intervals,root mean square of successive difference of the NN intervals had different distribution in 3 tasks (x2 =25.85,38.00,P＜0.05).The high frequency power,low frequency normalized unit and high frequency normalized unit showed significantly different among tasks (x2=19.18,26.96,24.00,P＜0.05).Standard deviation of the NN intervals,root mean square of successive difference of the NN intervals was the highest in pre-task and the lowest in comprehensive task.Conclusions The comprehensive task brings changes on the behavioristics of subjects.The HRV index verifies the raising of subjects' psychological stress in comprehensive task,and the aviation emergency that simulated on ground would induce subjects' fear mood to a certain extent.

Objective To verify the simulation effect by the performance of pedal and reaction tasks in aviation emergency simulation on ground and to evaluate the subjects' psychological stress response by heart rate variability (HRV).Methods Twenty-seven male subjects participated in the reaction task,the pedal task and the comprehensive tasks.In pedal task,subjects applied force on pedals with the feedback of force indication and the force curves were recorded.Subjects were asked to respond colored lights of reaction task in defined time (1 s) in reaction task.A safe-level current stimulus was applied on subject's wrist in case of wrong or prolonged response happened.Comprehensive task was the integration of pedal and reaction tasks.ECG signals were recorded at pre-task baselines before the task and in the tasks.The reaction rate,reaction accuracy and the performance of pedal task were all calculated.Results The subjects' reaction rate in the comprehensive tasks was faster than that in the reaction task (t=5.16,P＜0.05),while the accuracy was lower than that in the reaction task (t=1.97,P＜0.05).The performance of pedal force in the comprehensive task was the lowest (t=2.43,P＜0.05).Subjects' heart rate was significantly different among the pre-task,pedal task and comprehensive task (F=42.33,P＜0.05).HR was the lowest in the pre-task and the highest in comprehensive task.Standard deviation of the NN intervals,root mean square of successive difference of the NN intervals had different distribution in 3 tasks (x2 =25.85,38.00,P＜0.05).The high frequency power,low frequency normalized unit and high frequency normalized unit showed significantly different among tasks (x2=19.18,26.96,24.00,P＜0.05).Standard deviation of the NN intervals,root mean square of successive difference of the NN intervals was the highest in pre-task and the lowest in comprehensive task.Conclusions The comprehensive task brings changes on the behavioristics of subjects.The HRV index verifies the raising of subjects' psychological stress in comprehensive task,and the aviation emergency that simulated on ground would induce subjects' fear mood to a certain extent.

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI ＜ 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI ＞ 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P ＜ 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P ＜ 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P ＜ 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P ＜ 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83％, 47.80％, 28.40％, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.

Purpose To investigate 1H-MRS in differentiating intracranial lymphoma from tumor-like demyelinating lesions. Materials and Methods Thirty-three cases of intracranial lymphoma confirmed by pathology and 18 cases of tumor-like demyelinating lesions confirmed by pathology or clinic were recruited in this study. Imaging data including single-voxel (TE=144 ms) 1H-MRS was retrospective analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and lactate peak was visually categorized into 5 grades based on the ratio of Lip-Lac peak to the height of the Cr peak. 1H-MRS findings of the intracranial lymphoma and the tumor-like demyelinating lesions were compared. The differentiation of the two diseases diagnosed by 1H-MRS and conventional MR were evaluated by use of receiver operating characteristic curves. Results There were significant difference of Cho/Cr, Cho/NAA ratio and Lip-Lac peak level between the intracranial lymphoma and tumor-like demyelinating lesions (P<0.001). It was more likely to be intracranial lymphoma when Cho/Cr ratio was>2.56, Cho/NAA ratio was>1.71, and Lip-Lac peak grade was>3. Cho/Cr, Cho/NAA ratio and Lip-Lac peak grade were found higher in atypical intracranial lymphomas when compared with those of tumor-like demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was increased from 0.827 to 0.870 when Cho/NAA ratio was added for analysis in the 28 uncertain cases. Conclusion 1H-MRS has great clinical significance for differentiating intracranial lymphoma from tumor-like demyelinating lesions. The values of Cho/Cr ratio>2.56, Cho/NAA ratio>1.71 and Lip-Lac grade >3 suggest intracranial lymphoma rather than TDLs. When the conventional MR imaging features can not do the differentiation, Cho/NAA ratio is a useful complement.

OBJECTIVETo investigate the distribution and expression of transforming growth factor beta (TGF-β) receptors I and II, p38 mitogen-activated protein kinase (p38 MAPK), and type I and type III collagen in the lungs of rats with silicosis and cultured pulmonary fibroblasts, and to investigate the relationship of the anti-fibrosis effect of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) with its inhibition of TGF-β receptor-mediated p38 MAPK pathway activity.

METHODSRats were randomly divided into control group, silicosis model group, and AcSDKP treatment group (n = 10 for each group). For the model group and AcSDKP treatment group, rats were intratracheally instilled with silica to establish a silicosis model. Cultured pulmonary fibroblasts from neonatal rats were divided into control group, TGF-β1 stimulation group, TGF-β receptor inhibition group, p38 MAPK pathway inhibition group, and AcSDKP treatment group. The protein expression of TGF-β receptors I and II, p38 MAPK, and type I and type III collagen were determined by immunohistochemistry and Western blot. The mRNA expression of TGF-β receptors I and II were determined by real-time PCR. The distribution and nuclear translocation of phospho-p38 MAPK in cultured fibroblasts were determined by laser scanner confocal microscopy.

RESULTSIn the AcSDKP treatment group, AcSDKP reduced the expression of TGF-β receptors I and II, phospho-p38 MAPK, and type I and type III collagen to 86.12%, 41.01%, 42.63%, 89.05%, and 52.71%, respectively, of those of the silicosis model group (P < 0.05). In cultured fibroblasts, AcSDKP reduced the mRNA expression of TGF-β receptors I and II to 42.26% and 54.33%, respectively, of those of the TGF-β1 stimulation group; the protein expression of TGF-β receptors I and II, phospho-p38 MAPK, and type 1 and type III collagen was reduced to 58.14%, 51.40%, 45.6%, 58.04%, and 44.74%, respectively, of those of the TGF-β1 stimulation group. The phospho-p38 MAPK translocation from plasma to the nucleus was also inhibited; the nucleus/plasma ratio of p38 MAPK and the protein expression of type I and type III collagen were reduced to 68.60%, 58.04%, and 44.74%, respectively, of those of the TGF-β stimulation group (P < 0.05).

CONCLUSIONAcSDKP can inhibit the expression of collagen through inhibition of TGF-β receptor-mediated p38 MAPK pathway activity, and is thus able to exert anti-fibrosis effect in rats with silicosis.

Animals ; Cells, Cultured ; Collagen ; metabolism ; Disease Models, Animal ; Fibroblasts ; drug effects ; metabolism ; MAP Kinase Signaling System ; drug effects ; Male ; Oligopeptides ; pharmacology ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Rats, Wistar ; Receptors, Transforming Growth Factor beta ; metabolism ; Silicosis ; metabolism ; Transforming Growth Factor beta ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism