OBJECTIVE: To explore the advantages and effectiveness of the independently developed intelligent orthopedic robot-assisted distal locking of femoral intramedullary nails. METHODS: Thirty-two adult cadaveric femur specimens were randomly divided into two groups, with 16 specimens in each group. The experimental group used the intelligent orthopedic robot to assist in the distal locking of femoral intramedullary nail holes, while the control group used the traditional method of manual locking under X-ray fluoroscopy. The locking time, fluoroscopy times, and the success rate of first locking were recorded and compared between the two groups. RESULTS: The locking time of the experimental group was (273.94±38.67) seconds, which was shorter than that of the control group [(378.38±152.72) seconds], and number of fluoroscopies was (4.56±0.81) times, which was less than that of the control group [(8.00±3.98) times]. The differences were significant [ MD=73.054 (-37.187, 85.813), P=0.049; MD=1.969 (-1.437, 2.563), P=0.002]. The first locking success rate of the experimental group was 100% (16/16), which was significantly higher than that of the control group (68.75%, 11/16) ( P=0.043). CONCLUSION The efficiency of distal locking of femoral intramedullary nails assisted by the intelligent orthopedic robot is significantly higher than that of the traditional manual locking method under fluoroscopy, as it can markedly reduce the time required for distal locking of femoral intramedullary nails, decrease intraoperative radiation exposure, and increase the success rate of locking.
Humans ; Fracture Fixation, Intramedullary/instrumentation* ; Bone Nails ; Fluoroscopy ; Femur/diagnostic imaging* ; Femoral Fractures/surgery* ; Robotic Surgical Procedures/instrumentation* ; Cadaver ; Adult ; Robotics ; Male

Objective:To explore the clinical application value of the dual-layer detector spectral CTA in evaluation of brain perfusion impairment in patients with acute ischemic stroke.Methods:Clinical and imaging data of 35 patients with acute ischemic stroke in Weihai Central Hospital from March 2020 to October 2020 were reviewed retrospectively. All patients underwent head and neck spectral CTA examination and dynamic cerebral perfusion CT examination with dual-layer detector spectral CT. The iodine density map and effective atomic number map were reconstructed using CTA data, and the iodine density and effective atomic number, as well as the cerebral blood volume (CBV) and cerebral blood flow (CBF) values of the hypoperfusion area and the contralateral side were measured and compared; the areas of brain hypoperfusion regions were measured. Pearson′s correlation coefficient was used to analyze the correlation between iodine density values and CBV values, iodine density values and CBF values, effective atomic number values and CBV values, effective atomic number values and CBF values, as well as hypoperfusion area shown on CTA images and displayed on CTP-CBF map.Results:Of all the 35 patients, the iodine density value [(0.22±0.07) mg/ml], effective atomic number value (7.38±0.05), CBV value [(1.9±0.7) ml/100 g] and CBF value [(15.1±5.9) ml/(100 g·min)] of the hypoperfusion area were significantly lower than those of the healthy side [iodine density value (0.44±0.10) mg/ml, effective atomic number value (7.52±0.06), CBV value (3.4±0.7) ml/100 g, CBF value (57±27) ml/(100 g·min); t values were -14.7, -14.5, -11.2, -9.7, respectively, all P<0.001]. No significant difference was found between the hypoperfusion area shown on spectral CTA [(2 292±1 393) mm 2] and shown on CTP-CBF map [(2 290±1 359) mm 2] ( t=-0.076, P=0.944). There was a positive correlation between iodine density value and CBV (affected side: r=0.350, P=0.039, healthy side: r=0.551, P=0.001); a positive correlation was also found between effective atomic number value and CBV (affected side: r=0.488, P=0.003, healthy side: r=0.552, P=0.001); and there was a strong positive correlation between the hypoperfusion area on CTA and that on CTP-CBF ( r=0.993, P<0.001). Conclusion:Dual-layer detector spectral CTA can provide the “one-stop” assessement including head and neck vascular evaluation, as well as the hypoperfution area measument, which can be an alternative rapid method for evaluation of patients with acute ischemic stroke.

Objective To explore the more than 80-year-old age patients laparoscopic cholecystectomy clinical curative effects and complications.Methods More than 260 cases of 80-year-old require cholecystectomy older patients,patients with detailed records related history,select one of the 200 patients with laparoscopic cholecystectomy to treatment,the rest of the 60 patients to do open cholecystectomy treatment,to observe the clinical curative effect of the two groups ; For patients with laparoscopic group in postoperative patients according to whether there was the occurrence of complications were divided into two groups,using multiple factors regression analysis the factors caused by complications.Results Laparoscopic surgery group blood loss,operative time,length of hospital stay,drainage time,lead flow,the surgical incision length were (62.7 ± 60.3) ml,(62.7 ± 21.4) ml,(5.6 ± 1.3) d,(3.6 ± 0.7) d,(174.4 ± 121.4)ml,(4.9 ± 1.2)cm,open group were (210.4 ± 120.4)ml,(115.7 ±30.4)ml,(8.8 ±3.4)d,(6.2 ± 2.5) d,(318.2 ± 132.5) ml,(12.2 ± 1.4) cm,two groups of various observation indexes were statistically significant differences (t =3.16,4.16,2.18,3.16,2,56,5.18,P ＜ 0.05).Laparoscopic cholecystectomy patients in 200 cases of 6 patients with complications (3.0％),single factor analysis results showed that:age,diabetes history,operation time and blood loss,drainage laparoecopic cholecystectomy complications had a correlation (P ＜ 0.05) ;Multiple factors analysis results showed that:with the age increasing,diabetes history was laparoscopic cholecystectomy complications independent risk factor (P ＜ 0.05).Conclusion For age more than 80 years patients,laparoscopic cholecystectomy down than open surgery has good curative effect,its complications are the main factors for increased age and always have diabetes history.