Objective To explore the diagnostic value of ultrasonography in ischiofemoral impinge-ment syndrome(IFI).Methods Fifty-six patients who underwent hip MRI with confirmed IFI diagnosis and completed ultrasonography examinations were enrolled as the IFI group,including 44 females and 12 males.Twenty healthy volunteers were concurrently recruited as the control group,consisting of 10 females and 10 males.The control group underwent ultrasonography examinations of bilateral hip joints,whiletheischialfemoralspace(IFS)andquadratusfemoristhickness(QFT)of both groups were measured and recorded.Then measurements were compared within(by laterality and gender)and between the two groups using independent-samples t-tests.Moreover,receiver operating characteristic adults,males exhibited significantly higher IFS and QFT values than females(P<0.05).Within the IFI group,males with affected hips had significantly higher IFS than females(P<0.05),while no sig-nificant differences were observed in QFT between different genders(P>0.05).Moreover,affected hips in the IFI group showed significantly narrower IFS and thicker QFT compared to both contralateral hips and the control group(P<0.001).In addition,the diagnostic cut-off values of IFS and QFT for ultrasound diagnosis of IFI were 22.93 mm and 16.48 mm,respectively.At these thresholds,the ar-eas under the curve(AUC)were 0.997 and 0.977,with sensitivities of 97.8%and 91.8%,and speci-ficities of 98.4%and 97.8%,respectively.Conclusion Ultrasound can serve as a reliable diagnostic technique for IFI,where narrowing of the IFS and thickening of the QFT should raise suspicion of this condition.

Objective To explore the diagnostic value of ultrasonography in ischiofemoral impinge-ment syndrome(IFI).Methods Fifty-six patients who underwent hip MRI with confirmed IFI diagnosis and completed ultrasonography examinations were enrolled as the IFI group,including 44 females and 12 males.Twenty healthy volunteers were concurrently recruited as the control group,consisting of 10 females and 10 males.The control group underwent ultrasonography examinations of bilateral hip joints,whiletheischialfemoralspace(IFS)andquadratusfemoristhickness(QFT)of both groups were measured and recorded.Then measurements were compared within(by laterality and gender)and between the two groups using independent-samples t-tests.Moreover,receiver operating characteristic adults,males exhibited significantly higher IFS and QFT values than females(P<0.05).Within the IFI group,males with affected hips had significantly higher IFS than females(P<0.05),while no sig-nificant differences were observed in QFT between different genders(P>0.05).Moreover,affected hips in the IFI group showed significantly narrower IFS and thicker QFT compared to both contralateral hips and the control group(P<0.001).In addition,the diagnostic cut-off values of IFS and QFT for ultrasound diagnosis of IFI were 22.93 mm and 16.48 mm,respectively.At these thresholds,the ar-eas under the curve(AUC)were 0.997 and 0.977,with sensitivities of 97.8%and 91.8%,and speci-ficities of 98.4%and 97.8%,respectively.Conclusion Ultrasound can serve as a reliable diagnostic technique for IFI,where narrowing of the IFS and thickening of the QFT should raise suspicion of this condition.

Objective:To compare the efficacy of ultrasound volume navigation (UVN) and that of O-arm navigation in the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation.Methods:A retrospective study was conducted to analyze the clinical data of 29 patients with thoracolumbar vertebral fracture who had been treated with percutaneous pedicle screw fixation at Department Ⅰ of Minimally Invasive Spinal Surgery, Luoyang Orthopedic Hospital from January 2022 to June 2023. The patients were assigned into 2 groups according to different navigation methods. In group UVN of 17 cases, there were 14 males and 3 females with a mean age of 50.0 (44.0, 53.5) years, and the pedicle screw fixation was guided by UVN; in group O-arm of 12 cases, there were 10 males and 2 females with an age of (40.6±11.1) years, and the pedicle screw fixation was guided by O-arm navigation. The 2 groups were compared in terms of insertion time per screw, total dose of intraoperative radiation, radiation dose per screw, accuracy of screw placement, rate of facet joint violation, and visual analogue scale (VAS) pain scores for lumbar pain at postoperative 1, 3, and 6 months.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). There was no statistically significant difference in the insertion time per screw between group UVN and group O-arm [(13.2±1.3) min versus (14.1±1.3) min] ( P>0.05). The total dose of intraoperative radiation and radiation dose per screw in group UVN [(1.80±0.54) mSv and (0.41±0.10) mSv] were significantly lower than those in group O-arm [(3.52±0.33) mSv and (0.85±0.11) mSv] ( P<0.05). The accuracy of screw placement and rate of facet joint violation in group UVN [94.7% (71/75) and 17.6% (3/17)] were not significantly different from those in group O-arm [92.2% (47/51) and 8.3% (1/12)]] ( P>0.05). The VAS score at postoperative 1 month in group UVN [4.0 (3.5, 5.0) points] was significantly lower than that in group O-arm [5.0 (5.0, 6.0) points] ( P<0.05). There were no statistically significant differences between the 2 groups in the VAS pain scores at postoperative 3 and 6 months ( P>0.05). Conclusions:In the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation, screw placement guided by UVN is as time-saving, intuitive, and accurate as that guided by O-arm navigation. However, UVN is better than O-arm navigation in radiation avoidance and pain relief.

Objective:To compare the efficacy of ultrasound volume navigation (UVN) and that of O-arm navigation in the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation.Methods:A retrospective study was conducted to analyze the clinical data of 29 patients with thoracolumbar vertebral fracture who had been treated with percutaneous pedicle screw fixation at Department Ⅰ of Minimally Invasive Spinal Surgery, Luoyang Orthopedic Hospital from January 2022 to June 2023. The patients were assigned into 2 groups according to different navigation methods. In group UVN of 17 cases, there were 14 males and 3 females with a mean age of 50.0 (44.0, 53.5) years, and the pedicle screw fixation was guided by UVN; in group O-arm of 12 cases, there were 10 males and 2 females with an age of (40.6±11.1) years, and the pedicle screw fixation was guided by O-arm navigation. The 2 groups were compared in terms of insertion time per screw, total dose of intraoperative radiation, radiation dose per screw, accuracy of screw placement, rate of facet joint violation, and visual analogue scale (VAS) pain scores for lumbar pain at postoperative 1, 3, and 6 months.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). There was no statistically significant difference in the insertion time per screw between group UVN and group O-arm [(13.2±1.3) min versus (14.1±1.3) min] ( P>0.05). The total dose of intraoperative radiation and radiation dose per screw in group UVN [(1.80±0.54) mSv and (0.41±0.10) mSv] were significantly lower than those in group O-arm [(3.52±0.33) mSv and (0.85±0.11) mSv] ( P<0.05). The accuracy of screw placement and rate of facet joint violation in group UVN [94.7% (71/75) and 17.6% (3/17)] were not significantly different from those in group O-arm [92.2% (47/51) and 8.3% (1/12)]] ( P>0.05). The VAS score at postoperative 1 month in group UVN [4.0 (3.5, 5.0) points] was significantly lower than that in group O-arm [5.0 (5.0, 6.0) points] ( P<0.05). There were no statistically significant differences between the 2 groups in the VAS pain scores at postoperative 3 and 6 months ( P>0.05). Conclusions:In the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation, screw placement guided by UVN is as time-saving, intuitive, and accurate as that guided by O-arm navigation. However, UVN is better than O-arm navigation in radiation avoidance and pain relief.

OBJECTIVE: To explore the feasibility and accuracy of ultrasound volume navigation (UVN) combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation through a prospective randomized controlled study. METHODS: Patients with thoracic and lumbar vertebral fractures scheduled for percutaneous pedicle screw fixation between January 2022 and January 2023 were enrolled. Among them, 60 patients met the selection criteria and were included in the study. There were 28 males and 32 females, with an average age of 49.5 years (range, 29-60 years). The cause of injury included 20 cases of traffic accidents, 21 cases of falls, 17 cases of slips, and 2 cases of heavy object impact. The interval from injury to hospital admission ranged from 1 to 5 days (mean, 1.57 days). The fracture located at T ₁₂ in 15 cases, L ₁ in 20 cases, L ₂ in 19 cases, and L ₃ in 6 cases. The study used each patient as their own control, randomly guiding pedicle screw implantation using UVN combined with X-ray fluoroscopy on one side of the vertebral body and the adjacent segment (trial group), while the other side was implanted under X-ray fluoroscopy (control group). A total of 4 screws and 2 rods were implanted in each patient. The implantation time and fluoroscopy frequency during implantation of each screw, angle deviation and distance deviation between actual and preoperative planned trajectory by imaging examination, and the occurrence of zygapophysial joint invasion were recorded. RESULTS: In terms of screw implantation time, fluoroscopy frequency, angle deviation, distance deviation, and incidence of zygapophysial joint invasion, the trial group showed superior results compared to the control group, and the differences were significant ( P<0.05). CONCLUSION UVN combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation can yreduce screw implantation time, adjust dynamically, reduce operational difficulty, and reduce radiation damage.
Male ; Female ; Humans ; Middle Aged ; Pedicle Screws ; Prospective Studies ; X-Rays ; Surgery, Computer-Assisted/methods* ; Spinal Fusion/methods* ; Fluoroscopy/methods* ; Lumbar Vertebrae/injuries*

OBJECTIVE: To compare the effectiveness of O-arm navigation and ultrasound volume navigation (UVN) in guiding screw placement during minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery. METHODS: Sixty patients who underwent MIS-TLIF surgery for lumbar disc herniation between June 2022 and June 2023 and met the selection criteria were included in the study. They were randomly assigned to group A (screw placement guided by UVN during MIS-TLIF) or group B (screw placement guided by O-arm navigation during MIS-TLIF), with 30 cases in each group. There was no significant difference in baseline data, including gender, age, body mass index, and surgical segment, between the two groups ( P>0.05). Intraoperative data, including average single screw placement time, total radiation dose, and average single screw effective radiation dose, were recorded and calculated. Postoperatively, X-ray film and CT scans were performed at 10 days to evaluate screw placement accuracy and assess facet joint violation. Pearson correlation and Spearman correlation analyses were used to observe the relationship between the studied parameters (average single screw placement time and screw placement accuracy grading) and BMI. RESULTS: The average single screw placement time in group B was significantly shorter than that in group A, and the total radiation dose of single segment and multi-segment and the average single screw effective radiation dose in group B were significantly higher than those in group A ( P<0.05). There was no significant difference in the total radiation dose between single segment and multiple segments in group B ( P>0.05), while the total radiation dose of multiple segments was significantly higher than that of single segment in group A ( P<0.05). No significant difference was found in the accuracy of screw implantation between the two groups ( P>0.05). In both groups, the grade 1 and grade 2 screws broke through the outer wall of the pedicle, and no screw broke through the inner wall of the pedicle. There was no significant difference in the rate of facet joint violation between the two groups ( P>0.05). In group A, both the average single screw placement time and screw placement accuracy grading were positively correlated with BMI ( r=0.677, P<0.001; r=0.222, P=0.012), while in group B, neither of them was correlated with BMI ( r=0.224, P=0.233; r=0.034, P=0.697). CONCLUSION UVN-guided screw placement in MIS-TLIF surgery demonstrates comparable efficiency, visualization, and accuracy to O-arm navigation, while significantly reducing radiation exposure. However, it may be influenced by factors such as obesity, which poses certain limitations.
Humans ; Imaging, Three-Dimensional ; Lumbar Vertebrae/surgery* ; Minimally Invasive Surgical Procedures ; Pedicle Screws ; Retrospective Studies ; Spinal Fusion ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Treatment Outcome

Background The health and safety climate of workplace has an important impact on the physical and mental health of workers. There is no available scale for the evaluation of workplace health and safety climate in China at present. Objective This study aims to sinicize and evaluate the reliability and validity of the Health and Safety Climate Survey. Methods The English version of Health and Safety Climate Survey was translated to Chinese and back-translated to English, and followed by expert evaluation to develop a Chinese version. Quota sampling method was used to select 2600 employees from 16 enterprises and public institutions in Pudong New Area of Shanghai and to evaluate the reliability and validity of the Chinese version of the scale. Structural validity, convergent validity, and discriminant validity were included in validity evaluation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test structural validity. In EFA, an acceptable factor loading of items on their respective dimensions was > 0.60. In CFA, an acceptable root mean square error of approximation (RMSEA), a standard absolute fitness index, was < 0.05. Comparative fit index (CFI) and parsimony-adjusted non-normed fit index (PNFI), measures of incremental improvement and fit, > 0.90 indicated a good fit. Convergent validity was evaluated by average variance extracted (AVE), and an AVE > 0.50 indicated good convergent validity. Discriminant validity was determined as good by the square root of AVE greater than the correlation coefficient between latent variables. Cronbach’s α coefficient was used to evaluate the internal consistency of the scale; the internal consistency considered was very good with an α > 0.90. Cronbach’s α coefficient may cause underestimation of reliability in the case of error correlation. Therefore, composite reliability (CR) calculated based on structural equation model >0.70 indicated that the CR was good. Results The response rate was 95.69%. The Chinese version of Health and Safety Climate Survey included 22 items belonging to six dimensions which was extracted by the EFA, and the cumulative variance contribution rate was 74.79%. The corrected RMSEA was 0.045, the PNFI was 0.970, and the CFI was 0.975 in the CFA, indicating good fit. The dimensional AVE values were all greater than 0.50, indicating good CV. The square root of AVE was greater than the correlation coefficient between latent variables, indicating good DV. The Cronbach’s α was 0.90 for the total scale and were above 0.70 for all dimensions. The CR was 0.93 for the total scale and were above 0.70 for all dimensions, indicating that the overall reliability of the scale was good. Conclusion The Chinese version of Health and Safety Climate Survey has good reliability and validity, and can be further improved in field application.

An 82-year-old female patient received monotherapy with nivolumab (240 mg by an IV infusion on the firsr day, 14 days as a cycle) because of multiple metastases of central adenocarcinoma in the right upper lobe of the lung. After 8 cycles of immunotherapy (about 4 months), the patient developed severe nausea and vomiting. Laboratory tests showed random blood glucose 43.2 mmol/L and β-hydroxybutyric acid 5.3 mmol/L. Blood gas analysis showed pH 7.01, bicarbonate root 4.0 mmol/L, alkali residual -22.4 mmol/L, serum potassium 6.1 mmol/L, and lactic acid 2.9 mmol/L. The patient had no previous history of diabetes mellitus. Fulminant type 1 diabetes mellitus due to nivolimab was considered. Nivolumab was stopped and rehydration, hypoglycemia, acidosis correction, and other symptomatic treatments were given. Two days later, her symptoms were improved obviously. Laboratory tests showed fasting plasma glucose 15.8 mmol/L and β-hydroxybutyric acid 0.2 mmol/L. Blood gas analysis showed pH 7.39, bicarbonate root 21.2 mmol/L, alkali residual -3.8 mmol/L, serum potassium 4.3 mmol/L, and lactic acid 1.0 mmol/L.

An 82-year-old female patient received monotherapy with nivolumab (240 mg by an IV infusion on the firsr day, 14 days as a cycle) because of multiple metastases of central adenocarcinoma in the right upper lobe of the lung. After 8 cycles of immunotherapy (about 4 months), the patient developed severe nausea and vomiting. Laboratory tests showed random blood glucose 43.2 mmol/L and β-hydroxybutyric acid 5.3 mmol/L. Blood gas analysis showed pH 7.01, bicarbonate root 4.0 mmol/L, alkali residual -22.4 mmol/L, serum potassium 6.1 mmol/L, and lactic acid 2.9 mmol/L. The patient had no previous history of diabetes mellitus. Fulminant type 1 diabetes mellitus due to nivolimab was considered. Nivolumab was stopped and rehydration, hypoglycemia, acidosis correction, and other symptomatic treatments were given. Two days later, her symptoms were improved obviously. Laboratory tests showed fasting plasma glucose 15.8 mmol/L and β-hydroxybutyric acid 0.2 mmol/L. Blood gas analysis showed pH 7.39, bicarbonate root 21.2 mmol/L, alkali residual -3.8 mmol/L, serum potassium 4.3 mmol/L, and lactic acid 1.0 mmol/L.

To enhance the accuracy of computer-aided diagnosis of adolescent depression based on electroencephalogram signals, this study collected signals of 32 female adolescents (16 depressed and 16 healthy, age: 16.3 ± 1.3) with eyes colsed for 4 min in a resting state. First, based on the phase synchronization between the signals, the phase-locked value (PLV) method was used to calculate brain functional connectivity in the θ and α frequency bands, respectively. Then based on the graph theory method, the network parameters, such as strength of the weighted network, average characteristic path length, and average clustering coefficient, were calculated separately (
Adolescent ; Brain/diagnostic imaging* ; Diagnosis, Computer-Assisted ; Electroencephalography ; Female ; Humans ; Support Vector Machine