Intelligence, precision, and minimally invasive are the directions for the future development of spinal surgery, as well as the requirements put forward by social development for spinal surgery. Robot-assisted spinal surgery came into being. At present, the spinal robot surgery system is mainly used to assist in the placement of pedicle screws. This article provides an overview of the history and classification, advantages and limitations, precision and safety of spinal robot assisted nail placement, key technologies for applying spinal robots, X-ray radiation exposure, learning curve and cost-benefit analysis, expanded applications of spinal robots, and future technologies. This review mainly introduces the current status of robot research and proposes the future development of spine robots. Robot assisted autonomous screw placement, laminectomy decompression, tumor biopsy and resection, intelligent planning of screw placement for osteoporosis patients, soft tissue recognition and feedback, and establishment of minimally invasive surgical channels are higher requirements for robot-assisted spinal surgery. The further development of spinal robot can play its advantages of precision, stability and minimally invasive in cervical vertebra, spinal pelvic fixation, spinal tumor, spinal deformity surgery, etc., while improving surgical efficiency and cost benefit.

Objective: Progressive supranuclear palsy (PSP) involves a variety of visual symptoms that are thought to be partially caused by structural abnormalities of the retina. However, the relationship between retinal structural changes, disease severity, and intracranial alterations remains unknown. We investigated distinct retinal thinning patterns and their relationship with clinical severity and intracranial alterations in a PSP cohort. Methods: We enrolled 19 patients with PSP (38 eyes) and 20 age-matched healthy controls (40 eyes). All of the participants underwent peripapillary and macular optical coherence tomography. Brain 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane (11C-CFT) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography imaging were also performed in patients with PSP. We investigated the association between retinal thickness changes and clinical features, striatal dopamine transporter availability, and cerebral glucose metabolism. Results: The peripapillary retinal nerve fiber layer (pRNFL) and macula were significantly thinner in patients with PSP than in controls. The thickness of the superior sector of the pRNFL demonstrated a significant negative relationship with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III and Hoehn and Yahr staging scale scores. A significant negative correlation was found between outer inferior macular thickness and disease duration. Outer temporal macular thickness was positively correlated with Montreal Cognitive Assessment scores. In PSP, lower outer temporal macular thickness was also positively correlated with decreased dopamine transporter binding in the caudate. Conclusion The pRNFL and macular thinning may be candidate markers for monitoring disease severity. Additionally, macular thinning may be an in vivo indicator of nigrostriatal dopaminergic cell degeneration in PSP patients.

Objective:To compare the clinical value of CTA and CDU in perforator flap of peroneal artery.Methods:From February 2013 to October 2016, 47 patients who suffered with soft tissue defects and were hospitalised in the Department of Orthopaedics, the 920th Hospital of Joint Logistic Support Force of Chinese PLA were retrospectively reviewed and evaluated. All the defects were reconstructed by the perforator flap of peroneal artery. All patients received preoperative CTA and CDU scans before surgery. Appropriate perforator vessels were selected and the locating points in body surface and external diameters of the perforator vessels were recorded and compared with intraoperative findings. SPSS 22.0 statistical software was used for data analysis. P<0.05 was considered statistically significant. Results:The intraoperative coincidence rate of the proposed perforator vessels was 97.87% for CDU and 95.74% for CTA, with no significant difference between the 2 groups( P>0.05). It was found that the preoperative CTA and CDU measurements were consistent with the actual intraoperative measurements, and there was no significant difference between the 2 groups( P>0.05). For CTA combined with CDU, an intraoperative coincidence rate was 100% in the location of peroneal perforating vessels. All flaps were followed-up for 1 to 18(mean 13.5) months. All the flaps survived well with good texture and appearance without complication. Conclusion:CDU and CTA are reliable and useful in preoperative vascular evaluation of peroneal perforator flap, and both can be used in a complementary or combined manner.

Objective:To investigate the application value of mixed reality (MR) technology in reconstruction of soft tissue defect of extremities with free anterolateral thigh flap(ALTF).Methods:From December 2019 to November 2021, a retrospective analysis was performed on 10 patients who had undergone ALTF reconstruction of soft tissue defects in extremities in Department of Orthopaedics, the First People's Hospital of Yunnan Province. Four patients had the defects in hand and 6 patients in foot and ankle. For the 6 patients in emergency surgery, the time from injury to admission was 4.0-15.0 hours, with an average of 7.3 hours. Four patients with soft tissue defects caused by chronic infection and ulcers were given debridement, and the soft tissue defects were reconstructed by flap transfer at the second stage. The defect area were from 8.0 cm×5.0 cm to 22.0 cm×8.0 cm. Preoperatively, 3D bone-vessel-flap model was established based on the lower extremity CTA scans. Intraoperatively, MR technology was used to project the 3D model on the flap donor site to observe the virtual profile of vessel shape in real time, to locate the perforator and the course of the perforator, and observe the consistency between the virtual image and the actual anatomy of the perforator. The appearance, texture and colour of the flap were recorded at the last follow-up. Hand function was evaluated by the total activity movement (TAM), and foot and ankle function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS).Results:The position location and course of perforator vessels were reconstructed successfully in all patients before surgery. The MR technology was used to locate the perforator, and the course of the virtual perforator was consistent with the actual anatomy, and the matching reached 100%. The length of vascular pedicle measured before surgery was at 11.02 cm±1.37 cm. And that measured during surgery was at 11.21 cm±1.23 cm ( P=0.748, t=-0.326). The difference was not statistically significant ( P>0.05). The flap area was at 9.0 cm×6.0 cm to 23.0 cm×9.0 cm. The donor site was sutured directly in one stage. All patients were entered postoperative followed-up for 1 to 24 months, with an average of 13.5 months. All the flaps survived after surgery. The flap with good appearance, colour and texture, and only one linear scar was left in the donor site. According to the TAM of the hand function, 3 cases were excellent and 1 was fair. Foot and ankle function were evaluated according to the AOFAS, 5 cases were in excellent and 1 was good. Conclusion:MR technology applied to the surgery of ALTF can locate the course of the flap vessels in real time, guide the operation, improve the operation efficiency and reduce the risk in surgery.

Brain-computer interaction (BCI) is a transformative human-computer interaction, which aims to bypass the peripheral nerve and muscle system and directly convert the perception, imagery or thinking activities of cranial nerves into actions for further improving the quality of human life. Magnetoencephalogram (MEG) measures the magnetic field generated by the electrical activity of neurons. It has the unique advantages of non-contact measurement, high temporal and spatial resolution, and convenient preparation. It is a new BCI driving signal. MEG-BCI research has important brain science significance and potential application value. So far, few documents have elaborated the key technical issues involved in MEG-BCI. Therefore, this paper focuses on the key technologies of MEG-BCI, and details the signal acquisition technology involved in the practical MEG-BCI system, the design of the MEG-BCI experimental paradigm, the MEG signal analysis and decoding key technology, MEG-BCI neurofeedback technology and its intelligent method. Finally, this paper also discusses the existing problems and future development trends of MEG-BCI. It is hoped that this paper will provide more useful ideas for MEG-BCI innovation research.
Brain/physiology* ; Brain-Computer Interfaces ; Electroencephalography ; Humans ; Imagery, Psychotherapy ; Magnetoencephalography ; Technology

Brain-computer interface (BCI) is a revolutionary human-computer interaction technology, which includes both BCI that can output instructions directly from the brain to external devices or machines without relying on the peripheral nerve and muscle system, and BCI that bypasses the peripheral nerve and muscle system and inputs electrical, magnetic, acoustic and optical stimuli or neural feedback directly to the brain from external devices or machines. With the development of BCI technology, it has potential application not only in medical field, but also in non-medical fields, such as education, military, finance, entertainment, smart home and so on. At present, there is little literature on the relevant application of BCI technology, the current situation of BCI industrialization at home and abroad and its commercial value. Therefore, this paper expounds and discusses the above contents, which are expected to provide valuable information for the public and organizations, BCI researchers, BCI industry translators and salespeople, and improve the cognitive level of BCI technology, further promote the application and industrial transformation of BCI technology and enhance the commercial value of BCI, so as to serve mankind better.
Brain/physiology* ; Brain-Computer Interfaces ; Electroencephalography ; Humans ; Technology ; User-Computer Interface

Objective:To evaluate the effect of peer education on improving compliance of cardiac rehabilitation in patients with coronary heart disease.Methods:Totally 64 patients were randomly divided into two groups, namely, the experimental group and the control group with 32 cases in each group. Patients in the experimental group received routine education, nursing, and rehabilitation, plus the peer education treatment, whereas the control group only received routine treatment. The time lasts for 6 months. The compliance of cardiac rehabilitation and the score of China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases (CQQC) were measured after 1 month, 3month and 6 month.Results:After 1, 3, and 6 months of intervention, the compliance of cardiac rehabilitation in the intervention group increased by 18.75%, 21.37%, and 21.88%, respectively, compared with the control group. After the first and third months of intervention, there was a statistically significant difference in the compliance rate of rehabilitation exercise between the intervention group and the control group ( χ2 values were 18.050, 16.946, respectively, P <0.05), and at the sixth month after intervention, the compliance of the two groups of patients with cardiac rehabilitation was not statistically significant ( χ2 value was 6.489, P> 0.05). After 1, 3, and 6 months of intervention, the quality of life scores of the intervention group were (88.68 ± 6.65), (81.90 ± 6.78), and (76.33 ± 5.90) points, and the quality of life scores of the control group were (84.75 ± 4.72), (75.67 ± 5.88), and (74.71 ± 9.47) points. There was significant difference in the scores of the two groups in the first and third months after the intervention ( t values were 2.235, 2.520, respectively, P<0.05); and in the sixth month after the intervention, the difference in the scores of the two groups wasn`t statistically significant ( t value was 1.049, P >0.05). Conclusion:Peer education can improve the compliance of cardiac rehabilitation and the score of CQQC in patients with coronary heart disease in 3 month, but further research is needed to confirm the long-term effect of peer education.

Objective:To explore the morphology and vessel distribution of the scapholunate interosseous ligament and anatomical basis for the clinical reconstruction of scapholunate interosseous ligament.Methods:From October, 2018 to December, 2018, 12 fresh wrist joint specimens were perfused with gelatin-lead oxide solution from ulnar or radial artery and scanned under micro-CT. The morphology of scapholunate interosseous ligament in neutral position and the distribution of nutrient vessels in the ligament were observed on reconstructed 3D images by Mimics. The width, length and thickness of palmar, dorsal and proximal ligaments were measured. The anatomical parameters at the entrance of nutrient vessels in the scapholunate interosseous ligament were taken and their relationship with the blood supply to the scapholunate was analyzed.Results:①For scapholunate interosseous ligament, it was found that the average length of the proximal sub-region was the longest, the length of palmar and dorsal sides was similar to each other and the widest and thinnest was in palmar side, while the thickness and width of dorsal and proximal were similar. ②There was no nutrient vessel in the proximal part of the scapholunate interosseous ligament. But there were abundant nutrient vessels in the palmar and dorsal scapholunate interosseous ligament, and there was no significant difference in blood supply to palmar and dorsal scapholunate interosseous ligament ( P>0.05). ③The palmar and dorsal medial nutrient vessels that supply to the scapholunate interosseous ligament enter the scapholunate from the attachment of ligament of scapholunate interosseous joint. Conclusion:The palmar side of the scapholunate interosseous ligament is wider and thinner than that of the other subareas, which makes it more vulnerable to injury from an anatomical point of view. There is abundant blood supply to the palmar and dorsal subareas of the scapholunate interosseous ligament and the supplying vessels anastomose inside the scapholunate bone. There is no distribution of blood vessel at the proximal part of scapholunate interosseous ligament, hence is difficult to heal. An injury of palmar and dorsal ligaments may affect the blood supply of scapholunate.

The mammalian central nervous system (CNS) is considered an immune privileged system as it is separated from the periphery by the blood brain barrier (BBB). Yet, immune functions have been postulated to heavily influence the functional state of the CNS, especially after injury or during neurodegeneration. There is controversy regarding whether adaptive immune responses are beneficial or detrimental to CNS injury repair. In this study, we utilized immunocompromised SCID mice and subjected them to spinal cord injury (SCI). We analyzed motor function, electrophysiology, histochemistry, and performed unbiased RNA-sequencing. SCID mice displayed improved CNS functional recovery compared to WT mice after SCI. Weighted gene-coexpression network analysis (WGCNA) of spinal cord transcriptomes revealed that SCID mice had reduced expression of immune function-related genes and heightened expression of neural transmission-related genes after SCI, which was confirmed by immunohistochemical analysis and was consistent with better functional recovery. Transcriptomic analyses also indicated heightened expression of neurotransmission-related genes before injury in SCID mice, suggesting that a steady state of immune-deficiency potentially led to CNS hyper-connectivity. Consequently, SCID mice without injury demonstrated worse performance in Morris water maze test. Taken together, not only reduced inflammation after injury but also dampened steady-state immune function without injury heightened the neurotransmission program, resulting in better or worse behavioral outcomes respectively. This study revealed the intricate relationship between immune and nervous systems, raising the possibility for therapeutic manipulation of neural function via immune modulation.

Objective To evaluate the accuracy and feasibility of S2 alar-iliac screwing assisted by an individualized navigation template in clinic.Methods Five patients underwent S2 alar-iliac screwing from March 2015 to July 2017.They were 2 men and 3 women,aged from 41 to 61 years (average,54.8 years).After their preoperative CT scan data of the pelvis were used for 3D reconstruction,their individualized navigation templates were designed,3D printed and used to assist the implantation of S2 alar-iliac screws.After operation,their postoperative CT data were reviewed and reconstructed using software Mimics.The caudal angulation on the sagittal plane (sagittal angle,SA),lateral angulation on the transverse plane (transverse angle,TA),horizontal distance to the median sacral crest (horizontal distance,HD),and vertical distance to the first posterior sacral foramen's inferior margin (vertical distance,VD) of the screws were measured and compared with the corresponding values in the preoperative design.Results In the 5 patients,altogether 10 S2 alar-iliac screws were implanted through the sacroiliac joint without piercing the iliac bone cortex.There were no significant differences between the preoperative design and postoperative measurements in terms of SA (32.22°±5.57° versus 31.95°±5.78°),TA (42.59°±4.55° versus 42.21°± 5.29°),HD (5.04 ± 0.40 mm versus 5.00 ± 0.41 mm) orVD (19.58 ± 1.49 mm versus 19.54±1.12 mm) (P ＞ 0.05).Conclusion In the adult pelvic fixation,the S2 alar-iliac screwing can be assisted by an individualized navigation template to achieve high accuracy in implantation.