BACKGROUND:Finite element analysis is a commonly used mathematical modeling method to analyze the biomechanics of the lumbar spine.By constructing finite element models of the complex tissues such as muscles,blood vessels,and nerves in the lumbar region,mechanical analysis is performed to elucidate the pathogenesis of lumbar spine disorders and the mechanical mechanisms of treatment approaches. OBJECTIVE:To review the progress of finite element analysis in understanding the pathogenesis and treatment modalities of lumbar spine disorders,and to propose a new clinical workflow for the implementation of finite element analysis,aiming to provide a reference for future studies and promote the widespread utilization of finite element analysis in clinical diagnosis and treatment. METHODS:The PubMed database was searched using English keywords"finite element analysis,lumbar vertebra",while the WanFang and China National Knowledge Infrastructure(CNKI)databases were searched using Chinese keywords"finite element analysis,lumbar vertebra".A total of 73 articles were included for review. RESULTS AND CONCLUSION:(1)Lumbar spine degeneration in non-slipped patients typically originates from the posterior annulus fibrosus,while in patients with lumbar spine spondylolisthesis,degeneration starts from the lumbar facet joints due to abnormal mechanical mechanisms.(2)Restoring vertebral body height can prevent adjacent-level degeneration,and finite element analysis-measured vertebral compression strength can serve as an effective predictor of fracture risk,replacing bone density measurements.(3)In lumbar spine fusion surgery,selecting fusion devices of appropriate height and placing them transversely can prevent device subsidence.Increased intervertebral strain,circumferential stress,and intervertebral pressure in adjacent segments after fusion surgery may contribute to the occurrence of degenerative changes in neighboring segments.(4)Finite element analysis results suggest that preoperative planning for transforaminal endoscopic surgery should include considerations for osteotomy size to avoid excessive destruction of the articular process,and intraoperatively,preferential selection of a technique that traverses the superior articular process for foraminal dilatation.(5)In percutaneous kyphoplasty,bilateral pedicle screw augmentation should be performed,distributing bone cement on both sides of the pedicle.More advanced non-aluminum glass polyalkenoate cement materials should be selected.(6)Traction therapy should be personalized based on individual patient characteristics,including customized traction angles and forces,to achieve optimal therapeutic effects.(7)Manual therapy can induce relative displacement between the herniated intervertebral disc and the nerve root,thereby reducing compression.(8)The workflow involving CT/MR-AI Plus FEA-AI Plus Surgical robots can enable more precise diagnosis and treatment.

Objective To verify the mechanism of Buyang Huanwu decoction in the treatment of spinal cord injury based on network pharmacology and molecular docking.Methods The active ingredients and targets of Buyang Huanwu decoction were screened out by TCMSP,SymMap,PubChem and Swiss Target Prediction databases.Spinal cord injury targets were retrieved from OMIM,GeneCards,TTD,and DrugBank databases.Through venny software,the intersection target of Buyang Huanwu decoction and spinal cord injury was obtained.The active ingredient-target network for the treatment of spinal cord injury was constructed with Cytoscape software.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of common targets were carried out by DAVID,and the binding ability of drugs and targets was analyzed by molecular docking technology.Results A total of 106 active ingredients and 225 targets of Buyang Huanwu decoction,1315 targets of spinal cord injury and 112 targets of drug-disease intersection were obtained.The active ingredients of Buyang Huanwu decoction were quercetin,kaempferol,ellagic acid,luteolin and hederagenin in the treatment of spinal cord injury.Conclusion Buyang Huanwu decoction can achieve the purpose of treating spinal cord injury through various signal pathways.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Two children with late-onset congenital central hypoventilation syndrome were reported, one of whom was male and had no abnormal manifestations after birth, respiratory failure occurs at the age of 1 year and 6 months. After being hospitalized, he was treated with oxygen inhalation and non-invasive ventilation, but carbon dioxide retention could not be corrected. After one month of tracheal intubation, he was failure to wean from ventilator, so tracheostomy was performed. He needs a ventilator to help breath while sleeping, and can breath autonomously during the day without ventilator. The other case was a female, with no abnormalities after birth. At the age of 11 months, she developed respiratory failure. During sleep, the child needs non-invasive assisted ventilation through a nasal mask, and during the day, she breathed autonomously.Two patients were followed up forever 2 years and their growth and development were normal.
Humans ; Child ; Male ; Female ; Infant ; Sleep Apnea, Central/therapy* ; Respiration, Artificial ; Hypoventilation/congenital* ; Oxygen

Objective To analyze the plantar pressure distribution of knee osteoarthritis ( KOA) patients after medial opening wedge high tibial osteotomy ( MOWHTO), so as to provide biomechanical references for the surgical treatment and rehabilitation of patients. Methods A total of 31 patients with medial single compartmental KOA after unilateral MOWHTO treatment were selected as the experimental group, and 35 healthy subjects at same age were selected as the control group. The Pedomedic 40 􀅺 pressure measuring system was used to test dynamic plantar pressure. By comparing the maximum pressure ( pmax ), force-time integral ( FTI) and contact area (CA) of different plantar zones between the experimental group (operative side and unoperated side) and the control group during walking, the changes of plantar pressure in patients with medial single compartmental KOA after MOWHTO were evaluated. Results Compared with the unoperated side and the control group, the CA and FTI of the 1st metatarsal head (MH1) were higher (P<0. 05), the CA of the 4th metatarsal head (MH4)was smaller (P<0. 001), the pmax and FTI of the 5th metatarsal head (MH5) were smaller (P<0. 05), the CA of the lateral middle foot (MF-L) was smaller (P<0. 001), and the CA of the medial rear foot (RF-M) was larger (P<0. 05). Compared with the control group, the pmax of MH1 and MH2 was smaller (P<0. 05), the CA and FTI of MH5 were larger (P<0. 05), the pmax of MF-L was larger (P<0. 001), and the FTI of lateral rear foot (RF-L) was larger (P<0. 05). Conclusions Compared with healthy people, patients with medial single compartmental KOA have abnormal plantar pressure residual after MOWHTO. In clinical practice, targeted intensive rehabilitation therapy is necessary to restore the normal plantar distributions of patients.

Objective:To investigate the effect of fat mass index (FMI) on early recovery after total knee arthroplasty (TKA).Methods:Patients who underwent primary unilateral TKA in Xi'an Honghui Hospital from July 2020 to July 2021 were retrospectively analyzed. The preoperative body composition was measured by dual energy X-ray absorptiometry and the FMI was calculated. Patients were divided into normal group (male: 3.0-6.0 kg/m 2; female: 5.0-9.0 kg/m 2), overweight group (male: 6.1-9.0 kg/m 2; female: 9.1-13.0 kg/m 2), and obese group (male: >9 kg/m 2; female: >13 kg/m 2) according to level of FMI, and the operation time, blood loss, and incidence of postoperative complications were collected. Multifactorial analysis of the effect of FMI on early recovery after TKA was performed using a generalized linear model. Draw the receiver operating characteristics (ROC) curve of BMI and FMI on the predicted effect of postoperative Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores and Knee Society Score (KSS) to compare the effect of FMI with BMI on early recovery after TKA. Results:A total of 100 patients were included in the study, 24 males and 76 females, aged 65.0±8.2 years (range, 42-81 years). There were 15 cases in normal group, 55 cases in overweight group and 30 cases in obese group. All patients successfully completed the operation and were followed up for 3.15±0.72 months (range, 2.8-3.2 months). The WOMAC scores of the obese group at 2 weeks, 1 and 2 months postoperative were 34.57±3.68, 22.03±2.79, and 15.77±2.96, which were greater than those of the normal group (28.73 ±2.58, 19.07±2.71, 12.27±3.10), as well as the overweight group (30.05±4.09, 19.33±2.42, 14.84±2.42), with statistically significant differences ( P<0.05). The KSS scores of the obese group at postoperative 1 and 2 months were 68.83±5.52 and 81.17±4.49, which were lower than those of the normal group (77.33±5.63, 87.33±4.17), as well as the overweight group (72.64±5.43, 83.73 ±5.02), with statistically significant differences ( P<0.05). The WOMAC score, KSS score, and postoperative complications at 2 months postoperatively were selected as outcome indicators to plot the ROC curve, and the ROC curve for the WOMAC score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.744 (95% CI: 0.54, 0.82), which was greater than that of BMI [0.624 (95% CI: 0.51, 0.74)], and the difference was statistically significant ( Z=2.19, P=0.021). The ROC curve for the KSS score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.718 (95% CI: 0.62, 0.82), which was greater than that of BMI [0.612 (95% CI: 0.52, 0.74)], with a statistically significant difference ( Z=2.58, P=0.016). The ROC curve for postoperative complications showed an area under the curve of 0.639 (95% CI: 0.41, 0.88) for FMI and 0.605 (95% CI: 0.37, 0.84) for BMI, with no statistically significant difference ( Z=0.48, P=0.632). Conclusion:The greater the FMI the poorer the early functional recovery after initial TKA, and FMI is more valuable than BMI in predicting the early functional recovery.

ObjectiveTo investigate the characteristics of electromyography (EMG) and postural stability of lower limb muscles during Y-balance test (YBT) and their relationship. MethodsFrom October to November, 2021, a total of 26 female students aged 18 to 22 years were recruited from Binzhou Medical University to complete YBT; while the EMG of rectus femoris, biceps femoris, tibialis anterior and gastrocnemius of supporting legs were collected synchronously to measure root mean square (RMS), integral electromyography (iEMG), and muscle contribution rate; and the postural stabilities were measured with three-dimensional force platform, to record total, antero-posterior (A/P) and medio-lateral (M/L) path length of center of pressure (COP). ResultsIn three directions of YBT, the RMS of rectus femoris was the most (χ² > 56.952, P < 0.001), and the iEMG and contribution rate of the tibialis anterior were the most (χ² > 38.507, P < 0.001). All the path length of COP was the shortest in the anterior (P < 0.05). In the anterior, the total path length of COP correlated with iEMG of biceps femoris (r = 0.452, P = 0.02) and gastrocnemius (r = 0.397, P = 0.045); in the postero-medial, the total path length of COP correlated with iEMG of gastrocnemius (r = 0.478, P = 0.014); and in the postero-lateral, the total path length of COP correlated with iEMG of tibialis anterior (r = 0.437, P = 0.026). ConclusionFor YBT, the activation of rectus femoris, tibialis anterior and gastrocnemius muscles of supporting legs are significant, and different with the indicators of EMG. Postural stability is the best in the posterolateral. The joint extensors or flexors play a different role for dynamic postural stability in the different directions.

A new electrochemical sensor for organophosphate pesticide(methyl-paraoxon)detection based on bifunctional cerium oxide(CeO2)nanozyme is here reported for the first time.Methyl-paraoxon was degraded into p-nitrophenol by using CeO2 with phosphatase mimicking activity.The CeO2 nanozyme-modified electrode was then synthesized to detect p-nitrophenol.Cyclic voltammetry was applied to investigate the electrochemical behavior of the modified electrode,which indicates that the signal enhancement effect may attribute to the coating of CeO2 nanozyme.The current research also studied and discussed the main parameters affecting the analytical signal,including accumulation potential,accumulation time,and pH.Under the optimum conditions,the present method provided a wider linear range from 0.1 to 100 μmol/L for methyl-paraoxon with a detection limit of 0.06 μmol/L.To validate the proof of concept,the electrochemical sensor was then successfully applied for the determination of methyl-paraoxon in three herb samples,i.e.,Coix lacryma-jobi,Adenophora stricta and Semen nelum-binis.Our findings may provide new insights into the application of bifunctional nanozyme in electro-chemical detection of organophosphorus pesticide.

Objective:To explore nursing experimental teaching mode on the basis of simulation technology to improve learning effect.Method:s A total of 374 nursing students of Grade 2012 to 2014 were selected as the experimental group, and 292 nursing students of Grade 2010 to 2011 were selected as the control group. The experimental group adopted the comprehensive experimental teaching based on simulation technology, while the control group used traditional teaching. At the end of the course, the experimental group students were surveyed, and the two groups of students were given a unified examination. Data analyses were performed using SPSS 17.0 and the t-test was adopted to analyze the teaching effect for comparison of the two groups.Result:s The recovery rate of the questionnaires in the experimental group was 100%, and the satisfaction rate was 95%. Behavioral performance self-evaluation showed that students had high self-evaluation in improving their independent learning ability (3.47±0.63), and low self-esteem in caring for the patient's psychological problems (2.62±0.68). The theoretical score of the experimental group was (77.03±2.55), and the theoretical score of the control group was (71.75±3.49). The difference was statistically significant ( P=0.041). Conclusion:The comprehensive nursing experiment project on the basis of simulation technology is conducive to promoting students' autonomous learning and improving their comprehensive quality and professional ability.

Objective To test the teaching ability, teaching efficacy, teaching quality and its correlated factors of teaching quality in part-time nursing teachers. Methods The questionnaire survey were used in 201 part-time nursing teachers, and the factors influencing teaching quality were tested. Results The total scores in teaching ability were (75.43 ± 11.68) points, (110.45 ± 16.73) points for teaching efficacy, (105.38±12.17) points for teaching quality. There were moderate correlated relationships among these variables. The factors influencing teaching quality included over 5 years in teaching time, teaching training, teaching ability and teaching efficacy by multivariable regression analysis, these variables accounted for 62.0% variance. There were higher coefficients (?=0.61, 0.45) in teaching ability and efficacy. Conclusions The following measures should be performed for part-time nursing teachers, such as teaching training and supervision, in order to improve clinical teaching quality.