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.

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

Objective: To explore the clinical value of real-time ultrasound-guided closed reduction of nasal bone fracture. Methods: Sixty patients with clinically confirmed nasal bone fractures were randomly divided into experimental group and control group (each n=30). Both groups were treated with closed reduction of nasal bone fracture under general anesthesia. Patients in experimental group were treated with real-time ultrasound-guided closed reduction, while those in control group were treated with closed reduction of nasal bone fracture under traditional visual and palpation. After reduction, effect of reduction was evaluated with three-point method based on nasal CT scan. The second reduction rates, hospitalization time and post-operative CT scores were compared between the two groups. Results: The second reduction rate of fracture was 0 in the experimental group, whereas 13.33% (4/30) in control group (χ2=4.286, P=0.038).The hospitalization time of experimental group was 4 days, of control group was 5 days (Z=-5.024, P<0.001). The scoring of experimental group were 3 points and 2 points respectively in 19 cases and 11 cases, while of control group were 3 points in 11 cases, 2 points in 16 cases and 1 point in 3 cases. The reduction effect of experimental group was better than that of control group (χ2=6.059, P=0.048). Conclusion: Real-time ultrasound-guided closed reduction of nasal bone fracture is accurate and reliable, which can reduce the risk of second reduction of fracture and avoid X-ray radiation, also effectively shorten the hospitalization time of patients and improve the satisfaction of both doctors and patients.

Objective To explore value of high-frequency ultrasound-guided minimally invasive fixation treatment for metacarpus and phalange fractures.Methods Totally 26 patients of acute metacarpus and phalange fractures were selected and randomly divided into experimental group and control group (each n =13).The patients in experimental group underwent ultrasound-guided closed reduction,while in control group underwent C-arm X-ray fluoroscopy-guided reduction.Then the patients in two groups were followed up,and the curative effect of both methods were observed.Results The successful rate of closed reduction was 76.92％ (10/13) in experimental group,while was 84.62％ (11/13) in control group (x2=0,P=1.00).C-arm fluoroscopy was performed (0.62±1.19) times in experimental group,and (3.46±0.78) times in control group (t=-7.21,P＜0.01).The average healing time of fracture was (5.45±0.64) weeks in experimental group and (5.71±0.78) weeks in control group.The excellent and good rate of total active motion (TAM) was 84.62％ (11/13) in experimental group and 92.31％ (12/13) in control group,respectively.The average grip strength was (32.22±2.44) kg in experimental group,and (34.11±2.74) kg in control group (all P＞0.05).Conclusion High frequency ultrasound-guided minimally invasive fixation is reliable in treatment of metacarpal and phalangeal fractures,which can significantly reduce X-ray radiation.

Objective To explore the intra- and inter-rater reliability of shear wave elastography (SWE) for the patellar tendon and quadriceps femoris stiffness.Methods From October to November, 2017, the stiffness of the patellar tendon and quadriceps femoris of 20 healthy men was measured by SWE, and measured again five days later. The results were evaluated with interclass correlation coefficient (ICC).Results For patellar tendon, ICC=0.79 in intra-rater and inter-rater; for rectus femoris, ICC=0.71 in intra-rater and 0.73 in inter-rater; for vastus lateralis muscle, ICC=0.84 in intra-rater and 0.74 in inter-rater; for vastus medialis,ICC=0.95 in intra-rater and 0.94 in inter-rater.Conclusion It is a reliable and repeatable method to measure the stiffness of patellar tendon and quadriceps femoris by SWE.

The treatment of limb fractures with closed reduction and minimally invasive fixation with C-arm or conventional X-ray guidance has been widely accepted and gradually developed due to less trauma and rapid healing.However,the radiation damage of X-ray can not be ignored.With the continuous progresses of ultrasound technology,the application of ultrasound in clinic is involved not only in the diagnosis of fractures,but also in the closed reduction and fixation of fractures.The research progresses of ultrasound-guided closed reduction and minimally invasive fixation of limb fractures were reviewed in this article.

Objective To explore the effect of health education combine with nursing intervention on improving the awareness of patients′ tuberculosis ( TB) knowledge effectiveness. Methods A total of 1 186 cases of TB from June 2012 to June 2014 in our hospital were selected. According to accepted care measures, patients were divided into two groups, 593 cases received health education combined with nursing intervention were as the observation group, while another 593 cases received conventional care were as the control group. The questionnaires about TB knowledge, vital signs and prognosis of patient satisfaction outcomes were analyzed. Results Before accepting health education, the difference of knowledge of TB between the two groups was not statistically significant (P>0. 05). After the health education combined with nursing intervention, 540 (91. 1%) patients in the observation group got a score of TB knowledge over 60, which was significantly higher than 402 patients (67. 8%) in the control group (P<0. 05). 402 (67. 8%) patients in the observation group got a score of TB knowledge over 80, which was significantly higher than 207 patients (34. 9%) in the control group (P<0. 05). The total score of quality of life in the observation group were (603. 6 ± 127. 4), which was significantly higher than (512. 9 ± 114. 9) in the control group (t =2. 59,P<0. 05). The rate of satisfaction in observation group was significantly higher than that in the control group (Z=91. 3,P<0. 05). Conclusions Health education combined with nursing intervention can effectively improve the knowledge and awareness of TB patients. The psychological status and quality of life had significantly enhanced, thus it is worthy of further promotion in clinical practice.