Abstract： Diseases prognosis is often influenced by multiple factors, and some intricate non-linear relationships exist among those factors. Artificial neural network （ANN）, an artificial intelligence model, simulates the work mode of biological neurons and has a b capability to analyze multi-factor non-linear relationships. In recent years, ANN is increasingly applied in clinical medical fields, especially for the prediction of disease prognosis. This article focuses on the basic principles of ANN and its application in disease prognosis research.
Objective To investigate the clinical application of self-settingcalcium phosphate cement (CPC) in bone defect repair of extremities. Methods From May 1998 to January 2000, 32 cases of bone defect, in 36 sites, were repairedand reviewed, aged from 4 to 59 years old (24.7 years old on average), with bone defect 2 to 125 cm2 in size (13.1 cm2 on average). The causes of the bone defect werefracture, bone cyst, iliac bone harvesting, fibrous dysplasia, enchondroma and bone tuberculosis, which involved femur, iliac, tibia, humerus, phalanx, fibula, calcaneus, talus and acetabulum. All of the cases were followed up for 1 to 23 months, 15.3 months on average, before radiographic examination. Results All operations were successful and no general response was observed in all of the cases. X-ray examination showed an integrity interface between CPC and bone. And CT showed no gap existed. There was no increase of serum calcium and phosphate levels. Conclusion CPC is applicable in the low- or non-weight-bearing site of the extremities.
Prenatal diagnosis, as one of the core components in the prevention and control of birth defects, is constrained by both “time sensitivity” and “data availability”. The diagnostic model driven by expert experience and manual interpretation can no longer meet the demands of rapidly evolving detection technologies, which generate massive, high-dimensional data. Additionally, issues such as delayed professional training and regional development imbalances further hinder the overall improvement of prenatal diagnosis efficacy. This article systematically elaborates on typical application scenarios of artificial intelligence-assisted prenatal diagnosis from two core aspects: the intelligent optimization of diagnostic technologies and the standardization of institutional and personnel management. It also explores the potential of emerging intelligent technologies like federated learning and digital twins, aiming to promote the transformation and upgrading of the prenatal diagnosis field from standardization and normalization toward precision and systematic high-quality development.
Objective To discuss the clinical application of preserving femoral neck in total hip arthroplasty and to analyze the early stage results.Methods From January 1999 to June 2001, 12 patients underwent total hip arthroplasty with preservation of femoral neck. We cut off the femoral head in infra-head position with improved Moore micro-incisions to reserve intact neck of femur. Thensuitable size of extra cup was selected and placed at 55° eversion angle. The internal cup, made from ultra high polymer poly thene and with ultra radius design, was placed at 45°eversion angle. Harris scores were recorded before operation, after operation and during the follow-up. During the follow-up, the X-rayfilms were taken to assess position, loosening of the prosthesis and ectopic ossification.Results All 12 patients were followed up 2-4.5years with an average of 3.1 years. The mean Harris score of hip elevated from 54 scores before operation to 92 scores of the last follow-up. Mild ectopic ossification occurred in 3 cases. There was no prosthesis loosening and femoral prosthesis setting, and only onepatient had mild bone absorption around femoral prosthesis.Conclusion Total hip arthroplasty with femoral neck preservation is a good option for the patients who need total hip arthroplasty for variable reasons, which is indicated for the patients whose femoral neck is intact with no osteoporosis.
Objective To study the effect and complication of repairing depressed fracture of frontal part with hydroxylapatite particulate artificial bone. Methods From January 1994 to December 2002, 13 patients were all diagnosed as having depressed fracture of frontal part with clinical and X-ray examinations. Thesmall incision before the hair-edge or local small incision was made. After opening the incision, we performed creeping decollement. Then the hydroxylapatite particulate artificial bone was implanted into the sites of the depressed fracture. The effect and complication were observed with clinical and X-rayexaminations in all patients 1 week, 1 month, 3 months after operation.Results The quantity of hydroxylapatite implanted was 10-30g. Primary healing was obtained in all cases without any complication. All cases were followed up for 3 months. The contours of the frontal part were restored well. Conclusion It is a good method to repair depressed fracture of frontal part with hydroxylapatite particulate artificial bone.
In order to evaluate coral as a bone graft substitute in repair of bone defect, particulates of coral were implanted into skull bone defect of rabbit, 1.5 cm in diameter. Hydroxyapatite and blank were taken as controls. The rabbits were sacrificed at the second, fourth, eighth and twelveth weeks after the operation. The specimens were taken and performed histological examination and histomorphometry observation. Results were as follows: at the second week many multinucleus giant cells infiltrated. As time elapsed, the coral were progressively degenerated and new bone was formed to fill the defect. Up to the twelveth week, the coral degenerated completely and new bone formed in the center of the defect. Percentage of new bone was in defect was 36.9%. Compared with the controls, there were significant differences (P lt; 0.01). It was suggested that coral had good osteoconductility. Howevel, coral underwent rapid degeneration, it might result in inconplete repair of bone defect.
Objective To compare the bone resorption between the proximal fixation of the anatomique benoist giraud（ABG） hip and the distal fixation of the anatomic medullary locking（AML） hip by the medium-term X-ray films, and to evaluate the clinical results of the two prostheses. Methods From January 1992 to December 1996, 298 patients (396 hips) underwent the total hip arthroplasty at Wilson Hospital in Korea. In 125 patients, 176 hips were ABG hips, including 103 avascularnecrosis hips, 57 dysplasia hips, and 16 other diseased hips; In the other 173 patient the remaining 220 hips were AML hips, including 147 avascular necrosis hips, 65 dysplasia hips, and 8 other diseased hips. The A-P X-ray imagings were followed up for 5-12 years averaged 8 years, and were compared with the immediate postoperative X-ray imagings. The bone resorption area was measured and the bone resorption cases were recorded according to the Gruen zone obsesvation. Results During operation, 2 ABG hips and 5 AML hips were cracked at the femoral diaphysis; 3 ABG hips and 1 AML hip were cracked at the metaphysis; 6 ABGhips and 3 AML hips were fractured because of trauma after operation; among them, 2 ABG hips needed the stem revision and the remaining hips underwent the openreduction and the internal fixation. During the follow-up, 9 ABG hips were revised, 7 hips of which developed the aseptic loosening. No AML hip was revised, but 3 AML hips developed the aseptic loosening. The bone resorption pattern in theABG and AML hips was similar. The bone resorption occurred most commonly in theGruen zones 1 and 7, and it extended from the metaphysis to the diaphysis. In the Guren zones 2, 5, 6 and 7, there were more AML hips than ABG hips that developed the bone resorption. The bone resorption area around the AML hip was larger than that around the ABG hip. Conclusion The stress shielding bone resorption usually occurs proximally to the union area of the bone and the prosthesis. The ABG prosthesis is a proximal fixation prosthesis, therefore, the stress shielding bone resorption can be reduced. The bone resorption around the AML prosthesis develops slowly within 10 years after operation. The stress shielding bone resoption may reach the summit within 10 years and it will not develop endlessly, so the prosthesis will be stable for a long time. The probabilityof the bone resorption in the ABG prosthesis is smaller than that in the AMLprosthesis. The bone resorption around the AML prosthesis may develop slowly after 10 years and will not affect the stability of the prosthesis for a long time.
In order to restore the function of shoulder joint in patient with tumor of upper end of humerus, artificial humeral head replacement was performed. The materials included resinene, nylon-6 and large molecular polyethylene from 1978 to 1993, 14 patients were treated. The tumors involved in this group were giant cell tumor, synviosarcoma, bone cyst, osteochondroma, osteoblastoma, osteofibrosarcoma, osteosarcoma, chondrosarcoma, parosteosarcoma and malignant giant cell tumor. After resection of the tumor, the artificial prosthesis was implanted with bone cement. After 1 to 16 years follow-up, functions of the shoulder joint were reserved in 86% of the patients.
Objective To summarize the methods and experiences of surgical treatment of aortic arch diseases with four branches aortic graft under deep hypothermia circulatory arrest （DHCA） and antegrade selective cerebral perfusion （ASCP）. Methods In 2004 from September to December, surgical treatment of 12 patients with 7 aortic aneurysm（4 cases with ascending aorta and aortic arch aneurysm, 3 cases with aneurysm of aortic isthmus） and 5 aortic dissection（DeBakey Ⅰ 1 case, DeBakey Ⅱ 3 cases, DeBakey Ⅲ 1 case） were collected in Gunma Prefectural Cardiovascular Center. All operations were carried out under DHCA and ASCP, and four branches aortic graft were used to replace the aortic arch. The Bentall procedure, total and partial arch replacement and elephant trunk technique were undertaken in different patients. Results Total 12 patients recovered from the great vessel diseases smoothly without severe cerebral and other systematic complications, the time of operation was 5.5±1.7 h, the period of DHCA was 42.2±12.9min, 4 cases with no blood transfusion, the time of hospitalization was 22.3±7.2d. Conclusion ASCP is a safe. and effective method of cerebral protection during circulation arrest, and four branches aortic graft may shorten the time of DHCA and simplify the procedure of aortic arch replacement.