A mechanical study on the bones of 29 rabbits following implantation of carbontendon was carried out. The rabbits were divided into seven groups according to the observation time (2,4,6,8,12,20 and 30 weeks after operation). A bundle of artificial tendon composed of 7,000 carbon fibers was passedthrough a tunnel in the tibia, and both ends of the artificial tendon were ligated to the muscle fibers. The mechanical strength and histological structure of the carbonbone junction and their relationship were studied in each group. Carbon fiberwas split and degradated in six to eight weeks after operation. The tensile strength of carbontendon in the soft tissue was decreased from 82±4.6N in the second week to 27±5.31N and6.3±1.81N in the sixth and eighth week respectively. The tensile strength of carbontendon increased from 3.01±1.2N to 6.1±2.01N at the carbon -tendon-bone junction in the bone. The tensile strength of carbon-tendon was unsatisfactory for implantation into bone. The carbon-tendon was split and degradated and the tensile strength was not b enough to cope with the early functional exercises.
Objective To analyze the hot spot and future application trend of artificial intelligence technology in the field of intensive care medicine. Methods The CNKI, WanFang Data, VIP and Web of Science core collection databases were electronically searched to collect the related literature about the application of artificial intelligence in the field of critical medicine from January 1, 2013 to December 31, 2022. Bibliometrics was used to visually analyze the author, country, research institution, co-cited literature and key words. Results A total of 986 Chinese articles and 4 016 English articles were included. The number of articles published had increased year by year in the past decade, and the top three countries in English literature were China, the United States and Germany. The predictive model and machine learning were the most frequent key words in Chinese and English literature, respectively. Predicting disease progression, mortality and prognosis were the research focus of artificial intelligence in the field of critical medicine. ConclusionThe application of artificial intelligence in the field of critical medicine is on the rise, and the research hotspots are mainly related to monitoring, predicting disease progression, mortality, disease prognosis and the classification of disease phenotypes or subtypes.
Objective To analyze the biomechanical changes of the adjacent cervical facet joints when the angled cervical prosthesis is replaced. Methods A total of 400 northwestern people were involved, with an age of 40 years or older.The cervical vertebra lateral X-ray films were taken, and the cervical angles were measured by professional computer aided design software, then the cervical intervertebral disc prosthesis with 10° angle was designed. The finite element models of C4，5and C4-6 segments with intact cervical discs were developed; the C4，5 disc was replaced by the cervical prosthesis with 0° and 10° angle respectively; and then all models were subjected to axial loading, flexion/extension, lateral bending, and torsion loading conditions; the stress effects on adjacent facet joints after replacement were observed by comparing with that of the intact model. Results The cervical angles were (9.97 ± 3.64)° in C3，4, (9.95 ± 4.34)° in C4，5, (8.59 ± 3.75)° in C5，6, and (8.49 ± 3.39)° in C6，7, showing no significant difference between C3，4 and C4，5, C5，6 and C6，7 (P gt; 0.05) and showing significant differences between the other cervical angles (P lt; 0.05). When C4，5 model was axially loaded, no significant difference in equivalent shearing stress were observed in intact, 0°, and 10° groups; at flexion/extension loading, the stress was biggest in intact group, and was smallest in 10° group; at lateral bending, the stress got the high rank in intact group, and was minimum in 10° group; at torsion loading, the stress state of 10° group approached to the intact one condition. When C4-6 model was loaded, the facet joint stress of the replaced segment (C4，5) decreased significantly at axial loading, flexion/extension, and lateral bending; while no obvious decrease was observed at torsion loading; the stress of the adjacent inferior disc (C5，6) decreased significantly at axial loadingand lateral bending condition, while less decrease was observed at torsion loading, no significant change at flexion/extension condition, it approached to that of the intact one. Conclusion The finite element analysis reveals that the biomechanical properties of 10° designed prosthesis is approximate to that of the intact cervical disc, thus the 10° designed prosthesis can meet the requirements of biomechanical function reconstruction of the cervical spine.
Objective To study the development, investigation, and application of the artificial vertebral body so as to provide an essential reference for the future research and clinical application. Methods The recent articles on materials, types, and clinical applications of the artificial vertebral body were reviewed.Results The materials used for the artificial vertebral body were porcelain, alloy, variant bone, and composite. But each of them had its own advantages and disadvantages. The types of the artificial vertebral body were grouped as expandable and non-expandable ones; however, the expandable type was much better. The artificial vertebral body had been applied to the treatments of spinal tumor, tuberculosis, fracture, and infection, with better effects. Conclusion The artificial vertebral body can beextensively applied. However, the materials and types need to be improved.
With the development of society and the progress of technology, artificial intelligence (AI) and big data technology have penetrated into all walks of life in social production and promoted social production and lifestyle greatly. In the medical field, the applications of AI, such as AI-assisted diagnosis and treatment, robots, medical imaging and so on, have greatly promoted the development and transformation of the entire medical industry. At present, with the support of national policy, market, and technology, we should seize the opportunity of AI development, so as to build the first-mover advantage of AI development. Of course, the development and challenges are coexisted. In the future development process, we should objectively analyze the gap between our country and developed countries, think about the unfavorable factors such as AI chips and data problems, and extend the application and service of AI and big data to all links of medical industry, integrate with clinic fully, so as to better promote the further development of AI medicine treatment in China.
OBJECTIVE: To evaluate the clinical effect of drilling procedure following the hydroxyapatite orbital implantation. METHODS: From February 1996 to April 2000, 146 consecutive patients who received hydroxyapatite orbital implant were drilled and inserted a motility peg 6 to 16 months after hydroxyapatite implantation. Among them, there were 97 males and 49 females, aged from 18 to 60 years old, of the 146 motility pegs, 36 were sleeved pegs and 110 were nonsleeved. Goldman visual field analyzer was applied to measure the degree of artificial eye’s movement before and after drilling. RESULTS: Followed up for 1 to 40 months, no secondary infection occurred. The mobility of the prosthesis increased from (18.7 +/- 3.8) degrees preoperatively to (42.3 +/- 3.7) degrees postoperatively. CONCLUSION: The delayed drilling procedure and motility peg insertion improve the range of movement and the sensitivity of the artificial eye with a low rate of complications.
ObjectiveTo investigate the biomechanical properties of artificial ligament in the treatment of injuries to distal tibiofibular syndesmosis so as to provide a scientific basis for clinical application. MethodsSixteen fresh ankle specimens were harvested from 8 normal fresh-frozen cadavers. The initial tests were performed on 16 intact specimens (group A) and then the distal tibiofibular syndesmosis injury models were made (group B); the distal tibiofibular syndesmosis was fixed with artificial ligament in 8 specimens (group C) and with cannulated lag screw in the other 8 specimens (group D). The pros and cons of different fixation methods were analyzed by displacement, stress shielding effect, the strength and stiffness of ankle joints, the contact area of tibiotalar articular surface and the contact stress. ResultsUnder the physiological loading or combined with external rotation moment, the displacement of group C was significantly lower than that of groups B and D (P < 0.05), but no significant difference was found between groups A and C (P > 0.05); and there were significant differences among groups A, B, and D (P < 0.05). The rates of stress shielding in the tibia and fibula of group C were significantly lower than those of group D (t=-71.288, P=0.000;t=-97.283, P=0.000). The stress strength in tibia of group C was significantly higher than that of groups A and D (P < 0.05), but no significant difference was found between groups A and D (P > 0.05). Group C had the highest stress strength in fibula, followed by group A, group D had the lowest; differences were significant among 3 groups (P < 0.05). There was no significant difference in shear strength among groups A, C, and D (P > 0.05). The axial stiffness in tibia of group D was significantly lower than that of groups A and C (P < 0.05), but no significant difference was found between groups A and C (P > 0.05). The axial stiffness in fibula of group C was significantly higher than that of groups A and D (P < 0.05), but no significant difference was found between groups A and D (P > 0.05). Group C had the highest shear stiffness in tibia and fibula, followed by group D, group A had the lowest; differences were significant among 3 groups (P < 0.05). In groups A, C, and D, the contact area of tibiotalar articular surface gradually reduced, and the contact stress gradually increased, and differences were significant among 3 groups (P < 0.05). ConclusionFixation of distal tibiofibular syndesmosis injury with artificial ligament can better meet the physiological functions of the distal tibiofibular syndesmosis and has lower stress shielding, better stress distribution. Hopefully, it can reduce the complications of the distal tibiofibular syndesmosis injuries and become a better treatment choice.
Objective To construct a new composite artificial trachea and to investigate the feasibility of trachea repair and reconstruction with the new composite artificial trachea transplantation in dogs. Methods The basic skeleton of the new composite artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings at both ends. Dualmesh was sutured on titanium rings. Sixteen dogs, weighing (14.9 ± 2.0) kg, female or male, were selected. The 5 cm cervical trachea was resected to prepare the cervical trachea defect model. The trachea repair and reconstruction was performed with the new composite artificial trachea. Then fiberoptic bronchoscope examination, CT scan and three-dimensinal reconstruction were conducted at immediate, 1 month, and 6 months after operation. Gross observation and histological examination were conducted at 14 months to evaluate the repair and reconstruction efficacy. Results No dog died during operation of trachea reconstruction. One dog died of dyspnea at 37, 41, 55, 66, 140, and 274 days respectively because of anastomotic dehiscence and artificial trachea displacement; the other 10 dogs survived until 14 months. The fiberoptic bronchoscope examination, CT scan and three-dimensinal reconstruction showed that artificial tracheas were all in good location without twisting at immediate after operation; mild stenosis occurred and anastomoses had slight granulation in 6 dogs at 1 month; severe stenosis developed and anastomosis had more granulation in 1 dog and the other dogs were well alive without anastomotic stenosis at 6 months. At 14 months, gross observation revealed that outer surface of the artificial trachea were encapsulated by fibrous connective tissue in all of 10 dogs. Histological examination showed inflammatory infiltration and hyperplasia of fibrous tissue and no epithelium growth on the inner wall of the artificial trachea. Conclusion The new composite artificial trachea can be used to repair and reconstruct defect of the trachea for a short-term. Anastomotic infection and dehiscence are major complications and problems affecting long survival.
Artificial intelligence (AI) has been widely used in all walks of life, including healthcare, and has shown great application value in the auxiliary diagnosis of pulmonary nodules in the medical field. In the face of a large amount of lung imaging data, clinicians use AI tools to identify lesions more quickly and accurately, improving work efficiency, but there are still many problems in this field, such as the high false positive rate of recognition, and the difficulty in identifying special types of nodules. Researchers and clinicians are actively developing and using AI tools to promote their continuous evolution and make them better serve human health. This article reviews the clinical application and research progress of AI-assisted diagnosis of pulmonary nodules.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Early diagnosis and effective management are important to reduce atrial fibrillation‐related adverse events. Photoplethysmography (PPG) is often used to assist wearables for continuous electrocardiograph monitoring, which shows its unique value. The development of PPG has provided an innovative solution to AF management. Serial studies of mobile health technology for improving screening and optimized integrated care in atrial fibrillation have explored the application of PPG in screening, diagnosing, early warning, and integrated management in patients with AF. This review summarizes the latest progress of PPG analysis based on artificial intelligence technology and mobile health in AF field in recent years, as well as the limitations of current research and the focus of future research.