ObjectiveTo investigate the effect of one-stage posterior reduction single nail and rod fixation combined with the anterior operation on lower cervical fracture-dislocation combined with unilateral locked facet.MethodsA retrospective analysis of 28 patients with lower cervical fracture-dislocation combined with unilateral locked facet who underwent one-stage posterior-anterior approach surgery between June 2012 and March 2017 were conducted. The Cobb angle, vertebral body horizontal displacement, height of intervertebral space, recovery of nerve function and operative complications were observed before and after operation.ResultsAll patients were followed up for 12-24 months, with an average of (18.9±4.7) months. All the patients received good reposition after operation without complications such as large blood vessels, trachea, esophagus, spinal dura mater injury and so on. The incisions healed well in all patients. Postoperative complications: postoperative hoarseness and dysphagia occured in 3 cases, pharynx and larynx pain in 8 cases, pulmonary infection in 1 case, and hyponatremia in 2 cases; all patients recovered after the related symptomatic treatment. Postoperative X-ray showed that all the patients were completely corrected without residual small joint semi dislocation and kyphosis. No spinal cord or nerve injury aggravators occurred after surgery. The neurological function of all patients was improved to different degrees 12 months after operation. American Spinal Cord Injury Association (ASIA) classification showed that, of the 6 cases classified as type B preoperatively, 4 cases turned into type C and 2 cases into type D postoperatively; of the 13 cases classified as type C preoperatively, 10 cases turned into type D and 3 into type E postoperatively; and all the 8 cases classified as type D preoperatively turned into type E postoperatively. The ASIA scores increased by 1-2 levels compared with those before operation (P<0.05). The height of cervical intervertebral space, physiological curvature and cervical stability of all patients were well maintained 7 days and 12 months after operation, which were significantly improved compared with those before operation (P<0.05). There was no significant difference between the two follow-up visits at 7 days and 12 months after operation. The Japanese Orthopaedic Association score at 12 months after operation (14.6±2.3) was significantly better than that before operation (6.8±2.6), and the average improvement rate was (79.6±18.8)% (P<0.05). No complications such as screw loosening, fracture or displacement occurred during follow-up.ConclusionOne-stage posterior reduction single nail and rod fixation combined with the anterior operation is safe and effective for the treatment of lower cervical fracture-dislocation combined with unilateral locked facet.
Objective To compare germicidal effect of three disinfectants acting on frequently-touched surfaces in Intensive Care Unit (ICU) at different time points after disinfection so as to put forward the reasonable disinfection method and interval before the next disinfection. Methods We wiped the four frequently-touched surfaces in ICU with disinfectant containing acidic electrolyzed oxidizing water (EOW) from the building system of hospital, disinfectant wipes, and 500 mg/L chlorine respectively. The culture samples were collected from the surfaces before wiping, and 10 minutes, 30 minutes, 1 hour, 2 hours and 4 hours after wiping respectively. The bacterial clearance rate and the qualified rate of bacterial colony counts on the surfaces were compared among the three different disinfectants at different time points after disinfection. Results The bacterial killing rate of three methods for disinfection of object surfaces decreased with the passing of time. The bacterial killing rate of EOW from the building system of hospital was lower than that of the other two methods at all five time points after disinfection (P< 0.05). The bacterial killing rate at hour four after disinfection using chlorine-containing disinfectant and disinfectant wipes was higher than 90.0%. The qualified rate of bacterial colony counts on the surfaces at 10 and 30 minutes after disinfection among the three groups was not significantly different (P>0.05). The qualified rate of bacterial colony counts on the surfaces disinfected by EOW from the building system of hospital was lower than that in the other two groups at the other three time points (P<0.05), and it was totally unqualified at hour four after disinfection. Conclusions The germicidal effect of EOW from the building system of hospital is inferior to chlorine disinfectant and disinfectant wipes. Moreover, the surface can be easily recontaminated after disinfection. It is suggested that EOW should be used in ICU every other hour. and the other two disinfection methods should be used every two hours.
Brain-computer interface (BCI) based on functional near-infrared spectroscopy (fNIRS) is a new-type human-computer interaction technique. To explore the separability of fNIRS signals in different motor imageries on the single limb, the study measured the fNIRS signals of 15 subjects (amateur football fans) during three different motor imageries of the right foot (passing, stopping and shooting). And the correlation coefficient of the HbO signal during different motor imageries was extracted as features for the input of a three-classification model based on support vector machines. The results found that the classification accuracy of the three motor imageries of the right foot was 78.89%±6.161%. The classification accuracy of the two-classification of motor imageries of the right foot, that is, passing and stopping, passing and shooting, and stopping and shooting was 85.17%±4.768%, 82.33%±6.011%, and 89.33%±6.713%, respectively. The results demonstrate that the fNIRS of different motor imageries of the single limb is separable, which is expected to add new control commands to fNIRS-BCI and also provide a new option for rehabilitation training and control peripherals for unilateral stroke patients. Besides, the study also confirms that the correlation coefficient can be used as an effective feature to classify different motor imageries.
ObjectiveTo review the research progress of cementless intercalary prosthesis stem. MethodsThe literature about the cementless intercalary prosthesis in treatment of bone defects of extremities was reviewed, and the designing and application of prosthesis stem were analyzed. ResultsCementless intercalary prosthesis has the advantages of good biocompatibility. However, there are also some disadvantages, including the multiple factors affecting the fixation of the prosthesis stem and individual differences in the stability of the prosthesis. The methods to improve the fixation stability of prosthesis stem mainly include the optimization of prosthesis stem shape, addition of auxiliary fixation, and improvement of coating materials on the stem surface as well as porous structure of the stem surface. Among these methods, augment with auxiliary fixation has the most satisfactory effect on improving the stability of prosthesis. However, the deficiency of the method is the increasing risk of the larger incision exposure and surgical trauma. ConclusionImproving the design and fixation method of the cementless intercalary prosthesis stem can further improve the stability of the prosthesis. Under the premise of avoiding increasing surgical trauma as much as possible, addition of the auxiliary fixation can be a feasible choice to improve the fixation stability of prosthesis.
ObjectiveTo study the clinical features of children with seizures as core symptoms of neuronal surface antibody syndromes. MethodsThe clinical data of neuronal surface antibody syndromes between December 2015 and December 2016 were obtained and analyzed. All children presented to hospital with seizures as core symptoms. ResultsThere were 1 male and 9 females in this study. The ages ranged from 3 years to 13 years. The disease course was between 3 and 14 days. All children presented to hospital with seizures as core symptoms.Two children had tonic seizures. one had tonic-clonic seizure. Seven had partial seizures. Among them, six children had status epilepticus and cluster attack. The other symptoms in the course of the disease were psychiatric symptoms and extrapyramidal symptoms.The anti-NMDAR antibody were found in 9 patients' CSF and blood. The LGI1 antibody was found in one patients' CSF and blood.The EEG test of 7 patients showed slow wave and sharp slow wave. Two showed spike wave. One showed slow wave.The MRI test of one patient showed abnormal. Ten cases were treated with IVIG and methylprednisolone during acute stage. The patients had been followed up for 3 to 6 months. Eight of them recovered completely. Two cases had seizures. Two cases diagnosed with anti-NMDAR related epilepsy received sound effects after treated with cyclophosphamide. ConclusionsConvulsion may be the first common symptom of neuronal surface antibody syndromes in children. Immune factors should be screened when children with acute seizures and status epilepticus. Accompanying psychiatric symptoms, autoimmune epilepsy should be considered. The most common neuronal surface antibody in children with neuronal surface antibody syndromes is NMDAR antibody. EEG usually shows slow wave and sharp slow wave during seizures. Brain MRI is usually normal. Immunotherapy is effective in the majority of patients as the first line treatment. When the first-line treatment failed, second-line immunotherapy such as cyclophosphamide shock therapy on a regular basis is helpful.
Objective To define an objective evaluation model for metadata integrity of randomized controlled trials (RCTs) in traditional Chinese medicine (TCM), and to evaluate the data integrity of RCT reports published in TCM journals. Methods Retrieving Chinese medicine RCT literature and extracting data, using the metadata specification list and customized evaluation model defined in the project "Intelligent Construction and Application Demonstration of the Evidence System of Chinese Medicine Dominant Diseases" to analyze RCTs from the perspective of data integrity. Results A metadata interface specification and an objective evaluation model for RCT metadata integrity were proposed. A total of 37 361 articles of 10 diseases from 1986 to 2020 were evaluated. Among them, 6 743 reports failed to meet the basic requirements of metadata specifications. The proportion of reports with no missing required items was between 73% and 97%. "tcm_disease" and "num_drop_total" had a greater impact on completeness for the required items. The reporting rates of the items in the "age_sd" and "history_sd" in the "group" section, and "dosage", "dosage_form" and "dosage_freq" in the "interventions" section were low. The average score of RCT report was 71.39 points. Conclusions There is room for improvement in the integrity of RCT data in TCM, and data reporting is urgently required to be standardized. The metadata specification and completeness objective evaluation model proposed in this study can provide references for improving the data integrity of clinical trial reports of TCM.
ObjectiveTo three-dimensionally calculate the craniofacial parameters of midface of patients with Treacher Collins syndrome (TCS) in China, in order to understand the changes in the spatial position relationship between the various anatomical structures of the midface.MethodsCT imaging data of TCS patients and age- and gender-matched normal populations between January 2013 and July 2020 was retrospectively analyzed. A total of 33 cases met the selection criteria for inclusion in the study, including 14 cases in the TCS group and 19 cases in the control group. ProPlan CMF 3.0 software was used to perform three-dimensional digital reconstruction of the craniofacial bone, measure the anatomical parameters of the midface, and analyze its morphological structure; at the same time perform three-dimensional digital reconstruction of the upper airway for morphological analysis (measure upper airway volume).ResultsCT images analysis revealed that all 14 patients with TCS presented the typical features with downward slanting of the palpebral fissures and different degrees of zygomatico-orbital complex dysplasia. Cephalometric and morphological analysis of the midface revealed that, multiple transverse diameters of the midface of TCS patients were significantly decreased when compared with the control group (P<0.05), such as the width of the maxillary base, the length of the maxillary complex, and some distances related to the nasal morphology; but the distance between bilateral orbitales increased in TCS group (P<0.05). Several anteroposterior distances in TCS group were decreased significantly when compared to control group and the distance between the skull base point and the posterior nasal spine was the most shortened (P<0.05). But there was no significant difference of the distance between nasion and anterior nasal spine, which represented anterior midface height, between groups (P>0.05). The skull base angle and SNB angle (the angle between the sella point-nose root point-inferior alveolar seat point) of the TCS group both decreased when compared with the control group (P<0.05), but there was no significant difference in SNA angle (the angle between the sella point-nose root point-upper alveolar seat point) between the two groups (P>0.05). The total volume of the upper airway was (24 621.07±8 476.63) mm3 in the TCS group, which was significantly lower than that of the control group [(32 864.21±13 148.74) mm3] (t=2.185, P=0.037).ConclusionThe transverse distances, anteroposterior distances, and multiple craniofacial angles measurement of TCS patients were significantly decreased when compared to the control group, presented with different degrees of zygomatico-orbital complex dysplasia, nasal and maxillary dysplasia, but there was no obvious restriction in face height development. Reduced internal diameters of the upper airway maybe responsible for the decreased upper airway volume of patients with TCS.
In the process of lower limb rehabilitation training, fatigue estimation is of great significance to improve the accuracy of intention recognition and avoid secondary injury. However, most of the existing methods only consider surface electromyography (sEMG) features but ignore electrocardiogram (ECG) features when performing in fatigue estimation, which leads to the low and unstable recognition efficiency. Aiming at this problem, a method that uses the fusion features of ECG and sEMG signal to estimate the fatigue during lower limb rehabilitation was proposed, and an improved particle swarm optimization-support vector machine classifier (improved PSO-SVM) was proposed and used to identify the fusion feature vector. Finally, the accurate recognition of the three states of relax, transition and fatigue was achieved, and the recognition rates were 98.5%, 93.5%, and 95.5%, respectively. Comparative experiments showed that the average recognition rate of this method was 4.50% higher than that of sEMG features alone, and 13.66% higher than that of the combined features of ECG and sEMG without feature fusion. It is proved that the feature fusion of ECG and sEMG signals in the process of lower limb rehabilitation training can be used for recognizing fatigue more accurately.
Regarding to the channel selection problem during the classification of electroencephalogram (EEG) signals, we proposed a novel method, Relief-SBS, in this paper. Firstly, the proposed method performed EEG channel selection by combining the principles of Relief and sequential backward selection (SBS) algorithms. And then correlation coefficient was used for classification of EEG signals. The selected channels that achieved optimal classification accuracy were considered as optimal channels. The data recorded from motor imagery task experiments were analyzed, and the results showed that the channels selected with our proposed method achieved excellent classification accuracy, and also outperformed other feature selection methods. In addition, the distribution of the optimal channels was proved to be consistent with the neurophysiological knowledge. This demonstrates the effectiveness of our method. It can be well concluded that our proposed method, Relief-SBS, provides a new way for channel selection.
Titanium and its alloys have become one of the most widely used implant materials in orthopedics because of their excellent mechanical properties and biocompatibility. Implant-associated infection is the main reason of failure of orthopedic implant surgery. The anti-infection modification of implant surface has received more attention in the field of infection prevention and developed rapidly. This article focuses on the current research status of simple anti-infection surface modifications that make titanium implants possess anti-adhesion, bactericidal activity or antibacterial membrane activity, as well as the research progress of composite functional surface modifications that promote bone integration, osteogenesis or immunomodulatory effects on the basis of anti-infection, so as to provide references for the construction of orthopedic implants with composite functions.