The relationship between spinopelvic parameters and clinical symptoms of severe isthmic spondylolisthesis: a prospective study of 64 patients

Purpose

To investigate the relationship between spinopelvic parameters and clinical symptoms for patients with severe isthmic spondylolisthesis.

Methods

A series of spinopelvic parameters were measured in 64 patients with L5 severe isthmic spondylolisthesis. The patients were divided into two groups according to Oswestry score obtained preoperatively, i.e. mild or severe low back pain group. T test was used to compare parameters between two groups, and multiple linear regression analysis was employed to investigate the association between parameters and Oswestry score.

Results

Compared with two group patients, parameters of spondylolisthesis grade, pelvic tilt (PT), lumbar lordosis (LL), T9 tilting angle (T9TA), sacro-femoral horizontal distance (SFHD), distance between perpendicular line through C7 and sacrum (SC7D), pelvic tilt/sacral slope (PT/SS), sacro-femoral horizontal distance/vertical distance (SFHD/SFVD), and lumbar lordosis/thoracic kyphosis (LL/TK) were significantly increased in severe low back pain group, while SS and SFVD were significantly decreased, and no significant difference was found for pelvic incidence (PI) and TK. The statistical analysis showed that spondylolisthesis grade, PT, SC7D, LL, SFHD, PT/SS, SFHD/SFVD, and LL/TK had a significant positive correlation with Oswestry score, with an order of spondylolisthesis grade > PT/SS > SC7D > PT > SFHD/SFVD > SFHD > LL/TK > LL. No significant correlation was found for PI, TK, T9TA with Oswestry score, while SS and SFVD had a significant negative correlation with Oswestry score, with an order of SS > SFVD.

Conclusions

The spinopelvic parameters (spondylolisthesis grade, SS, PT, SC7D, LL, SFVD, SFHD, PT/SS, SFHD/SFVD, LL/TK) are significantly correlated with clinical symptoms of severe isthmic spondylolisthesis in patients. The association of the exacerbation of low back pain with SS (correlation coefficient −0.981, strong) and SFVD (correlation coefficient −0.802, strong) is the most significant correlation.     

不同体位肺复张对重症肺炎患者的临床治疗效果和安全性对比探讨

目的探讨不同体位肺复张对重症肺炎患者的临床治疗效果和安全性。方法选取本院收治的87例重症肺炎患者为研究对象,将患者分为仰卧位肺复张组和俯卧位肺复张组,分别使用不同的肺复张方法进行治疗,比较两组的临床效果。结果复张后5 min、1 h,两组患者的HR、CI、MAP与复张前比较,差异无统计学意义（P〉0.05）,复张后5 min的CVP与复张前比较,差异有统计学意义（P〈0.05）,复张后1 h与复张前比较,差异无统计学意义（P〉0.05）;复张后5 min、1 h的Pa O2/Fi O2高于复张前,差异有统计学意义（P〈0.05）。俯卧位肺复张组复张后5 min、1 h的Pa O2/Fi O2与仰卧位肺复张组比较,差异有统计学意义（P〈0.05）。在肺复张前后无一例患者出现气胸、皮下气肿等并发症;两组患者复张后5 min、1 h的胃黏膜p H与复张前比较,差异无统计学意义（P〉0.05）,两组患者复张后5 min、1 h的胃黏膜p H比较,差异无统计学意义（P〉0.05）。结论两种肺复张方法均能有效改善患者的血氧参数和呼吸功能,且俯卧位肺复张的效果稍显优势,需结合临床进行选择。     

An Exploratory Study on Resistance Spot Welding of Titanium Alloy Ti-6Al-4V

Resistance spot welding (RSW) is one of the most effective welding methods for titanium alloys, in particular Ti-6Al-4V. Ti-6Al-4V is one of the most used materials with its good ductility, high strength, weldability, corrosion resistance, and heat resistance. RSW and Ti-6Al-4V materials are often widely used in industrial manufacturing, particularly in automotive and aerospace industries. To understand the phenomenon of resistance spot weld quality, the physical and mechanical properties of Ti-6Al-4V spot weld are essential to be analyzed. In this study, an experiment was conducted using the Taguchi L9 method to find out the optimum level of the weld joint strength. The given optimum level sample was analyzed to study the most significant affecting RSW parameter, the failure mode, the weld nugget microstructure, and hardness values. The high heat input significantly affect the weld nugget temperature to reach and beyond the β-transus temperature. It led to an increase in the weld nugget diameter and the indentation depth. The expulsion appeared in the high heat input and decreased the weld nugget strength. It was caused by the molten material ejection in the fusion zone. The combination of high heat input and rapid air cooling at room temperature generated a martensite microstructure in the fusion zone. It increased the hardness, strength, and brittleness but decreased the ductility.     

HJ 564—2010工程实践与探讨

针对HJ 564—2010生活垃圾填埋场渗滤液处理工程技术规范中提出的渗滤液水质、浓缩液处理工艺、好氧生物处理工艺、工艺参数等内容,研究并探讨其与实际工程实践中存在的较大差异。     

双源CT质量控制方案技术初步研究

目的：通过对双源CT进行质量控制检测,保证其所有技术性能参数与生产厂家的基线值保持一致,误差在允许范围之内;同时对B成像系统进行实验检测,初步探讨出符合B成像系统的验收和检测方法。方法：对双源CT的2套成像系统分别进行检测,检测设备包括Catphall模体、CT剂量仪、头部剂量体模以及BarracudaX线机多功能检测仪。结果：在不改变曝光参数的条件下,CTDIAR=CTDIA＋CTDIB;在维修模式下,对B成像系统单独曝光可检测到CT辐射剂量、影响图像质量的关键性参数图像以及相关数值。结论：DSCT的B成像系统在维修模式下是可以独立检测的,它为制定出一套可行的、检测DSCT应用的质量控制方案奠定了坚实的基础。     

The dose–effect relationship in extracorporeal shock wave therapy: the optimal parameter for extracorporeal shock wave therapy

Background

Extracorporeal shock wave therapy (ESWT) has been demonstrated to have the angiogenic effect on ischemic tissue. We hypothesize that ESWT exerts the proangiogenesis effect with an energy density–dependent mode on the target cells.

Materials and methods

Endothelial progenitor cells (EPCs) of rats were obtained by cultivation of bone marrow–derived mononuclear cells. EPCs were divided into five groups of different energy densities, and each group was furthermore subdivided into four groups of different shock numbers. Thus, there were 20 subgroups in total. The expressions of angiogenic factors, apoptotic factors, inflammation mediators, and chemotactic factors were examined, and the proliferation activity was measured after ESWT.

Results

When EPCs were treated with low-energy (0.04–0.13 mJ/mm²) shock wave, the expressions of endothelial nitric oxide synthase, angiopoietin (Ang) 1, Ang-2, and B-cell lymphoma 2 increased and those of interleukin 6, fibroblast growth factor 2, C-X-C chemokine receptor type 4, vascular endothelial growth factor a, Bcl-2-associated X protein, and caspase 3 decreased. stromal cell-derived factor 1 changed without statistical significance. When cells were treated with high-energy (0.16 mJ/mm²) shock wave, most of the expressions of cytokines declined except the apoptotic factors and fibroblast growth factor 2, and cells lead to apoptosis. The proliferation activity and the ratio of Ang-1/Ang-2 reached their peak values, when cells were treated with ESWT with the intensity ranging from 0.10–0.13 mJ/mm² and shock number ranging from 200–300 impulses. Meanwhile, a minimal value of the ratio of Bax/Bcl-2 was observed.

Conclusions

There is a dose–effect relationship in ESWT. The shock intensity ranging from 0.10–0.13 mJ/mm² and shock number ranging from 200–300 impulses were the optimal parameters for ESWT to treat cells in vitro.     

髌骨形态异常与膝关节骨关节炎之间相关性

目的利用计算机辅助测量技术,对一定样本量的甘肃省中医院影像科膝关节X线片进行骨形态测量和相关比值分析研究,得出膝关节相关参数的正常范围,确立膝关节发育缺陷与膝关节骨关节炎之间相关性,找出导致髌股关节骨关节炎的骨性致病因素。方法测量指标:股骨髁宽度、胫骨髁宽度、髌骨宽度、髌骨纵径、髌骨关节面高度、髌骨厚度、髌骨下缘与关节间隙距离、股骨内髁前后径、胫骨平台前后径、髌骨关节面距胫骨平台距离、髌骨中点距股骨纵轴距离,采用SPSS 17.0软件对各有关比值进行处理和分析,采用90%(p5~p95)医学参考范围为正常参考范围描述;计数资料采用χ2检验,设检验水平为0.05,P0.05为差异有显著性意义。结果通过测量136例正常膝关节X线片各骨形态数据及相关比值,以90%医学参考范围为正常范围,得出髌骨厚度/股骨内髁前后径:0.162 362~0.335 135,髌骨纵径/髌骨关节面高度:1.217 105~1.643 902为正常范围。以此标准在481例膝关节骨关节炎病例中,髌骨厚度/股骨内髁前后径异常率6.4%,髌骨纵径/髌骨关节面高度异常率23.5%。结论髌骨偏厚、髌骨偏薄等形态异常在膝骨关节炎中占有一定的比例且女性发病率高于男性。     

p53和nm23在结直肠癌中的表达及临床意义

目的探讨p53和nm23在结直肠癌组织中的表达与临床病理参数的相关性及临床意义。方法收集临床资料完整的196例结直肠癌病例,采用免疫组化SP法对p53和nm23表达情况进行检测,分析其相关及与肿瘤组织分化、转移及预后的关系。结果本研究发现p53、nm23表达与肿瘤的分化程度、淋巴结转移情况有密切联系(P0.05),与年龄、性别、病变位置无关(P0.05),p53、nm23在结直肠癌中的阳性表达呈负相关(r=-0.314)。结论联合检测p53和nm23蛋白表达有助于阐释结直肠癌发生发展、浸润转移的机制,并可作为评估结直肠癌恶性生物学行为及预后的参考指标。