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Objective:To analyze the ideal entry parameters and entry points for C 7 pedicle screws based on three-dimensional CT reconstruction model. Methods:A retrospective case series study was used to analyze the cervical spine CT image data of 50 adult volunteers collected from April 2021 to March 2022 at Taizhou People′s Hospital Affiliated to Nanjing Medical University, including 25 males and 25 females; aged 20-67 years [(43.8±13.5)years]. No significant structural abnormalities were seen in the cervicothorax of all volunteers. First, the 50 CT images were imported into the medical engineering software Mimics 17.0 to reconstruct the three-dimensional C 7 model, and the C 7 pedicle screw diameter (PSD), pedicle screw length (PSL), sagittal angle (SA) and lateral angle (LA) were measured. Then, the anatomical markers, namely the lateral notch and the midpoint of the inferior edge of the C 6 articular process, were used to measure the horizontal distance between the midpoint of the inferior edge of the C 6 articular process and the ideal entry point (line segment A), and the horizontal and vertical distances between the lateral notch and the ideal entry point (line segments B and C). Finally, the lateral notch and the midpoint of the inferior edge of the C 6 articular process were used as markers to observe the distribution of entry points. The values of the above measured parameters were recorded and compared with each other to analyze the differences between different sides and genders. Intra-group correlation coefficients (ICC) were also used to assess intra- and inter-observer agreement. Results:All 100 pedicles from 50 C 7 models were accessed, with the PSD being (6.5±0.7)mm, PSL being (31.8±4.5)mm, SA being (89.8±8.8)°, LA being (31.0±6.7)°, line segment A being 0.9(-0.4, 2.1) mm, line segment B being (5.8±1.7)mm, and line segment C being (3.6±1.5)mm. All ideal entry points were located medial above the lateral notch; moreover, with the midpoint of the inferior edge of the C 6 articular process as a reference, 71 (71%) of the entry points were located laterally and 29 (29%) were located medially. The 12 mm area around the midpoint of the inferior edge of the C 6 articular process was divided into 6 sections, with 47% of the entry points being located within 2 mm lateral to the midpoint, 25% within 2 mm medial to the midpoint, 19% within 2-4 mm lateral to the midpoint, and only 9% within 50% lateral to the midpoint. The measured parameters were not significantly different between the left and right sides (all P>0.05). The PSD, SA, and line segment B in males were (6.8±0.7)mm, (92.0±8.2)°, and (6.3±1.6)mm, which were significantly greater than those in females [(6.2±0.6)mm, (87.5±8.0)°, and (5.3±1.6)mm] (all P<0.01). The remaining parameters were similar between two genders (all P>0.05). All measured parameters had high intra- and inter-observer agreement (ICC: 0.84-0.91), except for line segment A that had moderate intra- and inter-observer agreement (ICC: 0.46-0.63). Conclusions:For C 7 pedicle screw implantation, when the surface of the lateral mass is used as the reference plane, SA is approximately 90°; with reference to the lateral notch, all the ideal entry points are located medially above it; with reference to the midpoint of the inferior edge of the C 6 articular process, approximately 70% of the entry points are located laterally. There are no significant differences in the parameters between the different sides of screw implantation on pedicles. The measured parameters show high intra- and inter-observer agreement, except for line segment A.
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Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods:A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac. The length of hospital stay, mass absorption time and menstrual recovery time of the patients were recorded. Postoperative complications and serum human chorionic gonadotropin (HCG) negative conversion time were observed. At 3 months after the operation, hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes, all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results:All the 8 patients were successfully treated with radiofrequency ablation, and postoperative ultrasonography showed that the mass remained unenhanced. The length of hospital stay was (3.0±0.8)d. The packet absorption time was (32.4±14.3)d. The recovery time of menstruation was (39.6±2.7)d. There were no serious complications.Blood HCG levels decreased rapidly within a week, and all returned to normal level of non-pregnancy 2-3 weeks after the operation. Three months after the operation, the salpingogram showed that the fallopian tubes were recanalized in 3 patients. After a follow-up of 1 year, 1 patient had a natural intrauterine pregnancy, and there was no case of recurrent ectopic pregnancy.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery, and can retain the reproductive ability of patients to some extent, which is worth popularizing in clinical application.
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Objective To investigate the therapeutic effect of astragalus injection onβcells apoptosis of type 1 diabetes mice. Methods 32 mice were randomly divided into a control group, a diabetes group, a small dose group and a large dose group of astraglus. Except the control group, mice in the other 3 groups received intraperitoneal injection of STZ in order to induce diabetic mellitus. Then one week after injection of STZ, mice in the small dose group and the large dose group of astraglus were given 30, 60 g/(kg?d) doses of astragalus injection, while the other 2 groups were injected into an equal volume saline for 4 weeks. Serum NO, inducible nitric oxide synthase (iNOS) and insulin levels were detected by enzyme linked immunosorbent assay method, and apoptosis was measured by using a TUNEL assay. Results Compared with the diabetes group, the serum NO (25.81 ± 2.09μmol/L, 18.84 ± 3.95μmol/L vs. 30.34 ± 2.53μmol/L) and iNOS (21.38 ± 4.48μmol/L, 17.00 ± 3.05μmol/L vs. 26.62 ± 2.48μmol/L) levels were significantly reduced in the small dose group and the large dose group of astragalus (P0.05). Conclusion Astragalus injection can reduce the iNOS activity and NO production, but can not effectively decreasingβcells apoptosis.