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OBJECTIVE@#To establish finite element models of different preserved angles of osteonecrosis of the femoral head (ONFH) for the biomechanical analysis, and to provide mechanical evidence for predicting the risk of ONFH collapse with anterior preserved angle (APA) and lateral preserved angle (LPA).@*METHODS@#A healthy adult was selected as the study object, and the CT data of the left femoral head was acquired and imported into Mimics 21.0 software to reconstruct a complete proximal femur model and construct 3 models of necrotic area with equal volume and different morphology, all models were imported into Solidworks 2022 software to construct 21 finite element models of ONFH with LPA of 45°, 50°, 55°, 60°, 65°, 70°, and 75° when APA was 45°, respectively, and 21 finite element models of ONFH with APA of 45°, 50°, 55°, 60°, 65°, 70°, 75° when LPA was 45°, respectively. According to the physiological load condition of the femoral head, the distal femur was completely fixed, and a force with an angle of 25°, downward direction, and a magnitude of 3.5 times the subject's body mass was applied to the weight-bearing area of the femoral head surface. The maximum Von Mises stress of the surface of the femoral head and the necrotic area and the maximum displacement of the weight-bearing area of the femoral head were calculated and observed by Abaqus 2021 software.@*RESULTS@#The finite element models of ONFH were basically consistent with biomechanics of ONFH. Under the same loading condition, there was stress concentration around the necrotic area in the 42 ONFH models with different preserved angles composed of 3 necrotic areas with equal volume and different morphology. When APA was 60°, the maximum Von Mises stress of the surface of the femoral head and the necrotic area and the maximum displacement of the weight-bearing area of the femoral head of the ONFH models with LPA<60° were significantly higher than those of the models with LPA≥60° ( P<0.05); there was no significant difference in each index among the ONFH models with LPA≥60° ( P>0.05). When LPA was 60°, each index of the ONFH models with APA<60° were significantly higher than those of the models with APA≥60° ( P<0.05); there was no significant difference in each index among the ONFH models with APA≥60° ( P>0.05).@*CONCLUSION@#From the perspective of biomechanics, when a preserved angle of ONFH is less than its critical value, the stress concentration phenomenon in the femoral head is more pronounced, suggesting that the necrotic femoral head may have a higher risk of collapse in this state.
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Adult , Humans , Femur Head/surgery , Finite Element Analysis , Stress, Mechanical , Femur/diagnostic imaging , Femur Head Necrosis/surgeryABSTRACT
Objective To master the epidemic situation and control effect of schistosomiasis in Yugan County,Jiangxi Prov-ince. Methods The data of the schistosomiasis prevalence in human and cattle as well as Oncomelania hupensis snail status were collected and the change trends were analyzed in Yugan County from 2008 to 2012. Results The schistosome infection rates of residents in Yugan County have declined every year since 2008,and currently,the prevalence of schistosomiasis was at a low lev-el. No acute schistosomiasis case was found during the past 5 years. In 2012,the infection rate of bovine was above 1%in 88 en-demic villages,and the area with schistosome infected snails was 10 hm2. Conclusion In order to achieve the goal of schistosomi-asis transmission control in the whole county in 2015,the comprehensive control measures based on infection source control should be strengthened.
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It's a new financial management system that our country implemented the management of separating the income and expenditure in the community health services.Beijing is one of the former pilot cities which carried on the management of separating the income and expenditure.To know the effectiveness of the implementations and its influence to the health services,this article analyses the status of community health services,the financial investment and the performance results in Beijing.Considering the above,this paper also provides policy recommendations on the development of health services in Beijing to improve the new urban medical service system which based on the community health services.
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BACKGROUND: It is found reported that polymorphism of Fok 1 restriction endonuclease cut site on exon 2 of 5' end start codon of 5' end start codon (SC), which affected the structure of VDR amino acids,and was relative related to bone mineral density(BMD).OBJECTIVE: To analyze the association between Vitamin D receptor gene (Fok 1) polymorphisms and osteoporosis in the elderly men.DESIGN: case-controlled trialstudy.SETTING: Institute of Gerontology, Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA.PARTICIPANTS: A total of 26 elderly men with osteoporosis at out-patients clinic of Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA from January 2002 to June 2002 were selected involved as osteoporosis case group,with and the average age of was (70±5) years, and BMD in osteoporosis group was 2.0-2.5 SD lower than 2.0-2.5 SD of the peak of BMD. Totally 66 healthy men with average age of (70±5)years were selected as control group during at the same time. All the subjects signed the informed consent,who were Beijing inhabitants of Han nationality, and there was no blood relationship among them.METHODS:VDR-Fok1 genotypes in both groups were detected with by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),and distributiondistribution of VDR-Fok 1 genotypes were analyzedanalyzed.MAIN OUTCOME MEASURES: distribution Distribution of VDR-Fok1genotypes in both each groups.RESULTS: Totally 66 healthy elderly men and 26 elderly men with osteoporosis entered analysis of results. The frequencies of FF, Ff and ff genotype were found to be 42%, 42% and 15% in control group, and 15%,50%,35% in osteoporosis group, respectively,and there was significantly different between two groups(x2=12.078,P ＜ 0.01).Frequency of allele were significantly different between control group and osteoporosis group (64%,36% vs 40%,60%, x2=8.232,P ＜ 0.01).CONCLUSION: There is a significant difference in the frequency distrinution of VDR gene start codon polymorphism between healthy elderly men and those with osteoporosis.
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OBJECTIVE:To investigate the utilization of aspirin in patients with type 2 diabetes mellitus.METHODS:The utilization of aspirin in 510 inpatients with type 2 diabetes mellitus in the department of Endocrinology in our hospital from April 2004 to April 2007 was analyzed retrospectively.RESULTS:Of the total 510 cases,68.2% received aspirin,with daily dose reached 50～100mg.Aspirin was more often used in patients complicated with coronary heart disease and hypertension(P
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BACKGROUND:Bone mineral density(BMD) is still regarded as the standard of early diagnosis and treatment of osteoporosis(OP) at present.But it is found in detection that different sex,age and skeleton location have different OP detection rate,so it is necessary to analyze the difference. OBJECTIVE:To compare the difference of OP detection rate at different skeleton location between males and females with the increase of age. DESIGN:A cross-sectional study taking patients as the subjects. SETTING:Endocrine department of an artillery general hospital of Chinese PLA. PARTICIPANTS:A total of 147 patients,including 54 males and 93 females, aged from 50 to 78 years old,who were hospitalized in our outpatient clinic from September 2000 to January 2002,were selected and divided into 3 groups according to age,50 to 59 years old group (n=46,13 males and 33 females),60 to 69 years old group (n=66,26 males and 40 females) and 70 to 79 years old group (n=35,15 accordance with the OP diagnostic criteria recommended by WHO[1]. Exclusive criterion: secondary OP patients caused by chronic disease of liver,kidney, heart, and gastrointestinal tract and some endocrine disease such as diabetes,hyperthyroidism and so on. INTERVENTIONS:Every subject filled in the history questionnaire in detail.Height and body mass were measured accurately and body mass index(BMI) was calculated (kg/m2).A new type of Norland Excell plus dual-energy X-ray absorptiometry(DEXA) was used to detect BMD(g/cm2) of L2- 4 and proximate femur(neck of femur, Ward's triangle,greater trochanter).The detected values were compared with the normal data of young adults of the same sex and the T value(SD) was obtained. RESULTS:OP in lumber vertebra was predominant in female climacteric(χ 2=10.14,P< 0.01),and the detection rate of OP in lumber vertebra and neck of femur increased with age(χ 2=7.41, P< 0.05).OP in simple neck of femur increased significantly in males after 60 yeas old(χ 2=9.11,P< 0.05). Females were more liable to suffer from OP in simple lumber vertebra and in both lumber vertebra and neck of femur(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01).Age had significant negative correlation with BMD in neck of femur,Ward's triangle and great trochanter of females(r=- 0.364,- 0.389, P< 0.01;r=- 0.504,P< 0.001),while BMI was positively correlated with L2- 4,neck of femur and great trochanter significantly(r=0.306,0.329,0.338,P< 0.05). CONCLUSION:Detection rate of OP changes with skeleton detecting location and age.It is very significant to recognize and evaluate these objective phenomena correctly for the diagnosis and treatment of OP.
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To investigate the ratio of urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr) in diseases with bone loss, urinary Pyr and Dpyr levels were evaluated in 48 cases of osteoporosis, 8 cases of carcinoma with bone metastasis, 6 cases of rheumatoid arthritis, and 78 healthy volunteers. It was found that urinary Pyr and Dpyr increased significantly as compared to those in the control ( P 0 05), while it was dramatically lower in the patients with carcinoma bone metastasis ( P