ABSTRACT
ObjectiveTo explore the common syndromes of patients with cerebral infarction in rural areas of eastern Henan based on latent structure model and factor analysis，and provide reference for clinical differentiation of cerebral infarction. MethodThe data samples of patients with cerebral infarction in rural areas in eastern Henan were preprocessed. With Lantern 5.0 of latent structure method and LTM-EAST algorithm of two-step latent tree analysis， the manifest variable latent structure model of related symptoms was built to interpret different latent nodes， and common syndromes of cerebral infarction were obtained via comprehensive cluster analysis. SPSS 20.0 was used for factor analysis and cluster analysis of related symptoms to infer the distribution of syndrome types. ResultThe data of 888 patients with cerebral infarction were included， involving symptoms， tongue and pulse （88 in total）. The 65 symptoms with a frequency of ≥5% were constructed into a latent structure model， and 31 latent variables were obtained. The Bayesian information criterion （BIC） score was -15 367.17. Based on professional knowledge， s6 common syndrome types were found， namely， syndrome of upward disturbance of wind-fire， Qi deficiency and blood stasis syndrome， syndrome of phlegm and blood stasis blocking collaterals， syndrome of phlegm-heat and fu-organ excess， syndrome of wind phlegm obstructing collaterals， and syndrome of stirring wind due to yin deficiency. In factor analysis， the symptoms with a frequency of >10% were selected， and 13 common factors were obtained and used for systematic cluster analysis. And 5 syndrome types were inferred： syndrome of wind phlegm obstructing collaterals， syndrome of phlegm-heat and fu-organ excess， Qi deficiency and blood stasis syndrome， syndrome of combined phlegm and blood stasis， and syndrome of yin deficiency and internal heat. According to the determination criteria of syndrome types in traditional Chinese medicine （TCM）， 6 common syndrome types of cerebral infarction were finally determined. ConclusionAccording to the severity of the disease， the common syndromes of patients with cerebral infarction in rural areas of Eastern Henan were divided into the following categories： apoplexy involving channel and collateral： syndrome of upward disturbance of wind fire， syndrome of wind phlegm obstructing collaterals， and syndrome of stirring wind due to yin deficiency. Apoplexy involving zang and fu-viscera： syndrome of phlegm-heat and fu-organ excess， and syndrome of phlegm and blood stasis blocking collaterals. Recovery period： Qi deficiency and blood stasis syndrome. This study was basically consistent with the syndrome law in TCM theory， and provided reference for further establishing syndrome diagnostic criteria of cerebral infarction.
ABSTRACT
<p><b>OBJECTIVE</b>To study the anatomical and biomechanical features of sacral pedicle and lateral mass so as to provide reference for clinical screw fixation technology of sacral pedicle and lateral mass.</p><p><b>METHODS</b>A total of 60 adult patients'spiral CT images of the sacrum and coccyx were selected randomly. The entry points of sacral pedicle and lateral mass screws were determined, and the screw trajectory was measured using the three dimensional reconstruction method. Meanwhile, the gross anatomy was scrutinized in 15 adult cadaver specimens to determine the sacral pedicle and lateral mass screw entry points. The length, width and angle of sacral pedicle and lateral mass screw trajectory were measured. Eight of 15 cadaver specimens were selected to test the maximal extraction force of sacral pedicle and lateral mass screws. The clinical data of 15 cases treated by pedicle and lateral mass screw technology were collected and analyzed.</p><p><b>RESULTS</b>The diameter and length of S(1)-S(5) sacral pedicle and lateral mass screw trajectory were regular, with about 20 degree inclination angle. The S(1) pedicle screw entry point was located at the intersection point of the basal lateral part of articular process and median line of transverse process, and no significant difference was found for the maximal extraction force between pedicle and lateral mass screws (P larger than 0.05). The entry points of S(2)-S(5) pedicle screws were located at the intersection point of the line connecting adjacent posterior sacral foramina and median line of the transverse process. The lateral mass screw entry point of S(2)-S(5) was on the median side of intersection point between median line of the transverse process and lateral sacral crest. The maximal extraction force of pedicle screws was significantly greater than that of lateral mass screws (P less than 0.05).</p><p><b>CONCLUSION</b>Both the sacral pedicle and the lateral mass screw fixation techniques can offer effective fixation and reconstruction for fracture of the sacrum and coccyx, but pedicle screw fixation may be more convenient, safe and reliable than lateral mass screw fixation.</p>
Subject(s)
Adult , Female , Humans , Male , Biomechanical Phenomena , Bone Screws , Fracture Fixation, Internal , Methods , Imaging, Three-Dimensional , Sacrum , Physiology , General Surgery , Tomography, X-Ray ComputedABSTRACT
Objective To study the anatomical and biomechanical features of sacral pedicle and lateral mass to provide evidence for clinical sacral pedicle and lateral mass screw fixation technology. Method 60 adult patient's spiral CT images of sacrum and coccyx were selected randomly. The sacral pedicle and lateral mass screw entry point was determined, and the crew trajectory were measured using the three dimensional reconstruction. Meanwhile, the gross anatomy was done for 15 adult cadavers to determine the sacral pedicle and lateral mass screw entry point. The length, width and angle of sacral pedicle and lateral mass screw trajectory was measured. 8 of 15 cadaver specimens were selected to test for the maximal extraction force for sacral pedicle and lateral mass screws. ResultsThe diameter and length of S1～S5 sacral pedicle and lateral mass screw trajectory are significantly regular, with inclination angle is about 20°. The S1 pedicle screw entry point is located at intersection point of basal lateral part of articular process and median line of transverse process, no significant difference is found between the maximal extraction force of pedicle and lateral mass screws (P>0.05）. The entry points of S2～5 pedicle screws are located at the intersection point of the line connecting adjacent posterior sacral foramina and median line of transverse process. The lateral mass screw entry point of S2～5 is on the median side of intersection point between median line of transverse process and lateral sacral crest. The maximal extraction force of pedicle screws are significantly different from the lateral mass screws（P<0.05）. Conclusions Both the sacral pedicle and the lateral mass screw fixation technology can offer effective fixation and reconstruction for the fracture of sacrum and coccyx, but the pedicle screw fixation may be more convenient, safe and reliable than the lateral mass screw fixation technology.