Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults (version 2023) / 中华创伤杂志

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Clinical guideline for diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture (version 2023) / 中华创伤杂志

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

Follow control of upper limb rehabilitation training based on Kinect and NAO robot / 生物医学工程学杂志

Gesture imitation is a common rehabilitation strategy in limb rehabilitation training. In traditional rehabilitation training, patients need to complete training actions under the guidance of rehabilitation physicians. However, due to the limited resources of the hospital, it cannot meet the training and guidance needs of all patients. In this paper, we proposed a following control method based on Kinect and NAO robot for the gesture imitation task in rehabilitation training. The method realized the joint angles mapping from Kinect coordination to NAO robot coordination through inverse kinematics algorithm. Aiming at the deflection angle estimation problem of the elbow joint, a virtual space plane was constructed and realized the accurate estimation of deflection angle. Finally, a comparative experiment for deflection angle of the elbow joint angle was conducted. The experimental results showed that the root mean square error of the angle estimation value of this method in right elbow transverse deflection and vertical deflection directions was 2.734° and 2.159°, respectively. It demonstrates that the method can follow the human movement in real time and stably using the NAO robot to show the rehabilitation training program for patients.

Study on the relationship between habitat factors and the distribution / 公共卫生与预防医学

Objective To explore the relationship between the distribution characteristics and the habitat factors of the invasive B. straminea in South China. Methods From October 2016 to August 2017, the breeding condition and habitat factors of B. straminea were investigated in the rivers of Shenzhen and its adjacent areas in the dry season, normal season and wet reason. The generalized additive model (GAM) was used to study the main habitat factors affecting the distribution density of B. straminea. Results The distribution characteristics of B. straminea showed obvious aggregation and unevenness in space. In terms of time, the density of snails was the highest in the dry season, followed by the normal water season and the least in the wet season. The GAM model analysis showed that the main habitat factors affecting the distribution density of B. straminea were water depth, water temperature, flow velocity, dissolved oxygen, and total phosphorus. When the flow velocity and water temperature were 0.25 m / s and 26 °C, respectively, the largest distribution density of snails might appear. The distribution density of B. straminea was positively correlated with dissolved oxygen and total phosphorus. Conclusion B. straminea is suitable to live in the water environment with poor water quality. In the future, the monitoring should be strengthened to provide reference for the prevention and control of the spread of the snails.

Spatiotemporal distribution of oncomelania hupensis snail habitats in the Middle and Lower Reaches of the Yangtze River / 公共卫生与预防医学

Schistosomiasis is one of the major communicable diseases, which seriously impacts human health, Oncomelania hupensis snail is unique intermediate host of Schistosoma japonicum as well as posts significant influence on schistosomiasis transmission. The long-term serial data of oncomelania snail area in the Middle and Lower Reaches of the Yangtze River in the Schistosomiasis situation in People's Republic of China ,were collected from 1999 to 2018. The spatial and temporal variation characteristics of oncomelania hupensis area in five provinces were analyzed by Manner-Kendall test. In the spatial change, the area composition ratio of lake-and-marshland regions in Hunan increased, while that in Hubei and Jiangxi showed a slight decline. The lake-and-marshland snails in Anhui showed a significant downward trend, while Jiangsu showed no stable trend. In the spatial change, the area of lake-and-marshland snails in Jiangsu, Anhui, and Hubei showed a downward trend, among which the downward trend in Hubei was not obvious, while the upward trend in Jiangxi and Hunan had an upward trend but the trend was not obvious. the year of the sudden change in the area of the lake and marshes in in Jiangsu and Hubei were 2010 and 2017 ; There was no significant mutation in Anhui Province; the mutation point of the lake-and-marshland snails in Hunan was between 2001 and 2002; the mutation year of the lake-and-marshland snails in Jiangxi was 2002.This paper studies the temporal and spatial changes of the snail breeding area in the middle and lower Yangtze River, and the results can provide a basis for the elimination of snails in different types of distribution areas.

Construction of community remote rehabilitation networks for stroke patients based on Internet of things technology / 中华医院管理杂志

The development of information technology in the medical industry is accelerating the construction of 3-level rehabilitation networks centering on community-based rehabilitation, which is based on the Internet and in combination with the Internet of things(IOT). A municipal rehabilitation hospital cooperated with the health centers of sub-district communities in the city to build a remote rehabilitation network based on IOT technology, for rehabilitation training of community stroke patients. The two sides worked out a cooperation scheme on project management, designed and built a remote community rehabilitation management model. Under the remote monitoring and equipment data IOT, the medical team of the municipal rehabilitation hospital could formulate the therapeutic plan according to the immediately obtained relevant functional evaluation data, and the medical team of the community health service center was responsible for the implementation of the plan. Fifty-three patients in the experimental group received the training of remote lower limb intelligent feedback system based on IOT together with routine rehabilitation training. After 8 weeks of treatment, the functional evaluation data of the two groups were improved in varying degrees( P< 0.05), but the improvement of the experimental group was significantly better than that of the control group( P < 0.05). Remote rehabilitation under the construction path of remote rehabilitation network based on IOT technology could significantly promote the improvement of post-functional rehabilitation of community stroke patients. This study can provide reference for the construction of three-level remote rehabilitation networks based on IOT and the implementation of home-based remote rehabilitation therapy in the future.

An improved maximal information coefficient algorithm applied in the analysis of functional corticomuscular coupling for stroke patients / 生物医学工程学杂志

The functional coupling between motor cortex and effector muscles during autonomic movement can be quantified by calculating the coupling between electroencephalogram (EEG) signal and surface electromyography (sEMG) signal. The maximal information coefficient (MIC) algorithm has been proved to be effective in quantifying the coupling relationship between neural signals, but it also has the problem of time-consuming calculations in actual use. To solve this problem, an improved MIC algorithm was proposed based on the efficient clustering characteristics of K-means ++ algorithm to accurately detect the coupling strength between nonlinear time series. Simulation results showed that the improved MIC algorithm proposed in this paper can capture the coupling relationship between nonlinear time series quickly and accurately under different noise levels. The results of right dorsiflexion experiments in stroke patients showed that the improved method could accurately capture the coupling strength of EEG signal and sEMG signal in the specific frequency band. Compared with the healthy controls, the functional corticomuscular coupling (FCMC) in beta (14~30 Hz) and gamma band (31~45 Hz) were significantly weaker in stroke patients, and the beta-band MIC values were positively correlated with the Fugl-Meyers assessment (FMA) scale scores. The method proposed in this study is hopeful to be a new method for quantitative assessment of motor function for stroke patients.

A smart O2-generating nanocarrier optimizes drug transportation comprehensively for chemotherapy improving

@#Drug transportation is impeded by various barriers in the hypoxic solid tumor, resulting in compromised anticancer efficacy. Herein, a solid lipid monostearin (MS)-coated CaO2/MnO2 nanocarrier was designed to optimize doxorubicin (DOX) transportation comprehensively for chemotherapy enhancement. The MS shell of nanoparticles could be destroyed selectively by highly-expressed lipase within cancer cells, exposing water-sensitive cores to release DOX and produce O2. After the cancer cell death, the core-exposed nanoparticles could be further liberated and continue to react with water in the tumor extracellular matrix (ECM) and thoroughly release O2 and DOX, which exhibited cytotoxicity to neighboring cells. Small DOX molecules could readily diffuse through ECM, in which the collagen deposition was decreased by O2-mediated hypoxia-inducible factor-1 inhibition, leading to synergistically improved drug penetration. Concurrently, DOX-efflux-associated P-glycoprotein was also inhibited by O2, prolonging drug retention in cancer cells. Overall, the DOX transporting processes from nanoparticles to deep tumor cells including drug release, penetration, and retention were optimized comprehensively, which significantly boosted antitumor benefits.

Application value of new liver function scoring models in radiofrequency ablation for hepatocellular carcinoma / 临床肝胆病杂志

Comprehensive scoring models are one of the main methods for liver function evaluation and an important part of the treatment strategy for hepatocellular carcinoma. This article summarizes the value and limitations of traditional scoring models (Child-Turcotte-Pugh score and Model for End-Stage Liver Disease score) and new scoring models (albumin-bilirubin score, platelet-albumin-bilirubin score, and albumin-indocyanine green score) in radiofrequency ablation for hepatocellular carcinoma and points out that the new scoring models, especially platelet-albumin-bilirubin score, are advantageous.

The analysis of myofascial trigger points in the infraspinatus muscle misdiagnosed as cervical spondylotic radiculopathy / 中华老年医学杂志

Objective:To analyze the cause of myofascial trigger points(MTrPs)in the infraspinatus muscle misdiagnosed as cervical spondylotic radiculopathy(CSR).Methods:Clinical data of patients with MTrPs in the infraspinatus muscle misdiagnosed as CSR were collected in Peking University Third Hospital from October 2016 to September 2019.Results:A total of 28 cases with MTrPs in the infraspinatus muscle were misdiagnosis as CSR.All patients received CT or magnetic resonance imaging evaluation of cervical spine, while none of them received physical examination in posterior shoulder area before confirming MTrPs in the infraspinatus muscle.The pain range was mainly located in the radial side of the shoulder, upper arm and forearm(89.3%)and was mainly unilateral(89.3%). The MTrPs in the supraspinatus muscle were mostly 2~3 points(67.8%). The visal analogue scale(VAS) score was significantly decreased after dry acupuncture as compared with pre-treatment[(2.7±1.4) vs.(6.1±1.3), P<0.05], and the overall treatment efficiency defined as VAS score decrement by more than 50%, was 82.1%. Conclusions:The neglect of medical history inquire and physical examination, and over-reliance on imaging findings are the important factors for misdiagnosis of MTrPs in the infraspinatus muscle as CSR.

Diagnosis and Treatment of Rosai-Dorfman Disease of the Spine / 中华骨科杂志

Objective:to review the clinical features, diagnosis and treatment of spinal Rosai-Dorfman disease(RDD).Methods:we conducted a systemic review and collected the cases reported from 2010. The key words were Rosai-Dorfman disease, spine/central nervous system. We screened both English and Chinese database. There were 43 reports finally included in the study, containing 52 cases. We distracted the information of interest and, subsequently, analyzed the harvested data using specific statistical software packages. The study focused on the summary and description of the clinical features, diagnosis and treatment and prognosis of spinal RDD.Results:The included articles reported 52 cases. The average age was 32.1±17.1 years (ranging from 6 to 76 years old). The ratio of male to female was 1.9/1. The median follow-up period was 19.9 months. The initial symptoms of 41 patients (78.8%) were spinal lesion-related. The cases with painless lymph nodes enlargement, other organ lesions and abnormal lab tests were 11.5%, 36.5% and 23.1%, respectively. The frequent infringed segments were cervical (43.1%) and thoracic (39.2%) spine. 53.2% lesions were dura-based, while 17.0% and 10.6% for bone and cord, respectively. Surgery was the mainstream of the treatment armamentarium, composing 83.7% cases, among which 46.3% underwent total resection. Cases only treated with radiotherapy, chemotherapy and steroids were 10.2%. Very Few cases remitted spontaneously (2.0%). The risk of recurrence and occurrence at other vertebral levels was 22.0%.Conclusion:It is rare for spinal involvement of RDD. This entity has no pathognomonic clinical and imaging features. RDD has a tendency of multi-organ involvement and recurrence. Surgery remains the mainstay of the treatment, but the efficacy of other adjuvant therapies is not sure. A wait and watch strategy is employed for asymptomatic patients.

Clinical guideline for surgical treatment of symptomatic chronic osteoporotic vertebral fractures / 中华创伤杂志

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Alterations of cholinergic and monoamine neurotransmitters in cerebrospinal fluid in patients with postoperative delirium / 中华行为医学与脑科学杂志

Objective:To investigate the alterations of cholinergic and monoamine neurotransmitters in cerebrospinal fluid in patients with postoperative delirium.Methods:Sixty-eight patients with normal preoperative cognitive functions were enrolled.They were diagnosed with spinal extramedullary intradural space-occupying lesion and underwent surgical resection.Among these patients, 18 developed postoperative delirium (delirium group), 46 had no postoperative delirium (control group), and the diagnosis of delirium was unclear in four cases (excluded). Cerebrospinal fluid (CSF) was collected before the surgical resection of lesions and on the third day postoperatively.The concentrations of acetylcholine (Ach), norepinephrine (NE), adrenaline (E), dopamine (DA) and serotonin (5-HT) were measured using the high-performance liquid chromatography/electrochemical method.Results:Prior to the surgical resection, there were no significant differences in the Ach, NE, E, DA or 5-HT baseline levels in the CSF between the delirium group and the control group (all P>0.05). After surgery, the Ach level in the delirium group ((0.63±0.26) μmol/L) was significantly lower than that in the control group ((0.77±0.19) μmol/L) ( P=0.032), and there were no significant differences in other neurotransmitter levels (all P>0.05). In the delirium group, the level of Ach in the CSF after surgery ((0.63±0.26) μmol/L) was significantly lower than the baseline level ((0.75±0.19) μmol/L) ( P=0.021). The postoperative NE level ((1.58±0.28) μmol/L) was significantly higher than the baseline level ((1.49±0.21) μmol/L) ( P=0.036). There was no significant difference in the adrenaline level ( P=0.497). The postoperative DA level ((0.86±0.18) μmol/L) was significantly higher than the baseline level ((0.82±0.15) μmol/L) ( P=0.045), and the postoperative 5-HT level ((2.94±0.28) μmol/L) was also significantly higher than the baseline level ((2.75±0.35) μmol/L) ( P=0.022). In the control group, only the postoperative 5-HT level ((2.90±0.31) μmol/L) was significantly higher than the baseline level ((2.76±0.26) μmol/L) ( P=0.016), while the postoperative levels of other neurotransmitters were not significantly changed when compared to the baseline levels (all P>0.05). Conclusion:The cholinergic neurotransmitter levels were reduced while the monoamine neurotransmitter levels were increased in the cerebrospinal fluid in patients with postoperative delirium, which suggests that cholinergic hypoactivity and monoaminergic hyperexcitability may be important pathophysiological processes in the occurrence and development of postoperative delirium.

Research progress in the application status and development trend of artificial intelligence in the diagnosis and treatment of spinal disease / 中华骨科杂志

The cross-fusion research of artificial intelligence technology and spinal surgery represented by machine learning and neural network model is a new research direction and hot issue in the field of artificial intelligence in recent years.The anatomy and disease symptoms of the spine are complex,and the diagnosis and treatment of spinal surgery require rich clinical experience.However,the distribution of medical resources in China is seriously uneven.How to improve the ability of primary medical services so that the most extensive patient groups can benefitis still an urgent problem to be solved.Artificial intelligence is a technical science that researches and develops theories,methods,technologies,and application systems for simulating,extending and expanding human intelligence.With the advent of the era of big data medical technology,artificial intelligence technology may solve this problem by transforming "experts sinking" into "tech sinking".At present,technologies such as confrontation learning,weakly supervised learning,intensive learning and graph neural networks have become research hotspots in the field of artificial intelligence,and have also played an important role in many fields of clinical medicine.Based on the advantages of deep learning and neural network in disease learning,many spine surgeons combine it with the diagnosis and treatment of cervical spondylosis,low back pain,lumbar degenerative diseases,spinal deformity,spinal tumors,and other spine-related diseases.The rapid location and accurate diagnosis of the disease not only makes it an effective tool for the comprehensive diagnosis of spinal diseases but also provides the basis for the most reasonable treatment options for spinal diseases.In the domestic application of artificial intelligence in the diagnosis and treatment of spinal surgery,it can also solve the problems of difficult diagnosis and complicated treatment of spinal diseases faced by primary doctors,reduce the rate of misdiagnosis and missed diagnosis,and effectively reduce the economic and social burden of spinal diseases.This paper reviews the research progress of artificial intelligence represented by deep learning in the field of diagnosis and treatment of spinal surgery at home and abroad,and the advantages and application prospects of artificial intelligence in the diagnosis and treatment of spinal surgery.

Effectiveness analysis of muscle fatigue in rehabilitation based on surface electromyogram / 生物医学工程学杂志

Muscle fatigue has widespread application in the field of rehabilitation medicine. The paper studies the muscle fatigue using surface electromyogram (sEMG) in the background of rehabilitation training system. The sEMG and ventilatory threshold of vastus lateralis, rectus femoris and erector spinae are collected synchronously and the electromyogram fatigue threshold (EMG ) of different sEMG was analyzed by increasing load cycling experiments of 10 healthy subjects. This paper also analyzes the effect of isotonic and isometric contraction on EMG . Results showed that the appeared time of EMG was earlier than that of ventilatory threshold in the incremental load cycling. While the differences were subtle and EMG was verified to be effective. EMG has been proven effective for different muscle contraction by comparing the EMG of vastus lateralis and erector spinae. EMG could be used to keep muscle injuries from overtraining in the process of rehabilitation. Therefore, EMG has a great significance for femoral shaft fractures's fatigue monitoring in rehabilitation training.

Research progress in the application status and development trend of artificial intelligence in the diagnosis and treatment of spinal disease / 中华骨科杂志

The cross-fusion research of artificial intelligence technology and spinal surgery represented by machine learning and neural network model is a new research direction and hot issue in the field of artificial intelligence in recent years. The anatomy and disease symptoms of the spine are complex, and the diagnosis and treatment of spinal surgery require rich clinical experience. However, the distribution of medical resources in China is seriously uneven. How to improve the ability of primary medical services so that the most extensive patient groups can benefitis still an urgent problem to be solved. Artificial intelligence is a technical science that researches and develops theories, methods, technologies, and application systems for simulating, extending and expanding human intelligence. With the advent of the era of big data medical technology, artificial intelligence technology may solve this problem by transforming "experts sinking" into "tech sinking" . At present, technologies such as confrontation learning, weakly supervised learning, intensive learning and graph neural networks have become research hotspots in the field of artificial intelligence, and have also played an important role in many fields of clinical medicine. Based on the advantages of deep learning and neural network in disease learning, many spine surgeons combine it with the diagnosis and treatment of cervical spondylosis, low back pain, lumbar degenerative diseases, spinal deformity, spinal tumors, and other spine-related diseases. The rapid location and accurate diagnosis of the disease not only makes it an effective tool for the comprehensive diagnosis of spinal diseases but also provides the basis for the most reasonable treatment options for spinal diseases. In the domestic application of artificial intelligence in the diagnosis and treatment of spinal surgery, it can also solve the problems of difficult diagnosis and complicated treatment of spinal diseases faced by primary doctors, reduce the rate of misdiagnosis and missed diagnosis, and effectively reduce the economic and social burden of spinal diseases. This paper reviews the research progress of artificial intelligence represented by deep learning in the field of diagnosis and treatment of spinal surgery at home and abroad, and the advantages and application prospects of artificial intelligence in the diagnosis and treatment of spinal surgery.

Improvement role of aspirin combined with statins on carotid plaque of patients with cerebral thrombosis / 中国生化药物杂志

Objective To investigate the improvement role of aspirin combined with statins on carotid plaque of patients with cerebral thrombosis.Methods80 cases of patients with cerebral thrombosis in our hospital from May 2014 to May 2016 were selected, these patients were divided into aspirin combined with statins treatment group (combined treatment group, 40 cases) and single aspirin treatment group (single treatment group, 40 cases) two groups according to the treatment methods, the NIHSS scores, Barthel indexes, clinical curative effects, IMT, plaque areas of the two groups were statistically analyzed.ResultsThe NIHSS score of the combined treatment group was significantly lower (P<0.05), the Barthel index was significantly higher (P<0.05), the total treatment efficiency 95.0% (38/40) was significantly higher than the single treatment group 80.0% (32/40) (P<0.05), the IMT was significantly shorter (P<0.05), the plaque area was significantly smaller than the single treatment group (P<0.05).ConclusionAspirin combined with statins can more effectively improve the carotid plaque of patients with cerebral thrombosis than aspirin alone, so is worthy of promotion and use in the clinical.

Clinical comparison of polymethylmethacrylate and bone cement in the treatment of osteoporotic vertebral compression fractures: a retrospective study / 北京大学学报(医学版)

Objective:To analyze the outcomes of patients with osteoporotic vertebral compression fractures treated with polymethylmethacrylate (PMMA) and GeneX(R) bone cement in percutaneous kyphoplasty and to provide guidance in selecting the vertebral filling material for this procedure.Methods: In this study,86 patients with osteoporotic vertebral compression fractures treated at Peking University Third Hospital between June 2012 and June 2013 were retrospectively analyzed.The patients were followed-up with questionnaires and X-ray and CT examinations after 1 month,3 months,6 months,and 1 year.Postoperative conditions,including recovery rate of vertebral height,recovery rate of vertebral Cobb angle,CT data,reductions in visual analogue scale (VAS) and Oswestry scores,and postoperative complications,were evaluated.The results were analyzed using SPSS 18.0.Results: According to the rank sum test,there were significant differences in the recovery rate of vertebral height,vertebral Cobb angle and vertebral volume between the two groups after 3 months,6 months,and 1 year (P<0.05).The GeneX(R) group had greater losses in vertebral height,Cobb angle and volume than did the PMMA group.The PMMA group had 3 cases of cement leakage and 1 case of an adjacent vertebral fracture after percutaneous kyphoplasty.The GeneX(R) group had 2 cases of cement leakage.Conclusion: GeneX(R) bone cement is similar to PMMA in terms of postoperative pain relief.As the filling material in percuta-neous kyphoplasty,it is effective at maintaining vertebral height,quickly improves strength and stiffness of the vertebral body and has fewer complications.However,it is not satisfactory in maintaining long-term postoperative vertebral height.GeneX(R) bone cement can be used as the filling material for patients with osteoporotic vertebral compression fractures in percutaneous kyphoplasty.Patients with severe osteoporosis and vertebral compression should be treated with standardized osteoporosis treatment and should try to avoid early postoperative walking exercises.Sustained vertebral filling materials,such as PMMA,are more suitable for such patients.Research into better biodegradable materials is still needed.

CT and MR findings of Langerhans cell histiocytosis with multiple spinal involvement / 中国医学影像技术

Objective To investigate the CT and MRI features of Langerhans cell histiocytosis (LCH) with multiple spinal involvement.Methods The CT and MRI data of 13 patients with multiple LCH lesions in spine confirmed by pathology were retrospectively analyzed.All of 13 cases underwent CT examination (1 case underwent enhanced scanning) and 12 cases underwent MR examination (6 cases underwent enhanced scanning).Results In 13 cases,there were 8 cases of single central lesions invading the adjacent vertebrae and 5 cases of multiple central lesions.There were 19 core spinal lesions and 15 adjacent invading lesions in a total of 34 vertebrae lesions.Eighteen core lesions (18/19,94.74 ％) had different degrees and shape of vertebral compression.A total of 34 abnormal vertebrae were found in 13 cases by CT,which were manifested as osteolytic bone destruction.Eighteen cortical bones of 19 core vertebrae were incomplete,and a paravertebral soft-tissue masses were observed.There were 33 vertebrae lesions in 12 patients who underwent MR examination,including 18 core spinal lesions and 15 adjacent invading lesions.The lesions displayed equal,slightly lower or low signal on T1WI,slightly higher or high signal on T2WI and high signals on fat suppression sequences.A paravertebral soft-tissue masses were observed in 17 core spinal lesions (17/18,94.44％).Conclusion CT and MRI manifestations of spinal multiple LCH have certain characteristics.The level of diagnosis and differential diagnosis should be improved by deepen understanding of the disease image performance,but the diagnosis still depends on the pathology.

Effects of Walking in Water on Surface Electromyography of Lower Limbs and Neural Function in Spinal Cord Injury Patients / 中国康复理论与实践

Objective To explore the effects of walking in water on surface electromyography (sEMG) of lower limbs and neural func-tion in spinal cord injury (SCI) patients. Methods From June, 2014 to May, 2016, 42 patients with incomplete thoracolumbar SCI were di-vided into control group (n=21) and experimental group (n=21) randomly. All the patients accepted routine rehabilitation, while the experi-mental group accepted extra walking in water. Average electromyography (AEMG) of quadriceps femoris and tibialis anterior muscles was measured, and the motor and sense function was assessed with American Spinal Injury Association (ASIA) Classification before and six weeks after treatment. Results The AEMG (t>5.763, P10.871, P4.036, P<0.01). Conclusion Walking in water could further improve lower limbs muscle strength and neural function in patients with incomplete thoracolumbar SCI.