Three-dimensional morphological characteristics measurement of ankle joint based on computed tomography image post-processing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As precise positioning of ankle radiography is not possible, quantitative measurement of all syndesmotic parameters on repeated ankle X-ray films may be of little value. The purpose of this study was to provide a set of scientific and objective evaluation criteria for assessing the quality of ankle fracture reduction accurately and reliably by an intelligent combining three-dimensional (3-D) computed tomography (CT) measurement model.</p><p><b>METHODS</b>From June 2008 to March 2011, all the thin-slice CT images of 100 cases (50 males and 50 females) with normal ankle joint scanned by 16-slice spiral CT were collected. Two-dimensional (2-D) and 3-D images of ankle joints were generated by using multiple planar reconstruction (MPR) and surface shaded display (SSD) respectively. The relevant parameters about bone structures and their relationship were measured and analyzed based on 3-D topological narrow division technique and 3-D measurement techniques combining essential elements of point, line and surface.</p><p><b>RESULTS</b>In this study, the mean distance from lateral malleolus tip to talocrural articular surface, the tip of medial malleolus anterior colliculus to talocrural articular surface and lateral malleolus tip to the tip of medial malleolus anterior colliculus were (22.83 ± 1.12) mm, (12.84 ± 1.09) mm, and (61.18 ± 2.03) mm respectively in male group, and (20.16 ± 1.00) mm, (10.30 ± 1.05) mm and (53.00 ± 1.40) mm respectively in female group. The above three parameters were correlated with gender, height and weight (P < 0.05). However, the mean perpendicular distance from lateral malleolus tip to the plane through the tip of medial malleolus anterior colliculus, the talocrural angle, later clear space, medial clear space, and the superior clear space were (9.93 ± 0.29) mm, (10.01 ± 0.38)°, (1.94 ± 0.16) mm, (2.78 ± 0.19) mm, and (3.14 ± 0.15) mm respectively in 100 cases, were not significance correlated with gender, height and weight (P > 0.05).</p><p><b>CONCLUSIONS</b>This study could provide a certain amount of relevant data for the standard of injured ankle anatomical reduction and the second surgery planning after malunion. The methods of measurement are reliable, reproducible, and easy to apply in practice.</p>

Study of the morphology of heel spur and clinical significance: base on three-dimensional computed tomography / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the characteristic morphology of heel spur, and to investigate the relationship of heel spur and plantar heel pain.</p><p><b>METHODS</b>From June 2005 to April 2009, 210 cases (254 feet) with heel spur (according to Denis Pain Scale) were divided into cases group 1 (P2, n = 46), 2 (P3, n = 44), 3 (P4, n = 42), 4 (P5, n = 36) and controls group (P1, n = 42). Three-dimensional reconstruction of heel spur was performed in all groups using volume rendering based on multi-slice CT data by Super Image orthopedics edition 1.0. The characteristic morphology of heel spur was observed and the data were measured and analyzed, involving the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.</p><p><b>RESULTS</b>Parts of cases groups displayed coarse arcuate edge and undersurface with one or more little heel spurs adhere to heel spur, of which the numbers were greater than controls group, especially in cases group 4. No significant difference of the width of basilar part of heel spur was found among 5 groups (F = 2.32, P > 0.05). However, obvious difference was found in the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur (F = 8.23, 6.82, 5.87, P < 0.05). Compared with the controls group, the angle between heel spur and planta pedis of cases groups had higher degrees, but the difference of the other data presented irregular.</p><p><b>CONCLUSIONS</b>The characteristic morphology of heel spur varies in patients associated with plantar heel pain. No correlation is found between the severity and the morphological data, including the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.</p>

Effects of primary tumor excision on angiogenesis and pulmonary metastasis in osteosarcoma-bearing nude mice / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effects of primary tumor excision on osteosarcoma angiogenesis and pulmonary metastasis, and explore its possible mechanism and clinical significance.</p><p><b>METHODS</b>The tumor-bearing nude mice were constructed by injection of human osteosarcoma cell suspension, and divided into primary tumor resection, amputation and normal groups. The level of VEGF and endostatin was examined by ELISA assay. The hemoglobin content in Matrigel pellets was measured with HiCN method. Pulmonary metastasis was detected with dilated-squash technique and immunohistochemical staining.</p><p><b>RESULTS</b>The serum VEGF and endostatin level was significantly decreased in the primary tumor excision group compared with that in the normal and control groups after operation, but endostatin decreased more prominently [VEGF: (71.43 +/- 9.15) pg/ml vs. (115.81 +/- 4.38) pg/ml, (111.68 +/- 12.26) pg/ml, P < 0.01; ES: (40.77 +/- 5.41) ng/ml vs. (123.18 +/- 5.94) ng/ml, (128.06 +/- 4.52) ng/ml, P < 0.01]. The HB contents in Matrigel pellets increased in the primary tumor excision group compared with that in normal and control groups [(36.55 +/- 2.35) g/L vs. (16.84 +/- 1.15) g/L, (16.29 +/- 1.10) g/L, P < 0.01]. The rate of pulmonary metastasis in tumor excision group was much higher than that in the un-excised groups (80.0% vs. 40.0% and 35.0%, P < 0.05).</p><p><b>CONCLUSION</b>The excision of primary tumor can promote osteosarcoma angiogenesis and pulmonary metastasis, so anti-angiogenic treatment after operation has instructive clinical significance in preventing tumor metastasis.</p>

Assessment of subtalar joint neutral position: a cadaveric study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Subtalar joint (STJ) neutral position is the position typically used by clinicians to obtain a cast representation of a patient's foot before fabrication of biomechanical functional orthosis. But no method for measuring STJ neutral position has been proven accurate and reproducible by different testers. This study was conducted to investigate the STJ neutral position in normal feet in cadavers.</p><p><b>METHODS</b>Twelve fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of STJ. The contact areas for various foot positions and under axial loads of 600 N were determined based on the gray level of the digitized film. The STJ neutral positions were determined as the ankle-foot position where the maximum contact area was achieved, because the neutral position of a joint was defined as the position where the concave and convex surfaces were completely congruous.</p><p><b>RESULTS</b>In ankle-foot neutral position, the contact area of STJ was (2.79 +/- 0.24) cm(2). In the range of motion of adduction-abduction (ADD-ABD), the maximum contact area was (3.00 +/- 0.26) cm(2) when the foot was positioned 10 degrees of ABD (F = 221.361, P < 0.05). In the range of motion of dorsiflexion-plantarflexion (DF-PF), the maximum contact area was (3.61 +/- 0.25) cm(2) when the foot was positioned 20 degrees of DF (F = 121.067, P < 0.05). In the range of motion of inversion-eversion (INV-EV), the maximum contact area was (3.14 +/- 0.26) cm(2) when the foot was positioned 10 degrees of EV (F = 256.252, P < 0.05).</p><p><b>CONCLUSIONS</b>Joints, such as STJ, therefore, are not necessarily in neutral position when the ankle-foot is placed in the traditional concept of neutral position. The results demonstrate that the most approximate STJ neutral position was in the foot position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion.</p>

Effect of calcaneocuboid arthrodesis on kinematics of foot: a cadaveric study / 中国矫形外科杂志

[Objective]To discuss the effect of the calcaneocuboid arthrodesis on kinematics of foot and its clinical signifi-cance.[Method]In 10 fresh-frozen foot specimens,limitation dorsiflexion, plantoflexion, abduction, adduction , eversion, inver-sion motion of foot were determined before and after calcaneocuboid arthrodesis under non-weight with moment of couple, bendingmoment, equilibrium dynamic loading.[Result]A significant decrease in the motion of foot was observed (P

Relationship between serum load of HBV-DNA and therapeutic effect of oxymatrine in patients with chronic hepatitis B / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the relationship between serum load level of HBV-DNA and therapeutic effect of oxymatrine in patients with chronic hepatitis B.</p><p><b>METHODS</b>Forty-four patients of chronic hepatitis B were divided into two groups, the treated group was treated with oxymatrine 0.4 g/d by intramuscular injection for 3 months, the control group was treated with some liver protecting agents to estimate the therapeutic effect. The serum level of HBV-DNA was determined by quantitative polymerase chain reaction (PCR) before and after treatment.</p><p><b>RESULTS</b>The seroconversion rate of HBV-DNA and HBeAg in the treated group was 43.47% and 43.47% respectively, which was obviously better than those in the control group respectively (P < 0.05), the quantity of HBV-DNA decreased after treatment from 10(6.83 +/- 1.27) copy/ml to 10(3.35 +/- 3.08) copy/ml. Among them, in patient with HBeAg negative conversion, the pretreatment quantity of HBV-DNA was 10(6.30 +/- 1.42) copy/ml, while in those with no HBeAg negative conversion, it was 10(7.23 +/- 1.23) copy/ml, the difference was significant.</p><p><b>CONCLUSION</b>Oxymatrine is effective in treating chronic hepatitis B. The therapeutic effect is better for patients with lower quantity of serum HBV-DNA.</p>

Effect of calcaneocuboid joint arthrodesis on weight-bearing area of subtalar joint and its clinical significance:a cadaveric study / 中华创伤杂志

Objective To discuss the effect of the calcaneocuboid joint arthrodesis on the weight- bearing area of subtalar joint and its clinical significance.Methods Twelve fresh-frozen cadaver foot specimens were used for determination of weight-bearing area of the subtalar joint on foot and ankle neutral position,dorsiflexion,plantoflexion,adduction,abduction,inversion and eversion motion by means of pressure sensitive film before and after calcaneocuboid joint arthrodesis under weight loading.Results Weight-bearing area of the subtalar joint averagely increased for (32.54?7.45)% in all positions after calcaneocuboid joint arthrodesis,with statistical significance (P＜0.05).Conclusion Weight-bear- ing area of the subtalar joint increases after calcaneocuboid joint arthrodesis,which contributes to decrea- sing the pressure and increasing the stability of the subtalar joint.