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Objective To evaluate the short-term efficacy of Brostr(o)m-Gould repair combined with Internal Brace artificial ligament reinforcement under arthroscopy for anterior talofibular ligament injury in overweight and poor ligament quality population.Methods A total of 12 patients with anterior talofibular ligament injury treated by arthroscopy were enrolled from October 2017 to May 2018,involving 7 males and 5 females aged from 16 to 57 years old (mean 32.4 years).Patients were with ankle instability,and their BMI was 28.0-30.7 kg/m2 (average,28.8±0.91 kg/m2),among which there were 2 cases of poor ligament quality (Beighton score ≥-4).The anterior tibiofibular ligament injury and the quality of the ligament stump were intraoperatively evaluated under arthroscopy.A 4.75 mm diameter anchor with Internal Brace artificial ligament was inserted into the fibula insertion site,and non-absorbable suture was placed at the talus under total arthroscopy.Firstly,the non-absorbable line on the anchor was performed under the standard Brostr(o)m-Gould procedure to repair the anterior talofibular ligament,and the other end of the ligament was fixed near the distal end of the talus.The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and foot and ankle ability measure (FAAM) was compared before and after surgery.Results All the incisions were healed in the first stage after operation,and no operative complications such as infection occurred.All the 12 patients were followed up for 7 to 12 months (average 9.1 months).After 2 weeks,the patient began functional exercise and could walk with ankle braces.At the latest follow-up,the anterior drawer test was negative.The ankle-posterior foot score of AOFAS was increased from 61.3±7.9 (preoperative) to 85.0±6.0 (latest follow-up) (t=21.422,P＜ 0.01),and the FAAM score was increased from 57.5±10.1 (preoperative) to 86.3± 4.8 (latest follow-up) (t=15.032,P＜ 0.01).AOFAS score was excellent in 1 case and good in 11 cases.The excellent and good rate was 100％ (12/12).No complications such as infection and re-rupture occurred after operation.Conclusion For anterior talofibular ligament injury patients with overweight or poor quality of ligament,the Brostr(o)m-Gould procedure can be applied to strengthen under arthroscopic Internal Brace ligament without additional tendon reconstruction,which can also obtain good results.
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Objective@#To evaluate the short-term efficacy of Broström-Gould repair combined with Internal Brace artifi-cial ligament reinforcement under arthroscopy for anterior talofibular ligament injury in overweight and poor ligament quality popu-lation.@*Methods@#A total of 12 patients with anterior talofibular ligament injury treated by arthroscopy were enrolled from October 2017 to May 2018, involving 7 males and 5 females aged from 16 to 57 years old (mean 32.4 years). Patients were with ankle insta-bility, and their BMI was 28.0-30.7 kg/m2 (average, 28.8±0.91 kg/m2), among which there were 2 cases of poor ligament quality (Beighton score ≥4). The anterior tibiofibular ligament injury and the quality of the ligament stump were intraoperatively evaluated under arthroscopy. A 4.75 mm diameter anchor with Internal Brace artificial ligament was inserted into the fibula insertion site, and non-absorbable suture was placed at the talus under total arthroscopy. Firstly, the non-absorbable line on the anchor was per-formed under the standard Broström-Gould procedure to repair the anterior talofibular ligament, and the other end of the ligament was fixed near the distal end of the talus. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and foot and ankle ability measure (FAAM) was compared before and after surgery.@*Results@#All the incisions were healed in the first stage after operation, and no operative complications such as infection occurred. All the 12 patients were followed up for 7 to 12 months (average 9.1 months). After 2 weeks, the patient began functional exercise and could walk with ankle braces. At the latest follow-up, the anterior drawer test was negative. The ankle-posterior foot score of AOFAS was increased from 61.3±7.9 (preopera-tive) to 85.0±6.0 (latest follow-up) (t=21.422, P< 0.01), and the FAAM score was increased from 57.5±10.1 (preoperative) to 86.3±4.8 (latest follow-up) (t=15.032, P< 0.01). AOFAS score was excellent in 1 case and good in 11 cases. The excellent and good rate was 100% (12/12). No complications such as infection and re-rupture occurred after operation.@*Conclusion@#For anterior talofibu-lar ligament injury patients with overweight or poor quality of ligament, the Broström-Gould procedure can be applied to strengthen under arthroscopic Internal Brace ligament without additional tendon reconstruction, which can also obtain good results.
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Pulse signal contains a wealth of biological and pathological information. However, it is susceptible to the influence of various factors which results in poor signal quality, and causes the device to generate false alarms. First the pulse signals are processing into discrete symbols, and then compare the test signal with the pulse template by using Dynamic Time Warping (DTW) to get the threshold for which can be used to find the interference segment of the test signal. By analyzing the DTW distance of the pulse signal, we can get the interference degree of the signal, then the quality level of the plus signal can be defined by the relationship between the interference degree and quality of the signal. The 1 055 group pulse signals provided by MIMIC II physiological database are used to train and test the signal quality assessment algorithms, and compared with other existing algorithms. The results show that the algorithms can accurately detect interference segments in pulse signal and reflect the quality of it.
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Humanos , Algoritmos , Frequência Cardíaca , Pulso Arterial , Processamento de Sinais Assistido por ComputadorRESUMO
Objective To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy(mTLE)by using arterial-spin-labeling(ASL)based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status.Methods Twenty-five patients with left-sided and 23 with right-sided mTLE were enroiled,and 30 healthy volunteers were recruited.The cerebral blood flow(CBF)of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner.The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis.The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group.Results Compared with the volunteers,the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal,the frontal and parietal regions relating to the default-mode network and more serious in lesion side.The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration(r =-0.51,P ＜0.01).The asymmetric index of CBF as-0.01 has a 76.0％(19/25)sensitivity and a 78.3％(18/23)specificity to distinguish the lesion side.Conclusions The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE.The ASL technique is a useful tool for lateralizing the unilateral mTLE.