Abstract： Diseases prognosis is often influenced by multiple factors, and some intricate non-linear relationships exist among those factors. Artificial neural network （ANN）, an artificial intelligence model, simulates the work mode of biological neurons and has a b capability to analyze multi-factor non-linear relationships. In recent years, ANN is increasingly applied in clinical medical fields, especially for the prediction of disease prognosis. This article focuses on the basic principles of ANN and its application in disease prognosis research.
Objective To investigate the anatomic foundation of using main branch of posterior femoral nerve to restore the sensation function of distal basedsural island flap. Methods Thirty cases of adult human cadaver legs fixed by 4%formaldehyde were used. Anatomical investigation of the posterior femoral nerves of lower legs was conducted under surgical microscope to observe their distribution, branches and their relationship with small saphenous vein. Nerve brancheswith diameter more than 0.1 mm were dissected and accounted during observation.The length and diameter of the nerves were measured. Results The main branch of posterior femoral nerve ran downwards from popliteal fossa within superficial fascia along with small saphenous vein. 70% of the main branch of the posterior femoral nerves lay medially to small saphenous vein, and 30% laterally. They wereclassified into 3 types according to their distribution in lower legs: typeⅠ (33.3%) innervated the upper 1/4 region of lower leg (region Ⅰ), type Ⅱ (43.3%) had branches in upper 1/2 region (region Ⅰ and Ⅱ), and type Ⅲ (23.3%) distributed over the upper 3/4 region (region Ⅰ, Ⅱ and Ⅲ). In type Ⅱ, the diameter of the main branches of posterior femoral nerves in the middle of popliteal tossa was 10±04 mm and innervated the posterior upper-middle region (which was the ordirary donor region of distal based sural island flaps) of lower legs with 2.0±0.8 branches, whose diameter was 0.3±0.2 mm and length was 3.5±2.7 mm. The distance between the end of these branches and small saphenous vein was 0.8±0.6 mm. In type Ⅲ, their diameter was 1.2±0.3 mm and innervated the posterior upper-middle region of lower legs with 3.7±1.7 branches, whose diameter was 0.4±0.1 mm and length was 3.7±2.6 mm. The distancebetween the end of these branches and small saphenous vein was 0.8±0.4 mm. Conclusion 66.6% of human main branch of posteriorfemoral nerves (type Ⅱ and type Ⅲ) can be used to restore the sensation of distal based sural island flap through anastomosis with sensor nerve stump of footduring operation.
Objective To investigate the clinical features of multifocal choroiditis (MC) and guide the diagnosis and treatment. Methods Retrospective analysis of clinical data of 18 MC cases (28 eyes) who were diagnosed through fluorescein angiography (FFA) or indocyanine green angiography (ICGA) and fundus characteristics. Results Multiple round to oval lesions scattered throughout the posterior pole and peripheral areas of ocular fundi of all of the 28 eyes(binocular in 10 and monocular in 8) were found. Active focal lesions of ocular fundi were seen in 8 patients and inactive lesions in 10 patients. active and 10 cases were inactive. Choroidal neovascularization(CNV) in macular area was found in 7 patients. The images of FFA of the legions showed hypofluorescence in the early phase, with late leakage and gradual staining or window is defect in the late phase. Conclusions MC is a rare disease and often misdiagnosed to other disease and FFA helpful in diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 367-370)
ObjectiveTo report an improved classification system of Kümmell’s disease and its clinical application.MethodsBased on CT and MRI, an improved classification system of Kümmell’s disease was proposed in terms of the integrity of sagittal endplate, the integrity of posterior wall of vertebral body, and the degree of vertebral compression. Between January 2011 and March 2018, the improved classification system was used to evaluate and guide the treatment of 78 patients with Kümmell’s disease. There were 13 males and 65 females. The mean age was 69.1 years (range, 54-85 years). The mean disease duration was 4.0 months (range, 1-8 months). The mean T value of bone mineral density was −3.66 (range, −3.86- −3.34).The fractures located at thoracic vertebrae in 47 cases and lumbar vertebrae in 31 cases. According to the modified classification system of Kümmell’s disease, there were 11 cases of type A1, 13 cases of type A2, 2 cases of type A3, 10 cases of type B1, 18 cases of type B2, 4 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 11 cases of type C3. According to the classification results, the patients of types A and B were treated with percutaneous kyphoplasty (PKP), while the patients of type C were treated with PKP or intra- vertebral fixation according to the degree of vertebral reduction. Visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to evaluate clinical efficacy. The heights of the anterior, middle, and posterior edges of the vertebrae and the Cobb angle were measured to evaluate the reduction of the injured vertebrae and the improvement of kyphosis deformity. The complications were recorded.ResultsThe statistical analysis showed that the improved classification system has good consistency. All patients were followed up 12-36 months (mean, 24.3 months). The heights of anterior, middle, and posterior edges of the vertebrae, Cobb angle, VAS score, and ODI of all types of patients at last follow-up showed significant differences when compared with those before operation (P<0.05). After operation, 4 patients of type A2 had different degree of vertebral height loss; 2 patients of type B2, 3 patients of type C1, and 2 patients of type C2 developed asymptomatic bone cement leakage during PKP; 2 patients of type B3 and 3 patients of type C2 underwent percutaneous internal fixation and vertebral augmentation due to bone cement loosening.ConclusionThe modified classification system of Kümmell’s disease can be used to guide treatment of Kümmell’s disease, but the number of clinical application cases is limited, and further application and observation are needed.
Objective To investigate the effects of celecoxib-poly lactide-co-glycolide microparticles (CEL-PLGA-MS) on rat retina after intravitreal injection. Methods A total of 32 male Brown Norway rats were randomly divided into CEL-PLGA-MS group and celecoxib group, 16 rats in each group. The rats in CEL-PLGA-MS group were divided into four dosage group, four rats in each group, which received intravitreal injection of PLGA with celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. The rats in celecoxib group were divided into four dosage group, four rats in each group, which received intravitreal injection of celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. Phosphate buffer solution (PBS) was injected in two rats as PBS control group. Two rats as normal control group received no treatment. The difference of retinal thickness among groups was measured by optical coherence tomography (OCT). The morphological and histological change of retina was evaluated under light microscope and transmission electron microscope. Results There was no difference of retinal thickness between normal control group and PBS control group (F=0.12,P＞0.05). At the first week after injection, the retinal thickness of CEL-PLGA-MS group and celecoxib group were thicker than that in normal control group and PBS control group (F=9.62, 46.13;P＜0.01). The retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=165.15,P＜0.01). The retinal thickness was estimated equal among 40, 80, 320 mu;mol/L dosage groups in CEL-PLGA-MS group (F=4.79,P＜0.01). The retinal thickness of 160, 320 mu;mol/L dosage group were thicker than that in 40, 80 mu;mol/L dosage group in celecoxib group (F=28.10,P＜0.01). At the second week after injection, there was no difference of retinal thickness between CEL-PLGA-MS and celecoxib group (F=3.79,P＞0.05); the retinal thickness of CEL-PLGA-MS and celecoxib group became thinner gradually compare to the first week after injection (F=7.28, 103.99; P＜0.01). At the fourth week after injection, the retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=19.11,P＜0.01). The retinal thickness of CEL-PLGA-MS group was approximately the same to normal control group and PBS control group (F=2.02,P＞0.05). The retinal thickness of celecoxib group was thicker than that in normal control group and PBS control group. No considerable abnormality of the retina was seen by light microscope and the retinal thickness corresponded with the values measured by OCT at the first week after injection. The abnormal structures of the retina were seen in 160, 320 mu;mol/L dosage group of celecoxib group and inner changed evidently by the transmission electron microscope. Disordered arrangement of microfilaments, dilated microtubule and some mitochondria vacuolation were observed in 320mu;mol/L dosage group of celecoxib group. Others changed slightly. Conclusions CEL-PLGA-MS has less toxicity on the retina than free-celecoxib after intravitreal injection. The safety of intravitreal injection with CEL-PLGA-MS is better than celecoxib.
Objective To summarize the basic research and the cl inical appl ication of biodegradable interbody fusion Cage. Methods Recent l iterature concerning biodegradable interbody fusion Cage at home and abroad was extensively reviewed, and current developments of the basic research and the cl inical appl ication of biodegradable interbody fusion Cage were investigated. Results Basic research showes that the stiffness of biodegradable interbody fusion Cage is lower than that of metall ic Cage, so it can enhance interbody fusion. As interbody fusion proceeded, biodegradable interbody fusion Cage degrades constantly, but the speed of degradation can not keep in parallel with that of fusion. In addition, the tissue response to degradation products is controversy. Cl inical appl ication showes that the biodegradable interbody fusion Cage can enhance interbody fusion and maintain disc space height. The short term results are good, however, the long term results need further observation. Conclusion Biodegradable interbody fusion Cage can effectively enhance interbody fusion.