In order to investigate the effect of repair of paratendon in tendon healing, two different ways were performed to repair the transected extensor tendons of chick’s toe. End to end suture of the extensor tenon was performed in group 1 while the paratendon was also repaired simultaneously in addition to suture of the tendon in group 2. Gross observation and histological examination were undertaken in the 3rd and 6th week after operation. The result showed, in group 1, extensive adhesion and irregular proliferation of fibroblasts was found in the 3rd week, severe adhesion and irregular arrangement of fibroblasts with less collagen fiber was found in the 6th week; while in group 2, smooth and regular "fusiform structure" was formed, slight adhesion and regular proliferation of fibroblasts were found in the 3rd week, adhesion disappeared and the structure of paratendon and tondon recovered in the 6th week. It was concluded that repair of extensor tendon and paratendon simultaneously could promote the intrinsic tendon healing and prevent tendon adhesion.
The brain computer interface (BCI) can be used to control external devices directly through electroencephalogram (EEG) information. A multi-linear principal component analysis (MPCA) framework was used for the limitations of tensor form of multichannel EEG signals processing based on traditional principal component analysis (PCA) and two-dimensional principal component analysis (2DPCA). Based on MPCA, we used the projection of tensor-matrix to achieve the goal of dimensionality reduction and features exaction. Then we used the Fisher linear classifier to classify the features. Furthermore, we used this novel method on the BCI competitionⅡdataset 4 and BCI competitionⅣdataset 3 in the experiment. The second-order tensor representation of time-space EEG data and the third-order tensor representation of time-space-frequency EEG data were used. The best results that were superior to those from other dimensionality reduction methods were obtained by much debugging on parameter P and testQ. For two-order tensor, the highest accuracy rates could be achieved as 81.0% and 40.1%, and for three-order tensor, the highest accuracy rates were 76.0% and 43.5%, respectively.
Objective To introduce a new operative technique of the expansive laminoplasty with reattachment of the spinous process and theextensor musculature for treatment of a tumor in the cervical vertebral channeland evaluate the clinical outcome of the technique. Methods From July 2003 to June 2006, this technique was applied to 26 patients (14 males,12 females; age, 25-57 years; illness course, 3 months-2 years) in our hospital. The four limbs had a muscle force of ⅢⅣ degrees, and with a high musculartension. The tendon reflex was sthenic and 2 patients had patellar clonus and ankle clonus. MRI was used to measure the tumor size (from 1.5 cm ×0.8 cm to 2.8 cm×2.0 cm, at the C3-6 levels) before and after operation.There were 8 cases at the C3,4levels, 9 cases at the C4,5 levels, 9 casesat the C5,6 levles. Results The result of the follow-up (average,8months; range, 6-12 months) showed that all the patients achieved a recovery at different degrees,with no death or complication. Although 10 of the patients felt a pain in the neck, but the pain was relieved after the functional exercise; the cervical active scope was changed a little with no cervical intervertrbal instability. The postoperative MRI and CT showed that the posterior column was maintained, and the “close-door” phenomenon did not happen. The degree of latitule of the cervical vertebra after operation was measured. The antecollis was 28.43°(37.9° onaverage). The hyposokinesis was 3244°(41° on average), the left antecollis was 25.45°(23° on average), and the right antecollis was 35.45°(36.2° on overage).Conclusion The expansive laminoplasty with reattachment of the spinous process and the extensor musculature can provide enough operative space and reserve the normal posterior column of the cervical vertebra. The intervertebral stability can beobtained after conglutination between the spinous process and the vertebral lamina.
ObjectiveTo evaluate the effect of reconstruction of forearm interosseous membrane (IOM) using extensor carpi radialis longus combined with radial head replacement for restoring the forearm longitudinal stability. MethodsTen fresh-frozen adult cadaveric forearms were selected, including 8 males and 2 females with a mean age of 38.2 years (range, 29-74 years). Each forearm was treated as following steps: radial head excision (group A), radial head excision+the distal ulnar radial joints separation (group B), radial head excision+the distal ulnar radial joints separation+IOM central band excision (group C), reconstructed IOM with extensor carpi radialis longus tendon (group D), radial head prothesis replacement (group E), and reconstructed IOM with extensor carpi radialis longus tendon+radial head prothesis replacement (group F). The distance between ulna and radius and radioulnar joint displacement were observed under load and non load. The force loading on both ends of specimen was recorded when the radius shifted 5 mm proximally. ResultsRestoring the radial length could maintain normal distance between radius and ulna. The interosseous membrance reconstruction could restore the load transmission between radius and ulna. The force loading specimen was (74.507±4.967), (49.227±1.940), (17.827±1.496), (24.561±1.390), (140.247±8.029), and (158.423±9.142)N in groups A, B, C, D, E, and F respectively when the radius shifted 5 mm proximally, showing significant difference among groups (P < 0.01). ConclusionReconstruction of the IOM with the extensor carpi radialis longus tendon is insufficient to restore the forearm longitudinal stability. Reconstruction using extensor carpi radialis longus tendon combined with radial head replacement may be a new choice for treatment of forearm longitudinal instability.
In transcranial magnetic stimulation (TMS), the conductivity of brain tissue is obtained by using diffusion tensor imaging (DTI) data processing. However, the specific impact of different processing methods on the induced electric field in the tissue has not been thoroughly studied. In this paper, we first used magnetic resonance image (MRI) data to create a three-dimensional head model, and then estimated the conductivity of gray matter (GM) and white matter (WM) using four conductivity models, namely scalar (SC), direct mapping (DM), volume normalization (VN) and average conductivity (MC), respectively. Isotropic empirical conductivity values were used for the conductivity of other tissues such as the scalp, skull, and cerebrospinal fluid (CSF), and then the TMS simulations were performed when the coil was parallel and perpendicular to the gyrus of the target. When the coil was perpendicular to the gyrus where the target was located, it was easy to get the maximum electric field in the head model. The maximum electric field in the DM model was 45.66% higher than that in the SC model. The results showed that the conductivity component along the electric field direction of which conductivity model was smaller in TMS, the induced electric field in the corresponding domain corresponding to the conductivity model was larger. This study has guiding significance for TMS precise stimulation.
Objective To analysis the electrophysiological dominance weight of the triceps brachii muscle/extensordigitorum communis muscle innervated by brachial plexus and to conclude its effect on the ipsilateral C7 transfer so as to offer electrophysiological data for the safety and indication of i psilateral C7 transfer. Methods From August 2007 to October 2007, 15 patients with complete brachial plexus nerve root avulsion received contralateral C7 transfer. There were 13 males and 2 females aged 18-49 years (28 years on average). Injury was caused by fall ing in 1 case, by crush in 2 cases and by traffic accident in 12 cases, involving left side in 8 cases and right side in 7 cases. The upper, middle and lower trunk of the brachial plexus were stimulated respectively, the compound muscle action potential (CMAP) at the triceps brachii muscle/extensor digitorum communis muscle was recorded, and then the electrophysiological dominance weight of the triceps brachii muscle/extensor digitorum communis muscle innervated by brachial plexus was confirmed according to the comparison of the ampl itude percentage of the CMAP by three trunks. The muscle strength of triceps brachii muscle/extensor digitorum communis muscle was evaluated and the electromyogram was taken 6 months after operation. Results All patients were followed up for 6 months. Concerning the electrophysiological dominance weight, the triceps brachii muscle was mainly innervated by uppermiddle trunk in 3 cases (20%), by middle-lower trunk in 3 cases (20%), by whole trunk in 7 cases (47%) and by middle trunk in 2 cases (13%). While the extensor digitorum communis muscle was mainly innervated by middle-lower trunk in 3 cases (20%), by whole trunk in 10 cases (67%) and by lower trunk in 2 cases (13%). Concerning the triceps brachii muscle, 2 patients got the muscle strength of 4 grade with recruitment simple phase at 1 month after operation and returned to normal at 3 month after operation, while 13 patients got the muscle strength of 5 grade with recruitment simple or mixed phase at 1 month after operation. Concerning the extensor digitorum communis muscle, the muscle strength and the recruitment phase of all 15 patients recovered to normal at 1 month after operation. Conclusion To patients with various kinds of electrophysiological dominance weight, the cutting of C7 does not substantially damage the triceps brachii muscle or extensor digitorum communis muscle, indicating that the ipsilateral C7 transfer is safe and feasible. However, it should be appl ied prudently for the patients with high dominance weight since it may result in the short-term decrease of triceps brachii muscle strength.
Objective To investigate the pathological mechanism of epileptic comorbid sleep disorder by analyzing the changes of cerebral white matter diffusion tensor in patients with sleep disorder with negative magnetic resonance imaging (MRI) epilepsy based on the method of tract-based spatial statistics (TBSS). Methods MRI negative epilepsy patients comorbid sleep disorder who were epileptic patients treated l in China-Japan Union Hospital of Jilin University from January 2020 to December 2022 completed the Epworth sleepiness scale (ESS) and Pittsburgh sleep quality index (PSQI) tests, and those who complained of sleep disorder and PSQI index ≥11 were monitored by nighttime polysomnography (PSG) and those with objective sleep disorder confirmed by PSG were included in the epilepsy comorbid sleep disorder group. Healthy volunteers with matching gender, age, education were included in the health control group. Diffusion tensor image ( DTI) was collected for all subjects by using a 3.0T magnetic resonance scanner. Diffusion parameters were compared between the two groups using TBSS. Results This study included 36 epilepsy patients comorbid sleep disorder and 35 healthy volunteers. epilepsy patients comorbid sleep disorder showed significantly lower fraction anisotropy (FA) (P<0.05) and significantly higher mean diffusivity (MD) (P<0.05) than the health control group . Brain regions with statistical differences in FA reduction included middle peduncle of cerebellum, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum, anterior corona radiata, external capsule and right posterior thalamic radiation.Brain regions with statistical differences in MD degradation included genu of corpus callosum, body of corpus callosum, anterior limb of internal capsule, anterior corona radiata, superior corona radiata, external capsule and right posterior limb of internal capsul. Conclusion Patients with epilepsy comorbidities with sleep disorders have widespread and symmetric white matter damage.The white matter damage is concentrated in the front of the brain.
Non-rigid medical image registration is a popular subject in the research areas of the medical image and has an important clinical value. In this paper we put forward an improved algorithm of Demons, together with the conservation of gray model and local structure tensor conservation model, to construct a new energy function processing multi-modal registration problem. We then applied the L-BFGS algorithm to optimize the energy function and solve complex three-dimensional data optimization problem. And finally we used the multi-scale hierarchical refinement ideas to solve large deformation registration. The experimental results showed that the proposed algorithm for large deformation and multi-modal three-dimensional medical image registration had good effects.
Objective To assess the long-time results of reconstruction of the extensor pollicis longus (EPL) function by transfer of the extensorindicis(EI). Methods From August 1978 to March 2003, 46 cases of loss of the EPL function were treatedby transfer of the extensor indicis. Of 46 cases, there were 32 males and 14 females, aged 16-51 years with an average of 36 years; there were 24 cases of oldtraumatic rupture and 22 cases of secondary rupture. The disease course was 2 days to 5 months, averaged 74 days. A specific EIEPL evaluation method (SEEM) wasused to measure the EPL function after transfer.Results Fortyone cases were followed up 9 years and 3 months on average (7 months to 23 years). Based on the SEEM, the results were excellent and good in 39 of 41 patients. The elevation deficit and combined flexion deficit were 0-2.2 cm (1.8 cm on average) and 0-3 cm (1.6 cm on average); the independent extension deficit was 0°-8° (5° on average). Conclusion Restoration of the extensor pollicis function by transfer of the extensor indicis is an effective and safe treatment option and the SEEM is a valid method for assessing EPL function.
ObjectiveTo explore the correlation between cognitive function and diffusion tensor imaging (DTI) in children with self-limited epilepsy with centrotemporal spikes (SelECTS). Methods A total of 28 children with SelECTS who visited our hospital from June 2020 to December 2022 were selected as the SelECTS group. An additional 28 healthy children of similar age and gender were selected as the control group. Cognitive function was assessed using the Wechsler Intelligence Scale for Children (WISC). The SelECTS group also underwent cranial DTI. The results of the WISC were then combined with DTI values for correlation analysis. Results Children in the SelECTS group exhibited varying degrees of cognitive deficits. Their full-scale IQ and verbal IQ were significantly lower than those of the control group (P<0.05). Specific cognitive domains, including classification, verbal comprehension, block design, knowledge, and comprehension, also showed significantly lower scores compared to the control group (P<0.05). DTI revealed significant microstructural changes in multiple regions of interest in the SelECTS group (P<0.05), and these changes were correlated with the results of several cognitive function tests. Conclusion Children with SelECTS have certain cognitive deficits. There is evidence of occult damage in brain white matter, and cognitive function is correlated with damage in specific brain regions.