To explore the surgical feasibility and clinical outcome of transpedicle screw fixation in treatment of atlantoaxial instability and dislocation.From January 2007 to June 2009, 16 patients with atlantoaxial instability and dislocation were treated with transpedicle screw fixation. There were 13 males and 3 females, with a mean age of 42 years (range, 24-61 years). The transpedicle screw fixation was employed in 5 patients with old odontoid fracture (4 of Anderson type II and 1 of type III), in 4 patients with fresh odontoid fracture, in 4 patients with traumatic disruption of transverse atlantal ligament, and in 3 patients with congenital odontoid disconnection for atlantoaxial instability. All patients had symptoms of cervical pain and limiting of cervical motion, 10 patients complicated by dyscinesia and hypoesthesia of extremities. The Japanese Orthopaedic Association (JOA) score before operation was from 5 to 13, with an average of 8.5. The image examination showed atlantoaxial instability or dislocation in all patients. Granulated autogenous ilium (20-30 g) was placed onto the surface of the posterior arches of both atlas and axis in some patients with old fracture of odontoid process or disruption of transverse atlantal ligament.The mean operative time and bleeding amount were 1.6 hours (1.2-2.5 hours) and 100 mL (50-200 mL), respectively. All the incision healed by first intension. All patients were followed up for 3-18 months, with an average of 11.5 months. The JOA score 3 months after operation was from 12 to 17, with an average of 14.2. All screws were successfully placed in atlas and axis. No postoperative complications such as vertebral artery injury, dural rupture, exacerbation of neurological symptoms, wound infection, and broken screws were observed in 16 cases. Postoperative radiograph and CT showed that only one screw penetrated into vertebral canal, but there was no neurological symptoms. Bony fusion was observed after 6 to 18 months of operation, and atlantoaxial rotational function in all patients restored satisfactorily, but axial rotation was partially lost.Transpedicle screw fixation in upper cervical spine for treatment of atlantoaxial instability and dislocation is safe and reliable.
Background: Secondary brain damage plays a critical role in the outcome of patients with traumatic brain injury (TBI). The mechanisms underlying secondary brain damage are complex. A target that can interrupt multiple mechanisms underlying secondary brain damage may represent a promising new therapeutic approach for TBI. NF-E2-related factor 2 (Nrf2) is the key regulator in reducing oxidative stress, inflammatory damage, and the accumulation of toxic metabolites, which are all involved in secondary brain damage after TBI. Therefore, Nrf2 might represent a new direction for the treatment of TBI. However, the expression pattern of Nrf2 after TBI has not yet been studied. Methods: This study involved the detection of Nrf2 mRNA levels by reverse-transcriptase polymerase chain reaction, and its nuclear protein levels by Western blot from 3 hour to 72 hour after TBI. Nrf2 distribution in the brain after TBI was also investigated byimmunohistochemistry. Results: After TBI, the nuclear Nrf2 protein level is significantly increased, whereas its mRNA level remains unchanged. Increased Nrf2 immunostaining was detected not only in the vulnerable regions but also in the brain barrier system. Conclusion: Nrf2 might play a protective role in the brain after TBI, possibly by reducing oxidative stress and brain edema.
Bibliometric analysis.This study aims to identify and summarize the articles related to sacral fracture surgery, to compare the papers from different countries and journals, to show the trends of researches on sacral fracture surgery.In recent years, studies on sacral fracture are growing rapidly, but there were no bibliometric studies regarding sacral fracture surgery.Excel 2016 and VOSviewer were used to identify and summarize the articles from Web of Science between 1900 and 2018. Publication number, publication year, publication country, publication organization, publication source, author, sum of times cited, H-index, and journal's impact factors were recorded and analyzed. Bibliometric maps of co-citations and maps of co-occurrence of keywords are drawn.A total of 611 publications were extracted. United States published most articles (227, 37.2%), both total citations (3536) and H-index (32) of United States ranked first of all the countries. The most productive organization on sacral fracture surgery is Johns Hopkins University (14). Spine (43) published the most articles on sacral fracture surgery. The latest keyword "patterns" appeared in 2017 in 5 articles. Other relatively new keywords include "proximal junctional kyphosis," "spondylopelvic dissociation," "fragility fracture," "lumbopelvic fixation" that appeared in 2017 in eight, six, six, and 25 articles, respectively.This bibliometric study showed that there is a growing trend both in published articles related to sacral fracture surgery and relative research interest in the last 30 years. United States dominates the research regarding sacral fracture surgery. Johns Hopkins University, Johannes Gutenberg University of Mainz, and Harborview Medical Center are the best institutions related to sacral fracture surgery research. Spine, J Orthop Trauma, and Injury are the top three productive journals on sacral fracture surgery. Sacral fracture patterns, proximal junctional kyphosis, spondylopelvic dissociation, fragility fracture, and lumbopelvic fixation may be the new research hotspot in this field.5.
This research experimentally investigated the impact of adding Carbon Coated Nickel and Carbon Coated Aluminium on the sorption performance of conventional Strontium Chloride-Natural Expanded Graphite (SrCl2-NEG) chemisorption composite. In order to evenly distribute Nano particles into the material, manufacture methodology is developed and reported. In this study, experiments were set for testing the sorption performance of applying novel Ni/Al-additive adsorbent with the working fluid of ammonia. Compared with that of SrCl2-NEG, Ni-additive adsorbent improves the comprehensive heat and mass transfer performance as it reacted faster in both adsorption tests and low temperature desorption tests. By adopting Carbon coated Ni into the chemisorption composite, the overall sorption cycle time and require relatively lower energy for sorption cycles. While Al-additive adsorbent only improves the reaction speed in low temperature desorption tests, and may be applied in negative catalyser for its bad behaviour in adsorption performance tests. This paper reveals that adding Carbon Coated Nickel into conventional chemisorption composite would provide a potential way for improving the overall efficiency of an adsorption system and reducing the overall sorption cycle time.
This paper experimentally investigates the chemisorption refrigeration technology, mixing carboncoated Nickel and Iron (Ni@C and Fe@C) with the conventional composite of MnCl 2 -EG as the sorbents.A modified manufacture methodology is developed and reported.The thermal conductivity is improved by the nanomaterials with a maximum increase of 3.0 %, and adsorption and desorption are accelerated as well.SCP of the sorbents is enhanced up to 11.02 %, indicating the enhancement of the low-grade heat conversing into the cooling power, by the application of MnCl2-EG-Ni/Al@C chemisorption.
Placement is a critical step in the physical design for digital application specific integrated circuits (ASICs), as it can directly affect the design qualities such as wirelength and timing. For many domain specific designs, the demands for high performance parallel computing result in repetitive hardware instances, such as the processing elements in the neural network accelerators. As these instances can dominate the area of the designs, the runtime of the complete design’s placement can be traded for optimizing and reusing one instance’s placement to achieve higher quality. Therefore, this work proposes a mixed integer programming (MIP)-based placement refinement algorithm for the repetitive instances. By efficiently modeling the rectilinear steiner tree wirelength, the placement can be precisely refined for better quality. Besides, the MIP formulations for timing-driven placement are proposed. A theoretical proof is then provided to show the correctness of the proposed wirelength model. For the instances in various popular fields, the experiments show that given the placement from the commercial placers, the proposed algorithm can perform further placement refinement to reduce 3.76%/3.64% detailed routing wirelength and 1.68%/2.42% critical path delay under wirelength/timing-driven mode, respectively, and also outperforms the state-of-the-art previous work.
Objective To evaluate and compare the exposed sequence and field of anatomic structures between subtemporal and presigmoid approach for petrous bone drilling in virtual reality system. Methods Image data of CT scan performed to adult cadaver heads was inputted into the Dextroscope virtual reality system to build three-dimensional model of petrous bone. Subtemporal and presigmoid approaches were simulated respectively,and then,parameters were gauged. Results Visualization effect of simulation for petrous bone drilling in virtual reality system was well and data measurement was performed conveniently and rapidly. Geniculate ganglion and mastoidale were important anatomic markers for subtemporal and presigmoid approach intraoperatively. Bone drilling was more in presigmoid approach than in subtemporal approach. Block before reaching glomus jugulare was less in presigmoid approach than in subtemporal approach. Block before reaching internal carotid artery was less in subtemporal approach than in presigmoid approach. Conclusion Subtemporal approach was suitable for exposing internal carotid artery and presigmoid approach has advantages to expose region of glomus jugulare. Specimen saving and individualization were realized by simulating different approaches for the same model in virtual reality system.
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