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The purpose of this study was to investigate the value of sagittal lumbar flexion angle, end plate flexion depth and the difference of cross-sectional area of bilateral psoas major muscle in the diagnosis of lumbar disc herbination (LDH), as well as the relationship with the degeneration. The selected 120 cases of LDH patients as the observation group, and 100 healthy people as the control group. The Lumbar CT examination was performed on both groups. The results showed that there were statistically significant differences between the observation group and the control group in the following hems: the average endplate bucking depth, the average sagittal plane bucking angle and the average psoas major cross-sectional area (L3S1). Compared with patients of Purrmann grading II n observation group, the average depth of the end plate bucking of L1-S1 had statistically significant differences with those of patients in Purrmann grading I-V, as well as the average sagittal buckling angle and the average psoas major cross sectional area %P$ 0. 05). The area under the ROC curve of Purmann grade V diagnosed by the three parameters were 0. 701, 0. 890 and 0. 771. This study confirmed that Sagittal curvature angle, end plate plexon depth and the difference of cross-sectional area of bilateral psoas major muscle are related to the degree of intervertebral disc degeneration n patents with LDH, which has certain value in the diagnosis of intervertebral disc degeneration. [ABSTRACT FROM AUTHOR]

Objective: Surgical site infection (SSI) following hip fractures represents an important complication. This study aimed to investigate the incidence rate after surgery of hip fractures in the elderly and to identify the associated risk factors. Patients: Patients' demographic, injury, and surgery-related data and biochemical indexes were retrospectively reviewed and recorded during their hospitalization, between July 2015 and June 2017. After their discharge from hospital, patients were prospectively followed up at postoperative 1, 3, 6, and 12 months. SSIs were identified by review of patients' medical records and post-discharge telephone follow-up. Univariate and multivariate analyses were performed to determine the independent risk factors associated with SSI. Results: A total of 611 patients undergoing surgery for hip fractures with complete data were included for analysis. During the postoperative one year, 27 SSIs (19 superficial and 8 deep SSIs) developed, indicating the cumulative incidence of 4.4% (95%CI, 2.8–6.0%). Of them, 21 (77.8%) SSIs were detected during patients' hospitalization, and the 6 (22.2%) cases were confirmed via telephone during the post-discharge follow-up. After adjustment of multiple variables, BMI, current smoking, surgical duration, preoperative hospital stay, ASA class of III-IV, ALB <35g/L, and FBG > 110mg/dL were identified as independent risk factors for SSI. Conclusions: Three modifiable factors as smoking, preoperative ALB <35g/L, and FBG > 110mg/dL should be optimized preoperatively to reduce the SSIs. Other factors, although not modifiable, could be used for screening of at-risk patients, patient risk stratification, or for counseling of patients. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis aimed to assess whether preoperative intravenous corticosteroids reduced postoperative pain in patients undergoing spinal fusion surgery. Methods: We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Google databases, from inception to March 29, 2018. Randomized controlled trials (RCTs) that compared preoperative intravenous glucocorticoids against a control treatment for the effect on pain following spinal fusion surgery were included. A meta-analysis was performed to generate a pooled risk ratio (RR) and weighted mean difference (WMD) with corresponding 95% confidence interval (CI) for discontinuous outcomes (the occurrence of postoperative nausea and vomiting [PONV] as well as surgical-site infections) and continuous outcomes (visual analog scale [VAS] scores at 12 h, 24 h, 48 h, and 72 h; total morphine consumption and the length of hospital stay), respectively. Results: Ten RCTs that compared intravenous corticosteroids versus placebo were included in our final meta-analysis. Compared with controls, intravenous corticosteroids were associated with a statistically significant reduction in pain VAS scores at 12 h, 24 h, 48 h, and 72 h. Additionally, intravenous corticosteroids decreased total morphine consumption, PONV, and the length of hospital stay. There was no significant difference between intravenous corticosteroids and controls, regarding the occurrence of infection (p > 0.05). Conclusions: In summary, our results indicated that intravenous corticosteroids not only reduce pain but also have anti-emetic effects. More studies should focus on the adverse effects of administering intravenous corticosteroids. [ABSTRACT FROM AUTHOR]

As a minimally invasive surgery, percutaneous cement discoplasty (PCD) is now contemplated to treat lumbar disc degeneration disease in elder population. Here, we investigated whether the osteogenic mineralized collagen (MC) modified polymethylmethacrylate (PMMA) cement could be a suitable material in PCD surgery. Injectability, hydrophilicity and mechanical properties of the MC-modified PMMA (PMMA-MC) was characterized. The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation. Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress. Then, PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA. Three months after implantation, micro-computed tomography analysis revealed a 36.4% higher circumferential contact index between PMMA-MC and bone, as compared to PMMA alone. Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone, while the PMMA was covered by fibrous tissue. The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation. Therefore, the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro. We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages. Moreover, expressions of fibroblast-stimulating growth factors, insulin-like growth factor, basic fibroblast growth factor and tumor necrosis factor-β were significantly down-regulated in the macrophages cocultured with PMMA-MC. Together, the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery. [ABSTRACT FROM AUTHOR]

Background: The Judet-Letournel classification has been widely used to diagnose acetabular fractures since it was proposed. However, there has been growing evidence of incompleteness and comprehension difficulty in this classification, which may adversely affect its clinical use. The purposes of this study were to introduce a novel 3-column classification system for acetabular fractures and to evaluate its reliability and reproducibility.Methods: A total of 1,028 patients with acetabular fractures, who had undergone surgical treatment from June 2011 to January 2017 in 7 level-I trauma centers, were recruited into this study. Preoperative radiographs and computed tomographic (CT) scans were conducted for each patient. To evaluate the reproducibility of the 3-column classification system for acetabular fractures, the interobserver and intraobserver reliability (kappa coefficient, κ) of this classification system compared with those of the Judet-Letournel classification system was investigated by 4 observers.Results: A total of 209 patients (20.33%) could not be classified by the Judet-Letournel classification, and 3 cases (0.29%) could not be classified by the novel 3-column classification. The mean κ value of the interobserver reliability for the Judet-Letournel classification was 0.591 (range, 0.508 to 0.681), indicating moderate agreement, whereas the mean κ value was 0.735 (range, 0.594 to 0.930), indicating substantial agreement, when using the 3-column classification. The mean κ value for the intraobserver reliability was 0.751 (range, 0.708 to 0.793) for the Judet-Letournel classification and 0.909 (range, 0.792 to 0.957) for the 3-column classification.Conclusions: The 3-column classification, based on the anatomic character of the acetabulum, showed higher interobserver and intraobserver reliability than the Judet-Letournel classification. Additionally, certain fracture patterns in the 3-column classification scheme generally correlated with surgical approaches. This novel classification system may be used as a supplement to the traditional Judet-Letournel classification system.Clinical Relevance: The 3-column concept of the acetabulum proposed in this study is helpful to master acetabular fractures for less experienced surgeons. The novel classification system could assist with acetabular fracture diagnosis and the choice of surgical approaches. [ABSTRACT FROM AUTHOR]

The sulfolane extractive distillation process is successfully commercialized in benzene extraction unit with a production capacity of 100 X 10³ t/a in Qingyang Petrochemical Company. The operation results show that the purity of benzene is 99. 95%, the crystallizing temperature of benzene is above 5.4 °C, the recovery efficiency is 99. 81 % and the energy consumption is 9. 35 kg E0/t. Besides, some problems during the operation, such as extractive distillation flooding, removal of C6 tower energy waste, white earth inactivation are analyzed, and the solutions are carried out. [ABSTRACT FROM AUTHOR]

The application of the CT series catalysts in two sets of sulfur recovery units which processed S Zorb flue gas n Zhenhai Refining & Chemical Company are introduced in terms of catalyst activity, service life, the conversion of sulfur and he SO2 emission consistence of sulfur recovery unit. The operation for two years shows that operation parameters of the unit is regular, the catalyst maintains a high activity, the anti -sulfation and anti "oxygen leakage" property is good, the SO2 emision consistence of sulfur recycle unit which has treated S Zorb flue gas to meet the requirements of GB 16297-1996 Integrated emission standard of air pollutants. [ABSTRACT FROM AUTHOR]

Lower back pain is an extremely common medical issue in populations worldwide. One of the main contributors to lower back pain is intervertebral disc (IVD) degeneration. An ideal animal model of IVD degeneration is essential to study the pathophysiology of lower back pain and investigate potential therapeutic strategies. Rabbit models are reliable, economical, and easily established animal models. The retroperitoneal approach has been widely used to induce IVD degeneration in rabbit models. However, there are reported complications associated with this technique, such as the avulsion of segmental arteries and nerve root injury. In this paper, we aim to show a surgical protocol using needle puncture to establish rabbit lumbar disc degeneration via a transabdominal approach. Consequently, radiological checks and histological analyses indicated that lumbar disc degeneration was successfully established in rabbits. This surgical protocol presents the precise location of target discs and high reproducibility of IVD degeneration models with fewer complications.

Objective: To develop and test a deep learning (DL) model to distinguish acetabular fractures (AFs) on pelvic anteroposterior radiographs (PARs) and compare its performance to that of clinicians. Materials and methods: A total of 1,120 patients from a big level-I trauma center were enrolled and allocated at a 3:1 ratio for the DL model's development and internal test. Another 86 patients from two independent hospitals were collected for external validation. A DL model for identifying AFs was constructed based on DenseNet. AFs were classified into types A, B, and C according to the three-column classification theory. Ten clinicians were recruited for AF detection. A potential misdiagnosed case (PMC) was defined based on clinicians' detection results. The detection performance of the clinicians and DL model were evaluated and compared. The detection performance of different subtypes using DL was assessed using the area under the receiver operating characteristic curve (AUC). Results: The means of 10 clinicians' sensitivity, specificity, and accuracy to identify AFs were 0.750/0.735, 0.909/0.909, and 0.829/0.822, in the internal test/external validation set, respectively. The sensitivity, specificity, and accuracy of the DL detection model were 0.926/0.872, 0.978/0.988, and 0.952/0.930, respectively. The DL model identified type A fractures with an AUC of 0.963 [95% confidence interval (CI): 0.927-0.985]/0.950 (95% CI: 0.867-0.989); type B fractures with an AUC of 0.991 (95% CI: 0.967-0.999)/0.989 (95% CI: 0.930-1.000); and type C fractures with an AUC of 1.000 (95% CI: 0.975-1.000)/1.000 (95% CI: 0.897-1.000) in the test/validation set. The DL model correctly recognized 56.5% (26/46) of PMCs. Conclusion: A DL model for distinguishing AFs on PARs is feasible. In this study, the DL model achieved a diagnostic performance comparable to or even superior to that of clinicians., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ye, Li, Wang, Tian, Luo, Wu, Zhuang, Zhang, Grzegorzek and Hou.)