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Background: Previous studies have shown that the 5-year survival rates of patients with nasopharyngeal carcinoma (NPC) were still not ideal despite great improvement in NPC treatments. To achieve individualized treatment of NPC, we have been looking for novel models to predict the prognosis of patients with NPC. The objective of this study was to use a novel deep learning network structural model to predict the prognosis of patients with NPC and to compare it with the traditional PET-CT model combining metabolic parameters and clinical factors. Methods: A total of 173 patients were admitted to 2 institutions between July 2014 and April 2020 for the retrospective study; each received a PET-CT scan before treatment. The least absolute shrinkage and selection operator (LASSO) was employed to select some features, including SUVpeak-P, T3, age, stage II, MTV-P, N1, stage III and pathological type, which were associated with overall survival (OS) of patients. We constructed 2 survival prediction models: an improved optimized adaptive multimodal task (a 3D Coordinate Attention Convolutional Autoencoder and an uncertainty-based jointly Optimizing Cox Model, CACA-UOCM for short) and a clinical model. The predictive power of these models was assessed using the Harrell Consistency Index (C index). Overall survival of patients with NPC was compared by Kaplan–Meier and Log-rank tests. Results: The results showed that CACA-UOCM model could estimate OS (C index, 0.779 for training, 0.774 for validation, and 0.819 for testing) and divide patients into low and high mortality risk groups, which were significantly associated with OS ( P Conclusions: The deep learning network model based on 18F-FDG PET/CT can serve as a reliable and powerful predictive tool for NPC and provide therapeutic strategies for individual treatment.

Background: The purpose of this study is to evaluate the correlation between spinopelvicalignment and the body weight parameters in healthy Chinese adult volunteers. That has not been systematically studied yet. Methods: 100 Chinese healthy adult volunteers (36 males and 64 females) were included in this study, which grouped according to the gender. The obesity parameters, body mass index (BMI), waist circumference (WC), sagittal abdominal diameter (SAD), transverse abdominal diameter (TAD) and RR (the ratio of SAD to TAD) were measured. The sagittal spinopelvic parameters include pelvic incidence (PI), pelvic tilt (PT), pelvic angulation (PA), sacral slope (SS), sacral inclination (SI), lumbar lordosis (LL) and the disc angle of L5/S1. The coronal spinopelvic parameters include the Cobb angle of the major curve of the spine, lumbar scoliosis (LS) and pelvic obliquity (PO). Pearson's correlation analysis was used to determine correlations between obesity index and spinopelvic alignment parameters. Results: The mean BMI and WC of the males and females was 28.7 ± 3.7 kg/m2 vs 26.8 ± 2.3 kg/m2 and 88.39 ± 9 cm vs 82.6 ± 2.7 cm respectively. In the female group, a strong correlation was found between BMI and PI, WC and PT, WC and PI. However, there was no strong correlation between the obesity and spinopelvic alignment parameters in the male group. None of the coronal spinopelvic parameters showed a correlation with the obesity parameters in two groups. The RR showed a positive linear correlation with PA and PT in both groups. Conclusions: Body weight could influence the spinopelvic alignment,especially for females. People with abdominal obesity, the sagittal spinopelvic alignment is likely to change. But there is little effect on the coronal spinopelvic alignment.

This study evaluated the outcomes of using porous tantalum rods for the treatment of osteonecrosis of the femoral head (ONFH). We performed core decompression and inserted porous tantalum implants in 149 patients (168 consecutive hips) with ONFH. Hips had large (65), medium (64), or small (39) lesions; 63 lesions were lateral, 68 were central, and 35 were medial. Conversion to total hip arthroplasty (THA) was the end point of this survey. A total of 130 cases (138 hips) were followed. The mean follow-up time was 38.46 ± 5.76 months; 43 hips (31%) were converted to or needed THA. Of the 43 hips requiring THA, 33 had large lesions, including 1 medial, 3 central, and 29 lateral lesions; 9 had medium, lateral lesions, and 1 hip had a small, lateral lesion. Bone grafting was used in 59 hips, with 3 hips failing; 40 of 79 hips without bone grafts failed. The sum distances between the tops of the rods and the lateral lesion boundaries (SDTL, mm) were measured in anteroposterior and lateral radiographs. In the failure and spared groups, the average SDTLs were 7.65 ± 2.759 and 0.83 ± 2.286 mm, respectively. The survival of porous tantalum rods used for treating early-stage ONFH was affected by the size and location of the lesion, whether or not a bone graft was used, as well as the distance between top of the rod and the lateral boundary of the lesion.

Train compartment is very special confined spaces; fire smoke in compartment brings great hazards when fire broke out. It is the main reason which caused people to die or hurt. This paper uses CFD method based on the FDS. It analyzes the main features of fire smoke on the human body injury; simulate smoke flow caused by compartment fire; It computes and analyses the interior fire smoke's diffusion process, the cabin space area of smoke concentration distribution and the temperature distribution and trends, and discusses and analyses the impact of smoke and temperature change in the train personnel in emergency evacuation.

Nontraumatic osteonecrosis of the femoral head (non-ONFH) is a disorder that can lead to femoral head collapse and the need for total hip replacement. Various head-preserving procedures have been used for this disease to avert the need for total hip replacement. These include various vascularised and nonvascularised bone grafting procedures. We examined the effect of bone-grafting through a window at the femoral head-neck junction known as the “light bulb” approach for the treatment of osteonecrosis of the femoral head with a combination of demineralised bone matrix (DBM) and auto-iliac bone. The study included 110 patients (138 hips; 41 females, 69 males; mean age 32.36 years, range 17–54 years) with stage IIA–IIIA nontraumatic avascular necrosis of the femoral head according to the system of the ARCO (Association Research Circulation Osseous). The bone grafting procedure is called “light bulb” procedure in which the diseased bone was replaced by a bone graft substitute (combination of DBM and auto-iliac bone).The outcome was determined by the changes in the Harris hip score, by progression in radiographic stages, and by the need for hip replacement. The mean follow-up was 25.37 months (range 7–42 months). All data were processed by a statistics analysis including Cox risk model analysis and Kaplan-Meier survival analysis. Pre- and postoperative evaluations showed that the mean Harris hip score increased from 62 to 79. Clinically, 94 of 138 hips (68%) were successful at the latest follow-up, and radiological improvement was noted in 100% of patients in stage IIA, 76.67% of patients in stage IIB and 50.96% of patients in stage IIC and IIIA cases. Excellent and good results according to the Harris score were obtained in 100% of cases in stage IIA, 93.33% in stage IIB and 59.62% in stages IIIA and IIC stage, with a survivorship of 85% in stages IIA and IIB and 60% in stage IIIA and IIC cases. Cox risk model analysis showed that the clinical success rate correlated with both pre-operation stage and the necrotic area of the femoral head. The complications included ectopic ossification, lateral femoral cutaneous nerve lesion and joint infection. This procedure may be effective at avoiding or forestalling the need for total hip replacement in young patients with early to intermediate stages of osteonecrosis of the femoral head. Therefore, it may be the treatment of choice particularly in nontraumatic osteonecrosis of the femoral head of pre-collapse stage with small and middle area (

Objective: To evaluate the early and middle‐term results of in situ single screw fixation and subtrochanteric osteotomy of the femur with external fixator for slipped capital femoral epiphysis (SCFE). Methods: From June 1998 to July 2008, 11 patients (seven male [eight hips] and four female [four hips]) of average age 14.3 years (range, 9–18 years) were treated in our hospital. According to the Southwick measurement, seven hips were mildly affected (50°). The average body mass index (BMI) was 31.1 g/m(2) (range, 27–35 g/m(2)). All the mild and moderate cases underwent in situ single screw fixation, and the three severe cases subtrochanteric osteotomy of femur with external fixator. All cases were evaluated both clinically and radiographically at 3 months, 6 months and every year postoperatively. Results: All cases were followed up for 2–12 years (average 5.6 years). The Harris hip score increased from a mean of 74.8 (70 ∼ 85) points preoperatively to 90.6 (70 ∼ 100) points postoperatively. X‐ray films showed epiphyseal closure in the in situ single screw fixation cases, and no further increase in epiphyseal‐shaft angle. Partial reduction of slipped epiphysis with normal joint spaces was observed after subtrochanteric osteotomy of the femur in the external fixator cases. Conclusion: In situ single screw fixation for treating mild and moderate SCFE has a satisfactory clinical outcome, and the advantage of prevention of further slippage. Subtrochanteric osteotomy of the femur with external fixator is suitable for severe SCFE with late deformity; the realignment procedure can correct deformity and postpone or prevent subsequent osteoarthritis.

To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages II and III and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse.The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageII; Group B, 13 hips, stage III; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed.The values of T1Gd were 420 ± 60 (Group A), 361 ± 54(Group B) and 538 ± 26 (Group C) respectively. There was a significant difference among three groups. The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of TIGd of Group B was 14% lower than those of Group A. And the difference was significant statistically.Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.

To understand the curve of thoracolumbar junction in patients with thoracolumbar intervertebral disc herniation and analyze the relation between thoracolumbar intervertebral disc herniation and spinal sagittal curve.The radiographic films of thoracolumbar junction of spine from 27 patients with thoracic disc herniation and 37 healthy persons as control were taken at reclining position. The Cobb angles of sagittal plane of thoracolumbar junction of spine were measured and statistically compared by SPSS (statistics package for social science).The Cobb angles of T10-L2, T10-L12 and T12-L2 in patients with thoracolumbar intervertebral disc herniation were greater than those in healthy controls respectively.The Cobb angles of sagittal plane of thoracolumbar junction of spine in patients with thoracolumbar intervertebral disc herniation are greater than those in healthy controls. The abnormal spinal curve is possibly responsible for thoracolumbar intervertebral disc herniation by abnormal biomechanical action.

To assess the efficacy of UKA versus HTO in the treatment of unicompartmental knee osteoarthritis.Comparative studies of UKA and HTO were retrieved from the domestic and foreign literatures and included for a meta-analysis.Seven eligible randomized controlled trials included 196 UKAs and 219 HTOs. The result of Meta-analysis indicated that the ratio for an excellent outcome was higher in UKA than HTO. The combined OR was 2.43, 95%CI (1.46, 4.05) (P = 0.0006). The risks of revision and complications were lower in UKA than HTO. The combined OR was 0.47 and 0.24 and 95%CI (0.23, 0.97), (0.10, 0.56).UKA reduces the risk of postoperative revision and complications and provides excellent outcomes.

Osteonecrosis of the femoral head (ONFH) is one of the intractable diseases. It is controversial whether the lesion size assessed by magnetic resonance imaging (MRI) can change over time without any operative treatment. In this study, we used MRI to observe the lesion size changes of ONFH induced by corticosteroid administration in severe acute respiratory syndrome (SARS) patients. The study included 51 SARS patients (84 hips) with early-stage ONFH who did not receive any operative treatment and were diagnosed by MRI. All of the patients underwent MRI follow-ups. Each patient was evaluated on the basis of the lesion volume on MRI at every follow-up for further comparisons. At the first MRI scan, the mean lesion volume was 10.12 +/- 8.05 cm(3) (range: 0.39-41.62 cm(3)). At the mid-term follow-up (2.5 years), the mean lesion volume was 7.82 +/- 7.59 cm(3) (range: 0.11-39.65 cm(3)). At the final follow-up (five years), complete regression of the lesion was observed in six hips, and the mean lesion volume was 5.67 +/- 6.58 cm(3) (range: 0.00-31.47 cm(3)). Overall, the lesion volume was reduced by15% in 80 hips, and only four hips with relatively larger lesion volumes showed no apparent reductions. The reduction in lesion size of ONFH observed on MRI is a slow, discontinuous and time-dependent process.

To investigate the changes of structure and metabolism of the cartilage of femoral head overlying the bone defect in animal model and analyse the possible effect of the necrotic area of the femoral head on the cartilage overlying there.18 adult hybrid dogs was applied for bone defect model of femoral head. Of the femoral heads, the left was applied for bone defect model, the right for shame-operation. 5, 5, and 8 animals were sacrificed respectively 4, 12 and 24 weeks after operation and the femoral heads were received for examinations. The X-rays films were taken just before the animals were sacrificed. After the cartilage specimens were decalcified, dehydrated and embedded, sections 6, u thick were made. They were stained with hematoxylin-eosin, sirius-red and toilude blue. The biochemical assay were performed.12 and 24 weeks after operation of bone defect, cartilage histology and biochemistry demonstrated the signs of articular cartilage pathological changes. The arrangement of chondrocytes were disorder. The number of chondrocytes decreased. The cartilage surface lost its smoothness, and these kinds of changes were more severe in the area next to the bone defect. Fibrosis and vasi formation were found. Tidemark had the changes of discontinuation and veil. Glycosaminoglycans decreased.The bone defect, whose damaged structure strength and decreased blood supply is similar, had effect on the structure and metabolism of the articular cartilage near the bone defect, and suggest osteonecrosis at the stage of pro-collapse may affect the cartilage overlying it.

To investigate the hematological changes and related gene mutation of post-severe acute respiratory syndrome (SARS) patients with osteonecrosis so as to find the sensitive molecular symbols for early screening of the high risk populations.Fast peripheral venous blood samples were collected from 61 post-SARS patients with osteonecrosis, 25 males and 36 females, aged 30.4 (20 - 60), and 52 sex and age-matched healthy persons as controls. ELISA was used to detect the coagulation and fibrinolysis indicators: activated partial thromboplastin time (APTT), protein C (PC), antithrombin III (AT-III), plasminogen activator inhibitor (PAI), activated protein C resistance (APC-R), plasminogen (PLG), von Willebrand factor (VWF), D-dimer (D-D), and fibrinogen (Fib). Real-time PCR was used to detect the mutation of factor V G1601A (FV Leiden) and prothrombin G20210A.The levels of PC, AT-III, and PLG of the osteonecrosis group were 85% +/- 34%, 84 +/- 29%, and 69 +/- 23%, significantly lower than that of the control group (109% +/- 20%, 104% +/- 14%, and 94% +/- 15% respectively, all P0.01). PAI of the osteonecrosis group was 16 U/ml +/- 14 U/ml, significantly higher than that of the control group (8.0 U/ml +/- 4.3 U/ml, P0.01). The percentage of patients with abnormal indicators was 99.5% (54/61) in the osteonecrosis group, significantly higher than that of the control group (36.5%, 19/52, P0.01). The percentage of patients with 3 or more abnormal indicators was 72.1% (44/61) in the osteonecrosis group, significantly higher than that of the control group (17.3%, 9/52, P0.01). No mutations of F V Leiden and prothrombin G20210A was found in both groups.Trends of hypercoagulation and hypofibrinolysis exist in the post-SARS patients with osteonecrosis. APTT, PC, AT-III, and PLG can be used as sensitive indicator for screening high risk populations of osteonecrosis.

The purpose of this study was to detect changes in coagulation and fibrinolysis of post-severe acute respiratory syndrome (SARS) Chinese patients with osteonecrosis, investigate the aetiology of post-SARS osteonecrosis (ON), and select the sensitive molecular markers for identifying the susceptible population. For this study, blood samples were collected from 88 patients with post-SARS ON and 52 healthy people. Activated partial thromboplastin time (APTT), protein C (PC), antithrombin III (AT–III), plasminogen activator inhibitor (PAI), activated protein C resistance (APC–R), plasminogen (PLG), von Willebrand’s factor(vWF), D–dimer (D–D), fibrinogen (Fib), and homocysteine (HCY) were examined by enzyme-linked immunosorbent assay (ELISA). We noted that blood agents of patients with ON changed obviously. APTT, PC, AT–III, PAI, APC–R, and PLG were significantly different between the two groups. Hypercoagulation and hypofibrinolysis were found in patients with post-SARS ON. Therefore, these examinations can be used to screen a population susceptible to ON. Measurements of APTT, PC, AT–III, PAI, APC–R, and PLG are sensitive blood tests for screening purposes.

To explore the role of interleukin-1 receptor antagonist (IL-1Ra) in suppression of cartilage matrix degradation and pathologic changes.Thirty New Zealand White rabbits underwent partial synovectomy of the left knee. Synovial fibroblasts were isolated and cultured. The rabbits underwent anterior cruciate ligament transection (ACLT) in the right knee. After the ACLT the rabbits were forced to run 4 hours a day for 4 weeks so as to establish the osteoarthritis (OA) model. Three days after the ACLT the rabbits were randomly divided into 3 groups of 10 rabbits: group 1, to be injected with the cultured autologous synovial fibroblasts into the right knees; group 2, injected with the autologous synovial fibroblasts transfected with marker gene, and group 3, injected with autologous synovial fibroblasts transfected with IL-1Ra gene. Two and 4 weeks after the injection 5 rabbits in each group were killed respectively. Their right knee joints were lavaged and the lavage fluid was extracted. IL-1Ra level in the synovial fluid (SF) was determined by ELISA. 20 mg of articular cartilage were taken from the condyle of right femur and digested by papain. The glycosamino-glycan (GAG) level in the SF and in the cartilage digest were evaluated using dimethylmethylene blue assay. Two pieces of cartilage were taken from each rabbit's and were sliced and stained to undergo pathologic changes.The IL-1Ra level in the SF of the group 3 was (20.2 +/- 1.8) ng/ml 2 weeks after, and was (4.8 +/- 0.5) ng/ml 4 weeks after, significantly lower than those in the group 2 (84 +/- 7) micro g/ml and group 3 (84 +/- 6) micro g/ml IL-1Ra was not detected in the SF of the group 1. The GAG level in SF was 40.1 micro g/ml with an inhibitory rate of 56.2%, and those in the group 2 and group 3 were 30.2 micro g/mg and 10.8 micro g/mg respectively. The GAG levels 4 weeks after in the cartilage digest of the group 1 and group 2 were (10.1 +/- 1.2) micro g/mg and (10.8 +/- 0.9) micro g/mg respectively, both significantly lower than that in the group 3 [(30 +/- 3) micro g/mg, both P0.05]. Pathological examination showed that the articular cartilage of the left knee was all normal in all the rabbits. However, obvious damage was found in the articular cartilage of the right knees of all the rabbits. However, the damage in the group 3 was significantly milder than that in the other 2 groups.Intraartilcular injection of synovial cells transfected with IL-1Ra gene can suppress articular cartilage matrix degradation and pathologic changes.