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Abstract Background The Taiwanese government implemented stringent preventative health measures to curb the spread of COVID-19. However, these measures negatively affected the physical activity behaviors and psychological distress of individuals. In this study, we investigated the effects of Taiwan’s COVID-19 alert–based restrictions on the physical activity behaviors and psychological distress of community-dwelling older adults. Methods In this longitudinal study, 500 community-dwelling older adults were randomly sampled from a health promotion center in Taiwan. Telephone interviews were conducted between May 11, 2021, and August 17, 2021, which coincided with the Level 3 alert period when group physical activities were prohibited. Telephone interviews were again conducted between June 20, 2022, and July 4, 2022, after the alert level was reduced to Level 2 but group physical activities were prohibited period. Through the telephone interviews, data regarding the participants’ physical activity behaviors (type and amount) and 5-item Brief Symptom Rating Scale (BSRS-5) scores were collected. Moreover, data regarding physical activity behaviors were collected from the records of our previous health promotion programs, which were conducted before the national alert period. The obtained data were analyzed. Results The alert levels influenced physical activity behaviors. Because of strict regulations, physical activity amount decreased during the Level 3 alert period and did not recover rapidly during the Level 2 alert period. Instead of engaging in group exercises (e.g., calisthenics and qigong), the older adults chose to exercise alone (e.g., strolling, brisk walking, and biking). Our findings indicate that the COVID-19 alert level has a significant influence on the amount of physical activity for participants (p

The capillary rising is one of the most common phenomena in fine-grained soils. However, research is limited for capillary actions in cementitiously treated engineered soils. In this study, a soil column test was performed for the free capillary rising in compacted loess and modified loess samples. Moisture content of compacted soil samples was measured and analyzed to determine capillary height and rising rate. Results indicated that there was a considerable capillary rising in loess and lime-modified loess, while the capillary rising in cement-treated loess was significantly restrained. Current models are not appropriate for the rate and height predictions of capillary rising in cementitiously treated loess, especially in early ages. Therefore, a logarithmic form correlation was suggested and validated. In addition, salt migration effect and microscopic properties of soils after capillary rising were evaluated. Overall, the paper presented an experimental study and prediction on the capillary rising behavior of treated and recompacted engineered loess. Key words: modified loess, capillary rising model, soluble salt concentration, SEM L'ascension capillaire est l'un des phenomenes les plus courants dans les sols a grains fins. Cependant, la recherche est limitee quant a l'action capillaire dans les sols modifies au ciment. Dans cette etude, un essai sur colonne de sol a ete effectue pour evaluer l'ascension capillaire libre dans des echantillons de loess compacte et de loess modifie. La teneur en eau des echantillons de sol compacte a ete mesuree et analysee pour determiner la hauteur capillaire et le taux d'ascension capillaire. Les resultats ont indique qu'il y avait une ascension capillaire considerable du loess et du loess modifie a la chaux, tandis que l'ascension capillaire du loess traite au ciment etait sensiblement moderee. Les modeles actuels ne sont pas appropries en matiere de predictions du taux et de la hauteur de l'ascension capillaire dans les loess traites au ciment, en particulier aux jeunes ages. Par consequent, une correlation logarithmique a ete suggeree et validee. De plus, l'effet de migration du sel et les proprietes microscopiques des sols apres l'ascension capillaire ont ete evalues. Dans l'ensemble, l'article a presente une etude experimentale et une prediction du comportement de l'ascension capillaire du loess traite et recompacte. [Traduit par la Redaction] Mots-cles : loess modifie, modele d'ascension capillaire, concentration en sel soluble, microscopie electronique a balayage, Introduction Capillary water rising is a frequently found phenomenon in fine-grained soil structures, induced by the shallow groundwater levels. In particular, the poor gradation and high surface evaporation commonly lead [...]

Abstract In this cross-sectional study, we assessed the physical fitness levels of active community-dwelling older adults. Moreover, we investigated the correlation of their (stratified by age and sex) fitness levels with handgrip strength (HGS). Comprehensive physical fitness tests, including sarcopenia screening, were conducted with a total of 2,130 older adults residing in a rural area of Taiwan. The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of age- and sex-specific physical fitness levels were determined. Furthermore, we identified the key parameters for assessing the physical fitness of older adults and performed stepwise multiple linear regression analysis. Both men and women exhibited age-related decreases in all aspects of functional fitness, a trend indicating that older adults in Taiwan may lose their independence in the future. Furthermore, the regression analysis revealed that HGS was positively correlated with sex, body mass index, and the results of 30-s arm curl and back scratch tests but negatively correlated with age and the result of 8-foot up-and-go test. Our reference values for physical fitness may help assess the fitness levels of active community-dwelling older adults and design community-based health programs to prevent the early loss of independence in community-dwelling older adults in Taiwan.

Abstract Background As the community-dwelling population ages in Taiwan, concerns regarding long-term care have grown more urgent. Physical fitness plays a key role in enabling community-dwelling older adults to independently complete daily tasks and avoid falling accidents. However, the effect of physical fitness on falls and other fitness-related factors remains poorly understood. Methods In this retrospective cross-sectional study, 2130 community-dwelling older adults were recruited from a rural region of Taiwan. Each of these participants completed a demographics interview and frailty questionnaire and reported their history of falls. We evaluated each participant’s height and body weight measurements, calf circumference, bone mass density, and results on the grip strength, single-leg standing, chair sit-and-reach, 8-ft up-and-go, 30-second chair stand, 2-minute step, 30-second arm curl, 6-m walk, and back scratch tests to determine their overall physical fitness, which consisted of their body composition, muscular strength and endurance, flexibility, and cardiopulmonary fitness. Results The prevalence of falls in the preceding year among the older adults surveyed was 20.8%, and the resultant hospitalization rate was 10.9%. The older adults who were more physically active in the past week, had regular exercise habits, lived with family, and had no history of hospitalization due to falls, exhibited greater performance on the physical fitness tests. Three time fallers exhibited lower levels of overall physical fitness than did those who had not fallen. The nonfallers outperformed the fallers in grip strength (participants who had not fallen and those who had fallen once, twice, or three times in the preceding year: 24.66 ± 0.19 vs. 23.66 ± 0.35 vs. 20.62 ± 0.71 vs. 22.20 ± 0.90 kg) and single-leg standing duration (19.38 ± 0.39 vs. 16.33 ± 0.78 vs. 13.95 ± 1.67 vs. 12.34 ± 1.82 seconds). Conclusions Exercise habits, living status, hospitalization due to falls, and amount of exercise were all associated with physical fitness in community-dwelling older adults. The results of all of the assessments indicated that the participants who had fallen three times exhibited lower levels of physical fitness than did those who had not fallen in the previous year. Physical measurements, including grip strength and single-leg standing duration, are associated with an individual’s risk of falling, which indicates that they should be considered in the development of geriatric physical fitness and fall-prevention programs.

Based on the development status of thermal barrier coatings, SPS (suspension plasma spraying), SPPS (solution precursor plasma spraying) and PS-PVD (plasma spraying-physical vapor deposition) technologies and the structural performance characteristics of the thermal coatings prepared by the above methods were summarized. Meanwhile, the development of single-layer, multi-layer and gradient coatings of plasma sprayed thermal barrier coatings was reviewed, and the effects of structural changes of ceramic materials system of La2Zr2O7, Gd2Zr2O7 and La2Ce2O7 on the properties of coating were emphatically summarized. Furthermore, the development prospects of multilayer structure of thermal barrier coatings were prospected.

Compact and uniform coatings were fabricated on LY12 aluminum alloy surface by adjusting process parameters and oxygen flow after micro-arc oxidation (MAO) treatment. The thickness, morphology, phase compositions and corrosion resistance were examined by SEM, XRD and electrochemical test system. The mechanism of MAO with oxygen was discussed, and the effect of oxygen flow on the coating compactness was analyzed. The results indicate that with the increase of time, voltage and concentration of electrolyte, the coating thickness changes regularly. The effect of oxygen on sintering can promote the growth of compact coatings, and the thickness of compact coatings first increases and then decreases with O2 rising. Under the conditions of 105g/L KF, 85g/L KOH, 12g/L NaAlO2, 110V for the voltage, 15min for treatment time and 0.010L/s for oxygen flow, a 30μm-thick compact coating can be formed on LY12 aluminum alloy. The corrosion potential of the coating increases to -0.11V, and the current density reduces to 2.1×10-6A/cm2, which is reduced by two orders of magnitude compared with the matrix and the corrosion resistance of the LY12 aluminum alloy significantly improves.

Permanent deformation, or rutting, is one of several critical distresses in flexible pavements. This paper introduced a novel experimental method, a penetration test, for asphalt mixtures to quantify the effects of glass fibre geogrids embedded in asphalt under repeated loading. It was found that the evolution of permanent deformation (εp) and its strain rate have three clearly identifiable stages. It was also observed that the presence of the geogrid increased the flow number and the number of cycles to failure significantly compared to control samples. Some of the current εp fitting models were found to be valid for deformation prediction under penetration. In addition, a new simple FN calculation method was also proposed based on strain rate and it showed consistent results. In particular, geogrid type "Grid10", which has smaller aperture size (12.7 mm) had slightly better reinforcement performance regarding the rutting resistance due to its larger contact area. Overall, the test and data analysis method presented in this study could be an important reference for future investigations on geosynthetic-reinforced pavement materials. [ABSTRACT FROM AUTHOR]

Single‐frequency semiconductor lasers represent a critical role in optical communications, light detection and ranging systems, photonics integrated circuits, etc. Here, combining atom‐like quantum dot (QD) materials and advanced lateral gratings, a high‐power, ultra‐low‐noise 1.3 µm InAs/GaAs QD distributed feedback laser is demonstrated. Stable single‐longitudinal‐mode output power of 100 mW from 25 ℃ to 85 ℃ is achieved with a maximum side mode suppression ratio of 62.6 dB, and the variations of threshold current and slope efficiency over the temperature range are slight, indicting a high temperature stability. A record‐narrow intrinsic linewidth of 1.62 kHz is achieved at 55 ℃ with a white noise level of merely 515 Hz2 Hz–1, and a minimum averaged relative intensity noise of only –166 dB/Hz between 0.1 GHz and 20 GHz is obtained at 25 ℃. Furthermore, a strong tolerance to external optical feedback (〉 –14 dB) is demonstrated in the range from 25 ℃ to 85 ℃, with a maximum value of –8 dB at 85 ℃. This high‐quality single‐frequency laser fabricated with simplified processes and compact size paves the way for its future large‐scale applications such as high‐capacity optical communication, high‐precision optical detection, high‐speed optical interconnections, etc. [ABSTRACT FROM AUTHOR]

Freeze-thaw action is considered to be one of the most destructive actions that can induce significant damage in stabilized subgrades in seasonally frozen loess areas. Laboratory tests including frost heave--thaw shrinkage and microstructure change during freeze-thaw cycles were conducted to evaluate the volume change rate of loess stabilized with cement, lime, and fly ash under the impact of cyclic freeze-thaw conditions. The loess specimens collapsed after eight freeze-thaw cycles (192 h), but most stabilized loess specimens had no visible damage after all freeze-thaw cycles were completed. All of the stabilized loess samples underwent a much smaller volume change than the loess alone after the freeze-thaw cycles. Although surface porosity and equivalent diameter of stabilized loess samples increased, the stabilized loess can retain its microstructure during freezethaw cycles when the cement content was less than 6%. To ensure freeze-thaw resistance of stabilized loess subgrades, the mix proportions of the three additives was recommended to be 4 to 5% cement, 6% lime, and 10% fly ash. Key words: stabilized loess, freeze-thaw cycle, frost heaving, thaw shrinkage, microstructure, cement, lime, fly ash. On considere l'action du gel et du degel comme etant une des actions les plus destructives pouvant causer des dommages importants des sols de fondation stabilises dans les zones de loess ayant subi un gel saisonnier. Les essais en laboratoire comprennent le soulevement par le gel et le retrait du au degel alors qu'on a mene des changements de microstructure au cours des cycles de gel-degel afin d'evaluer le taux de changement du volume du loess stabilise au moyen du ciment, de la chaux et de la cendre volante sous l'effet des conditions de gel-degel. Les specimens de loess se sont effondres apres huit cycles de gel-degel (192 h), mais la plupart des specimens de loess stabilise n'avaient aucun dommage visible apres que tous les cycles de gel-degel furent completes. Tous les echantillons de loess stabilise ont subi un changement de volume bien moindre que le loess seul apres les cycles de gel-degel. Bien que la porosite de surface et le diametre equivalent des echantillons de loess stabilise aient augmente, le loess stabilise peut garder sa microstructure pendant les cycles de gel-degel lorsque le contenu en ciment etait moins de 6 %. Afin d'assurer la resistance au gel-degel des sols de fondation de loess, on a recommande que les proportions des melanges des trois adjuvants soient de 4 a 5 % ciment, de 6 % chaux et de 10 % de cendre volante. [Traduit par la Redaction] Mots-cles: loess stabilize, cycle de gel-degel, soulevement par le gel, retrait du au degel, microstructure, ciment, chaux, cendre volante., Introduction Loess is a collapsible soil covering approximately 10% of the Earth's surface, it appears in vast areas from Western Europe to China (Qian et al. 1985), across North America, [...]

Background: Because the reliability of repetitive transcranial magnetic stimulation (rTMS) in treating poststroke cognitive impairment has not been convincingly demonstrated, we systematically examined the effectiveness of this regimen with 2 protocols. Methods: We randomly allocated 41 patients with poststroke cognitive impairment to receive 5 Hz rTMS (n = 11), intermittent theta burst stimulation (iTBS; n = 15) or sham stimulation (n = 15). Each group received 10 stimulation sessions over the left dorsolateral prefrontal cortex. We performed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Beck Depression Inventory at baseline and after the intervention. Results: The 5 Hz rTMS group showed significantly greater improvement than the sham group in RBANS total score (p = 0.006), attention (p = 0.001) and delayed memory (p < 0.001). The iTBS group showed significantly greater improvement than the sham group in RBANS total score (p = 0.005) and delayed memory (p = 0.007). The 5 Hz rTMS group exhibited a superior modulating effect in attention compared to the iTBS group (p = 0.016). Patients without comorbid hypertension (p = 0.008) were predisposed to favourable therapeutic outcomes. Limitations: Although we included only patients with left hemispheric stroke, heterogeneity associated with cortical and subcortical implications existed. We did not investigate the remote effects of rTMS. Conclusion: Our results demonstrated that both 5 Hz rTMS and iTBS were effective for poststroke cognitive impairment in terms of global cognition, attention and memory function; the domain of attention was susceptible to 5 Hz modulation. Treatment with 5 Hz rTMS may slow cognitive decline, representing both a pivotal process in poststroke cognitive impairment and an aspect of neuroplasticity that contributes to disease-modifying strategies. Clinical trial registration: NCT02006615; clinicaltrials.gov/ct2/show/NCT02006615. [ABSTRACT FROM AUTHOR]

Osteosarcoma (OS) is the most common primary malignant bone tumor. Numerous studies have strongly implicated the ectopic expression of microRNAs (miRNAs/miRs), including miR-885-5p, which is aberrantly expressed in several cancer types, in multiple cancer-related processes. However, the role of miR-885-5p in OS remains unknown. In the present study, it was found that the expression of miR-885-5p was markedly upregulated in OS cell lines and clinical tissues. Moreover, high expression of miR-885-5p was significantly associated with the development of OS. The human OS MG-63 cell line was transfected with recombinant lentivirus to regulate miR-885-5p expression. Overexpressed miR-885-5p significantly promoted the proliferation and migration of MG-63 cells in vitro, while downregulating miR-885-5p expression reversed these effects. Furthermore, bioinformatic analysis was used to predict the potential target genes of miR-885-5p, and cell division cycle protein 73 homolog (CDC73) was identified as a novel and direct target of miR-885-5p. This interaction was further confirmed using reverse transcription-quantitative polymerase chain reaction, western blotting and luciferase activity assays. These findings suggest that miR-885-5p serves a critical role in facilitating OS proliferation and migration, and can regulate CDC73 expression in OS cells and tissues. Thus, miR-885-5p could be a promising novel therapeutic biomarker for OS. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the influence of pamidronate on cementoclast and osteoclast differentiation factor (ODF) expression during orthodontic tooth movement in rats. METHODS: 24 female, 6-week-old SPF Wistar rats were selected and the animal models for orthodontic tooth movement were established. Each rat's maxillary was divided into experimental side and control side. Pamidronate (50 µL) was injected into the sub-periosteum area adjacent to the left upper first molar (experimental side) every 3 days during the experiment, while 0.9% NS (50 µL) was injected into the corresponding area of the control side. The rats were executed in batch on the 3rd, 7th and 14th day respectively during the orthodontic treatment for detecting the amount of cementoclast and the expression of ODF in the periodontal tissues. AD statistical analysis was performed using PASW Statistics 18 software package. RESULTS: The amount of cementoclasts was significantly less in the experimental side than that in the control' side on the 7th and 14th days (P< 0.05). The expression of ODF was significantly less in the experimental side than that in the control side on the 7th and 14th days (P<0.05). CONCLUSIONS: Local injection of pamidronate can reduce the number of cementoclast and the expression of ODF. Supported by Shandong Provincial Science and Technology Development Project (2009GG20002042) and Science and Technology Project of Zibo Science and Technology Bureau (2010GG01070). [ABSTRACT FROM AUTHOR]

Aims: Nattokinase (NK), a potent serine endopeptidase, has exhibited a variety of pharmacological effects, including thrombolysis, anti-inflammation, and antioxidative stress. Building on previous research highlighting NK's promise in nerve regeneration, our study investigated whether NK exerted protective effects in transient middle cerebral artery occlusion (tMCAO)-induced cerebral ischemia-reperfusion injury and the underlying mechanisms. Results: The rats were administered NK (5000, 10000, 20000 FU/kg, i.g., 7 days before surgery, once daily). We showed that NK treatment dose dependently reduced the infarction volume and improved neurological symptoms, decreased the proinflammatory and coagulation cytokines levels, and attenuated reactive oxygen species (ROS) in the infarcted area of tMCAO rats. We also found that NK could exert neuroprotective effects in a variety of vitro models, including the microglia inflammation model and neuronal oxygen-glucose deprivation/reperfusion (OGD/R) model. Notably, NK effectively countered OGD/R-induced neuron death, modulating diverse pathways, including autophagy, apoptosis, PARP-dependent death, and endoplasmic reticulum stress. Furthermore, the neuroprotection of NK was blocked by phenylmethylsulfonyl fluoride (PMSF), a serine endopeptidase inhibitor. We revealed that heat-inactive NK was unable to protect against tMCAO injury and other vitro models, suggesting NK attenuated ischemic injury by its enzymatic activity. We conducted a proteomic analysis and found inflammation and coagulation were involved in the occurrence of tMCAO model and in the therapeutic effect of NK. Innovation and Conclusion: In conclusion, these data demonstrated that NK had multifaceted neuroprotection in ischemic brain injury, and the therapeutic effect of NK was related with serine endopeptidase activity.

Studying the physicochemical properties and biological activities of Lycium barbarum polysaccharides(LBPs) is of great significance. The previous study had extracted LBPs(LBP-1, LBP-2, LBP-3, LBP-4, and LBP-5) by five different methods(cold water extraction, boiling water reflux extraction of the residue after cold water extraction, ultrasonic extraction with 50% ethanol, ultrasonic extraction with 25% ethanol of the residue after 50% ethanol extraction, and hot water extraction). In this study, the structures of the obtained five LBPs were characterized by UV spectroscopy, thermogravimetric analysis, and scanning electron microscopy. Furthermore, the antioxidant, blood lipid-lowering, nitrosation-inhibting, acetylcholinesterase-inhibiting, and tyrosinase-inhibiting activities of the five LBPs were measured in vitro. The results showed that high-temperature extraction destroyed the polysaccharide structure, while ultrasound-assisted extraction ensured the structural integrity. The thermal stability and degradation behaviors differed among the five LBPs. However, the UV spectroscopic results of the five LBPs did not show significant differences, and all of the five LBPs showed the characteristic absorption peaks of proteins. LBP-3 and LBP-4 exhibited strong antioxidant activity, while LBP-3 had the strongest blood lipid-lowering activity. In addition, LBP-3 outperformed other LBPs in inhibiting nitrosation and acetylcholineste-rase, and LBP-2 showed the strongest inhibitory effect on tyrosinase. This study explored the effects of different extraction methods on the physicochemical properties and biological activities of LBPs, with a view to providing a basis for the selection of suitable extraction methods to obtain LBPs with ideal biological activities.

Objective: The aim of this study was to investigate ErbB2 expression in osteochondroma and its relationship with clinicopathologic features of osteochondroma, so as to identify a new biomarker for the malignant transformation potential of osteochondroma., Methods: Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) were used to investigate the expression status of ErbB2 protein and gene in 30 osteochondroma tissues and 20 non-neoplastic bone tissues. The association of ErbB2 gene and protein expression with clinicopathological parameters of osteochondroma was analyzed by using the χ2 test and Fishers exact test., Results: ErbB2 protein was found to be over-expressed in 4 of 30 (13.3%) osteochondromas and 1 of 20 (5%) non-neoplastic bone samples, which were not statistically significant (p=0.336). However, 13 of the 30 (43.3%) osteochondromas showed ErbB2 gene amplification, which was failed to be observed in any of the non-neoplastic bone tissue. ErbB2 gene amplification in osteochondroma was significantly higher compared with that in non-neoplastic bone tissue (p=0.001). In addition, the ErbB2 gene amplification was closely associated with clinical pathological parameters of osteochondroma, including high expression of cellularity (p=0.001), presence of binucleated cells (p=0.001), nuclear pleomorphism (p=0.003), calcification (p=0.002), nodularity (p=0.002), necrosis (p=0.009) and cartilage thickness (p=0.026). The association of the gene amplification with other clinicopathological parameters of osteochondroma, including permeation of trabecular bone, cystic/mucoid changes, mitosis, radiographic appearance, cap volume and subtype of osteochondroma was not observed. The over-expression of ErbB2 protein was not found to be associated with the above stated clinical pathological parameters of osteochondroma., Conclusion: ErbB2 gene amplification was associated with adverse clinicopathological status of osteochondroma and could serve as an index for malignant conversion of osteochondroma. Further research is required to verify the predictive values of ErbB2 for osteochondroma., Level of Evidence: Level IV, Diagnostic Study.

Objective: To observe the clinical efficacy of treating patients with coronary slow flow phenomenon by Yiqi Huoxue Recipe (YHR) combined Western drugs, thus providing clinical evidence for further studies., Methods: Totally 61 patients with coronary slow flow phenomenon were randomly assigned to the treatment group (31 cases) and the control group (30 cases). Patients in the control group were treated with basic treatment of Western medicine, while those in the treatment group were treated with basic treatment of Western medicine and YHR. The therapeutic course for all was two months. Clinical symptoms were observed, and electrocardiogram examinations taken, and left ventricular ejection fraction (LVEF) were evaluated before treatment and at two months after treatment., Results: Patients' clinical symptoms and electrocardiogram examinations were significantly improved in the treatment group. Its effective rate of improved symptoms was 90.32% in the treatment group, superior to that in the control group (76.67%, P < 0.05). The effective rate of electrocardiogram examinations was 87.10% in the treatment group, superior to that in the control group (73.33%, P < 0.05). But there was no statistical difference in LVEF between the two groups (P > 0.05)., Conclusion: YHR combined Western drugs could improve clinical symptoms and electrocardiographic ischemia in patients with coronary slow flow phenomenon.

Purpose: To investigate the influence of pamidronate on cementoclast and osteoclast differentiation factor(ODF) expression during orthodontic tooth movement in rats., Methods: 24 female, 6-week-old SPF Wistar rats were selected and the animal models for orthodontic tooth movement were established. Each rat's maxillary was divided into experimental side and control side. Pamidronate(50 μL) was injected into the sub-periosteum area adjacent to the left upper first molar(experimental side) every 3 days during the experiment, while 0.9%NS(50 μL) was injected into the corresponding area of the control side. The rats were executed in batch on the 3rd, 7th and 14th day respectively during the orthodontic treatment for detecting the amount of cementoclast and the expression of ODF in the periodontal tissues. All statistical analysis was performed using PASW Statistics 18 software package., Results: The amount of cementoclasts was significantly less in the experimental side than that in the control side on the 7th and 14th days(P<0.05). The expression of ODF was significantly less in the experimental side than that in the control side on the 7th and 14th days(P<0.05)., Conclusions: Local injection of pamidronate can reduce the number of cementoclast and the expression of ODF.

Objective: C(2) pedicle screw is the classic instrumentation for posterior C(2) fixation. But it could be dangerous in case of anatomical variation, such as high riding vertebral artery and small C(2) pedicle. C(2) trans-laminar screw could be an alternative choice. This retrospective study is to evaluate the feasibility of C(2) trans-laminar screw for atlantoaxial instability with anatomical variation., Methods: In our clinical work, we had nine atlantoaxial instability cases with C(2) pedicle malformation. If the malformation is unilateral, we inserted one C(2) trans-laminar screw and one C(2) pedicle screw in the normal pedicle; if the malformation is bilateral, bilateral trans-laminar screws were used. Then C(2) instrumentation could be connected with C(1) lateral mass screw or occipital screw in cases with C(1) occipitalization. Then atlantoaxial or occipitocervical fusion could be done with morselized autogenous cancellous iliac grafts., Results: Nine cases had C(2) trans-laminar screw, including 2 atlantoaxial fusion and 7 occipitocervical fusion. Six cases had unilateral trans-laminar screw and 3 had bilateral trans-laminar screw. Radiographs demonstrated all the screws were placed satisfactorily except one. There was no neurological deterioration or vertebral artery injury. All the cases had an average follow-up of 9 months (4 - 13 months). All patients attained solid fusion without screw failure. In the 8 cases with neurological deficit, 3 were excellent, 1 was good, 2 were fair and 2 had no change., Conclusions: C(2) trans-laminar screw fixation could provide sufficient stability. This technique could be an alternative to standard C(2) pedicle screw in cases with pedicle malformation and high riding vertebral artery. It is safe and simple in experienced hands.

Objective: To evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding., Methods: In the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass)., Results: Among the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation., Conclusion: Probing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.

Objective: To discuss the clinical characteristics, early diagnosis and treatment for pulmonary embolism after spine surgery., Methods: From January 1995 to May 2006, 11 cases suffered pulmonary embolism after spine surgery in the total of 10 993 patients. The clinical characteristics, diagnosis and treatment of these 11 cases were retrospectively analyzed., Results: The incidence of pulmonary embolism was 0.1% after spine surgery. Pulmonary embolism was found during 5 to 14 days after spine surgery (mean 9.8 days). All of them show characteristic syndrome of pulmonary embolism, such as difficult breathe, cardiopalmus, thoracodynia, hemoptysis. Five patients died, and the mortality was 45.5%. The earlier use of pulmonary angiography and embolectomy by catheter device, the lower mortality will be. It is significantly., Conclusions: Pulmonary embolism is one of the serious complications after spine surgery. It is the period of high happening on deadly PE and the mortality during 1 to 2 weeks after spine surgery. Pulmonary angiography and interventional therapy take an important part in the early diagnosis and treatment.

Objective: To evaluate the accuracy and reliability of atlantoaxial transarticular screw insertion (Magerl's technique) in atlas under lateral fluoroscopic monitoring without anteroposterior view., Method: Seventy-five consecutive patients with atlantoaxial instability, 48 males and 27 females, aged 35.1, were treated by Magerl's technique. The screw path in atlas was achieved by direct probing the isthmus of axial vertebrae then identifying its position through the atlantoaxial joint correlation. Postoperative transoral X ray and CT film were used for analysis of the position of the 150 screws in the mass of atlas. Three areas were delimitated in and around the lateral mass of atlas: area A (inside the joint face), area: B (outside the joint face but still in lateral mass), and area C area (outside the lateral mass) so as to analyze the location of screws., Results: Among the 150 screws 139 (92.7%) were located in area A, 8 in area B(1) and 3 in area B(2) (7.3%), and none in area C. All cases got atlantoaxial union 3 months after operation., Conclusion: The method of "direct probing" is reliable for identifying the path of screw in atlas.