Risk factors of common bile duct stones recurrence and nomogram for predicting recurrence after endoscopic retrograde cholangiopancreatography: a dual-center retrospective cohort study.

OBJECTIVE: Common bile duct stone (CBDS) is one of the common diseases in the digestive system, for which endoscopic retrograde cholangiopancreatography (ERCP) is a treatment procedure. However, the risk factors for CBDS recurrence after ERCP remains unclear. This study aims to compare the risk factors of CBDS recurrence after ERCP, and to set up a nomogram model to predict the long-term risk. PATIENTS AND METHODS: A retrospective analysis of 355 patients was reviewed. Univariate and multivariate analyses were performed to identify the risk factors for recurrence. The R packages were used for the model building. The validation set contained 100 patients. RESULTS: The patients were divided into three subgroups: treated by cholecystectomy after ERCP (11.76% recurrence rate), treated without surgery after ERCP (19.70%), and with a prior history of cholecystectomy (43.64%). Each of them has different independent risk factors, and high body mass index (BMI) is correlated with an increased risk among all the subgroups. A prior history of cholecystectomy is a candidate factor that increases the risk of CBDS recurrence in patients older than 60 years, with a greater BMI, or receiving ERCP combined with EPBD. We built a nomogram model to predict the risk of long-term CBDS recurrence based on the risk factors including age, BMI, CBD diameter, the number of CBDS, and the gallbladder- or biliary tract-related events. CONCLUSIONS: CBDS recurrence is related to congenital and anatomical factors. Cholecystectomy would not be helpful to prevent CBDS recurrence, and a prior history of cholecystectomy may indicate a high risk of recurrence.

Is ultrasound accurate for radiation-free quantitative assessment of spinal curvatures in patients with idiopathic scoliosis - a systematic review and meta-analysis.

Despite application of ultrasound for quantitative measurement of spinal curvatures has been reported with various studies, a systematic review for such is lacking. This systematic review aimed to evaluate (1) reliability of ultrasound; (2) validity of ultrasound using radiographic measurement as gold standard in idiopathic scoliosis patients; and (3) the use of various anatomical landmarks for measurement of spinal curvatures. MEDLINE, EMBASE, CINAHL, and CENTRAL databases were searched. QUADAS-2 quality assessment tool was adopted. Reliability of ultrasound in terms of intra-class correlation coefficient was recorded. Pearson correlation coefficients between ultrasound and radiographic measurements were extracted for meta-analysis. Subgroup analyses based on ultrasound measurement protocols of spinous process (SP), transverse processes (TP) and center of lamina (COL) were conducted. Eleven articles reporting 18 correlation analyses on 766 subjects were eligible for meta-analysis. The mean inter-rater reliability of ultrasound measurement was 0.87±0.07. Pooled correlation for all studies was 0.918 (95% CI: 0.868-0.949), exhibiting substantial heterogeneity (I2=90.50%, p<0.001). Subgroup analyses showed that pooled correlations were 0.887 for COL method (comprising 356 subjects); 0.924 for SP method (255 subjects); and 0.941 for TP method (117 subjects); all with notable heterogeneity (I2>90%, p<0.001). The overall risk of bias was rated moderate; yet publication bias was noted. Evidences showed that ultrasound was a promising non-invasive method with satisfactory validity and reliability for measuring coronal curvatures utilizing the SP, TP or COL methods. Further development of three-dimensional ultrasound towards scoliosis assessment will facilitate its translational application for managing scoliosis.

Using ultrasound for screening scoliosis to reduce unnecessary radiographic radiation - a prospective diagnostic accuracy study on 442 schoolchildren.

Scoliosis screening is important for timely initiation of brace treatment to mitigate curve progression in skeletally immature children. Scoliosis screening programs frequently include the protocol of referring children screened positive with Scoliometer and Moiré Topography for confirmatory standard radiography. Despite being highly sensitive (88%) for detecting those who require specialist referral, the screening program was found to have more than 50% false positive rate that leads to unnecessary radiation exposure. Radiation-free ultrasound has been reported to be reliable for quantitative assessment of scoliosis curves. The aim of this prospective diagnostic accuracy study was to determine the accuracy of ultrasound in determining the referral status for children initially screened positive for scoliosis. 442 schoolchildren with a mean Cobb angle of 14.0 ± 6.6° were recruited. Using x-ray as the gold standard, the sensitivity and specificity of ultrasound in predicting the correct referral status were 92.3% and 51.6% respectively. ROC curve analysis revealed an area under curve of 0.735 for ultrasound alone and 0.832 for ultrasound plus scoliometer measurement. The finding provided strong evidences on the accuracy of ultrasound in determining the referral status that could result in more than 50% reduction of unnecessary radiation exposure for children undergoing scoliosis screening.

Ultrasound volume projection image quality selection by ranking from convolutional RankNet.

Periodic inspection and assessment are important for scoliosis patients. 3D ultrasound imaging has become an important means of scoliosis assessment as it is a real-time, cost-effective and radiation-free imaging technique. With the generation of a 3D ultrasound volume projection spine image using our Scolioscan system, a series of 2D coronal ultrasound images are produced at different depths with different qualities. Selecting a high quality image from these 2D images is the crucial task for further scoliosis measurement. However, adjacent images are similar and difficult to distinguish. To learn the nuances between these images, we propose selecting the best image automatically, based on their quality rankings. Here, the ranking algorithm we use is a pairwise learning-to-ranking network, RankNet. Then, to extract more efficient features of input images and to improve the discriminative ability of the model, we adopt the convolutional neural network as the backbone due to its high power of image exploration. Finally, by inputting the images in pairs into the proposed convolutional RankNet, we can select the best images from each case based on the output ranking orders. The experimental result shows that convolutional RankNet achieves better than 95.5% top-3 accuracy, and we prove that this performance is beyond the experience of a human expert.

Effect of microRNA-7 on proliferation, invasion, migration and EMT of hepatoma cell line SMMC-7721.

OBJECTIVE: This study aimed to observe the effect of microRNA-7 on the proliferation and migration of human hepatocellular carcinoma cell line SMMC-7721 and its effect on epithelial-mesenchymal transition (EMT). PATIENTS AND METHODS: Eukaryotic expression vector pcDNA3.1(-)-pri-miR-7(p-miR-7) was used to instantaneously transfect human liver cancer cells of SMMC-7721 cells in vitro. The expression of microRNA-7 was detected by RT-qPCR. Western blot was used to detect the expression of EMT marker proteins E-cadherin, ß-catenin, N-cadherin and Vimentin. The proliferation of SMMC-7721 cells was detected by CCK-8 assay, and the invasion and migration ability of cells was detected by transwell assay. RESULTS: Compared with the normal group, the expressions of E-cadherin and ß-catenin in SMMC-7721 cells transfected with miR-7 were significantly increased (p<0.05), while the expressions of N-cadherin and Vimentin were significantly decreased (p<0.05). Meanwhile, the proliferation, invasion and migration ability of the cells were significantly weakened (p<0.05). CONCLUSIONS: The miR-7 can inhibit the proliferation and invasion of human hepatocellular carcinoma cell line SMMC-7721, and its mechanism may be related to upregulation of E-cadherin, ß-catenin protein, and downregulation of N-cadherin and Vimentin proteins.

RBMS3 delays disc degeneration by inhibiting Wnt/ß-catenin signaling pathway.

OBJECTIVE: To study the effect of RBMS3 on nucleus pulposus cells and its effect on the Wnt/ß-catenin signaling pathway. PATIENTS AND METHODS: We measured the expression of RBMS3 in human nucleus pulposus tissues with different degrees of degeneration. Recombinant human IL-1ß is used to stimulate the degeneration of human nucleus pulposus cells. We used Wnt/ß-catenin signaling pathway inhibitors and cell transfection to study the effect of RBMS3 on nucleus pulposus cells and its mechanism. RESULTS: RBMS3 was less expressed in the nucleus pulposus tissue of people with higher degeneration degree. IL-1ß reduced the expression of RBMS3 in nucleus pulposus cells. Overexpression of RBMS3 can promote the proliferation of nucleus pulposus cells and reduce the apoptosis and inflammation of cells. In addition, RBMS3 can reduce the expression of ß-catenin and c-myc in nucleus pulposus cells, and inhibit the activity of the Wnt/ß-catenin signaling pathway. CONCLUSIONS: RBMS3 inhibits the Wnt/ß-catenin signaling pathway, improves the proliferation ability of nucleus pulposus cells, inhibits their apoptosis and inflammation, and thus delays the degeneration of the intervertebral disc.

Association of SOX11 gene expression withclinical features and prognosis of mantle cell lymphoma.

OBJECTIVE: To study the expression of SOX11 in the patients with mantle cell lymphoma (MCL) and explore the clinical values of SOX11 in MCL. PATIENTS AND METHODS: In the paraffin-embedded MCL tissues of 75 patients diagnosed in the Department of Hematology, Shanxi Tumor Hospital, were performed the immunohistochemical labeling of Ki67 and SOX11 by the EnVision method. Meanwhile, the expression of SOX11 mRNA was also detected by reverse transcriptase-polymerase chain reaction (RT-PCR), and the association of SOX11 with such prognostic indexes as pathological typing, staging, immunophenotyping, and MIPI was analyzed using the statistical method. RESULTS: The immunohistochemistry showed that 97% of cases expressed SOX11 positive, and the RT-PCR results showed that the expression of SOX11 mRNA in the MCL patients was significantly higher than those with reactive hyperplasia lymphoid [3.097 (1.311, 6.216) and 1.058 (0.302, 2.623, respectively (p<0.05). Higher expression of SOX11 mRNA was positively correlated with some good prognostic factors such as ECOG<2, no bone marrow involvement and low-risk according to the International Prognostic Index (IPI). The comparison of the survival curves between group SOX11 mRNA

Posterior hemivertebra resection in combination with screw rod internal fixation in the treatment of pediatric congenital scoliosis.

Congenital scoliosis, a commonly seen disease occurring in children, can not only affect the growth, but also can uglify the individual which can severely affect the health and quality of life of children. To investigate the efficacy of posterior hemivertebra resection in combination with screw rod internal fixation in the treatment of congenital hemivertebra scoliosis, 115 patients were randomly divided into an observation group and a control group. Patients in the observation group were treated by posterior hemivertebra resection in combination with screw rod internal fixation, while patients in the control group were treated by posterior hemivertebra resection only. The surgical evaluation indicators, postoperative improvement of scoliosis and incidence of complications were recorded. The results demonstrated that the observation group had longer average operation time and less average blood loss compared to the control group, and the differences had statistical significance (P less than0.05); the correction efficacy of the observation group was superior to that of the control group (P less than 0.05); the incidence of postoperative complications in the two groups had no significant difference, but the incidence of correction loss of the observation group was much lower than that of the control group (P less than 0.05). In conclusion, posterior hemivertebra resection in combination with screw rod internal fixation is a highly efficient and safe treatment which can significantly relieve the clinical symptoms and cause few complications.

Solvent-free nanofluid with three structure models based on the composition of a MWCNT/SiO2 core and its adsorption capacity of CO2.

A series of core/shell nanoparticle organic/inorganic hybrid materials (NOHMs) with different weight ratios of two components, consisting of multi-walled carbon nanotubes (MWCNTs) and silicon dioxide (SiO2) as the core were synthesized. The NOHMs display a liquid-like state in the absence of solvent at room temperature. Five NOHMs were categorized into three kinds of structure states based on different weight ratio of two components in the core, named the power strip model, the critical model and the collapse model. The capture capacities of these NOHMs for CO2 were investigated at 298 K and CO2 pressures ranging from 0 to 5 MPa. Compared with NOHMs having a neat MWCNT core, it was revealed that NOHMs with the power strip model show better adsorption capacity toward CO2 due to its lower viscosity and more reactive groups that can react with CO2. In addition, the capture capacities of NOHMs with the critical model were relatively worse than the neat MWCNT-based NOHM. The result is attributed to the aggregation of SiO2 in these samples, which may cause the consumption and hindrance of reactive groups. However, the capture capacity of NOHMs with the collapse model was the worst of all the NOHMs, owing to its lowest content of reactive groups and hollow structure in MWCNTs. In addition, they presented non-interference of MWCNTs and SiO2 without aggregation state.

Proximal femoral nail antirotation internal fixation in treating intertrochanteric femoral fractures of elderly subjects.

This study compared the effect of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric femoral fractures of elderly subjects and evaluated the effect of PFNA internal fixation. Two hundred and sixteen elderly patients with intertrochanteric femoral fracture who received treatment in Binzhou Medical University Hospital, Shandong, China were selected. They were divided into a PFNA group which adopted PFNA for internal fixation and a DHS group which adopted DHS for internal fixation, 108 cases in each group. The physical condition of the patients in the two groups were recorded on admittance. The fracture was typed according to Evans-Jensen classification criteria. Patients were followed up after surgery to evaluate the postoperative recovery and Harris score of hip joint function. Except for the length of hospital stay, the length of incision, interoperative blood loss, volume of drainage and duration of operation of the PFNA group were all superior to those of the DHS group (P less than 0.05); the incidence of postoperative complications of the PFNA group was lower than that of the DHS group (P less than 0.05); the early Harris score of the treatment was superior to that of the DHS group, and there was no remarkable difference (P>0.05). PFNA has more advantages than DHS in treating intertrochanteric femoral fracture of the elderly; hence it is worth wide application in clinical use.

[Preliminary evaluation of PET-CT and DWI for the detection of lymphoma bone marrow infiltration].

Objective: To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma. Methods: The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed. 61 patients underwent PET-CT examination, and other 32 underwent DWI examination. With bone marrow biopsy results as "gold standard" , the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed, and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes. Results: 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI. The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0% and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6% and 89.5%, respectively. The detection rates of the two imaging techniques for aggressive lymphoma were 37.5% (18/48) and 38.1% (8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1% (3/13) and 27.3% (3/11)], although the differences were not statistically significant (P=0.521, P=0.660). For both aggressive lymphoma and indolent lymphoma, the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000). Conclusions: PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma. None of PET-CT and DWI can replace bone marrow biopsy (BMB). However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma.

BLCA-4 and UBC combined detection for early diagnosis of bladder cancer.

The objective of the present study was to report the clinical significance of bladder cancer specific nuclear matrix protein 4 (BLCA-4) and urinary bladder cancer (UBC) on early diagnosis of bladder cancers. Enzyme-linked immunosorbent assay (ELISA) was used to detect BLCA-4 and UBC of 56 bladder cancer patients and 26 patients with urinary tract benign diseases, serving as controls. Urine exfoliated cell test was performed, and then the significance of BLCA-4 and UBC on the diagnosis of bladder cancers was analyzed. The sensitivity of BLCA-4 and UBC of the bladder cancer patients was significantly higher than that of the urine exfoliated cell test (P less than 0.05). The difference of BLCA-4 and UBC was not significant (P >0.05). The difference of BLCA-4 and UBC in the tumors with different gradings and stagings was not significant (P >0.05). Combined detection of BLCA-4 and UBC could improve the diagnosis sensitivity and specificity of bladder cancers with the advantages of high maneuverability, repeatability and objective results.

[Clinical characteristics and prognosis of concurrent positive t(14; 18) and myc gene rearrangement in diffuse large B cell lymphoma].

OBJECTIVE: To study the incidence of positive t(14; 18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t(14; 18) and myc gene rearrangement "double-hit lymphoma" (DHL) in diffuse large B cell lymphoma. METHODS: The positive t(14; 18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization (FISH) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry. The relationship of positive t(14; 18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed. SPSS 16.0 software was used for statistical analysis. RESULTS: Among the 106 cases, there were 27 (25.5%) cases with positive t(14; 18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement. A relationship was observed between positive t(14; 18) and myc gene rearrangement (P=0.019). The follow-up data showed that the 7 DHL patients were in age of 52-84 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the 7 cases. Four patients had bone marrow involvement and were combined with leukemia. The survival time ranged from 0.5 to 6 months, with a median survival of 4 months. The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression, and myc gene rearrangement were all associated with poor prognosis (P<0.05 for all). The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression, myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival (P<0.05 for all), among them, the myc gene rearrangement was the strongest prognostic factor (OR=4.337, P<0.001). CONCLUSIONS: "Double-hit" DLBCL is rare and can be mainly identified only by molecular detection. Perhaps positive t(14; 18) and myc gene rearrangement play concurrent role in its "double-hit" pathogenesis. DHL are highly invasive, and most of DHL patients have poor prognosis. Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.

Measurement of diabetic wounds with optical coherence tomography-based air-jet indentation system and a material testing system.

OBJECTIVE: Material testing system is a conventional but destructive method for measuring the biomechanical properties of wound tissues in basic research. The recently developed optical coherence tomography-based air-jet indentation system is a non-destructive method for measuring these properties of soft tissues in a non-contact manner. The aim of the study was to examine the correlation between the biomechanical properties of wound tissues measured by the two systems. METHOD: Young male Sprague-Dawley rats with streptozotocin-induced diabetic were wounded by a 6 mm biopsy punch on their hind limbs. The biomechanical properties of wound tissues were assessed with the two systems on post-wounding days 3, 7, 10, 14, and 21. Wound sections were stained with picro-sirius red for analysis on the collagen fibres. Data obtained on the different days were charted to obtain the change in biomechanical properties across the time points, and then pooled to examine the correlation between measurements made by the two devices. Qualitative analysis to determine any correlation between indentation stiffness measured by the air-jet indentation system and the orientation of collagen fibres. RESULTS: The indentation stiffness is significantly negatively correlated to the maximum load, maximum tensile stress, and Young's modulus by the material testing system (all p<0.05). The orientation of collagen changes with the indentation stiffness over time. CONCLUSION: Our findings support the use of optical coherence tomography-based air-jet indentation system to evaluate the biomechanical properties of wounds in a non-contact manner. It is a potential clinical device to examine the biomechanical properties of chronic wounds in vivo in a repeatable manner.

Study on the correlation between the changes in intra-abdominal pressure and renal functional in the patients with abdominal compartment syndrome.

OBJECTIVE: To observe the effect on renal function from increased intra-abdominal pressure. PATIENTS AND METHODS: Sixty patients with abdominal compartment syndrome (ACS) were included in this study. Intra-abdominal pressure, mean arterial pressure (MAP) and central venous pressure (CVP) were recorded three times per day at a fixed time. Meanwhile, blood samples were collected for serum creatinine measurement and urine volume per hour was recorded. RESULTS: The urine volume gradually decreased with the increasing intra-abdominal pressure, from 92. 6 ± 20 ml/h to 27.9 ± 20 ml/h (p < 0. 05), and the serum creatinine increased from 68.4 ± 39.9 mol/L to 249.4 ± 111.5 mol/L (p < 0. 05). The CVP increased from 0.98 ± 0.19 kPa to 1.56 ± 0.31 kPa with the increase or decrease of the MAP. The increase in intra-abdominal pressure was negatively related to the urine volume (r = -0.193, p < 0.05), and positively related to the serum creatinine (r = 0.162, p < 0.05), but not related to the MAP. CONCLUSIONS: The increase of intra-abdominal pressure, was closely related to oliguria and increasing serum creatinine. The use of fluid resuscitation and diuretics had few effects on the recovery of the renal function. When the intra-abdominal pressure had decreased, the urine volume increased, and the serum creatinine decreased.

Development of an arthroscopic ultrasound probe for assessment of articular cartilage degeneration.

Quantitative assessment of articular cartilage is important for the early diagnosis of osteoarthritis, intra-operation joint tissue evaluation and judgment of repaired cartilage quality. This technique is also applicable to the cartilage if arthroscopic instrument embedding this technique can be developed. In this study, an arthroscopic water-jet ultrasound indentation probe was developed with the help of a small profile intra-articular ultrasound imaging (IAUS) catheter for the intra-articular measurement of cartilage condition. The probe can provide measurement of morphological, acoustical and mechanical properties of articular cartilage. Preliminary tests were conducted on 10 intact porcine knees with the guide of arthroscopy for the evaluation of cartilage degeneration, which was induced by trypsin digestion. Results showed the cartilage stiffness decreased significantly after the digestion (p < 0.001) with the measurement conducted by the developed probe. In summary, an arthroscopic ultrasound probe has been successfully developed and its utility in detecting the cartilage degeneration was demonstrated in this study. Future work includes the improvement of the probe design and studies on measurement of animal or human samples in vivo.

Detection of changes of scar thickness under mechanical loading using ultrasonic measurement.

The intervention of pressure therapy on management of hypertrophic scar (HS) after burn is based on the theoretical assumption that the mechanical force added onto the scar tissue will reduce the growth of myofibroblasts which create the collagen clusters and the interstitial space, and to realign fibrous tissues, thus reducing the thickness of HS. In this experimental study, a high frequency ultrasound imaging system (12 MHz) was applied to measure the real time changes of thickness of the post burn HS under a mechanical loading system with similar pressure generated to the scar tissue. The validity of the ultrasound system in measurement of the changes of scar thickness underneath the tissue was tested on the porcine skin in vitro followed by measurement of human skin in vivo. Results showed that the ultrasound measurement of thickness had both good validity (r(2)=0.98, p<0.0001) and good intra-rater reliability (ICC=0.89). Then, the system was used to test the thickness of 14 human HS samples in vivo among 7 subjects. External loading force with similar pressure range (10-45 mmHg) was then applied to these scar samples via ultrasound probe with rectangular contacting area at 4 cm(2) and each loading force was maintained unchange for 2 min over the scar tissue. The real time scar thickness was documented. Results showed that the mean scar thickness was found to be significantly decreased when the loading force applied was increased from 5 to 35 mmHg (with 10 mmHg interval) (p<0.001). A significant negative correlation between the pressure level and scar thickness was observed (r(2)=0.96, p=0.005). The decline of thickness was found more significant between 0 mmHg and 15 mmHg. The findings were in line with the postulate that pressure therapy is effective in reducing the thickness of HS. A long term followup study should be administered to determine the prolonged effect of pressure intervention.

Comparison of ultrasound and optical coherence tomography techniques for evaluation of integrity of spontaneously repaired horse cartilage.

The aim of this study was to compare sensitivity of ultrasound and optical coherence tomography (OCT) techniques for the evaluation of the integrity of spontaneously repaired horse cartilage. Articular surfaces of horse intercarpal joints, featuring both intact tissue and spontaneously healed chondral or osteochondral defects, were imaged ex vivo with arthroscopic ultrasound and laboratory OCT devices. Quantitative ultrasound (integrated reflection coefficient (IRC), apparent integrated backscattering coefficient (AIB) and ultrasound roughness index (URI)) and optical parameters (optical reflection coefficient (ORC), optical roughness index (ORI) and optical backscattering (OBS)) were determined and compared with histological integrity and mechanical properties of the tissue. Spontaneously healed tissue could be quantitatively discerned from the intact tissue with ultrasound and OCT techniques. Furthermore, several significant correlations (p < 0.05) were detected between ultrasound and OCT parameters. Superior resolution of OCT provided a more accurate measurement of cartilage surface roughness, while the ultrasound backscattering from the inner structures of the cartilage matched better with the histological findings. Since the techniques were found to be complementary to each other, dual modality imaging techniques could provide a useful tool for the arthroscopic evaluation of the integrity of articular cartilage.

Could clinical ultrasound improve the fitting of spinal orthosis for the patients with AIS?

PURPOSE: This study aimed to improve the effectiveness of orthotic treatment for the patients with AIS using the three-dimensional clinical ultrasound (3D CUS) method in which the optimal location of pressure pad of spinal orthosis was determined with the assistance of ultrasound image analysis. METHODS: By means of 3D CUS method, the spinous process angle (SPA) could be traced and used as a clinical parameter to estimate the Cobb's angle in order to determine the location of pressure pad. Twenty-one patients (test group) and 22 patients (control group) were recruited to the ultrasound-assisted fitting method and the conventional fitting method, respectively. All the measurements were done by a blinded observer. RESULTS: The intra-rater reliability of using 3D CUS to measure SPA was found >0.9 [ICC (3,3) = 0.91, p < 0.05]. In the test group, 13 out of 21 patients were required to adjust the location of pressure pad in order to achieve the largest curvature correction. The mean immediate in-brace corrections (Cobb's angle measured from radiographs) of the test group (mean thoracic curve correction: 10.3°, mean lumbar curve correction: 10.1°) were found significantly higher (p < 0.005) than that of the control group (mean thoracic curve correction: 4.6°, mean lumbar curve correction: 6.0°). The results showed that the ultrasound-assisted fitting method of spinal orthosis was effective and beneficial to 62 % of the patients in this study. CONCLUSIONS: The 3D CUS could be considered as an effective, non-invasive and fast assessment method to scoliosis, especially in enhancing the effectiveness of orthotic treatment and its applications could also be further extended to other spinal deformities.