Osteoporotic Vertebral Fracture(OVFs)is a common lumbar spine disorder that severely affects the health of patients.With a clear bone blocks boundary,CT images have gained obvious advantages in OVFs diagnosis.Compared...Osteoporotic Vertebral Fracture(OVFs)is a common lumbar spine disorder that severely affects the health of patients.With a clear bone blocks boundary,CT images have gained obvious advantages in OVFs diagnosis.Compared with CT images,X-rays are faster and more inexpensive but often leads to misdiagnosis and miss-diagnosis because of the overlapping shadows.Considering how to transfer CT imaging advantages to achieve OVFs classification in X-rays is meaningful.For this purpose,we propose a multi-modal semantic consistency network which could do well X-ray OVFs classification by transferring CT semantic consistency features.Different from existing methods,we introduce a feature-level mix-up module to get the domain soft labels which helps the network reduce the domain offsets between CT and X-ray.In the meanwhile,the network uses a self-rotation pretext task on both CT and X-ray domains to enhance learning the high-level semantic invariant features.We employ five evaluation metrics to compare the proposed method with the state-of-the-art methods.The final results show that our method improves the best value of AUC from 86.32 to 92.16%.The results indicate that multi-modal semantic consistency method could use CT imaging features to improve osteoporotic vertebral fracture classification in X-rays effectively.展开更多
The quadrilateral plate(QP)is an essential structure of the inner wall of the acetabulum,an important weight-bearing joint of the human body,which is often involved in acetabular fractures.The operative exposure,reduc...The quadrilateral plate(QP)is an essential structure of the inner wall of the acetabulum,an important weight-bearing joint of the human body,which is often involved in acetabular fractures.The operative exposure,reduction and fixation of QP fractures have always been the difficulties in orthopedics due to the special morphological structure and anatomical features of the QP.Fortunately,there have been many effective methods and instruments developed for QP exposure,reduction and fixation by virtue of the combined efforts of numerous orthopedists.At the same time,each method presents with its own advantages and disadvantages,resulting in different prognoses.It is necessary to have a thorough understanding of the anatomy,radiology and fixation techniques of the QP in terms of patient prognosis optimization.In this paper,the anatomical features,definition and classification of QP,operative approach selection,implant internal fixation methods and efficacy were reviewed.展开更多
Purpose:Intertrochanteric fracture(ITF)classification is crucial for surgical decision-making.However,orthopedic trauma surgeons have shown lower accuracy in ITF classification than expected.The objective of this stud...Purpose:Intertrochanteric fracture(ITF)classification is crucial for surgical decision-making.However,orthopedic trauma surgeons have shown lower accuracy in ITF classification than expected.The objective of this study was to utilize an artificial intelligence(AI)method to improve the accuracy of ITF classification.Methods:We trained a network called YOLOX-SwinT,which is based on the You Only Look Once X(YOLOX)object detection network with Swin Transformer(SwinT)as the backbone architecture,using 762 radiographic ITF examinations as the training set.Subsequently,we recruited 5 senior orthopedic trauma surgeons(SOTS)and 5 junior orthopedic trauma surgeons(JOTS)to classify the 85 original images in the test set,as well as the images with the prediction results of the network model in sequence.Statistical analysis was performed using the SPSS 20.0(IBM Corp.,Armonk,NY,USA)to compare the differences among the SOTS,JOTS,SOTS+AI,JOTS+AI,SOTS+JOTS,and SOTS+JOTS+AI groups.All images were classified according to the AO/OTA 2018 classification system by 2 experienced trauma surgeons and verified by another expert in this field.Based on the actual clinical needs,after discussion,we integrated 8 subgroups into 5 new subgroups,and the dataset was divided into training,validation,and test sets by the ratio of 8:1:1.Results:The mean average precision at the intersection over union(IoU)of 0.5(mAP50)for subgroup detection reached 90.29%.The classification accuracy values of SOTS,JOTS,SOTS+AI,and JOTS+AI groups were 56.24%±4.02%,35.29%±18.07%,79.53%±7.14%,and 71.53%±5.22%,respectively.The paired t-test results showed that the difference between the SOTS and SOTS+AI groups was statistically significant,as well as the difference between the JOTS and JOTS+AI groups,and the SOTS+JOTS and SOTS+JOTS+AI groups.Moreover,the difference between the SOTS+JOTS and SOTS+JOTS+AI groups in each subgroup was statistically significant,with all p<0.05.The independent samples t-test results showed that the difference between the SOTS and JOTS groups was statistically significant,while the difference between the SOTS+AI and JOTS+AI groups was not statistically significant.With the assistance of AI,the subgroup classification accuracy of both SOTS and JOTS was significantly improved,and JOTS achieved the same level as SOTS.Conclusion:In conclusion,the YOLOX-SwinT network algorithm enhances the accuracy of AO/OTA subgroups classification of ITF by orthopedic trauma surgeons.展开更多
Before 1980s,the circular suspension spring in automobile subjected to torsion fatigue load,under the cyclic normal tensile stresses,the majority of fatigue fracture occurred was in normal tensile fracture mode（NTFM...Before 1980s,the circular suspension spring in automobile subjected to torsion fatigue load,under the cyclic normal tensile stresses,the majority of fatigue fracture occurred was in normal tensile fracture mode（NTFM）and the fracture surface was under 45°diagonal.Because there exists the interaction between the residual stresses induced by shot peening and the applied cyclic normal tensile stresses in NTFM,which represents as＂stress strengthening mechanism＂,shot peening technology could be used for improving the fatigue fracture resistance（FFR）of springs.However,since 1990s up to date,in addition to regular NTFM,the fatigue fractures occurred of peened springs from time to time are in longitudinal shear fracture mode（LSFM）or transverse shear fracture mode（TSFM）with the increase of applied cyclic shear stresses,which leads to a remarkable decrease of FFR.However,LSFM/TSFM can be avoided effectively by means of shot peening treatment again on the peened springs.The phenomena have been rarely happened before.At present there are few literatures concerning this problem.Based upon the results of force analysis of a spring,there is no interaction between the residual stresses by shot peening and the applied cyclic shear stresses in shear fracture.This;means that the effect of＂stress strengthening mechanism＂for improving the FFR of LSFM/TSFM is disappeared basically.During shot peening,however,both of residual stress and cyclic plastic deformed microstructure are induced synchronously like＂twins＂in the surface layer of a spring.It has been found for the first time by means of force analysis and experimental results that the modified microstructure in the＂twins＂as a＂structure strengthening mechanism＂can improve the FFR of LSFM/TSFM.At the same time,it is;also shown that the optimum technology of shot peening strengthening must have both＂stress strengthening mechanism＂and＂structure strengthening mechanism＂simultaneously so that the FFR of both NTFM and LSFM/TSFM can be improved by shot peening.展开更多
BACKGROUND Tibial plateau fracture is one of the common fracture types.It occurs mainly in teenagers and is usually caused by a fall.After the occurrence of fracture,knee swelling,pain,limited activity,etc.greatly aff...BACKGROUND Tibial plateau fracture is one of the common fracture types.It occurs mainly in teenagers and is usually caused by a fall.After the occurrence of fracture,knee swelling,pain,limited activity,etc.greatly affect the patient’s exercise habits and lifestyle.X-ray,computed tomography(CT)and magnetic resonance imaging(MRI)were used in this examination.X-rays are relatively new and easy to operate.However,there are some errors in the observation of fracture collapse and fracture displacement.In recent years,CT and MRI have been actively used to diagnose various types of clinical fractures.They have more diagnostic power than X-ray film.However,some scholars believe that CT is also prone to errors in clinical application.The volume effect leads to missed diagnosis and misdiagnosis in some cases,while the multidirection scanning of MRI technology can effectively overcome the shortcomings of CT.To facilitate the selection of clinical examination regimens,this study further observed the diagnostic ability of these two regimens in the diagnosis of tibial plateau fractures.AIM To explore the value of nuclear MRI and CT in the clinical diagnosis of tibial plateau fractures.METHODS A total of 120 patients with tibial plateau fractures admitted from September 2017 to August 2019 were included.All patients were examined by nuclear MRI and CT scanning.The results were sent to senior physicians in our hospital to complete the diagnosis.RESULTS Nuclear magnetic resonance showed the same effects as CT in four aspects:fracture displacement,bone defect,fracture site and fracture comminution.There was no significant difference in the score data(P>0.05).Nuclear magnetic resonance and CT tended to be consistent in the B3,C2 and C3 fracture diagnosis coincidence rate,combined injury detection rate and fracture detection rate.The diagnostic coincidence rate of type B1,B2 and C1 fractures and the accuracy rate of overall fracture classification indicated that the MRI technique was significantly better than that of CT(P>0.05).CONCLUSION MRI and CT have good diagnostic typing in the diagnosis of tibial plateau fractures,but MRI is more accurate and may be preferred.展开更多
基金National Natural Science Foundation of China(U21A20390)National Key Research and Development Program of China(2018YFC2001302)+2 种基金Development Project of Jilin Province of China(nos.20200801033GH,20200403172SF,YDZJ202101ZYTS128)Jilin Provincial Key Laboratory of Big Data Intelligent Computing(no.20180622002JC)The Fundamental Research Funds for the Central University,JLU.
文摘Osteoporotic Vertebral Fracture(OVFs)is a common lumbar spine disorder that severely affects the health of patients.With a clear bone blocks boundary,CT images have gained obvious advantages in OVFs diagnosis.Compared with CT images,X-rays are faster and more inexpensive but often leads to misdiagnosis and miss-diagnosis because of the overlapping shadows.Considering how to transfer CT imaging advantages to achieve OVFs classification in X-rays is meaningful.For this purpose,we propose a multi-modal semantic consistency network which could do well X-ray OVFs classification by transferring CT semantic consistency features.Different from existing methods,we introduce a feature-level mix-up module to get the domain soft labels which helps the network reduce the domain offsets between CT and X-ray.In the meanwhile,the network uses a self-rotation pretext task on both CT and X-ray domains to enhance learning the high-level semantic invariant features.We employ five evaluation metrics to compare the proposed method with the state-of-the-art methods.The final results show that our method improves the best value of AUC from 86.32 to 92.16%.The results indicate that multi-modal semantic consistency method could use CT imaging features to improve osteoporotic vertebral fracture classification in X-rays effectively.
文摘The quadrilateral plate(QP)is an essential structure of the inner wall of the acetabulum,an important weight-bearing joint of the human body,which is often involved in acetabular fractures.The operative exposure,reduction and fixation of QP fractures have always been the difficulties in orthopedics due to the special morphological structure and anatomical features of the QP.Fortunately,there have been many effective methods and instruments developed for QP exposure,reduction and fixation by virtue of the combined efforts of numerous orthopedists.At the same time,each method presents with its own advantages and disadvantages,resulting in different prognoses.It is necessary to have a thorough understanding of the anatomy,radiology and fixation techniques of the QP in terms of patient prognosis optimization.In this paper,the anatomical features,definition and classification of QP,operative approach selection,implant internal fixation methods and efficacy were reviewed.
基金supported by the Technological Innovation and Application Development Project of Chongqing(CSTB2021TIADKPX0074)the Chongqing Science and Health Joint Project(2024MSXM084)the Innovative Capability Enhancement programme of Army Medical Center of PLA(ZXYZZKY01).
文摘Purpose:Intertrochanteric fracture(ITF)classification is crucial for surgical decision-making.However,orthopedic trauma surgeons have shown lower accuracy in ITF classification than expected.The objective of this study was to utilize an artificial intelligence(AI)method to improve the accuracy of ITF classification.Methods:We trained a network called YOLOX-SwinT,which is based on the You Only Look Once X(YOLOX)object detection network with Swin Transformer(SwinT)as the backbone architecture,using 762 radiographic ITF examinations as the training set.Subsequently,we recruited 5 senior orthopedic trauma surgeons(SOTS)and 5 junior orthopedic trauma surgeons(JOTS)to classify the 85 original images in the test set,as well as the images with the prediction results of the network model in sequence.Statistical analysis was performed using the SPSS 20.0(IBM Corp.,Armonk,NY,USA)to compare the differences among the SOTS,JOTS,SOTS+AI,JOTS+AI,SOTS+JOTS,and SOTS+JOTS+AI groups.All images were classified according to the AO/OTA 2018 classification system by 2 experienced trauma surgeons and verified by another expert in this field.Based on the actual clinical needs,after discussion,we integrated 8 subgroups into 5 new subgroups,and the dataset was divided into training,validation,and test sets by the ratio of 8:1:1.Results:The mean average precision at the intersection over union(IoU)of 0.5(mAP50)for subgroup detection reached 90.29%.The classification accuracy values of SOTS,JOTS,SOTS+AI,and JOTS+AI groups were 56.24%±4.02%,35.29%±18.07%,79.53%±7.14%,and 71.53%±5.22%,respectively.The paired t-test results showed that the difference between the SOTS and SOTS+AI groups was statistically significant,as well as the difference between the JOTS and JOTS+AI groups,and the SOTS+JOTS and SOTS+JOTS+AI groups.Moreover,the difference between the SOTS+JOTS and SOTS+JOTS+AI groups in each subgroup was statistically significant,with all p<0.05.The independent samples t-test results showed that the difference between the SOTS and JOTS groups was statistically significant,while the difference between the SOTS+AI and JOTS+AI groups was not statistically significant.With the assistance of AI,the subgroup classification accuracy of both SOTS and JOTS was significantly improved,and JOTS achieved the same level as SOTS.Conclusion:In conclusion,the YOLOX-SwinT network algorithm enhances the accuracy of AO/OTA subgroups classification of ITF by orthopedic trauma surgeons.
文摘Before 1980s,the circular suspension spring in automobile subjected to torsion fatigue load,under the cyclic normal tensile stresses,the majority of fatigue fracture occurred was in normal tensile fracture mode（NTFM）and the fracture surface was under 45°diagonal.Because there exists the interaction between the residual stresses induced by shot peening and the applied cyclic normal tensile stresses in NTFM,which represents as＂stress strengthening mechanism＂,shot peening technology could be used for improving the fatigue fracture resistance（FFR）of springs.However,since 1990s up to date,in addition to regular NTFM,the fatigue fractures occurred of peened springs from time to time are in longitudinal shear fracture mode（LSFM）or transverse shear fracture mode（TSFM）with the increase of applied cyclic shear stresses,which leads to a remarkable decrease of FFR.However,LSFM/TSFM can be avoided effectively by means of shot peening treatment again on the peened springs.The phenomena have been rarely happened before.At present there are few literatures concerning this problem.Based upon the results of force analysis of a spring,there is no interaction between the residual stresses by shot peening and the applied cyclic shear stresses in shear fracture.This;means that the effect of＂stress strengthening mechanism＂for improving the FFR of LSFM/TSFM is disappeared basically.During shot peening,however,both of residual stress and cyclic plastic deformed microstructure are induced synchronously like＂twins＂in the surface layer of a spring.It has been found for the first time by means of force analysis and experimental results that the modified microstructure in the＂twins＂as a＂structure strengthening mechanism＂can improve the FFR of LSFM/TSFM.At the same time,it is;also shown that the optimum technology of shot peening strengthening must have both＂stress strengthening mechanism＂and＂structure strengthening mechanism＂simultaneously so that the FFR of both NTFM and LSFM/TSFM can be improved by shot peening.
文摘BACKGROUND Tibial plateau fracture is one of the common fracture types.It occurs mainly in teenagers and is usually caused by a fall.After the occurrence of fracture,knee swelling,pain,limited activity,etc.greatly affect the patient’s exercise habits and lifestyle.X-ray,computed tomography(CT)and magnetic resonance imaging(MRI)were used in this examination.X-rays are relatively new and easy to operate.However,there are some errors in the observation of fracture collapse and fracture displacement.In recent years,CT and MRI have been actively used to diagnose various types of clinical fractures.They have more diagnostic power than X-ray film.However,some scholars believe that CT is also prone to errors in clinical application.The volume effect leads to missed diagnosis and misdiagnosis in some cases,while the multidirection scanning of MRI technology can effectively overcome the shortcomings of CT.To facilitate the selection of clinical examination regimens,this study further observed the diagnostic ability of these two regimens in the diagnosis of tibial plateau fractures.AIM To explore the value of nuclear MRI and CT in the clinical diagnosis of tibial plateau fractures.METHODS A total of 120 patients with tibial plateau fractures admitted from September 2017 to August 2019 were included.All patients were examined by nuclear MRI and CT scanning.The results were sent to senior physicians in our hospital to complete the diagnosis.RESULTS Nuclear magnetic resonance showed the same effects as CT in four aspects:fracture displacement,bone defect,fracture site and fracture comminution.There was no significant difference in the score data(P>0.05).Nuclear magnetic resonance and CT tended to be consistent in the B3,C2 and C3 fracture diagnosis coincidence rate,combined injury detection rate and fracture detection rate.The diagnostic coincidence rate of type B1,B2 and C1 fractures and the accuracy rate of overall fracture classification indicated that the MRI technique was significantly better than that of CT(P>0.05).CONCLUSION MRI and CT have good diagnostic typing in the diagnosis of tibial plateau fractures,but MRI is more accurate and may be preferred.
