采用同种异体腓骨植骨重建肱骨近端内侧柱的临床应用及疗效

目的:探讨同种异体腓骨移植重建肱骨近端内侧柱联合锁定钢板治疗肱骨近端骨折的临床疗效。方法:回顾性分析2011年3月至2013年9月于我院行同种异体腓骨移植联合锁定钢板治疗肱骨近端骨折患者38例。根据Neer分型:三部分骨折26例,四部分骨折12例;随访期间测量肱骨头内翻角度、肱骨头高度;患肩功能评分采用Constant肩关节评分标准、美国肩肘协会评分系统(ASES)及加州大学肩关节评分系统(UCLA),同时记录患者并发症。结果:患者随访时间平均15.5±1.8个月;末次随访Constant肩关节评分平均89.0±3.2分;美国肩肘协会评分系统(ASES)评分为平均81.2±14.5分;加州大学肩关节评分系统(UCLA)平均27.6±5.3;根据UCLA评分系统,患者术后优良率为89.4%。患侧肩关节前屈、外展、外旋及内旋运动范围分别是143±20°、138±9°、44±12°、42±9°。影像学结果显示:末次随访肱骨头高度平均丢失1.9 mm,颈干角度平均为128±16°。根据Paavolainen方法,末次随访优30例、良7例、差1例。结论:同种异体腓骨移植重建肱骨近端骨折内侧柱,术中联合肱骨近端锁定钢板能有效支撑肱骨头,预防肱骨头塌陷及螺钉穿出,短期临床疗效满意。     

血流变学指标及血清学指标在骨折延迟愈合患者中的临床意义

目的:探讨血流变学和血清学指标在骨折延迟愈合患者中的变化及其临床意义。方法:随机选取2010年1月~2016年6月在我院进行手术治疗的骨折延迟愈合及骨折正常愈合患者各90例,分别为观察组与对照组,对比分析两组患者术后第1、8、12周时血清可溶性血管细胞黏附分子1(sVCAM-1)、胰岛素样生长因子1(IGF-1)、血小板衍生生长因子(PDGF)及人可溶性细胞间黏附分子1(sICAM-1)和红细胞刚性指数、红细胞聚集指数、血浆黏度的差异。结果:术后第1、8、12周两组血清学及血流变学各指标整体相比差异均具有统计学意义(均P0.05),且组内两两比较均具有统计学差异(均P0.05)。术后8、12周观察组血清s ICAM-1、sVCAM-1、红细胞刚性指数、红细胞聚集指数、血浆黏度均高于对照组,而血清PDGF、IGF-1均低于对照组,比较差异均具有统计学意义(均P0.05)。结论:骨折患者血清sICAM-1、PDGF、IGF-1、sVCAM-1及红细胞刚性指数、红细胞聚集指数、血浆黏度水平会随着病程进展发生变化,并且血清sICAM-1、sVCAM-1及红细胞刚性指数、红细胞聚集指数、血浆黏度水平的升高,血清PDGF、IGF-1水平的降低可能是引起骨折延迟愈合的重要因素,对于骨折患者的临床治疗具有重要临床意义。     

髋臼粉碎性骨折治疗方法的选择与预后探讨

目的:研究髋臼粉碎性骨折采用骨牵引与手术治疗的疗效的比较。方法:将118例髋臼粉碎骨折患者分为骨牵引组(74例)和手术组(44例),分别进行比较。结果:骨牵引组解剖复位10例(13.5%)、满意复位26例(35.1%),自我感觉优8例(10.8%)、良24例(32.4%);手术组解剖复位9例(40.9%)、满意复位12例(54.5%),自我感觉优7例(31.8%))、良9例(40.9%)。结论:手术治疗髋臼粉碎性骨折疗效明显优于骨牵引。     

新型迭形接骨板的临床应用

目的：改进骨折接骨扳内固定技术．观察新型迭形接骨板临床效果。方法：选择四肢长管骨骨折患者165例(上肢骨折26例,下肢骨折139例),均采用新型迭形接骨板施行骨折内固定手术。结果：手术后平均随访1年4个月(5年7个月～51天),除5例(占3％)出现并发症外,其余骨折均愈合良好,很少发现接骨板和螺钉断裂、折弯和松动情况。结论：与传统接骨板比较,新型迭形接骨板结构设计新颖,力学原理独特,临床效果满意,并发症少,较好地改进了四肢长管骨(尤其是下肢)骨折接骨板内固定技术,值得推荐。     

Mechanical Properties of the Rhizome of Arundo donax L.

Abstract: The mechanical properties of rhizome segments of Arundo donax L. were studied in three dimensions: longitudinal (X), transverse-vertical (Y), transverse-horizontal (Z). Tensile, cyclic loading and torsional tests demonstrate that the distinct anisotropy found in the hollow stems is less pronounced in the rhizome. Morphological and anatomical examinations suggest that the mechanical anisotropy of the stem is caused by the arrangement parallel to the stem of the vascular bundles and sclerenchymatous fibres, embedded in lignified parenchyma. Anatomical inhomogeneity is less pronounced in the rhizome due to the short internode lengths, and predominance of nodal regions, where sclerenchymatous fibres form a complex three-dimensional arrangement embedded in unlignified starch-storing parenchyma. Cyclic loading experiments indicate viscoelastic behaviour of the rhizomatous tissues under tensile stress. Additionally, viscoelastic behaviour under torsional stress was studied. Mechanical behaviour of the rhizome under tension up to fracture is discussed with regard to the fracture surfaces, analysed by SEM.     

A model of amyloid's role in disease based on fibril fracture

Although the correlative evidence relating the presence of amyloid fibrils and certain disease states (e.g. Alzheimer's disease and Type 2 Diabetes) is overwhelming, a direct causative role for amyloid has proved harder to establish. Current thinking links a narrow region of the aggregate protein size distribution, the so called ‘early aggregate’ domain to cellular toxicity. A troubling feature of this theory however is that the nucleated reaction mechanism by which amyloid formation is believed to occur results in a very low number concentration of early aggregates which are rapidly extended to form amyloid fibrils. This situation means that the concentration of early aggregates is very low at the time when they are supposedly at their most toxic. Here we adopt a novel explicit simulation strategy to examine a kinetic regime involving nucleated growth combined with fibril fragmentation under which this situation can be reversed so as to produce a high number concentration of small on-pathway toxic aggregates. Dependent upon the rate of fragmentation, the time scale for generation of toxic early aggregates may be coupled, uncoupled or disassociated from the time scale for the appearance of amyloid fibrils. Furthermore the model presents itself as a biochemical ‘switch’ transitioning between modes of amyloid induced cell death dependent upon either specific amyloid toxicity or non-specific solid mass induced tissue damage.     

螺旋CT三维重建技术在胫骨平台骨折的诊疗应用分析

目的探讨螺旋CT三维重建在胫骨平台骨折中的临床应用。方法回顾性分析2007-2008年55例胫骨平台骨折病例．手术前均常规行X线摄片,行螺旋CT三维重建并与术中所见对照。结果所有病例螺旋CT三维重建明确地显示了骨折,并在骨折的分型和关节面碎裂情况的描述上较平片优越,与手术中所见一致。结论CT多种成像后处理技术可清晰显示骨折的部位、骨折线的走行方向、骨质碎裂程度和移位的距离以及关节面塌陷情况等,对术前分型、制订手术治疗方案具有重要的参考价值。     

Traumatic injury to the incisive bones and maxillary dentition in a male gray wolf (Canis lupus L.) from Slovakia

The paper presents the skull of a male gray wolf shot in the region of Snina, eastern Slovakia. Age at death of the wolf was estimated at 6 years. The skull was characterized by the almost-complete absence of the alveolar processes of the incisive bones and multiple dental abnormalities that were attributed to a severe trauma. All maxillary incisors and both maxillary first premolars were missing. In addition, both maxillary canines were fractured with only tooth fragments being left. The pulp exposure associated with the crown fractures of the maxillary canines had caused pulp necrosis and periapical lesions, as evidenced on radiographs. The right P², P³, and P⁴ were fractured, with only the remaining tooth structure of the second and third premolars being left. In the right P⁴ and the left M¹, periapical bone resorption was diagnosed radiologically. In the mandibular dentition, the right I₂ and left P₁ had been lost in life. The mandibular canines exhibited distinct wear facets that were caused by contact with the maxillary third incisors, which were subsequently lost. The fact that all fractured teeth showed signs of wear indicates that the trauma had occurred some time before the wolf was shot.     

Predicting changes in mechanical properties of trabecular bone by adaptive remodeling

Because changes in the mechanical properties of bone are closely related to trabecular bone remodeling, methods that consider the temporal morphological changes induced by adaptive remodeling of trabecular bone are needed to estimate long-term fracture risk and bone quality in osteoporosis. We simulated bone remodeling using simplified and pig trabecular bone models and estimated the morphology of healthy and osteoporotic cases. We then displayed the fracture risk of the remodeled models based on a cumulative histogram from high stress. The histogram showed more elements had higher stresses in the osteoporosis model, indicating that the osteoporosis model had a greater risk.