锁定钢板治疗胫骨平台骨折的疗效分析

目的:评价胫骨近端解剖型锁定接骨板在胫骨平台骨折中应用的疗效。方法:2008年6月~2011年12月使用胫骨近端解剖型锁定接骨板治疗胫骨平台骨折SchatzkeⅢ、Ⅳ、Ⅴ、Ⅵ型患者38例,术后早期进行非负重性功能锻炼,并进行随访。所有患者按照Merchant膝关节功能评分标准[1]及X线片随后评估疗效。结果:38例患者获得9~18个月随访(平均13.9个月),无死亡病例,所有患者均骨性愈合,平均愈合时间13周。无感染、内固定松动或接骨板断裂等并发症发生。有2例患者因半月板损伤致屈膝关节时疼痛,5例因前交叉韧带胫骨止点撕脱骨折止点重建后前抽屉试验弱阳性。Merchant评分平均91.5分,其中优25例,良8例,可4例,差1例,优良率86.84%。结论:应用胫骨近端解剖型锁定接骨板治疗胫骨平台骨折,手术操作简单,固定可靠,术后并发症少,骨折易愈合,临床疗效满意。     

MIPPO微侵入经皮钢板植入技术治疗胫骨远端骨折的临床效果评价

目的探讨评价MIPPO微侵入经皮钢板植入技术治疗胫骨远端骨折的临床效果。方法选取2010年5月~2014年5月在我院治疗的100例胫骨远端骨折患者,将患者随机分成对照组和实验组,其中对照组40例采用传统的常规治疗方法植入普通钢板,实验组60例采用MIPPO微侵入经皮钢板植入技术,观察两组患者治疗的临床效果、术中出血量、手术时间、住院时间和骨折愈合时间。结果实验组治疗的优良率（98.33%）明显高于对照组的治疗优良率（72.50%）,差异有统计学意义（P〈0.05）;实验组患者的手术时间、手术出血量、住院时间和骨折愈合时间均明显少于对照组,差异有统计学意义（P〈0.05）。结论 MIPPO微侵入经皮钢板植入技术在胫骨远端骨折患者治疗中简化了手术过程,减少了患者在手术过程中的出血量,缩短了患者的住院时间和骨折愈合时间,提高医院床位的转换率和治疗优良率,值得在临床上推广使用。     

A study of noise-induced hearing loss and blood pressure in steel mill workers

Summary A cross-sectional study on noise-induced hearing loss and blood pressure was conducted in a steel mill company. Three hundred testees were selected by cluster sampling. They were physically examined and an audiometry was done. Only 151 workers, who had the highest hearing threshold at 4000 Hz and without any family history of hypertension or treatment of drugs on cardiovascular troubles, were selected as subjects in this study. Multiple regression analyses revealed that body mass index, employment duration, age and hearing loss explained a significant amount of variation in systolic and diastolic blood pressure (R ² = 0.16 and 0.12, respectively). There was no significant relationship between hearing loss and blood pressure. In order to adjust confounding factors, analyses of covariances were used and the results suggest that hearing loss is unrelated to blood pressure. It seems that hearing loss is not appropriate as a noise exposure index to measure the relationship between noise exposure and blood pressure.     

肱骨干骨折术后桡神经损伤的诊治分析

目的 探讨肱骨干骨折钢板内固定术后发生桡神经损伤的病因特点及治疗分析。方法 对我科自1997～2003年间收治的15例肱骨干骨折钢板内固定术后发生桡神经损伤病例的致病原因、临床表现、诊治方法及预后转归进行回顾性分析。结果 所有病例随访6～18个月。所有病例自觉症状消失，伸腕、伸指肌力恢复至V级，肌电图复查神经传导速度和潜伏期恢复正常范围。结论 过度牵拉、粗暴操作和钢板卡压是医源性桡神经损伤的三大主要原因。早期诊断和早期手术松解可使神经功能完全恢复。     

The relationship between microbial metabolic activity and biocorrosion of carbon steel

The effect of metabolic activity (expressed by generation time, rate of H₂S production and the activity of hydrogenase and adenosine phosphosulphate (APS)-reductase enzymes) of the 8 wild strains of Desulfovibrio desulfuricans and of their resistance to metal ions (Hg²⁺, Cu²⁺, Mn²⁺, Zn²⁺, Ni²⁺, Cr³⁺) on the rate of corrosion of carbon steel was studied. The medium containing lactate as the carbon source and sulphate as the electron acceptor was used for bacterial metabolic activity examination and in corrosive assays. Bacterial growth inhibition by metal ions was investigated in the sulphate-free medium. The rate of H₂S production was approximately directly proportional to the specific activities of the investigated enzymes. These activities were inversely proportional to the generation time. The rate of microbiologically induced corrosion (MIC) of carbon steel was directly proportional to bacterial resistance to metal ions (correlation coefficient r = 0.95). The correlation between the MIC rate and the activity of enzymes tested, although weaker, was also observed (r = 0.41 for APS-reductase; r = 0.69 for hydrogenase; critical value r_c = 0.30, p = 0.05, n = 40).Nous avons étudié l'influence, sur le taux de corrosion de l'acier carboné, de l'activité métabolique (durée du cycle de reproduction, taux de production d'H₂S et activité de l'hydrogénase et de l'adénosinephosphosulfate (APS)-réductase) de 8 souches de Desulfovibrio desulfuricans, et de la résistance de ces souches aux ions métalliques (Hg²⁺, Cu²⁺, Mn²⁺, Zn²⁺, Ni²⁺, Cr³⁺).Le milieu contenant le lactate comme source de carbone et le sulfate comme accepteur d'électron a été utilisé pour l'étude du métabolisme bactérien et pour les tests de corrosion. L'inhibition de la croissance bactérienne par les ions métalliques a été étudiée en milieu sans sulfate. Le taux de production d'H₂S est approximativement directement proportionnel aux activités spécifiques des enzymes étudiées. Ces activités sont inversement proportionnelles à la durée du cycle de reproduction. Le taux de corrosion biologique (MIC, microbiologically induced corrosion) de l'acier carboné est directement proportionnel à la résistance bactérienne aux ions métalliques (coefficient de corrélation r = 0,95). Une corrélation entre les taux de MIC et ceux de l'activité enzymatique, bien que plus faible, a été aussi observée (r = 0,41 pour l'APS-réductase; r = 0,69 pour l'hydrogénase; valeur critique r = 0,30; p = 0,05; n = 40).     

Megakaryocytes in steel mutant mice

Summary The megakaryocytes in the bone marrow of steel mutant mice (Sl/Sl^d) and their normal littermates (+/+) were studied by light and electron microscopy with special emphasis on their maturity and distribution in the hematopoietic cords. A higher percentage of megakaryocytes lying against the sinus wall, a higher percentage of the sinus perimeter covered by megakaryocytes and a higher percentage of large megakaryocytes were found in Sl/Sl^d mice than in +/+ mice. In addition, more large megakaryocytes as well as senile megakaryocytes were observed in the spleen of Sl/Sl^d mice than in that of +/+ mice. These observations suggest that more platelets are produced in Sl/Sl^d mice than in +/+ mice on the basis of per unit area of the marrow tissue. Heretofore, the fate of the senile megakaryocytes in the marrow was not known. However, in Sl/Sl^d mice senile megakaryocytes were often found entering the marrow sinuses from the hematopoietic cords. They were also seen in the lung and the spleen where degradation of senile megakaryocytes was observed. These observations suggest that senile megakaryocytes in Sl/Sl^d mice leave the marrow and are removed by the reticuloendothelial system outside the marrow.     

Mutagenic/carcinogenic hazards in a cold-rolling steel plant exposed to mineral oils: environmental monitoring phase

Summary A survey was carried out in a cold-rolling steel plant exposed to mineral oils to study the mutagenic/carcinogenic hazards, following a coupled environmental/biological monitoring. The present paper deals only with the environmental phase by determining polycyclic aromatic hydrocarbons (PAH) and applying a mutagenicity test (Ames test), and includes the following steps: (a) work process and environment study; (b) sampling and analysing mineral oils before and after use (PAH determination and mutagenicity analysis); (c) sampling and analysing oil mist (TWA determination, PAH determination and mutagenicity analysis). The results showed that: (1) both unused and used (recycled) mineral oils contained only trace amounts of PAH and were not mutagenic; (2) the TWA concentrations of oil mists were lower than the TLV (< 5 mg/m³); (3) oil mists contained only trace amounts of PAH and were not mutagenic. The authors suggest that these results could be due to the moderate temperature of the oil during the work process and that there is a relationship between low PAH content and absence of mutagenicity in the oils and air samples.     

复杂粉碎性胫腓骨骨折治疗临床研究

目的 探讨腓骨切开复位钢板内固定加胫骨外固定支架闭合复位固定术治疗复杂粉碎性胫腓骨骨折的方法及疗效。方法 47例胫腓骨复杂粉碎性骨折均先将腓骨切开复位钢板螺丝钉内固定,再于胫骨内侧钻入4枚固定针,以直型支架衔接固定。结果 本组47例患者,皮肤一期愈合30例,二期愈合17例;5例皮肤缺损面积较大做植皮,3例骨质缺损较大做骨植入,12例发生感染,经换药、引流、抗生素应用或拔钉后愈合,未发生深部感染或骨髓炎;骨折3~12个月临床愈合,平均8.5个月;外固定器2~6个月拆除,平均3.5个月,内固定器8~24个月取出,平均18个月;44例随访6个月~2年,平均16个月,随访率94%。按Johner-Wruh评分标准：优37例、良4例、可2例、差1例,分别占84%、9%、5%、2%。结论 腓骨切开复位锁定钢板内固定加胫骨外固定支架闭合复位固定术是治疗复杂粉碎性胫腓骨骨折的有效方法。     

跟骨关节内骨折内固定治疗临床分析

目的:分析探讨跟骨关节内骨折切开复位钢板内固定治疗的临床疗效。方法:收集90例跟骨关节内骨折患者,按入组编号随机分为观察组与对照组,每组45例,观察组患者应用切开复位钢板内固定治疗,而对照组采用传统切开复位法治疗,观察随访,比较两组患者临床疗效、并发症情况及骨折愈合时间。结果:观察组临床优良率86.67%明显优于对照组66.67%(P<0.05);观察组并发症发生率8.89%明显低于对照组22.22%(P<0.05);且观察组骨折愈合时间明显短于对照组(P<0.05)。结论:跟骨关节内骨折切开复位钢板内固定治疗效果肯定,可显著提高临床疗效,减少并发症,促进骨折早日愈合,值得临床推广应用。     

锁骨钩钢板并喙肩韧带移位治疗Ⅲ型肩锁关节脱位

目的评价锁骨钩钢板并喙肩韧带移位固定治疗Ⅲ度肩锁关节脱位的临床效果。方法 29例Ⅲ肩锁关节脱位,应用喙肩韧带移位并锁骨钩钢板固定治疗。结果 29例患者均获随访,优26例,满意3例,肩锁关节无脱位,肩关节活动正常。结论应用喙肩韧带移位并锁骨钩钢板固定是治疗Ⅲ型肩锁关节脱位的一种好方法。可以使肩关节早期锻炼,疗效满意。