Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction

Abstract. The aim of this study was to investigate in patients with neurogenic orthostatic hypotension the mechanism and usefulness of abdominal compression to increase standing blood pressure. In three protocols, 23 patients underwent abdominal compression. Protocol 1 evaluated in a 40–60° head-up-tilt position, the effect of abdominal compression on caval vein and femoral diameter, arterial blood pressure and hemodynamics. Protocol 2 documented the relationship between the level of compression and the arterial pressure response. Protocol 3 investigated the ability to maintain standing blood pressure by an elastic binder. During head-up-tilt, compression (40 mm Hg) resulted in a reduction in diameter of the caval vein (mean –2.6mm, range –1.4 to 0.6), without a change in femoral vein diameter. Stroke volume increased by 14 % (range –1 to 23) and blood pressure (systolic/diastolic) by 30/14 mmHg (range 7/2 to 69/36), both p < 0.05; 40 mmHg compression was associated with a higher pressure response than 20 mmHg (mean 18/8 mmHg, range 6/2 to 43/20 vs. mean 9/4 mmHg, range –1/0 to 18/8, p < 0.05). Elastic abdominal binding increased standing blood pressure with 15/6mmHg (range –3/3 to 36/14, p < 0.05). We conclude that in patients with neurogenic orthostatic hypotension, abdominal compression increases standing blood pressure to a varying degree by increasing stroke volume.     

同种异体骨支撑架结合自体骨和DBM治疗股骨头坏死的生物力学研究

[目的]研究同种异体骨支撑架结合自体骨和脱钙骨基质（decalcified bone matrix，DBM）植入治疗股骨头坏死生物力学变化。[方法]建立羊双侧股骨头坏死模型，4周后分为4组：单纯行髓芯减压组（A组）、髓芯减压后植入自体松质骨和OSTEOSET^2 DBM组（B组）、髓芯减压后植入同种异体骨支撑架／自体松质骨OSTEOSE^2 DBM组（C组）和正常对照组。术后分别于5、10、20周对股骨头行影像学、组织学观察和生物力学测定。[结果]影像学和组织学检查结果显示C组在髓芯减压区骨缺损修复及成骨方面较B组略高，B、C两组都较同时期的A组明显增强。生物力学测试结果表明，术后5、10、20周时C组力学强度较A、B两组明显增高．差异有统计学意义（P〈0．05），在10、20周时C组股骨头生物力学强度和正常股骨头己无明显差异。[结论]应用同种异体骨支撑架结合自体骨和脱钙骨基质治疗股骨头坏死，能有效加强股骨头的力学结构，促进坏死骨的修复，防止股骨头关节面的塌陷。     

伊里扎诺夫支架治疗开放性胫骨干骨折

目的　报告伊里扎诺夫支架外固定治疗３２例开放性胫骨干骨折的疗效。方法采用清创、一期缝合或延期缝合、局部皮瓣转移、游离植皮方法闭合伤口，伊氏支架外固定治疗３２例开放性胫骨干骨折。用直径１．５ｍｍ带有阻挡子的克氏针绷紧固定骨折片。术后可早期关节功能锻炼及负重。结果按Ｈａｒｒｙ标准评价，３２例中，优１８例，良 １０例，可 ４例。结论伊里扎诺夫支架固定是治疗开放性胫骨干骨折的好方法。     

载氟陶瓷托槽材料的实验研究

目的研究载氟CePO₄/ZrO₂陶瓷托槽材料,并初步分析其表面性能。方法采用沉淀法和机械球磨法来制备载氟CePO₄包覆ZrO₂复合陶瓷。运用X射线衍射（XRD）和扫描电镜（SEM）观察复合陶瓷托槽材料的相组成和显微组织。结果制备出晶粒尺寸均一,分布均匀的载氟CePO₄/ZrO₂陶瓷材料。结论载氟陶瓷托槽材料表面性状及稳定性良好,能满足口腔正畸托槽材料的需要。     

Orthodontic apps for smartphones

Abstract

Background: The increasing use of technology is rapidly changing our personal and professional lives. Smartphones allow users to access information in ways previously not possible and our patients may be accessing apps to source information about orthodontics and help them through their treatment.

Aim: To provide an overview of the orthodontic apps currently available on four of the main operating systems with emphasis on those apps targeted towards new and existing orthodontic patients as well as practising clinicians.

Method: Four mobile devices were used to search four mobile operating systems (Android, Apple, Blackberry and Windows) using the key words ‘braces’, ‘orthodontist’, ‘orthodontic’ and ‘orthodontics’.

Results: Android and Apple operating systems derived all of the apps considered relevant to orthodontic clinicians and patients. Clinician apps (11) related to orthodontic meetings (3), publications (3), products (3) and tooth ratio calculators such as Bolton (2). Patient apps (8) related to reminding patients about elastic wear (2) and aligner wear (2), dealing with orthodontic emergencies (2), orthodontic products (1) and a progress tracker of treatment (1).

Conclusions: Apps are available for both orthodontic clinicians and patients; however, much of the information contained within them is often not independent and even more often not validated. Patients are increasingly likely to access apps and clinicians should direct patients to those that are most appropriate and useful.     

脂肪干细胞三维生长骨组织工程复合体的构建

背景：组织工程支架是模仿细胞赖以生长代谢的细胞外基质而构建的支架和环境,其选择、制备以及种子细胞的选择是骨组织工程领域中的一项十分重要的课题.目的：利用几丁质凝胶/异种骨构建脂肪干细胞三维生长环境,并对其相容性进行研究.方法：从出生8d新西兰大白兔腹股沟获取脂肪组织,提取脂肪干细胞.脂肪干细胞经过体外成骨诱导分化后,种植于几丁质凝胶/异种骨,构建新型骨组织工程复合体,并将其设为细胞/几丁质凝胶/异种骨组;将脂肪干细胞直接种植于异种骨,构成脂肪干细胞/异种骨复合体作为细胞/异种骨组,单独异种骨为空白组.体外诱导2周后进行电镜扫描,观察细胞与支架的复合情况.结果与结论：镜扫描观察显示几丁质凝胶充分渗透于支架的空隙内,形成一个细胞的三维生长环境,使原本只能在材料上贴壁生长的脂肪干细胞能够在三维的环境中生长,为细胞外基质的再生提供足够的空间.几丁质凝胶/异种骨悬浮诱导后的脂肪干细胞,承载了更多的细胞,减少了细胞在载体中的流失,是一种较好的骨组织工程载体.     

两种矫治技术治疗牙周病患者牙周组织应力的对比分析

目的探讨无托槽隐形矫治技术固定矫治技术治疗牙周病致前牙间隙牙周应力分布的异同。方法应用三维有限元的方法,建立无托槽隐形矫治技术与固定矫治技术施加矫治力治疗牙周病导致前牙间隙研究模型,对比分析两种矫治技术表面应力的分布特点。结果两种矫治技术平均主应力的分布规律基本一致。但在相同载荷下,无托槽隐形矫治技术应力绝对值小于固定矫治技术。结论相对于固定矫治技术而言,无托槽隐形技术产生的应力分布更小,更均匀,有利于牙周病患者治疗时牙周组织的健康。     

Lower extremity kinematics and ground reaction forces after prophylactic lace-up ankle bracing

CONTEXT: Long-term effects of ankle bracing on lower extremity kinematics and kinetics are unknown. Ankle motion restriction may negatively affect the body's ability to attenuate ground reaction forces (GRFs). OBJECTIVE: To evaluate the immediate and long-term effects of ankle bracing on lower extremity kinematics and GRFs during a jump landing. DESIGN: Experimental mixed model (2 [group] x 2 [brace] x 2 [time]) with repeated measures. SETTING: Sports medicine research laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 37 healthy subjects were assigned randomly to either the intervention (n = 11 men, 8 women; age = 19.63 +/- 0.72 years, height = 176.05 +/- 10.58 cm, mass = 71.50 +/- 13.15 kg) or control group (n = 11 men, 7 women; age = 19.94 +/- 1.44 years, height = 179.15 +/- 8.81 cm, mass = 74.10 +/- 10.33 kg). INTERVENTION(S): The intervention group wore braces on both ankles and the control group did not wear braces during all recreational activities for an 8-week period. MAIN OUTCOME MEASURE(S): Initial ground contact angles, maximum joint angles, time to reach maximum joint angles, and joint range of motion for sagittal-plane knee and ankle motion were measured during a jump-landing task. Peak vertical GRF and the time to reach peak vertical GRF were assessed also. RESULTS: While participants were wearing the brace, ankle plantar flexion at initial ground contact (brace = 35 degrees +/- 13 degrees , no brace = 38 degrees +/- 15 degrees , P = .024), maximum dorsiflexion (brace = 21 degrees +/- 7 degrees , no brace = 22 degrees +/- 6 degrees , P = .04), dorsiflexion range of motion (brace = 56 degrees +/- 14 degrees , no brace = 59 degrees +/- 16 degrees , P = .001), and knee flexion range of motion (brace = 79 degrees +/- 16 degrees , no brace = 82 degrees +/- 16 degrees , P = .036) decreased, whereas knee flexion at initial ground contact increased (brace = 12 degrees +/- 9 degrees , no brace = 9 degrees +/- 9 degrees , P = .0001). Wearing the brace for 8 weeks did not affect any of the outcome measures, and the brace caused no changes in vertical GRFs (P > .05). CONCLUSIONS: Although ankle sagittal-plane motion was restricted with the brace, knee flexion upon landing increased and peak vertical GRF did not change. The type of lace-up brace used in this study appeared to restrict ankle motion without increasing knee extension or vertical GRFs and without changing kinematics or kinetics over time.     

Technological advances in nontraditional orthodontics

New technological advances have helped the orthodontic profession progress in traditional and surgical methods of treatment. The profession has seen transitions from traditional braces to self-ligating brackets, lingual braces, removable aligners, and more advanced technology, which have helped to address concerns that include but are not limited to better diagnostics, anchorage control, length of treatment, and esthetics. An increase in the number of adult patients seeking orthodontic treatment and the need for a timely efficient care will continue to drive technology and the use of cone beam computed tomography, miniscrews, piezocision, distraction osteogenesis, and bioengineering.     

Physiotherapy management of knee osteoarthritis

Knee osteoarthritis (OA) is a prevalent chronic joint disease causing pain and disability. Physiotherapy, which encompasses a number of modalities, is a non-invasive treatment option in the management of OA. This review summarizes the evidence for commonly used physiotherapy interventions. There is strong evidence to show short-term beneficial effects of exercise on pain and function, although the type of exercise does not seem to influence treatment outcome. Delivery modes, including individual, group or home exercise are all effective, although therapist contact may improve benefits. Attention to improving adherence to exercise is needed to maximize outcomes in the longer-term. Knee taping applied with the aim of realigning the patella and unloading soft tissues can reduce pain. There is also evidence to support the use of knee braces in people with knee OA. Biomechanical studies show that lateral wedge shoe insoles reduce knee load but clinical trials do not support symptomatic benefits. Recent studies suggest individual shoe characteristics also affect knee load and there is current interest in the effect of modified shoe designs. Manual therapy, while not to be used as a stand-alone treatment, may be beneficial. In summary, although the research is not equivocal, there is sufficient evidence to indicate that physiotherapy interventions can reduce pain and improve function in those with knee OA.