电磁导航系统与徒手锁定在胫骨髓内钉远端锁定应用中的对比研究

目的对比研究电磁导航系统与徒手锁定在胫骨髓内钉远端锁定中的临床应用。方法将2013年1月~2014年12月需要行髓内钉固定的40例胫骨骨折患者平均分为两组(各20例),电磁导航组:男性11例,女性9例;年龄20~65岁,平均(44.3±1.8)岁;徒手锁定组:男性12例,女性8例;年龄18~66岁,平均(42.5±2.0)岁。比较电磁导航与徒手锁定组间远端锁定总耗时与术中放射线暴露时间。结果电磁导航组平均远端锁定耗时(668.2±195.0)s,徒手锁定组平均远端锁定耗时(1431.1±501.3)s。电磁导航组平均放射线暴露时间(3.1±2.2)s,徒手锁定组平均放射线暴露时间(18.3±6.9)s。结论电磁导航系统能显著缩短远端锁定时间,减少放射线暴露,值得推广。     

Differentiating ictal/subclinical spikes and waves in childhood absence epilepsy by spectral and network analyses: A pilot study

ObjectiveChildhood absence epilepsy (CAE) is a disease with distinct seizure semiology and electroencephalographic (EEG) features. Differentiating ictal and subclinical generalized spikes and waves discharges (GSWDs) in the EEG is challenging, since they appear to be identical upon visual inspection. Here, spectral and functional connectivity (FC) analyses were applied to routine EEG data of CAE patients, to differentiate ictal and subclinical GSWDs.MethodsTwelve CAE patients with both ictal and subclinical GSWDs were retrospectively selected for this study. The selected EEG epochs were subjected to frequency analysis in the range of 1–30 Hz. Further, FC analysis based on the imaginary part of coherency was used to determine sensor level networks.ResultsDelta, alpha and beta band frequencies during ictal GSWDs showed significantly higher power compared to subclinical GSWDs. FC showed significant network differences for all frequency bands, demonstrating weaker connectivity between channels during ictal GSWDs.ConclusionUsing spectral and FC analyses significant differences between ictal and subclinical GSWDs in CAE patients were detected, suggesting that these features could be used for machine learning classification purposes to improve EEG monitoring.SignificanceIdentifying differences between ictal and subclinical GSWDs using routine EEG, may improve understanding of this syndrome and the management of patients with CAE.     

In vitro chondrogenic differentiation of human articular cartilage derived chondroprogenitors using pulsed electromagnetic field

BackgroundThe ability to grow new cartilage remains the standard goal of any treatment strategy directed at cartilage repair. Chondroprogenitors have garnered interest due to their applicability in cell therapy. Pulsed electromagnetic field (PEMF) favors chondrogenesis by possible upregulation of genes belonging to TGFβ superfamily. Since TGFβ is implicated in chondrogenic signalling, the aim of the study was to evaluate the ability of PEMF to induce chondrogenesis via endogenous TGFβ production in chondroprogenitors vs differentiation using chondrogenic medium inclusive of TGFβ.MethodsChondroprogenitors were harvested from three non-diseased human knee joints via fibronectin assay. Passage 3 pellets were subjected to four different culture conditions: a) negative control contained chondrogenic medium without TGFβ2, b) positive control contained medium with TGFβ2, c) PEMF 1 contained medium of negative control plus single exposure to PEMF and d) PEMF 2 contained medium of negative control plus multiple exposures to PEMF. Following differentiation (day 21), pellets were assessed for gene expression of ACAN, SOX9, COL2A1, TGFβ1, TGFβ2, and TGFβ3. Alcian blue staining to detect glycosaminoglycan deposition was also performed. Medium supernatant was used to detect endogenous latent TGF-β1 levels using ELISA.ResultsAll study arms exhibited comparable gene expression without any significant difference. Although positive control and PEMF study arms demonstrated notably better staining than negative control, the level of latent TGF-β1 was seen to be significantly high in supernatant from positive control (P < 0.05) when compared to other groups.ConclusionOur results indicate that PEMF induced chondrogenesis might involve other signalling molecules, which require further evaluation.     

Role of pulsed electromagnetic fields after joint replacements

Although the rate of patients reporting satisfaction is generally high after joint replacement surgery, up to 23% after total hip replacement and 34% after total knee arthroplasty of treated subjects report discomfort or pain 1 year after surgery. Moreover, chronic or subacute inflammation is reported in some cases even a long time after surgery. Another open and debated issue in prosthetic surgery is implant survivorship, especially when related to good prosthesis bone ingrowth. Pulsed Electro Magnetic Fields(PEMFs) treatment, although initially recommended after total joint replacement to promote bone ingrowth and to reduce inflammation and pain, is not currently part of usual clinical practice. The purpose of this review was to analyze existing literature on PEMFs effects in joint replacement surgery and to report results of clinical studies and current indications. We selected all currently available prospective studies or RCT on the use of PEMFs in total joint replacement with the purpose of investigating effects of PEMFs on recovery, pain relief and patients' satisfaction following hip, knee or shoulder arthroplasty. All the studies analyzed reported no adverse effects, and good patient compliance to the treatment. The available literature shows that early control of joint inflammation process in the first days after surgery through the use of PEMFs should be considered an effective completion of the surgical procedure to improve the patient's functional recovery.     

三维多孔电磁复合支架构建与理化表征

模拟心肌细胞外基质(ECM)的组织结构和电生理特性,构建具有导电性和超顺磁响应性的三维多孔纳米纤维复合材料支架,为细胞黏附、增殖和分化提供有利的微环境。以明胶为壳层、聚乳酸为芯层,并在各层中引入四氧化三铁纳米颗粒,采用共轴静电纺丝技术,制备纳米纤维薄膜;将其粉碎并与碳纤维混合,经冷冻干燥和交联处理,得到三维多孔支架。用扫描电镜和透射电镜观察支架形貌及结构,用四探针仪测定支架的电导率,用振动样品磁强计测量支架磁滞回线,用万能材料试验机检测支架材料的压缩应力-应变曲线;根据质量和体积计算支架密度,根据支架吸水前后质量计算吸水率。用CCK-8和Western Blot,分析细胞在支架上的活性及功能。支架内部呈多孔蜂窝结构,孔隙间相互贯通;当碳纤维含量为0、1、3、5 mg/mL时,支架密度分别为73.07、72.56、65.88、63.34 mg/cm³,吸水率分别为1 164.60%、1 186.48%、1 284.84%、1 323.66%;电导率分别为0、0.008 8、0.246 7、2.662 5 s/m,最大磁饱和强度分别为3.68、3.15、2.45、2.90 emu/g,抗压缩能力也相应提高。上述复合材料支架能够显著促进心肌细胞成熟相关蛋白Cx43和RhoA的表达,诱导心肌细胞向成熟分化。三维多孔电磁复合支架同时具有超顺磁性和导电性,微观上具有纳米纤维网络和多孔结构,并通过碳纤维的复合,使力学性能得到显著提高,支持心肌细胞生长并促进其成熟。     

The various pathological manifestations of a lightning strike exemplified in a single four-fatality incident – A case report and review of a literature

The lightning strike is one of leading cases of weather-related death worldwide. We present an unusual case of four fatality-lightning strike with various pathological manifestations. All victims died from a single lightning strike in the mountains that also caused injury to 156 other people. All victims had mechanical damage and rock damage that are typical for lightning strikes in the mountainside. Another lesions indicative of lightning strike and electrical damage were, among others: burnt and torn clothes (all cases) current marks (Cases 1, 2 and 3) and Lichtenberg figures along with flashover marks on Case 1. In the review we described the pathophysiological mechanisms of lightning-induced lesions and injuries and epidemiological trends of lightning-strike deaths. Our study exemplifies various manifestations of lightning strikes on forensic examination and underlines the necessity to take lightning strike into consideration when investigating open-air deaths of unclear origin.     

经颅磁刺激的多尺度建模仿真研究

经颅磁刺激是一种无创无痛的电磁刺激手段，被广泛应用于神经调控，在临床上对多种精神疾病和神经类疾病有明显的治疗效果。本文从电磁场建模仿真，细胞跨膜电位建模仿真，以及神经元响应建模仿真3个方面对经颅磁刺激多尺度建模仿真研究进行了详细的综述，并提出现阶段存在的问题以及对未来的展望。经颅磁刺激的多尺度建模仿真对磁刺激仪的设计开发具有指导意义，对磁刺激的导航系统提供重要的理论基础，有助于我们更好的理解电磁刺激的神经调控机制。     

新型电磁搏动式血泵的实验研究

目的探究一种新型电磁搏动式血泵的动力输出性能及血液相容性。方法首先通过建立理论模型对该血泵驱动力进行分析,并基于该模型计算出满足条件的实验驱动电压。设计体外模拟循环实验,对新型血泵的输出流量和输出压力特性及血泵的体外溶血性能进行初步实验研究。结果实验测得当血泵后负荷为73.5 mmHg(9.78 kPa, 1 mmHg=0.133 kPa)、驱动电压达到35 V、搏动频率为75/min时,实际输出的流量为3.18 L/min,可以提供高压132 mmHg(17.56 kPa)、低压66 mmHg(8.78 kPa)、平均压力98 mmHg(13.03 kPa),体外实验标准溶血指数(normalized index of haematolysis, NIH)为(0.049 15±0.003 75) mg/dL。结论该新型搏动式血泵能够满足离体器官灌注和体外循环短期辅助的临床要求,对体外循环血泵的发展具有重要意义。