后路枕骨髁螺钉技术研究进展

正枕骨、寰椎和枢椎共同构成了枕颈部活动的结构功能单位,即枕颈交界区~([1-2])。炎症、创伤、肿瘤及畸形等因素会导致枕颈交界区失稳,从而引起颈脊髓或神经根的损伤、麻痹及难以忍受的疼痛,甚至危及生命~([3-4])。后路内固定融合技术是治疗枕颈部失稳的重要手段,目前常用术式为枕骨螺钉技术,该技术较钢丝固定技术有更好的生物力学稳定     

Myositis-specific autoantibodies and their clinical associations in idiopathic inflammatory myopathies: results from a cohort from China

Clinical Rheumatology - The purpose of this study was to determine the incidence of myositis-specific autoantibodies (MSAs) in a cohort of Chinese patients with idiopathic inflammatory myopathies...     

Association of anti-NXP2 antibody with clinical characteristics and outcomes in adult dermatomyositis: results from clinical applications based on a myositis-specific antibody

Clinical Rheumatology - The aim was to study and compare the clinical manifestations, auxiliary examinations, and therapeutic responses in patients with different myositis-specific antibody (MSA)...     

三维重建及3D打印技术在骨盆三维特征测量准确性研究

目的　研究分析尸体骨盆与其三维重建数字化模型及3D打印实体模型的三维特征测量结果差异。 方法　选择1具中年男性骨盆标本,根据骨盆的生理学结构特点在骨盆标本表面选取并固定共计14个特征点,并使用三坐标仪测量并记录特征点的三维坐标;使用CT设备对固定了特征点的骨盆标本进行1.0 mm的断层扫描;使用三维医学图像软件（Delta Medical Studio,DMS）对获取的扫描图像进行三维重建,并记录特征点的三维坐标;使用3D打印设备（熔融沉积成型,FDM）及光固化成型（Stereo Lithography Appearance,SLA）打印三维重建模型,三坐标仪测量记录特征点的三维坐标;通过记录的三维坐标分别计算尸体标本、数字模型、3D打印实体模型的特征点之间的距离及夹角;从最大误差、平均误差、t值验证等角度分析三组数据的误差情况。 结果　三维重建数字化骨盆模型的特征测量距离的平均误差约为0.5 mm,角度平均误差约为0.35 o;3D打印模型相对于骨盆标本的距离测量的平均误差约为0.8~1.1 mm,角度平均误差约为0.4°~0.5°。 结论 三维重建模型和3D打印实体模型对于骨盆术前的参考及测量精度方面具备可靠性,可根据实际需求选择3D打印模型作为骨盆术前规划的参考。     

三种内固定方式治疗股骨远端Müller分型C2和C3型骨折的疗效比较

目的比较3种内固定方式治疗股骨远端Müller分型C2、C3型骨折的疗效。方法回顾性分析2013年2月至2017年2月期间宁波市第六医院创伤骨科收治的58例股骨远端Müller分型C2、C3型骨折患者资料。根据内固定方式不同分为3组:单切口锁定钢板组(A组)21例,男13例,女8例;年龄为(50.6±12.9)岁。双切口锁定钢板联合重建钢板组(B组)18例,男11例,女7例;年龄为(53.5±13.0)岁。单切口锁定钢板联合重建钢板组(C组)19例,男10例,女9例;年龄为(48.1±12.2)岁。比较3组患者的手术时间、术中出血量、术中C型臂透视次数、骨折愈合时间、术后并发症发生率、膝关节活动度及膝关节功能等。结果3组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。3组患者术中C型臂透视次数、随访时间及术后并发症发生率比较差异均无统计学意义(P>0.05)。但A组、C组患者的手术时间[(96.7±16.4)、(101.9±16.5)min]和术中出血量[(237.8±47.5)、(253.6±46.6)mL]显著少于B组患者[(114.9±20.1)min、(290.1±60.9)mL],差异均有统计学意义(P<0.05)。B组、C组患者的骨折愈合时间[(6.9±1.6)、(6.6±1.7)个月]显著短于A组患者[(8.4±1.9)个月],术后12个月膝关节活动度(91.7°±16.7°、90.9°±14.4°)显著大于A组患者(78.8°±14.4°),术后12个月膝关节功能恢复优良率[77.8%(14/18)、73.7%(14/19)]显著高于A组患者[57.1%(12/21)],差异均有统计学意义(P<0.05)。结论采用股骨远端前外侧切口外侧应用锁定钢板、前侧附加重建钢板固定治疗股骨远端Müller分型C2、C3型骨折,固定坚强、对周围软组织损伤相对较小,兼具单切口锁定钢板和双切口内外侧锁定钢板固定的优点,术后患者膝关节功能恢复良好。     

A comparative study of weight-bearing and non-weight-bearing 3-dimensional lower extremity alignment in knee osteoarthritis

BackgroundLower extremity alignment is an important variable with respect to the development and progression of knee osteoarthritis. It is very essential for the preoperative planning of realignment surgeries such as total knee arthroplasty and high tibial osteotomy. Nevertheless, there have been no reports comparing 3D lower extremity alignment between weight-bearing upright and non-weight-bearing horizontal states in osteoarthritic knees in the same subject. Therefore, we determined whether the alignment of the lower extremity in the weight-bearing upright state differed from that in the non-weight-bearing horizontal or supine position in patients with knee osteoarthritis.MethodsAdduction–abduction, flexion–extension, and rotational angle of osteoarthritic knees were assessed in weight-bearing upright and non-weight-bearing supine positions. Knee alignment in the supine position was determined from preoperative computed tomography data. In the weight-bearing upright state, alignment was determined using a technique that utilized 2D-3D image-matching with biplanar computed radiography and 3D bone models of the complete lower extremity rebuilt using computed tomography-based information.ResultsWe assessed 81 limbs from osteoarthritic knee patients (74 women, 7 men; mean age 75.3 years, range 59–86 years). In the coronal plane, there were varus deformities in both the supine and standing positions, while there was flexion in both the supine upright state and position at the sagittal plane. In the axial plane, the rotation of the tibia to the femur was neutral in the supine position and internal in the upright state.ConclusionPatient position significantly affects lower extremity alignment in osteoarthritic knees. This study provides important data regarding the preoperative evaluation of realignment surgery in total knee arthroplasty and high tibial osteotomy. We believe that these results are an important contribution to the knowledge regarding knee osteoarthritis.