膝前框形钢丝内固定治疗髌骨骨折

目的　总结采用钢丝环扎 +膝前方框形张力带钢丝内固定法治疗髌骨骨折的经验和临床效果。方法　对 3 5例髌骨骨折应用此方法治疗 ,其中男性 2 4例 ,女性 11例 ,3 0例获得 3～ 2 4个月随访。结果　优 19例 ,良 10例 ,可1例 ,优良率 96 7%。术后未出现骨折再移位 ,无伤口感染。愈合时间 6～ 12周。结论　该方法符合生物力学原理 ,操作简便 ,适应证广 ,能早期关节活动 ,是治疗髌骨骨折的理想方法之一。     

3种术式矫正轻度先天性小耳畸形的临床分析

目的：观察并比较3种术式矫正轻度先天性小耳畸形的临床疗效。方法：1?135例轻度先天性小耳畸形患者根据其临床特征分别选择软骨管成形或加钢丝悬吊术(198例) 、耳廓复合组织游离移植术（72例）和组织扩张器结合自体肋软骨移植外耳再造术（865例）3种术式。通过对570例患者进行长期随访，比较不同术式的术后临床效果和优缺点。结果：长期随访观察表明，570例患者术后双耳位置、形态、大小基本对称，少有复发现象和严重并发症。3种术式修复Ⅰ度先天性小耳畸形的随访优良率,差异不具有显著性意义。结论：根据患者残耳临床特征选择以上3种不同术式修复轻度先天性小耳畸形，均可获得满意的临床治疗效果。     

钢丝张力带加钢板治疗胫腓骨骨折临床应用体会

目的探讨胫腓骨干骨折使用基层医院的治疗方法。方法采用钢丝张力带加普通或加压钢板切开复位内固定。结果24例病人切口均Ⅰ期愈合；临床愈合时间平均9周左右；无1例出现钢板断裂、断钉及再骨折现象。所有惠肢膝、踝关节功能良好。结论钢丝张力带加钢板治疗胫腓骨干骨折是基层医院较为常用的手术方法。     

改良钢丝固定术治疗Ⅲ度肩锁关节脱位26例体会

目的通过单独应用钢丝内固定治疗Ⅲ度肩锁关节脱位。方法在喙突打一骨孔,然后用双股钢丝穿出与对应的锁骨进行捆扎,已达到牢固内固定的作用。结果26例中,仅有1例出现过度牵拉导致肩锁关节轻度疼痛,余下恢复良好,优良率96.1%。结论此种方法为Ⅲ度肩锁关节体脱位的治疗提供了一个简单、有效、经济的手术方法。     

胫腓骨远端开放性骨折治疗分析

目的 探讨胫腓骨远端开放性骨折早期处理方法及疗效.方法 早期彻底清创,I期应用钢板螺钉内固定,根据软组织损伤程度和创口张力大小确定是否延期闭合伤口.结果 25例病人中无一例发生骨感染与骨不连;踝关节功能活动良好20例,活动受限5例,优良率80%(20/25).结论 胫腓远端开放性骨折早期彻底清创、应用钢板螺钉内固定以及对严重软组织损伤延期闭合伤口等处理,取得了满意的手术效果.     

Vishweshwaraiah Iron Steel Limited (VISL) fire disasters following steel converter blast, 30 July 2003

A fire disaster occurred in Vishweshwaraiah Iron Steel Limited (VISL), Bhadravathi, India on 30 July 2003. The steel converter containing 24,000 kg of liquid metal (pig iron) at very high temperature exploded. A total of 30 workers became victims. Seven persons died on the spot. Twenty-three victims were transferred to the VISL hospital; of these, six were transferred to the burns unit of the Kasturba Hospital, Manipal (180 km from VISL). All six treated at the burns unit suffered 3–65% total body surface area (TBSA) burn, two had external injuries and two had eye involvement. Out of the six patients admitted at the burns unit, two expired (one due to refractory shock and another due to pulmonary embolism). Out of four survivors, one underwent tangential excision; another underwent operation for removal of foreign body from both soles and the remaining two were managed conservatively. Of the four survivors, two who had eye injuries, one developed minute corneal opacities within 2 months. The total duration of hospital stay of survivors at the burns unit varied from 8 to 43 days. All the victims were counselled by VISL psychiatrists before resuming their duties. Except the one who developed mixed anxiety–depression disorder, all survivors returned to work. The article describes the mechanism of the incident, injuries sustained and suggestions in relation to future safety measures.     

自制光索支撑引导钢丝螺纹管插管在困难气管插管中的临床研究

目的探讨自制光索支撑引导行钢丝螺纹管气管内插管在困难气管插管中应用的有效性和安全性。方法将80例估计气管插管有困难的病人（舌咽关系Ⅲ～Ⅳ级）随机分为自制光索支撑引导插管组（A组）和常规导管芯引导插管组（B组）进行插管对比研究。结果自制光索引导插管组一次插管成功率与对照组比较,差异有统计学意义（P〈0.05）,并对咽喉部组织损伤小。结论自制光索支撑引导钢丝螺纹管行气管内插管在困难气管插管的病人中应用是经济实用,方便快捷有效的,并且安全可靠。     

Effects of Steel Mutation on Spermatogenesis Stimulated by Fetuin

The effect of the steel mutation on spermatogenesis was investigated using organ culture. Cultured cryptorchid testes from WB-+/+ mice showed an effective differentiation of type A spermatogonia in response to Pedersen type III fetuin. In contrast, the cryptorchid testes from WB-S1/+ showed neither differentiation nor division of type A spermatogonia. The findings reported here are the first demonstration of retarded response of steel mutation on a well-known agent, fetuin.     

The Effects of In-office Reconditioning on the Morphology of Slots and Bases of Stainless Steel Brackets and on the Shear/Peel Bond Strength

Abstract

Objectives: To compare the effect of five in-office bracket reconditioning methods on: (i) bracket slot width and interwing gap measurements; (ii) the appearance of the bracket bases under scanning electron microscope (SEM), and; (iii) shear/peel bond strength (SPBS).

Setting: Ex vivo study.

Method: One hundred and twenty-five brackets were initially bonded and were divided into five experimental groups and reconditioning by the following methods: (i) adhesive grinding using green stone (Gp II); (ii) sandblasting (Gp III); (iii) direct flaming (Gp IV); (iv) using the BigJane machine (Gp V), and; (v) application of Buchman method (Gp VI).

Outcomes: Distortion of the brackets. Scanning electron miscropy of three representative specimens from each group. The remaining brackets were rebonded, then shear/peel forces to failure were measured (SPBS).

Results: The ANOVA and multiple comparison test exhibited a statistical, but not clinical, significant increase in the bracket measurements of Group VI. There was a significant reduction (28%) in the SPBS of Group II. Under the SEM, the wire mesh structure was maintained; however, the amount of adhesive remnants greatly varied among the groups.

Conclusions: Although none of the in-office reconditioning methods employed adversely affected the bracket base and/or the bracket measurements, reconditioning with a green stone was not effective. Sandblasting method and direct flaming are recommended because of simplicity and time-saving advantages.     

Steel三联截骨治疗6～9岁儿童先天性髋脱位

目的　评价Steel三联截骨手术疗效。方法　对 5例 6～ 9岁、髋臼指数平均为 4 4°的患儿行Steel三联截骨 ,对其影像学、临床结果及满意率进行随访。结果　髋臼指数平均矫正至 2 1°,疼痛和跛行好转 ,没有发生股骨头无菌性坏死加剧。结论　Steel三联截骨对于治疗髋臼指数为 4 5°左右患儿 ,是一种安全有效的手术。