3D-printed prostheses for large bone defect reconstruction following bone tumor surgery北大核心

BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects atumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the follow-up period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

吸入糖皮质激素治疗肺炎支原体肺炎所致咳嗽疗效观察

目的探讨吸入糖皮质激素对肺炎支原体肺炎引起的剧烈咳嗽的疗效观察。方法选取60例肺炎支原体肺炎患儿随机分为治疗组32例和对照组28例，两组在控制感染的基础上治疗组局部雾化吸入布地奈德。结果治疗组咳嗽症状缓解时间与对照组比较差异显著（P〈0．025）。结论局部雾化吸入糖皮质激素治疗肺炎支原体感染所致咳嗽疗效确切。     

小剂量肝素治疗儿童过敏性紫癜对预防紫癜性肾炎的临床观察

目的:观察静脉用小剂量肝素治疗过敏性紫癜对预防紫癜性肾炎的效果。方法:将62例过敏性紫癜患儿随机分成治疗组32例,对照组30例,所有病例均按过敏性紫癜常规治疗,治疗组在常规治疗基础上加用小剂量肝素120～150 U/(kg.d),静脉滴注,连续5 d。两组患儿治疗后随访1～6个月后观察紫癜性肾炎的发生率。结果:治疗组并发紫癜性肾炎的几率明显低于对照组,差异有统计学意义(P<0.01?。结论:小剂量肝素可作为过敏性紫癜患儿预防紫癜性肾炎的主要措施之一。     

垃圾填埋场的结构设计及渗漏分析

介绍了国内外垃圾填埋场防渗技术的研究现状及存在问题。借鉴发达国家的应用经验和研究成果,对我国垃圾填埋场的结构设计进行分析,包括填埋场防渗衬垫的选材,结构布置和施工方法,填埋场封顶系统的设计,渗沥液收集与排放系统和填埋气收集与处理系统的设计。预估填埋场渗沥液渗漏量的计算方法,分析了渗沥液在压实黏土、土工膜中的渗漏特点,提出了对各种防渗衬垫的优化布置方法。     

高频震荡治疗新生儿胎粪吸入综合征(MAS)合并呼吸衰竭的疗效观察

目的:探讨并总结高频振荡对新生儿肽粪吸入综合征合并呼吸衰竭的临床疗效,进一步寻求更好的治疗措施。方法:选取儿科诊断为胎粪吸入综合征合并呼吸衰竭的新生儿70例,随机分为两组,每组35例。试验组采用高频振荡(HFO)辅助通气治疗呼吸衰竭,对照组采用常频通气(SIM)模式治疗。对比两组治疗前后血气改善情况、上机时间、并发症发生率及总有效率。结果:试验组上机时间(2.56±1.39)d、并发症的发生率8.75%、总有效率为77.19%,对照组上机时间(3.06±2.19)d、并发症的发生率为14.28%、总有效率为57.3%,两组的血气对比、上机时间、有效率及并发症的发生率之间比较,差异具有统计学意义(P<0.05)。结论:高频振荡治疗新生儿胎粪吸入综合征合并呼吸衰竭,值得临床推广。     

儿童哮喘发作危险因素的分析

目的探讨汕头市城区儿童哮喘发病的危险因素,为制订干预对策与措施提供依据。方法选择汕头市城区3～14岁儿童哮喘患者100例和非哮喘儿童100例,按1：1配对进行病例对照分析,应用单因素和多元逐步回归和多因素logistie回归分析,调查和分析儿童哮喘的危险因素。结果儿童呼吸道感染史、过敏史、特应性体质、家族哮喘史、家庭装修、被动吸烟、气质类型和婴儿期喂养方式等因素对儿童哮喘发病有统计学意义。结论儿童呼吸道感染史、过敏史、特应性体质、家族哮喘史、家庭装修、被动吸烟是儿童哮喘的危险因素。气质类型和婴儿期喂养方式对于儿童哮喘发病亦起重要作用。     

单切口交锁髓内钉治疗创伤性漂浮膝疗效分析

漂浮膝损伤(floating knee injury,FKI)被定义为胫骨和股骨的同侧骨折,可包括骨干、干骺端或关节内骨折,涉及从简单骨干到复杂关节内骨折.通常是高能量创伤,最常见于机动车碰撞,往往伴随着广泛的软组织损伤和危及生命的损伤.与FKI相关的血管损伤发生率在7％～29％.过度失血、脂肪栓塞、延迟或不愈合、关节...     

吸入糖皮质激素辅助治疗肺炎支原体肺炎疗效观察

目的探讨吸入糖皮质激素对肺炎支原体(MP)肺炎的治疗作用和疗效观察。方法选取60例肺炎支原体肺炎患儿随机分为治疗组32例和对照组28例。两组在控制感染的基础上治疗组局部雾化吸入普米克令舒。结果治疗组症状、体征缓解时间与对照组比较差异有统计学意义(P0.025)。结论局部雾化吸入糖皮质激素辅助治疗肺炎支原体肺炎,能有效缓解MP引起的剧咳和喘息等症状,疗效确切。     

被动吸烟与儿童哮喘关系探讨

目的探讨被动吸烟与儿童哮喘的关系。方法采用统一的流行病学调查表对176例哮喘儿童和1202例非哮喘儿童的父母进行问卷调查,分析儿童及母亲孕期是否被动吸烟、吸烟量与儿童哮喘的关系。结果儿童及孕妇被动吸烟会增加儿童哮喘的危险性,且随着被动吸烟量的增加,危险性也增加,提示儿童及孕妇暴露于香烟烟雾环境会增加儿童哮喘的危险性。结论室内被动吸烟影响儿童健康,是引发儿童哮喘的危险因素,控制被动吸烟对预防儿童哮喘意义重大。     

肺表面活性物质治疗胎粪吸入综合征的临床研究

目的探讨肺表面活性物质（pulmonary surfactant,PS）治疗新生儿胎粪吸入综合征（meconium aspiration syndrome,MAS）的临床效果。方法选择MAS患儿84例,随机分为两组,各42例。对照组予以机械通气和常规治疗,观察组在此基础上加用PS治疗,对比两组临床治疗效果。结果观察组患儿治愈率为95.24%,高于对照组的80.95%（P〈0.05）;观察组住院时间为（12.09±3.11）d,短于对照组的（17.81±4.07）d（P〈0.01）。两组治疗前动脉二氧化碳分压（PaCO2）和动脉氧分压（PaO2）差异均无统计学意义（P〉0.05）;治疗24 h后,观察组PaCO2低于对照组（P〈0.01）,PaO2高于对照组（P〈0.01）。结论机械通气联合PS治疗新生儿MAS临床效果明显,有利于改善血气情况。