Standard versus customised locking plates for fixation of schatzker ii tibial plateau fractures

Aim3D-printed implants could improve the capture of fracture fragments for improved stability of tibial plateau fracture fixation. The aim of this study was to compare the biomechanical strength of fixation constructs using standard and customised 3D-printed proximal tibial locking plates for fixation of tibial plateau fractures.MethodsThis is a biomechanical study utilising six pairs of cadaveric tibiae. Fractures were created in an identical fashion using an osteotome and mallet, and fixed using either a standard, commercially-available proximal tibia locking plate or a customised 3D-printed plate. Design and production of the customised plates followed a “3D printing at point-of-care” model. Customised stainless steel 316 L plates were produced within a local additive manufacturing laboratory based upon pre-operative CT scans. Determination of implant choice within each cadaver pair was performed via simple randomisation. Following fracture fixation, the tibiae were skeletalised and biomechanically tested using a customised loading jig and a size-matched femoral knee prosthesis. The constructs were loaded cyclically from 100 N to approximately three times the cadaveric body-weight at 5 Hz for 10 000 cycles. Every 1000 cycles, the test was paused and the tibia was physically checked for failure. If failure had not occurred by the end of the testing cycle, the construct was loaded to failure and the load at which the construct failed was noted.ResultsFixation constructs using the 3D-printed plates performed comparably to those using the standard plates. There was no significant difference in the degree of fracture fragment displacement in both constructs. Overall longitudinal construct stiffness and load to failure was higher in the 3D-plates group but this did not reach statistical significance.ConclusionProduction of customised plates for proximal tibia fractures at point-of-care is feasible, however fixation constructs with these plates did not provide any biomechanical advantage over standard plates in terms of axial loading stiffness.     

Same-Day Repeat Hepatopulmonary Shunt Measurement during Planning Angiography for Hepatic Radioembolization

This report describes a technique for measuring lung shunt fraction (LSF) twice in a single session during planning arteriography for radioembolization using low and standard dose technetium-99m macroaggregated albumin (^99mTc-MAA). A patient with a 16.0 cm hepatocellular carcinoma and LSF of 70% was treated with lenvatinib for 4 weeks. Planning arteriography with administration of 0.5 millicuries of ^99mTc-MAA was then performed. Arterial access was maintained while the LSF was calculated, which was persistently elevated at 54%. Embolization of arteriovenous shunts was performed during the same session and 5.0 millicuries of ^99mTc-MAA were administered. The repeat LSF was 29%. Successful radioembolization was subsequently performed.     

甲状腺~(99)Tc~mO_4~-显像冷结节的临床诊断价值

目的　探讨甲状腺99TcmO-4 显像冷结节对不同性质甲状腺疾病的诊断价值。方法　采用静脉注射99TcmO-4 185MBq ,2 0min后甲状腺前位静态显像 ,采集总计数 1× 10 6。显像显示甲状腺结节局部放射性分布缺损或低于正常甲状腺组织则定性为冷结节。结果　 34 2例甲状腺99TcmO-4 显像发现冷结节 85例 ,发生率为2 4.9% ,85例冷结节中 ,37例 (4 3.5 % )为甲状腺瘤 ,15例为甲状腺癌 (17.6 % ) ,2 0例 (2 3.5 % )为结节性甲状腺肿 ,8例 (9.4% )为甲状腺炎 ,4例 (4 .7% )为单纯性甲状腺囊肿 ,1例 (1.3% )为甲状腺外肿物。结论　冷结节在甲状腺99Tcm O-4 显像时较为常见 ,且不同性质甲状腺疾病的冷结节及其周围组织有一定的特征性表现 ,因此99TcmO-4显像冷结节对甲状腺腺瘤、甲状腺癌、甲状腺囊肿、甲状腺炎等常见疾病具有较高的临床价值。     

Bone scintigraphy in hereditary mutiple exostoses

A case of hereditary mutiple exostoses is presented. ^99mTc-MDP imaging demonstrated uptake of radiotracer in the lesions.     

无创伤性测定门静脉压力与肝血流二法联合应用研究肝硬化的价值

目的　为临床研究肝硬化提供有价值的手段。方法　采用99mTc -RBC测定 93例肝硬化患者肝血流 ,选择峰时 (Tmax) ,半廓清时 (T1/2 )、廓清率 (K值 )、肝血流 (LBF)等作为观察指标 ,与正常对照组比较 ;同时用99mTc-MIBI经直肠给药测定其中 5 4例患者门静脉压力 (PVP) ,以心 /肝 (H/L)比值作为分流指数。结果　肝硬化组Tmax、T1/2 、K及LBF分别为 1.2 6± 0 .99(93)min、5 .75± 3.38(93)min、0 .15 4± 0 .116 (93)及 0 .6 10± 0 .2 89(93)L/min ,除Tmax外 ,与对照组均有非常显著性差异 ;Child -A、B、C级各组之间 (除Tmax外 )也均有非常显著性差异或显著性差异 ;Child -A、B、C级各组H/L分别为 0 .49± 0 .18(2 1)、0 .6 9± 0 .16 (15 )、0 .91± 0 .2 1(18) ;PVP分别为 2 .2 2± 0 .5 7(2 1)kPa、2 .85± 0 .38(15 )kPa及 3.5 4± 0 .6 5 (18)kPa。而对照组的H/L及PVP分别为 0 .30± 0 .12 (16 )及 1.6 1± 0 .38(16 )kPa。Child -A、B、C级各组分别与对照组及各组之间比较 ,除Child -B与C级组PVP无显著性差异 (P >0 .0 5 )外 ,其余均有非常显著性差异 (P <0 .0 1)及显著性差异 (P <0 .0 5 )。结论　本法测定肝血流及门脉压力方便 ,无创伤 ,对分析病情 ,判断疗效 ,指导制订治疗方案 ,估计预后等均有较     

~(99)Tc-MDP对类风湿性关节炎患者外周血单核细胞产生细胞因子的影响

目的 :探讨“云克”(99Tc MDP)治疗类风湿性关节炎 (RA)的免疫机制。方法 :采用ELISA双抗体夹心法 ,观察“云克”体外对RA患者外周血单核细胞 (PBMC)产生白介素 1(IL 1)和可溶性白介素 2受体 (sIL 2R)的影响。结果 :“云克”有抑制RA患者IL 1的分泌及细菌脂多糖 (LPS)的促分泌作用 ,并对可溶性白介素 2受体的自发分泌及植物血素 (PHA)诱导分泌均有抑制作用。结论 :“云克”对RA的治疗机制可能与其降低IL 1和sIL 2R的作用有关     

腮腺显像对鼻咽癌放疗后腮腺功能的评价

目的利用腮腺显像研究鼻咽癌放疗后腮腺的摄取与排泄功能.方法48例鼻咽癌患者中,对38例肿瘤和肿大淋巴结行加速调强放疗（SMART）,其亚临床灶和预防照射区接受常规照射;余10例行常规放疗.放疗前后均行腮腺显像,计算腮腺的放射性摄取指数（UI）及酸性刺激后排泌指数（EI）,对腮腺功能损伤情况进行分析;同时记录患者口干程度并分级.结果鼻咽癌SMART组放疗后腮腺UI和EI分别下降21.9%和37.3%,中重度口干者12例;而常规放疗组腮腺功能明显下降,UI和EI分别下降56.1%和96.1%,中重度口干者9例,两者比较差异均有显著性（P＜0.05）.结论腮腺显像可灵敏地监测鼻咽癌放疗后腮腺功能.     

用99Tcm-HL91评价鼠心肌缺血模型

目的 探讨乏氧心肌显像剂99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)用于诊断实验性缺血心肌的价值.方法 建立大鼠心肌在体缺血再灌注模型,采用体外放射自显影法检测正常对照组(6只)、缺血再灌注组(8只)及无再灌注组(8只)鼠心肌对99Tcm-HL91的摄取.结果 对照组和无再灌注组心肌未见局灶性放射性浓聚,再灌注组心肌非坏死区有较高放射性浓聚,与正常心肌组织的摄取比值为1.634±0.354.结论 99Tcm-HL91表现出较强的亲乏氧组织特性,能较好区分存活和梗死心肌.     

胃肠道癌肿患者外周血CD4^＋CD25^＋FOXP3^＋调节性T细胞的表达及临床意义

目的：研究胃肠道癌肿患者外周血CD4^＋CD25^＋FOXP3^＋调节性T（Treg）细胞的表达，并探讨其临床意义。方法：通过免疫荧光术及流式细胞仪检测20例胃癌患者及20例结肠癌患者外周血CD4^＋CD25^＋FOXP3^＋Treg细胞、CD4^＋CD25^＋high Treg细胞、CD4^＋T细胞及CD4^＋ CTLA-4^＋T细胞。结果：胃癌组、结肠癌组与健康献血者比较外周血CD4^＋CD25^＋FOXP3^＋ Treg细胞、CD4^＋CD25^＋high Treg细胞及CD4^＋CTLA-4^＋T细胞显著增多，CD4^＋T细胞显著减少；胃癌、结肠癌患者之间其外周血中CD4^＋CD25^＋FOXP3^＋Treg细胞、CD4^＋CD25^＋high Treg细胞、CD4^＋T细胞及CD4^＋CTLA-4^＋T细胞无显著差异。结论：胃肠道癌肿患者外周血CD4^＋CD25^＋FOXP3^＋Treg细胞显著高于健康献血者，这可能与胃肠道癌肿患者的免疫抑制和肿瘤的进展相关。