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141.
142.

BACKGROUND CONTEXT

Intravertebral clefts (IVCs) are vacuum-like cavities commonly associated with osteoporotic vertebral compression fractures (OVCFs). IVCs promote cement leakage during kyphoplasty, suggesting a physical link with the basivertebral foramen, although this is uncertain.

PURPOSE

The present study aims to create IVCs in mechanical experiments on cadaveric spines in order to clarify their pathogenesis, structure, and links with the basivertebral foramen.

STUDY DESIGN AND METHODS

In total, 15 three-vertebra lumbar specimens from five cadavers aged 68 to 71 years were subjected to axial compressive overload followed by cyclic loading in flexion and extension to create an OVCF together with an IVC. Computed tomography scans and radiographs were used to confirm structural changes and micro-CT was used to measure trabecular bone properties in five specimens. Unipedicular vertebroplasty was then performed on 10 damaged specimens until fluoroscopy revealed extravasation of cement.

RESULTS

In every specimen, loading created an OVCF with an IVC. Dissection and imaging showed that the IVC was always connected with the basivertebral foramen. The central vertebral region, including the IVC, had the lowest connectivity density, trabecular number, and bone volume fraction, and the highest trabecular separation. Vertebroplasty caused cement leakage through the basivertebral foramen in nine specimens and into an adjacent disc in one specimen.

CONCLUSION

Cyclic loading in flexion and extension applied to a fractured osteoporotic vertebra can create an IVC, which then allows cement leakage via the basivertebral foramen.  相似文献   
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目的总结Remebot机器人辅助下立体定向脑组织活检术的护理配合方法。方法对19例患者行Remebot机器人辅助下立体定向脑组织活检术,其护理配合包括完善术前准备,合理布局手术间、正确安置体位、术中密切监护等,术后加强仪器设备的管理、特殊器械的维护和保养等。结果 19例均顺利完成手术,手术时间28~48min,平均35.5min;术后无一例发生并发症。结论 Remebot机器人辅助下立体定向脑组织活检术是一种高效、精准的新型手术方式,充分的术前准备、高质量的手术配合以及妥善的术后处理是手术成功的重要保证。  相似文献   
145.

Purpose

To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B 3.1) and provide evidence for clinical practice.

Methods

This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014. There were 13 males and 9 females, mean age 38.9 years (range, 17–73 years). Eight cases involved the left side and 14 the right side. The causes of fractures included road traffic accidents (11 cases), falling from height (6 cases) and sports injuries (5 cases). The mean period of hospitalization was 9.8 days (range, 6–14 days). For all the patients, MRI and three-dimensional CT were done before surgery and X-rays done preoperatively and during follow-ups. The external frame was kept for 8–10 weeks. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 56.86 ± 4.400, the Medical Outcomes Short Form 36-item (SF-36) questionnaire score was 57.41 ± 4.102 and the visual analog score (VAS) was 5.50 ± 1.058. Patients' main complaints about inconvenience of daily life were also recorded.

Results

All the 22 patients were followed up for 24–63 months (mean, 33.6 months). None of them developed nonunion during the follow-up; pin site infection was observed in one patient and posttraumatic osteoarthritis in another. At the final follow-up, the average AOFAS score, SF-36 score and VAS score were respectively 90.59 ± 5.096, 79.59 ± 5.394 and 1.82 ± 1.181, which were significantly improved compared with the preoperative data (t = 26.221, p < 0.001; t = 11.910, p < 0.001; t = 11.571, p < 0.001). The therapeutic effect was excellent in 13 cases, good in 7 cases and fair in 2 cases, with a good-excellent rate of 90.9%. Patients' main complaints were inconvenience of clothing (17 cases) and extremity cleaning (5 cases).

Conclusion

In the treatment of SER IV E ankle fractures, ORIF with TEF but no DLR can achieve satisfactory outcome, but long-term effect should be confirmed by large sample randomized controlled trials.  相似文献   
146.
147.
病毒性心肌炎是指由于感染病毒所导致的心肌局限性或弥漫性的急性、亚急性或慢性炎症病变,其临床表现轻重不一,以儿童和40岁以下的成年人患病居多,为临床心血管疾病中常见病之一.祖国医学中属"心悸"、"怔忡"、"胸痹"、"虚劳"、"心水"、"厥脱"等范畴.近年来,国内运用中医中药或中西医结合对本病进行治疗颇有成效,现概括如下:  相似文献   
148.
Purpose: To compare the effects and side-effects of fondaparinux sodium and low molecular weight heparin in patients with hypercoagulability accompanied with traumatic infection. Methods: Thirty-six patients with post-traumatic infections in our hospital intensive care center were diagnosed with hypercoagulability from February 2012 to February 2013. These patients were randomly divided into 2 groups. In group F (18 patients), the patients were treated with fondaparinux sodium, 2.5 mg, 1/d for 11 d. In group L (18 patients), the patients were treated with low molecular weight heparin, 4100 U, 1/12 h for 11 d. The incidence of deep vein thrombosis, bleeding events and multiple organ dysfunction syndrome (MODS) and mortality of two groups after anticoagulation therapy were analyzed. Fibrinogen, D-dimer level and activity of antithrombin III were measured by the coagulation analyzer. Results: The incidence of deep vein thrombosis, MODS incidence and mortality were not significantly different between the two groups. The rate of bleeding evens in group F was lower than group L (p < 0.05). Antithrombin III got an upward trend after anticoagulant therapy, in which it was higher in group F than in group L on the 5th d and 11th d (p<0.05). Fibrinogen levels were gradually increased, and there was no significant difference between two groups (p>0.05). D-dimer was significantly decreased after anticoagulant therapy for 5 d (p<0.01), and there were significant differences between two groups on the 5th d and 7th d (p < 0.05). It showed no significant difference on the 11th d (p>0.05). Conclusion: Fondaparinux sodium and low molecular weight heparin can effectively improve coagulopathy in patients with traumatic infection. Compared with low molecular weight heparin, fondaparinux sodium may reduce the risk of bleeding events in patients with hypercoagulability accompanied by traumatic infection.  相似文献   
149.
150.
Background: To investigate the efficacy and value of thoracoscopic hybrid surgery in the treatment of stage III chronic tuberculous empyema (CTE).Methods: 48 patients diagnosed as CTE with pleural thickening and encysted abscess cavity from were treated by hybrid operation (HO). Small incision operation was first used for resection of thickening pleural fibreboard and decortication of parietal pleura. Then, thoracoscopy was guided into chest to decorticate the visceral pleurali. Additional 25 patients with open operation of pleurectomy were set as control.Results: The average operation time of HO group was 70 ± 22 min compared to 130 ± 32 min of control. The amount of bleeding, hospitalization time and chest tube drainage of HO group (200 ± 55 ml, 18 ± 1.2 days, 3.5 ± 1.5 days) were significantly decreased compared to control (400 ± 45 ml, 28 ± 4.5 days, 6.5 ± 2.5 days). Post operation complications occurred in 5 (10.42%) and 3 (12%) cases for HO group and control, respectively.Conclusions: In stage III CTE, the small incision assisted thoracoscopic hybrid surgery help to remove thickening parietal pleura, promote the application of thoracoscopy, which has obvious advantages compared to traditional surgery.  相似文献   
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