Application of Burow's solution for cement foreign body in the external auditory canal

IntroductionOnly two reports in English literature have described cement foreign bodies in the external auditory canal.Case summaryWe present the case of a 37 year-old man with cement foreign body in the right external auditory canal. Removal of the foreign body was difficult because of severe adhesion to the external auditory canal and tympanic membrane. We therefore used acidic Burow's solution to dissolve the alkaline cement deposition. Application of Burow's solution immediately caused the deposition to take on a paste-like consistency that was easily removed.DiscussionBurow's solution seems useful for removing cement foreign bodies in the external auditory canal.     

采用现代骨水泥技术行全髋置换术

报道了现代骨水泥术固定的全髋置换术43例45髋。术后X线片提示股骨头假体固定质量(Barrack标准):A级25髋,B级20髋,无1例C级和D级,随访5～6年,结果:功能优良率94％,尚可6％,X线片显示臼杯可能松动1髋(2％),股骨头假体可能松动和很可能松动各2髋(4％),无1例肯定松动。表明第二代CTHR的临床疗效显著优于文献报道的第一代CTHR。作者还介绍了现代骨水泥固定术的方法,改善疗效的机制及手术必须注意的其它问题。     

自固化磷酸钙骨水泥修复牙种植体周围骨缺损实验研究

目的:本研究旨在应用国产自固化磷酸钙骨水泥修复牙种植体骨缺损的动物实验研究,观察磷酸钙骨水泥引导骨再生的方式,为将来磷酸钙骨水泥能修复牙种植体周围骨缺损奠定实验基础。方法:选取40只日本大耳白兔,在白兔右侧股骨大转子区植入BLB种植体(Φ=3.3 mm,L=8.0 mm),同时种植体冠部制造宽度为2.0 mm、深度为4.0 mm的环行骨缺损,骨缺损区充填CPC进行修复。实验组术后1、2、4、6个月随机处死大白兔10只,对骨缺损区X线骨密度分析,带种植体的硬组织磨片的组织学观察新骨的生成量,并进行统计学分析。结果:实验组磷酸钙骨水泥随时间延长而逐渐发生降解,新生骨组织沿降解裂隙长入,与种植体发生直接的接触,统计学分析结果表明各个月内的新骨量有显著性差别。结论:表明磷酸钙骨水泥在修复牙种植体周围骨缺损中展示了较好的引导骨再生性质。     

Cement use in total knee arthroplasty: 40 versus 80 grams

BackgroundStudies of cement use in total knee arthroplasty (TKA) have historically addressed mechanical properties and application strategies. Recently, cement technique has been studied as a means to reduce cost. We transitioned from opening two bags (80 grams) of cement to one bag (40 grams) of cement for primary TKA to improve cost efficacy. This study investigates the radiographic outcome and cost of TKAs performed with 40 versus 80 grams of cement.MethodsTKAs from January 2017 to January 2019 were evaluated. Cement mantle and implant alignment were assessed per the Modern Knee Society Radiographic Evaluation System at four months by three blinded reviewers. Data was analyzed according to quantity of cement used. Cement mantle quality at 16 implant zones was compared. Cost was evaluated.Results163 patients (age 66.8 yrs. +/− 8.9, 51.5% female) underwent TKA with 80 grams of cement, while 142 patients (age 67.1 yrs. +/− 9.3, 56.3% female) underwent TKA utilizing 40 grams of cement. There was no significant difference in cement mantle quality. The most common zone of cement deficiency was the femoral posterior flange (9% in 40 gram group versus 4% in 80 gram group, p value = 0.08). There was no difference in implant size. Cost saving was calculated at $7,810 for the 40 gram group.ConclusionThere was no difference in radiographic cement mantle appearance between primary knees performed with 40 or 80 grams of cement. Cement usage represents a target for cost saving and opportunity to increase the value of primary TKA. Based on the current incidence of TKA in the United States, cost savings could exceed 33 million dollars annually.     

骨粒羟基磷灰石加粘合剂植入后骨生长过程的实验研究

目的：研究以骨粒羟基磷灰石为粉碎性骨折及骨肿瘤切除术后作为骨质缺损的填充和固定应用,提供科学依据。方法：将骨粒羟基磷灰石加粘合剂,填入钻孔后的兔胫骨孔内,每月一次,分四批处死兔子,取出填入处胫骨作组织学切征,观察新生骨形成过程。结果：发现单纯羟基磷灰石真入处的羟基磷灰石周围,形成紧密包裹的骨膜样组织,新生骨细胞不能长入到羟基磷灰石内;而加入骨粒后的羟基磷灰石的材料,能见到新生骨组织长入到羟基磷灰石     

一期带蒂组织瓣联合万古霉素骨水泥及颗粒骨治疗小腿创伤后骨髓炎伴骨及软组织缺损

目的探讨一期带蒂组织瓣联合万古霉素骨水泥及颗粒骨治疗小腿创伤后骨髓炎伴骨及软组织缺损的方法及疗效。方法 2008年6月~2013年3月,收治小腿创伤后骨髓炎伴骨及软组织缺损患者36例。男25例,女11例;年龄22~60岁,平均46.5岁。病程1~5个月,平均2.5个月。软组织缺损面积为4 cm×5 cm~13cm×8 cm,骨缺损长度0.5 cm~2.5 cm,平均1.8 cm。采用带蒂组织瓣移位联合万古霉素骨水泥及颗粒骨植入一期治疗。选择带蒂的腓肠肌肌瓣16例,比目鱼肌肌瓣12例,腓肠神经营养血管肌皮瓣6例,远端蒂股前外侧肌皮瓣2例,同时一期联合万古霉素骨水泥填充及颗粒骨植骨,肌瓣表面游离植皮处理。结果 36例患者均获随访,随访时间24~55个月,平均39.5个月。2例组织瓣远端发生部分坏死,经清创换药及游离植皮后愈合,4例术后创面渗出患者经换药处理后愈合,2例感染未控制,经再次手术病灶清除及灌洗引流后愈合。所有骨折均骨性愈合,愈合时间6~21个月,平均12个月。末次随访时按Johner-Wruhs标准评定疗效,优20例,良12例,可4例,优良率为88.9%。结论一期应用带蒂组织瓣联合万古霉素骨水泥及颗粒骨治疗小腿创伤后骨髓炎伴骨及软组织缺损,有利于创面愈合、感染控制及骨缺损修复,可获得良好的临床疗效。     

单节段经皮椎体成形术后症状性椎体再骨折相关因素研究

目的探讨行单节段经皮椎体成形术(percutaneous vertebroplasty,PVP)后发生症状性椎体再骨折的危险因素。方法选取2015年5月~2016年10月,对诊断为骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)并行PVP的94例患者行回顾性研究,19位患者在术后随访期间出现症状性椎体再骨折(再骨折组),75位未发生再骨折(对照组)。比较分析两组的生物学和手术各参数。结果随访出现再骨折病例中,邻近椎体再骨折11例(57.89%,11/19),非邻近椎体再骨折8例(42.11%,8/19),邻位椎体骨折均为术后6月以内发生,非邻位椎体再骨折中仅2例(25.00%,2/8)发生在术后6月以内。既往骨折病史(P=0.01)、骨水泥是否分布对称(P=0.02)、骨水泥量(P=0.02)及骨水泥分布位置(P=0.03)是椎体再骨折发生的独立危险因素。结论骨水泥填充位置、骨水泥量、分布是否对称以及既往骨折病史是发生再骨折的影响因素,而PVP术后更长时间内出现椎体再骨折与骨质疏松(osteoporosis,OP)相关。     

不同厚度垫底材料对龋齿充填后应力分布的影响

目的采用有限元方法对比分析不同厚度垫底材料对充填后牙体应力分布的影响。方法选用正常形态下颌第1磨牙,基于MicroCT扫描建立Ⅰ类洞充填的三维有限元模型,选择Vitrebond和Dycal作为垫底材料,分别考虑4种不同的厚度(0.5、1.0、1.5和2.0mm),施加250N的咬合力,对各模型中牙体、充填体和垫底材料的最大/最小主应力进行比较。结果 Dycal垫底,厚度为2.0mm,牙体的最大主应力峰值超过其抗拉强度,垫底材料的最大/最小主应力峰值分别超过其抗拉和抗压强度;垫底厚度为1.5mm和2.0mm,充填体的最大主应力峰值接近其抗拉强度的90%。Vitrebond垫底时,各材料的最大主应力峰值也都在1.5mm或2.0mm时达到极值。结论从防止充填后牙体折裂的角度,建议临床上采用较薄的垫底层厚度,取0.5～1.0mm。     

2006～2007年龙岩市水泥企业作业工人乙肝病毒感染情况分析

[目的]了解水泥企业职工乙型肝炎病毒(HBV)感染情况,为制订乙型肝炎防治对策提供科学依据。[方法]对2006～2007年龙岩市市属4家水泥企业职工职业性健康体检资料中的HBV感染指标检测资料进行分析。[结果]检测755人,HBsAg阳性的133例,阳性率为17.62%。HBsAg阳性率,窑工工种为22.58%,其他工种为16.05%(P<0.05);31～40岁为21.80%,其他年龄者为13.66%(P<0.01);男性为20.77%,女性为11.74%(P<0.01)。133例HBsAg阳性者中,HBsAg、HBeAg、抗-HBc阳性的占21.80%,HBsAg、抗-HBe、抗-HBc阳性的占12.03%,HBsAg、HBeAg阳性的占43.61%,HBsAg、抗-HBc阳性的占22.56%。[结论]水泥企业职工HBsAg阳性率较高,男性青壮年尤其严重。     

Pollutants emitted by a cement plant: health risks for the population living in the neighborhood

The aim of this study was to investigate the health risks due to combustor emissions in the manufacturing of Portland cement for the population living in the neighborhood of a cement kiln in Catalonia, Spain. Pollutants emitted to the atmosphere in the course of cement production were modeled. The ISC3-ST model was applied to estimate air dispersion of the contaminants emitted by the cement plant. Air concentrations of NO(2), SO(2), PM(10), metals, and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), as well as the potential exposure in the vicinity of the facility, were assessed via models based on US EPA guidance documents. PCDD/F and metal concentrations were also modeled for soil and vegetation. Based on these concentrations, the levels of human exposure were calculated. Individual cancer and noncancer risks for the emissions of the cement kiln were assessed. Health effects due to NO(2), SO(2), and PM(10) emissions were also evaluated. Risk assessment was performed as a deterministic analysis. The main individual risk in the population was evaluated in a central-tendency and a high-end approach. The results show that the incremental individual risk due to emissions of the cement plant is very low not only with regard to health effects, but also in relation to toxicological and cancer risks produced by pollutants such as metals and PCDD/Fs emitted by the cement kiln.