锁定加压钢板治疗老年人桡骨远端骨折32例临床分析

目的:观察锁定加压钢板治疗老年人桡骨远端骨折的临床疗效。方法:回顾性分析本院2001年1月至2006年12月收治的老年人桡骨远端骨折32例的临床资料。结果:术后腕关节功能恢复良好31例,X摄片见骨痂生长的平均时间为(50±10)天,骨性愈合的平均时间为术后(10±2)月。结论:锁定加压钢板治疗老年人桡骨远端骨折疗效好,值得推广应用。     

Analgesic and anticonvulsant activity of new derivatives of 2-substituted 4-hydroxybutanamides in mice

Earlier in vitro studies of the compounds marked as GT27, GT28, GT29 and BM128 revealed their inhibitory action towards murine γ-aminobutyric acid (GABA) transporters (mGAT1-mGAT4). In the present paper, the pharmacological activity of four γ-hydroxybutyric acid (GHB) amide derivatives was investigated. The following procedures were involved: locomotor activity, hot plate and electroconvulsive threshold tests. The compounds' influence on motor coordination was evaluated in the chimney test, as well. Intraperitoneal (i.p.) administration of the GHB derivatives decreased animals' locomotor activity (ED(50) values ranged between 23.79 and 26.37 mg/kg). At a dose of 25 mg/kg (i.p.) the compounds prolonged the nociceptive reaction time latency in the hot plate assay to various degree and GT28 and GT29 were the most potent ones in this respect. Their analgesic efficacy was particularly pronounced 30 min after their administration [percent of maximal possible effect (%MPE) = 16.93 and 22.72, respectively]. The investigated GHB derivatives, except for GT29 at 100 mg/kg, increased the electroconvulsive threshold by approximately 4-11 mA as compared to the vehicle-treated mice. In the chimney test they impaired the animals' motor coordination to various degree. We suggest further investigations of the compounds to estimate their biological activity.     

Displaced proximal humerus fractures treated with ORIF via the deltoid interfascicular approach vs the deltopectoral approach: A prospective case-control study

Background:The purpose of this study was to evaluate the clinical outcomes and complications of displaced proximal humeral fractures treated with proximal humeral internal locking system (PHILOS) plate fixation via a deltoid interfascicular (DI) vs a deltopectoral (DP) approach.Methods:This prospective case-control study was conducted with patients admitted to our hospital from May 2015 to June 2018 who suffered from unilateral displaced proximal humerus fractures. Patients were treated with PHILOS plate fixation via a DI (DI group) or DP approach (DP group). The clinical outcomes and complication data were collected for comparison between the 2 groups. The patients were followed up at 3, 6, and 12 months; and every 6 months thereafter. The patients’ functional recoveries were evaluated according to the normalized Constant-Murley score, range of motion of the shoulder (flexion, abduction, external/internal rotation) and disabilities of the arm, shoulder and hand score.Results:A total of 77 patients, followed for an average of 15 ± 2.2months (range, 12–21), were enrolled (36 in DI group and 41 in DP group) for final analysis. No significant differences in age, sex, affected side, fracture type, injury mechanism or time from injury to operation were found between the 2 groups (all P > .05). The incision length, intra-operative blood loss, and duration of operation in the DI group were significantly less than those in the DP group, respectively (all P < .05). The functional outcomes assessed by the normalized Constant-Murley score and range of motion of flexion and internal rotation in the DI group were superior to those in the DP group at 3 and 6months after the operation (P < .05); however, no significant differences were observed at the 12-month and subsequent follow-ups (all P > .05). There was no significant difference in the range of shoulder external rotation and abduction during the postoperative follow-ups (P > .05). At the last follow-up, the mean disabilities of the arm, shoulder, and hand score was 14.0 (6.6) points in the DI group and 14.4 (6.9) points in the DP group (P = .793). Complications occurred in 1 patient in the DI group and 8 patients in the DP group (P = .049).Conclusion:The current study demonstrates that DI approach is a safe and effective alternative for the treatment displaced proximal humerus fractures. The DI approach rather than DP approach was recommended when lateral and posterior exposure of the proximal humerus is required, especially when fixed with PHILOS plate.     

A Novel Model of Ultrasonic Fatigue Test in Pure Bending

The very high cycle fatigue (VHCF) failure of in-service components is mainly caused by the vibration of thin-wall elements at a high frequency. In this work, a novel model of ultrasonic fatigue test was developed to test thin-wall material in bending up to VHCF with an accelerated frequency. The theoretical principle and finite element analysis were introduced for designing a sample that resonated at the frequency of 20 kHz in flexural vibration. In the advantage of the second-order flexural vibration, the gauge section of the sample was in the pure bending condition which prevented the intricate stress condition for thin-wall material as in the root of cantilever or the contact point of three points bending. Moreover, combining the constraint and the loading contact in one small section significantly reduced heating that originated from the friction at an ultrasonic frequency. Both strain gauge and deflection angle methods were applied to verify the controlling of stress amplitude. The fractography observation on Ti6Al4V samples indicated that the characterized fracture obtained from the novel model was the same as that from the conventional bending test.     

小儿尿道下裂尿道板组织中雌激素受体及微血管密度的表达及临床意义

目的 探讨尿道下裂患儿尿道板组织和尿道部皮肤组织中雌激素受体(ER)和微血管密度(MVD)的表达及意义.方法 选取2013年6月-2015年1月天津儿童医院收治的尿道下裂手术患儿30例,术中分别取部分尿道板和尿道部皮肤组织,检测不同组织中ER及MVD的表达及分布情况.结果 2组均检测到ER及MVD的表达.尿道板组织与尿道部皮肤组织中ER表达水平比较差异无统计学意义(P＞0.05),尿道板组织中MVD低于尿道部皮肤组织(P＜0.05).结论 尿道板组织和尿道部皮肤组织ER含量接近,可能与尿道发育异常有关;尿道板组织中存在微血管分布,为保留尿道板的尿道成形术提供了理论依据;尿道板组织内MVD显著降低,可能为术后发生尿瘘的原因之一.     

骨骺生长滑动钢板的设计及动物实验影像学研究

目的设计一种骨骺生长滑动钢板,在有效固定骨折的同时,又能减轻对骨骼纵向生长的抑制,减少肢体畸形的发生,并通过动物实验进行评估。方法根据青少年股骨髁部的解剖特点设计出适用于青少年儿童股骨髁部骨折的内固定滑动钢板。动物实验选24只健康幼年山羊,8只山羊为正常对照组,余16只为钢板内固定组,其中右后肢采用普通钢板固定,左后肢采用滑动钢板固定。术后1 d,1、2、3、6个月5个时相点对所有山羊双侧股骨进行X线摄片检查,并通过fPAX系统测量左右股骨的长度进行统计学分析。结果正常对照组山羊双侧股骨在5个时相点长度统计学均无显著性差异,钢板内固定组,在术后1 d、1个月双侧股骨长度统计学均无显著性差异,在术后3、6个月双侧股骨长度统计学存在显著性差异,滑动钢板侧股骨长度明显长于普通钢板侧,股骨长度术后1、2、3、6个月分别与术后1 d增长的数值进行比较分析,普通钢板侧和正常对照组右侧股骨长度存有显著性差异,滑动钢板侧和正常对照组左侧股骨长度无显著性差异。结论本组实验证实滑动钢板在动物体内随骨骺的生长过程中可自动延长,符合发育期青少年儿童骨骺生长的生理特点,可进行进一步的研究。     

跟骨解剖支持板的研制及临床应用

目的 设计跟骨解剖支持板并研究其治疗跟骨骨折的临床应用价值.方法 通过对跟骨生物力学和骨折机理的探讨,设计了一种用于跟骨骨折内固定治疗的新型跟骨解剖支持板,并应用该钢板治疗跟骨骨折38例(46足).其中39足经过6个月以上随访(6～46个月,平均14.6个月).均行跟骨侧、轴位X线片和印横轴位、冠状位检查,按Sanders分型,其中Ⅱ型骨折10足,Ⅲ型骨折17足,Ⅳ型骨折12足.手术前后对Bohler角、Gissane's角、跟骨水平全长、丘部总高、轴长和体宽等多项指标进行比较,采用Marryland足部评分系统评价术后功能.结果 术后4例切口延迟愈合,2例腓肠皮神经损伤,1例腓骨长短肌腱滑脱,对症处理后均痊愈.术后功能评价显示:优21足,良15足,可3足,优良率达92.3%.结论 跟骨解剖支持板设计合理,结构性能良好,对其进行的多项生物力学测定表明该板可达到跟骨骨折固定的要求.可有效减少并发症,为治疗跟骨骨折提供了一种新的内固定方法.     

雷公藤多甙对蟾蜍缝匠肌终板膜乙酰胆碱受体的作用

目的 观察雷公藤多甙（TWP）对终板膜乙酰胆碱受体（nAChR)的反应性的作用。方法 在不均匀牵张法制动的蟾蜍缝匠肌标本上，利用微电泳氯化及乙酰胆碱（AChCl)技术，在终板区引起的乙酰胆碱电位（AChP）来板映终板膜nAChP的反应性。结果 （1）20g L TWP组，用药20min后AChP振幅明显升高，40mg/L和60mg/LTWP组，用药10min后AChP振幅明显升高。（2）20mg/L和40mg/L TWP组内，AChP振幅除80min组外，其它各时间组间有显著性差异（P＜0．05），60min达最大值；（3）60mg/L TWP组，在用药后40min,60min和80min均记录到动作（AP）；（4）药物各浓度组引起的AChP振幅变化率之间有显著差异（P＜0．05），其中60mg/L TWP组引起的变化率最大。结论 TWP能提高终板膜nAChR的反应性，并有明显的量效关系和一定的时效关系。     

锁定钢板螺钉取出困难原因及解决方法的探讨

目的探讨锁定钢板螺钉取出困难的原因和解决方法。方法回顾分析10例锁定钢板螺钉取出困难患者的临床资料。结果螺钉取出困难的原因：钢板应力变形,锁定螺丝孔道变形,旋入螺钉时未使用卸力限制工具,螺钉内六角打滑,取钉方法错误。结论锁定钢板螺钉内固定及取出时应严格规范操作,使用专用工具及方法,可顺利取出内固定,并避免医源性骨折。     

A VAM-Based Equivalent Model for Triangular Honeycomb Sandwich Panels: Comparison with Numerical and Experimental Data

Due to their complex microstructures, the research on the static and dynamic behaviors of triangular honeycomb sandwich panels (triangular HSPs) is limited. In this study, the effective plate properties of triangular HSP was obtained by the homogenizing of the unit cell, and then the input to a VAM-based two-dimensional equivalent plate model (2D-EPM) to perform static and dynamic analyses. The accuracy of the proposed model for predicting the equivalent stiffness of the triangular HSP was verified by three-point bending experiments of 3D-printed specimens. Then, the static displacement, global buckling, and free vibrations predicted by 2D-EPM were verified with the results from three-dimensional finite element model simulations under various boundary conditions. The influences of structural parameters (including angle, core wall thickness, and cell side length of the unit cell) on the static and dynamic characteristics of triangular HSPs were also investigated, which can provide a useful tool for the modeling and evaluation of triangular HSPs under different conditions.