High Short-Term Loosening Rates with the Wagner Standard Cup

The stability of prosthetic fixation is to a large extent dependent on component design. The purpose of this study is to analyze the short-term radiological results obtained with the Wagner Standard Cup in primary hip arthroplasty. An assessment was made of one hundred primary hip arthroplasties. The radiological evaluation revealed bone ingrowth in 37 of cases, fibrous integration in 49 and loosening in 14. In summary, osseointegration of the Wagner Standard Cup was unsuccessful in a high percentage of cases. This finding, which was unrelated to the type of stem or bearing surface used, bore a statistically significant relation (P < 0.05) with an observed poor bone coverage of the acetabular component. Although insufficient bone coverage could arguably be attributable to a poor surgical technique, we would tend to agree with other authors that it is rather likely to result from a flawed implant design that impedes osseointegration.     

用Wagner本构方程对聚合物挤出胀大的三维有限元分析

采用有限元方法分析粘弹性聚合物熔体的三维挤出胀大。采用积分型本构方程 Wagner模型描述聚合物熔体的粘弹性记忆特性 ,并引入了非线性衰减函数。对于本构方程中偏应力张量给出了计算方法 ,采用迭代方法求解非线性方程组。并根据自由面处的边界条件 ,确定出口处自由面的最终位置。对圆形流道进行分析 ,结果与轴对称分析和实验相吻合 ,最后对矩型流道进行计算 ,得出挤出物的形状     

复方黄柏液中医外治溻渍法治疗Wagner1～2级糖尿病足的临床观察

目的：观察复方黄柏液中医外治溻渍法治疗Wagner1～2级糖尿病足溃疡的临床疗效。方法：通过使用随机对照试验设计的方式,将两组患者分为观察组与对照组,每组41例,两组患者在采用常规治疗的基础上分别采用复方黄柏液中医外治溻渍法与纳米银医用抗菌敷料的治疗方式,并观察两组患者治疗前后的溃疡面积、溃疡深度、中医证候评分、踝肱指数、经皮氧分压、血管内皮生长因子、表皮生长因子、晚期糖基化终末产物、超敏C-反应蛋白、白细胞介素-6、红细胞沉降率、不良事件。结果：与本组治疗前比较,两组患者治疗后溃疡面积、溃疡深度、中医证候评分、晚期糖基化终末产物、超敏C-反应蛋白、白细胞介素-6、红细胞沉降率均明显降低（P<0.05）,踝肱指数、经皮氧分压、血管内皮生长因子、表皮生长因子均明显升高（P<0.05）;治疗后与对照组比较,观察组溃疡面积、溃疡深度、中医证候评分、血管内皮生长因子、表皮生长因子、晚期糖基化终末产物、超敏C-反应蛋白、白细胞介素-6、红细胞沉降率明显降低（P<0.05）,踝肱指数、经皮氧分压、血管内皮生长因子、表皮生长因子明显升高（P<0.05）;观察组临床疗效优于对照...     

Wagner SL股骨假体治疗复杂股骨近端骨折的疗效观察

目的探讨Wagner SL股骨假体治疗复杂股骨近端骨折的疗效。方法自2009-01—2015-05采用Wagner SL股骨假体治疗60例复杂股骨近端骨折,记录手术时间及出血量,采用髋关节功能Harris评分进行评价。结果手术时间45~200(95±27)min,术中出血400~1 500(600±240)ml,术后输血2~10 U悬浮红细胞。所有患者切口均一期愈合,术后假体位置佳。共50例获得随访2~68(34±19)个月,术前Harris评分35~75(58±10)分,末次随访Harris评分65~93(81±9)分,假体无明显松动,假体周围无透亮带、下沉。结论采用Wagner SL股骨假体治疗复杂股骨近端骨折疗效满意,值得临床推广。     

Julius Wagner von Jauregg,Otto Diem and research methods for assessing the contributions of hereditary burden to mental illness risk: 1902–1906

After decades of methodological stasis in 19th century psychiatric genetics, when uncontrolled studies reported high rates of hereditary burden in hospitalized patients, Koller completed the first controlled study in 1895. We pick up this narrative 7 years later when the well‐known Julius Wagner v. Jauregg published a biting critique of the then current psychiatric genetics' literature. In 1905, partially in response to Wagner v. Jauregg, Otto Diem attempted to replicate and extend Koller's study. Wagner v. Jauregg then wrote a follow‐up to his earlier critique in 1906, commenting on Diem's investigation. Themes discussed in this point‐counterpoint included the necessity of statistical methods to draw meaningful conclusions about the impact of hereditary burden on mental illness, the required sample size and proper selection of controls, the classes of relatives which should optimally be studied, the problems of obtaining accurate information on familial illnesses, the nature of the disorders in families which contribute to mental illness risk and the common unquestioned dogmatic belief that insanity is very often due to hereditary causes. Both Wagner v. Jauregg and Diem spoke out forcefully against the common assumption that hereditary burden operated in a deterministic fashion and emphasized the need to consider other causes of illness.     

通痹汤联合西药治疗糖尿病足随机平行对照研究

[目的]观察通痹汤联合西药治疗糖尿病足疗效。[方法]使用随机平行对照方法,将62例住院患者按病志号抽签分为两组,对照组30例①控制血糖：胰岛素。②改善微循环：山莨菪碱＋盐酸普鲁卡因。③改善神经功能：弥可保。④降血脂：辛伐他汀类。⑤有溃疡进行局部清创,庆大霉素外敷。治疗组32例通痹汤（附子8g,地龙10g,细辛5g,牛膝20g,川芎15g,生地黄30g,玄参20g,当归15g,黄芪、双花各30g,连翘20g,红花、桂枝各10g）1剂／d,加水2000mL煎取500mL分早晚2次服用。西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、不良反应。连续治疗5疗程,判定疗效。随访3个月30例,观察皮肤颜色有无改变,溃疡有无复发或进展。[结果]治疗组显效21例,有效11例,无效0例,总有效率100．00％。对照组显效18例,有效10例,无效2例,总有效率93．33％。治疗组疗效优于对照组（P〈0．05）。随访3个月,痊愈病例中4例复发,因未规律治疗糖尿病,血糖不稳定,但对比发病时减轻。[结论]通痹汤联合西药治疗糖尿病足疗效满意。     

Evaluation of serial QRS changes during acute inferior myocardial infarction using a QRS scoring system

The evolution of changes in the QRS complex during the initial 3 days after the onset of an initial inferior myocardial infarction (MI) was studied in 82 consecutive patients. Each patient's standard 12-lead electrocardiogram was assigned points (a QRS score) according to the absolute duration of the Q and R waves and the amplitude ratios of R-to-Q and R-to-S waves. This QRS score has been demonstrated to correlate (r = 0.74) with the anatomic extent of single inferior MI. By this system, 43 patients (53% of the study group) had an initial electrocardiogram that registered a score of 0 and developed QRS points only after admission. The QRS scores of 18 additional patients (22% of the study group) changed after admission. Forty-nine score changes were noted on Day 2 and 18 on Day 3. All of these changes resulted in an increased QRS score. Alteration of the QRS complex during initial inferior MI evolves over 2 to 3 days in many patients. There is a distinct pattern to this evolution, which results in sequential increases in a QRS score based upon electrocardiographic indicators of the extent of myocardial necrosis. This QRS scoring system might be applied to evaluate clinically interventions aimed at limiting the extent of necrosis in patients with initial acute inferior MI.     

颈动脉内膜中层厚度对糖尿病足溃疡创面的影响

目的探讨颈动脉内膜中层厚度(IMT)对糖尿病足溃疡创面的影响。方法选取糖尿病足患者181例,未合并糖尿病足2型糖尿病患者62例(非糖尿病足组)为研究对象,测定IMT值,糖尿病足溃疡患者按IMT值分三组:颈动脉内膜厚度正常组(IMT<0.9 mm),颈动脉内膜增厚组(IMT≥0.9 mm)及颈动脉斑块组,回顾性分析患者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血压、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、踝肱指数(ABI)、糖尿病足Wagner分级等资料。结果颈动脉内膜厚度正常组、颈动脉内膜增厚组、颈动脉斑块组糖尿病足Wagner分级依次升高,差异有统计学意义(P<0.05);随着IMT升高,患者的FBG、HbA1c、LDL-C、Cr、ABI、血压等水平均逐渐增高,差异有统计学意义(P<0.05或P<0.01);相关性分析显示IMT值与FBG、HbA1c、LDL-C、Cr、ABI、收缩压呈正相关(r分别为0.183、0.149、0.304、0.421、0.840、0.161,P均<0.05);多元回归分析显示HbA1c、收缩压、ABI为血管内膜增厚的危险因素。结论颈动脉IMT值与糖尿病足创面严重程度密切相关,IMT值越高,糖尿病足创面情况越严重,IMT值可能可作为糖尿病足创面严重程度及预后的判断指标之一。     

糖尿病足严重程度评估指标的相关性分析

目的探讨糖尿病足Wagner分级相关的评估指标。方法选取2001 年11 月-2015 年4 月于解放军空军总医院收治的1 578 例糖尿病足（DF）患者（排除1 型、特殊类型DM 足患者21 例，Wagner 0级28 例，以及数据缺失较大193 例）临床资料，依据Wagner 分级分为5 组，对5 组间资料进行方差分析、χ2检验和Spearmen 等级相关性分析。结果1 578 例DF 患者中，Wagner 1～5 级分别为73 例（4.6%）、241 例（15.3%）、280 例（17.7%）、945 例（59.9%）及39 例（2.5%）。随着Wagner 分级的增高，DF 患者的C 反应蛋白（CRP）、血沉（ESR）、铁蛋白、住院费用、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、住院时间偏高，糖尿病周围血管病变（PAD）、糖尿病周围神经病变（DPN）、糖尿病视网膜病变（DR）的发病率也偏高，而血红蛋白（Hb）及体重指数（BMI）偏低，差异有统计学意义（P <0.05）。相关性分析显示，PAD、DPN、HbA1c、FBG 及感染指标（CRP、ESR、铁蛋白）与DF严重程度呈正相关（P <0.05）；而营养指标（Hb、BMI）与DF严重程度呈负相关（P <0.05）。结论PAD、DPN、HbA1c、FBG、感染以及全身营养状况与DF严重程度相关。