Intrapelvic migration of hip lag screw of proximal femoral nail-sequele to a paradoxical reverse Z effect and their critical analysis

A 40-year-male treated with hip screw for unstable inter trochanteric fracture femur, had an implant failure after an aggressive therapy session .The Dynamic Condylar Screw was removed and fracture was fixed with Proximal Femoral Nail. The nail also failed to achieve its goal of fracture union, as a result of a unique type of reverse Z effect, in contradiction to expected Z effect resulting in intrapelvic migration of proximal hip lag screw of the proximal femoral nail.     

Smoking cessation increases the resistance of low-density lipoprotein to oxidation

The effects of smoking cessation on the susceptibility to oxidation of low-density lipoprotein (LDL) was investigated in 14 men who quit smoking for 3 months. LDL was isolated and susceptibility of LDL to V-70 (4-methoxy-2,4-dimethylvalerinitrile)-mediated oxidation was assessed by measuring conjugated diene production at 234 nm, the lag phase being a measure of the resistance of LDL to oxidation. The mean duration of the lag phase became 1.9-fold longer after 3 months (P<0.001). The result suggests that the increase in resistance of LDL to oxidation contributes to the reduction of the risk of coronary heart disease by smoking cessation.     

经坐骨小切迹髋臼后柱打钉入路的应用解剖与导向器研究

目的为经坐骨小切迹髋臼后柱打钉入路提供解剖依据。方法用66侧成人髋骨标本,男36侧,女30侧;CT扫描男、女各30例骨盆,图像用Mimics软件行三维重建。根据坐骨小切迹的形态进行分型。结果髋骨标本分型:男性")"型44.4%;"C"型30.6%;"『"型16.7%;"丿"型8.3%。女性")"型73.3%;"C"型占3.3%;"『"型占6.7%;"丿"型1%。Mimics三维重建分型:男性")"型56.7%;"C"型26.7%;"『"型13.3%"丿"型3.3%。女性")"型76.7%;;"C"型10.0%;"『"型6.7%;"丿"型6.7%。结论坐骨小切迹"C"型时,坐骨小切迹的下端影响打钉,要用骨刀切下坐骨小切迹下端,打入导针;如坐骨小切迹为"『"型时,打导针易打滑,需要在坐骨小切迹的进钉点做一个台阶。     

维生素B12滴眼液联合视觉训练治疗调节性视疲劳患者的临床疗效分析

目的研究调节性视疲劳患者采用维生素B12滴眼液联合视觉训练治疗的疗效。方法669例调节性视疲劳患者,根据治疗方法不同分为对照A组、对照B组、研究组,每组223例。对照A组采取视觉训练,对照B组采取维生素B12滴眼液治疗,研究组实施维生素B12滴眼液联合视觉训练治疗。比较三组治疗效果、眼部不适症状评分、症状积分、泪液分泌情况。结果研究组治疗总有效率91.93%高于对照A组的78.48%和对照B组的76.23%,差异有统计学意义(P<0.05)。研究组头痛、眼及眼眶周围胀痛、记忆力减退、近距离工作不能持久评分分别为(10.52±1.85)、(9.65±1.69)、(8.52±1.58)、(7.63±1.46)分,均低于对照A组的(16.58±2.36)、(15.63±2.15)、(14.42±2.06)、(16.87±2.05)分和对照B组的(15.84±2.42)、(16.63±2.06)、(13.98±2.14)、(17.63±2.14)分,差异具有统计学意义(P<0.05)。治疗前三组患者症状积分比较,差异无统计学意义(P>0.05);治疗后,研究组症状积分(8.52±2.51)分低于对照A组的(16.08±2.36)分、对照B组的(15.85±2.45)分,差异具有统计学意义(P<0.05)。治疗前,三组患者每5分钟泪液分泌量比较,差异无统计学意义(P>0.05);治疗后,研究组每5分钟泪液分泌量(17.52±1.54)ml多于对照A组的(14.24±2.54)ml和对照B组的(14.63±2.45)ml,差异具有统计学意义(P<0.05)。结论对于调节性视疲劳患者可采取维生素B12滴眼液与视觉训练治疗,患者相关症状均明显改善,治疗效果显著,值得应用。     

Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods

Background  No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to these three key issues, we report our experience of managing 27 patients with ipsilateral femoral neck and shaft fractures by using two different treatment methods, i.e., reconstruction-type intramedullary nailing and various plate combinations. Materials and methods  We divided patients into two groups. Group I included 15 patients (13 males and 2 females) who were operated with cancellous lag screws or dynamic hip screws (DHS) for fractured neck and compression plate fixation for fractured shaft of the femur. Group II included 12 patients (11 males and 1 female) who were operated with reconstruction-type intramedullary nailing. Results  Mean age was 33.2 and 37.9 years in group I and II, respectively. Mean delay in surgery was 5.9 and 5.4 days in group I and II, respectively. Average union time for femoral neck fracture in groups I and II were 15.2 and 17.1 weeks, respectively; and for shaft fracture these times were 20.3 and 22.8 weeks, respectively. There were 13 (86.6%) good, 1 (6.7%) fair and 1 (6.7%) poor functional results in group I. There were 10 (83.3%) good, 1 (8.3%) fair and 1 (8.3%) poor functional results in group II. Conclusions  Both of the treatment methods used in the present study achieved satisfactory functional outcome in these complex fractures. Fixation with plate for shaft and screws or DHS for hip is easy from a technical point of view. Choice of the treatment method should be dictated primarily by the type of femoral neck fracture and the surgeon’s familiarity with the treatment method chosen. The femoral neck fracture should preferably be stabilized first, and a delay of 5–6 days does not affect the ultimate functional outcome.     

Medial migration of lag screw after gamma nailing

Fractures of the proximal femur are common in the elderly population. Intramedullary nailing has become the standard treatment for intertrochanteric fractures although several extramedullary implants (e.g. dynamic hip screw (DHS), blade plate, locking compression plate (LCP), etc.) exist. However, despite this being a very common operation in traumatology, there are numerous associated complications. We report the rare complication of the migration of the medial lag screw into the pelvis at five and a half weeks postoperatively. The implant was removed and replaced by a total hip arthroplasty with simultaneous grafting of the acetabular defect and strapping of the greater trochanter. The evolution was favourable. We also present a review of the literature and analyze our case.     

不同的多焦点可调节人工晶状体视觉效果比较

目的研究Tetraflex可调节、ReSTOR＋3D及Tecnis多焦点3种人工晶状体植入后的视觉效果。方法双眼植入同一类型人工晶状体，有完整记录及问卷调查结果。而且随访时间3～6个月者38例（76眼），按植入的人工晶状体类型分为3组。Tetraflex可调节人工晶状体组13例（26眼），ReSTOR＋3D人工晶状体组14例（28眼），Tecnis多焦点人工晶状体组11例（22眼）。结果高照度裸眼远视力：3组之间无明显差别（P〉0．05）。低照度裸眼远视力：Tetraflex及Tecnis明显优于ReSTOR＋3D（P〈0．05）。裸眼中间视力（以70em为准）：Tetraflex优于ReSTOR＋3D及Tecnis（P〈0．05）。裸眼近视力（以阅读距离30cm为准）：Tecnis优于ReSTOR＋3D及Tetraflex（P〈0．05）。夜间眩光及光晕：Tecnis及Tetraflex抱怨较少，ReSTOR＋3D较多（P〈0．05）。患者对阅读的满意度：Tecnis及ReSTOR＋3D抱怨较少，而Tetraflex则抱怨较多（P〈0．01），主要是随着时间的推移，近视力有所下降。结论3种人工晶状体各有优缺点，但是作为老视眼矫正的选择，目前还没有一种能够真正满足每位患者需要的人工晶状体，因此只能根据不同患者的实际情况来选择合适的人工晶状体。     

彩色多普勒血流系统中血流参数的算法分析

目的 本文通过讨论处理多普勒信号的常用算法：自相关法，AR模型法，希望找到一种性能较好的算法。方法 利用仿真数据以及取自人体的真实数据对算法进行仿真比较。结果 通过几组仿真数据的比较可看出，二者的中心频率估计差别不大，但AR模型法的分辨率及方差性能明显优于自相关法。由于CFM计算时数据较短（通常为8—16个），因此用自相关法估计方差时，谱展宽现象严重。结论 经典功率谱估计方法的方差性能较差，分辨率较低。     

利福定在大鼠离体肠囊内吸收机制研究

利福定从大鼠离体肠囊粘膜侧向浆膜侧的扩散为被动扩散过程,并需要一定时间。小肠各部位的理论延滞时间平均为31.4min,直肠部位为42.2min。     

儿童调节性内斜视临床观察

目的观察儿童屈光性调节性内斜视戴镜后的眼位、屈光度、视力及双眼单视功能情况。方法搜集106例调节性内斜视儿童,准确验光后即时配戴全矫正眼镜,随访观察4年,并进行回顾性分析。结果观察6个月以上,眼位正位者91例,占85.85%;部分性调节性内斜视,带全矫眼镜6个月以上,远视度数由初时的＋6.5 4D,下降为4年后的＋5.0 2D。视力由初诊时的0.36上升到4年后的0.82。结论调节性内斜视的治疗是一个综合治疗过程。既要注重眼位的矫正、又要进行弱视治疗,同时注意建立双眼单视功能。