三种不同内固定方法治疗髌骨粉碎性骨折的疗效比较

目的:探讨三种不同内固定方法治疗髌骨粉碎性骨折的疗效。方法:对92例髌骨粉碎性骨折的患者临床资料进行回顾性分析,分为克氏针张力带治疗组30例(A组),钢丝环扎治疗组31例(B组),镍钛聚髌器治疗组31例(C组),并对3组的治疗效果进行比较。结果:三组患者的骨折均临床愈合,平均愈合时间4个月,三组的优良率分别为83.3%、80.6%和96.8%。结论:镍钛聚髌器用于髌骨粉碎性骨折的治疗明显优于其他两种方式,是较为理想的内固定方法。     

髌骨接骨板结合钢丝治疗髌骨粉碎性骨折

目的:探讨髌骨接骨板结合钢丝治疗髌骨粉碎性骨折的临床疗效。方法:回顾32例手术患者的临床病例。结果:其中1例术后内固定物松脱,余均收到良好的治疗效果。结论:髌骨接骨板联合钢丝治疗髌骨粉碎性骨折是一种理想的手术方式。     

张力带钢丝结合记忆合金髌骨爪治疗髌骨粉碎性骨折的疗效分析

目的探讨张力带钢丝结合记忆合金髌骨爪治疗髌骨粉碎性骨折的临床疗效。方法 2009年2月—2012年2月,该院采用张力带钢丝结合记忆合金髌骨爪治疗的48例髌骨粉碎性骨折患者,其中男33例,女15例,术后对所有患者进行随访,观察骨折愈合情况及膝关节功能恢复情况。结果所有患者均获得随访,随访时间为10~24个月,平均17个月,所有患者骨折均愈合,根据膝关节活动评价标准,术后优良率为97.9%。结论采用张力带钢丝结合记忆合金髌骨爪治疗髌骨粉碎性骨折,不仅能够固定和复位粉碎性骨折,而且能防止骨折移位,骨折愈合率高,并发症少,有利于膝关节功能恢复。     

经皮空心钉把持闭合复位法治疗髌骨骨折的临床研究

目的根据目前的微创技术治疗髌骨骨折的手术特点,针对闭合复位困难及维持复位困难的问题,探讨经皮空心钉把持闭合复位法治疗髌骨骨折的设想。方法按照收入院顺序交替分为2组。观察组、对照组各11例,观察组采用经皮空心钉把持闭合复位方法;对照组采用常规闭合复位方法;观察手术时间、住院时间、术中出血量,分别统计两组患者治疗效果,比较两组患者远期关节功能。结果经过术后6~12个月跟踪随访,观察组住院时间、手术时间、术中出血量少于对照组。远期疗效:观察组和对照组6个月后远期临床总有效率均为100%,无显著差异。结论髌骨骨折经皮空心钉把持闭合复位法,降低了闭合复位的难度,不受伤后时间限制,缩短了住院时间、手术时间,为髌骨骨折的治疗提供了一种新的复位方法,在临床医学领域具有广泛推广应用价值。     

再生方治疗低危骨髓增生异常综合征临床研究

目的：观察中药再生方治疗治疗低危MDS的疗效及安全性。方法2008年2月至2010年7月低危MDS60例,按WHO诊断和分型,其中RA12例,RCMD42例,RAS2例,MDS-U 4例。随机分为再生方组与对照组,每组30例。再生方组应用再生方,水煎服,日一剂。对照组给予司坦唑醇,2 mg,3次/d,口服,或十一酸睾丸酮40 mg,2次/d,口服。治疗期间患者如有感染发热及时应用抗菌药物,贫血严重或出血明显时输注红细胞悬液或血小板,并统计血细胞输注数量。结果再生方组完全缓解3例、部分缓解3例、血液学改善14例,总有效率66 T．7％。对照组部分缓解2例、血液学改善9例,总有效率36．7％。2组疗效比较差异有统计学意义（χ2＝5．41, P ＜0．05）。细胞形态观察,中药再生方治疗低危MDS,可以使红系病态造血减轻。再生方组红细胞输注量为（15±10）U,对照组为（22±15）U,2组比较红细胞输注量差异有统计学意义（ t ＝2．18, P ＜0．05）。再生方组血小板输注量为（6±4）U（1人份为1 U）,对照组为（13±6）U,2组比较差异有统计学意义（ t ＝2．31, P ＜0．05）。再生方组4例发生不良反应,发生率为13．3％,均为轻微的消化道反应,未发现肝肾功能损害。对照组30例有20例发生各种不良反应,发生率为66．7％。2组不良反应发生率差异有统计学意义（χ2＝17．78, P ＜0．01）。结论再生方治疗低危MDS有较好疗效,有效率高于雄性激素类药物,并减少红血细胞和血小板输注,无严重不良反应。形态学观察再生方可改善红系病态造血,使红细胞和血红蛋白显著改善。     

The Effect of Various Si/Al,Na/Al Molar Ratios and Free Water on Micromorphology and Macro-Strength of Metakaolin-Based Geopolymer

The current work aimed to explore the effect of Na/Al ratios of 0.43, 0.53, 0.63, 0.73, 0.83, and 0.93, using NaOH to alter the molar ratio, on the mechanical properties of a geopolymer material, with fixing of the Si/Al molar ratio. While fixing the Na/Al molar ratio, alteration of the Si/Al ratios to 1.7, 1.75, 1.8, 1.85, 1.9, 1.95 was used, with silica fume and sodium silicate as a silica corrector. The influence on the micromorphology and macro-strength of samples was characterized through SEM, EDS, and compressive strength characterization methods. The results show that Si/Al and Na/Al molar ratios play a significant role in the microstructure and mechanical behavior of MK-based geopolymers, and revealed that the optimal molar Si/Al and Na/Al ratios for attaining maximum mechanical strength in geopolymers are 1.9 and 0.73, respectively. Under various Si/Al ratios, the macro-strength of the geopolymer mainly relies on the formation of NASH gel, rather than zeolites or silicate derivatives. The appropriate Na/Al molar ratio can contribute to the geopolymerization, but a ultra-high Na/Al molar ratio caused a high alkali state that destroyed the microstructure of the geopolymers. Regardless of the amount of water contained in the initial geopolymer raw material, the water content of Si/Al = 1.65 and Si/Al = 1.75 after curing for 10 days was almost the same, and the bound water content of the final geopolymer was maintained at about 15%. Structural water exists in geological polymer gels in the form of a chemical structure. It has effects on the structural performance strength, while free water affects the volume stability of the geological polymer. Overall, the current work provides a perspective on the elemental composition analysis, combined with the molecular structure and micromorphology, to explore the mechanical performance of geopolymers.     

Functionality of protective colloids affecting the formation,size uniformity and morphology of drug-free polylactic acid microspheres

Abstract

Drug-free polylactic acid (PLA) microsphcres were prepared by an emulsitication-solvent evaporation technique using different types of protective colloids. The influence of five types of hydrophilic prolymers (polysaccharides, proteins, synthetic cellulose derivatives, synthetic nonionic polymers and surfactants) on the formation, size uniformity and morphology of PLA microspheres was investigated. Four characteristic functions (surface activity, viscosity, electric charge and interfacial film formation) of the hydrophilic polymer aqueous solutions were used to evaluate the efficacy of these protective colloids used. The results indicate that these four functions were the key parameters to achieve the formation of PLA microspheres. The best protective colloid should have high surface activity, optimum viscosity, adequate electric charge, and form an interfacial film to give a higher recovery, better size uniformity and smoother topography of the PLA microsphcres.     

Influence of morphology and drug distribution on the release process of FITC-dextran-loaded microspheres prepared with different types of PLGA

The aim of the present work was to understand the collaborative roles and the comprehensive effects of polymer nature, morphology, drug distribution and release behaviour for PLGA microspheres prepared by the double emulsion method. The morphology and drug distribution of the FITC-dextran-loaded microspheres were investigated by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), respectively. The results show that the morphology and release profiles depend on the polymer nature. For the capped PLGA RG502, the porosity, pore size and drug distribution had no pronounced influence on the release profile beyond the initial release. No significant changes in size and morphology were found and there was negligible water uptake during the release process. PEG addition as a pore maker indicated a possible way to modify the release rate at the second release stage. However, in the case of the uncapped PLGA RG503H, release profiles were dependent upon changes in porosity, pore size and drug loading. Increases in porosity, internal pore size and loading resulted in a continuous release profile. Previous studies have shown the importance of different process parameters on morphology and drug release, but in this work it is clear that polymer nature is a determining factor.     

Corn Starches as Film Formers in Aqueous-Based Film Coating

The purpose of this study was to evaluate the film formation ability and mechanical stress–strain properties of aqueous native corn starches, using free films and film coatings applied to tablets. Free films were prepared from high-amylose corn (Hylon VII), corn and waxy corn starches, using sorbitol and glycerol as plasticizers. The tablets and pellets were film-coated using an air-suspension coater, and characterized with respect to the film coating surface topography, cross-sectional structure and thickness (SEM), and dissolution in vitro. The amylose content of the starch film formers affected both the tensile strength and the elongation. The elongations were under 5% for even the plasticized starches, and in most cases, no plasticization effect was seen by either of the plasticizers. Dissolution of native corn starch film-coated tablets (weight gain 1%) did not differ from uncoated ones. A notable delay in dissolution of the drug was found by increasing Hylon VII film coating thickness, suggesting controlled-release characteristics.     

Selection suitable solvents to prepare paclitaxel-loaded micelles by solvent evaporation method

Amphiphilic block copolymer micelle is one of the most important drug delivery systems to improve the water-solubility of lipophilic drugs. Blank micelles were prepared by solvent evaporation method in order to choose the suitable solvents for PBMA-b-PMPC (poly(n-butyl methacrylate)-b-poly(2-methacryloyloxyethyl phosphorylcholine)) copolymer micelles. The selected solvents, which include chloroform/ethanol mixture and ScCO₂, were used to prepare the paclitaxel-loaded micelles. The micelles with high drug encapsulation efficiency and drug-loading content showed both narrow size distribution and regularly spherical shape. In vitro drug release studies indicated that paclitaxel could be slowly and continuously released from the micelles. More than 50% incorporated drug was released within 132?h from the micelles prepared using ScCO₂ as solvent while only 20% was released at the same period from those prepared using chloroform/ethanol mixture. In addition, the environmentally-friendly solvent, ScCO₂, was used for the first time to prepare the paclitaxel-loaded micelles during the solvent evaporation process.