MSCT扫描重建健侧胫骨在患侧内固定材料塑形中的意义

[目的]探索一种内固定材料塑形新方法。[方法]扫描并三维重建健侧胫骨，在健侧测量患侧拟行L形钢板固定的横、纵曲线形状及各长度参数，然后利用曲线描绘工具等比例绘出2曲线。最后以2曲线为基础对L形钢板塑形。[结果]准确测量出了2曲线的形状及各长度参数，并等比例绘出了健侧2曲线，最后成功对钢板进行了塑形。[结论]该方法完全能等比例绘出拟行内固定的曲线，并对钢板进行塑形，可显著提高内固定物与胫骨表面的贴附率，缩短手术时间，提高手术疗效。部分病例健侧骨质增生可能影响塑形精度，但通过健侧仍可将内置板材塑出基本形状，术中稍微修改即可。     

分段齿形结扎合并消痔灵注射治疗环状混合痔

目的研究分析环状混合痔临床治疗效果。方法本组265例,男83例,女172例,最大年龄72岁,最小年龄33岁。手术方法:分段齿形结扎合并消痔灵注射。结果治愈211例(79.6%),基本治愈54例(20.4%),总有效率100%。结论①分段齿形结扎环状痔能防治肛门狭窄及肛门不全失禁的并发症。②消痔灵注射能消除残留内痔,并使松弛的直肠黏膜硬化、固定萎缩。③分段齿形结扎合并消痔灵注射治疗环状混合痔是目前最有效的方法。     

LISS和PFNA治疗老年人股骨转子间骨折的对比研究

目的 对比分析反向股骨远端微创内固定系统(1ess invasive stabilization system, LISS) 和股骨近端螺旋刀片抗旋髓内钉(proximal femoral nail antirotation blade, PFNA)治疗老年人股骨粗隆间骨折的临床疗效。 方法 回顾笔者医院2009年12月~2012年12月收治的48例患者。根据不同的手术方式分为:LISS组(n=24例)和PFNA组(n=24例),通过两组的手术时间、术中出血量、骨折愈合时间、Harris功能评分及相关并发症来评估两者的疗效。 结果 随访10~23个月后,两组的术后并发症、骨折愈合时间及末次随访功能评分差异无统计学意义,LISS组相对PFNA组的手术切口较长、手术时间较长、术中失血量较多。 结论 LISS和PFNA治疗股骨粗隆间骨折均可取得较好的疗效,对于老年人的股骨粗隆间骨折PFNA具有优势。     

Clinical and instrumental study of the efficacy of a new sebum control cream

Background Some botanical compounds are considered useful to reduce sebum production. Aim To evaluate the efficacy of a sebum control cream containing polyphenol‐rich extract from saw palmetto, sesame seeds, and argan oil in subjects with oily facial skin. Methods The study was carried out during the winter months (January and February). A total of 20 healthy volunteers (9 male and 11 female, aged 17–50 years, 16 with oily skin and 4 with combined skin) were studied. The test product was applied twice daily to the face for a period of 4 weeks. A clinical assessment and instrumental measurements were done before and after the treatment period. Casual sebum level on the forehead and both cheeks was determined with a photometric device (Sebumeter®). The quantity of sebum on the midforehead was determined using sebum collector foils (Sebufix®), which were then evaluated with skin camera Visioscope® and software SELS (Surface Evaluation of the Living Skin). A subjective evaluation questionnaire regarding the cosmetic characteristics, tolerance, and efficacy of the product was filled out by the volunteers at the end of study. Results The product was very well accepted by all the volunteers. A visible sebum‐regulating efficacy was reported in 95% of them. After 4 weeks of treatment, the clinical assessment scores decreased by 33%. There was a significant reduction in the casual sebum level by 20% and area covered with oily spots by 42%. The number of active sebaceous glands remained unaltered. Conclusion These results objectively and quantitatively show the efficacy of the sebum control cream tested to reduce the greasiness and improve the appearance of oily facial skin.     

Demonstration of Saw Blade Accuracy and Excursion : A Cadaveric Comparison Study of Blade Types Used in Total Knee Arthroplasty

In total knee arthroplasty, outcomes partly depend on accurate osteotomies and integrity of stabilizing structures. We compared accuracy and excursion between a conventional and an oscillating tip saw blade. Two sets of osteotomies were made on cadaveric knees. Bi-planar accuracy was compared using computer navigation, and excursion was compared using methylene blue. Wilcoxon-Mann–Whitney testing demonstrated no significant difference in blade accuracy (p = 0.35). Blades were within 0.5 degrees of neutral coronally and 2.0 degrees sagittally. The oscillating tip blade demonstrated less dye markings on the surrounding tissues. Accurate osteotomies and soft tissue protection are critical to successful arthroplasties. Although comparative accuracy was equal, the oscillating tip blade exhibited less excursion displaying potential for less iatrogenic soft tissue injuries leading to catastrophic failure.     

Piezoelectric tools versus traditional oscillating saw for distal linear osteotomy in hallux valgus correction: Triple-blinded,randomized controlled study

BackgroundThe main goal of the surgical correction of the hallux valgus is the morphological correction associated with the functional rebalancing of the first ray. The aim of this triple-blinded, randomized controlled study was to show the efficacy of piezosurgery in performing distal linear osteotomy of the first metatarsal bone in HV correction, in terms of clinical and radiological outcomes at 1-year final follow up.Methods and materialsThis study was performed collecting prospectively pre-operative and post-operative data for all patients. 34 patients were included in the trial and were randomly allocated (1:1) in a Piezoelectric Group (PG) that involved the use of piezoelectric tools and in a Control Group (CG) that provided for the use of a traditional oscillating saw. In both groups, all patients were treated with a distal linear osteotomy of the first metatarsal bone. Clinical and radiographic assessments were performed.ResultsThe AOFAS score between the two groups was similar pre-operatively and during the follow-up period, with a slight superiority in the PG at each evaluation. The osteotomy surgical time was registered for both groups. Among the endpoints of the study, the radiological bone healing time was independently assessed by a radiologist that reported a lower mean value in the piezoelectric group compared with the control group.ConclusionsThis trial has shown that piezoelectric surgery is not inferior to traditional methods from the clinical-functional point of view, but can even lead to an evident reduction of bone healing time with a statistical significance.Level of evidenceLevel I.     

经口内切口行下颌角及骨外板截除的面下部轮廓整形术

目的探讨经口内切口行下颌角及骨外板截骨术对面下部轮廓的治疗效果。方法在鼻气管插管全身麻醉下,对68例因下颌角肥大致方形脸的患者行口内切口定位,并肿胀麻醉,充分显露下颌截骨区,直视下用来复锯行下颌角和部分下颌骨升支、水平支外板斜行截除术,颏孔周围以小圆柱磨头磨平,放置负压引流并关闭黏骨膜切口。结果所有患者术中一次性截除的骨片完整,术中及术后无大出血、血肿、感染和神经损伤等并发症发生。术后随访效果满意,切口均I期愈合。结论经口内切口行下颌角及骨外板斜行截骨的手术操作方法简单、安全,手术时间短且效果良好,适合大部分情况的下颌角肥大的治疗,值得临床推广。     

一种新型股骨近端髓内内固定系统的设计

目的：设计一种新型股骨近端髓内内固定系统,以更好地固定骨折部位,最大程度上减少骨骼和周围组织损伤。方法：以螺旋刀片和主钉为基础,提供抗旋转和成角稳定性,采用解剖型设计和可屈性设计,易于主钉插入并避免受力集中。螺旋刀片设计成宽大刀面,尽可能多地压缩周围骨质,增大抓持力;主钉设计成外侧6°偏角,便于从大结节顶点置入,主钉外侧削薄处理,以减少对股骨近端外侧的压力,防止外侧劈裂。结果：经过临床测试,该新型股骨近端髓内内固定系统锁能够为股骨近端髓内实现有效的内固定。结论：该新型股骨近端髓内内固定系统非常适合股骨近端骨折的微创治疗。     

锯叶棕果实提取物治疗BPH引起的下尿路症状疗效观察

目的:探讨锯叶棕果实提取物治疗BPH引起的下尿路症状的疗效。方法:采用锯叶棕果实提取物单药治疗30例前列腺增生伴下尿路症状患者8周,分别比较患者治疗前后的最大尿流率、前列腺体积、剩余尿量、IPSS评分及QOL评分的变化情况。结果:治疗8周后,患者的最大尿流率、剩余尿量、IPSS评分及QOL评分均有明显改善,前列腺体积则无明显变化。所有患者均无明显不良反应。结论:锯叶棕果实提取物能有效改善BPH患者的下尿路症状。