一种平板流动腔重力灌流系统的力学分析

本文分析了一种采用重力灌流的平板流动腔灌流系统，并根据实验结果确定出相应的阻力系数，获得平板流动腔剪应力、雷诺数以及入口长度与流体重力灌流高度的关系。     

Noise characteristics of stainless-steel surface electrodes

Bioelectric events measured with surface electrodes are subject to noise components which may be significant in comparison with low-level biological signals such as evoked neuroelectric potentials, and myoelectric potentials. In an effort to better understand noise arising from these electrodes, electrode and measurement system noise is modelled. The effect of electrode surface area on electrode impedance and noise is studied using circular stainless-steel electrodes of varying diameters. The main contributions of the work are the development of a model for stainless-steel electrode noise as a function of electrode area, and demonstrating that, for the band-width of interest to evoked neuroelectric and myoelectric signals (8–10 000 Hz), the primary noise components are thermal and amplifier current generated. The magnitudes of both of these depend on the electrode impedance magnitude. Electrode impedance is shown to be a power function of both electrode diameter and frequency, consistent with a capacitive electrode model.     

老年转子间骨折角型钢板治疗失误和并发症分析

目的分析角型钢板治疗股骨转子间骨折中出现的各种失误和并发症,并提出预防措施。方法1990年10月以来共治疗股骨转子间骨折68例,逐例分析治疗失误的原因。结果术中操作失误致股骨外侧皮质崩裂2例;钢板刀口穿破股骨头进入髋臼1例,术后切口感染1例,共8例出现并发症,发生率14．7％。结论角型钢板治疗股骨转子间骨折效果好,但不应忽视可能发生的各种失误和并发症。     

Tension band plates have greater risks of complications in temporary epiphysiodesis

PurposeThis study aimed to compare the efficacy of decreasing leg-length discrepancy (LLD) and postoperative complications between tension band plates (TBP) and percutaneous transphyseal screws (PETS).MethodsThis retrospective study reviewed LLD patients who underwent temporary epiphysiodesis at the distal femur and/or proximal tibia from 2010 to 2017 (minimum two years follow-up). Efficacy of decreasing LLD was assessed one and two years postoperatively. Complications were classified with the modified Clavien-Dindo-Sink complication classification system. Knee deformities were assessed by percentile and zone of mechanical axis across the tibial plateau.ResultsIn total, 53 patients (25 boys, 28 girls) underwent temporary epiphysiodesis (mean age, 11.4 years). The efficacy of decreasing LLD at two years between the TBP (n = 38) and PETS (n = 15) groups was comparable. Seven grade III complications were recorded in six TBP patients and in one PETS patient who underwent revision surgeries for knee deformities and physis impingement. Four grade I and two grade II complications occurred in the TBP group. The mechanical axis of the leg shifted laterally in the PETS group and medially in the TBP groups (+7.1 percentile versus -4.2 percentile; p < 0.05). Shifting of the mechanical axis by two zones was noted medially in four TBP patients and laterally in two PETS patients.ConclusionMore implant-related complications and revision surgeries for angular deformities were associated with TBP. A tendency of varus and valgus deformity after epiphysiodesis using TBP and PETS was observed, respectively. Patients and families should be informed of the risks and regular postoperative follow-up is recommended.Level of evidenceLevel III     

The association between caudal block and urethroplasty complications of distal tubularized incised plate repair: experience from a South China National Children’s Medical Center

BackgroundThe effect of caudal block (CB) on the incidence of urethroplasty complications in hypospadias repair remains controversial. The evidence is conflicting, and some confounding bias issues need to be addressed. We sought to study a more homogenous group of distal hypospadias patients undergoing primary tubularized incised plate (TIP) repair by a senior pediatric urology surgeon in the past 2 years to examine the relationship between urethroplasty complications and the use of CB.MethodsWe reviewed our database to identify consecutive patients who had undergone hypospadias repairs by a senior director surgeon at our Center between January 2018 and November 2020. To be eligible to participate in the study, patients had to meet the following inclusion criteria: (I) have distal hypospadias; (II) have undergone a primary TIP repair; and (III) have attended follow-up appointments for a minimum period of 6 months. The primary outcome was the development of urethroplasty complications during the follow-up period. The principal variable of interest was whether or not CB was used perioperatively. The patients were categorized into a CB group (general anesthesia combined with CB) or a control group (general anesthesia only). Other potential risk factors were analyzed, including patient age at operation, patient weight, glans width, and the length of the urethral plate defect.ResultsThirty (12.2%) of the distal patients developed postoperative surgical complications. The postoperative surgical complication rates were similar between the different anesthesia groups. Weight, the length of the urethral plate length, and glans width did not contribute to the risk. Age was the only independent risk factor for postoperative surgical complications, and the complication rates increased in older patients.ConclusionsOur data from consecutive TIP repairs in distal hypospadias patients indicated no association between the use of CB anesthesia and the postoperative urethroplasty complication rate. Patients who were older in age when they underwent surgery had a higher risk of complications.     

Biomechanical activity of the growth plate

Summary The authors analyze at several levels the biomechanical activity of the epiphyseal plate.From a histologic point of view, they show the role played by the different cell layers in growth.The rapid growth of long bones is well known in animals, not entirely in human beings. The factors involved in mechanical regulation of the epiphyseal plate are analyzed according to distraction and compression stresses. Other factors have also been reported (periosteum and muscle).Analysis of the literature reveals that biomechanical activity and the factors managing growth are not well known yet.A combined effort should be made to obtain better understanding of the surgical procedures carried out in pediatric orthopedics.

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Comportement biomécanique du cartilage de croissance. Incidences cliniques

Résumé Les auteurs analysent le comportement biomécanique du cartilage de croissance à plusieurs niveaux.Sur le plan histologique ils montrent le rôle joué dans la croissance par les différentes couches cellulaires.La vitesse de croissance des os longs est bien connue chez les animaux et difficile à apprécier chez l'homme. Les facteurs intervenant dans la régulation mécanique du cartilage sont analysés en fonction des contraintes en compression et en détraction. Les autres facteurs (périoste et muscle) sont rapportés.L'analyse de la littérature montre combien le comportement mécanique et les facteurs régissant la croissance sont mal connus et mériteraient un effort de recherche conjugué pour mieux comprendre la portée des gestes chirurgicaux en orthopédie infantile.

     

Hydrolysis of Carbonates,Thiocarbonates, Carbamates,and Carboxylic Esters of α-Naphthol, β-Naphthol,and p-Nitrophenol by Human,Rat, and Mouse Liver Carboxylesterases

Thirty carbonates, thiocarbonates, carbamates, and carboxylic esters of -naphthol, -naphthol, and p-nitrophenol were synthesized and tested as substrates for liver carboxylesterases from the crude microsomal fractions of human and mouse, and purified isozymes, hydrolases A and B, from rat liver microsomes. The carbonates, thiocarbonates, and carboxylic esters of -naphthol were cleaved more rapidly than the corresponding -naphthol isomers by the mammalian liver esterases. -Naphthyl esters of acetic, propionic, and butyric acids were among the best substrates tested for these enzymes. The majority of the substrates was consistently hydrolyzed at higher rates by hydrolase B compared with hydrolase A, although the Michaelis–Menten constant (K _m) values of selected substrates differed widely with these two isozymes. Malathion was a 15-fold better substrate for hydrolase B than for hydrolase A. Compared with the corresponding carboxylates, the carbonate moiety of - and -naphthol and p-nitrophenol lowered the specific activities of the enzymes by about fivefold but improved stability under basic conditions. The optimum pH of mouse liver esterase with the acetate, methylcarbonate, and ethylthiocarbonate of -naphthol was between pH 7.0 and pH 7.6. Human and mouse liver microsomal esterase activities were about five orders of magnitude lower than the esterase activities of purified rat liver hydrolase B. A relationship between the catalytic activity of the enzymes and the lipophilicity of the naphthyl substrates indicated that (i) in the - and -naphthyl carbonate series, an inverse relationship between enzyme activity and lipophilicity of the substrates was observed, whereas (ii) in the -naphthyl carboxylate series, an increase in enzyme activity with increasing lipophilicity of the substrates up to a log P value of about 4.0 was observed, after which the enzyme activity decreased.     

胫骨外侧钢板治疗胫骨开放性骨折

目的:推荐使用胫骨外侧钢板。方法:将107例Ⅰ°、Ⅱ°开放性胫骨骨折随机分组,分别采用胫骨外侧钢板和普通加压钢板治疗,随诊1年～2.5年,比较两组术后功能和感染发生率。结果:发现两组功能评价无显著差异,但胫骨外侧钢板组感染发生率及骨髓炎发生率均明显低于普通加压钢板组(P<0.05)。结论:胫骨外侧钢板能明显降低开放性胫骨骨折的感染率和骨髓炎发生率,值得推荐。