西脉式环抱器用于骨折内固定术护理配合要点

目的:探讨西脉镍钛形状记忆合金环抱器用于骨折内固定术有关的护理配合问题。方法:12例不同部位骨折病人(其中男性8例、女性4例、年龄15～62岁)采用西脉镍钛(TiNi)形状记忆合金环抱器人实施内固定手术,观察术中护理配合要点和实际效果。结果:骨折复位满意,手术持续时间<2h。所有病人术后均无感染迹象,手术切口愈合良好。结论:围术期护理配合质量(如器械选择、塑形准备、无菌操作等)的优劣,是手术成功与否的重要因素之一。     

The effect of surface chemistry modification of titanium alloy on signalling pathways in human osteoblasts

Establishing and maintaining mature bone at the bone–device interface is critical to the long-term success of prosthesis. Poor cell adhesion to orthopaedic and dental implants results in implant failure. Considerable effort has been devoted to alter the surface characteristics of these biomaterials in order to improve the initial interlocking of the device and skeleton. We investigated the effect of surface chemistry modification of titanium alloy (Ti–6Al–4V) with zinc, magnesium or alkoxide-derived hydroxy carbonate apatite (CHAP) on the regulation of key intracellular signalling proteins in human bone-derived cells (HBDC) cultured on these modified Ti–6Al–4V surfaces. Western blotting demonstrated that modifying Ti–6Al–4V with CHAP or Mg results in modulation of key intracellular signalling proteins. We showed an enhanced activation of Shc, a common point of integration between integrins and the Ras/Mapkinase pathway. Mapkinase pathway was also upregulated, suggesting its role in mediating osteoblastic cell interactions with biomaterials. The signalling pathway involving c-fos (member of the activated protein-1) was also shown to be upregulated in osteoblasts cultured on the Mg and CHAP modified Ti–6Al–4V. Thus surface modification with CHAP or Mg may contribute to successful osteoblast function and differentiation at the skeletal tissue–device interface.     

Effects of fluid flow on elution of hydrophilic modifier from dialysis membrane surfaces

When uremic blood flows through dialyzers during hemodialysis, dialysis membrane surfaces are exposed to shear stress and internal filtration, which may affect the surface characteristics of the dialysis membranes. In the present study, we evaluated changes in the characteristics of membrane surfaces caused by shear stress and internal filtration using blood substitutes: water purified by reverse osmosis and 6.7 wt% dextran70 solution. We focused on the levels of a hydrophilic modifier, polyvinylpyrrolidone (PVP), on the membrane surface measured by attenuated total reflectance Fourier transform infrared spectroscopy. Experiments involving 4 h dialysis, 0-144 h shear-stress loading, and 4 h dead-end filtration were performed using polyester-polymer alloy (PEPA) and polysulfone (PS) membranes. After the dialysis experiments with accompanying internal filtration, average PVP retention on the PEPA membrane surface was 93.7% in all areas, whereas that on the PS membrane surface was 98.9% in all areas. After the shear-stress loading experiments, PVP retention on the PEPA membrane surface decreased as shear-stress loading time and the magnitude of shear stress increased. However, with the PS membrane, PVP retention scarcely changed. After the dead-end filtration experiments, PVP retention decreased in all areas for both PEPA and PS membranes, but PVP retention on the PEPA membrane surface was lower than that on the PS membrane surface. PVP on the PEPA membrane surface was eluted by both shear stress and internal filtration, while that on the PS membrane surface was eluted only by internal filtration.     

镍钛形状记忆合金血管内支架组织相容性实验研究

将锥形记忆合金支架分别植入６只猪右侧髂动脉。用以研究镍钛形状记忆合金血管内支架生物相容性，支架植入前入植入后８个月，观测动物血常规，肝肾功能以及毛发中镍钛元素含量，均无明显变化（Ｐ〉０．０５），支架植入后８个月处死动物，全身重要脏器（肝、脾、肾、肺、心、脑等）病理学检查结构正常，无淋巴细胞和单核细胞浸润，支架植入部位上游血管壁内膜光滑，内皮细胞结构正常，内弹力板完整，支架植入段为完整肉芽组织阻塞，     

Detachable shape-memory sewing ring for heart valves

The novel sewing ring concept consists of a detachable ring snap connection between valve housing or stent and suture cuff. The suture cuff itself is a memory metal ring of nickel-titanium (NiTi) that is embedded within a textile fabric torus. After a special training program the ring can assume two geometric shapes when alternately cooled and heated. Due to this physical property, the sewing ring can be safely fixed within a groove of the housing or stent by changing between room and physiological temperature. This allows the surgeon first to implant the sewing ring followed by arbitrary positioning and final fixation of the valve by the shape-memory effect. Additional advantages are an increased stiffening of the valve base for minimizing potential leaflet dysfunction, and reduced time and risk of implantation, particularly when a reoperation is necessary.     

The effect of sandblasting treatment on endurance properties of titanium alloy hip prostheses

Sandblasting is a procedure of increasing surface roughness. This treatment is common in the orthopedic field. An increased roughness may affect the endurance limit of the material. This study investigates the effect on the endurance limit of the Ti6Al4V due to two different sandblasting treatments: fine sandblasting and coarse sandblasting. Twenty hip stems, 10 finely sandblasted and 10 coarsely sandblasted, were tested under sinusoidal fluctuating bending. The staircase method was used to estimate the endurance limit of the material. The results show an important reduction in the endurance properties up to 40% for the coarsely sandblasted specimens. The failures of the sandblasted specimens were not due to material defects. Rather, the decreased endurance strength of the sandblasted stems was caused by surface defects, which act as crack initiators. By modulating the roughness with an appropriate sandblasting treatment, it is possible to limit the reduction in the endurance limit of the alloy.     

镍钛记忆合金环抱器治疗锁骨骨折利弊

锁骨骨折是临床较常见的骨折之一.近几年应用镍钛记忆合金环抱器治疗锁骨骨折的报道较多,但报道其优点较多,很少谈其缺点及不足.2005年1月～2007年1月,我科收治24例锁骨骨折患者,采用镍钛记忆合金环抱器治疗,笔者对其利弊进行分析如下.     

符合临床要求的烤瓷镍铬合金镀金技术最佳工艺参数的研究

目的:探索符合临床要求的烤瓷镍铬合金最佳镀金工艺参数。方法:根据不同参数组合将试件分为8组,每组8片,其中6片用显微观测划痕法测量镀金层的临界载荷,并用扫描电镜观察镀层截面的质地和厚度,剩余2片用牙刷磨耗试验法测试镀金层的耐磨性能。综合评价后得出符合临床要求的最佳工艺参数。结果:镀金层的临界载荷随镀金时间的增加先增大再减小;镀金电压为0.9V时随着镀金时间的增加,镀金层致密性明显增加而厚度增加不明显,镀金电压为1.0V时随着镀金时间的增加镀金层的致密性和厚度均有明显增加;参数为1.0V360s时镀金层耐磨性能最佳。结论:1.0V360s是符合临床要求的烤瓷镍铬合金镀金技术最佳工艺参数。     

Microstructure Evolution of Al6061 Alloy Made by Additive Friction Stir Deposition

In this paper, the phase structure, composition distribution, grain morphology, and hardness of Al6061 alloy samples made with additive friction stir deposition (AFS-D) were examined. A nearly symmetrical layer-by-layer structure was observed in the cross section (vertical with respect to the fabrication-tool traversing direction) of the as-deposited Al6061 alloy samples made with a back-and-forth AFS-D strategy. Equiaxed grains were observed in the region underneath the fabrication tool, while elongated grains were seen in the “flash region” along the mass flow direction. No clear grain size variance was discovered along the AFS-D build direction except for the last deposited layer. Grains were significantly refined from the feedstock (~163.5 µm) to as-deposited Al6061 alloy parts (~8.5 µm). The hardness of the as-fabricated Al6061 alloy was lower than those of the feedstock and their heat-treated counterparts, which was ascribed to the decreased precipitate content and enlarged precipitate size.     

Microstructure and Electrochemical Behavior of a 3D-Printed Ti-6Al-4V Alloy

3D printing (or more formally called additive manufacturing) has the potential to revolutionize the way objects are manufactured, ranging from critical applications such as aerospace components to medical devices, making the materials stronger, lighter and more durable than those manufactured via conventional methods. While the mechanical properties of Ti-6Al-4V parts manufactured with two major 3D printing techniques: selective laser melting (SLM) and electron beam melting (EBM), have been reported, it is unknown if the corrosion resistance of the 3D-printed parts is comparable to that of the alloy made with isothermal forging (ISF). The aim of this study was to identify the corrosion resistance and mechanisms of Ti-6Al-4V alloy manufactured by SLM, EBM and ISF via electrochemical corrosion tests in 3.5% NaCl solution, focusing on the effect of microstructures. It was observed that the equiaxed α + β microstructure in the ISF-manufactured Ti-6Al-4V alloy had a superior corrosion resistance to the acicular martensitic α′ + β and lamellar α + β microstructures of the 3D-printed samples via SLM and EBM, respectively. This was mainly due to the fact that (1) a higher amount of β phase was present in the ISF-manufactured sample, and (2) the fraction of phase interfaces was lower in the equiaxed α + β microstructure than in the acicular α′ + β and lamellar α + β microstructures, leading to fewer microgalvanic cells. The lower corrosion resistance of SLM-manufactured sample was also related to the higher strain energy and lower electrochemical potential induced by the presence of martensitic twins, resulting in faster anodic dissolution and higher corrosion rate.