简介:摘要目的比较Tight Rope联合锚钉固定与单纯Tight Rope固定治疗重度肩锁关节脱位的临床效果。方法回顾性研究。纳入2017年4月—2020年12月南京医科大学附属逸夫医院骨科收治的45例重度肩锁关节脱位患者临床资料,其中男30例、女15例,年龄25~61(47.8±10.5)岁。按照Rockwood分型:Ⅳ型31例,Ⅴ型14例。根据患者手术方法不同分为2组,采用Tight Rope联合锚钉固定治疗25例为Tight Rope+锚钉组,其中男17例、女8例,年龄25~60(48.1±9.9)岁;采用单纯Tight Rope固定治疗20例为Tight Rope组,其中男14例、女6例,年龄27~61(47.4±10.8)岁。比较2组患者临床基线资料、手术切口长度、手术时间、住院时间,以及术后伤口感染、关节活动受限、内固定松动等并发症发生情况。术后3个月,采用疼痛视觉模拟评分法(VAS)评价患肢疼痛程度,应用Constant-Murley评分(CMS)、美国加州大学洛杉矶分校(UCLA)肩关节评分系统评价肩关节功能;同时拍摄肩关节正位及改良Alexander位X线片,评定锁骨的垂直稳定程度和水平稳定程度。结果2组患者年龄、性别、受伤部位、受伤原因、受伤至手术时间等基线资料比较差异均无统计学意义(P值均>0.05)。2组患者均顺利完成手术,术中无相关并发症发生。2组手术切口长度、手术时间、住院时间差异均无统计学意义(P值均>0.05)。Tight Rope+锚钉组1例患者术后出现切口愈合不良,予相应处理后愈合良好。45例患者术后均获随访,随访时间6~26个月。随访期间2组患者均无关节活动受限、内固定松动等并发症发生。术后3个月,Tight Rope+锚钉组患肢疼痛VAS评分低于Tight Rope组,CMS评分、UCLA评分均高于Tight Rope组,差异均有统计学意义(t=2.96、14.16、18.26,P值均<0.01)。术后3个月影像学评估锁骨的垂直稳定程度,Tight Rope+锚钉组优20例、良5例,优良率为100.0%(25/25),Tight Rope组优10例、良8例、差2例,优良率为90.0%(18/20),差异无统计学意义(χ2=2.62,P=0.106);锁骨的水平稳定程度,Tight Rope+锚钉组优20例、良5例,优良率100.0%(25/25),Tight Rope组优5例、良10例、差5例,优良率75.0%(15/20),Tight Rope+锚钉组优良率高于Tight Rope组,差异有统计学意义(χ2=7.03,P=0.008)。结论Tight Rope固定联合锚钉固定治疗重度肩锁关节脱位效果可靠,可有效减少术后的疼痛,提高锁骨的水平稳定程度和肩关节功能。
简介:摘要目的探讨微小切口复位Tight Rope纽扣钢板内固定治疗急性Rockwood Ⅲ型肩锁关节脱位的临床效果。方法回顾性研究。纳入无锡市中医医院骨科2015年1月—2018年1月诊治的56例急性Rockwood Ⅲ型肩锁关节脱位患者的临床资料。采用微小切口复位Tight Rope纽扣钢板内固定治疗27例(微创组),其中男19例、女8例,年龄32~56(49.11±2.26)岁;采用传统切开复位Tight Rope纽扣钢板内固定治疗29例(切开组),其中男17例、女12例,年龄35~57(48.24±2.53)岁。比较两组患者的基线资料、手术切口长度、手术时间、术中出血量,以及疗效和并发症;术后3个月,采用Karlsson标准进行疗效评价;分别于手术前和术后3、6、12个月,应用Constant评分评价肩关节功能,采用VAS评价患肢疼痛程度;分别于术后第3天、术后6个月拍摄X线片,比较两组复位丢失情况。结果两组患者年龄、性别、受伤部位、受伤机制、受伤至就诊时间等基线资料比较差异均无统计学意义(P值均>0.05)。微创组患者术中出血量(27.89±5.87)mL、切口长度(0.98±0.25)cm,均小于对照组[(43.79±6.36)mL和(4.86±0.46)cm],差异均有统计学意义(t=9.701、38.801, P值均<0.01);两组患者手术时间、术后住院时间差异均无统计学意义(P值均>0.05)。术后3个月微创组疗效优12例、良11例、差4例,治疗有效率85.19%(23/27);切开组优15例、良10例、差4例,治疗有效率86.21%(25/29):组间比较差异无统计学意义(Z=0.310, P>0.05)。56例患者术后均获随访,随访时间13~39(中位数27)个月。随访期间微创组出现并发症1例(3.70%),切开组5例(17.24%),差异无统计学意义(P>0.05)。两组术前Constant评分、VAS比较差异均无统计学意义(P值均>0.05);微创组术后3、6、12个月Constant评分高于切开组,VAS低于切开组,差异均有统计学意义(P值均<0.05)。两组患者术后第3天、术后6个月复查X线片,测量喙锁距离比较差异均无统计学意义(P值均>0.05),微创组喙锁距离平均复位丢失与切开组比较差异亦无统计学意义(P>0.05)。结论微小切口复位Tight Rope纽扣钢板内固定术治疗Rockwood Ⅲ型肩锁关节脱位效果可靠,可有效减小手术创伤和患者术后疼痛程度,利于术后肩功能恢复。
简介:Tightfocusingofaxiallysymmetricpolarizedvortexbeamsisstudiednumericallybasedonvectordiffractiontheory.Themathematicalexpressionsforthefocusedfieldsarederived.Simulationresultsshowthatthefocusedfieldsandphasedistributionsatfocusarelargelyinfluencedbyboththepolarizationorderandtopologicalchargeoftheincidentbeams.Moreover,focalspotswithflat-toppedortightly-focusedpatternscanbeflexiblyachievedbycarefullychoosingthepolarizationorderandthetopologicalcharge,whichconfirmsthepotentialofsuchbeamsinwideapplications,suchasopticaltweezers,laserprinting,lithography,andmaterialprocessing.
简介:AbstractAtopic dermatitis (AD) is a chronic inflammatory skin disease with xerosis, itchiness, as well as interconnection with immunoglobulin E (Ig E), mediated foods including airborne allergies. AD is not only related to the diminished stratum corneum barrier but also presents with an unusual expression of tight junctions (TJs) proteins. TJ barrier dysfunction leads to impairment in the stratum corneum (SC) barrier. The significant role of TJs in the epidermal barrier as indicated by Claudin-1 (Cldn-1) deficient mice that undergo high transepidermal water loss (TEWL) and skin dehydration. In atopic dermatitis, downregulation of Cldn-1 was observed due to inflammation. Still, a lack of distinct understanding exists in considering tight junction barrier impairment as a cause or outcome in atopic dermatitis. This review summarizes TJs main role in skin barrier function and TJ proteins (TJPs) expression observed in AD patients.
简介:Inthisarticle,weintroduceanotionofnonuniformwaveletframesonlocalfieldsofpositivecharacteristic.Furthermore,wegaveacompletecharacterizationoftightnonuniformwaveletframesonlocalfieldsofpositivecharacteristicviaFouriertransform.OurresultsalsoholdfortheCantordyadicgroupandtheVilenkingroupsastheyarelocalfieldsofpositivecharacteristic.
简介:AKondomodelinasquaretight-bondinglatticeofconductionelectronsisconsidered.TheKondointeractiontakesad-wave.Usingmean-fieldtheoryandnumericalsimulations,itisfoundthatthereisapseudo-gapfortheimpuritydensityofstatesattheFermilevel.Numericalresultsalsoshowthattheexponentsofthelowtemperaturethermodynamicquantitiesarenon-universalbutdependentontheinteraction.
简介:Itisprovedthatevery3-connectedlooplessmultigraphhasmaximumgenusatleastone-thirdofitscyclerankplusoneifitscyclerankisnotlessthanten,andifitscyclerankislessthanten,itisupper-embeddable.Thislowerboundistight.Thereareinfinitelymany3-connectedlooplessmultigraphsattainingthisbound.
简介:Thefocusingofaradiallypolarizedbeamwithoutannularapodizationoraphasefilterattheentrancepupiloftheobjectiveresultsinawidefocusandlowpurityofthelongitudinallypolarizedcomponent.However,thepresenceofaphysicalannularapodizationorphasefiltermakessomeapplicationsmoredifficultorevenimpossible.Weproposearadiallypolarizedandamplitude-modulatedannularmulti-Gaussianbeammode.Numericalsimulationshowsthatitcanbefocusedintoasharperfocalspotof0.125λ~2withoutadditionalapodizationsorfilters.Thebeamqualitydescribingthepurityoflongitudinallypolarizedcomponentisupto86%.
简介:在Ziliujing形成的Daanzhai成员的紧密的石灰石的毛孔结构,侏罗记系统在中央四川盆,中国,对紧密的油的探索和发展复杂却必要。紧密的石灰石的毛孔结构被使用扫描电子学习显微镜学(SEM),氮吸附,高压的水银侵入,和原子磁性的回声(NMR)。试验性的结果建议毛孔主要是裂缝毛孔和mesopores和macropores贡献毛孔卷和特定的表面。排水量压力,平均毛孔尺寸,和有孔和渗透和罐头的同质系数相互关联被用来评估毛孔结构。完整的毛孔尺寸分发被联合氮吸附和高压的水银侵入获得。我们发现石灰石主要与250nm的直径包含mesopores。T2分发被变换成毛孔尺寸分发,很好匹配完整的毛孔尺寸分发。在T2和毛孔尺寸之间的关系与毛孔结构和罐头遵守一条幂定律和T2相互关联的几何平均数在毛孔结构评估被使用。