目的 比较髓内钉附加锁定钢板与髓内钉附加钢丝环扎内固定治疗不稳定股骨粗隆下骨折的临床疗效.方法 回顾性分析自2011-01-2020-12采用髓内钉附加锁定钢板和髓内钉附加钢丝环扎治疗的45例不稳定型股骨粗隆下骨折,根据不同的治疗方式分为髓内钉附加锁定钢板组(附加钢板组,n=14)和髓内钉附加钢丝环扎组(附加钢丝组,n-31),比较2组手术时间、切口长度、透视次数、术中出血量、骨折愈合时间、术后并发症发生情况、末次随访时的Harris髋关节功能评分.结果 附加钢丝组的手术时间、切口长度、术中出血量均优于附加钢板组,差异有统计学意义(P＜0.05);附加钢板组的透视次数、骨折愈合时间均优于附加钢丝组,差异有统计学意义(P＜0.05).附加钢板组有2例术后出现并发症(14.3％),均为切口感染;而附加钢丝组有5例术后出现并发症(16.1％),其中骨折延迟愈合1例,骨折不愈合1例,切口感染3例;两组总并发症发生率差异无统计学意义(x2=0.966,P=0.644).两组末次随访时的Harris髋关节功能评分的差异无统计学意义(t=0.653,P=0.517).结论 髓内钉附加锁定钢板与髓内钉附加钢丝环扎内固定治疗不稳定股骨粗隆下骨折均可取得良好疗效,髓内钉附加锁定钢板内固定的手术时间短、术中透视次数少、骨折愈合时间短,而髓内钉附加钢丝环扎内固定的手术切口小、术中出血量少,两种固定方式各有利弊.

WKYMVm (Trp-Lys-Tyr-Met-Val-D-Met) is a synthetic hexapeptide identified as a potent agonist of FPRs. FPRs are widely expressed on the cell membrane of immune cells. Therefore, WKYMVm participates in the regulation of immune cells by activating FPRs, and plays a therapeutic role in infections, tumors, autoimmune diseases and so on. WKYMVm can promote the chemotactic migration, increase the bactericidal activity of neutrophils and monocytes. WKYMVm also regulates the number and polarization of macrophages, affects the maturation of DCs and the differentiation of T cells, and promotes the activation and chemotaxis of NK cells. These functions make WKYMVm a candidate drug for immunotherapy. In this paper, we summarize the regulatory effects and underlying mechanisms of WKYMVm on six immune cells (neutrophils, monocytes, macrophages, DCs, T cells and NK cells) to increase comprehensive understanding and promote further research on WKYMVm.

目的 探讨肘关节松解联合外固定架固定治疗肘关节僵硬的疗效.方法 回顾性分析自2018-01-2020-12采用肘关节松解联合外固定架治疗的8例肘关节僵硬,比较术前以及末次随访时的肘关节活动度、Mayo肘关节功能评分.结果 8例均顺利完成手术并获得完整随访,随访时间13～45个月,平均31.4个月.末次随访时肘关节活动度较术前增大,Mayo肘关节功能评分较术前提高,差异有统计学意义(P＜0.05).末次随访时按Mayo肘关节功能评分评价疗效8例均为优,未出现感染、肘关节不稳定等并发症.结论 肘关节松解联合外固定架固定治疗肘关节僵硬效果显著,可获得满意的肘关节活动度.

BackgroundThere is accumulating evidence support human epidermal growth factor receptor 2 (HER2)-low as a biologically distinct subtype of breast cancer. The present study was conducted to explore whether HER2-low expression will affect the clinical efficacy of cyclin-dependent kinase (CDK) 4/6 inhibitor for patients with hormone receptor (HR)-positive, HER-2 negative metastatic breast cancer.MethodsPatients with HR+/HER2- metastatic breast cancer who were treated with palbociclib from January 2019 to June 2021 were retrospectively analyzed based on real-world clinical practice. HER2-zero was defined as immunohistochemistry (IHC) 0, and HER2-low was defined as IHC 1+ or IHC 2+/fluorescence in situ hybridization (FISH) negative. The primary end point was progression free survival (PFS), and the secondary end points were objective response rate (ORR), disease control rate (DCR), overall survival(OS) and safety.Results45 patients received palbociclib plus aromatase inhibitor (AI) or fulvestrant therapy, including 24 HER-2-zero and 21 HER-2-low patients. There were no statistically significant differences in clinicopathological characteristics between the two groups. No significant differences were observed in ORR (41.7% vs. 28.6%, P=0.360) and DCR (79.2% vs. 76.2%, P=0.811) between HER-2-zero and HER-2-low patients. And simultaneously, HER2-zero and HER2-low patients obtained similar median PFS (16.2m vs. 14.1m, P=0.263). The median OS was not reached. Neutropenia and leukopenia were the most common adverse events. Grade 3-4 adverse events(AEs) occurred in 58.3% and 57.1% of patients, respectively.ConclusionsHER2-low expression does not affect the clinical efficacy of palbociclib and our present study did not support incorporating HER2-low into systemic therapy decisions for patients with HR+/HER2- metastatic breast cancer treated with CDK4/6 inhibitor.

[目的]探讨环形外固定架联合膜诱导治疗胫骨近端骨折术后感染骨缺损的临床疗效.[方法]回顾性分析2013-2020年,采用上述技术治疗胫骨近端骨折术后感染骨缺损47例患者的临床资料.Ⅰ期感染创面清创、环架固定,Ⅱ期进行植骨或骨搬移.记录患者临床及实验室检查结果.[结果]所有患者均顺利完成手术,无严重并发症.所有患者均获随访6～62个月,平均(23.62±4.54)个月,所有病灶愈合,无感染复发.随时间推移,患者的膝ROM和HSS评分显著增加(P＜0.05).实验室检测方面,术后深部创面培养出金黄色葡萄球菌共23例,里昂葡萄球菌8例,大肠埃希菌12例,鲍曼不动杆菌4例.术后6个月WBC、CRP和ESR均较术前显著降低(P＜0.05).[结论]通过环形外固定架联合膜诱导技术治疗胫骨近端术后感染骨缺损临床效果满意.

目的 比较Coflex腰椎棘突间动态稳定系统与腰椎后路椎间融合内固定(Posterior lumbar interbody fusion,PLIF)治疗单节段腰椎退行性疾病的临床疗效.方法 回顾性分析自2007-06-2012-02诊治的90例单节段腰椎退行性疾病,45例采用Coflex腰椎棘突间动态稳定系统手术治疗(Coflex组),45例采用PLIF治疗(PLIF组).比较两组手术时间、术中出血量、住院时间、邻近节段退行性改变发生率以及术前、术后3年、末次随访时的疼痛VAS评分、ODI指数,比较两组术前、末次随访时的椎间后方高度、椎间孔高度、椎间活动度、上位椎间活动度、下位椎间活动度.结果 两组均顺利完成手术并获得至少5年的随访.Coflex组手术时间、术中出血量、住院时间较PLIF少,邻近节段退行性改变发生率较PLIF组低,差异有统计学意义(P＜0.05).两组术前、术后3年以及末次随访时的疼痛VAS评分、ODI指数比较差异无统计学意义(P＞0.05).末次随访时Coflex组手术节段椎间活动度较PLIF组大,上位椎间活动度较PLIF组小,差异有统计学意义(P＜0.05);末次随访时两组椎间后方高度、椎间孔高度、下位椎间活动度比较差异无统计学意义(P＞0.05).末次随访时PLIF组椎间后方高度、下位椎间活动度较术前增加,两组手术节段椎间活动度较术前减小,上位椎间活动度较术前增加,差异有统计学意义(P＜0.05).结论 Coflex腰椎棘突间动态稳定系统与PLIF治疗单节段腰椎退行性疾病均可以获得满意的长期临床疗效.与PLIF相比,Coflex腰椎棘突间动态稳定系统手术能更好地维持手术节段活动度,降低邻近节段退行性改变的发生率.

To evaluate the efficacy of endovascular therapy in patients with unilateral arteriosclerotic renal artery stenosis using nuclide renal dynamic imaging and to analyze the influencing factors that may affect the renal function. A retrospective analysis was made on 60 patients with >70% unilateral arteriosclerotic renal artery stenosis who underwent renal artery stent implantation. Serum creatinine, urea nitrogen, renal artery color Doppler ultrasonography, and renal dynamic imaging results were obtained before and after 1 year of operation. A regression model was used to analyze the influencing factors. All patients underwent balloon dilatation and stenting of the affected renal artery. The immediate intervention success rate was 100%. The residual stenosis of the affected renal artery was less than 20%. No serious complications occurred during the perioperative period. After operation, systolic blood and diastolic blood pressures were improved (P < 0.01), the serum creatinine was stable (P = 0.25), and the degree of renal artery stenosis of the affected side was relieved significantly (P < 0.01). One year after operation, the patency rate of renal artery stent was 85%. Based on the changes of differential glomerular filtration rate of the affected side, 40 patients (66.7%) were improved while 20 patients (33.3%) were not. A linear regression analysis showed that the renal insufficiency of the affected side before operation was the only significant influencing factor (B = 0.50, P < 0.01). Renal artery stenting is safe and effective in the treatment of unilateral renal artery stenosis. One-year patency rate is 85%. Two-thirds of the patients have an improved renal function after operation. The patients with preoperative renal insufficiency of affected side are more likely to benefit from renal artery stenting.

BackgroundHeterotrophic cultivation of microalgae has been proposed as a viable alternative method for novel high-value biomolecules, enriched biomass, and biofuel production because of their allowance of high cell density levels, as well as simple production technology. Tetradesmus bernardii, a newly isolated high-yielding oleaginous microalga under photoautotrophic conditions, is able to grow heterotrophically, meaning that it can consume organic carbon sources in dark condition. We investigated the effect of different carbon/nitrogen (C/N) ratios on the growth and lipid accumulation of T. bernardii in heterotrophic batch culture under two nitrogen sources (NaNO3 and CO(NH2)(2)). In addition, we conducted time-resolved transcriptome analysis to reveal the metabolic mechanism of T. bernardii in heterotrophic culture.ResultsT. bernardii can accumulate high biomass concentrations in heterotrophic batch culture where the highest biomass of 46.09 g/L was achieved at 100 g/L glucose concentration. The rate of glucose to biomass exceeded 55% when the glucose concentration was less than 80 g/L, and the C/N ratio was 44 at urea treatment. The culture was beneficial to lipid accumulation at a C/N ratio between 110 and 130. NaNO3 used as a nitrogen source enhanced the lipid content more than urea, and the highest lipid content was 45% of dry weight. We performed RNA-seq to analyze the time-resolved transcriptome of T. bernardii. As the nitrogen was consumed in the medium, nitrogen metabolism-related genes were significantly up-regulated to speed up the N metabolic cycle. As chloroplasts were destroyed in the dark, the metabolism of cells was transferred from chloroplasts to cytoplasm. However, storage of carbohydrate in chloroplast remained active, mainly the synthesis of starch, and the precursor of starch synthesis in heterotrophic culture may largely come from the absorption of organic carbon source (glucose). With regard to lipid metabolism, the related genes of fatty acid synthesis in low nitrogen concentration increased gradually with the extension of cultivation time.ConclusionT. bernardii exhibited rapid growth and high lipid accumulation in heterotrophic culture. It may be a potential candidate for biomass and biofuel production. Transcriptome analysis showed that multilevel regulation ensured the conversion from carbon to the synthesis of carbohydrate and lipid.

目的 探讨桥接组合式内固定系统治疗股骨干骨折合并同侧股骨近端、股骨远端骨折的临床疗效.方法 回顾性分析2013年1月至2016年12月于我院骨科接受手术治疗的4例股骨干骨折合并同侧股骨近端及远端骨折病人的临床资料,其中男3例,女1例,年龄为(33.5±9.3)岁(23～44岁),闭合性骨折3例,开放性骨折1例.3例病人存在合并损伤,其中颅脑损伤1例,胸腹部损伤1例,胫骨平台及骨盆骨折1例.入院后即确诊股骨近端骨折3例,延迟诊断1例,延迟时间为5d.所有病例均采用桥接组合式内固定系统治疗.观察病人骨折愈合时间,末次随访采用Friedman?Wyman功能评分评价病人功能恢复情况.结果 病人术后均获得随访,随访时间为(33.5±16.2)个月(20～57个月),手术时间为(193.3±36.2)min(155～241 min),术中出血量为(484.3±77.4)mL(415～582 mL).2例病人骨折顺利愈合,股骨近端骨折于术后4～5个月愈合,股骨干骨折于术后6～7个月愈合,股骨远端骨折于术后5～6个月愈合.1例病人术后出现股骨头缺血性坏死,骨折愈合后将股骨内固定物全部取出,但股骨干再次出现骨折,再次手术后骨折愈合;1例病人术后出现股骨干骨不连,再次手术后骨折愈合.末次随访时Fried?man?Wyman功能评分优1例,良2例,差1例,优良率为75％.结论 股骨干骨折合并同侧股骨近端、股骨远端骨折较为罕见,股骨近端骨折漏诊率或延迟诊断率高,需要详尽的术前检查.桥接组合式内固定系统可作为治疗股骨干骨折合并同侧股骨近端、股骨远端骨折的一种选择.

股骨远端骨折是指距离股骨髁关节面连线9 cm以内的骨折,其占股骨骨折的3％～6％,占全身骨折的0.4％[1].股骨远端骨折中约85％的患者为老年患者,多见于低能量损伤,其余患者以高能量损伤、多发伤为主[2].手术治疗已成为股骨远端骨折的首选治疗方案[3],而微创经皮钢板固定技术联合外侧锁定钢板内固定是最常用的术式,具有创伤小、有利于患者康复等优点[4].然而,股骨远端骨折的愈合率并没有随着锁定钢板的普及而得到明显提高,术后因骨折延迟愈合、骨折不愈合、内固定断裂等需要再次手术干预的并发症发生率仍较高[5-6].笔者采用逆行髓内钉附加外侧锁定钢板内固定联合扩髓冲洗抽吸系统植骨治疗1例股骨远端骨折钢板内固定术后顽固性骨折不愈合,取得良好效果,报道如下.

[目的]探讨Quadrant通道下经椎旁肌间隙入路椎弓根螺钉治疗上颈椎骨折的安全性及有效性.[方法]2015年1月～2016年12月,采用Quadrant通道下经椎旁肌间隙入路微创椎弓根螺钉治疗15例上颈椎骨折患者,其中男11例,女4例;年龄19～46岁,平均(33.45±9.70)岁.受伤至手术时间1～4d,平均(2.19±1.10)d.寰椎骨折6例,枢椎骨折7例,寰枢椎骨折2例.Frankel分级:D级5例,E级10例.比较术前及末次随访的Frankel分级、日本矫形外科协会(JOA)评分、视觉模拟评分(VAS).[结果]15例患者均顺利完成手术,术中未出现脊髓损伤及椎动脉破裂等并发症.手术时间75～120 min,平均(明.13±27.85) min;术中出血量40～180 ml,平均(96.20±43.26) nl.1例患者术后出现右后枕部皮肤麻木,对症处理1周后症状消失.所有患者切口均一期愈合,无感染.术后随访12～36个月,患者神经功能完全恢复,末次随访时Frankel分级均为E级.JOA评分从术前平均(8.13±1.91)分提高至末次随访时(13.20±2.75)分,VAS评分从术前平均(7.26±1.64)分改善至末次随访时(1.202.47),差异均有统计学意义(P＜0.05).影像评估方面,术后正侧位X线片和CT检查证实损伤节段复位满意,螺钉位置良好,所有患者骨折均获骨性愈合,平均愈合时间(12.90±5.42)周.[结论]Quadrant通道下经椎旁肌间隙入路微创椎弓根螺钉治疗上颈椎骨折具有组织损伤轻、出血少和降低手术创伤导致的椎旁肌退变以及术后颈背部疼痛、僵硬的发生率等优点.

Background: This study aimed to examine a quantitative method for evaluating calcification in failure in recanalization (FR) in endovascular treatment of superficial femoral artery (SFA) chronic total occlusion, and to investigate the possibility of using a formula to predict the incidence of true lumen recanalization (TR) in such cases. Methods: Patients who met the inclusion criteria were retrospectively analyzed in our center from January 2012 to September 2017. A Calcification Lesion Analyzing and Scoring System (CLASS) was established to quantify the characteristics of calcification in SFA computed tomography slices, which were ranked as grade 1-4 and class AeE. Corresponding scores were obtained, and the Cumulative Calcification Score (CCSO) of occlusive SFA was calculated on the basis of CLASS. The factors correlating to FR and the formula for predicting TR were evaluated. Results: A total of 215 patients were included in this study. There were 150 cases of TR and 65 cases of subintimal recanalization; 12 (5.6%) cases had FR. The maximum CLASS of occlusion was correlated with FR. Not only the formula including Trans-Atlantic Inter-Society Consensus II grade and CCSO but also the formula including occlusion length and CCSO predicted the incidence of TR well. Conclusions: The degree of the most severe calcification in occlusive lesions clearly affects success in recanalization. Two quantitative formulas that combine occlusion length or TransAtlantic Inter-Society Consensus II grade with CCSO can predict TR in endovascular treatment of SFA lesions with chronic total occlusion.

目的 探讨计算机辅助设计结合手术治疗复杂浮肩损伤的临床疗效.方法 回顾性分析自2013-08--2018-02采用计算机辅助设计结合手术治疗的24例复杂浮肩损伤,术前行CAD模拟复位,建立肩部骨折损伤模型及复位后的模型,根据骨折块模拟复位结果设计完整的手术实施方案.结果 24例均顺利完成手术并获得完整随访,随访时间平均27(15--45)个月.术后1例出现肩峰撞击征,1例出现切口愈合不良,对症治疗后治愈.术中选取的钢板及螺钉安放位置、钢板与螺钉的长度及数量基本与术前模拟结果相符.24例均骨性愈合,骨折愈合时间平均4.6个月.宋次随访时Con-stant-Murley评分平均86.4(56-97)分,其中活动,其中活动范围评分26-38分,平均33.6分;疼痛评分5～15分,平均12.3分;肌力评分15-25分,平均22.3分;日常活动评分10～20分,平均18.2分.Herscovici评分:优13例,良9例,可2例.结论 计算机辅助设计结合手术治疗复杂浮肩损伤可以缩短手术时间,减少手术创伤,指导术中快速正确复位固定,术前可依据不同病情及模拟结果制定个体化、精确化手术方案.

BACKGROUND Microalgae biotechnology is considered as a promising way to recover nutrients from centrate wastewater for value-added biomass production, but it is rarely adopted in a real-world application. Current study confirmed that carbon deficiency and suspended solids are two problems jeopardizing the microalgae-based wastewater remediation. In this regard, glycerol was added into centrate wastewater as exogenous carbon source and algal-bacterial cooperation for nutrients recovery assessment. RESULTS The results showed that glycerol addition increased the biomass yield of algae from 1.54 to 2.58 g L-1 in 5-day culture and, at the same time, improved the removal efficiency of nitrogen and phosphorus, which were further assessed by pilot-scale experiments. Bacterial community analysis indicated that algal-bacterial cooperation involves carbon dioxide and oxygen exchange, phosphorus absorption, and solid organics degradation, forming a complementary nexus beneficial for wastewater treatment. CONCLUSION Glycerol is proven to be a good carbon source for microalgae growth in the centrate wastewater. Additionally, the cooperation between microalgae and bacteria plays a key role in the nutrients removal during centrate wastewater. It is expected the technology and knowledge provided by current work can further promote the industrialization of microalgae-based wastewater remediation. (c) 2020 Society of Chemical Industry

The deposal of residual hydrogen peroxide (H2O2) in Fenton-like system and the requirement of oxygen in bioreactor are essential parts for the treatment of integrative Fenton-like/bioreactor. A novel low-cost integrative Fenton-like and MnO2-filled upward flow biological filter bed (Fenton-like/MBFB) equipped with the modified ceramsite was constructed to evaluate the main properties and catalytic activity of modified ceramsite, and the optimal conditions of integrative system and compare integrative and traditional systems. In this study, the Fenton-like reactor with modified ceramsite had higher catalytic ability whose Acid Orange 7 (AO7) degradation efficiency reached to 79.3% due to large surface area and high porosity, compared with that with raw ceramsite (44.3%). Furthermore, total utilization efficiency of H2O2 in integrative system (from 32.41% to 53.51%) and removal efficiencies of COD and AO7 were remarkably improved, which would effectively decrease the waste of H2O2 and the setting of regulation pool and aeration tank. Thus, the integrative system can save 0.51 CNY/m3 in construction cost and 0.21 CNY/m3 in operating cost. The average COD removal efficiency, AO7 degradation efficiency and effluent DO concentration were achieved to 64.8%, 79.5% and 9.3 mg/L respectively in integrative system were achieved in integrative system during sixty successive runs. Also, the potential degradation pathway of contaminants was also proposed according to the OH-enhanced at Fenton-like reactor due to catalyst and adsorption of modified ceramsite and the removal of microorganisms and modified ceramsite for contaminants at MBFB. This study demonstrated the feasibility of integrative Fenton-like/MBFB filled with modified ceramsite for simultaneously decreasing operational cost and complexity and enhancing removal efficiency, thus provided a one-step alternative for refractory dye wastewater.

目的 比较椎间盘切除植骨融合内固定术与单节段椎板开窗减压髓核摘除术治疗腰椎间盘突出症伴Modic Ⅰ型改变的临床疗效.方法 回顾性分析自2012-09-2016-09诊治的86例单纯腰椎间盘突出症伴Modic Ⅰ型改变.43例采用椎间盘切除植骨融合内固定术治疗(观察组),43例采用单节段椎板开窗减压髓核摘除术治疗(对照组).比较2组术后3个月与术后2年JOA评分、ODI指数、疼痛VAS评分,术后3个月与术后3年L3、4、L4、5、L5S1腰椎活动度,比较2组椎间隙高度变化值.结果 86例均顺利完成手术并获得随访,随访时间平均36.2(12～48)个月.对照组5例复发腰椎间盘突出症,二次手术治疗后治愈.2组术后3个月及术后2年JOA评分、ODI指数、术后3个月疼痛VAS评分比较差异无统计学意义(P＞0.05),术后2年观察组疼痛VAS评分较对照组低,差异有统计学意义(P＜0.05).观察组术后3个月与术后3年L3、4、L5S1活动度均较对照组高,差异有统计学意义(P＜0.05);观察组术后3个月与术后3年L4、5活动度丧失.观察组L3、4、L5S1椎间隙高度变化值大于对照组,对照组L45椎间隙高度变化值大于观察组,差异有统计学意义(P＜0.05).结论 椎间盘切除植骨融合内固定术与单节段椎板开窗减压髓核摘除术治疗腰椎间盘突出症伴Modic Ⅰ型改变均可取得满意疗效,医师应根据患者情况个性化设计治疗方案.

目的:观察穿支皮瓣修复对手外伤软组织缺损患者创面愈合及炎性反应的影响.方法:选择2018年2月-2020年2月本院收治的84例手外伤软组织缺损患者,依据随机数字表法将其分为对照组和观察组,各42例.对照组采用胸腹带蒂皮瓣修复术治疗,观察组采用穿支皮瓣修复术治疗.对比两组临床疗效、创面愈合时间、压觉、炎性反应[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]及并发症发生情况.结果:观察组治疗优良率(90.48％)高于对照组(73.81％);创面愈合时间为(5.71±1.48)d,早于对照组;压觉为(0.39±0.13)g,低于对照组,差异有统计学意义(P<0.05).术前两组TNF-α、IL-6水平对比,差异无统计学意义(P>0.05);术后观察组TNF-α与IL-6水平分别为(0.23±0.06)、(0.87±0.26)ng/ml,均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率相比,差异无统计学意义(P>0.05).结论:穿支皮瓣修复术用于手外伤软组织缺损治疗中有利于恢复患者手部外观及功能,控制炎性反应,促进创面愈合,有利于提升手外伤软组织缺损修复效果.

2013年11月～2016年11月,我科采用胫骨远段前外侧L形锁定钢板外置固定治疗16 例少年儿童胫骨远端近踝关节骨折患者,疗效满意,报道如下. 1 材料与方法 1. 1 病例资料 本组16 例,男11 例,女5 例,年龄 6 ～16 岁. 新鲜骨折 13例,其中闭合骨折8例(5例局部皮肤软组织严重挫伤、大量水疱形成甚至皮肤破溃,3例为闭合复位失败) ,开放骨折5例( Gustilo Ⅰ型 3 例, Gustilo Ⅱ型 2例);陈旧骨折3例. 骨折波及骺板3例( Salter-Harris 分型:Ⅱ型 2 例,Ⅴ型 1例). 开放骨折患者给予急诊手术治疗;其余患者待肿胀大部分消退、局部软组织稳定后手术. 患者伤后至手术时间为2～25 d.

[目的]前瞻性比较经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗单节段骨质疏松性椎体压缩骨折(OVCF)伴椎管狭窄但无神经症状的临床疗效.[方法]2014年7月～2016年6月87例单节段骨质疏松性椎体压缩骨折伴椎管狭窄但无神经症状的患者纳入本研究,按随机数字法分为PVP组43例和PKP组44例,分别行PVP和PKP治疗.比较分析两组手术时间、骨水泥注入量、X线曝光次数、术后住院时间、并发症和VAS和ODI评分.影像测量并比较椎体平均高度、后突骨块长度、后凸角.[结果] PKP组手术时间和骨水泥注入量显著大于PVP组(P＜0.05),但两组X线曝光次数和住院时间差异无统计学意义(P＞0.05),两组术后相关并发症发生率差异也无明显统计学意义(P＞0.05).所有患者均获得24～36个月的随访,两组末次随访的VAS及ODI评分较术前均明显减少(P＜0.05),但相应时间点两组间VAS和ODI评分差异无统计学意义(P＞0.05).影像测量方面,PKP组的椎体高度恢复及后凸角矫正显著优于PVP组(P＜0.05),此外PKP组后突骨块矫正也明显优于PVP组(P＜0.05).[结论] PVP与PKP治疗伴椎管狭窄但无神经症状的单节段骨质疏松性椎体压缩骨折的临床疗效基本相近,均能取得良好临床效果,但PKP椎体高度恢复、术后后凸矫正优于PVP.

目的 探讨内外侧联合入路合并早期支具固定治疗复杂肘关节脱位的临床效果.方法 回顾性分析解放军第175医院骨科2014年1月—2016年12月收治的复杂肘关节脱位患者86例,男性53例,女性33例;年龄21～55岁.根据手术方法分为手术组54例(内外侧联合入路手术治疗)和非手术组32例(非手术治疗),对比两组术后骨折愈合时间、术后3、6个月肘关节屈伸,旋转范围以及肘关节功能评分.结果 手术组的骨折愈合时间(13.4±1.6)周,明显少于非手术组(14.7±1.8)周;术后3、6个月,手术组的肘关节屈伸、旋转度数均显著高于同期的非手术组,肘关节疼痛、活动范围、稳定性及功能评分也均显著高于同期的非手术组;术后6个月,手术组的肘关节功能优于非手术组;上述比较差异均具有统计学意义(P<0.05).结论 内外侧联合入路合并早期支具固定治疗复杂肘关节脱位对患者术后肘关节功能恢复有利,愈合时间短,促进肘关节功能恢复,值得临床上推广.