ObjectiveTo explore the mechanical stability of the three-dimensional (3-D) external fixator for osteoporotic fracture so as to provide the biomechanical basis for clinical application. MethodsForty-five fresh frozen adult tibial specimens were selected to rapidly prepare the extracorporal tibia osteoporotic fracture models, and were randomly divided into 3 groups (n=15). Fractures were fixed with 3-D external fixators (3-D external fixators group), intramedullary nails (intramedullary nail group), and plate (plate group) respectively. Five specimens randomly from each group were used to do axial compression test, three-point bending test, and torsion test with microcomputer control electronic universal testing machine, then the mechanical parameters were calculated. ResultsIn the axial compression test, the displacement of 3-D external fixator group and intramedullary nail group were shorter than plate group, showing significant differences (P<0.05); but no significant difference was found between 3-D external fixator group and intramedullary nail group (P>0.05). In the three-point bending test and torsion test, the deflection and the torsional angle of 3-D external fixator group and intramedullary nail group were smaller than plate group, showing significant differences (P<0.05); but no significant difference was found between 3-D external fixator group and intramedullary nail group (P>0.05). ConclusionThe 3-D external fixator can fix fracture three-dimensionally from multiple plane and it can offer strong fixing. It is biomechanically demonstrated to be suitable for osteoporotic fracture.
ObjectiveTo review the research progress of constructing injectable tissue engineered adipose tissue by adipose-derived stem cells (ADSCs). MethodsRecent literature about ADSCs composite three-dimensional scaffold to construct injectable tissue engineered adipose tissue is summarized, mainly on the characteristics of ADSCs, innovation of injectable scaffold, and methods to promote blood supply. ResultsADSCs have a sufficient amount and powerful ability such as secretion, excellent compatibility with injectable scaffold, plus with methods of promoting blood supply, which can build forms of injectable tissue engineered adipose tissue. ConclusionIn despite of many problems to be dealt with, ADSCs constructing injectable tissue engineered adipose tissue may provide a promising source for soft-tissue defect repair and plastic surgery.
Tracheal stents are often used to maintain the patency of the trachea and bronchia in patients suffering from central airway lesions. Metallic tracheal stents are now widely used in the clinical setting, but these types of stents can cause many intractable material-related complications. Biodegradable tracheal stents are made of biodegradable polymer materials with good mechanical strength for maintaining the patency of the lesion segment during a certain period of time, and then they can be gradually degraded into harmless products in human body. Compared with conventional metallic tracheal stent, biodegradable tracheal stents have a good prospect in clinic. In this article, we review the choice of biodegradable tracheal stent materials, experimental progress in biodegradable tracheal stent as well as the challenges we are facing.
Objective To systematically review the effectiveness and safety of coronary artery bypass grafting (CABG) versus percutaneous coronary stent implantation (PCI) in the treatment of patients with unprotected left main coronary artery disease (ULMCA). Methods Databases including The Cochrane Library (Issue 2, 2012), PubMed, EMbase, CBM, CNKI, WanFang Data and VIP were electronically searched from inception to September 2012 for randomized controlled trials on the effectiveness and safety of coronary artery bypass grafting (CABG) versus percutaneous coronary stent implantation (PCI) for ULMCA; References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0. Results Four studies were included involving 1 611 cases, of which, 802 cases are in the CABG group, while 809 cases were in the PCI group. The results of meta-analysis showed that: comparing with PCI, CABG significantly reduced the postoperative repeat revascularization rate (OR=0.45, 95%CI 0.31 to 0.66, Plt;0.000 1), but there was no significant difference between the two groups in reducing the myocardial infarction incidence (OR=1.28, 95%CI 0.47 to 3.48, P=0.63), mortality rate (OR=1.36, 95%CI 0.80 to 2.34, P=0.26), and the incidence of major adverse cardio-cerebral vascular events (OR=0.92, 95%CI 0.66 to 1.28, P=0.61). Conclusion This study indicates that CABG is superior to PCI in reducing postoperative rate of target vessel revascularization. But CABG and PCI are alike in reducing myocardial infarction incidence, mortality rate, and the incidence of major adverse cardio-cerebral vascular events. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality RCTs.
目的:评价外固定支架治疗桡骨远端骨折的疗效。方法:2004年3月至2008年8月以外固定支架或辅以克氏针、可吸收螺钉内固定治疗桡骨远端骨折３7例。结果:31例获得4～28 个月(平均14 个月)的随访,所有骨折均临床愈合,平均愈合时间8周。腕关节功能按Sarmiento标准进行评定,优17例,良9例,可4例,差1例,优良率839%。结论:外固定支架治疗桡骨远端骨折疗效可靠,值得推广。
目的:探讨带膜支架腔内隔绝术治疗B型主动脉夹层的技术方法及疗效。方法:对近年我院收治的40例主动脉夹层进行分析。40例患者均行股动脉穿刺插管至升主动脉造影，了解主动脉真假腔、夹层裂口及其与重要血管分支位置关系。切开右或左侧股动脉置入覆膜血管内支架，封堵原发破口，置入支架后重复造影检查。观察真假腔血流变化、主动脉分支供血的情况。结果:40例患者支架置入定位准确，术后即刻造影显示真腔血流恢复正常。手术成功率100%，无术中转开胸手术，无截瘫及瘤体破裂等严重并发症，无围手术期死亡。所有患者术后3～6个月复查增强CT，假腔不再显影，支架通畅，无扭曲、移位。结论:带膜支架腔内隔绝术治疗B型主动脉夹层具有创伤小，术后恢复快，手术死亡率低，手术成功率高的优点，但远期效果有待进一步观察。
目的：探讨覆膜支架治疗外伤性颈内动脉海绵窦瘘（TCCF）的临床治疗经验。方法：11例TCCF经血管内介入治疗，1例外伤性颈内动脉海绵窦瘘患者复发，压迫颈总动脉无效，行球囊闭塞颈内动脉及瘘口。结果：术后杂音立即消失，数天后结膜水肿消退，造影见瘘口完全闭塞，10例TCCF患者颈内动脉保持通畅。1例患者颈内动脉闭塞。无操作所产生的并发症出现。结论：覆膜支架是处理TCCF的有效手段；瘘口再通可能与支架移位、贴壁不良有关。压迫颈总动脉对再通瘘口的治疗无效。