简介：AbstractPurpose:By comparing the outcomes of total hip arthroplasty with hemiarthroplasty in elderly patients with a femoral neck fracture to investigate the one-year mortality, dislocation, infection, reoperation rate, and thromboembolic event.Methods:The PubMed, EMBASE databases, and Cochrane library were systematically searched from the inception dates to April 1, 2020 for relevant randomized controlled trials in English language using the keywords: "total hip arthroplasty" , "hemiarthroplasty" and "femoral neck fracture" to identify systematic reviews and meta-analyses. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’ stools, and discussed any disagreements. The third reviewer was consulted for any doubts or uncertainty. We derived risk ratios and 95% confidence intervals. Mortality was defined as the primary outcome. Secondary outcomes were other complications, dislocation, infection, reoperation rate, and thromboembolic event.Results:This meta-analysis included 10 studies with 1419 patients, which indicated that there were no significant differences between hemiarthroplasty and total hip arthroplasty in reoperation, infection rate, and thromboembolic event. However, there was a lower mortality and dislocation rate association with total hip arthroplasty at the one-year follow-up.Conclusion:Based on our results, we found that total hip arthroplasty was better than hemiarthroplasty for a hip fracture at one-year follow-up.

简介：在从Libixia节的Jialingjiang形成的破裂的大多数静脉mineralsdeposited，Hechan区域包括大量僵绳白云石和伴随的天青石，方解石和荧石。这研究分析了性质，来源，由飞机光岩相学的液体的进化，液体包括方法，阴极射线发光图象，和稳定的同位素的作文。在白云石的二阶段的水的液体包括的homogenization温度在100和270°C之间变化。与δ18O数据，为破裂屑的降水负责的液体有δ18在10‰之间的O值并且18‰(相对降雪)。僵绳白云石和伴随的矿物质是在提高的温度的稠密的盐水的活动的结果。而且，液体从导出水兵的盐水的混合物被导出并且更深传播的分析表演流动。这液体在成岩作用期间在Sr被充实并且在骨折并且为地区性的矿化作用形成了天青石。僵绳白云石的溶解被归因于冷却Mg/Ca-decreased液体，它可以联系到一在包围碳酸盐石膏沥滤到天青石。

简介：摘要目的探讨MRI基于受限回波间距的快速梯度回波类CT成像（FRACTURE）序列与CT图像评估膝关节和踝关节骨质改变的一致性。方法回顾性收集2020年11月至2021年11月大连医科大学附属第一医院行CT及MRI FRACTURE序列检查的膝关节或踝关节患者，共17例，其中膝关节14例，踝关节3例。依据关节组成骨数量共纳入80个组成骨，其中股骨及髌骨各14个，胫骨及腓骨各17个，距骨、足舟骨、内侧楔骨、中间楔骨、外侧楔骨及跟骨各3个。由2名观察者分别通过CT及FRACTURE图像对关节组成骨的骨折、骨质增生、骨质破坏进行评估。采用Kappa检验分析观察者间采用CT和FRACTURE图像对关节组成骨病变评估的一致性。结果观察者1通过CT和FRACTURE图像对骨折、骨质增生、骨质破坏一致性评估的Kappa值（95%CI）分别为0.925（0.823~1.027）、0.905（0.799~1.011）和0.895（0.752~1.038），观察者2分别为0.963（0.892~1.034）、0.933（0.843~1.023）、0.886（0.731~1.041）。观察者1和观察者2通过CT图像对骨折、骨质增生、骨质破坏评估的一致性Kappa值（95%CI）分别为1.000（1.000~1.000）、0.937（0.851~1.023）、0.945（0.839~1.051），通过FRACTURE图像分别为0.962（0.888~1.036）、0.966（0.899~1.033）、0.836（0.656~1.016）。结论对于评价膝关节、踝关节组成骨的骨折、骨质增生、骨质破坏，MRI FRACTURE序列与CT图像具有高度的一致性。

简介：这研究调查低温实验法的张力的性质和小说的破裂行为搅动焊接并且32Mn-7Cr-1Mo-0.3N钢的焊接以后的对待热的关节。低温实验法的易碎的骨折，发生在同样焊接的关节，与在联合乐队结构包含钨的剩余粒子有关。韧化的焊接以后的水导致了关节的低温实验法的intergranular易碎物，它在韧化的焊接以后的水期间与溶质原子的非平衡分离有关。在550点退火吗？？

简介：AbstractBackground:The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.Methods:The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.Results:Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI:-2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.Conclusions:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.

简介：【摘要】目的：探讨腰硬联合麻醉和全身麻醉在股骨颈骨折（FNF）手术的临床麻醉效果。方法：将2020年09月-2021年03月本院收治的114例行FNF手术治疗患者随机分为对照组（n=57）和研究组（n=57），对照组予以全身麻醉，研究组予以腰硬联合麻醉，比较两组麻醉指标及疼痛程度。结果：研究组麻醉起效时间、意识恢复时间较对照组明显缩短，麻醉用药量较对照组明显减少（P＜0.05）；研究组疼痛严重程度较对照组明显降低（P＜0.05）。结论：FNF手术治疗患者予以腰硬联合麻醉效果理想，对患者疼痛程度缓解效果突出，值得推广。

简介：无

简介：Inthispaper,thefractureprocessofaunidirectionalCF/SiCsingleedge-notchedbeam(SENB)underthree-pointbending(TPB)isstudiedbymeansofmacro/micro-statisticalMonteCarlosimulation.Thesimulatedp-△curvesareinagreementwiththeexperimentalresultsbeforethepeaksofcurves,andthesimulatedmicroevolutionpatternsareinagreementwiththepatternsofthecracksurfaces,whichhaveverifiedthismethod.ItispreliminarilydemonstratedthatthesecondturningpointinthecompliancechangingratecurvecorrespondstothefractureinitiationforexperimentsonSENBunderTPBofunidirectionalCF/SiCcomposites.

简介：AbstractPurpose:There is a common opinion that spinal fractures usually reflect the substantial impact of injuries and therefore may be used as a marker of significant associated injuries, specifically for intra-abdominal injury (IAI). The impact of concomitant spinal cord injury (SCI) with the risk of associated IAI has not been well clarified. The aim of this study was to evaluate the incidence and severity of IAIs in patients suffering from spinal fractures with or without SCI.Methods:A retrospective cohort study using the Israeli National Trauma Registry was conducted. Patients with thoracic, lumbar and thoracolumbar fractures resulting from blunt mechanisms of injury from January 1, 1997 to December 31, 2018 were examined, comparing the incidence, severity and mortality of IAIs in patients with or without SCI. The collected variables included age, gender, mechanism of injury, incidence and severity of the concomitant IAIs and pelvic fractures, abbreviated injury scale, injury severity score, and mortality. Statistical analysis was performed using GraphPad InStat ® Version 3.10, with Chi-square test for independence and two sided Fisher’s exact probability test.Results:Review of the Israeli National Trauma Database revealed a total of 16,878 patients with spinal fractures. Combined thoracic and lumbar fractures were observed in 1272 patients (7.5%), isolated thoracic fractures in 4967 patients (29.4%) and isolated lumbar fractures in 10,639 patients (63.0%). The incidence of concomitant SCI was found in 4.95% (63/1272), 7.65% (380/4967) and 2.50% (266/10639) of these patients, respectively. The overall mortality was 2.5%, proving higher among isolated thoracic fracture patient than among isolated lumbar fracture counterparts (11.3% vs. 4.6%, p < 0.001). Isolated thoracic fractures with SCI were significantly more likely to die than non-SCI counterparts (8.2% vs. 3.1%, p < 0.001). There were no differences in the incidence of IAIs between patients with or without SCI following thoracolumbar fractures overall or in isolated thoracic fractures; although isolated lumbar fractures patients with SCI were more likely to have renal (3.4% vs. 1.6%, p = 0.02) or bowel injuries (2.3% vs. 1.0%, p = 0.04) than the non-SCI counterparts.Conclusion:SCI in the setting of thoracolumbar fracture does not appear to be a marker for associated IAI. However, in a subset of isolated lumbar fractures, SCI patient is associated with increased risks for renal and bowel injury.

简介：[摘要]目的：分析下颈椎骨折脱位合并脊髓损伤早期急救治疗对预后的影响。方法：选取我中心2019年3月~2021年5月收治的下颈椎骨折脱位合并脊髓损伤患者182例实施回顾性分析研究，分析患者的一般资料，根据四肢瘫痪不同程度，通过Frankel分级课氛围四个不同的等级：A级89例，B级30例，C级21例，D级42例。受伤类型包括高空坠落患者38例，车祸受伤患者144例。评估患者的脊髓损伤水平：C2患者5例，C3患者12例，C4患者30例，C5患者88例，C6患者35例，C7患者12例。结果：为患者采取日本顾客学会的评估标准，手术前的JOA评分为（4.21±1.81）分，患者手术治疗一周后的评分为（7.95±2.23）分，最后一次随访调查评分为（10.25±2.13）分，患者术后一周后和最后一次随访调查评分较手术前评分对比具有极大差异表示统计学有意义。患者实施8小时内开展甲强龙冲击治疗的患者有68例，开展早期气管切开治疗的患者有40例。实施前路手术治疗的患者有111例，实施后路手术治疗的患者有40例，实施前后路联合手术治疗的患者有31例，患者治疗后出现4例死亡，发生肺感染的患者有5例，低蛋白血症患者有22例，发生深静脉血栓患者有3例。结论：为下颈椎骨折脱位合并脊髓损伤喊着开展早期急救治疗，能够有效促进患者机体康复，降低并发症的发生，不仅保证了治疗效果也保证了治疗安全性，提高患者治疗后的生活质量评分。