两种方法治疗桡骨远端骨骺骨折的临床疗效比较研究

目的:比较桡骨远端骨骺骨折闭合手法复位夹板外固定与闭合手法复位克氏针内固定的临床疗效差异。方法:回顾性分析2016年2月至2019年2月诊治的107例桡骨远端骨骺骨折患者,按治疗方法不同分为观察组和对照组,分别施行手法复位夹板外固定和手法复位克氏针内固定治疗。末次随访时基于掌倾角和尺偏角对骨折愈合及复位情况进行影像学评估,基于腕关节活动度、Gartland-Werley腕关节评分及家属满意度方面综合评估两组患者的临床疗效和并发症情况。结果:所有病例均获得12~32个月随访(平均18个月),均未发现骨不连、延迟愈合、桡骨远端骨骺早闭等并发症发生。两者在掌倾角、尺偏角、腕关节活动度、Gartland-Werley评分结果优良率方面,组间比较差异均无统计学意义(P>0.05)。但并发症发生率及患者家属对疗效的满意率组间比较,差异均有统计学意义(P<0.05)。结论:手法复位夹板外固定为桡骨远端骨骺骨折患者及临床医师提供了一种并发症少,创伤及痛苦小,简单及时,经济有效,患者家属满意度高的治疗方法选择,值得临床推广。

CFD calculations on the unsteady aerodynamic characteristics of a tilt-rotor in a conversion mode

In order to calculate the unsteady aerodynamic characteristics of a tilt-rotor in a conver- sion mode, a virtual blade model （VBM） and an real blade model （RBM） are established respec- tively. A new multi-layer moving-embedded grid technique is proposed to reduce the numerical dissipation of the tilt-rotor wake in a conversion mode. In this method, a grid system generated abound the rotor accounts for rigid blade motions, and a new searching scheme named adaptive inverse map （AIM） is established to search corresponding donor elements in the present moving- embedded grid system to translate information among the different computational zones. A dual-time method is employed to fulfill unsteady calculations on the flowfield of the tilt-rotor, and a second-order centered difference scheme considering artificial viscosity is used to calculate the flux. In order to improve the computing efficiency, the single program multiple data （SPMD） model parallel acceleration technology is adopted, according to the characteristic of the current grid system. The lift and drag coefficients of an NACA0012 airfoil, the dynamic pressure distributions below a typical rotor plane, and the sectional pressure distributions on a three-bladed Branum- Tung tilt-rotor in hover flight are calculated respectively, and the present VBM and RBM are val- idated by comparing the calculated results with available experimental data. Then, unsteady aero- dynamic forces and flowfields of an XV-15 tilt-rotor in different modes, such as a fixed conversion mode at different tilt angles （15°, 30°, 60°） and a whole conversion mode which converses from 0° to 90°, are numerically simulated by the VBM and RBM respectively. By analyses and comparisons on the simulated results of unsteady aerodynamic forces of the tilt-rotor in different modes, some meaningful conclusions about distorted blade-tip vortex distribution and unsteady aerodynamic force variation in a conversion mode are obtained, and these investigation results could provide a good foundation for tilt-rotor aircraft design in the future.

富血小板血浆联合复方辣椒贴治疗肱骨内上髁炎60例

目的:观察局部注射自体富血小板血浆(Platelet Rich Plasma,PRP)联合复方辣椒贴治疗肱骨内上髁炎的临床效果。方法:选取2018年2月至2019年12月收治的60例肱骨内上髁炎患者为研究对象,采用PRP结合复方辣椒贴治疗;于治疗前,治疗后1、12个月评定患者视觉模拟疼痛评分(VAS)、Mayo肘关节功能评分、患肢握力及治疗12个月后的治疗有效率。结果:治疗后1个月患者的VAS疼痛评分、Mayo肘关节功能评分、患肢握力与治疗前比较,差异有统计学意义(P<0.05);治疗后12个月患者的VAS疼痛评分、Mayo肘关节功能评分、患肢握力显著优于治疗后1个月,差异有统计学意义(P<0.05);治疗后总有效率为100%,治愈例数为57例。结论:采用PRP结合复方辣椒贴治疗肱骨内上髁炎长短期疗效肯定,能缓解疼痛、恢复肘关节的功能、提高患肢的握力,不良反应少,值得临床推广应用。