Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium...Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.展开更多
In order to provide anatomical basis for transoral approach （TOA） in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dis...In order to provide anatomical basis for transoral approach （TOA） in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults＇ fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the .width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2±3.5 mm and 39.3±3.7 mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1±5.2 mm and 50.2±4.6 mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0±2.9 mm and 24.0±3.5 mm respectively, and the distance of bilateral axis screw inserting points was 18.0±1.2 mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces： mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.展开更多
Joint clearance,as an important stochastic factor,can significantly deteriorate positioning and repeatability accuracies and lower assembly quality of a 6-DOF docking mechanism.Considering pose accuracy with tradition...Joint clearance,as an important stochastic factor,can significantly deteriorate positioning and repeatability accuracies and lower assembly quality of a 6-DOF docking mechanism.Considering pose accuracy with traditional error model that possesses inherent imprecision,both probabilistic and deterministic approaches based on forward kinematics are presented to analyze comprehensive pose error(CPE)in simulation.Results indicate an identical trend emerges for each CPE with both approaches,and both CPEs perform opposite variations as the moving platform upgrades.The findings provide theoretical reference for refinement of assembly quality evaluation of this mechanism.展开更多
This study presents a visualized approach for tracking joint surface morphology.Three-dimensional laser scanning(3DLS)and 3D printing(3DP)techniques are adopted to record progressive failure during rock joint shearing...This study presents a visualized approach for tracking joint surface morphology.Three-dimensional laser scanning(3DLS)and 3D printing(3DP)techniques are adopted to record progressive failure during rock joint shearing.The 3DP resin is used to create transparent specimens to reproduce the surface morphology of a natural joint precisely.The freezing method is employed to enhance the mechanical properties of the 3DP specimens to reproduce the properties of hard rock more accurately.A video camera containing a charge-coupled device(CCD)camera is utilized to record the evolution of damaged area of joint surface during the direct shear test.The optimal shooting distance and shooting angle are recommended to be 800 mm and 40?,respectively.The images captured by the CCD camera are corrected to quantitatively describe the damaged area on the joint surface.Verification indicates that this method can accurately describe the total sheared areas at different shear stages.These findings may contribute to elucidating the shear behavior of rock joints.展开更多
BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a go...BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a good option not only because it allows direct observation of ligament damage and fixation of bone fragments but also because the thin subcutaneous tissue makes the approach easier.CASE SUMMARY A 45-year-old man with a right hand injury visited the hospital.A small bone fragment was identified using plain radiography.Lateral radiography revealed the fragment as lying over the volar aspect of the carpometacarpal(CMC)joint.Computed tomography revealed that approximately one-third of the CMC joint surface of the second metacarpal was damaged.We provisionally diagnosed an intra-articular fracture with significant CMC joint instability and performed open reduction and internal fixation.We made a dorsal longitudinal incision over the CMC joint between the second and third metacarpals.The dorsal ligament of the third CMC joint was torn.We thought it had been dislocated to the volar side and spontaneously reduced to that position.There are only few reports of volar dislocation of CMC joint fractures,particularly of the second and third metacarpals;our report is unique as our patient had an intact interosseous ligament between the second and third metacarpals.CONCLUSION Although past reports have used a palmar approach,the dorsal approach is a good option for these cases.展开更多
Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelo...Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelopathy caused by展开更多
Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods...Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods This展开更多
目的:探讨后路寰枢椎侧块关节cage植骨融合内固定术治疗难复性寰枢椎脱位的临床疗效,并与经口咽松解后路复位固定融合术进行疗效对比。方法:回顾性分析2018年1月~2022年8月我科采用后路寰枢椎侧块关节cage植骨融合内固定术(23例,cage组...目的:探讨后路寰枢椎侧块关节cage植骨融合内固定术治疗难复性寰枢椎脱位的临床疗效,并与经口咽松解后路复位固定融合术进行疗效对比。方法:回顾性分析2018年1月~2022年8月我科采用后路寰枢椎侧块关节cage植骨融合内固定术(23例,cage组)与经口咽松解后路复位固定融合术(25例,对照组)治疗的难复性寰枢椎脱位患者的临床资料,cage组男8例,女15例,年龄9~79岁(48.35±14.38岁);对照组男6例,女19例,年龄21~69岁(47.84±13.51岁)。记录两组患者手术时间、术中出血量、住院时间及并发症情况,术前、术后及末次随访时使用JOA评分评估患者神经功能状态,测量术前、术后及末次随访时的寰齿间距(atlantodental interval,ADI)、齿状突顶点距离Chamberlain线的垂直距离(vertical distance from odon to idprocess to Chamberlain′s line,DOCL)、延髓颈髓角(cervicomedullary angle,CMA)、斜坡枢椎角(clivus-axial angle,CAA),评估寰枢椎复位情况。评估侧块关节cage及后方植骨融合情况。结果:所有患者内固定位置良好,减压充分复位满意,症状均明显缓解,未出现椎动脉损伤和脊髓损伤加重。cage组手术时间133.04±34.04min、术中出血量119.13±54.77mL、住院时间14.74±6.10d,均明显短于或少于对照组(253.20±53.98min、181.20±45.40mL、23.96±5.47d)。cage组术前JOA、ADI、DOCL、CMA、CAA分别为6.33±1.13分、7.31±3.05mm、9.47±3.32mm、122.89°±12.58°、122.02°±12.50°,术后分别为13.04±2.17分、2.18±0.67mm、0.89±1.00mm、148.81°±5.43°、146.70°±9.32°,末次随访时分别为14.89±1.17分、2.09±0.69mm、0.83±0.86mm、149.10°±5.11°、146.89°±8.95°;对照组术前JOA、ADI、DOCL、CMA、CAA分别为6.76±1.21分、7.70±0.97mm、10.56±1.99mm、121.53°±4.87°、123.77°±8.95°,术后分别为13.26±1.32分、1.89±0.50mm、1.13±1.08mm、151.40°±6.15°、149.86°±5.58°,末次随访时分别为15.02±0.88分、1.87±0.44mm、0.87±1.39mm、149.48°±4.06°、149.94°±6.61°,两组术后及末次随访JOA、ADI、DOCL、CMA及CAA均较术前明显改善(P<0.05),术后JOA评分与末次随访相比存在统计学差异(P<0.05),但ADI、DOCL、CMA及CAA无统计学差异(P>0.05)。cage组仅1例切口感染;对照组3例切口感染(口咽2例,后路1例),1例脑脊液漏。两组随访期间内固定在位稳定,末次随访植骨均达到骨性融合,cage组关节间隙高度无丢失。结论:难复性寰枢椎脱位采用后路寰枢椎侧块关节cage植骨融合内固定术与经口咽松解后路复位固定融合术相比疗效相当,但增加了植骨融合位点,能更有效融合,避免了经口手术,减少了手术时间、术中出血量、住院时间及并发症的发生。展开更多
文摘Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.
文摘In order to provide anatomical basis for transoral approach （TOA） in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults＇ fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the .width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2±3.5 mm and 39.3±3.7 mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1±5.2 mm and 50.2±4.6 mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0±2.9 mm and 24.0±3.5 mm respectively, and the distance of bilateral axis screw inserting points was 18.0±1.2 mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces： mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.
基金supported by the National Defense Basic Scientific Research Program(No.A0320110019)the Shanghai Science and Technology Innovation Action Plan(No.11DZ1120800)
文摘Joint clearance,as an important stochastic factor,can significantly deteriorate positioning and repeatability accuracies and lower assembly quality of a 6-DOF docking mechanism.Considering pose accuracy with traditional error model that possesses inherent imprecision,both probabilistic and deterministic approaches based on forward kinematics are presented to analyze comprehensive pose error(CPE)in simulation.Results indicate an identical trend emerges for each CPE with both approaches,and both CPEs perform opposite variations as the moving platform upgrades.The findings provide theoretical reference for refinement of assembly quality evaluation of this mechanism.
基金This experimental study was partially funded by the National Natural Science Foundation of China(Grant Nos.41572299and 41831290)the 3D-printed modeling work was supported by the Zhejiang Provincial Natural Science Foundation of China(Grant No.LY18D020003),which is gratefully acknowledged.
文摘This study presents a visualized approach for tracking joint surface morphology.Three-dimensional laser scanning(3DLS)and 3D printing(3DP)techniques are adopted to record progressive failure during rock joint shearing.The 3DP resin is used to create transparent specimens to reproduce the surface morphology of a natural joint precisely.The freezing method is employed to enhance the mechanical properties of the 3DP specimens to reproduce the properties of hard rock more accurately.A video camera containing a charge-coupled device(CCD)camera is utilized to record the evolution of damaged area of joint surface during the direct shear test.The optimal shooting distance and shooting angle are recommended to be 800 mm and 40?,respectively.The images captured by the CCD camera are corrected to quantitatively describe the damaged area on the joint surface.Verification indicates that this method can accurately describe the total sheared areas at different shear stages.These findings may contribute to elucidating the shear behavior of rock joints.
文摘BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a good option not only because it allows direct observation of ligament damage and fixation of bone fragments but also because the thin subcutaneous tissue makes the approach easier.CASE SUMMARY A 45-year-old man with a right hand injury visited the hospital.A small bone fragment was identified using plain radiography.Lateral radiography revealed the fragment as lying over the volar aspect of the carpometacarpal(CMC)joint.Computed tomography revealed that approximately one-third of the CMC joint surface of the second metacarpal was damaged.We provisionally diagnosed an intra-articular fracture with significant CMC joint instability and performed open reduction and internal fixation.We made a dorsal longitudinal incision over the CMC joint between the second and third metacarpals.The dorsal ligament of the third CMC joint was torn.We thought it had been dislocated to the volar side and spontaneously reduced to that position.There are only few reports of volar dislocation of CMC joint fractures,particularly of the second and third metacarpals;our report is unique as our patient had an intact interosseous ligament between the second and third metacarpals.CONCLUSION Although past reports have used a palmar approach,the dorsal approach is a good option for these cases.
文摘Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelopathy caused by
文摘Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods This
文摘目的:探讨后路寰枢椎侧块关节cage植骨融合内固定术治疗难复性寰枢椎脱位的临床疗效,并与经口咽松解后路复位固定融合术进行疗效对比。方法:回顾性分析2018年1月~2022年8月我科采用后路寰枢椎侧块关节cage植骨融合内固定术(23例,cage组)与经口咽松解后路复位固定融合术(25例,对照组)治疗的难复性寰枢椎脱位患者的临床资料,cage组男8例,女15例,年龄9~79岁(48.35±14.38岁);对照组男6例,女19例,年龄21~69岁(47.84±13.51岁)。记录两组患者手术时间、术中出血量、住院时间及并发症情况,术前、术后及末次随访时使用JOA评分评估患者神经功能状态,测量术前、术后及末次随访时的寰齿间距(atlantodental interval,ADI)、齿状突顶点距离Chamberlain线的垂直距离(vertical distance from odon to idprocess to Chamberlain′s line,DOCL)、延髓颈髓角(cervicomedullary angle,CMA)、斜坡枢椎角(clivus-axial angle,CAA),评估寰枢椎复位情况。评估侧块关节cage及后方植骨融合情况。结果:所有患者内固定位置良好,减压充分复位满意,症状均明显缓解,未出现椎动脉损伤和脊髓损伤加重。cage组手术时间133.04±34.04min、术中出血量119.13±54.77mL、住院时间14.74±6.10d,均明显短于或少于对照组(253.20±53.98min、181.20±45.40mL、23.96±5.47d)。cage组术前JOA、ADI、DOCL、CMA、CAA分别为6.33±1.13分、7.31±3.05mm、9.47±3.32mm、122.89°±12.58°、122.02°±12.50°,术后分别为13.04±2.17分、2.18±0.67mm、0.89±1.00mm、148.81°±5.43°、146.70°±9.32°,末次随访时分别为14.89±1.17分、2.09±0.69mm、0.83±0.86mm、149.10°±5.11°、146.89°±8.95°;对照组术前JOA、ADI、DOCL、CMA、CAA分别为6.76±1.21分、7.70±0.97mm、10.56±1.99mm、121.53°±4.87°、123.77°±8.95°,术后分别为13.26±1.32分、1.89±0.50mm、1.13±1.08mm、151.40°±6.15°、149.86°±5.58°,末次随访时分别为15.02±0.88分、1.87±0.44mm、0.87±1.39mm、149.48°±4.06°、149.94°±6.61°,两组术后及末次随访JOA、ADI、DOCL、CMA及CAA均较术前明显改善(P<0.05),术后JOA评分与末次随访相比存在统计学差异(P<0.05),但ADI、DOCL、CMA及CAA无统计学差异(P>0.05)。cage组仅1例切口感染;对照组3例切口感染(口咽2例,后路1例),1例脑脊液漏。两组随访期间内固定在位稳定,末次随访植骨均达到骨性融合,cage组关节间隙高度无丢失。结论:难复性寰枢椎脱位采用后路寰枢椎侧块关节cage植骨融合内固定术与经口咽松解后路复位固定融合术相比疗效相当,但增加了植骨融合位点,能更有效融合,避免了经口手术,减少了手术时间、术中出血量、住院时间及并发症的发生。
