Roles of Sex Steroids in the Crowings with Sexual and Non-Sexual Motivations in Female Japanese Quail, <i>Coturnix Japonica</i>

To examine the sex differences in the crowing behavior of the Japanese quail, we investigated the effects of sex steroids on calling behaviors using female birds, and the data were compared with those obtained in our previous study in male birds which was performed using the same experimental procedures as those in the present study. We injected the female quails daily from 11 to 41 days after hatching with testosterone propionate (TP), 5α-dihydrotestosterone (DHT;a non-aromatizable androgen), estradiol benzoate (EB) or vehicle, and examined their calling behaviors in both sexual and non-sexual contexts. In a non-sexual context of the birds being isolated in a recording chamber, androgens, either TP or DHT, induced crowing in place of distress calling while EB simply inhibited distress calling. These effects of sex steroids on the calling behaviors were almost identical to those in the male quails. In a sexual context of the birds being left undisturbed in their home cages, crowing was induced by chronic treatment with TP, but not either DHT or EB, suggesting that both estrogenic and androgenic actions are required to induce the sexually motivated crowing. Although these results were basically the same as those in the male quails, the crowing in the female quails occurred much less frequently compared to that of the male quails. These data suggest that in the Japanese quail, crowing behavior, when it is restricted to sexually motivated one, is quantitatively different between male and female in the responsiveness to sex steroids.

CroweⅢ-Ⅳ型DDH患者全髋关节置换术后不满意及相关因素分析

目的:探讨全髋关节置换术的CroweⅢ-Ⅳ型发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者的满意度及造成不满意的相关因素。方法:回顾性分析2013年3月至2018年3月行全髋关节置换术的169例CroweⅢ-Ⅳ型DDH患者,通过微信进行调查问卷,调查患者对手术总体满意度、10项日常功能满意度和患者认为对自己日常生活影响比较大的前5个问题。手术前后采用髋关节Harris评分进行功能评价。结果:收到完整调查问卷145份,所有患者获随访,时间1~5(3.23±1.22)年。145例患者分成两组,其中对手术疗效满意的118例,不满意的27例,手术总体满意率81.38%(118/145)。患者认为对生活影响比较大的前5个问题分别是术后髋部疼痛,肢体明显不等长、行走、上下楼梯、蹲起。两组术前Harris评分比较,差异无统计学意义(P>0.05),不满意组术后Harris评分较低。术后髋关节疼痛、肢体不等长是影响手术不满意的直接因素。结论:采用全髋关节置换术治疗CroweⅢ-Ⅳ型DDH患者手术难度大;术后髋关节疼痛(轻度以上),肢体不等长(>2 cm)是术后不满意的独立危险因素。

自体股骨头结构植骨重建髋臼辅助THA在改良CROWE Type ⅣB型DDH中的临床疗效分析

目的:分析和总结自体股骨头结构植骨重建髋臼辅助全髋关节置换术(total hip arthroplasty,THA)治疗改良Crowe TypeⅣB型成人髋关节发育不良性脱位(developmental dysplasia of the hip,DDH)患者的临床疗效。方法:按照改良Crowe分型,选取山东大学齐鲁医院德州医院关节外科2015年8月至2023年3月收治的TypeⅣB型DDH患者26例,其中男25例,女1例,采用自体股骨头结构植骨重建髋臼辅助THA,记录患者手术时间、术中失血量、术中术后输血量、术后血红蛋白、手术相关并发症和骨愈合时间等,并行骨盆正位X线片了解假体位置、假体骨长入、假体松动以及骨愈合情况等,采用视觉模拟评分表(visual analogue scale,VAS)评价髋关节的疼痛不适,采用髋关节Harris评分和Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)来评价髋关节功能及临床疗效。结果:所有患者的平均随访时间(9.73±8.35)个月,术中出血平均为(715.38±143.37) mL,术中平均输血(415.38±282.41) mL,手术时间平均为(118.62±18.27) min,术后平均输血为(192.31±236.51) mL。所有患者转子下骨端、自体股骨头和假臼之间均骨愈合良好。髋关节VAS评分从术前6.73±0.45,至术后末次随访时VAS评分1.73±0.53,差异有统计学意义(P=0.000),髋关节活动度均较术前明显改善,髋关节Harris评分从术前24.27±1.66,至术后末次随访时Harris评分74.77±2.89,差异有统计学意义(P=0.000),WOMAC术前术后评分分别为130.08±5.72和67.85±3.23,差异均有统计学意义(P=0.000)。结论:自体股骨头结构植骨重建髋臼辅助THA治疗改良Crowe TypeⅣB型DDH,具有操作相对简单、固定牢固、手术相对安全和疗效确切的优点。

Enterococcus faecalis provides protection during scavenging in carrion crow (Corvus corone)

The gut microbiota significantly influences host physiology and provides essential ecosystem services.While diet can affect the composition of the gut microbiota,the gut microbiota can also help the host adapt to specific dietary habits.The carrion crow(Corvus corone),an urban facultative scavenger bird,hosts an abundance of pathogens due to its scavenging behavior.Despite this,carrion crows infrequently exhibit illness,a phenomenon related to their unique physiological adaptability.At present,however,the role of the gut microbiota remains incompletely understood.In this study,we performed a comparative analysis using 16S rRNA amplicon sequencing technology to assess colonic content in carrion crows and 16 other bird species with different diets in Beijing,China.Our findings revealed that the dominant gut microbiota in carrion crows was primarily composed of Proteobacteria(75.51%)and Firmicutes(22.37%).Significant differences were observed in the relative abundance of Enterococcus faecalis among groups,highlighting its potential as a biomarker of facultative scavenging behavior in carrion crows.Subsequently,E.faecalis isolated from carrion crows was transplanted into model mice to explore the protective effects of this bacterial community against Salmonella enterica infection.Results showed that E.faecalis down-regulated the expression of pro-inflammatory cytokines tumor necrosis factor alpha(TNF-α),interferon gamma(IFN-γ),and interleukin 6(IL-6),prevented S.enterica colonization,and regulated the composition of gut microbiota in mice,thereby modulating the host’s immune regulatory capacity.Therefore,E.faecalis exerts immunoregulatory and anti-pathogenic functions in carrion crows engaged in scavenging behavior,offering a representative case of how the gut microbiota contributes to the protection of hosts with specialized diets.

A Real-time Lithological Identification Method based on SMOTE-Tomek and ICSA Optimization

In petroleum engineering,real-time lithology identification is very important for reservoir evaluation,drilling decisions and petroleum geological exploration.A lithology identification method while drilling based on machine learning and mud logging data is studied in this paper.This method can effectively utilize downhole parameters collected in real-time during drilling,to identify lithology in real-time and provide a reference for optimization of drilling parameters.Given the imbalance of lithology samples,the synthetic minority over-sampling technique(SMOTE)and Tomek link were used to balance the sample number of five lithologies.Meanwhile,this paper introduces Tent map,random opposition-based learning and dynamic perceived probability to the original crow search algorithm(CSA),and establishes an improved crow search algorithm(ICSA).In this paper,ICSA is used to optimize the hyperparameter combination of random forest(RF),extremely random trees(ET),extreme gradient boosting(XGB),and light gradient boosting machine(LGBM)models.In addition,this study combines the recognition advantages of the four models.The accuracy of lithology identification by the weighted average probability model reaches 0.877.The study of this paper realizes high-precision real-time lithology identification method,which can provide lithology reference for the drilling process.

Crowe Ⅲ型髋关节发育不良人工全髋关节置换髋臼解剖重建与非解剖重建髋关节生物力学有限元分析

目的:应用有限元分析研究CroweⅢ型发育性髋关节发育不良(developmental dysplasia of the hip,DDH)全髋关节置换(total hip arthroplasty,THA)髋臼解剖重建与非解剖重建髋关节的生物力学为临床THA髋臼解剖重建提供理论基础和实验依据。方法:选取1例因左侧CroweⅢ型DDH伴终末期髋骨关节炎于2020年4月就诊并行左侧全髋关节置换的患者,女,57岁。术前、术后分别行骨盆CT平扫三维重建。在Mimics和3-Matic软件里建立14组髋臼杯不同前倾角、外展角、旋转中心高度模型并进行材料赋值,在Abaqus软件里设置边界和负载条件,计算并观察髋关节应力峰值和分布。结果:对于CroweⅢ型DDH全髋关节置换术,当旋转中心解剖重建,髋臼杯外展角设置为40°时,髋臼杯前倾角5°~25°变化时,髋臼杯、聚乙烯内衬最低Von Mises值出现在前倾角20°;当旋转中心解剖重建,髋臼杯前倾角设置为15°时,髋臼杯外展角30°~55°变化时,髋臼杯、聚乙烯内衬最低Von Mises值出现在外展角35°;当髋臼杯前倾角设置为15°、外展角设置为40°时,旋转中心上移0~20 mm变化时,髋臼杯、聚乙烯内衬最低Von Mises值出现在旋转中心上移10 mm。在所有14组髋臼杯参数模型中,旋转中心解剖重建,髋臼杯前倾角15°、外展角35°时,髋臼、髋臼杯、聚乙烯内衬Von Mises值最低。结论:在CroweⅢ型DDH全髋关节置换术中,建议解剖重建旋转中心,髋臼杯前倾角15°、外展角35°,同时进行髋臼外上方植骨并增加螺钉以进一步减少髋关节应力峰值。

Scale Invariant Feature Transform with Crow Optimization for Breast Cancer Detection

Mammography is considered a significant image for accurate breast cancer detection.Content-based image retrieval(CBIR)contributes to classifying the query mammography image and retrieves similar mammographic images from the database.This CBIR system helps a physician to give better treatment.Local features must be described with the input images to retrieve similar images.Exist-ing methods are inefficient and inaccurate by failing in local features analysis.Hence,efficient digital mammography image retrieval needs to be implemented.This paper proposed reliable recovery of the mammographic image from the data-base,which requires the removal of noise using Kalman filter and scale-invariant feature transform(SIFT)for feature extraction with Crow Search Optimization-based the deep belief network(CSO-DBN).This proposed technique decreases the complexity,cost,energy,and time consumption.Training the proposed model using a deep belief network and validation is performed.Finally,the testing pro-cess gives better performance compared to existing techniques.The accuracy rate of the proposed work CSO-DBN is 0.9344,whereas the support vector machine(SVM)(0.5434),naïve Bayes(NB)(0.7014),Butterfly Optimization Algorithm(BOA)(0.8156),and Cat Swarm Optimization(CSO)(0.8852).

Scale Invariant Feature Transform with Crow Optimization for Breast Cancer Detection

Mammography is considered a significant image for accurate breast cancer detection.Content-based image retrieval(CBIR)contributes to classifying the query mammography image and retrieves similar mammographic images from the database.This CBIR system helps a physician to give better treatment.Local features must be described with the input images to retrieve similar images.Exist-ing methods are inefficient and inaccurate by failing in local features analysis.Hence,efficient digital mammography image retrieval needs to be implemented.This paper proposed reliable recovery of the mammographic image from the data-base,which requires the removal of noise using Kalmanfilter and scale-invariant feature transform(SIFT)for feature extraction with Crow Search Optimization-based the deep belief network(CSO-DBN).This proposed technique decreases the complexity,cost,energy,and time consumption.Training the proposed model using a deep belief network and validation is performed.Finally,the testing pro-cess gives better performance compared to existing techniques.The accuracy rate of the proposed work CSO-DBN is 0.9344,whereas the support vector machine(SVM)(0.5434),naïve Bayes(NB)(0.7014),Butterfly Optimization Algorithm(BOA)(0.8156),and Cat Swarm Optimization(CSO)(0.8852).

Improved Interleaved Single-Ended Primary Inductor-Converter forSingle-Phase Grid-Connected System

The generation of electricity based on renewable energy sources,parti-cularly Photovoltaic(PV)system has been greatly increased and it is simply insti-gated for both domestic and commercial uses.The power generated from the PV system is erratic and hence there is a need for an efficient converter to perform the extraction of maximum power.An improved interleaved Single-ended Primary Inductor-Converter(SEPIC)converter is employed in proposed work to extricate most of power from renewable source.This proposed converter minimizes ripples,reduces electromagnetic interference due tofilter elements and the contin-uous input current improves the power output of PV panel.A Crow Search Algo-rithm(CSA)based Proportional Integral(PI)controller is utilized for controlling the converter switches effectively by optimizing the parameters of PI controller.The optimized PI controller reduces ripples present in Direct Current(DC)vol-tage,maintains constant voltage at proposed converter output and reduces over-shoots with minimum settling and rise time.This voltage is given to single phase grid via 1�Voltage Source Inverter(VSI).The command pulses of 1�VSI are produced by simple PI controller.The response of the proposed converter is thus improved with less input current.After implementing CSA based PI the efficiency of proposed converter obtained is 96%and the Total Harmonic Distor-tion(THD)is found to be 2:4%.The dynamics and closed loop operation is designed and modeled using MATLAB Simulink tool and its behavior is performed.

Selective Mapping Scheme for Universal Filtered Multicarrier

The next step in mobile communication technology,known as 5G,is set to go live in a number of countries in the near future.New wireless applica-tions have high data rates and mobility requirements,which have posed a chal-lenge to mobile communication technology researchers and designers.5G systems could benefit from the Universal Filtered Multicarrier(UFMC).UFMC is an alternate waveform to orthogonal frequency-division multiplexing(OFDM),infiltering process is performed for a sub-band of subcarriers rather than the entire band of subcarriers Inter Carrier Interference(ICI)between neighbouring users is reduced via the sub-bandfiltering process,which reduces out-of-band emissions.However,the UFMC system has a high Peak-to-Average Power Ratio(PAPR),which limits its capabilities.Metaheuristic optimization based Selective mapping(SLM)is used in this paper to optimise the UFMC-PAPR.Based on the cognitive behaviour of crows,the research study suggests an innovative metaheuristic opti-mization known as Crow Search Algorithm(CSA)for SLM optimization.Com-pared to the standard UFMC,SLM-UFMC system,and SLM-UFMC with conventional metaheuristic optimization techniques,the suggested technique sig-nificantly reduces PAPR.For the UFMC system,the suggested approach has a very low Bit Error Rate(BER).

髋臼中心定位工具在CroweⅣ型发育性髋关节发育不良关节置换术中的应用

目的研究髋臼中心定位工具在CroweⅣ型发育性髋关节发育不良关节置换术中的可行性及安全性。方法回顾性分析2020年1月至2022年1月在新疆维吾尔自治区伊犁哈萨克自治州新华医院行全髋关节置换术的37例(44髋)发育性髋关节脱位患者,分为两组:A组20例(24髋),参考定位工具,B组17例(20髋),参考髋臼横韧带,比较两组患者的手术时间、切口大小、术中出血量、下地时间、Harris髋关节评分、双侧肢体长度差,术后臼杯外展角、前倾角,以及术后假体旋转中心与解剖旋转中心的水平、垂直距离差值。结果所有的患者术后未出现脱位、感染、深静脉血栓形成、假体松动等。两组患者的手术时间、术中出血量、切口大小、下地时间、Harris评分、双侧肢体长度差比较,差异无统计学意义(P>0.05)。对比两组臼杯外展角、前倾角,差异无统计学意义(P>0.05);旋转中心垂直距离A组为(21.54±2.32)mm、B组为(22.40±2.23)mm,水平距离A组为(29.42±2.45)mm、B组为(29.85±2.92)mm,重建髋臼的旋转中心距离及其与解剖旋转中心距离差进行组间比较,差异无统计学意义(P>0.05)。结论髋臼中心定位工具可以在CroweⅣ型发育性髋关节发育不良全髋关节置换术中给术者提供髋臼中心点的参考标志,有一定的临床使用价值。

Crowe Ⅳ型发育性髋关节发育不良病人全髋关节置换术中解剖位安放臼杯并粗隆下截骨治疗前后步态参数分析

目的 分析CroweⅣ型发育性髋关节发育不良(DDH)病人全髋关节置换(THA)术中解剖位安放臼杯并粗隆下截骨治疗前后步态参数变化。方法 选取2018年1月~2022年6月CroweⅣ型DDH病人46例为观察组,均行THA术,术中解剖位安放臼杯并行粗隆下截骨。术前、术后6个月分别进行步态试验,分析治疗前后时空参数、运动学参数、动力学参数[关节力矩峰值、地面反作用力峰值]。同时根据年龄、性别、身高匹配同期健康体检者46例作为对照组,进行同样的步态试验。结果 观察组术后6个月多项时空参数、运动学参数、动力学参数较术前改善,双侧时空参数、关节力矩峰值、地面反作用力中除内侧峰值之外的参数均趋于一致;观察组术前、术后6个月术侧步长、步频、摆动期、髋关节屈曲力矩、髋关节伸展力矩、膝关节屈曲力矩、踝关节跖屈力矩、纵向峰值1、纵向峰值2、向前峰值、向后峰值、髋关节最大屈曲、髋关节最大伸展、髋关节矢状面活动范围、膝关节最大屈曲、膝关节矢状面活动范围、踝关节最大背伸、踝关节矢状面活动范围均小于对照组,术前、术后6个月术侧步时、支撑期、膝关节最大伸展和内侧峰值大于对照组,差异有统计学意义(P<0.05)。结论 CroweⅣ型DDH病人THA术中解剖位安防臼杯并粗隆下截骨治疗后步态明显改善,对称性良好,但与正常病人仍存在一定差异,提示仍需加强康复训练。

The Historical and Current Characteristics of“Plague Writing”-Rereading Chi Zijian’s Novel White Snow Crow in the Post Epidemic Era

Chi Zijian’s novel White Snow Crow is about the pestis in Northeast China from the autumn and winter of 1910 to the spring of 1911,focusing on the living conditions of people in Fujiadian,Harbin,under the shadow of the pestis,and thus connects the vicissitudes of Harbin in the development of modern Chinese history.Re-reading this novel in the context of the post-epidemic era not only allows us to immerse ourselves in the specific temporal and spatial fields described in the text with an immersive reading mindset,feel the heavy impact that the disaster has brought to the people of Northeast China,but also provide us with a different perspective to observe the current social reality.In particular,the social problems shown by the novel through the pestis and the description of ordinary people’s life experience under the plague still deserve further discussion.

基于CROW原则的阿姆斯特丹与昆明自行车交通规划建设对比研究

低碳交通背景下自行车道的建设与发展逐渐成为各国所追求的交通模式,许多国家已经开始重视并相继提出符合本国自行车发展的规划目标及策略。本文选取自行车基础设施建设经验较为丰富的阿姆斯特丹和经验较少的昆明市作为研究对象,以荷兰的CROW原则为基础,从五个方面对比研究了阿姆斯特丹和昆明市的自行车交通建设策略和管理模式,并对昆明市的自行车道发展和慢行系统建设提出了一些针对性策略和建议。

Crowe Ⅳ型髋关节发育不良的新分型

目的 ：比较有继发臼和无继发臼两种病理形态的CroweⅣ型髋关节发育不良（DDH）行全髋关节置换术（THA）时是否存在实质上的不同,从而决定有无必要将CroweⅣ型DDH进一步分出亚型。方法 ：回顾性分析2007年6月至2015年5月由同一名高年资医生应用S-ROM假体对CroweⅣ型DDH行THA患者112例（145髋关节）,单侧79例,双侧33例,年龄18~68岁,分为无继发臼组和继发臼形成组。无继发臼组108髋,男12髋,女96髋,平均年龄（39.38±11.19）岁;继发臼形成组37髋,男2髋,女35髋,平均年龄（38.19±10.92）岁。术前及术后随访时均拍X线片进行观察,对临床结果采用Harris评分进行评价。比较两组在脱位高度、髓腔闪烁指数、是否需要做粗隆下截骨、髋关节Harris评分及术后并发症方面有无差异。结果：无继发臼组髋关节脱位高度为（4.74±1.57）cm,继发臼形成组（3.12±1.15）cm,无继发臼组大于继发臼形成组。无继发臼组髓腔闪烁指数为2.69±0.68,继发臼形成组3.42±0.79,继发臼形成组大于无继发臼组。无继发臼组术前Harris评分58.1±15.3,继发臼形成组58.3±16.9,两组之间差异无统计学意义;术后评分无继发臼组91.0±4.1,继发臼形成组91.0±5.1,两组之间差异无统计学意义。术后并发症：无继发臼组4髋发生股骨假体周围骨折,4髋脱位,4例出现神经症状;继发臼形成组无假体周围骨折,1髋脱位,1例出现神经症状,两组差异无统计学意义。结论：有继发臼的CroweⅣ型DDH与无继发臼者在脱位高度和股骨解剖形态方面有差异,这也决定了两者在手术方式的选择方面存在不同,因此有必要将其进一步分成无继发臼的IVA型和有继发臼的IVB型2个亚型。

全髋关节置换治疗CroweⅣ型成人髋关节发育性不良

背景:人工全髋关节置换为治疗髋关节发育性不良晚期患者的最佳选择,然而髋关节发育性不良的患者特别是CroweⅣ型因其髋关节解剖结构的显著异常,增加了手术难度且手术方法颇有争议。目的:探讨人工全髋关节置换治疗CroweⅣ型成人髋关节发育性不良的疗效及髋臼重建与股骨侧处理的方法。方法:纳入12例(14髋)CroweⅣ型成人髋关节发育不良患者进行人工全髋关节置换,Harris评分术前平均(35.0±6.8)分,髋臼侧采用小臼杯结合髋臼加深技术安置臼杯假体,股骨侧行转子下短缩截骨放置股骨假体,采用Harris评分评价置换后髋关节功能。结果与结论:所有患者随访1-7年,平均4.6年,2例2髋发生置换过程中股骨大转子不全骨折,予钢丝固定。1例置换后出现坐骨神经刺激症状,1个月后恢复正常,无感染、假体松动及有明显临床表现的深静脉血栓形成等并发症。股骨侧截骨处均骨性愈合。置换后末次随访Harris评分平均为(84.0±7.0)分,置换后肢体延长4-6 cm,平均5 cm,短缩的肢体得到满意纠正。说明采用小臼杯、髋臼内陷技术、股骨短缩截骨对CroweⅣ型成人髋关节发育性不良患者行全髋关节置换能重建关节功能,恢复下肢长度,长期疗效有待于进一步观察。

全髋关节置换修复CroweⅢ和Ⅳ型髋关节脱位:假体位置及其稳定性

背景:发育性髋关节脱位是成人髋关节发育不良的一种类型,其中CroweⅢ和Ⅳ型髋关节脱位是病情较严重的类型。临床采用全髋关节置换治疗需要对髋臼进行复杂的重建处理。对受损髋臼采用自体骨植骨可有效重建髋臼的结构,为髋臼提供良好的覆盖率和稳定性,置换后结合有效的功能锻炼可保证髋臼功能的恢复。目的:分析全髋关节置换过程中假体位置选择与CroweⅢ、CroweⅣ型髋关节脱位临床短中期疗效的相关性。方法:回顾性分析2011年12月至2012年12月内蒙古医科大学第二附属医院关节外科收治的28例髋关节发育不良关节脱位并严重骨关节炎患者的临床资料,所有患者均行全髋关节置换治疗,置入材料为生物型人工全髋关节假体。随访2年,置换后定期影像学复查以分析髋臼假体位置的影像学变化及植骨融合情况,采用Harris髋关节评分对髋关节功能的恢复情况进行评价。分析患者假体位置与短中期疗效的相关性。结果与结论:置换后患者假体髓腔填充率在75%以上,初始位置固定稳定,股骨-假体界面稳定率高达100%。与置换前相比,置换后6个月患者的髋关节功能明显改善,差异有显著性意义(t=25.55,9.07;P<0.05)。提示全髋关节置换修复CroweⅢ和CroweⅣ型髋关节脱位可有效重建髋臼,恢复髋关节功能,稳定假体,具有假体填充率良好、股骨-假体界面稳定率高、初始内固定稳定等优点,其临床修复效果与假体安放的位置密切相关。

全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良的疗效分析

目的 观察成人Crowe Ⅳ型髋关节发育不良患者行人工全髋关节置换术后的临床疗效.方法对19 例24髋成人Crowe Ⅳ型髋关节发育不良患者行人工全髋关节置换术,其中男5 例,女14 例,年龄39～72 岁,平均48.2 岁.术前进行详细影像学分析,患肢短缩平均（4.68±0.95） cm,术中通过结构性植骨重建髋臼,均采用生物型假体,以术前、术后Harris评分和放射学检查评价疗效.结果 19 例均得到随访,随访时间平均31个月（11个月～6年）.术前Harris评分平均（44.20±19.51）分,术后（88.70±9.34）分（P＜0.05）,下肢延长平均（4.46±0.94） cm.1 例患者术后出现坐骨神经损伤,对症治疗6个月后完全恢复,另有一例患者术后6个月出现后脱位,予以牵引固定3周后功能恢复.结论通过对成人Crowe Ⅳ型髋关节发育不良患者行人工全髋关节置换术的中期随访结果的分析,证实该治疗方法的临床效果显著.

全髋关节置换并结构性植骨治疗CroweⅢ型髋臼发育不良性骨关节炎

背景:CroweⅢ型髋关节发育不良在继发骨关节炎时需要行全髋关节置换,置换中髋臼的重建是重点和难点。目的:观察全髋关节置换并结构性植骨治疗CroweⅢ型髋臼发育不良性骨关节炎的效果。方法:选择北京朝阳医院骨科2006-01/2009-08收治的CroweⅢ型髋关节发育不良继发骨关节炎患者15例(18髋),均施行了全髋关节置换+髋臼自体结构性植骨。结果与结论:全部患者均获得随访,随访时间12-24个月,平均18个月。所有病例髋臼旋转中心都接近正常,置换前双下肢长度差为2.0-3.5cm,置换后双下肢长度差为0-1.5cm。至末次随访,Harris评分由置换前的平均38分(17-69分)升高至92分(86-96分)。提示CroweⅢ型髋关节发育不良继发骨关节炎的全髋关节置换中,将髋臼重建于真臼内、把髋臼旋转中心内移、辅以结构性植骨,可有效恢复髋臼覆盖、维持臼杯稳定并恢复下肢长度。

组配式与非组配式股骨假体全髋关节置换术治疗Crowe Ⅱ型髋关节发育不良的对比研究

背景:CroweⅡ型髋关节发育不良(DDH)患者的股骨侧重建采用组配式或非组配式假体均可,目前尚无相关研究对比两种假体的临床疗效。目的:对比应用组配式S-ROM股骨假体与非组配式Tri-Lock股骨假体行全髋关节置换术(THA)治疗CroweⅡ型DDH的临床疗效。方法:回顾性分析2014年6月至2016年6月行THA治疗的87例CroweⅡ型DDH患者的临床资料。根据股骨假体类型分为两组:组配组42例,采用S-ROM假体;非组配组45例,采用Tri-Lock假体。比较两组的手术时间、术中出血量、围手术期并发症发生率、术后住院时间、双下肢不等长发生率及末次随访Harris评分是否存在差异。结果:围手术期并发症发生率、术后住院时间、末次随访Harris评分两组比较差异均无统计学意义。组配组手术时间为60~175 min,平均(97±25)min,非组配组为55~150 min,平均(87±20)min,差异有统计学意义(P<0.05)。组配组术中出血量200~1450ml,平均(568±258)ml,非组配组为200~1100ml,平均(469±168)ml,差异有统计学意义(P<0.05)。组配组和非组配组双下肢不等长的发生率分别为45.2%(19/42)和24.4%(11/45),差异有统计学意义(P<0.05)。结论:应用组配式S-ROM股骨假体或非组配式Tri-Lock股骨假体行THA治疗CroweⅡ型DDH均可取得良好的临床疗效。应用非组配式Tri-Lock假体THA的手术时间更短,术中出血量更少,双下肢肢体长度平衡效果更好。