The field data of shale fracturing demonstrate that the flowback performance of fracturing fluid is different from that of conventional reservoirs,where the flowback rate of shale fracturing fluid is lower than that o...The field data of shale fracturing demonstrate that the flowback performance of fracturing fluid is different from that of conventional reservoirs,where the flowback rate of shale fracturing fluid is lower than that of conventional reservoirs.At the early stage of flowback,there is no single-phase flow of the liquid phase in shale,but rather a gas-water two-phase flow,such that the single-phase flow model for tight oil and gas reservoirs is not applicable.In this study,pores and microfractures are extracted based on the experimental results of computed tomography(CT)scanning,and a spatial model of microfractures is established.Then,the influence of rough microfracture surfaces on the flow is corrected using the modified cubic law,which was modified by introducing the average deviation of the microfracture height as a roughness factor to consider the influence of microfracture surface roughness.The flow in the fracture network is simulated using the modified cubic law and the lattice Boltzmann method(LBM).The results obtained demonstrate that most of the fracturing fluid is retained in the shale microfractures,which explains the low fracturing fluid flowback rate in shale hydraulic fracturing.展开更多
BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of c...BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage defect.The relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely understood.AIM To comparatively analyze the functional,radiological,and histological outcomes,and complications of various generations of MFx available for the treatment of cartilage defects.METHODS A systematic review was performed using PubMed,EMBASE,Web of Science,Cochrane,and Scopus.Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis.We included only randomized controlled trials(RCTs)reporting functional,radiological,histological outcomes or complications of various generations of MFx for the management of cartilage defects.Network meta-analysis(NMA)was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of evidence.RESULTS Forty-four RCTs were included in the analysis with patients of mean age of 39.40(±9.46)years.Upon comparing the results of the other generations with MFX-I as a constant comparator,we noted a trend towards better pain control and functional outcome(KOOS,IKDC,and Cincinnati scores)at the end of 1-,2-,and 5-year time points with MFx-III,although the differences were not statistically significant(P>0.05).We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture(weighted mean difference:17.44,95%confidence interval:0.72,34.16,P=0.025;without significant heterogeneity)at 1 year.However,the difference was not maintained at 2 years.There was a trend towards better defect filling on MRI with the second and third generation MFx,although the difference was not statistically significant(P>0.05).CONCLUSION The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.展开更多
The limited intrinsic healing potential of human articular cartilage is a well-known problem in orthopedic surgery. Thus a variety of surgical techniques have been developed to reduce joint pain, improve joint functio...The limited intrinsic healing potential of human articular cartilage is a well-known problem in orthopedic surgery. Thus a variety of surgical techniques have been developed to reduce joint pain, improve joint function and delay the onset of osteoarthritis. Microfractures as a bone marrow stimulation technique present the most common applied articular cartilage repair procedure today. Unfortunately the deficiencies of fibrocartilaginous repair tissue inevitably lead to breakdown under normal joint loading and clinical results deteriorate with time. To overcome the shortcomings of microfracture, an enhanced microfracture technique was developed with an additional collagen Ⅰ/Ⅲ membrane(Autologous, Matrix-Induced Chondrogenesis, AMIC). This article reviews the pre-clinical rationale of microfractures and AMIC, presents clinical studies and shows the advantages and disadvantages of these widely usedtechniques. PubM ed and the Cochrane database were searched to identify relevant studies. We used a comprehensive search strategy with no date or language restrictions to locate studies that examined the AMIC technique and microfracture. Search keywords included cartilage, microfracture, AMIC, knee, ChondroGide. Besides this, we included our own experiences and study authors were contacted if more and non published data were needed. Both cartilage repair techniques represent an effective and safe method of treating full-thickness chondral defects of the knee in selected cases. While results after microfracture deteriorate with time, mid-term results after AMIC seem to be enduring. Randomized studies with long-term followup are needed whether the grafted area will maintain functional improvement and structural integrity over time.展开更多
Relationship among deformation history,fracture process and stress distribution of granular bainite has been investigated.The main process of fracture of granular bainite is the forma- tion.growth and coalescence of t...Relationship among deformation history,fracture process and stress distribution of granular bainite has been investigated.The main process of fracture of granular bainite is the forma- tion.growth and coalescence of the microvoids.Even though the microcracks have formed at the earlier stage of deformation,they are not fateful for fracture because in the successive deformation stage the microcracks change their orientation toward the tensile axis.The strain hardening rate of granular bainite has a minimal value during the deformation process. Before and after the strain of the minimal value,the material shows different stress distribu- tion and microfracture mechanism.展开更多
Based on the rock typing method of pore geometry and structure(PGS), rock samples from carbonate reservoir A and carbonate reservoir B were classified using data of routine and special core analysis and thin section i...Based on the rock typing method of pore geometry and structure(PGS), rock samples from carbonate reservoir A and carbonate reservoir B were classified using data of routine and special core analysis and thin section images, and microfractures in the carbonate reservoir samples were identified and characterized. Establishment of rock types demonstrates that microfractures have developed in all rock types in carbonate reservoir A, but only partially in certain rock types in carbonate reservoir B with porosity of 1%–11%, less vuggy, and hardness of medium hard to hard. The cut-off porosity was determined for each type of rock to distinguish samples with and without conductive microfractures. The impact of conductive microfractures on improving permeability was analyzed. On the basis of relationship of permeability and original initial water saturation, the permeability equation was derived by certain special core analysis data with conductive microfractures selected by PGS equation, and the permeability of samples with conductive microfractures has been successfully predicted.展开更多
A high-precision microseismic(MS)monitoring system was built to monitor surrounding rock microfractures in the underground powerhouse on the left bank of Shuangjiangkou Hydropower Station.The surrounding rock damage a...A high-precision microseismic(MS)monitoring system was built to monitor surrounding rock microfractures in the underground powerhouse on the left bank of Shuangjiangkou Hydropower Station.The surrounding rock damage area with spatiotemporal clustering of MS activities was studied for qualitative analysis of the damage mechanism of surrounding rock microfractures,based on the source parameters of MS events.The surrounding rock microfracture scale characterized by the source radius of MS events was considered to establish the constitutive relation.MS information was imported into the model for numerical analysis using fast Lagrangian analysis of continuain 3 dimensions(FLAC^(3D)).The results indicated that the numerical simulation results considering MS damage can better reflect the actual situation of the field.The surrounding rock microfractures mainly showed mixed failure characteristics.Shear failures appeared in localized areas while the fracture scale of sections from K0e33 m to K0e15 m on the vault was large.The deformation increment caused by microfracture damage in the shallow surrounding rock of the top arch accounted for 10%e13%,and the stress decrement in the surrounding rock caused by microfracture damage accounted for about 10%.展开更多
Objective:To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of mini...Objective:To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of minipigs was taken out and the bone marrow derived mesenchymal stem cells (BMSCs) were isolated and cultured to passage 3. Then 6 minipigs were randomly divided into 2 groups with 6 knees in each group. After the articular cartilage defect was induced in each knee, the left defect received microfracture surgery and was injected with 2.5 ml BMSCs cells at a concentration of 3×107 cells/ml into the articular cavity; while right knee got single microfracture or served as blank control group. The animals were killed at 8 or 16 weeks, and the repair tissue was histologically and immunohistochemically examined for the presence of type Ⅱ collagen and glycosaminoglycans (GAGs) at 8 and 16 weeks. Results: Eight weeks after the surgery, the overlying articular surface of the cartilage defect showed normal color and integrated to adjacent cartilage. And 16 weeks after surgery, hyaline cartilage was observed at the repairing tissues and immunostaining indicated the diffuse presence of this type Ⅱ collagen and GAGs throughout the repair cartilage in the treated defects. Single microfracture group had the repairing of fibrocartilage, while during the treatment, the defects of blank group were covered with fewer fiber tissues, and no blood capillary growth or any immunological rejection was observed. Conclusion: Microfracture technique and BMSCs transplantation to repair cartilage defect is characterized with minimal invasion and easy operation, and it will greatly promote the regeneration repair of articular cartilage defect.展开更多
Based on the comprehensive understanding on microfractures and matrix pores in reservoir rocks,numerical algorithms are used to construct fractured porous media and fracture-pore media models.Connectivity coefficient ...Based on the comprehensive understanding on microfractures and matrix pores in reservoir rocks,numerical algorithms are used to construct fractured porous media and fracture-pore media models.Connectivity coefficient and strike factor are introduced into the models to quantitatively characterize the connectivity and strike of fracture network,respectively.The influences of fracture aperture,fracture strike and fracture connectivity on the permeability of porous media are studied by using multi-relaxation-time lattice Boltzmann model to simulate fluid flow in them.The greater the strike factor and the smaller the tortuosity of the fractured porous media,the greater the permeability of the fractured porous media.The greater the connectivity coefficient of the fracture network is,the greater the permeability of the fracture-pore media is,and the more likely dominant channel effect occurs.The fracture network connectivity has stronger influence on seepage ability of fracture-pore media than fracture aperture and fracture strike.The tortuosity and strike factor of fracture network in fractured porous media are in polynomial relation,while the permeability and fracture network connectivity coefficient of the fracture-pore media meet an exponential relation.展开更多
When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of t...When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of the newly-formed fibrocartilage.After performing arthroscopic debridement and microfracture treatment on OCLT patients with subchondral bone defects,we allowed patients to have an early postoperative weightbearing exercise to observe their clinical outcome.Forty-two OCLT patients with subchondral bone defects were analyzed.Patients were randomly divided into two groups with 21 patients in each group.After arthroscopic debridement and microfracture treatment,group A was allowed to have early partial weightbearing while weightbearing was delayed in group B.Visual analogue scale(VAS)was used to evaluate joint pain before and after surgery.American Orthopaedic Foot and Ankle Society(AOFAS)anklc-hindfoot score was used to evaluate joint function.Tegner activity scale was used to assess patient's exercise level.The AOFAS ankle-hindfoot score in group A increased from 54.4 to 87.6,and that in group B increased from 54.9 to 87.3.The VAS score in group A decreased from 6.5 to 2.2,and that in group B decreased from 6.4 to 2.3.The Tegner activity scale increased from 2.6 to 4.4 in group A,and that in group B increased from 2.6 to 3.9.There was significant difference in the Tegner activity scale between group A and group B(P<0.05).It was suggested that when performing microfracture treatmenf on OCLT patients with subchondral bone defects,early postoperative weightbearing may achieve similar clinical outcomes as delayed weightbearing,and patients may be better able to return to sports.展开更多
Fluid invasion through fractures is frequently observed in subsurface engineering. To elucidate the microkinetic behavior of fracture fluids, the microfracture structure of coal from the Surat Basin was reconstructed ...Fluid invasion through fractures is frequently observed in subsurface engineering. To elucidate the microkinetic behavior of fracture fluids, the microfracture structure of coal from the Surat Basin was reconstructed using a 3D morphometric system and stitching algorithm, then the transparent models characterizing the fracture structure were produced using microfluidics, and water invasion in the microfracture model was measured via visualization experiments under various conditions. High flow rate facilitated the invasion of the water phase into the closed channel, improving the efficiency of water invasion in the neutral wetting system. Wettability reversal changed the dominant channel for water invasion in the hydrophobic system. The invasion efficiency in closed and small aperture bypass channels was low.The reduction of effective seepage channels led to the fastest breakthrough time. Higher surface tension and interfacial curvature promoted the hysteresis effect. The reduction of effective seepage channels led to the fastest breakthrough time. The larger surface tension and interfacial curvature make the hysteresis effect more significant. These results will enable a better understanding of the rock-gas-liquid multiphase interaction mechanisms under unsaturated conditions of rocks.展开更多
Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-c...Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-cartilage regeneration to focal lesions. The procedure has shown that small fractures to the subchondral bone can recruit mesenchymal stem cells and growth factors to regenerate the fibrocartilage without compromising the subchondral plate. With the simplicity of this procedure and the positive effect it can have on patients, it is natural to want to push the bounds of rehabilitation to see what is necessary. The patient in this case report exhibits the potential for positive outcomes with early weight-bearing status in patients receiving microfractures via subchondral drilling. This positive outcome, along with others, should encourage clinicians to consider reestablishing evidence-guided rehabilitation post microfracture with new studies. Shortened rehabilitation time would decrease a barrier to surgery for many patients and would only enhance our treatment with this surgical modality.展开更多
背景:距骨骨软骨损伤根据不同分型或临床症状,采取不同的治疗方法,包括保守治疗、手术治疗和生物制剂治疗。保守治疗大多可短时缓解症状和延缓病情;近年来关节镜下微骨折、克氏针钻孔、距骨软骨移植、自体骨软骨细胞移植、干细胞移植和...背景:距骨骨软骨损伤根据不同分型或临床症状,采取不同的治疗方法,包括保守治疗、手术治疗和生物制剂治疗。保守治疗大多可短时缓解症状和延缓病情;近年来关节镜下微骨折、克氏针钻孔、距骨软骨移植、自体骨软骨细胞移植、干细胞移植和生物制剂富血小板血浆等方法,都取得了不错的疗效。目的:对距骨骨软骨损伤的治疗进展进行总结,为其临床治疗提供参考。方法:第一作者以“talus,osteochondral lesions of the talus,微骨折,移植术,富血小板血浆,干细胞”为检索词,检索Pub Med数据库及中国知网2019年1月至2024年1月的相关文章。共纳入67篇文献进行综合分析。结果与结论:(1)目前治疗距骨骨软骨损伤的方式较多,对于Hepple分型Ⅰ和Ⅱ型病变保守康复治疗和生物制剂可缓解病情;Hepple分型Ⅲ型及以上且病变直径<15 mm选择微骨折或克氏针钻孔骨髓刺激治疗,但长期疗效不佳;更大病变面积选择置换和再生策略,移植失败是其最主要风险;(2)生物制剂治疗作为一种治疗新方式,多用于组合治疗;(3)针对距骨骨软骨损伤的治疗,需要考虑到软骨损伤的面积、部位等诸多因素,其治疗方案的选择还应考虑医疗技术开展情况以及患者接受程度、经济状况等因素,建议对各种方案进行个性化组合治疗,以取得更为良好的效果。展开更多
Objective:To evaluate the clinical efficacy of combining arthroscopic patellar denervation with microfracture in the treatment of patellofemoral arthritis under cold weather conditions.Methods:A total of 134 patients ...Objective:To evaluate the clinical efficacy of combining arthroscopic patellar denervation with microfracture in the treatment of patellofemoral arthritis under cold weather conditions.Methods:A total of 134 patients with patellofemoral arthritis who underwent treatment between June 2019 and June 2021 were included in this study.Patients were randomly divided into two groups:the control group,which received standard arthroscopic debridement and conventional therapy,and the study group,which underwent additional peripatellar denervation and microfracture procedures.Clinical outcomes,including Tegner scores,hospital for special surgery(HSS)scores,and treatment-related adverse events,were evaluated and compared between the two groups.Results:The study group achieved a significantly higher excellent treatment rate(95.52%,64/67)compared to the control group.Post-treatment Tegner scores(5.48±1.86)and HSS scores(86.37±11.25)were also significantly better in the study group than in the control group.Furthermore,the incidence of adverse reactions was lower in the study group(4.48%,3/67),with statistically significant differences observed(P<0.05).Conclusions:Arthroscopic patellar denervation combined with microfracture markedly improves clinical outcomes,including Tegner and HSS scores,in the treatment of patellofemoral arthritis,particularly under cold weather conditions.The procedure is effective and safe,supporting its broader clinical application.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.52022087).
文摘The field data of shale fracturing demonstrate that the flowback performance of fracturing fluid is different from that of conventional reservoirs,where the flowback rate of shale fracturing fluid is lower than that of conventional reservoirs.At the early stage of flowback,there is no single-phase flow of the liquid phase in shale,but rather a gas-water two-phase flow,such that the single-phase flow model for tight oil and gas reservoirs is not applicable.In this study,pores and microfractures are extracted based on the experimental results of computed tomography(CT)scanning,and a spatial model of microfractures is established.Then,the influence of rough microfracture surfaces on the flow is corrected using the modified cubic law,which was modified by introducing the average deviation of the microfracture height as a roughness factor to consider the influence of microfracture surface roughness.The flow in the fracture network is simulated using the modified cubic law and the lattice Boltzmann method(LBM).The results obtained demonstrate that most of the fracturing fluid is retained in the shale microfractures,which explains the low fracturing fluid flowback rate in shale hydraulic fracturing.
文摘BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage defect.The relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely understood.AIM To comparatively analyze the functional,radiological,and histological outcomes,and complications of various generations of MFx available for the treatment of cartilage defects.METHODS A systematic review was performed using PubMed,EMBASE,Web of Science,Cochrane,and Scopus.Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis.We included only randomized controlled trials(RCTs)reporting functional,radiological,histological outcomes or complications of various generations of MFx for the management of cartilage defects.Network meta-analysis(NMA)was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of evidence.RESULTS Forty-four RCTs were included in the analysis with patients of mean age of 39.40(±9.46)years.Upon comparing the results of the other generations with MFX-I as a constant comparator,we noted a trend towards better pain control and functional outcome(KOOS,IKDC,and Cincinnati scores)at the end of 1-,2-,and 5-year time points with MFx-III,although the differences were not statistically significant(P>0.05).We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture(weighted mean difference:17.44,95%confidence interval:0.72,34.16,P=0.025;without significant heterogeneity)at 1 year.However,the difference was not maintained at 2 years.There was a trend towards better defect filling on MRI with the second and third generation MFx,although the difference was not statistically significant(P>0.05).CONCLUSION The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.
文摘The limited intrinsic healing potential of human articular cartilage is a well-known problem in orthopedic surgery. Thus a variety of surgical techniques have been developed to reduce joint pain, improve joint function and delay the onset of osteoarthritis. Microfractures as a bone marrow stimulation technique present the most common applied articular cartilage repair procedure today. Unfortunately the deficiencies of fibrocartilaginous repair tissue inevitably lead to breakdown under normal joint loading and clinical results deteriorate with time. To overcome the shortcomings of microfracture, an enhanced microfracture technique was developed with an additional collagen Ⅰ/Ⅲ membrane(Autologous, Matrix-Induced Chondrogenesis, AMIC). This article reviews the pre-clinical rationale of microfractures and AMIC, presents clinical studies and shows the advantages and disadvantages of these widely usedtechniques. PubM ed and the Cochrane database were searched to identify relevant studies. We used a comprehensive search strategy with no date or language restrictions to locate studies that examined the AMIC technique and microfracture. Search keywords included cartilage, microfracture, AMIC, knee, ChondroGide. Besides this, we included our own experiences and study authors were contacted if more and non published data were needed. Both cartilage repair techniques represent an effective and safe method of treating full-thickness chondral defects of the knee in selected cases. While results after microfracture deteriorate with time, mid-term results after AMIC seem to be enduring. Randomized studies with long-term followup are needed whether the grafted area will maintain functional improvement and structural integrity over time.
文摘Relationship among deformation history,fracture process and stress distribution of granular bainite has been investigated.The main process of fracture of granular bainite is the forma- tion.growth and coalescence of the microvoids.Even though the microcracks have formed at the earlier stage of deformation,they are not fateful for fracture because in the successive deformation stage the microcracks change their orientation toward the tensile axis.The strain hardening rate of granular bainite has a minimal value during the deformation process. Before and after the strain of the minimal value,the material shows different stress distribu- tion and microfracture mechanism.
基金P3MI Bandung Institute of Technology for providing the financial support to conduct this study。
文摘Based on the rock typing method of pore geometry and structure(PGS), rock samples from carbonate reservoir A and carbonate reservoir B were classified using data of routine and special core analysis and thin section images, and microfractures in the carbonate reservoir samples were identified and characterized. Establishment of rock types demonstrates that microfractures have developed in all rock types in carbonate reservoir A, but only partially in certain rock types in carbonate reservoir B with porosity of 1%–11%, less vuggy, and hardness of medium hard to hard. The cut-off porosity was determined for each type of rock to distinguish samples with and without conductive microfractures. The impact of conductive microfractures on improving permeability was analyzed. On the basis of relationship of permeability and original initial water saturation, the permeability equation was derived by certain special core analysis data with conductive microfractures selected by PGS equation, and the permeability of samples with conductive microfractures has been successfully predicted.
基金support from the National Key R&D Program of China(Grant No.2017YFC1501100)the Science Foundation for Distinguished Young Scholars of Sichuan Province(Grant No.2020JDJQ0011)the National Natural Science Foundation of China(Grant No.42177143).
文摘A high-precision microseismic(MS)monitoring system was built to monitor surrounding rock microfractures in the underground powerhouse on the left bank of Shuangjiangkou Hydropower Station.The surrounding rock damage area with spatiotemporal clustering of MS activities was studied for qualitative analysis of the damage mechanism of surrounding rock microfractures,based on the source parameters of MS events.The surrounding rock microfracture scale characterized by the source radius of MS events was considered to establish the constitutive relation.MS information was imported into the model for numerical analysis using fast Lagrangian analysis of continuain 3 dimensions(FLAC^(3D)).The results indicated that the numerical simulation results considering MS damage can better reflect the actual situation of the field.The surrounding rock microfractures mainly showed mixed failure characteristics.Shear failures appeared in localized areas while the fracture scale of sections from K0e33 m to K0e15 m on the vault was large.The deformation increment caused by microfracture damage in the shallow surrounding rock of the top arch accounted for 10%e13%,and the stress decrement in the surrounding rock caused by microfracture damage accounted for about 10%.
基金Supported by the National Natural Science Foundation ofChina (No. 30070224)the Key Project of the ScientificResearch Foundation for Medical Science and Public Healthof PLA(No. 01Z072)
文摘Objective:To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of minipigs was taken out and the bone marrow derived mesenchymal stem cells (BMSCs) were isolated and cultured to passage 3. Then 6 minipigs were randomly divided into 2 groups with 6 knees in each group. After the articular cartilage defect was induced in each knee, the left defect received microfracture surgery and was injected with 2.5 ml BMSCs cells at a concentration of 3×107 cells/ml into the articular cavity; while right knee got single microfracture or served as blank control group. The animals were killed at 8 or 16 weeks, and the repair tissue was histologically and immunohistochemically examined for the presence of type Ⅱ collagen and glycosaminoglycans (GAGs) at 8 and 16 weeks. Results: Eight weeks after the surgery, the overlying articular surface of the cartilage defect showed normal color and integrated to adjacent cartilage. And 16 weeks after surgery, hyaline cartilage was observed at the repairing tissues and immunostaining indicated the diffuse presence of this type Ⅱ collagen and GAGs throughout the repair cartilage in the treated defects. Single microfracture group had the repairing of fibrocartilage, while during the treatment, the defects of blank group were covered with fewer fiber tissues, and no blood capillary growth or any immunological rejection was observed. Conclusion: Microfracture technique and BMSCs transplantation to repair cartilage defect is characterized with minimal invasion and easy operation, and it will greatly promote the regeneration repair of articular cartilage defect.
基金Supported by the Science and Technology Major Project of PetroChina(2016E-06)National Natural Science Foundation of China(U1562217)。
文摘Based on the comprehensive understanding on microfractures and matrix pores in reservoir rocks,numerical algorithms are used to construct fractured porous media and fracture-pore media models.Connectivity coefficient and strike factor are introduced into the models to quantitatively characterize the connectivity and strike of fracture network,respectively.The influences of fracture aperture,fracture strike and fracture connectivity on the permeability of porous media are studied by using multi-relaxation-time lattice Boltzmann model to simulate fluid flow in them.The greater the strike factor and the smaller the tortuosity of the fractured porous media,the greater the permeability of the fractured porous media.The greater the connectivity coefficient of the fracture network is,the greater the permeability of the fracture-pore media is,and the more likely dominant channel effect occurs.The fracture network connectivity has stronger influence on seepage ability of fracture-pore media than fracture aperture and fracture strike.The tortuosity and strike factor of fracture network in fractured porous media are in polynomial relation,while the permeability and fracture network connectivity coefficient of the fracture-pore media meet an exponential relation.
文摘When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of the newly-formed fibrocartilage.After performing arthroscopic debridement and microfracture treatment on OCLT patients with subchondral bone defects,we allowed patients to have an early postoperative weightbearing exercise to observe their clinical outcome.Forty-two OCLT patients with subchondral bone defects were analyzed.Patients were randomly divided into two groups with 21 patients in each group.After arthroscopic debridement and microfracture treatment,group A was allowed to have early partial weightbearing while weightbearing was delayed in group B.Visual analogue scale(VAS)was used to evaluate joint pain before and after surgery.American Orthopaedic Foot and Ankle Society(AOFAS)anklc-hindfoot score was used to evaluate joint function.Tegner activity scale was used to assess patient's exercise level.The AOFAS ankle-hindfoot score in group A increased from 54.4 to 87.6,and that in group B increased from 54.9 to 87.3.The VAS score in group A decreased from 6.5 to 2.2,and that in group B decreased from 6.4 to 2.3.The Tegner activity scale increased from 2.6 to 4.4 in group A,and that in group B increased from 2.6 to 3.9.There was significant difference in the Tegner activity scale between group A and group B(P<0.05).It was suggested that when performing microfracture treatmenf on OCLT patients with subchondral bone defects,early postoperative weightbearing may achieve similar clinical outcomes as delayed weightbearing,and patients may be better able to return to sports.
基金Projects(52174159, 52074169, 52174026, 51904167, 52004146) supported by the National Nature Science Foundation of ChinaProject(ZR2020QE102) supported by the Natural Science Foundation Youth Branch of Shandong Province,ChinaProject(SKLMRDPC21KF06) supported by the Open Fund for State Key Laboratory of Mining Response and Disaster Prevention and Control in Deep Coal Mines,China。
文摘Fluid invasion through fractures is frequently observed in subsurface engineering. To elucidate the microkinetic behavior of fracture fluids, the microfracture structure of coal from the Surat Basin was reconstructed using a 3D morphometric system and stitching algorithm, then the transparent models characterizing the fracture structure were produced using microfluidics, and water invasion in the microfracture model was measured via visualization experiments under various conditions. High flow rate facilitated the invasion of the water phase into the closed channel, improving the efficiency of water invasion in the neutral wetting system. Wettability reversal changed the dominant channel for water invasion in the hydrophobic system. The invasion efficiency in closed and small aperture bypass channels was low.The reduction of effective seepage channels led to the fastest breakthrough time. Higher surface tension and interfacial curvature promoted the hysteresis effect. The reduction of effective seepage channels led to the fastest breakthrough time. The larger surface tension and interfacial curvature make the hysteresis effect more significant. These results will enable a better understanding of the rock-gas-liquid multiphase interaction mechanisms under unsaturated conditions of rocks.
文摘Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-cartilage regeneration to focal lesions. The procedure has shown that small fractures to the subchondral bone can recruit mesenchymal stem cells and growth factors to regenerate the fibrocartilage without compromising the subchondral plate. With the simplicity of this procedure and the positive effect it can have on patients, it is natural to want to push the bounds of rehabilitation to see what is necessary. The patient in this case report exhibits the potential for positive outcomes with early weight-bearing status in patients receiving microfractures via subchondral drilling. This positive outcome, along with others, should encourage clinicians to consider reestablishing evidence-guided rehabilitation post microfracture with new studies. Shortened rehabilitation time would decrease a barrier to surgery for many patients and would only enhance our treatment with this surgical modality.
文摘背景:距骨骨软骨损伤根据不同分型或临床症状,采取不同的治疗方法,包括保守治疗、手术治疗和生物制剂治疗。保守治疗大多可短时缓解症状和延缓病情;近年来关节镜下微骨折、克氏针钻孔、距骨软骨移植、自体骨软骨细胞移植、干细胞移植和生物制剂富血小板血浆等方法,都取得了不错的疗效。目的:对距骨骨软骨损伤的治疗进展进行总结,为其临床治疗提供参考。方法:第一作者以“talus,osteochondral lesions of the talus,微骨折,移植术,富血小板血浆,干细胞”为检索词,检索Pub Med数据库及中国知网2019年1月至2024年1月的相关文章。共纳入67篇文献进行综合分析。结果与结论:(1)目前治疗距骨骨软骨损伤的方式较多,对于Hepple分型Ⅰ和Ⅱ型病变保守康复治疗和生物制剂可缓解病情;Hepple分型Ⅲ型及以上且病变直径<15 mm选择微骨折或克氏针钻孔骨髓刺激治疗,但长期疗效不佳;更大病变面积选择置换和再生策略,移植失败是其最主要风险;(2)生物制剂治疗作为一种治疗新方式,多用于组合治疗;(3)针对距骨骨软骨损伤的治疗,需要考虑到软骨损伤的面积、部位等诸多因素,其治疗方案的选择还应考虑医疗技术开展情况以及患者接受程度、经济状况等因素,建议对各种方案进行个性化组合治疗,以取得更为良好的效果。
基金supported by grants from the Natural Science Foundation of Heilongjiang Province of China(JQ2020H003)Heilongjiang Postdoctoral Fund(NO.LBH-Z23257)+1 种基金the Innovative Science Research Fund of Harbin Medical University(also known as Heilongjiang Provincial University's Project of Graduate Scientific Research Business Fees)(2022-KYYWF-0274)the Youth TCM scientific research Project of Heilongjiang Province TCM Administration(ZHY2024-283).
文摘Objective:To evaluate the clinical efficacy of combining arthroscopic patellar denervation with microfracture in the treatment of patellofemoral arthritis under cold weather conditions.Methods:A total of 134 patients with patellofemoral arthritis who underwent treatment between June 2019 and June 2021 were included in this study.Patients were randomly divided into two groups:the control group,which received standard arthroscopic debridement and conventional therapy,and the study group,which underwent additional peripatellar denervation and microfracture procedures.Clinical outcomes,including Tegner scores,hospital for special surgery(HSS)scores,and treatment-related adverse events,were evaluated and compared between the two groups.Results:The study group achieved a significantly higher excellent treatment rate(95.52%,64/67)compared to the control group.Post-treatment Tegner scores(5.48±1.86)and HSS scores(86.37±11.25)were also significantly better in the study group than in the control group.Furthermore,the incidence of adverse reactions was lower in the study group(4.48%,3/67),with statistically significant differences observed(P<0.05).Conclusions:Arthroscopic patellar denervation combined with microfracture markedly improves clinical outcomes,including Tegner and HSS scores,in the treatment of patellofemoral arthritis,particularly under cold weather conditions.The procedure is effective and safe,supporting its broader clinical application.