Similar to hydraulic fracturing(HF), the coalescence and fracture of cracks are induced within a rock under the action of an ultrasonic field, known as ultrasonic fracturing(UF). Investigating UF is important in both ...Similar to hydraulic fracturing(HF), the coalescence and fracture of cracks are induced within a rock under the action of an ultrasonic field, known as ultrasonic fracturing(UF). Investigating UF is important in both hard rock drilling and oil and gas recovery. A three-dimensional internal laser-engraved crack(3D-ILC) method was introduced to prefabricate two parallel internal cracks within the samples without any damage to the surface. The samples were subjected to UF. The mechanism of UF was elucidated by analyzing the characteristics of fracture surfaces. The crack propagation path under different ultrasonic parameters was obtained by numerical simulation based on the Paris fatigue model and compared to the experimental results of UF. The results show that the 3D-ILC method is a powerful tool for UF research.Under the action of an ultrasonic field, the fracture surface shows the characteristics of beach marks and contains powder locally, indicating that the UF mechanism includes high-cycle fatigue fracture, shear and friction, and temperature load. The two internal cracks become close under UF. The numerical result obtained by the Paris fatigue model also shows the attraction of the two cracks, consistent with the test results. The 3D-ILC method provides a new tool for the experimental study of UF. Compared to the conventional numerical methods based on the analysis of stress-strain and plastic zone, numerical simulation can be a good alternative method to obtain the crack path under UF.展开更多
We present an efficient three-dimensional coupled-mode model based on the Fourier synthesis technique. In principle, this model is a one-way model, and hence provides satisfactory accuracy for problems where the forwa...We present an efficient three-dimensional coupled-mode model based on the Fourier synthesis technique. In principle, this model is a one-way model, and hence provides satisfactory accuracy for problems where the forward scattering dominates. At the same time, this model provides an efficiency gain of an order of magnitude or more over two-way coupled-mode models. This model can be applied to three-dimensional range-dependent problems with a slowly varying bathymetry or internal waves. A numerical example of the latter is demonstrated in this work. Comparisons of both accuracy and efficiency between the present model and a benchmark model are also provided.展开更多
AIM To assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP). METHODS In this unmatched case control stud...AIM To assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP). METHODS In this unmatched case control study, 30 consecutive female patients with CP and 25 normal women (control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincter (IAS), thickness of puborectalis muscle (PR), length of the external anal sphincter (EAS) plus PR, and puborectalis angle were measured and compared between the two groups. RESULTS Patients with CP had significantly shorter IAS length and greater PR thickness, as compared to those in normal individuals (26.28 +/- 3.59 mm vs 28.87 +/- 4.84 mm, P < 0.05 and 9.67 +/- 1.57 mm vs 8.85 +/- 0.97 mm, P < 0.05, respectively). No significant between-group differences were observed with respect to IAS thickness and the EAS plus PR length (P > 0.05). Puborectalis angle in the CP group was significantly decreased, both in resting (88.23 degrees +/- 1.81 degrees vs 89.94 degrees +/- 2.07 degrees in control group, P < 0.05) and straining (88.47 degrees +/- 3.32 degrees vs 90.72 degrees +/- 1.87 degrees in control group, P < 0.05) phases, which suggest the presence of paradoxical contraction of PR in patients with CP. In the CP group, no significant difference in puborectalis angle was observed between the resting and straining phases (88.23 degrees +/- 1.81 degrees vs 88.47 degrees +/- 3.32 degrees respectively, P > 0.05). CONCLUSION The association of greater PR thickness and paradoxical contraction of PR with CP suggest their potential value as markers of CP.展开更多
Acoustic modal behavior is reported for an L-shape hydrophone array during the passage of a strong nonlinear internal wave packet. Acoustic track is nearly parallel to the front of nonlinear internal waves. Through mo...Acoustic modal behavior is reported for an L-shape hydrophone array during the passage of a strong nonlinear internal wave packet. Acoustic track is nearly parallel to the front of nonlinear internal waves. Through modal decomposition at the vertical array, acoustic modes are identified. Modal evolution along the horizontal array then is examined during a passing internal wave. Strong intensity fluctuations of individual modes are observed before and during the internal waves packet passes the fixed acoustic track showing a detailed evolution of the waveguide modal behavior. Acoustic refraction created either uneven distribution of modal energy over the horizontal array or additional returns observable at the entire L-shape array. Acoustic ray-mode simulations are used to phenomenologically explain the observed modal behavior.展开更多
Heat and mass transfer effects in three-dimensional flow of Maxwell fluid over a stretching surface were addressed.Analysis was performed in the presence of internal heat generation/absorption. Concentration and therm...Heat and mass transfer effects in three-dimensional flow of Maxwell fluid over a stretching surface were addressed.Analysis was performed in the presence of internal heat generation/absorption. Concentration and thermal buoyancy effects were accounted. Convective boundary conditions for heat and mass transfer analysis were explored. Series solutions of the resulting problem were developed. Effects of mixed convection, internal heat generation/absorption parameter and Biot numbers on the dimensionless velocity, temperature and concentration distributions were illustrated graphically. Numerical values of local Nusselt and Sherwood numbers were obtained and analyzed for all the physical parameters. It is found that both thermal and concentration boundary layer thicknesses are decreasing functions of stretching ratio. Variations of mixed convection parameter and concentration buoyancy parameter on the velocity profiles and associated boundary layer thicknesses are enhanced. Velocity profiles and temperature increase in the case of internal heat generation while they reduce for heat absorption. Heat transfer Biot number increases the thermal boundary layer thickness and temperature. Also concentration and its associated boundary layer are enhanced with an increase in mass transfer Biot number. The local Nusselt and Sherwood numbers have quite similar behaviors for increasing values of mixed convection parameter, concentration buoyancy parameter and Deborah number.展开更多
Eco-translatology provides a new perspective and methodology for the international publicity translation of political texts.This paper applies the viewpoint and methodology of eco-translatology,focuses on the three-di...Eco-translatology provides a new perspective and methodology for the international publicity translation of political texts.This paper applies the viewpoint and methodology of eco-translatology,focuses on the three-dimensional transformation of language,culture,and communication,and discusses how translators can adapt to the eco-environment of political texts through the specific example of the keynote speech of China’s president at the opening ceremony of the Third Belt and Road Forum for International Cooperation and select suitable translation strategies and techniques to achieve an ecological balance of the target text in multiple dimensions.展开更多
Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We...Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.展开更多
Background:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum.Seldom study has compared the application o...Background:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum.Seldom study has compared the application of three-dimensional(3D)printing technology and traditional methods of contouring plates intra-operatively for the surgical treatment of both-column acetabular fractures.We presented the use of both 3D printing technology and a virtual simulation in pre-operative planning for both-column acetabular fractures.We hypothesized that 3D printing technology will assist orthopedic surgeons in shortening the surgical time and improving the clinical outcomes.Methods:Forty patients with both-column acetabular fractures were recruited in the randomized prospective case-control study from September 2013 to September 2017 for this prospective study(No.ChiCTR1900028230).We allocated the patients to two groups using block randomization(3D printing group,n=20;conventional method group,n=20).For the 3D printing group,1:1 scaled pelvic models were created using 3D printing,and the plates were pre-contoured according to the pelvic models.The plates for the conventional method group were contoured during the operation without 3D printed pelvic models.The operation time,instrumentation time,time of intra-operative fluoroscopy,blood loss,number of times the approach was performed,blood transfusion,post-operative fracture reduction quality,hip joint function,and complications were recorded and compared between the two groups.Results:The operation and instrumentation times in the 3D printing group were significantly shorter(130.8±29.2 min,t=-7.5,P<0.001 and 32.1±9.5 min,t=-6.5,P<0.001,respectively)than those in the conventional method group.The amount of blood loss and blood transfusion in the 3D printing group were significantly lower(500[400,800]mL,Mann-Whitney U=74.5,P<0.001 and 0[0,400]mL,Mann-Whitney U=59.5,P<0.001,respectively)than those in the conventional method group.The number of the approach performed in the 3D printing group was significantly smaller than that in the conventional method group(pararectus+Kocher-Langenbeck[K-L]approach rate:35%vs.85%;x2=10.4,P<0.05).The time of intra-operative fluoroscopy in the 3D printing group was significantly shorter than that in the conventional method group(4.2±1.8 vs.7.7±2.6 s;t=-5.0,P<0.001).The post-operative fracture reduction quality in the 3D printing group was significantly better than that in the conventional method group(good reduction rate:80%vs.30%;x2=10.1,P<0.05).The hip joint function(based on the Harris score 1 year after the operation)in the 3D printing group was significantly better than that in the conventional method group(excellent/good rate:75%vs.30%;χ^2=8.1,P<0.05).The complication was similar in both groups(5.0%vs.25%;χ^2=3.1,P=0.182).Conclusions:The use of a pre-operative virtual simulation and 3D printing technology is a more effective method for treating bothcolumn acetabular fractures.This method can shorten the operation and instrumentation times,reduce blood loss,blood transfusion and the time of intra-operative fluoroscopy,and improve the post-operative fracture reduction quality.展开更多
BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can c...BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.展开更多
The temperature uniformity and component concentration distributions in solid oxide fuel cells during operating processes can influence the cell electrochemical and thermal characteristics.A three-dimensional thermal-...The temperature uniformity and component concentration distributions in solid oxide fuel cells during operating processes can influence the cell electrochemical and thermal characteristics.A three-dimensional thermal-fluid numerical model including electrochemical reactions and water-gas-shift(WGS)reaction for a single channel solid oxide fuel cell was developed to study the steady-state characteristics,which include distributions of the temperature(T),temperature gradient((35)T/(35)x),and fuel utilization.It was shown that the maximum temperature(Tmax)changed with operating voltage and the maximum temperature gradient(((35)T/(35)x)max)occurred at the inlet of the channel of a solid oxide fuel cell by simulation.Moreover,the natural convection condition had a great influence on T and(35)T/(35)x.The thermal stress generated by temperature differences was the key parameter and increasing the convection heat-transfer coefficient can greatly reduce the thermal stress.In addition,the results also showed that there were lower temperature gradients and lower current density at high working voltage;therefore,choosing the proper operating voltage can obtain better cell performance.展开更多
基金supported by the National Natural Science Foundation of China (Grant Nos. 52104125, U1765204 and 51739008)
文摘Similar to hydraulic fracturing(HF), the coalescence and fracture of cracks are induced within a rock under the action of an ultrasonic field, known as ultrasonic fracturing(UF). Investigating UF is important in both hard rock drilling and oil and gas recovery. A three-dimensional internal laser-engraved crack(3D-ILC) method was introduced to prefabricate two parallel internal cracks within the samples without any damage to the surface. The samples were subjected to UF. The mechanism of UF was elucidated by analyzing the characteristics of fracture surfaces. The crack propagation path under different ultrasonic parameters was obtained by numerical simulation based on the Paris fatigue model and compared to the experimental results of UF. The results show that the 3D-ILC method is a powerful tool for UF research.Under the action of an ultrasonic field, the fracture surface shows the characteristics of beach marks and contains powder locally, indicating that the UF mechanism includes high-cycle fatigue fracture, shear and friction, and temperature load. The two internal cracks become close under UF. The numerical result obtained by the Paris fatigue model also shows the attraction of the two cracks, consistent with the test results. The 3D-ILC method provides a new tool for the experimental study of UF. Compared to the conventional numerical methods based on the analysis of stress-strain and plastic zone, numerical simulation can be a good alternative method to obtain the crack path under UF.
基金Supported by the National Natural Science Foundation of China under Grant No 11774374the Natural Science Foundation of Shandong Province of China under Grant No ZR2016AL10
文摘We present an efficient three-dimensional coupled-mode model based on the Fourier synthesis technique. In principle, this model is a one-way model, and hence provides satisfactory accuracy for problems where the forward scattering dominates. At the same time, this model provides an efficiency gain of an order of magnitude or more over two-way coupled-mode models. This model can be applied to three-dimensional range-dependent problems with a slowly varying bathymetry or internal waves. A numerical example of the latter is demonstrated in this work. Comparisons of both accuracy and efficiency between the present model and a benchmark model are also provided.
基金Supported by the State administration of Traditional Secretary and the nanjing health Bureau,no.YKK12142
文摘AIM To assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP). METHODS In this unmatched case control study, 30 consecutive female patients with CP and 25 normal women (control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincter (IAS), thickness of puborectalis muscle (PR), length of the external anal sphincter (EAS) plus PR, and puborectalis angle were measured and compared between the two groups. RESULTS Patients with CP had significantly shorter IAS length and greater PR thickness, as compared to those in normal individuals (26.28 +/- 3.59 mm vs 28.87 +/- 4.84 mm, P < 0.05 and 9.67 +/- 1.57 mm vs 8.85 +/- 0.97 mm, P < 0.05, respectively). No significant between-group differences were observed with respect to IAS thickness and the EAS plus PR length (P > 0.05). Puborectalis angle in the CP group was significantly decreased, both in resting (88.23 degrees +/- 1.81 degrees vs 89.94 degrees +/- 2.07 degrees in control group, P < 0.05) and straining (88.47 degrees +/- 3.32 degrees vs 90.72 degrees +/- 1.87 degrees in control group, P < 0.05) phases, which suggest the presence of paradoxical contraction of PR in patients with CP. In the CP group, no significant difference in puborectalis angle was observed between the resting and straining phases (88.23 degrees +/- 1.81 degrees vs 88.47 degrees +/- 3.32 degrees respectively, P > 0.05). CONCLUSION The association of greater PR thickness and paradoxical contraction of PR with CP suggest their potential value as markers of CP.
基金Supported by U.S. Office of Naval Research,Ocean Acoustics Program(322OA)under Nos.N00014-11-1-0701 and N00014-13-1-0306
文摘Acoustic modal behavior is reported for an L-shape hydrophone array during the passage of a strong nonlinear internal wave packet. Acoustic track is nearly parallel to the front of nonlinear internal waves. Through modal decomposition at the vertical array, acoustic modes are identified. Modal evolution along the horizontal array then is examined during a passing internal wave. Strong intensity fluctuations of individual modes are observed before and during the internal waves packet passes the fixed acoustic track showing a detailed evolution of the waveguide modal behavior. Acoustic refraction created either uneven distribution of modal energy over the horizontal array or additional returns observable at the entire L-shape array. Acoustic ray-mode simulations are used to phenomenologically explain the observed modal behavior.
文摘Heat and mass transfer effects in three-dimensional flow of Maxwell fluid over a stretching surface were addressed.Analysis was performed in the presence of internal heat generation/absorption. Concentration and thermal buoyancy effects were accounted. Convective boundary conditions for heat and mass transfer analysis were explored. Series solutions of the resulting problem were developed. Effects of mixed convection, internal heat generation/absorption parameter and Biot numbers on the dimensionless velocity, temperature and concentration distributions were illustrated graphically. Numerical values of local Nusselt and Sherwood numbers were obtained and analyzed for all the physical parameters. It is found that both thermal and concentration boundary layer thicknesses are decreasing functions of stretching ratio. Variations of mixed convection parameter and concentration buoyancy parameter on the velocity profiles and associated boundary layer thicknesses are enhanced. Velocity profiles and temperature increase in the case of internal heat generation while they reduce for heat absorption. Heat transfer Biot number increases the thermal boundary layer thickness and temperature. Also concentration and its associated boundary layer are enhanced with an increase in mass transfer Biot number. The local Nusselt and Sherwood numbers have quite similar behaviors for increasing values of mixed convection parameter, concentration buoyancy parameter and Deborah number.
文摘Eco-translatology provides a new perspective and methodology for the international publicity translation of political texts.This paper applies the viewpoint and methodology of eco-translatology,focuses on the three-dimensional transformation of language,culture,and communication,and discusses how translators can adapt to the eco-environment of political texts through the specific example of the keynote speech of China’s president at the opening ceremony of the Third Belt and Road Forum for International Cooperation and select suitable translation strategies and techniques to achieve an ecological balance of the target text in multiple dimensions.
文摘Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.
基金This work was supported by the grants from the High Level University Development Foundation of Southern Medical University(No.LC2016PY045)the Science and Technology Projects of Tianhe District in Guangdong Province(No.2018YZ011)the Science and Technology Projects in Guangdong Province(No.2016B090917001).
文摘Background:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum.Seldom study has compared the application of three-dimensional(3D)printing technology and traditional methods of contouring plates intra-operatively for the surgical treatment of both-column acetabular fractures.We presented the use of both 3D printing technology and a virtual simulation in pre-operative planning for both-column acetabular fractures.We hypothesized that 3D printing technology will assist orthopedic surgeons in shortening the surgical time and improving the clinical outcomes.Methods:Forty patients with both-column acetabular fractures were recruited in the randomized prospective case-control study from September 2013 to September 2017 for this prospective study(No.ChiCTR1900028230).We allocated the patients to two groups using block randomization(3D printing group,n=20;conventional method group,n=20).For the 3D printing group,1:1 scaled pelvic models were created using 3D printing,and the plates were pre-contoured according to the pelvic models.The plates for the conventional method group were contoured during the operation without 3D printed pelvic models.The operation time,instrumentation time,time of intra-operative fluoroscopy,blood loss,number of times the approach was performed,blood transfusion,post-operative fracture reduction quality,hip joint function,and complications were recorded and compared between the two groups.Results:The operation and instrumentation times in the 3D printing group were significantly shorter(130.8±29.2 min,t=-7.5,P<0.001 and 32.1±9.5 min,t=-6.5,P<0.001,respectively)than those in the conventional method group.The amount of blood loss and blood transfusion in the 3D printing group were significantly lower(500[400,800]mL,Mann-Whitney U=74.5,P<0.001 and 0[0,400]mL,Mann-Whitney U=59.5,P<0.001,respectively)than those in the conventional method group.The number of the approach performed in the 3D printing group was significantly smaller than that in the conventional method group(pararectus+Kocher-Langenbeck[K-L]approach rate:35%vs.85%;x2=10.4,P<0.05).The time of intra-operative fluoroscopy in the 3D printing group was significantly shorter than that in the conventional method group(4.2±1.8 vs.7.7±2.6 s;t=-5.0,P<0.001).The post-operative fracture reduction quality in the 3D printing group was significantly better than that in the conventional method group(good reduction rate:80%vs.30%;x2=10.1,P<0.05).The hip joint function(based on the Harris score 1 year after the operation)in the 3D printing group was significantly better than that in the conventional method group(excellent/good rate:75%vs.30%;χ^2=8.1,P<0.05).The complication was similar in both groups(5.0%vs.25%;χ^2=3.1,P=0.182).Conclusions:The use of a pre-operative virtual simulation and 3D printing technology is a more effective method for treating bothcolumn acetabular fractures.This method can shorten the operation and instrumentation times,reduce blood loss,blood transfusion and the time of intra-operative fluoroscopy,and improve the post-operative fracture reduction quality.
文摘BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.
基金National Natural Science Foundation of China(No.51376018)。
文摘The temperature uniformity and component concentration distributions in solid oxide fuel cells during operating processes can influence the cell electrochemical and thermal characteristics.A three-dimensional thermal-fluid numerical model including electrochemical reactions and water-gas-shift(WGS)reaction for a single channel solid oxide fuel cell was developed to study the steady-state characteristics,which include distributions of the temperature(T),temperature gradient((35)T/(35)x),and fuel utilization.It was shown that the maximum temperature(Tmax)changed with operating voltage and the maximum temperature gradient(((35)T/(35)x)max)occurred at the inlet of the channel of a solid oxide fuel cell by simulation.Moreover,the natural convection condition had a great influence on T and(35)T/(35)x.The thermal stress generated by temperature differences was the key parameter and increasing the convection heat-transfer coefficient can greatly reduce the thermal stress.In addition,the results also showed that there were lower temperature gradients and lower current density at high working voltage;therefore,choosing the proper operating voltage can obtain better cell performance.