Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

Treatment of Complex Proximal Tibial Fractures (Types V &VI of Schautzker Classification) by Double Plate Fixation with Single Anterior Incision

Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).

Teriparatide anabolic therapy as potential treatment of type Ⅱ dens non-union fractures

Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type Ⅱ odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid nonunion successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.

C反应蛋白/白蛋白比值对2型糖尿病合并急性心肌梗死患者远期不良心脑血管事件的预测价值研究

背景急性心肌梗死(AMI)是威胁全球公众健康的主要原因之一。虽然已有相应的再灌注治疗策略,但AMI相关的主要不良心脑血管事件(MACCEs)仍然是全世界人口死亡的原因之一。尤其合并糖尿病的AMI患者,因冠状动脉病变复杂,病变程度严重,尽早发现和判断该部分患者远期预后相对困难,因此寻找相对简便、易获得的实验室指标,有利于为2型糖尿病(T2DM)合并AMI患者经皮冠状动脉介入(PCI)术后MACCEs的预测提供依据。目的探讨血清C反应蛋白(CRP)/白蛋白(Alb)比值(CAR)对T2DM合并AMI患者PCI术后远期MACCEs的预测价值。方法纳入2014—2019年就诊于宁夏医科大学总医院心血管内科1683例T2DM合并AMI患者为研究对象,收集患者的一般临床资料与检查结果。对所有患者进行电话或门诊随访,以全因死亡、非致死性心肌梗死、再发不稳定型心绞痛、非致死性脑卒中、新发心力衰竭或心力衰竭加重再入院、再次血运重建作为MACCEs。根据患者随访期间是否发生MACCEs分为MACCEs组(508例)和非MACCEs组(1175例)。采用单因素及多因素Logistic回归分析探讨T2DM合并AMI患者MACCEs事件的影响因素。采用Kaplan-Meier法绘制患者的生存曲线,生存曲线的比较采用Log-rank检验。采用受试者工作特征(ROC)曲线分析CAR对T2DM合并AMI患者远期发生MACCEs的预测效能,使用净重分类改善指标(NRI)和综合判别指数(IDI)评价CAR对T2DM合并AMI患者预后评估的改善效果。结果1683例患者中508例(30.18%)患者发生MACCEs。多因素Logistic回归分析显示高血压病[OR(95%CI)=1.994(1.142~3.483)]、冠状动脉植入支架长度[OR(95%CI)=1.031(1.002~1.062)]、CRP[OR(95%CI)=0.950(0.915~0.986)]、Alb[OR(95%CI)=0.933(0.880~0.989)]及CAR[OR(95%CI)=5.582(1.705~18.277)]是T2DM合并AMI患者PCI术后发生MACCEs的影响因素(P<0.05)。根据CAR中位表达水平(0.86),将患者分为CAR<0.86组和CAR≥0.86组,Log-rank检验结果显示,CAR≥0.86组MACCEs发生率高于CAR<0.86组(52.68%与22.92%;χ^(2)=65.65,P<0.001)。ROC曲线显示CAR预测T2DM合并AMI患者发生MACCEs的ROC曲线下面积为0.728(95%CI=0.702~0.754),最佳截断值为0.576,灵敏度为0.617,特异度为0.747。在基线模型基础上,与CRP、Alb相比,CAR能明显改善对患者发生MACCEs的预测效果(NRI=0.377,IDI=0.166,C指数=0.690;P<0.05)。结论CAR是T2DM合并AMI患者PCI术后远期MACCEs发生风险的有效预测指标。

Blasingame production decline type curves for analysing a multi-fractured horizontal well in tight gas reservoirs

Production decline analysis has been considered as an important method to obtain the flow parameters, reservoir properties and original gas in place. Although advanced Blasingame production decline analysis methods for vertical wells, fractured wells and horizontal wells are widely used, limited study has conducted on Blasingame production decline type curves for multi-fractured horizontal well(MFHW). Based on the perpendicular bisection(PEBI) grids, a numerical model was developed and the solution was obtained using control volume finite element method and the fully implicit method. Blasingame production decline-type curves of the infinitely conductive MFHW were plotted through computer programming. A field case was presented to analyse and verify the model developed. Five flow regimes, including early formation linear flow, early radial flow, compound linear flow, transient flow and pseudo-radial flow, are recognized. Fracture spacing is the main factor that affects early radial flow, compound linear flow and transient flow, the distance from the well to the circular boundary affects the pseudo-radial flow, and the type curves are also significantly affected by the formation permeability, fracture number and fracture half-length. The validation of field case suggests that the Blasingame production decline type curves proposed in this work can be applied to the production decline analysis for MFHW in tight gas reservoirs.

Study on the Impact of Massive Refracturing on the Fracture Network in Tight Oil Reservoir Horizontal Wells

Class III tight oil reservoirs have low porosity and permeability,which are often responsible for low production rates and limited recovery.Extensive repeated fracturing is a well-known technique to fix some of these issues.With such methods,existing fractures are refractured,and/or new fractures are created to facilitate communication with natural fractures.This study explored how different refracturing methods affect horizontal well fracture networks,with a special focus on morphology and related fluid flow changes.In particular,the study relied on the unconventional fracture model(UFM).The evolution of fracture morphology and flow field after the initial fracturing were analyzed accordingly.The simulation results indicated that increased formation energy and reduced reservoir stress differences can promote fracture expansion.It was shown that the length of the fracture network,the width of the fracture network,and the complexity of the fracture can be improved,the oil drainage area can be increased,the distance of oil and gas seepage can be reduced,and the production of a single well can be significantly increased.

Hybrid External Fixation for Open Severe Comminuted Fractures of the Distal Femur

Background: The treatment of distal femoral open comminuted fractures is a major problem for orthopedic surgeon. The basic and important aim in treatment of these fractures is to assemble the condylar fragments and then fix the condyles to the femoral shaft by minimum handling of the bone and soft tissues. Objectives: To evaluate the treatment of distal femoral open comminuted fractures (type C2 and C3) with hybrid external fixator. Methods: Thirty-four patients with distal femur open comminuted fracture (type C2 and C3) were treated by hybrid external fixator between January 2005 and December 2008. All of the fractures were opened with extension to joint surface. 30 patients were male and 4 were female. Their average age was 30.5 years (17 to 72 years). Average follow up period was 36 months. 12 patients had isolated fracture and 22 patients had multiple fractures. The bony and functional results were evaluated by the association for the study and application of the method of Ilizarov (ASAMI) protocol and knee society score. Results: 29 out of 34 fractures (85%) had union without bone grafts. Average time of union was 6.1 months (4 - 19 ms). The average knee range of motion was 87.5 degrees (30 - 115 degrees). The bony results were excellent in 24 patients (70.5%), good in 6 (17.7%), fair in 2 (5.9%), and poor in 2 (5.9%), and the functional results were excellent in 10 (29.4%) patients, good in 14 (41.2%), fair in 6 (17.6%), and poor in 4 (11.8%), and the functional results were excellent in 10 (29.4%) patients, good in 14 (41.2%), fair in 6 (17.6%), and poor in 4 (11.8%) according to ASAMI protocol. According to the knee society score the functional results were excellent in 9 (26.44%) patients, good in 13 (38.26%), fair in 7 (20.6%), and poor in 5 (14.7%). Conclusion: Hybrid external fixator is an effective method for treatment of distal femoral open comminuted fractures (type C2 and C3) and may be considered as an alternative surgical methods in the management of these fractures.

Treatment of Anderson Type II Odontoid Fracture in Elderly Patients by Posterior Pedicle Screw Fixation Combined with Iliac Bone Grafting

Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence;no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.

Effect of viral hepatitis on type 2 diabetes:A Mendelian randomization study

BACKGROUND The effects of viral hepatitis(VH)on type 2 diabetes(T2D)remain controversial.AIM To analyze the causal correlation between different types of VH and T2D using Mendelian randomization(MR).METHODS Single nucleotide polymorphisms of VH,chronic hepatitis B(CHB),chronic hepatitis C(CHC)and T2D were obtained from the BioBank Japan Project,European Bioinformatics Institute,and FinnGen.Inverse variance weighted,MREgger,and weighted median were used to test exposure-outcome associations.The MR-Egger intercept analysis and Cochran’s Q test were used to assess horizontal pleiotropy and heterogeneity,respectively.Leave-one-out sensitivity analysis was used to evaluate the robustness of the MR analysis results.RESULTS The MR analysis showed no significant causal relationship between VH and T2D in Europeans[odds ratio(OR)=1.028;95%confidence interval(CI):0.995-1.062,P=0.101].There was a negative causal association between CHB and T2D among East Asians(OR=0.949;95%CI:0.931-0.968,P<0.001),while there was no significant causal association between CHC and T2D among East Asians(OR=1.018;95%CI:0.959-1.081,P=0.551).Intercept analysis and Cochran’s Q test showed no horizontal pleiotropy or heterogeneity(P>0.05).Sensitivity analysis showed that the results were robust.CONCLUSION Among East Asians,CHB is associated with a reduced T2D risk,but this association is limited by HBV load and cirrhosis.Although VH among Europeans and CHC among East Asians are not associated with the risk of T2D,focusing on blood glucose in patients with CHC is still relevant for the early detection of T2D induced by CHCmediated pathways of hepatic steatosis,liver fibrosis,and cirrhosis.

Correlation between cerebral neurotransmitters levels by proton magnetic resonance spectroscopy and HbA1c in patients with type 2 diabetes

BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.

Division of Matrix- and Fracture-Type Shale Oils in the Jiyang Depression and Their Differences

This study discussed the division of matrix- and fracture-type shale oils in the Jiyang Depression, and proposed the concept of fracture development coefficient. The fracture development coefficient is defined as the ratio of fault throw to the distance between a shale oil well and the nearest fault. Based on CO_2 content, state of water, oil production and logging response of shale oil formations, the classification of shale oils was established, i.e., a fracture-type shale oil well has a fracture development coefficient greater than 0.2, while a matrix-type one has a fracture development coefficient less than 0.2. Furthermore, the key control factors of matrix- and fracture-type shale oil enrichment were analyzed using typical anatomical and statistical methods. For matrix-type shale oil enrichment, these factors are lithofacies, total organic carbon（TOC）, shale porosity and abnormal pressure; for fracture-type shale oil enrichment, they are lithofacies, extent of fracture development, and abnormal pressure. This study also first described the differences between matrix- and fracture-type shale oils. The results provide reference for the exploration of terrestrial faulted basins in eastern China.

Frequency of the C677T Polymorphism of MTHFR, G20210A of Prothrombin and R506Q of Factor V Leiden in Type 2 Diabetics in Abidjan

In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.

Pseudo S-Asymptotically(ω,c)-Periodic Solutions to Fractional Differential Equations of Sobolev Type

In this paper,we firstly recall some basic results on pseudo S-asymptotically(ω,c)-periodic functions and Sobolev type fractional differential equation.We secondly investigate some existence of pseudo S-asymptotically(ω,c)-periodic solutions for a semilinear fractional differential equations of Sobolev type.We finally present a simple example.

Tensile and tear-type fracture toughness of gypsum material:Direct and indirect testing methods

In this context,four specimens,i.e.(i)circumferentially notched cylindrical torsion(CNCT),(ii)circum-ferentially notched cylindrical direct tension(CNCDT),(iii)edge notch disc bend(ENDB)and(iv)three-point bend beam(3PBB),were utilized to measure the modesⅠandⅢfracture toughness values of gypsum.While the CNCT specimen provides pure modeⅢloading in a direct manner,this pure mode condition is indirectly produced by the ENDB specimen.The ENDB specimen provided lower KⅢc and a non-coplanar(i.e.twisted)fracture surface compared with the CNCT specimen,which showed a planar modeⅢfracture surface.The ENDB specimen is also employed for conducting pure modeⅠ(with different crack depths)and mixed modeⅠ/Ⅲtests.KIc value was independent of the notch depth,and it was consistent with the RILEM and ASTM standard methods.But the modeⅢfracture results were highly sensitive to the notch depth.While the fracture resistance against modeⅢwas significantly lower than that of modeⅠ,the greater work of fracture under modeⅢwas noticeable.

Detection of serum biochemical indexes in elderly patients with type 2 diabetes mellitus with osteoporotic fracture

Objective: To study the detection and study of serum biochemical indexes in elderly patients with type 2 diabetes mellitus with osteoporotic fracture, and to provide reference for clinical diagnosis and treatment. Methods: A retrospective analysis of our hospital from December 2014 to December 2017 were elderly type 2 diabetic patients with osteoporotic fractures in 154 cases as the observation object, the other during the same period were selected in elderly type 2 diabetic osteoporosis fracture group of 166 cases of elderly type 2 diabetes mellitus group of 192 cases, 120 cases of healthy persons. The changes of serum biochemical indexes in the four groups were compared, and the changes of serum biochemical indexes in different age and gender patients were compared according to sex and age. Results: Compared four groups of patients with type 2 diabetes, serum CTX, P1NP, ALP and OC group is lower than fracture fracture group, osteoporosis group, control group, serum CTX, P1NP, ALP and OC were lower than the other three groups, the differences were statistically significant, but the fracture group and fracture osteoporosis no comparison between the two groups the difference. In terms of gender, the serum CTX, P1NP, ALP and OC levels in fracture group, osteoporotic fracture group and type 2 diabetes group were lower than those in female patients, and there was no significant difference between the above indexes in the control group and those in the control group. In terms of age, fracture group, osteoporosis group, bone fractures in type 2 diabetic group and control group four group age <60 patients serum CTX, P1NP, ALP and OC were lower than those of 60 years of age or older group. Conclusion: The serum markers of bone CTX, P1NP, ALP and OC in elderly patients with type 2 diabetes mellitus osteoporotic fracture increased significantly, and increased with the severity of the disease, which is worthy of clinical reference.

Fracture Distribution Characteristics within Low-Permeability Reservoirs:Cases Studies from Three Types of Oil-bearing Basins,China

The permeability or/and porosity in low-permeability reservoirs mainly depends on fracture system. Wthin this kind of low-permeability reservior, fractures play a very important role on exploration and development. Because there are so many differences, such as basin properties and tectonic characteristics, among the eastern,western and central basins, the types and distribution characteristics of fractures are also obviously different. Quantitative information on fracture distribution is very important. Through the contrastive study of 7 oilfield, the differences and distribution characteristics of fractures in three types of oil-bearing basins are summarized. Due to the different geological conditions and stress state during the formation of fractures, the fracture systems in three types of basins are also different. Fractures are mainly composed of tectonic fractutres related to normal faultes in eastern basins, related to folds and reverse faultes in western basins, and regional fractures which widely distributed not only in outcrops but also at depth of the relatively undeformed strata in central basins. So, besides jointed-fractures, we can often see faulted-fractures similar to normal faults in eastern basins and similar to reverse faults in western basins. According to statistical data, fracture spacing generally has a lognormal distribution and is linearly proportional to layer thickness. The development degree of fractures is controlled by lithology, bed thickness, sedimentary microfacies and faults or folds, etc. The permeability, aperture and connectedness of fractures are related to the modern stress field. Though there are 3-4 sets of fractures in a oilfield, the fractures parallel to the maximum principal stress direction are main for the pattern arrangement of low-permeability reservoirs.

Review of Management of Type-2 Odontoid Fracture in Elderly

Odontoid fracture accounts for 15% - 20% of all cervical spine injuries. Among the odontoid fracture, type-2 fracture is the most common variety. This injury is associated with a high incidence of morbidity, mortality and nonunion in the elderly irrespective of mode of treatment. Management of odontoid fracture cannot be standardized till to date and ideal treatment for type-2 odontoid fractures still has some controversial issues. Objective of this review is to find a controversial aspect of management along with opinion to find out a standard guideline by searching the literature in Pubmed and Google scholar databases with key words: odontoid, fracture, type-2, management, nonoperative and operative management. Nonoperative treatment with halo vest is associated with very high rate of complication in elderly patient. When conservative treatment of this fractures is indicated that should be carried out with hard cervical collar or cervicothoracic orthosis. Current studies suggest that surgical management of odontoid fractures may offer a protective benefit but it is limited to patients younger than 75 years of age. Though surgical treatment has a better outcome, it is also limited by the co-mobidities and hazards of anesthesia and surgery in elderly patients. Conservative treatment of this fracture in the elderly should preferably be carried out with hard collar or avoiding halo vest. Surgical treatment is associated with little advantage but should be selected with proper attention to age, comorbidities, fracture geometry and it is better to individualize the treatment strategy.

Ilizarov external fixators for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ

Objective To evaluate the clinical effects of Ilizarov external fixator for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.Methods From July 2006 to February 2009,25 patients suffering from maluninon of obsolete calcaneal

Usage of buttress plate internal fixation associated with autografting of fibula and iliac bone for the treatment of distal femoral C_3 type fracture

To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.

Bending properties and fracture mechanism of C/C composites with high density preform

C/C composites with banded structure pyrocarbon were fabricated by fast chemical vapor infiltration（CVI）,with C3H6 as carbon source,N2 as carrier gas,and three-dimensional（3D） 12K PAN-based carbon fabric with high density of 0.94 g/cm3 as preform.Experimental results indicated that the fracture characteristics of C/C composites were closely related to the frequency of high-temperature treatment（HTT） at the break of CVI process.According to the load？displacement curves,C/C composites showed a pseudoplastic fracture after twice of HTT.After three times of HTT,load？displacement curves tended to be stable with a decreasing bending strength at 177.5 MPa.Delamination failure and intrastratal fiber fracture were observed at the cross-section of C/C composites by scanning electronic microscope.Because the content of pyrocarbon and fibers has a different distribution in layers,the C/C composites show different fracture characteristics at various regions,which leads to good toughness and bending strength.