导航和传统全膝关节置换后肢体和假体力线恢复对比的Meta分析

背景:目前计算机辅助导航技术已经越来越多地应用于全膝关节置换中。计算机辅助导航全膝关节置换是否比传统全膝关节置换更具优势目前尚无定论。目的:系统评价计算机辅助导航和传统全膝关节置换后肢体和假体力线的恢复情况。方法:计算机检索2013年6月前PubMed/Medline、EMBASE、Cochrane CENTRAL、ScienceDirect数据库,纳入计算机辅助导航和传统全膝关节置换的随机对照试验,应用Cochrane协作网提供的RevMan 5.2.5软件进行Meta分析。选取髋-膝-踝机械轴或胫股关节角、股骨假体冠状角、股骨假体矢状角、胫骨假体冠状角、股骨假体矢状角5个指标进行比较,以偏离中线2°或3°确定为力线不良。结果与结论:共纳入19篇随机对照试验文献,共2 654例(3 392膝)。Meta分析结果显示,计算机辅助导航全膝关节置换后机械轴恢复精确率明显优于传统全膝关节置换,其中偏倚3°时,P<0.000 01;偏倚2°时,P=0.000 8。计算机辅助导航全膝关节置换后股骨假体冠状角恢复精确率(3°)明显优于传统全膝关节置换(P=0.002);偏倚2°时两种方案差异无显著性意义(P=0.290)。计算机辅助导航全膝关节置换后股骨假体矢状角恢复精确率(3°)明显优于传统全膝关节置换(P=0.040);偏倚2°时两种方案差异无显著性意义(P=0.950)。计算机辅助导航全膝关节置换后胫骨假体冠状角恢复精确率明显优于传统全膝关节置换,偏倚3°时,P=0.000 7;偏倚2°时,P=0.002。计算机辅助导航全膝关节置换后股骨假体矢状角恢复精确率(3°)明显优于传统全膝关节置换(P=0.030);偏倚2°时两种方案差异无显著性意义(P=0.260)。提示计算机辅助导航全膝关节置换后肢体力线、股骨/胫骨假体力线偏倚3°以内的精确率均优于传统全膝关节置换,但股骨假体冠状角、股骨假体矢状角、股骨假体矢状角偏倚2°以内的精确率两种方案无明显差异。

交锁钉固定胫骨远端粉碎性骨折

目的：探讨治疗胫骨远端粉碎性骨折的方法并评价其治疗效果。方法：胫骨远端粉碎多块骨块，骨折远段较短，只可置入l枚带锁髓内钉的患者11例。其中男8例，女3例；年龄23岁～59岁。全部患者均采用先置入主钉，再恢复胫骨骨折块的轴线序列，用钢丝捆扎固定骨折块，最后置入远近两端锁钉。结果：全部手术顺利完成，术后复查X平片显示对位对线良好。11例患者骨折全部愈合，骨折临床愈合时间平均为130d。术后随访1年～3年，疗效评价：全部患者无不适感觉，各关节活动度良好。结论：胫骨远端粉碎骨折，远折端较短，仅能够置1枚锁钉，再用钢丝环扎骨折块，骨折固定可靠，术后不需要石膏外固定，可早期行患肢各关节功能锻炼。

Influence of Relative Electrode-Electrolyte Movement over Productivity for Silver Recovery from Diluted Solutions

The paper presents the influence of relative electrode-electrolyte movement over productivity for silver ions recovery by electrodeposition from diluted solutions. Wasted photographic fixing agent solution in various concentrations was used. For each concentration three regimes were studied： stationary, electrode rotation with 100 rpm and electrode rotation with 300 rpm. Polarization curves were drawn and working conditions from silver recovery point of view were discussed.

A novel o-nitrobenzyl-based photocleavable antitumor prodrug with the capability of releasing 5-fluorourail

An o-nitrobenzyl-based photocleavable antitumor prodrug with a terminal carboxyl group was designed and synthesized.The photolysis properties of the prodrug were investigated by means of1H NMR,HPLC,UV,and MTT methods.The results showed that the toxicity of the anticancer drug was effectively shielded before release.However,the prodrug effectively regained the antitumor capability against cancer cells by release of 5-fluorouracil when it was exposed to ultraviolet irradiation.