一种便携式安全智能雷管切割机的研究开发

雷管解剖是对出现质量问题的雷管进行解剖后进行分析时的一种方式,同时为精确了解和分析雷管内部状态,以便改进和提升雷管质量,提高雷管生产和使用本质安全提供有价值信息的一种手段。目前普遍使用外卡式手工切管机或使用钢锯将雷管切割开。存在相当大的安全隐患。本文设计的便携式雷管切割机,其功能是可以自动完成雷管任意位置的切断,同时在切割雷管时,使人和雷管隔离,避免发生安全事故。该设备小巧轻便,便于携带和野外作业。

Alignment Techniques in Total Knee Arthroplasty:Where do We Stand Today?

Achieving optimal alignment in total knee arthroplasty(TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral postoperative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery have augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation.

Autopsy study of anatomical features of the posterior gastric artery for surgical contribution

AIM： To investigate features of the posterior gastric arten/（PGA） with respect to incidence, location and size by using autopsy subjects. METHODS： Autopsies were performed on 72 cadavers of adults with no history of abdominal operations. The localization of the PGA, the distance between the root of the splenic artery and the origin of the PGA, and the external diameter of the PGA were examined. RESULTS： The PGA was recognized in all patients. In 70 （97.2%） cadavers, the PGA branched from the splenic artery, and one female in this group had two PGAs. In 1 （1.4%） patient, the PGA originated from the root of the celiac trunk and in another （1.4%） patient, the PGA branched from the superior polar artery. Overall, the PGA extended for a length of 5.8-12.2 （mean, 8.4） cm from the root of the splenic artery, and the external diameter of the PGA was 1.2-3.2 （mean, 2） mm. CONCLUSION： The anatomical features of the PGA can be readily observed and characterized by autopsy. This study has provided valuable information on the features of the PGA useful in the planning of surgical treatment.

Value of FDG PET/CT in the Management of Mesothelioma

The aim of this study is to compare and discuss the efficacy of FDG PET/CT （fludeoxyglucose positron emission tomography/computated tomography） in the diagnosis, staging, prognosis, pre-therapeutic planning, therapeutic assessment and detecting recurrence of mesothelioma. Following method has been used： （1） Search setting on PubMed （by priority）： meta-analysis, randomized controlled trial, other study types; （2） The key words： ＂FDG PET/CT＂, ＂mesothelioma＂, ＂diagnosis＂, ＂staging＂, ＂prognosis＂, ＂therapeutic＂, ＂assessment＂ and ＂recurrences＂; （3） Review the literature that discusses the imaging modalities in the management of mesothelioma; （4） Create an evidence table; （5） Compare and discuss the different modalities and their sensitivity and specificity in managing mesothelioma; （6） Construct the passage reviewing the articles chosen. There is evidence that suggests that FDG PET/CT is superior to most other modalities in the diagnosis, staging, prognosis, pre-therapeutic planning, therapeutic assessment and detecting recurrence of mesothelioma. There are some close contenders like PET scan by itself as a modality to detect mesothelioma. However, due to the lack of anatomical presentation, there were many occurrences of misdiagnosis. FDG PET/CT, which superimposes functional imaging over the anatomical mapping, yields a more accurate presentation ofmesothelioma. The nature of this hybrid imaging enables diagnosis and management to be carried-out in a minimally invasive manner. PET/CT to a great extent has tranformed the way we diagnose neoplastic occurences heretofore. By amalgamating anatomic localization to functional imaging, this hybrid modality yields valuable information that was remotely attainable before. Although there are a few flaws to PET/CT that have been discussed in some studies, there is an apparent potential to this modality that is waiting to be uncovered. Evidently, PET/CT is highly effective in differentiating benign and malignant pleural lesion. Likewise, it is substantially useful in the management of mesothelioma particularly in the diagnosis, staging, prognosis, treatment, monitoring and detecting recurrences. With PET/CT having such adequacy in managing mesothelioma, it is imperative to acknowledge and further investigate this modality as a central tool in the management of the latter for the exclusive benefit of the patient.

The anatomical study of transoral atlantoaxial reduction plate internal fixation

Objective： To study relevant anatomical features of the structures involved in transorai atlanto-axiai reduction plate （TARP） internal fixation through transorai approach for treating irreducible atlanto-axiai dislocation and providing anatomical basis for the clinical application of TARP. Methods： Ten fresh craniocervicai specimens were microsurgicaily dissected layer by layer through transorai approach. The stratification of the posterior pharyngeal wail, the course of the vertebral artery, anatomical relationships of the adjacent structures of the atlas and axis, and the closely relevant anatomical parameters for TARP internal fixation were measured. Results： The posterior pharyngeal wall consisted of two layers and two interspaces： the mucosa, prevertebrai fascia, retropharyngeai space, and prevertebrai space. The range from the anterior edge of the foramen magnum to C3 could be exposed by this approach. The thickness of the posterior pharyngeal wall was （ 3.6 ± 0.3 ） mm （ranging 2.9-4.3 mm） at the anterior tubercle of C1, （6.1 ±0.4） mm （ ranging 5.2-7.1 mm） at the lateral mass of C1 and （5.5±0.4） mm （ranging4.3-6.5 mm） at the central part of C2, respectively. The distance from the incisor tooth to the anterior tubercle of C1, C1 screw entry point, and C2 screw entry point was （82.5 ±7.8） mm （ranging71.4-96.2 mm）, （90. 1 ±3.8） mm （ranging 82.2-96.3 mm）, and （89.0±4.1） mm （ranging 81.3- 95.3 mm）, respectively. The distance between the vertebral artery at the atlas and the midline was （25.2 ± 2.3） mm （ ranging 20.4-29.7 mm ） and that between the vertebral artery at the axis and the midline was （ 18.4 _ 2.6 ） mm （ ranging 13.1-23.0 mm）. The allowed width of the atlas and axis for exposure was （39.4 ±2. 2） mm （ ranging 36.2-42. 7 mm ） and （ 39.0 ± 2.1 ） mm （ ranging 35.8-42.3 mm ）, respectively. The distance （ a ） between the two atlas screw insertion points （center of anterior aspect of C1 lateral mass ） was （ 31.4 ± 3.3 ）mm （ ranging 25.4-36.6 mm）. The vertical distance （b） between the line connecting the two C1 screw entry points and that connecting the two C2 screw entry points （at the central part of the vertebrae, namely 3-4 mm lateral to the midline of C2 vertebrae） was （21.3±2.7） mm （ranging 19.4- 24.3mm）, with an a/b ratio of 1.3-1.5. The screws of TARP had a lateral tilt of 12.2°± 0.4° （ranging 10.2° -14.6°at C1 and a medial tilt of 7.3°±0.3° （ranging5.1°-9.4°） at C2 relative to the coronal plane. Conclusions ： An atlanto-axiai surgery through transorai approach is safe and feasible. This approach is suitable for an anterior TARP internal fixation, and the design of the internal fixation system should be based on the above anatomical data.

Specific effect of acupuncture on the neural pathway in the acute stage of migraine headache

To discuss the hazard of migraine in acute phase and analgesic effect, acupoint selection features, method as well as mechanism of acupuncture; to put forward relevant questions, answer these questions, propose relative specificity hypothesis on neural pathway of analgesic effect of acupoints in different nerve distribution areas（trigeminal nerve distribution area, occipital nerve distribution area, and spinal nerve distribution area） in treatment of migraine in acute phase, and analyze the deficiencies of hypothesis.

Application of computer-assisted surgery techniques in the management of zygomatic complex fractures

Patients suffering from zygomatic complex fractures always present facial deformity and dyslunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prog- nosis for the zygomatic complex fractures because of the complicated anatomical structures. Computer- assisted surgery techniques, as the new emerging auxiliary methods, can optimize the surgical protocol, predict operation outcomes, and improve the accuracy and quality of the operation. Meanwhile the postoperative complications can be reduced effectively. This review aims to provide a comprehensive overview of the application of computer-assisted surgery techniques in the management of zygomatic complex fractures.

Anatomic and radiological study on posterior pedicle screw fixation in the atlantoaxial vertebrae of children

Objective： To investigate the feasibility of posterior fixation with 3.5-mm pedicle screws in the atlantoaxial vertebrae of children. Methods： In this study, atlantoaxial vertebrae specimens were obtained from 10 cadavers of children aged 6-8 years. We measured the height and width of the C1 pedicle and the midportion of C1 lateral mass; the width of C1 posterior arch under the vertebral artery groove and the height of the external and internal one-third of this part; the external, internal height and the superior, middle, inferior width of the C2 pedicle （transverse foramen）. Furthermore, computed tomography （CT） axial scan was performed on 20 agematched volunteers to obtain relative data of their atlantoaxial vertebrae. We measured the length and width of the C1 and C2 pedicles in the atlantoaxial cross-sectional plane. On CT workstation, we also measured the angles between the longitudinal axes of the atlantoaxial pedicles and the midsagittal plane. Results： For the cadaveric specimen group, the height and width of the C1 pedicle were （5.26±0.44） mm and （6.26±0.75） mm respectively. The height of the medial one-third of the Ct posterior arch under the vertebral artery groove was （4.07±0.24） mm. The external, internal height and superior, middle, inferior width of the C2 pedicle was （6.86±0.48） mm, （6.67±0.49） mm, （6.63 ±0.61） mm, （5.41±0.39） mm and （3.71±0.30） mm, respectively. For the volunteer group measured by CT scan, the height and width of the C1 pedicle were （5.47 ±0.34） mm and （6.63±0.54） mm respectively, while （6.59±0.51） mm and （5.13 ±0.42） mm of the C2 pedicle. The angles between the atlas, axis pedicles and the midsagittal plane were （9.60±1.32）° and （27.80±2.22）° respectively. Conclusion： It is feasible to place a 3.5-mm pedicle screw in the C1 and C2 pedicles of children aged 6-8 years old.