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上颌组牙三维有限元模型的建立及Carrière Distalizer矫治器的力学分析 被引量:6
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作者 曾琳 胡玲玲 兰泽栋 《北京口腔医学》 CAS 2009年第1期27-30,共4页
目的建立一侧有效的自然排列的上颌尖牙和第一磨牙及周围牙槽骨的三维有限元模型,分析在Carrière Distalizer矫治器作用下,组牙的应力分布及其位移特点。方法通过螺旋CT扫描获得精确的组牙及颌骨DICOM格式的图像信息,采用Mimics三... 目的建立一侧有效的自然排列的上颌尖牙和第一磨牙及周围牙槽骨的三维有限元模型,分析在Carrière Distalizer矫治器作用下,组牙的应力分布及其位移特点。方法通过螺旋CT扫描获得精确的组牙及颌骨DICOM格式的图像信息,采用Mimics三维建模软件和Ansys有限元分析软件建立及拟合上颌骨中正常位置的上颌组牙及其周围牙槽骨的三维有限元模型,模拟Carrière Distalizer矫治器的力学实验并进行相关分析。结果成功建立了上颌组牙及其周围牙槽骨的三维有限元模型。力学实验显示,尖牙和磨牙颈部剖面腭侧应力分布及位移明显小于颊侧、远中和近中,表现为类似旋转移动的柱状图形;而尖牙和磨牙整个远中剖面的应力分布及位移规律基本相同,均表现为自牙颈部向牙根部逐渐衰减的倾斜移动的曲线。结论本实验创建的上颌组牙及其周围牙槽骨的三维有限元模型,达到了几何外形和生物力学的相似性,可用于精确的生物力学分析;尖牙和磨牙在CD的作用下,应力分布及位移规律均呈现有旋转和倾斜移动的趋势。 展开更多
关键词 carrière distalizer 建模 三维有限元 载荷
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长、短型Ⅱ类牵引对Carrière Distalizer作用的有限元分析 被引量:2
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作者 曾琳 胡飞 +1 位作者 肖珲 兰泽栋 《北京口腔医学》 CAS 2009年第5期249-251,共3页
目的利用有限元分析法,比较Carrière Distalizer矫治器作用下,长、短型Ⅱ类牵引对上颌组牙应力分布及位移的影响。方法构建Carrière Distalizer矫治器作用模式的三维有限元模型,分别以下颌第一或第二磨牙作Ⅱ类牵引的起点,实... 目的利用有限元分析法,比较Carrière Distalizer矫治器作用下,长、短型Ⅱ类牵引对上颌组牙应力分布及位移的影响。方法构建Carrière Distalizer矫治器作用模式的三维有限元模型,分别以下颌第一或第二磨牙作Ⅱ类牵引的起点,实施长、短型牵引。本研究设定加载力值为150克,分析上颌尖牙和磨牙应力分布及位移的差异。结果两个位置的牵引效果总体趋势相同。尖牙的旋转移动和倾斜移动趋势强于磨牙,两个牵引起点的作用差异不显著。结论在做Ⅱ类弹性牵引时,无论长牵引还是短牵引,都不会过多的影响牵引效果。 展开更多
关键词 carrière distalizer 有限元分析 Ⅱ类牵引
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Carriere Distalizer矫治器牵引力加载高度对尖磨牙的影响 被引量:3
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作者 曾琳 武月霞 《现代医院》 2013年第12期31-33,共3页
目的利用有限元分析法,比较Carriere Distalizer矫治器作用时,加载于尖牙不同高度的牵引力对上颌组牙应力分布及位移的影响。方法构建Carriere Distalizer矫治器作用模式的三维有限元模型,分别以6个不同牵引高度加载,加载力值均为150 g... 目的利用有限元分析法,比较Carriere Distalizer矫治器作用时,加载于尖牙不同高度的牵引力对上颌组牙应力分布及位移的影响。方法构建Carriere Distalizer矫治器作用模式的三维有限元模型,分别以6个不同牵引高度加载,加载力值均为150 g,分析上颌尖牙和磨牙应力分布及位移的差异。结果六个载荷点下无论尖牙还是磨牙,其应力和位移变化几近相同,应力及位移曲线表现为完美的重叠线;不同尖牙牵引钩高度,对尖牙牙颈部应力的影响主要表现在远中侧和颊侧,对磨牙牙颈部的影响主要表现在近中侧和颊侧。二者对腭侧的影响均为最小。结论 CD牵引钩高度的变化对尖牙应力及位移影响趋势和强度趋同;对磨牙的影响趋势一致,但强度不同,呈递进态势。 展开更多
关键词 carriere distalizer加载高度 应力 位移
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Carriere Distalizer矫治器治疗安氏Ⅱ类骨性Ⅰ类错畸形的临床应用
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作者 苏牧 《航空航天医学杂志》 2011年第4期403-403,405,共2页
目的:观察Carriere Distalizer矫治器在安氏Ⅱ类骨性Ⅰ类错畸形患者前期治疗的应用效果。方法:选择安氏Ⅱ类骨性Ⅰ类错12例,上颌粘结Carriere distalizer矫治器,下颌双侧第一磨牙上放置附带固定舌弓的带环,颌间弹性Ⅱ类牵引拉双侧... 目的:观察Carriere Distalizer矫治器在安氏Ⅱ类骨性Ⅰ类错畸形患者前期治疗的应用效果。方法:选择安氏Ⅱ类骨性Ⅰ类错12例,上颌粘结Carriere distalizer矫治器,下颌双侧第一磨牙上放置附带固定舌弓的带环,颌间弹性Ⅱ类牵引拉双侧上颌磨牙远移。结果:经过1-6个月调整,12例患者平均每侧上颌磨牙远中移动3.68mm,建立稳定Ⅰ类磨牙关系。结论:通过高效、快速远中移动上颌磨牙,矫正磨牙关系,Carriere Distalizer矫治器为安氏Ⅱ类骨性Ⅰ类错非拔牙固定正畸治疗提供了可能。 展开更多
关键词 carriere distalizer矫治器 安氏Ⅱ类骨性Ⅰ类错
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Distal margin distance in radical resection of locally advanced rectal cancer after neoadjuvant therapy
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作者 Jun Luo Mingxuan Zhu +6 位作者 Long Zhao Meiwen He Bei Li Yifan Liu Yuhan Sun Guoqing Lyu Zhanlong Shen 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2024年第2期226-232,共7页
Colorectal cancer has a high incidence and mortality rate in China, with the majority of cases being middle and low rectal cancer. Surgical intervention is currently the main treatment modality for locally advanced re... Colorectal cancer has a high incidence and mortality rate in China, with the majority of cases being middle and low rectal cancer. Surgical intervention is currently the main treatment modality for locally advanced rectal cancer, with the common goal of improving oncological outcomes while preserving function. The controversy regarding the circumferential resection margin distance in rectal cancer surgery has been resolved. With the promotion of neoadjuvant therapy concepts and advancements in technology, treatment strategies have become more diverse.Following tumor downstaging, there is an increasing trend towards extending the safe distance of distal rectal margin. This provides more opportunities for patients with low rectal cancer to preserve their anal function.However, there is currently no consensus on the specific distance of distal resection margin. 展开更多
关键词 Colorectal cancer distal resection margin neoadjuvant therapy
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Knee Osteoarthritis Progression after Distal Femur Closing Wedge Osteotomy
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作者 Ferdinand Nyankoué Mebouinz Khalifa Fall +5 位作者 Kennedy Muluem Justine Raphaela Nyekel Moustapha Niane Alioune Badara Gueye Daniel Handy Eone Charles Valerie Kinkpé 《Open Journal of Orthopedics》 2024年第4期187-199,共13页
Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to id... Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve. 展开更多
关键词 KNEE OSTEOARTHRITIS PROGRESSION OSTEOTOMY distal Femur
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Evaluation of Surgical Treatment of Distal Humeral Fractures in Adults
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作者 Abdoulaye Camara Karinka Kéita +7 位作者 Mamady Doukouré Abdoul Karim Baldé Léopold Lamah Fatoumata Camara Alpha Mamadou Felah Diallo Ibrahima Marie Camara Mamadou Madiou Diallo Mamadou Cellou Diallo 《Open Journal of Orthopedics》 2024年第7期287-294,共8页
Introduction: Fractures of the distal end of the humerus are becoming increasingly frequent in young subjects because of the increase in road traffic accidents, and in elderly subjects because of osteoporosis related ... Introduction: Fractures of the distal end of the humerus are becoming increasingly frequent in young subjects because of the increase in road traffic accidents, and in elderly subjects because of osteoporosis related to aging populations. Materials and Methods: It was a prospective, monocentric study from January 2018 to December 2020 involving 14 patients who received and were treated surgically for distal humeral fractures and followed up. Results: We collected 14 patients, including 11 men (78.57%) and 3 women (21.43%), with a sex ratio of 3.7. The mean age was 36.41 years. The circumstances of onset were dominated by road traffic accidents, with 12 cases (85.71%). The dominant side was right-handed, with 11 cases (78.57%). Standard elbow radiography revealed 8 cases of type A fractures (57.14%), 4 cases of type B and 2 cases of type C fractures of the AO. We performed Lecestre plate osteosynthesis in 12 patients and external fixator in 2 others, using the trans-olecranial and transtricipital approaches. Elbow stiffness was the most frequent complication, with 6 cases (42.86%). After six months’ follow-up, our results were excellent and good in 78.57% of cases (MEPS). Conclusion: Surgical treatment with posterior approaches enabled us to achieve restitution of the articular surfaces, solid restraint and early mobilization of the elbow with satisfactory functional results. 展开更多
关键词 FRACTURE distal Humerus Lecestre Plate External Fixator Trans-Olecranial Transtricipital
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Hemiarthroplasty for irreparable distal radius fractures in the elderly:A comprehensive review
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作者 Adriano Cannella Ludovico Caruso +4 位作者 Giulia Maria Sassara Giuseppe Taccardo Marco Passiatore Marina Marescalchi Rocco De Vitis 《World Journal of Orthopedics》 2024年第6期578-584,共7页
BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with lon... BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial findings.AIM To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.METHODS A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and Scopus.The search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related terminology.The search was restricted to articles published in English from 1980 until June 2023.Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed journals.RESULTS A total of 2508 articles from PubMed and 883 from Scopus were identified initially.Following screening and removal of duplicates,13 articles met the inclusion criteria.These articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and complications.Hemiarthroplasty was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe osteoporosis.Functional outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across studies.Complications included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant choice.Long-term outcomes were inadequately documented,warranting further research.CONCLUSION Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly.Long-term outcomes and complications require further study. 展开更多
关键词 Irreparable distal radius fracture HEMIARTHROPLASTY OSTEOPOROSIS Wrist prosthesis ELDERLY
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Preoperative systemic inflammatory response index as a prognostic marker for distal cholangiocarcinoma after pancreatoduodenectomy
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作者 Wen-Hui Zhang Yu Zhao +3 位作者 Cheng-Run Zhang Jin-Can Huang Shao-Cheng Lyu Ren Lang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第9期2910-2924,共15页
BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomark... BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma(dCCA)who underwent pancreat-oduodenectomy(PD).METHODS This single-center study included 216 patients with dCCA after PD between January 1,2011,and December 31,2022.The individuals were categorized into two sets based on their systemic inflammatory response index(SIRI)levels:A low SIRI group(SIRI<1.5,n=123)and a high SIRI group(SIRI≥1.5,n=93).Inflam-matory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves.Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival(OS)and recurrence-free survival(RFS).RESULTS The study included a total of 216 patients,with 58.3%being male and a mean age of 65.6±9.6 years.123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA.SIRI had an area under the curve value of 0.674 for diagnosing dCCA,showing better performance than other inflammatory biomarkers.Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD,leading to lower OS[hazard ratios(HR)=1.868,P=0.006]and RFS(HR=0.949,P<0.001).Additionally,survival analysis indicated a significantly better prognosis for patients in the low SIRI group(P<0.001).CONCLUSION It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD. 展开更多
关键词 distal cholangiocarcinoma PANCREATODUODENECTOMY BIOMARKER Systemic inflammatory response index Prognosis
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Treating acute low back pain with acupuncture:A randomized controlled study protocol to compare the effectiveness between distal and local acupoints
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作者 Singleung Chan Shukyan Lam +7 位作者 Sinyin Ho Wanyi Au Poyi Lin Waiming Chan Taking Yu Shungchi Tam Bacon F.L.Ng Linda L.D.Zhong 《Journal of Traditional Chinese Medical Sciences》 CAS 2024年第3期351-356,共6页
Objective:To compare the efficacy of using“distal acupoints only”vs.“local acupoints mainly combined with distal acupoints”in cases of acute low back pain(ALBP).Methods: A total of 102 eligible patients aged 18–6... Objective:To compare the efficacy of using“distal acupoints only”vs.“local acupoints mainly combined with distal acupoints”in cases of acute low back pain(ALBP).Methods: A total of 102 eligible patients aged 18–65 years with ALBP lasting less than 6 weeks will be randomized in a 1:1 ratio to the distal acupoints only group(DPOG)and the local acupoints mainly combined with the distal acupoints group(LPMG).During a 4-week treatment period,patients in the DPOG will receive acupuncture at distal acupoints only(Houxi[SI 3]and Yaotongxue[EX-UE 7])twice a week,while those in the LPMG group will receive acupuncture at local acupoints(mainly Shenshu[BL 23]and Dachangshu[BL 25])combined with distal points(Weizhong[BL 40]).The patients in both groups will be evaluated at every session of treatment,and the follow-up will be performed for 3 months.The primary outcome measure will be the change in ALBP intensity,assessed using visual analogue scale scores before and after treatment.The secondary outcome measure will be the evaluation of functional disability using the Oswestry Disability Index.Discussion: This study compares the DPOG and LPMG to explore the feasibility of the DPOG in the treatment of ALBP. 展开更多
关键词 ACUPUNCTURE Acute low back pain Motion style acupuncture Activating qi acupuncture distal acupoints Local acupoints
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Lung cancer metastasis-induced distal esophageal segmental spasm confirmed by individualized peroral endoscopic myotomy:A case report
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作者 Hong Shi Su-Yu Chen +2 位作者 Zhao-Fei Xie Li-Lin Lin Yan Jiang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第10期3321-3327,共7页
BACKGROUND Peroral endoscopic myotomy(POEM)has been widely performed as a standard treatment for achalasia;however,its efficacy and safety for treating distal esophageal segmental spasms induced by cancer metastasis r... BACKGROUND Peroral endoscopic myotomy(POEM)has been widely performed as a standard treatment for achalasia;however,its efficacy and safety for treating distal esophageal segmental spasms induced by cancer metastasis remain unknown.CASE SUMMARY A 72-year-old male was referred to our hospital and complained of progressive dysphagia for two years.Endoscopy revealed a 2 cm long segment esophageal stenosis with intact mucosa and normal cardia.Computed tomography showed a right upper lung mass,and pathology of the right pleural effusion confirmed the diagnosis of right upper lung adenocarcinoma with multiple rib and mediastinal lymph node metastases and right malignant pleural effusion.Individualized POEM was performed first to alleviate dysphagia,and the final diagnosis was changed to esophageal muscle metastasis arising from lung adenocarcinoma.After treatment,the patient could eat soft solid food and received multiple rounds of pembrolizumab-combination chemotherapy.The patient’s progression-free survival was approximately 16 months.Long stable disease was obtained during the 24-month follow-up.CONCLUSION The incidence of distal esophageal segmental spasms induced by muscular metastasis arising from lung adenocarcinoma is extremely low.Individualized POEM can effectively improve a patient’s nutritional status before subsequent chemotherapy can be combined with immune checkpoint inhibitors. 展开更多
关键词 Peroral endoscopic myotomy distal esophageal segmental spasm Lung cancer Esophageal metastasis Case report
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The Quest for Haven in Sister Carrie
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作者 ZHANG Yi-wen 《Journal of Literature and Art Studies》 2024年第5期315-324,共10页
This essay analyses Theodore Dreiser’s Sister Carrie through the lens of cultural studies,examining the portrayal of domesticity and the quest for an ideal home in late-nineteenth-century America.It explores the comp... This essay analyses Theodore Dreiser’s Sister Carrie through the lens of cultural studies,examining the portrayal of domesticity and the quest for an ideal home in late-nineteenth-century America.It explores the complex relationships between the main characters,Carrie and Hurstwood,and their families,as well as their struggles with materialism and alienation.Through close analysis of societal context,the characters’familial backgrounds and emotional yearnings,the essay delves into the characters’longing for stability and belonging and their journey toward understanding the true essence of dwelling amidst the changing urban landscape.It argues that Dreiser’s novel critiques the superficial pursuit of material comforts and highlights the importance of introspection and self-discovery in finding lasting happiness amidst societal turmoil.Ultimately,through the prism of domesticity,the essay delves into broader themes of identity,belonging,and existential fulfillment in a heartless society marked by materialism and alienation. 展开更多
关键词 Theodore Dreiser Sister carrie HOME DOMESTICITY belonging
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Anisotropy of Trabecular Bone from Ultra-Distal Radius Digital X-Ray Imaging: Effects on Bone Mineral Density and Age
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作者 Jian-Feng Chen 《Open Journal of Radiology》 2024年第1期14-23,共10页
Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions... Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age. 展开更多
关键词 ANISOTROPY Trabecular Bone Score Bone Mineral Density Ultra-distal Radius Digital X-Ray Image
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New Distalizer矫治器与Pendulum矫治器推磨牙远中移动的疗效比较 被引量:1
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作者 陈宇 祁姗姗 朱友家 《武汉大学学报(医学版)》 CAS 2007年第6期813-816,共4页
目的:比较New distalizer矫治器与Pendulum矫治器2种方法推磨牙远中移动的临床疗效。方法:选择24例牙源性安氏Ⅱ类错轻、中度拥挤病例,按照配对实验设计的原理分为2组,分别使用New distalizer矫治器(N组)和Pendulum矫治器(P组)进行不... 目的:比较New distalizer矫治器与Pendulum矫治器2种方法推磨牙远中移动的临床疗效。方法:选择24例牙源性安氏Ⅱ类错轻、中度拥挤病例,按照配对实验设计的原理分为2组,分别使用New distalizer矫治器(N组)和Pendulum矫治器(P组)进行不拔牙矫治。矫治前后拍摄头颅侧位片,采用Pancherz分析法进行头影测量分析,比较2组矫治前后牙颌结构的变化。结果:两种矫治器的戴用时间上,N组明显短于P组,P<0.01;矫治前后相比较,两组磨牙远中移动效果明显,但磨牙远中倾斜N组1.0°±0.8°,P组3.7°±0.8°,两组的差异具有显著性(P<0.05);N组上颌前牙唇向倾斜1.2°±1.7°,改变不明显,P组2.4°±2.4°,矫治前后的比较具有显著性差异(P<0.05)。结论:在本研究中两种矫治器都能有效推磨牙远移,但New distalizer矫治器表现出快速、整体地上颌磨牙远中移动,前牙支抗消耗相对要低。 展开更多
关键词 矫治器 磨牙远移
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Robotic versus laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: A propensity score-matched analysis 被引量:2
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作者 Dakyum Shin Jaewoo Kwon +6 位作者 Jae Hoon Lee Seo Young Park Yejong Park Woohyung Lee Ki Byung Song Dae Wook Hwang Song Cheol Kim 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第2期154-159,共6页
Background: Minimally invasive surgery is becoming increasingly popular in the field of pancreatic surgery. However, there are few studies of robotic distal pancreatectomy(RDP) for pancreatic ductal adenocarcinoma(PDA... Background: Minimally invasive surgery is becoming increasingly popular in the field of pancreatic surgery. However, there are few studies of robotic distal pancreatectomy(RDP) for pancreatic ductal adenocarcinoma(PDAC). This study aimed to investigate the efficacy and feasibility of RDP for PDAC. Methods: Patients who underwent RDP or laparoscopic distal pancreatectomy(LDP) for PDAC between January 2015 and September 2020 were reviewed. Propensity score matching analyses were performed. Results: Of the 335 patients included in the study, 24 underwent RDP and 311 underwent LDP. A total of 21 RDP patients were matched 1:1 with LDP patients. RDP was associated with longer operative time(209.7 vs. 163.2 min;P = 0.003), lower open conversion rate(0% vs. 4.8%;P < 0.001), higher cost(15 722 vs. 12 699 dollars;P = 0.003), and a higher rate of achievement of an R0 resection margin(90.5% vs. 61.9%;P = 0.042). However, postoperative pancreatic fistula grade B or C showed no significant intergroup difference(9.5% vs. 9.5%). The median disease-free survival(34.5 vs. 17.3 months;P = 0.588) and overall survival(37.7 vs. 21.9 months;P = 0.171) were comparable between the groups. Conclusions: RDP is associated with longer operative time, a higher cost of surgery, and a higher likelihood of achieving R0 margins than LDP. 展开更多
关键词 Minimally invasive surgery Robotic distal pancreatectomy Laparoscopic distal pancreatectomy Pancreatic ductal adenocarcinoma Propensity score matching
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Optimal choice of stapler and digestive tract reconstruction method after distal gastrectomy for gastric cancer:A prospective case–control study 被引量:3
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作者 Zhen Wu Zhi-Gang Zhou +2 位作者 Ling-Yu Li Wen-Jing Gao Ting Yu 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第7期1354-1362,共9页
BACKGROUND Gastric cancer is the most common cause of cancer-related deaths,and is classified according to its location in the proximal,middle,or distal stomach.Surgical resection is the primary approach for treating ... BACKGROUND Gastric cancer is the most common cause of cancer-related deaths,and is classified according to its location in the proximal,middle,or distal stomach.Surgical resection is the primary approach for treating gastric cancer.This prospective study aimed to determine the best reconstruction method after distal gastrectomy for gastric cancer.AIM To explore the efficacy of different staplers and digestive tract reconstruction(DTR)methods after radical gastrectomy and their influence on prognosis.METHODS Eighty-seven patients who underwent radical gastrectomy for distal gastric cancer at our institution between April 2017 and April 2020 were included in this study,with a follow-up period of 12-26 mo.The patients were assigned to four groups based on the stapler and DTR plan as follows:BillrothⅠ(B-I)reconstruction+linear stapler group(group A,22 cases),B-I reconstruction+circular stapler group(group B,22 cases),Billroth II(B-II)reconstruction+linear stapler group(group C,22 cases),and B-II reconstruction+circular stapler group(group D,21 cases).The pathological parameters,postoperative gastrointestinal function recovery,postoperative complications,and quality of life(QOL)were compared among the four groups.RESULTS No significant differences in the maximum diameter of the gastric tumors,total number of lymph nodes dissected,drainage tube removal time,QLQ(QOL questionnaire)-C30 and QLQ-STO22 scores at 1 year postoperatively,and incidence of complications were observed among the four groups(P>0.05).However,groups A and C(linear stapler)had significantly lower intraoperative blood loss and significantly shorter anastomosis time,operation time,first fluid diet intake time,first exhaust time,and length of postoperative hospital stay(P<0.05)than groups B and D(circular stapler).CONCLUSION Linear staplers offer several advantages for postoperative recovery.B-I and B-II reconstruction methods had similar effects on QOL.The optimal solution can be selected according to individual conditions and postoperative convenience. 展开更多
关键词 Gastric cancer distal radical gastrectomy Reconstruction of digestive tract STAPLER Quality of life Prognosis
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Distal clavicle fractures treated by anteroinferior plating with a single screw: Two case reports 被引量:1
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作者 Xin-Lei Zhao Yan-Qing Liu +4 位作者 Jian-Guo Wang You-Cai Liu Jia-Xuan Zhou Bei-Yu Wang Yi-Jun Zhang 《World Journal of Clinical Cases》 SCIE 2023年第30期7502-7507,共6页
BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal... BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal clavicle fractures treated utilizing an anterior inferior plate with a single screw placed in the distal,in anticipation of providing a better surgical approach to distal clavicle fracture treatment.Two patients were admitted to the hospital after trauma with a diagnosis of distal clavicle fracture,and were admitted to the hospital for internal fixation of clavicle fracture by incision and reduction,with good postoperative functional recovery.CONCLUSION With solid postoperative fixation and satisfactory prognostic functional recovery,this technique has been shown to be simple,easy to perform and effective. 展开更多
关键词 distal clavicle fractures Anteroinferior PLATING Single screw Case report
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Locking plates for distal fibula fractures in young and elderly patients:A retrospective study 被引量:1
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作者 Francesco Roberto Evola Giovanni Francesco Di Fede +3 位作者 Giuseppe Evola Martina Barchitta Antonella Agodi Gianfranco Longo 《World Journal of Orthopedics》 2023年第7期540-546,共7页
BACKGROUND Ankle fractures are common injuries in the young and elderly populations.To prevent post-traumatic arthritis,an anatomic reconstruction of the ankle structure is mandatory.Open reduction and internal fixati... BACKGROUND Ankle fractures are common injuries in the young and elderly populations.To prevent post-traumatic arthritis,an anatomic reconstruction of the ankle structure is mandatory.Open reduction and internal fixation is the treatment of choice among orthopaedics.Conventional plates allow stability of the fracture if bone quality is present.Locking plates might offer an advantage for the treatment of lateral malleolar fracture in patients with comminution,severe instability,distal fractures,or osteoporotic bone.Our hospital introduced a new locking plate for fracture of the distal fibula.AIM To evaluate locking plates in terms of outcomes and complications in young and elderly patients.METHODS We retrospectively reviewed a total of 67 patients treated for displaced distal fibula fractures.Demographic data,number of comorbidities,use of inter fragmentary screw,complication,time of fracture healing,partial or full weight bearing,and reoperation were recorded for all patients.Clinical outcome was assessed by the American Orthopedic Foot and Ankle Society clinical scoring system.Radiographs were obtained at 4,8,12,16,20,and 24 wk until radiographic union was obtained.RESULTS All patients displayed complete bony union on radiographic assessment,and no patients developed any serious complications.We observed two superficial infections,one delayed wound healing,and two plate intolerances.Significant differences were observed between the two age groups in terms of radiographic healing(11.9 wk in younger patients vs 13.7 wk in older patients;P=0.011)and in the American Orthopedic Foot and Ankle Society score at 6 mo after surgery(88.2 in younger patients vs 86.0 in older patients;P=0.001)and at 12 mo after surgery(92.6 in younger patients vs 90.0 in older patients;P=0.000).CONCLUSION Locking plates provide a stable and rigid fixation in multifragmentary and comminuted fractures or in the presence of poor bone quality. 展开更多
关键词 Ankle fracture Locking plate distal fibula fracture OUTCOME COMPLICATIONS OSTEOPOROSIS
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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel TouréUniversity Hospital
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作者 Mahamadou Diallo Abdoul Kadri Moussa +7 位作者 Layes Toure Kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou Diallo Amadou Maiga Adégné Togo 《Surgical Science》 2023年第2期61-71,共11页
Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, s... Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to December 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. Surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. 展开更多
关键词 Epiphyseal Detachment distal Femur Treatment SURGICAL
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Spleen-preserving distal pancreatectomy from multi-port to reducedport surgery approach
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作者 Ching-Lung Hsieh Tung-Sheng Tsai +2 位作者 Cheng-Ming Peng Teng-Chieh Cheng Yi-Jui Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第7期1501-1511,共11页
BACKGROUND Minimally invasive pancreatic surgery via the multi-port approach has become a primary surgical method for distal pancreatectomy(DP)due to its advantages of lower wound pain and superior cosmetic results.So... BACKGROUND Minimally invasive pancreatic surgery via the multi-port approach has become a primary surgical method for distal pancreatectomy(DP)due to its advantages of lower wound pain and superior cosmetic results.Some studies have applied reduced-port techniques for DP in an attempt to enhance cosmetic outcomes due to the minimally invasive effects.Numerous recent review studies have compared multi-port laparoscopic DP(LDP)and multi-port robotic DP(RDP);most of these studies concluded multi-port RDP is more beneficial than multi-port LDP for spleen preservation.However,there have been no comprehensive reviews of the value of reduced-port LDP and reduced-port RDP.AIM To search for and review the studies on spleen preservation and the clinical outcomes of minimally invasive DP that compared reduced-port DP surgery with multi-port DP surgery.METHODS The PubMed medical database was searched for articles published between 2013 and 2022.The search terms were implemented using the following Boolean search algorithm:(“distal pancreatectomy”OR“left pancreatectomy”OR“peripheral pancreatic resection”)AND(“reduced-port”OR“single-site”OR“single-port”OR“dual-incision”OR“single-incision”)AND(“spleen-preserving”OR“spleen preservation”OR“splenic preservation”).A literature review was conducted to identify studies that compared the perioperative outcomes of reduced-port LDP and reduced-port RDP.RESULTS Fifteen articles published in the period from 2013 to 2022 were retrieved using three groups of search terms.Two studies were added after manually searching the related papers.Finally,10 papers were selected after removing case reports(n=3),non-English language papers(n=1),technique papers(n=1),reviews(n=1),and animal studies(n=1).The common items were defined as items reported in more than five papers,and data on these common items were extracted from all papers.The ten studies included a total of 337 patients(females/males:231/106)who underwent DP.In total,166 patients(females/males,106/60)received multi-port LDP,126(females/males,90/36)received reduced-port LDP,and 45(females/males,35/10)received reduced-port RDP.CONCLUSION Reduced-port RDP leads to a lower intraoperative blood loss,a lower postoperative pancreatic fistula rate,and shorter hospital stay and follow-up duration,but has a lower spleen preservation rate. 展开更多
关键词 Minimally invasive surgery Robotic distal pancreatectomy Laparoscopic distal pancreatectomy Spleen preservation Reduced-port MULTI-PORT
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