简介:摘要目的探讨O-arm导航辅助下后路椎弓根螺钉复位内固定治疗寰枢椎骨折的疗效。方法采用回顾性病例对照研究分析2016年1月至2018年6月河北医科大学第三医院收治的37例寰枢椎骨折患者临床资料,其中男22例,女15例;年龄29~68岁[(50.9±9.8)岁]。24例行O-arm导航辅助下后路椎弓根螺钉复位内固定术(导航组),13例行徒手后路椎弓根螺钉复位内固定术(徒手组)。比较两组手术时间和术中出血量。术前、术后7 d及末次随访采用日本骨科学会(JOA)评分和颈椎功能障碍指数(NDI)评分对患者临床疗效进行评估。观察患者并发症情况。采用Neo分级评价螺钉位置分级及皮质穿透率。结果患者均获随访24~38个月[(27.7±4.0)个月]。导航组手术时间[(189.8±35.4)min]显著短于徒手组[(221.5±48.6)min](P<0.05),术中出血量[300.0(250.0,537.5)ml]显著少于徒手组[500.0(425.0,625.0)ml](P<0.05)。两组患者术后7 d及末次随访JOA评分较术前显著升高(P<0.05),NDI评分较术前显著降低(P<0.05)。而组间差异无统计学意义(P>0.05)。术中未见神经、血管损伤等严重相关并发症。导航组共置入椎弓根螺钉86枚,包括Neo分级0级83枚,1级2枚,2级1枚;徒手组共置入椎弓根螺钉44枚,包括Neo分级0级36枚,1级5枚,2级2枚,3级1枚(P<0.05)。导航组螺钉皮质穿透率为3%(3/86),徒手组为18%(8/44)(P<0.05)。结论对于寰枢椎骨折,在行后路椎弓根螺钉复位内固定术时,应用O-arm导航辅助可以显著缩短或减少手术时间和术中出血量,提高椎弓根螺钉置入的精确率。
简介:摘要目的比较O-arm导航辅助下与C形臂X线机透视辅助下经皮骶髂关节螺钉内固定治疗骶髂关节复合体损伤的临床疗效。方法采用回顾性病例对照研究分析2016年7月— 2019年1月陆军军医大学第二附属医院收治的32例骶髂关节复合体损伤患者临床资料,其中男21例,女11例;年龄20~59岁,平均41.3岁。骨折按Tile分型:B1型7例,B2型13例,B3型5例,C1型5例,C2型2例。17例采用O-arm导航辅助下经皮骶髂螺钉内固定治疗(A组),15例采用C形臂X线机透视辅助下经皮骶髂螺钉内固定治疗(B组)。比较两组单枚螺钉置钉时间、术中透视时间、术中出血量、骨折愈合时间,采用Matta标准评分评价术后骨折复位质量。采用Majeed功能评分评价末次随访时关节功能,并观察并发症情况。结果患者均获随访6~37个月,平均18.6个月。A组单枚螺钉置钉时间为(27.3±5.1)min,B组为(52.3±5.9)min(P<0.05)。A组术中透视时间为(43.3±3.2)s,B组为(64.6±5.4)s(P<0.05)。A组术中出血量为(17.8±2.6)ml,B组为(20.7±3.1)ml;A组骨折愈合时间为(13.4±1.4)周,B组为(14.1±1.9)周;A组和B组Matta标准评分的优良率分别为88%(15/17)和87%(13/15);A组和B组末次随访时Majeed评分的优良率分别为94%(16/17)和87%(13/15)(P均>0.05)。术后B组1例患者出现1枚螺钉稍突破椎体前皮质。两组均无血管、神经损伤、伤口感染、螺钉松动等并发症。结论与C形臂X线机透视辅助下相比,O-arm导航辅助下经皮骶髂关节螺钉内固定治疗骶髂关节复合体损伤具有置钉时间短、术中透视时间短等优势。
简介:【摘要】几何图形是培养学生空间思维的重要板块,平行四边形是几何的基础图形,学好平行四边形,是教师进一步开展其他图形教学工作的基础。教师要立足于学生的学习进度,结合教学大纲要求,从基础入手,带领学生逐渐深入探索,将数理知识掌握和动手操作实践相结合,提高几何图形学习的效率和乐趣。就具体的平行四边形教学而言,要找到平行四边形面积、周长、性质等知识点切入,分不同的课时连贯教学,就某一具体指示精讲细讲,让学生把知识点吃牢、吃透。下面,笔者将从自身教学经验出发,以小学五年级的平行四边形面积教学为例,具体谈谈如何进行课时的深度教学设计,如何让学生把握数学学习内核,回归数学本位。
简介:AbstractObjective:It remains unclear whether adjuvant chemoradiotherapy (CRT) improves survival outcome of pancreatic ductal adenocarcinoma (PDAC) patients after surgery. This study aimed to investigate the efficacy and safety of tegafur/gimeracil/oteracil (S-1)-based adjuvant concurrent chemoradiotherapy in resected PDAC patients with defined high-risk pathological features.Methods:We conducted a single-arm, prospective, and interventional study at Zhongshan Hospital Fudan University from December 2012 to December 2019 and the last follow-up was conducted in December 2021. This study was approved by the Ethics Committee of Zhongshan Hospital Fudan University on December 27, 2012 (approval No. B2012-139). Resected PDAC patients with high-risk pathological features, including positive resection margin, pathological T3-4N1-2M0 disease, peripancreatic fat invasion, microvascular invasion, and perineural invasion, were recruited. Primary endpoint was overall survival and secondary endpoints were disease-free survival, treatment toxicity, and 2-, 5-year survival rates.Results:A total of 54 patients were recruited. Mean age was 63.6 years old (±7.2). The distribution of T and N stages were 24.1% for T1, 46.3% for T2, 27.8% for T3, 1.9% for T4, 33.3% for N1, and 11.1% for N2. Seven patients had R1 resection. The median overall survival and disease-free survival were 27.1 and 13.7 months, respectively, while no fatal adverse events were recorded. Subgroup analyses showed differences in survival outcomes among patients with microvascular invasion, different N stages, and preoperative CA 19-9 levels. Further, a Cox proportional hazard model demonstrated associations of lymph node metastases, CA 19-9 level, and microvascular invasion with overall survival and disease-free survival.Conclusion:S-1 -based adjuvant CRT showed promising efficacy and manageable toxicity in resected PDAC patients with highrisk pathological features.
简介:无
简介:
简介:【摘要】:此文以南宁广播电视台现状为出发点,重点分析并解释了作为资金并不十分充裕的城市电视台如何利用自身的技术优势和业务传承,建设一条能够符合4K/UHD的节目形态的探索之路。