背景骨盆肿瘤切除重建术中,软组织重建的有效性尚无系统研究。目的 评估骨盆肿瘤切除术中应用改良Ganz-髂腹股沟入路联合Lars韧带与假体进行骨与软组织缺损重建的临床疗效。方法 回顾性分析解放军总医院第四医学中心2019年2月—2022年1...背景骨盆肿瘤切除重建术中,软组织重建的有效性尚无系统研究。目的 评估骨盆肿瘤切除术中应用改良Ganz-髂腹股沟入路联合Lars韧带与假体进行骨与软组织缺损重建的临床疗效。方法 回顾性分析解放军总医院第四医学中心2019年2月—2022年1月收治的骨盆Ⅱ区肿瘤患者资料,按照不同的手术方式分为改良Ganz—髂腹股沟入路联合Lars韧带与假体行骨盆重建术组和传统髂腹股沟入路联合假体行骨盆重建组。记录并比较两组患者围术期指标以及术后12个月时MSTS评分、Harris评分、VAS评分,影像学方法复查肿瘤复发及转移情况。结果 改良手术组中,男10例,女9例,平均年龄(38.42±19.89)岁,恶性肿瘤16例,非恶性肿瘤3例;传统手术组中,男9例,女7例,平均年龄(39.68±17.52)岁,恶性肿瘤14例,非恶性肿瘤2例。两组一般资料差异无统计学意义(P>0.05)。两组患者均按术前计划完成半骨盆假体重建,无围术期死亡病例,均实现完整切除。相较于改良组,传统组术后放置引流管时间更长[(7.57±0.80) d vs (10.06±1.08) d,P<0.001],术后引流量更多[(1 519.84±280.57) mL vs (1 711.25±266.07) mL,P=0.023],差异均有统计学意义。术后12个月两组VAS评分差异无统计学意义(P>0.05);改良组MSTS评分(23.18±1.34 vs 21.10±1.03,P=0.004)、Harris评分(68.65±7.57 vs 64.17±6.94,P=0.040)均高于传统组,差异有统计学意义。传统组2例发生伤口感染,3例深部感染,改良组无并发症发生。术后平均随访(21.51±6.92)个月,两组均无肿瘤复发。结论 对于骨盆Ⅱ区肿瘤切除,与传统髂腹股沟入路重建手术相比,改良Ganz-髂腹股沟入路联合Lars韧带可更有效地恢复患者术后功能,并发症发生率更低。展开更多
BACKGROUND Femoroacetabular impingement(FAI)is a predisposing factor for secondary osteoarthritis of the hip joint.The two extensively described impingement mechanisms of FAI are CAM and Pincer-type.Initially managed ...BACKGROUND Femoroacetabular impingement(FAI)is a predisposing factor for secondary osteoarthritis of the hip joint.The two extensively described impingement mechanisms of FAI are CAM and Pincer-type.Initially managed conservatively,operative intervention should be offered to the persistently symptomatic patient.The measurement of the alpha angle is considered a standard method of assessing the severity of pathology in Cam-type FAI on pre-operative plain radiographs.The radiological correction of the alpha angle has not been previously compared between different surgical approaches.We hypothesize that there is no difference in alpha angle correction between Ganz surgical hip dislocation and the anterior mini-open approach.AIM To compare the magnitude of alpha angle correction achieved by using the Ganz surgical hip dislocation and the anterior mini-open approach.METHODS This is a retrospective study assessing seventy-nine patients identified in a 5-year period.These patients had preoperative radiographic evidence of FAI and underwent surgery by a single surgeon at our institution,a tertiary care center.Patients with missing radiographic documentation,radiographs with insufficient quality which then precluded accurate measurement of the angleα,a diagnosed congenital condition,isolated type II pathology(Pincer),and history of prior surgery were excluded from the study.Either the Ganz surgical hip dislocation or the anterior mini open approach was used.Postoperative radiographic evaluation of the alpha angle between the two surgical methods was done and corrected for age and gender using two-sample t-tests and Chi-square analyses.RESULTS A total of 79 patients met the inclusion and exclusion criteria.Forty-seven males(mean age of 35.3,range 16-53)and 32 females(mean age 36.7,range 16-60)were enrolled.Forty-seven patients underwent the anterior mini-open approach,and 32 underwent the Ganz surgical hip dislocation.There were no significant differences in age between the two surgical groups or in pre-and post-operative alpha angles based on patient gender.The mean pre-operative alpha angle for the Ganz surgical hip dislocation group was 88.0 degrees(SD 12.3)and 99.4 degrees(SD 7.2)for the anterior mini-open group.Mean post-operative angles were 49.9 degrees(SD 4.3)for the Ganz surgical hip dislocation and 43.8(SD 4.3)degrees for the anterior mini-open group.There was a statistically significant difference in patient’s pre-operative and post-operative angles(P=0.000)with both surgical approaches.CONCLUSION Statistically significant decreases in alpha angle were noted for both surgical techniques,with larger decreases seen in the anterior mini-open group.展开更多
The timing of the closure of the Paleo-Tethys Ocean in West China remains debated.To investigate this problem,we examined the geochemical characteristics,zircon U-Pb chronology,and Hf isotopes of monzogranites and qua...The timing of the closure of the Paleo-Tethys Ocean in West China remains debated.To investigate this problem,we examined the geochemical characteristics,zircon U-Pb chronology,and Hf isotopes of monzogranites and quartz diorites from the Duocai granite in the Zhiduo region,at the intersection of the Jinshajiang and GanzeLitangsutures.The monzogranites have the chemical characteristics of calc-alkalineⅠ-type granites and yield a weighted mean zircon U-Pb age of 234.6±0.9 Ma[mean square weighted deviation(MSWD)=0.36].InitialεHf(-t)values are high and positive,ranging from+7.9 to+13.6 with a mean of+10.7,corresponding to two-stage Hf isotope model ages(TDM2)of 762-395 Ma.Geochemical and isotopic data indicate that the source magma of the monzogranites formed from mantle-derived magmas mixed with the overlying crustal materials.The quartz diorites,which also have compositional characteristics of calcalkaline I-type granites,yield a weighted mean zircon UPb age of 209.1±0.7 Ma(MSWD=0.29).InitialεHf(-t)values range from-2.5 to+0.6 with a mean of-1.5,with the corresponding TDM2 of 1402-1210 Ma.Geochemical and isotopic data indicate that the primary magma of the quartz diorites was derived mainly from partial melting of the mafic lower crust and small amount mantle-derived magma involved.Combining these results with regional data,the studied granites are inferred to have formed as a result of continuous subduction of plates underlying the Western Jinshajiang Ocean-Ganze-Litang Ocean from 234 to 209 Ma,and were unrelated to subduction of the South Jinshajiang oceanic plate.We suggest that the Western Jinshajiang Ocean-Ganze-Litang Ocean closed by the end of Late Triassic.展开更多
文摘背景骨盆肿瘤切除重建术中,软组织重建的有效性尚无系统研究。目的 评估骨盆肿瘤切除术中应用改良Ganz-髂腹股沟入路联合Lars韧带与假体进行骨与软组织缺损重建的临床疗效。方法 回顾性分析解放军总医院第四医学中心2019年2月—2022年1月收治的骨盆Ⅱ区肿瘤患者资料,按照不同的手术方式分为改良Ganz—髂腹股沟入路联合Lars韧带与假体行骨盆重建术组和传统髂腹股沟入路联合假体行骨盆重建组。记录并比较两组患者围术期指标以及术后12个月时MSTS评分、Harris评分、VAS评分,影像学方法复查肿瘤复发及转移情况。结果 改良手术组中,男10例,女9例,平均年龄(38.42±19.89)岁,恶性肿瘤16例,非恶性肿瘤3例;传统手术组中,男9例,女7例,平均年龄(39.68±17.52)岁,恶性肿瘤14例,非恶性肿瘤2例。两组一般资料差异无统计学意义(P>0.05)。两组患者均按术前计划完成半骨盆假体重建,无围术期死亡病例,均实现完整切除。相较于改良组,传统组术后放置引流管时间更长[(7.57±0.80) d vs (10.06±1.08) d,P<0.001],术后引流量更多[(1 519.84±280.57) mL vs (1 711.25±266.07) mL,P=0.023],差异均有统计学意义。术后12个月两组VAS评分差异无统计学意义(P>0.05);改良组MSTS评分(23.18±1.34 vs 21.10±1.03,P=0.004)、Harris评分(68.65±7.57 vs 64.17±6.94,P=0.040)均高于传统组,差异有统计学意义。传统组2例发生伤口感染,3例深部感染,改良组无并发症发生。术后平均随访(21.51±6.92)个月,两组均无肿瘤复发。结论 对于骨盆Ⅱ区肿瘤切除,与传统髂腹股沟入路重建手术相比,改良Ganz-髂腹股沟入路联合Lars韧带可更有效地恢复患者术后功能,并发症发生率更低。
文摘BACKGROUND Femoroacetabular impingement(FAI)is a predisposing factor for secondary osteoarthritis of the hip joint.The two extensively described impingement mechanisms of FAI are CAM and Pincer-type.Initially managed conservatively,operative intervention should be offered to the persistently symptomatic patient.The measurement of the alpha angle is considered a standard method of assessing the severity of pathology in Cam-type FAI on pre-operative plain radiographs.The radiological correction of the alpha angle has not been previously compared between different surgical approaches.We hypothesize that there is no difference in alpha angle correction between Ganz surgical hip dislocation and the anterior mini-open approach.AIM To compare the magnitude of alpha angle correction achieved by using the Ganz surgical hip dislocation and the anterior mini-open approach.METHODS This is a retrospective study assessing seventy-nine patients identified in a 5-year period.These patients had preoperative radiographic evidence of FAI and underwent surgery by a single surgeon at our institution,a tertiary care center.Patients with missing radiographic documentation,radiographs with insufficient quality which then precluded accurate measurement of the angleα,a diagnosed congenital condition,isolated type II pathology(Pincer),and history of prior surgery were excluded from the study.Either the Ganz surgical hip dislocation or the anterior mini open approach was used.Postoperative radiographic evaluation of the alpha angle between the two surgical methods was done and corrected for age and gender using two-sample t-tests and Chi-square analyses.RESULTS A total of 79 patients met the inclusion and exclusion criteria.Forty-seven males(mean age of 35.3,range 16-53)and 32 females(mean age 36.7,range 16-60)were enrolled.Forty-seven patients underwent the anterior mini-open approach,and 32 underwent the Ganz surgical hip dislocation.There were no significant differences in age between the two surgical groups or in pre-and post-operative alpha angles based on patient gender.The mean pre-operative alpha angle for the Ganz surgical hip dislocation group was 88.0 degrees(SD 12.3)and 99.4 degrees(SD 7.2)for the anterior mini-open group.Mean post-operative angles were 49.9 degrees(SD 4.3)for the Ganz surgical hip dislocation and 43.8(SD 4.3)degrees for the anterior mini-open group.There was a statistically significant difference in patient’s pre-operative and post-operative angles(P=0.000)with both surgical approaches.CONCLUSION Statistically significant decreases in alpha angle were noted for both surgical techniques,with larger decreases seen in the anterior mini-open group.
基金funded by the Geological Survey Project(12120113098300)of China Geological Surveythe National Natural Science Foundation of China(41272093)。
文摘The timing of the closure of the Paleo-Tethys Ocean in West China remains debated.To investigate this problem,we examined the geochemical characteristics,zircon U-Pb chronology,and Hf isotopes of monzogranites and quartz diorites from the Duocai granite in the Zhiduo region,at the intersection of the Jinshajiang and GanzeLitangsutures.The monzogranites have the chemical characteristics of calc-alkalineⅠ-type granites and yield a weighted mean zircon U-Pb age of 234.6±0.9 Ma[mean square weighted deviation(MSWD)=0.36].InitialεHf(-t)values are high and positive,ranging from+7.9 to+13.6 with a mean of+10.7,corresponding to two-stage Hf isotope model ages(TDM2)of 762-395 Ma.Geochemical and isotopic data indicate that the source magma of the monzogranites formed from mantle-derived magmas mixed with the overlying crustal materials.The quartz diorites,which also have compositional characteristics of calcalkaline I-type granites,yield a weighted mean zircon UPb age of 209.1±0.7 Ma(MSWD=0.29).InitialεHf(-t)values range from-2.5 to+0.6 with a mean of-1.5,with the corresponding TDM2 of 1402-1210 Ma.Geochemical and isotopic data indicate that the primary magma of the quartz diorites was derived mainly from partial melting of the mafic lower crust and small amount mantle-derived magma involved.Combining these results with regional data,the studied granites are inferred to have formed as a result of continuous subduction of plates underlying the Western Jinshajiang Ocean-Ganze-Litang Ocean from 234 to 209 Ma,and were unrelated to subduction of the South Jinshajiang oceanic plate.We suggest that the Western Jinshajiang Ocean-Ganze-Litang Ocean closed by the end of Late Triassic.
