We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classi...We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1 403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First,angulation of the upper first molar varied significantly with age and tipped most distally in cases aged,12 years and least distally in cases aged.16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability.展开更多
Glycogen, a polymer of glucose, is an important means of storing energy. It is degraded by glycogen phosphorylase （GPH） and hexokinase （HK）, glycogen phosphorylase, and hexokinase cDNAs （Ca-GPH and Ca- HK, respec...Glycogen, a polymer of glucose, is an important means of storing energy. It is degraded by glycogen phosphorylase （GPH） and hexokinase （HK）, glycogen phosphorylase, and hexokinase cDNAs （Ca-GPH and Ca- HK, respectively）, which encode the primary enzymes involved in glycogen use, cloned and characterized and used to investigate the regulation of glycogen metabolism at the mRNA level in Crassostrea angulata. Their expression profiles were examined in different tissues and during different reproductive stages. Full-length cDNA of GPHwas 3 078 bp in length with a 2 607 bp open reading frame （ORF） predicted to encode a protein of 868 amino acids （aa）. The full-length HK cDNA was 3 088 bp long, with an ORF of 1 433 bp, predicted to encode a protein of 505 aa. Expression levels of both genes were found to be significantly higher in the gonads and adductor muscle than in the mantle, gill, and visceral mass. They were especially high in the adductor muscle, which suggested that these oysters can use glycogen to produce a readily available supply of glucose to support adductor muscle activity. The regulation of both genes was also found to be correlated with glycogen content via qRT-PCR and in situ hybridization and was dependent upon the stage of the reproductive cycle （initiation, maturation, ripeness）. In this way, it appears that the expression of Ca-GPH and Ca-HK is driven by the reproductive cycle of the oyster, reflecting the central role played by glycogen in energy use and gametogenic development in C. angulata. It is here suggested that Ca- GPH and Ca-HK can be used as useful molecular markers for identifying the stages of glycogen metabolism and reproduction in C. angulata.展开更多
This study was undertaken to examine which factors contributed to the correction of crowding in two patients who underwent nonextraction orthodontic treatment. A study model analysis was conducted to determine the eff...This study was undertaken to examine which factors contributed to the correction of crowding in two patients who underwent nonextraction orthodontic treatment. A study model analysis was conducted to determine the effects of the orthodontic treatment for crowding with high canines on crown angulation and dental arch width in two patients. The results showed that the crown angulation was significantly increased, indicating distal tipping in the maxillary dental arch. This tendency was most commonly observed in the premolars among the lateral teeth. With respect to the dental arch width, the largest change was evident in the first molar and first premolar regions in cases 1 and 2, respectively. On the basis of these results, up-righting of mesially tipped lateral teeth and expansion of narrow dental arches could prove to be the keys to the success of space regaining or correction of high canines and mild crowding.展开更多
The Adaptive Quality Control Phantom (AQCP) is a computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to produc...The Adaptive Quality Control Phantom (AQCP) is a computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to produce a spatial distribution of gamma rays to perform QC Tests such as the Collimator Hole Angulation (CHA) and the Center of Rotation (COR) of Single Photon Emission Computer Tomography (SPECT). The collimator hole angulation for six collimators was measured using a point source and a computer-controlled cylindrical positioning system. In this method, the displacement of the image of a point source was examined as the AQCP was moving point source vertically away from the collimator face. The results of the high-accuracy measurement method of CHA show that the measurement accuracy for absolute angulation errors is better than ±0.024°. The Root Mean Square (RMS) of CHA for LEHR, LEHS and LEUHR collimators of SMV dual heads camera and LEGP, MEGP and HEGP of GE Millennium MG were evaluated to be 0.290°, 0.292°, 0.208°, 0.154°, 0.220° and 0.202°, respectively. It is to be added in this connection that the evaluated RMS of CHA for LEHR collimator with the distance variation from the collimator’s surface ±1 mm has been varied ±0.04 degree. A new method for the center of rotation assessment by AQCP is introduced and the results of this proposed method as compared with the routine QC test and their differences are discussed in detail. We defined and measured a new parameter called Dynamic Mechanical Error (DME) for applying the gantry motion correction.展开更多
The Adaptive Quality Control Phantom (AQCP) is the computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to prod...The Adaptive Quality Control Phantom (AQCP) is the computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to produce any spatial distribution of gamma rays to perform the QC Tests such as the Collimator Hole Angulation (CHA) of Single Photon Emission Computer Tomography (SPECT). The collimator hole angulation for seven collimators were measured with the method by using a point source and computer-controlled cylindrical positioning. In this method the displacement of the image of a point source examined as the AQCP move point source vertically away from the collimator face. The results of the high-accuracy measurement method of CHA show that the measurement accuracy for absolute angulation errors is better than ±0.024°. The Root Mean Square (RMS) of CHA for LEHR, LEHS, LEUHR, MEGP-250, MEGP-300, MEGP-360 and HEPH collimators of SMV dual heads camera were measured to be 0.290°, 0.292°, 0.208°, 0.194°, 0.181°, 0.177°, 0.150°, respectively. The Root Mean Square (RMS) of CHA for LEGP, MEGP and HEGP collimators of GE Millennium MG were measured to be 0.154°, 0.220° and 0.202° respectively. It is to be added in this connection that the measured RMS of CHA for LEHR collimator with the distance variation from the collimator’s surface +/– 1 mm has been varied +/– 0.04 degree.展开更多
Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 pat...Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 patients who had展开更多
Objective:This study aimed to explore the impact of aortic annulus angulation on outcomes in patients with bicuspid aortic valves(BAVs)undergoing transcatheter aortic valve replacement(TAVR)with new-generation valves....Objective:This study aimed to explore the impact of aortic annulus angulation on outcomes in patients with bicuspid aortic valves(BAVs)undergoing transcatheter aortic valve replacement(TAVR)with new-generation valves.Methods:A retrospective study was conducted among patients who underwent TAVR with new-generation self-expandable(SE)or balloon-expandable(BE)transcatheter heart valves(THVs)at West China Hospital between January 2018 and November 2022.Their CT scans,from which the annulus angulation was derived,and other clinical information were retrieved through the electronic patient record system.The mean annulus angulation of the whole cohort served as the cut-off value for further group assignment.The primary endpoint was device success at 30 d.Secondary endpoints included the need for>1 THV,vascular complications,permanent pacemaker implantation,paravalvular leak of at least mild severity,30-day and 6-month mortality,etc.Multivariable logistic regression analysis was performed to identify independent predictors of the clinical outcomes.Results:A total of 180 patients were included in the study,137 with SE THVs and 43 with BE THVs.The annulus angulation of all patients was 55.6°±10.0°,therefore,the patients were further stratified by 56°.Among the 43 BE THV recipients,the annulus angulation≥56°group was older,shorter,had less valve calcification,and larger sinotubular junction and maximal ascending aorta diameters(all P<0.05);however,the primary and secondary endpoints did not differ significantly between the annulus angulation<56°and≥56°groups.Among the 137 SE THV recipients,despite larger maximal ascending aorta diameters in annulus angulation≥56°group((43.4±4.3)mm vs.(41.3±4.0)mm;P=0.003),it did not influence device success at 30 d,the requirement for>1 THV,vascular complications,paravalvular leak of at least mild severity,and 6-month mortality(all P>0.05).However,the SE THV group with annulus angulation≥56°had a higher incidence of permanent pacemaker implantation(27.6%vs.8.9%,P=0.004).Annulus angulation≥57°was an independent predictor of permanent pacemaker implantation in patients with BAV receiving SE TAVR(odds ratio:3.28,95%confidence interval:1.28-8.40;P=0.01).Conclusion:Increased annulus angulation did not influence device success for both new-generation BE and SE THVs in patients with BAV.However,increased annulus angulation was associated with a higher risk of permanent pacemaker implantation in patients undergoing SE TAVR,while no such association was observed in those who underwent BE TAVR.展开更多
Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemody...Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.Methods: This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).Results: In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 Nvs. 4.283 ± 1.460 N,P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 ×α-0.006 ×β + 2.818, α: 95% confidence interval [CI] 0.070-0.094;P = 0.001;β: 95% CI -0.019 to 0.007;P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years;459 males) and 208 SNA patients (72.5 ± 7.8 years;135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23;Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07;Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP.Conclusions: SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.展开更多
At present,the common surgical procedures for the Chiari malformation typeⅠare comprised of posterior fossa decompression,duraplasty and tonsillectomy.Some neurosurgeons prefer these so called minimally invasive surg...At present,the common surgical procedures for the Chiari malformation typeⅠare comprised of posterior fossa decompression,duraplasty and tonsillectomy.Some neurosurgeons prefer these so called minimally invasive surgeries.However,there are still some failures for patients undergoing the above surgeries in clinical practice.Analyzing causes of many surgical failures,the author put forward the anatomical concept of occipitocervical dura angulation(ODA).The ODA is defined as the included angle between the cerebral dura mater and spinal dura mater at the posterior foramen magnum on the median sagittal plane.For Chiari malformation typeⅠwithout atlantoaxial instability,the selection of appropriate surgeries and accurate evaluation on the effect of the decompression can be realized after the comprehensive analysis both on the severity of tonsil herniation and the ODA.Tonsillectomy may be needed to add to posterior fossa decompression(PFD)and duraplasty for Chiari malformation typeⅠwith the ODA being the larger obtuse angle and/or the tonsil herniation to the level of arcus posterior atlantis.展开更多
目的总结Ilizarov环形外固定架矫正马蹄内翻足畸形中踝关节铰链位置设计与放置方法,探讨其在预防踝关节脱位中的应用价值。方法回顾分析2021年9月—2024年12月收治且符合选择标准的28例(34足)僵硬型马蹄内翻足畸形患者临床资料。男19例,...目的总结Ilizarov环形外固定架矫正马蹄内翻足畸形中踝关节铰链位置设计与放置方法,探讨其在预防踝关节脱位中的应用价值。方法回顾分析2021年9月—2024年12月收治且符合选择标准的28例(34足)僵硬型马蹄内翻足畸形患者临床资料。男19例,女9例;年龄19~47岁,平均31.8岁。按Dimeglio分型为Ⅲ度21足、Ⅳ度13足。致病原因:创伤后遗症9例,先天性足畸形15例,脊柱裂后遗症1例,周围神经病变1例,大脑性瘫痪后遗症2例。畸形存在时间6~46年,平均29.3年。均采用Ilizarov环形外固定架治疗,术前根据患者足踝部标准侧位X线片,依照Ilizarov肢体畸形矫正成角旋转中心(center of rotation angulation,CORA)原则规划踝关节处铰链位置。采用2008年国际马蹄足畸形研究学组(ICFSG)评分系统评价疗效。结果患者马蹄内翻足畸形均获得完全矫正,可足底负重行走,足踝负重行走较术前明显改善,矫正过程中无踝关节脱位、距骨撞击或挤压、局部皮肤坏死、针道感染、肢端感觉麻木等并发症发生。患者均获随访,随访时间5~39个月,平均18.1个月。末次随访时根据ICFSG评分系统评价疗效,获优23足、良10足、可1足,优良率97%。结论术前按照肢体畸形矫正CORA原则设计踝关节铰链位置,可有效避免马蹄内翻足畸形矫正过程中出现踝关节脱位、距骨撞击、胫距关节挤压等踝关节不良事件,治疗效果良好。展开更多
基金supported by the Specific Research Project of Health Pro Bono Sector, Ministry of Health, China (200802056)
文摘We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1 403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First,angulation of the upper first molar varied significantly with age and tipped most distally in cases aged,12 years and least distally in cases aged.16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability.
基金The National Basic Research Program(973 program)of China under contract No.2010CB126403the Program for Changjiang Scholars and Innovative Research Team of Xiamen University under contract No.IRT0941+1 种基金the Earmarked Fund for Modern Agro-industry Technology Research System under contract No.nycytx-47the Programme of Introducing Talents of Discipline to Universities under contract No.B07034
文摘Glycogen, a polymer of glucose, is an important means of storing energy. It is degraded by glycogen phosphorylase （GPH） and hexokinase （HK）, glycogen phosphorylase, and hexokinase cDNAs （Ca-GPH and Ca- HK, respectively）, which encode the primary enzymes involved in glycogen use, cloned and characterized and used to investigate the regulation of glycogen metabolism at the mRNA level in Crassostrea angulata. Their expression profiles were examined in different tissues and during different reproductive stages. Full-length cDNA of GPHwas 3 078 bp in length with a 2 607 bp open reading frame （ORF） predicted to encode a protein of 868 amino acids （aa）. The full-length HK cDNA was 3 088 bp long, with an ORF of 1 433 bp, predicted to encode a protein of 505 aa. Expression levels of both genes were found to be significantly higher in the gonads and adductor muscle than in the mantle, gill, and visceral mass. They were especially high in the adductor muscle, which suggested that these oysters can use glycogen to produce a readily available supply of glucose to support adductor muscle activity. The regulation of both genes was also found to be correlated with glycogen content via qRT-PCR and in situ hybridization and was dependent upon the stage of the reproductive cycle （initiation, maturation, ripeness）. In this way, it appears that the expression of Ca-GPH and Ca-HK is driven by the reproductive cycle of the oyster, reflecting the central role played by glycogen in energy use and gametogenic development in C. angulata. It is here suggested that Ca- GPH and Ca-HK can be used as useful molecular markers for identifying the stages of glycogen metabolism and reproduction in C. angulata.
文摘This study was undertaken to examine which factors contributed to the correction of crowding in two patients who underwent nonextraction orthodontic treatment. A study model analysis was conducted to determine the effects of the orthodontic treatment for crowding with high canines on crown angulation and dental arch width in two patients. The results showed that the crown angulation was significantly increased, indicating distal tipping in the maxillary dental arch. This tendency was most commonly observed in the premolars among the lateral teeth. With respect to the dental arch width, the largest change was evident in the first molar and first premolar regions in cases 1 and 2, respectively. On the basis of these results, up-righting of mesially tipped lateral teeth and expansion of narrow dental arches could prove to be the keys to the success of space regaining or correction of high canines and mild crowding.
文摘The Adaptive Quality Control Phantom (AQCP) is a computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to produce a spatial distribution of gamma rays to perform QC Tests such as the Collimator Hole Angulation (CHA) and the Center of Rotation (COR) of Single Photon Emission Computer Tomography (SPECT). The collimator hole angulation for six collimators was measured using a point source and a computer-controlled cylindrical positioning system. In this method, the displacement of the image of a point source was examined as the AQCP was moving point source vertically away from the collimator face. The results of the high-accuracy measurement method of CHA show that the measurement accuracy for absolute angulation errors is better than ±0.024°. The Root Mean Square (RMS) of CHA for LEHR, LEHS and LEUHR collimators of SMV dual heads camera and LEGP, MEGP and HEGP of GE Millennium MG were evaluated to be 0.290°, 0.292°, 0.208°, 0.154°, 0.220° and 0.202°, respectively. It is to be added in this connection that the evaluated RMS of CHA for LEHR collimator with the distance variation from the collimator’s surface ±1 mm has been varied ±0.04 degree. A new method for the center of rotation assessment by AQCP is introduced and the results of this proposed method as compared with the routine QC test and their differences are discussed in detail. We defined and measured a new parameter called Dynamic Mechanical Error (DME) for applying the gantry motion correction.
文摘The Adaptive Quality Control Phantom (AQCP) is the computer-controlled phantom which positions and moves a radioactive source in the Field of View (FOV) of an imaging nuclear medicine device on a definite path to produce any spatial distribution of gamma rays to perform the QC Tests such as the Collimator Hole Angulation (CHA) of Single Photon Emission Computer Tomography (SPECT). The collimator hole angulation for seven collimators were measured with the method by using a point source and computer-controlled cylindrical positioning. In this method the displacement of the image of a point source examined as the AQCP move point source vertically away from the collimator face. The results of the high-accuracy measurement method of CHA show that the measurement accuracy for absolute angulation errors is better than ±0.024°. The Root Mean Square (RMS) of CHA for LEHR, LEHS, LEUHR, MEGP-250, MEGP-300, MEGP-360 and HEPH collimators of SMV dual heads camera were measured to be 0.290°, 0.292°, 0.208°, 0.194°, 0.181°, 0.177°, 0.150°, respectively. The Root Mean Square (RMS) of CHA for LEGP, MEGP and HEGP collimators of GE Millennium MG were measured to be 0.154°, 0.220° and 0.202° respectively. It is to be added in this connection that the measured RMS of CHA for LEHR collimator with the distance variation from the collimator’s surface +/– 1 mm has been varied +/– 0.04 degree.
文摘Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 patients who had
基金supported by Key Research and Development Project of Science&Technology Department of Sichuan Province(2022ZDZX0020)“1·3·5 project for disciplines of excellence-Clinical Research Fund,West China Hospital,Sichuan University”(23HXFH009)Sichuan Science and Technology Program(2022ZDZX003).
文摘Objective:This study aimed to explore the impact of aortic annulus angulation on outcomes in patients with bicuspid aortic valves(BAVs)undergoing transcatheter aortic valve replacement(TAVR)with new-generation valves.Methods:A retrospective study was conducted among patients who underwent TAVR with new-generation self-expandable(SE)or balloon-expandable(BE)transcatheter heart valves(THVs)at West China Hospital between January 2018 and November 2022.Their CT scans,from which the annulus angulation was derived,and other clinical information were retrieved through the electronic patient record system.The mean annulus angulation of the whole cohort served as the cut-off value for further group assignment.The primary endpoint was device success at 30 d.Secondary endpoints included the need for>1 THV,vascular complications,permanent pacemaker implantation,paravalvular leak of at least mild severity,30-day and 6-month mortality,etc.Multivariable logistic regression analysis was performed to identify independent predictors of the clinical outcomes.Results:A total of 180 patients were included in the study,137 with SE THVs and 43 with BE THVs.The annulus angulation of all patients was 55.6°±10.0°,therefore,the patients were further stratified by 56°.Among the 43 BE THV recipients,the annulus angulation≥56°group was older,shorter,had less valve calcification,and larger sinotubular junction and maximal ascending aorta diameters(all P<0.05);however,the primary and secondary endpoints did not differ significantly between the annulus angulation<56°and≥56°groups.Among the 137 SE THV recipients,despite larger maximal ascending aorta diameters in annulus angulation≥56°group((43.4±4.3)mm vs.(41.3±4.0)mm;P=0.003),it did not influence device success at 30 d,the requirement for>1 THV,vascular complications,paravalvular leak of at least mild severity,and 6-month mortality(all P>0.05).However,the SE THV group with annulus angulation≥56°had a higher incidence of permanent pacemaker implantation(27.6%vs.8.9%,P=0.004).Annulus angulation≥57°was an independent predictor of permanent pacemaker implantation in patients with BAV receiving SE TAVR(odds ratio:3.28,95%confidence interval:1.28-8.40;P=0.01).Conclusion:Increased annulus angulation did not influence device success for both new-generation BE and SE THVs in patients with BAV.However,increased annulus angulation was associated with a higher risk of permanent pacemaker implantation in patients undergoing SE TAVR,while no such association was observed in those who underwent BE TAVR.
基金National Natural Science Foundation of China(Nos. 81770471 and 12072214)Post-Doctor Research Project, West China Hospital, Sichuan University(No. 2021HXBH012)
文摘Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.Methods: This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).Results: In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 Nvs. 4.283 ± 1.460 N,P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 ×α-0.006 ×β + 2.818, α: 95% confidence interval [CI] 0.070-0.094;P = 0.001;β: 95% CI -0.019 to 0.007;P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years;459 males) and 208 SNA patients (72.5 ± 7.8 years;135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23;Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07;Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP.Conclusions: SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.
文摘At present,the common surgical procedures for the Chiari malformation typeⅠare comprised of posterior fossa decompression,duraplasty and tonsillectomy.Some neurosurgeons prefer these so called minimally invasive surgeries.However,there are still some failures for patients undergoing the above surgeries in clinical practice.Analyzing causes of many surgical failures,the author put forward the anatomical concept of occipitocervical dura angulation(ODA).The ODA is defined as the included angle between the cerebral dura mater and spinal dura mater at the posterior foramen magnum on the median sagittal plane.For Chiari malformation typeⅠwithout atlantoaxial instability,the selection of appropriate surgeries and accurate evaluation on the effect of the decompression can be realized after the comprehensive analysis both on the severity of tonsil herniation and the ODA.Tonsillectomy may be needed to add to posterior fossa decompression(PFD)and duraplasty for Chiari malformation typeⅠwith the ODA being the larger obtuse angle and/or the tonsil herniation to the level of arcus posterior atlantis.
文摘目的总结Ilizarov环形外固定架矫正马蹄内翻足畸形中踝关节铰链位置设计与放置方法,探讨其在预防踝关节脱位中的应用价值。方法回顾分析2021年9月—2024年12月收治且符合选择标准的28例(34足)僵硬型马蹄内翻足畸形患者临床资料。男19例,女9例;年龄19~47岁,平均31.8岁。按Dimeglio分型为Ⅲ度21足、Ⅳ度13足。致病原因:创伤后遗症9例,先天性足畸形15例,脊柱裂后遗症1例,周围神经病变1例,大脑性瘫痪后遗症2例。畸形存在时间6~46年,平均29.3年。均采用Ilizarov环形外固定架治疗,术前根据患者足踝部标准侧位X线片,依照Ilizarov肢体畸形矫正成角旋转中心(center of rotation angulation,CORA)原则规划踝关节处铰链位置。采用2008年国际马蹄足畸形研究学组(ICFSG)评分系统评价疗效。结果患者马蹄内翻足畸形均获得完全矫正,可足底负重行走,足踝负重行走较术前明显改善,矫正过程中无踝关节脱位、距骨撞击或挤压、局部皮肤坏死、针道感染、肢端感觉麻木等并发症发生。患者均获随访,随访时间5~39个月,平均18.1个月。末次随访时根据ICFSG评分系统评价疗效,获优23足、良10足、可1足,优良率97%。结论术前按照肢体畸形矫正CORA原则设计踝关节铰链位置,可有效避免马蹄内翻足畸形矫正过程中出现踝关节脱位、距骨撞击、胫距关节挤压等踝关节不良事件,治疗效果良好。
