BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pa...BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.展开更多
Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters call...Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.展开更多
血管再生是骨增量成功的关键因素之一。去皮质被认为是骨增量手术过程中促进血管生成的一个重要步骤。然而,关于去皮质在骨增量过程中的作用,目前的研究结论尚未统一。本文通过文献回顾,总结了去皮质在引导骨再生术(guided bone regener...血管再生是骨增量成功的关键因素之一。去皮质被认为是骨增量手术过程中促进血管生成的一个重要步骤。然而,关于去皮质在骨增量过程中的作用,目前的研究结论尚未统一。本文通过文献回顾,总结了去皮质在引导骨再生术(guided bone regeneration,GBR)、块状骨移植术(block bone grafting)和骨膜牵张成骨术(periosteal distraction osteogenesis,PDO)中的研究结果,分析了去皮质影响骨再生的机制,并探讨了研究结果不一致的原因,以期为临床医生在骨增量手术时实施去皮质提供参考。展开更多
[目的]介绍脊髓型颈椎病前路“V”形截骨“Y”形减压融合术(anterior cervical V-osteotomy,Y-decompression and fusion,ACVYF)的手术技术和初步临床结果。[方法]充分显露术椎并处理上下椎间隙,在术椎两侧使用超声骨刀沿颈长肌内侧缘外...[目的]介绍脊髓型颈椎病前路“V”形截骨“Y”形减压融合术(anterior cervical V-osteotomy,Y-decompression and fusion,ACVYF)的手术技术和初步临床结果。[方法]充分显露术椎并处理上下椎间隙,在术椎两侧使用超声骨刀沿颈长肌内侧缘外倾30°~40°对术椎进行截骨(截骨深度以椎体矢状径1/2为宜),完整取出“V”形骨块保存。在截骨基底部开槽,深度达后侧皮质后,使用刮匙和椎板钳向椎体两侧潜行扩大减压范围,呈“Y”形。自椎间隙向上或下切除后纵韧带及致压物进行彻底减压。将“V”形的截骨块原位回植于截骨的“V”形骨槽内,选择合适大小的笼架置入上下间隙,打压至嵌合牢固,带锁钢板固定并锁定。[结果]所有患者顺利完成手术,术中及术后无严重并发症发生;术后颈椎CT及MRI显示致压物切除干净,神经减压彻底。随访时间平均(16.4±3.1)个月,与术前相比,术后12个月,患者颈椎JOA评分[(8.3±1.4)vs(14.8±1.1),P<0.001]、C2~7Cobb角[(15.7±2.5)°vs(19.9±1.9)°,P<0.001]均显著增加。所有患者均植骨融合良好,未出现骨块位移、置入物松动、断裂等情况。[结论]ACVYF治疗后纵韧带骨化、椎体后缘骨赘增生以及椎间盘钙化严重、椎间隙明显狭窄等脊髓型颈椎病安全可行。展开更多
文摘BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.
基金the Coordination for the Improvement of Higher Education Personnel(CAPES),No.88882.366181/2019-01the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro(FAPERJ),No.E-26/202.682/2018National Council for Scientific and Technological Development(CNPq),No.467513/2014-7
文摘Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.
文摘血管再生是骨增量成功的关键因素之一。去皮质被认为是骨增量手术过程中促进血管生成的一个重要步骤。然而,关于去皮质在骨增量过程中的作用,目前的研究结论尚未统一。本文通过文献回顾,总结了去皮质在引导骨再生术(guided bone regeneration,GBR)、块状骨移植术(block bone grafting)和骨膜牵张成骨术(periosteal distraction osteogenesis,PDO)中的研究结果,分析了去皮质影响骨再生的机制,并探讨了研究结果不一致的原因,以期为临床医生在骨增量手术时实施去皮质提供参考。
文摘[目的]介绍脊髓型颈椎病前路“V”形截骨“Y”形减压融合术(anterior cervical V-osteotomy,Y-decompression and fusion,ACVYF)的手术技术和初步临床结果。[方法]充分显露术椎并处理上下椎间隙,在术椎两侧使用超声骨刀沿颈长肌内侧缘外倾30°~40°对术椎进行截骨(截骨深度以椎体矢状径1/2为宜),完整取出“V”形骨块保存。在截骨基底部开槽,深度达后侧皮质后,使用刮匙和椎板钳向椎体两侧潜行扩大减压范围,呈“Y”形。自椎间隙向上或下切除后纵韧带及致压物进行彻底减压。将“V”形的截骨块原位回植于截骨的“V”形骨槽内,选择合适大小的笼架置入上下间隙,打压至嵌合牢固,带锁钢板固定并锁定。[结果]所有患者顺利完成手术,术中及术后无严重并发症发生;术后颈椎CT及MRI显示致压物切除干净,神经减压彻底。随访时间平均(16.4±3.1)个月,与术前相比,术后12个月,患者颈椎JOA评分[(8.3±1.4)vs(14.8±1.1),P<0.001]、C2~7Cobb角[(15.7±2.5)°vs(19.9±1.9)°,P<0.001]均显著增加。所有患者均植骨融合良好,未出现骨块位移、置入物松动、断裂等情况。[结论]ACVYF治疗后纵韧带骨化、椎体后缘骨赘增生以及椎间盘钙化严重、椎间隙明显狭窄等脊髓型颈椎病安全可行。
