期刊文献+
共找到11,253篇文章
< 1 2 250 >
每页显示 20 50 100
TfOH-Catalyzed O-H Insertion of Carboxylic Acids with α-Aryl Diazoesters
1
作者 Chen Guifang Li Hongqiang Zeng Xingrong 《有机化学》 北大核心 2025年第7期2537-2544,共8页
An efficient TfOH-catalyzed O—H insertion reaction of α-aryl diazoesters with carboxylic acids is reported.This metal-free protocol provides an operationally simple method for a one-pot assembly of diverse α-acylox... An efficient TfOH-catalyzed O—H insertion reaction of α-aryl diazoesters with carboxylic acids is reported.This metal-free protocol provides an operationally simple method for a one-pot assembly of diverse α-acyloxy esters in moderate to high yields with a broad substrate scope.All starting materials are readily available,and the reactions can be conducted in the open air at room temperature. 展开更多
关键词 carboxylic acids α-aryl diazoesters TfOH O-H insertion
原文传递
Blue Light-Induced Formal Insertion Reaction ofα-Siloxy Carbene into C-H Bond of 1,3-Diketones
2
作者 Jiang Xinyu Zhang Xinke +1 位作者 Fang Xi Xu Xinfang 《有机化学》 北大核心 2025年第6期2231-2238,共8页
A blue light-induced formal insertion reaction ofα-siloxy carbene into the C—H bond of 1,3-diketones has been reported.Under the irradiation of blue light,acylsilane converts toα-siloxy carbene,which then undergoes... A blue light-induced formal insertion reaction ofα-siloxy carbene into the C—H bond of 1,3-diketones has been reported.Under the irradiation of blue light,acylsilane converts toα-siloxy carbene,which then undergoes formal C—H bond insertion reaction with the enol form of 1,3-diketone.This method uses readily available and relative stable acylsilane as car-bene precursor,which features a simple and metal-free approach under mild conditions.Moreover,the synthetic potential of this protocol has been demonstrated by performing the reaction on a gram scale with comparable high yield. 展开更多
关键词 photoinduction α-siloxy carbene 1 3-diketone C-H bond insertion reaction
原文传递
Rhodium-catalyzed site-selective cross-couplings of indoles and pyridotriazoles through carbene insertion
3
作者 Hua Tian Xin Yang +2 位作者 Ge Shi Heng Xu Yi Dong 《Chinese Chemical Letters》 2025年第7期302-307,共6页
The switchable cross-coupling of indoles and pyridotriazoles through carbene insertion at C_(2)-or C_(3)-positon has been developed in this paper.This highly site-selective C-H carbenoid functionalization is determine... The switchable cross-coupling of indoles and pyridotriazoles through carbene insertion at C_(2)-or C_(3)-positon has been developed in this paper.This highly site-selective C-H carbenoid functionalization is determined by both the Rh-catalyst species and auxiliary groups.[Cp∗RhCl_(2)]_(2) and coordinating pyrimidyl group direct the C-H carbenoid functionalization to occur at the C_(2)-position,while Rh2OAc4 and noncoordinating benzyl group lead the reaction to occur at the C_(3)-position of the indoles.This regioselective C−H functionalization strategy is of significant importance for the discovery of indole drugs. 展开更多
关键词 RHODIUM-CATALYZED Site-selective CROSS-COUPLINGS Carbene insertion Pyridotriazoles
原文传递
Personalizing withdrawal time by insertion time to achieve target adenoma detection rate in colonoscopy
4
作者 Bing-Xin Xu Cong-Zhou Xu +3 位作者 Hao-Yan Zhang Xu-Jin Chen Bing-Ni Wei Cheng Yang 《World Journal of Gastroenterology》 2025年第38期105-119,共15页
BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdr... BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes. 展开更多
关键词 COLONOSCOPY Withdrawal time insertion time Adenoma detection rate Machine learning
暂未订购
Construction and validation of a machine learning algorithm-based predictive model for difficult colonoscopy insertion
5
作者 Ren-Xuan Gao Xin-Lei Wang +6 位作者 Ming-Jie Tian Xiao-Ming Li Jia-Jia Zhang Jun-Jing Wang Jing Gao Chao Zhang Zhi-Ting Li 《World Journal of Gastrointestinal Endoscopy》 2025年第7期149-161,共13页
BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intr... BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intraoperative strategies.AIM To evaluate the predictive performance of machine learning(ML)algorithms for DCI by comparing three modeling approaches,identify factors influencing DCI,and develop a preoperative prediction model using ML algorithms to enhance colonoscopy quality and efficiency.METHODS This cross-sectional study enrolled 712 patients who underwent colonoscopy at a tertiary hospital between June 2020 and May 2021.Demographic data,past medical history,medication use,and psychological status were collected.The endoscopist assessed DCI using the visual analogue scale.After univariate screening,predictive models were developed using multivariable logistic regression,least absolute shrinkage and selection operator(LASSO)regression,and random forest(RF)algorithms.Model performance was evaluated based on discrimination,calibration,and decision curve analysis(DCA),and results were visualized using nomograms.RESULTS A total of 712 patients(53.8%male;mean age 54.5 years±12.9 years)were included.Logistic regression analysis identified constipation[odds ratio(OR)=2.254,95%confidence interval(CI):1.289-3.931],abdominal circumference(AC)(77.5–91.9 cm,OR=1.895,95%CI:1.065-3.350;AC≥92 cm,OR=1.271,95%CI:0.730-2.188),and anxiety(OR=1.071,95%CI:1.044-1.100)as predictive factors for DCI,validated by LASSO and RF methods.Model performance revealed training/validation sensitivities of 0.826/0.925,0.924/0.868,and 1.000/0.981;specificities of 0.602/0.511,0.510/0.562,and 0.977/0.526;and corresponding area under the receiver operating characteristic curves(AUCs)of 0.780(0.737-0.823)/0.726(0.654-0.799),0.754(0.710-0.798)/0.723(0.656-0.791),and 1.000(1.000-1.000)/0.754(0.688-0.820),respectively.DCA indicated optimal net benefit within probability thresholds of 0-0.9 and 0.05-0.37.The RF model demonstrated superior diagnostic accuracy,reflected by perfect training sensitivity(1.000)and highest validation AUC(0.754),outperforming other methods in clinical applicability.CONCLUSION The RF-based model exhibited superior predictive accuracy for DCI compared to multivariable logistic and LASSO regression models.This approach supports individualized preoperative optimization,enhancing colonoscopy quality through targeted risk stratification. 展开更多
关键词 COLONOSCOPY Difficulty of colonoscopy insertion Machine learning algorithms Predictive model Logistic regression Least absolute shrinkage and selection operator regression Random forest
暂未订购
Concise synthesis of NDP-activated uronic acid by an oxidation reaction insertion strategy
6
作者 Nana Yang Rui Yuan +5 位作者 Xinyue Fu Xiao Tian Jin Yu Shengzhou Ma Liuqing Wen Jiabin Zhang 《Chinese Chemical Letters》 2025年第8期296-302,共7页
Uronic acids are prevalent components of crucial glycoconjugates,pivotal in various biological processes.In nature,NDP-uronic acids,the nucleosides-activated uronic acids,serve as glycosylation donors catalyzed by uro... Uronic acids are prevalent components of crucial glycoconjugates,pivotal in various biological processes.In nature,NDP-uronic acids,the nucleosides-activated uronic acids,serve as glycosylation donors catalyzed by uronosyltransferases(UATs)to construct glycans containing uronic acids.Despite their biological importance,the synthesis of naturally occurring NDP-uronic acids on a large scale remains challenging.Here,we developed an oxidation reaction insertion strategy for the efficient synthesis of NDP-uronic acids,and 11 NDP-uronic acids were successfully prepared in good yield and on a large scale.The prepared NDP-uronic acids can be used to explore new uronosyltransferases and synthesize uronic acids containing carbohydrates for fundamental research. 展开更多
关键词 NDP-uronic acids BIOCATALYSIS Enzyme-mediated biomimetic synthesis Oxidation reaction insertion strategy
原文传递
Evidence-Based Nursing Optimization for Catheter Tip Positioning in PICC Insertion in Patients with Persistent Left Superior Vena Cava
7
作者 Qian Wang Yaran Zhang +5 位作者 Haiqing Huang Ziwei Xu Xinxin Wang Chenli Zhang Shuqi Wang Bo Xu 《Journal of Clinical and Nursing Research》 2025年第12期21-29,共9页
Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC... Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC).Methods:For one ovarian cancer patient with PICC malposition in the coronary sinus(CS)due to PLSVC,multimodal imaging techniques were integrated to accurately locate the catheter tip.The catheter position was adjusted based on evidence(withdrawing 5 cm),and a standardized nursing process was established,including personalized health education,catheter fixation and displacement monitoring,complication monitoring,establishment of a specialized disease information archive system,and formulation of a follow-up plan.Results:The catheter tip was successfully withdrawn from the coronary sinus(at the T8 level)to the middle and lower part of the PLSVC(at the T6 vertebral level),and the catheter functioned normally after adjustment.No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period.Conclusion:The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC(at the T5–T7 vertebral level).This new standard can effectively avoid CS-related complications.The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion. 展开更多
关键词 Persistent left superior vena cava Peripherally inserted central catheter PICC NURSING
暂未订购
德标减振轨道插入损失率的理论修正方法及应用
8
作者 韦凯 刘延滨 +1 位作者 王显 蒲前华 《西南交通大学学报》 北大核心 2026年第1期117-126,共10页
为准确高效评价轨道减振性能,德国标准DIN V 45673-4规定了插入损失率的高效计算方法,能够排除线路运营条件与轨道不平顺等随机因素的干扰,但该方法在模型等效时未考虑轨道抗弯刚度的贡献,不能准确得到实际轮轨系统共振频率,进而无法准... 为准确高效评价轨道减振性能,德国标准DIN V 45673-4规定了插入损失率的高效计算方法,能够排除线路运营条件与轨道不平顺等随机因素的干扰,但该方法在模型等效时未考虑轨道抗弯刚度的贡献,不能准确得到实际轮轨系统共振频率,进而无法准确判断减振轨道的减振频带.为提高计算精度,在不降低计算效率的前提下改进德标插入损失率计算模型,以弹性地基梁近似反映轨道实际结构尺寸与刚度特征,综合考虑弹性元件与轨道抗弯刚度对轨道刚度的贡献,修正模型刚度;以减振垫浮置板轨道为例,针对我国环评要求的1~80 Hz减振频带,讨论轨道尺寸及弹性元件减振优化方案.研究结果表明:刚度修正后,轮轨系统共振频率误差由76.0%大幅降低至4.9%;单纯提高扣件损耗因子可以实现环评1~80 Hz频带的整体减振,然而在30~90 kN/mm扣件刚度范围内,单纯降低(单纯提高)扣件刚度仅能提高60~80 Hz(30~60 Hz)频带的插入损失率,但是却降低了30~60 Hz(60~80 Hz)的插入损失率,无法实现环评1~80 Hz频带的整体减振;只有当扣件刚度提升至90 kN/mm以上时,才可实现环评1~80 Hz频带的整体减振,且当减振垫刚度越低或浮置板厚度越大时,所需提高的扣件刚度越大. 展开更多
关键词 插入损失率 弹性地基梁 环境振动 刚度修正 扣件参数
在线阅读 下载PDF
Genetic Analysis of a Small Grain Mutant Induced by T-DNA Insertion in Rice 被引量:5
9
作者 张向前 朱海涛 +1 位作者 邹金松 曾瑞珍 《Agricultural Science & Technology》 CAS 2008年第3期63-66,91,共5页
[Objective] The aim of this study is to understand the genetic characteristics of a grain shape mutant and its possible role in genetic improvement of grain yield in rice. [Method] On the basis of the collection of T-... [Objective] The aim of this study is to understand the genetic characteristics of a grain shape mutant and its possible role in genetic improvement of grain yield in rice. [Method] On the basis of the collection of T-DNA tag lines, the progeny of homozygous plants carrying T-DNA insertion were screened for mutants with mutated phenotypes. The genetic analysis of the mutant and test for the linkage between the mutated phenotype and the T-DNA insertion were carried out to determine its genetic characteristics. [Result] In the present study, a grain shape mutant induced by T-DNA insertion in rice was identified, which showed small grain. Genetic analysis of the mutant showed that the two types of phenotype, normal and small grain in the segregating populations derived from the T-DNA heterozygotes, fit the ratio of 3∶1. Test for Basta resistance showed that all the mutants were resistant while the normal plants segregated for resistant and susceptible by the ratio of 2∶1. The results indicated that the mutant phenotype cosegregated with Bar gene. The small grain mutant caused by T-DNA insertion was confirmed by PCR amplification aiming at T-DNA. [Conclusion] The grain shape mutant is useful for isolation of the tagged gene and genetic improvement in rice. 展开更多
关键词 ORYZA SATIVA GRAIN shape MUTANT T-DNA insertion
在线阅读 下载PDF
针刺穴位得气时针感的力学机理分析
10
作者 罗银淼 詹倩 《湖南工业大学学报》 2026年第1期79-84,共6页
通过生物力学分析方法,系统揭示了传统针灸疗法中“得气”现象的力学作用机制,阐明施针者手部力学感知的物理来源及其定量表征。基于针刺过程中组织位移与针体受力显著增强的生物力学实验现象,构建了弹性针体与周围组织的力学耦合系统... 通过生物力学分析方法,系统揭示了传统针灸疗法中“得气”现象的力学作用机制,阐明施针者手部力学感知的物理来源及其定量表征。基于针刺过程中组织位移与针体受力显著增强的生物力学实验现象,构建了弹性针体与周围组织的力学耦合系统。通过建立界面压力-位移动态关系方程,提出基于针尖受力诱导的针体变形位移函数假设,推导施针者手感的力学表征,并采用Langevin团队的生物力学实验数据完成模型验证。研究结果表明:得气效应的力学本质源于针尖刺激引发的周缘组织收缩形变,该过程通过组织-针体耦合作用,导致针体曲率改变及插提阻力增加;施针者的力学感知可量化为组织形变梯度与界面摩擦因数的函数关系。 展开更多
关键词 针刺手法 得气效应 插提阻力 组织界面力学 生物力学建模
在线阅读 下载PDF
基于《黄帝内经》“审查卫气,为百病母”浅析皮部浅刺针法
11
作者 李伟 王吉 +1 位作者 屈志远 付于 《河南中医》 2026年第1期56-62,共7页
皮部既是经气外应体表之界域,亦为经络网络最外层结构单元。浅刺调卫作为皮部理论的临床应用,通过针刺皮部特定区域激发经气运行,其作用机理包含三个层面:其一,疏调腠理以畅达营卫气血;其二,通利络脉以调和表里经气;其三,引邪外达以调... 皮部既是经气外应体表之界域,亦为经络网络最外层结构单元。浅刺调卫作为皮部理论的临床应用,通过针刺皮部特定区域激发经气运行,其作用机理包含三个层面:其一,疏调腠理以畅达营卫气血;其二,通利络脉以调和表里经气;其三,引邪外达以调整脏腑虚实。当卫气失于固摄,邪气遂乘虚循经脉-络脉-皮部传变,通过浅刺腧穴可激发卫阳、驱邪外出,恢复“卫外而为固”的生理功能,从而阻断病邪内传途径。其操作要领体现三大特点:其一,刺法浅表,仅刺入真皮层而不及皮下组织,有效规避深部血管、神经及脏腑组织损伤风险;其二,施术无需追求传统针刺的“得气”效应,以轻刺激量维持经气感应,显著降低患者不适体验;其三,治疗过程中痛感轻微,患者心理负担小,依从性较传统深刺法显著提升。该治疗模式既保留了针灸“调气”的本质特征,又创新了“重卫气调节”的干预路径,形成“轻刺激-强调节-高依从”的临床优势,为虚证调理及特殊人群治疗提供参考。 展开更多
关键词 皮部浅刺针法 卫气 “审查卫气 为百病母” 《黄帝内经》
暂未订购
Lack of association between ADRA2B-4825 gene insertion/deletion poly- morphism and migraine in Chinese Han population
12
作者 倪健强 贾莎莎 +4 位作者 刘民 陈守恭 姜玉婷 董万利 高玉振 《Neuroscience Bulletin》 SCIE CAS CSCD 2010年第4期322-326,共5页
Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion (indel) polymorphism in promoter region ofα 2B -adrenergic receptor gene (AD... Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion (indel) polymorphism in promoter region ofα 2B -adrenergic receptor gene (ADRA2B).Methods A case-control study was carried out in Chinese Han population,including 368 cases of migraine and 517 controls.Genomic DNA was extracted from blood samples,and DNA fragments containing the site of polymorphism were amplified by PCR.Data were adjusted for sex,age,migraine history and family history,and analyzed using a logistic regression model.Results There was no association between indel polymorphism and migraine,at either the allele or the genotype level.Conclusion These findings do not support a functional significance of ADRA2B indel polymorphism at position-4825 relative to the start codon in the far upstream region of the promoter in the present migraine subjects. 展开更多
关键词 MIGRAINE promoter ofα 2B -adrenergic receptor gene insertion/deletion polymorphism genetic association
原文传递
Path-Based Timing Optimization by Buffer Insertion with Accurate Delay Model
13
作者 张轶谦 周强 +1 位作者 洪先龙 蔡懿慈 《Journal of Semiconductors》 EI CAS CSCD 北大核心 2004年第5期520-525,共6页
An algorithm of path based timing optimization by buffer insertion is presented.The algorithm adopts a high order model to estimate interconnect delay and a nonlinear delay model based on look up table for gate dela... An algorithm of path based timing optimization by buffer insertion is presented.The algorithm adopts a high order model to estimate interconnect delay and a nonlinear delay model based on look up table for gate delay estimation.And heuristic method of buffer insertion is presented to reduce delay.The algorithm is tested by industral circuit case.Experimental results show that the algorithm can optimize the timing of circuit efficiently and the timing constraint is satisfied. 展开更多
关键词 buffer insertion timing optimization interconnect planning routing algorithm
在线阅读 下载PDF
Fine-Grain Sleep Transistor Insertion for Leakage Reduction
14
作者 杨华中 汪玉林 +1 位作者 海罗嵘 汪蕙 《Journal of Semiconductors》 EI CAS CSCD 北大核心 2006年第2期258-265,共8页
A fine-grain sleep transistor insertion technique based on our simplified leakage current and delay models is proposed to reduce leakage current. The key idea is to model the leakage current reduction problem as a mix... A fine-grain sleep transistor insertion technique based on our simplified leakage current and delay models is proposed to reduce leakage current. The key idea is to model the leakage current reduction problem as a mixed-integer linear programming (MLP) problem in order to simultaneously place and size the sleep transistors optimally. Because of better circuit slack utilization, our experimental results show that the MLP model can save leakage by 79.75%, 93.56%, and 94.99% when the circuit slowdown is 0%, 3%, and 5%, respectively. The MLP model also achieves on average 74.79% less area penalty compared to the conventional fixed slowdown method when the circuit slowdown is 7%. 展开更多
关键词 leakage current reduction fine-grain sleep transistor insertion delay model mixed-integer linearprogramming
在线阅读 下载PDF
Parallel EOI algorithm with different insertion schemes
15
作者 刘庆富 仲伟俊 《Journal of Southeast University(English Edition)》 EI CAS 2003年第3期283-288,共6页
A parallel embedding overlapped iterative (EOI) algorithm about classicimplicit equations with asymmetric Saul'yev schemes (CIS-EOI) to solve one-dimensional diffusionequations is discussed to improve the properti... A parallel embedding overlapped iterative (EOI) algorithm about classicimplicit equations with asymmetric Saul'yev schemes (CIS-EOI) to solve one-dimensional diffusionequations is discussed to improve the properties of the segment classic implicit iterative (SCII)algorithm. The structure of CIS-EOI method is given and the stability of scheme and convergence ofiteration are proved by matrix method. The property of gradual-approach convergence is alsodiscussed. It has been shown that the convergent rate is faster and the property of gradual-approachconvergence also becomes better with the increasing of the net point in subsystems than with theSCII algorithm. The simulation examples show that the parallel iterative algorithm with a differentinsertion scheme CIS-EOI is more effective. 展开更多
关键词 diffusion equation different insertion scheme convergent rate property ofgradual-approach convergence
在线阅读 下载PDF
海床基三脚架基础局部冲刷与防护技术研究
16
作者 俞梅欣 王彤 +2 位作者 李小军 喻国良 张民曦 《海洋工程》 北大核心 2026年第1期82-93,共12页
基础冲刷是海工结构安全的主要威胁之一,如何降低冲刷深度是当下亟待解决的关键问题。针对某工程中的海床基三脚架基础,采用FLOW-3D软件建立了三维水动力和冲刷仿真数值模型,并根据前人试验验证了数值模型的准确性,研究了水流作用下海... 基础冲刷是海工结构安全的主要威胁之一,如何降低冲刷深度是当下亟待解决的关键问题。针对某工程中的海床基三脚架基础,采用FLOW-3D软件建立了三维水动力和冲刷仿真数值模型,并根据前人试验验证了数值模型的准确性,研究了水流作用下海床基周围的水动力特征和局部冲刷特性;基于海床基周围的近床面水动力特性,提出了一种插板式底坎冲刷主动防护措施,并通过数值模拟对采用插板式底坎防护后的海床基局部流场和冲刷特性进行了分析。结果表明,插板式底坎有效减小了海床基周围的近床面流速,可将桩周最大冲刷深度削减70%,防护效果较好,可为实际工程中同类基础结构的冲刷防护提供参考。 展开更多
关键词 多桩组 复合桩基 局部冲刷 主动防护 插板 底坎
在线阅读 下载PDF
Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty
17
作者 Zoe Alpert Farouk Khury +5 位作者 Nicholas Sauder Alan D Lam Greta Laudes Christopher M Melnic Chad A Krueger Ran Schwarzkopf 《World Journal of Orthopedics》 2026年第1期88-96,共9页
BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar k... BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design. 展开更多
关键词 Total knee arthroplasty Medial dished insert CRUCIATE-RETAINING Native kinematics Kinematically-designed Medial dished liner Constrained liner
暂未订购
改良塞丁格微创技术在极低/超低出生体重儿PICC置管中的应用
18
作者 唐熙 胡晓静 +3 位作者 吕天婵 姚莉莉 王丽 李丽玲 《护理研究》 北大核心 2026年第3期479-483,共5页
目的:探讨改良塞丁格微创技术在极低/超低出生体重儿经外周静脉穿刺中心静脉置管(PICC)中的应用效果。方法:选取2019年7月—2022年5月在复旦大学附属儿科医院新生儿重症监护室进行PICC置管的496例极低/超低出生体重儿为研究对象,其中201... 目的:探讨改良塞丁格微创技术在极低/超低出生体重儿经外周静脉穿刺中心静脉置管(PICC)中的应用效果。方法:选取2019年7月—2022年5月在复旦大学附属儿科医院新生儿重症监护室进行PICC置管的496例极低/超低出生体重儿为研究对象,其中2019年7月—2020年10月采用传统置管技术,使用穿刺鞘针进行穿刺置管的患儿作为对照组;2020年11月—2022年5月采用改良塞丁格微创置管技术,使用24G留置针进行穿刺置管的患儿作为试验组。比较两组患儿置管时的一次置管成功率、穿刺点渗血发生率、导管相关血栓发生率、肢体肿胀发生率及置管后静脉炎的发生情况。结果:试验组一次置管成功率(67.65%)高于对照组(16.10%);穿刺点渗血发生率(2.94%)低于对照组(43.49%);静脉炎发生情况(6.37%)低于对照组(12.33%),差异均有统计学意义(P<0.05)。结论:对极低/超低出生体重儿进行PICC置管时采用改良塞丁格微创技术,不仅能提高一次置管成功率,还能降低其穿刺点渗血及静脉炎的发生率。 展开更多
关键词 改良塞丁格技术 微创技术 PICC置管 极低出生体重儿 超低出生体重儿 早产儿
暂未订购
有限元分析肩袖撕裂时在不同骨密度条件下锚钉不同置入深度的应力分布
19
作者 王猛 路坦 +2 位作者 李敏杰 刘志成 郭霄勇 《中国组织工程研究》 北大核心 2026年第3期561-569,共9页
背景:关节镜下锚钉修复已成为目前肩袖撕裂主要的治疗方式,其中锚钉置入状况是手术成败的关键因素;然而,目前不同骨密度条件下锚钉置入深度对骨道及锚钉应力的影响尚不明确。目的:运用三维有限元分析技术探究不同骨密度条件下锚钉置入... 背景:关节镜下锚钉修复已成为目前肩袖撕裂主要的治疗方式,其中锚钉置入状况是手术成败的关键因素;然而,目前不同骨密度条件下锚钉置入深度对骨道及锚钉应力的影响尚不明确。目的:运用三维有限元分析技术探究不同骨密度条件下锚钉置入深度不同时骨道及锚钉的应力分布情况。方法:采集志愿者肱骨CT影像数据,利用Mimics、3-Matic、Solidworks软件构建肱骨和锚钉模型;在3-Matic中,于肱骨相同位置分别创建距其表面0,2,4,6,8 mm的孔洞并与锚钉装配;在Mimics中基于CT灰度值赋值,得到骨量正常(T值≥-1.0)的模型,改变参数构建骨量减少(-2.5<T值<-1.0)和骨质疏松(T值≤-2.5)模型;在各模型中沿与骨道内侧边缘相切方向给锚钉施加70 N拉力,观察不同骨密度条件下置入不同深度时骨道及锚钉应力分布及大小。结果与结论:①置入深度相同,骨密度降低时,锚钉最大等效应力增加,骨道最大等效应力降低;②骨密度相同,随锚钉置入深度增加,锚钉最大等效应力减小,置入深度为4 mm时骨道应力最小且分布较均匀;锚钉应力主要分布在下方锚孔和近端螺纹周围,骨道应力主要在与近端螺纹接触部分,置入深度增加会改变应力分布的均匀性及模式,而骨密度对应力分布模式影响较小;③提示肱骨骨密度对肩袖撕裂锚钉修复至关重要,建议临床医生术前应测量肱骨大结节骨密度;锚钉置入过深并未显著增加其稳定性,临床医师可结合患者实际情况使用有限元分析法进行个性化术前评估,以达到最佳修复效果。 展开更多
关键词 肩袖撕裂 锚钉 置入深度 骨道 有限元分析 骨质疏松 骨科植入物
暂未订购
髓内钉治疗股骨干骨折过程中改良矩形锁定装置的应用
20
作者 张平 周大方 +3 位作者 陈辉 张莹 刘青 史册 《中国组织工程研究》 北大核心 2026年第21期5510-5516,共7页
背景:矩形框架式瞄准器分左、右2个模块,不利于术中灵活使用,容易产生形变和误差,连接完成后仍需要反复透视确认进行螺钉的钻孔、置入。目的:探讨改良矩形锁定装置在股骨干骨折髓内钉治疗时精准置入远端锁钉的关键技术研发及临床应用效... 背景:矩形框架式瞄准器分左、右2个模块,不利于术中灵活使用,容易产生形变和误差,连接完成后仍需要反复透视确认进行螺钉的钻孔、置入。目的:探讨改良矩形锁定装置在股骨干骨折髓内钉治疗时精准置入远端锁钉的关键技术研发及临床应用效果。方法:收集徐州医科大学附属宿迁医院和宿豫区人民医院2021-2023年收治的股骨干骨折患者的病历资料,选择18-65岁、经影像学检查确诊为股骨干骨折(AO分型:A、B或C型)、接受闭合复位髓内钉内固定治疗且术中采用改良矩形锁定装置置入远端锁钉的患者;临床资料(包括病史、影像学、手术记录、随访记录等)完整。符合条件的病例有41例,其中男30例,女11例;年龄20-62岁,平均(41.17±8.14)岁。收集术中远端锁钉置入时透视次数、锁定成功率、远端锁钉成功置入时间、术后1个月和骨折愈合后美国膝关节协会评分及骨折愈合时间。结果与结论:①41例患者均采用改良矩形锁定装置置入远端锁钉,术中远端锁钉置入时透视次数0-2次,平均(1.1±0.5)次;锁定成功率为98%;远端锁钉成功置入时间6-10 min,平均(7.0±1.5)min;术后1个月膝关节美国膝关节协会评分140-190分,平均(150±15)分;②有38例患者获得完整随访,随访时间12-24个月,骨折愈合时间9-14个月,平均(10.5±2.5)个月,骨折愈合后膝关节美国膝关节协会评分150-190分,平均(185±8)分,其中优35例,良3例;③结果表明,相较于徒手锁定远端锁钉、斜位透视置入远端锁钉、关节镜辅助置入远端锁钉、电磁导航锁定远端锁钉这几种方式置入股骨髓内钉远端锁钉,改良矩形锁定装置应用于髓内钉治疗股骨干骨折时置入远端锁钉的优势包括不依赖关节镜、电磁导航设备,不需要丰富的手术经验,步骤简单、锁定准确、可重复性高及减少辐射暴露。 展开更多
关键词 股骨干骨折 髓内钉 锁钉置入 内固定 改良矩形锁定装置 矩形框架式瞄准器 徒手置钉 斜位透视置钉 关节镜辅助置钉 电磁导航
暂未订购
上一页 1 2 250 下一页 到第
使用帮助 返回顶部