Clinical efficacy of anterior radius head fracture combined with lateral ligament complex injury / 中华骨科杂志

Objective:To investigate the operation efficacy of anterior radius head fracture combined with lateral ligament complex injury.Methods:The patients with radial head fracture admitted from September 2017 to August 2021 were retrospectively analyzed, 51 males and 54 females, average age of 38.84±13.63 years (range of 16-70 years). Based on the radial head fractures of Mason classification of type II, the cases involving the anterior radius head fracture were divided into three subtypes according to the number of fracture blocks and the type of displacement: type A (53 cases): one part of the anterior radius head collapse fracture; type B (50 cases): two or more parts of the anterior radial head collapse fracture; type C (2 cases): anterior radius head dissociated and displaced fracture. All fractures were treated with open reduction and internal fixation. Among them, the lateral ligament complex of type B were elongated due to the injury but the continuity existed. Therefore, the lateral ligament complex in 21 cases were not repaired in the early period (unrepaired group); in recent years, 29 cases repaired the lateral ligament complex (repair group). The postoperative efficacy was evaluated by elbow range of motion, table-top relocation test, Mayo score, and Broberg Morrey score. the patients were evaluated at final follow-up, except table-top relocation test was recorded according to the actual completion time.Results:All operations were successfully completed. The mean follow-up was 14.08±1.52 months (range of 12-18 months). Type A: the flexion and extension range was 115.70°±6.35°; the completion time of the table-top relocation test was 75.68±11.90 days; the Mayo score was 93.72±2.40 point, and the Broberg Morrey score was 92.89±2.28 point. Type B: lateral ligament repair group (repaired group) 29 cases and unrepaired lateral ligament group (unrepaired group) 21 cases. The flexion and extension range of elbow in repaired group was 112.1°±4.4°, which was better than that in unrepaired group 105.8°±3.7° ( t=5.31, P<0.001). The completion time of table-top relocation test was 77.72±6.51 days in repaired group and 104.29±18.45 days in unrepaired group ( t=6.32, P<0.001). The Mayo score of the repaired group was 90.21±5.88 points and that of the unrepaired group was 87.14±5.26 points ( t=1.90, P=0.063), and there was no significant difference between the two groups. Broberg Morrey score of 90.93±6.43 points in the repaired group was better than 86.95±6.37 points in the unrepaired group ( t=2.17, P=0.035). Type C for 2 patients, the flexion and extension range of elbow were 107°and 106°; the completion time of table-top relocation test were 82 days and 98 days; the Mayo scores were 91 point and 87 point; Broberg Morrey scores were 93 point and 85 point. There was a patient developed myositis ossificans in unrepair group of tybe B. Conclusion:The elbow joint is stable when one part of the anterior radius head collapse fracture; there is a degree of instability in the elbow when two or more parts of the anterior radial head collapse fractures suggest to repair the lateral ligament complex. The elbow joint is extremely unstable when anterior radius head dissociated and displaced fractures, the lateral ligament complex should be repaired in time.

Desarrollo de la ciencia y la tecnología en las habilidades del internado rotatorio de Cirugía General / Development of science and technology in the skills of a General Surgery rotatory internship

Introducción: El desarrollo científico técnico mundial impone nuevos retos sociales y económicos, y responde a una educación de calidad, que permita la aplicación de este avance en las nuevas tecnologías. Objetivo: Exponer el desarrollo de la ciencia y la tecnología en el mejoramiento de la enseñanza de las habilidades teórico-prácticas en los estudiantes de medicina del internado rotatorio de Cirugía General. Métodos: El estudio empleó la contrastación de métodos teóricos como el histórico-lógico, el análisis documental y la sistematización teórica, para la recolección de información, la construcción, el desarrollo y la conformación final del producto. Conclusiones: Se actualizaron los fundamentos filosóficos, y los conocimientos teóricos del aprendizaje y las nuevas tecnologías para el mejoramiento de la enseñanza de las habilidades teórico-prácticas en los estudiantes de medicina del internado rotatorio de Cirugía General. El desarrollo tecnológico, la enseñanza y la práctica de la ética médica permiten solucionar los problemas de salud de la población en los distintos niveles de atención, lo cual contribuye con la formación integral del futuro médico general(AU)

Introduction: The global scientific-technical development imposes new social and economic challenges, as well as it responds to a quality education, which allows for the application of this advance to new technologies. Objective: To expose the development of science and technology for improving the theoretical-practical skills of medical students during a general surgery rotatory internship. Methods: The study used the opposition of theoretical methods such as the historical-logical, document analysis and theoretical systematization, for the collection of information, construction, development and final conformation of the product. Conclusions: The philosophical foundations were updated, together with the theoretical knowledge about learning and new technologies for improving the teaching of theoretical-practical skills among medical students during a general surgery rotatory internship. Technological development, teaching and practice of medical ethics allow solving the health problems of the population at different levels of care, which contributes to the integral formation of the future general physician(AU)

Analysis of Kawasaki disease complicated with atlantoaxial rotatory subluxation / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics of children with Kawasaki disease (KD) complicated with atlantoaxial rotatory subluxation (AARS).Methods:Clinical characteristics of 60 AARS patients complicated with KD (the atlantoaxial rotatory subluxation group) and 60 patients with KD only diagnosed (the control group)in the Children′s Hospital of Chongqing Medical University from December 2010 to December 2019 were retrospectively analyzed.Differences between groups were compared by the Chi- square test and the t test. Results:A total of 8 365 KD patients were diagnosed during the study period, involving 60 cases (0.72%) complicated with AARS.which usually occurred in the acute phase with the onset ages of 3 to 6 years ( P<0.001). Initial clinical symptoms of KD complicated with AARS included fever with restricted neck movement (100.00%), neck mass (66.67%), torticollis (21.67%) and neck pain (11.67%). CT or X-ray exa-mination of the neck indicated AARS, with thickening and swelling of the cervical soft tissues in some cases.Compared with those of control group, red, dry, cracked lips ( P=0.01) and cervical lymph node swollen ( P<0.001) were significantly pronounced in KD patients complicated with AARS.The absolute and relative count of neutrophils were significantly higher in KD patients complicated with AARS (all P< 0.05). Cervical soft tissue swelling and thickening in B-ultrasound were more obvious than those in the control group( P<0.05). However, there were no significant differences in coronary artery lesions and the response to intravenous immunoglobulin (IVIG) combined with Aspirin between groups ( P>0.05). Head traction could relieve neck symptoms to a certain extent, but there was no significant difference between groups ( P>0.05). Conclusions:Cervical lymphadenopathy, red, dry, cracked lips, increase of absolute and relative count of neutrophils, and swelling and thicke-ning of cervical soft tissues were the high-risk factors of KD complicated with AARS.The complication of AARS in KD patients did not increase the risk of coronary artery injury and IVIG resistance.IVIG combined with aspirin achieved a good prognosis in the majority of KD patients complicated with AARS.

Risk Assessment of Carotid Atherosclerotic Plaque Rupture under Cervical Rotatory Manipulation Based on Fluid-Structure Interaction Finite Element Model / 医用生物力学

Objective To evaluate the rupture risk of carotid atherosclerotic plaque under cervical rotatory manipulation. Methods The fluid-structure interaction (FSI) model of carotid atherosclerotic plaque was established, and tensile deformation of the plaque and lumen under cervical rotatory manipulation was simulated.Mechanical parameters such as the maximum flow shear stress(FSS), the maximum wall shear stress (WSS), the maximum plaque wall stress (PWS), wall tensile stress (WTS) and wall pressure (WP) of the plaque and lumen were recorded. Results Under 16% carotid tensile deformation, the maximum WSS of the plaque was 40.54 Pa. The maximum PWS was 66.16 kPa, which was far smaller than the threshold of plaque rupture.The maximum WTS of fiber cap and the maximum strain were 156.75 kPa and 0.56, which were larger than the fracture strain range. The maximum WTS of the lumen was 1 040.30 kPa, which approached the threshold of medial membrane rupture and might cause vascular injury. Conclusions When the cervical spine rotates to the end range of motion, large carotid artery stretch may cause damage to epidermal tissues of the plaque, leading to abscission. Lesions, ulcers, bleeding and vascular damage may form inside the plaque, which will affect stability of the plaque. Cervical rotatory manipulation should be performed cautiously in patients with cervical diseases who also have carotid atherosclerotic plaques.The finite element assessment of plaques before manipulation may be an effective safety screening method.

Traumatic Atlantoaxial Rotatory Subluxation in Adult: Case Report

Traumatic atlantoaxial rotatory subluxation (AARS) is generally found in pediatric patients, rarely found in adults, being a life-threatening condition especially when early diagnosis is not possible, which can lead to severe late neurological deficits.We describe a 38-year-old patient, victim of physical aggression caused by strangulation attempt who developed AARS, an uncommontraumatic cause. During the hospital care, the early diagnosis allowed us to institute a conservative treatment, which made the case uncommon, since most of the time surgical treatment is imperative. With the patient awake and under analgesia, a closed reduction was performed that promoted immediate pain relief, followed by a prescription of wearing a Philadelphia-type collar for 8 weeks. During the follow-up, cervical spine radiographies demonstrated no subluxation after removing the cervical collar. The patient was asymptomatic after 6months of treatment. This case supports the importance of nonoperative management of AARS in selected cases.

Traumatic atlantoaxial rotatory dislocation in the pediatric population / Luxação rotacional traumática de c1-c2 na população pediátrica / Luxación rotatoria traumática de c1-c2 en población pediátrica

ABSTRACT Objective: The treatment of C1-C2 rotatory dislocation remains controversial and surgery is rare. Surgical treatment is indicated when the injury satisfies the instability criteria or when it cannot be reduced. The objective of this study is to analyze the principles and the adaptations necessary for treating these injuries in the pediatric population. Methods: A retrospective case series study. Three cases of patients diagnosed with traumatic C1-C2 rotatory dislocation and treated surgically in our hospital were studied. Through critical analysis of the available literature, a practical guide was proposed to establish the principles and competencies for the treatment of these injuries. Results: The operated cases were female patients between 8 and 16 years of age, with a diagnosis of traumatic atlantoaxial dislocation. Two patients required preoperative skeletal traction with halo. All patients underwent posterior instrumented arthrodesis, two with a transarticular screw technique and one with mass and C2 isthmic (Göel-Harms) screws. Conclusion:. It is essential to determine if the injury is stable and reducible. We recommend treating this type of injury keeping the criteria and competencies related to the stability, alignment, biology and function of the spine in mind. Level of evidence IV; Case series.

RESUMO Objetivo: O tratamento da luxação rotacional de C1-C2 permanece controverso, e a cirurgia é rara. O tratamento cirúrgico é indicado quando a lesão satisfaz os critérios de instabilidade ou quando não pode ser reduzida. O objetivo deste estudo é analisar os princípios e a adequação necessários para tratar essas lesões na população pediátrica. Métodos: Estudo retrospectivo de série de casos. Foram estudados três casos em pacientes tratados cirurgicamente em nosso hospital com diagnóstico de luxação rotacional traumática de C1-C2. Por meio de análise crítica da literatura disponível, foi proposto um guia prático para estabelecer os princípios e a adequação do tratamento dessas lesões. Resultados: Os casos submetidos à cirurgia foram pacientes do sexo feminino, entre 8 e 16 anos de idade, com diagnóstico de luxação atlantoaxial traumática. Duas pacientes precisaram de tração esquelética pré-operatória com halo. Todas as pacientes foram submetidas à artrodese instrumentada por via posterior, duas com técnica de parafuso transarticular e uma com parafusos de massa e pedículo e lâmina em C2 (técnica de Göel-Harms). Conclusões: É essencial determinar se a lesão é estável e se pode ser reduzida. Recomenda-se tratar esse tipo de lesão tendo em mente os critérios e a adequação relacionados com estabilidade, alinhamento, biologia e função da coluna vertebral. Nível de evidência IV; Série de casos.

RESUMEN Objetivo: El tratamiento de la luxación rotatoria de C1-C2 permanece controversial y la cirugía es rara. Se indica tratamiento quirúrgico cuándo la lesión cumple criterios de inestabilidad o cuándo es considerada irreductible. El objetivo de este estudio es revisar los principios y competencias necesarios para tratar esas lesiones en la población pediátrica. Métodos: Estudio retrospectivo de serie de casos. Se estudian tres casos en pacientes tratados quirúrgicamente en nuestro hospital con diagnóstico de luxación rotatoria de C1-C2 traumática. A través del análisis crítico de la literatura disponible se elabora un esquema práctico para establecer los principios y competencias para el abordaje de estas lesiones. Resultados: Los casos intervenidos fueron pacientes de sexo femenino entre 8 y 16 años, con diagnóstico de luxación atlantoaxoidea traumática. Dos pacientes requirieron tracción esquelética preoperatoria con halo. A todas las pacientes se les practicó artrodesis instrumentada por vía posterior, dos con técnica de tornillos transarticulares y una con tornillos de masa e ístmicos de C2 (Göel-Harms). Conclusiones: Resulta imprescindible determinar si la lesión es estable y reductible. Siempre abordar este tipo de lesiones teniendo presentes los criterios y competencias relacionados con la estabilidad, alineación, biología y función de la columna vertebral. Nivel de Evidencia IV; Serie de casos.

Instrumental piezoeléctrico en comparación a instrumental rotatorio convencional para la exodoncia de terceros molares mandibulares / Piezoelectric bone surgery versus conventional rotatory system for lower third molar surgery

RESUMEN: Introducción: Tradicionalmente la osteotomía requerida en la exodoncia de terceros molares mandibulares incluidos o semi-incluidos ha sido realizada con instrumental manual o rotatorio. Con el advenimiento de la técnica ultrasónica de la cirugía piezoeléctrica, se hace necesario comparar la seguridad y efectividad de ambas técnicas. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos ocho revisiones sistemáticas que en conjunto incluyeron 22 estudios primarios, de los cuales 12 corresponden a ensayos clínicos aleatorizados. Concluimos que el uso de instrumental piezoeléctrico en comparación con el instrumental rotatorio convencional podría aumentar el tiempo quirúrgico y podría disminuir el dolor temprano y tardío, junto con el edema al día siete, pero la certeza de la evidencia es baja. Por otra parte, el uso de instrumental piezoeléctrico podría resultar en poca o nula diferencia en el desarrollo de alteraciones neurológicas postoperatorias ya que la certeza de la evidencia es baja. Además, el uso de piezoeléctrico probablemente resulte en poca o nula diferencia en la apertura bucal.

ABSTRACT: Introduction: Traditionally, osteotomy techniques required in exodontia of included or semi-included mandibular third molars has been performed with manual or rotary instruments. With the advent of the ultrasonic technique of piezoelectric surgery, it is necessary to evaluate the effectiveness and safety of both osteotomy techniques. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed primary studies' data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified eight systematic reviews that together included 22 primary studies overall, of which 12 were randomized trials. We conclude that the use of piezoelectric surgery compared with conventional rotary instruments may increase operative time and reduce early and late pain, along with edema at day seven, but the certainty of the evidence is low. On the other hand, the use of piezoelectric instrumentation may result in little or no difference in the development of postoperative neurologic disturbances as the certainty of the evidence is low. Also, piezoelectric use probably makes little or no differences in mouth opening.

Effects of cervical rotatory manipulation on severe rabbit carotid atherosclerosis in flow sheer stress / 解剖学报

Objective: To investigate the effects of cervical rotatory manipulation (CRM) on severe carotid atherosclerosis of rabbits in hemodynamics. Methods: Totally 40 New Zealand rabbits were divided randomly into 3 groups, including the manipulation group, the model group and the control group. Left carotid atherosclerotic plaques models were developed in the rabbits of manipulation group and model group. Then, the manipulation group was treated with CRM lasting for 2 weeks; meanwhile no intervention was given on rabbits in the model group and control group. At the end of manipulation, flow sheer stress (FSS) was calculated with velocity and viscosity of blood. One way AN OVA and LSR-t test were performed to explore the significance. Results: FSS of left carotid artery in rabbit decreased significantly in the manipulation group and the model group, in comparison with the control group. Moreover, FSS in the manipulation group was lower than that in the model group. Conclusion: FSS of severe atherosclerotic carotid artery in rabbit may become decreased following with CRM.

Exploración de los conductos semicirculares verticales con estimulación rotatoria inducida / Exploration of vertical semicircular ducts with induced rotatory stimulation

Las pruebas rotatorias han sido utilizadas durante más de un siglo para el estudio de la función vestibular por ser un estímulo fisiológico controlado muy efectivo sobre el laberinto posterior, habitualmente son los conductos semicirculares horizontales los que se exploran, pues se afectan con más frecuencia y son más fáciles de estudiar, sin embargo en ocasiones son los verticales los lesionados y por tanto deben emplearse otras alternativas para llegar a un diagnóstico certero. Se presenta un caso donde se evalúa la función fisiológica de los conductos semicirculares verticales a través de la electronistagmografía con estimulación rotatoria, empleando la técnica de estimulación tiempo-velocidad, con fases sucesivas de aceleración, velocidad constante, desaceleración y parada brusca, con una silla rotatoria computarizada, acoplada a un electronistagmógrafo. Se obtuvo arreflexia del canal vertical anterior derecho. A velocidades inferiores a 1 Hz es posible evaluar el reflejo vestíbulo ocular en los conductos semicirculares verticales, a pesar de que la frecuencia del estímulo está por debajo del nivel en que este reflejo funciona en las actividades diarias(AU)

Rotatory tests have been used for over a century for the study of vestibular function because it is a very effective physiological controlled stimulus on the posterior labyrinth, usually the horizontal semicircular ducts that are explored, since they are affected more frequently and are more easy to study, however sometimes the injured are vertical and therefore other alternatives must be used to arrive at a correct diagnosis. The aim of this study is to evaluate the range of physiological function of vertical semicircular ducts using electronystagmography and rotary stimulation. The method used was the technique of time - speed stimulation, with successive phases of acceleration, constant speed, deceleration and abrupt stop, with a computerized rotating chair. Vestibulo-ocular arreflexia of the right anterior vertical channel. It was shown that at speeds lower than 1 Hz it is possible to evaluate the Ocular Lobe Reflex in the vertical semicircular ducts, although the frequency of the stimulus is below the level at which this reflex works in daily activities(AU)

Research progress of posteromedial rotatory instability of the elbow / 中国修复重建外科杂志

Results: The most important factors related to PMRI of the elbow joint are lateral collateral ligament complex (LCLC) lesion, posterior bundle of the medial collateral ligament complex (MCLC) lesion, and anteromedial coronoid fracture. Clinical physical examination include varus and valgus stress test of the elbow joint. X-ray examination, computed tomography, particularly three-dimensional reconstruction, are particularly useful to diagnose the fracture. Also MRI, arthroscopy, and dynamic ultrasound can assistantly evaluate the affiliated injury of the parenchyma. It is important to repair and reconstruct LCLC and MCLC and fix coronoid process fracture for recovering stability of the elbow joint. There are such ways to repair ligament injury as in situ repairation and functional reconstruction, which include direct suturation, borehole repairation, wire anchor repairation, and transplantation repairation etc. The methods for fixation of coronal fracture include screw fixation, plate fixation, unabsorbable suture fixation, and arthroscopy technology.

The Clinical Efficacy of Vestibular Function Tests in Patients with Acute Unilateral Vestibulopathy / 대한평형의학회지

OBJECTIVES: Aim of this study is to investigate the clinical efficacy of the vestibular function tests (VFTs) and the predictability of lesion side of vestibular asymmetry parameters in acute unilateral peripheral vestibulopathy. METHODS: Medical records and results of VFTs (caloric, rotatory chair, and head impulse tests) of 57 patients with acute unilateral vestibulopathy were reviewed retrospectively. The VFTs were examined within 7 days after the clinical onset. RESULTS: For the caloric test, 74% showed significant canal paresis and the predictability of lesion side was 88%. For the sinusoidal harmonic acceleration test, 91% had low gain in at least 1 Hz, phase lead showed 70%, 89% showed phase asymmetry and the predictability of lesion side was 90%. For velocity step test, 67% had abnormal Tc asymmetry and the predictability of lesion side was 95%. In bedside head impulse test (HIT), abnormal catch up saccades were observed in 89% and the predictability of lesion side was 100%. For the video HIT, cover or overt catch-up saccades were observed in 95% and the predictability of lesion side was 100%. One hundred percent (100%) had low gain on the video HIT, but the lesion sides were uncertain because of bilateral involvements or artifacts. CONCLUSIONS: The most important things in the diagnosis of acute unilateral vestibulopathy are typical clinical symptoms and spontaneous nystagmus. A combination of rotatory, caloric, and HITs will result in a more complete examination of the vestibular system. Among them, HIT is recommended as the best tool in acute unilateral vestibulopathy.

Reconstrucción mínimamente invasiva de la esquina posterolateral con sustitución simultánea del ligamento cruzado anterior para lesiones ligamentarias complejas de rodilla / Minimally invasive reconstruction of the posterolateral corner with simultaneous replacement of the anterior cruciate ligament for complex knee ligament injuries

Resumen: Introducción: Es importante conocer la efectividad del uso de técnicas combinadas para el tratamiento de las lesiones ligamentarias complejas de la rodilla, su evolución y las estrategias utilizadas para su desarrollo. Objetivo: Evaluar y describir los resultados de reconstruir de manera simultánea con una técnica mínimamente invasiva el complejo posterolateral (CPL) y el ligamento cruzado anterior (LCA). Material y métodos: Se realizó la reconstrucción del LCA y el CPL en siete pacientes, mediante la técnica descrita, en el período de Marzo a Noviembre de 2012. Todos los pacientes se evaluaron a los seis meses del procedimiento a través del uso de pruebas subjetivas IKDC, IKSS. Se valoró su retorno a actividades laborales y su índice de satisfacción. Resultados: Seis pacientes fueron del sexo masculino y solo uno del femenino, con rangos de edad entre los 26 y 46 años. La mayoría de las lesiones fueron causadas por accidentes asociados al deporte. Todos los participantes eran personas en la etapa productiva de la vida que requirieron un período promedio de tres meses de incapacidad. A los seis meses, conforme a la escala de IKDC, obtuvimos un paciente con IKDC de A, cuatro con un IKDC de B, uno de C y uno de D. En la escala subjetiva de IKSS, 80% promedió estabilidad de la rodilla por arriba de los 90 puntos, un paciente tuvo escala de 100 puntos y otro de 70 puntos.

Abstract: Objective: To evaluate and describe the results of a simultaneous reconstruction with minimally invasive technique of the posterolateral complex (PLC) and the anterior cruciate ligament (ACL). Material and methods: ACL and PLC reconstruction was performed in seven patients using the technique described, in the period from March to November 2012. All patients were evaluated at six months after the procedure using IKDC and IKSS subjective tests. Their return to work activities and their level of satisfaction were assessed. Results: Six male and one female patients ranging in age between 26 and 46 years were evaluated. The injuries were mostly caused by sports related accidents. All patients were economically active and required an average period of three months of disability. The assessment and outcomes at six months, according to the IKDC scale, were: one patient with IKDC A, four with IKDC B, one patient with C, and one with D. In the subjective scale IKSS, 80% averaged a knee stability of over 90 points, a patient had a 100-point scale and another, of 70 points.

Effects of cervical rotatory manipulation on tensile mechanical properties of rabbit carotid artery with atherosclerotic plague / 医用生物力学

Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.

Effects of cervical rotatory manipulation on tensile mechanical properties of rabbit carotid artery with atherosclerotic plague / 医用生物力学

Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.

Effects of cervical rotatory manipulation on tensile mechanical properties of rabbit carotid artery with atherosclerotic plague / 医用生物力学

Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque. Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group, model control group and blank control group. Carotid atherosclerosis model were made in the experimental group and model control group. The experimental group received the intervention of cervical rotatory manipulation, but the model control group did not. The blank control group did not receive any intervention. After 3 groups received different interventions, the differences in tensile mechanical properties of rabbit carotid artery in three groups were observed. Results The ultimate strain, ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P<0.05); The ultimate strain in the experimental group was 24.87% and 52.09% smaller than that in the model control group and blank control group, respectively; The ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group, respectively; The physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group, respectively. Conclusions Compared with normal carotid artery, the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery, and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque. Therefore, for patients with carotid atherosclerotic plaque, it is better to avoid cervical manipulation.

Effect of Cervical Rotatory Manipulation on Displacement and Intra-stress of Cervical Disc in Different Positions / 中国康复理论与实践

Objective To simulate the cervical rotatory manipulation(CRM)in flexion,neutral and extension positions using three-di-mensional finite element,so as to investigate the effect of this manipulation on the displacement and intra-stress of cervical disc in different positions.Methods By using the method of reverse engineering with Mimics 10.01,Geomagic Studio and Solidworks 14.0,a three-dimen-sional geometric CAD model of C5-6was developed from the CT scan images of a normal adult female aged 25 years.The model was import-ed into Ansys Workbench 14.5,and a three-dimensional finite element model was verified and simulated the CRM.The CRM was decom-posed by principium of manipulation in flexion,neutral and extension,respectively.The parameter of mechanics was analyzed with the fi-nite element system.The change of displacement and intra-stress distribution in cervical disc simultaneous were displayed during simulating the manipulation.Results The posterior part of opposite rotary side of annulus fibers was all retracted,and the displacement was toward an-terior,maximal in flexion position,followed as neutral position and minimal in extension position.In the meantime,the posterior part of the rotary side of annulus fibers was expanded into posterior,minimal in flexion position,followed as neutral position and maximal in extension position.The intra-stress in cervical disc was focused on posterior part of opposite rotary side,opposite rotary side and posterior part of the rotary side in flexion position,neutral position and extension position,respectively,maximal in flexion position,followed as extension posi-tion and minimal in neutral position. Conclusion To treat with cervical spondylotic radiculopathy in the perspective of safety of cervical disc,the CRM should rotate to the unaffected side,first in neutral position,second in flexion position if with poor efficacy.Patients with cer-vical spinal stenosis should not be treated with the CRM.

Effects of cervical rotatory manipulation on tensile mechanical properties of rabbit carotid artery with atherosclerotic plague / 医用生物力学

Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.

Sterilisation Of Rotary Cutting Instruments – A Survey On Current Practices

Aim: The aim of this study was to obtain the information regarding present sterilization procedures followed for sterilizing Rotary cutting instruments or burs in routine dental practices using a Questionnaire and to assess the effectiveness of those procedures in preventing cross infection, and to recommend an effective sterilization protocol to be followed while using rotary cutting dental burs. Materials and Methods: A questionnaire which was pre-validated was used to collect the information regarding the methods followed to sterilize the rotary cutting instruments in 100 dental clinics in and around Hyderabad and the effectiveness of those methods were analyzed using descriptive analysis. Results: The procedures undertaken by our clinicians in their day to day practice to resterilize rotary cutting burs are poorly effective, the risk of cross-infection is very high with those methods. Conclusion: The cleaning and resterilization procedures of rotary cutting instruments that were followed regularly in clinical practice were not adequate, and more rigorous procedures are needed. If such procedures cannot be devised, these instruments should perhaps be considered single-use devices.

Sistema rotatorio protaper: un modelo educativo en la enseñanza de grado / Protaper rotary system: an educational model in predoctoral teaching

Objetivos: El objetivo del presente trabajo fue analizar el nivel de eventos (estiramiento/fractura) en el instumental rotatorio endodonticode niquel- titanio después del uso en Practicas Preclínicas de Grado en dientes ex vivos y tacos de acrílico Materiales y métodos: Seseleccionaron alumnos de grado de la materia Endodoncia de cuatro comisiones (n= 60) que en las pruebas de apropiación deconocimientos y destrezas, superaron el valor de 7/10. A cada alumno se le entregó un kit de ProTaper Universal, nuevo para larealización de dos prácticas: 1° en tacos de acrílicos simuladores de piezas dentarias y 2° en una pieza unirradicular extraída de bajacomplejidad. Se evaluaron las series de limas S1, S2, F1, F2 y F3 en cada población. Se realizó una lectura macro de cada instrumentocon lupa 4X, efectuada por un operador entrenado. Previamente, se realizó en el unaevaluación de los instrumentos sin uso y luego de los estirados o fracturados. Para el análisis de eventos producidos en cada serie de limas seutilizó el Test de Chi cuadrado de homogeneidad con niveles de significación de p= 0,05 (sofware estadístico Infostat) Resultados: No seencontraron diferencias significativas entre las distribuciones de los eventos en dientes y en taco. (Test de Chi2 p=0.0957). En el primeruso, de un total de 300 instrumentos utilizados, 6 sufrieron un evento, siendo en el segundo uso de 270, 12 sufrieron un evento. Para cadainstrumento, las diferencias no resultaron estadísticamente significativas (p valor de Irwin Fisher) S1 p=0.29, S2 p=0.10, F1 p=0.33,F2 p=0.81, F3 p=0.81. Observamos la frecuencia de eventos por instrumento, surgiendo que son más frecuentes los eventos con F1 y F2que con los restantes instrumentos...

Objective: The aim of this study was to analyze the behavior (events: stretching/fracture) of Ni-Ti rotatory Endodontic instruments afterthe utilization in preclinical practice, either ex vivo teeth or acrilic dowels. Materials and methods: undergraduate Endodontic studentsbelonging to four different courses with higher califications (more than 7/10) have been selected (n = 60). Each student has been deliveredwith a brand new ProTaper Universal Kit with the purpose of carrying out two endodontic practices, 1° in acrilics dowels, simulating ateeth and, 2° in a natural low complexity single rooted teeth. The series of files S1, S2, F1, F2 y F3 were assessed in each population. Amacro observation with a 4x magnified lens was performed by a qualified operator. Previously, a MEB observation had been performed onthe brand new instruments and in the post-use stretched or fractured instruments. The Chi square test of homogenity with significancelevels of p = 0.05 have been utilized for the analysis of the events (Infostat Estatistical Software). Results: No significant differences hasbeen found between the event distributions (Teeth/Acrilics dowels) (Test Chi2 p = 0,0957). A total of 300 files used for first time, 6suffered some kind of event, while in the second, a total of 270 files, 12 suffered some kind of event (stretching/fracture). The differenceswere not statistically significant on each file (p = Irwin Fisher value) S1 p=0.29, S2 p=0.10, F1 p=0.33, F2 p=0.81, F3 p=0.81.The event for each instrument has been detected to be more frequent with files F1 and F2 than with other files...

Shaping ability of rotatory or reciprocating instruments in curved canals: a micro-computed tomographic study

Abstract This study aimed to compare apical transportation, centering ratio, and working time during root canal preparation with Wizard Navigator (WN), WaveOne (WO), or ProTaper Universal (PT) and to describe deformation and fracture of these instruments. Thirty-six mesiobuccal roots from maxillary molars were micro-computed tomography (micro-CT) scanned and then sorted into three groups (n = 12): Wizard Navigator (WN), WaveOne (WO), and ProTaper Universal (PT). The root canals were prepared using WN, WO, or PT; the time of each canal preparation was timed; and the specimens were micro-CT re-scanned. The instruments were submitted to scanning electron microscopy (SEM) before and after their use. The data on canal transportation at 1, 2, 3, 4 and 5 mm and preparation time were analyzed by the Kruskal-Wallis test, followed by the Mann-Whitney U test. The centering ratio was analyzed by ANOVA, followed by Tukey's test. Both instrument deformation and fracture were described. Apical transportation was similar among groups at 1, 2, 3 and 4 mm. The WO group showed higher canal transportation at 5mm than the other groups (p = 0.03). There was no significant difference in centering ratio among the groups. Preparation time in the WO group was significantly lower than in the other groups (p = 0.004). Small differences were observed in the surface area of all instruments. The WN, WO, and PT groups had a similar centering ratio without procedural errors or significant structural changes. At 5 mm from the apex, the WO group showed the largest canal transportation toward the furcation and root canal preparation was faster than in the WN and PT groups.