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Aiming at the medical practice problems of the surgical steel medical instruments, such as the crevice corrosion, the poor mechanical compatibility and the Ni, Cr plasma exudation, the laser deposition of Ti-6Al-4V alloy cladding layer at the local functional area as alternative coating was proposed and realized as a new process method. The accurate element content and good formability Ti-6Al-4V cladding powder was chosen, the low power and high duty cycle optimized laser process was adopt, the alternative coating of good fusion and low dilution was prepared. Through the elemental line scanning, the interface microstructure analysis and the experiments of basic mechanical properties, the basic properties of the cladding were characterized and verified. The experiments results showed that, the Ti, Al and V contents of the top coating were respectively about 88%, 4.9% and 3.9%, no sensitizing ions such as Cr and Ni were detected. Initial equiaxed α phase, flake β phase dist were distributed in the coating and interface, the α' martensite was precipitated at the boundary of the flake β phase, some refined granular β phase dispersion pinned to the grain boundary of basket structure. The microhardness of cladding layer was 352.08~312.76 HV0.1. The friction coefficient of the cladding layer was about 0.22~0.65. A new technology and method reference for improving and upgrading the performance of surgical medical devices is provided by this research.
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Alliages , Corrosion , Test de matériaux , Acier , TitaneRésumé
Objective To assess the symptom burden and its predictive factors in patients with prostate cancer. Methods A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS). Results The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P<0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden. Conclusions The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.
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Objective To analyze the reliability and validity of the Expanded Prostate cancer Index Composite 26-item version (EPIC-26) in Chinese patients with prostate cancer. Methods Totally 402 patients with prostate cancer at the Fudan University Shanghai Cancer Center were invited to fill in the Chinese version of EPIC-26. 402 samples were divided into two parts by random number table method. 201 samples were analyzed by exploratory factor analysis and another 201 samples were analyzed by confirmatory factor analysis. Results The total Cronbach alpha coefficient of Chinese version EPIC-26 was 0.845, and the Cronbach′s α coefficient of each domain ranged from 0.576 to 0.957. The results of exploratory factor analysis showed that the Chinese version of EPIC-26 was a 5-factor model , which could explain 63.456% of the total variance. The results of confirmatory factor analysis were as follows: χ2/df=1.641, GFI=0.863, AGFI=0.829, NFI=0.886, IFI=0.952, CFI=0.951, TLI=0.944, RMSEA= 0.057, which all met the standard of model fitting. Conclusion The Chinese version of EPIC-26 is a reliable and valid tool which is suitable for assessing the health-related quality of life of Chinese patients with prostate cancer.
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Objective To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer. Methods The Chinese version of SCNS-SF34 was translated and revised . The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale. Results Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500% . Except for item 17, the maximum load value was<0.4, and the other item load values were>0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940. Conclusions The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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Ameloblastoma in the tibia is rare. Limb reconstruction after tumor resection is challenging in terms of selection of the operative method. Here, we report a case of radical resection of an ameloblastoma in the mid-distal tibia combined with limb salvage using a three-dimensional (3D)-printed prosthesis replacement, with 1-year follow-up results. After receiving local institutional review board approval, a titanium alloy prosthesis was designed using a computer and manufactured with 3D-printing technology. During the operation, the stem of the prosthesis was inserted closely into the proximal tibial medullary cavity. Then, the metal ankle mortise and the talus were compacted closely. Radiographic results at 1-year follow up showed that the prosthesis was well placed, and no loosening was observed. The Musculoskeletal Tumor Society (MSTS) 93 functional score was 26 points, and the functional recovery percentage was 86.7%. Computer-assisted 3D-printing technology allowed for more volume and structural compatibility of the prosthesis, thereby ensuring a smooth operation and initial prosthetic stabilization. During the follow up, the presence of bone ingrowths on the porous surface of some segments of the prosthesis suggested good outcomes for long-term biological integration between the prosthesis and host bone.
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Alliages , Améloblastome , Cheville , Comités d'éthique de la recherche , Membres , Études de suivi , Sauvetage de membre , Méthodes , Prothèses et implants , Talus , Tibia , TitaneRésumé
Objective@#To assess the symptom burden and its predictive factors in patients with prostate cancer.@*Methods@#A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS).@*Results@#The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P < 0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden.@*Conclusions@#The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.
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Objective@#To analyze the reliability and validity of the Expanded Prostate cancer Index Composite 26-item version (EPIC-26) in Chinese patients with prostate cancer.@*Methods@#Totally 402 patients with prostate cancer at the Fudan University Shanghai Cancer Center were invited to fill in the Chinese version of EPIC-26. 402 samples were divided into two parts by random number table method. 201 samples were analyzed by exploratory factor analysis and another 201 samples were analyzed by confirmatory factor analysis.@*Results@#The total Cronbach alpha coefficient of Chinese version EPIC-26 was 0.845, and the Cronbach′s α coefficient of each domain ranged from 0.576 to 0.957. The results of exploratory factor analysis showed that the Chinese version of EPIC-26 was a 5-factor model, which could explain 63.456% of the total variance. The results of confirmatory factor analysis were as follows: χ2/df=1.641, GFI=0.863, AGFI=0.829, NFI=0.886, IFI=0.952, CFI=0.951, TLI=0.944, RMSEA= 0.057, which all met the standard of model fitting.@*Conclusion@#The Chinese version of EPIC-26 is a reliable and valid tool which is suitable for assessing the health-related quality of life of Chinese patients with prostate cancer.
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Objective@#To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer.@*Methods@#The Chinese version of SCNS-SF34 was translated and revised. The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale.@*Results@#Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500%. Except for item 17, the maximum load value was <0.4, and the other item load values were >0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940.@*Conclusions@#The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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Distress thermometer (DT) and problem list (PL) are rapid screening tools recommended by National Comprehensive Cancer Network for cancer patients' levels of distress. DT has good validation and reliability and widely used around the world. In this paper, we reviewed the cutoff score of DT, grading disputes of PL, and application situations of them to provide a reference for the tools selection and applying of psychological distress screening of cancer patients in China.
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<p><b>OBJECTIVE</b>A remote wireless electrocardiogram (ECG) monitoring system is designed by using the CC2530 micro-controller as the device core.</p><p><b>METHODS</b>Acquisition, conversion and data processing for ECG signals are realized on CC2530 micro-controllers. And the ECG data is transmitted to the coordinator by using ZigBee. It realizes the real-time monitoring of ECG signals and heart rate variability (HRV) data.</p><p><b>RESULTS</b>The test results show that the maximum error of the designed ECG monitoring analyzer is 3 beats per minute and the average error is 1.6 beats per minute, which can meet the requirement of pharmaceutical industry standards of the People's Republic of China.</p><p><b>CONCLUSIONS</b>The ECG monitoring analyzer has good portability, high measurement precision and good practical application values.</p>
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Chine , Électrocardiographie , Rythme cardiaque , Monitorage physiologique , Traitement du signal assisté par ordinateurRésumé
T he finite element method (FE m) is a mathematical technique using modern computer tech-nology for stress analysis, and has been gradually used in simulating human body structures in the biomechanical field, especially more widely used in the research of thoracolumbar spine traumatology. T his paper reviews the establishment of the thoracolumbar spine FE m, the verification of the FE m, and the thoracolumbar spine FE mresearch status in different fields, and discusses its prospects and values in forensic thoracolumbar traumatology.
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Objective To explore the possibility of immortalized human precartilaginous stem cells (IPSCs) differentiating into nucleus pulposus-liked cells induced by transforming growth factor-β1 (TGF-β1)and examine its biological characters.Methods The IPSCs were seeded on the thermosensitive chitosan/glycerophosphate (C/GP) scaffolds and induced into nucleus pulposus-like cells in culture medium with the adding of TGF-β1 under hypoxia condiction.The growth and differrentiation of IPSCs on C/GP scaffolds were observed.Seven days later,Alcian blue staining was used to detect the formation of glycosaminoglycans (GAG) of extracellular matrix by the differentiating cell.RT-PCR was carried out to identify the expression of characteristic genes of nucleus pulposus-liked cells,including collagen Ⅱ and Aggrecan.Western blot were used to examine the expression of β-catenin.Results IPSCs grew well on the thermosensitive C/GP scaffolds.After 7 days,Alcian blue staining exhibited more formation of GAG in experimental group as compared with control group.RT-PCR manifested that the gene expression of collagen Ⅱ and Aggrecan were upregulated.Likewise,Western blot manifested that the expression of β-catenin was upregulated.Respectively,all of the content in the induction group obviously increased compared with that of the control group.Conclusion IPSCs can be differentiated into nucleus pulposus-like cells under the induction of TGF-β1,the differentiating cells have a favourable secretory function,which can secrete extracellular matrix effectively.Differentiation of IPSCs to nucleus pulposus-liked cells may be through upregulating the expression of β-catenin in cells.
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Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.
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[Objective]To assess the effect of femoral head reshaped surgery for treatment of collapse stage of femoral head necrosis in dogs.[Method]Experimental femoral head necrosis models were made in unilateral femoral head of 10 adult dogs.Under anaesthesia,the necrotic mass in the collapse area of femoral head necrosis was fully curreted through a passage from femoral neck to callapse head,a self-designed ball-tube apparatus enveloped with a cannula was put into under the curreted area,normal saline injected to fill the ball in the collapse cavity till the collapse area forced to reshape a spherical femoral head;After withdraw of normal saline,bone cement of calcium phosphate was injected into the reshaped cavity to maintain the reshaped femoral head.Finally the ball-tube apparatus was taken out.Preoperative and postoperative X-ray film of femoral head were taken to evaluate the reshaping.Femoral heads of experimental side and normal femoral head of contralateral side as control were take out after the dogs sacrifice for biomechanical examination of maximum compression strength.[Result]In experimental group,as compared to preoperative radiograms,the postoperative radiograms of 10 dogs showed the curreted necrotic cavity was fully filled with bone cement and reshape was maintained.The maximum comopression strength of femoral heads of control group was 49 Mpa to 60 Mpa,and that of experimental group was 49~54 Mpa with no statistical significant difference.[Conclusion]Femoral head reshaping surgery may be a method of choice for treatment of collapse stage of femoral head necrosis in experimental animal,but long-term effect should be evaluated thereafter.
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AIM: To study the altion of aminophylline or doxapram attenuate somnolence induced by postoperative intravenous analgesia with butorphanol.METHODS: One hundred and five adult patients were randomly divided into three groups under epidural blockade.0.01% butorphanol and 0.25% aminophylline analgesia-pump(groupⅠ,n=35),0.01% butorphanol and 0.15% doxapram analgesia-pump(groupⅡ,n=35),and 0.01% butorphanol analgesia-pump(group Ⅲ,n=35).Lethargy and analgesia effect were compared.RESULTS: The analgesia effects were satisfactory in the three groups after operation.conscious-sedation score(OAA/S)(at 8-24 h after operation)in groupⅢ was higher than those in groupⅠand Ⅱ(P
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Objective To investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.