Non-linear Finite Element Analysis of Trans-Tibial Residual Limb and Prosthetic Socket / 医用生物力学

Objective To study the load transfer mechanics between residual limb and prosthetic socket, as well as stress distributions below the residual limb, so as to provide a theoretical basis for designing and optimizing of prosthetic socket and improving the wearing comfort. Methods Aiming at compression-release stabilization （CRS）, the finite element software ABAQUS was used to analyze the stress distribution at the interface between the residual limb and CRS socket. The soft tissues were defined using the Mooney-Rivlin function. The interface pressures and shear stresses between the residual limb and CRS socket during mid-stance were obtained. A three-dimensional finite element model of the patellar tendon bearing (PTB) socket was established, and the results were compared. Results The interface pressures between the residual limb and CRS socket were mainly distributed at lateral tibia, media tibia and popliteal depression regions, which were similar to the main force regions of PTB socket. The mean interface pressures on the end of stump for CRS socket was increased by 19 kPa over PTB socket. Conclusions CRS socket had better breathability and reasonable stress distributions. The stress distribution of biomechanical interface was different due to the different shapes of socket. Therefore, the optimization of prosthetic socket can help to improve the wearing comfort of prosthetic limbs.

Clinical analysis of curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty. METHODS A retrospective analysis of 60 inflammatory chronic suppurative otitis media patients from January 2014 to January 2015 in Genenral Hospital of PLA Guangzhou Military Area were conducted.All cases were perpormed the ear incision under local anesthesia, including 32 cases(32 ears) with acellular dermal matrix, 28 cases(28 ears) with temporal fascia. The operation time, postoperative pain, the healing of tympanic membrane and the postoperative recovery were compared between the two groups. RESULTS There was significant difference in the operation time and postoperative pain between the two groups(P0.05). CONCLUSION The effect of acellular dermal matrix for repairing tympanic membrane is similar to the temporalis fascia. The use of acellular dermal matrix has the advantage of shorter operation time, less postoperative pain, and can avoid regional two incisions, it is worthy of clinical application.

Factors Affecting Tympanic Membrane Perforation in Refractory Secretory Otitis Media after the Extubation of Ventilation Tube / 听力学及言语疾病杂志

Objective To explore the treatment using two different ventilation tubes insertion for secretory o-titis media ,and to determine which factors are associated with the tympanic membrane perforation after a extrusion or surgical removal of a ventilation tube(VT) .Methods A retrospective analysis of 121 cases (210 ears) with re-fractory secretory otitis media from 1998 June to 2013 March was carried out .There were 58 cases (105 ears ) and 63 cases (105 ears) in patients and control group ,respectively .All subjects had more than 2 years of history ,and were treated by two types of ventilation tube (Goode -T and Shepard tube) .Various factors were analyzed to deter-mine the factors associated with persistence of a tympanic membrane perforation after VT extrusion or removal ,in-cluding gender ,age ,medical history ,ventilation tube pattern ,location ,history of previous VT insertions ,intuba-tion period reason for VT insertion ,condition of the TM ,nature of the tympanic cavity effusion and previous ade-noidectomy ,et .Results Analysis factors of perforation group (105 ears) and the control group (without perfora-tion ,105 ears) ,were statistically significant in ventilation tube pattern (χ2 =6 .916 ,P<0 .01) ,history of previous VT insertions(χ2 =7 .325 ,P<0 .01) ,frequency of previous VT insertions (χ2 =13 .01 ,P<0 .01)and the nature of the tympanic cavity effusion(χ2 =7 .04 ,P<0 .01) .The proportion of perforation group about Goode - T ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were 58 .4% ,57 .3% ,66 .7% and 57 .9% respectively ,others had no significant difference between the two groups . The multivariate analysis showed that ,regardless of the ventilation tube ,the frequency of tube was the tympanic membrane perforation risk factor ;Goode-T tube increased the risk of perforation of tympanic membrane was 1 .637 times than Shepard tube(OR=1 .637 ,P<0 .01) .Conclusion Using the Goode - T type ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were four risk factors for persistence of a tympanic membrane perforation after VT insertion for secretory otitis media .

Risk Factors for Refractory Secretory Otitis Media / 听力学及言语疾病杂志

Objective To identify the risk factors of refractory secretory otitis and analyse the results .Meth-ods The study subjects were 42 patients(56 ears) with secretory secretory otitis media from June 2003 to June 2011 ,all patients were performed with ears ,nose ,pharynx and throat routine inspection and mastoid HRCT .All patients were retrospectively analyzed possible risk factors :suchas history ,infection ,eustachian tube dysfunction , chronic sinusitis ,deflection of nasal septum ,nose pharynx ministry malignant tumor ,tonsillitis ,adenoid hypertro-phy ,allergic rhinitis ,etc .Results In the multivariate analysis of 42 patients(56 ears) with refractory secretory oti-tis media and the control group of 50 patients(66 ears) ,statistically significant in the history (χ2 = 9 .814 ,P<0 .01) ,mastoid pneumatization adverse (χ2 =15 .301 ,P<0 .01) ,and allergic rhinitis (χ2 =32 .614 ,P<0 .01)were observed .Two of them were found to be significant in the logistic regression model :mastoid pneumatization adverse (OR=4 .44) ,and allergic rhinitis(OR = 15 .13) .Patients of mastoid pneumatization adverse with refractory otitis media is 4 .164 times (95% CI ,1 .903 ~9 .112);patients of allergic rhinitis was 17 .192 times higher than that of in no allergic patients (95% CI ,5 .850 ~ 50 .524) .Conclusion Mastoid pneumatization adverse and allergic rhinitis are the risk factors for refractory secretory otitis media .

Normal anatomy of aditus of antrum and antrum on high-resolution CT and three-dimensional reconstruction / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the normal anatomy of aditus of antrum and antrum on the high-resolution CT (HRCT) and the three-dimensional reconstruction, testing the normal range. And comparison was carried out according to the age, sex and side.@*METHOD@#Ninety cases were randomly selected without ear lesions. Scanning were taken in sagittal, transverse and coronal planes on HRCT respectively. The structure of aditus and antrum was displayed by three-dimensional reconstruction. The left-right distances and up-down distances, antero-posterior distances were measured and analyzed.@*RESULT@#The image of antrum varied with age, while aditus remained constant on the HRCT and the three-dimensional reconstruction. The average of left-right distance of aditus was (5.19 +/- 1.39) mm, and the average of up-down distance of aditus was (5.74 +/- 1.16) mm. The average of left-right distance of antrum was (8.27 +/- 1.41) mm ( or = 6 years old). The average of up-down distance of antrum was (11.78 +/- 1.65) mm ( or = 6 years old). The average of antero-posterior distance of antrum was (12.25 +/- 1.23) mm ( or = 6 years old). No statistically significant differences were seen in left-right distance of aditus by age, sex and side (P > 0.05). Significant differences in up-down distance of aditus was found between male and female, and the distance in male was greater than that in female (P 0.05).@*CONCLUSION@#Imaging of aditus ad antrum is relatively constant in the normal persons, while the aditus is more diverse. Significant gender differences were seen in up-down distance. There were significant differences in left-right distance, up-down distance, and antero-posterior distance of aditus among all age groups.

Analysis of psychological characteristics and requirement of primipara during parturition period and the Chinese medical nursing / 中国实用护理杂志

Objective To improve patients' satisfaction degree with nursing work,understand the psychological characteristics and demands of primipara during parturition period.Methods From January 2008 to January 2010,480 cases of primipara from department of obstetrics of our hospital were selected and divided into the observation group and the control group with 240 cases in each group.The control group adopted routine nursing,while the observation group was given psychological nursing and the Chinese medical nursing.The incidence of urinary retention and satisfaction degree of both groups were compared.Results The psychological characteristics and demands of primipara during primipara period showed no remarkable difference.The incidence of urinary retention was lower and satisfaction degree with nursing work was higher in the observation group than the control group.Conclusions The primiparas have anxiety because of fearing pain during parturition period,psychological nursing combined with Chinese medical nursing can reduce the occurrence of postpartum urinary retention and improve the satisfaction degree with nursing work.

Mastoidectomy and ventilation tube placement for refractory secretory otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the mastoidectomy and ventilation tube placement for refractory secretory otitis media of clinical efficacy and mechanism.@*METHOD@#Retrospective analysis of 22 patients (33 ears) in refractory secretory otitis media, all patients treated by ventilation tube placement have 3 or more than 3 times, but not significantly alleviate the symptoms. Mastoid surgery and ventilation tube placement were basic surgical management. Tympanic membrane ventilation tube was pulled out at 3 to 6 months.@*RESULT@#Twenty-two patients perceived improvement of hearing after surgery, ear fullness disappeared; tympanic membrane was gray, no significant tympanic membrane mobility is limited; 33 ears conductive hearing loss, air-bone gap(13.54 +/- 4.86) dB; after 29 ears tympanograms showed A-type, 4 ears for C-type, 30 ears appear ipsilateral acoustic reflex.@*CONCLUSION@#For 3 or more than 3 times repeated ventilation tube insertion, patients more than 2 years of refractory secretory otitis media were treated with mastoidectomy and ventilation tube placement, it was satisfied that ears lesions were cleaned and expanded middle ear and mastoid air cell volume, good drainage of the tympanic membrane ventilation tube.

Clinical analysis of plasma cell granuloma occurred in head and neck / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the diagnosis and treatment of plasma cell granuloma in the head and neck region.@*METHOD@#Retrospective analysis of 3 cases of plasma cell granuloma occurred in head and neck. One case treated with endoscopic surgery and nasal and oral steroids after operation. Two cases treated with Caldwell-Luc style resection, followed by oral steroids and radiotherapy, one of the two cases combined with chemotherapy simultaneously.@*RESULT@#The patient done with endoscopic surgery followed up for 5 years, there was no tumor recurrence in the nasal cavity and maxillary sinus openings and sinus lining. Paranasal sinus CT was examed on the patient done with partial resection and radiotherapy 2 years after operation, no residual tumor proliferation. The third patient underwent paranasal sinus CT examination 3 years after operation, and no limitation of mouth opening was found.@*CONCLUSION@#The incidence rate of Plasma cell granuloma occured in head and neck is low. It is an inflammatory disease, but its physical signs and imaging findings are similar to malignant tumors. Because of the invasion feature, surgical resection should be the first choice, and if combined with radiotherapy and chemotherapy, the prognosis could be better.