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OBJECTIVE@#To explore the feasibility of using computer-aided design(CAD) combined with 3D printing technology to repair and reconstruct the comminuted fracture of the posterior wall of acetabulum with osteochondral defect, to evaluate the biomechanical properties of composite titanium nitride bioceramic coatings with porous titanium alloy scaffolds and steel plate integrated implants.@*METHODS@#Based on CT images of continuous tomography, the computer-aided design software was used to construct a digital model of porous titanium alloy plate implant with a specially open cellular three-dimensional structure, and the three-dimensional implant was prepared with Ti6Vl4V powder by using the 3D printing technology, following by titanium nitride coating on its articular surface. The degree of matching and attachment between the implant and acetabulum were observed; Ansys software was used for finite element modeling to analyze the stress distribution, stress conduction and deformation displacement of the acetabulum of the normal group, the traditional group and the implant group under the same load state, and to verify the biomechanical properties of the implant.@*RESULTS@#The porous titanium alloy implant fit well with the acetabular bone defects, the shape of the plate was well attached to the bone surface, and it was rated as excellent according to the Matta criteria. The Von Mises stress peak of the implant group 13.38 MPa was close to the normal group 13.11 MPa and smaller than that in the traditional group 15.66 MPa. The Von Mises stress distribution and conduction of implant group were basically consistent with the normal group, slightly better than the traditional group; the maximum relative displacement of the implant was 0.166 mm, according to the finite element analysis.@*CONCLUSIONS@#The porous titanium alloy stent plate implant with titanium nitride coating prepared by 3D technology has excellent matching degree and biomechanical properties; the anatomical reconstruction makes the stress distribution and conduction recovery well, close to normal hip joints, which provides a new option for the clinical treatment of comminuted posterior acetabular wall fractures with severe bone defects.
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Humanos , Acetábulo , Placas Ósseas , Análise de Elementos Finitos , Fraturas Cominutivas , Impressão Tridimensional , TitânioRESUMO
<p><b>OBJECTIVE</b>To apply mixed logit model for analyzing the data of new rural cooperative medical with suitability and identify the factors affecting the residents choices of insurance mode.</p><p><b>METHODS</b>Hypothesis test of IIA was performed using the mogtest module of Stata10.0 to test the eligibility of the condition. The mixed logit model was established to allow the parameters to vary in the population using SAS9.1 MDC module.</p><p><b>RESULTS</b>The data in this study did not satisfy the IIA assumption (P<0.01), so that the multinomial logit model was not applicable. The adjusted Estrella of the mixed logit model was 0.6658.</p><p><b>CONCLUSION</b>The mixed logit approach does not rely on the restrictive IIA assumption and allows for correlation patterns between choices and individual variation. This approach can help in the determination of the choices in new rural cooperative medical system.</p>
Assuntos
Coalizão em Cuidados de Saúde , Seguro Saúde , Modelos Logísticos , Saúde da População Rural , Serviços de Saúde RuralRESUMO
Objective To analyze the result of treatment for acute-on-chronic liver failure patients with fast high efficiency Nucleoside and to explore the relations among inhibition to virus replication , liver failure development and immune rejection .Methods Sixty-two cases of acute-on-chronic liver failure pa-tients with HBV DNA(+) were divided into study group (treated with a kind of fast and nucleoside , n =30) and control group( n =32).HBV DNA,CD4 +T,CD8 +T, C3,C4 TBIL,PTA were observed at treat-ment 0w,2w and 4w.Results All of the study and control group patients , serum HBV DNA were positive before treated.And the levels of CD4+,CD8 +,C3,C 4,TBIL,PTA of study group were not significantly compared with control group .At treatment 2w , the rate of HBV DNA diverted negative in study group 90.0%(27/30), was significantly more then control group (9.4%, 3/32)(χ2=37.14 , P <0.01).But the CD4 +,CD8 +,C3,C4,TBIL,PTA levels were not significantly however between study and control group . At treatment 4w ,the rate of HBV DNA diverted negative in study group (96.7%, 29/30), was significant-ly more then control group(12.5%,4/32) (χ2 =40.74, P <0.01).CD4 +, CD8 +,C3,C4,TBIL,PTA levels of the study group were significantly more compared with the control group .The CD4 +level of study group (495.33 ±89.91)cells/ml, was higher significantly then control group (270.34 ±97.74)cells/ml( t=9.42, P <0.01),the CD8 +level (571.03 ±120.15 ) cells/ml, was higher significantly then control group(224.88 ±79.68)cells/ml( t =13.45, P <0.01).The C3 level of the study group (0.28 ±0.11) g/L, was lower significantly then control group ( 0.68 ±0.13 ) g/L ( t =13.13 , P <0.01 ) , the C4 level (0.12 ±0.06)g/L, was lower significantly then control group (0.23 ±0.10)g/L( t =4.92, P <0.01). The TBIL level of study group ( 653.93 ±131.02 )μmol/L, was higher significantly then control group (285.63 ±154.63)μmol/L( t =10.09, P <0.01),the PTA level (17.13 ±7.07)%, was lower signifi-cantly then control group(50.94 ±13.68)%( t =12.10, P <0.01).The death rate of the study group( 57.9%) was higher significantly compared with the control group (28.1%)(χ2 =6.39, P <0.05).Con-clusion Treatment of chronic severe hepatitis with fast and high efficiency nucleoside may arise the T cell subset level and make the immune rejection strength , as a result the liver failure maybe far away from cure .
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<p><b>OBJECTIVE</b>To observe therapeutic effect of the method for nourishing blood and moisturizing eye on xerophthalmia.</p><p><b>METHODS</b>Fifty-one cases of xerophthalmia were randomly divided into a treatment group and a control group. The treatment group were treated by acupuncture, moxibustion with Chinese medicine, and auricular point pressing, and the control group were treated with dripping of artificial tears. Local symptoms of eyes, tear secretion amount (Schirmer method) and BUT were observed before and after treatment.</p><p><b>RESULTS</b>The total effective rate of 88.5% in the treatment group was better than 52.0% in the control group (P<0.05).</p><p><b>CONCLUSION</b>The method for nourishing blood and moisturizing eye is a better therapy for xerophthalmia.</p>