Background Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head （ONFH） in pre-collapse ONFH without extensive lesion. However, for pre-co...Background Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head （ONFH） in pre-collapse ONFH without extensive lesion. However, for pre-collapse ONFH with extensive necrotic area, it is still challenging to preserve the femoral head. The current study aimed to introduce a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus and to evaluate its short-term outcomes.Methods From January 2008 to December 2008, 10 ONFH patients （12 hips） underwent operations by a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus （group A）.According to the ARCO classification system, there were two hips in stage Ⅱ B and 10 hips in stage Ⅱ C. Also in the same period, 12 ONFH patients （16 hips） underwent operations by the conventional procedure of quadratus femoris pedicled bone grafting （group B）. There were 6 hips in stage Ⅱ B and 10 hips in stage Ⅱ C. All patients were males and suffered from alcohol induced ONFH. For the new technique, the necrotic area was evaluated, and a titanium mesh piece of the same size （range from 2.5 cm×2.8 cm to 2.8 cm×3.4 cm） was obtained and shaped to match the contour of the head. The cancellous bone was first placed underneath the subchondral bone and was densely impacted （about 1 to 2 mm thick）.Then the titanium mesh piece was inserted. The length of the decompressive trough was measured. A titanium cylinder mesh cage with a diameter of 1.6 cm of the same length was obtained, with a ＂U＂ shaped window in the wall being created to make room for the muscle pedicle. The muscle pedicle bone was inserted into the titanium mesh cage to form a bone graft-titanium cage complex and, then the complex was inserted. The hundred percent score method was used for outcome evaluation. Clinical and radiographic outcomes were compared between group A and group B.Results The average展开更多
BACKGROUND: Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction(STEMI).This study assessed the effectiveness of post-dilatation in pr...BACKGROUND: Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction(STEMI).This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention(pPCI) for acute STEMI.METHODS: The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation.Patients were randomly assigned to control group(n=20) or post-dilatation group(n=21) in which a non-compliant balloon was inflated to >16 atm pressure.Strut apposition and coverage were evaluated by optical coherence tomography(OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up.The primary endpoint was rate of incomplete strut apposition(ISA) at 7 months after pPCI.RESULTS: There were similar baseline characteristics except for stent length(21.9 [SD 6.5] mm vs.26.0 [SD 5.8] mm, respectively, P=0.03).In post-dilatation vs.control group, ISA rate was lower(2.5% vs.4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate(95.2% vs.95.0%, P>0.05) or corrected TIMI frame counts(22.6±9.4 vs.22.0±9.7, P>0.05); and at 7-month follow-up(0.7% vs.1.8%, P<0.0001), the primary study endpoint, with similar strut coverage(98.5% vs.98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events(MACE).CONCLUSION: In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate.Larger and longer term studies are warranted to further assess safety(Clinical Trials.gov identifier: NCT02121223).展开更多
针对某包含引射、亚燃两模态（马赫数为0～4．0）的支板式火箭基组合循环（rocket based combinedcycle）发动机地面集成试验，设计了样机用带支板的二元进气道．数值模拟对比分析了在亚燃模态下进气道加入支板前后的性能以及流道内的...针对某包含引射、亚燃两模态（马赫数为0～4．0）的支板式火箭基组合循环（rocket based combinedcycle）发动机地面集成试验，设计了样机用带支板的二元进气道．数值模拟对比分析了在亚燃模态下进气道加入支板前后的性能以及流道内的流动情况，验证了设计的合理性，并且给出了支板位置以及构型的改变引起RBCC发动机进气道性能变化的规律和优化设计结果．展开更多
In densely built-up Singapore,relatively stiffsecant-bored piles and diaphragm walls are commonly used in cut-and-cover works to minimize the impact of ground movement on the adjacent structures and utilities.For exca...In densely built-up Singapore,relatively stiffsecant-bored piles and diaphragm walls are commonly used in cut-and-cover works to minimize the impact of ground movement on the adjacent structures and utilities.For excavations in stiffresidual soil deposits,the asso-ciated wall deflections and ground settlements are generally smaller than for excavations in soft soil deposits.However,if the residual soil permeability is high and the underlying rock is highlyfissured or fractured,substantial groundwater drawdown and associated seepage-induced settlement may occur.In this study,the excavation performance of four sites in residual soil deposits with maximum excavation depths between 20 and 24 m is presented.The maximum wall deflections were found to be relatively small compared to the significantly larger maximum ground settlements,owing to the extensive lowering of the groundwater table.In this paper,details of the subsurface conditions,excavation support system,field instrumentation,and observed excavation responses are presented,with particular focus on the large groundwater drawdown and associated ground settlement.Specific issues encountered during the excavation,as well as the effectiveness of various groundwater control measures,are discussed.The case studies will provide useful references and insights for future projects involving braced excavations in residual soil.展开更多
文摘Background Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head （ONFH） in pre-collapse ONFH without extensive lesion. However, for pre-collapse ONFH with extensive necrotic area, it is still challenging to preserve the femoral head. The current study aimed to introduce a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus and to evaluate its short-term outcomes.Methods From January 2008 to December 2008, 10 ONFH patients （12 hips） underwent operations by a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus （group A）.According to the ARCO classification system, there were two hips in stage Ⅱ B and 10 hips in stage Ⅱ C. Also in the same period, 12 ONFH patients （16 hips） underwent operations by the conventional procedure of quadratus femoris pedicled bone grafting （group B）. There were 6 hips in stage Ⅱ B and 10 hips in stage Ⅱ C. All patients were males and suffered from alcohol induced ONFH. For the new technique, the necrotic area was evaluated, and a titanium mesh piece of the same size （range from 2.5 cm×2.8 cm to 2.8 cm×3.4 cm） was obtained and shaped to match the contour of the head. The cancellous bone was first placed underneath the subchondral bone and was densely impacted （about 1 to 2 mm thick）.Then the titanium mesh piece was inserted. The length of the decompressive trough was measured. A titanium cylinder mesh cage with a diameter of 1.6 cm of the same length was obtained, with a ＂U＂ shaped window in the wall being created to make room for the muscle pedicle. The muscle pedicle bone was inserted into the titanium mesh cage to form a bone graft-titanium cage complex and, then the complex was inserted. The hundred percent score method was used for outcome evaluation. Clinical and radiographic outcomes were compared between group A and group B.Results The average
基金funded by grants from National Natural Science Foundation of China(81100141 and 81570322 for JJ,81320108003 for JW)jointly supported by Boston Scientific
文摘BACKGROUND: Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction(STEMI).This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention(pPCI) for acute STEMI.METHODS: The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation.Patients were randomly assigned to control group(n=20) or post-dilatation group(n=21) in which a non-compliant balloon was inflated to >16 atm pressure.Strut apposition and coverage were evaluated by optical coherence tomography(OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up.The primary endpoint was rate of incomplete strut apposition(ISA) at 7 months after pPCI.RESULTS: There were similar baseline characteristics except for stent length(21.9 [SD 6.5] mm vs.26.0 [SD 5.8] mm, respectively, P=0.03).In post-dilatation vs.control group, ISA rate was lower(2.5% vs.4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate(95.2% vs.95.0%, P>0.05) or corrected TIMI frame counts(22.6±9.4 vs.22.0±9.7, P>0.05); and at 7-month follow-up(0.7% vs.1.8%, P<0.0001), the primary study endpoint, with similar strut coverage(98.5% vs.98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events(MACE).CONCLUSION: In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate.Larger and longer term studies are warranted to further assess safety(Clinical Trials.gov identifier: NCT02121223).
文摘针对某包含引射、亚燃两模态（马赫数为0～4．0）的支板式火箭基组合循环（rocket based combinedcycle）发动机地面集成试验，设计了样机用带支板的二元进气道．数值模拟对比分析了在亚燃模态下进气道加入支板前后的性能以及流道内的流动情况，验证了设计的合理性，并且给出了支板位置以及构型的改变引起RBCC发动机进气道性能变化的规律和优化设计结果．
文摘In densely built-up Singapore,relatively stiffsecant-bored piles and diaphragm walls are commonly used in cut-and-cover works to minimize the impact of ground movement on the adjacent structures and utilities.For excavations in stiffresidual soil deposits,the asso-ciated wall deflections and ground settlements are generally smaller than for excavations in soft soil deposits.However,if the residual soil permeability is high and the underlying rock is highlyfissured or fractured,substantial groundwater drawdown and associated seepage-induced settlement may occur.In this study,the excavation performance of four sites in residual soil deposits with maximum excavation depths between 20 and 24 m is presented.The maximum wall deflections were found to be relatively small compared to the significantly larger maximum ground settlements,owing to the extensive lowering of the groundwater table.In this paper,details of the subsurface conditions,excavation support system,field instrumentation,and observed excavation responses are presented,with particular focus on the large groundwater drawdown and associated ground settlement.Specific issues encountered during the excavation,as well as the effectiveness of various groundwater control measures,are discussed.The case studies will provide useful references and insights for future projects involving braced excavations in residual soil.
