目的评价腓骨近端截骨术治疗膝关节骨关节炎的初期疗效。方法回顾性收集2014年11月至2015年8月收治的内侧间室型膝关节骨关节炎患者5例,其中男2例,女3例,年龄52~77岁,平均年龄(61±10)岁。分别于术前、术后1d、4周、3个月、...目的评价腓骨近端截骨术治疗膝关节骨关节炎的初期疗效。方法回顾性收集2014年11月至2015年8月收治的内侧间室型膝关节骨关节炎患者5例,其中男2例,女3例,年龄52~77岁,平均年龄(61±10)岁。分别于术前、术后1d、4周、3个月、6个月随访并比较行腓骨近端截骨术前后的疼痛视觉模拟评分(visual analogue score,VAS)、美国特种外科医院(hospital for special surgery,HSS)膝关节评分及膝关节协会评分(keen society score,KSS),并拍摄膝关节前后位和下肢负重X线片对比手术前后下肢力线股胫角的变化。结果5例患者均获得完整随访,随访时间为3~12个月,平均(7±3)个月,手术时间(24±4)min,住院时间(4.6±0.5)d,术中出血量(17.6±2.5)ml。末次随访时,患者的VAS评分由术前的7(0.5)分降低到3(1.5)分,差异有统计学意义(t=10.371,P〈0.01);HSS评分由术前(59±4)分提高到(72±6)分,差异有统计学意义(t=-3.944,P〈0.05);KSS评分由术前(62.2±2.3)分提高到(80.4±8.4)分,差异有统计学意义(t=-4.684,P〈0.05)。下肢力线股胫角由术前的(182.2±0.7)°降低到(179.6±0.9)°,差异有统计学意义(t=-2.339,P〈0,05)。结论腓骨近端截骨术治疗膝关节骨关节炎手术操作简单,创伤小,可明显减轻患者疼痛,改善膝关节功能,初期疗效确切。展开更多
Combined with a digital bored photography system and in-situ statistics concerning the joints and fissures of both ore-body and surrounding rock,a 2D discrete model was constructed using UDEC.The stress field and disp...Combined with a digital bored photography system and in-situ statistics concerning the joints and fissures of both ore-body and surrounding rock,a 2D discrete model was constructed using UDEC.The stress field and displacement field changes of different sublevel stoping systems were also studied.Changes in the overlying rock strata settlement pattern has been analyzed and validated by in-situ monitoring data.The results show that:in the caving process,there exists an obvious delay and jump for the overlying rock strata displacement over time,and a stable arch can be formed in the process of caving,which leads to hidden goafs.Disturbed by the mining activity,a stress increase occurred in both the hanging wall and the foot wall,demonstrating a hump-shaped distribution pattern.From the comparison between simulation results and in-situ monitoring results,land subsidence shows a slow-development,suddenfailure,slow-development cycle pattern,which leads eventually to a stable state.This pattern validates the existence of balanced arch and hidden goafs.展开更多
为探究浅埋黄土地层盾构隧道施工下穿对不同特性地下管线的变形受力影响机制,依托河南省某公路隧道工程,以工程黄土为试验材料进行室内模型试验。通过设置3种管隧交角,研究两种接头刚度的非连续管线和连续管线的沉降、弯矩和管土接触压...为探究浅埋黄土地层盾构隧道施工下穿对不同特性地下管线的变形受力影响机制,依托河南省某公路隧道工程,以工程黄土为试验材料进行室内模型试验。通过设置3种管隧交角,研究两种接头刚度的非连续管线和连续管线的沉降、弯矩和管土接触压力变化规律,并在管隧正交工况下,研究不同地下管线的遮拦效应及地表沉降变形规律,得出预测管线沉降的拟合公式。结果表明:在3种管隧交角下,地下管线沉降存在3个阶段,在管线沉降集中区阶段低密度聚乙烯(Low Density Polyethylene,LDPE)接头非连续管线的平均沉降增长速率是聚氯乙烯(Polyvinyl Chloride,PVC)接头非连续管线的2倍;管隧交角的减小,使得非连续管线的最大正负弯矩均减小,PVC接头非连续管线弯矩曲线由“W”形转变为“V”形;管隧交角和接头刚度对土压力变化曲线和峰值位置几乎无影响,土压力变化均呈“M”形;在管隧正交下,管线整体刚度越大对地表沉降抑制作用越显著,管线沉降与地表沉降呈指数关系。展开更多
文摘目的评价腓骨近端截骨术治疗膝关节骨关节炎的初期疗效。方法回顾性收集2014年11月至2015年8月收治的内侧间室型膝关节骨关节炎患者5例,其中男2例,女3例,年龄52~77岁,平均年龄(61±10)岁。分别于术前、术后1d、4周、3个月、6个月随访并比较行腓骨近端截骨术前后的疼痛视觉模拟评分(visual analogue score,VAS)、美国特种外科医院(hospital for special surgery,HSS)膝关节评分及膝关节协会评分(keen society score,KSS),并拍摄膝关节前后位和下肢负重X线片对比手术前后下肢力线股胫角的变化。结果5例患者均获得完整随访,随访时间为3~12个月,平均(7±3)个月,手术时间(24±4)min,住院时间(4.6±0.5)d,术中出血量(17.6±2.5)ml。末次随访时,患者的VAS评分由术前的7(0.5)分降低到3(1.5)分,差异有统计学意义(t=10.371,P〈0.01);HSS评分由术前(59±4)分提高到(72±6)分,差异有统计学意义(t=-3.944,P〈0.05);KSS评分由术前(62.2±2.3)分提高到(80.4±8.4)分,差异有统计学意义(t=-4.684,P〈0.05)。下肢力线股胫角由术前的(182.2±0.7)°降低到(179.6±0.9)°,差异有统计学意义(t=-2.339,P〈0,05)。结论腓骨近端截骨术治疗膝关节骨关节炎手术操作简单,创伤小,可明显减轻患者疼痛,改善膝关节功能,初期疗效确切。
基金financially supported by the National Natural Science Foundation of China(No.51374033)the Doctoral Program of Higher Education Research Fund(No.20120006110022)the Chenchao Iron Mine and the technical support of Itasca
文摘Combined with a digital bored photography system and in-situ statistics concerning the joints and fissures of both ore-body and surrounding rock,a 2D discrete model was constructed using UDEC.The stress field and displacement field changes of different sublevel stoping systems were also studied.Changes in the overlying rock strata settlement pattern has been analyzed and validated by in-situ monitoring data.The results show that:in the caving process,there exists an obvious delay and jump for the overlying rock strata displacement over time,and a stable arch can be formed in the process of caving,which leads to hidden goafs.Disturbed by the mining activity,a stress increase occurred in both the hanging wall and the foot wall,demonstrating a hump-shaped distribution pattern.From the comparison between simulation results and in-situ monitoring results,land subsidence shows a slow-development,suddenfailure,slow-development cycle pattern,which leads eventually to a stable state.This pattern validates the existence of balanced arch and hidden goafs.
文摘为探究浅埋黄土地层盾构隧道施工下穿对不同特性地下管线的变形受力影响机制,依托河南省某公路隧道工程,以工程黄土为试验材料进行室内模型试验。通过设置3种管隧交角,研究两种接头刚度的非连续管线和连续管线的沉降、弯矩和管土接触压力变化规律,并在管隧正交工况下,研究不同地下管线的遮拦效应及地表沉降变形规律,得出预测管线沉降的拟合公式。结果表明:在3种管隧交角下,地下管线沉降存在3个阶段,在管线沉降集中区阶段低密度聚乙烯(Low Density Polyethylene,LDPE)接头非连续管线的平均沉降增长速率是聚氯乙烯(Polyvinyl Chloride,PVC)接头非连续管线的2倍;管隧交角的减小,使得非连续管线的最大正负弯矩均减小,PVC接头非连续管线弯矩曲线由“W”形转变为“V”形;管隧交角和接头刚度对土压力变化曲线和峰值位置几乎无影响,土压力变化均呈“M”形;在管隧正交下,管线整体刚度越大对地表沉降抑制作用越显著,管线沉降与地表沉降呈指数关系。