骨科髋膝关节置换术临床路径实施体会

目的总结临床路径在骨科髋膝关节置换术中的实施体会。方法选取我院2009年11月至2010年12月收治的102例实施髋膝关节置换术的患者,按入院的先后顺序随机分为对照组和实验组,对照组仅采用传统模式,实验组在传统模式基础上实施临床路径。统计2组在住院天数、医疗费用、术后首次下床时间、术后首次功能锻炼时间、并发症发生情况以及患者满意度方面的相关数据,并比较其差异。结果所有方面的数据显示,实施临床路径的实验组明显比对照组有优势。结论骨科髋膝关节置换术实施临床路径的效果显著,值得在临床中加以推广应用。     

Wear Simulation of Alumina-on-Alumina Prosthetic Hip Joints Using a Multidirectional Motion Pin-on-Disk Device

The wear of a state-of-the-art implant alumina against itself was studied with a circularly translating pin-on-disk (CTPOD) device, a wear simulator for prosthetic hip joint materials. The direction of sliding changed continually relative to the pin, preventing erroneous uniaxial grooving typical of ordinary pin-on-disk devices. The dominating wear mechanism was mild abrasion manifested as a relieflike surface, which agreed with clinical findings. The wear factor ranged from 1 × 10⁻⁸ to 6 × 10⁻⁸ mm³/(N·m). The CTPOD device, validated earlier for ultrahigh molecular weight polyethylene, was shown to be the first simple wear test device to produce wear similar to that known to occur clinically in alumina-on-alumina total hip prostheses.     

Fabrication of New Porous Metal-Bonded Grinding Wheels by Hip Method and Machining Electronic Ceramics

Grinding wheels with different abrasive grains and different bonding materials were fabricated using hot isostatic press (HIP) sintering. Poly-crystal diamond powder of #1000 mesh size, single-crystal diamond powder of #1000 mesh size, and synthetic single-crystal diamond abrasive grains of #325 mesh size were used as abrasive grains. Cast-iron, and two different particle sizes of iron powders were used for the bonding material. The grinding capacity of these grinding wheels as well as conventional grinding wheels was evaluated by constant-pressure-grinding method to grind Al₂O₃-TiC component ceramics, which are typical electronic ceramics used for magnetic memory devices. The hardness of the bonding materials, the adhesion strength between abrasive diamond grains and the bonding materials, and the porosity of sintered body strongly relate to the grinding capacity. The porous bonded grinding wheels showed higher grinding capacity than the conventional wheels. The HIP method enables to fabricate excellent porous metal-bonded grinding wheels.     

Indian Hedgehog in Synovial Fluid Is a Novel Marker for Early Cartilage Lesions in Human Knee Joint

To determine whether there is a correlation between the concentration of Indian hedgehog (Ihh) in synovial fluid (SF) and the severity of cartilage damage in the human knee joints, the knee cartilages from patients were classified using the Outer-bridge scoring system and graded using the Modified Mankin score. Expression of Ihh in cartilage and SF samples were analyzed with immunohistochemistry (IHC), western blot, and enzyme-linked immunosorbent assay (ELISA). Furthermore, we detected and compared Ihh protein levels in rat and mice cartilages between normal control and surgery-induced osteoarthritis (OA) group by IHC and fluorescence molecular tomography in vivo respectively. Ihh expression was increased 5.2-fold in OA cartilage, 3.1-fold in relative normal OA cartilage, and 1.71-fold in OA SF compared to normal control samples. The concentrations of Ihh in cartilage and SF samples was significantly increased in early-stage OA samples when compared to normal samples (r = 0.556; p < 0.001); however, there were no significant differences between normal samples and late-stage OA samples. Up-regulation of Ihh protein was also an early event in the surgery-induced OA models. Increased Ihh is associated with the severity of OA cartilage damage. Elevated Ihh content in human knee joint synovial fluid correlates with early cartilage lesions.     

用于牙硬组织的弥补物材料

生物活性陶瓷或玻璃取代物和生物可降解的有机材料是人工制造的,可以转换成一定形状作为牙硬组织的弥补物,此时嵌进一个生物金属或其他生物材料支撑,是生物相容性的。并被认为有极好的力学性质,对矫形学或牙修补物是有用的。     

环境陶瓷材料

介绍了环境保护的基本要求和国内外环境陶瓷材料的基本情况,重点针对几种环境陶瓷材料在降低污染和消费方面的应用及发展。     

Ceramics for motor building

Simples method for fabricating inexpensive ceramic fibers suitable for reinforcing metal and manufacturing high-porosity ceramic parts with a fiber structure for service in the bottom of ICE pistons are described. Translated from Steklo i Keramika, No. 6, pp. 21–22, June, 2000.     

Ceramics for Milling Bodies

Ceramic materials have been developed with a sintering temperature of 1475 – 1520°C, mean density of 3.55 – 3.75 g/cm³, sealed porosity about 3%, and average strength in three-point bending 250 – 350 MPa. These materials are promising for application as milling bodies. Industrial tests indicated that the wear resistance of the specified materials in milling ceramic paints is 10 – 15 higher that that of uralite milling bodies.     

High-pressure Self-Combustion Sintering for Ceramics

The high-pressure self-combustion sintering process can be used to synthesize and simultaneously sinter ceramics in a very short time by taking advantage of exothermic reactions under high pressure. A dense TiB₂ compact was fabricated in a few seconds by electric ignition on one end of a powdered mixture of Ti and B under 3 GPa.     

工程陶瓷材料磨削加工技术研究

工程陶瓷材料具有优良的物理、化学、力学性能,在许多领域得到广泛的应用。目前,使用金刚石工具(主要是砂轮)的磨削加工是工程陶瓷去除加工的基本途径。本文概述了陶瓷材料磨削加工技术的进展,并对磨削后的陶瓷工件表面损伤进行了分析。