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反式全肩关节置换术治疗肩袖关节病患者的早期临床疗效
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作者 任世祥 张博 +2 位作者 马德思 周磊 林源 《中华外科杂志》 CAS CSCD 北大核心 2019年第2期124-128,共5页
目的探讨反式全肩关节置换术治疗肩袖关节病患者的临床疗效。方法回顾性分析2012年1月至2017年6月在首都医科大学附属北京朝阳医院骨科行反式全肩关节置换的肩袖关节病患者12例(12肩)的临床资料,其中男性8例,女性4例,年龄69.4岁(范围:64... 目的探讨反式全肩关节置换术治疗肩袖关节病患者的临床疗效。方法回顾性分析2012年1月至2017年6月在首都医科大学附属北京朝阳医院骨科行反式全肩关节置换的肩袖关节病患者12例(12肩)的临床资料,其中男性8例,女性4例,年龄69.4岁(范围:64~73岁),手术均采用常规方式,术中修补肩胛下肌,肱二头肌肌腱止点重建。患者于术后1、3、6、12个月门诊复查,此后每年复查一次,统计患者术前及末次随访时的美国肩肘外科协会(ASES)评分、加州大学洛杉矶分校(UCLA)评分,记录并发症的情况及影像学检查结果。数据分析采用配对样本t检验。结果12例患者均获得随访,随访时间(34.7±18.1)个月(范围:3~66个月)。末次随访时,患者ASES评分由术前的(58.2±8.2)分提升至(92.9±2.9)分(t=14.32,P=0.00),UCLA评分由术前的(13.2±1.5)分提升至(30.8±1.7)分(t=23.14,P=0.00),手术前后差异有统计学意义。影像学检查未见明显假体松动病例,无肩关节脱位、感染等并发症发生。结论反式全肩关节置换术治疗肩袖关节病可获得良好的临床效果。 展开更多
关键词 关节成形术 置换 反式肩关节 肩袖损伤 关节炎
除痹通络汤外用配合循经推拿对颈肩腰腿痛患者的影响 预览
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作者 王波 张凯 《西部中医药》 2019年第7期113-117,共5页
目的:探讨除痹通络汤外用配合循经推拿治疗颈肩腰腿痛的远期疗效及对其疼痛程度和关节功能恢复的影响。方法:将颈肩腰腿痛患者136例按照随机数字表法分为观察组和对照组各68例,2组均给予常规治疗,在此基础上对照组给予循经推拿治疗,观... 目的:探讨除痹通络汤外用配合循经推拿治疗颈肩腰腿痛的远期疗效及对其疼痛程度和关节功能恢复的影响。方法:将颈肩腰腿痛患者136例按照随机数字表法分为观察组和对照组各68例,2组均给予常规治疗,在此基础上对照组给予循经推拿治疗,观察组在对照组治疗的基础上配合除痹通络汤外用治疗。10天1个疗程,2组均治疗4个疗程,随访1年。观察2组患者中医证候积分、日常生活能力(ADL)、睡眠质量(PSQI)、疼痛程度(VAS)、腰椎功能(JOA)、肢体运动功能(FMA)、肩关节功能(C-M)及远期疗效。结果:治疗后2组患者中医证候积分低于治疗前(P<0.05),且观察组低于对照组(P<0.05);观察组远期总有效率为91.2%,高于对照组的77.9%(P<0.05);治疗后2组患者ADL、JOA、FMA、C-M评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05);2组患者PSQI、VAS评分低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。结论:除痹通络汤外用配合循经推拿能有效促进颈肩腰腿痛患者关节功能恢复,减轻其疼痛程度,提高临床疗效。 展开更多
关键词 颈肩腰腿痛 关节功能 疼痛程度 远期疗效 除痹通络汤 循经推拿
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关节镜下TightRope固定与锁骨钩钢板固定治疗NeerⅡ型锁骨远端骨折的比较 预览
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作者 吴程 夏亚卿 +2 位作者 王建吉 刘日光 范建楠 《中国组织工程研究》 CAS 北大核心 2019年第32期5117-5125,共9页
背景:TightRope固定装置已被广泛用于治疗肩锁关节脱位。国外有少量文献报道将其应用到NeerⅡ型锁骨远端骨折,但缺乏其与传统锁骨钩钢板治疗方式的对比研究。目的:观察并比较关节镜下TightRope固定与锁骨钩钢板固定治疗NeerⅡ型锁骨远... 背景:TightRope固定装置已被广泛用于治疗肩锁关节脱位。国外有少量文献报道将其应用到NeerⅡ型锁骨远端骨折,但缺乏其与传统锁骨钩钢板治疗方式的对比研究。目的:观察并比较关节镜下TightRope固定与锁骨钩钢板固定治疗NeerⅡ型锁骨远端骨折的临床疗效。方法:研究对象选自贵州医科大学附属医院2015年10月至2018年2月收治的26例NeerⅡ型锁骨远端骨折的患者。治疗组12例行关节镜下TightRope绊钢板内固定,对照组14例行锁骨钩钢板内固定。比较两组患者自入院至固定后1年内的围术期指标、疼痛评分、肩关节功能评分,影像学结果及不良反应发生情况。结果与结论:TightRope固定组固定后6,12个月的牛津肩关节评分(OSS)、加州大学肩关节等级评分(UCLA)及Constant-Murley肩关节功能评分(CMS)优于锁骨钩钢板组(P<0.05)。TightRope固定组固定后3,6个月的肩关节前屈外展活动范围优于锁骨钩钢板组(P<0.05)。TightRope固定组有1例固定后3个月复查提示有骨折端的愈合欠佳,固定后6个月复查示骨折愈合。锁骨钩钢板组有1例发生骨不连,2例有明显肩部疼痛,1例肩关节外展活动受限,去除内固定后均有缓解。结果显示,关节镜下TightRope固定作为一种微创手术更具优势,损伤小、疼痛轻、功能恢复更好,且不需二次手术取出内固定物,患者满意度高。临床试验方案于2019-05-15通过贵州医科大学附属医院临床试验伦理委员会批准(伦理批准号:2019伦申第226号)。 展开更多
关键词 锁骨远端骨折 喙锁韧带 关节镜 锁骨钩钢板 TIGHTROPE 肩关节 肩锁关节脱位 微创手术 内固定 愈合
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Is CT scan a predictor of instability in recurrent dislocation shoulder?
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作者 K.P.Shijith Munish Sood +1 位作者 Ajay Deep Sud Amresh Ghai 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期177-181,共5页
Purpose: Glenoid bone defect and the defect on the posterior-superior surface of the humerus “Hill- Sachs lesion” are the commonly seen bony lesions in patients with recurrent dislocation shoulder. Computed tomograp... Purpose: Glenoid bone defect and the defect on the posterior-superior surface of the humerus “Hill- Sachs lesion” are the commonly seen bony lesions in patients with recurrent dislocation shoulder. Computed tomography (CT) scan is considered as the best option in assessing the bony defects in the recurrent dislocation shoulder. The aim of this study was to assess the clinical and radiological corelation in the patients with recurrent dislocation shoulder. Methods: Forty-four patients of recurrent dislocation shoulder who were evaluated between January 2015 and December 2017 at a tertiary care center, clinically and radiologically using CT scan and meeting the inclusion criteria, were included. The correlation between the clinical history of the number of dislocations and the bone loss using CT scan was evaluated. Two sided statistical tests were performed at a significance level of α=0.05. The analysis was conducted using IBM SPSS STATISTICS (version 22.0). Results: All the patients were male with mean age of 25.95 (SD ± 4.2) years were evaluated. Twenty-four patients sustained injury in sporting activities while 20 patients sustained injury in training. There were an average of 4.68 (SD ± 3.1, range 2e15, median 3) episodes of dislocation. Forty-one patients had the glenoid bone loss while 40 had the Hill-Sachs lesions. The mean glenoid width defect was 10.80%(range 0e27%) while the mean Hill-Sachs defect was 14.27 mm (range 0e26.6 mm). The mean area of bone loss of the glenoid surface was 10.81%(range 0e22.4%). The lesions were on track in 34 patients and off track in 10 patients. Conclusions: CT scan of the shoulder joint is an effective method for assessing the amount of bone loss. The number of dislocations are correlated significantly with off-track lesions and the amount of bone loss on the glenoid and Hill-Sachs lesion. The glenoid width bone loss of more than 9.80% or Hill-Sachs defect of more than 14.80 mm are the critical defects after which the frequency of dislocations increases. 展开更多
关键词 SHOULDER joint RECURRENT DISLOCATION HILL-SACHS LESION
康复护理在中老年颈肩腰腿痛中的临床应用价值体会
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作者 胡婵 《智慧健康》 2019年第15期42-43,共2页
目的探讨对中老年颈肩腰腿痛患者给予康复护理后获得的临床效果。方法选择我院2015年05月至2018年06月收治的74例中老年颈肩腰腿痛患者作为实验对象;采用抽签法分组后进行护理对策研究;对照组(37例):基础护理对策;观察组(37例):基础护... 目的探讨对中老年颈肩腰腿痛患者给予康复护理后获得的临床效果。方法选择我院2015年05月至2018年06月收治的74例中老年颈肩腰腿痛患者作为实验对象;采用抽签法分组后进行护理对策研究;对照组(37例):基础护理对策;观察组(37例):基础护理对策+康复护理对策;最终就护理结果展开对比。结果同对照组中老年颈肩腰腿痛患者运动功能改善总有效率以及疼痛评分对比,观察组获得显著改善(P<0.05)。结论护理人员对于中老年颈肩腰腿痛患者给予康复护理干预,对于运动功能改善以及疼痛减轻效果显著,值得广泛应用。 展开更多
关键词 康复护理 中老年颈肩腰腿痛 临床效果
Bank gully extraction from DEMs utilizing the geomorphologic features of a loess hilly area in China
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作者 Xin YANG Jiaming NA +2 位作者 Guoan TANG Tingting WANG Axing ZHU 《地球科学前沿:英文版》 SCIE CAS CSCD 2019年第1期151-168,共18页
As one of most active gully types in the Chinese Loess Plateau,bank gullies generally indicate soil loss and land degradation.This study addressed the lack of detailed,large scale monitoring of bank gullies and propos... As one of most active gully types in the Chinese Loess Plateau,bank gullies generally indicate soil loss and land degradation.This study addressed the lack of detailed,large scale monitoring of bank gullies and proposed a semi-automatic method for extracting bank gullies,given typical topographic features based on 5 m resolution DEMs.First,channel networks,including bank gullies,are extracted through an iterative channel bum-in algorithm.Second,gully heads are correctly positioned based on the spatial relationship between gully heads and their corresponding gully shoulder lines.Third,bank gullies are distinguished from other gullies using the newly proposed topographic measurement of "relative gully depth (RGD)."The experimental results from the loess hilly area of the Linjiajian watershed in the Chinese Loess Plateau show that the producer accuracy reaches 87.5%. The accuracy is affected by the DEM resolution and RGD parameters,as well as the accuracy of the gully shoulder line.The application in the Madigou watershed with a high DEM resolution validated the duplicability of this method in other areas.The overall performance shows that bank gullies can be extracted with acceptable accuracy over a large area,which provides essential information for research on soil erosion,geomorphology,and environmental ecology. 展开更多
关键词 BANK GULLY DEMS topographic FEATURES LOESS SHOULDER line relative GULLY depth
关节镜止点重建术治疗中老年肩关节盂唇损伤的初步疗效 预览
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作者 张博 林源 +1 位作者 王志为 任世祥 《中华关节外科杂志(电子版)》 CAS CSCD 2019年第3期273-277,共5页
目的 探讨关节镜下肌腱固定术治疗Ⅱ型肩关节盂唇上部从前到后的损伤(SLAP)的新方法并评价其初步临床疗效。方法 回顾性分析2012年9月至2015年2月因肩部疼痛于北京朝阳医院骨科行肩关节镜手术的中老年患者共计75例。纳入标准为:年龄大... 目的 探讨关节镜下肌腱固定术治疗Ⅱ型肩关节盂唇上部从前到后的损伤(SLAP)的新方法并评价其初步临床疗效。方法 回顾性分析2012年9月至2015年2月因肩部疼痛于北京朝阳医院骨科行肩关节镜手术的中老年患者共计75例。纳入标准为:年龄大于40岁,保守治疗3个月无效,体格及影像学检查满足Ⅱ型SLAP损伤合并有肩袖损伤的临床诊断;排除标准为:肩关节不稳或曾经行肩部手术的患者,以及因精神系统问题不能配合的患者。记录术前及最后一次随访时患者的美国肩肘外科协会评分(ASES)、加州大学洛杉矶分校评分(UCLA)以及出现不良事件的情况,并采用配对 t 检验进行术前及术后评分的差异性分析。结果 最终纳入66例患者(男38例,女28例),平均年龄(56±11)岁,平均随访时间为(17±8)月。患者术前ASES及UCLA评分分别为(62.3±6.6)分、(12.1±2.3)分,最后一次随访时分别为(93.7±4.6)分、(31.3±2.8)分,术后随访结果同术前相比,ASES( t =15.46, P <0.05)及UCLA( t =22.19, P <0.05)评分差异有显著的统计学意义。结论 利用带线锚钉配合界面螺钉重建二头肌腱止点治疗SLAP损伤合并肩袖损伤的方法安全、可靠,可以降低手术失败率,并获得良好的临床效果。 展开更多
关键词 回旋套 创伤和损伤 肌腱固定术 肩关节 关节镜
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Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report 预览
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作者 Cosmin Ioan Faur Bogdan Anglitoiu Ana-Maria Ungureanu 《世界临床病例杂志》 2019年第7期849-854,共6页
BACKGROUND Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral hea... BACKGROUND Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The “mandatory” treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. However, the results in these cases do not approach those seen in classical dislocations. CASE SUMMARY This case report is the first description of an anterior open glenohumeral dislocation without associated fractures, but with complete avulsion of the soft tissue envelope of the proximal humerus. Surgical treatment consisted of copious lavage with saline solution, meticulous debridement of the nonviable soft tissues, reduction of the dislocated humeral head and reconstruction of the soft tissue envelope of the humeral head. The selected surgical approach was an inferior extension of the wound at the level of the delto-pectoral groove, as the best choice to be able to perform an adequate debridement and capsulo-tendinous reinsertion. At 6 mo there were no clinical signs of instability of the glenohumeral joint, the functionality of the joint was restricted to 90o of anterior elevation, internal rotation to L2, with severe limitation of abduction (60o) and external rotation (0o) but without residual pain, with an Oxford shoulder Score of 28. CONCLUSION Thorough reconstruction of the soft tissues surrounding the shoulder joint and an early rehabilitation program are key points to a good functional result. 展开更多
关键词 OPEN shoulder DISLOCATION Case report Functional impairment Surgical treatment AVASCULAR necrosis
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Combination of fire needle and filiform needle for frozen shoulder in different clinical stages
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作者 高艳 刘美颖 +3 位作者 王爽 陈跃辉 解秸萍 冀美琦 《世界针灸杂志:英文版》 CSCD 2019年第2期119-122,共4页
Objective:To observe the clinical efficacy of fire needle combined with filiform needle for different clinical stage frozen shoulders,and to choose the best treatment opportunity for clinical treatment of frozen shoul... Objective:To observe the clinical efficacy of fire needle combined with filiform needle for different clinical stage frozen shoulders,and to choose the best treatment opportunity for clinical treatment of frozen shoulder.Methods:120 patients with frozen shoulders who met the inclusion criteria were numbered according to the visiting order.They were randomized into control group(60 cases)and treatment group(60 cases)according to the random number table.Both groups were treated with filiform needles once every other day and 3 times a week,and a course of treatment included 6 times and 2 courses were taken.The treatment group was treated by applying a fire needling point bloodletting on the local tender points once a week.Jiānyú(肩髃 LI 15),Jiānliáo(肩髎 TE 14),Jiānzhēn(肩贞 SI 9),Tiáokǒu(条口 ST 38),and local tender points were taken according to different meridian pains.The clinical efficacy of the frozen shoulder patients in the two groups in different clinical stages was compared.The evaluation indicators were scores of pain,joint activity range and activities of daily living,as well as clinical efficacy of traditional Chinese medicine.Results:After treatment,the total scores of hundred-mark five-grade in both groups were significantly higher than those before treatment,and the differences were statistically significant(Treatment group82.02 ± 14.23 vs 43.37 ± 22.10,Control group 66.80 ± 18.98 vs 42.67 ± 23.03,both P<0.01),and the total score of the treatment group was significantly higher than the control group(P<0.01).The hundred-mark five-grade assessment scores after treatment in the treatment group during the frozen stage were significantly higher than the control group(77.2± 14.40 vs 68.43 ± 16.94,P<0.01);as to the clinical efficacy,the total effective rate of the treatment group was higher than the control group,and the difference was statistically significant(91.67% vs 76.67%,P<0.01);The total effective rate of the control group in the acute stage and functional recovery stage was co 展开更多
关键词 PERIARTHRITIS of the SHOULDER CLINICAL STAGE Fire NEEDLE FILIFORM NEEDLE
自拟中药汤剂熏蒸联合针灸治疗颈肩腰腿痛的效果评价 预览
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作者 张先才 《中医临床研究》 2019年第9期129-131,共3页
目的:评价自拟中药汤剂熏蒸联合针灸治疗颈肩腰腿痛的效果。方法:研究对象为颈肩腰腿痛患者,例数80 例,采用抽签分组方式对研究对象80 例进行分组,患者收取时间在2015 年10 月2 日- 2016 年2 月10 日,分为观察组(40 例)、对照组(40 例)... 目的:评价自拟中药汤剂熏蒸联合针灸治疗颈肩腰腿痛的效果。方法:研究对象为颈肩腰腿痛患者,例数80 例,采用抽签分组方式对研究对象80 例进行分组,患者收取时间在2015 年10 月2 日- 2016 年2 月10 日,分为观察组(40 例)、对照组(40 例),分别实施自拟中药汤剂熏蒸联合针灸治疗以及常规治疗,将两组患者的总有效率、JOA 评分和VAS 评分进行对比。结果:观察组颈肩腰腿痛患者的总有效率95.00%(其中显效患者30 例、有效患者8 例、无效患者2 例)高于对照组患者75.00%(P < 0.05);治疗后观察组颈肩腰腿痛患者的JOA 评分高于对照组患者(P < 0.05);观察组颈肩腰腿痛患者治疗后VAS 评分低于对照组(P < 0.05)。结论:通过对颈肩腰腿痛患者实施自拟中药汤剂熏蒸联合针灸治疗后,取得显著效果,能提高患者总有效率,降低患者疼痛感,改善患者JOA 评分,促进患者早期康复。 展开更多
关键词 自拟中药汤剂熏蒸 针灸 颈肩腰腿痛 评价
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高速铁路路肩结构的施工方法创新分析 预览
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作者 李忠玉 《高速铁路技术》 2019年第2期100-104,共5页
高速铁路路基电缆槽采用的钢筋混凝土在工厂预制,待路基基床表层施工完毕后,采用切割的方法把路肩位置填筑好的路基表层填筑体去除,然后再在切割面上施工电缆槽和路基护肩。路基表层填筑材料为级配碎石,由于其强度较大,造成切割困难、... 高速铁路路基电缆槽采用的钢筋混凝土在工厂预制,待路基基床表层施工完毕后,采用切割的方法把路肩位置填筑好的路基表层填筑体去除,然后再在切割面上施工电缆槽和路基护肩。路基表层填筑材料为级配碎石,由于其强度较大,造成切割困难、效率低、影响环境等问题。针对这些问题,本文通过研究,提出了高速铁路路基电缆槽及护肩结构新的施工方法,解决了传统施工存在的技术问题,对工程实践具有重要的借鉴意义。 展开更多
关键词 高速铁路 路肩 结构 创新 施工方法
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反式肩关节置换治疗陈旧性肱骨近端骨折伴肱骨头缺如1例 预览
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作者 谢尚举 曹国平 +1 位作者 全仁夫 汪灿峰 《中国骨伤》 CAS CSCD 2019年第8期746-749,共4页
患者,女,48岁,因左肩关节疼痛伴活动不利3年余,加重2个月入院。患者3年前因外伤致左肱骨近端粉碎性骨折,当时因要求保守治疗未及时手术。3年来左肩关节间歇性疼痛,症状时轻时重,活动时疼痛加重,长期服用非甾体类镇痛药物缓解症状。左肩... 患者,女,48岁,因左肩关节疼痛伴活动不利3年余,加重2个月入院。患者3年前因外伤致左肱骨近端粉碎性骨折,当时因要求保守治疗未及时手术。3年来左肩关节间歇性疼痛,症状时轻时重,活动时疼痛加重,长期服用非甾体类镇痛药物缓解症状。左肩关节外观畸形,功能基本丧失,无法完成前臂抬举、梳头、进食等基本生活动作。后曾至多家医院就诊,均建议行肩关节置换手术治疗。近2个月来患者因轻度外伤致左肩关节疼痛加剧,左上肢活动明显受限,静息时易感疼痛,影响正常睡眠,遂来我院就诊。患者既往有先天性脊柱侧弯病史;高血压及糖尿病10余年,平时血压及血糖控制尚可。素来无重体力劳动,无吸烟饮酒等不良嗜好。 展开更多
关键词 关节成形术 置换 肱骨骨折 病例报告
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Experimental and numerical investigations of bonding interface behavior in stationary shoulder friction stir lap welding
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作者 Q.wen W.Y.Li +3 位作者 W.B.Wang F.F.Wang Y.J.Gao V.Patel 《材料科学技术学报:英文版》 SCIE EI CAS CSCD 2019年第1期192-200,共9页
Stationary shoulder friction stir lap welding(SSFSLW) was employed to weld 2024 aluminum alloy. A coupled Eulerian-Lagrangian(CEL) model was developed to investigate the lap interface behavior during SSFSLW. Numerical... Stationary shoulder friction stir lap welding(SSFSLW) was employed to weld 2024 aluminum alloy. A coupled Eulerian-Lagrangian(CEL) model was developed to investigate the lap interface behavior during SSFSLW. Numerical results of material movement and equivalent plastic strain were in good agreement with the experimental work. With increasing welding speed, the distances from the hook tip to the top surface of the upper workpiece on the retreating side(RS) and the advancing side(AS) increase, while the distance between two wave-shaped alclads decreases. A symmetric interface bending is observed on the AS and the RS during plunging, while the interface bending on the AS is bigger than that on the RS during welding. The peak temperature of the interface on the AS is higher than that on the RS. The equivalent plastic strain gradually increases as the distance to the weld center decreases, and its peak value is obtained near the bottom of the weld. 展开更多
关键词 STATIONARY SHOULDER FRICTION STIR LAP welding Coupled Eulerian-Lagrangian Temperature field Material distribution EQUIVALENT plastic strain
基于Abaqus软件的轮胎有限元模型建立及仿真分析 预览
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作者 宿晓峰 付平 +2 位作者 丁忠军 李德威 杨明飞 《橡胶工业》 CAS 2019年第2期121-127,共7页
基于Abaqus软件建立轮胎有限元模型,对305/75R24. 5全钢载重子午线轮胎的充气外缘尺寸、胎肩应力分布、带束层应力分布、胎圈与轮辋接触应力分布进行预测分析。有限元仿真结果表明:轮胎的充气外缘尺寸符合国家标准要求,静负荷状态下沉... 基于Abaqus软件建立轮胎有限元模型,对305/75R24. 5全钢载重子午线轮胎的充气外缘尺寸、胎肩应力分布、带束层应力分布、胎圈与轮辋接触应力分布进行预测分析。有限元仿真结果表明:轮胎的充气外缘尺寸符合国家标准要求,静负荷状态下沉率满足轮胎的整体刚度要求;胎肩应力最大处位于3~#带束层端部;在充气和静负荷状态下,2~#带束层的应力均小于3~#带束层;胎圈与轮辋过盈配合处及其周围应力较大。 展开更多
关键词 全钢载重子午线轮胎 有限元分析 胎肩 带束层 应力分布 模型 仿真
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声辐射力脉冲成像评估针灸治疗肩部肌筋膜疼痛综合征的预后 预览
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作者 马小琳 《影像研究与医学应用》 2019年第9期76-78,共3页
目的:探讨声辐射力脉冲弹性成像(ARFI)技术评估针灸治疗肩部肌筋膜疼痛综合征(MPS)的预后效果。方法:选择105例肩部MPS患者进行为期10天的针灸治疗,治疗结束后在停止止痛药的服用前提下,进行ARFI和简式疼痛评分量表(SF-MPQ)双重评估,分... 目的:探讨声辐射力脉冲弹性成像(ARFI)技术评估针灸治疗肩部肌筋膜疼痛综合征(MPS)的预后效果。方法:选择105例肩部MPS患者进行为期10天的针灸治疗,治疗结束后在停止止痛药的服用前提下,进行ARFI和简式疼痛评分量表(SF-MPQ)双重评估,分析两者的交互作用以及相关性。结果:ARFI模式检测的SWV值与SF-MPQ评分存在交互作用(F交互=3.267,P交互=0.042),具有良好的相关性(r=0.786,P=0.000)。结论:ARFI技术是评估针灸治疗肩部肌筋膜疼痛综合征患者预后效果的潜在方法。 展开更多
关键词 声辐射力脉冲成像 肌筋膜疼痛综合征
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肩袖滑囊面Ⅱ度撕裂单纯清理术与双滑轮缝合处理的疗效比较 预览
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作者 范国明 陈刚 +4 位作者 潘界恩 黄成龙 沈杰 尹海波 徐海超 《中国内镜杂志》 2019年第3期39-43,共5页
目的比较关节镜下单纯清理与双滑轮缝合治疗肩袖滑囊面Ⅱ度撕裂的临床疗效。方法收集2014年6月-2016年6月68例肩袖滑囊面Ⅱ度撕裂患者进行回顾性分析。按处理方式分为两组,单纯清理组(n=34)和双滑轮缝合组(n=34),比较两组术后视觉模拟评... 目的比较关节镜下单纯清理与双滑轮缝合治疗肩袖滑囊面Ⅱ度撕裂的临床疗效。方法收集2014年6月-2016年6月68例肩袖滑囊面Ⅱ度撕裂患者进行回顾性分析。按处理方式分为两组,单纯清理组(n=34)和双滑轮缝合组(n=34),比较两组术后视觉模拟评分(VAS)、Constant评分和美国肩肘外科评分(ASES)和撕裂扩大情况。结果所有患者术后随访6~22个月(平均13.3个月)。单纯清理组:VAS评分由术前(7.35±0.83)分降至末次随访时(1.12±2.11)分,ASES评分由术前(48.88±12.19)分提高至末次随访时(90.80±16.10)分,Constant评分由术前(48.38±18.02)分提高至末次随访时的(88.02±11.77)分。前屈上举活动度从术前(78.40±25.60)°提高到术后(168.20±10.20)°,外展上举从术前(73.30±32.10)°到术后(171.00±7.50)°。缝合组:VAS评分由术前(8.04±1.72)分降至末次随访时(1.05±1.88)分,ASES评分由术前(51.99±14.10)分提高至末次随访时(88.78±10.10)分,Constant评分由术前(49.56±18.49)分提高至末次随访时的(87.12±12.06)分。前屈上举活动度从术前(75.40±33.50)°提高到术后(170.50±12.00)°,外展上举从术前(70.50±25.50)°提高到术后(169.50±20.70)°。单纯清理组和缝合组末次随访与术前比较,临床疗效差异有统计学意义(P <0.01),术后两组间差异无统计学意义(P>0.05)。撕裂扩大程度,单纯清理组6例(17.6%),缝合组1例(2.9%)。结论关节镜下单纯清理与双滑轮缝合治疗肩袖滑囊面Ⅱ度撕裂,均能取得满意的临床疗效,缝合技术在防止肩袖扩大撕裂上可能存在一定的优势,但不是临床上患者满意的主要因素。 展开更多
关键词 肩袖 关节镜检查 缝合技术
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心律失常引发意识障碍致肩关节后脱位伴骨折1例报道及文献回顾 预览
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作者 马蔓 陈建海 +6 位作者 张一翀 张晓萌 王艳华 寇玉辉 饶峰 陈小锋 张殿英 《中华骨与关节外科杂志》 2019年第4期294-297,共4页
肩关节后脱位的主要原因是高能量损伤,交通事故、高处坠落等[1]。另外,电击伤、癫痫、药物或酒精戒断症状发作甚至糖尿病低血糖发作也可导致肱骨头后脱位,也有骨囊肿造成病理性骨折合并肩关节后脱位的报道[2-4]。
关键词 肩关节 后脱位 骨折 改良McLaughlin手术
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倒T型支挡结构在路肩病害整治中的应用 预览
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作者 侯海方 祁华 《高速铁路技术》 2019年第1期74-77,共4页
路基持续下沉易导致路肩宽度不足,常规的路肩加宽方法施工速度缓慢,对既有铁路行车影响较大,且无法缓解下沉迹象,因此有必要研究一种新型的路肩加宽整治方法。文章系统总结既有铁路路肩宽度不足的原因,对比分析常见路肩加宽整治方法的... 路基持续下沉易导致路肩宽度不足,常规的路肩加宽方法施工速度缓慢,对既有铁路行车影响较大,且无法缓解下沉迹象,因此有必要研究一种新型的路肩加宽整治方法。文章系统总结既有铁路路肩宽度不足的原因,对比分析常见路肩加宽整治方法的优缺点,研究提出一种现浇倒T型支挡结构,该结构施工简便、安全性高、工期短,可同时用于整治既有铁路路肩宽度不足及路基下沉等病害。该结构已成功应用于宁波北环线路肩整治工程,整治效果显著。 展开更多
关键词 既有铁路 路基 路肩 倒T 型支挡结构
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Comparison between direct repair and human acellular nerve allografting during contralateral C7 transfer to the upper trunk for restoration of shoulder abduction and elbow flexion 预览
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作者 Liang Li Wen-Ting He +3 位作者 Ben-Gang Qin Xiao-Lin Liu Jian-Tao Yang Li-Qiang Gu 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第12期2132-2140,共9页
Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct re... Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion 展开更多
关键词 NERVE REGENERATION CONTRALATERAL C7 NERVE root TRANSFER NERVE graft brachial plexus avulsion injury direct REPAIR human acellular NERVE allograft shoulder function elbow function NERVE TRANSFER phrenic NERVE accessary NERVE neural REGENERATION
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颈肩腰腿痛物理治疗的方法与临床效果分析
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作者 郭安玲 《双足与保健》 2019年第12期103-104,共2页
目的探讨颈肩腰腿痛物理治疗的临床价值。方法选取该院2017年12月—2018年12月收取的88例颈肩腰腿痛患者,以简单随机法分为研究组和对照组各44例,对照组予以常规治疗,研究组在此基础上予以物理治疗,对两组患者的治疗有效率、治疗后疼痛... 目的探讨颈肩腰腿痛物理治疗的临床价值。方法选取该院2017年12月—2018年12月收取的88例颈肩腰腿痛患者,以简单随机法分为研究组和对照组各44例,对照组予以常规治疗,研究组在此基础上予以物理治疗,对两组患者的治疗有效率、治疗后疼痛感评分以及治疗依存性做观察比较。结果研究组患者的治疗有效率明显高于对照组,差异有统计学意义(P<0.05);研究组患者的治疗后疼痛感评分明显小于对照组,差异有统计学意义(P<0.05);研究组患者的治疗依存性明显高于对照组,差异有统计学意义(P<0.05)。结论颈肩腰腿痛物理治疗具有显著的临床效果,能够有效地减轻患者的疼痛感,提升治疗效果和患者的生活质量,提高患者的治疗依存性,值得临床推荐。 展开更多
关键词 颈肩腰腿痛 物理治疗 临床效果
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