Objective To investigate the effect of femoral condyle sliding osteotomy (FCSO) on the flexion gap and external rotation of the prosthesis in balancing coronal instability during initial total knee arthroplasty (TKA). MethodsBetween November 2021 and October 2024, FCSO technique was applied to balance the coronal medial and lateral spaces during initial TKA in 3 patients, including medial condyle sliding osteotomy (MCSO) and lateral condyle sliding osteotomy (LCSO). There were 1 male and 2 females with the age of 81, 68, and 68 years old. The affected knee has varus or valgus deformity, with tibia-femoral angles of 169.7°, 203.3°, and 162.2°, respectively. The hip-knee-ankle angle (HKA), range of motion (ROM), knee society scoring system (KSS), and pain visual analogue scale (VAS) score were used to evaluate joint function and pain relief. Based on model bone, the thickness and bone bed area of the medial and lateral femoral condyle osteotomy blocks in FCSO were measured. During TKA in 12 patients, the range of osteotomy block movement was evaluated. By simplifying the upward and forward movement of the osteotomy block into a geometric model, the impact of movement on the flexion gap and external rotation of the prosthesis was calculated. Results After application of FCSO during TKA, the limb alignment and medial and lateral balance at extension and flexion positions were restored in 3 patients. Three patients were followed up 23, 11, and 3 months, respectively. Postoperative HKA, pain VAS score, KSS score, and ROM all showed significant improvement compared to preoperative levels. The maximum thickness of osteotomy blocks by MCSO and LCSO was 17 and 12 mm, respectively. The simple upward movement of the osteotomy block mainly affected the extension gap, and had little effect on the flexion gap and external rotation of the prosthesis. Moving the osteotomy block forward at the same time had a significant impact on the flexion gap and external rotation of the prosthesis, especially on LCSO. Mild forward movement leaded to a decrease in external rotation of more than 3°, which had a serious impact on the patellar trajectory. ConclusionFCSO can effectively solve the problem of imbalance between the medial and lateral spaces during initial TKA, avoiding knee joint instability caused by excessive loosening and limiting the use of constrained condylar prosthesis. The distance for the downward movement of the osteotomy block in MCSO and LCSO was 3-5 mm and 6-8 mm, respectively, with 10-15 mm of space for forward movement and almost no space for backward movement. For MCSO, the upward and forward movement of the osteotomy block will increase the external rotation of the prosthesis, which is beneficial for improving the patellar trajectory and suitable for valgus knee. LCSO is suitable for varus knee, and the osteotomy block only slides vertically up and down without moving forward and backward.
目的:探討液相芯片檢測胰腺炎患者外周血中細胞因子濃度的可行性,及其在胰腺炎中的臨床應用價值。方法: 收集90例胰腺炎患者(包括重癥和輕癥)和30例正常對照者的外周血,離心提取血清,利用液相芯片檢測血清中細胞因子IL10,IL6,TNFα的濃度,比較不同程度炎癥患者以及與對照之間細胞因子的濃度差異,分析血清中細胞因子濃度差異與臨床表現之間的關系。結果:液相芯片可以方便地在僅25 μl的血清樣本中同時準確檢測這三種細胞因子的含量,檢測的有效范圍為0.10～2000 pg/mL。IL10 的濃度在對照、輕型和重型胰腺炎組中分別為51.97±31.72 pg/mL, 32.88±9.70 pg/mL和3.57±0.99 pg/mL, 輕型組與重型組間以及重型組和對照間差異有顯著性(P lt; 005)。IL10在發病三天內和三天后的濃度分別為 42.47±10.15 pg/mL和12.28±5.04 pg/mL, 兩者間差異有顯著性(P lt; 0.01). Il6 的濃度在三天后從60.90±24.37 pg/mL下降到34.52±13.57 pg/mL,但差異沒有顯著性(Pgt;0.05);TNF-α的濃度在各組間沒有顯著差異(Pgt;0.05)。結論:液相芯片檢測技術可以快速準確的檢測少量血樣標本中IL10,IL-6,TNFα等細胞因子的濃度,在胰腺炎患者中細胞因子IL-10的濃度與胰腺炎輕重程度以及患病時間密切相關,IL-10的濃度可以作為該病臨床處理的依據和藥物療效的監測指標。
After the Wenchuan Earthquake on May 12th, 2008, under the b leadership of the SichuanProvincial Party Committee, the People’s Government of Sichuan Province, and the Ministry of Health of the People’sRepublic of China, the Medical Security Team working at the Sichuan Provincial Headquarters for Wenchuan Earthquakeand Disaster Relief Work constructed a secure medical material distribution system through coordination and interactionamong and between regions, systems, and departments.