目的:探讨液相芯片检测胰腺炎患者外周血中细胞因子浓度的可行性,及其在胰腺炎中的临床应用价值。方法: 收集90例胰腺炎患者(包括重症和轻症)和30例正常对照者的外周血,离心提取血清,利用液相芯片检测血清中细胞因子IL10,IL6,TNFα的浓度,比较不同程度炎症患者以及与对照之间细胞因子的浓度差异,分析血清中细胞因子浓度差异与临床表现之间的关系。结果:液相芯片可以方便地在仅25 μl的血清样本中同时准确检测这三种细胞因子的含量,检测的有效范围为0.10～2000 pg/mL。IL10 的浓度在对照、轻型和重型胰腺炎组中分别为51.97±31.72 pg/mL, 32.88±9.70 pg/mL和3.57±0.99 pg/mL, 轻型组与重型组间以及重型组和对照间差异有显著性(P lt; 005)。IL10在发病三天内和三天后的浓度分别为 42.47±10.15 pg/mL和12.28±5.04 pg/mL, 两者间差异有显著性(P lt; 0.01). Il6 的浓度在三天后从60.90±24.37 pg/mL下降到34.52±13.57 pg/mL,但差异没有显著性(Pgt;0.05);TNF-α的浓度在各组间没有显著差异(Pgt;0.05)。结论:液相芯片检测技术可以快速准确的检测少量血样标本中IL10,IL-6,TNFα等细胞因子的浓度,在胰腺炎患者中细胞因子IL-10的浓度与胰腺炎轻重程度以及患病时间密切相关,IL-10的浓度可以作为该病临床处理的依据和药物疗效的监测指标。
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.
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.