In the early development of skull repair, flannel and gold sheet were used, but the effect was not good.
The rapid development of skull repair materials really came after the 19th century. In the 19th century, a foreign medical expert used animal bone materials to repair the skull, but it was quickly abandoned because of its easy absorption, easy infection, foreign body reaction and psychological disorder. At that end of the 19th century, the metal used include gold, silver, aluminum, lead, platinum, tantalum, live alloy, stainless steel, etc., which were eliminated because most of them could be corroded, conduct heat, and were relatively impervious to X-ray and foreign body reactions. Later developed light apatite, calcium phosphate cement, plexiglass, etc., also failed to achieve ideal results, and are generally not used now.
At present, the widely used titanium mesh material has made some progress compared with the traditional materials, but there are still many shortcomings and problems. It is worth mentioning that the PEEK material used by Professor Mu Cangshan in neurosurgery of cerebrovascular disease in Aviation General Hospital has become the darling of skull repair. This kind of PEEK is a polymer material, which has good biocompatibility, complex plasticity, excellent mechanical properties, good protective performance and high postoperative comfort, and has gradually become the latest trend of skull repair materials. Second, what is vertebroplasty
percutaneousvertebroplasty,PVP) is a minimally invasive spinal surgery technique, which aims at increasing the strength and stability of vertebral body, avoiding collapse, relieving pain and even partially recovering the height of vertebral body by injecting bone cement into the vertebral body through the pedicle or outside the pedicle.
Vertebroplasty, as an open operation, has been used to strengthen pedicle screws and fill the defects left after tumor resection for several decades. Percutaneous kyphoplasty is to inject bone tissue or bone cement into the vertebral body to enhance its structural strength mechanically.
In some cases, because of the high risk of open surgery, both doctors and patients stopped, so percutaneous vertebroplasty (PVP) appeared. Percutaneous vertebroplasty inherits the advantages of vertebroplasty without complications related to open surgery.
This operation was first performed by Galibert and Deramond in the Medical Radiology Department of Amiens University in France in 1984. A patient with cervical vertebral hemangioma was successfully treated by percutaneous injection of polymethyl-methacrylatePMMA, which was the first percutaneous vertebroplasty. Neuroradiologists and neurosurgeons in the Affiliated Hospital of the University of Lyon, France, used a slightly improved technique (18G) to inject bone cement into the vertebral body of 7 patients, including 2 cases of vertebral hemangioma, 1 case of spinal metastatic tumor and 4 cases of osteoporotic vertebral compression fracture.
Results The pain of 7 patients was relieved, 1 case was good and 6 cases were excellent. In 1989, Kaemmerlen and others reported that this technique was used to treat vertebral metastases. Among 2 patients with vertebral metastases, 16 patients achieved remarkable results, 2 patients were ineffective, and 2 patients had complications. The author believes that painful osteolytic vertebral metastases without pedicle invasion is one of the best surgical indications for percutaneous vertebroplasty.
in 1994, PVP (using the method of Deramond) was first introduced to the United States by the University of Virginia. Since then, PVP has become a commonly used method to treat painful vertebral diseases.
The use of percutaneous vertebroplasty is gradually promoted, except for vertebral hemangioma, myeloma and osteolytic metastasis, it is more used in patients with osteoporotic vertebral compression fracture accompanied by stubborn pain. With the extension of the survival time of patients with tumor metastasis, the requirements of their quality of life and the ability to move in the final stage of the disease also increase.
In patients with spinal metastases, it is reported that PVP can relieve pain and structurally strengthen the vertebral body damaged by osteolysis, so that the patient can relieve pain and continue normal weight-bearing activities. The experience of Europeans mainly focuses on the treatment of pain related to tumors (both benign and malignant), while the experience of Americans mainly focuses on the treatment of pain related to osteoporotic compression fractures. Third, the development process of artificial bone < P > Bone is composed of organic matter and inorganic salt. The organic substance is mainly bone glue protein, which makes the bone have certain toughness. Inorganic salts are hard minerals (hydroxyapatite crystals, that is, the compound of calcium phosphate and calcium hydroxide), which make bones hard and unyielding and stand proudly, and are the factors affecting bone hardness. There is a constant ratio between organic components and inorganic components. Generally speaking, the former accounts for 34% of the adult backbone and the latter accounts for 65%. The combination of the two makes the bone have great toughness and firmness. Hydroxyapatite has good chemical stability, bone conductivity and bone induction, so it is widely used in the manufacture of artificial bone.
Since 1971, people found that sea corals have pore structures similar to human bones, and they began to use original coral calcium carbonate as bone grafting materials. A coral of 15-2 pounds can provide hundreds of artificial bone materials, but the coral bone is brittle and fast to absorb, and it only has the function of scaffold and bone guidance at the bone defect, but has no bone induction ability. Simple coral has a certain volume loss after being implanted into the body, and it is difficult to completely repair the large bone defect with coral alone.
inspired by bionic thought, in 1986, scientists of American Dental Association L. C. Chow and W. E. Brown invented calcium phosphate cement, and in 1996, FDA approved CPC to be used for the treatment of bone defects of non-load-bearing bones. However, due to its low strength and toughness, the application range of hydroxyapatite is limited, and how to improve its performance has become a hot topic of research. Hydroxyapatite/collagen bionic composite has entered the stage, and the addition of collagen makes artificial bone closer to the natural bone composition of human body.
In recent years, in addition to artificial bone used for bone repair and replacement, artificial bone used for osteomyelitis, bone defect and prevention of artificial joint infection has been continuously developed. Drug-loaded artificial bone has dual functions of drug carrier and bone defect repair, mainly including hydroxyapatite, calcium phosphate cement, bioglass, etc. The former two have been gradually applied in clinical research and treatment, and bioglass is a relatively new material recently, and its characteristics and specific application need further study. Four, ankylosing spondylitis is it good to have stiff waist and legs for eight years? < P > It is impossible to have stiff waist and legs after eight years.
how old are you? Hubei group (AS-RA- necrosis) group 12915762, the patient's own group.
Hubei group (AS-RA- necrosis), 12915762. As- sky, a public welfare forum for rheumatism, is a good place to study. It is our patients' own forum, which contains our patients' treatment experience, exercise methods, life help and inner voice.
Don't believe the folk prescription if you have the upper disease, and pay close attention to the regular hospital. Don't let yourself regret it.
voluntary publicity of rheumatism forum 1. western medicine treatment of ankylosing spondylitis 1. NSAID (non-steroidal anti-inflammatory drug): traditionally, this is the first-line drug used to treat ankylosing spondylitis. (1) Mechanism of action: By inhibiting the effect of cyclo-oxygenase, COX), the synthesis of prostaglandin is inhibited, and the inflammatory reaction and pain are reduced, which is beneficial to the rehabilitation exercise of patients, but it does not change the course of the disease, so patients can adjust their drugs according to their condition.
(2) Classification: (i) Non-selective non-steroidal anti-inflammatory drugs: There are basically two kinds of COX in human body -COX-1 and COX-2, and the traditional non-steroidal anti-inflammatory drugs have the same inhibitory effect on COX-1 and COX-2. Include aspirin, indomethacin, diclofenac, tiaprofenic acid, piroxicam, sulindac, naproxen, ibuprofen and ketoprofen. (ii) Selective nonsteroidal anti-inflammatory drugs: drugs that selectively inhibit COX-2 developed in recent years can reduce the side effects on the stomach and intestines caused by long-term medication, such as rofecoxib, celecoxib, meloxicam, etodolac, nimesulide and nabumetone.
(3) Side effects and precautions: (i) Side effects of gastrointestinal tract: stomach pain, nausea, vomiting, gastric or duodenal ulcer or bleeding, diarrhea, constipation and colitis. (ii) Allergy: asthma, rash and acute dyspnea.
(iii) Renal dysfunction: proteinuria and hematuria, blood urea nitrogen (BUN) and Creatinine (Creatine) increase, Creatinine clearance rate decreases, and this side effect is more likely to occur in elderly people, patients with liver and kidney dysfunction, heart failure and patients who use diuretics. (iv) Cardiovascular: water retention, edema, congestive heart failure and hypertension.
(v) Liver function damage: jaundice, abnormal liver function index and drug-induced hepatitis are caused, especially for patients with liver diseases. (vi) Bleeding tendency: Because non-steroidal anti-inflammatory drugs are drugs that inhibit platelet function, long-term use will cause bleeding tendency, especially gastrointestinal bleeding, and the elderly, high-dose patients who use anticoagulant at the same time are high-risk groups. Therefore, if there are symptoms of gastrointestinal bleeding, such as black stool, syncope, or hemorrhagic purple spots on the skin, it is necessary to suspect such side effects.
(vii) Central nervous system: dizziness, headache and drowsiness. (viii) Blood: leukopenia or thrombocytopenia.
(4) medication for pregnant women: ketoprofen, naproxen, diclofenac, piroxicam, sulindac and indomethacin belong to Grade B, which can be used, but they are Grade D in the last trimester of pregnancy and should not be used. Aspirin, mefenamic acid, tiaprofenic acid, rofecoxib, meloxicam, celecoxib, nabumetone belong to Grade C, and it is not suitable for breastfeeding mothers, because most drugs are passed to their babies through milk. 2, other symptoms treatment drugs (1) muscle relaxants: For morning stiffness, muscle spasms will be helpful, such as chlorzoxazone (Chlorzoxazone), tolperisone (Tolperisone), baclofen (Bakrofen), mephenoxalone.
(2) steroid: (i) Timing of use:-Acute inflammation of local peripheral joints or inflammation of tendon attachment points that is difficult to control can be used for local injection of steroid. -Non-steroidal anti-inflammatory drugs and immunomodulators are uncontrollable acute attacks, which can be temporarily taken orally or injected with steroids, and then slowly stopped.
-iridocyclitis of the eye: topical steroid eye drops, serious need for steroid intraocular injection, the effect is good. (ii) Side effects: central obesity, femoral head avascular necrosis, osteoporosis, hypertension, acne, hair hyperplasia, increased blood sugar, insomnia, infection, thinning skin, etc. Frequent local injection of steroids may cause tendon rupture.
(3) Drugs for the treatment of central pain: should be added only when immunomodulators and non-steroidal anti-inflammatory drugs are ineffective and the pain seriously affects daily life, such as some antiepileptic drugs, such as carbamazepine and gabapentin；; Antidepressants such as imipramine (imipramine) and trazodone (trazodone); Morphine drugs, such as Tramadol. 3. Immunomodulators: traditionally regarded as second-line drugs, they are used only when non-steroidal anti-inflammatory drugs are not well controlled, or when there is serious peripheral joint invasion, and the invasion of tendons and bones (such as eyes, heart and lungs). However, there is a trend of active drug use at present, especially for patients with early onset, it is more necessary to use such drugs to achieve the purpose of controlling the course of disease.
(1)Sulfasalazine(Salazopyrin, sulfasalazine, SASP, SSZ): the most commonly used drug at first. (i) Dosage: take 25mg in the morning and evening of the first week, 5mg in the morning and evening of the second week, 5mg in the morning, middle and evening of the third week, and increase by 5mg for about one week, and take it twice or three times, until the daily maintenance dose is about 3 mg of body weight (kilograms). When it exceeds 3g per day, it will obviously increase the chance of side effects.
(ii) Side effects:-Allergy: erythema and itching are the most common side effects. If the symptoms are mild, the dosage can be reduced, and antihistamine can be used. If the dosage is improved, the dosage will be gradually increased. Very few patients will have severe allergies, such as Steven-Johnson syndrome, so they must stop taking the medicine and seek medical treatment as soon as possible. -Headache, dizziness and gastrointestinal discomfort can usually be improved by reducing the dosage.
-impaired liver function: especially hepatitis. Please be proud of China's name. One day, China will use your name
Yes, I will go out again this autumn, "he told his friends.
and every time he talks about it, he has an illusory feeling, as if he was talking about someone else instead of himself. At the same time, I feel the need to explain clearly, for myself, more than for others.
It seems that a "period" is coming to an end, and a new, unnamed "period" is waiting for him to unveil the veil in the distance. It seems that there is a door, and the classical copper son with a glaring ring is closing on him with a huge shadow. The sound of rolling is heart-rending.
outside the door, the car dust is like fog, and the endless road is the prodigal son, stretching to some strange trees and clouds, and even more strange road signs. Every time I talk about it, it's like announcing my own death.
what happened here, after he left, seems to be behind him. Of course, people will chew his name, like a fragrant olive, but the olive tree is no longer here.
for others, his departure will be like one.