椎体成形术在椎体压缩骨折并发神经痛的临床应用

【摘要】 目的 探讨经皮椎体成形术（PVP）在椎体压缩性骨折伴相应节段神经根性疼痛的临床疗效。方法 回顾性分析2017年1月至2018年12月，收治的椎体压缩骨折并神经痛患者47例，所有患者在药物止痛、抗骨质疏松治疗基础上，予以PVP治疗。观察手术前和手术后1 d、1周、1个月采用视觉模拟评分（VAS）、功能障碍指数（ODI）、PD- Q量表评分，观察不良反应。结果 与术前相比，术后患者VAS评分、ODI、PD- Q量表评分较术前均下降，差异有统计学意义。结论 PVP不仅能部分恢复椎体压缩骨折的高度，缓解腰背痛，对伴有神经根性疼痛的患者也能缓解疼痛。

     

开放式MR导引下经皮椎体成形术在椎体转移瘤治疗中的应用研究

【摘要】 目的 初步评价开放式磁共振（MR）引导下经皮椎体成形术（PVP）的可行性、安全性和有效性。 方法 回顾性分析2014年1月至2018年6月收治的溶骨性椎体转移瘤17例（29节椎体）。采用0.4 T开放式MR成像系统结合光学导航仪系统行PVP，观察术前、术后视觉模拟评分（VAS）、美国东部肿瘤协作组（ECOG）评分、椎体前缘高度及术后相关并发症。 结果 17例患者（29节椎体）均准确穿刺至拟定靶点，顺利完成PVP。术后VAS、ECOG评分均低于术前（P＜0.05），椎体前缘高度与术前相比差异无统计学意义（P＞0.05）。术后5节段椎体发生骨水泥外渗，2例出现穿刺点皮下血肿，无严重并发症发生。 结论 MR导航引导下PVP成像清晰、导引准确，是一种安全有效的椎体转移瘤治疗方法。

     

C臂CT在经皮椎体成形术治疗骨质疏松性椎体压缩骨折中的临床应用

【摘要】 目的 探讨C臂CT技术在经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折（OVCF）中的应用价值。方法 自2010年1月—2013年12月期间，对110例OVCF患者实施PVP治疗，所有患者分为两组，A组48例在普通DSA引导下完成，B组62例在平板DSA C臂CT引导下完成，比较两组的术前、术后1 d和1个月的视觉模拟评分（VAS），骨水泥注入量、骨水泥填充率及骨水泥渗漏率。结果 所有病例均成功完成手术，术后两组VAS评分与术前比较差异有统计学意义（P < 0.05），同时期组间VAS评分比较差异无统计学意义（P > 0.05）。A组骨水泥渗漏率明显高于B组，而骨水泥注入量、骨水泥填充率明显低于B组，两组间比较差异有统计学意义（P < 0.05）。两组均无严重并发症发生。结论 利用C臂CT成像技术可以更直观地监测PVP中的穿刺过程，准确评判骨水泥的分布和泄漏情况，降低高龄患者手术风险。
     

经皮椎体成形术在多节段椎体骨折中的应用

目的探讨经皮椎体成形术（PVP）治疗多节段骨质疏松性椎体压缩骨折的安全性及疗效。方法回顾性分析PVP治疗骨质疏松性椎体压缩骨折患者８６例,其中２３例患者为多节段椎体骨折。分析患者术前、术中、术后的临床及影像学资料。采用模拟视觉评分（VAS）及Oswesty功能障碍指数（ODI ）评价术后疼痛缓解及日常活动功能恢复情况。结果１９例患者一次手术完成３节椎体,４例患者一次手术完成４节椎体。３例患者术中出现一过性血压升高和呼吸困难。术前VAS评分及ODI 值平均８．５８±１．１２、８１．４３±１２．５４,术后１d平均为３．０３±０．９８、３１．０４±１１．１１,疼痛缓解及日常活动功能恢复显著。５例患者１年内出现再发椎体压缩骨折。１３节椎体发生骨水泥外漏。结论PVP是治疗多节段骨质疏松性椎体压缩骨折安全、有效的方法。必须注意脂肪栓塞并发症,一次手术至多完成３节椎体。     

高黏骨水泥在骨质疏松性严重椎体压缩骨折中的应用

【摘要】 目的 探讨高黏骨水泥行经皮椎体成形术（PVP）治疗骨质疏松性严重椎体压缩骨折的近期疗效及安全性。方法 回顾性分析2010年12月—2013年5月,用高黏骨水泥行PVP治疗严重椎体压缩（压缩程度大于70%）骨折患者100例,随访患者至少1个月,通过对术前及术后视觉模拟评分（VAS）,生活质量（QOL）评分及骨水泥外漏的发生率等指标进行综合评价,以评估高黏骨水泥行PVP在治疗骨质疏松性严重椎体压缩骨折的疗效及安全性。结果 行高黏骨水泥PVP术后1周随访,92例疼痛明显缓解（92%）,VAS评分由术前（7.0±1.2）分,降低到（2.0±1.5）分,QOL评分由术前（30±5）分,升高为（80±18）分。两者与术前相比,P＜0.01,差异均有显著统计学意义;1个月后随访,91例缓解（91%）,VAS评分术前（7±1.2）分,降低到（1.5±1.0）分,QOL评分由术前（30±5）分,升高为（80±15）分。两者与术前相比,P＜0.01,均有显著统计学意义。骨水泥外溢40例（40%）,未见引起严重神经症状,其中,椎体上下椎间盘漏共28例;椎体前缘漏11例,椎体后缘漏占1例。结论 应用高黏骨水泥行PVP术治疗骨质疏松性严重椎体压缩骨折是一种安全、有效的方法。

     

分期注射法在经皮椎体成形术中的应用

【摘要】 目的 探讨经皮椎体成形术（PVP）中分期注射法对于脊柱病变治疗的安全性及有效性。方法 回顾性分析228例患者，443节手术椎体，根据手术方法的不同将患者分为两组:A组（采用分期注射法）和B组（无分期注射法），所有患者随访12个月，随访过程中采用视觉模拟评分（VAS）及Oswestry功能障碍指数（ODI）评价临床疗效，采用统计学方法对随访数据进行统计学分析。结果 所有患者顺利完成手术，A组患者每节椎体骨水泥注入量平均（4.75±0.85） mL，B组患者骨水泥注入量平均（4.23±1.16） mL，A组患者81节椎体（23.9%）发生骨水泥渗漏，B组患者36节椎体（34.6%）发生骨水泥渗漏，骨水泥渗漏周围组织，未引起明显不适。对随访数据进行统计学分析显示，A组术后1 d和1个月VAS及ODI评分优于B组，差异有统计学意义，但是A组与B组术后6和12个月VAS及ODI评分差异无统计学意义。结论 PVP是治疗椎体病变安全有效的方法，为达到解剖学上的修复，从而最大程度恢复脊柱稳定性，缓解症状，在PVP中采用分期注射法是一种安全及有效的手术方法。
     

经皮椎体成形术治疗上胸椎转移瘤的应用

目的 评价经皮椎体成形术(PVP)治疗上胸椎转移瘤的疗效.方法 回顾分析20例(31个椎体)T1～T4水平的转移性肿瘤的PVP资料.其中9个T1椎体、7个T2椎体、8个T3椎体和7个T4椎体.采用视觉模拟评分(VAS)评价患者术前、术后3 d和1个月的疼痛程度.分析上胸椎PVP穿刺技术、骨水泥注射量和术后并发症.结果 所有患者手术均获成功.骨水泥分别在T1、T2、T3和T4椎体注入1.7～2.8 ml、1.8～3.2 ml、1.7～3.1 ml和1.6～3.1 ml,平均(2.4±0.8)ml.术后疼痛缓解率为100%.术前VAS为7.2±2.0,术后3 d VAS为2.5±2.3(P<0.01).术后1个月VAS为2.2±2.3,与术前比较差异有统计学意义(P<0.01).13个椎体出现骨水泥外渗,包括5个椎旁渗漏,3个静脉渗漏,3个椎旁软组织渗漏,2个硬膜外渗漏.除1例出现轻微并发症,其他未发生严重临床症状的并发症.结论 PVP治疗上胸椎转移瘤安全、有效.     

经皮椎体成形术治疗严重椎体压缩性骨折的临床价值

【摘要】 目的 探讨经皮椎体成形术（PVP）对严重椎体压缩性骨折治疗的临床价值。方法 回顾性分析2012年6月—2013年3月行PVP治疗严重椎体压缩性骨折30例患者、累及30节病变椎体的临床资料。根据椎体压缩形态分为楔形、双凹型以及长方形3种，楔形骨折采取健侧椎弓根入路，双凹形骨折采取单侧椎弓根入路，长方形压缩性骨折根据骨水泥填充情况采取单侧或双侧椎弓根入路。采用视觉模拟评分法（VAS）和WHO疼痛标准分级程度评价效果，测量压缩椎体术前高度及术后恢复高度。所有患者术后均通过门诊随访或电话随访6个月。结果 30节病变椎体穿刺成功率为100%。VAS评分术前平均6.9 ± 0.9，术后1 d、1个月、3个月、6个月分别为5.0 ± 0.9、3.5 ± 0.7、2.5 ± 0.8、1.6 ± 0.7。依据WHO标准完全缓解（CR）25例、部分缓解（PR）3例；无效2例；临床有效率（CR + PR）为93.3%；术前压缩椎体高度为（5.77 ± 1.09）mm；术后平均恢复高度为（14.33 ± 2.03）mm。结论 单纯PVP治疗严重椎体压缩性骨折方法可行，短期临床效果肯定。
     

双针双平面法和单针法治疗伴有致密带形成的骨质疏松性椎体压缩骨折疗效比较

【摘要】 目的 对比研究双针双平面法和单针法经皮椎体成形术（PVP）治疗伴有致密带形成的骨质疏松性椎体压缩骨折的临床疗效。方法 回顾性分析2011年1月—2016年1月采用PVP治疗伴有致密带形成的骨质疏松性椎体压缩骨折患者共43例,所有患者均仅伴有单节椎体致密带形成。在透视引导下,采用双针法或单针法PVP向病椎内穿刺并注入骨水泥聚甲基丙烯酸甲酯（PMMA）。术后X线片和CT观察,对比分析手术时间、X线暴露时间、X线透视次数、骨水泥注入量、骨水泥分布情况及并发症的发生,并且采用疼痛视觉模拟评分（VAS）、及Oswestry功能障碍指数（ODI）、椎体前壁高度、椎体后凸Cobb角进行手术疗效比较。结果 使用双针法在手术时间、X线暴露时间、X线透视次数、骨水泥用量及分布情况方面均显著多于单针法（P＜0.05）,骨水泥渗漏率少于单针法（P＜0.05）。术后3 d、6周及1年时,两组VAS评分及ODI指数较术前均有改善（P＜0.05）,椎体高度恢复率、椎体后凸Cobb角较术前虽有改善,但差异无统计学意义（P＞0.05）。组间比较,术后3 d两组VAS评分、ODI指数有显著差异（P＜0.05）,而术后6周及1年时,两组间VAS评分、ODI指数均无显著差异（P＞0.05）。随访1年时,两组再发及邻近椎体新发骨折率差异无统计学意义（P＞0.05）,均未发生脊髓神经损伤、肺栓塞等严重并发症。结论 采用不同入路PVP治疗伴有致密带形成的骨质疏松性椎体压缩骨折中,尽管双针法较单针法手术时间更长,X线暴露时间和透视次数也更多,但却能取得更理想的骨水泥分布、更好的早期疗效以及更少的近期并发症,而在中远期VAS评分、ODI指数、椎体前壁高度和椎体后凸Cobb角恢复及长期并发症发生率方面两种方法疗效相近。
     

椎体成形术治疗骨质疏松性椎体压缩骨折的生命质量评价

目的评价经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折的长期生活质量。方法随访PVP治疗骨质疏松性椎体压缩骨折患者１８３例，获得完整随访资料２５例，用形象类比（VAS）评价术前、术后不同时期的疼痛程度，用日常生活自理能力（ADL）和下腰部功能活动障碍（OLBPDQ）量表分别观察患者术前、术后大于１年的生活质量，并观察骨水泥渗漏对生命质量的影响。结果术后末次随访平均３６．５个月（１３～４２个月）。术前、术后１d、３、６个月及１年以上随访时VAS疼痛分值分别为８．９６±１．１１、４．５８±２．５６、３．１６±２．２８、２．１１±０．２７、１．６３±０．２１；ADL量表（Barthel指数）术前、术后分别为５４．３４±１３．２１、８４．２８±１８．３０，较术前提高了５５％；OLBPDQ量表穴ODI指数雪术前、术后分别为２５．６４±１３．８４、１７．５２±１０．７１，较术前下降了３２％。两组间P值均＜０．０５。术后CT证实少量骨水泥渗漏５例，平均随访３２个月均无临床症状。结论PVP术治疗骨质疏松性椎体压缩骨折不仅可迅速缓解患者疼痛，而且可长期提高患者生活质量；少量无症状的骨水泥渗漏对患者长期生命质量无明显影响。     

Optimization of hydrogen production by filtration combustion of natural gas by water addition

The effect of adding steam during filtration combustion of natural gas–air mixtures was studied with the aim to evaluate the optimization of hydrogen production. Temperature, velocity, chemical products of combustion waves, and conversion from fuel to H₂ and CO were evaluated in the range of equivalence ratio (φ) from stoichiometric (φ = 1.0) to φ = 3.0 and steam content in the mixture from 0% to 39%, at filtration velocities from 12 to 25 cm/s. Numerical simulation was carried out using GRI-MECH 3.0. Results suggest that H₂ and CO concentrations, dominant for rich and ultrarich combustion, are products from partial oxidation and steam natural gas reforming processes. Experimental and numerical results show that hydrogen yield increase with an increase of steam content in the natural gas–air mixtures.     

Optimization of hydrogen production by filtration combustion of methane by oxygen enrichment and depletion

Transient filtration combustion waves formed in a porous matrix of randomly arranged alumina pellets are studied experimentally for rich and ultra-rich methane/air waves with oxygen enrichment and depletion. A single filtration velocity $\text{(12}\text{cm/s}\text{)}$ was used and the mixture equivalence ratio was varied from 1 to 3.5. The air and oxidizer content were adjusted to retain the filtration velocity constant for each equivalence ratio. Six oxidizer compositions (10%, 15%, 21%, 25%, 30%, and 35% O₂) were comparatively analyzed focusing on combustion temperatures, combustion wave velocities, major and minor products of combustion. The studied range of equivalence ratios covered the underadiabatic (upstream) and superadiabatic (downstream) regimes of transient filtration waves where combustion temperatures are less than and greater than adiabatic temperatures, respectively.     

Hydrogen production by steam-oxidative reforming of bio-ethanol assisted by Laval nozzle arc discharge

The hydrogen production from an easily transported liquid feedstock can be an efficient alternative for fuel cells application. The steam-oxidative reforming of bio-ethanol by a novel gliding arc discharge named Laval nozzle arc discharge (LNAD) was investigated in this paper at low temperature and atmospheric pressure. The conversion efficiency and product distributions, mainly of H₂ and CO, were studied as functions of O/C ratio, S/C ratio, the ethanol flow rate and input power. The voltage–ampere (V–I) characteristic is also discussed here concerning the non-thermal plasma effect on the bio-ethanol reforming. A high conversion rate and fair H₂ yield have been achieved, 90% and 40% respectively. When the ethanol flow rate (G_ethanol) was 0.15 g s⁻¹ and S/C = 2.0, the minimum specific energy requirement of H₂ and CO were achieved at O/C = 1.4 with the specific energy input of 55.44 kJ per ethanol mole, 72.92 kJ mol⁻¹ and 80.20 kJ mol⁻¹ respectively. The optimal conditions for ethanol reforming seem to be S/C = 2.0 and O/C = 1.4–1.6, which are higher than those of the reaction's stoichiometry. This paper shows interesting results in comparison with the ethanol reforming assisted by other discharges. Compared with others, it features good conversion rate, low energy consumption and significantly reduced nitrogen oxide emission.     

Hydrogen generation by aluminum corrosion in seawater promoted by suspensions of aluminum hydroxide

Nowadays, new processes of H₂ generation from water via Al corrosion are mainly limited by Al passivation. Here we report on the systematic assessment of H₂ production by corrosion of Al in seawater suspensions prepared with NaAlO₂. The reported results are encouraging, since it was observed that seawater suspensions tested can prevent Al passivation during H₂ evolution, reaching 100% yields at ca. 700 cm³ H₂ min⁻¹. XRD analysis revealed the formation of solid Al(OH)₃ (bayerite) in initial seawater suspensions. So, model suspensions were prepared using NaAlO₂ + Al(OH)₃ in distilled water, which even improved the results obtained in seawater. Suspended particles of Al(OH)₃ act as nuclei in a mechanism of seeded crystallization, which prevents Al surface passivation. Moreover, a synergistic effect of Al(OH)₃ suspensions in combination with NaAlO₂ solutions was key in promoting Al corrosion. The effect of NaCl in aqueous suspensions was also studied, but it was insignificant compared to this synergistic effect. The composition of suspensions was optimized and a 0.01 M NaAlO₂ solution with 20 g dm⁻³ Al(OH)₃ was selected as candidate to generate H₂ at pH ca. 12 with high efficiency. Consecutive runs of the selected composition were performed obtaining ca. 90% yields in all of them.     

Exploitation of solar energy collected by solar stills for desalination by membrane distillation

The aim of this work was to evaluate the technical feasibility of producing potable water from simulated seawater by integrating a membrane distillation module with a solar still. The relatively hot brine in the solar still was used as a feed to the membrane module. The synergistic action of the solar still and the membrane module in the production of potable water was quantified. For this purpose, two types of experiment were conducted, indoor experiments and outdoor experiments. The sensitivity of the permeate flux to the brine temperature, flow rate, salt concentration and solar irradiation were all investigated. Overall, the flux of water from the solar still was no more than 20% of the total flux. The brine temperature significantly affected the flux of both the solar still and the membrane module, while the effect of salt concentration was marginal. The effect of these process parameters was more noticeable in the membrane module than in the solar still.     

The operation of loads powered by separate sources or by a commonsource of solar cells

A procedure is introduced for analyzing the interaction between different loads connected to a common solar cell (SC) source, and the performances of these loads when powered by separate and common sources are compared. It is shown that for identical loads (the same type and size), either optimal or nonoptimal, powered by identical SC arrays, and for loads of the same type but different sizes that are powered by proportional sizes of SC arrays, the operation of the loads is the same when powered either by separate sources or by a common SC source. The arrays in the separate source systems are of the same sizes, and in the common source system the arrays are of double size. The loads in both setups are of the same type. Two types of loads are considered in this study: two different ohmic loads; two different water electrolyzer loads. A comparison of the operation of the above two load types is performed for systems that incorporate a maximum-power point-tracker (MPPT), for both the separate and common SC sources. The criterion for comparing the performances is the energy utilization efficiency. It is shown that the performance of one load affects the performance of another load in a common source system. In systems not including MPPTs, the total performance of the loads in a common source system is improved as compared to the total performance of the loads when they are powered separately by individual sources. In systems including MPPTs, the total performance of the loads is the same when powered either by a common source or by single sources. MPPTs improve the performance of loads, the amount of improvement depending on the mismatch of the loads to the solar cells     

Improvement of hydrogen-sorption characteristics of Mg by reactive mechanical grinding with prepared by spray conversion

Nano-structured Cr₂O₃ powder could be produced by spray conversion (spray drying of an aqueous of Cr nitrate, oxidation and milling).The samples Mg—10 wt% Cr₂O₃ using nano-structured Cr₂O₃ synthesized by spray conversion were prepared by mechanical grinding under H₂ (reactive mechanical grinding) under the optimum conditions, previously studied, for the preparation of the sample Mg—10 wt% Fe₂O₃ using purchased Fe₂O₃. The sample Mg—10 wt% Cr₂O₃ as milled absorbed 4.48 wt% H₂ at 593 K under 12 bar H₂ for 60 min. Its activation was accomplished after two hydriding–dehydriding cycles. The activated sample absorbed 5.48 wt% H₂ for 10 min and 5.93 wt% H₂ for 60 min at 593 K, 12 bar H₂, and desorbed 3.65 wt% H₂ at 603 K, 1.0 bar H₂ for 60 min. H₂-storage capacity was 6.38 wt% under 12 bar H₂ at 593 K (from P–C-T curve). Reactive mechanical grinding of Mg with Cr₂O₃ by spray conversion increased the hydriding rate effectively but increased a little the dehydriding rate, compared with reactive mechanical grinding of Mg with Fe₂O₃ purchased, Fe₂O₃ by spray conversion, MnO and SiO₂ by spray conversion.     

Regulation of hydrogen production by Enterobacter aerogenes by external NADH and NAD

Experiments involving the addition of external nicotinamide adenine dinucleotide, reduced form (NADH) or nicotinamide adenine dinucleotide (NAD⁺) have been designed to examine how the hydrogen in Enterobacter aerogenes is liberated by NADH or NAD⁺. The addition of external NADH or NAD⁺ was found to regulate hydrogen production by E. aerogenes in resting cells, batch cultures, and chemostat cultures. Particularly in chemostat cultivation, with the external addition of NADH, hydrogen production via the NADH pathway was decreased, while that via the formate pathway was increased; in the end, the overall hydrogen p was decreased. The addition of NAD⁺, on the other hand, gave the opposite results. The membrane-bound hydrogenase was found to play a central role in regulating hydrogen production. The occurrence of NADH oxidation (NAD⁺ reduction) on the cell membrane resulted in an electron flow across the membrane; this changed the oxidation state and metabolic pattern of the cells, which eventually affected the hydrogen evolution.     

Stability of a-Si:H solar cells deposited by Ar-treatment or by ECR techniques

Stability against light soaking was studied for amorphous silicon (a-Si:H) solar cells using three different i-layers; (a) device-quality a-Si:H (standard a-Si:H) with bandgap of 1.75 eV, (b) narrow bandgap (1.55 eV) a-Si:H fabricated by Ar* chemical annealing and (c) a-Si:H(Cl) fabricated from SiH₂Cl₂. Both the narrow bandgap a-Si:H and the a-Si:H(Cl) solar cells showed much improved stability than that of the standard a-Si:H solar cells: e.g., fill factor of the narrow bandgap a-Si:H cell only slightly decreased from 56% to 53%, while that of the standard a-Si:H cell degraded from 62% to 51%. In addition, mobility–lifetime products of the a-Si:H(Cl) cell also exhibited improved stability than that of the standard a-Si:H solar cell.     

Thermophysical characterization by solar convective drying of thyme conserved by an innovative thermal-biochemical process

The solar drying for preservation of food products is the most attractive and promising application. It leads to reduce the water activity in the product and thereby prolongs its shelf life by decreasing the microbial contamination. Thymus satureioides, a medicinal and aromatic plant, was conserved using a nondestructive innovative preservation process integrating sustainable energy. The process is based on a combination of pretreatment by aqueous solutions of natural organic acid followed by a partial solar convective drying. Therefore, it is overridden to understand the mechanisms influencing the treated thyme drying process compared with the drying kinetics of witness thyme. The effect of drying conditions (season, temperature ranging from 50 to 80 °C and drying volume flow rates of 150 and 300 m³/h) and the pretreatment conditions (concentration and volume of citric acid) on the process efficiency were studied. Furthermore, the effects of temperature, season, drying volume flow rates and citric acid on drying rate and total phenolic content were also investigated. Moreover, nine mathematical models have been used to describe the drying curves. The best mathematical models which represented treated and witness thyme were Wang-Singh and Midilli-Kucuk models. Hence, the characteristic drying curve of the pretreated product was determined.