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Objective:To analyze the application value of negative pressure closed drainage in tuberculous surgery infected wounds and its effect on wound healing and Th1/Th2 expression.Methods:A prospective study was conducted on 120 patients with tuberculous surgery infected wounds admitted to Hebei Provincial Chest Hospital from January 2019 to June 2021. The patients were divided into observation group and control group according to the random envelope method, with 60 cases in each group. The control group received conventional suture drainage tube intervention, while the observation group received negative pressure closed drainage intervention. The survival rate of skin grafting at 2 weeks after operation, the wound healing rate at 8 weeks after operation, and the pain situation during the first 3 dressing changes were observed. The levels of interferon γ (IFN-γ), interleukin 2 (IL-2), tumor necrosis factor α (TNF-α), IL-6, alkaline phosphatase (ALP), phosphorus (P), calcium (Ca), Th1 and Th2 in serum were detected before treatment and 14 days after treatment.Results:The survival rate of skin grafting at 2 weeks and the wound healing rate at 8 weeks in the observation group were significantly higher than those in the control group, with statistically significant differences (all P<0.05). The Visual Analog Scale (VAS) scores of the observation group were significantly lower than those of the control group during the second and third dressing changes (all P<0.05). At 14 days after treatment, the serum levels of Th1 and Th2 in the observation group were significantly higher than those in the control group, while the levels of IFN-γ, IL-2, TNF-α, IL-6, ALP, P, Ca, Th1/Th2 in serum were significantly lower than those in the control group (all P<0.05). Conclusions:Using negative pressure closed drainage technology can effectively promote wound healing in patients with tuberculous surgery infected wounds and improve the balance of Th1/Th2 in blood.
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Objective To explore hemodynamic performance of the aortic dissection after lesions, so as to provide a more scientific basis for patient treatment. Methods Based on computed tomography angiography (CTA) image data from a patient with complex Stanford B-type aortic dissection, the personalized aortic dissection models with different rupture shapes (H-type, O-type, and V-type) at proximal end of the aortic dissection were established. Combined with computational fluid dynamics (CFD) and morphological analysis method, distributions of the velocity at rupture section, the blood flow, the wall pressure and the wall shear stress (WSS) were analyzed. Results The flow velocity, the highest pressure difference and the WSS proportion at entrance of the H-shaped rupture showed larger hemodynamic parameters than those of the other two types. The risk of dissection rupture for type H was the largest, while type V was in the middle, and type O was the smallest. Conclusions This study provides an effective reference for further numerical analysis the cases and formulation of treatment plans.
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Objective To study the influence of different support heights, support numbers and cross-sectional dimensions on support performance of NiTi thoracic aortic stents. Methods Twenty-seven scaffold models with different parameters were established by using AutoCAD 2016 and SoildWorks 2014 software. HyperMesh 14.0 was used for tetrahedral mesh division, and ABAQUS 2017 was used for support performance simulation analysis. Results With the decrease of support height, the support stiffness would increase; a larger cross-section size would lead to a larger support stiffness; with the increase of support numbers, the support stiffness would increase. Among the influencing factors of support performance, the order of influence degree was support height＞section size＞support numbers. Conclusions The research findings have certain guiding significance for the development and research of thoracic aortic stents, and provide theoretical basis for the selection and optimization of clinical stents.
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Objective To conduct simulation analysis on support performance of the stent by using finite element method, and optimize structure parameters of the stent by using Kriging surrogate model, so as to provide more scientific guidance for clinical treatment with design and development of the stent. Methods The contact model was established by penalty function method. The generalized variational principle was selected as theoretical basis of the numerical simulation, and the theory of Kriging surrogate model was used for finite element optimization on support stiffness of the stent, so as to study the effect from the number of circumferential support, the length of the support and the initial diameter on support performance of the stent. Results With the increase of the number of circumferential support or the length of the support, the support performance showed the decreasing tendency; with the increase of the initial diameter, the support performance showed the increasing tendency. From seven stents by using the theory of Kriging surrogate model, it was concluded that structural parameters of the optimal stent were: the number of circumferential support was six, the length of the support was 1.15 mm, and the initial diameter was 1.65 mm. Conclusions The numerical result agreed well with the experimental data and the error was smaller than 5%, and the error rate of experimental repeatability was within 0.5%, which verified effectiveness and rationality of the finite element analysis. The optimization of support performance provides an important reference for design and exploration of new magnesium alloy stent.
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Objective To investigate filtration efficiency of convertible vena cava filters on treating pulmonary embolism under the condition of different thrombus diameters and contents.Methods Three kinds of convertible vena cava filter models with different filtering unit structures (L-style,S-style,W-style) were constructed to numerically simulate hemodynamics based on computational fluid dynamic (CFD) methods,and their filtration efficiency was comparatively analyzed under the condition of different thrombus diameters (5,10,15 mm) and contents (10％,15％,20％).Results With the increasing of thrombus diameter and content,the volume fraction of thrombus distributed on the filter bars increased and the filtration efficiency of the filter became better.When the thrombus diameter was 5 mm,the S-style filter's filtration efficiency was the best as compared with the other two kinds of filters.When the thrombus diameter was 10 mm,the W-style filter showed the best filtration efficiency.When the thrombus diameter was 15 mm,the S-style and W-style filter showed the same filtration efficiency,which was better than the L-style filter.Conclusions The implantation of vena cava filters will cause hemodynamic changes,and its filtration efficiency is not only related to filtering unit structures,but also closely related to the diameter and content of thrombus.These results provide a theoretical reference basis for the design and clinical choice of the novel convertible vena cava filter.