奇正消痛贴膏治疗软组织损伤急性期的疗效观察

目的:观察奇正消痛贴膏治疗软组奴损伤急性期的效果.方法:将我院60例明确诊断为怠性软组织损伤患者随机分成两组,治疗组和对照组,各30例.治疗组30例软组织损伤急性期患者应用奇正消痛贴膏治疗,对照组30例患者采用伤湿止痛膏.结果:治疗组经治疗1个疗程后总有效28例.总有效率93%;对照组总有效20例,总有效率67%.两组比较差异有统计学意义(P<0.05).治疗组总有效率及显效率与对照组比较,治疗效果治疗组优于对照组.结论:用奇正消痛贴膏治疗软组织损伤急性期,作用快,疗效显著.     

奇正消痛贴膏与扶他林软膏治疗急性软组织挫伤临床疗效观察

目的:评估奇正消痛贴膏治疗急性软组织挫伤的临床疗效及安全性.方法:采用随机对照试验设计将220例急性软组织挫伤的患者按照1:1随机分为两组,治疗组110例,予奇正消痛贴膏于患处外敷;对熙组110例,扶他林乳胶剂局部外用.结果:治疗组107例完成试验,总有效率为91.6%,过敏率2.7%;对照组109例完成试验,总有效率为80.7%,过敏率0.9%.有效率相比差异具有统计学意义.结论:奇正消痛贴膏治疗急性软组织挫伤效果确切,起效迅速,值得临床推广.     

奇正消痛贴膏在关节镜下交叉韧带重建术后功能锻炼中的应用

目的:观察奇正消痛贴膏在关节镜下交叉韧带重建术后功能锻炼中的应用及疗效.方法:将我科自2008年2月-2010年8月收治的102例患者按就诊顺序随机分为奇正消痛贴膏组(治疗组)和未用外敷药(对照组)进行治疗,各组功能锻炼后对比观察治疗效果.结果:治疗组明显比对照组术后功能锻炼效果好,恢复快结论:奇正消痛贴膏在关节镜下交又韧带重建术后功能锻炼中的应用疗效满意,适合临床应用.     

奇正消痛贴膏治疗急性软组织损伤临床观察

目的:观察奇正消痛贴膏治疗急性软组织损伤的临床疗效.方法:我院急诊科和骨科明确诊断为闭合性软组织损伤患者60例,男性45例,女性15例,随机分为治疗组和对照组.每组各30例,治疗姐给予西藏林芝奇正藏药厂生产的奇正消痛贴膏.用药方法:患者入院行相应抢救措施后,尽早给予清洁患部皮肤,将消痛贴骨直接贴在患部,每日更换1次,对照纽给予所用药物为市售麝香镇痛膏.用药方法:清洁局部皮肤,将麝香镇痛骨,直接贴在惠部,每日更换1次,观察一周.结果:治疗组显效25例,有效3例,无效2例,总有效率93%,对照组显效5例,有效15例,无效10例,总有效率67%.治疗组没有出现不良反应,对照组用药过程中出现2例皮肤过敏现象.结论:奇正消痛贴膏治疗急性软组织损伤效果好.     

奇正消痛贴膏改善膝骨关节炎症状的临床研究

目的:探讨奇正消痛贴膏疗法对膝骨关节炎关节功能的改善效果.方法:共观察80例,随机分为消治疗组、对照组,每组40例.治疗组给予奇正消痛贴膏,1贴/天,对照组给予活血止痛膏,1贴/天,治疗4周.观察治疗后的中医症状积分改善和疼痛评分改善情况.结果:治疗前后两组症状积分比较,治疗组与对照组比较有统计学意义(P＜0.05);治疗前后两组疼痛评分比较,治疗贴组与对照组比较有统计学意义(P＜0.05).结论:奇正消痛贴膏改善膝骨关节炎的症状优于活血止痛膏.     

护脉膏预防诺维本致静脉损伤的实验研究

目的探讨护脉膏预防诺维本致静脉损伤的作用。方法将54只健康、同龄、体重为2．5～3．0kg的新西兰大白兔随机分为A、B、C3组，每组兔左、右耳缘静脉注射相同剂量的诺维本化疗药物。A组左耳不涂药膏，右耳涂护脉膏；B组左耳不涂药膏，右耳涂喜疗妥药膏；C组左耳涂喜疗妥膏，右耳涂护脉膏。分别在24h、7d、15d后观察兔耳缘静脉局部反应及病理学改变，并将每只兔左、右耳对照。结果A、B组兔左耳缘静脉局部反应重、病理学改变明显；A、C组兔右耳缘静脉局部反应及病理学改变不明显；B组兔右耳、C组兔左耳缘静脉局部反应及病理学改变介于二者之间。结论诺维本易致静脉损伤，护脉膏及喜疗妥均有预防诺维本致兔耳缘静脉损伤的作用，但护脉膏效果曼佳。     

肢体缺血预处理对兔颈髓慢性缺血后再灌注损伤的影响

目的：探讨肢体缺血预处理对兔颈髓慢性缺血后再灌注损伤的影响及其机制。方法：建立兔颈髓慢性压迫损伤模型，随机分为实验组和对照组。实验组在脊髓减压再灌注前给予肢体缺血预处理，对照组不做预处理。两组兔在减压前和减压后2h、8h、24h，7d、21d分别进行后肢神经功能评分。在减压后即刻、0．5h、1h和以上时间点分别进行脊髓血流测定。处死动物取脊髓(C1～T1)进行组织病理学检查。结果：实验组于再灌注8h后神经功能评分明显好于对照组。实验组脊髓组织丙二醛含量于再灌注8h后显著低于对照组。两组再灌注后脊髓血流均显著下降，实验组优于对照组。病理学检查示对照组神经元呈缺血改变，白质水肿、脱髓鞘；实验组病理改变轻微。实验组热休克蛋白70表达阳性，对照组为阴性。结论：肢体缺血预处理对脊髓慢性缺血后的再灌注损伤具有明显保护作用。     

护脉膏预防诺维本致静脉损伤的实验研究

目的 探讨护脉膏预防诺维本致静脉损伤的作用.方法 将54只健康、同龄、体重为2.5～3.0kg的新西兰大白兔随机分为A、B、C 3组,每组兔左、右耳缘静脉注射相同剂量的诺维本化疗药物.A组左耳不涂药膏,右耳涂护脉膏;B组左耳不涂药膏,右耳涂喜疗妥药膏;C组左耳涂喜疗妥膏,右耳涂护脉膏.分别在24 h、7 d、15 d后观察兔耳缘静脉局部反应及病理学改变,并将每只兔左、右耳对照.结果 A、B组兔左耳缘静脉局部反应重、病理学改变明显;A、C组兔右耳缘静脉局部反应及病理学改变不明显;B组兔右耳、C组兔左耳缘静脉局部反应及病理学改变介于二者之间.结论 诺雏本易致静脉损伤,护脉膏及喜疗妥均有预防诺维本致兔耳缘静脉损伤的作用,但护脉膏效果更佳.     

“奇正杯”止痛消肿外用药临床应用有奖征文通知

奇正消痛贴膏和奇正青鹏膏剂是临床广泛应用于骨骼肌肉疼痛的传统外用止痛药。为总结和评估其临床疗效、交流临床用药经验,进一步提高临床治疗水平,由中国骨与关节损伤杂志社与西藏奇正藏药股份有限公司联合举办奇正杯止痛消肿外用药临床应用有奖征文活动。     

“奇正杯”止痛消肿外用药临床应用有奖征文通知

奇正消痛贴膏和奇正青鹏膏剂是临床广泛应用于骨骼肌肉疼痛的传统外用止痛药。为总结和评估其临床疗效、交流临床用药经验,进一步提高临床治疗水平,由中国骨与关节损伤杂志社与西藏奇正藏药股份有限公司联合举办奇正杯止痛消肿外用药临     

颈前路椎体次全切术后椎前软组织肿胀的影像学研究

目的:研究颈前路椎体次全切钛网植骨融合内固定术后椎前软组织肿胀的变化规律。方法:自2015年11月至2018年7月进行颈前路单一椎体次全切钛网植骨融合内固定术治疗脊髓型颈椎病患者151例,男109例,女42例;年龄44~81(59.77±8.34)岁。通过术后随访观察,测量C_2-C_7平面椎前间隙距离,评估椎前软组织肿胀变化规律。结果:151例患者术后均获得随访,时间15~40(28.00±3.52)个月。颈前路单一椎体次全切钛网植骨融合内固定手术后1周,椎前软组织肿胀达到高峰,随后出现椎前软组织肿胀减退,术后8个月时C_5、C_6、C_7平面椎前软组织肿胀恢复正常,术后12个月时C2、C3、C4平面椎前软组织恢复正常。结论:前路颈椎体次全切钛网植骨融合内固定手术后椎前软组织均会发生肿胀,术后1周内应高度重视患者椎前软组织肿胀的加重,避免吞咽困难、呼吸道梗阻、窒息等并发症的发生。     

单节段和双/多节段颈椎前路减压融合术后椎前软组织肿胀及吞咽困难发生率的比较

目的比较分析单节段和双/多节段颈椎前路融合术后椎前软组织肿胀程度和吞咽困难发生率。方法纳入颈椎前路融合术病例123例,单节段组50例,双/多节段组73例,在侧位X线片上测量椎前软组织宽度,比较术后椎前软组织肿胀程度及吞咽困难发生率。结果单节段组术后椎前软组织肿胀宽度为(8.29±3.98)mm,吞咽困难发生率为40.0%,均低于双/多节段组的(11.14±5.17)mm和64.4%。且无论高位(C4/C5节段及以上)或低位手术(C5节段以下),单节段术后椎前软组织肿胀宽度和吞咽困难发生率均低于双/多节段术后。结论多节段手术可能是颈椎前路手术术后椎前软组织肿胀和吞咽困难发生的危险因素之一,术前针对相关人群的宣教具有一定的必要性和临床意义。     

股骨干骨折合并脑损伤后大鼠多器官功能损害的生化指标观察

目的：对大鼠血清中多种生化指标的检测,探讨股骨干骨折合并脑损伤后对大鼠多器官功能的影响。方法：4月龄雄性SD大鼠30只,体重（280±10）g,用随机数字表法将大鼠随机分为对照组,创伤第1天组,创伤第2天组,创伤第3天组,创伤第5天组,创伤第7天组,每组5只。5个创伤组制造大鼠右侧股骨干骨折合并脑损伤的模型,然后分别在造模后第1,2,3,5,7天抽取各组腹主动脉,检测血清中天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、肌酐（Cr）、尿素氮（BUN）、乳酸脱氢酶（LDH）、磷酸肌酸激酶（CK）的含量,对照组不做任何处理,只进行上述检测。对各组检测的生化指标进行比较。结果：各组血清中AST、ALT、Cr、BUN、LDH、CK含量差异均有统计学意义（P〈0．01）,其中AST、ALT、BUN、CK在创伤第1天组达到峰值（P〈0．05）;Cr在创伤第3天组达到峰值（P〈0．05）;LDH在创伤第2天组达到峰值（P〈0．05）。结论：股骨干骨折合并脑损伤后会引起大鼠血清中多种生化指标的升高,尤其以创伤后前3d的影响较为显著,这些生化指标改变可间接的反应心、肝、肾器官的功能下降。     

Cervical Prevertebral Soft Tissue Swelling in the Traumatized Patient: What is Normality in the Intubated Patient?

Abstract   Interpretation of prevertebral soft tissue swelling is generally thought to be invalid in the presence of an endotracheal tube (ETT). There is however little scientific data to support this. We evaluate the prevertebral soft tissue swelling of 43 traumatized patients that have had an endotracheal tube (ETT) placed in the acute setting. A control group of 92 patients were also evaluated which had been subjected to acute trauma and no ETT. There was a significant increase in soft tissue swelling (p < 0.0001) found in the ETT group at the C2 level compared to the non-tube group. There was no significant difference between the two groups at the C4 and C6 levels. We feel that interpretation of prevertebral swelling in the traumatized patient at the C2 level is invalid in the presence of an ETT, and indeed is significantly increased after intubation despite no injury at this level. However, the interpretation of soft tissue swelling at and below C4 remains a useful tool in the evaluation of an occult cervical injury.     

Acute staphylococcal hind foot osteomyelitis in a healthy adult: A case report

IntroductionAcute osteomyelitis of the hind foot is uncommon in a normal immunocompetent adult.Case presentationWe present a previously healthy 52year old caucasian male who developed painful swelling of his ankle/hindfoot following closed soft tissue football injury. He had no antecedent systemic symptoms. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of Staphylococcus aureus hind foot osteomyelitis. He underwent triple fusion after debridement and had suppressive antibiotics. His pain and swelling resolved at 6 weeks postoperation and CT confirmed fusion at 6 months. His inflammatory markers normalised over the course of 7 months. After 18 months, he remained asymptomatic without any evidence of recurrence.ConclusionThis case represents an unusual and important variation of presentation of acute osteomyelitis in a healthy adult. It can be easily overlooked when a normal patient presents with pain and functional impairment after a closed soft tissue trauma, but a high index of suspicion is paramount because virulent organisms can infect immunologically normal patients.     

Beneficial effects of (-)-epigallocatechin gallate on ischemia-reperfusion testicular injury in rats

Background/PurposeThe purpose of the study was to determine the effect of (?)-epigallocatechin gallate (EGCG) on testicular ischemia-reperfusion injury in rats.MethodsForty male Wistar rats were assigned to 5 groups. A sham operation was performed on the animals in group 1. In group 2, after 4 hours of unilateral testicular ischemia, 4 hours of testicular reperfusion was performed with EGCG administered 1 hour before reperfusion. In group 3, the same surgical procedure as in group 2 was performed, but without EGCG. Serum superoxide dismutase activity, creatine kinase, and lactate dehydrogenase were then measured in blood samples from groups 1 to 3. In group 4, after 4 hours of unilateral testicular ischemia, testicular reperfusion was performed. In group 5, the same procedure as in group 4 was performed, but with EGCG administered 1 hour before reperfusion. For groups 4 and 5, bilateral orchiectomy was performed for histologic examination 4 weeks after reperfusion was started.ResultsSerum superoxide dismutase activity was significantly higher in group 2 than in group 3. The ratios of bilateral testicular weight, mean seminiferous tubule diameter, and germinal epithelial cell thickness were significantly higher in group 5 than in group 4.ConclusionsTherapy with EGCG before reperfusion might exert protective effects via antioxidant activities in a rat experimental model of testicular ischemia-reperfusion injury.     

显微外科修复足跟部软组织缺损的临床观察

目的：探讨足跟部皮肤软组织缺损修复方法及其临床效果.方法：自1998年6月至2009年6月,收治42例足跟部皮肤及软组织缺损患者,其中男23例,女19例;年龄18～65岁,平均37岁.皮肤缺损范围3 cm×2 cm～18 cm×16 cm.伤后至手术时间8h～10年.足底内侧皮辫13例,腓肠神经小隐静脉营养血管蒂皮瓣18例,隐神经大隐静脉营养血管蒂皮瓣11例.观察术后皮瓣外观、血运、质地、弹性及皮肤两点辨别觉评价术后疗效.结果：术后皮瓣全部成活,其中2例皮瓣远端部分表皮坏死,经换药切痂后用中厚皮片植皮愈合.3例术前有严重深部感染术后残留窦道,经5～12个月换药后窦道痊愈.所有患者获得随访,时间8个月～6年.术后皮瓣外形满意,患肢正常步态行走,皮瓣耐磨,无溃疡发生,有痛觉,两点辨别觉为4～12 mm.结论：足跟部软组织缺损小于8 cm×6 cm选用足底内侧皮瓣修复,手术简单,疗效显著.足跟部缺损面积大于8 cm×6 cm选用皮神经营养血管皮瓣,该类皮瓣具有血供可靠、不牺牲主要动脉、存活率高等优点.     

Endothelial necrosis at 1 hour postburn predicts progression of tissue injury

Burn injury progression has not been well characterized at the cellular level. To define burn injury progression in terms of cell death, histopathologic spatiotemporal relationships of cellular necrosis and apoptosis were investigated in a validated porcine model of vertical burn injury progression. Cell necrosis was identified by high mobility group box 1 protein and apoptosis by Caspase 3a staining of tissue samples taken 1 hour, 24 hours, and 7 days postburn. Level of endothelial cell necrosis at 1 hour was predictive of level of apoptosis at 24 hours (Pearson's r = 0.87) and of level of tissue necrosis at 7 days (Pearson's r = 0.87). Furthermore, endothelial cell necrosis was deeper than interstitial cell necrosis at 1 hour (p < 0.001). Endothelial cell necrosis at 1 hour divided the zone of injury progression (Jackson's zone of stasis) into an upper subzone with necrotic endothelial cells and initially viable adnexal and interstitial cells at 1 hour that progressed to necrosis by 24 hours and a lower zone with initially viable endothelial cells at 1 hour but necrosis and apoptosis of all cell types by 24 hours. Importantly, this spatiotemporal series of events and rapid progression resembles myocardial infarction and stroke and implicates mechanisms of these injuries, ischemia, ischemia reperfusion, and programmed cell death in burn progression.     

伸直位石膏夹板固定治疗儿童肱骨髁上骨折

目的:探讨非手术治疗儿童肱骨髁上骨折预防肘内翻畸形的有效方法。方法:自1992年5月至2013年12月,采用手法复位伸直位石膏夹板外固定治疗无神经血管损伤的儿童肱骨髁上骨折319例,男253例,女66例;年龄1岁3个月～13岁,平均6.7岁。伸直型肱骨髁上骨折284例,屈曲型肱骨髁上骨折35例。左侧167例,右侧152例。受伤至治疗时间1 h～7 d,平均1.8 d.不包括神经血管损伤病例及手术病例。结果:所有患者获得随访,时间3个月～14年,平均37.3个月。所有患儿获得骨性愈合,骨折愈合时间6～8周,平均6.9周。无严重肘内翻畸形、血管神经损伤或Volkmann挛缩等并发症发生。183例提携角与自身健侧一致,在5°～15°范围内,105例提携角较自身健侧有不同程度的减小,26例在复位时即有尺偏者提携角在-5°～0°,5例在复位时即有桡偏者提携角在15°～18°,基本不影响外观。所有病例肘关节活动度正常。结论:肘关节伸直位石膏夹板固定对预防儿童肱骨髁上骨折非手术治疗后的肘内翻畸形具有一定价值,希望有更多学者做进一步的研究。     

闭合手法复位U形螺旋石膏功能位固定治疗Colles骨折

目的:探讨Colles 骨折手法复位后U形螺旋石膏功能位固定的疗效。方法:2011年1月至2014年4月采用闭合手法复位U型螺旋石膏功能位固定47例Colles骨折患者,其中男12例,女35例;年龄8～72岁,平均54.8岁。伤后来院就诊时间40 min～3 d.患者均为闭合性骨折,无神经血管损伤。手法复位后采用U形螺旋石膏功能位固定,术后即可在健手牵引患侧拇指同时余四指伸曲功能握力练习。根据骨折愈合情况,4～8周拆除石膏,拆石膏后加强腕关节功能锻炼。结果:所有患者获得随访,时间6～12个月,平均6.4个月,骨折4～8周愈合。按改良Cooney 腕关节功能评价:优44例,良2例,可1例。结论:U形螺旋石膏功能位固定治疗Colles骨折,限制了拇指及拇伸肌腱活动,可以用健手牵引患侧拇指降低桡骨短缩率,有利于手及腕部的血液循环,肿胀易消退。