超声波检查对新生儿发育性髋关节异常（DDH）的早期诊断及临床价值

目的分析超声波检查在新生儿发育性髋关节异常（DDH）的发生率及早期诊断和临床价值。方法选择我院2008年11月至2009年12月检查的6月龄内新生儿及小婴儿2874例进行髋关节超声波检查。结果首次超声检查共检出DDH89例,发生率3.1%。经早期干预及治疗后,超声复查髋关节不稳定型者全部恢复至髋关节正常型。结论超声波能早期诊断DDH,为临床早期干预及治疗提供依据。     

德州地区婴儿发育性髋关节异常的超声早期筛查及流行病学研究

目的分析德州市婴儿发育性髋关节异常(DDH)流行病学结果,分析超声早期筛查DDH患儿的临床价值,为提升婴儿健康保健质量提供参考。方法采用超声Graf法结合Harcke法对2016年12月～2017年12月期间在我院行儿保检查的4个月内婴儿4000例进行髋关节检查。详细记录每次检查时的超声测量结果,阳性病例复查,对筛查出的患儿进行综合干预,记录其转归情况。按照性别、月龄、出生体重、阳性体征、合并症、胎儿期胎位、羊水量、孕妇情况、家族史等统计婴儿髋关节超声检查结果,分析婴儿DDH患儿的临床特点。探讨早期超声筛查婴儿发育性髋关节异常的对策。结果 4000例婴儿共筛查出发育性髋关节异常88例,患病率2.2%。体格检查共发现11例DDH患儿,超声Graf法检出61例,Harcke检出70例。超声Graf法联合Harcke法检出88例DDH患儿,超声Graf法联合Harcke法检出DDH阳性率显著高于体格、单纯Graf法和单纯Harcke法(P0.05)。超声Graf法和Harcke法诊断DDH类型有基本的对应关系。低月龄、发育性髋关节脱位家族史、先天性马蹄内翻足、肌性斜颈、四肢畸形、臀位产、剖宫产、女婴并发DDH风险较大(P0.05)。88例发育性髋关节异常患儿经综合干预后,髋关节均恢复正常。结论 DDH在婴儿期发病率较高,超声Graf法结合Harcke法可有效筛查早期DDH,及早采取干预措施予以纠正,提升婴儿优育水平。     

Crowe Ⅳ型髋关节发育不良患者全髋关节置换术下肢长度平衡的调节

目的探讨CroweⅣ型髋关节发育不良（DDH）全髋关节置换术（THR）中肢体长度平衡的调整原则及方法。方法回顾性分析2009年7月—2012年6月行THR治疗的39例（41髋）CroweⅣ型DDH患者的临床资料,根据双髋脱位情况对其进行分型,按分型设计并实施手术,分析随访结果。结果根据双髋脱位情况分为4个亚型,其中Ⅰ型2例、Ⅱ型18例、ⅢA型6例、IIIB型9例、Ⅳ型4例。术前患者两下肢长度平均差异为5．1cm,术后为～1．4cm。患者随访时间12—36个月平均22．4个月。最终随访的平均SF-12健康评分为16分（区间为13～22分）。结论根据不同分型对CroweⅣ型DDH患者设计个体化重建手术方案,按设计方案可有效调整下肢长度差异。     

全髋关节置换术治疗成人髋臼发育不良髋臼重建与术式选择

目的探讨全髋关节置换术治疗髋臼发育不良（DDH）的髋臼重建与术式选择。方法对25例（28髋）因DDH致髋关节骨性关节炎患者行全髋关节置换术。根据Crowe分期,Ⅰ期4髋,Ⅱ期12髋,III期9髋,IV期3髋。术前Harris评分20～55分,平均46分。结果 25例均获随访,时间6个月～6年,平均随访时间4年。术后Harris评分为82～95,平均90分。结论全髋置换术解除患者症状,改善关节功能,提高生活质量,是一种行之有效的治疗方法。手术成功的关键在于髋臼的重建与假体的选择。     

婴幼儿发育性髋关节异常的超声波筛查

目的研究超声波检查婴幼儿发育性髋关节异常（DDH）的发病率和超声波检查的重要性及应用范围。方法选择2008年10月～2009年8月婴幼儿4512例,其中男性2121例,女性2391例;年龄28天～6个月,平均年龄35d;9024个髋关节。予以出生史、家族史、其他畸形等危险因素调查。采用高频线阵探头按Graf方法进行检查及评估分析,于出生1个月做髋关节超声波检查,测α、β值;对于50°〈α〈60°的婴幼儿,于第4个月再次做患侧髋关节超声波检查,50°〈α〈60°仍然无改变的,定义为Ⅱb型髋。其中Ⅱb型、Ⅱc型、Ⅱd型、Ⅲ型（脱位髋）及Ⅳ型（脱位髋）髋均称为DDH髋。结果Ⅰ型髋占80.20%;Ⅱ型者19.28%,其中Ⅱa型髋占9.87%,Ⅱb型6.84%、Ⅱc型1.73%、Ⅱd型0.84%;Ⅲ型和Ⅳ型髋共占0.52%,其中出生1个月检查50°〈α〈60°的髋关节在发育中有变化,α在出生第4个月前后测量有差异,具有显著统计学意义（P〈0.001）。出生1个月检查的Ⅱc型、Ⅱd型、Ⅲ型和Ⅳ型髋（家庭中均无家族病史）及第4个月复查50°〈α〈60°的Ⅱb型髋,皆认为患有DDH,占9.92%。结论髋关节超声波筛查是一种安全、有效的诊断方法,能够准确地对髋关节进行定性、定量评估,3个月后进行髋关节超声波检查的准确率会增高,假阳性率也会逐渐减小。     

髋臼结构植骨在Crowe Ⅲ或Ⅳ型髋关节发育不良关节置换术中的应用

目的探讨髋臼结构植骨在CroweⅢ、Ⅳ型髋关节发育不良（DDH）人工全髋关节置换术（THR）中应用的短期效果。方法对2008年7月—2011年6月,全髋关节置换术（THR）中采用结构性植骨结合非骨水泥臼杯进行髋臼侧重建治疗的38例43髋Crowe Ⅲ型或Ⅳ型DDH患者的短期疗效进行回顾性分析。男5例（5髋）,女33例（38髋）,平均年龄41岁。术前Harris评分平均51分,19髋术中联合行转子下横行短缩截骨,平均1．6cm。结果术后平均随访39个月。末次随访Harris评分平均92分。肢体长度差异由术前的平均4．4cm减少至术后0．7cm。术后髋关节旋转中心平均下移3．2cm,内移2．8cm。所有髋臼假体无松动或感染,髋臼结构植骨块均愈合。术后异位骨化1髋,关节脱位1髋,闭合复位成功。结论自体结构性植骨结合非骨水泥臼杯重建Crowe Ⅲ、Ⅳ型髋关节发育不良的旋转中心,短期效果令人满意,无植骨不愈合、骨块吸收或松动等并发症。     

高频超声对婴儿发育性髋关节发育不良的诊断进展

发育性髋关节发育不良(development dislocation of the hip,DDH)是婴儿常见的发育性骨关节畸形之一。未经治愈的DDH有随着患儿生长发育而病情逐渐加重甚至恶化,DDH是成年人退化性髋关节炎病变的主要原因。因此,早期诊断DDH能改善治疗效果,降低出现并发症的风险。近年来DDH的早期筛查在国内外受到重视,高频超声检查对婴儿髋关节结构具有高分辨力、重复性好且无放射性损害的特点,已成为早期诊断DDH的首选方法。本文就高频超声检查在婴儿DDH中的应用现状及进展予以综述。     

应用角度钢板治疗发育性髋关节脱位的临床研究

目的探讨应用角度钢板治疗儿童发育性髋关节脱位（DDH）的临床疗效。方法回顾分析本组48例（52髋）采用角度钢板行开放复位,股骨短缩内翻去旋转截骨术加Salter或Pemberton截骨术式治疗的DDH患儿临床资料。其中男6例,女42例;左侧26例,右侧18例,双侧4例。患儿手术年龄为2～9岁,平均3.5岁。按Tonnis系统分级：Ⅲ度10例,Ⅳ度38例。结果患儿随访1～4年,平均2.4年,股骨颈前倾角术前测量30°～50°,术中皆矫正至20°左右。股骨颈干角术前140°～160°,术后矫正至125°左右。术前髋臼指数35°～55°,术后矫正至18°～35°。术中行短缩截骨长度0.8～3.0 cm,平均2.0 cm。McKay评分,优35例,良13例。结论角度钢板应用于治疗儿童发育性髋关节脱位临床疗效良好,值得推广应用。     

31例发育性髋关节脱位的手术治疗

目的：探讨发育性髋关节脱位（DDH）手术治疗方法的选择及手术操作技巧。方法：术前充分骨牵引后,对其中25例30例髋采用Salter骨盆截骨术或改良Salter骨盆截骨术,4例5例髋行髋臼加盖术,2例2侧髋行沙氏手术（Zahradnicek手术）同时行Chiari骨盆内移截骨术（术中同时短缩股骨1.8-2cm),术后用双髋穗形石膏外固定4－6周,拆除石膏后康复训练。结果;全组31例患者均获3－5年随访。根据SeverinX线评定标准和Mckey临床评定标准,31例37例髋中优32例（86％）,仅一例为差（3％）,无一例伤口感染及截骨处不愈合。结论;对于闭合复位失败及年龄较大（6岁以上）的患儿根据其年龄及病理特点,选择合适的手术方法,其治疗效果令人满意。     

髋关节发育不良髋臼骨囊性变的特征

目的观察髋关节发育不良（DDH）继发骨性关节炎时髋臼骨囊性变的位置和大小,为全髋关节置换术（THR）中髋臼重建提供参考。方法回顾性分析2007年6月—2008年11月我院行THR的DDH患者的临床资料,共38例（45髋）;以同期行THR的38例（45髋）原发性髋关节骨性关节炎作为对照组,在髋关节正位x线片和螺旋CT扫描片上观察髋臼骨囊性变的位置,测量骨囊性变的大小。结果DDH组髋关节正位片发现16侧髋臼存在骨囊性变,螺旋CT扫描片发现21侧髋臼存在骨囊性变,髋臼冠状面测定囊变面积为（4．7±5．1）mm2。对照组髋关节正位片发现6侧髋臼存在骨囊性变,螺旋CT片发现10侧髋臼存在骨囊性变,囊变区面积为（1．3±2．4）mm2,两组间骨囊性变的发生率和面积差异均有统计学意义（P值均〈0．05）。结论DDH继发骨性关节炎的髋臼存在高发的骨囊性变。在THR髋臼重建过程中应对其进行刮除植骨,否则可能影响到髋臼假体的稳定性。     

Role of the hormonal status of the father in involution of the thymus in the progeny

This study was aimed at assessing the consequences of the influence of exogenous androgens on the epididymal sperm of fathers for their progeny. A single injection of testosterone or dihydrotestosterone to adult rats caused a transient increase of the level of the corresponding androgen, later leading to augmentation of the androgen-dependent organs and loss of thymus weight. Hyperandrogeny and earlier age-associated involution of the thymus were observed in the male progeny of androgenized males of reproductive age. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 121, No. 5, pp. 562–564, May, 1996     

Role of noradrenalin in the dorsal hippocampus in the mechanism of the self-stimulation response in rats

Laboratory of Neurophysiology of Reinforcement, A. I. Karaev Institute of Physiology, Academy of Sciences of the Azerbaijan SSR, Baku. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 109, No. 1, pp. 5–6, January, 1990.     

Changes in the structure of the cilia of the ciliated epithelium of the bronchi in Kartagener's syndrome in children

Biopsies of bronchial mucous membrane taken from 4 children with Kartagener's syndrome and 10 children with chronic pneumonia were examined electron microscopically. Structural changes in cilia and apical parts of cells are detected in all patients with Kartagener's syndrome. Cilial changes provoked by chronic inflammatory process are shown. The importance of ultrastructural investigations of bronchial mucous membrane cilia in the understanding of pathogenesis of chronic lung conditions in children is underlined.     

The Beauty of the Network in the Brain and the Origin of the Mind in the Control of Behavior

Behavior is not adequately described as a stimulus-response process. It is initiated by the animal and is generated because of its expected outcome in the future. The outcome can be good or bad for the animal. The brain is in charge of the selection process. This is the basic function of the brain. Taking Drosophila as a study case, this paper discusses initiating activity, several examples of outcome expectations, trying out (the internal search for a suitable behavior), chaining of actions, and the functional roles of chance in action selection. It takes mental processes and states such as goals, intentions, feelings, memories, cognition, and attention as higher levels of behavioral control that have their origin in biological evolution.     

Challenges in the Management of Asthma in the Elderly

Recent literature has emphasized the clinical and socio-epidemiological significance of asthma in the elderly. However, why the disease burden remains high in this group is unclear. Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated. This review aims to summarize the literature associations between comorbidities and asthma in elderly patients. In addition, we discuss patient management issues.     

Role of the time interval in the effect of neurochemical signals in the changes in the ultrastructure of cortical synapses

Translated from Zhurnal Vysshei Nervnoi Deyatel'nosti imeni I. P. Pavlova, Vol. 41, No. 4, pp. 836–838, July–August, 1991.     

On the role of the lymphoid follicle-associated areas in the organization of the bursal follicle in the cloacal bursa in birds

The present paper contains data on the morphological modifications present in chicks which, after treatment with testosterone lasting 10 days (from the seventh to the seventeenth days after hatching), were killed on the 30th, 35th, 40th, 50th and 70th day of life; this interval of time might theoretically have allowed a gradual re-establishment of the bursal architecture. Examination of the bursae of Fabricus of the animals treated showed greatly varying pictures. The 2 main types of behaviour were the following: the histological pattern of certain bursae had been completely restored to normal. Others did not act in the same way but wide areas of their plicae proved to be devoid of lymphoid tissue and well-formed lymphoid follicles were observed only in certain places. These 2 kinds of behaviour, and particularly what we observed in the second case, might suggest that, since the lymphoid follicle-associated epithelial cells are the last to disappear after treatment with testosterone propionate and the follicles are restored only where these cells remain, the lymphoid follicle-associated epithelial cells may be considered to be responsible for the re-establishment of the bursal follicle.     

Role of the inferior colliculus in the inhibition of acoustic startle in the rat

Fifteen rats were tested for amplitude reduction of the acoustic startle response using auditory and visual prestimuli. Eight subjects then received large lesions of the inferior colliculus, and the remaining subjects served as normal controls. All animals were reassessed on a post-test identical to the pre-test. In addition, all subjects were tested for latency reduction of startle using auditory prestimuli. There were no significant differences between groups on the pre-test for startle amplitude, visual amplitude reduction, or auditory amplitude reduction, nor did the control group differ significantly on these measures from pre-test to post-test. After surgery, the lesion group displayed a large, significant increase in startle amplitude. Auditory prestimuli were no longer effective in reducing startle amplitude in this group, but visual prestimuli still produced reliable amplitude reduction. Both groups displayed reliable latency reduction to auditory prestimuli; the groups were not significantly different from each other on this measure. These data support the proposition that the inferior colliculus is part of a neural circuit for startle amplitude reduction by auditory prestimuli.