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目的应用数值仿真方式探讨脉冲响应法对骨关节退变的评估能力。方法依据髌骨与股骨的接触模式,设定3种厚度的髌骨-股骨间软骨,构建简化的髌骨股骨接触模型,设定相关组织的物理参数。在股骨侧方模拟放置加速度传感器,模拟力锤敲击髌骨,获得通过股骨-髌骨接触面之后的振动波形。观察波形在不同不同厚度软骨情况下的变化规律。结果随着关节软骨的变薄,加速度曲线中的高频振荡区域到来得越来越早。速度曲线在开始阶段呈震荡增加,而后趋于稳定值,并在该稳定值附近强烈震荡。在去除软骨的模型中,观测点的速度曲线在迅速增大之后突然回归到零,并在零附近小幅震荡,在回归过程中经历了很高的加速度。结论通过仿真研究发现,脉冲响应发能够比较明显地观测到关节软骨退变后的振动变化情况。 相似文献
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关节退行性改变在地方性氟骨症诊断中的意义 总被引:7,自引:2,他引:5
近年,有些报道提出关节的X线改变可作为氟骨症诊断、分度的重要依据。有人建议将关节改变较多的病人作为氟骨症的独立类型——关节型。但是,有一些调查结果与上述意见不同。所以,对氟骨症关节改变的意义一直尚未定论。 相似文献
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我们于 1997年 1月至 1999年 12月在建立犬膝前交叉韧带切断导致关节软骨进行性退变模型的基础上 ,观察实验性骨关节炎 (OA)退变软骨中 3B3表位表达 ,以寻求早期诊断软骨退变的理想方法。 一、材料与方法 1.实验动物 :2 1只成年家犬 ,体重 15~ 36kg ,平均(2 5 4± 5 5 )kg ,随机分成 3组 ,即实验A、B组和对照组 ,每组 7只犬。实验A与B组犬在麻醉下切断前交叉韧带 ,造成膝关节不稳定 ,缝合切口 ,自由饲养 ,两组犬分别于术后 6、12周时处死 ;对照组家犬右膝关节未做任何处理 ,处死后直接取材。 2 .光镜观察 :3组犬处死后 ,将… 相似文献
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腰椎关节突关节(LFJ)退变作为腰痛根源之一,通常被称为“小关节综合征”,组织中发生率为15%~45%〔1〕。腰椎失稳也与LFJ的退变、损伤密切相关〔2〕。临床上,退变发生在结构和细胞水平,与年龄,损伤,感染或炎症有关。这个过程改变了小关节的材料和机械性能,最终导致受影响组织完整性的进一步损害,其中最突出的标志是病理学改变,包括软骨磨损、撕裂、坏死、纤维化、硬化、软骨下骨暴露、骨赘形成、软骨下囊肿及关节囊钙化等〔3〕。研究表明,LFJ是位于腰椎后外侧真正的滑膜关节,除了抵抗腰椎平移,这些成对的关节根据不同的体位可以支撑3%~33%的压缩负载,并通过促进或限制腰椎运动节段的运动增加腰椎稳定性〔4~6〕。 相似文献
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肩锁关节由锁骨远端与肩峰内面构成.肩锁关节的肩峰关节面凹陷,朝向前内,与突起的锁骨远端关节面形成关节.肩锁关节的关节囊比较松弛,由位于上、下、前、后四个方向的肩锁韧带所加强.关节内有纤维软骨盘,但常常不完整或缺如.由于肩锁关节为微动关节(各个方向上的活动度在5~8度以下[1]),又因其处于上肢带骨的非显要位置,肩锁关节所受到的关注明显少于其他关节.然而,肩锁关节的旋转运动,加上由于三角肌所产生的高剪切应力和高压力,肩锁关节和纤维软骨盘的退变在人生的第二个十年就开始了,并且随着年龄的增长而逐渐加重. 相似文献
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脊髓型颈椎病是颈椎间盘退变及继发椎间关节退变使其周围组织受累,导致颈髓受压而出现临床症状的一种颈椎病。2003~2005年,我们采用前路手术治疗脊髓型颈椎病38例,疗效满意。现报告如下。 相似文献
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腰椎间盘退行性变是引起老年人腰腿痛常见原因之一 ,目前CT已成为诊断腰椎间盘病变主要手段。现将我院 5 2例老年人腰椎间盘退行性变的CT表现进行分析报道如下。1 资料与方法1.1 材料 我院 1998年 3月至 2 0 0 0年4月期间 ,无明确外伤史经CT诊断为腰椎间盘退变的 5 2例 ,其中男 2 1例 ,女 3 1例 ,年龄 60~ 86岁 ,平均 66.6岁。病程 2周~ 10年 ,平均 3 .5年。腰痛 14例 ,腰痛伴双下肢放射痛 16例 ,腰痛伴单下肢放射痛 16例 ,单下肢麻木、疼痛 4例 ,双下肢麻木、疼痛 2例 ,间歇性跛行 5例。1.2 方法 CT检查采用MAX 64 0C… 相似文献
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赵勇 《实用心脑肺血管病杂志》2012,20(7):1184-1185
目的探讨跟骨关节内骨折手术的临床疗效。方法将60例跟骨关节内骨折患者随机分为观察组和对照组各30例,观察组给予切开复位内固定的方法治疗,对照组给予手法复位非手术治疗,术后随访1年。观察两组患者的临床效果。结果观察组患者的骨折均愈合,功能恢复良好,优良率为70.00%,而对照组的优良率为36.67%,两组比较差异有统计学意义(P<0.05)。结论切开复位是治疗跟骨关节内骨折的有效方法。 相似文献
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赵源 《国际内分泌代谢杂志》1989,9(1):34-36
儿童胰岛素依赖型糖尿病(IDD/c)骨、关节表现,近年来引起注意。本文对其骨病(贫骨,Osteoponia)及其常见的关节病变(关节活动受限,LJM)的临床表现和发病机理作简单介绍。 相似文献
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João Paulo Telles Juliette Cieslinski Felipe Francisco Tuon 《The Brazilian journal of infectious diseases》2019,23(3):191-196
BackgroudDaptomycin has been used in bone and joint infections (BJI) and prosthesis joint infections (PJI) considering spectrum of activity and biofilm penetration. However, the current experience is based on case reports, case series, cohorts, and international surveys. The aim of this systematic review was to evaluate studies about daptomycin treatment efficacy in BJI/PJI compared to other antibiotic regimens.MethodsPubMed, LILACS, Scielo and Web of Science databases were searched for articles about daptomycin and treatment of BJI and PJI from inception to March 2018. Inclusion criteria were any published researches that included patients with BJI treated with daptomycin. Diagnosis of BJI was based on clinical, laboratory and radiological findings according to IDSA guidelines.ResultsFrom 5107 articles, 12 articles were included. Only three studies described the outcomes of patients with BJI treated with daptomycin with comparator regimen (vancomycin, teicoplanin and oxacillin). Studies presented large heterogeneity regarding device related infections, surgical procedures, and daptomycin regimens (varied from 4 mg/kg to 10 mg/kg). A total of 299 patients have been included in all studies (184 infections associated with orthopedic disposal and 115 osteomyelitis/septic arthritis). Two hundred and thirty-three patients were treated with daptomycin. The clinical cure rates on device related and non-device related infections (i.e. osteomyelitis) were 70% and 78%, respectively. Compared to all regimens evaluated, daptomycin group outcomes were non-inferior.ConclusionAlthough a randomized clinical trial is needed, this systematic review tends to support daptomycin usage for bone and joint infections. 相似文献
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Summary Although temporomandibular joint involvement is frequent in ankylosing spondylitis, ankylosis seldom ensues. A patient with a temporomandibular joint ankylosis secondary to ankylosing spondylitis is presented. Treatment consisted of an osteoarthrectomy, followed by a costochondral ribgraft. A follow-up period of 39 months showed a satisfactory result. 相似文献
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《Best Practice & Research: Clinical Rheumatology》2020,34(3):101508
Joint hypermobility is relatively common and has many influences such as age, gender, training, and ethnicity among many. Joint hypermobility may be asymptomatic or symptomatic. It may also be non-syndromic or syndromic. However, “asymptomatic” joint hypermobility may result in repetitive use injury, alter biomechanics of joints at other body sites, or become symptomatic later in life. Symptomatic joint hypermobility can result from soft-tissue rheumatism (e.g. bursitis, tendonitis, etc.) or muscular tension pain due to muscular imbalance. Generalized joint hypermobility (GJH) can be easily assessed using a standardized, quick, in-office examination. Management is relatively straight forward once joint hypermobility is recognized using neuromuscular re-training. It is important to recognize that GJH may also be a feature of a heritable connective tissue disorder with other systemic findings. Therefore, assessing joint hypermobility in those with musculoskeletal complaints may lead to recognizing systemic manifestations and allow the appropriate management. 相似文献
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Objective The aim of this study was to determine the prevalence of joint hypermobility among high school students and to define the characteristics of patients with joint hypermobility.Methods The students underwent complete history and physical examination. In order to designate marfanoid habitus, body weight, height, and span/height and upper/lower segment ratios were recorded. The degree of joint hypermobility was scored by the Beighton scoring system. The following features were also examined: arthralgia, myalgia, low back pain, sciatica, spinal deformities, temporomandibular joint pain and crepitus, effusion, swan neck deformity, arachnodactyly, joint dislocation, joint sprain, Raynauds phenomenon, stria, varicose veins, abdominal and inguinal hernia, heart disease history, myopia, dropping eyelids, and antimongoloid slant.Results Eight hundred sixty-one students (433 females and 428 males) with a mean age of 15.4±1.1 years (range 13–19) were examined. Joint hypermobility was observed in 101 (11.7%) of the students. According to the Beighton scoring system, the majority of these (61.4%) were observed to score 4. Our results show that phenotype has no relation with joint mobility. Of the total number of students, there were 31 male (7.2%) and 70 female (16.2%) hypermobile subjects. The difference between sexes was highly significant (P=0.00005). Joint sprain was detected in 14 of hypermobile students (13.9%) and 50 of nonhypermobile students (6.6%). Its presence was the only significant parameter between hypermobile and nonhypermobile students (P=0.0094).Conclusions Joint hypermobility was found in 11.7% of the students in our study, and the results are in harmony with the previous studies on Western populations. Although hypermobility does not seem to be very problematic in young people, as in our focus group, we believe that it is important for physicians to recognize this problem to ensure correct diagnosis and treatment, since it may lead to mimic rheumatic diseases in the future. 相似文献
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目的探讨全身振动治疗仪结合弹力带对膝关节进行动态稳定性训练的应用价值及提高脑卒中患者步行能力的方法。
方法选取瑞盛康复医院康复科自2015年1月至2018年8月收治的刚开始独立步行的脑卒中患者30例,按随机数字表法分成对照组(15例)和治疗组(15例)。对照组进行常规康复治疗,治疗组在对照组基础上增加全身振动治疗仪上进行0°~30°蹲起站立训练,平衡杠内利用弹力带进行伸膝抗阻步行训练以及本体感觉滑板上原地踏步训练,2组患者均治疗2个周期(1个月为1个周期)。于治疗前后分别对2组患者进行下肢Fugl-Meyer运动功能(FMA)、10 m步行时间(MWS)、起立-行走测试(TUGT)、以及三维步态分析中的患肢支撑相时间评估。
结果治疗2个月后,2组患者进行组间比较,治疗组的FMA评分较对照组相比明显提高,TUGT时间、10 m MWS时间、患腿支撑相时间较对照组相比明显缩短,治疗组患者的步行能力及稳定性明显好于对照组,差异有统计学意义(P<0.05)。
结论全身振动治疗仪结合弹力带针对膝关节训练可以改善脑卒中患者步行稳定性,提高步行能力。 相似文献
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2型糖尿病足部振动感觉损伤相关危险因素分析 总被引:1,自引:2,他引:1
目的 研究2型糖尿病足部振动感觉损伤相关危险因素.方法 用振动感觉分析仪对3270名2型糖尿病患者行振动感觉检查,分为振动感觉减退的研究组及无振动感觉减退的对照组,测定尿蛋白、血脂、体重指数、血糖、HbA_(1C)、血清果糖胺、C肽、血压等及眼底检查.结果 研究组年龄平均为(59±12)岁,病程≥5年、24 h尿蛋白定量≥300 mg/d、有糖尿病视网膜病变、足部症状及男性比例均高于对照组,空腹血清C肽(0.56±0.45)nmol/L、餐后2 hC肽(1.81±0.95)nmol/L均低于对照组[(0.65±0.56)和(2.14±0.82)nmoL/L,P<0.05].Loistic回归分析显示,足部症状、24 h尿蛋白定量、糖尿病病程与振动感觉减退明显相关.结论 24h尿蛋白量、糖尿病病程、足部症状是2型糖尿病振动感觉损伤的危险因素. 相似文献
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Standardising joint assessment in rheumatoid arthritis 总被引:2,自引:0,他引:2
Dr. D. L. Scott E. H. S. Choy A. Greeves D. Isenberg D. Kassinor E. Rankin E. C. Smith 《Clinical rheumatology》1996,15(6):579-582
Summary Evaluating joint involvement in rheumatoid arthritis in a key clinical assessment. We investigated the extent of variation in measurement of joint swelling and tenderness and evaluated the impact of training to standardise methods. Eight observers (medical and nursing staff) examined eight rheumatoid patients for joint swelling and tenderness before and after training in clinical methods. The EULAR handbook for joint evaluation was used for training and assessments were based on the 28 joint count. There was extensive variability in both numbers of swollen and tender joints. Coefficients of variation for articular indices recorded by the 8 observers in individual patients were often high (up to a maximum of 204%), indicating considerable differences between observers. Training had an impact on the assessment of the numbers of swollen joints which increased by a mean of 32% (P<0.05) and the number of tender joints which increased by 41% (p<0.01). Training had only a limited impact on the variation among observers in determining the number of swollen and number of tender joints. After training, the mean coefficients of variation were still 59% for swollen joints and 65% for tender joints. These results highlight the extent of variation in clinical assessment of rheumatoid arthritis and show the advantages of training. It leads to increased sensitivity of measurement. Standardisation appears essential for clinical studies. 相似文献
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震动感觉阈值检查在糖尿病神经病变诊断中的应用 总被引:11,自引:0,他引:11
震动感觉阈值检查(VPT)用于诊断糖尿病神经病变简便、无创、重复性好、患者顺应性好。其敏感性优于其他依赖临床症状、体征的方法和尼龙单丝检查。本文介绍VPT及其与其他临床常用诊断糖尿病神经病变方法的比较,简述了VPT检查时需要注意的问题,如年龄、探头的压力、检查者的经验和患者对于检查的理解等。 相似文献