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1.
目的 婴幼儿髋关节发育不良目前最有铲、最简捷的方法是采用闭合复位治疗。通过对3周岁以下不同年龄段、单侧DDH患儿闭合复位治疗结果进行分析,探讨年龄因素对DDH闭合复位治疗疗效而后的影响。方法 自1982-1996年采用闭合复位治疗3周岁以下DDH413例,随机选用〈1周岁,1-2周岁、〉2周岁的单侧完全性DDH各30例。测定(量)各病例复位前及复位后6、12、24个月患侧、正常侧髋臼指数、髋臼指数  相似文献   

2.
TH1/TH2类细胞因子对血液透析患者淋巴细胞死亡的影响   总被引:7,自引:0,他引:7  
血液透析(HD)患者常常表现为淋巴细胞减少及免疫功能不全,如反复感染、恶性肿瘤发生率增高等。目前认为,活化诱 导 的 淋 巴 细 胞 死 亡(activation-induced cell death,AICD)在免疫应答的负调节中发挥重要作用,而细胞因子能影响AICD[1]。为了探讨HD患者免疫功能低下以及免疫细胞耗竭的发病机制,我们选择代表TH1/TH2的两种典型的细胞因子干扰素/肿瘤坏死因子(IFN-γ/TNF-α),应用流式细胞仪,观察它们对HD患者AICD的影响。 一、材料与方法 1.实验分组:(…  相似文献   

3.
作者从1977年5月-1983年10月,曾一期采取切开复位、髋臼造顶和股骨短缩截骨术治疗先天性髋脱位(CDH)75例,其中26例33个髋关节获得平均12.7年的随访。没有文献中的Mckay临床评定标准和SeverinX线评定标准对本组病例做了疗效评价。其临床优良率为85%,X线优良率为73%;术前髋臼指数平均为35度,术后降到18.1度,术前股骨头上移平均为3.5cm,术中短缩股骨2.1cm,结果  相似文献   

4.
采用RTPCR方法,观察CD28通路活化后淋巴细胞Th1/Th2细胞因子mRNA表达水平及CsA的抑制作用。取正常人外周血淋巴细胞,培养过程中分别给予抗CD3mAb单独刺激或抗CD3mAb+抗CD28mAb共同刺激。提取细胞总RNA并逆转录成cDNA,对Th1细胞因子(IFNγ、IL2)和Th2细胞因子(IL4、IL10)cDNA进行扩增。结果显示:共刺激信号可使Th1细胞因子基因mRNA转录增加,且对CsA的抑制作用产生抵抗;而对Th2细胞因子则不产生明显影响。研究表明:CD28共刺激信号主要增强淋巴细胞Th1细胞因子基因mRNA表达,并可能参与其分化调节;这一活化通路不被CsA阻断。  相似文献   

5.
Ma C  Cai G  He R 《中华外科杂志》2000,38(9):711-712
目的 探讨V形镍钛合金(记忆合金)支架植入髋臼顶部后,对其髋臼发育不良的矫正及对其髋臼发育的影响。方法 选用髋臼发育不良的幼犬10只,随机分为2组,在髋臼顶部距臼缘上0.5cm处用弧形骨刀做与髋臼弧度一致的截骨,其截骨深达Y形软骨,将截骨后的骨瓣向下扳压,在骨瓣上方植入2 ̄3只V形镍钛合金支架,术后4、12周行双髋关节X线摄片,进行大体及组织学观察。结果 术后12周髋臼顶部由术前斜坡形恢复为弧形,  相似文献   

6.
观察超前缺血(preconditioningwithischemia,PCI)对培养乳鼠心肌细胞缺血再灌注(ischemia-reperfusion,I-R)损伤的影响。发现(1)心肌细胞经PCI后,其ATP含量及培养液LDH无明显变化;(2)经PCI诱地的心肌细胞,持续3h缺糖,缺氧,其ATP消耗较对照组显著减少,(3)复灌期PCI组ATP含量增加,LDH下降,(4)在各时相(Ca^++)i与对  相似文献   

7.
刘扬  吴孟超 《中华外科杂志》1994,32(11):650-653
放射性核素 ̄(131)I标记抗人小扁豆凝聚素结合型甲胎蛋白异质体单克隆抗体(AFP-R-LCAMcAb)后,经裸鼠腹腔注射,能选择性地在裸鼠实验性人类肝癌模型(简称:人肝癌)肿瘤区积聚,裸鼠人肝癌的放射性核素浓度是裸鼠肝脏的5.2倍,而 ̄(131)I标记的正常小鼠IgG(mIgG)或游离 ̄(131)I却无瘤区积聚,且在荷瘤裸鼠体内呈均一性分布。 ̄(131)I标记单抗组γ照相均可清晰显示裸鼠所荷肝癌组织的阳性影象。实验发现, ̄(131)I标记AFP-R-LCAMcAb后治疗荷人肝癌棵鼠,肿瘤生长受到明显抑制(85%),其治疗效果优于 ̄(131)I-mIgG组、单纯核素组和单纯抗体组(46%、20%、7%、P<0.05)。结果表明,AFP-R-LCAMcAb对人肝癌细胞有较强的特异性和亲和力,有希望成为肝癌放射免疫诊断及治疗的理想载体。  相似文献   

8.
髋臼发育不良动物模型的建立及其临床意义   总被引:8,自引:0,他引:8  
Ma C  Cai G  He R 《中华外科杂志》1998,36(9):559-560
目的探讨髋臼发育不良在先天性髋关节脱位发病过程中的意义。方法将12只幼犬通过外科手术造成单侧髋关节脱位,术后3、4周通过大体标本、组织学及X线摄片,观察髋臼变化。结果术后3周幼犬实验性髋关节脱位侧即出现髋臼发育不良,髋臼上部呈斜坡状,髋臼浅,X线片上可见髋臼指数增大,由实验前平均132±13度增大为平均278±15度,组织学观察见髋臼软骨退行变化。结论髋臼发育不良为髋关节脱位的继发病变,不是髋关节脱位的原因;如果髋关节脱位或髋关节松驰得到及时治疗,髋臼发育不良可以恢复正常  相似文献   

9.
1,25二羟维生素D3对乳腺癌细胞株生长及凋亡的影响   总被引:2,自引:0,他引:2  
目的 研究1 ,25 二羟维生素 D3[1 ,25( O H)2 D3] 对乳腺癌细胞株 M C F7 生长及凋亡的影响。 方法 采用四唑氮蓝比色( M T T) 法检测细胞增殖,光镜和电镜形态学观察,流式细胞仪测定细胞周期和凋亡率,末端脱氧核苷酸转移酶介导的原位酶标记( T U N E L) 法计数凋亡细胞,免疫印迹法检测bcl2 蛋白表达。 结果 10 - 7 mol/ L 的1 ,25( O H)2 D3 就可以抑制 M C F7 增生,改变细胞周期时相分布,致 G0/ G1 期阻滞,加强细胞毒性化疗药阿霉素( Adr) 的作用,促进细胞凋亡,下调bcl2 蛋白表达。 结论 1 ,25( O H)2 D3 可以作为细胞调亡诱导剂成为新一类乳腺癌激素治疗药。  相似文献   

10.
全髋关节置换治疗髋关节发育不全   总被引:9,自引:2,他引:7  
目的:研究全髋关节置换治疗髋关节发育不全(DDH)的外科技术。方法:47例(54髋)因髋关节发育不全引起严重骨性关节炎的患者行全髋关节置换治疗,其中男8例,女39例。随访12个月~14年,平均53个月。结果:根据MerleD'Aubigne评分方法,优8例(17~18分)、良30例(13~16分)、中8例(9~12分)、差1例(<8分)。结论:根据髋关节脱位的程度可将髋关节发育不全分成四度,其中Ⅰ度、Ⅱ度为半脱位型;Ⅲ度、Ⅳ度为全脱位型。DDHⅠ度,即低位半脱位,髋臼加深为其手术要点;DDHⅡ度,即高位半脱位,通过上移髋臼假体可以避免植骨;对于DDHⅢ度、Ⅳ度则使用小型髋臼假体并且植骨。我们提出的分类方法较Crowe方法简便且实用,特别是对髋臼的处理有指导意义。对髋关节发育不全进行全髋关节置换应严格掌握适应证,只有当疼痛和功能障碍非常明显而保守治疗无明确效果时采用  相似文献   

11.
髋臼骨折记忆合金三维内固定系统在髋臼骨折中的应用   总被引:2,自引:0,他引:2  
目的 探讨髋臼骨折记忆合金三维内固定系统(ATMFS)在髋臼骨折中的应用效果.方法 ATMFS治疗髋臼骨折18例,其中新鲜骨折6例,陈旧性骨折12例.结果 18例经12~24个月随访,X线片未见骨折再移位及内固定物松动、脱落,15例术后2个月达骨性愈合,发生异位骨化5例,按Merie d'Aubigne与Postel评分法:优10例,良6例,中等2例.结论 ATMFS为髋臼骨折的解剖重建,提供了一种新的有效方法.  相似文献   

12.
At an average of 6.3 years after surgery, we evaluated midterm results of uncemented acetabular reconstruction in 31 hips with posttraumatic arthritis that developed after acetabular fracture. Patients were categorized by previous fracture treatments (open-reduction group and conservative-treatment group) and fracture patterns (simple group and complex group). Surgery duration and blood loss were greater in the open-reduction and complex groups than in the conservative-treatment and simple groups (P < .05). The mean Harris Hip Score increased from 49 before surgery to 89 after surgery. Survival with revision or radiographic acetabular loosening as an end point was 100%. Fracture treatments and patterns were associated with increased surgery duration and increased blood loss. Open reduction and internal fixation of a fracture favor anatomical restoration of the hip's rotational center.  相似文献   

13.
2001~2005年,我院采用手术治疗髋关节骨折患者15例,获得良好疗效。1材料与方法1.1病例资料本组15例,男12例,女3例,年龄21~56岁。左侧6例,右侧9例;均为新鲜骨折。其中合并多发骨折11例,合并髋脱位2例,合并颅脑及腹部复合伤2例。按照Letournel-Ju-det分类法分类:前柱骨折2例,前壁  相似文献   

14.
目的探讨髋臼旋转截骨术治疗早中期髋关节发育不良的手术技术要点及中期疗效。方法2000年5月至2006年5月对12例(14髋)早、中期髋关节发育不良患者进行了髋臼旋转截骨术,所有患者均为女性,手术时年龄13—46岁,平均28.9岁。随访时间3.1—9.1年,平均6.0年。术前、术后及随访时X线片上测量CE角,髋臼顶角及头外移指数。Harris评分判断髋关节功能。手术采用Oilier外侧“U”形入路,股骨大转子截骨显露。术后未行外固定。结果患者疼痛症状得到明显改善,Harris评分术前72分,术后91分(P〈0.001)。CE角术前0.9°,术后27°(P〈0.001);髋臼顶角术前为29°,术后5°;头外移指数术前为0.68,术后0.65。所有病例截骨块及股骨大转子截骨处愈合良好。结论Oilier外侧“U”形入路行髋臼旋转截骨术髋臼缘显露充分;治疗早中期髋关节发育不良可以缓解疼痛,延缓骨关节炎的进展速度,中期随访疗效满意。  相似文献   

15.
Reconstruction of major acetabular defects continues to challenge surgeons. There are many surgical options for these situations, including oversized hemispherical cups, oblong cups, acetabular cages, bulk allografts, and impaction allografting. We present the case of a modification to the impaction grafting technique for acetabular reconstruction. In our case, a porous-coated modular titanium acetabular component was cemented in place instead of an all-polyethylene acetabular component, which is the standard technique for impaction grafting reconstruction. The use of the modular component allowed a greater number of surgical options at the time of surgery. At 5 years from surgery, the patient has a successful reconstruction and the radiographs continue to look excellent.  相似文献   

16.
We describe two patients with a constrained acetabular component who required treatment for recurrent dislocation showing postoperative periprosthetic acetabular bone loss. These hips required revision surgery and demonstrated considerable bone loss caused by the migrated acetabular component. Impingement may have occurred with increased stress at the bone-prosthesis interface, and the sharp ends of screws with a metal shell may have gradually plowed up the acetabular bone. These failures illustrate the potential risk of using a constrained acetabular component.  相似文献   

17.
Severe acetabular bone loss remains a challenge at the time of revision hip arthroplasty. A novel modular system is available to aid in the reconstruction of these challenging cases. This technique can provide support for an uncemented acetabular shell. By using the augments in combination with the revision acetabular component, the following goals of revision surgery on the acetabular side can be achieved at the time of surgery: initial stable fixation, restoration of the center of rotation, and maximization of host bone contact.  相似文献   

18.
19.
The combined anteversion technique for acetabular component placement of total hip arthroplasty is beneficial because of the surgeons' limited ability to control the anteversion of a cementless femoral stem. Our data show that the cementless stem anteversion can be 15 degrees different than anticipated. By determining femoral stem anteversion before positioning cup anteversion, the cup anteversion can be adjusted for the stem anteversion. The combined anteversion technique should provide a mean near 35 degrees with a safe zone of 25 degrees to 50 degrees.  相似文献   

20.
Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In the case of major bone loss where less than 50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring in association with a cemented component and allograft bone should be used. Herein we describe the technical details of the use of the Kerboull acetabular reinforcement device and the GAP cup. Both these devices have a hook that has to be placed under the teardrop of the acetabulum and a plate for iliac fixation. The main advantages of these devices are their help in restoring the normal hip center of rotation, guiding the reconstruction, and partially unloading the graft. The Kerboull acetabular reinforcement device has provided a 92% survival rate free of loosening at 13-year follow-up in a consecutive series of 60 type III and IV deficiencies.  相似文献   

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