肱骨髁上部的三维有限元分析研究

采用超级空间有限元计算程序ＳＵＰＥＲ—ＳＡＰ最新版本对肱骨髁上部进行各种受力条件的空间有限元分析。结果表明：１．旋后位肱骨髁上部内侧是压应力，外侧是拉应力；中立位、旋前位肱骨髁上部内侧是拉应力，外侧是压应力。２．旋后位、中立位、旋前位三种不同位置的剪应力变化不大（Ｐ＞０．０５）。３．在旋后位肱骨髁上部不论是内侧还是外侧节点均向内侧位移；中立位、旋前位与旋后位正相反，均向外侧位移，其中立位与旋前位不论是内侧还是外侧，位移无明显差异（Ｐ＞０．０５）。结合Ｓａｌｔｅｌ理论，作者提出了肱骨髁上骨折合理的固定方法。     

杉树皮夹板固定治疗肱骨髁上骨折预防肘内翻的研究

根据已矿名老中医张绍富的经验,采用手法整复、杉树皮夹板屈肘前臂旋前位固定的方法治疗肱骨髁上骨折１２０例。经１８个月随访,结果优良率达８３．３４％,肘内翻发生率为１５．２％,明显优于文献报道的各种疗法。运用传感器对不同固定体位下骨折断端间内外侧皮质骨处的压力变化进行测量,证明屈肘旋前位时夹板固定效力最大,断端最稳定,移位倾向最小,能有效预防肘内翻的发生。认为屈肘前臂旋前位固定是治疗肱骨髁上骨折的最佳     

肱骨外髁的电测实验应力分析

采用电测实验方法探讨肱骨外髁翻转骨折的发生机制和合理的固定方法。取一具6岁儿童新鲜尸体的肘关节,处理后粘贴电阻应变片,模拟肘关节伸直和屈曲45°状态下前臂旋前、中立、旋后6种体位,和屈曲90°时前臂旋前、中立、旋后3种体位的应力测定,结果显示肱骨外髁前后部竖直方向的应变无论伸肘还是屈肘均为压应变,屈肘45°位为拉应变。肱骨外髁在屈肘90°前臂旋后位时,水平方向的压应变最大,中立位次之,旋前位时其前方呈拉应变。提示肱骨外髁骨折的好发部位是肘关节半屈曲位,骨折后最佳的固定体位是屈肘90°前臂旋后位。     

前臂旋后位夹板固定治疗儿童肱骨髁上骨折

前臂旋后位夹板固定治疗儿童肱骨髁上骨折广东省花都市中医院（５１０８００）孙红旗孙广生１儿童肱骨髁上骨折极易发生肘内翻畸形，其原因多认为是由于骨折远端内倾、内旋（即旋前）所致。笔者经过长期观察，认为肱骨髁上部骨质扁薄，骨折时断端象两片薄板相对，极不稳定...     

肱骨外髁的空间有限元计算与实验研究

目的：从生物力学角度,采用三维有限元方法,研究肱骨外髁在不同体位时的实际受力状况,探讨肱骨外髁翻转骨折的发生机制。方法：利用儿童尸体肱骨作为样本建立肱骨中下部三维空间模型,测算肽关节伸直和屈曲位时旋前、中立、旋后等六种位体状态下,肱骨远段各点的应力值。结果：无论何种体位下加载,肱骨外髁区的平均等效应力值最大,滑车桡侧区次之,滑车尺侧区最小;且屈曲位时各区应力均大于伸直位。屈曲位后区应力显著大于前区。而伸直位时伸肌腱作用点的有效应力值均较屈曲位大,且大了35％－77％。结论：肽关节屈曲位跌倒时暴力沿前臂通过桡骨小头,向上传导撞击肱骨小头最易引起肱骨外髁骨折,并可延及滑车桡侧区,而滑车尺侧区较少发生破坏;伸直位时则因前臂伸肌群强烈收缩而拉脱外髁致骨折。     

按摩配合展筋丹治疗肱骨外上髁炎38例

肱骨外上髁炎是一种发生在肱骨外上髁伸肌总腱起点处的慢性损伤性炎症,故俗称“网球肘”。肱骨外上髁炎的产生是因为在前臂过度旋前或旋后位,被动牵拉伸肌(握拳)和主动伸缩伸肌(伸腕)将对肱骨外上髁处的伸肌总腱起点产生较大的张力,如此反复刺激即可引起该处的慢性损伤。网球运     

挠骨小头半骨折误诊为肱骨外髁骨折1例

1病例介绍患者男性，30岁，主因右肘部外伤后肿胀，疼痛3天，症状加重伴肘关节活动受限工天人院。右肘及前臂明显肿胀，肘关节呈半屈曲位，肘部外侧有压痛，可触及骨擦感。肘关节伸160°屈90°。前臂旋转活动好。X线片示右肽骨外髁部有一游离骨块。1990年5月20日拟行右肽骨外髁骨折切开复位术。取右肘关节外侧切口长约8cm，显露肘关节肱骨外侧髁，其下方有─2cm×1．5cm×0．5cm游离骨块。未见肽骨外髁骨质缺损。查看肱骨小头、挠骨头均未见骨缺损。旋转前臂致旋后位发现挠骨小头前面缺损。检查环状韧带完好。把骨折块放于挠骨头缺损处正好…     

艾灸治疗肱骨外上髁炎临床应用文献调查

肱骨外上髁炎,又名肘外侧疼痛综合症,俗称网球肘。以肘关节外侧疼痛,用力握拳及前臂作旋前伸肘动作时可加重,局部有多处压痛,而外观无异常为主要临床表现,是主要以肱骨外上髁部疼痛等为主要表现的慢性损伤性疾     

5种手术入路内固定治疗儿童伸直型Ⅲ型肱骨髁上骨折的临床观察

儿童肱骨髁上由于其局部解剖结构的原因容易发生骨折,若治疗不当,易引起血管、神经损伤,遗留肘关节功能障碍和肘内翻畸形等并发症.我院1999年1月-2009年1月采用肘后肱三头肌舌状瓣、肘外侧或内侧、肘外侧和内侧联合、肘前外侧、肘后正中切口,从肱三头肌两侧暴露5种手术入路,骨折断端应用2枚1.5～2.0mm克氏针交叉内固定,共治疗儿童伸直型Ⅲ型肱骨髁上骨折152例,现报道如下.     

手法整复小夹板固定治疗肱骨外髁翻转移位型骨折38例临床体会

手法整复小夹板固定治疗肱骨外髁翻转移位型骨折３８例临床体会广东茂名市中医院骨伤科易焕彪肱骨外髁骨折多发生于４—１０岁小儿。骨折病因与肱骨髁上骨折相同。折下的骨片多为整个肱骨小头骨骺连同肱骨外侧与一块干骺端，或连及肱骨滑车的外侧部，因受伤时前臂伸肌腱的...     

基于ICP-MS法的加味左金丸中无机元素分析

目的 通过电感耦合等离子体质谱（inductively coupled plasma mass spectrometry,ICP-MS）法建立加味左金丸中Cd、Pb、As、Hg、Co、V、Ni、Cu、Li、Sb、Ba、Mo、Sn、Cr、Na、Mg、Al、Ca、Ti、Mn、Fe、Zn、Ga、Se、Sr、Tl共计26种无机元素的测定方法。方法 加味左金丸通过微波消解法处理后,根据相对分子质量的大小选择内标物,其中⁷Li、²³Na、²⁴Mg、²⁷Al、⁴⁰Ca、⁴⁸Ti、⁵¹V、⁵²Cr、⁵⁵Mn、⁵⁶Fe、⁵⁸Ni、⁵⁹Co、⁶³Cu、⁶⁶Zn、⁷⁰Ga、⁷⁵As、⁷⁷Se、⁸⁶Sr以⁷²Ge作为内标;⁹⁵Mo、¹¹⁴Cd、¹¹⁸Sn、¹²¹Sb、¹³⁷Ba以¹¹⁵In作为内标;²⁰²Hg、²⁰⁵Tl、²⁰⁸Pb以²⁰⁹Bi作为内标。对标准品溶液、空白溶液与供试品溶液进行分析,采用标准曲线法进行定量分析。通过ICP-MS法进行测定。结果 26种无机元素线性的相关系数r ≥ 0.999 6,检出限为0.001~1.500μg/L,定量限为0.01~5.00 μg/L,精密度与重复性试验的RSD均小于5%,平均回收率在82.64%~106.44%,RSD均小于5%。对3个厂家的12批样品进行了测定,26种元素的含量差异较大,其中Na、Mg、Ca、Fe 4种元素的含量比较高,均大于500 μg/g,Cd、Pb、As、Hg、Co、Li、Sb、Mo、Sn、Cr、Se、Tl的含量比较低,均小于1 μg/g。由结果可知,人体的常量元素,如Na、Mg、Ca的含量比较高,Cd、Pb、As、Hg等有害元素含量比较低。根据《中国药典》2020年版一部的要求,本品中Cd、Pb、As、Hg与Cu均符合规定。结论 该方法快速、准确,可以用于加味左金丸中无机元素的测定。     

Erstaunliches Ergebnis einer Schädelakupunktur nach Yamamoto bei Hemihypsarrhythmie rechts

A girl, three and a half years old at the respective date, premature in 25th week of gestation, had been presented. On day three after birth, she had had a IVH III° right and left with severe involvement of parenchyma and other multiple complications, e. a. infant respiratory distress syndrome up to the 42nd day postpartum, and epileptic attacks with apnoeic events.     

七味红花殊胜散对缺血再灌注肝损伤的保护作用

目的::研究七味红花殊胜敬对缺血再灌注肝损伤的保护作用.方法:在大鼠肝缺血再灌注模型上,观察七味红花殊胜散对缺血再灌注肝损伤引起的血清丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、一氧化氮(NO)含量的变化.结果:七味红花殊胜散对大鼠血清MDA、SOD、GSH与再灌组比较有明显差异(P<0.05),NO含量与再灌组比较有明显差异(P<0.05).结论:七味红花殊胜散对大鼠急性缺血再灌注肝损伤具有保护作用.     

Methodology of Canine/Feline YNSA and Tail Acupuncture

BackgroundYamamoto New Scalp Acupuncture (YNSA) is a well-known acupuncture system for human patients which was developed by Dr. Yamamoto.ObjectiveMy aim was to transpose the human YNSA map onto canines and felines.MethodI started researching a canine/feline YNSA map in 2002. I investigated approximately 3,000 canines and felines for YNSA and 2,500 for Tail Acupuncture. The ratio of canines and felines was 6 to 4. I researched and found all the equivalent points by palpating animal patients on the basis of an exact Neck Diagnosis.ResultsI nearly completed the map in 2006. The points in the occipital region are incomplete and my research is still in progress. In the process of researching canine/feline YNSA points, I accidentally found the other microsystems around the tail and named it “Tail Acupuncture”.ConclusionsYNSA and Tail Acupuncture are acupuncture systems utilizing microsystems and support each other in canines and felines. The merits of YNSA and Tail Acupuncture are 1) immediate effects, such as in cases of lameness, 2) simplicity in finding the exact points to treat and 3) the scalp and the tail can be utilized separately or together as treatment zones, according to the situation.     

基于ICP-MS法的麝香保心丸中26种无机元素分析

目的采用电感耦合等离子体质谱(ICP-MS)法建立麝香保心丸中26种无机元素(Li、Na、Mg、Al、Ca、Ti、V、Cr、Mn、Fe、Co、Ni、Cu、Zn、Ga、As、Se、Sr、Mo、Cd、Sb、Ba、Hg、Tl、Pb、Bi)的测定方法。方法麝香保心丸样品以浓硝酸为消解试剂经微波消解后,以Ge、In元素为内标,以灌木枝叶标准物质作为质控标准物质,采用ICP-MS法测定其中26种无机元素的量。结果待检测的26种元素线性关系良好,相关系数r≥0.999 4,各元素的检出限在0.010~2.987μg/L,定量限在0.035~10.000μg/L,回收率在79.88%~105.76%,RSD≤4.55%。测定的12批样品中Ca、Mg、Na、Fe量较高,均超过1.000 mg/g;Mn、Cu、Zn、Al、Ga量也相对较高,而Sb、Hg、Tl、Bi量相对较低,均在0.050μg/g以下。结论该方法操作简便,分析速度快,灵敏度高,适用于麝香保心丸中无机元素的测定。     

基于ICP-MS法分析九味熄风颗粒中25种重金属及微量元素

目的采用电感耦合等离子体质谱(ICP-MS)法建立九味熄风颗粒中25种重金属及微量元素(Li、Mg、Cd、Sn、Al、Mn、Fe、Ti、V、Co、Zn、Ga、Cr、Ni、Tl、Pb、Cu、As、Be、B、Sb、Ba、Sr、Hg、Bi)的测定方法。方法九味熄风颗粒样品经微波消解后,以Ge、In元素为内标,以灌木枝叶标准物质作为质控标准物质,采用ICP-MS法进行测定。结果检测的25种元素线性关系良好,相关系数R2≥0.999 2,各元素的检出限在0.009~16.051μg/L,回收率在70.75%~107.66%,RSD≤6.44%。测定的6批样品中Cr、Sn、Hg、Pb均未检出,Tl、Cd、As、Cu的量均较低或未检出,Cd≤0.011μg/g,Cu≤0.373μg/g,Tl≤0.021μg/g,As≤0.571μg/g。结论该方法操作简便,分析速度快,灵敏度高,适用于九味熄风颗粒中重金属及微量元素的测定。     

Chinesische Orthopädie: Teil 1: Die Zukunft der Akupunktur in der Postmoderne

The locomotor system is one of the major fields of application for acupuncture. The results of the large acupuncture studies funded by German Health Insurances from 2000 until 2006 are impressive and repressive: they restrict acupuncture application by allocation of reimbursement and create the necessity of reorientation, since acupuncture can neither be adequately described nor prescribed solely on the basis of disease entities. Regarding these disease entities, it seems rather necessary to analyse the layers of problems and formulate a hierarchy of therapeutic goals instead. Only in this way the effects of acupuncture, related techniques and further therapeutic modalities can be matched with the set of objectives. The article presents general principles and follows their application from biological aspects to implications for the locomotor system and consequences for the application of physical therapy. The manual of acupuncture focuses on therapeutic effects and objectives first, and then goes on to sketch simple therapeutic strategies and finally complex approaches within acupuncture. These may encompass acupuncture, microsystem acupuncture and complex therapeutic modes.     

Fallbericht: Patientin mit Schlafstörung

Background

Since the onset of her menopause about ten years ago, a sixty-year old patient has been suffering from hot flashes and sleep disorders causing her to become increasingly anxious and nervous. As the patient's mother had died of breast cancer, substitution of hormones was not advisable. Relaxation methods such as Yoga and Autogenic Training could only mildly alleviate the symptoms.

Objective

To effectively treat the sleep disorder, improve quality of life, lessen frequency and severity of hot flashes

Methods

Weekly sessions with ear- and body acupuncture for ten weeks

Results

After the third acupuncture session the patient reported a decrease of nightly waking episodes but suffered from acute pain in the neck as well as shoulder region. After nine therapy sessions, the patient reported a 50% decrease of nightly waking episodes. The hot flashes, however, remained unchanged.

Discussion

In this case, acupuncture significantly improved the patient's sleeping disorder. It also reduced the symptoms of anxiety and nervousness. Other menopausal symptoms such as hot flashes and dryness of mucous tissues, could not be influenced.