股骨下端形态学观测及其临床应用

目的 :为股骨下端骨折钢板内固定及人工全膝关切置换术人工假体的设计、安装提供可靠的解剖学数据。方法 :对 2 0 0例 (左、右各 10 0例 )正常成人股骨下端上髁宽、侧髁宽等相关项目进行了观测。结果 :上髁宽为 7.80± 0 .4 2 cm,侧髁宽为 6 .2 4± 0 .33cm。股骨体下部最小正中矢径约为横径的 3/ 4。结论 :本文提供的数据在人工全膝关节置换术人工假体的设计、安装及股骨下端骨折钢板内固定中具有一定的参考价值。     

股骨远端骨折两种内固定方式疗效分析

目的:分析股骨远端骨折两种内固定方式的临床疗效,寻求最佳内固定方式。方法:观察选择95°角钢板、髁支持钢板的内固定股骨远端骨折、骨折功能复位、骨折不稳定和膝关节功能恢复情况。结果:角钢板骨折复位差,髁支持钢板内固定植入提高骨折解剖复位率、增加骨折稳定性和较好地恢复膝关节功能方面具有明显优越性。     

95°髁钢板内固定治疗股骨粗隆部骨折的疗效观察

目的 :探讨 95°髁钢板内固定治疗股骨粗隆部骨折的疗效。方法 :术前行股骨髁上牵引 5～ 7天 ,在全麻下取髋关节外侧手术入路 ,显露股骨大粗隆及股骨上部 ,打入 2根克氏针 ,安上 95°髁钢板 ,经X线片确认位置准确后再以螺钉完成固定。结果 :2 3例中 ,优 19例 (82 .6% ) ,良 3例 (13 .0 % ) ,中 1例 (4 .3 % ) ,无功能差者。结论 :该法具有手术适应证宽、手术操作简便、固定牢固、手术损伤小、下地活动早、康复迅速等优点 ,易于基层临床推广应用     

股骨髁部骨折1 6例治疗分析

目的总结16例股骨髁部骨折治疗效果。方法对3例伤口严重污染或感染的病例采用外固定架治疗,7例单髁骨折采用A0髁螺钉固定,6例髁间及粉碎性骨折采用螺栓及预弯钢板或L型髁钢板内固定,术后适当石膏外固定。结果随访14例9个月～2年,骨折均在3个月以内愈合,膝关节屈曲90°以上,骨折无畸形。活动无异常13例,1例畸形愈合,不能正常负重。结论股骨髁部骨折经早期切开复位,使关节面恢复平整,根据骨折类型分别采用不同内固定,术后适当外固定和及早进行功能锻炼,可取得良好的治疗效果     

AO髁支撑钢板在股骨远端骨折治疗中的应用

目的　探讨AO髁支撑钢板治疗A型和C型 (AO分类 )股骨远端骨折的临床效果。②方法　应用AO髁支撑钢板治疗股骨远端骨折 18例 (A型 8例 ,C型 8例 ,AC混合型 2例 )。③结果　术后X线检查示 18例均达解剖复位或近解剖复位 ,固定可靠。 3例膝屈曲 45°受限 ,15例住院期间膝屈曲达 90°以上 (占 83.3% )。 11例获0 .5～ 2 .0年随访骨折均愈合。④结论　AO髁支撑钢板和股骨远端的解剖形态较为匹配 ,治疗A型和C型股骨远端骨折可达坚强内固定。     

髁支撑钢板治疗股骨下端骨折

目的 总结19例髁支撑钢板治疗股骨下端骨折的方法,以提高骨折的治疗水平.方法 对19例股骨下端骨折进行切开复位髁支撑钢板内固定.结果 骨折均顺利愈合,平均18个月.根据X线片骨折解剖复位18例.根据Merchan膝关节功能评价标准,优9例,良7例,可1例,差2例.结论 髁支撑钢板治疗股骨下端骨折,固定可靠,骨折愈合佳,关节功能恢复满意.     

动力髁螺钉治疗21例股骨粗隆部不稳定骨折体会

目的:探讨采用动力髁螺钉(DCS)股骨粗隆间及粗隆下粉碎性不稳定骨折的治疗效果。方法:取股外侧切口入路,显露骨折部及股骨大粗隆,先将较大骨折块复位,再将两断端之主干复位,于大粗隆顶部之下1.5cm、前中1/3交界点部作为进针点,与股骨粗隆部成95°角,常规操作向股骨颈及股骨头下部拧入适当长度的动力髁螺钉,将钢板套筒套入动力髁螺钉上,使钢板贴附于股骨骨皮质,至少有1枚螺钉固定于股骨矩,再固定其余螺钉。结果:本组21例手术复位钢板内固定满意,平均随访19个月,骨折均愈合,髋关节功能恢复良好。结论:采用动力髁螺钉(DCS)治疗股骨粗隆间及粗隆下粉碎性不稳定骨折是一种行之有效的方法,具有固定牢固、颈干角不变小、内固定螺钉不松动、术后髋关节功能恢复好的优点。     

股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的诊治

目的 对股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的治疗进行分析.方法 2002年12月至2008年12月安徽医科大学附属省立医院骨科收治8例股骨干合并同侧股骨颈或股骨髁上骨折漏诊患者,年龄25～59岁,平均41.7岁,初步诊断为股骨干骨折,后修正为股骨干合并同侧股骨颈或股骨髁上骨折.股骨干骨折行钢板内固定.股骨颈骨折行3枚空心加压螺丝钉内固定;股骨髁上骨折2例行股骨远端外髁解剖钢板的内固定,1例术中更改行逆行股骨交锁髓内钉内固定.结果 术后平均随访3.5年,骨折均愈合,髋膝关节功能良好.结论 凡强大暴力及有扭转暴力者股骨干合并同侧股骨颈或股骨髁上骨折易漏诊,术前常规髋膝摄片是避免漏诊的有效方法.     

可吸收缝线在儿童肘内翻畸形肱骨髁上截骨中的应用

儿童肱骨髁上骨折继发肘内翻畸形行肱骨髁上截骨矫正术后 ,传统的固定方法多采用钢板螺丝钉、骑缝钉、螺丝钉钢丝、克氏针作内固定。我院自 1998年 1月～ 2 0 0 0年 12月 ,对 12例肱骨髁上骨折继发肘内翻畸形患者行截骨矫正术后骨断端采用可吸收缝线固定 ,疗效满意 ,报道如下。1　临床资料1.1　一般资料　本组 12例 ,男性 9例 ,女性 3例 ;年龄 10～13岁 ;右侧 7例 ,左侧 5例 ;受伤 (肱骨髁上骨折 )距本次畸形矫正时间 2～ 6年。1.2　方法　术前摄双侧肘关节 (范围从肱骨中段至尺挠骨中段 )伸直位正位片 ,屈肘 90°位侧位片。测量健侧携带角…     

累及髁部的股骨下端粉碎性骨折的治疗

伴随交通工具高速行驶,车祸损伤暴力及能量增大,累及股骨髁部的股骨下端骨折发生率高,且多呈粉碎性,开放性骨折并骨缺损也不鲜见.我院自2001年2月-2003年8月,对12例累及股骨髁部的股骨下端粉碎性骨折行切开复位,AO解剖钢板或动力髁(DCH)内固定治疗,取得了良好的临床效果.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.