儿童肱骨远端骨骺损伤的X线诊断和预后评价

目的:探讨、总结儿童肱骨远侧骨骺损伤的X线诊断和预后评价。材料与方法:整理216例14岁以下儿童肱骨远端骨骺损伤的X线资料,进行回顾性分析总结,按肱骨小头骨骺分离、肱骨内髁骨折及远端全骨骺分离分组,对各组的骨折机制及X线表现进行分析及随访观察。结果:远端全骺分离25例,占11.6%。肱骨小头骨骺分离134例,占62%,其中96例,愈合后出现不同程度的关节畸形;肱骨内上髁骨折57例,占26.4%。结论:骨骺损伤导致血供障碍是造成畸形愈合的主要原因,准确的X线诊断,满意的复位,及时合理的治疗,对防止严重畸形的发生会起到积极的作用。     

肱骨远端全骨骺分熟15例X线分析

报道肱骨远端全骨骺分离１５例均为小于８岁的儿童，陈旧性外伤１例，伸直型闭合性损伤１４例，Ｓａｌｔｅｒ－ＨａｒｒｉｓⅠ型１例，Ⅱ型１４例，Ｘ线检查见肱肌远端骨折线在髁上较低的生长板与干骺端相连部位可确诊为全骺分离。     

肱骨远端全骺分离的鉴别诊断—附21例分析

肱骨远端全骺分离是小儿罕见的损伤［１，２］。骨折部位于肱骨远端骨骺软骨与干骺端连接处，有的带一侧干骺端的三角形或薄层骨片移向一侧。由于小儿骨骺未骨化，在Ｘ线上直接征象少，故易误诊为肘部其他损伤，以致处理不当。为进一步认识此损伤，本文结合作者治疗的２１...     

肱骨远端全骺分离骨折(附12例报告)

肱骨远端全骺分离骨折为儿童肘部损伤中少见损伤,常与肱骨髁上骨折和婴幼儿的肘关节脱位相混淆。本文报告12例,占同期肱骨远端骨骺损伤的7.1%。12例中骨骺内移9例、外科3例。根据X线片和手术发现,属Salter-Harris Ⅰ型8例、Ⅱ型3例、Ⅴ型1例。骨骺碎裂为2块或3块者4例,其中1例兼有压缩。手法复位5例,手法整复失败或陈旧损伤,行切开复位7例。结果6例满意、3例较好,3例肘关节活动受限明显。12例中肘内翻5°～14°者4例,前臂无不稳现象。本文还就病因、损伤机理、诊断和鉴别诊断等问题进行了讨论。     

儿童肱骨远端骨骺损伤X线诊断与鉴别诊断(附182例分析)

骨骺损伤包括骨骺分离、骨骺和骺软骨骨折。骨骺由骺软骨和骨化中心组成,而软骨在X线平片上不能显示,X线诊断受到限制。因而有必要熟悉软骨损伤间接征象,以判断损伤的部位、范围和错位程度,防止诊断错误、处理不当而造成畸形和功能障碍。我们把10年来182例15岁以下儿童肱骨远端骨骺损伤的X线资料进行分析,探讨其X线表现,鉴别诊断及预后评估。     

儿童肱骨远端全骨骺分离的诊治分析

目的探讨儿童肱骨远端全骨骺分离的诊断要点及治疗方法。方法回顾性分析我院2004年1月至2010年12月收治的42例儿童肱骨远端全骨骺分离的患儿;男24例,女18例,年龄4个月～6.5岁(平均2.4岁),按Delee分型:A型8例,B型18例,C型16例;闭合复位石膏固定治疗19例,手术治疗23例;术后2～3周行肘关节功能锻炼。结果本组共42例,随访6个月～5年,平均2.8年;按Docle’s肘关节功能评定标准,闭合复位组优良率为52.6%,手术治疗组优良率为91.3%。结论掌握肱骨远端骨骺发育及损伤的特点,可降低儿童肱骨远端全骨骺分离的误诊率;合理的采用手术治疗,可减少肘内翻的发生,恢复肘关节功能。     

肱骨远端全骨骺分离1例

肱骨远端全骨骺分离是婴幼儿外伤中较罕见的骨骺损伤，现报告1例。1病历报告患儿，男，5岁，4h前摔倒，左手掌着地，肘部受伤，疼痛，活动受限就诊。查体：左肘部软组织肿胀，前臂旋转不灵，畸形，压痛明显。X线片显示：左肱骨小头骺及尺、桡骨同步向尺侧与肱骨干骺部呈分离移位，肱骨内髁干骺端一较大骨折块，桡骨与肱骨小头纵轴延长线正常，尺桡关节无异常。X线诊断：防骨远端全骨骺分离。2讨论肱骨远端全骨髓分离在儿童肘关节损伤中较罕见，占0．5％。肱骨远端全骨骺包括内上髁、外上髁、滑车和肱骨小头，它们藉软骨联成一体。全骨骺分…     

儿童肱骨远端全骺分离的X线诊断

目的探讨儿童肱骨远端全骺分离的损伤机制及X线片表现、鉴别诊断。方法收集32例儿童肱骨远端全骺分离患者的肘关节X线正侧位片进行回顾性分析。结果儿童肱骨远端全骺分离X线片特点如下：（1）肘关节正位及侧位片均显示桡骨纵轴线通过肱骨小头;（2）肱骨内外髁只是与肱骨干骺端之间的关系发生变化,而与尺骨鹰嘴间关系并无变化;（3）尺桡骨带肱骨干骺端骨折片或肱骨外髁移向内侧;（4）上尺桡关系不变。结论肱骨远端全骺分离极易误诊为肘关节脱位、肱骨外髁骨折、内髁骨折,掌握儿童肱骨远端骨骺发育的解剖生理特点及儿童肘关节损伤规律,重视临床症状、体征、X线片表现仍可做出正确诊断。     

小儿肱骨远端全骨骺分离20例X线征象分析

肱骨远端全骨骺分离是小儿少见的骨骺损伤,因该部位骨骺尚未出现或仅出现一个肱骨小骨骺,骨折块大部分是软骨,X线征象少,常发生误诊和漏诊,甚至因处理不当而发生肘外翻畸形和功能障碍.     

肱骨远端全骺分离8例报告

肱骨远端全骺分离８例报告民和县医院骨科张忠国自１９９０年以来，我院对肱骨远端全骨骺分离的８例儿童，采用切开复位克氏针内固定，效果满意，报告如下。临床资料本组男５例，女３例，年龄１．５～７岁，伤后至入院时间最短３天，最长２５天，１０天以下２例，１０天以...     

干骺端截骨延长对骨骺板影响的实验研究

对２８只幼龄绵羊胫骨上干骺端截骨并延长，从Ｘ线、光镜和电镜方面观察不同延长幅度对骨骺板生长的影响。结果发现，每６小时延长０．２５ｍｍ，延长７．５％时有１／３动物出现不同程度的骨骺板缩窄；延长１０％时有１／２动物出现骨骺板缩窄；延长１２．５％～１５％时所有动物均出现骨骺板缩窄。对照组显示，骨骺板缩窄与载骨本身无关。提示，延长在７．５％以内，延长所引起的压应力对骨骺板生长的阻滞作用最小，比较安全。     

经椎板开窗手术治疗腰椎间盘突出症的临床体会

目的 探究临床上经椎板开窗式椎间盘摘除手术治疗腰椎间盘突出症的可行性.方法对32例腰椎间盘突出症患者的手术治疗情况进行了总结.结果 优良率90.6%其中优21例,良8例,可3例.结论 手术治疗腰椎间盘突出症的基本保证是病例的严格选择,手术方法的恰当选择,手术适应证的牢固掌握,手术并发症的预防控制.     

腰椎牵引与强的松龙硬膜外注射治疗椎间盘突出症

235例腰椎间盘突出症应用腰椎牵引及强的松龙硬膜外注射治疗,少数病例配合造影观察,证实药液进入硬膜外腔隙沿着神经根鞘向下延伸显影。腰椎牵引治疗中,反应较重及牵引结束后疗效不显著的患者作强的松龙硬膜外注射,疗效优于腰椎牵引对照组,P<0.01。腰椎牵引反应重,用硬膜外强的松龙治疗,缩短了治疗时间;并优于牵引结束后疗效不显著的强的松龙治疗组,P<0.01。单侧椎间盘突出其疗效优于中央性椎间盘突出合并椎管狭窄及黄韧带肥厚者。     

正常乳猪股骨头骨骺的MSCT灌注研究

目的运用多层螺旋CT灌注技术评价正常乳猪股骨头骨骺、骺板软骨、干骺端等不同解剖区域的血液供应特征。方法对15只2周龄的健康乳猪进行多层螺旋CT电影模式灌注扫描，对生成的动态图像数据进行测量分析，共获得26个股骨头的完整图像资料，统计并比较血流量（BF）、血容量（BV）、平均通过时间（MTT）、对比剂到达峰值时间（TTP），并与相应组织学表现进行对照。结果骺板软骨的BF比骨骺的BF有明显增高（P〈0．05）。各解剖区域中干骺端的BV最高（P〈0．05）、MTT最长（P〈0．05），而骺板与骨骺的MTT比较差异无统计学意义（P〉0．05）。各解剖区域中骺板软骨的TTP最短（P〈0．05），骨骺与干骺端的TTP基本相同。组织学发现骨骺、骺板软骨、干骺端的血管密度分布特征与相应部位的CT增强率所提示的血供状态基本吻合。结论多层螺旋CT灌注能够显示股骨头不同解剖区域的血液灌注特征。     

食指背侧皮瓣的临床应用

通过对右手虎口挛缩以及左拇指皮肤剥脱损伤各一例应用直指背侧皮瓣修复的成功经验,提出该手术的适应症和优点,并重点介绍其应用解剖学和手术方法。     

Investigation of hypoglycemic,hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark in diabetic rats

Objective

To investigate the hypoglycemic, hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark (AETPB) in streptozotocin (STZ)-induced diabetic rats.

Methods

Acute toxicity was studied in rats after the oral administration of AETPB to determine the dose to assess hypoglycemic activity. In rats, diabetes was induced by injection of STZ (60 mg/kg, i.p.) and diabetes was confirmed 72 h after induction, and then allowed for 14 days to stabilize blood glucose level. In diabetic rats, AETPB was orally given for 28 days and its effect on blood glucose and body weight was determined on a weekly basis. At the end of the experimental day, fasting blood sample was collected to estimate the haemoglobin (Hb), glycosylated haemoglobin (HbA1c), serum creatinine, urea, serum glutamate-pyruvate transaminase (SGPT), serum glutamate-oxaloacetate transaminase (SGOT) and insulin levels. The liver and kidney were collected to determine antioxidants levels in diabetic rats.

Results

Oral administration of AETPB did not exhibit toxicity and death at a dose of 2 000 mg/kg. AETPB treated diabetic rats significantly (P<0.001, P<0.01 and P<0.05) reduced elevated blood glucose, HbA1c, creatinine, urea, SGPT and SGOT levels when compared with diabetic control rats. The body weight, Hb, insulin and total protein levels were significantly (P<0.001, P<0.01 and P<0.05) increased in diabetic rats treated with AETPB compared to diabetic control rats. In diabetic rats, AETPB treatment significantly reversed abnormal status of antioxidants and lipid profile levels towards near normal levels compared to diabetic control rats.

Conclusions

Present study results confirm that AETPB possesses significant hypoglycemic, hypolipidemic and antioxidant activities in diabetic condition.     

大肠多发原发性癌:危险因素、诊治和预防(附8例报告)

综述分析1954～84年国内外文献,探讨了大肠多发原发性癌的诊断标准、发病情况、临床表现、发病危险因素、外科处理以及预防和诊断检测技术等问题,强调了大肠腺瘤,遗传基础、免疫缺陷、慢性溃疡性结肠炎等在发病上的作用,及高危险组患者应按方案进行常规检测监护之重要性。述介了大肠多发原发性癌系一种原发性大肠癌多中心发生的形式,在诊治上前者与后者有一致性,亦各有其独特性。报告宁夏医学院附属医院肿瘤科1977～84年收治的8例住院大肠多发原发性癌病例的临床资料,对诊治经过进行了初步总结。     

具有抗细菌黏附和杀菌双重功能的(HA/CHI-Van)5涂层的制备

目的：研究开发一种涂覆(HA/CHI-Van)5多层膜结构的骨科内植入物以用于预防骨内植入物感染。方法：将透明质酸（HA）和壳聚糖-万古霉素（CHI-Van）溶液进行层层自组装,制备得到(HA/CHI-Van)5多层膜结构;通过zeta电位检测组装过程,通过活细菌染色实验评价多层膜的抗细菌黏附效果,通过越狱实验和FE-SEM实验检测体外抗菌效果。SD大鼠随机分为空白组、(HA/CHI-Van)5组和假手术组,并以X线、Micro-CT、骨组织切片等方法检测该材料的体内动物实验效果。结果：每次组装不同的单层,zeta电位交替变化,证明多层膜组装成功。活细菌染色实验显示多层膜结构中的CHI具有一定的抗细菌黏附作用。越狱实验和FE-SEM实验证明(HA/CHI-Van)5多层膜结构在体外具有良好的抗菌作用。在体外实验中,(HA/CHI-Van)5组的X线评分为0.7,而空白组的评分为12.3,(HA/CHI-Van)5组在骨密度、骨小梁数量、骨体积分数、骨组织切片方面均优于空白组（均P＜0.05）,且非常接近假手术组（均P＞0.05）。结论：通过在骨科内植入物表面涂覆(HA/CHI-Van)5多层膜结构能够获得一定的抗细菌黏附功能和良好的抗菌作用,可以预防骨内植入物感染。     

Association of smoking,alcohol and NSAIDs use with expression of cag A and cag T genes of Helicobacter pylori in salivary samples of asymptomatic subjects

Objective

To determine the association of smoking, alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) use with presence and virulence of Helicobacter pylori (H. pylori) infection in a representative sample of a random adult population of asymptomatic subjects.

Methods

Non virulent 16S rRNA and virulent cag A and T genes from salivary samples of 854 asymptomatic subjects were determined using polymerase chain reaction. The presence and absence of virulent and non virulent infection was statistically compared with consumption of smoking, alcohol and NSAIDs.

Results

The prevalence of infection in male and female subjects was found to be 69.25% and 66.90%, respectively. The prevalence of infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (31.22%), former (52.20%) and never (43.58%). The prevalence of infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (88.80%), former (57.14%) and never (33.33%). The prevalence of infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 82.75% and 21.16%, respectively. Virulence in male and female subjects was found to be 60.00% and 50.00%, respectively. The presence of virulent infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (28.57%), former (40.15%) and never (50.00%). The prevalence of virulent infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (79.32%), former (75.00%) and never (50.00%). The prevalence of virulent infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 88.23% and 66.66%, respectively.

Conclusions

It can be concluded that smoking and NSAIDs consumption are aggravating factors for virulence of H. pylori and alcohol can inhibit H. pylori infection in asymptomatic subjects.