跨腕关节支撑钢板外固定架治疗桡骨远端粉碎性骨折的生物力学实验

目的比较跨腕关节支撑钢板与外固定支架治疗桡骨远端粉碎性骨折的生物力学特性。方法取16个新鲜前臂标本的桡骨远端,制备AO C3型不稳定性骨折模型。标本随机分为A、B、C、D 4组（n=4）,A组为钢板固定组,B组为钢板结合克氏针固定组,C组为外固定架固定组,D组为外固定架结合克氏针固定组。每组标本在生物力学实验机上依次进行抗压缩、抗弯曲、抗扭转实验,并收集数据进行比较。结果生物力学结果显示,在轴向压缩以及弯曲试验中,钢板组稳定性要强于外固定架组（P〈0.05）;在扭转试验中,两组间差异无统计学意义（P〉0.05）;结合克氏针固定后,可以增加钢板组与外固定架组的抗弯曲和抗扭转的强度（P〈0.05）。结论对于桡骨远端粉碎性骨折,跨腕关节支撑钢板固定在抗压缩和抗弯曲的稳定性上,要强于外固定架,而在抗水平扭转的稳定性上两种方法无差异;结合克氏针固定,可以增加跨腕关节支撑钢板和跨腕关节外固定架,抗弯曲以及抗扭转的稳定性。     

三种方式治疗四肢枪击伤骨折的体会

目的：探讨治疗四肢枪击伤骨折的手术方法及适应证。方法对稳定骨折用单臂外固定架;对粉碎性骨折用 Ilizarov 全环外固定架;对骨缺损的骨折用Ⅰ期短缩原位延长法。结果所有患者伤口愈合良好,无感染,3组骨折平均11个月愈合。有2例膝关节、3例踝关节僵硬,2例下肢用单臂外固定架在负重后畸形。结论 Ilizarov 全环外固定架具有微创和可靠的稳定性。Ⅰ期短缩原位延长法可使骨折端对位良好、愈合牢固,还能将断裂的组织和伤口直接吻合。单臂外固定架与全环外固定架相比稳定性差,在下肢骨折中应少用。     

外固定支架配合中药治疗胫腓骨骨折的临床疗效

目的本研究旨在观察单臂外固定支架、全环Ilizarov式外固定架配合中药治疗胫腓骨骨折的临床疗效。方法将纳入病例的64例胫腓骨骨折患者作为观察对象,随机分为治疗组、对照组,尽量确保两组在病种,病情程度等方面具有可比性。患者全部随访,随访时间8～21个月,平均时间16．5个月。治疗组患者33例,给予单臂外固定支架治疗;对照组31例患者,给予全环Ilizarov式外固定架治疗。2组均配合口服中药组方。观察两组在骨折治疗的治疗效果。结果治疗组在骨折治愈后肢体功能恢复程度方面各项指标均比对照组有显著差异（P〈0．05）,具有统计学意义。结论微创术式单臂外固定支架配合中药组治疗胫腓骨骨折,可以促进骨痴生长,加速骨折愈合,有利于骨折肢体功能的恢复。     

组合式骨外固定架在骨科临床的应用

骨外固定架是将上、下折段穿针，在皮外将所穿针固定在外固定架上，从而达到骨折两端良好的对位和固定目的。此法既不是单纯内固定，也不是单纯的定外固定，是一种二者兼而有之的固定方法。该固定方法已有100多年的历史，但直到50年代后才被重视和发展，并广泛应用于新鲜骨折、骨折不连结、开放粉碎骨折及肢体延长等，起到了过去内固定及外固定所不能达到的效果。目前国内的外固定架有半环式、四边式、全环式以及组合式等，我们所用的全部为组合式外固定架。     

组合式外固定支架治疗四肢骨折118例分析

外固定支架起始于1840年，由Malgaigen首创，经历单钉、双钉靠全皮带连接，发展为固定架和固定架可调节型。1931年Bover始有不锈钢，直至50年代~70年代以Hoffmann、Ilizovov等为代表发展为近代各类不同支架。70年代国内首先由李起鸿教授等引进。支架分类为①单边或称单侧半针外固定支架；②双边式外固定支架；③四边式；④半环、全环三角式外固定支架。近年来首都医科大教授研制的组合式外固定支架得到较广泛的应用。我院自1997年7月引用于各类四肢骨折，至今使用治疗不同类型骨折共118例。现报告如下。 临床资料 1 一般资料：本组共118例…     

单边外固定架结合克氏针有限固定治疗桡骨远端开放性骨折26例疗效分析

目的 应用单边外固定架结合克氏针有限固定治疗桡骨远端开放性骨折的治疗体会.方法 回顾性分析采用腕关节外固定架结合克氏针有限固定治疗桡骨远端开放性骨折26例,对26例30肢进行6～39个月随访(平均22.1个月).结果 26例获得随访患者30侧骨折均获得骨折愈合,优19例,良5例,可2例,优良率92.3%.结论 腕关节外固定架结合克氏针有限固定治疗桡骨远端开放性骨折操作简单,并发症少,疗效满意.     

肱骨近端骨折患儿的外科治疗方案研究

目的:探讨切开复位克氏针内固定和切开复位外固定架治疗儿童肱骨近端骨折的临床效果和并发症。方法:选取2013年1月-2015年1月于本院住院治疗的64例肱骨近端骨折患儿,根据手术治疗方法分为两组,切开复位克氏针固定组36例,切开复位外固定架组28例,比较两种外科治疗方案对患儿的治疗效果。结果:两组患儿住院时间、骨折愈合时间、术后并发症比较差异无统计学意义(P0.05);固定架组手术时间、手术出血量和切口长度少于克氏针组,两组比较差异均有统计学意义(P0.05)。固定架组术后Neer评分及术后1、2、3个月骨折愈合率均高于克氏针组,两组比较差异有统计学意义(P0.05)。克氏针组患儿主观满意度为80.6%,低于固定架组100%,两组比较差异有统计学意义(P0.05)。结论:切开复位外固定架治疗儿童肱骨近端骨折对于损伤严重、移位严重的患者是较好的治疗方式,手术操作简单、损伤小,有利于患儿的上肢恢复和早期功能锻炼。     

小儿肱骨髁上骨折两种克氏针内固定方法稳定性的力学研究

目的判定小儿肱骨髁上骨折切开复位后，交叉和平行穿克氏针两种内固定方法的稳定性。方法采用6只幼猪肱骨髁部作为模型，人为地造成肱骨髁上骨折，复位后分两组先后行交叉和平行克氏针内固定，并进行生物力学实验研究。结果小儿肱骨髁上骨折切开复位后，交叉克氏针内固定较平行克氏针内固定有明显的力学稳定性。结论小儿肱骨髁上骨折切开复位后交叉克氏针内固定术在力学上有明显的优势，值得临床肯定。     

不同手术方式治疗儿童肱骨近端骨折的临床观察

目的 比较切开复位克氏针内固定和切开复位外固定架治疗儿童肱骨近端骨折的效果.方法 2010年10月至2013年8月南阳市中心医院小儿外科行克氏针和外同定架治疗的肱骨近端骨折的患儿62例.其中克氏针内固定组患儿40例,外固定架组22例.比较两种手术方式的临床效果.结果 两组患儿手术时间[(40.3±7.2)min比62.3±6.7)min]、手术出血量[(28.9±14.5)ml比(71.7±17.5) ml]、切口长度[(32.4±11.3) cm比(63.3±13.2) cm]和术后肩关节Neer评分[(96.8±9.8)分比(92.3±8.5)分]等方面外固定架组要优于克氏针组,差异有统计学意义(P＜0.05).而在住院时间、骨折愈合时间和术后并发症方面差异无统计学意义(P＞0.05).结论 对儿童肱骨近端骨折,切开或闭合复位外固定架治疗,手术操作简单易行,对干骺端损伤小,固定可靠利于早期功能锻炼,对术后上肢功能的恢复具有良好的效果.     

锁骨骨折克氏针内固定的不稳因素

目的研究锁骨骨折克氏针内固定存在的不稳定因素。方法分析术后出现克氏针失稳的情况,从锁骨的解剖结构和骨折力学改变及克氏针缺陷等方面探索失稳的原因。结果锁骨骨折克氏针内固定不稳的因素较多,但主要是锁骨骨折力学改变及克氏针存在缺陷所致。结论锁骨呈“S”形和螺旋状,其整体形状不在同一矢状面,螺旋形的结构在骨折后容易出现旋转应力,骨折内固定因旋转应力不均出现移位;克氏针两端光滑,其轴向加压作用几乎不存在。而内固定锁骨只单用一根克氏针,缺乏双面或多面交叉,完全不能抵抗骨折产生的旋力,在多种肌力的作用下骨折易产生分离,克氏针容易出现不稳定。将克氏针尖端加工出螺纹, 使骨折产生轴向加压,是减少骨折不稳定的关键。     

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.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.