人尺侧腕屈肌亚部化研究

目的 拟用Sihler‘s肌内神经染色法证实人尺侧腕屈肌的肌亚部分。方法 用改良Sihler’s染色法对10侧人尺侧腕屈肌进行肌内神经染色，以观察肌内神经分支分布。结果 尺神经干发出2支神经分别进入尺侧腕屈肌尺侧半和桡侧半，尺侧半神经和桡侧半神经在各自半侧肌内发出数级神经分支，各级神经分支间有丰富的吻合。结论 尺侧腕屈肌可分为尺侧亚部和桡侧亚部，两亚部各有一独立神经支配。     

正中腕屈肌1例

<正>在制作左上肢浅层肌标本(性别、年龄不详)时,在前臂浅层肌中见一罕见变异肌——正中腕屈肌1例,报道如下。1解剖观察此变异肌行于尺侧腕屈肌和掌长肌之间,指浅屈肌尺侧浅面(图1)。该肌以一较长的肌腱起于肱骨内上髁下部,肌     

人桡侧腕屈肌应用解剖学研究

目的　研究人桡侧腕屈肌亚部的划分及各亚部肌构筑的特征。为临床桡侧腕屈肌的移位特别是半肌移位提供较为详细的形态学依据。方法　 1.用童尸 5具取下桡侧腕屈肌共 10侧进行Sihler’s肌内神经染色。 2 .用成年男尸 10具桡侧腕屈肌 2 0块 ,沿肌腱纵轴剖开桡侧腕屈肌 ,对其尺侧亚部和桡侧亚部进行肌构筑研究。结果　 1.肌构筑特征 ,桡侧腕屈肌为羽肌 ;桡侧亚部 :肌重 13.79± 1.11g ,肌纤维长 4 .4 8± 0 .2 0cm ,羽状角 12 .82°± 1.4 4°,生理横切面积 2 .84± 0 .73cm2 ;尺侧亚部 ,上述指数分别为 :8.4 9± 2 .0 1g、4 .4 4± 0 .19cm、 6 .76°± 1.5 5°、1.79± 0 .4 2cm2 。 2 .肌内神经的分支分布 ,桡侧腕屈肌支在肌的近 1 3深面入肌 ,主干发出第一支支配近侧的肌纤维 ,主干继续向下发出第二、第三支支配桡侧亚部和尺侧亚部。结论　根据肌内神经的分布特点桡侧腕屈肌可分为尺侧亚部和桡侧亚部。桡侧亚部产生的肌力是尺侧亚部的 1.6倍。桡侧腕屈肌的两亚部可单独取材用于肌移位     

儿童尺侧腕屈肌的应用解剖

用72侧3岁左右的童尸上肢,对尺侧腕屈肌的位置、形态、动脉和神经进行了观测。肌腹的长、宽和厚分别为86.72±1.61mm、11.06±0.23mm和2.70±0.08mm。腱的长、宽和厚分别为27.05±0.25mm、2.78±0.06mm和1.19±0.03mm。动脉来源于尺侧返动脉和尺动脉,前者主要供应肌腹的上1/3,后者主要供应下2/3。尺神经在尺神经沟附近发出至该肌的分支,并从肌腹上1/4段的深面穿入肌内。还就其临床应用进行了讨论。     

尺神经前移术的解剖及其临床

目的 :为尺神经前移术治疗肘管综合征提供必要的解剖学基础。方法 :4 8侧成人上肢标本对肘部尺神经的营养血管伴行长度及其分支 ,屈肘时尺神经拉长长度、移位和摩擦点等进行观测。2侧上肢标本摹拟手术。结果 :尺侧上副动脉、尺侧下副动脉和尺侧返动脉后支分别与尺神经伴行长度为 14 .8± 1.1cm、4 .9± 1.0cm、6 .3± 1.1cm ;尺神经在肘部发出 1～ 2支关节支 ,2～ 3支肌支 ;肘关节自伸直位至屈曲 135°尺神经平均向近端拉长 5 .2mm ,向远端拉长 3.4mm ,并有向前移位和拉紧 ,以肱骨内上髁为固定摩擦点 ,以尺骨冠突内侧结节为活动摩擦点。结论 :保护尺神经血供及其肌支行尺神经前移术是治疗肘管综合征有效可行的方法。     

人尺侧腕屈肌肌亚部肌梭分布研究

目的：查滞尺侧腕屈肌尺侧亚部和桡侧亚部的肌梭分布情况，进一步揭示该肌的形态学特征。方法：取10侧人尺侧腕屈肌尺侧亚部和桡侧亚部的各部位肌组织做石蜡切片。经HE染色后采用体视学方法检测肌内肌梭的分布。结果：尺侧腕屈肌肌梭密度尺侧亚部大于桡侧亚部。结论：尺侧腕屈肌尺侧亚部的肌梭密度高于桡侧亚部，推测尺侧亚部对牵张的敏感度应高于桡侧亚部。     

尺神经卡压综合症的手术治疗体会

肱骨内上髁为肱骨内髁的非关节部分,有前臂屈肌的肌起点和肘部内侧副韧带附着.内上髁后面尺神经沟内有尺神经通过.内上髁骨骺出现于7岁.闭合于18岁,故骨骺分离多见于7-18岁的青少年,内上髁骨折较少见,约占2.6%.尺神经在上肢走行过程中可因肌肉肿瘤、肌腱囊肿、尺神经周围结缔组织增生肥厚束缚及肱骨内上髁增生肥大等综合因素造成尺神经卡压,肱骨内上髁部肘管内受压及腕掌侧尺管卡压最为典型.有的学者把这种病例称为尺神经双卡综合征.     

副掌长肌一例报告

在制作教学标本中,发现一成年男性之右前臂有一块异常肌肉。肌全长25.3厘米,位于指浅屈肌浅面,其上部位于尺侧腕屈肌深面,下部位于掌长肌深面。该肌以腱起于肱骨内上髁和尺骨鹰咀,至肱骨内上髁以下3厘米处合并。肌腹位于中间,呈梭形,长9.9厘米,最宽1.3厘米,最厚     

人下肢拇长屈肌肌构筑和肌内神经的研究

目的探讨人下肢拇长屈肌肌构筑和肌内神经的关系。方法肌构筑法、改良Sihler＇s染色法。结果人下肢拇长屈肌为羽肌。肌内腱板长（15.52±2.30）cm,宽（0.68±0.24）cm,厚（0.18±0.06）cm。肌重（50.48±2.44）g。肌长（20.84±2.08）cm,肌纤维长（4.12±0.30）cm,羽状角（14.3±0.65）°,肌生理横切面积（11.34±0.45）cm2。支配下肢拇长屈肌的神经于该肌内侧缘分为上下两支1级神经入肌,上支较细,支配该肌上1/4部,下支较粗支,支配该肌下3/4部,神经入肌后于腱板前方进一步分成外侧支和内侧支,神经分支在肌内发出数目不等的次级支,继而向肌的深面和边缘发出终末支。结论人下肢拇长屈肌是羽肌,肌内腱板宽大厚实,倾向力量型设计,拇长屈肌可分为内侧和外侧两部份。     

比目鱼肌内侧半肌瓣逆行转位的应用解剖学研究

目的 :为临床治疗胫骨中下段及踝部慢性骨髓炎合并软组织缺损提供一种行之有效的新方法。方法 :35侧经动脉内灌注红色乳胶的成人下肢标本 ,观测了比目鱼肌内侧半的形态及血供特点。结果 :比目鱼肌内侧半肌瓣血供主要来自胫后动脉分支节段性供应 ,平均每侧 6支 ,其中最下 2支距内踝突出点上距离分别为 (5 .45± 2 .0 8)cm、(9.70± 2 .43)cm ,管径分别为 (1.31± 0 .2 8)mm、(1.42± 0 .33)mm。从而设计出比目鱼肌内侧半肌瓣逆行转位的新术式。结论 :该术式可用于修复胫骨中下段及踝部慢性骨髓炎并软组织缺损 ,手术简便实用。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…