锚钉缝线减张重建内侧髌股韧带髌骨止点治疗复发性髌骨脱位

目的探讨锚钉缝线减张重建内侧髌股韧带(MPFL)髌骨止点的技术及其治疗复发性髌骨脱位的效果。方法回顾性分析自2009-03—2013-03采用锚钉缝线减张缝合法重建MPFL髌骨止点治疗复发性髌骨脱位21例,其中17例非固定型髌骨脱位,4例固定型脱位。采用自体肌腱双束重建,髌骨止点用缝线固定并锚钉加强。比较术前及术后1 d、6周、1年于膝关节0°位CT测量髌骨倾斜角、髌股关节匹配角、锚钉尖距髌骨外缘距离,术前及术后1年Kujala评分。结果本组均获得12个月以上随访,术后2例髌骨再脱位,2例屈膝受限,17例膝关节活动正常、无髌骨不稳。19例术后1年髌骨倾斜角、髌股关节匹配角较术前明显减小,差异有统计学意义(P0.05);术后1 d、6周、1年髌骨倾斜角、髌股关节匹配角、锚钉尖距髌骨外缘距离差异无统计学意义(P0.05)。非固定型脱位17例术后1年Kujala评分(85.8±3.4)分,较术前(54.1±5.6)分明显提高,差异有统计学意义(P0.05)。结论关节镜下缝线结合锚钉内固定重建的MPFL髌骨止点治疗复发性髌骨脱位能够明显改善髌骨稳定性。     

永生化人骨髓基质干细胞系的生物学特征

[目的]明确永生化人骨髓基质干细胞系MSCxj的生物学特征.[方法]MSCxj细胞在连续体外培养过程中,相差显微镜及透射显微镜观察细胞的形态特征;计算群体倍增时间,测定细胞增殖周期,计算克隆形成率等生长增殖特征并与原代人骨髓基质干细胞BMSCs-2比较.[结果]细胞形态为成纤维细胞样,细胞器发达;群体倍增时间40.8 h,较BMSCs-2的43.82 h短,MSCxj生长增殖活跃;MSCxj克隆形成率10.9%,BMSCs-2为11.5%,具有克隆形成能力.[结论]MSCxj细胞保持了人骨髓基质干细胞的生物学特征.     

老年性肱骨近端骨折的手术治疗

目的探讨老年人肱骨近端粉碎性骨折的临床特点及外科治疗方法。方法对17例老年肱骨近端粉碎性骨折的病例行切开复位、肱骨近端钢板内固定。内固定方式分别选用“T”型钢板、改良分叶状钢板及锁定钢板固定,17例均取自体骼骨作肱骨头颈部骨缺损处填塞植骨术,术中同时修复撕裂的肩袖及关节囊。术后及早功能锻炼。结果17例随访时间6个月～8年,平均3年7个月。疗效评定标准结合Neer评定法和肩肘外科功能评定法综合评估优良率达87．5％。结论老年肱骨近端粉碎性骨折时因骨质疏松常造成骨折断端骨质丢失严重,在进行切开复位内固定时应正确把握手术指征,采用有效、简便和损伤小的较牢固内固定物并植骨重建肱骨颈部,可获得较为满意的临床效果。     

重度畸形膝关节病全膝关节置换的疗效分析

目的:探索重度膝关节病关节置换的假体选择、注意事项与疗效分析。方法:1996年1月至2009年7月,对50例58膝重度膝关节病进行了全膝关节置换并进行了随访,其中男12例,女38例;年龄46～80岁,平均66.5岁。根据膝关节的畸形情况选择不同假体,使用铰链式膝关节6个,普通膝关节37个,高屈度膝关节15个。术后根据HSS评分系统对膝关节功能进行评价。结果:随访6个月～8年,按美国HSS评分系统进行评定,术前平均(38.6±8.76)分,术后平均(86.50±9.45)分,50例58膝中20例23膝评分为优,28例32膝评分良,2例3膝评分尚可。结论:重度膝关节病依关节畸形程度,选用不同膝关节假体置换,可获得一个无痛、稳定、畸形纠正良好功能恢复的关节。     

全髋关节置换治疗伴有股骨头坏死的成人先天性髋关节脱位

目的探讨全髋关节置换治疗伴有股骨头坏死的成人先天性髋关节脱位疗效。方法2000年1月~2007年1月,对10例16个伴有股骨头坏死成人先天性髋关节脱位进行全髋关节置换术,其中双侧6例,单侧4例。结果术后平均随访2年6个月,采用Harris评分评定髋关节功能,由术前的平均36.6分恢复到术后89分。术后肢体延长3~5 cm,平均3.5cm,疼痛缓解,关节伸屈功能、负重、行走,日常生活自理能力获完全恢复。结论采用全髋关节置换术式治疗伴有股骨头坏死、假髋臼骨性关节炎的成人先天性髋关节脱位,行之有效,可恢复关节的正常负重,消除疼痛,改善了关节活动度,提高了生活质量。     

"仿真医院"构建的理论与实践

通过对仿真医院构建的原则、内容和软件环境的探讨，论证仿真模拟护理实训能有效地实现校园环境的企业化，建立起有利于培养学生综合运用所学理论知识解决实际问题的护理实践教学模式，实现高职教育培养技术应用型人才的根本任务。     

银杏叶提取物对糖尿病大鼠血液、睾丸组织中内皮素和一氧化氮水平的影响

目的:探讨银杏叶提取物(EGb)对糖尿病大鼠血液、睾丸组织中内皮素(ET)和一氧化氮(NO)水平的影响.方法:将SD大鼠分为三组:正常对照组、糖尿病组、EGb治疗组.EGb治疗5 w后,分别测定三组大鼠血液中葡萄糖、胰岛素、ET和NO水平以及睾丸组织中ET、NO水平和一氧化氮合酶(NOS)活性.结果:EGb治疗组与糖尿病组大鼠比较血糖明显降低(P＜0.01),血清胰岛素水平轻度升高(P＞0.05).各组大鼠血浆中ET水平无明显差异(P＞0.05),血浆NO水平糖尿病组显著高于对照组,而EGb治疗组明显低于糖尿病组(P＜0.05).睾丸组织中ET水平糖尿病组显著高于对照组(P＜0.05),EGb治疗组低于糖尿病组(P＞0.05);EGb治疗组大鼠睾丸组织中N0水平、NOS和iNOS活性显著低于糖尿病组(P＜0.01和P＜0.05).结论:EGb可通过降低糖尿病大鼠血液中葡萄糖和NO水平及睾丸组织中ET、N0水平和NOS活性,从而减轻糖尿病对睾丸组织所造成的损害.     

银杏叶提取物对糖尿病大鼠一氧化氮水平的影响

目的 研究银杏叶提取物(EGb)对糖尿病大鼠心肌、睾丸、脑组织一氧化氯水平的影响。方法用链脲佐菌素制备SD大鼠糖尿病模型。测定EGb对糖尿病大鼠心肌、睾丸、脑组织一氧化氯(NO)的含量及一氧化氯合酶(NOS)、诱导型一氧化氯合酶(iNOS)、结构型一氧化氯合酶(cNOS)的活性的影响。结果与正常组相比，糖尿病大鼠心肌、睾丸组织NO含量及NOS，iNOS活性升高，脑组织NO含量及NOS活性升高。与糖尿病组相比，EGb治疗组大鼠心肌、睾丸组织NO含量及NOS、iNOS活性下降。结论 EGb能够对抗糖尿病大鼠过量NO对心肌、睾丸组织的损伤。     

银杏叶提取物对糖尿病大鼠膈肌的保护作用

目的:研究银杏叶提取物(EGb)对糖尿病大鼠膈肌的保护作用。方法: 用光镜和透射电镜观察EGb对糖尿病大鼠膈肌的形态学改变,并测定膈肌线粒体琥珀酸脱氢酶(SDH)、超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)的活性,一氧化氮(NO)、丙二醛(MDA)的含量。结果:糖尿病大鼠膈肌线粒体SDH、SOD活性下降,NOS活性及MDA、NO含量增高;电镜下主要表现为膈肌线粒体扩张,嵴变短,空泡化。EGb治疗组病变明显减轻。与糖尿病组比较,膈肌线粒体SDH、SOD活性升高,NOS活性及NO、MDA含量下降。结论: EGb通过减轻自由基和过量一氧化氮对膈肌线粒体造成损伤,提高SDH活性,改善线粒体呼吸链的功能,从而对糖尿病大鼠膈肌起到保护作用。     

Three-dimensional finite element analysis of the treatment of lumbar spondylolysis with cannulated lag screw北大核心

BACKGROUND: The cannulated lag screw technique has many advantages in the treatment of spondylolysis, but there is still the risk of fracture and loosening of the internal fixation. OBJECTIVE: To analyze the biomechanical stability of cannulated lag screw treatment of spondylolysis by establishing L4-S normal model, spondylolysis model and cannulated lag screw treatment model of spondylolysis through three-dimensional finite element software. METHODS: One male healthy young soldier volunteer was selected. 3D CT scan was performed on the volunteer’s lumbar spine and sacral spine. The imaging data were obtained and saved in Dicom format. CT data were imported into Mimics research 21.0 software to initially establish a geometric model, and deviation analysis was carried out. The obtained model was output in STEP format. Three groups of models of normal L4-S segment, L5 bilateral isthmus and cannulated lag screw in the treatment of spondylolysis were established after imported into Solidworks 21.0 software. They were represented by A, B and C respectively. The biomechanical characteristics of the three groups of models were compared under five motion states, such as axial compression, flexion, extension, left bending, and left rotation. RESULTS AND CONCLUSION: (1) Compared with models A and C, model B had the largest overall maximum displacement under the five working conditions of axial compression, flexion, extension, left bending, and left rotation. However, the overall maximum displacement of models A and C was not significantly different. (2) After removing the internal fixation in the model C, the maximum stress trend was similar to the model A. The stress of the model B was significantly higher than that of the models A and C during left bending and left rotation. (3) The overall maximum rotation angle of the three groups of models showed that the maximum rotation angle of the model B under the five working conditions was significantly larger than that of the models A and C. The models A and C were similar. The range of motion of the L4 vertebral body in the three groups did not change significantly. The range of motion of the L5 vertebral body in the model B was significantly higher than that in the models A and C, and it was more obvious in the left rotation and left bending. (4) These findings indicate that under the condition of physiological movement of the spine, the change trend of cannulated lag screw in the treatment of lumbar spondylolysis model is the same as that of normal model, which obtains good biomechanical stability and retains the normal mechanical characteristics of the spine, but excessive extension and rotation should be avoided immediately after operation. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.