纤维蛋白胶黏合修复周围神经抗牵拉强度的动态变化

背景：目前周围神经损伤断裂后依然用缝线缝合的方法进行修复，而用纤维蛋白胶的黏合作用修复周围神经损伤将成为临床又一新的研究课题。目的：了解利用纤维蛋白胶黏合作用修复周围神经损伤后抗牵拉强度及其动态变化。设计：随机对照实验研究。地点和对象：在华中科技大学同济医学院附属协和医院骨科生物力学实验室完成。健康成年雄性Wistar大鼠，体质量250～300g。千预：采用完全随机的方法将96只Wistar大白鼠分成缝合组和黏合组。切断大鼠坐骨神经，对合整齐，黏合组用纤维蛋白胶黏合进行修复，缝合组用11—0缝线缝合进行修复。分别于术后当天(术毕)，3，7，14，21，28d从缝合组与黏合组各取8只大鼠，游离出坐骨神经立即进行生物力学检测。主要观察指标：测量神经断裂时的最大负荷、功耗，并描绘出神经应力一应变曲线。结果：正常神经抗牵拉强度曲线表现出黏弹性特性。缝合组与黏合组的最大抗牵拉强度及功耗在术后当天，第14，21和28天差异无显著性意义(P&;gt;0．05)；但在术后第3天时最大抗牵拉强度分别为(1．35&;#177;0．27)，(1．97&;#177;0．23)N／mm^2，功耗分别为(0．028&;#177;0．007)，(0．040&;#177;0．003)J／mm^2，第7天最大抗牵拉强度(1．93&;#177;0．26)，(2．74&;#177;0．30)N／mm^2，功耗分别为(0．047&;#177;0．009)，(0．063&;#177;0．007)J／mm^2，差异均有显著性意义(P&;lt;0．05)。结论：纤维蛋白胶有足够的抗牵拉强度，可以满足此类神经修复的需要。     

带血管蒂的逆行腓骨移植治疗先天性胫骨假关节25例报告

目的 提高先天性胫骨假关节治疗水平。方法 对先天性胫骨假关节25例患者采用带血管蒂的同侧腓骨逆行移植治疗。结果 其中23例均在术后3－6个月愈合,效果良好。结论 此方法所移植的腓骨具有丰富的血供,长度理想,能保证病变的胫骨切除长度,骨愈合快,操作简单,不损伤健侧,成功率高,易于被患儿家长所接受。     

The protective effect of EGB761 on vessels of denervated gastrocnemius in rats and its mechanism

This study investigated the protective effect of EGB761 on blood vessels of denervated gastrocnemius of rat and its possible mechanism.Fifteen male adult SD rats were randomly divided into three groups...     

淫羊藿苷通过促进负调控因子Gα13的表达抑制破骨细胞形成

目的 研究淫羊藿苷对破骨细胞分化和鸟嘌呤核苷酸结合蛋白亚基α13(Gα13)介导的信号通路的影响,探讨淫羊藿苷治疗骨质疏松的可能机制.方法 从C57/BL6小鼠四肢骨骨髓中提取原代单核巨噬细胞(bone marrow derived macrophages,BMMs),使用核因子κB受体活化因子配体(receptor ...     

The characteristics of acute rejection after limb allotransplantation in rats—An experimental study

Summary To study the characteristics of acute rejection after limb allotransplantation, 29 male Sprague-Dawley rats were randomly divided into 2 groups, with 15 rats in control group and 14 rats in experimental group. Each rat in control group underwent limb replantation. Each rat in experimental group received limb transplantation from Wistar rat. No immnosuppressive drugs were used after operation. The circulation of the transplanted limb, time and signs of rejection, histopathological changes in the tissues of the limb graft when rejected and survival time of limb grafts were evaluated. In the control group, no signs of rejection were observed, the circulation of each replanted limb was normal, it could survive for a longer time. The experimental group showed clinical signs of rejection (sub dermal edema and erythema) after a mean time of 3.36±1.15 days, and the mean survival time of the allografts was only 7±0.78 days. Histopathological examination showed most violent rejection reaction in skin. It is concluded that with Wistar-to-SD limb transplantation without use of immunosuppression, rejection of the grafts would occur after a mean time of 3, 36±1, 15 days; the earliest signs of rejection were edema and erythema of the skin, being the most representative component of limb graft rejection. KANG Hao, male, born in 1968, Associate Professor     

股骨髁和距骨剥脱性骨软骨炎关节镜手术治疗的随访

剥脱性骨软骨炎(OD)是骨、软骨局限性病变,主要表现为软骨下骨无菌性坏死、剥脱并形成关节游离体。常发生在膝关节,多累及股骨内髁,其它好发部位有肘关节、踝关节(OSG)的距骨。本文将通过对股骨髁OD和距骨OD患者施行关节镜手术后进行临床随访观察和MRT检查,以更好地估价治疗效果。     

肩袖部分断裂的关节镜诊断和治疗

肩袖部分断裂早在1934年已由Codman发现并将其分为深部和浅部断裂。我们于1989年～1993年对100例撞击综合征(Ⅱ期)的患者进行了关节镜手术治疗。     

小腿后部巨大腓动脉逆行皮瓣修复足部皮肤软组织缺损

目的 探讨小腿后部巨大腓动脉逆行皮瓣在修复足部、足远侧半大面积皮肤缺损的应用效果.方法 应用小腿后部巨大腓动脉逆行皮瓣修复11例含一个或多个跖趾关节外露的、足部大面积皮肤缺损.皮瓣设计:上界超过腓骨头平面.外侧界达腓骨前缘前2 cm,内侧界达腓肠肌内侧缘,下界达内外踝连线,以外踝上1 cm为旋转点.手术要点:解剖皮瓣时应将腓动脉在外踝上11～13 cm和5～7 cm两个肌皮支和(或)皮支带入,并包含腓肠神经、小隐静脉在内的3 cm宽筋膜蒂.结果 本组11例中10例皮瓣全部成活,1例皮瓣边缘1 cm宽区域坏死,经换药处理后愈合.结论 应用小腿后部巨大腓动脉逆行皮瓣修复足部大面积皮肤缺损,尤其是含足远侧半的皮肤缺损,皮瓣成活率高,对肢体供血影响小,血管蒂恒定,解剖容易,易于推广.