2018年济南市14株柯萨奇病毒A组6型VP1基因特征分析

目的 分析济南市导致手足口病(hand, foot and mouth disease, HFMD)的柯萨奇病毒A组6型(Coxsackievirus A6, CVA6)分离株VP1基因特征及氨基酸变异。方法 2018年济南市HFMD常规监测病例样本经实时荧光RT-PCR检测,随机选择部分CVA6核酸阳性样本进行细胞分离鉴定,扩增阳性分离株VP1基因序列并进行同源性比较、氨基酸变异及系统进化分析。结果 2018年共检测652份样本,其中CVA6核酸阳性率为47.85%（312/652）,远高于人肠道病毒A组71型（human enterovirus A 71, EV71）（7.06%, 46/652）和柯萨奇病毒A组16型(Coxsackievirus A16, CVA16)（8.44%,55/652 ）,为济南市HFMD最主要病原体。通过细胞分离成功获得14株CVA6病毒,经VP1基因系统进化分析显示,济南市CVA6分离株均为基因D5亚型,VP1基因核苷酸及氨基酸序列同源性分别为94.2%~100%和98.0%~100%,与2017年广东株（GenBank 登录号MG385796、MG385815）、广西株（GenBank 登录号MH018512）、云南株（GenBank 登录号LC413143）及2014年江西株（GenBank 登录号KY913482）等亲缘关系较近。VP1蛋白主要存在V174I等位点变异,与国内流行的D5亚型基本一致。结论 2018年CVA6病毒为导致济南HFMD的主要病原,与广东、广西、云南和江西等省分离株亲缘关系较近,属于我国目前流行的基因D5亚型。     

手部肌腱吻合术后康复

目的作者自2000年初至2004年7月进行手部肌腱吻合120例,随访120例,手部肌腱吻合术后进行程序化的康复训练,方法肌腱吻合法均采用3-0或4-0聚丙烯单针缝线、改良的Bunnell、Kessler和肌腱编制缝合法,患者肌腱均为I期手术吻合,术后伤口I/乙愈合105例、II/乙15例,手部肌腱吻合术后均采用程序化的康复训练, 结果对手部肌腱吻合术后的患者进行程序化的康复训练,取得良好的效果. 结论本康复训练程序目前已逐渐形成我院的治疗常规,并逐步推广和普及.     

High resolution MRI of the normal finger at 0.1 T: anatomic correlations

Summary MR images of the fingers are obtained in a 128×128 or 256×256 matrix format using a prototype of a mini imager dedicated to the hand. The vertical field of 0.1 T is provided by an electro-magnet with an air gap of 15 cm equiped with a single solenoidal coil. No Faraday cage is used. The maximum in plane pixel resolution of 100 µ is obtained for a field of view of 2.5 cm with a slice thickness of 2 mm. The identification of fine structures of the finger is demonstrated by the anatomical and histological correlations. This type of imager which is adapted to very limited field of views demonstrate that high resolution MRI of limb extremities can be achieved at 0.1 T.

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IRM en haute résolution du doigt normal à 0,1 T. Corrélations anatomiques

Résumé Les images IRM des doigts sont réalisées dans un format de 128×128 ou 256×256 pixels par un mini imageur prototype spécialisé pour la main. Le champ magnétique vertical de 0,1 T est délivré par un électro-aimant dont l'entrefer de 15 cm est équipé d'une antenne solénoïdale simple. Il n'y a pas de cage de Faraday. La résolution maximale de 100 µ par pixel est obtenue pour un champ de vue de 2,5 cm et une épaisseur de coupe de 2 mm. L'identification de structures fines du doigt est démontrée par les corrélations avec des coupes anatomiques et histologiques. Ce type d'appareil, adapté à de si petits champs d'exploration, démontre que l'imagerie ostéoarticulaire périphérique en haute résolution est possible à 0,1 T.

     

手外伤所致经济损失的流行病学研究

目的 研究手外伤所致经济损失以及在不同类型手外伤中的分布。方法 对１９９８年１月在上海医科大学附属华山医院就诊的１６０例急诊手外伤患者进行问卷调查,并在伤后４周进行随访。结果 患者的平均年龄为３６．３岁;２０～５０岁的青壮年占６３．１％;男女性别比为２．０８：１。工作时发生的手外伤占３６．３％;６２．７％的患者月收入在１０００元以下。手外伤所造成的人均经济损失为１１３１．５元,其中生活性手外伤为９     

Haptic localization and the internal representation of the hand in space

As the hand actively explores the environment, contact with an object leads to neuronal activity in the topographic maps of somatosensory cortex. However, the brain must combine this somatotopically encoded tactile information with an internal representation of the hand's location in space if it is to determine the position of the object in three-dimensional space (3-D haptic localization). To investigate the fidelity of this internal representation in human subjects, a small tactual stimulator, light enough to be worn on the subject's hand, was used to present a brief mechanical pulse (6-ms duration) to the right index finger before, during, or after a fast, visually evoked movement of the right hand. In experiment 1, subjects responded by pointing to the perceived location of the mechanical stimulus in 3-D space. Stimuli presented shortly before or during the visually evoked movement were systematically mislocalized, with the reported location of the stimulus approximately equal to the location occupied by the hand 90 ms after stimulus onset. This pattern of errors indicates a representation of the movement that fails to account for the change in the hand's location during somatosensory delays and, in some subjects, inaccurately depicts the velocity of the actual movement. In experiment 2, subjects were instructed to verbally indicate the perceived temporal relationship of the stimulus and the visually evoked movement (i.e., by reporting whether the stimulus was presented before, during, or after the movement). On average, stimuli presented in the 38-ms period before movement onset were more likely to be perceived as having occurred during rather than before the movement. Similarly, stimuli in the 145-ms period before movement termination were more likely to be perceived as having occurred after rather than during the movement. The analogous findings of experiments 1 and 2 indicate that the same inaccurate representation of dynamic hand position is used to both localize tactual stimuli in 3-D space and construct the perception of arm movement.     

某金矿凿岩工症状自评量表调查分析

探讨局部振动对工人心理,行为功能的影响。方法 应用ＳＣＬ－９０量表及一般症状查体资料,对４０名金矿井正业凿岩机工人及其对照组２０名工人进行了调查分析。结果 与对照组比较,凿岩组工人在耳鸣,听力下降,高血压等方面有显著性意义;症状量表听各项指标均与对照组有显著差异,且在工作后１０年内易发生。结论局部振动可造成工人心理,行为功能的改变及一些症状的出现,二者又可相互作用,进一步加重对工人身心健康的危害。     

High-frequency ultrasound examination of the wrist and hand

High-frequency ultrasound (US) is an efficient, rapid and inexpensive altenative to magnetic resonance imaging (MRI) for investigation of diseases in the soft tissues of the wrist and hand. US allows detection of foreign bodies and the reliable identification of a variety of traumatic lesions affecting tendons, annular pulleys, ligaments, vessels and nerves. Inflammatory diseases of tendons, including acute and chronic tenosynovitis and some degenerative conditions in the wrist and hand, can also be diagnosed. In entrapment neuropathies, US is able to identify nerve shape changes and possible extrinsic space-occupying lesions that may cause nerve compression within the tunnels. In patients with localized swelling of the hand or wrist, US is able to assess the presence of an expansile lesion and to characterize its nature in most cases. The objective of this article is to review the main findings and the primary indications of US in the investigation of disorders of the hand and wrist. Received: 10 September 1998 Accepted: 24 November 1998     

Clinical observations of juvenile nonprogressive muscular atrophy localized in hand and forearm

Summary Twenty-seven patients with juvenile nonprogressive muscular atrophy localized in the hand and forearm were analyzed. The clinical characteristics were juvenile male occurrence, insidious onset, specific distribution of localized muscular atrophy and a stationary course. On electromyography, denervation voltage (or giant NMU) is found in the atrophied muscles and sometimes in contralateral nonatrophied ones. Sensory disturbance was not remarkable. Although the etiological factor was not known, strenuous exercise of arms in sports was noted frequently in the history.

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Zusammenfassung 27 Patienten mit juveniler nonprogressiver Muskelatrophie, lokalisiert an der Hand und dem Vorderarm wurden analysiert. Klinisch charakteristische Merkmale waren Vorkommen bei jungen Männern, schleichender Beginn, lokalisierter Befall der erwähnten Muskelgruppe und stationärer Verlauf nach einer anfänglichen Progression. Elektromyographisch wurde eine Denervation in den atrophischen Muskeln und manchmal in den Muskeln der kontralateralen Seite bemerkt. Sensible Ausfälle waren nicht eindrücklich. Obgleich die Ätiologie nicht klar war, wurde häufiger Gebrauch der Hand im Sport in der Krankheitsgeschichte bemerkt.

     

手十二井穴刺络放血对中风患者意识状态、心率等影响的临床观察

目的：观察手十二井穴刺络放血对中风初期患者意识状态等的影响。方法：以中风发病后3d有意识障碍的患者为观察对象，按病情分为损伤大面积、中面积、小面积3组，每组随机分为刺络组与对照组， 刺络组和对照组均进行正常治疗，仅刺络组增加井穴刺络放血。将意识状态进行量化，观察患者意识状态、血压、心率等的变化。结果：手十二井穴刺络放血可使损伤面积小的患者意识状态好转；收缩期血压上升；可使各组患者的心率加快。结论：手十二井穴刺络放血可使损伤面积小的患者意识状态好转。     

The relationship between phalangeal bone density and vertebral deformities

Radiographic absorptiometry (RA) of the phalanges is a convenient and reliable technique for measuring bone mineral density (BMD). It needs only a radiograph of the hand, which can be sent for evaluation to a central facility, whereas other techniques require specialized equipment. We assessed the relationship between RA measurements and the presence of vertebral deformities in a population-based cohort of postmenopausal women, and to compare the results with simultaneously obtained BMD of the hip by dual-energy X-ray absorptiometry (DXA). A total of 389 women aged 55–84 (mean age 67.2 years, SD 8.7) were randomly selected from a large general practice. RA, DXA of the hip, and vertebral deformities in the lateral spine X-rays by vertebral morphometry were assessed. Thirty-eight women (9.8%) had severe (grade II) vertebral deformities, and their BMD at the phalanges and femoral neck was significantly lower than that of women without severe vertebral deformities. Odds ratios for the presence of severe vertebral deformities of 1.5 (95% CI: 1.1–2.1) for RA and 1.3 (95% CI: 0.9–1.9) for DXA, together with similar receiver operating characteristics curves, were found using age-adjusted logistic regression. Phalangeal BMD is related to vertebral deformities at least as closely as BMD of the femoral neck BMD. RA may therefore help to evaluate fracture risk, especially if no DXA equipment is available. Received: 21 July 1998 / Accepted: 1 July 1999