前臂肌肉的血供来源及其血供的实验研究

我们用二例新鲜上肢,从肱动脉灌注铅丹乳胶液。另二例用动物胶封闭桡动脉干,从尺动脉灌注铅丹乳胶液,对比观察肌肉的血供来源。观察结果发现,前臂肌肉大部分(67.6%)由尺动脉肌支供血,而只有一部分(26.8%)由桡动脉肌支供应。而桡动脉供应的10块肌肉同时有尺动脉肌支和肱动脉等肌支供应。这些肌肉为双重血供肌。而由尺动脉供应的16块肌肉中只有9块由桡动脉肌支供应。因此,尺动脉担负着前臂大部分肌肉的血液供应,而桡动脉只供应前臂一部分肌肉的营养。故前臂皮瓣游离移植术截取一段桡动脉干,对前臂肌肉血供无何影响。此时,前臂的营养可由尺动脉及其在肌肉的吻合支供应原桡动脉肌支的分布区,保证前臂肌肉的功能。     

生物反馈电刺激盆底肌肉训练治疗慢性盆腔疼痛综合征

目的:探讨生物反馈电刺激盆底肌肉训练治疗慢性盆腔疼痛综合征的效果。方法:40例慢性盆腔疼痛综合征患者,治疗前后常规行前列腺液(EPS)、慢性前列腺炎症状评分(NIH-CPSI)和尿流动力学检查。使用生物反馈治疗仪进行盆底肌肉电刺激,每次20 min,每天1次,5次为1疗程。治疗结束后1月评价其治疗效果并追踪观察6月。结果:40例慢性盆腔疼痛综合征的患者治疗后最大尿流率(MFR)、平均尿流率(AFR)均上升(P<0.05),最大后尿道压(MPUP)、最大尿道闭合压(MUCP)均下降(P<0.05);治疗后NIH-CPSI评分降低(P<0.01),EPS中白细胞计数降低(P<0.01);治疗后疼痛消失21例,占52.5%;疼痛缓解16例,占40%;无效3例,占7.5%,有效率达92.5%。40例患者中有31例获得半年追踪,无一例症状复发。结论:生物反馈电刺激盆底肌肉训练治疗慢性盆腔疼痛综合征是一种有效的、治愈率较高的治疗方法。     

继发性环咽肌失弛缓症1例

环咽肌功能失调或丧失可引起吞咽困难和食管反流及吞咽时胸骨下疼痛等症状,其严重后果在于误吸而致喉、气管、支气管、肺部反复感染。环咽肌失弛缓症是环咽肌常见疾病,大多原因不明。笔者收治一例因行胃镜检查后致环咽肌失弛缓症,报告如下。1临床资料患者,男性,63岁。2年前因患     

臀肌挛缩症的整体护理

目的:探讨整体护理在小儿臀肌挛缩症术后功能恢复中的应用价值.方法:实施整体护理的患儿,制定术前、术后功能训练计划,随机抽30例,与常规护理30例进行对照.用膝、髋关节的功能恢复满意程度作为评价指标[1].结果:两组患儿术后功能恢复比较有显著性差异P＜0.01.结论:整体护理对小儿臀肌挛缩症术后功能恢复具有较高的应用价值.     

腮腺周围间隙的断层解剖学及临床意义

目的　为腮腺周围间隙疾病的影像诊断提供解剖学基础。方法　选用成年尸体头颈部 6 0例 ,分别作冠状、矢状和横断层解剖。在三维断面上观察腮腺周围间隙的解剖学关系、围成、内容及其交通 ,测量腮腺周围间隙的面积及间隙周围重要结构的面积和宽度。结果　两侧腮腺周围间隙及间隙周围重要结构呈对称性 ,面积及宽度差异均无显著性 (P >0 0 5 )。冠状、矢状和横断面是分别显示腮腺周围间隙、颊间隙和腮腺间隙的最佳断层解剖。腮腺周围间隙可直接相通或借结缔组织和通行于间隙中的神经、血管间接相通。翼内肌、翼外肌、茎突、颈内动脉和颈内静脉是MRI等断层影像诊断的重要解剖学标志。结论　腮腺周围间隙的断层解剖对腮腺周围间隙疾病的影像诊断具有重要意义。     

Increased activities of prolyl 4-hydroxylase and galactosylhydroxylysyl glucosyltransferase,enzymes of collagen biosynthesis,in skeletal muscle of endurance-trained mice

The activities of prolyl 4-hydroxylase (PH) and galactosylhydroxylysyl glucosyltransferase (GGT), and the concentration of 4-hydroxyproline were measured in red and white parts of quadriceps femoris muscle of mice after 3, 10, and 20 sessions of daily endurance training. The activities of PH and GGT increased in the red part of the muscle after training for 3 and 10 times and returned to the control level after 20 training sessions. In the white muscle the increase of PH activity was less than in the red muscle. No alteration in GGT activity was observed in the white muscle. The concentration of hydroxyproline was unchanged in the both types of skeletal muscle. The results suggest that collagen turnover in leg muscles may be enhanced during the early phase of adaptation to endurance training. The enhancement is more prominent in red than in white skeletal muscle.     

Muscular attachments along the medial border of the scapula

Summary The authors described in this report the mode of attachments of muscles along the medial border of the scapula, as seen in sixty adult Indians. The levator scapulae, rhomboideus major and minor muscles comprise of double folds at the scapular end. The posterior folds of the levator scapulae and the rhomboideus minor muscles were attached to the dorsal surface of the medial border of the bone opposite the supraspinous fossa and the root of the spine respectively, while their anterior flaps gained attachment on the costal surface of the border at the level of the root of the scapular spine. The latter muscle reached much lower than the former. The rhomboideus major muscle was attached on the medial border of the scapula opposite the infraspinous fossa and could be traced to the dorsal surface of the bone just above the inferior angle. All the three muscles overlapped the costal surface of the serratus anterior fascia for about three centimeters. The fasciae of the muscles merged with each other along a straight line joining the free margins of their costal flaps. The serratus anterior muscle surrounds the superior and inferior angles of the scapula and is thus attached to both the surfaces of the bone at these sites.

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Les insertions musculaires le long du bord médial de l'omoplate

Résumé Etude des insertions musculaires sur le bord médial de l'omoplate à partir de soixante sujets indiens adultes. Le muscle élévateur de l'omoplate et les muscles grand et petit rhombo?des présentent une insertion scapulaire par deux feuillets. Les feuillets postérieurs de l'élévateur de l'omoplate et du petit rhombo?de s'insèrent sur la face dorsale du bord médial de l'omoplate au niveau de la fosse sus-épineuse et de la racine de l'épine de l'omoplate, tandis que leurs feuillets antérieurs s'insèrent sur la face ventrale du bord spinal de l'omoplate à la hauteur de l'épine de l'omoplate. Les insertions du petit rhombo?de descendent plus bas sur le bord spinal que celles de l'angulaire. Le muscle grand rhombo?de envoie des insertions sur le bord spinal de l'omoplate au niveau de la fosse sous-épineuse jusqu'à la face dorsale de l'angle inférieur de l'omoplate. Les trois muscles recouvrent la surface costale du fascia du muscle dentelé antérieur sur environ trois centimètres. Les aponévroses des 3 muscles se rejoignent le long d'une ligne droite reliant les bords libres de leurs feuillets costaux. Le muscle dentelé antérieur entoure les angles supérieur et inférieur de l'omoplate où il s'insère sur les deux faces de l'os.

     

Adiponectin 基因转染对肌细胞糖原合成和葡萄糖氧化的影响

目的：研究adiponectin对C2C12肌细胞糖原合成和葡萄糖氧化的影响。 方法： 用阳离子脂质体介导转染和随后G418筛选建立稳定转染小鼠adiponectin cDNA真核表达质粒（pcDNA3.0-mad）及空载pcDNA3.0的C2C12细胞株并鉴定。C2C12肌细胞糖代谢实验分对照组、空载体组和pcDNA3.0-mad(mad)组共3组进行，每组又分 0、0.5、5、100 nmol/L胰岛素刺激4个亚组。通过液闪测定细胞合成的糖原中［14C］的放射活性和氧化产生的［14CO2］，分别检测肌细胞的糖原合成和葡萄糖氧化情况。 结果： Western blotting和免疫组化检测证实mad组细胞表达adiponectin蛋白。Mad组葡萄糖氧化量随胰岛素浓度增加的速率较其它两组快，对照、空载体和mad组线性回归系数分别为23.34、23.23和26.06。Mad组C2C12肌细胞基础状态下和胰岛素刺激下的葡萄糖氧化和糖原合成与其它两组无显著差异（P>0.05）。 结论： 转染adiponectin基因对C2C12肌细胞葡萄糖氧化和糖原合成无显著影响。     

Interaction of H+ and Ca++ in the regulation of local pial vascular resistance

Summary Mock CSF of various compositions was injected into the perivascular space of different small pial arteries by means of micropipettes. Acid CSF (pH 6.5) caused local vascular dilatation, as did normal CSF with the addition of EDTA or EGTA. Systemic acidosis caused by CO₂ respiration also caused pial vasodilatation. Tiny silver-chloride electrodes were placed directly on the surface of small pial arterioles. Current-constant stimulation with series of DC-impulses (2–5 mA strength, duration 1 ms/imp.; stimulation lasted 10 sec) caused local vasoconstriction of the stimulated vessel. The constricted region of the vessel was of a different shape. Most frequently spindle-shaped constrictions with an extention not exceeding the length of the indifferent electrode were seen. In some cases the constriction was unilaterally placed near the different electrode (100 m ) and in a few cases the constriction was propagated along the whole vessel.Stimulation after application of acid CSF or during CO₂-respiration caused a constrictory action of about the same degree as in normal CSF. The acidotic dilatation, however, remained visible because the resulting vascular diameter after stimulation remained greater than in the controls with normal CSF. In Ca⁺⁺-free CSF the stimulation elicited a small response and during EGTA no constriction appeared after stimulation.In CSF with EDTA the constrictory response was distinctly diminished. From the experiments it cannot be excluded that the constriction of pial vessels caused by electrical stimulation is based on another mechanism than that caused by extravascular alkalosis. Ca⁺⁺ is necessary for both mechanisms.     

Wrist muscle activation patterns and stiffness associated with stable and unstable mechanical loads

Summary The objectives of this study were to examine the effects of load mechanical characteristics and agonist-antagonist muscle cocontraction, on the stretch reflex response of wrist flexor muscles, and to measure the associated wrist stiffness. Subjects were required to maintain a constant wrist angle while operating against flexor loads with different stability characteristics (constant, elastic or unstable). We measured the stretch reflex responses and joint stiffness by applying step displacements of 3° and 10°. Subjects used very little cocontraction of wrist flexor and extensor muscles when the load was constant or elastic, but increased cocontraction dramatically when the load was unstable, in order to increase the wrist stiffness. Although the magnitude of stretch reflex responses also increased with cocontraction, this simply reflected the level of tonic flexor muscle activity. We found no evidence to suggest that phasic stretch reflexes contributed significantly to the joint stiffness in this task. Clear differences in flexor muscle synergy were observed in the presence and absence of cocontraction, particularly when comparing the FCR and FCU muscles.