骨膜在骨组织再生中的作用

骨膜是一种高度血管化的成骨器官,有着复杂、精密而又有序的复合结构。骨膜具有良好的成骨特性、屏障膜特性、材料学特性,同时又有来源广泛、不存在免疫原性等诸多优点,在骨缺损修复、骨组织再生、骨组织工程等方面有着理想的应用前景,近年来也得到了骨科、颌面外科、种植科、牙周科等相关领域医生及学者越来越多的关注。研究并利用好骨膜,将在骨组织再生、骨缺损修复等领域中开辟新的天地。     

复合型人工骨预制体在颌面骨缺损修复中的应用

目的探讨计算机辅助设计与制造（CAD／CAM）技术制作的复合型人工骨预制体在个性化颌面骨缺损修复中的临床应用价值。方法对6例颌面骨缺损的患者利用复合人工骨进行骨缺损修复,术前对颌面骨缺损部位进行螺旋cT扫描并三维重建,应用计算机辅助设计软件、计算机辅助制造快速成型机、复合人工骨材料及一系列的工序处理后制成三维颌面模型及个性化的颌面骨预制体．术中在模型指导下将颌面骨预制体精确定位与固定。其中3例并明显皮肤软组织缺损患者．则予同期或二期行皮肤软组织缺损的修复。结果全部颌面预制体术中能准确快速的就位及固定．无预制体断裂等发生,转移修复皮肤软组织缺损的皮瓣血运良好．除1例经口内切口患者术后部分伤口裂开予二期清创缝合后伤口愈合外,余伤口愈合良好。随访6个月至4年,无预制体移位、排斥等并发症发生,双侧颌面外形基本对称,外形满意。结论应用CAD／CAM制成的个性化复合材料颌面骨预制体能达到颌面骨缺损的精确重建．有效地解决植入体塑形困难．简化了手术程序及缩短手术时间．且并发症少,效果良好,值得临床推广应用。     

输尿管导管及锥形导丝在输尿管中上段碎石术中的临床应用

目的 探讨输尿管导管及锥形导丝在输尿管中上段碎石术中的临床应用效果。方法 选取于该院就诊的输尿管中上段结石患者150例,随机分为对照组（锥形导丝组）和观察组（输尿管导管组）,每组各75例。比较两组患者的手术时间、住院天数、总费用、术中结石逃逸情况、术后血尿、发热、肾绞痛等并发症发生情况和术后1个月结石排净率。结果 两组患者手术时间和治疗费用比较,差异均有统计学意义;住院天数、术中结石逃逸情况、术后并发症发生率和术后1个月结石排净率比较,差异均无统计学意义。结论 应用锥形导丝及输尿管导管治疗输尿管中上段结石,治疗效果明确且并发症少。输尿管导管较锥形导丝手术时间长,但锥形导丝治疗费用相对较高。     

Myocardial Infarction Type 2: Avoiding Pitfalls and Preventing Adverse Outcomes

Myocardial infarction type 2 (MI type 2) is an elevation of cardiac biomarkers in a physiologically stressful state leading to demand-supply mismatch of oxygen. This type of myocardial infarction is commonly seen in hospitalized patients. Since the introduction of clear definition, diagnostic criteria and International Classification of Disease (ICD) codes, the diagnosis has become increasingly common. There still remains plenty to learn about MI type 2 especially prevention and treatment strategies. Studies have shown that there is increased mortality and morbidity associated with MI type 2 when compared to MI type 1, and there may be benefit in having a multi-disciplinary approach including cardiology when treating such patients. Secondary prevention therapies may also play a role in decreasing adverse events from MI type 2. However, randomized control trials are insufficient, and results of studies are cautiously interpreted. In this article we have assessed the current evidence on MI type 2 and the gap in literature that will potentially be the focus of future analyses.     

认知行为干预对输尿管结石体外碎石术病人心理状况、自我效能及术后康复的影响

[目的]探讨认知行为干预对输尿管结石体外碎石术病人心理状况、自我效能及术后康复的影响。[方法]根据随机数字表法将2018年6月—2019年6月泌尿外科收治的96例输尿管结石体外碎石术病人分为观察组及对照组各48例,对照组行常规健康教育,观察组在常规健康教育基础上实施认知行为干预。比较两组干预前后心理状况、自我效能及术后康复情况。[结果]干预后观察组病人抑郁自评量表(SAS)评分、焦虑自评量表(SDS)评分低于对照组(P<0.05),自我效能评分较对照组高(P<0.05)。观察组治疗依从率、取石成功率及治疗满意率高于对照组(P<0.05),并发症发生率低于对照组(P<0.05),病人住院时间短于对照组(P<0.05)。[结论]认知行为干预能有效提高输尿管结石体外碎石术病人自我效能,提高病人治疗依从率,降低病人术后不良反应率,有利于病人术后康复。     

The Masquelet technique: Current concepts,animal models,and perspectives

Bone reconstruction within a critical‐sized defect remains a real challenge in orthopedic surgery. The Masquelet technique is an innovative, two‐step therapeutic approach for bone reconstruction in which the placement of a poly (methylmethacrylate) spacer into the bone defect induces the neo‐formation of a tissue called “induced membrane.” This surgical technique has many advantages and is often preferred to a vascularized bone flap or Ilizarov's technique. Although the Masquelet technique has achieved high clinical success rates since its development by Alain‐Charles Masquelet in the early 2000s, very little is known about how the process works, and few animal models of membrane induction have been developed. Our successful use of this technique in the clinic and our interest in the mechanisms of tissue regeneration (notably bone regeneration) prompted us to develop a surgical model of the Masquelet technique in rats. Here, we provide a comprehensive review of the literature on animal models of membrane induction, encompassing the defect site, the surgical procedure, and the histologic and osteogenic properties of the induced membrane. We also discuss the advantages and disadvantages of those models to facilitate efforts in characterizing the complex biological mechanisms that underlie membrane induction.     

旋转皮瓣在头面部肿物术后皮肤缺损中的应用

目的评价应用旋转皮瓣修复头面部肿物切除术术后皮肤缺损的效果。方法自2015年以来,收治头面部基底细胞癌、鳞状细胞癌、色素痣、血管瘤等切除后皮肤缺损的患者86例,应用旋转皮瓣修复,术中切除病变组织后,在缺损邻近设计皮瓣,在合适层次分离皮瓣后修复创面。结果皮瓣成活良好,无一例有血运障碍,切口均良好愈合,局部组织无明显移位,修复效果满意。结论应用旋转皮瓣修复头面部皮肤缺损,方法易于操作,美容效果良好。     

Acute Exposure to the Mitochondrial Complex I Toxin Rotenone Impairs Synaptic Long‐Term Potentiation in Rat Hippocampal Slices

Aims: To evaluate the acute effects of the mitochondrial complex I inhibitor rotenone on rat hippocampal synaptic plasticity. Methods: Electrophysiological field potential recordings were used to measure basal synaptic transmission and synaptic plasticity in rat coronal hippocampal slices. Synaptic long‐term potentiation (LTP) was induced by high‐frequency stimulation (100 Hz, 1 second × 3 at an interval of 20 seconds). In addition, mitochondrial complex I function was measured using MitoSOX imaging in mitochondrial preparations. Results: Acute exposure of hippocampal slices to 50 nM rotenone for 1 h did not alter basal CA3–CA1 synaptic transmission though 500 nM rotenone significantly reduced basal synaptic transmission. However, 50 nM rotenone significantly impaired LTP and this rotenone's effect was prevented by co‐application of rotenone plus the ketones acetoacetate and β‐hydroxybutyrate (1 mM each). Finally, we measured mitochondrial function using MitoSOX imaging in mitochondrial preparations and found that 50 nM rotenone partially reduced mitochondrial function whereas 500 nM rotenone completely eliminated mitochondrial function. Conclusions: Our findings suggest that mitochondrial activity driven by complex I is a sensitive modulator of synaptic plasticity in the hippocampus. Acute exposure of the hippocampus to rotenone eliminates complex I function and in turn impairs LTP.     

应用生物补片修复腹壁疝及缺损的围术期护理

目的总结应用生物补片修复腹壁疝及缺损,防止切口积液、积血及感染的护理经验。方法回顾性分析本院2010年10月～2013年1月开展的17例应用生物补片修补腹壁疝及缺损患者的围术期护理资料。结果术后15例切口Ⅰ期愈合,2例Ⅱ期愈合,随访3～18个月,未发现腹壁疝发生或疝复发,无腹壁异物感或慢性疼痛。结论完整、及时、有效的围术期护理是应用生物补片修补腹壁疝和缺损手术成功的重要保证。     

爱情、性行为、痛苦与快乐模型

根据神经系统在学习、记忆和遗忘过程中表现出的特征和心理感觉，构建了一个快乐模型。在快乐模型中，作者把自由、快乐、幸福和痛苦等心理感觉统一到一个数学公式中，并且提出了神经依赖和痛苦的阶段性消失特征。根据建立的快乐模型，分析了爱情文化和性文化的形成和发展过程。最后指出：爱情文化和性文化是快乐模型的两个应用案例，并且给出了可能会产生自由爱情的四个基本条件。