正交试验优选制首乌水煎煮工艺

目的优选制首乌最佳水煎煮工艺。方法以制首乌的代表成分2,3,5,4′-四羟基-二苯乙烯-2-O-β-D-葡萄糖苷为评价指标,采用L9（34）正交试验设计、高效液相色谱法考察药材粒度、浸泡时间、煎煮时间、煎煮次数四个因素,对制首乌的水煎煮工艺进行优选。结果最佳水煎煮工艺：粒度为小块,浸泡30 min,煎煮时间70min,煎煮次数3次。结论优选所得的最佳煎煮工艺科学合理。     

LISS接骨板联合髓内针治疗Ⅱ型浮膝损伤19例疗效分析

目的探讨提高治疗Ⅱ型浮膝损伤的手术治疗效果。方法对我科2007年8月至2011年9月收治的19例Ⅱ型浮膝损伤患者应用髓内针、LISS接骨板治疗,并进行随访分析。按Frase等分型,ⅡA型11例,ⅡB型7例。结果经过8~20个月随访,平均14个月,骨折愈合时间为12~19周,平均15.3周。治疗结果按Karlstrom等制定的浮膝损伤肢体功能评分标准。优,13例,良,4例,中,2例,优良率89.5%。结论应用LISS接骨板联合髓内针治疗Ⅱ型浮膝损伤具有创伤小、固定强度可靠、功能恢复快、骨折不愈合率低、骨折并发症少的优点。     

Achromatopsia: case presentation and literature review emphasising the value of spectral domain optical coherence tomography

A literature review and case presentation are used to discuss the diagnostic value of spectral domain optical coherence tomography (SD‐OCT) in the assessment and management of congenital achromatopsia. A 24‐year‐old Hispanic man presented to the clinic with a longstanding history of decreased vision and associated possible recent progression. A comprehensive eye examination and a battery of tests including SD‐OCT, fundus photography, electroretinogram (ERG) and Farnsworth D‐15 were completed. SD‐OCT and photopic ERG confirmed the clinical diagnosis of congenital achromatopsia. There was the classic subfoveal flattened hyporeflective ‘punched out’ zone, resulting from an absence of inner segment/outer segment junction. SD‐OCT findings associated with congenital achromatopsia have been documented recently, helping in the diagnosis of the condition. The SD‐OCT findings have further expanded our knowledge of congenital achromatopsia, while also aiding in the management of the disease.     

椎板减压椎间植骨融合器椎弓根钉棒系统固定融合术治疗老年人退行性腰椎滑脱的疗效分析

目的探讨椎板减压椎间植骨融合器椎弓根钉棒系统固定融合术治疗老年人退行性腰椎滑脱的疗效。方法对本院2010年3月—2012年5月收治的78例退行性腰椎滑脱老年患者的临床资料进行回顾性分析。综合考虑患者身体状况和经济水平等因素后,对36例患者实施椎板减压联合椎间植骨融合术,设为2联组;其余42例患者实施椎板减压椎间植骨融合器联合椎弓根钉棒系统固定融合术,设为3联组。术后对患者进行长期随访,观察并比较2组患者手术前后及随访JOA评分、椎间隙高度、融合率、手术时间、术中出血量和并发症发生率的情况。结果 2联组和3联组患者术后JOA评分相比于治疗前均明显升高(P<0.05),末次随访2联组JOA评分相比于术后差异无统计学意义(P>0.05),而末次随访3联组JOA评分相比于术后明显升高(P<0.05);2联组和3联组患者术后椎间隙高度较治疗前明显提高(P<0.05),末次随访2联组椎间隙高度与术后相比明显下降(P<0.05),而3联组椎间隙高度相比于术后差异无统计学意义(P>0.05);3联组植骨融合率明显高于2联组(P<0.05);3联组手术时间、出血量、并发症均显著高于2联组(P<0.05)。结论椎板减压椎间植骨融合器椎弓根钉棒系统固定融合术用于治疗老年人退行性腰椎滑脱时,可以长期缓解患者的下腰痛症状,提高椎间隙高度。但是,该手术时间长,术中出血量多,导致并发症发生率增加,故在治疗时,应根据患者的身体状况选择合适的手术方式。     

Low-Level Gestational Lead Exposure Increases Retinal Progenitor Cell Proliferation and Rod Photoreceptor and Bipolar Cell Neurogenesis in Mice

Background

Gestational lead exposure (GLE) produces novel and persistent rod-mediated electroretinographic (ERG) supernormality in children and adult animals.

Objectives

We used our murine GLE model to test the hypothesis that GLE increases the number of neurons in the rod signaling pathway and to determine the cellular mechanisms underlying the phenotype.

Results

Blood lead concentrations ([BPb]) in controls and after low-, moderate-, and high-dose GLE were ≤ 1, ≤ 10, approximately 25, and approximately 40 μg/dL, respectively, at the end of exposure [postnatal day 10 (PND10)]; by PND30 all [BPb] measures were ≤ 1 μg/dL. Epifluorescent, light, and confocal microscopy studies and Western blots demonstrated that late-born rod photoreceptors and rod and cone bipolar cells (BCs), but not Müller glial cells, increased in a nonmonotonic manner by 16–30% in PND60 GLE offspring. Retinal lamination and the rod:cone BC ratio were not altered. In vivo BrdU (5-bromo-2-deoxyuridine) pulse-labeling and Ki67 labeling of isolated cells from developing mice showed that GLE increased and prolonged retinal progenitor cell proliferation. TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) and confocal studies revealed that GLE did not alter developmental apoptosis or produce retinal injury. BrdU birth-dating and confocal studies confirmed the selective rod and BC increases and showed that the patterns of neurogenesis and gliogenesis were unaltered by GLE.

Conclusions

Our findings suggest two spatiotemporal components mediated by dysregulation of different extrinsic/intrinsic factors: increased and prolonged cell proliferation and increased neuronal (but not glial) cell fate. These findings have relevance for neurotoxicology, pediatrics, public health, risk assessment, and retinal cell biology because they occurred at clinically relevant [BPb] and correspond with the ERG phenotype.     

椎弓根钉棒系统内固定在胸腰椎骨折治疗的应用体会

目的：总结应用椎弓根钉棒系统内固定治疗胸腰椎骨折的临床效果。方法：对62例胸腰椎骨折的患者行34例AF系统内固定,28例钉棒系统内固定。通过了解术中及术后并发症、伤椎椎体前缘高度的恢复、Cobb角的矫正、椎管狭窄的改善及脊髓神经功能的恢复情况,自制疗效评定标准判定疗效。结果：所有患者随访3个月-2年,平均20个月,X线及CT复查提示骨折复位率达90%以上,椎管有效容积正常;平均骨折愈合时间3个月。其中5例合并神经系统症状者,按美国脊髓损伤分级,均有不同程度的神经功能恢复。结论：通过对椎弓根钉棒系统固定胸腰椎骨折的病例分析,证实其为临床的一种切实可行的手术方法,操作简便,宜于推广。     

可吸收棒或钛合金螺钉治疗MasonⅡ型桡骨头骨折的疗效

文题释义：可吸收棒、钛合金螺钉内固定：两者均属于MasonⅡ型桡骨头骨折螺钉内固定法，主要区别在于其制作材质不一样，前者是由聚乳酸制成的可吸收高分子聚合物，而后者为钛合金制成，需二次手术取出。桡骨头骨折Mason分类：Ⅰ型，为线状骨折，即无移位型骨折，骨折线可通过桡骨头边缘或呈劈裂状；Ⅱ型，为有移位的骨折，有分离的边缘骨折；Ⅲ型，为粉碎型骨折，移位或无移位或呈塌陷性骨折；Ⅳ型，为桡骨头骨折伴有肘关节脱位。 背景：目前切开复位内固定是治疗MasonⅡ型桡骨头骨折的有效方法，内固定的选择有螺钉、微型钢板、克氏针、可吸收棒或钉等，临床疗效报道不一致。 目的：对比可吸收棒或钛合金螺钉内固定治疗MasonⅡ型桡骨头骨折的临床疗效。方法：选择2016年1月至2017年2月四川省人民医院收治的桡骨头骨折患者25例，其中男16例，女9例，年龄38-61岁，均进行切开复位内固定治疗，其中13例的内固定材料为钛合金螺钉，另12例的内固定材料为可吸收棒。术后随访拍摄X射线片，确定骨折愈合时间。末次随访时，对比两组目测类比评分、肘关节活动度及肘关节功能Mayo评分与Broberg-Morrey 评分。该研究已通过四川省医学科学院·四川省人民医院伦理委员会的审批。结果与结论：①可吸收棒组、钛合金螺钉组的骨折愈合时间分别为(2.35±0.92)，(2.10±0.47)个月，组间比较差异无显著性意义(P > 0.05)；②末次随访时，两组间肘关节功能Mayo评分与Broberg-Morrey 评分比较差异均无显著性意义(P > 0.05)；③末次随访时，两组间肘关节屈曲、伸直、旋后、旋前角度比较差异均无显著性意义(P > 0.05)；④末次随访时，两组目测类比评分比较差异均无显著性意义(P > 0.05)；⑤结果表明，可吸收棒与钛合金螺钉治疗MasonⅡ型桡骨头骨折的临床疗效相似，但可吸收棒避免了二次手术取出内固定及应力性遮挡等情况。 ORCID: 0000-0003-4778-7050(杨晓) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

Deformation and Fracture Failure of a High-Speed Long Rod Intercepted by Linear Explosively Formed Penetrators Sequence

The fracture failure of a high-speed long rod has historically been a challenge. Since the flying plate and flying rod have a relatively low velocity, it is challenging to achieve a multi-stage fracture of the high-speed long rod within the range of existing technology. In this paper, the linear explosively formed penetrators (LEFPs) sequence with a stable flight velocity of 850 m/s were used to cut a high-speed long rod. We investigated the deformation and fracture of Φ10 mm tungsten alloy long rods having different length-diameter ratios (20, 26, 35) and different speeds (1200, 1400, 1600 m/s) by employing the LEFPs sequence with different spacings (0–40 mm) and different interception angles (30°, 60°). In the meantime, the fractured rods movement pattern was recorded with a high-speed camera to elucidate the change law of the length, speed, linear momentum, and angular momentum of fractured rods. It was found that the length loss rate of the fractured rods is as high as 27%. The fractured rods rotated around the center of mass, and the vertical speed change could reach up to 18% of the muzzle velocity of the long rod, and the greatest reduction of horizontal speed and momentum could reach 37%. The longer the interaction time between LEFPs sequence and the long rod, the more beneficial the failure of the long rod. The application of LEFPs sequence solved the difficult problem of disabling the high-speed long rod, and the quantitative analysis of the fracture failure of the long rod had an important sense for studying the terminal penetration effect of the fractured rods.     

Quadrant可扩张通道显微镜下手术治疗腰椎间盘突出症的研究

目的探讨腰椎间盘突出症应用Quadrant可扩张通道系统显微镜下不同手术方法治疗的临床效果。方法选择2017年3月～2018年4月腰椎间盘突出症患者40例为研究对象,按随机数表法分为单侧组和双侧组各20例,患者均应用Quadrant可扩张通道系统显微镜下手术,对单侧组实施单侧钉棒系统固定治疗,对双侧组实施双侧钉棒系统固定治疗,分析患者手术指标、术后并发症、JOA评分变化、疗效。结果单侧组患者术中出血量、手术时间、手术切口长度、术后住院时间、单病种总医疗费用低于双侧组,差异有统计学意义(P0.05)。患者术后脊柱稳定性均良好,术后1年植骨融合。单侧组术后并发症发生率、术后1年恢复优良率与双侧组比较,差异无统计学意义(P0.05)。单侧组术后1周JOA评分高于双侧组,差异有统计学意义(P0.05)。结论应用Quadrant可扩张通道系统显微镜下手术治疗腰椎间盘突出症效果良好,并发症少,且实施单侧钉棒系统固定时比双侧固定创伤更小,早期恢复效果更好。     

Edwards套棒方法治疗胸腰段脊柱不稳定损伤的生物力学实验研究

本文报告Edwards套棒装置及单纯Harrington分离棒治疗胸腰椎不稳定损伤的力学实验研究结果。取成年猪新鲜胸腰椎脊柱6具,切断前纵韧带、椎间盘纤维环、后纵韧带,造成前中柱不稳定损伤15处。测力传感器固定于椎体前缘并骑跨损伤处,使之检测纵向复位力。单侧内固定装置固定。实验结果表明:单侧Edwards套棒装置产生纵向复位力量89N,较Harrington分离棒48.7N提高82.7％(P<0.0005);二种内固定装置分别用于胸、腰椎时,纵向复位力均无显著差异(P<0.05),表明胸段肋骨对纵向复位力无影响。生物力学分析,纵向复位力与横向前推力成正比例关系,增大内固定装置对伤椎的横向前推力,可提高纵向复位力量。同时其它学者也报告Edwards套棒装置具有良好的脊柱三维稳定作用。所以,作者认为Edwards套棒装置集对脊柱骨折复位与稳定于一体,是理想的内固定装置。