屈髋屈膝按压法作用于骨盆的三维有限元分析

目的 应用有限元法研究仰卧位屈膝屈髋按压法对骨盆应力及骶髂关节应变分布特点的影响,讨论该手法扳动整个骶髂关节的可能性。方法 利用CT图像建立正常骨盆三维有限元模型。根据手法原理,将屈膝屈髋按压法分解为两个方向的力,将这两个力加载于三维有限元模型并进行计算分析,得到该加载下骨盆应力和骶髂关节应变的分布情况。结果 加载模拟手法后,骨盆的主要应力位于骶髂关节前下1/3处、坐骨大切迹及臀下线和臀前线的中1/3;骶髂关节的最大应变主要位于骶髂关节的后上缘、后下缘及上缘中部1/2。结论 屈膝屈髋按压法只能扳动骶髂关节的下1/3处,而不能扳动整个骶髂关节。     

Mast cell degranulation during abdominal surgery initiates postoperative ileus in mice

BACKGROUND & AIMS: Inflammation of the intestinal muscularis following manipulation during surgery plays a crucial role in the pathogenesis of postoperative ileus. Here, we evaluate the role of mast cell activation in the recruitment of infiltrates in a murine model. METHODS: Twenty-four hours after control laparotomy or intestinal manipulation, gastric emptying was determined. Mast cell degranulation was determined by measurement of mast cell protease-I in peritoneal fluid. Intestinal inflammation was assessed by determination of tissue myeloperoxidase activity and histochemical staining. RESULTS: Intestinal manipulation elicited a significant increase in mast cell protease-I levels in peritoneal fluid and resulted in recruitment of inflammatory infiltrates to the intestinal muscularis. This infiltrate was associated with a delay in gastric emptying 24 hours after surgery. Pretreatment with mast cell stabilizers ketotifen (1 mg/kg, p.o.) or doxantrazole (5 mg/kg, i.p.) prevented both manipulation-induced inflammation and gastroparesis. Reciprocally, in vivo exposure of an ileal loop to the mast cell secretagogue compound 48/80 (0.2 mg/mL for 1 minute) induced muscular inflammation and delayed gastric emptying. The manipulation-induced inflammation was dependent on the presence of mast cells because intestinal manipulation in mast cell-deficient Kit/Kitv mice did not elicit significant leukocyte recruitment. Reconstitution of Kit/Kitv mice with cultured bone marrow-derived mast cells from congenic wild types restored the manipulation-induced inflammation. CONCLUSIONS: Our results show that degranulation of connective tissue mast cells is a key event for the establishment of the intestinal infiltrate that mediates postoperative ileus following abdominal surgery.     

Ploidy manipulation and induction of alternate cleavage patterns through inhibition of centrosome duplication in the early zebrafish embryo

Results : A heat pulse at a later time point during the first cell cycle (22 mpf, HS2) results in a high (>80%) frequency of embryos exhibiting a precise one‐cell division stall during the second cell cycle, inducing whole genome duplication. Coupled with haploid production, HS2 generates viable gynogenetic diploids with yields up to 4 times higher than those achieved through standard Heat Shock. The cell cycle delay also causes blastomere cleavage pattern variations, supporting a role for cytokinesis in spindle orientation during the following cell cycle. 相似文献   

中医手法复位及小夹板外固定治疗儿童尺桡骨闭合骨折的病例报告

儿童尺桡骨双骨折是创伤骨科里常见病之一,临床对于骨折全错位治疗的方法常常是手术内固定治疗。但我院自2012年9月至2014年8月两年的时间,采用中医手法复位,小夹板外固定治疗48例,效果满意,现报告如下。     

The durability of operational improvements with rotational patient assignment

Introduction

Previous work has suggested that Emergency Department rotational patient assignment (a system in which patients are algorithmically assigned to physicians) is associated with immediate (first-year) improvements in operational metrics. We sought to determine if these improvements persisted over a longer follow-up period.

正骨十四法联合中药外敷在桡骨远端骨折中的应用效果分析

【摘要】 目的 研究探讨正骨十四法联合舒筋定痛散外敷治疗桡骨远端骨折的临床疗效。方法 选取 2019年1月至2021年1月郑州市骨科医院收治的100例桡骨远端骨折患者作为研究对象,按照随机数表法将其随机分为观察组 (50例)与对照组(50例)? 观察组患者采用正骨十四法联合舒筋定痛散外敷治疗,对照组患者单纯采用正骨十四法治疗,对比观察两组患者功能训练开始时间、肿胀消退时间、骨折愈合时间、腕关节活动度以及腕关节功能? 结果 观察组患者功能训练开始时间、肿胀消退时间、骨折愈合时间均明显短于对照组 (t =6.809、4.761、4.859,P 均 <0.001); 治疗后 3 个月,观察组患者腕关节旋前、旋后、掌屈活动度均明显大于对照组 (t =20.384、22.656、20.190,P 均 <0.001); 治疗后6个月,观察组患者腕关节功能为优者7例、良者23例、可者17 例、差者3 例,与对照组患者腕关节功能为优者4例、良者19例、可者18例、差者9例无明显差异(Z = -1.800,P =0.072)。结论 正骨十四法联合舒筋定痛散外敷治疗桡骨远端骨折,可有效促进肿胀消退,缩短骨折愈合时间,改善腕关节活动度,值得临床推广应用。     

Preoperative rotational assessment of the distal femur with CT may cause femoral component malrotation in TKA

BackgroundBefore total knee arthroplasty (TKA), rotational assessment of the distal femur can be performed using either magnetic resonance imaging (MRI) or computed tomography (CT). Until now, there has been no study comparing the two modalities regarding rotational assessment of the distal femur in the same patients.MethodsWe retrospectively reviewed the preoperative CT and MRI images of 110 knees in 110 patients who underwent TKA. In the axial planes of CT and MRI scan, the posterior condylar axis (PCA), anatomical transepicondylar axis (aTEA), and perpendicular line to anteroposterior axis (pAPA) were identified; the angles between these studied lines were calculated. During TKA, the angles measured on the preoperative CT and MRI were compared with the measurements obtained in the intraoperative field.ResultsThe mean aTEA-PCA angle was 6.2 ± 1.9° with CT and 5.1 ± 1.8° with MRI. The mean pAPA-PCA angle was 4.7 ± 2.1° with CT and 3.5 ± 2.0° with MRI. The mean aTEA-PCA (1.1 ± 1.3°, p = 0.001) and pAPA-PCA (1.2 ± 1.2°, p = 0.012) angles significantly differed between CT and MRI. Intra-operatively, the mean aTEA-PCA angle was 4.7 ± 1.1° and the mean pAPA-PCA angle was 3.2 ± 0.9°. Reliability analysis between the preoperative CT/MRI and the intraoperative measurements gave kappa values of 0.72 for aTEA-PCA and 0.66 for pAPA-PCA with CT, and 0.82 for aTEA-PCA and 0.84 for pAPA-PCA with MRI.ConclusionsPreoperative rotational assessment of the distal femur with CT may cause higher external rotation of femoral component in TKA.     

脊柱推拿生物力学研究的几个关键问题

推拿学历史悠久,源远流长,在中国传统医学中占有重要的地位。由于推拿手法治法简便,疗效独特,脊柱推拿手法对伤科疾患与疼痛病症有很好的疗效。虽然脊柱推拿临床应用广泛,但基础研究薄弱。本文从脊柱推拿手法作用的"力"本质及其与手法"形"关系、脊柱推拿所致咔哒声响、脊柱推拿时髓核内压力的实时监测、推拿对椎管内结构影响以及推拿时脊椎结构在空间位置上变化等方面的研究进行论述,这为更加科学地阐述脊柱推拿的作用机制提供坚实的实验依据和理论基础。     

中医斜扳疗法治疗腰椎间盘突出的生物力学研究

目的对椎间盘突出等腰椎病中医推拿斜扳疗法进行生物力学建模分析研究,比对脉冲激励的传统斜扳法和简谐激励的改良斜扳法两种不同手法的力学特性。方法假设椎骨为刚体,椎间盘及周围韧带等软组织为黏弹性体,建立模拟L1～5的5自由度振动系统,对基本方程进行解析求解。结果简谐激励改良斜扳法的疗效与频率有关。在频率≤1的简谐激励改良斜扳法作用下,病变节段最大位移都大于脉冲激励传统斜扳法下的最大位移。随着病变位置下移,简谐激励改良斜扳法的损伤比相比脉冲激励传统斜扳法逐渐下降,安全性增高。结论使用频率≤1的简谐激励改良斜扳法,治疗效果优于脉冲激励传统斜扳法,且可控制损伤。