动力型手内在肌功能重建术18例临床分析

目的 分析动力型手内在肌功能重建手术的临床疗效和影响因素.方法 回顾分析18例动力型手内在肌功能重建手术的临床结果(其中改良Bunnell法14例,Brand法4例).术后按疗效功能评定标准和Brand手功能评定标准,得出术后疗效的优良率.结果 术后随访时间为2～30个月,18例术后疗效总优良率为33%.结论 动力型手内在肌功能重建术的适应证为单纯尺神经损伤者,其他复合性损伤术后疗效较差.同时应注重移位动力肌的选择、止点缝合张力等问题.     

Effect of pulley integrity on excursions and work of flexion in healing flexor tendons

Effect of pulley integrity on excursions and work of flexion in healing flexor tendons@Wang YH @Gu YT @Chen F     

组织工程化肌腱研究进展

对组织工程化肌腱领域中目前研究的主要成果进行综述，着重阐述了肌腱细胞外基质替代物、肌腱细胞生物学性质及肌腱细胞与细胞外基质材料复合研究中的主要问题。认为，研制适于肌腱细胞生长、粘附和发挥功能的细胞外基质材料；建立生长、增殖可调控的肌腱细胞系；在模拟体内力学条件下，进行肌腱细胞三维培养，将是研究具有特定修复功能的组织工程化肌腱的重要问题。     

Use of Air-Liquid Two-Phase Flow in Hydrophobic Microfluidic Channels for Disposable Flow Cytometers

This paper describes a disposable flow cytometer that uses an air-liquid two-phase microfluidic system to produce a focused high-speed liquid sample stream of particles and cells. The susceptibility of thin liquid columns to instabilities may suggest that focusing of sample liquids with streams of air would be difficult. The design of channel geometry, control of flow rates, and use of appropriate surface chemistries on the channel walls, however, enabled the generation of thin (15–100 m) and partially bounded sample streams that were stable and suitable for rapid cell analysis. Using an inverted epi-fluorescence microscope with a photo-multiplier tube, we demonstrated that the system is capable of counting the number of beads and C₂C₁₂ myoblast cells. The effects of different flow rates and surface chemistries of the channel walls on the air-liquid two-phase flows were characterized using optical and confocal microscopy. Use of air instead of liquids as a sheath fluid eliminates the need for large sheath liquid reservoirs, and reduces the volume and weight requirements. The low manufacturing cost and high volumetric efficiency make the air-sheath flow cytometer attractive for use as a stand-alone device or as an integrated component of bio-artificial hybrid microsystems.     

Local injection of a mixture of beta-aminopropionitril fumarate and sodium hyaluronate together with controlled exercise for treatment of subacute superficial digital flexor tendonitis in horses

Local injection of a mixture of beta-aminopropionitril fumarate (BAPN-f) and sodium hyaluronate (NaH⁺) together with controlled exercise were evaluated for treatment of superficial digital flexor tendon (SDFT) injuries in horses. Fourteen mixed breed horses with subacute SDF tendon injuries in forelimbs were randomly assigned to two groups. One group received BAPN-f (0.7 mg/ml) and the other received NaH⁺ (10 mg/ml) all by intratendinous injection. Controlled exercise started during the first week after intratendinous treatment and continued for 12 weeks. Cross-sectional area (CSA) of the SDFT, diameter of the SDFT, and relative area of the lesion (presence of CSA) were measured by ultrasonographic examination. Lesions were semiquantitatively graded for echogenicity on a scale of 0 to 4. The lesion severity in CSA was significantly reduced by BAPN and NaH compared to those horses treated by BAPN only (p < 0.05). Lesion echogenicity score was significantly higher in horses treated with BAPN and NaH⁺ at day 0 compared to horses treated with BAPN (p < 0.05). At the end of the study, lesion echogenicity score was significantly reduced in the horses treated with BAPN and NaH⁺ compared to horses treated by BAPN only (p < 0.05). According to the results of the present study, a combination of BAPN-f and NaH⁺ has a greater beneficial effect on tendon healing and remodeling in horses, as assessed by sonographic examination, compared to treatment with single drugs.     

Collagenous colitis: A disease of pericryptal fibroblast sheath?

Mucosal biopsies from four women with collagenous colitis and ten controls were studied. By light microscopy the cells of the pericryptal fibroblast sheath appeared diminished in number but increased in size in collagenous colitis. Electron optically in the controls the pericryptal fibroblasts were in intimate contact with the epithelial basal lamina in the crypts. On the free surface the fibroblasts maintained contact with the epithelial cells by attenuated cell processes. In collagenous colitis, in the middle and upper thirds of the crypts the fibroblasts sheath was separated from the epithelium and the fibroblasts assumed the characteristics of myofibroblasts. The separation was accentuated towards the mouths of the crypts. Beneath the surface epithelium the attenuated fibroblast cell processes seen in normal colon were grossly deficient. The basal lamina was also deficient focally and the surface epithelial cells were resting directly on a thickened collagen table. In collagenous colitis the excess collagen appeared to be secreted by the activated myofibroblasts of the pericryptal sheath.     

In vivo and in vitro effects of imidacloprid on sheep keds (Melophagus ovinus): a light and electron microscopic study

The effects of imidacloprid (Advantage) on sheep keds (Melophagus ovinus Linné 1758) were studied in vivo and in vitro by means of direct observation (monitored on video tape) and by light and electron microscopy. It was found that: 1. Imidacloprid acted rapidly on all motile stages of the sheep keds. Within 3–4 min after exposure they became immobile and their legs and the abdomen started tetanic trembling movements for 15–30 min, leading to death. 2. The compound is apparently taken up by the body, since it also acted on those sheep keds that had been exclusively exposed to imidacloprid-contaminated filter papers. 3. The compound is available and active for more than 1 month in the wool of sheep; even rainfall does not reduce its efficacy. Body contact between treated mother sheep and their lambs protects them from infestation with these ectoparasites. 4. The compound initiates an ultimately lethal destruction of the ganglia, nerve chords and related muscle fibers, as can be seen in electron micrographs. Received: 7 October 2000 / Accepted: 18 October 2000     

Plexiform neurilemoma: A clinicopathological and immunohistochemical analysis of 23 tumours from 20 patients

Summary A clinicopathological and immunohistochemical study was done on 23 plexiform (multinodular) neurilemomas excised from 20 Japanese. Ages of the subjects ranged from 2 years to 69 years with a mean age of 30 years. The tumours occurred most often on the trunk (14), and were located commonly in the dermis and subcutis (19). Three lesions apparently originated from the peripheral nerve trunks. Multiple tumours were observed in six instances, and two were associated with von Recklinghausen's disease. Microscopically, they appeared as multinodular growths, most nodules were moderately cellular, and both Antoni A and B patterns were distinct in 10 tumours. Obvious Verocay bodies were noted in seven tumours and abortive ones in five. Immunohistochemical reactivity to S-100 protein was demonstrated in both nuclei and cytoplasm of almost all tumour cells of all lesions examined. Recurrences are nil among the 4 patients who could be followed. Correlations with trauma and with von Recklinghausen's disease are briefly discussed.     

取腱器配合腓肠肌筋膜瓣翻转术治疗跟腱断裂疗效观察

目的介绍利用取腱器切取腓肠肌筋膜瓣,翻转缝合断裂跟腱的临床效果。方法选取2008年1月~2012年12月我院跟腱断裂病人21例,男15例,女6例,平均年龄33.5岁,为剧烈运动后跟腱撕裂伤,均采用手术治疗。俯卧位,跟腱断裂部位纵行手术切口,马尾状撕裂部位梳理整齐后编织缝合,根据需要腱膜的长度于切口近端相应部位作纵行小切口,用取腱器取筋膜条,自皮下隧道牵出远端切口,翻转,光滑面朝后加固缝合断裂跟腱。术后长腿石膏固定4周,短腿石膏固定2周。结果 21例患者均获得术后随访,平均随访时间2.3年(1~5年)。根据Arner Lindholm评分标准,优16例,良4例,差1例,优良率95.2%。结论取腱器微创小切口下取腓肠肌腱膜方法具有小切口,创伤小,美观等优点,术后正规康复功能锻炼后临床效果良好。     

Kinaesthetic role of muscle afferents in man,studied by tendon vibration and microneurography

Summary The characteristics of vibration-induced illusory joint movements were studied in healthy human subjects. Unseen by the subject, constant frequency vibration trains applied to the distal tendon of the Triceps or Biceps induced an almost constant velocity illusory movement of the elbow whose direction corresponded to that of a joint rotation stretching the vibrated muscle. Vibration trains of the same duration and frequency applied alternatively to the Biceps and Triceps evoked alternating flexion-extension illusory movements.During successive application of vibration trains at frequencies from 10 to 120 Hz, the perceived velocity of the illusory movements increased progressively from 10 to 70–80 Hz, then decreased from 80 to 120 Hz. The maximal perceived velocity was three times higher during alternating vibration of the Biceps and Triceps than during single muscle stimulation.Unit activity from 15 muscle spindle primary endings and five secondary endings located in Tibialis anterior and Extensor digitorum longus muscles were recorded using microneurography in order to study their responses to tendon vibration and passive and active movements of the ankle.Primary endings were all activated by low amplitude tendon vibration (0.2–0.5 mm) previously used to induce illusory movements of the elbow. The discharge of some was phase-locked with the vibration cycle up to 120 Hz, while others responded one-to-one to the vibration cycle up to 30–50 Hz, then fired in a sub-harmonic manner at higher frequencies. Secondary endings were much less sensitive to low amplitude tendon vibration.Primary and secondary ending responses to ramp and sinusoïdal movements of the ankle joint were compared. During the movement, the primary ending discharge frequency was almost constant, while the secondary ending activity progressively increased. During ankle movements the primary ending discharge appeared mainly related to velocity, while some secondary activities seemed related to both movement velocity and joint angle position.Muscle spindle sensory ending responses to active and passive ankle movements stretching the receptor-bearing muscle (plantar flexion) were qualitatively and quantitatively similar. During passive reverse movements (dorsiflexion) most of the sensory endings stopped firing when their muscle shortened. Active muscle shortening (isotonic contraction) modulated differently the muscle spindle sensory ending discharge, which could stop completely, decrease or some times increase during active ankle dorsiflexion. During isometric contraction most of the muscle spindle sensory endings were activated.The characteristics of the vibration-induced illusory movements and the muscle spindle responses to tendon vibration and to active and passive joint movements strengthened the possibility of the contribution of primary endings to kinaesthesia, as suggested by several previous works. Moreover, the present results led us to attribute to proprioception in the muscle stretched during joint movement a predominant, but not exclusive, role in this kind of perception.