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ObjectiveTo determine if individuals with chronic ankle instability (CAI) demonstrate altered landing kinematics, muscle activity, and impaired dynamic postural stability during a unilateral jump-landing task.Methods21 studies were included from PubMed, MEDLINE, Embase and CINAHL searched on September 26, 2021. Mean differences in joint angles and muscle activity between CAI and controls were analysed as continuous variables and pooled using a random-effects model to obtain standardised mean differences and 95% confidence intervals. Dynamic postural stability measured using time to stabilisation (TTS) was assessed qualitatively.ResultsWe found greater plantarflexion (pooled SMD = 0.33, 95%CI [0.02,0.65]), reduced knee flexion (pooled SMD = −0.67, 95%CI [−0.97, −0.37]), and reduced hip flexion (pooled SMD = −0.52, 95%CI [−0.96, −0.07]) in CAI after landing. Regarding muscle activity, we observed reduced peroneus longus muscle activation (pooled SMD = −0.77, 95% CI [−1.17, −0.36]) in CAI prior to landing.ConclusionOur study provides preliminary evidence of altered landing kinematics in the sagittal plane and reduced peroneus muscle activity in CAI during a dynamic jump-landing task. These results may have clinical implications in the development of more effective and targeted rehabilitation programmes for patients with CAI.  相似文献   
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目的 探讨三级命名法在旋股外侧动脉(LCFA)主要分支命名中应用的可行性及意义。方法 解剖37具69侧成人防腐下肢标本,观察LCFA的起源以及其主要分支数目、口径、长度、走行分布等情况。使用三级命名法对主要分支进行命名并分析主要分支间关系。结果 69侧LCFA起源于股深动脉64侧(92.8%)、股动脉5侧(7.2%)。按照三级法对69侧下肢标本的LCFA各主要分支进行命名:65侧(94.2%)出现斜向上走行的升支共65支,其起始处外径(1.17 ± 0.42) mm,自发出位置至入肌长度(3.21 ± 0.91) cm;65侧(94.2%)出现近乎水平走行的横支共65支,其起始处外径(1.00 ± 0.51) mm,自发出位置至入肌长度(2.9 ± 1.1) cm;66侧(95.7%)出现斜向下走行的斜支共78支,其中12侧(17.4%)为双斜支,其起始处外径(0.94 ± 0.48) mm,自发出位置至入肌长度(4.6 ± 2.4) cm;69侧(100.0%)出现近乎垂直走行的降支共72支,其中4侧(5.8%)为双降支,其起始处外径(1.40 ± 0.68) mm,自发出位置入肌长度(11.1 ± 4.6) cm。69侧中,采用一级命名法命名者44侧(63.8%)、二级命名17侧(24.6%)、三级命名8侧(11.6%)。结论 LCFA主要分支发出位置及形态学变化较大,首次采用三级法可以准确命名各主要分支,可行性高,对股前外侧皮瓣血供解剖研究有较高的参考价值。  相似文献   
4.
赵智勇  姜士超  徐鹏  穆卫东 《骨科》2022,13(2):130-134
目的 探讨单一L型钢板治疗累及后外侧髁的胫骨平台外侧骨折的临床疗效。方法 回顾性分析2016年10月至2021年3月山东大学附属山东省立医院收治的23例累及后外侧髁的胫骨平台外侧骨折病人的临床资料,其中男12例,女11例,年龄为22~73岁,平均40.5岁。受伤原因:高处坠落10例,交通事故10例,重物挤压3例,均为闭合性骨折。病人受伤至入院时间为2~72 h,入院至手术时间为3~14 d。均采用改良的腓骨小头上入路,骨折复位后L型钢板固定,一期处理合并前交叉韧带及半月板损伤。末次随访采用美国特种外科医院(American Hospital for Special Surgery,HSS)膝关节评分评价膝关节功能。结果 平均手术时间为53 min(45~71 min),平均术中出血量为122 mL(55~150 mL),平均随访时间为16.1个月(11~20个月)。X线复查结果示骨折均愈合,愈合时间为12~17周。末次随访时膝关节伸直度为0°~35°,膝关节屈曲度为100°~150°,HSS评分平均为92.2分(81~100分)。结论 单一L型钢板可以同时有效地固定胫骨平台后外侧髁及外侧骨折块,手术操作简便,可获得较好疗效。  相似文献   
5.
《Clinical neurophysiology》2021,132(9):2003-2011
ObjectiveA large N20 and P25 of the median nerve somatosensory evoked potential (SEP) predicts short survival in amyotrophic lateral sclerosis (ALS). We investigated whether high frequency oscillations (HFOs) over N20 are enlarged and associated with survival in ALS.MethodsA total of 145 patients with ALS and 57 healthy subjects were studied. We recorded the median nerve SEP and measured the onset-to-peak amplitude of N20 (N20o-p), and peak-to-peak amplitude between N20 and P25 (N20p-P25p). We obtained early and late HFO potentials by filtering SEP between 500 and 1 kHz, and measured the peak-to-peak amplitude. We followed up patients until endpoints (death or tracheostomy) and analyzed the relationship between SEP or HFO amplitudes and survival using a Cox analysis.ResultsPatients showed larger N20o-p, N20p-P25p, and early and late HFO amplitudes than the control values. N20p-P25p was associated with survival periods (p = 0.0004), while early and late HFO amplitudes showed no significant association with survival (p = 0.4307, and p = 0.6858, respectively).ConclusionsThe HFO amplitude in ALS is increased, but does not predict survival.SignificanceThe enlarged HFOs in ALS might be a compensatory phenomenon to the hyperexcitability of the sensory cortex pyramidal neurons.  相似文献   
6.
目的探讨侧卧位通气对重症新型冠状病毒肺炎(COVID-19)患者的临床价值。 方法采用回顾性研究,收集2020年1月20日至3月7日在重庆三峡中心医院重症应急病区住院的41例COVID-19并中、重度急性呼吸窘迫综合征(ARDS)患者的临床资料。在经鼻高流量湿化氧疗(HFNC)或无创通气(NIV)的基础上,按是否进行侧卧位通气将患者分为侧卧位组(24例)和仰卧位组(17例)。统计2组患者的性别、年龄、急性生理与慢性健康状况(APACHEⅡ)评分和合并基础疾病情况,比较治疗前及治疗后第1、3、5天的心率(HR)、呼吸频率(RR)、氧合指数(PaO2/FiO2)、二氧化碳分压(PaCO2)、平均动脉压(MAP),以及轻症化率、HFNC或NPPV时间、气管插管发生率、住院时间、压疮发生情况等预后指标。 结果41例患者中,男性21例,女性20例;年龄43~79岁,平均(60.9±11.1)岁。2组患者年龄、性别、APACHEⅡ评分、合并基础疾病,以及治疗前RR、PaO2/FiO2、PaCO2和MAP等比较,差异均无统计学意义(P均>0.05)。2组患者治疗后HR、RR、MAP较治疗前下降,而PaCO2、PaO2/FiO2上升,其中PaO2/FiO2在第5天较治疗前明显改善[侧卧位组:(166.4±45.4)mmHg vs(253.0±66.0)mmHg,仰卧位组:(183.8±54.4)mmHg vs(227.4±62.8)mmHg,P均<0.05,1 mmHg=0.133 kPa]。2组间比较,侧卧位组在治疗后第1天RR较仰卧位组降低(P=0.006);侧卧位组的中、重度ARDS患者PaO2/FiO2在治疗后第5天较仰卧位组改善,差异有统计学意义[(260.8±58.5)mmHg vs (221.6±64.9)mmHg,P=0.043]。2组HFNC或NIV时间和气管插管发生率比较,差异无统计学意义(P均>0.05),而侧卧位组总住院时间明显短于仰卧位组,差异有统计学意义[(15.5±7.2)d vs (21.5±9.8)d,P=0.028],ICU住院时间也短于仰卧位组,差异有统计学意义[(10.3±6.3)d vs (16.9±11.0)d,P=0.021],侧卧位组病死率低于仰卧位组,差异有统计学意义(8.3 % vs 23.5 %,P = 0.047)。 结论侧卧位通气能改善COVID-19并中、重度ARDS患者的氧合,缩短住院时间,降低病死率,提高疗效,促进患者康复。  相似文献   
7.
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by death of motor neurons in the cortex and the spinal cord. This loss of motor neurons causes progressive weakness and amyotrophy. To date, the median duration of survival in patients with ALS, from first symptoms to death, is estimated to be 36 months. Currently the treatment is limited to two options: riluzole which prolongs survival for a few months and edaravone which is available in only a few countries and also has a small impact on disease progression. There is an urgent need for more effective drugs in this disease to significantly improve progression. Over the last 30 years, all trials have failed to find a curative drug for ALS. This is due, partially, to the heterogeneity of the clinical features and the pathophysiology of motor neuron death. We present in this review the various treatment options currently being developed for ALS, with an emphasis on the range of therapeutic approaches being explored, from old drugs tested in a new indication to innovative drugs obtained via biotechnology or gene therapy.  相似文献   
8.
ObjectivesThe purpose of this study was to identify prospectively the anatomical and functional intrinsic risk factors for lateral ankle sprain (LAS) in adolescent athletes participating in team sports.DesignA prospective cohort study.SettingUniversity research laboratory.ParticipantsA total of 152 adolescent male athletes (age: 14.45 ± 2.96 years; height: 165.63 ± 15.33 cm; weight: 55.60 ± 16.56 kg; body mass index: 19.97 ± 3.58 kg/m2) participated in this study.Main outcome measuresThe participants were assessed during the preseason for previous ankle sprain history, navicular drop, tibia vara, Q angle, tibia torsion, knee recurvatum, and ankle ROM. LASs were prospectively recorded and diagnosed for two consecutive seasons (20 months).ResultsPrevious ankle sprain history (odds ratio [OR] = 60.911, p < 0.001), increased navicular drop (OR = 1.767, p < 0.001), and knee recurvatum (OR = 1.881, p = 0.002) were positively associated with the incidence of LAS. The receiver operating characteristic (ROC) analyses revealed the predictive potentials of previous ankle sprain history (the area under the ROC [AUROC] = 0.706, p < 0.001), navicular drop (AUROC = 0.906, p < 0.001), and knee recurvatum (AUROC = 0.724, p < 0.001).ConclusionAthletes with previous ankle sprain history, knee recurvatum, and especially navicular drop may have a greater risk of LAS injury. The data from this study can help therapists and trainers to identify people with a higher risk of LAS.  相似文献   
9.
Lateral lymph nodes in low, locally advanced, rectal cancer have proven implications for local recurrence rates, which increase drastically in the presence of persistently enlarged lateral lymph nodes. These clinical implications warrant a thorough understanding of lateral nodal disease with awareness and knowledge from all three specialties involved – radiology, radiation oncology, and surgery – to ensure proper treatment. Relevant literature for each specialty, including all current guidelines and perspectives, were examined. Variations in definitions and treatment paradigms were evaluated. There is still no consensus for the standardized treatment of lateral nodal disease. Each discipline works according to their own available evidence, but relevant data are scarce. Current international guidelines and standard recommendations for the diagnostics and treatment of lateral lymph nodes are lacking. This results in differing perspectives and interpretations between the disciplines which can lead to challenging communication in an area where multidisciplinary collaboration is essential. This review addresses this by presenting the current evidence, perspectives and practices of each specialty and makes suggestions for each phase of the diagnostic and treatment process for patients with lateral nodal disease. By doing this, steps are taken toward achieving international consensus, and multidisciplinary collaboration.  相似文献   
10.
BackgroundStandard Western management of rectal cancers with pre-treatment metastatic lateral lymph nodes (LLNs) is neoadjuvant (chemo)radiotherapy (nCRT) followed by total mesorectal excision (TME). In recent years, there is growing interest in performing an additional lateral lymph node dissection (LLND). The aim of this systematic review and meta-analysis was to investigate long-term oncological outcomes of nCRT followed by TME with or without LLND in patients with pre-treatment metastatic LLNs.MethodsPubMed, Ovid MEDLINE, Embase, Cochrane Library and Clinicaltrials.gov were searched to identify comparative studies reporting long-term oncological outcomes in pre-treatment metastatic LLNs of nCRT followed by TME and LLND (LLND+) vs. nCRT followed by TME only (LLND-). Newcastle-Ottawa risk-of-bias scale was used. Outcomes of interest included local recurrence (LR), disease-free survival (DFS), and overall survival (OS). Summary meta-analysis of aggregate outcomes was performed.ResultsSeven studies, including 946 patients, were analysed. One (1/7) study was of good-quality after risk-of-bias analysis. Five-year LR rates after LLND+ were reduced (range 3–15%) compared to LLND- (11–27%; RR = 0.40, 95%CI [0.25–0.62], p < 0.0001). Five-year DFS was not significantly different after LLND+ (range 61–78% vs. 46–79% for LLND-; RR = 0.72, 95%CI [0.51–1.02], p = 0.143), and neither was five-year OS (range 69–91% vs. 72–80%; RR = 0.72, 95%CI [0.45–1.14], p = 0.163).ConclusionIn rectal cancers with pre-treatment metastatic LLNs, nCRT followed by an additional LLND during TME reduces local recurrence risk, but does not impact disease-free or overall survival. Due to the low quality of current data, large prospective studies will be required to further determine the value of LLND.  相似文献   
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