外消旋聚乳酸复合神经生长因子缓释导管促周围神经再生的形态学研究

目的 建立外消旋聚乳酸复合神经生长因子（poly-D，L-lactic acid／nerve growth factor，PDLLA／NGF）可吸收性缓释导管桥接修复大鼠坐骨神经缺损的动物模型，观察复合导管对大鼠坐骨神经缺损再生的促进作用。方法利用溶剂挥发法制备PDLLA单纯导管和PDLLA／NGF缓释导管，每根缓释导管含NGF450U。SD大鼠40只随机分成4组，每组10只，切除中段坐骨神经10mm之后分别行自体神经移植（A组）、单纯导管桥接（B组）、单纯导管加一次性给药（C组）、PDLLA／NGF缓释导管桥接（D组）修复坐骨神经，除A组外，均保留10mm缺损。术后3个月观察神经再生情况，比较各组光镜、电镜及图像分析等指标。结果术后3个月导管与周围组织粘连松，并开始降解，但外形仍保持完整。再生神经均顺利通过导管腔，组织学观察A组和D组内神经纤维数目多，大小均匀，成熟良好；B组和C组纤维结缔组织多，神经纤维细小，髓鞘薄。图像分析显示除神经纤维计数D组高于A组外，A组和D组在纤维直径、轴突直径和髓鞘厚度方面差异均无统计学意义（P〉0．05），并明显优于B组和C组（P〈0．05）。结论 PDLLA／NGF缓释导管能够有效促进大鼠坐骨神经缺损再生，组织学观察指标接近自体神经移植。     

骨盆骨折严重度分类与休克的关系探讨

出血是导致骨盆骨折死亡的主要原因,为了认识骨盆骨折严重度与出血多少之间的关系,将我院1980.3～1993.6间连续性收入院合并伤较轻、对出血影响不大的106例骨盆骨折病例进行回顾性分析,发现骨盆3处或3处以上骨折者其发生休克为36～80％,而骨折1处或2处者则发生休克为6～23％,现报告如下。     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

交通事故伤的伤情特点及预防和救治措施的探讨

本文对1120例交通事故伤做了研究,并对本组病例的流行病学特点进行了分析。发现行人损伤居首位,其次是骑自行车者;损伤最常发生的部位是四肢和头部;最严重的损伤是汽车—摩托车冲突,其次分别为汽车—自行车冲突、汽车—行人冲突。作者根据交通事故伤的伤情特点,提出了预防和救治的具体措施。     

创伤性假性动脉瘤血流动力学的实验研究

1994年我们应用创伤法和显微外科技术研制成功创伤性假性动脉瘤(Traumatic Pseudoaneurysm,TPA)的动物模型。根据此模型,又对动脉瘤进行了血流动力学的研究,结果报告如下。1 材料和方法1.1 动物模型建立1.1.1 动物选择 健康日本大耳白兔40只,体重2.5～3.5kg。     

钝伤致不伴骨盆骨折的臀上动脉破裂一例

患者,女性,65岁,入院前9 h不慎从高约1米的木凳上摔倒,左臀部着地,当即出现左臀部疼痛、肿胀,逐渐加重,急诊入院.查体:一般情况可,左臀部高度肿胀,皮肤青紫质硬,有挫伤痕迹,左小腿外侧及足背前内侧针觉减退,下肢肌力正常,足背动脉搏动存在.拍X光片未见骨盆骨折;急诊血管造影检查见左臀上动脉在相当于坐骨切迹水平处破裂.     

治疗桡尺远侧关节慢性疾患手术的生物力学研究

目的 :对尺骨头切除术及Sauve′ Kapandji手术后尺骨传递载荷的变化进行生物力学比较分析。方法 :采用8侧青年新鲜尸体上肢标本 ,用MTS试验机控制加载 ,压敏感片方法测压力。计算出 2种手术后尺侧腕传递载荷的变化值。结果 :尺骨头切除术后传递至尺骨的载荷量显著减小 (P <0 .0 1) ;Sauve′ Kapandji手术后 ,尺骨传递轴向载荷的量接近正常标本水平。结论 :尺骨头切除后影响桡尺远侧关节的稳定性 ,使尺骨载荷量显著性降低 ,从生物力学角度看此手术不宜采用     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

老年人的肥厚性心肌病

肥厚性心肌病是一种常见疾病,梗阻型也称特发性肥厚性主动脉瓣下狭窄,具有特征性的临床表现,包括喷射性收缩期     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.