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     

休克的处理

休克的类型 Weil和Shubin将之分为四类,各类均有其血流动力学特点。心源性休克在血流前向不足的情况下,心肌功能障碍可导致心源性休克。它多由于左室功能障碍,偶可源于右室;常伴随衰竭心室之后有过量液体积聚。此型休克典型的血流动力学特点是心脏指数低、周围血管阻力高、充盈压力(左心衰竭的楔压和右     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

目的 探讨RGD多肽接枝聚/β-TCP/PLA复合神经导管桥接周围神经缺损的治疗效果.方法 45只雄性成年Wister大鼠,随机分为3组,每组15只.切断右侧坐骨神经形成10 mm缺损,A组采用单纯PLA神经导管桥接缺损,B组采用RGD多肽接枝聚/β-TCP/PLA复合神经导管桥接缺损,C组采用自体神经移植.术后12周进行大体观察、电生理、小腿三头肌恢复率、组织学、超微结构等测定.结果 B组运动神经传导速度和肌肉湿重恢复率明显优于A组,差异有统计学意义(P<0.05);B组与C组相近,差异无统计学意义(P>0.05).组织学、超微结构测定发现B、C组神经再生情况明显优于A组.结论 在坐骨神经损伤修复中,RGD多肽接枝聚/β-TCP/PLA复合神经导管桥接修复效果与自体神经移植相近,可作为一种较理想的神经缺损修复材料.     

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.     

PDLLA/NGF复合膜用于自体神经移植促进神经再生实验研究

目的：探讨外消旋聚乳酸／神经生长因子(PDLLA／NGF)复合膜用于自体神经移植是否具有促进神经再生作用。方法：雌性Wistar大白鼠16只，随机分为2组：A组(自体神经移植)8只；B组(自体神经移植并包绕PDLLA／NGF复合膜)8只。显露每只动物的右侧坐骨神经，A组将坐骨神经切除10mm长一段，以外膜缝合法行原位移植；B组与A组同样行神经原位移植并在远近两个神经缝接部位各包绕1块PDLLA／NGF复合膜(含NGF总量为400u)。6个月后观察比较两组神经再生情况。结果：B组的小腿三头肌湿重恢复率、运动神经传导速度、再生的有髓神经纤维数量、直径、轴突直径、髓鞘厚度均优于A组：结论：PDLLA／NGF复合膜包绕自体神经移植的神经缝接部位具有促进神经再生作用.     

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     

外消旋聚乳酸/神经生长因子复合膜包绕神经缝接部位促进神经再生

目的探讨外消旋聚乳酸／神经生长因子（PDLLA／NGF）复合膜包绕神经缝接部位是否具有促进神经再生作用。方法雌性Wistar大白鼠16只，随机分为2组：A组（神经端端缝接）8只；B组（神经端端缝接并缝接部位包绕PDLLA／NGF复合膜）8只。显露每只动物的右侧坐骨神经，利刀横断。A组以外膜缝合法端端缝接；B组以外膜缝合法端端缝接后，在缝接部位包绕1层PDLLA刷GF（含量250U）复合膜。6个月后，观察比较两组神经再生情况。结果B组的小腿三头肌湿重恢复率、运动神经传导速度、再生的有髓神经纤维直径、轴突直径、髓鞘厚度均优于A组。结论PDLLA／NGF复合膜包绕神经缝接部位具有促进神经再生作用。     

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.     

FK506及其衍生物的神经营养作用

FK506又称他克莫司(tacrolimus)，商品名普乐可复(prograft)，于1984年由日本Fujisawa制药公司的研究人员从放线菌属streptomycestsukubaensis的酵解产物中提取。最初它是作为一种强力免疫抑制剂被批准上市的其效力较CsA强１０～１００倍。近年来，其神经营养作用和神经保护作用正越来越引起人们的重视。１实验研究早在１９９４年，Gold等１就发现将大鼠的坐骨神经切断后修复，使用FK５０６后可以明显促进坐骨神经恢复。Wang等２利用该模型对FK５０６促神经再生作用进行了定量分析，结果再生轴突的数目、髓鞘面积、轴突直径等指标均显…