形态原在软骨内骨化中的作用

软骨内骨化发生于肢体芽及生长板的形态形成中,也发生于骨折后的骨痂形成中。骨形态形成蛋白(BMPs)及维甲酸(RA)是涉及在肢体发育中的两类可扩散的形态原样分子(morphogen-like molecules)。它们是模型形成的有力调节者,也涉及组织的增殖与分化。骨折过程中有软骨内骨化,这提示形态原样分子在骨折中也有作用。本文复习有关骨形成中的形态原样分子的文献,并探讨它们在骨折愈合中的作用。     

正确确定服装放松量

服装放松量包括运动舒适量、生理舒适量和造型放松量,服装的放松量对服装的造型及服装的舒适性有很大的影响.作者论述了确定运动舒适量、生理舒适量和造型放松量的原则及各部分的基本放松量.     

精子形态对宫腔内人工授精妊娠率的影响

目的探讨正常形态精子比率对宫腔内人工授精（IUI）临床妊娠率的影响。方法回顾分析328个周期宫腔内人工授精临床资料,根据男方精子形态学检查结果分为三组：正常形态精子百分率≥4%、2%～〈4%、〈2%,比较各组间精液处理前后精子浓度、活力、前向运动精子总数以及IUI临床妊娠率。结果处理前精子浓度、活力及前向运动精子总数各组间比较无显著性差异（P〉0.05）,处理后精子浓度、活力、前向运动精子总数各组间比较有显著性差异（P〈0.05）,≥4%、2%～〈4%、〈2%各组临床妊娠率分别为19.5%、17.9%、2.6%,有显著性差异（P〈0.05）。结论正常形态精子比率影响IUI临床妊娠率,正常形态精子百分率≥2%可获得较满意的临床妊娠率。     

精子形态与宫腔内人工授精妊娠结局的关系

目的回顾性分析宫腔内人工授精（IUI）周期中精子形态与临床妊娠率及子代安全性的关系。方法281个IUI周期按精子形态分为轻、中、重度畸形精子症和正常形态4组,统计临床妊娠率;观察IUI的子代安全性,以1,226例自然妊娠者为对照组,比较两者的多胎率、流产率、早产率、剖官产率、出生缺陷率和围生儿死亡率。结果畸形精子症组的总临床奸娠牢为9．20％,正常形态组临床妊娠率18．69％,两者差异有统计学意义（P〈O．05）;轻、中、重度畸形精子症组的临床妊娠牢分别为12．86％、7．46％、5．4％,组间差异无统计学意义（P〉O．05）;IUI组与自然妊娠组多胎率（11．11％vs．3．75％）、异位妊娠牢（13．89％vs．4．65％）、剖宫产率（76．00％vs．46．63％）,均有显著差异（P〈0．05）,流产率（16．67％vs．10．69％）、早产率（13．33％vs．7．03％）、出生缺陷率（3．57％vs．5．02％）和围生儿死亡率（0％vs．0．74％）,差异无统计学意义（P〉0．05）。结论精子形态影响IUI的临床妊娠率;对于畸形精子症患者,IUI是一种安全的助育方法。     

鼠脑内立体定向注射胶原酶产生的脑内血肿及血肿容量大小与病程的关系

将胶原酶用立体定向方法注入鼠脑尾状核后１、４、１２、２４小时，分别取鼠脑在计算机辅助下计算血肿容量和行病理检查。结果发现：血肿容量随注入的胶原酶量的增加而增大，并随时间的推移而变化，即同等量胶原酶注入后，血肿逐渐增大，至１２小时达最高峰，然后血逐渐减小，与其相适应的病理变化也得到证实。与以前的脑内血肿模型比较，本模型具有血肿发生发展的自然病理过程，可重复性好，为自发性脑内出血的基础和临床应用研究提供了新的和较为理想的模型。     

脾肿大形态结构与吞噬功能关系的实验研究

用甲基纤维素造成充血性脾肿大，并用５１铬标记变性红细胞测定脾吞噬功能．观察脾脏形态结构改变与免疫作用的关系．探讨保留部分病脾的价值。结果表明脾结构紊乱，单位重量组织的吞噬功能明显减退，提示保留部分病脾需持慎重态度。     

猫脑内立体定向注射胶原酶建立脑内血肿模型

目的　采用立体定向注射胶原酶于猫脑尾状核,建立一种新的脑内血肿模型。方法　在实验中采用立体定向技术,将一定量的胶原酶（加或不加肝素）用微量注射泵精确地注入猫脑尾状核［ 坐标（Ａ１．０ ,Ｌ５．０ ,Ｈ１４．０）］。术后２４ 小时处死动物,取全脑固定于福马林溶液,观察大体及镜下改变,测量血肿大小。结果　注射胶原酶（ 加或不加肝素）可以形成局灶性出血,且出血量大小与胶原酶用量有关,加用肝素后血肿扩大。结论　注射胶原酶（２ Ｕ／２０μｌ） 于猫脑尾状核,血肿大小适中,动物术后有短时间昏迷及固定的对侧偏瘫。     

再论胰头形态,结构与近邻关系及其临床意义

本文作者从临床应用角度研究了20具尸体的胰头形态结构与其邻近解剖关系,其结果不仅为指导手术的设计与实施提供依据,且修饰了作者已往对该部位的某些解剖学概念,现介绍研究结果并讨论其临床意义。材料选择与标本制作盘选用无胰腺及胆道疾病的成人尸体20具,解剖时将十二指肠、上部空肠、胰、脾、远段胆总管,近侧段上肠系膜血管以及所属     

镍钛形态记忆合金环抱器内固定治疗尺桡骨骨折

目的探讨镍钛形态记忆合金环抱器内固定治疗尺桡骨骨折的临床疗效。方法2001年8月～2004年1月,对32例尺桡骨骨折行切开复位镍钛形态记忆合金环抱器内固定术,观察其临床疗效。结果所有患者随访10～24个月,平均18个月,术后骨折解剖复位率达95%,临床治愈率达90%以上。前臂活动功能好,形态记忆合金环抱器无松脱、断裂。结论镍钛形态记忆合金环抱器内固定治疗尺桡骨骨折具有操作简便、骨折愈合率高的特点,值得推广应用。     

两种内固定后兔骨痂中成骨细胞内骨形态生成蛋白含量的比较

目的：比较钢板和矩形髓内钉固定对兔胫腓骨骨折成骨细胞内骨形态生成蛋白（BMP）含量的影响。方法：新西兰兔24只，对同一动物的两侧胫骨分别用矩形髓内钉和4孔不锈钢钢板固定，并分3批于固定后14、21、28d处死。用兔疫组化方法检测骨痂中成骨细胞中BMP的分布，用计算机图像分析系统将结果进行定量分析。结果：矩形髓内钉组骨痂中成骨细胞内BMP含量高于钢板组（P＜0．05）。结论：矩形髓内钉内固定胫骨后骨痂含量增加可能与矩形髓内钉的微动有关，可能有利于骨折愈合。     

Can Inner Peace be Improved by Mindfulness Training: A Randomized Controlled Trial

This article reports a randomized controlled trial to investigate whether mindfulness training can successfully improve inner peace in participants with no known mental disorder. Fifty‐seven participants were randomized to either mindfulness training (n = 29) or wait‐list control (n = 28). The experience sampling method was used to measure the fleeting momentary experience of inner peace in participants. In addition, we used an experimental approach to assessing ability to focus attention: the Meditation Breath Attention Score, as well as the self‐report Five‐Facet Mindfulness Questionnaire (FFMQ). Compared with the wait‐list control group, mindfulness training led to an increase in scores of inner peace, Meditation Breath Attention Score and FFMQ, using analysis of repeated measures analysis of variance. Change in inner peace was not, however, mediated by changes in self‐rated mindfulness (FFMQ) nor by increased attentional focus. The findings provide first evidence suggesting that using mindfulness training improves the participants' inner peace. The focus here was on the immediate effects and future studies need to use follow‐up. © 2013 The Authors. Stress and Health published by John Wiley & Sons Ltd.     

狭长U形槽状切口在坐骨直肠间隙脓肿和坐骨直肠间隙肛瘘手术中的应用价值

为探讨狭长U形槽状切口在坐骨直肠间隙脓肿和坐骨直肠间隙肛瘘手术中的应用价值,回顾分析采用常规底小口大切口手术（对照组,205例）和狭长U形槽状切口手术（治疗组,232例）治疗的脓肿及肛瘘患者资料,对比分析两种切口对创面愈合的影响。结果显示,两组患者均痊愈出院。治疗组平均创面愈合时间（22．4d）明显短于对照组（27．7d）,P〈0．05。随访半年以上,治疗组创口无异常;对照组21例（10．2％）创口表层组织颜色变黑,7例（3．4％）创口愈合后又自行坏死溃烂。结果表明,狭长U形槽状切口有利于切口较深的坐骨直肠间隙脓肿和坐骨直肠间隙肛瘘的痊愈;     

Joint Space in Normal Gleno-Humeral Radiographs

The gleno-humeral joint space in standard antero-posterior images of 175 normal subjects was measured at three different sites. the average of the three measurements, the integral joint space, was calculated and was found to be between 4 and 5 mm. the value does not change with age, except in women, in whom it increases slightly. A narrow joint space in an elderly patient should not be expected simply because the patient is old. the measuring techinque described is useful in population studies. in individual cases a simple measurement with a ruler serves the same purpose.     

腰椎间盘术后椎间隙感染的诊断和治疗

目的探讨腰椎间盘术后椎间隙感染的诊断和治疗。方法分析手术后腰椎间隙感染14例的临床资料及特点，非手术治疗10例，手术治疗4例。结果随访6～36个月，13例恢复正常生活，1例遗有腰痛和腰椎活动受限。结论依靠临床体征结合ESR，CRP以及MRI检查可建立早期诊断。多数患经保守治疗可以治愈，保守治疗2～3周无效，炎症扩散出现相应临床症状，应行病灶清除术。     

鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用

目的探讨鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用价值。方法回顾分析2002年1月～2006年12月采用鼻内镜下上颌窦（扩大）内壁切除术治疗鼻内翻性乳头状瘤10例的临床资料。结果10例均在鼻内镜下完全切除。10例随访12～72个月,平均30个月;术后仅1例术后1年后复发;10例均无溢泪发生。结论鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用是可行的,基本接近鼻侧切开的手术范围;最大优点是可避免面部瘢痕、创伤小、手术视野清晰、能够准确完整地切除肿瘤、术后复发率低。     

Congenital Thumb-Index Web Space Deficiency

Background: There are several congenital hand differences that cause thumb-index (TI) web space deficiency. There is a knowledge gap in the literature about the hand differences that are associated with TI web space deficiency. We aimed to identify these congenital differences and the various specific reconstructive surgical procedures that are used for these conditions. Methods: We conducted a retrospective chart review of children treated operatively over a period of 30 years for congenital TI web space deficiency by the senior author (G.M.R.). We gathered data on demographics and associated congenital hand differences and compiled a list of all surgical procedures performed for the web space and the ipsilateral upper extremity. Results: We included 71 patients (77 hands) with 12 congenital hand differences (62 developmental and 9 spastic). The total number of upper extremity operations, (ie), anesthetics performed for these patients was 186, averaging 2.6 settings and 7.5 procedures for each patient. Cutaneous reconstructive procedures included first dorsal metacarpal artery pedicle flaps (49 patients), 4-flap Z-plasties (15), and transposition flaps (13). In addition, 16 different thumb reconstructive procedures were necessary. Ten patients required revision of their TI web space procedures for recurrence. Conclusions: The prevalence of TI web space deficiency is underappreciated. These patients often have multiple musculoskeletal anomalies of the hand and upper extremity that should be ruled out and require surgical treatment to optimize hand function. Consideration should be given to performing more than one procedure in one setting when possible.     

Effect of Inner Membrane Tearing in the Treatment of Adult Chronic Subdural Hematoma: A Comparative Study

The postoperative results of chronic subdural hematoma (CSDH) procedures using catheterization and tearing of inner membrane (CTIM) technique have not previously been discussed in the literature. This article compares the effects of CTIM technique on brain re-expansion and re-accumulation with cases operated on with a burr-hole craniotomy and outer membrane incision (BCOMI) technique. The study involved operations on 144 patients (Group 1) using the CTIM technique and 108 patients (Group 2) using the BCOMI technique. In the operations using the CTIM technique in Group 1, the mean effusion measured in the subdural space (SDS) was 10.0 ± 0.2 mm, and for Group 2, 14.3 ± 0.6 mm in the postoperative period on the first and third days and this difference was found to be significant (p < 0.05). The means were 6.6 ± 0.2 mm for Group 1 and 10.3 ± 0.5 mm for Group 2 on the seventh day (p < 0.05). Recurrence rate was 8.3% in Group 2 and 0 in Group 1. This difference was statistically significant (p = 0001). The length of hospital stay was 7.0 ± 0.1 days for the Group 1 and 8.8 ± 0.2 days for Group 2 and this difference was significant (p < 0.05). These results indicate that the CTIM technique is preferable because it results in earlier re-expansion, lower recurrence, less subdural effusion and pneumocephalus, and shorter hospital stays.     

Arthroscopic Anatomy and Surgical Techniques for Peritrochanteric Space Disorders in the Hip

Disorders of the lateral or peritrochanteric space (often grouped into the greater trochanteric pain syndrome), such as recalcitrant trochanteric bursitis, external snapping iliotibial band, and gluteus medius and minimus tears, are now being treated endoscopically. We outline the endoscopic anatomy of the peritrochanteric space of the hip and describe surgical techniques for the treatment of these entities. Proper portal placement is key in understanding the peritrochanteric space and should be first oriented at the gluteus maximus insertion into the linea aspera, as well as the vastus lateralis. When tears of the gluteus medius and minimus are encountered, suture anchors can be placed into the footprint of the abductor tendons in a standard arthroscopic fashion. Our initial experience indicates that recalcitrant trochanteric bursitis, external coxa saltans, and focal, isolated tears of the gluteus medius and minimus tendon may be successfully treated with arthroscopic bursectomy, iliotibial band release, and decompression of the peritrochanteric space and suture anchor tendon repair to the greater trochanter, respectively.     

两种方法消毒呼吸机内部气路效果观察

目的观察两种方法消毒呼吸机内部气路的效果,防止主机内部气路污染和尾气对空气的污染。方法将61例使用呼吸机患者随机分为戊二醛组（31例）和过滤器组（30例）。戊二醛组在呼气回路采用自制的2%戊二醛液消毒装置对患者的呼出气体消毒,消毒装置每周更换;过滤器组在呼吸机呼气回路安装过滤器。观察消毒时两组患者的呼吸参数;分别于消毒前及消毒后第1、7、14、21天对患者的呼出气体和呼吸机尾气采样进行细菌培养,观察菌落数。结果消毒时两组患者的呼吸参数均在正常范围。两组消毒前后,患者呼出气体、呼吸机尾气菌落数比较,差异有显著性意义（均P〈0.01）;第21天时,过滤器组患者的呼出气体和呼吸机尾气菌落数有回升。结论自制戊二醛消毒装置和过滤器均能对呼吸机内部气路进行消毒,安全性好,可操作性强;每周更换戊二醛装置可保持消毒效果,而过滤器使用至21d时消毒效果有所下降。