趾长伸肌腱内侧束转位修复下胫腓联合分离的解剖学基础

目的　探索趾长伸肌腱内侧束转位修复下胫腓联合分离的解剖学依据。方法　在 30侧成人下肢标本上对趾长伸肌腱进行形态学观测 ;2侧标本进行摹拟术式设计。结果　趾长伸肌腱在起始处分为 2～ 4束 ,其中内侧束在踝关节平面上长为 (16 7± 2 .4)cm ;上、中、下段宽分别为 (0 .4± 0 .1)cm ,(0 .4± 0 .2 )cm ,(0 .4± 0 .1)cm ;上、中、下段厚为 (2 .0±0 .5 )mm ,(1.8± 0 .4)mm ,(1.6± 0 .3)mm。结论　趾长伸肌腱内侧束有足够的长度和宽厚度转位修复下胫腓联合分离 ,术式经标本摹拟具有可行性。     

失血性休克大鼠血管平滑肌细胞钙超载的三磷酸腺苷酶机制

目的　探讨失血性休克大鼠血管平滑肌细胞 (VSMC)钙超载的三磷酸腺苷 (ATP)酶机制。　方法　雄性Wistar大鼠 2 4只 ,随机分为对照组 (C组 )、休克开始组 (S0组 )、休克后 2 ,4h组 (分别为S2和S4组 ) ,每组 6只。以改良Wigger法 ,即股动脉插管放血并维持血压 4 0mmHg 2h建立失血性休克大鼠模型 ,观察休克后大鼠VSMC胞浆游离钙离子浓度及细胞膜、线粒体膜Ca2 +-ATPase ,Na+ -K+ -ATPase活性变化。　结果　C、S0、S2、S4组VSMC胞浆游离Ca2 + 浓度平均通道荧光对数值分别为 2 .0 3± 0 .15、2 .37± 0 .32、2 .5 5± 0 .4 6、2 .80± 0 .4 3,呈休克时间依赖性升高 ,S0组显著大于C组 (P <0 .0 5 ) ,S2、S4组非常显著地大于C组 (P <0 .0 1)。细胞膜Ca2 + -ATPase活性 :C组为 (36 .0± 7.2 ) μmol·mg- 1 ·h- 1 ;S0组 [(35 .3± 8.5 ) μmol·mg- 1 ·h- 1 ]与C组比较 ,差异无显著性意义 ;S2、S4组分别为 (2 6 .5± 6 .9)、(2 4 .3± 4 .7) μmol·mg- 1 ·h- 1 ,均显著低于C组 (P <0 .0 5和P<0 .0 1) ;细胞膜Na+ -K+ -ATPase活性 :C组为 (34.0± 5 .8) μmol·mg- 1 ·h- 1 ;S0、S2组分别为 (37.3± 6 .9)、(32 .2± 6 .3) μmol·mg- 1 ·h- 1 ,与C组比较 ,差异无显著性意义 ;S4组为 (2 7.0±4 .9) μmol·     

骨基质明胶植入后与转化生长因子-β1的相关性研究

目的　检测植入骨基质明胶 (BMG)后转化生长因子 - β1(TGF - β1)的含量 ,以此评价BMG的生物活性及抗原性。　方法　BMG组 2 0例 ,为骨折愈合障碍病例 ;对照组 2 0例为新鲜骨折病例 ,两组均行内固定术 ,并于术前、术后 1周、术后 2周检测血清TGF - β1。　 结果　 (1)BMG组术后 1,2周 [TGF - β1分别为 (10 4.489± 16.0 7)ng ml、(113 .40 6± 2 3 .70 6)ng ml]与术前 [(92 .897±16.13 5 )ng ml]比较 ,差异有非常显著性意义 (P <0 .0 1) ,术后 2周与术后 1周比较 ,差异有显著性意义 (P <0 .0 5 ) ;(2 )对照组术前 [TGF - β1为 (110 .472± 19.72 3 )ng ml]与术后 [(114.679± 2 0 .3 5 8)ng ml、(116.42 3± 2 4.10 9)ng ml]比较 ,差异无显著性意义 (P >0 .0 5 ) ;(3 )BMG组与对照组术前比较 ,差异有显著性意义 (P <0 .0 5 )。　结论　BMG植入后表现出明显的成骨活性 ,且不引起免疫反应     

运动对2型糖尿病大鼠脂肪组织中肥胖基因表达的影响

目的 :研究运动对 2型糖尿病大鼠脂肪组织中肥胖基因 (obesegene ,obgene)表达水平的影响 ,在基因转录水平上探讨 2型糖尿病大鼠obmRNA表达水平的变化 ,以及运动改变 2型糖尿病大鼠obmRNA表达的机制。方法 :4 0只自发发病的 2型糖尿病模型 :OLETF大鼠分成 4组 ,分别为基础饲料非运动组、基础饲料运动组、高脂饲料非运动组和高脂饲料运动组 ;15只LETO大鼠(与OLETF大鼠同系 ,但不同株 ,系不发病对照组 )用基础饲料饲养 ,随机分为两组 :非运动组和运动组 ,分别进行 9周的运动和高脂饮食干预 ,9周后用实时荧光定量RT -PCR法检测每只大鼠腹膜后脂肪组织obmRNA的表达水平。结果 :基础饲料饲养的OLETF大鼠非运动组和运动组脂肪组织obmRNA的平均拷贝数分别为 4 0 2 4× 10 6 ± 5 4 67× 10 5/ μgRNA和 1 2 5 8× 10 6 ± 3 862× 10 5/ μgRNA ;高脂饲料饲养的OLETF大鼠非运动组和运动组脂肪组织obmRNA的平均拷贝数为 4 832×10 6 ± 1 0 34× 10 6 / μgRNA和 1 5 74× 10 6 ± 6 783× 10 5/ μgRNA ;而基础饲料饲养的LETO大鼠非运动组和运动组脂肪组织obmRNA的平均拷贝数分别为 1 979× 10 6 ± 6 4 77× 10 5/ μgRNA和 1 82 4×10 6 ± 4 0 89× 10 5/ μgRNA。OLETF大鼠脂肪组织obmRNA表达水平运动     

周围神经端侧吻合新方法大鼠实验模型的建立

目的 设计制作端侧吻合新方法的动物实验模型，并进行检测。方法实验用Wistar大白鼠，共28只。按拟行神经吻合的方式，将大鼠的左下肢定为实验侧，右下肢定为对照侧。实验侧：切断大鼠左侧胫神经，将胫神经的近断端与腓总神经端侧吻合；对照侧：切断大鼠右侧腓总神经，将腓总神经的远断端与胫神经端侧吻合。3个月后，进行电生理检查，比较两侧固定刺激量的波幅、潜伏期、最大波幅。比较实验侧吻合口远、近端的腓总神经纤维计数。结果实验侧与对照侧相比，波幅、潜伏期、最大波幅差异无统计学意义。实验侧吻合口远侧的神经纤维计数多于近侧神经纤维计数（P〈0．05）。结论端侧吻合新方法的轴突再生机制为胫神经轴突发芽，再生的轴突通过吻合口沿着腓总神经外膜或束膜管道向靶肌肉生长。     

慢传输型便秘大鼠结肠肌间神经丛胆碱能神经及氮能神经的组化研究

目的　研究慢传输型便秘大鼠结肠肌间神经丛内胆碱能 (AchE)神经及氮能 (NOS)神经的变化 ,探讨慢传输型便秘的发病机制。方法　建立大鼠慢传输型便秘模型 ,利用铺片技术制作结肠肌间神经丛标本 ,采用组织化学技术行结肠肌间神经丛内AchE神经及NOS神经染色。结果　与正常大鼠比较 ,模型组结肠肌间神经丛内AchE阳性神经分布较稀疏 ,神经元数量较少 ,但胞体增大 ,染色加深 (阳性细胞数、核浆比例分别为 14 34± 4 5 6vs2 7 5 6± 6 6 4 ;0 5 7± 0 2 0vs 0 76± 0 18,P <0 0 1) ;NOS阳性神经元分布较稀疏 ,数量较少 ,染色较淡 ,节间束纤维减少 (阳性细胞数、弱阳性细胞数分别为 7 10± 2 0 4vs 11 16± 2 81;2 2 1± 1 38vs 0 84±0 6 7,P <0 0 1)。结论　慢传输型便秘大鼠肠神经系统存在明显的病理改变 ,结肠传输功能障碍与肠壁内胆碱能和氮能神经的病理改变和 (或 )功能障碍有关。     

西沙必利治疗胃电节律失常机制的实验研究

目的　探讨西沙必利治疗胃电节律失常的机制。方法　建立大鼠胃电节律失常模型 ,给予西沙必利治疗 ,并设正常大鼠作为对照 ,检测胃窦肌间神经丛内胆碱能神经、氮能神经及cAMP、cGMP含量变化情况。结果　西沙必利使模型大鼠胃电节律失常明显减少 ,慢波频率变异系数 (2 3 2 0± 1 89%vs36 0 1± 8 6 6 % )、异常节律指数 (6 4 3±3 6 0 %vs 18 0 1±11 0 8% )显著下降 (P <0 0 1) ;胃窦肌间神经丛内胆碱能神经增多 (2 2 95± 8 37%vs15 2 1± 5 6 0 % )、氮能神经减少 (9 5 1±3 16 %vs15 0 2± 4 4 6 % ) (P <0 0 1) ,平滑肌组织中cAMP(2 4 5 0 5 5±6 8 6 6 1FM/mgvs5 10 4 93± 2 6 9 6 79FM/mg)、cGMP(13 791± 2 15 8FM/mgvs 17 5 78± 4 5 82FM/mg)含量降低 (P<0 0 5 )。结论　西沙必利治疗胃电节律失常是通过增加胃窦肌间神经丛胆碱能神经含量、减少氮能神经含量 ,进而使胃窦平滑肌组织中cAMP、cGMP含量减少实现的。     

去细胞异体神经材料复合碱性成纤维细胞生长因子修复周围神经缺损

目的　研究成纤维细胞生长因子 (bFGF)和去细胞异体神经联合修复周围神经缺损的效果。　方法　将日本大耳白兔 16只随机分为实验组和对照组。实验组用 3cm去细胞异体神经材料 (来源于新西兰兔 )修复异体神经缺损 ,术后每日注射bFGF到移植体周围 ,对照组注射等渗盐水。 2 0周进行形态和功能学检测。　结果　实验组白兔诱发电位幅值及神经传导速度恢复率分别为 (6 7.5 9± 2 9.6 3) %和 (5 9.79± 2 1.11) % ,显著高于对照组的 (4 9.0 7± 15 .74 ) %和 (36 .85± 18.6 9) % (P <0 .0 5 )。实验组移植体中央再生有髓纤维数为 (87.2 6± 2 0 .18)根 / 10 4μm2 ,显著高于对照组的 (6 8.79± 17.92 )根 / 10 4μm2 (P <0 .0 5 )。　结论　去细胞异体神经材料结合bFGF能较满意地修复一定长度神经缺损。     

胶质细胞源性神经营养因子对大鼠脊髓损伤后前角神经元的保护作用

目的　研究胶质细胞源性神经营养因子 (GDNF)对大鼠脊髓损伤后前角运动神经元的保护作用。　方法　雄性SD大鼠 4 5只随机分为等渗盐水组、GDNF组、神经生长因子 (NGF)组 ,每组 15只 ,采用改良Nystr¨om法后路压迫大鼠胸段脊髓模型 ,经蛛网膜下腔局部注射GDNF(1μg μl,10 μg d) 1周。伤后 1,2 ,4周应用尼氏染色、酶组织化学染色方法观察前角运动神经元存活数目及胆碱酯酶 (CHE)和酸性磷酸酶 (ACP)的变化。　结果　脊髓损伤后第 1,2周 ,GDNF组前角运动神经元存活数目 [(2 1.4± 3.8,2 0 .7± 3.6 )个 前角视野 ]明显多于等渗盐水对照组的 (17.3± 2 .8,16 .5± 3.0 )个 前角视野 (P <0 .0 1) ;GDNF组前角运动神经元中CHE灰度值 (6 5 .2± 2 3.8,98.7±31.6 )低于等渗盐水组 (94 .5± 35 .2 ,12 5 .6± 4 1.6 ) (P <0 .0 1) ;ACP灰度值 (74 .2± 2 5 .7,6 8.6±30 .6 )高于等渗盐水组 (5 8.5± 18.2 ,4 9.6± 2 1.6 ) (P <0 .0 1)。　结论　外源性GDNF能保护脊髓不完全性损伤后引起的运动神经元损害。     

心梗部位对超声多普勒左室舒张功能测定的影响

目的 :观察心梗患者缺血部位不同对常规超声多普勒左室舒张功能检测指标的影响。资料与方法 :以核素心肌扫描显像为定位标准 ,将 84例急性、陈旧性心肌梗塞患者按缺血部位不同分成 :(1)前壁心梗 ,(2 )间壁心梗 ,(3 )下 (后 )壁心梗 ,(4 )侧壁心梗 ,(5 )广泛前壁 ,(6)前壁伴下壁及侧壁心梗 ,(7)心尖部室壁瘤形成 7组 ;观察了描述左室舒张功能的超声多普勒二尖瓣口血流速度指标 E/A比值和核素心血池造影左室峰值充盈率 LVPFR在各分组中的变化。结果 :缺血范围较局限的左室前壁、间壁及侧壁心梗组之间的 L VPFR测值无明显差别 ,分别为 (1.82± 0 .48)、(2 .0 7± 0 .79)、(2 .18± 0 .90 ) EDV/S,但多明显高于下 (后 )壁、广泛前壁、室壁瘤及左室壁多个部位缺血组 ,其 LVPFR分别为 (1.63± 0 .3 3 )、(1.2 2± 0 .68)、(1.45± 0 .43 )、(1.15± 0 .3 8) EDV/S,而后 4组之间的 L VPFR测值差别不显著 ;单有左室前壁、间壁缺血的心梗组的 E/A比值也高于左室下 (后 )壁、广泛前壁、多部位心肌缺血的心梗组 ,其 E/A比值分别为 1.17± 0 .3 1、1.0 9±0 .2 6、0 .78± 0 .2 8、0 .80± 0 .5 1、0 .81± 0 .3 1;除下 (后 )壁心梗组外 ,其它各组的 E/A比值与室壁瘤形成组差别不显著 ,后者的 E/A比值为 1.0 2± 0 .     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.