环状韧带修复对儿童陈旧性孟氏骨折的影响

目的 探讨环形韧带修复对儿童陈旧性孟氏骨折尺骨截骨术预后的影响。方法 回顾2013年3月至2022年1月收治的30例陈旧性孟氏骨折患儿的病例资料，采用单纯尺骨截骨矫形17例（A组），联合环状韧带修复13例（B组）。末次手术后随访13～96个月，平均随访18个月。按照Kim评分标准、肘关节活动度及影像学结果分析其预后。结果 按照Kim功能评分标准，术后两组优良率比较差异无统计学意义（P>0.05）。肘关节总活动度两组比较，差异无统计学意义（P>0.05）;X光片结果显示30例截骨端均愈合良好,28例肱桡关节复位良好，2例术后桡骨头向外侧轻度半脱位。结论 尺骨延长-成角是治疗儿童陈旧性孟氏骨折的关键，此基础上环形韧带修复不是预后的决定性因素。     

儿童陈旧性孟氏骨折治疗的新方法

儿童陈旧性孟氏骨折治疗的新方法应用自行设计的钢丝套环法治疗陈旧性孟氏骨折１６例，取得了良好的效果。用０．８ｍｍ直径钢丝套住复位后的桡骨颈并固定在尺骨近端，重新修复环状韧带，尺骨近端骨折用钢板或髓内钉固定，术后４８ｈ可练习肘关节伸屈及前臂旋转活动，待修...     

手术治疗陈旧性孟氏骨折疗效分析

目的探讨手术治疗陈旧性孟氏骨折临床效果。方法选择2005年9月-2010年7月陈旧性孟氏骨折患者25例,其中男性18例,女性7例;年龄5~13岁,平均年龄7岁。应用切开复位、环状韧带修复或重建和尺骨延长截骨术进行治疗。以术中出血量、手术持续时间及术后肱桡关节位置作为观察指标。术后患者根据Mackay功能评级、有无桡骨小头再脱位、桡神经是否麻痹来进行随访。结果手术时间为（95±20）min,术中出血量为（200±41）mL（使用止血带）。桡骨小头稳定者10例行环状韧带修补,其余15例行环状韧带重建。23例获得随访,随访时间为12个月~3年6个月,平均随访时间24个月。根据Mackay等功能评级,优18例,良4例,差1例,综合优良率达95.7%。结论采用切开复位、环状韧带修复或重建和尺骨延长截骨术是治疗陈旧性孟氏骨折的有效方法之一。     

尺骨截骨联合环状韧带重建治疗儿童陈旧性孟氏骨折的临床疗效

目的探讨尺骨截骨联合环状韧带重建治疗儿童陈旧性孟氏骨折的临床疗效。方法选择我院2010年2月至2015年2月30例陈旧性孟氏骨折患者,根据不同的手术治疗方式将其分为2组,观察组(15例)行尺骨截骨联合环状韧带重建术,对照组(15例)行尺骨截骨术。采用Mackay肘关节功能评定标准评价2组疗效,并比较2组骨折愈合时间、前臂屈伸、旋转角度、并发症的差异。结果 30例患者均随访2～6. 6年,平均随访3. 6年。2组患者骨折愈合时间比较差异无统计学意义(P 0. 05); 2组术后屈曲、伸直、旋后角度均较术前显著增加,差异具有统计学意义(P 0. 05),但组间对比差异无统计学意义(P 0. 05)。2组Mackay优良率、总并发症发生率对比差异无统计学意义(P 0. 05);观察组桡骨小头脱位发生率低于对照组,差异具有统计学意义(P 0. 05)。结论环状韧带重建术联合尺骨截骨治疗儿童陈旧性孟氏骨折可增加桡骨头稳定性,显著矫正肘关节畸形、改善肘关节功能。     

儿童难复性孟氏骨折手术治疗的临床探讨

目的探讨儿童难复性孟氏骨折临床特点及其手术治疗方法。方法本文对33例儿童孟氏骨折闭合复位失败中转行手术治疗的患者进行回顾性总结。骨折按Bado分类I型17例,II型3例、III型7例,Ⅳ型6例,均为新鲜骨折,其中开放性骨折3例、伴桡神经损伤3例。男23例,女10例,年龄3~16岁,平均7.9岁。所有骨折均为闭合复位不稳定而中转采用切开复位内固定治疗,尺骨骨折均采用切开复位钢板镙钉内固定,而桡骨头脱位27例采用闭合复位,6例采用切开复位。结果 33例患者均获随访,随访时问10~72个月,平均27个月。根据Mackay疗效评定标准,30例为优,3例为良(2例为开放性骨折,1例伴神经损伤)。结论儿童不稳定性孟氏骨折应行尺骨解剖复位和钢板内固定,恢复尺骨正常长度及力线非常重要,尺骨骨折解剖复位和坚强固定后桡骨头大部分能闭合复位且稳定,如不能闭合复位且稳定则行开放复位。如伴随桡神经损伤者闭合复位需谨慎。     

小儿孟氏骨折合并前臂骨间背侧神经受压综合征

<正> 报道了10例小儿孟氏骨折合并前臂骨间背侧神经受压综合征,讨论了该症的诊断和发病的解剖基础,及对闭合性,开放性,新鲜和陈旧性的各类孟氏骨折合并本症患儿采取的不同治疗方     

全踝关节镜手术治疗陈旧性外踝撕脱骨折并发踝关节不稳的疗效观察

目的:探讨全踝关节镜手术治疗陈旧性外踝撕脱骨折并发踝关节不稳的临床疗效及可行性。方法:回顾性分析。纳入2017年1月—2019年1月徐州市中心医院骨科陈旧性外踝撕脱骨折并发踝关节不稳患者21例(21足),其中男12例、女9例,年龄16～63 (31.34±12.17)岁,右侧13例、左侧8例。21足均采用全踝关节镜下修...     

前臂深筋膜重建环状韧带治疗Montaggias骨折

Montaggias骨折为小儿常见骨折,新鲜骨折闭合复位多能获得满意效果,但陈旧性骨折治疗困难,自1991年～1997年,我们应用前臂深筋膜重建环状韧带治疗18例,效果满意。 1 临床资料 1.1 一般资料:男11例,女7例,右侧10例,左侧8例,年龄最小5岁,最大15岁;就诊时间;3周以内7例,3周～8周5例,8周～1年3例,2年2例,5年1例,按Bado分型:Ⅰ型2例,Ⅱ型1例,Ⅲ型13例,Ⅳ型2例,其中8例并发骨间背侧神经损伤。 1.2 手术方法:取肘关节后外侧切口,自肘上2cm处起,沿肱三头肌腱外缘至尺骨鹰嘴突外     

儿童陈旧性孟氏骨折：需要重建环状韧带吗？

背景：桡骨头的再次脱位一直是陈旧性孟氏骨折令人担忧的并发症之一,许多治疗方法已描述治疗中骨折和环状韧带重建的需要,但并不明确。 目的：通过两组儿童治疗上的对比,从而强调探讨环状韧带重建的实用性。 方法：纳入12例陈旧性孟氏骨折儿童并进行前瞻性研究,所有儿童均接受桡骨头切开复位内固定。其中5例儿童接受尺骨延长矫形截骨和环状韧带重建治疗;7例患儿仅行尺骨延长矫形截骨而没有韧带重建治疗;病程从损伤至临床表现为3-18个月(平均9个月)。10例患儿为Bado用Ⅰ型,另外2例分别是Bado Ⅱ、Ⅲ型。治疗前后采用Kim标准评价韧带重建对于治疗的可靠性。 结果与结论：12例均获得随访,平均随访22个月(8-26个月)。愈后按照 Kim标准进行评估：优 10例,无畸形,无疼痛,关节活动度>250°,无肘关节受限,日常生活活动能力25分）;良 2例,轻度畸形,轻度或间歇性疼痛,关节活动度200°-250°,肘关节受限,日常生活活动能力15分;差 0例,严重畸形,疼痛,关节活动度< 200°,肘关节严重受限,日常生活活动能力0分。随访22个月,所有患儿尺骨截骨平均愈合时间为8周(6-14周)。伤口均一期愈合,无感染及骨不连发生。说明尺骨延长截骨矫形在桡骨头稳定性中具有重要意义,是否行环状韧带重建基于受伤时间、手术方式及术中桡骨头稳定性而定。     

儿童肱骨下端解剖特点与髁上骨折手术治疗疗效分析

目的:探讨儿童肱骨髁上移位骨折的特点与手术治疗效果。方法:对2001年1月至2006年1月作者手术治疗的106例3-14岁Ⅱb及Ⅲ型儿童肱骨髁上移位骨折患者进行随访,根据McIntyre分型,Ⅱb型27例,Ⅲ型79例;伸直型98例,曲屈型8例;均在麻醉状态下行外侧或前外侧切口入路,使骨折解剖复位,内、外侧髁交叉克氏针固定。结果:本组106例中99例获得有效随访,随访6~36个月,均在4周内达临床愈合;按Flynn评分标准,优92例,良4例,差3例,优良率达97%。结论:通过对儿童肱骨髁上移位骨折手术治疗的临床观察,手术治疗肱骨髁上骨折是一项值得推广的治疗手段,手术的关键是对骨折的解剖复位及内固定的稳固。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.