左上肢全层皮肤脱套及断腕再植成功1例

1994年6月，我科对皮带绞伤上肢，腕部撕脱性断离1例再植成功，报告如下。1病例报告患者女性，19岁。左上肢卷入制砖机皮带内致全上肢皮肤脱套，腕部离断，经简单包扎1h后入院。局部检查：左上肢于腋、肩部以下全上肢皮肤脱套，脱套层次上臂在深、浅筋膜间，前臂在深筋膜下，肌肉外露。前臂屈、伸肌住在肌肉与肌腱交界处完全撕断，神经亦在此平面撕断。桡动脉从近端拉出，尺动脉在骨离断平面撕断。前臂全部浅静脉在脱套的皮肤上。尺桡骨在远端骨骺处拉断，其远端1／3骨外露。肘可做屈伸运动。胸大肌肌腱与肌腹交界处断裂，靠近腋窝处胸前外…     

生物膜重建腱鞘防止手屈肌腱粘连40例临床分析

生物膜重建腱鞘防止手屈肌腱粘连４０例临床分析武警河北总队医院外三科（石家庄０５００８１）牛艳辉，邵新中，孟凡军，李超发，赵杰，李红旗，郑修存关键词生物膜，腱鞘，手屈肌键，修复手屈肌腱损伤修复后，在保证肌腱愈合的前提下，减少与周围组织粘连，恢复滑动功能...     

高频声像图诊断肩周软组织损伤的研究

目的：研究超声显像在肩周软组织损伤诊断的应用价值。材料和方法：对１０例肩周痛病人进行了超声检查，并以健侧作为对照组。结果：急性损伤时，肌腱组织内水肿，图像显示肌腱回声减低。慢性损伤时，肌腱内回声杂乱，光点增粗增强，并可伴有钙化。１０例肩周痛病人中，Ｂ超诊断３例肱二头肌长头腱炎，４例肱二头肌长头腱腱鞘积液，１例肩胛下肌腱鞘积液，４例冈上肌腱炎，３例三角肌下或肩峰下滑囊炎，１例冈下肌建炎，１例冈下肌腱鞘积液，２例肱骨大结节骨折。结论：本研究对肩周软组织损伤作出了定位定性诊断，为临床诊治提供了客观依据。     

逆行皮神经营养血管岛状皮瓣修复小腿远端组织缺损21例

小腿远端软组织缺损在临床上经常出现,因其独特的组织解剖和功能特点,缺损后常伴有骨骼、肌腱外露及感染等并发症,创面修复比较困难。我院自2006年1月～2007年12月,应用小腿逆行皮神经营养血管岛状皮瓣修复小腿远端组织缺损21例。     

实验性肌肉拉伤的组织学和酶组织化学观察

本文采用生物力学方法，控制兔胫前肌的牵拉，并观察兔胫前肌牵拉后的组织学和酶组织化学改变。结果提示：以屈服载荷，相当于１２８％动物体重牵拉兔胫前肌，可建立肌肉拉伤的实验模型；肌纤维部分断裂发生于靠近肌肉－肌腱连接处；损伤部位肌内膜纤维化和疤痕组织的形成，可能是肌肉拉伤后频繁复发的重要原因。     

掌长肌腱在远端尺桡关节脱位手术治疗中的应用(附11例报告)

掌长肌腱串缝修复远端尺桡关节脱位,能达到理想的治疗效果.掌长肌腱修复远端尺桡关节脱位,应逐渐取代传统切除尺骨头的方法.     

肩袖肌腱损伤动物模型的建立及初步研究

目的:采用兔肩胛下肌建立肩袖肌腱损伤动物模型,验证其可行性并进行肩袖肌腱损伤生物力学、组织学研究。方法:40只成熟雄性新西兰大白兔随机编号,选取4只不进行任何处理,用于前期准备及调试工作,其数据不计入实验结果;其余36只均行右侧肩胛下肌部分离断,建立肩袖部分损伤模型,对侧行假手术进行对照。术后不限制活动。分别于术后2、4、6、8周行肩关节MRI观察肩袖肌腱愈合情况;采用HE染色观察肌腱愈合情况;采用Masson染色观察组织中肌纤维愈合情况;采用生物力学测试检测肌腱强度。结果:兔肩胛下肌具有与人相似的解剖结构和组织结构,适用于建立肩袖损伤模型,手术操作过程简便,可重复性高。除去实验麻醉死亡4只,实验动物右侧肌腱损伤后8周,HE染色及Masson染色可观察到肌腱基本愈合;MRI检查显示肌腱内信号均匀,关节腔内基本无高信号影。生物力学结果显示术后2、4、6周肌腱最大载荷均低于假手术侧,差异有统计学意义(P<0.05),术后8周肌腱最大载荷与假手术侧差异无统计学意义(P>0.05)。结论:兔肩袖肌腱损伤8周时,基本恢复正常的肌腱排列结构,肌腱的生物力学强度基本恢复正常。采用兔肩胛下肌建立肩袖损伤模型适用于肩袖疾病的研究。     

冷冻同种异体肌腱小鼠移植的细胞毒、IL－2水平及组织学观察

了解冷冻同种异体肌腱移植术后宿主的免疫排斥反应。方法采用ＢＡＬＢ／Ｃ小鼠肌袋模型，植入冷冻Ｃ５７小鼠跟腱，观察术后各期宿主血清微量细胞毒性，局部组织浆ＩＬ－２水平和局部组织学变化。结论经冷冻／冻干处理后，同种异体肌腱移植免疫斥反应显著降低，但未消失。     

大强度训练对动物肌肉和结缔组织生物力学性质的影响

利用兔进行大强度跳跑练习，测定其股骨、膝内侧副韧带、屈趾肌腱、胫前肌的生物力学特性，结果表明上述组织在一段时间大强度训练后，其生物力学性质均有不同程度增强，表明组织对大强度训练仍有良好的适应。     

异体肌腱移植的实验研究

 采用兔跟腱-80 ℃低温冷冻保存2周后异体移值,术后2、4、6、8周观察其组织形态学变化,测定肌腱的生物力学强度,并与正常肌健、新鲜自体移植肌腱对照.结果表明冷冻异体肌腱和新鲜自体肌腱的生物力学强度基本相同,但弱于正常肌腱,没有明显的排斥反应,异体肌腱经低温冷冻处理后可以代替自体肌腱移植.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.