与内固定器设计有关的髋骨解剖学观测

目的:为临床髋关节中心脱位内固定器的设计提供相关数据。方法:测量109副成人髓骨双侧弓状线的弧长,并计算出纵向弧度;用几何法测算出经弓状线三等分中点骨面的横向弧度;同时测量髋臼中心到弓状线的垂直距离。对所得结果用SPSS软件处理。结果:男女弓状线弧长为57.71±5.59mm和52.08±6.27mm;纵向弧度为61.41±11.86°和67.42±11.94°;男女弓状线横向弧度分别为前111.16±12.37°和111.14±21.09°;中106.81±14.60°和109.58±16.50°;后138.00±16.60°和144.46±15.21°;男女臼心弓距为22.64±3.45mm和18.71±2.55mm。男女弓状线性差非常显著(P<0.01),同性别双侧差别不显著。结论:弓状线周围测量的数据,可为设计更合适髋关节中心脱位内固定钢板,提供参数值。     

运用三维摄影测量桡骨腕关节面

目的 :测量桡骨腕关节面的形态 ,为临床手术提供理论依据。方法 :用三维摄影测量的方法对 4 0例成人桡骨腕关节面进行摄影 ,测量各关节面的倾角、曲率和弧度。结果 :桡骨腕关节面前倾角为 10 .58± 1.75度 ,内倾角为2 3.0 7± 2 .14度 ,冠状面曲率为 0 .158± 0 .0 2 8,矢状面曲率为 0 .134± 0 .0 2 2。冠状面弧长为 30 .2 8± 2 .2 7mm,矢状面弧长为 15.90± 1.2 1mm。结论 :此方法测量桡骨腕关节面形态 ,精确度高 ,适用于对不规则物体表面的测量 ,对临床手术具有指导性意义     

髌骨沟的应用解剖

目的　为全膝关节成形术重建下肢正确力线提供解剖学基础。方法　在 40根干性股骨标本上用金属丝标记解剖轴、机械轴、髁上轴、经髁轴和髌骨沟全长 ,拍摄正位、侧位和轴位X线片 ,观测髌骨沟的弧长和弧度 ,髌骨沟与 4条基本轴线的角度。结果　髌骨沟的弧长和弧度变化幅度分别为 (2 0 .6± 1.8) (18.6～ 2 4.5 )mm和 115 .4°± 5 .6°(10 8.6°～ 118.4°) ;髌骨沟和股骨的 4条基本轴线的关系变化极大 ,变化范围在 10 .0°～ 16 .5°,髌骨沟最接近垂直干经上髁轴线。结论　在设计全膝人工关节股骨假体部分时 ,可参考髁上轴来确定髌骨沟的位置 ,使髌股关节能最大限度的匹配 ,减少术后并发症     

经左颈静脉插管肝内门-体静脉分流术的应用解剖

为给临床经左颈静脉插管行肝内门 -体静脉支架分流术提供解剖学依据 ,在 4 8例成人尸体上解剖并观测了双侧颈内静脉、头臂静脉、上腔静脉、右心房、下腔静脉上段的长度、外径、以及各有关静脉间的角度。结果为左颈内静脉长度 :10 6.9± 18.3 m m,外径 :13 .6± 3 .4 mm ;左头臂静脉长度 :66.3± 10 .8mm ,外径 :15 .9± 4 .1mm;上腔静脉长度 :4 8.5± 9.8mm,外径 :2 1.4± 8.4 mm;右心房长度 :68.7± 17.4 m m,上口外径 :2 0 .2± 4 .7mm,下口外径 :2 3 .9± 6.0 m m;下腔静脉上段长度 :2 1.5± 6.5 m m;左颈内静脉延长线与左头臂静脉间的角度 :4 5 .5°± 10 .3°,左头臂静脉延长线与上腔静脉间的角度 :5 8.3°± 12 .7°;5 8.3°± 12 .7°;左颈内静穿刺点至肝静脉口的总长 :2 4 3 .2± 2 3 .6m m。结论 :在经左颈内静脉行肝内门 -体静脉分流术时只要掌握了插管静脉的角度和深度仍具备和右侧穿刺途径一样多的优点     

与内固定器设计有关的髋骨弓状线的测量和计算

目的:为髋臼骨折内固定器的设计提供骨骼标本测算方法和计算式。方法:对髋骨隆起呈弧形的弓状线骨面形态进行观察、标记、分段,常规测出弦长、弧长、弦高等参数,用几何原理推导出计算式,用SPSS统计软件进行统计分析。结果:男女弓状线外凸弧度分别是:(67.42±11.94)°和(61.41±11.86)°;曲率半径分别是:(45.99±10.43)mm和(55.23±11.22)mm,男女弓状线断面弧后3等分中点的弧度和曲率半径分别是:(144.46±15.21)°、(138.00±16.60)°和(17.16±1.68)mm、(17.93±2.10)mm,差别均有显著性意义。结论:为设计内固定器提供了参数,为骨骼人类学髋骨的性别差异研究补充国人数据和测算方法提供了价值。     

改良"叉"形钢板固定股骨髁部C1型骨折的生物力学评价

目的 :评价改良“叉”形钢板对股骨髁部C1型骨折固定的生物力学性能。方法 :18具新鲜股骨下段及胫骨上段标本随机分成 3组 ,均制成股骨髁部C1型骨折模型 ,A组 :用改良“叉”形钢板固定 ;B组 :用股骨塑形钢板固定 ;C组 :用GSH钉固定。分别在MTS试验机上进行纵向压缩试验和轴向扭转试验 ,测量标本的纵向压缩位移、横向分离位移和扭转角度。结果 :改良“叉”形钢板、GSH钉、股骨塑形钢板固定组的纵向压缩位移分别为 (0 .41± 0 .0 3 )、(0 .3 8± 0 .0 1)、(0 .81± 0 .10 )mm ;横向分离位移分别为 (0 .2 0± 0 .0 1)、(0 .19± 0 .0 1)、(0 .3 0± 0 .0 1)mm ;扭转角度为 1.62°± 0 .0 7° ,1.69°± 0 .0 6° ,4.2 6°± 0 .72°。改良“叉”形钢板和GSH钉固定明显优于股骨塑形钢板 ,具有显著性差异 (P <0 .0 1)。结论 :改良“叉”形钢板用于固定股骨髁部C1型骨折 ,具有良好的生物力学性能 ,是治疗股骨髁部C1型骨折的一种较理想的内固定器械。     

有关跟骨骨折复位与内固定的应用解剖

目的 :为跟骨骨折的内固定设计提供解剖学基础。方法 :对 5 4对 10 8侧成人跟骨干燥标本的一些与其骨折内固定有关的骨性标志进行测量。结果 :跟骨的长度为 68.6± 6.4mm ;跟骨前部、跟骨沟部及跟骨后部的宽度分别为 2 2 .3± 3 .2mm ,2 4.4± 2 .9mm和 3 0 .3± 3 .2mm。载距突的长、宽、高分别为2 3 .6± 3 .0mm ,15 .3± 2 .2mm和 9.5± 1.2mm ,载距突与跟骨水平面存在 2 7.7°± 6.8°的上翻角。Gissane′s角为 116.7°± 8.0°。结论 :本文结果对跟骨骨折的复位和固定具有指导意义。     

筛泡的临床解剖学研究及其意义

目的 :为临床开展鼻窦内窥镜手术提供外科手术解剖学依据。方法 :在 2 0具 40侧经防腐处理的完整成人尸头标本上观测筛泡气化发育的情况 ,测量筛泡气房的最大内外径、最大上下径、筛泡骨壁的厚度及其相关临床数据。结果 :测得筛泡的内外径为 (9.9± 2 .9)mm(5 .0～ 16.0mm ) ;上下径为 (14 .9±7.3 )mm(5 .0～ 2 9.0mm) ;骨壁厚为 (0 .2± 0 .1)mm(0 .1～ 0 .4mm) ;筛泡中心至前鼻棘的距离为 3 9.3± 5 .2(3 1.0～ 5 0 .0 )mm ;其连线与鼻底平面间的夹角为 (5 3 .3± 9.1)°(3 2 .0～ 69.0 )°。结论 :筛泡气房的气化发育是影响上颌窦开口引流的主要原因之一。     

国人股骨假体设计的解剖学基础

目的 :为选择和设计适合中国人的髋关节假体提供参考值。方法 :对 12 9例成人股骨标本进行X线摄片 ,并对其中 2 0例标本行CT扫描 ,测量小转子及其上下 2cm平面处髓腔宽度、前倾角等参数。结果 :小转子处髓腔宽为 ( 2 4.85± 2 .94)mm ,其上 2cm处为 ( 4 2 .47± 5 .14 )mm ,其下 2cm处为 ( 17.87±3 .0 4)mm ,个体间有较大差异。CT测量值与X片测量值无明显统计学差异。结论 :股骨上段的解剖学资料 ,可为选择和设计适合国人的人工髋关节假体提供参考。     

颈椎椎弓根的形态观测及临床意义

为给颈椎弓根螺钉的设计和手术方法提供解剖学基础，采用测量方法对20例成人骨骼的颈2至胸1的椎弓根及其相关结构作了观测。椎弓根高为6．4±1．1－9．1±1．3mm，其厚为3．6±1．8－7．2±1．3mm，长为9．6±1．4－15．1±1．2mm.。根体长为25±1．1－30±1．9mm，椎弓根内倾角为26．2°±6．0°－46．0°±3．5°，体根柱角为90．7°±2．3°－105．6°±4．6°，PS值为0．5±0．4mm-4.4±1.2mm，PM值为0．8±0.2-7.4±1.2mm。颈椎弓根螺钉的直径以3．0mm以内较安全，其长度不宜短于15．1±1．2mm，不宜长于29．1±1．4mm，颈椎弓根入钉是位于关节突柱背面，可根据纵向的上关节突关节面最低点下方距离（PS值）和横向上关节突柱外缘内侧距离（PM值），在胸1此值为椎板外缘外侧距离）来确定，螺钉置入方向通过水平面上的内倾角和矢状面上的体根柱角确定。     

纳米水平分子成像与诊疗一体化研究进展与挑战

分子成像能以非侵入性的方式重现活体细胞的生理功能和生物学过程,提高疾病的早期和特异性诊断水平。纳米颗粒/材料具有物理性质可控性高、易于表面修饰、血液循环时间长和可功能化等优点,在疾病诊断与治疗中显示出巨大潜力。但如何阐明纳米材料多功能间的内在联系、解决其代谢及安全性等关键机制难题、实现纳米颗粒/材料多功能性到临床多功能...     

Association between functional alterations of senescence and senility and disorders of gait and balance

OBJECTIVES:

Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil.

METHODS:

Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale.

RESULTS:

Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores.

CONCLUSIONS:

Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity.     

男性乳腺发育症临床病理分析及雌,孕激素受体检测

对１１３例男性乳腺发育症进行临床病理分析。同时检测其中３０例乳腺组织中雌激素受体和孕激素受体分布情况，结果发现两者阳性率分别为８０．０％和８３．３３％。结合文献讨论了男性乳腺发育症的发生与高血清激素浓度及乳腺组织高受体水平的关系。     

Alterations of regular and mature monocytes are distinct,and dependent of intensity and duration of exercise

Circulating monocytes comprise functionally distinct regular (CD14^bright+) and mature (CD141^low+) cells. Cell surface receptors were determined by three colour flow cytometry in 8 healthy control subjects. Compared to regular monocytes, mature monocytes had lower levels of the high affinity Fcy receptor 1 (CD64), complement receptor 3 (CDllb), CD45RO and higher levels for HLA-DR, LFA-1 (CD11a/CD18), interleukin-2 receptor (CD25), CD45RA and the Fc receptor 3 (CD16). Both regular and mature monocytes were measured before and up to three hours after four different types of exercise (Ex) in endurance trained athletes (n=9-16). Immediately after anaerobic exercise of I min with a maximal lactate concentration (la_max) of I2.3 (SD I.4) mmol · l^–1 and exhaustive exercise of 24 (SD 8) min with a maximal lactate concentration (la_max) of 7.4 (SD 2.6) mmol· l^–1 mature monocytes increased more than regular monocytes. Exhaustive endurance exercise of 87 (SD 21) min [la_max 3.7 (SD I.0)] led to a similar increase of regular and mature monocytes. 15–33 min after a 100km run regular monocytes increased significantly, whereas mature monocytes decreased. Up to three hours after the end of all exercises mature monocytes fell below pre-exercise values. In conclusion, duration and intensity of exercise alter distinct maturation stages of monocytes differently. It is probable that the avidity of adhesion molecules like LFA-1 to their endothelial ligands is increased to enable the firm attachment to the endothelium.     

Triptorelin and cetrorelix induce immune responses and affect uterine development and expressions of genes and proteins of ESR1, LHR,and FSHR of mice

Context: GnRH immunity can reduce the expression of pituitary GnRH levels, and cause the changes in reproductive behaviors. It is unclear whether triptorelin (TRI) and cetrorelix (CET) immunity influences uterine development and expression of follicle-stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR), and estradiol receptor 1 (ERS1) in the uterus.

Objective: The study investigated the effects of active immunity of GnRH agonist and antagonist on uterine development, microstructures, expression of hormone receptors mRNAs, and proteins in uteri.

Materials and methods: One hundred and five mice were assigned into CET, TRI, and control groups (CG). Mice in CET-1, CET-2, and CET-3 (n?=?15) were subcutaneously injected with 10, 20, and 40?μg CET antigens for seven days, respectively. Mice in TRI-1, TRI-2, and TRI-3 were injected with 10, 20, and 40?μg TRI antigens for seven days, respectively. The qPCR and Western blot were implemented to determine expressions of ESR1, LHR and FSHR mRNAs, and proteins.

Results: Compared with CG, the uterine weights of CET-1, CET-2, and CET-3 increased by 42.86, 62.86, and 10.00% on day 35 (p?p?p?p?p?Conclusions: CET immunity promoted the uterine development, improved EET and UWT, and also promoted the expressions of ESR1 and FSHR protein levels. It lessened the LHR protein levels. TRI immunity blocked EET and UWT, inhibited uterine growth and development. The efficacy of CET immunity was more obvious than TRI.     

韧带和肌腱的生物力学和力学生物学研究

国际韧带和肌腱研讨会(The International Symposium on Ligaments and Tendons,ISI&T)于2000年在美国佛罗里达州奥兰多市首次召开。研讨会的宗旨是引起对韧带和肌腱研究的重视,并为生物工程师、生物学家、临床医师提供一个可以分享、评论、讨论韧带和肌腱最新研究成果的论坛。从2000年起,国际韧带和肌腱研讨会已经开展了15届;每届研讨会上涌现了大量令人振奋的关于当前韧带和肌腱研究热点和未来挑战的讨论。多年来,韧带和肌腱领域内的研究数量大幅增加,研究质量不断提升。为纪念《医用生物力学》杂志创刊30周年,本文总结过去30年里韧带和肌腱研究的主要进展,包括组织力学、力学生物学、损伤与治愈机制、组织修复和再生。     

Morphology and cytochemistry of leucocytes and thrombocytes of six species of fish

Cytochemical reactions of blood leucocytes and thrombocytes from six species of fish, rainbow trout (Onchorhynchus mykiss), coho salmon (Onchorhynchus kisutch), white sturgeon (Acipenser transmontanus), goldfish (Carassius auratus), striped bass (Morone saxatulis), and channel catfish (Ictalurus punctatus) were determined. Because the staining reactions were generally similar to the reactions found in mammalian leucocytes with similar morphological features, it is reasonable to classify fish leucocytes using the same terminology as is used for mammalian leucocytes. However, in some species leucocytes with features similar to mammalian eosinophils or basophils were not found. In goldfish leucocytes were found that had segmented nuclei and unstained, moderately refractile cytoplasmic granules. These cells were classified as segmented, granular leucocytes. Although these cells do not appear similar to any mammalian or avian leucocyte, the pattern of positive cytoplasmic alkaline phosphatase staining and negative granular staining is similar to that of equine eosinophils.     

Pathology and genetics of phaeochromocytoma and paraganglioma

Phaeochromocytoma and paraganglioma (PHEO/PGL) are rare tumours with an estimated annual incidence of 3 per million. Advances in molecular understanding have led to the recognition that at least 30–40% arise in the setting of hereditary disease. Germline mutations in the succinate dehydrogenase genes SDHA, SDHB, SDHC, SDHD and SDHAF2 are the most prevalent of the more than 19 hereditary genetic abnormalities which have been reported. It is therefore recommended that, depending on local resources and availability, at least some degree of genetic testing should be offered to all PHEO/PGL patients, including those with clinically sporadic disease. It is now accepted that that all PHEO/PGL have some metastatic potential; therefore, concepts of benign and malignant PHEO/PGL have no meaning and have been replaced by a risk stratification approach. Although there is broad acceptance that certain features, including high proliferative activity, invasive growth, increased cellularity, large tumour nests and comedonecrosis, are associated with an increased risk of metastasis, it remains difficult to predict the clinical behaviour of individual tumours and no single risk stratification scheme is endorsed or in widespread use. In this review, we provide an update on advances in the pathology and genetics of PHEO/PGL with an emphasis on the changes introduced in the WHO 2017 classification of endocrine neoplasia relevant to practising surgical pathologists.     

壬基酚与卵清蛋白的结合与鉴定

目的：合成壬基酚与卵清蛋白的偶联物。方法：在磷酸盐（PBS，pH=8．0）缓冲液中利用甲醛通过曼尼希反应连接壬基酚与卵清蛋白（OVA）；通过抗体芯片技术与紫外扫描鉴定偶联物。结果：壬基酚与OVA偶联成功，壬基酚单克隆抗体对偶联物的识别浓度小于2．68μg／ml。结论：本方法可用于壬基酚与卵清蛋白的偶联，且方法简单易实现。