Ponseti方法治疗先天性马蹄内翻足

先天性马蹄内翻足（CFF）是小儿足部常见的一种先天性畸形，其发病率约为1‰。男孩为女孩的3倍，单侧略多于双侧，患儿出生后可根据外观畸形得到诊断，以前足内收、内翻、跖屈和踝关节马蹄足为特征。CFF严重影响小儿的骨与关节生长发育，可能是骨科领域内最常见、需要特别治疗的先天性畸形。我院采用Ponseti方法，治疗先天性马蹄内翻足取得较满意疗效。     

手术治疗先天性马蹄内翻足78例报告

先大性马蹄内翻足的国内发病率约为存活儿童的1‰。本病可能由发育异常或胎儿在子宫内体位异常所致。畸形最严重者包括足跖屈、高弓、足跟内翻、足中部及前部内收和旋后。多数病例经保守治疗或软组织手术后亦难得保持矫正位,复发率可高达4G—80％。我院1977—1990年共收治先天性马蹄内翻足103例。以下报告获随访的78例124只足的治疗结果。     

内因型先天性马蹄内翻足的综合手术治疗

本文报告作者对１７例２４肢内因型先天性马蹄内翻足进行足内侧软组织松解、跖屈肌延长、跟骨关节软骨面切除、并舌形筋膜瓣转位、胫后肌止点外移、三关节融合等综合手术治疗。经随访观察，疗效满意。     

金属夹板治疗新生儿马蹄内翻足

新生儿马蹄内翻足临床并非少见。如若不及时予以处理 ,可能造成终身残疾。近几年我们应用“凵”型金属夹板治疗新生儿马蹄内翻足 5例 ,取得满意效果 ,现简单介绍如下。1　临床资料1.1　一般资料　本组新生儿 5例 ,男 2例 ,女 3例。左足马蹄内翻足 3例 ,右足马蹄内翻足 2例 ,均于出生后半小时至 1d发现。其含有内踝下缘皮肤皱折 ,外踝部皮肤紧张 ,足内翻伴踝跖屈前足内收。用手予以矫正 ,得以踝关节 90°屈曲平置位 ,畸形消失。1.2　治疗方法　取自制的金属铝夹板 ,厚约 3mm ,宽 3～3.5 cm,折成“凵”形 ,两臂一短一长 ,其臂的长度 ,根据患儿…     

手术矫治小儿先天性马蹄内翻足25例

手术矫治小儿先天性马蹄内翻足２５例福建医学院附属第一医院叶君健，吴天中，蔡华秀小儿先天性马蹄内翻足畸形是矫形外科常见的一种先天性疾病，外科手术矫治可使患足在正常或较正常状态下生长发育。近十年来，我院共收治该种畸形患儿２５例，手术矫治３３足，治疗效果满...     

Ponseti方法治疗新生儿先天性马蹄内翻足20例

目的评价Ponseti方法治疗新生儿先天性马蹄内翻足的效果。方法采用Ponseti方法治疗28d以内的先天性马蹄内翻足患儿20例22足,评价治疗效果。结果平均随访11个月,19足进行经皮跟腱切断术,4足随访发现复发,3足再次行石膏矫形治疗,1足进行第2次经皮跟腱切断+石膏矫形。最后随访时McKay评级:优16足,良6足,优良率达100%。结论 Ponseti方法治疗新生儿先天性马蹄内翻足效果满意。坚持正确穿戴支具是防止复发的关键。     

跟腱滑动延长治疗先天性马蹄内翻足35例分析

先天性马蹄内翻足疗程较长，许多患儿未能坚持连续的治疗而使治疗失败或复发，导致二次治疗的复杂性。作者对１９９２年以来采用跟腱滑动延长加石膏矫正治疗３５例患儿，并进行了随访，只要适应证选择正确，坚持治疗连续性，疗效令人满意，且较单纯石膏矫治疗程缩短。本组优良率为９７．１％。     

Penseti方法治疗先天性马蹄内翻足

目的分析采用Ponseti方法治疗先天性马蹄内翻足的临床效果。方法随机选择42例48足先天性马蹄内翻足患儿,对患者采用Ponseti方法治疗,包括手法矫正、石膏固定、经皮跟腱切断以及足外展支具等治疗,观察患者的治疗效果。结果经随访发现,42例48足中共40例45例矫形效果满意,其余2例3足进行手术治疗。结论 Ponseti方法是治疗于先天性马蹄内翻足的有效手段,治疗效果明显,值得临床推广。     

81例维吾尔族先天性马蹄内翻足术后的康复护理

目的总结81例维吾尔族先天性马蹄内翻足术后的康复护理。方法选择我院于2012年1月至2014年12月共收治了81例维吾尔族先天性马蹄内翻足的患者为研究对象,采取心理护理、密切观察术肢感觉、运动功能,指导正确的功能训练等综合护理,观察患者康复情况。结果 81例患者均成功完成手术,"马蹄内翻矫正术"效果满意,术后4例有轻度内收。随访3个月,患者疗效满意,无一例出现并发症。结论通过精心护理,保证了手术的成功,达到了患者的满意。     

微信群延续护理+同伴教育在小儿先天性马蹄足门诊治疗中的应用

目的分析微信群延续护理+同伴教育在小儿先天性马蹄足(CTEV)门诊治疗中的应用效果。方法选择2018年1月至2020年12月南阳市骨科医院门诊治疗的42例CTEV患儿进行随机对照试验, 采用随机数字表法将其分为对照组和观察组, 各21例。对照组男14例, 女7例, 年龄(6.95±1.20)个月。观察组男16例, 女5例, 年龄(6.98±1.23)个月。对照组实施常规护理, 观察组实施微信群延续护理+同伴教育, 两组均持续护理6周。比较两组家属疾病相关知识掌握情况、并发症发生率和家属满意度。采用t检验和χ2检验, P<0.05差异有统计学意义。结果观察组护理后家属疾病相关知识中发病机制(82.29±2.65)分、石膏护理(83.94±3.25)分、生活护理(83.46±3.62)、并发症观察(80.16±3.11)分, 均高于对照组, 差异均有统计学意义(t=6.778、5.029、3.195、4.884, 均P<0.05)。观察组未发生并发症, 低于对照组的28.57%(6/21), 差异有统计学意义(χ2=4.861, P=0.028);观察组家属满意度中服务态度(8...     

脑瘫患儿足外翻畸形综合康复治疗前后的足底压力特征的比较

目的 运用足底压力技术为脑瘫足外翻患儿的康复评估提供依据;为下肢功能障碍的脑瘫患儿的步态评估及治疗找到一条有效的途径.方法 选取2012年10月至2014年10月在安徽医科大学第二附属医院康复科就诊的脑瘫患儿68例,经过两个周期的康复治疗后,对治疗前后的足底压力特征进行对比,以评估疗效.结果 治疗后患足内侧缘的接触面积减小,整足接触时相增加,离地时相减小,足前掌内侧缘、足弓内侧缘压力减小,而足前掌外侧缘和足弓外侧缘所占压力百分比增加,治疗前后的差异有统计学意义.结论 综合康复治疗使得足外翻脑瘫患儿的足底压力分布情况明显改善,足外翻畸形得到有效矫治,而足底压力技术的运用让康复效果有一个直观、量化的标准.     

三关节融合法治疗小儿马蹄内翻足40例疗效分析

目的观察三关节融合＋跟腱延长＋跖筋膜切断的手术方法治疗马达加斯加共和国（以下简称马国）小儿先天性马蹄内翻足的临床疗效。方法40例（60足）患儿采用三关节融合＋跟腱延长＋跖筋膜切断的手术方法治疗,术后长腿管形石膏固定足踝部于矫正位、膝关节屈曲30°,抬高患足,密切观察患肢血液循环,12～14d拆线,6周后拔除克氏针,更换短腿管形石膏固定,逐渐练习关节活动,带管形石膏下地功能锻炼。术后进行疗效评价,术前及末次随访分别测量足跖屈角度、背屈角度及侧位X线片距跟角度。结果术后40例患儿获得随访,随访时间8月至2年,平均16月,畸形矫正满意,未见复发,足负重行走功能良好。其中优34足,良15足,可11足,优良率达81．7％;术后末次随访时跖屈角度与术前比较,差异具有统计意义（P〈0．05）;术后末次随访时背屈角度及侧位距跟角度与术前比较,差异具有高度统计意义（P〈0．01）。结论施行三关节融合＋跟腱延长＋跖筋膜切断术方法治疗小儿先天性马蹄内翻足,只要手术操作过程准确得当,术后矫形处置得当,可以获得满意的疗效;在马国这种一次性手术是治疗小儿先天性马蹄内翻足的一种有效方法。     

Proteomic analysis of kidney in fluoride-treated rat

The recent development of proteomic techniques has enabled investigators to directly examine the population of proteins present in biological systems. We first report here the proteomic changes of renal protein induced by fluoride. To investigate molecular mechanisms of renal injury induced by fluoride, proteins were isolated from rat kidney and profiled by two-dimensional gel electrophoresis (2DE). With the analysis of Image-Master 2D Elite software, 141 up-regulated and eight down-regulated protein spots in 2DE gels of fluoride-treated group were gained by comparison to the control group, 13 of which were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The identified proteins are mainly related with cell proliferation, metabolism and oxidative stress, and provide a valuable clue to explore the mechanism of renal fluorosis. This study also shows that the proteomic techniques were powerful in fluoride toxical field.     

石膏固定与足外展矫形器治疗脑瘫患儿马蹄内翻足的临床研究

目的探讨石膏固定与足外展矫形器对脑瘫患儿马蹄内翻足的治疗效果。方法选取2014年1月~2015年6月期间广州市社会福利康复医院收治的32例马蹄内翻足脑瘫患儿为受试对象,按照入院顺序随机分为观察组与对照组各16例。对照组患儿实施脑瘫肢体综合训练治疗,而观察组患儿则在其基础上予以石膏固定结合足外展矫形器进行治疗。比较治疗前及治疗1年后两组患儿步态功能[Tinetti步态评分量表(TGA)]、踝关节被动形态(屈膝位双踝关节被动背屈角度、伸膝位双踝关节被动背屈角度)、步态时空参数(支撑相、摆动相、步长、步速)变化,分析治疗1年内两组患儿跟腱复发挛缩情况差异。结果治疗1年后,观察组患儿TGA评分、摆动相、步长、步速水平较治疗前有显著提升,且明显高于对照组(P均<0.05);观察组患儿屈、伸膝位双踝关节被动背屈角、支撑相水平均较治疗前有显著下降,且明显低于对照组(P均<0.05)。治疗1年内,观察组患儿跟腱复发挛缩率明显低于对照组(P<0.05)。结论石膏固定与足外展矫形器治疗脑瘫患儿马蹄内翻足可取得较为理想的效果,有利于步行功能预后恢复。     

Proteomic response analysis of endothelial cells of human coronary artery to stimulation with carbachol

AIM: To identify the molecular basis of the endothelial target for acetylcholine (ETA). METHODS: Proteomic methods were used to monitor changes in protein expression in the first 10h following the stimulation of human coronary endothelial cells with carbachol 100μmol/L. Thirty proteins showing the largest changes were identified by mass spectrometry. RESULTS: Based on analysis with Image Master 2-D Elite software, about 623 protein spots were detected in control cells and 825 protein spots in carbachol-treated cells, the matching rate was 68.1%. Among all the detected spots, 39 were up-regulated and 29 were down-regulated, showing detectable changes varied from 1.7-3.8 folds. Forty one spots in the peptide mass fingerprints were successfully obtained. The most interesting feature was that all the four newly synthesized proteins belonged to the heat shock protein family.CONCLUSION: These identified proteins played key roles in the molecular mechanism of ETA.     

Proteomic analysis of silver nanoparticle toxicity in rat

Silver nanoparticles (SNPs) have received considerable attention recently, because SNPs with different shapes and sizes exhibit variable antimicrobial activity, which makes them useful for medical and hygienic purposes. SNPs have been detected in various tissues and organisms after inhalation, oral ingestion, and contact with the skin, indicating that SNPs can be distributed to different body tissues after uptake. Thus, the toxicity of SNPs to different body tissues after their uptake needs to be studied. In this study, we performed a proteomic analysis of liver, lung, and kidney tissues in rats exposed to approximately 50 nm SNPs by intravascular injection. Then, the differentially expressed proteins representing a dose-dependent response were identified. The differentially expressed proteins were mostly related to the known toxicity of SNPs, such as apoptosis, increased reactive oxygen species, thrombus formation, and inflammation. Additionally, proteins related to metabolic disorders including diabetes were identified as differentially expressed proteins in kidney, based solely on the analysis of the protein profile and related disease pathway. In conclusion, the differentially expressed proteins identified in this study could provide basic data for understanding the toxic and pathological responses of SNP-exposed tissues and to identify candidate SNP toxicity biomarkers.     

Proteomic analysis of acrylamide-protein adduct formation in rat brain synaptosomes

Evidence suggests that the neurological defects (gait abnormalities, foot splay, and skeletal muscle weakness) associated with acrylamide (ACR) intoxication are mediated by impaired neurotransmission at central and peripheral synapses. ACR can form adducts with nucleophilic residues on proteins and thereby alter corresponding structure and function. To evaluate protein adduction in nerve terminals as a possible mechanism of action, recombinant N-ethylmaleimide sensitive factor (NSF) was exposed in vitro to ACR (10 micromol) and mass spectrometry (MS) was used to identify adduct sites. MS analyses demonstrated that ACR formed adducts with sulfhydryl groups on cysteine residues (carbamoylethylcysteine, or CEC) of NSF. Ex vivo incubation of whole brain synaptosomes with ACR (0.001-1.0 M) produced concentration-dependent increases in CEC that were inversely correlated to reductions in neurotransmitter release that occurred over the same neurotoxicant concentration range. In synaptosomes isolated from rats intoxicated at a higher (50 mg/kg per day x 3, 5, 8, or 11 days) or a lower (21 mg/kg per day x 14, 21, or 28 day) ACR dose rate, CEC levels increased progressively up to a moderate level of neurotoxicity. To identify protein adducts, synaptosomal proteins labeled by ex vivo 14C-ACR exposure were separated by gel electrophoresis and probed by immunoblot analysis. Results showed that NSF and the SNARE protein, SNAP-25, were tentative ACR targets. Subsequent experiments indicated that ACR exposure increased synaptosomal levels of the 7S SNARE core complex, which is consistent with inhibition of NSF, SNAP-25 function, or both. These data suggest that adduction of cysteine residues on NSF and certain SNARE proteins might be causally involved in the nerve terminal dysfunction induced by ACR.     

在固相pH梯度4~7范围内海洛因成瘾者血浆蛋白质组分析(英文)

目的比较鉴定海洛因成瘾者和正常人血浆蛋白质组差异,为研究海洛因成瘾相关血浆蛋白提供线索。方法海洛因成瘾者(n=5)和正常对照者(n=5)血浆蛋白经剔除白蛋白和免疫球蛋白IgG后,以固相pH梯度4~7胶条等电聚焦为第一向,SDS聚丙烯酰胺凝胶电泳为第二向,进行蛋白双向电泳。图像分析软件Image Master Elit 5.0分析蛋白质2维图谱。手工挖取组间相差1.5倍的差异点,串联质谱分析鉴定。结果每张图谱平均检测到350±21个蛋白(亚基)斑点,其中5个蛋白点在2组图谱中差异1.5倍以上,鉴定结果分别为γ纤维蛋白原、人α1B糖蛋白、α1-抗胰蛋白酶原、视黄醇结合蛋白载体蛋白四聚体单体和铜蓝蛋白。结论海洛因成瘾者血浆与正常人血浆对比存在蛋白质组差异。某些差异蛋白可能与海洛因成瘾造成的神经损伤相关。     

小鼠子宫内膜异位症模型的建立及其异位内膜蛋白质的差异表达谱分析*

目的：同源子宫内膜异位移植建立小鼠子宫内膜异位症模型，并初步观察异位内膜蛋白质的差异表达。方法：完整剥离小鼠子宫内膜，按每段5mm分别接种于右侧子宫旁、右侧腹壁和小肠系膜。动物分别于术后30，90和180d剖腹探察模型成功率，并采用双向电泳初步分析建模180d异位内膜的蛋白质差异表达。结果：内膜移植30，90和180d模型的成功率分别为25．0％，50．0％和84．2％；不同接种部位异位内膜形态以清亮囊肿为主，子宫旁内膜移植成功率明显高于另外2个接种部位。双向电泳图谱提示，异位内膜与正常内膜之间完全匹配的蛋白点有99个，丰度大于5倍的差异点有13个，异位子宫内膜的蛋白质表达在种类和数量上明显增多。结论：同源子宫内膜异位移植90和180d可以成功建立小鼠子宫内膜异位症模型，异位子宫内膜的蛋白质表达明显增多增强。