极重度放烧复合伤大鼠异体骨髓和皮肤移植后的病理学…

大鼠３Ｇｙ全身照射复合１５％Ⅲ度烧伤，伤后６小时内进行异体骨髓和同一供体皮肤移植，治疗组大鼠５０天动物存活５０％，其异体皮全部存活，至伤后１００和４８０天时，存活动物的异体皮仍然生长良发，组织结构正常，骨髓移植后５天，受体骨髓现出现再生，第１０天再生明显增多，淋巴结和脾脏皮质区淋巴细胞第１５天出现生。致伤对照大鼠于伤后７天内全部死亡，骨髓无明显再生，结果表明，在极重度放烧复合伤情况下，早期进行异体     

放射损伤复合烧伤对异体皮存活及某些免疫变化的影响

本文作者探讨了１５％Ⅲ度烧伤复合３～８Ｇｙ全身照射对大鼠异体皮存活及其免疫反应的影响。单烧组异体皮１０天全部排斥，早期免疫反应增强；而放烧复合伤时免疫反应明显受抑制，所植异体皮在复合３Ｇｙ或４Ｇｙ照射时，１０天存活率分别为２０％和３０％；复合５，６，８Ｇｙ者则上升为６９％，８８％和１００％，存活至３０天仍达３６％，４２％和１００％，与单烧植皮组相比，复合５Ｇｙ以上照射者均有显著性差异。表明放烧复合伤时异体皮存活率主要随受照射剂量增加而增高，随时间后延有所降低。     

局部纤维连接蛋白对大鼠III度烫伤创面愈合作用的研究

目的　研究混合皮肤移植对促进Ⅲ度烫伤皮肤愈合的机制。方法　在大鼠Ⅲ度烫伤及烫伤后切痂移植异体皮打洞嵌植自体皮片 (混合移植 )的模型上比较单纯Ⅲ度烫伤创面与混合移植后 3 ,5 ,7,14 ,2 1和 2 8天自体皮区、异体皮区皮肤 (包括部分皮下组织 )中纤维连接蛋白 (FN)含量的变化。结果　单纯Ⅲ度烫伤大鼠创面炎性反应明显 ,伤后 2 8天仍未愈合 ,混合移植异体皮出现排异现象 ;自体皮生长良好 ,植皮后 2 8天自体表皮相连。相应的未进行切痂混合移植的大鼠烫伤创面FN在烫伤后 17天才达到最高峰 ,混合移植异体皮区的FN在植皮后 3天即升高 ,第 7天为最高 ,第 14天降低 ,而自体皮区FN在移植后 2天即已达到最高峰。混合移植早期 ,自体皮区FN含量均高于异体皮区和烧伤创面。结论　自体皮片比异体皮片更易与创面粘连 ,建立血供 ,上皮更易扩展 ,从而有利于创面愈合。     

局部纤维连接蛋白对大鼠Ⅲ度烫伤创面愈合作用的研究

目的 研究混合皮肤移植对促进Ⅲ度烫伤皮肤愈合的机制。方法 在大鼠Ⅲ度烫伤及烫伤后切痂移植异体皮打洞嵌植自体皮片（混合移植）的模型上比较单纯Ⅲ度烫伤创面与混合移植后３,５,６,１７,２１和２８天自体皮区、异体皮区皮肤（包括部分皮下组织）中纤维连接蛋白（ＦＮ）含量的变化。结果 单纯Ⅲ度烫伤大鼠创面炎性反应明显,伤后２８天仍未愈合,混合移植异体皮出现排异现象;自体皮生长良好,植皮后２８天自体表皮相连。相     

自体表皮细胞培养与异体真皮组合应用研究

严重烧伤病人皮肤修复中主要未解决的问题是真皮的替代。动物实验结果表明，异体皮移植后５天，用自体培养表皮细胞膜片覆盖真皮床，１４天后复合皮成活率是８４．６％±２．４％。组织学检查证实表皮已形成了复层结构，可见基底层、颗粒层和角质层。临床应用中，异体皮移植后１０天，去除异体表皮覆盖病人的自体培养表皮，３５天后未见排斥征象，异体真皮促进了培养表皮的分层、成熟和完整，组织学检查证实表皮细胞的边缘清楚，已分化形成颗粒层和角质层，真皮多细胞，已血管化，但表皮嵴缺乏。     

放烧复合伤Ⅲ度烧伤创面处理的实验研究

放烧复合伤的创面处理是综合治疗的关键环节。本所近年研究了早期切痂植整张自体皮或异体皮对放烧复合伤疗效的影响,取得了较好效果［１４］,但也感到取自体皮面积较大时会加重伤情,异体皮移植因排异反应有时需做二次手术［５,６］。本研究采用自体与异体皮混合移植的方法,试图用较少面积的自体皮,覆盖较大面积的切痂创面,同时采用重组碱性成纤维细胞生长因子（ｂＦＧＦ）和保痂疗法,观察对放烧复合伤创面愈合的影响,为临床救治提供依据。一、材料和方法１－动物：实验用Ｗｉｓｔａｒ大鼠,１５周龄,体重２００～２３０克,由本…     

反植皮联合负压封闭引流治疗肢体大面积皮肤撕脱伤

目的 探讨反植皮联合应用负压封闭引流（vacuum sealing drainage，VSD）治疗肢体大面积皮肤撕脱伤的效果。方法 对近2年来收治的肢体大面积皮肤撕脱伤患者16例采用筛孔状中厚皮片反取皮原位移植法修复，皮片表面用多聚乙烯醇明胶海绵材料（商品名为“威克伤”）覆盖封闭，24小时不间断负压吸引。结果 平均使用VSD7天，12例皮片全部存活，创面愈合。4例皮片存活90％～95％，经换药后，创面愈合，患肢运动功能及外观恢复良好。结论 筛孔状中厚皮片反取皮原位移植法修复联合VSD处理肢体撕脱创面能在Ⅰ期关闭创面的同时更好地进行全创面引流，降低感染的发生，促进皮片与创面的良好贴附，有利于皮片存活，是治疗肢体撕脱伤较好的处理方法。     

大鼠烫伤创面愈合过程中皮肤基底膜层黏连蛋白的变化

目的：研究烫伤愈合过程中层黏连蛋白(LN)的表达。方法：采用免疫组化方法在大鼠浅Ⅱ度烫伤（伤后1,3,5,7,10,14d组）、Ⅲ度烫伤切痂混合移植模型（大张异体皮移植3,5,7,14,21,28d组）上研究了愈合过程中LN的变化。结果：正常皮肤基底膜中含有LN，而创伤后表皮细胞迁移缘LN消失，愈合后表皮下LN又出现。混合移植后7d出现异体皮排异反应，表现为异体表皮细胞铲除，而异体表皮下仍可见LN阳性表达。异体皮移植后10d，从自体皮迁移来的表皮细胞下有零星LN，而异体表皮细胞被完全铲除，异体皮基底膜处LN仍基本保持完整。异体皮移植后21d，自体表皮已基本覆盖异体皮区，此时LN表达已基本完整。结论：烫伤愈合过程中LN的变化有助于创面愈合。     

放烧复合伤对小鼠骨髓基质祖细胞体外集落生成能力的 …

目的 观察放烧复合伤对小鼠骨髓基质细胞集落形成能力（ＣＦＵ－Ｆ）的影响。方法 采用Ｄｅｘｔｅｒ型方法,检测经５．０Ｇｙγ射线放射损伤,１５％Ⅲ度体表面烧伤和放烧复合伤小鼠于伤后不同时间骨髓基质细胞集落形成能力。结果 单放组和复合伤组于伤后各时相点均显著低于正常组和单烧组;单烧组除伤后第３天低于正常组外（Ｐ〈０．０５）,至伤后第１４天与正常组差异无显著性。单放组骨髓基质细胞在伤后３天和７天经２１天培     

放烧复合伤对小鼠骨髓基质祖细胞体外集落生成能力的影响

目的观察放烧复合伤对小鼠骨髓基质细胞集落形成能力（ＣＦＵＦ）的影响。方法采用Ｄｅｘｔｅｒ型方法,检测经５０Ｇｙγ射线放射损伤、１５％Ⅲ度体表面积烧伤和放烧复合伤小鼠于伤后不同时间骨髓基质细胞集落形成能力。结果单放组和复合伤组于伤后各时相点均显著低于正常组和单烧组;单烧组除伤后第３天低于正常组外（Ｐ＜０．０５）,至伤后第１４天与正常组差异无显著性。单放组骨髓基质细胞在伤后３天和７天经２１天培养时呈小团片状生长,至培养第２８天时仍未长满培养皿底。结论单放组和复合伤组骨髓基质细胞受损后恢复缓慢;放烧复合伤对骨髓基质细胞的损伤具有放射损伤为主的特点     

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.     

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).     

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.     

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.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）