胎儿头颈部动脉铸型标本制作

胎儿头颈部动脉铸型标本是铸型标本制作和设计中难度较大的标本之一,与成人材料相比,胎儿的血管管径比成人小得多。因此,在冲洗、插管、灌注等方面相对较困难。由于胎儿标本来源不受限制,我们参阅相关文献[1-2],并结合胎儿头颈部的结构特点及研究需要,采用改良环氧树脂作填充剂     

胎儿头臂干铸型标本的制作

由于胎儿的主动脉管径明显比婴儿小,且管壁弹性差,在插管、冲洗、灌注及后期处理等方面难度较大,因此制作婴儿颈部动脉铸型标本比起头颈部动脉铸型标本的制作方法要困难得多[1]。为此,作者根据临床应用和教学需要的特点,设计和制作保留骨骼胎儿头臂干铸型标本,清晰地显示右上半身动脉     

胎儿头颈部血管铸型设计的某些改进

作曾撰介绍婴儿头颈部动脉铸型标本制作的方法，浅谈了一些制作经验。多数报道头颈部血管铸型的制作，通常将头颈部离断取下，冲洗并在颈总动脉和（或）颈内静脉处插管灌注填充剂的技术方法。但由于胎儿头颈部的血管细小、弹性差，在冲洗、插管及灌注等方面较困难。因此，我们采取近心端插管灌注法，经过多次实验，铸型效果都较理想，现将方法介绍如下：     

保留骨骼胎儿全身动脉铸型标本的研制及临床应用

<正>保留骨骼胎儿全身动脉铸型是铸型标本制作和设计中难度较大的标本之一,但由于其能够直观展示全身动脉系统和骨骼的立体结构及毗邻关系,对临床应用和整形外科等领域具有重要应用价值。为此,我们在参考国内相关资料和结合临床应用的基础上[1<正>-2],开展研究保留骨骼胎儿全身动脉铸型标本制作的简便方法,以提高铸型标本制作成功率及临床应用价值。     

保留骨骼的胎儿全身及胎盘血管联合铸型标本的制作

由于胎儿骨骼的组成成分上,有机质大大超过无机质,胎儿保留骨骼的血管铸型标本制作,比常规的保留骨骼铸型标本难度大。为了清楚地显示胎儿、胎盘脉管系的立体构造和整体性,以及胎儿血管与骨骼的毗邻关系,我们在前期成功制作胎儿全身血管铸型标本的基础上,选择妊娠晚期的胎儿标本,用改良自凝牙托材料为填充剂,饱和Ca（OH）2的乙醇碱液腐蚀,制作了保留骨骼的胎儿全身血管及胎盘血管联合铸型标本,效果良好,现报告如下。1材料与方法     

胎儿肺动脉铸型标本的制作

目的通过制作胎儿肺动脉铸型标本为胎儿基础医学研究和胎儿宫内手术提供真实的形态学资料。方法自制塑料插管对1例26周以上胎儿肺标本进行肺动脉插管,按常规灌注红色的环氧树脂填充剂并铸型。结果铸型标本既能充分显示整体胎儿肺部动脉血管的形态结构,又能清晰地显示左肺动脉、左上肺动脉、左下肺动脉和右肺动脉、右上肺动脉、右下肺动脉等分布及走行情况。结论制作好的胎儿肺动脉铸型标本既能为胎儿基础医学研究提供真实的形态学资料,又可以为构建宫内胎儿肺部手术术前模拟训练平台奠定形态基础。     

较小胎儿保留骨骼的动脉铸型标本制作

<正>国内已有胎儿整体血管铸型标本制作的相关报道,但铸型标本均没有保留骨骼,这样不能较直观地定位血管位置,缺乏整体立体感。目前,20W以下较小胎儿保留骨骼的动脉铸型标本制作尚未见有相关报道[1-2]。为此,我们制作一例17W胎儿保留骨骼的动脉铸型标本,清晰地定位显示全身主要动脉主干与整体骨骼的立体结构与毗邻关系,为临床应用和教学需要提供较为直观的三维立体模型。现报道如下。     

全身保留骨骼血管铸型标本明胶加固自然腐蚀法

保留骨骼的血管铸型技术是解剖学标本制作技术中最富有表现力的一种特殊技术,也是最难以掌握的解剖学技术之一,尤其是制作全身整体保留骨骼的血管铸型技术难度很大。其主要难点为:灌注不均匀,在腐蚀过程中易断枝,要保留全身骨骼更是困难。我们采用多点分部灌注法制作童尸全身血管铸型标本取得成功[1]。在此基础上,经过进一步实验研究,探索出了用明胶加固自然腐蚀法成功地制作出了保留骨骼成人整体血管铸型标本,报道如下。1材料和方法1·1尸体材料选用身高1·55~1·65 m非外伤致死的新鲜尸体材料。1·2填充剂低浓度填充剂:过氯乙烯10~15 g,乙…     

胎儿头颈部静脉铸型标本的制作

胎儿头颈部血管铸型是铸型标本制作和设计中难度较大的标本之一,特别是静脉铸型。结合胎儿头颈部的结构特点及研究需要,我们参考有关文献,简化了操作和改进填充剂的配制方法[1～3]。经过多次实验,现已制作出高质量胎儿头颈部静脉铸型标本,铸型效果较理想。现将制作方法介绍如下     

多点插管法制作上肢离体铸型标本

目的研究显示上肢动脉铸型标本方法,为临床应用及教科研提供直观细致的局部循环标本。方法截取新鲜成人尸上肢6例,从腋动脉、尺动脉及桡动脉分别向肢体两端进行多点灌注牙托、过氯乙烯等填充剂,然后进行腐蚀冲洗处理。结果上肢动脉铸型标本外形美观,具有结构完整性和连续性,血管分支毗邻关系明确,疏密有度。结论采用沿动脉管道多点插管灌注法是制作上肢动脉铸型标本较为有效的方法。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.