髋关节外固定器对股骨头压力影响的三维有限元分析

目的从三维有限元分析的角度,探讨髋关节外固定器对股骨头压力的影响。方法建立正常的髋关节三维有限元模型、安装单轴髋关节外固定器(A型)髋关节三维有限元模型、安装双轴髋关节外固定器(B型)的髋关节三维有限元模型,应用接触压力分析的方法,观察并分析髋关节双足站立位、单腿站立髋关节中立位股骨头的峰值压力,并进行统计学分析。结果髋关节外固定器均能减少股骨头的接触压力(P<0．05),髋关节外固定器在双腿站立时减少最明显,B型髋关节外固定器组较A型髋关节外固定器的股骨头接触压力减小。结论髋关节外固定器可减少股骨头的压力,可辅助治疗髋关节疾病。     

单臂多功能外固定支架治疗不稳定性胫腓骨骨折

目的 评估单臂多功能外固定支架治疗不稳定性胫腓骨骨折的疗效。方法 使用单臂多功能外固定支架治疗不稳定性胫腓骨骨折４２例。结果 骨折均愈合,患肢功能恢复良好,愈合平均时间６．２个月。钉道感染率１２％。结论 单臂多功能外固定支架可纵轴方向滑动,起延长加压作用,两端有球状万向关节,可做各方向调节,使用灵活和容许早期活动。单臂多功能外固定支架是治疗不稳定性胫腓骨骨折较好的方法。     

Leptomeningeal lipid storage patterns in Fabry disease

We found two patterns of leptomeningeal storage that reflect two basic visceral storage patterns in Fabry disease. (i) A generalized-type leptomeningeal storage pattern, affecting all main leptomeningeal cell types (external arachnoideal epithelium, fibroblasts, vessel wall elements), was a consistent finding in three cases of classical generalized visceral phenotype. (ii) A localized leptomeningeal storage pattern was expressed, to a high degree, solely in the external arachnoidal epithelium; this pattern was found in one case with the variant visceral-restricted-type storage (confined to the cardiocytes). Thus, the external arachnoidal epithelium may be particurlarly susceptible to Fabry lipid storage, probably caused by a distinctly larger sustained lysosomal lipid load as compared to other cell types.     

Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: A randomized,single-blind,controlled trial

BackgroundThe best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial therapy is a therapeutic approach in which the aim is to release fascial tension and regain mobility although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization.MethodsPatients were randomly assigned to a control group or to the intervention group.Both groups completed a therapeutic exercise program. Main Outcome Measures: The QuickDash questionnaire was the primary outcome, Pain Visual Analog Scale and the Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3)Results44 participants were included. In the analysis of evolution over time, a significant improvement in functionality and range of motion measurements was observed in both groups (p < 0.05), although at 12 weeks only Myofasical Group achieved a clinically and statistically significant reduction in pain. Comparative analysis at 12 weeks revealed no statistically significant differences between the two therapies in the variables explored.ConclusionsBoth, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain.Trial registrationTrial registration: ClinicalTrials.gov NCT04944446.     

Anatomy and physiology of the male urethral sphincter and its preservation in prostatic surgery

Radical prostatectomy is commonly used in the management of localized prostate cancer. Urinary incontinence after prostatectomy is of great concern to many patients. Improved understanding of the anatomy of the external urethral sphincter complex has resulted in a statistically significant decrease in the incidence of postprostatectomy incontinence. Most recent anatomic studies have described the external urethral sphincter complex as consisting of an intrinsic rhabdosphincter surrounding the smooth musculature of the urethra and an extrinsic sphincter incorporating the levator ani muscle and the pelvic floor. Both form a condensed striated muscle ring around the membranous urethra. Preservation of as much as possible of the normal anatomy of the sphincter mechanism and its nerve supply results in an excellent return to continence after radical prostatectomy. Received: 26 February 1999 / Accepted: 20 May 1999     

充分利用境外智力资源 创造对外合作美好前景——解放军总医院对外改革开放的回顾与展望

90年代以来,解放军总医院充分发挥自身的优势和潜力,进一步加快改革开放、对外交流合作的步伐,不失时机地利用境外智力资源,为医院现代化建设服务,使总医院的各方面建设发生了历史性的变化。文章论述了在新时期军队医院对外加强合作的必要性和可能性,认为充分利用境外智力资源是加快医院现代化建设的必要手段。只要在观念和体制上进行适当调整,就能有效地引进国际上最先进的科学技术成果和人才,在医院现代化建设方面收到事半功倍的效果。     

齐刺、温针灸治疗肱骨外上髁炎74例临床观察

目的：观察针灸治疗肱骨外上髁炎的疗效。方法：126例患者随机分成阿是穴齐刺加温针灸组74例和单一针刺组52例，治疗2个疗程观察比较两组的疗效。结果：齐刺、温针灸组与单一针刺组疗效比较，差异有极显著性意义（P＜0．01），结论：阿是穴齐刺加温针灸治疗该病的临床疗效优于单一针灸疗法。     

Clinical analysis of knee osteoarthritis treated mainly by acupuncture

目的:了解不同治疗方法对膝关节骨关节炎的临床治疗效果.方法:对148例患膝随机分为4组进行针灸、中药频谱照射法、综合法、西药内服治疗,观察其疗效.结果:4组总有效率分别为78.9%,72.7%,92.3%和78.9%,各组之间无差异(P＞0.05).综合组显效率优于其他各组(P＜0.05).结论:针灸、中药频谱照射对膝骨关节炎有一定疗效,综合法能协同两者作用,使疗效提高.     

Treatment of 30 cases of vitiligo by cupping method plus external application of Chinese herbs

在皮损区拔罐,然后外涂中药治疗白癜风患者30例,对照组予西药治疗,3个疗程后,治疗组总有效率96.7%,对照组总有效率76.7%.治疗组疗效好于对照组(P＜0.05).     

192Ir-HDR放疗合并外照射治疗口腔癌报道

目的 探讨早、中期口腔癌应用外照射合并^192Ir—HDR后装放疗的疗效。方法 对16例早、中期口腔癌患者，首先给^60Co或6MV—X加速器外照射，外照总剂量为Dt46～56Gy，23～28次，4～6周。外照结束后1周，给^192Ir—HDR后装组织插植或肿瘤表面贴敷放疗，参考点剂量为Dt18～32Gy,2～5次，3～15天,间隔1～5天。结果 5年生存率为81．3％，无严重的放射后遗症。结论 对早、中期口腔癌，就用外照射合并^192Ir—HDR后装放疗疗效与手术疗效相似，无严重的放射后遗症，且患者能保持外观和正常组织功能，提高了病人生存质量。