关节镜下肱二头肌长头肌腱转位治疗不可修复巨大肩袖撕裂的研究进展

目的综述关节镜下肱二头肌长头肌腱(long head of biceps tendon,LHBT)转位治疗不可修复巨大肩袖撕裂的研究进展。方法查阅近年来国内外关节镜下不同方式LHBT转位治疗不可修复巨大肩袖撕裂的相关文献,并进行总结分析。结果关节镜下LHBT转位是一种治疗不可修复巨大肩袖撕裂的有效方法,目前主要采用断近端、两头断、断远端及不切断4种方式。临床研究表明上述方式均能取得良好疗效,但远期疗效有待进一步随访明确。结论关节镜下LHBT转位治疗不可修复巨大肩袖撕裂手术简便、有效,患者损伤小、术后恢复快,但对术者技术要求较高,需严格把握手术适应证。     

Distal biceps tendon rupture: Is surgery the best course of treatment? Two case reports

Study DesignRepeated case study.IntroductionComplete rupture of the distal biceps tendon occurs mostly within the middle-aged male population. Surgical repair is traditionally recommended. Given the potential for complications, questions remain whether surgical repair is indicated.PurposeTo explore non-operative management for full distal biceps tendon ruptures.CasesTwo participants with complete tears of the distal biceps tendon confirmed with magnetic resonance imaging/ultrasound had chosen to not undergo surgical repair. First, a 48-year-old police officer was an avid weight lifter and recreational athlete. Second, a 43-year-old detailer has minimal physical activity participation other than work duties and light recreational sports. Strength testing was performed immediately after rupture and at 24 weeks after a structured physical therapy program focused on strengthening and stretching the elbow flexors and supinator.OutcomesInitial strength deficits of 17/21% in flexion and 13/19% for supination were detected. In both patients, flexion and supination strength returned to normal limits when compared with the opposite upper extremity. After intervention, functional and disability scores were normal in both cases, and both patients reported return to preinjury repetitive work and weight training.DiscussionAlthough patients are typically counseled that a reason for surgical repair after biceps rupture is substantial loss of flexion and supination strength, these cases indicate that full recovery of strength and function is possible through rehabilitation.ConclusionThese cases question the traditional wisdom that a surgical repair is needed for all distal biceps ruptures. Level of Evidence: Therapy, level 5. ICD-10 Code: M66.3.     

The functional and structural changes in the basilar artery due to overpressure blast injury

Overpressure blast-wave induced brain injury (OBI) leads to progressive pathophysiologic changes resulting in a reduction in brain blood flow, blood brain barrier breakdown, edema, and cerebral ischemia. The aim of this study was to evaluate cerebral vascular function after single and repeated OBI. Male Sprague-Dawley rats were divided into three groups: Control (Naive), single OBI (30 psi peak pressure, 1 to 2 msec duration), and repeated (days 1, 4, and 7) OBI (r-OBI). Rats were killed 24 hours after injury and the basilar artery was isolated, cannulated, and pressurized (90 cm H₂O). Vascular responses to potassium chloride (KCl) (30 to 100 mmol/L), endothelin-1 (10⁻¹² to 10⁻⁷ mol/L), acetylcholine (ACh) (10⁻¹⁰ to 10⁻⁴ mol/L) and diethylamine-NONO-ate (DEA-NONO-ate) (10⁻¹⁰ to 10⁻⁴ mol/L) were evaluated. The OBI resulted in an increase in the contractile responses to endothelin and a decrease in the relaxant responses to ACh in both single and r-OBI groups. However, impaired DEA-NONO-ate-induced vasodilation and increased wall thickness to lumen ratio were observed only in the r-OBI group. The endothelin-1 type A (ET_A) receptor and endothelial nitric oxide synthase (eNOS) immunoreactivity were significantly enhanced by OBI. These findings indicate that both single and r-OBI impairs cerebral vascular endothelium-dependent dilation, potentially a consequence of endothelial dysfunction and/or vascular remodelling in basilar arteries after OBI.     

Alkali-activated concrete mixes with ground granulated blast furnace slag and paper sludge ash in seawater environments

Predicted sea level rise due to global warming will necessitate the construction of coastal defenses to protect the populations in the vicinity of the coasts. Large quantities of concrete will be required with consecutive increases in greenhouse emissions, hence an increasing need for alternative to Ordinary Portland Cement (OPC) cements. Feasible potential alternatives could be found in alkali-activated cements, which also include industrial by-products or waste materials. This paper presents a laboratory study of concrete mixes based on the alkali-activation of an industrial by-product, ground granulated blast furnace slag (GGBFS) and includes an industrial waste, paper slugde ash (PSA) in the alkali-activator mixes. The use of seawater as mixing and curing water was also examined. The compressive strength and a number of durability-related properties of alkali-activated mixes in marine environment were investigated and compared to OPC systems. The incorporation of paper sludge ash led to high early strengths, a decrease in the effective porosity of alkali-activated slag concretes and generally a reduced water absorption, and enhanced the performance against chloride ion attack in mixes with freshwater, as well as the resistance of the cements in sulphate attack especially when mixed with seawater. The addition of seawater in the mixes increased the resistance to sulphate attack and the compressive strength in alkali-activated systems, as opposed to OPC concretes in which mixing and curing in seawater had deleterious effects. The study gives promise for the suitability of the tested alkali-activated concrete mixes in seawater environments.     

水下爆炸致水面泅渡战位比格犬脑和肺的损伤特点

目的 研究水下爆炸引起水面泅渡战位比格犬脑和肺的损伤情况.方法 20只健康比格犬随机分为4个实验组(距爆源5、8、11和15 m)和1个对照组(n=4).利用1 kg 2,4,6-三硝基甲苯(TNT)裸药在水下2 m实施爆炸对水中漂浮比格犬进行致伤,采用水下及颅内压力传感器和高速摄像机记录爆炸致伤的过程.爆炸后3 h内...     

慢性髓细胞白血病急变期的免疫表型和细胞遗传学研究

目的探讨慢性髓细胞白血病急变期(CML-BC)免疫表型和细胞遗传学异常的关系。方法对33例成人CML-BC以四色流式细胞仪进行表面抗原检测及R显带技术进行核型分析。结果典型易位组CD34阳性率高于变异易位组(P＜0．05):无附加异常、伴附加异常、伴复杂染色体异常(CCAs)各组中抗原表达阳性率无统计学差异;平衡易位、非平衡易位组中抗原表达阳性率无统计学差异。涉及17号染色体变异的病例中各抗原的阳性率与CML-BC总体阳性率比较末发现统计学差异。7例涉及17号染色体变异的病例均为CML-AML。结论典型t(9;22)易位CD34阳性率高于变异易位;有无附加染色体异常及是否平衡易位对免疫表型无直接影响。涉及17号染色体变异的CML-BC中急非淋变多见。     

眼眶爆裂骨折的CT表现

【目的】探讨CT检查对眼眶爆裂骨折的早期诊断价值。【方法】回顾性分析了47倒眼眶爆裂骨折的临床及CT表现及好发部位。【结果】眼眶骨折,直接征象是眶壁骨质连续性中断,粉碎,移位及曲度失常。根据骨折的特点可将眼眶骨折分为三类,即单眼眶骨折,多眼眶骨折,并发其他面部直接骨折的眼眶骨折。眼眶爆裂骨折最好发于眼眶内侧壁和底壁,占93．6％。副鼻窦内“泪滴”征是诊断眼眶下壁骨折的特异性间接征象。【结论】CT对早期诊断眼眶爆裂骨折有重要的临床价值。     

白细胞介素-6单独或与其他细胞因子联合应用对白血病细胞的影响

目的;观察ｒｈＩＬ－６对急性白血病原代细胞体外生长的作用。方法：应用ＭＴＴ,ＣＦＵ－Ｌ及间接免疫荧光法对１８例急性病进行观察。结果：ＩＬ－６体外单独应用对急性白血病原代细胞无明显促增殖及诱导分化作用,但与Ｇ－ＣＳＦ联合则常可抑制原代白血病细胞增殖。结论;ＩＬ－６与Ｇ－ＣＳＦ联合用于化疗,放疗后的骨髓抑制更安全。