Characterization and mapping of dipolar interactions within macromolecules in tissues using a combination of DQF, MT and UTE MRI

This study shows that by combining a double‐quantum filtered magnetization transfer (DQF‐MT) with an ultra‐short TE (UTE) MRI that it is possible to obtain contrast between tissue compartments based on the following characteristics: (a) the residual dipolar coupling interaction within the biomacromolecules, which depends on their structure, (b) residual dipolar interactions within water molecules, and (c) the magnetization exchange rate between biomacromolecules and water. The technique is demonstrated in rat‐tail specimens, where the collagenous tissue such as tendons and the annulus pulposus of the disc are highlighted in these images, and their macromolecular properties along with those of bones and muscles can be characterized. DQF‐MT UTE MRI also holds promise because collagenous tissues that are typically invisible in conventional MRI experiments produce significant signal intensities using this approach. Copyright © 2012 John Wiley & Sons, Ltd.     

舒筋活络中药结合水疗治疗痉挛型脑瘫患儿的疗效观察

目的 观察舒筋活络中药结合水疗法对痉挛型脑瘫患儿的临床疗效.方法 将80例痉挛型脑瘫患儿随机分为治疗组和对照组各40例,对照组给予药物、高压氧、功能训练等常规治疗;治疗组除给予常规治疗外,每日辅助水疗1次.结果 治疗组患儿的粗大运动功能改善及肌张力的缓解均优于对照组.结论 舒筋活络中药结合水疗有利于加速痉挛型脑瘫患儿的...     

前交叉韧带损伤应用自体胭绳肌肌腱镜下重建的临床研究

目的探讨前交叉韧带损伤应用四股自体胭绳肌肌腱镜下重建的方法与疗效。方法对35例前交叉韧带（ACL）损伤患者行自体四股半腱肌腱与股薄肌腱镜下重建ACL,肌腱取自同侧,将两股肌腱分别对折组成4股,编织后等长点部位钻胫骨、股骨隧道,将肌腱拉入骨隧道,分别在屈膝90°和伸膝位将移植肌腱收紧,两端可吸收空心界面螺钉内同定。结果术后随访27-60月,平均29月;术后6周关节活动达正常范围,术后抽屉试验除6例1度外,余29例均阴性;Lysholm评分,术后75～100分,平均92分,较术前52分明显提高;Tegner运动评级术后6～8级,平均7级,较术前平均3级有较大提高。结论镜下四股自体胭绳肌肌腱重建前交叉韧带,界面螺钉固定,是治疗ACL损伤的较好方法。     

Minimally Invasive Achilles Tendon Stripping for the Management of Tendinopathy of the Main Body of the Achilles Tendon

Achilles tendinopathy is a common cause of disability. New nerves fibers grow from the paratenon into the Achilles tendon, and they could play a central role in the development of pain. We report the results of minimally invasive Achilles tendon stripping for Achilles tendinopathy in 47 active patients. The Victorian Institute of Sports Assessment-Achilles questionnaire score improved from 53.8 preoperatively to 85.3 postoperatively (p < .001). After a mean follow-up period of 40.5 months, 41 patients had resumed sporting activities at an average of 3.5 months postoperatively. A sural nerve injury was recorded in 5 patients (10.6%), and all 5 complications occurred during the first 12 cases. As a result, the technique was slightly modified, and no sural nerve neuropathy was observed subsequently. One superficial infection (2.1%) was recorded. Minimally invasive Achilles tendon stripping seems to be an effective, technically simple, and inexpensive treatment of Achilles tendinopathy. Further randomized controlled trials involving more patients are needed to confirm these outcomes.     

Clinical benefits and drawbacks of local corticosteroids injections in tendinopathies

Introduction: local glucocorticoids injections are widely administered for the treatment of tendinopathies. positive results have been observed in some tendinopathies but not in others. moreover, worsening of symptoms, and even spontaneous tendon ruptures has been reported. the characteristics of the tendinopathies, the clinical peculiarities of the patient, and the technique used to administer glucocorticoids, can influence the therapeutic response.

Areas covered: After reviewing the pertinent literature on the clinical results, basic information, both on the pathogenesis of tendinopathies and the effects of glucocorticoids on tendons, is reported. The pharmacological properties of glucocorticoids are useful to counteract some pathogenetic mechanisms of tendinopathies. However, several experimental studies suggest that the direct action of glucocorticoids on tendons is detrimental. Loss of collagen organization, impaired viability of fibroblasts, depletion of stem cells pool, and reduced mechanical properties have been observed.

Expert opinion: Drawbacks of local glucocorticoids injections could be predicted on an individual basis, after a careful appraisal of patient characteristics and concomitant medications, along with the specific stage of tendon disease.     

In vivo (1)H double quantum filtered MRI of the human wrist and ankle.

Proton double quantum filtered (DQF) NMR imaging was applied in vivo to the human wrist and ankle with a clinical 1.5 T MR scanner. Water molecules having anisotropic motion were detected from tendons and ligaments. Images of Achilles tendon were obtained for a voxel size of 1.25 x 1.25 x 20 mm with three values of TR = 1.0, 0.5, and 0.2 sec, resulting in total acquisitions time of 17, 8.5, and 3.4 mins, respectively. Some degradation of the signal-to-noise ratio was observed at the shortest TR value and the contrast was significantly reduced due to SQ coherence leakage. The in vivo DQF images showed structure within the tendon that is otherwise not visible by conventional gradient-recalled echo (GRE) methods. Published 2000 Wiley-Liss, Inc.     

骨髓基质细胞对移植肌腱在骨隧道内愈合作用的影响

目的:研究骨髓基质细胞对移植肌腱在骨隧道内愈合方式的影响。方法:采用兔膝关节自体半腱肌重建前交叉韧带悬吊固定模型,实验分为空白对照组、胶原海绵组和骨髓基质细胞(MSCs)组,MSCs组在骨隧道内植入骨髓基质细胞。分别于手术后4、8和12周采取组织,采用HE、Masson染色,观察骨隧道和肌腱移植物间的界面组织学特殊变化,分析腱骨愈合信息。结果:4周时MSCs组腱骨间充满结缔组织,空白对照组和胶原海绵组腱骨间有少量结缔组织;8周MSCs组形成Sharpey’s纤维,空白对照组合胶原海绵组无Sharpey’s纤维出现;12周时MSCs组形成大量Sharpey’s纤维,在移植肌腱和骨隧道之间有纤维软骨,矿化软骨形成,空白对照组和胶原海绵组出现Sharpey’s纤维,无矿化软骨形成。结论:MSCs对移植肌腱在骨隧道内的愈合起明显的促进作用,可以缩短腱骨愈合时间。     

经筋围刺电针治疗加康复负重训练对小脑损伤患者步态的影响

目的:探讨经筋围刺电针及康复负重训练对小脑损伤患者步态的影响.方法:40例脑卒中所致小脑损伤患者随机分为A、B 2组各20例,均在内科常规治疗的基础上,A组采用患侧臀中肌(足少阳处)经筋围刺电针治疗并配合神经促通技术、减重肌力训练、主动负重及患侧单足负重控制训练等;B组行易化技术为主的常规康复训练.治疗前后采用徒手肌力...     

自体与同种异体肌腱重建膝关节前交叉韧带的比较*

背景：关节镜辅助下重建前交叉韧带的移植物主要有自体移植物、同种异体移植物和人工韧带3种,关于移植物的选择,存在较多争议。 目的：评估自体健侧腘绳肌腱和同种异体肌腱两种移植物在膝关节前交叉韧带重建中的效果。 方法：纳入2007-01/2009-01在承德医学院附属医院骨科就诊的经关节镜检查证实为前交叉韧带损伤的患者70例(70膝),分别采用自体健侧腘绳肌腱和同种异体肌腱重建前交叉韧带,记录膝关节Lysholm功能评分、KT-1000测量值及不良反应。 结果与结论：患者随访18~24个月,均未发生血管神经损伤,无感染、植入物断裂等并发症;同种异体肌腱移植患者有2例膝关节引流管口持续渗出,经换药半月后愈合,其余切口均一期愈合。末次随访时,自体健侧腘绳肌腱和同种异体肌腱重建患者的Lysholm评分均显著提高,双侧膝关节前向松弛度差值显著减少,且两种方法比较差异无显著性意义(P > 0.05)。说明应用自体健侧腘绳肌腱与同种异体肌腱重建膝关节前交叉韧带疗效相当,效果满意。