Strecker stent in stenotic hemodialysis Brescia-Cimino arteriovenous fistulas

Flexible tantalum stents (Strecker) were used as an adjunct to percutaneous transluminal angioplasty (PTA) in the treatment of stenotic arterial or venous limbs of Brescia-Cimino hemodialysis fistulas. The diagnostic procedure was performed using retrograde fistulography. After PTA with unsatisfactory results, stents were placed in 5 patients with significant residual stenoses and poor fistula function. Within the mean follow-up period of 6.4 months (range 3–10 months) all fistulas were functioning. We conclude that Strecker stent is useful in the treatment of stenotic hemodialysis arteriovenous fistulas as an adjunct to PTA.     

Long-term Outcomes of Patients Undergoing War-related Amputations of the Foot and Ankle

Long-term clinical and functional outcomes for patients undergoing foot and ankle amputations are not well documented. We attempted to document long-term outcomes for patients who required lower extremity amputations as a result of wounds suffered during wartime. For this study, 27 Iranian soldiers who had wounds requiring amputation of the foot and ankle were selected for follow-up. The participants' wartime medical records were reviewed, a clinical examination was performed, and each participant completed a questionnaire. Postamputation follow-up averaged 17.5 years. The most prevalent (66.6%) cause of injury was a land mine. The prevalences of different clinical symptoms reported by the amputees at the time of the last follow-up were as follows: 11 (40.7%) with phantom sensation, 6 (22.2%) with phantom pain, 12 (44.4%) with stump pain, 12 (44.4%) with back pain, 9 (33.3%) with contralateral knee pain, and 4 (14.8%) with ipsilateral knee pain; 20 (74%) reported treatment for psychological conditions. In regard to social conditions, 13 (48.1) were currently employed, or had been employed, for a number of years after the amputation; 26 (96%) had children, and all of the patients were married. The results of this observational study indicate that individuals have significant long-term pain and discomfort after war-related lower extremity amputation. Although all 27 (100%) of the amputees were able to maintain satisfactory family functioning, only 13 (48.1%) of the study participants were able to remain productively employed after undergoing amputation, and 20 (74%) reported long-term psychological problems in addition to their physical pain.     

Cranioplasty with an autoclaved bone flap,with special reference to tumour infiltration of the flap

Summary The results of a total of 25 cranioplasties are reported. In 10 patients, a reinforced acrylic prosthesis was utilized. In the remaining 15 cases, the patient's own autoclaved bone flap was re-implanted. Six of these bone flaps were autoclaved to kill tumour cells, and was re-implanted during the same surgical procedure. In the remaining 9 patients, the flaps were removed to allow brain swelling, preserved in a freezer and re-implanted several months later. All the prostheses and re-implanted flaps were accepted by the patients without complications such as infections or resorption, and with cosmetically satisfying results. The tumour infiltrated flaps remained tumour free for the entire period of observation.     

小儿遗尿症指南和专家共识质量评价

背景 小儿遗尿症是儿科常见病之一,有效的小儿遗尿症诊疗指南有助于症状的规范化控制和缓解,而制定高质量的临床实践指南是提高小儿遗尿症诊疗水平的重要方式。目的 基于AGREEⅡ和RIGHT工具,评价2010年以来国内外发布的小儿遗尿症指南和专家共识的质量,以期为临床实践及后续指南的制订提供参考。方法 检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库和PubMed(补充检索医脉通、世界卫生组织以及英国国家临床示范研究所等数据库)2010-01-01至2022-01-31公开发表的小儿遗尿症相关的诊疗指南和专家共识。采用AGREEⅡ和RIGHT工具评价纳入文献的方法学和报告质量。根据AGREE Ⅱ工具评价结果,将各指南/共识推荐等级评定为“推荐(A级)”“更新后推荐(B级)”和“不推荐(C级)”。使用组内相关系数(ICC)进行一致性评价。结果 纳入8部指南和5部专家共识。共形成推荐意见185条,其中44条为诊断评估方面的意见,140条为治疗方面的推荐意见,1条为随访推荐意见。AGREEⅡ工具评价结果显示,范围和目的、参与人员、严谨性、清晰性、应用性和独立性6个领域的总得分(报...     

Computed tomographic study of the posterior condylar angle in arthritic knees: its use in the rotational positioning of the femoral implant of total knee prostheses

The epicondylar axis is a reliable reference to check the rotation of the femoral implant in total knee prostheses (TKPs). However, during the operation it seems easier to use the posterior condylar axis as a landmark. The angle between these two axes is called the posterior condylar angle (PCA). The aim of this study was to measure the PCA in arthritic knees to assess the reliability of the posterior condylar axis as a reference for the control of the rotation of the femoral implant and to look for correlation with other radiological measurements. This prospective study consisted of 103 arthritic knees (81 varus, 22 valgus) before a TKP had been done in 103 patients (75 women, 28 men). The assessment of the PCA was made by computed tomographic scanning (CT). The HKA, HKS and HKT angles were measured on the pangonogram. The posterior condylar axis was internally rotated with respect to the epicondylar axis. The average value for all the patients was 2.65° degrees with a range from 0° to 7°. The PCA was significantly increased in the valgus knees. There was no correlation between the angles on the pangonogram and the posterior condylar axis. While the preoperative assessment of the PCA by CT scanning is reliable, the results obtained indicate the marked variability in its value. If one wishes to use the posterior condylar axis as a guide for rotation, it is therefore necessary to assess the PCA for each patient using adjustable jigs according to the value obtained. No measurement on standard radiographs allowed an extrapolation of the value of the PCA, and CT scanning seems to be the preferable radiological examination.

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Electronic Supplementary Material The french version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at

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Etude tomodensitométrique de l'angle condylien postérieur dans les genoux arthrosiques. Intérêt dans le positionnement en rotation de l'implant fémoral dans les prothèses totales de genou

Résumé L'axe épicondylien est une référence fiable pour le contrôle de la rotation de l'implant fémoral dans les prothèses totales de genou (PTG). Mais, lors de l'intervention, il semble plus facile d'utiliser l'axe condylien postérieur comme repère. L'angle entre ses deux axes est appelé angle condylien postérieur (ACP). Le but de cette étude était de mesurer l'ACP dans les genoux arthrosiques, d'évaluer la fiabilité de l'axe condylien postérieur comme référence pour le réglage de la rotation de l'implant fémoral, de rechercher une corrélation avec d'autres mesures radiologiques. Une étude prospective comportant 103 genoux arthrosiques (81 varus et 22 valgus), avant PTG a été effectuée, chez 103 patients (75 femmes et 28 hommes). L'évaluation de l'ACP a été faite par examen tomodensitométrique (TDM). Les angles HKA, HKS et HKT ont été mesurés sur le pangonogramme. L'axe condylien postérieur était en rotation interne par rapport à l'axe épicondylien. La valeur moyenne pour tous les patients était de 2.65°, avec des valeurs de 0 à 7°. La valeur de l'angle CP augmentait avec une différence significative dans le groupe des genu valgum. Il n'y avait pas de corrélation entre les angles du pangonogramme et l'ACP. Si l'évaluation pré-opératoire de l'ACP par TDM est fiable, les résultats obtenus mettent en évidence une variabilité importante de sa valeur. Il faut donc, si l'on veut utiliser l'axe condylien postérieur comme repère de rotation, évaluer pour chaque patient l'ACP, et utiliser un ancillaire réglable reportant la valeur obtenue. Aucune mesure sur des radiographies standard ne permettant d'extrapoler la valeur de l'ACP, la TDM semble l'examen radiologique de choix.

     

颅骨缺损状态下区域血流速度变化

目的 :探讨颅骨缺损病理状态下区域血流速度变化。方法 :应用TCD测定不同缺损面积的颅骨缺损病人术前患侧及健侧和术后患侧ICA、ACA、MCA、PCA、BA平均血流速度。结果 :≥ 35cm2 病人患侧颅内血管平均血流速度高于正常 ,而健侧颅内血管平均血流速度正常。 <35cm2 病人患侧及健侧颅内血管平均血流速度均在正常范围。结论 :颅骨缺损病理状态下常可引起区域血流速度改变 ,血流速度改变是指导颅骨缺损修补的重要依据     

听骨检测实验装置

目的：探讨对人工听骨赝复物传音功能进行评价的客观方法。方法：用两块圆形的弹性膜来分别代替鼓膜和卵圆窗，两膜之间放置人工听骨，在人工外耳道侧给予纯音刺激，同时记录其声强，在卵圆窗膜处用激光测振仪测量卵圆窗膜的振动速度，通过比较振动速度的大小来比较人工听骨的传音特性。结果：模型“感觉阈曲线”和正常人听阈曲线对比，两者走势基本相同。结论：中耳机械模型是检验人工听骨传音特性并进行人工听骨赝复物客观评价理想的工具之一。     

高糖下调大鼠许旺细胞calpainⅡ的表达

目的：观察高糖对体外培养的大鼠许旺细胞calpainⅡ表达的影响。 方法： 体外培养大鼠许旺细胞，用MTT检测许旺细胞的存活力，用原位杂交和免疫细胞化学方法分别测定许旺细胞calpainⅡmRNA和蛋白的表达。 结果： 高糖（50 mmol/L）培养24 h，许旺细胞存活力明显低于对照组（30 mmol/L）（73.95% vs 100%， P＜0.01）。许旺细胞calpainⅡ mRNA阳性颗粒和calpainⅡ蛋白阳性颗粒也明显少于对照组。 结论： 高糖培养下调许旺细胞calpainⅡ表达。     

A quantitative method for thein vitro study of sounds produced by prosthetic aortic heart valves Part II: an experimental,comparative study of the sounds produced by a normal and simulated-abnormal Starr-Edwards series 2400 aortic prosthesis

A comparative study was made of the sounds produced by a normal Starr-Edwards 2400 aortic valve prosthesis with those produced by the same valve but having a simulated overgrowth at the apex of the struts. Comparisons were made over the entire cardiac cycle for time and amplitude, power-density spectra, power-distribution spectra, power-distribution surfaces associated with individual valves, and three-dimensional power-distribution-difference surface. Power-density spectra were compared for portions of the cycle corresponding to the opening, systolic, and closing sounds of the valve. Physical parameters of an acoustical model were estimated from the power-density spectra. The results showed that each comparison gave information pertinent to the simulated malfunction. Opening. systolic and closing sounds, respectively, were different for each valve. The opening sound of the abnormal valve displayed a much lower frequency. Systolic sounds for the two valves were similar in frequency, but the normal valve produced more total power for this sound. The closing sound of the abnormal valve occurred later than that of the normal valve. These differences were more clearly seen when viewed in the frequency domain.     

β-1,4-半乳糖基转移酶Ⅱ、Ⅴ表达的亚细胞结构定位研究

为了研究β-1,4-半乳糖基转移酶 和 (β-1,4-Gal T- and )蛋白表达的亚细胞结构定位 ,本实验构建了β-1,4-Gal T- 和 融合绿色荧光蛋白 (GFP)表达质粒 ,分别将构建的质粒转染到 PC12细胞和肝癌 772 1细胞中 ,在荧光显微镜下观察β-1,4-Gal T- 和 在其中表达的亚细胞结构定位。发现 ,β-1,4-Gal T- 和 主要表达在这两种细胞的细胞核旁的 Golgi复合体 ,说明它们主要分布在 Golgi复合体上。提示它们可能是在 Golgi复合体参与蛋白质的糖链修饰