单侧多功能外固定支架治疗不同形状胫腓骨骨折的临床观察

目的：对比观察单侧多功能外固定支架治疗不同形状胫腓骨骨折的临床愈合时间。方法：对283例采用单侧多功能外固定支架治疗的新鲜闭合性胫腓骨骨折病人进行随访分析。结果：不同形状的骨折愈合时间不同,分别为横形骨折93d、斜形骨折121．5d、螺旋形骨折130．3d、粉碎形骨折191．4d。结论：胫腓骨骨折经单侧多功能外固定支架固定后,骨折愈合速度依次为横形骨折、斜形骨折、螺旋形骨折、粉碎形骨折。     

针灸治疗运动性损伤选穴规律集纳

对近10年针灸治疗运动性损伤选穴规律进行归纳,主要有以痛为腧法、上病下取法、下病上取法、对应取穴法、交叉取穴法、巨刺法、缪刺法、生物全息法、局部取穴法、腕踝针法,循经取穴等。对不同的取穴方法之间的疗效对比研究以及其作用机理探讨的文献不多,尤其设有客观观察指标的更少。     

《伤寒论》君药桂枝药证组方规律研究

建立《伤寒论》方剂数据库。运用统计方法,探究《伤寒论》中最有代表性的君药桂枝,探寻其与芍药、葛根、石膏等配伍的比例和药证规律。     

基于数据挖掘的中医药治疗雄激素性脱发用药规律研究

目的：对中药内外治疗雄激素性脱发（AGA）的方剂用药规律进行统计分析,为临床治疗AGA提供理论依据。方法：检索国家知识基础设施数据库（CNKI）、中国生物医学文献数据库（CBM）、中国学术期刊数据库（CSPD）及中文科技期刊数据库（CCD）,收集自建库至2022年2月18日与AGA有关的中医药文献,运用IBM SPSS Modeler、IBM SPSS Statistics 26.0等软件对中药数据进行关联规则、系统聚类及用药规律分析。结果：共筛选出183篇文献,获得内服方药178首,外用方药56首,内服单味药188味,外用单味药124味。内服单味药应用频次前3位分别为何首乌、茯苓、丹参,性味归经统计分析多性寒、味甘、归肝经,功效分析多为补益药,关联规则分析常用药对为墨旱莲+女贞子,聚类分析共得出4个内服核心方药。外用单味药应用频次前3位分别为何首乌、侧柏叶、苦参,性味归经统计分析多性温、味苦、归肝经,功效分析多为清热药,关联规则分析常用药对为墨旱莲+女贞子,聚类分析共得出2个外用核心处方。结论：治疗AGA内服中药多以补益药、利水渗湿药为主,性味多以甘寒为主,归经以肝脾为主;外用中药多以清热药、解表药为主,性味多以苦温为主,归经以肝肺为主,为临床提供参考。     

高海拔对骨折愈合生物力学性能的影响

目的 旨在探讨高海拔对实验性骨折愈合生物力学性能的方法。方法 分别在拉萨和重庆,采用当地家兔制成戏有横形骨折模型,三角针内固定。术后２,４,６,８,１０,２周分别截取标本,行Ｘ线摄片。在ＷＤ－１０Ｅ电子万能试验机上行拉伸,扭转力学测试。结果 骨痂的力学性能与Ｘ线照片骨痂密度相一致。     

Does focal destruction of the thoracic aorta wall by Staphylococcus aureus lead to the development of infected aneurysms? An experimental study

Objective: The infrequency of infected aneurysms suggests that either infection of segments of the aortic wall is uncommon, or that infections do not always lead top infected aneurysm formation. The purpose of the study was to determine whether focal Staphylococcus aureus infection of aortic wall segments leads consistently to the development of infected aneurysms and to evaluate the segments in which infection did not lead to the infected aneurysm formation. Methods: Twenty pigs were inoculated with 0.1 ml of a Staphylococcus aureus inoculum in three segments of the thoracic aorta wall (study group). In another 10 pigs, 0.1 ml of saline solution was injected in three segments of the thoracic aorta wall (control group). Study group: histological abnormalities and bacterial culture of the inoculation sites were evaluated at 10 days (n=5 pigs), 30 days (n=5 pigs), and 90 days (n=10 pigs). Control group: histological abnormalities were evaluated at 10 days (n=5 pigs) and 90 days (n=5 pigs). Results: Study group: infected aneurysms developed in only two animals killed at 30 days. At 90 days, destruction of the elastic tissue, scar tissue and neointima formation were found in all the aortic segments studied. Control group: no significant changes were found in any of the segments evaluated. Conclusion: In our experimental model, acute local infection by S. aureus caused the development of infected aortic aneurysm in only 10% of the animals. In the remaining 90%, healing of the site of infection followed resolution of the infection.     

复方表皮生长因子膜治疗家兔口腔溃疡的实验研究

目的研制治疗口腔粘膜溃疡的膜性制剂,观察其疗效.方法以表皮生长因子(EGF)为主药制成EGF膜,通过治疗家兔口腔溃疡,观察其病理改变及愈合时间.结果EGF膜组溃疡愈合时间较对照组明显缩短(P＜0.01),EGF膜组溃疡愈合程度明显好于对照组.结论EGF膜有明显促进家兔口腔溃疡愈合的作用.     

中国医疗保险法律体系的发展与改革

医疗保险作为社会保障的重要组成部分,其法律体系建设依然存在立法滞后、层次较低、执法主体不协调、程序不规范和司法救济严重错位等诸多问题。因此,应抓住全面推进依法治国的重要机遇,推动我国医疗保险法律体系的发展与改革。本文在梳理我国医疗保险法律体系发展历程的基础上,提出了立法层次向上集中、加快单项专项立法进程、探索建立个人信用体系和明确并公开司法工作等对策建议,以促进医疗保险法律体系的完善。     

The use of porcine small intestinal submucosa to enhance the healing of the medial collateral ligament--a functional tissue engineering study in rabbits.

INTRODUCTION: Small intestinal submucosa (SIS) from porcine has been successfully used as a collagen scaffold for the repair of various tissues, including those of the human vascular, urogenital, and musculoskeletal systems. The objective of this study was to evaluate whether SIS can be used to enhance the healing process of a medial collateral ligament (MCL) with a gap injury in a rabbit model. METHODS: A 6 mm wide gap was surgically created in the right MCL of 20 skeletally mature, female New Zealand White rabbits. In 10 rabbits, a strip of SIS was sutured onto the two ends of the MCL, while for the other 10 animals their injured MCL remained untreated and served as a non-treated group. The left MCL of all animals was exposed and undermined serving as the sham-operated side. At 12 weeks post-healing, eight hind limbs from each group were used for mechanical testing. The cross-sectional areas (CSA) of the MCLs were measured. The femur-MCL-tibia complex (FMTC) was tensile tested to failure. The load-elongation curves representing the structural properties of the FMTC and the stress-strain curves representing the mechanical properties of the healing MCL were obtained. The remaining two animals from each group were prepared for histological evaluation. RESULTS: The CSA between the SIS-treated and non-treated groups were not significantly different (p>0.05). Both treatment groups appeared to increase by nearly 40% compared to the sham-operated side, although statistical significance was not found for the non-treated group (p>0.05). The stiffness of the FMTC from the SIS-treated group was 56% higher than the non-treated group (45.7+/-13.3 N/mm vs. 29.2+/-9.2 N/mm, respectively, p<0.05) and the ultimate load also nearly doubled (117.434.5 N vs. 66.4+/-31.4 N, respectively, p<0.05). These values were lower compared to the sham-operated side (89.7+/-15.3 N/mm and 332.0+/-50.8 N, respectively). The tangent modulus of the healing MCL (279.7+/-132.1 MPa vs. 149.0+/-76.5 MPa, respectively) and stress at failure (15.7+/-4.1 MPa vs. 10.2+/-3.9 MPa, respectively) both increased by more than 50% with SIS treatment (p<0.05). Yet, each remained lower compared to the sham-operated side (936.3+/-283.6 MPa and 75.6+/-14.2 MPa, respectively). Blinded histological comparisons between the SIS-treated MCL and the non-treated control demonstrated qualitatively that the SIS treated group had increased cellularity, greater collagen density, and improved collagen fiber alignment. CONCLUSION: Healing of a gap MCL injury was significantly enhanced with SIS. The improved mechanical properties and histological appearance of the MCL suggest that SIS treatment improves the quality of tissue and renders the possibility for future studies investigating functional tissue engineering of healing ligaments.     

High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes

Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n = 770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1, 1983 to December 31, 2012 were considered for the study. Seven hundred one patients (median age 67 [22–95]) fulfilled the inclusion criteria and were followed according to a preset protocol until final outcome (healing or death). Severe peripheral vascular disease was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty‐five percent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, 9% (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy‐nine percent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing.