不锈钢麻花牵引圈的制作及在管腔器械清洗质量检查中的应用

目的制作不锈钢麻花牵引圈并探讨其在管腔器械清洗质量检查中的应用效果。方法将制作的不锈钢麻花牵引圈用于管腔器械清洗质量的检查,通过与目测+光源放大镜法、探条纱布法、ATP生物荧光法做比较,评价其在管腔器械清洗质量检查中的效果。结果 A类空腔器械清洗质量检查中,麻花牵引圈法、目测+放大镜法和ATP生物荧光法的清洗质量检查合格率差别有统计学意义(P<0.010),两两比较,目测+放大镜法合格率最高,与其他2组的检查合格率差异具有统计学意义(P<0.017),麻花牵引圈法与ATP生物荧光法的检查合格率差异无统计学意义(P>0.017)。B类空腔器械清洗质量检查中,4种清洗质量检查方法合格率差异具有统计学意义(P<0.010),两两比较,目测+放大镜法合格率最高,与其他3组的检查合格率差异具有统计学意义(P<0.008)。麻花牵引圈法、探条纱布法和ATP生物荧光法的检查合格率差异无统计学意义(P>0.008)。结论不锈钢麻花牵引圈在管腔器械清洗质量检查中,能发现目测+放大镜法无法检出的不合格器械,其检测效果与探条纱布法、ATP生物荧光法相当,比ATP生物荧光法...     

The Müller acetabular support ring

Summary A series of 41 total hip arthroplasties with acetabular reinforcement by a Müller support ring is reviewed. The postoperative management was the same as that used in conventional cemented total hip arthroplasty. The overall clinical results and the radiological findings were most satisfactory after one to six years. Of the 30 hips available for functional assessment using the Merle d'Aubigné scale, 16 were excellent, 10 good, 2 fair, 1 poor and 1 bad. These results indicate that, regardless of the primary disorder, the Müller support ring has been helpful when dealing with severe osteoporosis, an acetabular floor lined by bone which does not allow adequate penetration of methyl methacrylate, a small acetabulum needing a small polyethylene socket and localised destruction of the acetabular roof or of the anterior or posterior acetabular pillar. A good result can only be guaranteed if the ring makes a perfect fit with the reamed acetabular cavity.

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Résumé Les auteurs analysent une série de 41 prothèses totales de hanche ayant nécessité un renforcement par anneau de Müller. Les résultats cliniques de 30 prothèses, ayant un recul compris entre 1 et 6 ans ont été appréciés suivant les critères de Merle d'Aubigné. Le résultat global était excellent dans 16 cas, bon dans 10 cas, passable dans 2 cas et mauvais dans 1 cas. Moyennant une technique rigoureuse, l'anneau de Müller a permis de résoudre de manière satisfaisante les difficultés techniques posées par les problèmes cotyloïdiens suivants: ostéoporose sévère, os scléreux ne permettant pas une pénétration adéquate du ciment, taille du cotyle nécessitant une petite cupule de polyéthylène (diamètre externe de 44 ou moins), destruction localisée du toit, du pilier antérieur, ou du pilier postérieur.

     

Avulsion of the cervical spinal ring apophyses: acute and chronic appearance

Avulsion of the superior or inferior ring apophyses of the cervical spine was found in 12 of 1922 patients aged 10–20 years. Clinical and radiological follow-up of 9 of these patients was undertaken 3–25 years after trauma. Avulsion of the superior apophysis occurs after flexion, while extension trauma causes avulsion of the inferior ring apophysis. The follow-up appearance is characteristic in both instances. In superior ring apophysis avulsion, there is a bow shape of the superior aspect of the involved vertebral body. In inferior avulsion, the avulsed apophysis fuses with the vertebral body and forms an osteophyte, whose shape and size depend on the degree of displacement.     

Asymmetry in gait pattern following bicondylar tibial plateau fractures—A prospective one-year cohort study

IntroductionDespite the high number of studies evaluating outcomes following tibial plateau fractures, the literature lacks studies including the objective assessment of gait pattern. The purpose of the present study was to evaluate asymmetry in gait patterns at 12 months after frame removal following ring fixation of a tibial plateau fracture.Patients and methodsThe study design was a prospective cohort study. The primary outcome measurement was the gait patterns 12 months after frame removal measured with a pressure-sensitive mat. The mat registers footprints and present gait speed, cadence, as well as temporal and spatial parameters of the gait cycle. Gait patterns were compared to a healthy reference population.ResultsTwenty-three patients were included with a mean age of 54.4 years (32–78 years). Patients presented with a shorter step-length of the injured leg compared to the non-injured leg (asymmetry of 11.3%). Analysis of single-support showed shorter support time of the injured leg compared to the non-injured leg (asymmetry of 8.7%). Moreover, analysis of swing-time showed increased swing-time of the injured leg (asymmetry of 8.9%). Compared to a healthy reference population, increased asymmetry in all gait patterns was observed. The association between asymmetry and health-related quality of life (HRQOL) showed moderate associations (single-support: R = 0.50, P = 0.03; step-length: R = 0.43, P = 0.07; swing-time: R = 0.46, P = 0.05).ConclusionCompared to a healthy reference population, gait asymmetry is common 12 months after frame removal in patients treated with external ring fixation following a tibial plateau fracture of the tibia.     

Bangle pessary: An unusual cause of vesicovaginal fistula

Vaginal pessaries are commonly used for uterine prolapse. Long forgotten pessaries get incarcerated in the vagina and may erode in the bladder and rectum. We present a unique case of a 60-year-old female patient who presented with dysuria and urge incontinence. In remote areas, bangles are still used as a pessary, which may present with atypical symptoms due to bladder perforation, encrustation, and Vesicovaginal fistula (VVF). VVF with a long curved tract can heal with prolonged catheterization. To our knowledge, this is the first case of glass bangle pessary being reported.     

Different nuclear/cytoplasmic distributions of RET finger protein in different cell types

The RET finger protein (RFP), which belongs to the B box zinc finger protein family, has a tripartite motif consisting of a Ring finger, a B box finger and a coiled-coil domain. The RET finger protein becomes oncogenic when its tripartite motif is fused with the tyrosine kinase domain of the RET protein. This study examined the RFP expression in normal and tumor tissues by immunohistochemistry. RFP was detected in the nuclei of various cells, including peripheral and central neurones, hepatocytes, adrenal chromaffin cells and male germ cells. Among them, RFP was expressed at high levels in male germ cells such as primary spermatocytes and round spermatids, and formed a perinuclear cap structure in primary spermatocytes. On the other hand, high levels of cytoplasmic expression of RFP were observed in some plasma cells as well as solitary plasmacytoma and multiple myeloma. These results suggested that different nuclear/cytoplasmic distributions of RFP might play a role in the regulation of growth or differentiation of different cell types.     

壮医脐环穴及其临床应用

阐述壮医脐环穴的理论基础,脐环穴的定位、脏腑归属、作用主治、用穴原则以及操作方法.壮医认为,脐是人整体的缩影,人体各脏腑器官在脐部均有相应的投影,犹如一个正立位的胎儿.脐既是人体的“微诊系统”,又是治疗全身疾病的“窗口”,分为天、人、地三部,分别与不同的脏腑器官相通应,临床常取脐内环穴和脐外环穴,统称脐环穴,可疏通三道两路、调节气血平衡,具有调气、解毒、补虚、祛瘀等作用,可治疗全身多种疾病.