Chorionic villi sampling: Laboratory experience with 4,000 consecutive cases

Experience with 4,000 consecutive CVS cases shows that 1) the combination of both the direct and culture methods greatly reduces false diagnoses and maternal cell contamination; 2) the time interval between the sampling procedure and processing of villus specimens influences the quality of direct preparations; 3) maternal cell contamination (MCC) can be minimized with dissection of CVS specimens. We have compiled a large volume of confined placen-tal mosaicism (CPM) cases to serve as a resource in interpreting mosaic cytogenetic findings. It was noted that, in up to 92% of the mosaic cases, the abnormal cell line was confined to the placenta. The frequency of true chromosomal mosaicism was 0.2%, and is not different from that for amniocentesis. © 1994 Wiley-Liss, Inc.     

The use of continuous passive motion after arthroscopically assisted anterior cruciate ligament reconstruction: help or hindrance?

One hundred and eight patients having undergone arthroscopic anterior cruciate replacement and having had continuous passive motion (CPM) as part of their immediate post-operative regime were prospectively compared with 108 patients having an identical operative procedure but not receiving CPM. All patients were operated on by the same surgeon, and the two groups were well matched for age, weight and associated injuries and procedures. These not receiving CPM required significantly less analgesia (P-0.0001), had less blood loss measured in the drains (P=0.001) and had a shorter hospital stay (P=0.0001). At review 6 months after surgery, there was no significant difference between the two groups in the range of movement of the operated leg compared to the normal leg.     

动力髁部螺钉治疗股骨远端骨折

目的报告应用动力髁部螺钉(DCS)治疗股骨远端骨折15例的体会。方法本组15例均采用DCS手术治疗,固定方法因骨折类型不同而异,手术后均辅以持续被动活动(continuouspassivemotion,CPM)。结果15例病人均获得随访,时间为6～12个月,骨折愈合良好,平均愈合时间3.1个月,膝关节功能按Merchan评分标准,优良率为13/15(86.7%)。结论DCS是治疗股骨远端骨折的良好方法之一,它具有固定可靠,有利于骨折愈合和膝关节功能的康复等优点。     

Persistent lymphadenopathy associated with hypertransfusion in sickle-cell disease

We report the results of an immunologic evaluation of two hypertransfused (HT) patients with sickle-cell disease (SCD) who have developed persistent generalized lymphadenopathy. In order to interpret the results of this evaluation, we studied seven other HT patients with SCD and seven nonhypertransfused patients with SCD. Patients with SCD had decreased percentages of T-lymphocytes to include both helper and suppressor subsets in their peripheral blood. These decreases resulted in T helper/suppressor ratios not different from those of healthy normal control subjects. Lymphocyte proliferative responses to mitogen were decreased in the nonhypertransfused group, whereas mononuclear cell populations from both patient groups had higher levels of spontaneous suppressor cell activity than did control subjects. The patients with lymphadenopathy were distinguished from other HT sickle-cell anemia patients by immunologic abnormalities that included decreased percentages of T4+ lymphocytes, decreased T helper/suppressor ratios, and decreased lymphocyte responses to mitogen. Furthermore, the serum of these patients contained antibody specific for human T cell lymphotropic virus type III (HTLV-III). We believe that these two patients have developed acquired immunodeficiency syndrome-related lymphadenopathy as the result of transfusion-acquired HTLV-III. We propose that hypertransfusion treatment in SCD, possibly in association with phenytoin administration, places individuals at risk for HTLV-III-associated syndromes.     

CPM机在断指再植术后功能锻炼中的应用

目的 探讨断指再植手术治疗后患指使用CPM机进行功能锻炼的恢复效果.方法 2004年1月至2006年12月,对32例患者44指离断伤行断指再植术治疗,其中20例术后使用CPM机进行功能锻炼,12例术后未使用CPM机进行功能锻炼.观察手指功能的康复情况. 结果 32例患者术后获6～14个月(平均10个月)随访,患指全部成活.20例使用CPM机患者与12例末使用CPM机患者均纳入结果分析.运用顾玉东断指再植评定标准,使用CPM机组共20例26指,优6指,良13指,可4指,差3指,优良率为73.1%;未使用CPM机组共12例18指,优2指,良7指,可5指,差4指,优良率为50.0%. 结论断指再植术后2～12周使用CPM机进行功能锻炼,早期可以减轻疼痛,防止术后粘连,促进指间关节的功能恢复.     

解剖钢板内固定和应用CPM治疗胫骨近端骨折

目的探讨解剖钢板(高尔夫型)内固定和应用CPM治疗胫骨近端骨折的临床价值。方法采用切开复位、高尔夫钢板内固定(必要时植骨,对损伤的韧带、半月板进行修补,腓总神经损伤者探查修复)和应用CPM机治疗胫骨近端骨折,对关节功能进行评价。结果43例患者均获随访,随访6～81个月,平均28个月,膝关节功能评分:优28例,良11例,可3例,差1例。结论切开复位、高尔夫钢板内固定(必要时植骨)和应用CPM机治疗胫骨近端骨折,是目前治疗胫骨近端骨折较为理想的治疗方法之一。     

单侧外固定器结合CPM机治疗下肢骨折的临床观察

目的:探讨单侧外固定器结合CPM机对下肢骨折治疗作用。方法:对本院2006年9月~2008年9月的64例下肢骨折患者进行效果评价分析,随访时间4~15个月,平均9个月,每个患者均在医师指导下进行CPM练习,每周一次进行X光复查。结果:优良率达92.2%,平均卧床时间、下肢消肿时间、住院时间都有所缩短。结论:单侧外固定器结合CPM机治疗下肢骨折可缩短治疗周期。     

应用CPM预防下肢骨折术后深静脉血栓的效果评价

目的：评价CPM在预防下肢骨折术后深静脉血栓形成（DVT）的效果。方法：将268例下肢骨折患者随机分为对照组（134例）和观察组（134例）,对照组常规术后抬高患肢及术后24 h鼓励和指导患者做主动肌力锻炼,观察组在对照组的基础上加用CPM装置进行训练,观察两组在预防深静脉血栓形成的效果及患者对护理工作的满意度。结果：观察组在预防下肢深静脉血栓形成效果明显优于对照组（P〈0.05）,其对护理工作的满意度显著高于对照组（P〈0.01）。结论：下肢骨折术后应用CPM装置有利于预防下肢深静脉血栓的形成及提高患者对护理工作的满意度。     

持续被动运动对预防截瘫患者并发膝关节僵硬的效果观察

目的观察持续被动运动（CPM）和人工手法被动运动2种方法对预防截瘫患者并发膝关节僵硬的临床效果。方法 60例截瘫患者随机分为CPM组32例和对照组28例,对照组应用常规的手法被动运动,CPM组应用CPM被动运动。比较运动前后膝关节被动屈曲的活动范围（ROM）。结果 CPM组和对照组病人卧床一段时间后,膝关节都出现一定程度的活动受限（P〈0.05）,但CPM组膝关节活动范围（被动屈曲ROM）受影响的程度较对照组明显要小（P〈0.05）。结论使用CPM行康复功能锻炼可以明显减少截瘫患者膝关节僵硬的发生或改善截瘫患者膝关节的被动屈曲度。