Radiologic anatomy of the metacarpophalangeal joints II to V

Summary The metacarpophalangeal (MCP) joints II to V of 21 hands were examined radiologically and arthrographically. Different recesses of the joint cavity were demonstrated both radiologically and macroscopically, with a dominating dorsal recess. The existing forms of the dorsal recess were one-tailed, two-tailed, three-tailed, symmetric and caplike. Additionally, a palmar recess was found in the specimens examined, which presented as a small protrusion of the capsule and lay between the metacarpal head and the palmar plate. Furthermore, a distal recess was filled and unfolded in almost all the cases. Lateral recesses were found in the radial and ulnar directions beneath the collateral ligaments. The dorsal recess, due to its ability to collect fluid, is of clinical importance in pathologic processes causing effusions, while the clinical importance of the lateral recesses lie in their proximity to the stabilizing collateral ligaments of the metacarpophalangeal joints. The above mentioned recesses were seen as normal formations of the MCP joints and should therefore be taken into account in pathologic processes in this area.

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Radioanatomie des articulations métacarpo-phalangiennes des 2ème au 5ème doigts

Résumé Les articulations métacarpophalangiennes (MCP) des 2ème au 5ème doigts de 21 mains ont été explorées en radiographie standard et en arthrographie. Plusieurs récessus articulaires, dont un récessus dorsal prédominant, ont été mis en évidence à la fois sur les radiographies et macroscopiquement. Les récessus dorsaux observés pouvaient comprendre une, deux ou trois cornes ou prendre un aspect de coiffe. Un récessus palmaire a été également trouvé sur 49 pièces sous la forme d'une petite expansion capsulaire entre la tête métacarpienne et la plaque palmaire. Un récessus distal était de plus rempli dans presque tous les cas. Des récessus latéraux étaient trouvés sur les bords radial et ulnaire, entre les ligaments latéraux. Les épanchements articulaires se collectent volontiers dans le récessus dorsal qui se manifeste cliniquement. Les récessus latéraux sont cliniquement intéressants par leur proximité avec les ligaments latéraux des MCP. Les récessus décrits sont des structures normales des MCP et ne doivent pas être pris pour des éléments pathologiques.

     

Convergent inputs from articular,cutaneous and muscle receptors onto ascending tract cells in the cat spinal cord

Summary 1.Responses were recorded from 160 ascending tract cells in segments L4 to L6 of the spinal cord in chloralose anaesthetized, spinalized cats. The tract cells were identified by antidromic activation following stimulation of pathways in the lateral and ventral funiculi at the level of the spinal cord transection at the thoracolumbar junction. Axonal conduction velocities ranged from 9 to 114 m/s. 2. A sample of 152 of the neurones examined could be subdivided according to the distribution of their receptive fields into 49 cells activated just from receptors located in skin (s cells), 17 neurones excited by receptors in deep tissues (d cells), 15 units with a convergent input from receptors in skin and deep tissues (sd cells), and 25 neurones with a convergent input from the knee joint and either skin (sj cells), deep tissues (dj cells) or both (sdj cells). No receptive fields could be demonstrated for the remaining 46 neurones. 3. S and sj cells were found almost exclusively in the dorsal horn, whereas many d, sd, sdj and dj units were in the ventral horn. Almost all of the cells that lacked receptive fields were in the ventral horn or intermediate grey. 4. Ninety-one of 158 cells (56%) demonstrated no background activity. Of these, 43 cells (27%) lacked receptive fields. Many of the silent neurones were in the ventral horn, but some were in the dorsal horn. Of 25 cells having knee joint input, 18 (72%) had background activity. 5. All of the neurones that had a receptive field in the knee joint also had a convergent input from receptors in other tissues. In 3 cases, there was a receptive field in the skin over the foot (sj cells). For 16 cells, receptive fields included not only the knee joint but also skin and deep tissue (sdj cells). Usually, the cutaneous receptive field was near the knee joint, but sometimes it was remote, such as on the foot. The deep receptive fields were chiefly in the muscles of the thigh and/or leg. For 6 dj cells, the receptive fields included not only the knee joint but also deep fields like those of sdj cells. 6. Cutaneous receptive fields were classified as low threshold (cells excited best by innocuous intensities of mechanical stimulation), wide dynamic range (cells activated by weak mechanical stimuli, but the best responses were to noxious stimuli) or high threshold (innocuous stimuli had little effect, but noxious mechanical stimuli produced a vigorous discharge). Similarly, stimulation of the knee joint with weak mechanical stimuli could excite some neurones, while others could be activated by weak or strong articular stimuli but were excited best by noxious stimuli, and still other neurones were activated by knee joint stimuli only if the intensity was noxious. 7. In several instances, contralateral receptive fields were noted. These were generally in deep tissue or in the knee joint. 8. It was concluded that many of the responses to articular stimulation of the spinal cord ascending tract cells examined in this study could have been mediated by the fine afferent fibres that supply the knee joint. Although further work will be required to determine which particular ascending tracts transmit nociceptive information concerning the knee joint, it can be proposed that many of the responses demonstrated here were likely to play a role in either joint pain of in triggering responses associated with joint pain.     

组态视角下的新冠疫情防控成效研究——基于22个国家的定性比较分析*

目的 识别影响疫情防控的关键要素和路径组合,探求影响各国防控差异的机制,为疫情常态化防控提供理论指导。方法 运用清晰集定性比较分析(csQCA)方法,以世界22个典型国家为案例对象,主要从Our World in Data网站获取新冠疫情相关数据,对案例各条件变量及其非集进行必要性分析,对条件组态进行充分性分析。结果 必要性检验一致性水平均低于0.9; 输出5种组态,且单个解(组态)和总体解的一致性均为1,实现了完全一致性。结论 单个要素影响力较弱; 国家低确诊人数存在5条驱动路径,可归纳为资源丰富-弱疫苗型、信任驱动-强疫苗型、经济发达-地理优势型3种模式; 较高的人均GDP、人均床位数和信任度是影响新冠确诊人数的核心要素。     

英文科技期刊促进公共卫生学术交流与传播的策略——以《生物安全与健康(英文)》的办刊实践为例

【目的】 探讨建设促进公共卫生学术交流与传播的国际化英文科技期刊的有效途径,为我国科技期刊,特别是新创办的英文科技期刊提供借鉴和参考。【方法】 结合《生物安全与健康(英文)》(Biosafety and Health,B&H)的办刊实践,归纳新创办的英文科技期刊的办刊背景、提升国际影响力的举措及获得的成效。【结果】 B&H创刊3 年以来,先后被国内外重要数据库,如DOAJ、RCCSE、CSCD、Scopus、CSTPCD等收录,期刊的国际影响力正在快速提升,期刊的开放获取政策、出版质量和规范性达到国际评估机构的认可标准。【结论】 B&H可填补我国生物安全学科领域期刊的空白,通过坚持国际化办刊之路、吸引优质稿源、积极策划专刊出版、多渠道宣传推广等特色举措,使期刊国际影响力得到快速提升,从而助力公共卫生领域的学术交流与传播。     

Rasch Analysis of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales Administered to Patients With Duchenne Muscular Dystrophy

ObjectivesThe objective of this study was to examine the psychometric properties of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0 GCS) in Duchenne muscular dystrophy (DMD), a rare, severely debilitating, and ultimately fatal neuromuscular disease.MethodsPatients with DMD were recruited from 20 centers across 9 countries as part of the Cooperative International Neuromuscular Research Group Duchenne Natural History Study (NCT00468832). The psychometric properties of the PedsQL 4.0 GCS were examined using Rasch analysis.ResultsIn total, 329 patients with DMD (mean age 9 years, range 3–18 years, 75% ambulatory) completed the PedsQL 4.0 GCS. The most difficult instrument items, expressing the greatest loss in health-related quality of life, were those associated with emotional well-being (eg, being teased by other children, feeling sad, and not making friends), as opposed to somatic disability (eg, lifting heavy objects, participating in sports, and running). The mean item and person fit residuals were estimated at 0.301 (SD: 1.385) and −0.255 (1.504), respectively. In total, 87% (20 of 23) of items displayed disordered thresholds, and many exhibited nontrivial dependency. The overall item-trait interaction χ² value was 178 (115 degrees of freedom, P<.001). Our analysis also revealed significant issues with differential item functioning, and by investigating residual principal component loadings, the PedsQL 4.0 GCS total score was found to be multidimensional.ConclusionsThe PedsQL 4.0 GCS records information clinically relevant to patients with DMD, but the total scale score may not be fit for purpose as a measure health-related quality of life in this disease population.     

中国“顶刊热”的冷思考:基于40年研究主题的多层次国际比较研究

【目的】 在全球视野下,从宏观、中观、微观层面分析中国顶刊论文研究主题的特征及趋势。【方法】 基于1980—2020年Nature和Science期刊上的研究型论文,利用对比分析法,从时间维度对我国顶刊论文不同层级的研究主题展开国际比较研究。【结果】 中国顶刊论文学科结构沿着与全球趋同的方向演进;中国顶刊论文覆盖的研究领域较少,一些增长型和衰减型研究领域呈现追随全球的显著趋势;中国顶刊论文研究主题多为追随型,起步晚、时滞长。【结论】 高水平研究的发展,不仅需要科研人员更加注重论文的内在质量,科技期刊也应充分发挥“把关人”作用,机构与国家应健全科研评价体系,为推动我国高水平研究提供良好的发展氛围与制度保障。     

颞下颌关节紊乱病(附278例临床分析)

目的　总结我科自 1996～ 2 0 0 0年诊断的颞下颌关节紊乱病 2 78例 ,选用保守治疗为主的序列综合疗法 ,取得一定的治疗效果。方法　本组 2 78例病人 ,男 135例 ,女 143例。年龄 15～ 55岁 ,平均年龄 2 9 5岁。病史 1～ 10年临床表现为关节弹响 ,关节周围肌群疼痛 ,头痛及下颌运动异常 ,完全符合 1997年全国第二届颞下颌关节紊乱综合征会议制订的诊断标准。根据以保守治疗为主的序列疗法的要求 ,我们选用 4种综合治疗法 ,即激光 +超短波 +超声波 +肌肉封闭 ;上颌咬合板 +理疗 +肌肉封闭 ;关节腔及关节周围药物注射 ;手术治疗。并根据病人主、客观反应分成有效、明显有效、无效 3个疗效判定标准 ,在同一条件下进行客观评价。结果　根据疗效判定标准 ,对 2 78例患者逐人进行评定 ,治疗有效者 112例占 4 0 % ,明显有效者 145例占 52 % ;无效者 2 1例占 8%。以上结果经 4年随访。结论　①咀嚼肌紊乱病是由于关节周围肌群功能不协调造成 ,主要表现是肌肉疼痛 ,治疗就是止痛并消除产生肌肉疼痛的原因。②结构紊乱病是由于髁状突、关节盘、关节窝出现结构关系的异常改变 ,主要是上下颌之间垂直距离过低造成关节盘前移 ,关节盘附着松弛或撕脱。治疗就是要恢复上下颌间的垂直高度 ,增加关节腔间隙 ,减轻髁状突对?     

Role of high tibial osteotomy in medial compartment osteoarthritis of the knee: Indications,surgical technique and outcomes

Knee osteoarthritis (OA) is the most common joint disorder worldwide. In particular, primary knee OA often presents with a varus malalignment. This increases the loads going through the medial compartment resulting in cartilage degeneration and symptomatic arthritis. High tibial osteotomy (HTO) is the workhorse surgical procedure for treating medial knee OA. When performed precisely in the hands of an experienced surgeon, HTO can delay or avoid knee arthroplasty. Of note, outcomes of knee arthroplasty are at best unpredictable in patients of younger age. Hence, there is a growing need for joint preservation procedures for younger patients presenting with knee OA, of which HTO is one. Through this article, the authors of whom all are joint preservation surgeons with a special interest in osteotomy hope to share from their experience as well as the available literature on the indications, perioperative planning, surgical technique, outcomes as well as pearls and pitfalls of HTO.