加长柄骨水泥型人工股骨头置换合张力带钢丝治疗老年股骨粗隆间骨折18例

目的：评价加长柄骨水泥型人工股骨头置换合克氏针张力带钢丝治疗老年非稳定型股骨粗隆间骨折患者的疗效。方法：采用这种改良的固定方法对2009年10月-2011年4月收治的18例Evans分型为Ⅳ型伴不同程度骨质疏松的高龄非稳定型股骨粗隆间骨折患者行人工股骨头置换术。结果：随访6～18个月,平均10个月,未出现假体松动、下沉、脱位及假体周围骨折,其中优13例,良3例,尚可1例,差1例,优良率88.9%。结论：这种改良的新型固定方法治疗老年非稳定型股骨粗隆间骨折,符合生物力学原理,固定牢靠、下床早、并发症少、死亡率低,可明显提高患者术后生活质量,只要严格掌握病例选择标准,是一种具有较高临床实用性和推广性的方法。     

吐温80与抗氧剂没食子酸丙酯间相互作用的研究

研究易氧化药物维生素丁在乳状液中的稳定性时,发现乳化剂吐温80与抗氧剂没食子酸丙酯,在不同浓度时产生白浊甚至成油状物析出。本文研究了吐温80与没食子酸丙酯相互作用生成油状物的条件、机制及产生相互作用后对吐温80的表面活性的影响。     

急性颈痛患者局部软组织张力的临床研究

目的:观察急性颈痛患者有明显压痛及无压痛部位的力-位移曲线,探索软组织张力测试诊断颈痛的生物力学指标及其方法。方法:采用自制软组织张力测试系统,观察急性颈痛患者自身压痛点及无压痛点的力-位移曲线,分上颈椎、下颈椎及颈肩背部等三部位,对生物力学指标按照“压痛点”、“无痛点”配对比较。结果:在α=0.05水平,上颈椎压痛点与无痛点的所有指标均无统计学差异,下颈椎压痛点的D0.5Kg显著低于对应无痛点,颈肩背部的压痛点只有斜率显著高于无痛点,其余指标则无显著性差异。结论:局部软组织张力测试能将急性颈痛患者的压痛点与无痛点区分开,但是,应根据具体部位采用敏感生物力学指标左右配对比较。     

针刀松解法对第3腰椎横突综合征局部软组织张力的影响

目的:探讨针刀治疗第3腰椎横突综合征的作用机制。方法:180例第3腰椎横突综合征患者随机分为针刀组和电针组,每组90例。针刀组在第3腰椎横突尖部(即压痛点处)进行针刀治疗,配合腰部过伸过屈手法,每周1次,共3周;电针组取双侧肾俞、腰阳关、阿是穴(局部压痛点)、患侧委中进行电针治疗,每周3次,共3周。采用JZL-Ⅱ软组织张力计测量两组治疗前、治疗后及治疗后6个月随访时第3腰椎横突局部软组织500g压力位移和能量吸收比的变化,采用日本骨科协会(JOA)下腰痛评分表评价两组的临床疗效。结果:针刀组500g压力位移在治疗后和随访时较治疗前升高(均P<0.01),而电针组较治疗前降低(P<0.05,P<0.01);针刀组组织能量吸收比在治疗后和随访时均较治疗前升高(均P<0.01),而电针组治疗后与治疗前比较差异无统计学意义(P>0.05),仅随访时较治疗前升高(P<0.01)。治疗后和随访时两组总体疗效等级分布,针刀组优于电针组(P<0.05,P<0.01)。结论:针刀治疗能显著提高第3腰椎横突局部软组织的500g压力位移和能量吸收比,降低局部软组织的张力,从而改善或减轻疼痛,且临床疗效优于电针。     

The importance of biomechanics and the kinetic chains of human movement in the development and treatment of burn scars – A narrative review with illustrative cases

BackgroundBurn scars are a major clinical sequelae of severe burn wound healing. To effectively establish a successful treatment plan and achieve durable results, understanding the pathophysiology of scar development is of utmost importance.MethodsA narrative review of the principles of the kinematic chain of movement and the hypothesised effect on burn scar development based on properties of burn scars was performed. An examination of the literature supporting these concepts is presented in conjunction with illustrative cases, with a particular focus on the effect of combination treatments that include ablative fractional resurfacing with surgical contracture releases.DiscussionAblative fractional resurfacing combined with the surgical release of contractures are an effective treatment modality for burn scar reconstruction. This treatment approach seems particularly effective because it is one of the only approaches where the principles of functional kinematics can be addressed when tailoring a reconstructive approach to an individual burn patient. The presented cases illustrate the importance of recognising and including the principles of functional kinematic chains in any reconstructive treatment approach for burn scars. Further, epifascial contracture bands are cord like structures which can be found underneath the subcutaneous fat of scar contractures which follow the principles of functional kinematics. Contractures can be more efficiently released if these structures are divided as well.ConclusionAblative fractional resurfacing combined with local tissue re-arrangements is a promising approach to address the underlying forces leading to hypertrophic burn scarring. To achieve an optimal outcome, it is essential to recognise and address the origin of the pathology when treating burn scars. Ablative fractional laser resurfacing allows a different scar approach as it is not limited to one surgical site and thus enables for effective treatment at the cause of the pathology.     

MEBO治疗张力性水泡14例体会

目的 :研究MEBO治疗张力性水泡的疗效。方法 :对 1 4例下肢闭合性骨折引起的张力性水泡进行治疗。以MEBO直接涂于水泡 ,配合应用大剂量抗菌素及脱水药物。结果 :1 4例张力性水泡在 1 0天内全部治愈 ,为及早手术治疗骨折提供了条件。结论 :MEBO治疗张力性水泡 ,方法简单、疗效确切、值得临床推广。