CPM在髌骨骨折张力带内固定术后的应用

目的 探讨CPM在髌骨骨折改良张力带内固定术后的应用效果。方法 早期应用CPM治疗髌骨骨折行改良张力带内固定术后病人156例。结果 所有病例均得到随访，临床疗效优良率为98％。结论 在髌骨骨折行改良张力带内固定术后早期应用CMP，可显著利于膝关节功能恢复，提高治愈率。     

Effect of female sex hormone supplementation and withdrawal on gastrointestinal and colonic transit in postmenopausal women

Females are disproportionately affected by constipation, which is often aggravated during pregnancy. Bowel function also changes during the luteal phase of the menstrual cycle. The aim was to compare the effects of acute administration of female sex steroids on gastric emptying, small bowel transit and colonic transit in healthy postmenopausal subjects. A second aim was to determine whether withdrawal of the hormones was associated with a change in transit. Forty-nine postmenopausal females were randomized to receive for 7 days 400 mg day(-1) micronized progesterone, 0.2 mg day(-1) oestradiol, combination of the two, or placebo. Treatment groups were balanced on age. Participants underwent whole gut transit measurement by scintigraphy using a 99m-labeled technetium-egg meal and 111-labeled indium-charcoal via a delayed-release capsule. Transit measurement was repeated after withdrawal of the study medications. The primary endpoints were ascending colon (AC) emptying half-life time (t1/2) and colonic geometric centre (GC) at 24 h. Secondary analysis variables were GC at 4 and 48 h, gastric emptying t1/2 and colonic filling at 6 h. There was a significant overall effect of progesterone on colonic transit with shorter AC emptying t1/2 and significantly greater colonic GC at 48 h. No transit endpoints were altered by oestradiol or combined hormonal treatment relative to placebo. Oestradiol and progesterone resulted in looser stool consistency. Withdrawal of the hormone supplement was not associated with significant alteration in transit. Micronized progesterone does not retard colonic transit in postmenopausal females.     

定量组织速度成像对右室起搏患者左室收缩运动的研究

目的　应用定量组织速度成像 (QTVI)评价右室心尖起搏 (RVAP)VVI型对左心收缩功能的影响。方法　应用GEVivid 7彩色多普勒超声显像仪对 2 0例RVAP患者和 2 0例正常人的心尖四腔切面的室间隔和左室外侧壁速度和位移曲线进行观察 ,测量心电图Q波分别至室间隔和左室外侧壁收缩期峰速度的时间 ,并除以R R间期进行校正。结果　QTVI显示右室起搏器置入者的室间隔与左室外侧壁速度曲线的收缩期S波非同步出现。Q波至室间隔收缩期峰速度的时间短于Q波至左室外侧壁收缩期峰速度的时间 ,两者分别为 ( 0 .12± 0 .0 2 )s和 ( 0 .14± 0 .0 2 )s,P <0 .0 5。结论　右室起搏后早期的左室整体收缩功能虽未见明显下降 ,但QTVI可以发现室间隔与左室壁收缩明显的不协调 ,可作为早期分析左室收缩运动的定量方法。     

99TCm-RBC显像在下消化道出血诊断中的应用

目的　研究 99TCm-RBC显像诊断下消化道出血的临床价值。方法　对 2 5例下消化道出血患者行 99TCm-RBC显像 ,并与手术及病理检查结果作比较。结果　99TCm-RBC显像诊断下消化道出血阳性率为 80 .0 %,定位诊断率为 68.0 %,特异性为 85 .0 %。结论99TCm-RBC显像可作为下消化道出血诊断及定位的一种有效方法。     

The Relationship Between Daily Life Stress and Gastrointestinal Symptoms in Women with Irritable Bowel Syndrome

Research on irritable bowel syndrome (IBS), a functional disorder of the gastrointestinal (GI) system, has linked GI symptoms to stress. This study examined the relationship between daily stress and GI symptoms across women and within woman in IBS patients (n = 26), IBS nonpatients (IBS-NP; n = 23), and controls (n = 26), controlling for menstrual cycle phase. Women (ages 20–45) completed daily health diaries for two cycles in which they monitored daily GI symptoms and stress levels. The Life Event Survey (LES) was used as a retrospective measure of self-reported stress. The across-women analyses showed higher mean GI symptoms and stress in the IBS and IBS-NP groups relative to controls but no group differences in LES scores. The within-woman analyses found a significant and positive relationship between daily stress and daily symptoms in both the IBS-NP and the IBS groups. Controlling for menstrual cycle had no substantial impact on the results.     

Measurement of upper extremity orientation by video stereometry system

In the attempt to gain a broader understanding of the causal relationships behind work-related symptoms of pain in the human shoulder, monitoring of arm position is crucial. Different methods have been used with varying accuracy. A video-based stereometry system, using infra-red light and reflecting markers for motion analysis, has been introduced for measurements in the fields of ergonomics, biomechanics and sports medicine. The purpose of this study is to investigate the sources of error in using this system for posture registration of the upper limb. Measurements are performed on a calibration fixture, on a mechanical model of the upper limb and on a subject with an exoskeleton. Particular, attention is given to inconsistencies and relative errors due to the finite geometrical precision with which the markers are positioned in the calibration fixture and on the studied objects, the limited capability to align the objects relative to the coordinate system of the calibration fixture and the errors connected to angular measurements using protractors etc. It is concluded that the system makes a valuable addition to existing instruments for non-contact posture measurement, and produces position data with an adequate accuracy in normal handling.     

The biomechanics of vibration and low back pain

This work is a review of the mechanical factors related to low back pain production in a vibration environment. The sitting posture is an extreme orientation for the lumbar intervertebral disc that 1) increases its internal pressure, 2) increases its anteroposterior shear flexibility, while: 3) decreasing its resistance to buckling instability and 4) stressing the posterior region of the disc. Vibration is an additional mechanical stressor. Several studies suggest that the following preventive measures be taken to reduce the risk of low back pain due to driving: 1) minimize the vibration reaching the driver, 2) avoid lifting or bending immediately following driving, and 3) walk around for a few minutes following driving. © 1993 Wiley-Liss, Inc.     

屈膝过程中的胫股运动特性分析

本文采用三维位移测量方法，测试１０例离体人膝标本的胫股关节三维运动特性。发现屈膝过程中，胫股运动也具有典型的三维运动特点。其中在屈膝初期的３０°内，胫骨内旋最明显并伴有胫骨内翻现象，平均内旋８°，内翻６－７ｍｍ，膝关节完全伸直时胫股扣锁使膝关节稳定，屈曲时胫股“解锁”使膝关节松弛，具重要的临床意义，同时提示，在解释传统的胫股扣锁现象时不应遗漏伴随发生的胫骨内／外翻现象。     

单开门颈椎管扩大椎板成形术对颈椎运动的影响

目的：研究单开门颈椎管扩大椎板成形术对颈椎运动功能的影响及相关因素。方法：对52例因脊髓型颈椎病接受单开门颈椎管扩大椎板成形术患者进行回顾性研究，平均随访37．5个月，在颈椎过屈、过伸侧位X线片上比较手术前后颈椎总的运动范围(总活动度)、各椎体间活动度。结果：术后3年颈椎总活动度、总屈曲及总仰伸角度均减小(P≤0．001)，与术前相比平均下降15％，其中42例伴有颈部僵硬、疼痛等症状。颈椎总活动度的改变与神经功能的改善无相关性。各椎体间的屈伸运动范围从C2至C6均明显减小，而C6／7却稍有增加；椎体间滑移在C3／4、C4／5两个节段明显减少(P≤0．05)。结论：单开门颈椎管扩大椎板成形术可以使颈椎总活动度和各椎体间活动度均减少并伴有颈部僵硬和疼痛。术后短期围领制动并早期主动伸、屈颈部的锻炼可能有助于减少颈部僵硬和疼痛的发生。     

内镜下应用保护性套管取上消化道异物

食管、胃异物经内镜取出是目前认可的方法 ,成功率约90 % [1 ] 。但是对部分异物特别是细长锐利性异物取出时 ,易有出血、穿孔合并症 ,且极易伤及食道及咽喉部黏膜 ,甚至出现黏膜撕裂、剥脱及引起嵌顿等严重并发症。大连医科大学第二临床学院消化内科 1 995年 1月～ 2 0 0 3年 5月应用食管保护性套管成功取出食管及胃细长锐利性异物 6 9例 ,无 1例异物造成继发性食管黏膜损伤发生。现报告如下。1　材料和方法1 .1　一般资料①本组 6 9例患者。男 4 2例 ,女 2 7例 ;年龄 2 2岁～ 92岁。误服异物史 :30min～ 7d。②异物种类 :缝被针、铁钉、铁…