基于模拟体验系统的VAD教学法在关节镜手术教学中的应用评价

目的 探索基于模拟体验系统的VAD教学法在关节镜手术模拟教学中的应用效果。方法 选取2021年4—5月在陕西省人民医院参加住院医师规范化培训的120名学员,按照随机对照原则分为试验组(n=60)与对照组(n=60)。试验组接受基于模拟体验系统的VAD教学法,对照组接受单纯VAD教学法;培训周期均为4周。培训结束后对所有学员完成关节镜下各项操作的效率进行评估。结果 两组学员在年龄、性别、优势手、专业及既往有无关节镜操作史方面的差异无统计学意义(P>0.05);试验组完成膝关节镜下标准化诊断操作的评分为(63.0±4.4),显著高于对照组的(38.0±5.2)分,差异具有统计学意义(P<0.05);试验组完成膝关节镜下游离体取出和套环操作的评分为(23.0±3.8),也显著高于对照组的(14.0±4.5),差异具有统计学意义(P<0.05);在最终的DASS评分方面,试验组的得分为(86.0±5.2),高于对照组的(48.0±5.8)分,差异具有统计学意义(P<0.05)。结论 模拟体验系统与VAD相结合的教学方法可有效提高住培学员的关节镜操作技能,提升住培学员对关...     

Clinical Effects of Acupuncture after Surgical Operation in Patients with Prolapse of the Lumbar Intervertebral Disc

Objective;To investigate the clinical effects of acupuncture after surgical operation in patients wim prolapse of the lumbar intervertebral disc(PLID).Methods;Sixty-nine patients in this series,who had undergone the removal of nucleus pulposus and the intervertebral fusion as well,were randomly divided into a treatment group of 35 cases and a control group of 34 cases.The former was treated by acupuncture and conventional rehabilitation therapy,and the latter only by the rehabilitation therapy.The therapeutic effects were evaluated according to the scoring system stipulated by Japanese Orthopedics Association(JOA).Results;In the treatment group,the average functional recovery rates in 3-month,6-month and one-year periods were respectively 49.93 ,90.3 1%and 95.08%;while the rates were repesctively 26.24%,63.42%and 71.36%in the control group,showing statistically significant difference between the two groups(P＜0.05).Conclusions;Acupuncture can confirmatively promote the functional recovery for patients with prolapse of the lumbar intervertebral disc after surgical removal of nucleus pulposus and with intervertebral fusion.     

葛根素对骨髓基质干细胞氧化损伤的保护作用

目的 观察葛根索对氧化应激后骨髓基质干细胞(BMSCs)损伤的影响.方法 应用密度梯度离心联合贴壁筛选的方法 ,体外分离培养兔骨髓来源的BMSCs进行实验.氧化应激由过氧化氢(100 μmol/L)诱导产生.应用不同浓度葛根素对过氧化氢诱导前的BMSCs预处理.通过噻唑蓝法观察葛根素对氧化后BMSCs增殖活性的影响.通过对碱性磷酸酶活性检测,观察葛根素对氧化后BMSCs早期成骨分化能力的影响.应用2',7'-二氯荧光黄双乙酸盐检测活性氧含量反映细胞内氧化应激水平.应用流式细胞仪检测细胞凋亡情况.结果 体外成功分离培养原代兔BMSCs.葛根素能够保护氧化应激导致的BMSCs损伤,提高细胞增殖能力,增强细胞碱性磷酸酶活性,降低细胞内活性氧含量,抑制细胞凋亡,具有浓度依赖性.结论 葛根素通过抗氧化作用,抑制细胞凋亡,发挥对BMSCs氧化损伤的保护.     

大鼠丘脑中央下核GABA纤维终末与腹外侧眶皮质投射神经元的突触联系

目的:观察大鼠丘脑中央下核(Sm)GABA纤维终末与腹外侧眶皮质(VLO)投射神经元的突触联系。方法:18只大鼠麻醉后固定于脑立体定位仪上,于VLO微量注射辣根过氧化物酶(HRP),48h后,应用包埋前HRP组化和GABA免疫组化双重标记电镜技术观察大鼠SmGABA纤维终末与VLO投射神经元的突触联系。结果:光镜下Sm内有大量GABA纤维终末及少数阳性神经元,电镜下可见GABA纤维终末与HRP标记的阳性神经元胞体及树突间构建了对称性和(或)非对称性突触。结论:形态学上证实了Sm内GABA纤维终末与VLO投射神经元胞体及树突发生突触联系。     

AF椎弓根固定技术治疗骨质疏松伴胸腰椎骨折脱位疗效分析

目的探讨AF椎弓根固定技术治疗骨质疏松伴胸腰椎骨折脱位效果。方法回顾分析29例患者术前术后临床及影像学资料和随访结果,测量矢状指数、椎体压缩高度、后凸畸形Cobb角,评估植骨融合的远期治疗效果。结果术后随访3-48个月,骨折复位满意,椎体高度矢状径指数从伤前的41%恢复到术后的92%,未发生螺钉断裂或脱出现象。22例二次术后18个月取出内固定后随访12-36个月,椎体高度矢状径指数为91%,X线片未见后凸加重或变形,未出现再次塌陷。结论骨质疏松伴胸腰椎骨折脱位应采用综合治疗,有效的椎弓根复位固定技术、撬拨复位恢复椎体高度及充足可靠的植骨融合技术是保持良好疗效的关键。     

股骨近端髓内钉与动力髋螺钉治疗老年不稳定股骨粗隆间骨折分析

目的:比较股骨近端髓内钉(PFN)与动力髋螺钉(DHS)两种内固定方法治疗老年不稳定股骨粗隆间骨折的疗效。方法:67例不稳定股骨粗隆间骨折老年患者中,PFN组36例,DHS组31例,对术中指标(切口长度、术中出血量、手术时间)及术后指标(术后引流量、骨折愈合时间、髋关节功能评分)进行比较。结果:67例患者平均随访18个月。在术中指标中,PFN切口长度较DHS短且术中失血量较DHS少,差异有统计学意义。PFN组优良率(91.67%)高于DHS组优良率(83.87%),差异有统计学意义。其余指标在两组间比较无统计学意义。结论:对于老年不稳定股骨粗隆间骨折的治疗,PFN和DHS两种术式均行之有效。与DHS相比,PFN手术损伤较小,更适于骨科医师选择。     

骨组织神经在激素性股骨头坏死中作用的探讨

糖皮质激素诱发股骨头坏死的机制目前有多种,但其发病确切机制仍存在争议,从而使得其预防性的治疗措施无法实施.与此同时,越来越多的实验和临床研究揭示了正常的骨代谢需要骨组织中感觉神经和交感神经的参与.故作者认为骨组织神经的损伤和(或)改变在激素诱发的股骨头坏死发病中起到作用,并就此进行探讨.     

超声引导下穿刺减压联合体外冲击波疗法治疗肩袖钙化性肌腱炎短期疗效观察

目的:探讨超声引导下穿刺减压联合体外冲击波疗法(ESWT)治疗肩袖钙化性肌腱炎(RCCT)的短期疗效.方法:选择RCCT患者57例(60个患肩),随机分为试验组(30个患肩)和对照组(30个患肩).试验组采用超声引导下穿刺减压联合ESWT治疗.对照组行超声引导下穿刺减压治疗.比较两组患者短期临床疗效,治疗前后肩关节视觉...     

In vitro and in vivo effects of puerarin on promotion of osteoblast bone formation

Objective:To assess the effect of puerarin,a natural flavonoid found in Chinese Pueraria Lobata (Wild.) Ohwi,on promotion of new bone formation.Methods:Osteoblasts isolated from calvarial of newborn rats were cultured in vitro in the presence of puerarin at various concentrations.The viability of osteoblasts and alkaline phosphotase activity and mineral node formation were determined.In addition,osteoblasts seeded in theβ-tricaclium phosphate scalfolds as bone substitute were implanted in rat dorsal muscles.Half of the recipient rats received intramuscular injection of puerarin at 10 mg/(kg·d) for 7 days.Osteogenesis was analyzed by examining the histology after 4 weeks of implantation.Results:The viability of osteoblasts treated with puerarin at either 40 or 80μmol/L was significantly higher than that of the control(P<0.05 and P<0.01, respectively).Alkaline phosphatase and mineral modules were significantly increased in osteoblasts cultured with puerarin at 40 or 80 mol/L when compared with that of the untreated cells.The puerarin-treated rats had a higher rate of bone formation in the osteoblast implants than the control rats(6.35%vs.1.32%,respectively, P<0.05).Conclusion:Puerarin was able to affect osteoblast proliferation and differentiation,and promote the new bone formation in osteoblast implants.