股骨上端解剖学观测与人工股骨头置换

目的：为选择人工股骨头提供可靠的解剖学数据。方法：对２５０例正常成人股骨上端进行了观测,并对大小转子间距与股骨头最大径作直线相关分析。结果：大小转子间距与股骨头最大径呈正相关（左侧ｒ＝０．４３１,右侧ｒ＝０．４４６,Ｐ〈０．０１）,大小转子间距与头颈长基本等长。结论：用大小转子间距估计股骨头最大径准确、实用、方便。     

部分少见类型腹外疝的超声诊断

[目的]探讨部分少见类型腹外疝的超声诊断价值。[方法]运用彩超检查18例腹白线疝和半月疝并经手术证实患者,确定其发生位置,测量疝口直径及疝块大小。[结果]本组18例病例中,白线疝12例,半月疝5例,1例半月疝误诊为下腹壁脂肪瘤,符合率94.4%。[结论]超声检查对部分少见类型腹外疝的诊断很有价值。     

The normal width of the linea alba in nulliparous women

The function of the linea alba is to maintain the abdominal muscles at a certain proximity to each other. In the case of long‐lasting increased intra‐abdominal pressure, the linea alba widens. Yet, as the existence of the linea a priori implicates a physiological distance between the two rectus muscles, the question arises as to what the normal width of the linea alba is. To evaluate the normal width of the linea alba, we examined 150 nulliparous women between 20 and 45 years of age with a body mass index < 30 kg m^?2 by ultrasound at three reference points: the origin at the xiphoid and 3 cm above and 2 cm below the umbilicus. The examination revealed a broad range of widths at the three reference points. The linea was widest at 3 cm above the umbilicus (?35 mm), followed by the reference point 2 cm below the umbilicus (?31 mm) and the origin at the xiphoid (?31 mm). The mean width was 7 ± 5 mm at the xiphoid and 13 ± 7 mm above and 8 ± 6 mm below the umbilicus. For the definition of the normal width of the linea, the 10th and 90th percentiles were taken. The linea alba can be considered “normal” up to a width of 15 mm at the xiphoid, up to 22 mm at the reference point 3 cm above the umbilicus and up to 16 mm at the reference point 2 cm below the umbilicus in nulliparous women. Clin. Anat. 22:706–711, 2009. © 2009 Wiley‐Liss, Inc.     

Lasso-惩罚计分检验在小样本回归模型自变量筛选与统计推断中的应用

目的 将Lasso-惩罚计分检验应用于小样本数据回归分析中影响因素的筛选与推断.方法 以前列腺癌数据为例,推断影响前列腺特异抗原(prostate-specific antigen,PSA)水平的因素.首先建立PSA及其影响因素的多重对数线性模型,采用Lasso-惩罚计分检验进行统计推断,把有统计学意义的变量纳入最终模型,计算该模型的校正决定系数R2和Cp值,然后与逐步法得到的一般多重回归校正R2和Cp值比较.结果 Lasso-惩罚计分检验得到4个有意义的变量:前列腺癌体积、前列腺重量系数、良性前列腺增生量、精囊入侵;一般多重回归得到前列腺癌体积、前列腺重量系数2个变量.两种方法得到模型的校正R2分别为0.637、0.603,Cp值分别为7.724、12.160.结论 Lasso-惩罚计分检能较好的筛选出重要变量且得到假设检验P值.     

沿骨盆界线放置内固定物的临床解剖学研究

目的:通过对骨盆界线进行解剖学研究,探讨如何才能避免在骨盆骨折和髋臼骨折手术中沿骨盆界线放置内固定物时发生螺钉进入关节、损伤重要血管和神经等严重并发症。方法:在12具骨盆标本的界线上做O,Q,A,B,C,D,E,F,G等标记点,并分为耻骨嵴区、闭孔区、髋臼区、后柱区、坐骨大切迹区和骶骨翼区6区,分别测定每区的长度和高度。结果:耻骨嵴区、闭孔区、髋臼区、后柱区、坐骨大切迹区和骶骨翼区的长度(x±s)分别为:(18.98±0.74)mm,(37.42±1.52)mm,(40.87±1.69)mm,(18.71±0.61)mm,(20.39±1.13)mm,(23.63±1.84)mm;高度分别为:(38.52±1.63)mm,(15.15±0.72)mm,(14.78±0.86)mm,(106.64±4.97)mm,(26.36±1.34)mm,(35.79±1.91)mm。结论:沿骨盆界线放置内固定物时应对骨盆界线进行分区,在各区内使用不同的固定方法。     

Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review

Background

Diastasis of the rectus abdominis muscle (DRAM) is common during and after pregnancy, and has been related to lumbopelvic instability and pelvic floor weakness. Women with DRAM are commonly referred to physiotherapists for conservative management, but little is known about the effectiveness of such strategies.

Objectives

To determine if non-surgical interventions (such as exercise) prevent or reduce DRAM.

Data sources

EMBASE, Medline, CINAHL, PUBMED, AMED and PEDro were searched.

Study selection/eligibility

Studies of all designs that included any non-surgical interventions to manage DRAM during the ante- and postnatal periods were included.

Study appraisal and synthesis methods

Methodological quality was assessed using a modified Downs and Black checklist. Meta-analysis was performed using a fixed effects model to calculate risk ratios (RR) and 95% confidence intervals (CI) where appropriate.

Results

Eight studies totalling 336 women during the ante- and/or postnatal period were included. The study design ranged from case study to randomised controlled trial. All interventions included some form of exercise, mainly targeted abdominal/core strengthening. The available evidence showed that exercise during the antenatal period reduced the presence of DRAM by 35% (RR 0.65, 95% CI 0.46 to 0.92), and suggested that DRAM width may be reduced by exercising during the ante- and postnatal periods.

Limitations

The papers reviewed were of poor quality as there is very little high-quality literature on the subject.

Conclusion and implications

Based on the available evidence and quality of this evidence, non-specific exercise may or may not help to prevent or reduce DRAM during the ante- and postnatal periods.     

The brown forehead ring: A pattern of facial pigmentation

The brown forehead ring (linea fusca), a distinctive but infrequently recognized pattern of facial pigmentation, is described. The history of this sign is recounted. In modern times it seems to be associated with other well recognized patterns of facial pigmentation, chemical photosensitizers and excessive sun exposure. Three cases in adult males are described and the different aetiologies illustrated.     

一根3/0可吸收线会阴切口皮下美容缝合术对产妇康复的影响

目的探讨一根3/0可吸收线会阴切口皮下美容缝合术对产妇产后康复的影响。方法将900例阴道分娩且会阴切开的产妇随机分成观察组和对照组,观察组450例采用3/0可吸收线会阴切口皮下美容缝合,对照组450例采用传统缝合;观察比较两组术后切口疼痛、线结反应、切口愈合情况及术后住院时间。结果观察组产后24h切口疼痛程度显著轻于对照组,线结反应明显小于对照组;切口愈合显著优于对照组,术后住院时间明显短于对照组(P均<0.001)。结论应用皮下美容缝合术,会阴切口疼痛轻、线结反应小、切口愈合好、术后住院时间短且操作简便、不用拆线,值得临床推广应用。