中国组织工程研究杂志
Chinese Journal of Tissue Engineering Research 중국조직공정구여림상강복
- 主管单位: 中华人民共和国卫生部
- 主办单位: 中国康复医学会,《中国组织工程研究与临床康复》杂志社
- 影响因子: 1.38
- 审稿时间: 1-3个月
- 国际刊号: 2095-4344
- 国内刊号: 21-1581/R
- 论文标题 期刊级别 审稿状态
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人发角蛋白植入大鼠损伤脊髓部位的电镜观察
目的:脊髓外伤后的继发性病理改变,是影响脊髓神经组织再生修复的重要因素.采用入发角蛋白(human hair keratin,HHK)植入脊髓损伤(spinal cord injury,SCI)部位,以期达到减轻继发性损害,诱导和促进损伤脊髓组织的再生.方法:采用改制Ⅱ型纽约大学(New York University,NYU)装置,在建立大鼠脊髓损伤模型基础上,将经过特殊处理后能在体内降解的HHK植入大鼠损伤脊髓部位,对植入后1,4,12,26周的损伤脊髓组织进行电镜观察.结果:第1周为急性炎症时期,HHK周围结构紊乱,集聚大量的炎症细胞,灰质出现坏死;第4周时,炎症细胞减少,巨噬细胞吞噬髓鞘,胶质细胞增生;第12周时,多核巨噬细胞出现在HHK周围,HHK开始崩解,崩解物被多核巨细胞所吞噬;第26周时,神经轴突沿HHK间隙排列生长,灰质中神经元数量增加,HHK周边细胞有序生长.结论:植入的人发角蛋白具有诱导神经胶质细胞增生,阻止脊髓空洞的形成,从而减轻了脊髓损伤组织的继发性伤害的程度,改善了神经元再生的外环境,并可以桥接诱导神经轴突定向再生的作用.
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碱性成纤维细胞生长因子促进兔下颌骨骨折愈合
目的:防止下颌骨骨折后骨不连,骨延迟愈合是骨愈合研究中的重要课题,外源性应用重组人碱性成纤维细胞生长因子(recombinant human basicfibroblast growthfactor,rhbFGF)将对兔下颌骨骨折愈合发生哪些影响.方法:在兔下颌骨骨折动物模型中,以牛胶原蛋白I型为载体,外源性应用rhbFGF于骨折局部.分别于术后1,2,4,8,12周时取材,采用ABC(avidin-biotin complex,ABC)方法进行增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)及Ⅷ因子相关抗原(factor Ⅷ related antigen,F8-RA)的免疫组化染色,并测定了骨痂中钙离子的含量及标本的抗力性能.结果:术后1,2周时rhbFGF治疗组骨痂内PCNA阳性细胞比率明显高于对照组(P<0.05),术后1,2,4,8周时rhbFGF治疗组骨痂内血管密度明显高于对照组(P<0.01),术后4周时rhbFGF治疗组骨痂钙离子含量明显高于对照组(P<0.01),术后4,8周时rbbFGF治疗组抗弯曲强度明显高于对照组(P<0.05).结论:rhbFGF在兔下颌骨骨折愈合过程起十分重要的促进作用.
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不同程度腰椎椎管狭窄对脊髓背角神经肽的影响
目的:探讨不同程度的腰椎椎管狭窄时,相应节段脊髓背角中P物质(SP)和血管活性肠多肽(VIP)等神经肽含量和分布的变化特点,以及该变化的临床意义.方法:以家犬建立腰椎椎管狭窄的动物模型.实验分为A组:正常组;B组:对照组;C组:25%狭窄组;D组:50%狭窄组等4组,每组6只.分别检测各组脊髓背角SP、VIP的表达及含量变化.结果:脊髓背角中SP含量25%狭窄组各时相点差异无显著性意义(P>0.05).50%狭窄组各时相点均非常显著升高(P<0.01).脊髓背角中VIP含量25%狭窄组术后1,4周时较正常组、对照组有显著升高(P<0.05).50%狭窄组在各时相点均显著(P<0.05)或非常显著(P<0.01)升高.结论:椎管狭窄造成的马尾神经压迫性损害可引起脊髓背角SP、VIP显著升高;脊髓背角中SP含量的升高随狭窄程度的增加而增加.VIP含量的升高不随狭窄程度的增加而增加.SP、VIP等神经肽类物质在腰椎椎管狭窄引起的下腰部和下肢疼痛的机制中扮演了重要的角色.
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去细胞异体神经材料修复不同长度周围神经缺损
目的:为开发新的神经组织工程材科,研究去细胞异体神经修复周围神经缺损的神经再生效果.方法:采用神经电生理功能学指标和免疫组织化学染色等形态学方法,对1,2和3 cm长度神经缺损修复后的神经再生进行检测.结果:再生神经纤维流畅地通过了不同长度的移植体,各组动物电生理功能均有不同程度的恢复.随移植材料长度的延长神经再生效果减低,3 cm长度缺损在修复后20周再生有髓纤维数为(77±20)根/104μm2.结论:去细胞异体,神经材料能够成功修复3 cm内的周围神经缺损.
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压敏胶片法在记忆生物力学实验中的新应用
目的:寻求记忆生物力学实验的新途径,探讨压敏胶片的生物力学特性及其在记忆生物力学实验中的应用.方法:利用生物力学实验装置,对待测试压敏胶片施加不同压力,得到不同颜色,分析比较颜色的灰度值,找出应力与颜色灰度值之间的关系.结果:对所得20组实验结果进行分析得到应力与颜色灰度值之间的关系,同时采用曲线拟和及小二乘法得出应力与灰度值的对应关系式:yi=83.38816xi2-39244.89748xi+5199277.493.结论:压敏胶片法能够将动态的压力转化成静态的颜色灰度,在记忆生物力学实验中,选择合适的压敏胶片及工作环境,压敏胶片法将不失为一种较为理想的新方法.
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胎脑提取液对坐骨神经损伤大鼠脊髓神经元的保护作用
目的:研究大鼠坐骨神经损伤后,胎脑提取液对脊髓运动神经元酸性磷酸酶(acid phosphatase,ACP)活性的影响.方法:Wistar大鼠54只,随机分为实验组、对照组和正常组,前两组再随机分成术后4个时间组.无菌条件下制作坐骨神经钳夹损伤模型,酶组织化学方法结合显微图像分析,观察各组大鼠脊髓运动神经元ACP活性的变化.结果:ACP反应产物的光密度值正常组为0.28±0.03;对照组术后1 d为0.35±0.05,术后1周为0.40±0.05,术后2周为0.47±0.06,术后3周为0.38±0.04;实验组术后1 d为0.30±0.04,术后1周为0.38±0.04,术后2周为0.34±0.05,术后3周为0.30±0.06.结论:胎脑提取液对坐骨神经损伤后脊髓前角运动神经元具有保护作用.
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脱钙骨基质复合骨水泥修复猪股骨干缺损的生物力学评估
目的:近年来脱钙骨基质复合骨水泥已用于微波诱导高温原位灭活骨肿瘤性骨缺损修复,本实验拟对脱钙骨基质骨水泥复合材料修复猪股骨中段骨缺损的生物力学性能进行研究.方法:将32根猪股骨随机分为4组,分别为正常组、对照组、重建组及内固定组,后3组制成中段骨缺损,将猪脱钙骨基质与骨水泥按1:1质量比均匀混合的复合材料充填骨缺损,其中对照组不重建,内固定组加钢板内固定,对各组分别进行三点弯曲及压缩实验.结果:内固定组与对照组差异有显著性意义,而单纯材料修复组与对照组差异无显著性意义.结论:脱钙骨基质骨水泥复合材料易于塑形,能根据需要适应不同部位骨缺损的要求,但是在骨重建的早期,对骨的生物力学性能影响不大,提示在临床上需行预防性内固定,在康复治疗阶段患者应在免负重支架的保护下活动.
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α-促黑素细胞激素在瘢痕疙瘩中的表达
目的:研究α-促黑紊细胞激素在瘢痕疙瘩中的表达及对其成纤维细胞增殖的影响,为治疗瘢痕疙瘩提供新的途径.方法:取人的瘢痕疙瘩,常规石蜡包埋,同时利用组织块培养法进行成纤维细胞原代培养,DMEM培养液传代、扩增培养,以细胞形态学鉴定成纤维细胞.应用免疫组织化学染色方法检测瘢痕疙瘩组织中α-MSH的表达,并通过MTY法从细胞生长及增殖特性分析不同浓度的α-MSH对人瘢痕疙瘩成纤维细胞生长和增殖的影响.结果:瘢痕疙瘩组织能够表达α-MSH,1×10-6~1×10-8 mmol/L质量分数的α-MSH可明显促进瘢痕疙瘩成纤维细胞生长、增殖.结论:瘢痕疙瘩组织能够表达α-MSH,α-MSH对体外培养的人瘢痕疙瘩成纤维细胞具有促生长和增殖作用,其有效质量分数为1×10-6~1×10-8mmol/L.
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腰椎间盘切除与人工椎间盘对关节突关节内压力的影响
目的:测量腰椎间盘切除及人工椎间盘置换后关节突关节内的压力变化,探讨椎间盘切除及人工椎间盘置换对关节突关节的影响.方法:分别测量L4-5椎间盘切除前、后及SB-ChaitcⅢ型人工椎间盘置换后轴向、后神、侧弯载荷下关节突关节内的压力变化,采用自身对照法进行比较.结果:相同的轴向、后伸、侧弯载荷下,椎间盘切除后关节突关节内的压力变化率明显大于椎间盘切除前与人工椎间盘置换后,差异均有显著性意义(P<0.01),人工椎间盘置换后较椎间盘切除前差异无显著性意义(P>0.05).结论:椎间盘切除后关节突关节内压力变化率的增高提示椎间盘切除后腰椎生物力学的改变可能是关节突关节退行性变的重要原因;人工椎间盘置换可以消除椎间盘切除对关节突关节内压力改变的负面影响,恢复关节突关节内近似正常的压力改变,提示人工椎间盘可以起到正常椎间盘的作用.
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胎兔皮肤创伤消减文库构建与瘢痕愈合基因的初步筛选
目的:许多哺乳动物的胎儿在妊娠期前2/3内皮肤创伤为无瘢痕愈合,其发生机制至今尚不完全清楚.应用抑制性消减杂交获得差异表达的片段并构建消减文库,为差异基因的筛选及可能出现的未知基因的功能研究提供前期铺垫.方法:选择孕20 d的胎兔及孕兔分别在腰部做全层皮肤切口,12h后取材作为胎兔创伤(fetal trauma,FT)、胎兔对照(fetal control,FC)和成兔创伤(adult trauma,AT).提取总RNA,合成dscDNA,经RsaⅠ酶切、Adaptor连接,两次杂交及两次抑制性PCR可获得差异性表达的片段.将扩增产物插入T载体并转染工程菌,培养后挑选阳性克隆.结果:经逐步验证获得61个较为可靠的阳性克隆.结论:设计并应用改良的SSH(2Drivers)替代传统的SSH,经实验证实在理论及实际操作上均可行且合理.消减文库的构建对无瘢痕愈合相关基因及其功能的后续研究提供了可靠的材料.
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不同类型骨组织工程支架材料的比较研究
目的:探讨本实验室所用的3类材料作为骨组织工程支架材料的可行性,、寻找骨组织工程的佳支架材料.方法:采用生物力学检测仪观察材料的强度;利用扫描电镜观察材料的立体结构;取4周龄兔骨髓,体外分离培养骨髓基质细胞,并加入诱导液,使细胞向成骨细胞分化,将细胞与支架材料共培养1、3,5,7 d,通过倒置显微镜及扫描电镜观察细胞在材料表面粘附、伸展及生长情况;将细胞与支架材料复合,并植入腚裸鼠背部皮下,植八4,8周后取材,行组织学检查,观察新骨形成情况.结果:3类材料均具有细胞复合成骨能力,其中珊瑚、珊瑚转化多孔羟基磷灰石(CHA)具有较为良好的物理性状、多孔性、细胞粘附性,及细胞复合成骨能力,作为支架材料更为优越.结论:珊瑚和珊瑚转化多孔羟基磷灰石(CHA)是骨组织工程比较理想的支架材料,与细胞复合为骨的再造及骨缺损修复开辟了新途径.
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兔关节软骨细胞在藻酸盐串珠中培养维持其表型稳定的研究
目的:软骨细胞在单层培养时,多次传代后细胞表型发生改变.将兔关节软骨细胞在藻酸盐串珠中作立体培养,以保持其特有表型.方法:用酶消化法获取兔关节软骨细胞,分别在普通培养瓶中作贴壁的单层培养,并传代;或制成细胞/藻酸盐悬液,再进一步制成串珠,使细胞在具有三维立体结构的串珠中生长、繁殖.细胞涂片、石蜡切片,爱尔新蓝染色,采用倒置显微镜、透射电镜观察;以RT-PCR方法检测软骨细胞中Ⅱ型胶原及凝集聚糖mRNA的表达.结果:单层培养时有较高的细胞增殖率,5代以后渐失去软骨细胞特有的表型.立体培养时细胞分泌的基质大部分位于自身的周围,特有表型可长期保持稳定.3个月后藻酸盐串珠中的软骨细胞仍可测得Ⅱ型胶原和凝集聚糖的表达.结论:软骨细胞在藻酸盐串珠中培养有助于其合成、分泌基质,维持细胞特有表型的稳定.
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正常人皮肤表皮干细胞定位特征对修复皮肤创伤的意义
目的:研究正常人皮肤中表皮干细胞的定位特征,探讨表皮干细胞与烧伤创面愈合的关系.方法:在需手术治疗的患者身上获取正常皮肤组织共24例,用α2、β1整合素和K10角蛋白作为第一抗体标记表皮干细胞,采用ISAB免疫组化方法研究皮肤中的表皮干细胞的表达位置.结果:分化高的K10阳性细胞分布于除表皮基底层以外的所有基底上层包括角质层、透明层、颗粒细胞层和棘细胞层的细胞中,而阴性染色区域则集中于表皮基底层.说明表皮基底层细胞不表达K10角蛋白;而α2、β1整合素阳性细胞位于基底膜上、邻接真皮的基底层,呈波浪状,起伏不平分布,同时在头皮的真皮网状层、毛囊末端底部及汗腺周围也发现有阳性细胞.而阴性染色细胞则位于基底层以上的表皮细胞.结论:表皮基底层、毛囊及汗腺周围中存在的表皮干细胞可能与皮肤创伤的修复有关,不同创面中残存的表皮干细胞可能是创伤修复过程中再上皮化的细胞来源,这提示对残存的表皮干细胞的保护、激活、促进其增殖和分化是研究促进创面愈合的关键,从而可以部分阐明创伤愈合的机制.
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体育健身旅游与抗衰老研究
0 引言从生理学角度看,人体的老化,首先是从四肢、尤其是从腿部开始感觉.这给中老年人带来了沉重负担.然而,理论与实践证明,外界环境可加速或延缓衰老的进程.
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运动员比赛后的心理恢复训练
0 引言运动员在比赛中要承受较大的身体和心理负荷,赛后的心理调整.目前常用按摩、理疗等,这些手段都是对机体各部组织进行的主动和被动的机械性恢复,只能反射性地改善和调节中枢神经系统的机能,而不能主动地对中枢神经系统产生直接影响.
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应用超短波治疗前列腺术后膀胱痉挛性疼痛的研究
目的:探讨超短波治疗前列腺术后膀胱痉挛性疼痛的效果.方法:前列腺增生患者行耻骨上经膀胱前列腺摘除术后频繁发作膀胱痉挛性疼痛者,按随机抽样分为两组,第1组28例接受超短波治疗,第2组25例作为对照,不用任何可能影响下尿路功能的药物.结果:膀胱痉挛每日次数和持续天数,治疗组和对照组分别为:(8.8±3.7)d、(2.7±1.3)d和(5.3±2.8)d、(2.2±0.3)d,两组差异有显著性意义(P<0.001或P<0.05).结论:超短波治疗前列腺术后膀胱痉挛性疼痛作用确切,且具有方便,元痛苦、无不良反应的优势.
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腰腿痛患者腰椎牵引失败的病例分析
目的:尽管许多证据均已说明牵引治疗腰腿痛的有效性及安全性,但临床实施过程中仍有许多导致失败的因素.分析腰腿痛患者进行腰椎牵引无效的原因.方法:对48例诊断为腰椎间盘突出行腰椎牵引无效的患者重新检查体征,修正诊断、重新制定治疗方案,以分析牵引失败的原因.结果:35例患者属于诊断错误(占全部病例的72.9%),其中28例应为臀上皮神经卡压征,占全部病例的58.3%,3例患者为梨状肌综合征,2例患者为第三腰椎横突综合征,1例为棘上韧带损伤,1例为跗管综合征,以上患者经重新选择治疗方案后症状明显好转.其余13例患者属诊断正确,建议行腰椎间盘手术治疗或改变牵引参数,但未能随访.结论:腰椎牵引无效的主要原因在于患者被误诊.腰腿痛的原因较复杂,建议对腰腿痛的患者必须仔细检查体征,不可仅依靠影像学报告.
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多裂肌在脊柱突然失平衡时的肌电表现
目的:研究多裂肌在维持腰椎稳定中的作用.方法:健康志愿者15名,男8名,女7名,平均年龄33.7岁(18~45岁),运用表面电极记录快速上肢前屈、外展、后伸时多裂肌、长肌、腰髂肋肌及三角肌的肌电信号,对各椎旁肌收缩的潜伏期与三角肌收缩的潜伏期之差值作比较.结果:多裂肌在上肢3个运动方向中的潜伏期差值[(-17±11)ms,外展(0±11)ms,后伸(4±16)ms]与长肌[前屈(-2±13)ms,外展(13±14)ms,后伸(22±14)ms],腰髂肋肌[前屈(1±12)ms,外展(12±10)ms,后伸(23±10)ms ]间差异均有显著性意义.结论:椎旁肌群中多裂肌反应快、先起作用,在腰椎稳定中发挥重要作用.
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负压封闭技术治疗下肢慢性大面积溃疡24例机制研究
目的:下肢慢性溃疡采用传统换药方法效果不佳,负压封闭技术(vacuum sealing,VS)治疗下肢慢性大面积溃疡的机制及疗效有待探讨.方法:24例患者接受VS治疗,清创后将Vacuseal材料覆盖在相应大小的创面上,接50~60 kPa的负压,5~7 d后植皮或皮瓣转移.结果:24例患者完全治愈,无一例因使用VS死亡,无全身和局部并发症发生;与传统换药方法比较,在植皮或皮瓣转移的时间、换药次数、总体治疗费用等方面差异均有显著性意义(P<0.01).通过采用局部转移皮瓣关闭5个,植皮关闭19个.结论:VS能防止创面污染,充分引流和刺激创面肉芽组织快速和良好生长.
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心理干预对骨科择期手术患者改善认知减轻焦虑的作用
0 引言骨科择期手术患者心理应激反应较常见[1],严重的常影响手术疗效,有的甚至由于过度的恐惧、焦虑等应激反应而使手术或麻醉无法进行.本文旨在观察心理干预对择期手术患者改善认知,减轻焦虑反应的效果.
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老年人术后认知障碍的分析
0 引言老年人术后常出现中枢神经系统的并发症,表现为精神错乱、焦虑、人格的改变及记忆的受损.这种手术后人格、社交能力及认知能力和技巧的变化即为术后认知功能障碍(POCD).
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儿童大脑半球切除术后脑功能重建
INTRODUCTIONSince 1950, hemispherectomy was used widely for infantile hemiplegia with epilepsy. There are many new advances in the evaluation of hemispherectomy as the use of fMRI (functional magnetic resonance image), PET(positron emission tomograph), EP(evoked potential). Reorga-Nization of brain function were reviewd.
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变异性肉芽肿性血管炎患者非对称性周围神经损害的电生理特征
INTRODUCTIONAllergic granulomatous vaseulitis is a rare kind of systemic vascular disease which belongs to rheumatic vasculitis and invade small artery and vein. This disease was first reported by Racherann and Greene in 1939 and Churg and Strauss clarified the relation between pathology of this disease and clinic in 1951.8 cases were reported by Ma Jiliang in 1994 among which, 6 cases conformed to diagnosis of this disease and 2 cases were diagnosed by biopsy.
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经皮穿刺微球囊压迫技术治疗三叉神经痛62例
BACKGROUND: Generlly, therapeutic effect is unclear of traditional Chinese and western drugs, acupuncture, or injection of alcohol and glycerine on prosoplagia, and recurrence and adverse reactions are common which annoy patients badly. Currently used percutaneous puncture saccule compression is characterized by the higher success rate, and less risks.
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CT定位水针治疗腰椎间盘突出症30例
INTRODUCTIONHydro-acupuncture has a satisfying effect on protrusion of lumbar intervertebral discs under CT localization of protrusion site.
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间隙连接通讯功能对小剂量甲状旁腺激素成骨效应调控的机制
AIM: To investigate mediating and regulatory effects of osteoblastic gap junctional intercelinlar communication(GJIC) on low-dose parathyroid hormones(PTH) -stimulated bone formation activities in vitro. METHODS: Rat calvarial osteoblasts (ROBs) in cultures were divided into three groups according to the different mode of exposure. Group A: vehicle (sodium acetate, SA) -treated group; Group B: 1 × 10-8 mol/L hPTH(1 -34) intermittent exposure group; Group C: 1 × 10-8 mol/L hPTH(1 - 34) + 1 × 10-7mol/L TPA exposure group. 48 h incubation cycles in three groups were repeated for eignt times. GJIC and mineralized bone nodules formation in three groups were detected using Lucifer Yellow (LY) scrape loading dye transfer (SLDT) and mineralized nodule staining together with nodule index, respectively. RESUITS: At various measuring time points of SA × 6 h in group A, PTH × 6 hin group B, PTH×6h+1 hingroupBandPTH×6h+TPA×1 bin group C, LY( + ) cell numbers were 6. 8 ±2.5, 19.5 ±6.5, 14.0 ± 3.6 and 5.7 ± 2.4, respectively. Diffusion and transfer of LY fluorescent probe was much more noticeably discerned in group B than in group A and C( P < 0.01 ) Mineralized bone nodule indices were 45.2 ± 12.5, 88.0 ± 15.3 and 38. 5 ± 17.9 in group A, B and C respectively. Bone formation activity was much better reveaied in group B than in group A and C ( P < 0. 01 ),whereas no statistically significant difference of bone formation activities were found in group A compared with group C( P =0. 465) . CONCLUSION:Mediations aod regulations of the coordinating signals in ostooblastic network via GJIC essentially contribute to PTH-stimulated bone anabolism. However, disruption of GJIC not only hinders ostooblastic intercellular coordination but also frustrates PTH-induced bone formation activities in vitro. Therefore, GJIC may evidently play important roles in regulations on low-dose PTH-induced bone formation.
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鬼针草乳剂膏涂抹法治疗烧伤疼痛72例
BACKGROUND: Traditional emulsion has been used in treatment of burn for hundreds of years and spreaded in cililian. In Compendium of Materia Medica, A Complete Book of External Disease and The Golden Mirror of Medicine we can find the records. But there were no reports found about the effects of emulsion combined with beggarticks.
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手部烧伤治疗后早期系统康复护理及效果评价
INTRODUCTIONHand is the most common site in burn. Early timely and late systemic rehabilitation treatment can avoid or reduce scar.
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辐照猪皮促进Ⅱ度烧伤创面愈合
INTRODUCTIONAs a kind of organic dressing, irradiated hogskin is broadly used to cover burn surface.
关键词: 辐照猪皮 -
梅花针配合拔罐治疗带状疱疹及后遗神经痛33例
BACKGROUND: If the zoster patients were not treated properly or failed to be cured in time, secondary infection or postherpetic neuralgia may appeared. Severe pain might exist for years although the herpes recovered completely.
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持续被动活动对老年膝关节镜术后功能恢复的作用
INTRODUCTIONWith popularit and development of arthroscope technique, it has been broadly ursed in treatment of disease of knee joint. Rehabilitation after arthroscope operation especially after senile arthxoscope operation of knee joint is very important.
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局部阻滞疗法并激光治疗肱骨外上髁炎
BACKGROUND: External epicondylitis of distal humerus is often caused by overwork of wrist which pathological change are hyperemia, edema, exudation and adhesion of local tissue, laceration, calcification, aseptic necrosis of extensor tendon, or local synovitis, burstis.
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四肢骨肿瘤显微外科治疗与功能康复
INTRODUCTIONApplication of microscopy introduced revolutionary changes in surgical field. Accompanied with improved radiotherapy and chemiotherapy, it becomes an important prerequisite of cancer therapy.
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下肢外伤术后康复治疗促肢体功能恢复
BACKGROUND: With the development of medicine, rehabilitation treatment from early stage to later stage tends to systematization and specialization that are very important to function recovery of severe limb injury.
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腰椎管狭窄内固定术后功能锻炼32例报告
BACKGROUND: The aim of internal fixation of lumbar vertebral canal is to restore function early and in maximal degree and postoperative function exercise is an effective method to ensure it.
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重组人表皮生长因子对植皮创面成活的影响
AIM: To investigate the effects of recombinant human epithelium growth factor (rhEGF) applied to skin graft. METHODS: 96 cases between February 2000 and December 2001, were treated. During the operation, After scar removed and skin grafted, the rhEGF was injected under the skin graft. 80 cases without injection of rhEGF were made as contrast. Ten days later, the area of survived skin was measured and the livability of skin was calculated. RESULTS: The skin livability of cases with injection of rhEGF was (90.67 ± 10.02)% and the skin livability of contrast cases was(76. 85 ± 8.35)%. There axisted evident differences between them( P < 0. 01) . CONCLUSION: The rhEGF was an effective method for increasing livability of skin graft.
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术后功能锻炼对膝关节镜下半月板部分切除术后关节功能恢复的作用
INTRODUCTIONIt is well known that semilunar plate is capable of conducting load, absorbing concussion, stablilizing knee joit. Semilunar plate can conduct 40% -60% of load, increase contact area, and reduce pressure endured by cartilage of knee joint.
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髌骨骨折关节镜下闭合复位内固定术后的康复训练
INTRODUCTIONClosed reduction internal fixation under arthroscope is performed from August, 2000 to April, 2001 and advanced domestic and foreign rehabilitation programs are combined to treat fracture of patella comprehensively, satisfying effects are achieved.
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气针加手法治疗急性踝关节扭挫伤90例
BACKGROUND: Air acupuncture therapy is to make use of time and space stimuli of air in acupoint and promote blood circulation to remove blood stasis, relieve swelling and pain through interstitial osmosis and absorption. Manipulation to acute sprain and bruising of ankle joint can achieve anatomic reduction as soon as possible, clear incarceration of synovium, promote circulation of qi and relieve pain and increase blood circulation of affected tissue.
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交感神经型颈椎病及相关疾病的系统康复
INTRODUCTIONThere are many symptoms of sympathetic nerve type of cervical spondylopathy, most of which are subjective symptoms and one of the most common symptom is flustered, chest distress. Disease condition is often prolonged, main symptoms of disturbance of posterior thoracic vertebrae joints are back pain and chest distress. Diagnosis of both diseases are mainly according to clinical manifestation, but some symptoms aren't typical and often missed or misdiagnosed. Some patients with disturbance of posterior thoracic vertebrae don' t present with obvious back pain but chest distress, If complicated with cervical spondylopathy, all symptoms are explained with cervical spondylopathy and disturbance of posterior thoracic vertebrae joints is neglected that will lead to prolongation.
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纳米材料对常见厌氧致病菌低浓度的测定
INTRODUCTIONNanometer technology is a new cross-linked progressing science. It has quickly be applied into biology or pharmacy field generally for its definite antibacterial effect. We have proved in above paper that the maximum antiseptic concentration is 109 Cfu/ml in 33 ordinary strains isolated from 11 genera. In this experiment, we continue to explore the minimal bacteriostasis of nanometer materials. Through reports of maximal bactericidal concentration and minimal bacteriostasis, we can confirm bacteriostasis effect of nanometer materials and do some preparations on clinical application.
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大腿逆行易位皮瓣对儿童腘部烧伤后瘢痕挛缩畸形的修复作用
BACKGROUND: There're many kinds of correction methods to the contraction due to the cicatrix after popliteal burn.
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自热灸疗帖配波姆光治疗多发性肋骨骨折320例
BACKGROUND: Fractures of rib are often caused by blunt injuries such as accident, falling, tumble and contrusion of lung, hematopneumothorax, respiratory failure are complicated at the same time. Active and effective treatment in recovery stage has an important significance to analgesia, healing, improving respiratory state. In middle stage, hydrops existed in thoracic cavity and large amount of fluids might be pumped , but less fluids depend on absorption of body. Auto-warmed soft TDP Jiuliaotie applies a chemowarming device in place of electric energy. Drug-towel will give out heat for over 12 hours when contact with oxygen after disclosed and have TDP effects at the same time. Pome spectra (infrared therapeutic appliance, BPM-V type) is the red light spectrum of visible light with strong piercing ability and mucosal warm solidification.
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单层辐射人羊膜对皮损创面的促愈作用
INTRODUCTIONFresh human amnion used to cover burn wound surface has been reported, but its preparation and store is complicated that make it difficult for clinical application. Clinical application of single-layer radiation-treated human amnion in skin-offering and abrasion wound has achieved a good effect.
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放射性皮肤溃疡中端粒酶逆转录晦表达与癌变及难愈合的机制
AIM: To study the expression of the catalytic subunit of telomerase, telomerase revere transcriptase(TRT) and explore the possible relationship between the TRT and cancer txanaformation or poor healing in radiation-induced chronic human skin ulcer. METHODS: Rabbit antibody to human TRT and SP immunohistochemical method were used to detect TRT expression in 24 cases of formalin-fixed, paraffin-embeded chronic human skin ulcer tissues induced by radiation, 5 cases of normal skin, 2 of burnt skin, and 8 of carcinoma. RESULTS: The TRT was detected positive in 14 of 24 (58.3%) chronic radiation ulcers, of which the stxongly positive was 10 of 24 (41.7%) and the weakly positive 4 of 24 (16. 7% ); in 0 of 5 normal and 0 of 2 burnt skins; and in 8 of 8 (100%) carcinomas. The expression of TRT was observed almost always strongly positive in the cytoplasm and nucleus of squamous epithelial cells of epidermis but negatively in the endoepithelial cells of capillaries and small blood vessels, or weakly in the cytoplasm of smooth myocytes of media and fibroblssts, of dermis. Chronic inflammtory cells, such an plasma cells and lymphocytes also showed weakly positive for TRT. CONCLUSION: The strong TRT expression in the epidermis could be involved in the cancer transformation from chronic radiation ulcer to scuamous carcinoma, whereas the negative or weak TRT expression in the capillaries, small blood vessels and fibroblasts of dermis might be responsible for the poor healing of chronic ulcers induced by radiation, caused by sclerosis of small blood vessels and lack of granulation tissue consisting of capillaries and fibroblasts.
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周围神经损伤后远端效应器的变化
INTRODUCTIONThe peripheral nerve injury can result in loss of neural function and the rehabilitation after injuries is the problem remained to be solved in medicine. The studies of nerve injury should begin with the study of the local depressed site. Then the neuron, axon and effective apparatus should be studied[1, 2]. The function of the nerve mainly depend on the distal effective apparatus, so it is more important to study it. Recently the scholars home and abroad pay more attention to form and dynamics of the cell proliferation of the distal effective apparatus such as motor endplate, sensory corpuscle and muscle. The review about this research is as follows.
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老年性腰椎间盘突出症的诊断及早期康复体会
INTRODUCTIONSenile protrusion of lumbar intervertebral disc has many difference compared with the middle-aged and younger at etiology, pathological change, symptom, sign, image change, diagnosis and treatment, which character is: no traumatic history, long disease course, untypical symptom and sign, many complications, bad body quantity and complicated treatment.
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钙拮抗剂对缺血性脑损伤后Bcl-2和Bax基因表达的作用
AIM: In order to explore whether the member of Bcl-2 gene family, for example, Bcl-2 and Baa, are induced after cerebral ischemia, and whether expression of genes can be modulated by calcium-antagonist. METHODS: The rat cerebraliachemic models were made by Nagasawa and Zea Longa improvement method, by occluding left middle cerebral artery; the expression of Bcl-2 and Baa mRNA were measured by RT-PCR method. RESULTS: After administration of nimodipine, Bcl-2 mRNA was up-regulated in the hippocampus at 6 and 24 h alter ischemia, while Bax mRNA was down-regulated at 6 and 24h after ischemia. CONCLUSION: Calcium-antagonist can up-regulate Bcl-2 mRNA and down-regulate Baa mRNA. Increasing the ratio of Bcl-2 and Bax mRNA may contribute to the anti-apoptic effect of nimodipine.
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人组织工程化肌腱构建的实验研究
AIM: To investigate the technique of tissue engineered tendon with human tenocytes. METHODS: Human tenocytes in vitro, then the tenocytes were mixed with Polyglycolic Acid(PGA) to form cell-polymer constructs and cultured in vitro. After one week, the constructs were surgicallly implanted subcutaneously into athymic mice. Specimens were harvested at 6 weeks for gross, histologic examinations and immuno-histological analysis. RESULTS: The engineered tendon resembled natural tendon grossly in both color and texture. Histologically, most tenocytes and collagen bundles were aligned along the longitudinal axis of engineered tendon. CONCLUSION: Human tenocytes be used as seed cell, engineered tendon can be generated in the nude mice by means of tissue engineering technique.
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椎弓根螺钉系统矫治脊柱侧凸围手术期的康复指导
BACKGROUND: If scoliosis isn't be treated actively, it will lead to serious appearance deformity, decreasing of heart and lung function, cardiac conducting obstruction and even injury of kidney function.
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硬膜外药物滴注并手法还纳治疗腰椎间盘突出症87例
INTRODUCTIONThere are a lot of non-operative managements for prolasped lumbar intervctebral disc. Epidural injection of drugs, manual reduction were used for prolapsed lumbar intervetebral disc (PLID) combining advantages of various non-operative managements and types of PL[D, age and course of disease. We observed the therapeutic effect.
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钉钩棒系统植入复位术后康复训练对其神经功能恢复的影响
BACKGROUND: Implantation and reduction peg-claw-rod system has resolved the reduction problems after fracture of vertebrae, but some rehabilitation measures are necessary to postoperative complications and sequela.
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陈旧性髌骨骨折后功能锻炼促进膝关节功能恢复
RACKGROUND: The main aim for treatment of fracture of patella is to restore contnuity of knee joint extension apparatus and anatomic reduction of knee joint, avoid occurrence of traumatic arthritis. Problems in treatment of old comminuted fracture of patella are the same with fresh fracture that has been agreed on in recenl years. Except serious comminuted fracture of patella can' t be reserved, removal of patella shouldn' t be performed to others. Orthopaedics Hospital of Shenyang city thinks that the ideal method is relax of knee extension apparatus, reduction of fracture, strong internal fixation and early postoperative function exercises.
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推拿手法治疗增生性膝关节炎80例
BACKGROUND: Hyperplastic gonitis belongs to rheumatism involving the bone. According to traditional Chinese Medicine, knee is the government of tendons, where three Yang Channels and three Yin Channels of Foot converged. Liver is capable of storing blood, kidney is capable of nurturing bone, bone is capable of flexing and stretching, storing energy, and spleen controlls muscle and is the origin of blood generation. Deficiency of liver-yin and kidney-yin, deficiency of energy and blood, fatigue of tendon and bone will result in reduced working ability and hence hyperplastic gonitis. Manipulation of massage will remove obstruotion, relieve pain and nurture qi and blood by managing tendon and repairing, activating and removing stasis and dredging qi within channels of liver, stomach, spleen, and kidney.
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皮片移植与运动训练对足底Ⅲ度烧伤的作用
BACKGROUND: To explore the effects of skin flap graft and sports training on desree Ⅲ burn of sole of foot.
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肢体功能锻炼对老年股骨颈骨折功能恢复的促进效应
BACKGROUND: Senile fracture of neck of femur needs a long-term recovery out of hospital even after clinical cure, so clinical nursing and rehabilitation instruction are very important.
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无骨折脱位型颈髓损伤18例分析
BACKGROUND: Traditionaly , operation should not be performed on patients suffered from cervical injury without fracture and dislocation during rehabilitation or patients with complete paralysis. Dang Gengting suggested that although external force resulting cervical injury is slight, fracture and dislocation are rare, spinal damage is severe. So, doctors should consider risk factors of vertebral canal affecting spinal cord. Acute nerve and spinal injury, for example, will progress into chronic spinal disease or nerve root disease if not properly managed. So, once diagnosis was confirmed, traction, mobilization should be carried out to prevent other injury. Treatment protocol should be determined according to type of injury. If object increasing pressure, operation should be done to remove pressure. Additionaly, stability of cervical cord must be ensured.
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陈旧性下颌骨折颌面畸形术后咀嚼功能锻炼
BACKGROUND: The beat therapeutic time is often delayed to old fracture of lower jaw bone because of emergent condition that will lead to deformity of jaw and dysfunction.
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足跟后皮肤损伤修复与术后康复
INTRODUCTIONInjury of posterior skin of heel often causes skin necrosis and when area of soft tissue defect is large or complicated with exposure of Achilles tendon and bone, the repair is very troublesome.
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脑超声扫描仪及生物电反馈对颅脑损伤后持续性植物状态的康复作用
BACKGROUND: Persistent vegetable state(PVS) means a special vegetable state. Brain ultrasonic wave scaning apparatus can improve the activity of enzyme, strenthen the permeability of cellular membrane and stimulate peripheral nerve to expand cerebral blood vessels. It also can add brain emtabolism, increase cerebral blood quantity and benefit the building of collateral circulation.
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先天性髋关节脱位术后康复训练38例体会
BACKGROUND: Postoperative long-tern immobilization ofdislocation of hip joint may lead to degradation of ligament structure, decreasing of intensity and decline of stress ability. Besides tissue proliferation, organization and adhesion in the course of repairing will lead to dysfunction of hip jolt even stiffness. So planned rehabilitation training on hip joint is very necessary.
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异体脱钙骨基质骨粒复合骨水泥骨缺损修复材料结构特征及生物力学性能
AIM: To analyze constructive and biomechanical properties of different quality ratio material impregnated decalcified bone matrix (DBM) with bone cement (BC) . METHODS: The DBM particles and the materials impregnated 0 rmg/g, 300 mg/g and 400 mg/g maas ratio DBM particles with BC were made according to the methods of Urist et al. The compound material constructions were observed by scanning electron microscope and the biomechanical properties were measured by Instron mechanics testing-machine. RESULTS: The DBM particles with irregular gaps existing within interspace were connected with BC by the multipoint mode in the compound material. The ultimate compressive strength were 0 mg/g DBM in (59.3 ±2.2) MPa, 300 mg/g in (27.1 ±1.8) MPa, 400 mg/g in (19.3±1.6) MPa. The ultimate bending strength were 0 mg/g in (54.3±3.7) MPa, 300 mg/g in (18.5±1.1) MPa, 400 mg/g in (13.3±1.4) MPa. CONCLUSION: The materials of DBM impregnated with BC had perfect plastic property with much more irregular gaps existing within interspace. The materials could provide abundant biomechanical support.
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早期放射治疗并手术对瘢痕疙瘩的作用
INTRODUCTIONIn present days, treatment of keliod includes simple operation, radiation, drug therapy, immune therapy, laser therapy and freezing therapy, but their effects aren't satisfying. Operation combined with radiation on keliod has achieved satisfying effect.
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腰椎间盘突出症术后早期康复干预69例疗效分析
BACKGROUND: Though operation skill to lumbar disc protrusion therapy is important, postoperative rehabilitation is also important to patients' functional restoration.
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外源性神经节苷脂对脑损伤的保护作用
AIM: To investigate protection function of ectogenesis ganglioside (GM1)to brain injury of epilepsy rats. METHODS: Inducing rat epilepsy model with sulfo-semicarbazide(7.5mg/kg), dynamically observe nerve growth factor (NGF) expression of epilepsy group and GM1 intervention group in Hippocampus and cerebral cortex nerve cell 24 h, 48 h, 72 h and 7 d after epileptic attack and control group after 72 h with immunohistochemistry method. At same time we observed change of nerve cell shape and structure with electron microscope techniques. RESULTS: Electron microscope showed nerve cell injury of epilepsy rats but injury relieved after GM1 intervention. CONCLUSION: GM1 play some protective function to brain injury of epilepsy rats through induced NGF expression increase.
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颅内血肿微创清除术后肢体功能锻炼指导
BACKGROUND: Instruction of limb function exercises after intracranial hematoma microtraumatic debridement promotes recovery of nerve function of patients with cerebral injury and improves local metabolism.
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末期癌症患儿疼痛管理
Data is clear that many children with cancer at the end of life suffer substantially. Treatment was viewed as successful in only 27% of the patients. Pain in children who are dying of cancer can be complex and challenging to manage. Children and parenta are equal partners with members of the health care team in managing the patient's pain. Prevention and alleviation of pain is a primary goal of care in the child dying of cancer. Children dying of cancer may require aggressive dosing of analgesics. Medications that do not have a dose maximum should be escalated, sometimes rapidly, to achieve adequate pain control or to maintain pain control when tolerance has occurred. The nurse' s role in caring for children who are in pain at the end-of-life includes assessment, identifying expected outcomes, and planning, performing, and evaluating interventions.
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带蒂骨膜瓣移位修复手舟骨骨不连改善患者腕部背伸功能26例
AIM: To explore the clinical result treating the scaphoid bone nonunion with vascularized periosteal flap. METHODS: 26 cases of scaphoid bone nonunion underwent transplantation with the periosteal flap with dorsal carpal branch of anterior interosseous artery. RESULTS: Following up 4 months to 18 months, in the 26 cases of scaphoid bone nonunion, 19 cases appeared excellent (73%), 7 cases appeared good(27% ) . CONCLUSION: The periosteal flap with dorsal carpal branch of anterior interosseous were used in repairing of scaphoid bone nonunion, the effect is food.
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微波凝固术改善慢性鼻炎鼻通气功能的作用
BACKGROUND: The character of chronic hypertrophic rhinitis is localized proliferation and hypertrophy of mucosa and submucosa with longterm blocked nose, headache, dizziness, reduced olfaction that will seriously influence work, study and life. Conservertive therapy by conchae injection is limited. Microwave is a kind of high frequency electromagnetic wave which therapeutic effects are heat effect and nonheat effect.
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肢体高能量火器伤后脑病理生理变化机制
AIM: To study the mechanism of cerebral pathological and pathophysiological changes after extremity gunshot wounds at molecular level. METHODS: M-193, 5.56 mm bullets were used to shoot the most plentiful part of the hind extremities of the dogs. C-fos gene expression in neurons of cerebral tissues of different time intervals after gunshot in the subject and control groups were detected with immunohistochemistry. RESULTS: No C-fos gene expression was detected in the cerebral cortical neurons in the control group. But in the subject group, C-fos expression increased in the cerebral neurons 30 min after injury, reached the peak 6 houre(P<0.05), and began to decrease 10 hours post-injury. CONCLUSION: After extremity gunshot wound C-fos expression in neurons of distal parts is the early response of the body to the injury, which might be caused by Leao' s spreading depression(SD), and correlated to extracellular transduction and cell apoptosis.
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本期继教园地思考题(答题卡参见1期第79页)
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医学相关网址介绍
关键词: 医学 -
背阔肌瓣移植矫治面瘫术后护理方法探讨
0 引言面瘫以面部表情肌群的功能障碍为主要特征,可造成患者表情障碍、面形改变以及一些重要功能的丧失.对于永久性面瘫,利用跨面吻合血管神经的超长蒂背阔肌瓣移植一期治疗可以取得良好的治疗效果[1].术后对患者进行面部运动功能的护理,能够有效促进面部功能的康复.
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自拟方治疗烧伤后创面瘙痒
0 引言深Ⅱ度烧伤及Ⅲ度烧伤患者创面愈合后,局部常有瘙痒的感觉,搔抓后可致创面破溃,形成残余创面,较难愈合,甚至影响患者夜间睡眠,给患者带来较大的痛苦,本文讨论应用中药内服治疗烧伤创面搔痒的疗效.
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血小板衍生生长因子受体-β在瘢痕疙瘩中的表达
目的:当前,生长因子与瘢痕形成的关系已成为整形外科研究的热点,本文探讨了血小板衍生生长因子(Platelet-derived growthfactor,PDGF)在瘢痕疙瘩形成中的作用.方法:收集15例瘢痕疙瘩,瘢痕病程为0.5~2年,并取6例正常人皮肤做为对照,采用免疫组织化学技术检测了两组在PDGF受体-β(PDGFR-β)的表达.结果:15例瘢痕疙瘩皮损的PDGFR-β全部染色阳性,阳性率100%,并且在染色的强度中,(+++) 8例,(++)5例,(+)2例,而6例正常人皮肤对照中仅2例有PDGFR-β的微弱表达,阳性率30%,故PDGFR-β在瘢痕疙瘩中表达的强度和阳性率都明显高于正常对照.统计学检验分析显示两组间差异有显著性(P<0.01).结论:PDGFR-β在瘢痕疙瘩中的表达增强,提示PDGFR-β可能参与了瘢痕疙瘩的形成并起着重要的作用.
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三氧治疗仪在慢性损伤性溃疡创面中的应用
目的:观察三氧治疗仪对慢性损伤性溃疡创面的疗效.方法:选择37例慢性损伤性溃疡创面,利用三氧治疗仪产生的臭氧对其治疗,观测创面愈合时间,并与30例未用该法的同性质创面进行比较.结果:应用三氧治疗仪的创面愈合时间显著少于对照组而创面愈合率显著高于对照组.结论:三氧治疗仪可以促进慢性损伤性溃疡创面的愈合.
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皮肤护理技术在面部烧伤康复初期的应用
目的:将皮肤护理技术应用于面部烧伤康复期,减少皮肤色素沉积,改善皮肤色泽、质地.方法:选取7例面部烧伤、深度Ⅱ度康复期患者,应用汉方醋疗美肤组合及褪黑美白护理组合行面部皮肤护理.结果:所有7例患者面部皮肤晦暗肤质改善,充血减轻,均取得黑白均匀,色素淡化,皮肤色泽红润,外观光泽白嫩亮丽效果,患者满意.结论:皮肤护理技术应用于面部烧伤康复期可以改善皮肤晦暗肤质,减少皮肤色索沉积,改善皮肤色泽、质地.
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炉甘石凝胶制剂的止痒作用
0 引言目前临床上使用的炉甘石洗剂具有消炎、收敛、止痒等功效,它是一种混悬剂,具有较好的止痒作用[1].炉甘-石洗剂的不足之处在于不易保持混悬状态,且涂用时有砂砾感,储存时易结块,不易再分散.水性凝胶制剂是目前烧伤创面使用较多的一种制剂,具有较好的水溶性和保湿性,使用方便,易于清洗.本研究用海藻酸钠作为助悬剂,制成炉甘石止痒凝胶.
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褪黑素在临床中的应用
0 引言褪黑索(melatonin,MT)化学名为N-乙酰-5-甲氧基色胺,主要由松果体分泌,具有广泛的生理和药理活性.它能维持昼夜节律、改善睡眠,具有镇静镇痛作用;可增强人体免疫功能,抑制肿瘤细胞生长,具有调节神经系统、内分泌系统、生殖系统和免疫系统的作用.有关MT的临床研究和应用已有文献报道,本文就近年来这一领域的研究进展作一综述.
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综合疗法治疗腰椎间盘突出症560例特点探讨
0 引言腰椎间盘突出症采用非手术治疗有良好的疗效,其方法较多,各有优缺点,如何选用相适应的治疗方法综合辨证施治、扬长避短、提高疗效、缩短疗程是本文所探讨的主要目的.
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腰椎间盘突出症及胶原酶溶盘术
0 引言自从证实腰椎间盘突出症是引起腰腿痛的重要原因以来,众多医学家对本病的诊断与治疗进行了深入广泛的研究,积累了极为丰富的基础科学知识和临床经验,形成了公认为行之有效的保守疗法、外科手术疗法及近20年迅速发展起来的介入疗法.
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推拿诊治疲劳综合征
0 引言大样本调查结果表明,人群中有疲劳症状的占24%,其中症状持续3个月以上者占4%,符合疲劳综合征的占0.2%[1].实践证明推拿疗法对本病有良好疗效,但治疗中需注意所施手法的辨证加减.
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腰椎间盘突出症术后严重腰痛的心理康复
0 引言1993-05/2002-05本科经手术治疗腰椎间盘突出症950例,术后发生椎间隙感染致严重腰痛6例.由于严重不堪忍受腰痛的恐惧、折磨,常使患者有绝望的心理,甚至对抗治疗.
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应用运动疗法预防和治疗低位腰痛
0 引言诊断各种类型低位腰痛的方法很多,在详细分析脊椎解剖结构,结构复:杂性、组成部分及其功能的基础上,现已知腰痛可以由多种因素引起,例如:日益增加的久坐的生活方式,成年人体力活动减少,现代生活的便利,体重超重或肥胖引起脊柱负担过重,不良姿势习惯,工作过程中身体机械受力不良或车祸与外伤等[1].
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骨盆牵引治疗腰椎间盘突出症影响疗效的因素分析
0 引言腰椎间盘突出症大多数经非手术疗法能够改善和缓解症状,需要手术的病例不超过10%,且手术失败率高达15%~53%[1].骨盆牵引是一种操作简单,疗效确实的治疗方法,但作者从实际工作中发现患者的性别、年龄、体位、病程、首发或复发、病变部位、病变性质等因素有关.
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点穴治疗腰椎管狭窄症
0 引言虽然Verbist[1]于1954年即提出腰椎管狭窄症这一概念,但由于椎管造影在当时尚不能普遍开展,从而影响了对本病诊断和治疗.近年来,随着影像学的发展和普及,本病的诊断越来越简便而准确.因此在临床工作中被诊断为腰椎管狭窄症的患者日渐增多,但是对于腰椎管狭窄症的非手术治疗的报道却极少见.
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经络点穴治疗颈椎病100例
0 引言颈椎病又称颈椎综合征,导致出现颈臂痛、头晕、心悸等相应的临床症状,极大影响着患者的工作学习和生活,根据"通则不痛、痛则不通"的治疗原则,采取经络点穴法,对颈椎病的康复起到一定的促进作用.
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电刺激小脑顶核治疗椎动脉型颈椎病
目的:观察电刺激小脑顶核治疗椎动脉型颈椎病临床效果.方法:前瞻性随机对照研究,观察比较脑循环治疗仪电刺激小脑顶核与其他物理因子治疗椎动脉型颈椎病的临床治疗效果.结果:脑循环治疗组38例,显效28例,有效9例,头晕加重1例,显效率74%,总有效率97%,常规治疗组36例,显效17例,有效11例,无效8例,显效率47%,总有效率74%.结论:脑循环治疗能显著改善椎动脉型颈椎病患者头晕等症状.
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三维快速牵引配合骶管注射治疗腰椎间盘突出症69例
0 引言腰椎间盘突出症一般以非手术治疗为多.本文通过分组对比观察疗效,发现采用三维快速牵引、骶管注射及超短波联合治疗的方法,在提高疗效,缩短治疗时间,预防复发等方面都有较明显的优势.
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腰椎间盘突出症术后复发及腰椎不稳的预防
0 引言腰椎间盘突出症术后并发症较多,有椎间隙感染,脑脊液漏,神经根损伤,术后复发,腰椎不稳等.术后并发症中复发与腰椎不稳同手术方式的选择有着密切的联系.本文就此二者的关系作一粗略阐诉,并提出预防方法.(排除因诊断和手术失误所致首次失败者).
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三维CT评价颈椎间盘退变对神经、血管和脊髓的影响
目的:探讨三维CT(3DCT)诊断颈椎病的价值.方法:采用3DCT技术检查了临床诊断为颈椎病的300例患者.结果:21.3%的患者有颈椎椎体骨质增生,42.3%的钩突关节和16.2%的小关节突有骨质增生,另外有12个小关节突有错位改变.在145例神经根型颈椎病患者中,发现狭窄的椎间孔438个.其中,C6-7和C5-6椎间孔狭窄占81.3%.椎动脉型颈椎病表现为骨赘压迫椎动脉(22.0%)和椎动脉变细或粗细不均(65.9%),12.1%的患者未见异常.脊髓型颈椎病3DCT表现有颈椎管狭窄、椎体后缘骨质增生、后纵韧带钙化、椎间隙狭窄和颈椎间盘突出等.结论:3DCT能全面评价颈椎间盘退变和颈椎骨质增生对神经、血管和脊髓的影响,是一种诊断颈椎病的实用影像学检查方法.
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脊髓型颈椎病45例临床特点及病因分析
0 引言脊髓型颈椎病早期临床表现隐匿,不易引起患者重视,常被临床医生忽视,容易漏诊.为提高临床诊断率,更全面了解脊髓型颈椎病的特点,对近期收住45例脊髓型颈椎病患者的病因及临床特点加以分析.
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练功十八法治疗肩周炎的疗效评定
0 引言肩关节周围炎简称"肩周炎",又称为"五十肩"、"冻结肩",中医称为"漏肩风",因正气不足,属"痹阻",是肩关节周围软组织的无菌性炎症,多由慢性劳损,气血不足复感风寒湿邪所致,虽有自愈可能,但疼痛症状持续半年以上,而关节活动范围需要更长时间恢复.本文总结练功十八法治疗肩周炎的方法和疗效.
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瞬间三维牵引治疗腰椎间盘突出症126例
0 引言腰椎间盘突出症的非手术疗法颇多,三维、快速腰椎牵引适应人体脊柱的解剖特点、符合中医整复原理,且具有牵引时间短、患者痛苦少等特点,临床治疗效果确实.
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背根神经节钠通道与疼痛
慢性疼痛是周围神经、组织损伤或炎性刺激所诱导的周围神经性病变的一种主要症状.近一些研究表明背根神经节(dorsal root ganglion,DRG)钠通道表达及位置的改变与某些病理性疼痛有关,钠通道基因表达的可塑性及电生理的改变导致DRG细胞呈高兴奋性、产生自发动作电位及异常高频电活性,DRG钠通道在疼痛的病理生理中起做重要的作用.通过选择性地影响伤害性神经元产生动作电位及阻滞特异性钠通道可缓解神经性及炎性疼痛,有希望成为疼痛治疗的又一新领域.
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穴位注射等治疗增殖性骨关节疼痛60例
0 引言增殖性骨关节病特点是关节长期持续疼痛活动不便,77%以上为脊椎退行性的病变,临床突出表现为病变部位的疼痛及放射性疼痛、麻木为主,故治疗以"通"、"消"着手,所谓"通"即淤滞,"通则不痛",所谓"消"即消组织,从形态学上改变病理.采用穴位注射加经络诊疗探讨其缓解骨关节痛的疗效.
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颈部硬膜外腔注药治疗颈性眩晕症313例
0 引言有些患颈椎病的患者常有以眩晕症状为主的一组临床表现,其多见于交感型及椎动脉型颈椎病.交感型颈椎病常表现为植物神经功能紊乱,出现头晕、耳鸣、心悸、视力模糊等许多症状.椎动脉型颈椎病由于椎动脉受压或刺激,也出现眩晕症状.本院自1985年开始用颈部硬膜外腔注药治疗此类患者,观察总结疗效及安全性.
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关于完善疼痛定义的探讨
20世纪的疼痛定义:"疼痛是一种与组织损伤或潜在组织损伤相关的不愉快的主观感觉和情感体验".极大的推动了疼痛的基础研究和临床医学的发展,进入21世纪由于疼痛医学发展迅速,该定义对疼痛的诊断和治疗,尤其是对疼痛的测量,就显得无能为力,不能全面的解释疼痛发生的前因和后果.难以对疼痛研究起指导性作用.疼痛是由伤害性刺激诱发的"痛知觉"和"痛反应".且"痛反应"对疼痛的测量、诊断、治疗和预后可起到决定性作用,是疼痛定义不可缺少的重要的一部分.完善后的疼痛定义:疼痛是一种与组织损伤或潜在组织损伤相关的不愉快的主观感觉和情感体验,以及保护性或病理性反应.
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腰椎间盘突出症的家庭治疗
0 引言腰椎间盘突出症应坚持防治并重,前期治疗与后期功能锻炼并重的治疗原则.早诊断、早正确治疗很重要,除巨大中央型突出有马尾神经受压症状者应急症手术外,一般采用卧床休息、牵引、理疗、药物等综合疗法,70%的患者可获得痊愈或症状明显好转,经严格保守治疗半年无效者,可考虑手术治疗.治疗和康复长达半年的时间,患者不可能都在医院度过,在家中如何治疗呢? 这是本文要阐明的重点.
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经侧隐窝注射胶原酶治疗腰椎间盘突出症
0 引言腰椎间盘突出症是腰腿痛常见及重要的原因,严重影响患者的劳动力和生活质量.普通的腰椎间盘胶原酶溶解术的穿刺进路较长,准确性不高,医生与患者暴露在X线下时间长,宋文阁侧隐窝穿刺技术[1]较好地解决了这一问题,为经一步提高穿刺准确性,作者操作中又作了一些改进.
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硬膜外腔注射治疗颈椎病68例
0 引言颈椎病是长期慢性劳损或外伤导致.患者髓核逐渐失去了弹性,萎缩,纤维环膨出、破裂,上、下椎体骨赘增生压迫刺激神经根和周围软组织充血水肿,产生无菌性炎症所致,临床表现颈肩部疼痛、僵硬,或上肢疼痛伴麻木感,迫使患者需止痛治疗.本文将探讨采用颈部硬膜外腔注射药物治疗颈椎病的疗效[1].
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物理因子治疗颈椎病122例疗效对比观察
0 引言颈椎病主要是颈椎椎间盘的退变,椎体退行性改变,骨质增生骨刺形成,继发性椎管狭窄等刺激和压迫邻近血管神经及相关软组织引起多种症状和体征的一组病症.除有手术指征外,治疗宜以非手术疗法为主,尤以热治疗、自主动态间隙牵引、药物离子导入综合治疗为有效.
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腰椎间盘突出症行椎间盘镜手术后的康复训练
目的:探讨腰椎间盘突出症行后路显微椎间盘镜手术后康复训练的方法及其意义.方法:1999-02/2002.-02采用椎间盘镜治疗腰椎间盘突出症患者434例,男248例,女186例;年龄14~82岁.康复训练方法为:仰卧直腿抬高训练,仰卧下肢骑车训练,仰卧腰肌训练和俯卧腰肌训练等.通过术前讲解、术后指导、示范及辅助训练,使患者尽可能的完成本套康复训练计划.结果:全组共手术491个椎间隙.术后无椎间隙感染及死亡.随访387例,随访时间平均27个月,按Nakai疗效评定标准分级,优191例;良154例;可26例;差16例.结论:本套术后康复训练计划简单易行,有助于椎间盘镜治疗腰椎间盘突出症术后患者的恢复,较为实用.
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肩关节术后的功能康复训练
0 引言目前,肩关节术后一般都采取外固定,一至数月后组织就发生了粘连,关节囊、韧带、肌肉、肌腱发生了挛缩,骨愈合后往往产生了严重的关节障碍,严重影响了患者的生活质量[1].为探索肩关节术后的功能康复问题,收集肩关节术后或外伤的患者进行早期(2周开始)康复训练,探讨其疗效.
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三维正脊仪治疗腰椎间盘突出症2500例
0 引言腰椎间盘突出以往非手术治疗以推拿、针灸配合慢牵引等综合疗法为主,短期效果尚可,但治疗时间长,持续疗效不甚理想,同时如果两个以上椎间盘突出伴脊柱生理弧度改变较重时,治疗较棘手.为此运用三维正脊仪治疗腰椎间盘突出症探讨疗效.
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腰背肌锻炼对预防腰椎间盘突出症复发的意义
0 引言非手术治疗是治疗腰椎间盘突出症常用的方法,效果满意,但对治疗后复发问题研究甚少.本文旨在探讨腰背肌功能锻炼对预防保守治疗腰椎间盘突出症再次复发的价值.
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后路椎间盘镜治疗腰椎间盘突出症
目的:探讨后路椎间盘镜治疗腰椎间盘突出症的有效性.方法:经椎板间隙入路,通过特制的工作通道在内窥镜系统辅助下,实施开窗减压,摘除突出髓核,探查神经根管.结果:完成手术50例,获得随访38例.其中优21例,良13例,优良率达89.5%.结论:后路椎间盘镜髓核摘除术具有手术创伤小、减压彻底、术后恢复快并保持了腰椎生物力学稳定性等特点,是治疗腰椎间盘突出症的有效方法.
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神经肌电图检查对糖尿病周围神经病变的诊断价值
目的:探讨电生理检查对糖尿病周围神经病变的早期诊断价值.方法:运用肌电诱发电位仪检测200例糖尿病患者四肢运动神经传导速度(MCV),感觉神经传导速度(SCV).结果:临床诊断为糖尿病周围神经病为127例.经肌电图检查增至184例,确诊率由63.5%上升到92.0%;存无症状的73例中经肌电诊断异常为57例,异常率为78.1%.结论:神经肌电图检查是糖尿病周围神经病早期诊断一种有价值的检查手段,可为糖尿病周围神经病临床疗效评估及治疗方案拟定提供重要依据.
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根型"坐骨神经痛"的电生理检测
目的:探讨根型"坐骨神经痛"的电生理特点及肌电图诊断"坐骨神经痛"所致神经根压迫的可靠性.方法:检测一侧或双侧肢体的拇短屈肌、胫前肌、股四头肌内侧头、腓肠肌及椎旁肌肌电图,及胫后神经SCV、SNAP、CMAP.结果:50例根型"坐骨神经痛"患者肌电图上表现为受损神经根所支配肌肉的神经源性损害,而SCV、SNAP正常,CMAP潜伏期正常,波幅下降或正常.结论:神经电生理检查对根型"坐骨神经痛"具有重要意义,如肌电图上出现肯定异常的肌电位,则有肯定的诊断价值,但阴性的肌电图不能排除诊断.
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脑出血后白细胞增高与趋化功能和神经功能的关系
目的:探究急性脑出血后白细胞计数增高与趋化功能的相关性及其变化与预后的关系.方法:通过对117例中白细胞增高者50例(A组)与不增高者67例(B组)脑出血患者进行白细胞计数及中性粒细胞趋化指数、血清趋化因子活性测定,研究组与对照组治疗前或治疗后神经缺损分和预后的比较,了解两组患者白细胞计数与趋化功能和预后的差异.结果:A组白细胞计数和趋化指数均显著高于B组,A组治疗无效率和恶化率也显著高于后者(P<0.01).结论:脑出血后白细胞计数增高者粒细胞趋化功能增高,其导致的神经功能损害较重,预后较白细胞不增高者为差.
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综合康复治疗持续性植物状态5例
0 引言持续性植物状态(Persistent Vegetative Srate,PVS)患者多数由于脑的重要结构或弥散性损害所致,神经功能恢复困难[1].目前由于心肺复苏技术日臻完善,使许多重症患者得到了救治,但由于意识不能恢复,从而使PVS的发病率呈逐年上升的趋势,因此寻求有效的PVS治疗手段显得尤为迫切和重要.
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手术时机对重型颅脑伤并四肢骨折患者运动及生活能力的影响
目的:探讨骨折手术时机对重型颅脑伤并四肢长骨骨折患者运动及日常生活活动能力(ADL)的影响.方法:对120例重型颅脑伤昏迷患者不同时机手术治疗四肢长骨骨折进行分析.结果:急诊手术组(组1)肢体功能恢复正常占86.7%,伤后7~10 d内手术组(组2)肢体恢复正常占86.0%,伤后14~45 d内手术组(组3)肢体恢复正常占65.8%,组1、组2与组3比较均差异有显著性意义(P<0.05);组1与组2两组肢体运动功能、ADL能力方面均显著改善,两组比较差异无显著性意义,但组1与组2两组肢体运动功能、ADL能力改善方面均极显著优于组3(P<0.001).结论:重型颅脑伤并四肢长骨骨折患者手术治疗骨折的时机宜根据创伤的具体情况来选择,在生命体征基本稳定的情况下尽早(伤后7~10 d)手术治疗四肢长骨骨折.
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综合康复治疗对脑外伤后认知障碍的恢复作用
0 引言脑外伤患者多数病情重,卧床时间长,如不及时行早期康复及合理的药物治疗常产生不同程度的继发性功能障碍,因此综合康复治疗是脑外伤恢复过程中不可缺少的重要组成部分.
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高压氧治疗脑外伤并发上消化道出血机制及预防的探讨
目的:探讨重型闭合性颅脑损伤高压氧治疗(HBOT)中并发上消化道出血的原因和预防措施.方法:统计12侧重型闭合性颅脑损伤患者的格拉斯哥昏迷量表(GCS)评分;分析HBOT中并发上消化道出血的原因及治疗;再次HBOT的时机、疗程、格拉斯哥预后量表(GOS)评分.结果:HBOT中并发上消化道出血与GCS评分有关,评分低者出血多、出血量大;HBOT配合使用H2受体拮抗剂可预防出血的发生.结论:HBOT重型颅脑损伤中应使用H2受体拮抗剂,HBOT应掌握时机、制定患者适应的治疗方案.
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急性颅脑外伤后伤情判断及影响预后转归临床研究因素
目的:综合利用临床及某些生化指标对脑外伤患者的伤情及预后作出判断,并在方法学上予以初步探讨.方法:采用多因素Logistic回归分析方法对112例急性闭合性脑外伤患者的各项有关资料进行分析.结果:临床指标结合生化指标可以提高预测脑外伤患者预后及判断伤情的能力,具有较高的灵敏度和特异度,建立了多因素Logistic回归分析模型.结论:采用多因素分析方法,综合利用临床及某些生化指标可以提高预测脑外伤患者预后的准确性.
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脑死亡的无效治疗与经济及医学伦理学问题
0 引言1996-01/2002-01本科共收治特重型颅脑损伤78例,其中诊断为脑死亡18例,占特重型颅脑损伤患者的23%.18例脑死亡者共花费人民币约90万元.
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高压混合氧治疗颅脑损伤性精神障碍226例
0 引言颅脑损伤伴发的精神障碍是指大脑直接或间接遭受各种外伤而造成脑组织损伤后所致的精神活动失调.可以在轻度外伤后立即出现,但大部分重度外伤患者是在昏迷清醒后的恢复过程中出现,目前尚无较为理想的治疗方法.本文采用高压混合氧治疗,观察其疗效.
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关节镜治疗膝关节纤维性强直术后功能恢复体会
目的:通过对22例膝关节纤维性强直患者术后随访,评价关节镜下松解治疗膝关节纤维性强直的远期疗效.方法:采用膝关节镜常规前内、前外两处入路,经钝性分离、松解清除关节腔内粘连组织,术后3 d应用CPM功能锻炼,治疗膝关节纤维性强直患者22例,随访7~18(平均11.6)个月.结果:关节活动度由术前(40±16)°,增加到(93±25)°,平均改善53°(P<0.01).而且住院时间短,恢复快,并发症少.结论:膝关节纤维性强直的关节镜下松解术创伤小,效果好.
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皮牵引下"甩肩疗法"促进肱骨外科颈骨折功能恢复43例
0 引言肱骨外科颈骨折是接近肩关节附近的骨折,以老年患者居多,其治疗方法以往多采用手法复位后单纯夹板固定肩关节或手术治疗,直至骨折愈合.预后常产生凝肩.采用皮牵引下"甩肩疗法"治疗观察功能恢复的疗效.
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关节腔内注射透明质酸钠治疗退行性膝关节炎
0 引言对于早期退行性膝关节炎的有效治疗方法较少.关节腔内注射透明质酸钠是近年来治疗退行性膝关节炎的常用方法[1],追踪随访120例该类患者,分析其对影响疗效的相关因素.
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减张张力带内固定髌骨下极粉碎性骨折术后康复干预12例
0 引言髌骨骨折传统的钢丝环扎法固定不牢,术后需长期外固定,容易导致膝关节僵凝.近10余年来广泛应用张力带内固定,固定牢,甚至对粉碎性骨折也可取得较好疗效.但对于髌骨下极粉碎性骨折、薄壳样骨折难以有效固定,有时仍需行髌骨部分切除而影响膝关节功能[1-2].本文设计减张张力带内固定探讨其作用.
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膝关节镜术后注射透明质酸钠对关节功能恢复的探讨
目的:通过临床随机对照研究探讨膝关节镜术后关节腔内注射透明质酸钠治疗的效果.方法:对关节镜手术118例于手术结束时在关节腔内注射透明质酸钠2 ml,术后第4天抽出关节积液,再注入透明质酸钠2ml;1次/周,连续4次为1个疗程,根据病情注射一二个疗程.观察患者关节疼痛(休息痛及运动痛)、肿胀、压痛、活动度及行走情况6个项目综合评分.与同期手术未用药的58例进行比较.结果:用药组术后疼痛程度、关节肿胀、压痛、活动度评分均低于未用药组.结论:透明质酸钠在膝关节镜手术后关节腔内注射是一种行之有效的关节保护剂和生物止痛剂,有助于关节功能恢复.
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全髋关节置换术后康复治疗17例
0 引言全髋关节置换术后常易发生髋、膝关节僵硬,深静脉血栓形成,以及原有疾病加重,甚至导致死亡.本院采用朱维继等…手术方式.应用术前教育、预防性使用抗生素、术后使用抗凝药物及采用各种措施进行康复治疗并对患者进行了随访.
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老年人全膝关节置换术后镇痛与早期功能锻炼
0 引言老年患者全膝关节置换术后早期功能锻炼对患者功能恢复至关重要,硬膜外镇痛利于此锻炼.为了观察术后硬膜外镇痛的效果,本组选择老年患者全膝关节置换术后硬膜外镇痛并应用线性视觉模拟评分法(VAS)评价镇痛效果.
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股骨骨折术后膝关节僵硬的原因
0 引言股骨骨折术后引起的膝关节僵硬以股骨中段以远的损伤,对膝关节动力结构的损害大,从而影响股骨骨折的远期治疗效果.本文探讨股骨骨折术后引起膝关节僵硬的原因.
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腕部骨折愈合后功能障碍的康复治疗
0 引言腕部骨折愈合去除外固定后,腕关节会出现不同程度的僵硬、肌萎缩、肿胀、疼痛等.采用以腕部关节松动术、关节功能牵引、肌力训练为主配合物理疗法观察疗效.
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膝关节及其附近骨折分阶段康复治疗184例
0 引言由于膝关节及其附近骨折,因创伤,血肿机化等原因.很容易引起股四头肌粘连,膝关节僵硬、强直,造成膝关节活动受限、障碍等并发症.为了防止此并发症的发生,对此类骨折,应采用早期积极的康复治疗措施.
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外固定支架治疗胫腓骨干骨折术后早期康复训练
0 引言探讨胫腓骨干骨折外固定支架固定术后早期康复训练的方法,根据患者的骨折类型,软组织损伤情况和其他合并伤的病情制定康复训练计划,在医务人员正确指导下,发挥患者的主观能动性,按计划进行早期主动,短时多次,循序渐进的下肢康复训练,以大限度恢复患肢功能,减少并发症的发生.
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股骨远端骨折术后康复治疗
目的:探讨股骨远端骨折手术后的康复治疗方法.方法:回顾分析1999-01/2001-06股骨远端骨折患者68例的临床资料.通过手术治疗达到了良好的复位和稳妥的固定,术后从康复评价、康复计划、康复治疗和再评价方面着手,有效利用持续被动运动(CPM)机,科学合理地进行康复治疗.结果:68例71侧骨折,经术后4~38个月随访,骨折均获愈合,愈合时间2~16个月,平均4.5个月.按Kolmert评价标准,优44侧,良15侧,优良率83.1%.结论:对于股骨远端骨折,精湛的手术技术只有与科学的康复治疗相结合,才能大限度的恢复患肢功能.
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髋臼骨折伴同侧膝关节韧带损伤的术后康复
0 引言髋臼骨折和膝关节各种韧带损伤常导致髋、膝关节活动受限.本文在改进手术方法的基础上,配合早期康复训练,观察其损伤后6~8周内关节活动度的改善情况.
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肱骨近端骨折患者术后早期康复治疗31例
0 引言肩关节活动受限,是肱骨近端骨折常见的并发症,在骨折解剖复位,坚强固定的基础上,早期给予积极有效的康复治疗,能大程度的恢复肩关节功能.
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"功能康复链"在全臂丛根性撕脱伤手术过程中的实施探讨
目的:介绍一种治疗全臂丛神经根性撕脱伤的新术式及其全程康复治疗.方法:收集全臂丛神经根性撕脱伤患者13例,分行一期膈神经移位修复肩胛上神经和对侧股薄肌移植手术,以恢复肩外展功能和重建屈肘与伸拇、伸指功能;部分患者二期行同侧股薄肌移植重建患肢屈拇、屈指功能.注意在术前、术中和术后进行综合性康复治疗.结果:随访时间超过1年的8例患者,在术后3~5个月,出现移植肌肉神经再生电位;12月屈肘60°~90°、肌力M4,伸拇、伸指肌力M3~M4,3例行肩胛上神经修复者,肩外展30°~45°.2例二期手术后六七个月,移植肌肉有随意收缩;12个月屈拇、屈指肌力M3~M4,但手部感觉尚未恢复.结论:早期股薄肌皮瓣移植联合神经移位修复全臂丛神经根性撕脱伤,已显示初步的疗效.应注重患者的术前、术中、术后的全程康复治疗.
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高压氧治疗断肢(指)再植术后微循环障碍33例
0 引言断肢(指)再植术后,由于各种原因引起的微循环障碍,可严重影响其成活.为提高再植肢(指)的成活率,近6年来本院采用高压氧(hyperbaric oxygen,HB0)配合治疗断肢(指)再植术后微循环障碍33例36个肢(指)体.
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士兵训练所致手外伤心理康复
0 引言基层部队经常性的军事训练使青年士兵的手外伤时有发生.在于外伤治疗过程中,如果忽视青年士兵的心理康复问题,势必造成患者的康复期延长,致残率增加,影响部队战斗力.本院自1997-05/2001-04对收治的因各种军事训练导致的手外伤士兵先后采用间卷法、观察法、谈话法分别对其进行了分析.
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盐酸米多君治疗高位脊髓损伤后体位性低血压31例分析
目的:研究盐酸米多君治疗体位性低血压的疗效和不良反应.方法:对55例高位脊髓损伤患者进行临床斜立试验,根据斜立试验结果筛选出有体位性低血压症状的31例患者,给予口服盐酸米多君3次/d,2周后对其中24例患者再次进行临床斜立试验.结果:治疗后症状改善率87.5%,治疗前后斜立时间差异有显著性意义,4例患者因不良反应退出试验.结论:根据本临床研究,初步认为盐酸米多君对脊髓损伤患者具有提高直立位血压和脑血流速度,改善患者的体位性低血压症状的作用,但需注意服药剂量的个体化及副作用,长期疗效需进一步观察.
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我国器官移植现状(15)
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两院院士投票选出十大科技进展新闻(14)
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关于"颈椎病"的病名(12)
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骨髓干细胞修复受损心肌(13)
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骨形成蛋白载体材料研究进展
对于骨形成蛋白(bone morphogeneticprotein,BMP)性的三载体材料的研究很多,主要包括无机性的、合成的多聚物、天然多聚物和三者的复合物4种,但各有不足之处,许多学者不断对其加以改进,并采用复合技术、理化方法等改善载体的性能,更有利于发挥BMP的诱骨活性.这对于进一步扩展BMP的临床应用范围,确保其安全性问题至关重要.
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表皮干细胞的定向分化:隆突激活假说的新认识
0 引言自1990年孙司天等提出毛囊干细胞定位于毛囊的隆突部--立毛肌的附着点处,即隆突激活假说,为表皮干细胞的研究奠定了坚实的理论基础.
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组织工程化皮肤重建皮肤功能的研究进展
随着组织工程学的兴起和发展,组织工程化皮肤的研究有可能成为解决这一难题的有效途径.自从Rheinwald和Green成功建立表皮细胞培养方法以来,表皮培养的技术方法有了很大改进;胶原海绵、无细胞异体或异种真皮基质等真皮替代物的研究使复合皮的建立成为可能;干细胞的研究、基因转染在皮肤组织工程学中的应用将使组织工程化皮肤的研究更加成熟;组织工程化皮肤的生产和应用,使其成为第一个商品化的、也时目前成功应用的组织工程化产品,并且可能成为皮肤缺损后愈合时间短、愈合后效果好、瘢痕轻的创面愈合方法,以达到皮肤结构和功能的恢复.
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骨髓基质细胞诱导为雪旺细胞修复周围神经缺损
骨髓基质细胞(bone marrow stroma cell8,BMSCs)是来源于骨髓基质的一种间充质细胞,来源丰富,可以解决雪旺细胞来源不足的缺点.骨髓基质细胞在体外诱导为神经细胞,诱导后进行培养.用特异性抗体检测细胞内蛋白.(1)利用新方法制作组织工程化的神经,为临床解决失神经肌肉的不可逆萎缩提供新的思路.(2)利用细胞诱导的方法,为组织工程化神经的临床应用提供研究基础.
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智能假手控制研究
0 引言假手的发展与不断完善,为残肢患者带来福音.其经历了装饰假手、机械假手、肌电假手几个阶段.目前广泛使用的肌电假手,改善了残肢者的生活自理能力,使用也方便,但其大的缺陷,一是控制准确性问题,再是握物时无法有针对性地调整握力与速度.
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循证医学的发展与临床医学
循证医学正越来越深刻地影响着临床医学实践.在临床医疗实践中,充分应用循证医学的原则与方法,可为临床、科研、卫生决策、医学教育等提供佳证据,并应用佳证据指导临床决策.通过循证医学的概念、物理结构(Cochrane协作网)、主要期刊;进一步论述了循证医学与临床医学的相互关系及其应用于临床的重要指导意义,强调了单凭推理或病理生理学理论来指导临床行为有时是不可靠的.并通过具体实例说明了循证医学在临床实践中所起的重要作用.
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Cochrane系统评价的基本方法
Cochrane系统评价是Cochrane协作网成员在Cochrane协作网统一工作手册的指导下所作的系统评价,是循证医学的临床实践指南,通过收集、汇总和评价原始临床研究结果,得出有关干预措施的综合结论,为临床实践和卫生决策提供真实、可靠的证据.与传统综述不同,他采用了科学、明确、可重复的研究方法以减少偏倚因素的影响.了解Cochrane系统评价的基本方法,对进行Cochrane系统评价的研究人员有所帮助.
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Cochrane图书馆检索方法
循证医学实践的基本过程就是结合临床经验与好证据对患者进行处理.这个过程包括提出问题、检索证据、评价证据、结合临床经验与好证据对患者作出处理、效果评价5个步骤.进行临床循证实践的重要步骤之一是寻找佳证据.Cochrane图书馆是获取高质量证据的重要来源之一,通过光盘和因特网均可对Cochrane Library进行检索.介绍Cochrane图书馆的内容,Cochrane图书馆光盘检索方法及Cochrane图书馆因特网检索方法,并举例说明.
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循证医学的定义、发展、基础及实践
循证医学是结合医生的个人专业技能和临床经验,考虑患者的愿望,对患者作出医疗决策而发展起来的新兴临床学科.高质量的证据是指尽可能保证结果真实性的、以患者为中心的临床研究数据.证据及其质量是循证医学的关键.研究人员应该尽量提供高质量的证据,临床医生应尽可能使用现有的佳证据.循证医学在进行诊断和治疗决策时,考虑患者的愿望,从而体现以患者为中心的医疗服务宗旨.高素质的临床医生、佳的研究证据、临床流行病学的基本方法和知识及患者的参与是循证医学的基础.循证医学实践包括提出问题,检索证据,评价证据,结合临床经验与好证据对患者进行处理和效果评价5个步骤.
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Meta-分析中的统计学过程
从应用的角度出发,介绍Meta-分析的目的、意义、主要统计内容、两种统计模型、统计指标.后引入了一个实例用Revman4.1软件处理,并对该分析结果进行了临床意义的解释.着重于Meta-分析的思路介绍,回避了统计学的数学公式,有助于临床医生对Meta-分析的认识和理解.
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循证医学的基本概念
1. 病例对照研究(Case-control study):一种研究设计.观察经历某一事件(通常为不良事件)的一组个体与未经历同样事件的另一组个体,让他回顾是否曾暴露于可疑(通常为有害的)因素,并分析其暴露的差异.这种类型研究对确定罕见事件的原因较有用,例如,罕见的癌症.
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Cochrane图书馆的主要内容介绍
Cochrane协作网是以已故的英国著名流行病学家和内科医生Archie Cochrane(1909/1988)的姓氏命名,在英国合法注册的一个非赢利性国际学术团体.Cochrane协作网的宗旨是制作、保存和传播有关卫生保健措施的系统评价,为确保系统评价的质量,协作网成立了由临床流行病学家、生物医学统计学家和医学编辑专家组成的8个方法学工作组,制作了系统评价手册"Cochrane Handbook"和相关软件,1996年Cochrane图书馆(Cochrane Library,CL)以光盘形式正式发行.
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康复医学的循证治疗决策
循证治疗决策是指根据患者的具体情况,康复医生利用自己的临床经验、专业知识,结合当前好的研究证据,再考虑患者的愿望,制定出适宜的治疗方案,将有效、安全、经济的治疗措施用于自己的患者.循证治疗决策分为4个步骤:提出临床治疗问题并转化成可以回答的问题;找出恰当的相关临床研究文献;评价研究结果的真实性及临床和统计学意义;结合患者的其体情况,考虑患者的需求,将研究结果用于自己的患者.
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第42届国际脊髓学会学术年会征文及会议通知
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中国老年学学会骨质疏松委员会2003年度两会通知