吴中亮;王通;程飚;付小兵;李校堃
目的:观察颅脑损伤老年患者骨钙丢失情况,为预防此类患者继发骨质疏松提供依据.方法:分析同一时期住院,一般情况相近的颅脑损伤老年患者的血清碱性磷酸酶 (AKP)、尿钙 (Ca)、尿羟脯氨酸 (Hyp), 尿肌酐 (Cr)等与骨吸收和骨形成有关的生化指标的检测值,并与健康老年人的检测值对比.结果:颅脑损伤老年患者的血清 AKP、尿 Hyp/Cr、尿 Ca/Cr平均值高于健康老年人的检测值.提示颅脑损伤老年患者骨吸收率高于健康老年人.结论:颅脑损伤老年患者可能存在较健康老年人更严重的骨钙丢失情况.
作者:崔军阳 刊期: 2003年第06期
目的:神经干细胞的发现为神经系统退行性疾病的治疗,提供了新的方法.通过碱性成纤维细胞生长因子( basic fibroblast growth factor,bFGF)反应性神经干细胞的移植 ,探讨神经干细胞在帕金森病 (Parkinson'disease,PD)治疗中的作用.方法:体外用 bFGF作为丝裂原培养 E16大鼠中脑神经干细胞,经 BrdU标记后植入 PD大鼠纹状体,了解 PD大鼠旋转行为的改善情况.结果:神经干细胞移植组 PD大鼠旋转行为改善明显.结论: bFGF反应神经干细胞移植对 PD有明显的治疗作用.
作者:阴金波;周政;杨辉;张可成;宋业纯 刊期: 2003年第06期
目的 :观察培养生长于羊膜的角膜缘干细胞移植治疗完全性角膜缘缺陷的效果.方法 :建立兔完全性角膜缘缺陷模型, 7 d后分别给予羊膜移植、自体角膜缘移植、体外培养的角膜缘干细胞移植,比较观察 3组治疗后的临床表现.结果 :羊膜移植组有明显的新生血管和上皮缺损,角膜浑浊.而自体角膜缘移植和体外培养的角膜缘干细胞羊膜移植组术后角膜上皮光滑完整,无上皮缺损和新生血管新成.结论 :自体角膜缘干细胞体外培养羊膜移植是治疗完全性角膜缘缺陷的有效方法,可恢复角膜缘屏障功能.
作者:马世红;李丽 刊期: 2003年第06期
0 引言 手术作为一种应激源严重地影响着择期手术患者的心理变化.面临手术,患者会产生不同程度的焦虑、恐惧等不良情绪反应,进而影响患者的术后康复.为了探讨骨科择期手术患者围手术期的焦虑情绪变化,以便采取适当心理干预措施,促进术后康复.
作者:何志晶;汤盛钦;吴其常 刊期: 2003年第06期
AIM: To study the expression of SMAD3 and SMAD7 of transforming growth factor-β 1 ( TGF-β 1) on keloid- derived fibroblasts. METHODS: The expression of SMAD3 (at 1,2,4,24,48 h)and SMAD7(at 0.5 1,1.5, 2,4,24 h) were detected by using methods of Western blot after 500 pmol/L TGF-β 1 were added to the monolayer culture system.RESULTS: The level of SMAD3 were down regulated at 24 h and the SMAD7 were maximum up regulated at 4 h when TGF-β 1 were used.CONCLUSION: TGF-β 1 may down regulate the expression of SMAD3,but up regulate that of SMAD7 .
作者:杨力;李荟元;郭树忠;韩岩;汤苏阳;张琳西;舒茂国;潘宝华 刊期: 2003年第06期
INTRODUCTIONSlippage of lumbar vertebrae is a second common disease afterprotrusion of intervertebral discs. Although some patients werecured by conservstive therapy, surgical treatment is needed in somecases[1] . From March 1994 to March 2001, we used steal plateinternal fixation to treat 18 cases of slippage and the effect wasobvious. The following is the report.
作者:陈建明;肖茂明;王元山;周全;陈雪松 刊期: 2003年第06期
目的:探讨节段性脊髓运动诱发电位在脊髓病变中的应用价值.方法: 42例经脊髓造影、 MR或 CT及经手术确诊的脊髓病变患者,采用国产 CCS-Ⅰ型大脑皮层电刺激仪对脊髓采取分段经皮单个超强电刺激,同时应用日产 Neuropack- 7102k型诱发电位仪记录相关电位.结果: 42例脊髓病患者 41例可记录到脊髓中枢传导时间 (center motor conductive time, CMCT)、体感诱发电位( somatosensory evoked potentials,SEP)、运动神经传导速度( motor conduction velocity, MCV)在不同节段病变的特异性表现.结论:经皮电刺激节段性脊髓运动诱发电位对脊髓病变的定位诊断有较肯定价值,可以作为筛选脊髓病的一个重要手段.
作者:梁宪光;齐尚书;刘恒方 刊期: 2003年第06期
目的:比较 3种抗病毒药物治疗带状疱疹瘙痒症的经济效果和安全性.方法:选择 120例带状疱疹患者,用 3种不同的药物治疗,分别为 A组无环鸟苷组 ,B组泛昔洛韦组 ,C组利巴韦林组疗程 15 d,应用药物经济学成本-效果分析方法进行评价.结果: A、 B、 C 3种方案的总成本分别为 48 900.8元、 30 719.2元、 28 837.6元,痊愈率分别为 32.5%, 22.5% ,15% 有效率分别为 97.5%, 82.5%, 72.5%.结论: B方案痊愈率、 B组有效率的成本-效果比均低. B方案为佳治疗方案.
作者:廖日房;伍俊妍;杨鸿 刊期: 2003年第06期
0 引言 低周波治疗仪与低频电子治疗仪均可以应用于腰椎间盘突出症的临床治疗中,但其治疗效果如何需临床实践验证.
作者:房凌君;胡中;周博凤 刊期: 2003年第06期
脊椎骨折、脊髓损伤可导致截瘫,如何使患者早日进行站立、行走等功能锻炼是康复期治疗中的一个重要问题. 材料: 1984- 12/1995- 12本院收治截瘫患者 14例,男 10例,女 4例,年龄 16~ 37岁,平均 25岁;其中 L1骨折伴不完全性截瘫 10例,肌力 0~ 2级; C7、 T5骨折伴双下肢完全性截瘫各 1例; T12、 L1骨折伴完全性截瘫各 1例.病程 2 h~ 3 d. 方法:( 1)竹片的制作:用苗竹将其削成长 60 cm,宽 2.5 cm,厚 0.5 cm的竹片,周围刨光滑以备用.( 2)裹帘布的制作:用一般的棉布折叠成双层,裁剪成梯形状,根据患肢臀横纹处周径为下底,踝上 2 cm处周径为上底,二者之间长度为梯形的高度,分别在上底和下底分成若干等分(上底 2.5 cm,下底 3 cm),然后从上下底相对应的等分点连线缝合(双层),距上底 0.5 cm处与底线平行将各口缝合成盲口,下底仍保持开口,这样便成子弹袋一样.( 3)竹片裹帘的制作:将削好的竹片,从裹帘布下底处放入,呈间隔排列.再在距下底 0.5 cm处与底线平行将开口缝合,这样竹片便被固定不会脱落.然后在梯形的两腰分别缝上多条布带用于绑扎.( 4)双杠的制作:材料用木质或水管均可,高度以患者腋下至地面为准,宽度以患者双肩的宽度为准,长度为 2 m.在双杠纵向的一面将其横杆做成活动入口,以便出入.( 5)使用方法:患者平卧,用竹片裹帘将患者下肢包绕绑扎固定,扶持站起后,打开双杠的活动横杆进入双杠,将双臂放于杠上,则可进行站立和行走的练习. 结果: 14例患者中, 5例未做手术, 6例作椎板减压加钢板内固定手术, 3例作椎板减压加 U形棒内固定手术.未手术者 2个月后上杠,手术者 1个月后上杠,但腰部均需腰围加固.全部患者以 6个月后回访,上杠练习时间 2周~ 6个月,平均 4个月.除 3例双下肢完全性截瘫患者对其下肢运动的恢复无效外,其余患者均得到不同程度的康复.其中有 5例上杠 2~ 6个月后恢复完全,生活自理; 3例需拄双拐扶持行走; 3例只需拄手杖行走,均不需再用竹片裹帘护膝. 讨论:竹片裹帘固定下肢结合双杠扶持练习对截瘫患者康复锻炼是一个简单易行的方法,能为患者提供一个早日进行站立行走功能锻炼的行之有效的手段.由于条件所限,观察难于细致,回访时间尚短,病例较少,还有不少问题有待探讨.
作者:钟延炎;廖小琴;陈婵珠;钟裕权 刊期: 2003年第06期
目的:筛选并克隆正常组小鼠腭突与腭裂组小鼠腭突组织中差异表达的基因,探讨它们在腭裂发生过程中表达的意义.方法:建立 C57BL/6N小鼠腭裂模型,分别提取胚胎 12 d的正常组及维甲酸处理组小鼠腭突组织中的 mRNA,利用 PCR的改良消减杂交技术,筛选并克隆小鼠腭突正常发育时期与腭裂形成过程中差异表达的基因及测序. 结果:共获得差异表达的基因 40个, 2个为新基因.结论:克隆的新基因及 fau基因可能对腭突间充质细胞的生长、分化具有重要的调控作用.
作者:李鑫;金岩;岳文;刘源;王新文 刊期: 2003年第06期
0 引言 肩关节周围炎是一种肩关节囊及周围韧带、肌腱和滑囊的退行性变和慢性非特异性炎症 [1],造成肩关节疼痛及活动受限,单纯外敷膏药治疗,更进一步限制了肩关节的活动,不利于肩周炎的恢复,局部封闭及小针刀治疗有一定痛苦及禁忌证,且患者有惧怕心理,如不配合系统的康复训练,难以起效.
作者:吕尚军 刊期: 2003年第06期
INTRODUCTIONSelf-prevention taught to patients by example and instruction has anidentified effect with high good rate and shortening therapeuticcourses, consolidating therapeutic effect and preventing relapse wereachieved.
作者:荆兆峰;孙西周;刘磊 刊期: 2003年第06期
BACKGROUND: To patients with burn of face, how to preventand reduce facial deformity in maximal degree is an important sub-ject in burn iatreusiology.
作者:刘海霞;肖康菊;黄贤慧 刊期: 2003年第06期
BACKGROUND:Fracture of lower part of femur is very common.Anatomic character is spongy bone at condyle with thin cortex and lower part is cortex which axis isn't vertical with axis of knee joint.Due to traction,angulation transposition of condyleis often caused after fracture that will injure popliteal vessels.So,it is difficult to achieve ideal reposition by closed manipulation rediction.Common steal plate in open reduction can't achieve reliable internal fixation that must be combined with long- term external fixation, often leads to adhesion of knee extension apparatus and needs a secondary relax causing patients' pain.
作者:申永秀 刊期: 2003年第06期
AIM: To explore the long-term therapeutic effects of surgical treatmeut foristhnic spondylolisthesis. METHODS: 42 cases of isthunic spondylolisthesiswere analyzed retrospectively among which 13 cases underwent simple lum-bar interlaminar bone implant and 29 cases underwent transpecdicular fixationcombined with bone implantation. Assessment was made according to JOAstandards before and after treatment. RESULTS: At a 3 years of follow-upassessment, the functional outcome in transpedicular fixation assessed byJOA was excellent and good in 79.3% as compared with the group withoutfixation in which the excellent and good result was 76. 9%. The level of painand functional disability were similar in the two groups, but fusion rate in thegroup with transpedicular fixation was higher than that in group withoutit. CONCLUSION: Surgical treatment for isthmic spondylolisthesis improvesfunction and relieves pain.
作者:袁岱军;靳安民;吴广森 刊期: 2003年第06期
AIM:To compare the effects of early enteral nutrition and early parenteral nutrition on ameliorating visceral ischemia and relieving free radical damage.METHODS:66 Wistar rats were divided into 3 groups: control group(C),parenteral nutrition group( PN) and enteral nutrition group( EN), PN and EN groups made up of 30% TBSAⅢ degree burn model.We delivered nutrient solution with same calorie and calorie- nitrogen ratio via vein or enteral tract respectively.Blood flow of liver,kidney and change of SOD of heart,liver and kidney at 6,12,24,48,72 h after burn were tested.RESULTS:Tissue blood flow and SOD of EN group were higher than those of PN group in many phase( P< 0.05-0.01) .CONCLUSION: Early enternal nutrition can relieve the increase of visceral vascular permeability and damage of oxygen free radical.
作者:徐世伟;冯怀志;尤忠义;王裴;汪仕良 刊期: 2003年第06期
INTRODUCTIONFracture of neck of femur consisted an important position in seniletraumatic fracture system and ischemic necrosis of head of femurcaused by fracture of neck of femur had a higher proportion. Toanalyze has an instructive significance on prevention and treatmentof necrosis of head of femur.
作者:崔振铎;邹宝林;张艳丽;李文梓 刊期: 2003年第06期
0 引言 脑血管意外、颅脑外伤起病危急,一经 CT确诊有手术指征,则手术抢救作为主要问题,虽能幸存但由于神经受损,常遗留有不同程度的肢体功能障碍.此类患者在救治后一旦病情稳定即应及早实施康复计划,进行康复医疗.
作者:杜学菊;朱美云 刊期: 2003年第06期
INTRODUCTIONSciatica is a kind of syndrome with pain along with sciatic nervepathway and its distribufion area. To investigate the effectivemethods by traditional medicine, we classified the pathway on baseof pain position, take points on the pathway as major and rueridianprinciple as assistance. All the sciatic patients were treated withacupuncture with physiotherapy compared with patients with tradi-tional medical drugs and the latter had a very good efiects.
作者:白伟 刊期: 2003年第06期