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  • Plastic surgery treatment on cicatricial deformation in child burn of hand 收费下载
  • Background:cicatricial deformation in child burn of hand often leads to severe squaelae.According to different causes of disease,different plastic surgery were adopted.The key of operation lies in skin repairing,articulation dealing,and thumb correcting,which aim is to resume normal longitudinal and transverse arce,holding and clenching ability.Objective:To investigate plastic surgery treatment on cicatricial deformation in child burn of hand.Unit:first People‘s Hospital of Yancheng City.Subjects:34 cases of burn were investigated including 23 males,11 females,aged 5-12 years old.Cicatricial reason:deep degree Ⅱ burn,19 cases;degree Ⅲ burn 11 cases;electric injury,4 cases.Scar type:hypertrophic scar,21 cases,areophic scar,13 cases.portion:dorsum of hand,22 cases,palm,12 cases.Time from healing to dealing:within 6 months,9 cases,within 1 year,8 cases,1-2 years,13 cases,over 3 years,4 cases.Intervention:Before operation,hypertrophic scar and adhesive web-space were cleaned with soap solution,1:5000 bromogeramine,30 min per time,twice a day.Anesthesia:general anesthesia to simple cicatricial contracture,scar removing,relaxing and free graft were adopted,full split thickness graft of palm,intermediate split thickness graft of dorsum of hand.To severe contracture,besides complete removing and full and intermediate split thickness graft,repairing of extensor tendon and articulate surgery,proximal finger joint was fixed at functional position when function couldn‘t be resumed.Tourniquet was used routinely,great saphenous venous and dorsal cutancous branch of radioulnar nerve avoiding exposing extensor tendon,fixed with plaster support and kirschner pins for some cases.Direct skin flap was used after incision and relaxing in 19 cases,skin flap graft was combined with repair in 15 cases.To scar contracture of part between thumb and index finger,because soft tissue had a good condition in this part,“Z”plastic operation was adopted for linar scar,local transfering of dorsal skin flap i 5 cases.To slight false web-space and adhesion,“Z”plastic operation was adopted,“M”or “T” skin flap repair to severe deformation and reconstructing of web-space with free skin graft when necessary.Result:Following up for 3-6 months,hand function recovered completely,improved obviously in 12 cases,no obvious effect was found in cases of deep burn.Conclusion:Different plastic surgery has an obvious effect on child hand bur,but the recovery of function needed long and effective rehabilitation therapy.
  • Therapy for persistent vegetative state with SW cerebral reflex therapeutic instrument 收费下载
  • The influence of early nutritional support to the rehabilitation of severe head-injured patients 收费下载
  • Correlation of early functional exercises after the operation with vertebrascope in route of retreat to treat lumbar disc protrusion 收费下载
  • Objective: To observe therapeutic effect in the near future of the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and complications.Method: According to symptoms,signs,myelography and CTM results to determine protrusion interspace and side type,applied the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and perform functional exercises.Results: 86 patients were followed up,and within these patients,58 appeared excellent (67%),25 appeared good (29%),2 appeared not bad (2%),and 1 appeared bad (1%).Conclusion: The technology has many advantages,such as little wound,little hemorrhage,little pain and fast restoration,which provide advantageous conditions for early functional exercises after operation.
  • Microacupuncture therapy of 80 cases of chronic fasciitis at neck and back 收费下载
  • Backgroung:Etiology of fasciitis is that fasciitis in acute phase isn‘t cured timely or completely.Adhesion,hypertrophy,nodes and cords appear that pull peripheral tissue leading to local aching pain,spasm soft tissue,cervical intervertebral friction,and hyperosteogeny and protrusion of cervical intervertebal disc in the end,After that,a serie of clinical symptoms appear.Acupuncture,massage,physical therapy and adhesive plaster for external application are often used clinically,but therapeutic course is long.Objective: To investigate therapeutic effect of microacupuncture on chronic fasciitis at neck ad back.Unit: People‘s Hospital of Hebei.Subjects:80 cases of chronic fasciitis at neck and back from 1999 to 2002 were investigated to which modified needle was adopted,including 34 males,46 females,aged from 29-74 years old with disease courses from 2 months to 20 years.68 cases at shoulder and back,12 cases at lumbar region.Intervention: Microneedle was made from needle (Huatuobrand) that was grindded at oil whetstone,needle tip changed into flat blade,sterilized and prepaired for use,after routine sterilization,microneedle was stabbed longitudinally and swiftly into aching region,then separating,lifting and thrusting.When the sound that muscle fiber was cut was heared,cupping jar was used by Sanhuo.2-3 points were selected for each time,twice a week,4 weeks as a therapeutic course.Main prognosis index and result: Recovery:local pain dissappeared,nodes and cords disappeared or shrank,no touching pain,48 cases,60%;Effective:Focal pain alleviated,nodes or cords reduced,focal touching pain alleviated,32 cases,40%.Total effective rate was 100%.Conclusion: Microneedle therapy on chronic fasciitis could obviously alleviate pain.Because of the small size,microneedle therapy was fit for the weak or thin muscle tissue,but not for thicker muscle tissue.
  • Rehabilitation nursing of unstable lumbar vertabrae in bed 收费下载
  • Background:clinical rehabilitation of unstable lumbar vertebrae in an important part of mordern rehabilitation medicine.Because of its plentiful contents,rapid developing,comprehensive using of methods,it has been paid more and more attention to.Objective:To investigate effect of rehabilitation nursing on prognosis of unstable lumbar vertabrae in bed.Unit:people‘s Hospital of Anyang City.Subjects:112 cases of unstable lumbar vertebrae were investigated,including 70 cases of spinal injury(62.5%),most of which were incomplete injury,38 cases of retrograde affection (34.0%),others 4 cases (3.5%).Interventions:(1)rehabilitation of muscle:Grouped exercises were directed to shoulder,elbow,wrist,hip,knee and ankle joints.Both active and passive exercises of each group took 200 times of flexing and extending,3-4 groups each day and increased successively;If patients couldn‘t coordinate or needed a larger amount,CPM and special OT,PT rehabilitation were given suplementarily:①upper part of body and head were elevated with both arms bracing and hip on bed.②both lower limbs extended backward in turn,with knee joint extending.③upper part of body and head were elevated without upper limbs bracing.④both lower limbs stable.⑤“swallow”movement.⑥upper and lower part turned over at the same time,combined with abdominal muscles exercise.Exercises varied with each individual,amount increased gradually.(3) Rehabilitation training of detrusor urinae and sphinctor of anus:before defectation,massaging of abdomen for 5-10min,hot water was drunk 15 min before defectation.Actively contracting detrusor usinae and sphinctor of anus,100 times pergroup,3-4groups every day.Rubbing anus sliphtly,15-30s,1-2 times every day.(4)Rehabilitation of complications:turning over once every 2h.Massage of sacrococcygeal region,sacroiliac region and calcaneus,15-20 min.Irrigation of bladder with furacilin(1:5000).Cleaning of perineum with bromogeramine.Results: In 2 cases of panplegia,patients could do simple activities with the help of wheel-chair;In 77 cases of incomplete pletia,muscle strength recovered to grade Ⅳ-Ⅴ.Besides 2 cases of panplegia,all cases achieved self-dependence of daily living.Conclusion:Rehabilitation nursing of nustable lumbar vertebrae in bed could accelerate the clinical rehabilitation and shorten therapeutic course.
  • Effect of cocolyster on defecation function of patients with rectal carcinoma after operation 收费下载
  • Background:Defecation of patients with rectal carcinoma after operation cannot be controlled freely,which brings patients many mental burdens.Cocolyster operation can improve obviously the symptom.Objective.To explore the effect of cocolyster on defecation function of patients with diagnosed rectal carcinoma.Unit:Fifth People‘s Hospital of Shenyang.Subjects:90 patients with rectal carcinoma,47 males and 43 females,aged 29-66 years old.The patients were divided randomly into three groups,30 cases in each group of A,B and C.Intervention.Colostomy was used in both groups to train relieving themselves.After three weeks of operation,suitable 38 warm water 500-1000 ml was poured into intestinal cavity through water collector and catheter which nomally inserted 15-20 cm.Them the patients should be told to mix uniformly water and excrement by proper activities and excreted.The speed of enema should not be too fast to avoid intestinal colic,generally 15-20 minutes.Once intestinal colic occurred,the pouring was paused,then rubbed abdomen 5-10 minutes,continued pouring when abdominal pain relieved.A group choosed the defecation time when the patient was healthy and poured regularly,once per day,continuously for 12 days.b group oured regularly when getting up and evening,continously for 14 days.C group was as control group.Results:The defecation habit of A and b group could be controlled freely and the patients hadn‘t excrement and peripheral dermatitis of artificial anus.Involuntary defecation times of A group decreases 20%.Involuntory defecation times of b group decreased 20%.c group was not poured.Defecation times of each day:>5 times accounted for 40%,3-4 times accounted for 30%,1-2 times accounted for 30%.Meanwhile involuntary defecation times accounted for 50%.Peripheral dermatitis of artificial anus accounted for 19%.Conclusion:Using cocolyster can train regular peristalsis of intestinal tract,make the patient have same defecation habit and involuntary defecation times decrease.It also eliminates peripheral dermatitis of fistula,relieves the mental burdens and improves life quality of patients.
  • Early treatment of deep burn of hand to keep the function and prevent scar proliferation 收费下载
  • Background:Deep burn of hands can cause severe dysfunction.Early plerosis to the hands will play an important role to the functional exercise and the recovery.Objective:To observe the effect of early treatment of deep burn of hands to the functional reservation and prevention of scar proliferation.Unit:Department of Burn,People‘s Hospital of Gansu Province.Subjects: 1118 burned patients were recruited during December of 1998 to December of 2001.In them 252 patients were complicated with burn of hands,in which 129 hands were deep burns (96 males and 33 females,aged from 1 to 67,most of them were yound).The causes of burns were flame burn,scald by hot fluid,electric burn,chemical burn and hot crush injuries.Intervention:Excise the eschar of 59 hands with burns of deep Ⅱ to superficial Ⅲ and 21 hands with burn of Ⅲ degree.Perform dermatoplasty of local skin flap,abdominal flap,dorsolateral flap of index finger,reticular thin flaps with pedical containing subdermal vessels and fascial flaps to the 15 hands with injuries of tendons,bones and joints;Cut off granular wound surface and transplant large piece of intermediate split thickness skin graft and full split thickness skin graft to 5 hands;transplant postage stamp-shaped razor-thin graft or intermediate split thickness skin graft to 14 hands.Results:In the 129 hands,103 hands could keep the functios in maximal degrees 1-2 weeks after burning,most of them could begin to move after taking out stitches and could care themselves in the end.After 4-5 weeks,the hands with deep Ⅱ burn could recovery functions after dressing change,new skin excision,transplantation of large piece of intermediate of full split thickness skin graft,All of Hands Could resume the functions.In 14 patients with transplantation of stamp-shaped skin flaps on granular wound surfaces of hands‘ bank and fingers,the contracture were prominent and claw hands were formed in the late phase.11 hands of mixed burns of deep Ⅱ and Ⅲ were self-healed after repeated dressing change,proliferative scars appeared 4-5 weeks after burn.Although local medication and active and passive training,the hands were still with dysfunctions and take operative plerosis in late phase.Conclusion:Deep burn of hands should be treated with corresponding methods 1-2 weeks after the burning,which could reserve the functions,decrease mutilation rate and prevent contracture of scars in greatest degrees.
  • 麦肯基力学诊断治疗技术(续三):麦肯基对下腰痛的力学诊断 收费下载
  • 文章介绍了麦肯基(McKenzie)基于下腰痛产生的机制创立的一套诊断系统,将机械性腰痛分为3大综合征:姿势综合征、功能不良综合征、间盘移位综合征,并以此诊断分类为基础进行针对性治疗。McKenzie力学诊断(估价)的主要方法包括病史、检查、运动缺失的估价和患者对运动试验的反应等4项基本内容。
  • 腰痛的运动疗法 收费下载
  • 腰痛是骨科和康复科的常见病。由于其发生率和复发率提高,影响患者工作能力和生存质量,因此,为适应现代社会的快节奏和强竞争,人们投入对腰痛进行诊断和治疗的费用逐年增加。近些年来,人们依据循证医学的原则,对腰痛的诊断和治疗进行了重新的分析和评价,以寻求既有良好治疗效果又有节省费用的治疗方法。文章介绍了腰痛的运动疗法,并认为运动疗法是指导患者预防和治疗某些腰痛的简易、有效方法。
  • 造血系统肿瘤患者的生存质量评估 收费下载
  • 随着生物医学模式向生物心理社会医学模式转变,仅以发病率、患病率、病死率作为反映临床治疗和卫生预防措施的效果存在一定的局限性,人们越来越多地以生存质量(quality of life,QOL)作为终点指标。特别对于肿瘤等严重危及生命但尚不能完全治愈的疾病,许多患者宁愿有一个短时间但高质量的生命,不愿痛苦地、低质量地活着。国内外对实体瘤的QOL研究较多,但对血液系统肿瘤和白血病、淋巴瘤等的研究较少,文章对QOL的概念、评价方法和在血液系统肿瘤中的应用作一介绍,并介绍FACT-G量表在国内的应用情况。
  • 脊髓损伤后自主神经反射不良 收费下载
  • T6脊髓节段以上的损伤,常伴发以血压骤然升高为特征的自主神经反射不良,对患者的生命危害极大。文章综述了自主神经反射不良的流行病学、发生机制、临床特征、激发因素和处理方法等。
  • 颅脑损伤患者的运动处方 收费下载
  • 颅脑损伤后的运动疗法是该损伤综合康复治疗方法的重要一环,对胶体运动障碍,疗效确切。是促使患者早日康复,尽快恢复运动功能最有效的方法之一。康复期不同阶段所实施的运动种类不同、方法不一,运动强度因人而易。
  • 妇科恶性肿瘤患者的生存质量评价 收费下载
  • 文章主要介绍了妇科肿瘤(宫颈癌、卵巢癌、子宫内腺癌和外阴癌)患者的生存质量评价方法。妇科肿瘤生存质量测定量表主要包括个人特征、家庭情况、生理状况、心理状况、躯体焦虑、社会关系、满意程度及生存质量总分,量表的计算采用评分法,以低优原则评价生存质量的好与坏。如何用一综合指标来反映这些变化,是目前研究的重要课题。在评价妇科恶性肿瘤患者生存质量时,采用了多维、简明、可靠、有效的量表来反映患者的真实情况,以供在研究中参考应用。
  • 乳腺癌患者放疗期间生存质量的调查 收费下载
  • 目的:探讨大连市乳腺癌患者放疗期间的生存质量。方法:采用已经过检验的美国希望城(hope city)医学研究中心编制的《乳腺癌患者生存质量评定量表》。于2001年3-12月对放射治疗的71例女性乳腺癌根治术后的患者进行问卷调查。统计学方法采用配伍组方差分析。结果:乳腺癌患者在放疗过程中,QOL总分有下降趋势,但无统计学意义;QOL的躯体因子分下降,治疗前后差异存在显著性意义,P=0.019,而心理、社会支行和精神因子分统计学差异无显著性意义;乳腺癌患者在放疗过程中QOL分值与放疗前QOL分值比较呈显著正相关,P<0.01。结论:放疗对乳腺癌患者的QOL无影响,患者个体QOL的高低取决于患者放疗前QOL的状况。
  • 颅内肿瘤患者术前生存质量及其影响因素研究 收费下载
  • 目的:探讨颅内肿瘤患者术前生存质量及其影响因素。方法:采用诺丁汉健康调查表(Nottingham health poofite,NHP)对89例CT、MRI诊断颅内肿瘤患者的生存质量进行评价研究。结果:颅内肿瘤患者术前生存质量的损坏程度与颅内肿瘤的大小之间没有线性关系,颅内肿瘤的体积>25ml比≤25ml者生存质量差,颅内肿瘤位于右侧半球的患者比位于右侧半球的患者生存质量要差,肿瘤位于幕下者比幕上者生存质量更差,恶性程度高的颅内肿瘤患者显示了较差的生存质量。结论:对颅内肿瘤患者术前生存质量进行估计评价时,不仅要考虑社会、医学因素,还应考虑到肿瘤的位置、大小和恶性程度对术前生存质量的影响。
  • 轻型颅脑损伤后精神障碍的临床特征 收费下载
  • 目的:探讨轻度颅脑损伤后精神障碍的临床特征。方法:对急性期和后遗症期患者进行临床观察,以找出有共性的临床特征。采用症状自评量表进行精神卫生调查,对所产生的精神卫生症状进行分析。结果:颅脑损伤后所有患者均存在不同程度的精神障碍;51%的患者存在有颅脑损伤后神经综合征的表现。精神卫生症状以躯体化、抑郁、焦虑、强迫和恐怖为主。结论:颅脑损伤后存在较多的精神障碍表现,治疗中要给予足够的重视。
  • 持续性植物状态电生理动态变化和预后的相关性 收费下载
  • 目的:探讨持续性植物状态(PVS)患者治疗过程脑电生理的变化情况与预后的关系。方法:选择符合PVS诊断标准的患者35例,在中药、神经营养药、高压氧、电刺激等综合治疗期间,间断怀的进行脑电图、脑干诱发电位检查,对比其动态变化及患者意识恢复之间的关系。结果:35例患者进行PVS评分,其中11例18分,意识安全恢复(31%);9例12分以上,意识基本恢复(26%);10-11分8例,明显好转(23%);1-5分4例好转(11%),2例无明显变化(6%),1例死于严重肺部感染(3%)。总有效率为91%。脑电图、脑干诱发电位检查出现由重到轻的动态变化。结论:PVS患者康复治疗过程中脑电生理的检查情况作为评定患者意识恢复的客观指标,与患者的预后有一定的相关性。
  • 有限度的选择性脊神经后根切断术联合有限度的腱松解术治疗下肢痉挛型脑瘫 收费下载
  • 目的:探讨有限度的选择性脊神经后根切断术(LSPR)联合有限度的腱松解术(LSTR)治疗下肢痉挛型脑瘫的方法和疗效。方法:对52例痉挛型脑瘫患者,选择性的切断L5、S1脊神经后根,同时对下肢软组织挛缩畸形行有限度的腱松解术治疗。结果:术后患者双下肢痉挛及挛缩状态明显缓解;术后2年以上随访31例,步态均较术前有明显改善(P<0.01)。术后未发现明显并发症。结论:该疗法可有效的解除痉挛并一次性纠正肢体挛缩畸形,同时最大限度的避免并发症。
  • 常州市0—6岁残疾儿童的流行病学调查 收费下载
  • 目的:掌握目前常州市残疾儿童的患病率及致残原因。方法:参照2001年全国0-6岁残疾儿童抽样调查所采用的方法对市区5个街道0-6岁儿童5102人进行了各类残疾的流行病学调查。结果:确诊各类残疾共44人,患病率为8.62‰,各类残疾共57人次,残疾发生率为1.12%,其中智力残疾27人次,肢体残疾18人次,精神残疾7人次,视力残疾3人次,听力残疾2人次,残疾发生率分别5.29‰、3.53‰、1.37‰、0.59‰、0.39‰。结论:常州市残疾儿童的患病率较1987年有明显下降,但残疾儿童的康复现状仍不容乐观。
  • 周围神经损伤晚期修复后脊髓后角P物质和降钙素基因相关肽变化的定量研究 收费下载
  • 目的:探讨周围神经损伤晚期修复后脊髓后角内P物质(SP)、降钙素基因相关肽(CGRP)变化,以反映脊髓后角的功能状态。方法:新西半兔16只腓总神经切断1年后修复,术后1,3,5月取腰骶段脊髓,切片作SP、CGRP免疫组化染色。采用计算机图像分析对后角内SP、CGRP含量进行定量分析研究。结果:失神经1年后,脊髓后角内SP、CGRP含量分别为正常的70%和86%。腓总神经晚期修复后,后角内SP、CGRP先丧失,随后逐步恢复,至术后5月,后角内SP、CGRP含量接近正常。结论:周围神经损伤晚期修复后,脊髓后角有再生表现,从神经肽角度证明晚期神经损伤有修复价值。
  • 胚胎脊髓神经干细胞的培养和鉴定 收费下载
  • 目的:从胚胎脊髓组织中分离,培养并鉴定神经干细胞。方法:采用无血清培养和单克隆培养的方法获得大量细胞克隆并对其进行诱导分化,同时应用免疫细胞化学的方法对上述克隆及分化后的细胞进行鉴定。结果:从脊髓分离的细胞克隆具有较强的增殖能力,呈Nestin抗原阳性;对其诱导后能分化为神经元、星形胶质细胞和少突胶质细胞。结论:所获得的细胞具有自我更新和多向分化的潜能,是脊髓来源的神经干细胞。
  • 免疫球蛋白G在游离型腰椎髓核再吸收过程中的分布及其再吸收的机制 收费下载
  • 目的:探讨游离髓核组织再吸收或缩小的可能机制,为临床保守治疗某些类型腰椎间盘突出症提供新的思路和依据。方法:25只健康成年狗,制作成游离型腰椎间盘突出模型。于术后第2,4,6,8,12周,各处死一组动物,切取、观察移植的髓核组织,用免疫组化方法对髓核组织中IgG沉积分布的特点进行了检测;另外同一动物的正常髓核组织作组织学对照。结果:(1)肉眼可见术后不同时期移植的髓核组织出现不同程度的皱缩、变小乃至消失。(2)所有标本髓核组织中可见呈片状、带状或丝状分布的IgG沉积,且随时间推移沉积程度呈现增高趋势。(3)正常髓核组织中可见有微量IgG沉积。结论:游离型腰椎间盘突出中的髓核组织,通过引发免疫应答,从而导致IgG的沉积,产生自体免疫反应,因此导致了突出髓核组织再吸收的自然过程。
  • 人间充质干细胞成骨诱导培养后的细胞成分研究 收费下载
  • 目的:了解构建组织工程化骨的人间充质干细胞(MSCs),在体外成骨诱导环境中培养2代后,成骨细胞、软骨细胞、脂肪细胞的比例。方法:体外扩增培养人MSCs,然后在含地塞米松、β-甘油磷酸钠、维生素C等的培养液中诱导培养2代,进行成骨细胞、软骨细胞、脂肪细胞的鉴定。结果:人MSCs体外成骨诱导培养2代后,碱性磷酸酶阳性细胞数65%,1型胶原免疫组化阳性细胞数55%,骨钙素阳性细胞数52%,Ⅱ型胶原免疫组化染色为阴性,油红O法染色阳性细胞数2.5%。结论:人MSCs体外夸骨诱导培养2代后,可有约50%的成骨细胞,少量脂肪细胞形成,无成熟的软骨细胞出现。该结构可为利用间充质干细胞构建组织工程化提供理论参考。
  • 长骨骨巨细胞瘤微波高温治疗肢体关节功能观察评定 收费下载
  • 目的:评价长骨骨巨细胞瘤原位分离插入式微波天线阵列诱导高温原位灭活治疗后肢体关节功能。方法:应用原位分离插入式微波天线阵列诱导高温灭活技术治疗46例长骨骨巨细胞瘤,从手术技术、肢体关节功能等方面全面综合评价此方法临床应用后肢体关节功能学结果。结果:应用该方法治疗46例长骨骨巨细胞瘤,平均随访7.6年。肢体关节功能评定:好者44例,可者2例,差者0例。结论:应用原位分离插入式微波天线阵列诱导高温治疗长骨骨巨细胞瘤能获得优良的肢体关节功能。
  • 人骨髓基质细胞在骨细胞工程临床应用中的探讨 收费下载
  • 目的:研究人骨髓基质干细胞经体外诱导表达成骨细胞表型,作为骨组织工程临床应用种子细胞的可行性。方法:人骨髓中密度梯度法分离骨髓基质干细胞,诱导组予条件培养液,对照组予单纯DMEM培养液,分别培养至第3代细胞,计算各代倍增时间和3代总的扩增倍数,经相差显微镜观察,钙结节茜素红染色,四环素荧光,免疫荧光检测骨钙蛋白,成骨细胞转录因子,RT-PCR检测I型胶原,骨钙蛋白mRNA表达。结果:诱导组骨髓基质干细胞(MSC)经体外诱导,三代平均扩增163.4倍后,形成钙结节,骨钙蛋白(OCN),成骨细胞转录因子(cbfal)免疫荧光结果阳性,RT-PCR证实I型胶原,骨钙蛋白mRNA的表达;对照组未能形成钙结节,无成骨细胞特征性蛋白OCN,cbfal的表达。结论:人MSC体外经条件培养液诱导培养三代后仍可表达成骨细胞表型,可以满足骨组织工程临床应用对种子细胞质和量的需要。
  • 新型骨支架材料20%β—TCP/PDLLA亲水性、组织相容性和生物安全性观察 收费下载
  • 目的:观察新型骨支架材料20%β-TCP/PDLLA支架亲水性、组织相容性和生物安全性。方法:体外滴水法观察比较支架材料20%β-TCP/PDLLA及PDLLA亲水性;体内研究,将材料植入大鼠体内,2,4,8,12周进行血常规、肝功能、肾功能,Ca^2+、P、ALP检测。观察伤口局部情况及心肝肾组织学变化,植入材料局部取材进行组织学检查。结果:β-TCP/PDLLA支架亲水性明显高于PDLLA支架,血常规、肝功能、肾功能,Ca、P、ALP检测两种材料无明显差异,心肝肾组织学检查观察均未见病理性改变。植入体内β-TCP/PDLLA支架组织学检查巨噬细胞2周时最高且多于PDLLA支架组,而后逐渐下降,12周时两组相当,均基本消失。结论:新型骨支架材料具有良好的亲水性、生物相容性和生物安全性。
  • 体外评价抗生素对人重组骨形成蛋白—2诱骨活性的影响 收费下载
  • 目的:研究抗生素对骨形成蛋白诱骨活性的影响。方法:以人骨髓成骨细胞为作用细胞,选用合适剂量的人重组骨形成蛋白-2(rhBMP-2m)为作用底物,分别加入不同浓度的替硝唑(Tinidazole,TNZ)、克拉霉素(Clarithromycin,CLM),以及二者的混合物进行体外培养,96h后观察细胞生长情况,MTT法测定细胞活力,并检测定细胞内碱性磷酸酶(Alkaline phosphatase,ALP)活性。结果:(1)高剂量(≥1000μg/ml)的克拉霉素对人骨髓成骨细胞的增殖具有轻微的抑制作用,而高剂量的替硝唑则有一定的细胞毒性,较多的细胞漂浮,裂解为碎片;联合用药对细胞增殖的影响与替硝唑剂量成正比。(2)药物对碱生磷酸酶活性的影响,同细胞的增殖程度成正相关,剂量小于1000μg/ml时对酶活性无影响。结论:局部应用克拉霉素和替硝唑应选用小于1000μg/ml的药物浓度为宜;两抗生素对BMP的诱骨活性并不产生直接的影响,而是由于对细胞增殖的抑制作用间接影响了碱性磷酸酶的活性。
  • 实验性肌肉拉伤的生物学和生物力学研究 收费下载
  • 目的:探讨骨骼肌牵拉伤的生物学与生物力学特性。方法:采用生物力学方法,建立肌肉拉伤的实验模型,70只兔的左胫前肌为实验肌,右胫前肌作为对照,分别在拉伤后0,1,2,3d和7d,进行组织学、酶组织化学与生物力学研究,生物力学指标包括量大肌力、断裂载荷、断裂时伸长、能量吸收与肌肉硬度。结果:以相当于128%动物体重的载荷牵拉兔胫前肌,可建立肌肉拉伤的实验模型;部分肌纤维断裂和肌肉完全断裂均发生于靠近缺肉-肌腱连接处;最大肌力在拉伤后0d下降,1d时最低,7d时恢复正常;极限断裂载荷在拉伤后0d下降,2d时最低,7d时仍没有恢复正常。结论:肌肉的被动强度比肌力恢复缓慢,提示拉伤肌肉易于再伤;损伤部位肌内膜纤维化和瘢痕组织形成,是肌肉拉伤后频繁复发的重要原因。
  • 腰椎椎管狭窄症患者脑脊液中神经肽的变化与临床表现的关系 收费下载
  • 目的:探讨腰椎椎管狭窄症患者脑脊液中P物质(SP)、血管活性脑多肽(VIP)含量变化以及与临床表现间的关系。方法:测定35例腰椎椎管狭窄症患者行走能力,VAS疼痛程度评定,感觉、运动、腱反射改变及直腿抬高试验结果及脑脊液中神经肽含量,并进行相关性分析。结果:腰椎椎管狭窄症患者脑脊液中SP、VIP含量明显高于对照组(P<0.05),脑脊液中SP、VIP水平与行走能力呈显著负相关(P<0.05),与疼痛评分呈非常显著(P<0.01)或显著(P<0.05)正相关。临床体征阴性组与阳性组间脑脊液中SP及VIP含量差异无显著性意义(P>0.05)。结论:腰椎椎管狭窄症患者脑脊液中SP、VIP含量明显升高,且行走能力严重障碍者升高更加明显。表明上述改变与神经源性间歇性跛行的发生存在着显著的相关关系。而与临床上是否出现感觉、运动、腱反射、直腿抬高角度等的改变无关。
  • 通痹灵对于胶原诱导型关节炎大鼠关节炎及骨质破坏的影响 收费下载
  • 目的:研究通痹灵对于胶原诱导型关节炎(CIA)大鼠关节炎以及骨质破坏的影响。方法:采用CIA大鼠动物模型,容积法测量足肿胀度,血小板计量,整体X线片分析骨质破坏情况。结果:通痹灵高剂量明显减轻CIA大鼠的关节炎所致的足肿胀和降低血小板总数(P<L0.05),通痹灵高剂量和甲氨喋呤高剂量可抑制CIA大鼠骨质破坏(P<0.05)。结论:通痹灵可通过降低CIA大鼠血小板总数,减轻关节的炎症,并且具有抑制骨质破坏的作用。
  • 以藻酸钙为载体的可注射性组织工程软骨和骨研究 收费下载
  • 目的:在裸鼠背部皮下注射软骨细胞/藻酸钙复合物、骨髓基质成骨细胞/藻酸钙复合物,观察体内软骨、骨形成的可行性。方法:分别从兔耳软骨和髂骨获取软骨细胞和骨髓基质干细胞,体外扩增培养,次获得的软骨细胞和骨髓基质成骨细胞与藻酸盐复合,注射于裸鼠背部皮下,以单纯藻酸钙植入作为对照组,6,12周后进行组织学检查和X线检查,观察软骨和骨的形成。结果:注射软骨细胞复合物组,裸鼠背部皮下有软骨样组织形成,软骨细胞位于类似于正常软骨组织的陷窝中,注射骨髓基质成骨细胞复合物组,裸鼠背部皮下有骨样组织形成,具有骨髓腔样结构,而对照组无软骨或骨形成。结论:藻酸钙可用作软骨和骨组织工程的支架材料,以藻酸钙为载体的可注射性组织工程软骨和骨是可行的。
  • 白介素—1α在退变腰椎间盘中的分布与神经根性疼痛的相关性 收费下载
  • 目的:研究白介素-1α(IL-1α)在退变腰椎间盘中的表达与分布,探讨其在坐骨神经痛发生机制中的作用。方法:收集30例腰椎间盘突出症手术切除的椎间盘组织,每例在3个部位取材:(1)凸椎管内与神经根紧贴的椎间盘组织(A组);(2)软骨终板间的椎间盘(B组);(3)软骨终板(C组)。6份正常髓核取自4例急性腰椎外伤骨折患者。应用IL-1α单克隆技术,采用SP免疫组化染色技术,对标本中IL-1α表达水平进行检测。结果:IL-1α表达水平A组明显高于B组及C组(P<0.05)。结论:IL-1α在退变腰椎间盘3个部位均有表达,但分别不一致;腰椎间盘突出症术后坐骨神经痛不能缓解,可能与残留椎间盘中IL-1α有关。
  • 谷氨酸在低氧性脑损伤中的作用 收费下载
  • 目的:探讨谷氨酸(Glu)在低氧性脑损伤的作用机制。方法:实验采用氨基酸分析和放免技术,研究缺氧后12,24,48h脑组织Glu和钙调蛋白(CaM) 含量的变化以及钙/钙调蛋白激酶Ⅱ(Ca^2+/CaM-PKⅡ)活性的影响及其机制。结果:缺氧组脑组织Glu、CaM含量在缺氧后48h明显高于12,24h和对照组;缺氧组脑组织Ca^2+/CaM-PKⅡ活性在缺氧后48h明显低于12,24h和对照组;而N-甲基-D-天冬氨酸(NMDA)受体拮抗剂地佐环平(MK-801)和钙通道拮抗剂尼莫地平(nimodipine)可对抗这种改变。结论:缺氧后Glu的兴奋毒引起脑损伤和Ca^2+/CaM-PKⅡ的活性下降,主要由NMDA受体介导和胞外Ca^2+内流增加有关。
  • 植物雌激素与突触素表达及空间认知水平的相关性研究 收费下载
  • 目的:观察两种雌激素-α-玉米赤霉醇(α-ZAL)和苯甲酸雌二醇(EB)对β淀粉蛋白毒性片段Aβ25-35所致神经损伤小鼠学习记忆的保护作用。方法:选用雌性Balb/C小鼠,经侧脑室注射Aβ25-35造成拟老年性痴呆模型,用Morris水迷宫测其空间学习记忆能力,用RT-PCR,Western blot等方法观察脑突触素的表达。结果:模型组小鼠寻找平台的潜伏期明显延长,经两种雌激素治疗后有明显改善。模型组小鼠海马突触素mRNA表达水平较对照组明显降低,经两种雌激素治疗后其表达明显增强。结论:模型小鼠学习记忆能力下降的原因之一与突触素表达下降密切相关。植物雌激素α-ZAL和EB一样能对抗Aβ25-35的毒性作用,促进突触素的表达,从而改善小鼠的学习记忆能力。
  • 增生性瘢痕胶原含量与微血管构筑的相关性 收费下载
  • 目的:研究增生性瘢痕(HS)胶原含量与微血管构筑的影响,以及两者的变化规律和相互关系。方法:对两组HS病例,分别采取PDL照射(A组)及TA皮损内注射(B组)治疗,在治疗后1个月、3个月分别切取标本与自然病程未经治疗的相应时段标本,进行微血管构筑及胶原含量的对比分析。结果:在治疗组第1个月,A1组血管密度明显降低,B1组血管密度亦有降低;在第3个月,血管与胶原纤维密度明显低于对照组。结论:在HS中微血管构筑和胶原含量呈较强的正相关。
  • 瘢痕疙瘩成纤维细胞P53基因突变检测 收费下载
  • 目的:探讨瘢痕疙瘩体外培养成纤维细胞是否存在P53基因突变及形成发展机制。方法:对所取新鲜组织标本进行细胞培养,设计P53基因外显子4,5,6的引物序列,从所培养各组成纤维细胞中提取细胞总DNA,采用PCR技术对所需基因片段进行扩增,并对目的的基因进行测序。结果:对PCR产物DNA序列分析后发现,所有体外培养瘢痕疙瘩成纤维细胞(6/6)均存在P53外显子4的基因突变,有2例(2/6)P53外显子5存在基因突变,表现为点突变及移码突变,而正常皮肤成纤维细胞则未发现有任何形式的基因突变。结论:瘢痕疙瘩成纤维细胞存在P53基因突变,这可引起其细胞增殖凋亡异常。
  • 混合型皮肤替代物的构建及移植试验 收费下载
  • 目的:构建含自体表皮细胞和异种表皮细胞的混合型皮肤替代物,并用于移植封闭全层皮肤缺损创面。方法:以无细菌真皮基质为载体,将Balb/c小鼠的表皮细胞(自体表皮细胞)和人表皮细胞(异种表皮细胞)按1:1比例混合后种植于无细菌真皮基质表面,经体外培养后形成含表皮细胞层的皮肤替代物,然后移植于Balb/c小鼠全层皮肤缺损创面,观察移植效果。结果:皮肤替代的移植于小鼠全层皮肤缺损创面后,可封闭创面,新生皮肤基底膜结构较完整,抗层粘连蛋白、Ⅳ型胶原染色阳性。移植后人表皮细胞随时间延长,数量逐渐减少并最终被小鼠自体表皮细胞替代。结论:含自体表皮细胞和异种表皮细胞的混合型皮肤替代物可封闭全层皮肤缺损创面,可望节省自体皮源,缩短体外培养时间。
  • 前纤维蛋白在增生性瘢痕收缩中的作用 收费下载
  • 目的:探讨前纤维蛋白在增生性瘢痕形成与收缩中所起的作用及意义。方法:收集患者不同时期增生与非增生瘢痕作为研究对象,利用前纤维蛋白的基因特异片段,制成寡核苷酸探针与瘢痕组织切片原位杂交,同时,钭各标本进行组织块培养,制成成纤维细胞爬片,进行原位杂交,分析基因在组织与细胞中变化规律。结果:前纤维蛋白基因在早期增生性瘢痕中表达均明显强于晚期增生及非增生瘢痕。结论:瘢痕增生挛缩与细胞骨架运动的相关基因存在密切关系,而前纤维蛋白起到十分重要的作用。同时,如果抑制该基因的表达,可能实现减轻瘢痕挛缩。
  • 复合壳多糖人工皮肤毒副作用评价 收费下载
  • 目的:评价复合壳多糖人工皮肤的毒副作用。方法:根据文献,对复合壳多糖人工皮肤进行一系列的毒副作用研究,包括皮下埋植争性毒性试验、经口急性毒性试验、经静脉急性毒性试验、溶血试验、微核试验。结果:皮下埋植人工皮肤后对手术切口愈合没有任何影响,毒性试验结果试验组和对照组的动物体重没有明显差异,溶血试验显示人工皮肤直接接触的溶血率为1.8%,微核试验中试验组的微核检出率仅为2.17%,未高于阳性标准。结论:毒性试验结果初步显示复合壳多糖人工皮肤具有良好的生物学安全性,基本符合临床试验应用的安全性要求。
  • 保存羊膜移植治疗中、重度眼化学烧伤和热烧伤急性期的作用 收费下载
  • 目的:讨并分析保存羊膜在眼中、重度化学烧伤和热烧伤急性期的治疗作用以及对晚期并发症的预防作用。方法:选择兰州医学院第二附属医院急性化学烧伤和热烧伤的住院患者19例(21眼)根据病情分为中度组(14眼烧伤为Ⅱ-Ⅲ度)和重度组(7眼烧伤为Ⅳ度),入院I1周内分别行单纯羊膜移植术和羊膜移植术+自体(异体)角膜缘上皮干细胞移植术。观察早期眼表重建时间,晚期角膜血管化,睑球粘连,视力改善情况。结果:中度组的眼表重建时间较重度组短,视力提高较后者明显,差异有显著性意义(P<0.001)。。在角膜血管化,睑球粘连等方面也较后者轻。结论:羊膜可用于眼中、重度化学烧伤和热烧伤的急性期治疗,其预后效果同眼部损伤程度有直接关系。
  • 应用自制神经束内微电极采集周围神经即时电信号 收费下载
  • 目的:采用显微外科技术于家兔后肢坐骨神经中植入自制神经束内微电极,采集周围神经的即时电生理信号,并与Bionic单电极进行比较,探索获取周围神经电信号方法的更多选择。方法:以95%铂5%铱合金制模均匀拉丝成直径60μm金属丝外加5μm聚脂类绝缘体涂层制成微电极。用显微外科操作技术将微电极直接插入家兔坐骨神经一神经束中作为记录电极。以神经束外同样微电极作参考电极,远端连接肌电图仪,在神经束插入点近端以两个钩状电极刺激,记录神经束电信号。同法埋入Bionic单电极作为比较。结果:神经束内微电极可以稳定地记录到周围神经的电信号。除1只外在4只家兔后肢中成功导出电信号。经分析已作为比较。结果:神经束内微电极可以稳定地记录到周围神经的电信号。除1只外在4只家兔后肢中成功导出电信号。经分析已导出的电信号波形具运动神经动作电位特征。结论:以神经束内微电极直接插入神经束对家兔坐骨神经神经束电信号进行采集可获取周围神经束即时电信号。
  • 聚乳酸对皮肤成纤维细胞生物学行为的影响 收费下载
  • 目的:观察种植在聚乳酸材料上的皮肤成细胞的生物学特性,为其在人工真皮中的应用打好基础。方法:将体外培养的人皮肤成纤维细胞接种到聚乳酸膜上,观察细胞在膜上的粘附、增殖,形态结构。结果:接种后的皮肤成纤维细胞在聚乳酸膜上有较高的粘附率,并且增殖良好。HE染色明显可见细胞在膜上所形成的复层化结构。结论:聚乳酸可以支持皮肤成纤维细胞的正常生长,在皮肤组织工程中有一定的应用价值。
  • 大鼠创伤修复中血小板源生长因子免疫组织化学的变化 收费下载
  • 目的:探讨创伤模型大鼠皮肤创面愈合过程中,血小板源生长因子(PDGF)表达的动态变化。方法:采用免疫组织化学研究伤后3,6,9,12d PDGF表达的变化。结果:创伤愈合PDGF表达在伤后6d呈强阳性,图像象分析,伤后6d与3d比较PDGF表达差异有显著性意义(P<0.01)。结论:PDGF的表达变化和创面修复有密切关系,PDGF在创面愈合过程中有着规律性的变化并发挥十分重要的调控作用。
  • 磁共振成像诊断半月板病变的价值及对治疗的指导意义 收费下载
  • 目的:探讨MRI诊断半月板病变的价值及对治疗的指导意义。方法:对48例54个怀疑半月板有病变的膝关节进行MRI检查,对其中42例(46膝)进行手术。结果:MRI发现了一些细微的半月板损伤,内侧半月板后角是最好发部位,MRI与手术的符合率为96%。结论:MRI对半月板病变具有非常高的诊断价值,对治疗具有良好的指导意义。
  • 视觉诱发电位对眼外伤视功能鉴定的价值 收费下载
  • 目的:研究图形翻转视觉诱发电位(P-VEP)对眼外伤视功能鉴定的价值。方法:对98例眼外伤患者分组进行P-VEP检测,并与48例正常人进行比较。结果:98例眼外伤患者与48例正常对照组P-VEP比较,P100波潜伏期及P100波幅差异有显著性意义(P<0.05)。眼外伤眼底异常组P100波峰潜伏期较对照组及外伤后眼底正常组明显延迟。眼外伤眼底正常组与对照组比较P100波峰潜伏期及P100波幅差异均无显著性意义。结论:P-VEP检测可以对眼外伤致视神经病变及伪盲做出客观、正确的判定。
  • 实验性胶原酶盘外溶核的肌电图分析 收费下载
  • 目的:主要观察胶原酶盘外溶核后神经根的变化。方法:使用丹麦维迪公司生产的Keupoint肌电图仪对40只家兔胶原酶溶核的实验组坐骨神经传导速度在术前及术后1,7,15,30d的变化分别进行测定。结果:在实验组中,注射胶原酶后第1天坐骨神经传导速度明显低于术前,而第7,15,30天其传导速度较术前传导速度明显增快;对照组在注射后1,7,15,30d传导速度均较术前减慢。结论:胶原酶治疗椎间盘突出,可使损伤的神经根得到恢复而对神经根无破坏作用。
  • 胸廓出口综合征的电生理特征 收费下载
  • 腕部正中神经病变的肌电图分析 收费下载
  • 体外培养肌腱细胞功能老化的观测 收费下载
  • 目的:研究体外贴壁培养肌腱细胞的功能老化。方法:取材成年鸡的趾深屈肌腱,经胶原酶消化法获取肌腱细胞,在体外进行传代培养,收集不同培养时期的细胞,进行形态学、细胞增殖、组织学、逆转录聚合酶连反应(RT-PCR)及Western blot技术分析,观察不同体外培养时间肌腱细胞表型的变化。结果:组织学、RT-PCR及Western blot等均证实随着体外培养时间的延长,肌腱细胞传至第5代后,细胞形态发生明显改变,产殖能力显著减弱,胶原分泌明显减少。结论:体外贴壁培养的肌腱细胞传至第5代后,细胞表型发生显著老化的改变。
  • 碳/碳复合材料人工骨骼RPM—CVI复合成形技术的初步研究进展 收费下载
  • 文章提出RPM-CVI复合成形技术以解决碳/碳(C/C)复合材料人工骨骼制备过程中的瓶颈问题。将快速原型制造与化学气相渗透技术有机地结合起来,可以在较短的周期内制备出形状复杂的碳/碳复合材料人工骨骼。并通过数值模拟技术,对沉积温度、反应气浓度等工艺参数对该工艺致密化过程的影响进行了分析。
  • 人工股骨头置换治疗高龄股骨颈骨折 收费下载
  • Richard钉治疗股骨粗隆间骨折术后康复58例 收费下载
  • 改良手法治疗急性腰扭伤110例疗效观察 收费下载
  • 单侧多功能外固定器对肢体骨折不愈合的康复作用 收费下载
  • 掌骨干骨折内固定术后早期康复锻炼27例 收费下载
  • 髋关节术后持续被动活动机结合主动运动54例效果分析 收费下载
  • 目的:探讨小儿髋关节术后用持续被动活动(CPM)机行功能锻炼的效果。方法:对比分析了1999-2000年期间手术治疗的小儿发育性髋脱位和股骨头无菌性坏死54例(65个髋)患儿术后关节功能的恢复情况。结果:两组患儿在应用CPM机进行被动活动时效果无明显差异,而去掉CPM机进行主动活动时,实验组关节功能恢复时间平均为54.5d,对照组为86.5d,且实验组患肢肌力明显强于对照组。结论:CPM机只能部分改善患肢功能,在应用CPM机的同时加强指导及配合主动运动则能更好地改善患肢肌力和关节功能。
  • 进行性骨化性肌炎51例中国文献报道的综合分析 收费下载
  • 目的:进行性骨化性肌炎(myositis ossificans progressiva,MOP)是一种先天性遗传性疾病,临床较罕见,国内多为个案报道,临床资料不系统,文章综合分析了国内51例MOP病例,总结MOP在我国发病的基本情况。方法:光盘检索出自1979-2001年共31篇有关MOP文献报道,共51例,综合分析了51例MOP的临床表现、诊断、治疗及预后。结果:我国MOP男性较女性患病率稍高,发病时间主要集中在0-5岁,从发病到明确诊断的间隔为7.88年,33例报道有手指、脚趾异常,首发症状多为颈后软组织包块,脊柱最容易受累。在12岁内,可导致身体大关节僵直,造成患者生活能力丧失。我国有关MOP临床治疗资料较少,且缺乏长期随访资料。结论:MOP在我国发病多在0-5岁期间。脊柱是最常被侵犯的部位。
  • 全髋关节置换术后早期脱位的原因分析 收费下载
  • 目的:分析全髋关节置换术后早期髋关节脱位原因,探讨防治方法。方法:自1986年6月-2001年10月,596例(632髋)全髋关节置换术病例中,共有19例发生早期脱位。分别对这19例早期脱位的多方面进行评估。结果:该组早期髋关节脱位发生率为3.0%(19/632髋),脱位多发生在术后1-6周,多因姿势不当,超范围活动为诱因。X线检查,有7例假体位置不良,12例髋周软组织不平衡,髋部外展肌力乏力11例。结论:全髋关节置换术后早期脱位由多种因素引起,假体位置不良、软组织张力低和外展肌力乏力是目前引起早期脱位主要原因。
  • 影响人工肱骨头置换手术效果的因素 收费下载
  • 目的:探讨影响人工肱骨头置换治疗肱骨近端四部分骨折和骨折脱位手术效果的有关因素。方法:用人工肱骨头置换方法治疗30例肱骨近端四部位移位骨折和四部分骨折脱位。平均年龄69岁,(43-79岁)。30例均采用骨水泥固定假体。使用单极肱骨头17例,双极肱骨头13例。结果:平均随访19个月(12-54个月)。手术侧上肢主动上举平均87°(60°-140°)。UCLA总平均分达到26.4分。ASES平均评分22分。影像学并发症包括3例肱骨大结节位置上移,3例假体后倾位置不良。临床并发症包括1例肩关节僵硬,2例肩袖无力。结论:人工肱骨头置换是治疗复杂的肱骨近端四部分骨折和骨折脱位的一种值得推荐的方法。手术技巧、患者年龄、假体选择、手术时机和功能康复治疗影响手术效果。
  • 环抱器治疗人工髋关节假体周围骨折 收费下载
  • 目的:分析人工髋关节置换假体周围骨折发生的原因,观察记忆合金环抱器治疗股骨骨折的疗效。方法:采用记忆合金环抱器对9例人工髋关节置换术中及术后发生的假体周围股骨骨折进行内固定治疗。全髋术后发生骨折有6例,全髋术中发生骨折有3例。结果:9例均获随访,平均随访17.6月(12-19月)。术后1年,除1例翻修术结合环抱器固定有屈髋受限外(45°),其余髋关节屈曲度在85°-95°。结论:人工髋关节假体周围骨折的发生,主要与老龄人骨质疏松,骨溶解导致的骨机械强度下降有关;翻修手术操作不当,增加了这类骨折术中发生的机会;记忆合金环抱器内固定为这类骨折的治疗提供了一经济、实用的手段。
  • 强直性脊柱炎晚期治疗方法的选择 收费下载
  • 持续被动活动在微波诱导高温原位灭活治疗膝关节周围骨肿瘤术后关节功能康复中的意义 收费下载
  • 目的:探讨持续被动活动(CPM)在微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤术后关节功能康复中的意义。方法:微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤,灭活处骨缺损应用脱钙骨基质颗粒加骨水泥修复,局部用钢板或异体皮质骨板内固定,不用外固定。将75例患者随机分为A、B两组。A组40例,术后24h开始使用CPM对患肢进行持续被动功能锻炼,连续3周。B组35例术后进行常规功能锻炼。结果:75例均获随访,平均随访时间13个月,骨缺损处无骨折和骨不连,内固定良好。至3个月时,A组膝关节活动度110°-160°,平均141°,B组膝关节活动度90°-140°,平均126°,统计学差异有显著性意义,P<0.01。结论:微波诱导高温原位灭活治疗膝关节周围骨肿瘤保持手术,能最大程度地保留膝关节功能,术后CPM能进一步改善膝关节的活动度。
  • 体操运动员肘关节损伤的原因 收费下载
  • 测力式骨科固定器骨伤生物力学特征分析 收费下载
  • 从骨伤生物力学观点出发,依照骨折治疗的弹性固定准则,具体分析了测力式骨科固定器的生物力学基本特征。其结果不仅为该器械临床应用提供理论依据,也可做为分析骨折医疗器械优劣、设计和改进骨折医疗器械是否符合骨愈合规律参考。
  • 武术运动员膝关节损伤的调查分析 收费下载
  • 全髋关节置换术后脱位危险因素分析及防治措施 收费下载
  • 目的:分析全髋置换术(THR)后脱位易发因素。方法采用后外侧切口,THR患者412例437髋,其中发生脱位11例(2.52%),文章通过分析其基本情况,关节类型及脱位原因。结果:11例患者大多数为肌胖体质,10例后脱位,均为无防脱位内衬假体,1例前脱位,脱位时间均在术后2周内。除1例术后2周发现脱位需手术切开复位外,其余均行牵引加手法复位成功,经术后随访,未再发生脱位。Harris评分,平均83分。结论:脱位的主要原因是假体安放不当及软组织失衡,均与医师的手术操作技术及经验有关,同时术后早期康复护理及术后脱位的预防也应引起医患双方的高度重视。
  • 持续被动活动装置在膝关节术后功能康复中的临床应用 收费下载
  • 目的:评价持续被动活动(CPM)装置在膝关节手术后早期应用对膝关节术后功能康复中的作用。方法:25例膝关节术后的患者,早期应用CPM装置,从30°开始,观察其膝关节的康复情况。结果:除一例因切口感染而终止应用外,余24例患者均得到满意的膝关节活动范围,并未影响骨折的愈合。1例患者发生骨折的轻度移位。结论:对于膝关节周围骨折行切开复位内固定的患者在坚强可靠内固定的前提下,早期应用膝关节CPM装置,可以得到良好的膝关节功能。
  • 失败人工髋关节假体的临床分析 收费下载
  • 骨水泥型人工髋关节安装技术与防止术后髋关节脱位的体会 收费下载
  • 胸腰段脊髓肿瘤切除后重建脊柱后柱稳定性的临床观察 收费下载
  • 神经源性膀胱功以障碍的康复训练 收费下载
  • 全应用椎弓根螺钉及棒系统三维矫治脊柱侧凸 收费下载
  • 腰椎间盘突出症体感诱发电位改变及其机制 收费下载
  • 目的:探讨腰椎间盘突出症(LDH)体感诱发电位(SEP)改变及其机制。方法;分析65例经手术确诊的LDH患者术前SEP的检查结果,并检测分析LDH相关动物模型(大鼠坐骨神经结扎,分正常组、假手术组、急性和亚急性结扎组)的诱发电位(EP)改变。结果:LDH患者术前SEP检测的阳性率达90.8%(59/65),主要表现为N40峰伏期延长;急性结扎组EP传导速度(V)与正常组、假手术组比较差异无显著性意义,而亚急性结扎组V与正常组、假手术组比较均明显降低。结论:SEP改变与腰骶神经根受压迫有良好相关性,可判断神经根功能,是一种良好的辅助诊断LDH的方法。LDH患者SEP检测异常主要表现为N40峰潜伏期延长。这主要是由于神经髓鞘受到较长时间压迫所致缺血、炎症等的影响,髓鞘受到不同程度的破坏,从而导致传导速度减慢。
  • 仰卧手法牵引加定点整复推拿治疗颈性眩晕 收费下载
  • 目的:观察仰卧手法牵引加定点整复推拿治疗颈性眩晕的疗效,并探讨其可能的治疗机理。方法:仰卧手法牵引加定点整复推拿治疗颈性眩晕40例为手法治疗组,并设牵引对照组40例,分析比较两组的疗效。结果;两组治疗前后对症状与功能积分评估结果显示均有极显著差异(P<0.01),而治疗后两组指标积分显示眩晕、颈肩痛、头痛、日常生活和工作积分以及症状总积分均有统计学意义(P<0.01)。结论:手法治疗组对颈性眩晕的疗效优于牵引对照组。仰卧手法牵引加定点整复推拿通过缓解颈部肌肉的痉挛、纠正错位的颈椎,从而解除椎动脉的痉挛、压迫、改善胸部血液循环,达到治疗颈性眩晕的目的。
  • 骶管神经阻滞治疗下腰痛 收费下载
  • 病变定位、同心轴旋转治疗腰椎间盘突出症疗效分析 收费下载
  • 老年性两种腰腿痛神经阻滞治疗效果比较 收费下载
  • 快速牵引加手法推拿治疗腰椎间盘突出症 收费下载
  • 针刀松解治疗肩胛上神经卡压综合征31例 收费下载
  • 点按法并物理因子治疗神经根型颈椎病:随机分组对照 收费下载
  • 针灸对急性腰扭伤的治疗 收费下载
  • 骶管注药术治疗腰椎间盘突出症53例 收费下载
  • 早期综合康复治疗防凼烧伤后遗症112例 收费下载
  • 不同发育阶段细胞的分化与调控机制 收费下载
  • 细胞增殖与分化是创伤修复过程中组织修复重建、再生的基础。回顾性研究发现,创伤修复中的许多基本问题并没有安全解决,而这些基本问题在很大程度上又涉及发育学与比较生物学。文章概述了国内外目前对胚胎成成人两上发育阶段细胞分化现象的认识和研究进展。
  • α—促黑素细胞激素及其对成纤维细胞的生物学作用 收费下载
  • 促黑素细胞激素(MSH)是一种神经内分泌激素,分为α-MSH、β-MSH、γ-MSH3种。MSH的前体是前阿黑皮素(POMC),受体有5种:MCR1-MCR5。下丘脑在调节垂体中间叶MSH分泌中起关键性作用。已有实验证实人皮肤成纤维细胞(HDF)能够表达POMC、α-MSH和MCR1。α-MSH能够抑制HDF中前列腺素E2的增殖,诱导HDF中IL-8/IL-8RA mRA的表达和生成以发挥抗炎和免疫调节作用。对纤维增生性疾病(FPDs)具有多效性作用,一方面可能间接促进HDF的增生,另一方面能通过多种途径减少胶原的含量,在活体上还具有抗纤维化的作用。α-MSH结构与功能关系及其对成纤维细胞生物学作用的研究成果为其在临床的应用提供了坚实的基础。
  • 无细胞异体真皮基质的研究进展 收费下载
  • 皮肤磨削仪在瘢痕整形中的应用 收费下载
  • 颅脑损伤后生物节律紊乱的康复调整 收费下载
  • 目的:探讨颅脑损伤后生物节律(BT)的紊乱的规律以及对康复的影响。方法:颅脑损伤伴BT紊乱者34例,给予心理治疗、严格作息时间、运动疗法等突出整体功能调整。结果:清晨体温、心率、血压及夜间睡眠BT的主要评估内容均有明显改善。调整治疗的变量作为评定的指标进行效果评价。结论:颅脑损伤后康复治疗使BT的恢复有利于整体功能的恢复。
  • 不同家庭及社会支持对重度脑损伤患者康复的影响 收费下载
  • 氟西汀对脑出血抑郁症状患者预后的影响 收费下载
  • 目的:研究氟西汀抗抑郁治疗对脑出血患者预后的影响。方法:65例脑出血伴发抑郁症患者在常规治疗基础上随机分为治疗组34例和对照组31例。治疗组给氟西汀20mg,口服,1次/d。疗效用神经功能缺损评分(NIHSS),生活状态评分(ADL)及汉密顿量表(HAMD)进行评定。结果:氟西汀组与对照组各项指标比较差异有显著性意义(P<0.01)。结论:氟西汀能有效治疗脑出血患者抑郁症状,对患者的预后起积极作用。
  • 颅脑外伤后肢体功能恢复的康复训练 收费下载
  • 神经康复在大面积梗死并脑疝减压术后的应用 收费下载
  • 脑卒中后排尿功能障碍的治疗体会 收费下载
  • 康复流程训练对脑出血偏瘫患者的早期康复 收费下载
  • 电针灸八Liao穴治疗脑损伤后排尿障碍36例 收费下载
  • 老年颅脑损伤患者高压氧治疗期间的护理 收费下载
  • 腹股沟疼痛与低位腰椎间盘突出关系的探讨 收费下载
  • 目的:探讨低位腰椎间盘突出症患者腹股沟疼痛的临床特点和CT表现。方法:319例L4-5和L5-S1单节段腰椎间盘突出的患者,其中34例有腹股沟疼痛,将其临床特点和CT表现与没有腹股沟疼痛的患者进行比较。结果:腹股沟疼痛主要见于L4-5节段椎间盘突出,疼痛程度为I-Ⅲ级,有腹股沟疼痛的患者腰痛症状的发生率减少。结论:L4-5节段椎间盘突出最可能发生腹股沟疼痛,窦椎神经可能是腹股沟疼痛的传入神经,部分患者的腹股沟疼痛可能被腰痛、臀部同等症状掩盖。
  • 带状疱疹后遗神经痛3种神经阻滞方法比较 收费下载
  • 目的:探讨3种不同神经阻滞方法治疗带状疱疹后遗神经痛(PHN)的疗效。方法:根据阻滞方法不同分为:A组为三叉神经上、中、下浅支阻滞;B组为肋间神经阻滞;C组为硬膜外腔阻滞。根据阻滞神经的部位,选择不同的药物用量。结果:A组优10例,良6例,可2例,差2例;B组优11例,良3例,可5例,差1例;C组优11例,良6例,可2例。经用Fisher精确检验,各组间比较差异没有显著性意义。结论:3种神经阻滞方法治疗不同部位的带状疱疹后神经痛都可收到良好的疗效。
  • 氟桂利嗪与心得安防治偏头痛对照观察 收费下载
  • 支架治疗食管肿瘤所致进食功能障碍 收费下载
  • 目的:评价置入自膨覆膜支架治疗食管、贲门恶性狭窄所致进食功能障碍康复的疗效。方法:对41例食管、贲门恶性狭窄患者行食管内支架治疗,透视下用胃管引导导丝通过狭窄部位,再沿导丝插入支架置入器,定位准确后推放。结果:置入操作顺利35例(15min内),6例在20-40min内完成,无术中并发症。术后常见反应为胸骨后胀痛,一般可耐受。术后所有患者吞咽困难症状明显改善,一般状态好转。结论:支架是治疗食管、贲门恶性狭窄所致进食功能障碍康复的一种安全有效的方法。有可能代替空肠造瘘术、胃转流术,成为主要的姑息性康复治疗方法。
  • 直肠癌根治术后生存质量研究现状和进展 收费下载
  • 运动疗法配合微波治疗肩关节撞击综合征 收费下载
  • 目的:观察运动疗法配合微波对肩关节撞击综合征的治疗效果。方法:将52例肩关节撞击综合片患者随机分为2组,其中对照组25例采用常规治疗,康复组27例在常规治疗基础上加以运动疗法并配合微波治疗。采用Rowe肩功能评定法来评定治疗效果。结果:治疗后两组Rowe评分均有提高,但两组间差异有非常性意义(P<0.01)。结论:运动疗法配合微波治疗更能有效地提高肩关节撞击综合征的治疗效果。
  • 空气加压舱氧浓度监测系统存在的问题及改进建议 收费下载
  • 超短波并电针治疗面神经炎60例 收费下载
  • 足跟痛的电磁疗法与低频调制的中频电水浴疗法的比较 收费下载
  • 胸、腰椎骨折并脊髓损伤术后的康复治疗1例报告 收费下载
  • 随机对照分析中频电药物透入与单纯中频电治疗腰椎间盘突出症126例 收费下载
  • 大黄多糖对脑损伤后大鼠脑皮层热休克蛋白70表达的影响 收费下载
  • 目的:观察大黄多糖(Tanguticum Maxim polysaccharides,TMP)对大鼠脑损伤后不同时间热休克蛋白(heat shock protein,HSP)70表达的影响,探讨大黄多糖的脑保护作用机制,为其用于临床治疗脑损伤寻求依据。方法;复制大鼠脑挫裂伤模型,分别在伤后6,24,48h以免疫组织化学方法检测大脑皮层表达HSP70的神经细胞,以Western-blot蛋白印迹方法检测脑皮层HSP70表达变化。结果:大黄多糖治疗组6h HSP 70表达高于损伤组,24,48h均低于治疗组.结论:大黄多糖能促进HSP 70的表达,这可能是其脑保护作用的机制之一。
  • 都可喜治疗认知功能障碍不良反应的临床应用前瞻观察 收费下载
  • 现代敷料研究现状 收费下载
  • 传统的纱布敷料于创面修复中仅起单纯覆盖创面的作用,随着分子生物学的迅速发展,现代敷料不仅要覆盖创面,还应具有促进组织修复的功能。文章就创面保湿环境愈合新概念和创伤敷料的研究现状作一阐述。
  • β—七叶皂甙钠辅佐治疗坐骨神经痛18例:随机对照 收费下载
  • 舒安注射液促进脑出血大鼠神经功能恢复的作用 收费下载
  • 目的:观察舒安注射液(SAI)对大鼠脑出血模型的治疗作用。方法:采用大鼠自体股动脉血微量注射入内囊造成脑出血模型,舒安注射液静脉注射给药治疗7d,记录脑出血模型大鼠的神经病学评分,脑组织的含水量,及对脑指数的影响。结果:SAI治疗后,大鼠神经病学评分明显低于治疗前及生理盐水组;大鼠脑组织含水量,Na^+含量明显及脑指数均显著低于生理盐水对照组。结论:SAI可明显促进脑出血大鼠的神经功能的恢复及脑水肿的减轻。
  • 胎脑提取液对大鼠的抗疲劳作用 收费下载
  • 目的:探讨胎脑提取液的抗疲劳作用。方法:选用Wiustar大鼠240只,随机分为常温组、低温组和高温组,每组再分成4组;观察记录大鼠注射不同剂量胎脑提取液后,在不同温度水中自由游泳最终沉入水中的时间。结果:胎脑提取液能显著延长大鼠在不同温度水中的游泳时间,并具有良好的显效关系。结论:胎脑提取液具有一定的抗疲劳作用
  • 血府逐瘀汤治疗带状疱疹后疼痛30例 收费下载
  • 经静脉自控止痛治疗中晚期癌性疼痛18例 收费下载
  • 休闲娱乐康复在老年康复中应用 收费下载
  • 指神经修复和移植后的早期被动运动 收费下载
  • 背景:肌腱及神经的复合伤临床治疗有多种方案。单独的肌腱损伤修补后尽早运动,预防粘连发生,而单独的神经损伤通常采用制动以防止断裂,容许轴突再生,已发表的文献推荐治疗肌腱、神经复合伤的方法不明确,有些建议制动3周。目的:确定采用修订的Duran运动方法及无规则的运动引起神经断裂时神经缺损的长度及运动后神经移植是否有断裂的危险。方法:在一具新鲜的尸体上采用修订的Duran方法及无托板托起的方法对10只手指上100条神经进行检测,每个手指的指神经在用两种方法检测后,随之以5个逐渐增宽的神经缺损长度进行切断及缝合。结果:采用支托方法及非支托方法检测发生断裂时神经缺损长度有明显区别,分别为(9.7±0.8)mm和(7.3±1.9)mm,经t检验P<0.001。采用修订的Duran方法,5mm以内的神经缺损无断理解发生,采用非支托方法,2.5mm以内的缺损无断裂发生。在背侧保护性夹板内所有神经移植均保持连接。结论:考虑到神经修补机制的完整性,本结果数据提示为避免由于制动引起的肌腱后遗症,神经损伤后可以采用肌腱损伤后的运动方案。
  • 手损伤患者Dexter评估和治疗系统的有效性和可靠性 收费下载
  • 目的:本研究对比采用Dexter评估和治疗系统与采用手动测角器及捏握测力计获得的数据。同时评定两种方法组内及组间的可靠性。方法:对30例患者进行重复的指活动范围和力量测定,所有患者均有上肢损伤史。3位治疗师完成所有的评定任务,采用Dexter系统及手动仪器对每位患者评定3次,采用变量分析及组间的相关系数评定有效性及治疗师的可靠性。结果:电脑化的Dexter指测角器及抓握、捏测力计测定结果有相似的统计学意义。有效性变量分析结果显示治疗师间采用电脑化的Dexter指测角器测定的平均值与手法工具检测的结果没有明显的差异(P≥0.54)。几位治疗师评定的结果间没有统计学差异。4次检测中组内及组间的可靠性ICCs的范围为0.86-0.99。而采用双侧的变量分析揭示了在捏力检测中由一位治疗师评定的结果是一致的(P≤0.05)。结论:结果提示如果不用Dexter捏力计进行进一步的评定,必须由同一位治疗师采用同样的方法进行评定。
  • 手腕部损伤患者接受作业治疗或物理治疗后健康状态的改变 收费下载
  • 目的:描述在骨科急诊接受物理治疗和作业治疗的手或腕部损伤患者自觉健康状态的改变。方法:从FOTO国家康复数据库选择1996年7月到1997年6月接受治疗的患者1399,腕部损伤692例,手部损伤707例,每位患者入院及出院时完成一份健康状态问卷,数据包括门诊就诊次数、一次治疗的时间及6个功能量表的健康状态评分。计算出治疗强度、整体健康状态、整体利用及患者的满意度。对作业治疗及物理治疗的效果进行评定。结果;在整个治疗过程中患者感到健康状态明显改善(P<0.05)。患者到作业治疗师及物理治疗师处就诊的次数、健康状态的评定和患者的满意度相似。到作业治疗师处就诊的患者每次治疗的时间更长(P<0.05),治疗强度更低(P<0.05)。结论:在骨科急诊中心接受康复治疗的患者可以感觉到功能能力及健康状况的改善。结果也证实了这种评定方法对患者自我感觉健康状态临床变化的敏感性,支持采用健康状态作为临床结果的评估方法。
  • 建立一个标准的病态手功能和假手功能临床评定方法:规范的数据,可靠性,有效性 收费下载
  • 目的:详尽描述一种新的评估方法--Southampto手评估程序,以便在临床的工作中很容易获得手功能的连续评定。设计:与标准的医疗结果评估方法相比较,确定新评估方法的可靠性及有效性。地点:在一所大学实验室收集规范的数据。对象:以患者最理想的手功标准,选择24例患者,年龄18-25岁,没有其它的手外伤及神经损伤或上肢残疾。主要结果评定:评定规范对照组数据的变化性;评定新程序组内及组间的可靠性;没有直接的对比限制了标准的建立,而内容的有效性通过专家的评论进行。结果:对照组数据显示为高斯多变量,重复试验及组内比较可靠性为95%的可信水平,内容的有效性采用专题讨论小组意见。结论:对照组结果确定了SHAP统计学的完善性。虽然这项量表在基础护理和康中心已被大力提倡,用于物理治疗和作业疗法进行手功能康复效果的评定,但临床实践还远远不足。
  • 断指患者康复程序及功能结局 收费下载
  • 背景:断指即是一种生理的创伤,也是一种心理的创伤,影响患者的日常生活。断指的康复是一个复杂的过程,要考虑多种影响因素,例如:患者的手功能、情感、社会和职业的康复。目的:评估断指患者的功能水平,了解影响康复的因素。对象:1990年1月到1998年12月间的断指患者50例,男42例,女8例,年龄7-84岁,断指水平在掌骨或手指末节,至少进行6个月的随访检查。方法:所在患者分为3组,末节手指截断与近端指节截断相对比,单指截断与多指截断相对比,工作中造成的手指截断与共它事件造成的手指截断相对比,核实断指时间并作为功能水平的影响因素。结果:远端指节截断比近端指节截断感觉和运动功能恢复效果更好,单指截断患者比多指截断患者有更好的运动、感觉及日常生活活动能力的恢复,工作造成的断指比其它事件造成的断指运动和感觉功能水平低,时间是影响运动和情感恢复的重要因素。
  • 手屈肌腱2区修补后的康复方法 收费下载
  • 对象:对1996年12月到1998年10月在Nancy大学医院急诊室进行手术的47例患者54指的治疗效果进行回顾性分析。方法:对这些患者采用3种不同方法进行术后康复:(1)根据Duran技术进行被动运动;(2)根据Kleinert技术进行主动被动运动;(3)根据Strickland方法进行即刻的主动运动。采用3种不同的方法对患者进行评估:(1)根据Strickland量表获得的主动活动范围;(2)400点的伸肌功能检测;(3)恢复工作的时间。结果:结合3种评估评估方法显示65%效果满意,22%患者效果可及不好,13%患者断裂。通过对运动训练技术的分析,显示Strickland方法有明显的优势。这需要更大范围的前瞻性研究来进一步确认。康复训练的方法对患者恢复工作的时间没有影响,但Strickland方法副作用更小。单纯关节主动活动范围的结果不能全面反应伸肌腱修补的效果。功能检测在后期的评定中更好,整体400点的评分比单个组成部分的检测更有意义,功能评定在指导医疗组确定治疗方案中更有帮助。
  • 指神经损伤康复中早期触觉刺激的使用 收费下载
  • 目的:指神经损伤是最常见的周围神经损伤。为改善指神经损伤患者功能敏感性的恢复,我们采用前瞻性随机对照研究观察早期触觉刺激在指神经损伤康复中的作用。方法:制定两套特定的触觉刺激方法,并应用于指神经损伤患者。24例患者(32指神经损伤)接受触觉刺激治疗,为试验组,另外25例患者(33指神经损伤)只接受传统治疗,为对照组。结果:与对照组相比,试验组有明显的不同(P<0.05)。不同级别的损伤间有一些差异,对神经、肌腱及骨的复合伤也是有好处的。结论:本研究结果提示早期触觉刺激对改善指神经损伤患者功能敏感性质和量的恢复是有效的,但伴有神经、肌腱和骨复合损伤除外。
  • 美国明尼苏达州工作相关断指患者的医疗、个性及职业结局 收费下载
  • 背景:明尼苏达州职业危险监测系统(SENSONR)收集了1992年以来的工作中断指患者的医疗、个性及职业结局。方法:SENSOR将断肢定久为任何手指的截断及任何身体其它部分的丢失。1994年到1995年间832例患者诊断为断肢,对其中72%患者完成电话随访。结果:20%患者要求住院治疗;91%患者失去工作;56%患者误工10d或更多的时间,损伤后仍可从事原工作的患者报告的医疗及职业结局可能更轻。结论:损伤严重程度与医疗、个性及职业结局明显相关。
  • 采用自体静脉移植在急性手重建感觉神经修复中的效果及意义 收费下载
  • 目的:手指损伤及手部其他部位感觉神经的损伤很常见。基于静脉移植支持周围神经再生的实验研究,作者采用简单的静脉移植连接感觉神经缺损治疗急性手损伤。方法:对22例手外伤患者进行回顾性的分析,所有患者急诊手重建中无法进行一次性缝合,采用列脉移植修复感觉神经,并告诉患者将来很可能有必要进行第二次神经移植。由两位观察者分别对患者进行至少1年的访视,并采用由MacKinnon和Dellon修订的最高量表进行评估。评估量表内包括修补对康复程序、神经瘤疼痛、瘢痕及患者满意度的影响。结果:采用Sakellarides方法进行分类,22例中有20例患者为好及非常好。分类为差的患者满意,但未进行第二次神经移植。其它损伤的康复,例如肌腱断裂,骨及软组织的损伤,没有因神经修复而被影响,在这组病例中没有痛性神经瘤发生。结论:文献报道的采用神经移植修复指神经的效果不令人满意,不修复感觉神经又常引起疼痛性瘢痕及疼痛性神经瘤,医生又不愿意在急诊的情况下进行神经移植,所以我们推荐这种易行、低花费、有效的简单方法。
  • 急性创伤性手损伤的早期阶段的定量研究 收费下载
  • 目的:对20例手创伤后8-20d的患者进行访视,目的是研究应对方法及手损伤患者处理应激因素和情绪波动的思想及行为特征。方法:应激因素在早期的研究中已经报道过,该视分析以一个修订的基础理论修订模型进行描述。结果:在这次访视中共有11项应对方法,患者通过与更糟的事情对比、正性思维、信任个人能力、分散注意力方法尽量贬低损伤及问题的严重程度。手损伤患者采用的其它应对方法还有接受这个事实、寻找社会支持、保持克制、自己解决实际问题、减轻疼痛及积极的处理创伤。结论:本研究发现,为了给予患者足够的心理支持,研究患者自己应对急性应激情况的方式是十分重要的。
  • Anterior interspace catheterization of the epidural cavity through sacral hiatus and its applications in treatment of protrusion of lumbar intervertebral disc 收费下载
  • Kinesitherapy in treatment of 35 cases with spinal cord injury 收费下载
  • Background:It is significant how to reserve residual myodynamia of parients with spinal cord injury,increase the ability of self-care and make them return to the family and society.We adopted kinesitherapy to treat 35 patients with spinal cord injury and reported the results as follows.Objective:To observe the effect of kinesitherapy on the treatment of spinal cord injury.Unit:Orthopaedics Hospital of Jincheng City of Shanxi.Subjects:35 patients with spinal cord injury during January of 1999 to 2001,31 males and 4 females,aged from 16 to 71,with mean age of 35.2.The causes of wound 4 of crash wound,2 of falling wound,26 of road accident and 3 of other wounds.The site of injuries:7 in cervical vertebra,14 in thoracic spine,12 in lumbarvertebrae(T12-L1-4) and 2 in multiple segments.The courses were from 40 days to 5 years.Standard lesion degrees of ASIA92: 6 of grade A,8 of grade B,18 of grade C and 3 of grade D.Intervention:The kinesitherapy were taken in 4 stages:(1)Stage of lying in bed:exercise in bed,training motion of joints and stretching exercise mainly.(2) Stage of wheel chair:train muscles of pectoral girdle,biceps and triceps muscle of arm to increase myodynamia of upper limb.(3) Stage of standing:standing training,standing on bed from 30° to 90° to resolve postural hypotension from long-term bed,and train iliopsoas muscles,gluteus muscles,muscles of lumber and back and quadriceps of femoris.(4) Stage of walking:use proper braces according to the myodynamia until remedial walking and functional walking were achieved step by step.All the training were taken once a day.for 45 minutes per time,5 times per week and 1 course for 3 months.Results:Evaluate the effect of functional independence and rehabilitation of patients with standard by Specification of diagnosis and treatment of China Rehabilitation Medicine.Before therapy,there were non of grade 1,non of grade 2,1 of grade 3,1 of grae 4,8 of grade 5,12 of grade 6,13 of grade 7.After therapy,there were 2 of grade 1,3 of grade 2,10 of grade 3,7 of grade 4,5 of grade 5,5 of grade 6,3 of grade 7.Conclusion:Kinesitherapy could enhance the force of all the muscles which could still be used,improve the ability of residual myodynamia and functional ability and in crease the residual functions.
  • Study on expression of endothelin in experimental cerebral concussion in rats 收费下载
  • Objective:To study changes and significance of endothelin (ET) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on 1,3,7,14 and 30 days after injury and the brain tissue were taken off.The expression of ET was studied in the course of cerebral concussion by means of immunohistochemistry.Results:Typical clinical manifestation was observed in the 100g group in which the pathological changes included cerebral vascular constriction and dilatation,congestion and edema of cerebral tissue,neuronal degeneration,necrosis,and obviously decreased even disappeared Nissl bodies.Increased expression of ET was observed on the first day,the positive area was seen in the plasma of endothelial cells in cerebral cortex,hippocampus,cerebellum and thalamus.ET expression peak occurred on the 7th day,the positive area was also found in the plasma of Purkinje cells in the cerebellum.Decreased ET expression was found on 14th day and returned to normal level on the 30th day.Conclusion:The main pathological changes of cerebral concussion contained blood circulation disorder,and degeneration and necrosis of substantial cells.ET was involved n the brain tissue injury during the pathological process of cerebral concussion and might be related to regulation of cerebral vascular reaction,and neuron degeneration and necrosis.
  • Effect of sodium β—escin on early rehabilitation of the patients with traumatic cerebral infarction 收费下载
  • Background:Sodium β-esci is involved in Aesculus chinensis Bunge,Could increase the tension of veins,improve blood rheology making the blood flow faster,fasten the absorption of the edema around the cerebral infarction,and improves blood supply in the cerebral infarction and around it,and promote the recovery of brain function.Objective:To evaluate the effect of sodium β-escin on early rehabilitation of traumatic cerebral infarction.Unit:The 180th Hospital of PLA.Subjects:55 cases including 34 males and 21 females,aging 5-63 years(meanly 27.4 years),were contained in this study.Causes included traffic accident in 27 cases,falling injury in 16,pounding injury in 9,and craniotomy in 3.Hemiplegia of different levels was found in all cases,complete hemiplegia in 13,incomplete hemiplegia in 42,myodynamia I-Ⅳ.Accompanying aphasia was found in 6 cases.Diagnosis was cofirmed by cranial CT examination in all cases.Injuries were found in the basal ganglion in 35 cases,in the temporoparietal lobe in 12,in the occipital lobe in 6,and the frontal lobe in 2.No past history of hypertension or cardiovascular disease was found in any of the cases.All the subjects were randomly divided into test group (28 cases) and the controls(27 cases).There was no significant difference in age,location of the injury,injury time,seriousness,or functional disorder of the limbs between the two groups (P>0.05).Intervention:In the test group:Decompression withdrawing the bone flap was performed in two cases.Conservative treatment was performed in 26 cases,which contained (1) 25mg of sodium β-escin (provided by the Green Leaf Pharmaceutical Co,Yantai,Shandong) in 250ml of 5% glucose solution i.v.drop,once a day,15days a course,and (2) 125 ml of 20% mannitol i.v.drop,twice a day,which was gradually decreased till stopped in a week.In the controls:Decompression withdrawing the bone flap wasperformed in two cases.Conservative treatment was performed in 25 cases,which contained 91) 250 ml of 20% mannitol i.v.drop quickly,three times a day,which was gradually decreased to 125 ml,twice a day,then till stopped in another week.Other comprehensive treatments including using of vascular dilators i.e.low molecular dextran,compound Red sage root,nitrendipine injection etc,activators of the brain cells,nutrient supporting was same in the two groups.Patients in bothe groups received rehabilitation train in 24 hours after confirmed diagnosis according to the Rehabilitation rules of cerebrovascular diseases in the acute stage,made by the China Rehabilitation Center.Main Prognosis indexes:Limb motor functions of the patients before and after treatment was evaluated with the simple Fugl-Meyer Analysis(FMA).Activities of daily living (ADL) were evaluated with barthel index.Result:Conditions in the two groups before and after treatment were shown in table 1.Conclusion:Early use of sodium β-escin in treatment of cerebral infarction is beneficial for recovery of limb motor functions and ADL abilities and is beneficial for early rehabilitation of traumatic cerebral infarction.
  • Mechanism research on promoted survival rate of tension skin flap after meshed relaxing short incision suture 收费下载
  • Objective:To observe effects of meshed relaxing short incisions (MRSI) on the content of endothelin(ET) in rat tension skin flap,and to investigate the mechanism of meshed relaxing short incisions (MRSI) on wound healing process of tension skin flap.Method:We designed an experimental model to investigate the change of ET content caused by MRSI and observe the distribution of ET in rat skin flap tissue each period of wound healing.In the meantime,the immunohistochemistry and auto-image analysis were employed.Results:our results showed:(1) ET positive immunologic reaction granules involved in small vascular endothelial cell in rat skin flap tissue increased with prolonging of time within 3 days;(2)the content of ET in MRSI group were significant lower than that of hypertension group (P<0.05).Conclusion:The decrease of ET contents may be one of the causes that MRSI improves microcirculation of skin flap,and reduces edema and facilitates healing of skin flap.
  • Relationship between exon deletion frequency of CDKN2/P16 and pathological type,metastasis,sex in osteosarcoma 收费下载
  • Objective:To study on the CDKN2/P16 gene i primary osteosarcoma.Method:By using molecular biological methods that inclued genome DNA extraction from paraffined tissue and PCR-SSCP analysis technique,we studied alternations of CDKN2/P16 gene in 25 primary osteosareomas.Results:(1)The deletions frequency in differentiation degree of osteosarcomas was ①bone brood cell,16.7%;②cartilage brood cell,12.5%;③Fiber brood cell:20%,(P>0.05).(2)The deletion frequency in male patients was 17.6,female patients 12.5%,(P>0.05).(3)In early metastatic osteosarcomas the deletion rate was 33.3%,which was significantly higher than that of the control group with the rate of 10.5%(P<0.05).(4)The deletion rate was 16% and the mutations were not found.Conclusion:(1)The deletion rate was 16% and the mutations were not found.This suggests that the deletions of CDKN2/P16 gene were closely related to the genesis of primary osteosarcoma and that the main type of the alternation of CDKN2/P16 gene was deletion.(2) In early metastatic osteosaarcomas the deletion rate was 33.3%,which was significantly higher than that of the control group with the rate of 10.5%.This indicates to great extend that the deletions of CDKN2/P16 gene were closely related to the metastatic ability.(3)The deletions frequency had no significant relationship with differentiation degree of osteosarcomas,so was with the sex of the patient.
  • Comprehensive rehabilitation of closed injury of brain 收费下载
  • Objective:To observe the effect of physical factors and promotion canalization on closed injury of brain,Method:68 cases of closed injury of brain were given the comprehensive rehabilitation therapy with many physical factors and promoting canalization technique,Result:The patients‘ consciousnesses were significantly improved after treatment.The motorial function of hemiplegic limbs was distinctly improved(P<0.05).The balance functions were distinctly improved (P<0.001).The activities of daily living abilities were significantly improved (P<0.05).Conclusion:The physical factors and promoting canalization treatment on the closed injury of brain are functionally effective.
  • Quantitative assessment of motor function on children with cerebral palsy before and after wearing ankle foot orthopedic instruments 收费下载
  • Objective:To assess motor function quantitatively on children with cerebral palsy before and after wearing ankle foot orthopedic instruments.Method:Ankle foot orthopedic instruments were made by Dalian Prosthesis Factory.Children‘ motor function was assessed with self-made quantitative assessment scale according to the forth,fifth function area of motor assessment scale of children with cerebral palsy after one week of wearing orthopedic instruments.Result:In all 23 patients,orthopedic instruments proved effective in controlling leg muscular tension,correcting equines,genu recurvatum,talips valgus and talipes varus,keeping erect posture and modifying gait.Motor function assessed show significant difference before and one week after wearing orthopedic instruments (P<0.001).Conclusion:Ankle foot orthopedic instruments play a positive role in improving motor function of lower extremity in cerebral palsy patients.
  • Vitrifficated cryopreservation of biological tissue and cells 收费下载
  • Vitrificated indicates the high adhesion state of solution at extremely low temperature(-115℃)^[1].No ice crystals are formed when extracellular and intracellular solution is under state of vitrification,and hence eliminating mechanic injury and preserving activity of biological tissues.In 1980‘s,cryopreservation of mouse embrgos,red cells,rats ocytes,human monocytes was successfully performed^[2-4].After that,some researchers successfully preserved cornea and skin by vitrification^[5-8].In order to elucidate preservation of cells and tissues by vitrification and widen apply of vitrification,we investigate principle of vitrification,solution,devitrification and its application.
  • Hyperbaric oxygen plus naloxone in the treatment of severe head trauma 收费下载
  • Background:Secondary head injury following severe head trauma is a main factor affecting prognosis,treatment for which is an effective measure in improving prognosis.It is indicated that hyperbaric oxygen can facilitate recovery of injured nerve cells.Objective:To investigate effect of hyperbaric oxygen plus naloxone in the treatment of severe head trauma.Unit:Daping Hospital,Third Military Medical University.Subjects:During February 1999 to December 2001,50 patients suffered from head trauma aged 11-60 years were randomly divided into two groups,treatment group (hyperbaric oxygen plus naloxone beyond routine management) and control group(routing treatment),each group having 25 patients.Injury causes included traffic accidents(n=17),and falling injury(n=8).there were no significant difference in age,sex,and injury causes between the two groups.Severe head injury was confirmed at admission with GCS score varying between 3-8(P>0.05).GCS score was used to evaluate patients before and after treatment.GCS and KPS behavior evaluation was performed 3-6 months after discharge.Intervention:Routine treatment consisted of craniotomy(n=17),antiinfection,maintenance of water and electrolyte balance and decompression of intracerebral pressure for extensive axon injury,and neuroactivator management.10 cases was dead (40%),5 showed favorable rehabilitation (20%),3 suffered from moderate disability (12%),5 from severe disability,2 lived a vegetarian life (8%).Comatose lasted for 14 days averagely.In treatment group,16 accepted craniotomy,and 9 suffered from extensive axon injury.Treatment groups received hyperbaric oxygen plus naloxone beyond routine treatment.Patients undergoing surgery were treated 48 hours without operation received hyperbaric oxygen 24 hours after admission.Method:Patients were placed in a large Hyperbaric oxygen cabin and oxygen was given for 35min×2.0 xygen was given with mask or head mask under 0.2 MPa and an interval of 10 min.Pressure increase and decrease lasted for about 45 min,once a day.10 days was a treatment course.5-2 treatment course were adopted in our study.8mg naloxone was administered during hyperbaric oxygen treatment,once a day.Result:7 cases were dead(28%),12 showed good recovery (48%),4 suffered from moderate disability (16%),2 from severe disability (8%).Comatose time lasted for about 9 days for all patients.Conclusion:Hyperbasic oxygen plus naloxone can decrease mortality,disability rate,and rehabilitation duration after severe head trauma.
  • Therapeutic effect of hyperbaric oxygen on 32 cases of magraine 收费下载
  • Background:Clinical manifestation of magraine is periodical onset of fluctuating headache caused by dysfunction of nerve-vessel,which mechanism is still unclear.Objective: To evaluate therapeutic effect of hyperbaric oxygen on magraine.Unit:Central Hospital of Jinzhou City.Subjects: According to diagnosis standards formulated by 1998 International Headache association,64 cases magraine in neural department of central hospital of Jinzhou city were randomly divided into 2 groups.Treatment group:12 males,20 females,aged 18-50 (mean:34)years old with disease course 4 months to 20 years (mean:4.5 years).Control group:13 males,19 females,aged 16-48(mean:33)years old with disease course 3 months to 18 years(mean:5 years).There was no obvious difference at sex,age,conditon between 2 groups.Intervention:Control group:Buflomedil was used,0.1g,once a day,venous injection and 14 days as a therapeutic course.Control group:On base of drug therapy,hyperbaric oxygen chamber therapy was adopted,raising pressure for 30-35min,stabilized pressure for 40 min,reducing pressure for 20 min,therapy pressure 0.2 MPa,once a day,10 days as a therapeutic course.Main prognosis index:Control:no relapse of headache when treating;Marked:Headache alleviated,continuing time shortened obviously,onset times reduced over 60%;Effective:Headache alleveated and continuing time shortened,onset times reduced over 50%;Ineffective:above standards couldn‘t be achieved.Result: Comparison of therapeutic effects between two groups see table 1.Conclusion: Both combination of hyperbaric oxygen with drug and simple drug therapy could reduce onset frequency of magraine,but combination therapy was more effective,and could shorten effect-producing time.
  • Observation of therapeutic effect for 26 patients with lumbar vertebrae slippage treated by RF internal fixed instrument 收费下载
  • Early repairing with full thickness skin graft and postoperational rehabilitation treatment of deep burn of hand 收费下载
  • Background: To deep burn of hand,Some adopted natural healing,some adopted removal of eschar,thin and intermediate thickness skin flap repairing,But after healing,proliferation and contracture of scar of pigmentation,obvious dryness,no brightness,had elasticity often appeared that would reduce tolerance of abrade and impair function and appearnce of fingers.Objective: To investigate the clinical effect of full thickness skin graft after removal of eschar on deep burn of hand.Unit:169th Hospital of PLA.Subjects: 36 cases of deep burn of hand were investigated including 28 males,8 females,aged 2-46 years old among which were 24 cases of flame burn,6 cases of scald,3 cases of acid burn,2 cases of alkali burn with 8 cases at both hands,3 cases at both palm and dorsum of hand.Intervention:(1)After 6-8d,when edema disappeared,routine therapy was adopted to circular eschar,relief incision;One day before operation,wet packing with antibiotics and bandaging was adopted to achieve relative asepsis circummstance.(2) 0.5 before operatioin,surface of wound was brushed completely,hibitane soaking for 30 min complex iodine sterilizing operation region.(3)Eschar was removed under tourniquet.Necrosed tissue was deleted completely,avoiding injuring vessels (if longe quantity of bone substance was exposed,transferred to other method;After complet hemostasis,wet packing with saline containing antibiotics for 10 min.(4) Full thickness skinflap was reilled to keep apporiate tension.After suture subcutaneous stasis of blood was irrigated;Skin flap was pressed with bits of ganze and compression bandage.Finger and wrist were fixed with plaster support.(5) Antibiotics was used systemicly;Operation part was elevated and stitches were removed after 10d.Movement was started from 15-20d,and increased successively.Result:Wound surface of all cases healed within 25d,survival rate of skin flap was over 95%.After 0.5-1 year of follow-up,no obvious proliferation and spasm of scar and dysfunction were found,outward appearance of hand,elasticity,brightness and abrade tolerance approached normal level.Conclusion: Early full thickness skin graft could promote healing of wound surface in deep burn of hand and decrease incidence of dysfunction leaded by proliferation and spasm of scar.
  • Massotherapy combined with traction on 47 cases of semiluxation of articulatio atlantoepistrophica 收费下载
  • Background:Massotherapy was the main method adopted in treatment of semiluxation of articulatio atlantoepistrophica and traction was also used.An obvious effect was observed when two methods were combined.Objective:To observe effect of massotherapy combined with traction on semiluxation of articulatio atlantoepistrophica.Unit:Guilin Hospital of Traditional Chinese Medicine.Subjects:47 cases were in vestigated including 27 males,20 females.29 cases were 4-12 years old,2 cases were 12-18 years old,16 cases over 18 years old.Injury history was found in 28 cases,respiratory infection or tonsillitis in 6 cases,degenerative lesion of cervical vertebral or strain of cervical muscles in 7 cases,indefinite reasons in 6 cases with disease courses 1 day to 6 weeks.Pain of cervical muscles in 47 cases,complicated with headache in 39 cases,dizzingess in 40 cases;Tender point at cervical part in 47 cases,limit of motion in 41 cases;Tender point at cervical part in 47 cases,limit of motion in 41 cases,torticollis in 6 cases.films of orthophoria and lateral and C1,2 were taken in all cases.Asymmetry of inter-space of articulation atlantoepistrophica in 47 cases,abnormal physiological curvature in 8 cases,hyperosteogeny in 7 cases,complicated with fracture of spinous process of C1 in 1 case.Main prognosis index:Excellent:symptoms and signs disappeared,X-film showed,middle axis of articulatio allantoepistrophica coincided;Good:symptoms and signs disappeared a large part,middle axis of articulatio atlantoepistrophica didn‘t coincided,or paralleled,improved than before;Fair:symptoms and signs improved than before,and middle axis of articulatio atlantoepistrophica improved than before;Bad:no improvement.Result:Excellent,9 cases;Good,20 cases;Fair,16 cases;Bad,2 cases;Total Effective rate,96%.Conclusion;Massotherapy combined with traction on semiluxation of articulatio atlantoepistrophica had an obvious therapeutic effect.
  • Application of arthroscope and postoperative functional exercises in diagnosis and treatment of knee joint diseases 收费下载
  • Effect of rehabilitation exercises on urinary function of incontinence after per urethra prostate opertation 收费下载
  • Background:Urinay incontience is complication following benign hyperlasia of prostate undergo endoscopic removal.Due to internal imbalance of micturition mechanism mainly,such as incompetence of posterior urethra or unstable detrusor.Urinary incontinence causes not only physiological,psychological disorder,but also family and social problems.Objective:To observe effect of rehabilitation exercises on urinary function of urinary incontinence patients following per urethrakprostate operation.Unit:South-west Hospital,Third Military Medical University.Subjects:1525 male patients,aged 62-95 years old.Perurethra prostate electric technique,prostate holmium laser were done under peridural or general anesthesia.Urinary catheter was removed at 3-5 days after operation.There were 78 cases urinary incontinence after urinary catheter was taken out.After urodynamic study and culture of midstream urine,78 urinary incontinence were divided into:imminent urinary incontinence 48 cases,compression urinary incontinence 26 cases,real urinary incontinence 4 cases.Intervention:(1)To imminent urinary incontinence caused by infection,first strengthening anti-infection treatment,sensitive antibiotic was used.Sitz bath in potassium permanganate warm water patients were encouraged to drink more water and get liquid 1500-2000ml/d in case of no venous inflow,drink water once every 2-3h.Urinary mechanical douche was kept so as to lighten urinary irritation.Water intake should be reduced at night and in winter.(2) To precipitant urinary incontinence caused by unstable bladder.Patients should be guided whten they had urination consciousness,horizontal and genuflex position,deep breathed,relaxed abdominal muscle,constracted pelvic muscle and sphincter of anus,time of urination was delayed as for as possible.After urgent feeling decrease,went to toilet.With improvement of self-controlled ability of urination,went of toilet at fixed time.Patients were warned to tried their best to micturite once each hour.They should micturite at fixed time as far as possible,the time was prolonged to once every 3-4h.According to rehabilitation state of patients later finally biofeedback model was formed.Results: 14 urinary incontinence caused by inflammatory stimulus,remitted after 7-21d,normal micturition recovered after 1 month,9 cases.In 25 cases of urgent urinary incontinence,12 cases could control micturition,after 2 weeks,7 cases could control micturition after 1 month,other 6 cases could control micturition partly.In compression urinary incontinence patients,16 cases couldf control micturition after 1 month.10 Cases kept exercises after discharge,in those 8 cases could control micturition after 2-3 months,2 cases could control micturition at daytime.Two real urinary incontinence patients symptom was improvement.Conclusion: Rehabilitation exercises of urinary incontinence patients after per urethra prostate operation can improve their micturition function effectively.
  • The early enteral feeding and rehabilitation of severely burned patients 收费下载
  • Objective:To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients.Method: A total of 22 Patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF).The levels of serum endotoxin were detected in the members of both groups in 1,3,and 5 days.Result: The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P<0.01).The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P<0.01).Conclusion:Early enteral feeding may decrease enterogenic infection and it helps the nutrition support,improve the patient resistance,facilitate the repair of damaged tissue,so it contributes to the rehabilitation of burned patients.
  • “X” plastic operation and postoperative rehabilitative treatment of hand proximal interphalangeal joint flexion contraction deformity 收费下载
  • Background:The contraction deformity of hand proximal interphalangeal joint flexion often occurs after different injury of palmar digital skin,which has effections on hand functions in different extent (varying degrees) and brings many difficults to patients in their life and work.And marked effect are achieved when “X” plastic operation and postoperative recovery therapy are put into use.Objective:To investigate “X” plastic operation and curative effect of postoperative rehabilitative treatment of contraction deformity of hand proximal interphalangeal joint flexion.Unit:First Clinical Medical College of Harbin Medical Universkty.Subjects:4 patients,3 males and 1 females,all the deformity of six fingers were caused by deep trauma of hand skin,timely ranged from 0.5 to 8 years.Intervention:In the location of finger flexion contraction “X” incision was done across the joint,which reached deeply the surface of flexor aponeurosis and fully slacked contraction.After X-shaped incision,two side triangular flaps were formed,which should not be separated in order to prevent necrosis of tips.Two triangular flaps crisscrossed and were connected to finger flexion joint.One or two new surface of wound left over by proximal and distal ends of flaps can be done with free skin grafting of thick graft of thick faint graft.After operation the affected fingers were bandaged and fixed.The patients should be told passive flexion and extension of finger joint in early postoperative period and active floxion and extension in later period.The mobility should be refined to the range of joint sour and endurance.The child can be fixed for three months with plaster model or small splint according to the conditions and assigned with floxion and extension.Results: Flaps growed well after operation and all survived.Following up three cases half one year and founding that no one case recurred up to now ad the flaps were extending and the function of flexion and extension were good.Conclusion: Two side flaps caused by this operation can easily acrossly connect to the joint of flexion surface and can gradually extend with the flexion and extension of joint.It achieve marked effect that other operations cannot achieve.Early rehabilitative training after operation can not only add patients‘ confidence,make them fully realize the importance of practices,but also improve the early recovery of joint function.
  • Rehabilitation treatment of ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus 收费下载
  • Baskground:Ankylosis is the result of adhesion of knee extension apparatus that is often the complications of trauma of femoral shaft and knee.Because ankylosis will impair the flexion of knee joint,postoperational exercise is the key to rebuild flexing function of knee joint.Objective:To investigate therapeutic effect of rehabilitation treatment on ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus.Unit:Yuanbaoshan Ore Hospital of Chifeng City.Subjects:38 cases of ankylosis were investigated including 29 males,9 females aged 23-58 (mean:36) years old,with disease course 7 months-5 years.All cases were given operation and after operation fixed with plaster,fixing time:58-142 (mean:94) days.Mobility of knee joint before operation:4 cases over 50°,7 cases over 40°,others 5°-30°(mean:24°0.x-ray showed:no deformity of space,atrophy of quadriceps muscle of thigh,bad mobility of patella.Relaxing and plastic operation of adhesion of knee extension apparatus was given to all cases.Intervention:Knee joint was fixed at maxium flexing degree with solichocnemic plaster.Skin blood should be paid attention to.24h after operation affected limb was layed on removable orthodontic applicance at daytime,passive movement of joint was adopted,with painlessness as discipline for flexing,normally 10°-80°,increased successively.Knee joint was fixed at flexion position at nighttime.Exercise,twice a day,2-3h every time.Active exercise was adopted in intervals of passive exercise:kicking toes,straight leg elevating,After 2 weeks of passive exercise and 3 weeks of active exercise,patients took simple activity active movement mainly.Combined physical therapy:hot compression,keeping for 3 months.Result:Follow-up survey 9 months-3years(mean:1 year and 4 months).motion range:60°-130°(mean:110°).Conclusion: Function exercises after relaxing and plastic operation of adhesion could promote self-repairing of articular cartilage,accelerate healing of articular cartilage and peripheral tissue and prevent adhesion.
  • Effect of health education in treatment of cervical spondylopathy by blocking of nerve ganglion 收费下载
  • Background:Blocking of cervical nerve ganglion is an effective method in treatment of cervical spondylopathy.Health education before and after operation could solve many nursing problems.Objective: To investigate effect of health education in treatment of cervical spondylopathy by blocking of nerve ganglion.Unit:Rongjun General Hospital of Shandong.Subjects:88 cases of cervical spondylopathy were diagnosed for cervical stifness,painess and numb of upper limbs,Including 61 males,27 females,aged 31-78 years old.Brachial plexus puling test and intervertebral foramen pulling test were both positive,and X-ray showed varying degrees of hyperosteogeny.Randomly divided into A group and B group.Intervention:A group:routine test and preparing before operation,answering questions asked;B group:reading case data,grasping condition,acknowledge of patients,mastering of information,and mental state,which was the base for health education.Health education varied with each individual.(1) Mental prepairing:Before blocking,besides answering requirement,the following must be explained:therapeutic method,aim,operational process,possible reaction,feelings in puncture and injection.It must be noted that patient shouldn‘t move body.(2)Position prepairing:To peridural anesthesia,patients were helped to exercise repeatedly embracing knees with two hands,flexing of head towards chest,flexing of knees towars abdomen.(3)Importance of determining “pressure pain point” which was often the location of lession.(4) Prevention of infection:Besides strict aseptic manipulation,patients were told to keep puncture position clean.(5) After treatment,patients were instructed to press back cervical vertebral joint,extending neck fully backward.Families were instructed massotherapy to prevent relapse.Result:Effect of pain relieving in two groups was satisfying,but increasing of blood pressure,speeding of pulse,hematoma at puncture portion appeared,in A group,11 cases in 45cases(24%),in B group 3 cases in 43 cases(7%).After 6 months of follow-up,9 cases relapsed in 45 cases(18%)in A group while in B group,2 cases relapsed in 43 cases(5%).All data was dealed with χ^2 test,there was obvious statistical significance(P<0.05).Conclusion:In treatment of cervical spondylopathy by ganglion blocking,effective education could make patient accept treatment physiologically and mentally,change behaviors harmful to health,achieve a healthy state of mind and body reducing relapse of disease.
  • The ultrasonic wave treatment of 116 disorders of temporomandibular joint 收费下载
  • Background:The clinical symptoms of disorders of temporomandibular joint,clicking of joint and dyscinesia of mandibular,which treatment ways are virious and its curative effect is different.Objective:To explore the effect of the ulotrasonic wave treatment of 116 patients with disorders of temporomandibular joint.Unit:Affiliated Second Hospital of Qiqihaer Medical College.Subject:116 patients with temporomandibular joint,47 males and 69 females,aged 14-70 years old,average 36 years old.Disease history recorded from 2 days to several months.Pathosenic parts:18 cases were bilateral,42 cases were dextral and 56 cases were left.Pathogenic factors included mental,traumatic and others factors.clinical stages:75 cases in dysfunction period of masseter (65 per cent),36 cases in disturbance period of structure of joint (31 per cent) and 5 cases in period of organic changes.Intervention:With CSL-I type ultrasonic wave treatment machine produced by Shanghai,frequency 800 kHz,diameter 3.5cm,we used the method of contact and movement,which adopted liquid paraffin as coupled agent.We told patients open mouth slightly and placed sound-head on the part of temporomandibular joint,0.75-1.0W/cm,once 10 minutes,once each day and 10 days as a treatment course.We can observe the effect after two courses of treatment,meantime adopt comprehensive treatment like rehabilitative therapy to eliminate causes of diseases.Main result measurements index:recovery:joint pain disappears,extent of opening mouth normal,snap disappears and figure of opening mouth abnormity disappears;improved:joint pain obviously alleviates,extent of opening mouth obviously improves and snap and figure of opening mouth alleviate;ineffective:no changes before and after treatment.Results:75 cases disorders of masseter function,75 cured (58 in one treatment course,17 in two treatment course),recovery rate 100 per cent;36 cases of disorders of joint structure,28 cured (18 in one treatment course,10 in two treatment course),recovery rate 77.78 per cent.8 cases improved (two treatment courses),total effective rater 100 per cent;5 cases of organic changes,4 cases improved (two treatment courses),1 case ineffective,total effective rate 80 per cent.Conclusion:The treatment of ultra wave of temporomandibular joint can alleviate pain and improve blood circulation,ralax contracted muscle,and improve injury recovery.
  • Health education and rehabilitation measures of patients with osteoporosis 收费下载
  • Reconstruction of trachea—esophagus vocalization by tunnel method in 12 cases 收费下载
  • Objective:To study to therapeutic effectof reconstruction in improving trachea-esophagus vocalization after total laryngectomy.Method:We reviewed the reconstruction of vocalization with trachea-esophagus tunnel in 12 cases patients of total laryngectomy,i.e.a triangular mucous valve was made by incision of the posterior wall of the trachea with the correlative anterior wall of the esophagus made into a tunnel and the mucous valve would vocalize.Result:11 of the 12 cases obtained successful vocalization,counting for 91% of the total.Atresia of the vocalizing valve occurred in one case.Conclusion:Trachea-esophagus tunnel vocalization reconstruction has better therapeutic effect with good vocalization effect and fewer complications and easily performed.It avoided the shortcomings of necrosis and atresia of the vocalization valve and pharyngeal fistula formation,and the complexity of exchange of artificial vocalization tube again and again.
  • 癌症治疗功能评价系统——乳腺癌生存质量测评量表 收费下载
  • 乳腺癌是妇女常见的肿瘤,在北美和欧洲的妇女中乳腺癌是发病率最高的肿瘤,据统计,1996年单在美国就有18400名妇女患有乳腺癌,并有逐年增加的趋势。治疗的主要手段是手术、化疗、放疗、内分泌治疗,这些治疗手段对提高乳腺癌患者的生存率起到了重要的作用。然而,患者的生存质量则由于疾病及治疗而受到了极大的影响,即使是用最保守的治疗也会使患者的生存质量受到破坏,而且随着疾病的进展、常用治疗方法的失效等情况的出现,使得患者的生存质量与生存期变得同等重要。测量乳腺癌的生存质量目前没有金标准^[1],因为乳腺癌患者既有疼痛、精神疲倦、担心肿瘤复发、情绪低落等癌症患者所共有的问题,也有乳腺癌患者的特殊问题,如性征的变化使得情感的吸引力下降,手术后外观的改变及上肢肿胀等。
  • Plastic surgery treatment on cicatricial deformation in child burn of hand
    Therapy for persistent vegetative state with SW cerebral reflex therapeutic instrument
    The influence of early nutritional support to the rehabilitation of severe head-injured patients
    Correlation of early functional exercises after the operation with vertebrascope in route of retreat to treat lumbar disc protrusion
    Microacupuncture therapy of 80 cases of chronic fasciitis at neck and back
    Rehabilitation nursing of unstable lumbar vertabrae in bed
    Effect of cocolyster on defecation function of patients with rectal carcinoma after operation
    Early treatment of deep burn of hand to keep the function and prevent scar proliferation
    麦肯基力学诊断治疗技术(续三):麦肯基对下腰痛的力学诊断(徐军)
    腰痛的运动疗法(孙启良)
    造血系统肿瘤患者的生存质量评估(王小钦 林果为)
    脊髓损伤后自主神经反射不良(陈世民 顾玉东 等)
    颅脑损伤患者的运动处方(吴明方)
    妇科恶性肿瘤患者的生存质量评价
    乳腺癌患者放疗期间生存质量的调查
    颅内肿瘤患者术前生存质量及其影响因素研究(李志兵 丁永忠 等)
    轻型颅脑损伤后精神障碍的临床特征(郭克锋 苏景宽 等)
    持续性植物状态电生理动态变化和预后的相关性(徐强 徐如祥 等)
    有限度的选择性脊神经后根切断术联合有限度的腱松解术治疗下肢痉挛型脑瘫(王博 李长胜 等)
    常州市0—6岁残疾儿童的流行病学调查
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    胚胎脊髓神经干细胞的培养和鉴定(刘媛 龙在云 等)
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    人间充质干细胞成骨诱导培养后的细胞成分研究(段小军 杨柳 等)
    长骨骨巨细胞瘤微波高温治疗肢体关节功能观察评定(周勇 范清宇 等)
    人骨髓基质细胞在骨细胞工程临床应用中的探讨(柴岗 张艳 等)
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    实验性肌肉拉伤的生物学和生物力学研究
    腰椎椎管狭窄症患者脑脊液中神经肽的变化与临床表现的关系(李长青 周跃 等)
    通痹灵对于胶原诱导型关节炎大鼠关节炎及骨质破坏的影响(陈光星 周伟生 等)
    以藻酸钙为载体的可注射性组织工程软骨和骨研究(雷德林 陈书军 等)
    白介素—1α在退变腰椎间盘中的分布与神经根性疼痛的相关性(吴小涛 赵延勋)
    谷氨酸在低氧性脑损伤中的作用
    植物雌激素与突触素表达及空间认知水平的相关性研究(郭安臣 刘凤华 等)
    增生性瘢痕胶原含量与微血管构筑的相关性(苏永涛)
    瘢痕疙瘩成纤维细胞P53基因突变检测
    混合型皮肤替代物的构建及移植试验(肖仕初 夏照帆 等)
    前纤维蛋白在增生性瘢痕收缩中的作用(王珍祥 吴军 等)
    复合壳多糖人工皮肤毒副作用评价(鲁元刚 伍津津 等)
    保存羊膜移植治疗中、重度眼化学烧伤和热烧伤急性期的作用(刘建亭 鲁建华 等)
    应用自制神经束内微电极采集周围神经即时电信号(贾晓枫 陈中伟 等)
    聚乳酸对皮肤成纤维细胞生物学行为的影响(王新文 金岩 等)
    大鼠创伤修复中血小板源生长因子免疫组织化学的变化
    磁共振成像诊断半月板病变的价值及对治疗的指导意义(陈国强 徐建立)
    视觉诱发电位对眼外伤视功能鉴定的价值
    实验性胶原酶盘外溶核的肌电图分析(于绍斌 米立新 等)
    胸廓出口综合征的电生理特征(郑晓君 彭盛 等)
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    碳/碳复合材料人工骨骼RPM—CVI复合成形技术的初步研究进展(姜开宇 王敏杰 等)
    人工股骨头置换治疗高龄股骨颈骨折(李红良 康文凯)
    Richard钉治疗股骨粗隆间骨折术后康复58例
    改良手法治疗急性腰扭伤110例疗效观察(黄建良)
    单侧多功能外固定器对肢体骨折不愈合的康复作用(张远金 陈又年 等)
    掌骨干骨折内固定术后早期康复锻炼27例(孔祥燕)
    髋关节术后持续被动活动机结合主动运动54例效果分析(张学兵)
    进行性骨化性肌炎51例中国文献报道的综合分析(张浩 金大地 等)
    全髋关节置换术后早期脱位的原因分析
    影响人工肱骨头置换手术效果的因素(翟伟韬 仲飙 等)
    环抱器治疗人工髋关节假体周围骨折(眭述平 张先龙 等)
    强直性脊柱炎晚期治疗方法的选择(周淑杰)
    持续被动活动在微波诱导高温原位灭活治疗膝关节周围骨肿瘤术后关节功能康复中的意义
    体操运动员肘关节损伤的原因(贺新成)
    测力式骨科固定器骨伤生物力学特征分析
    武术运动员膝关节损伤的调查分析(覃凤珍)
    全髋关节置换术后脱位危险因素分析及防治措施(田京 李奇 等)
    持续被动活动装置在膝关节术后功能康复中的临床应用(闻久全 蒋阅)
    失败人工髋关节假体的临床分析(宋科官 张波 等)
    骨水泥型人工髋关节安装技术与防止术后髋关节脱位的体会(蒋俊威 王红川 等)
    胸腰段脊髓肿瘤切除后重建脊柱后柱稳定性的临床观察(范少地 钟桂午 等)
    神经源性膀胱功以障碍的康复训练(徐燕忠)
    全应用椎弓根螺钉及棒系统三维矫治脊柱侧凸(陈建明 肖茂明 等)
    腰椎间盘突出症体感诱发电位改变及其机制(李鹤平 庄文权 等)
    仰卧手法牵引加定点整复推拿治疗颈性眩晕
    骶管神经阻滞治疗下腰痛(邱继忠 范春明 等)
    病变定位、同心轴旋转治疗腰椎间盘突出症疗效分析
    老年性两种腰腿痛神经阻滞治疗效果比较(姚军 李前进 等)
    快速牵引加手法推拿治疗腰椎间盘突出症(杨正山)
    针刀松解治疗肩胛上神经卡压综合征31例(刘卫校 赵秀云)
    点按法并物理因子治疗神经根型颈椎病:随机分组对照(李素华 王博 等)
    针灸对急性腰扭伤的治疗(谢长英 邱春复)
    骶管注药术治疗腰椎间盘突出症53例(王继伟 李庆珍)
    早期综合康复治疗防凼烧伤后遗症112例(尹清)
    不同发育阶段细胞的分化与调控机制(赵志力 付小兵)
    α—促黑素细胞激素及其对成纤维细胞的生物学作用(郑健生 邢新 等)
    无细胞异体真皮基质的研究进展
    皮肤磨削仪在瘢痕整形中的应用(易阳艳 胡琼华 等)
    颅脑损伤后生物节律紊乱的康复调整(王立新 吕多 等)
    不同家庭及社会支持对重度脑损伤患者康复的影响(张淑勤)
    氟西汀对脑出血抑郁症状患者预后的影响(李积荣 宿长军 等)
    颅脑外伤后肢体功能恢复的康复训练(王惠玲 王丽萍 等)
    神经康复在大面积梗死并脑疝减压术后的应用(牛俊英 尹世敏 等)
    脑卒中后排尿功能障碍的治疗体会
    康复流程训练对脑出血偏瘫患者的早期康复(徐海波 孙书君 等)
    电针灸八Liao穴治疗脑损伤后排尿障碍36例
    老年颅脑损伤患者高压氧治疗期间的护理(李静艳)
    腹股沟疼痛与低位腰椎间盘突出关系的探讨
    带状疱疹后遗神经痛3种神经阻滞方法比较(林明忠 严兴福 等)
    氟桂利嗪与心得安防治偏头痛对照观察(马传根 赵冬梅)
    支架治疗食管肿瘤所致进食功能障碍(刘瑞林 李永军 等)
    直肠癌根治术后生存质量研究现状和进展
    运动疗法配合微波治疗肩关节撞击综合征(陈述荣)
    空气加压舱氧浓度监测系统存在的问题及改进建议(王勤周 陆薇 等)
    超短波并电针治疗面神经炎60例(徐健生 马滨)
    足跟痛的电磁疗法与低频调制的中频电水浴疗法的比较(李继华 肖红雨 等)
    胸、腰椎骨折并脊髓损伤术后的康复治疗1例报告(胡中 莫天才 等)
    随机对照分析中频电药物透入与单纯中频电治疗腰椎间盘突出症126例
    大黄多糖对脑损伤后大鼠脑皮层热休克蛋白70表达的影响
    都可喜治疗认知功能障碍不良反应的临床应用前瞻观察
    现代敷料研究现状(刘德伍)
    β—七叶皂甙钠辅佐治疗坐骨神经痛18例:随机对照(陈运平 孙圣刚 等)
    舒安注射液促进脑出血大鼠神经功能恢复的作用(徐江平 杨雪梅 等)
    胎脑提取液对大鼠的抗疲劳作用(李质馨 窦肇华 等)
    血府逐瘀汤治疗带状疱疹后疼痛30例(胡加富)
    经静脉自控止痛治疗中晚期癌性疼痛18例(赵晔 朱静芬)
    休闲娱乐康复在老年康复中应用
    指神经修复和移植后的早期被动运动
    手损伤患者Dexter评估和治疗系统的有效性和可靠性
    手腕部损伤患者接受作业治疗或物理治疗后健康状态的改变
    建立一个标准的病态手功能和假手功能临床评定方法:规范的数据,可靠性,有效性
    断指患者康复程序及功能结局
    手屈肌腱2区修补后的康复方法
    指神经损伤康复中早期触觉刺激的使用
    美国明尼苏达州工作相关断指患者的医疗、个性及职业结局
    采用自体静脉移植在急性手重建感觉神经修复中的效果及意义
    急性创伤性手损伤的早期阶段的定量研究
    Anterior interspace catheterization of the epidural cavity through sacral hiatus and its applications in treatment of protrusion of lumbar intervertebral disc(张少臣 陈枢芹)
    Kinesitherapy in treatment of 35 cases with spinal cord injury(王瑞生)
    Study on expression of endothelin in experimental cerebral concussion in rats
    Effect of sodium β—escin on early rehabilitation of the patients with traumatic cerebral infarction(张银清 陈汉民 等)
    Mechanism research on promoted survival rate of tension skin flap after meshed relaxing short incision suture(年申生 吴岳嵩 等)
    Relationship between exon deletion frequency of CDKN2/P16 and pathological type,metastasis,sex in osteosarcoma
    Comprehensive rehabilitation of closed injury of brain(郭非 任力 等)
    Quantitative assessment of motor function on children with cerebral palsy before and after wearing ankle foot orthopedic instruments(李润洁)
    Vitrifficated cryopreservation of biological tissue and cells(吴志谷 陈圣清)
    Hyperbaric oxygen plus naloxone in the treatment of severe head trauma(张香菊 王强 等)
    Therapeutic effect of hyperbaric oxygen on 32 cases of magraine(孙旭红 王泓杰 等)
    Observation of therapeutic effect for 26 patients with lumbar vertebrae slippage treated by RF internal fixed instrument(陈庆贺 高吉昌 等)
    Early repairing with full thickness skin graft and postoperational rehabilitation treatment of deep burn of hand(宋知仁)
    Massotherapy combined with traction on 47 cases of semiluxation of articulatio atlantoepistrophica(甘霖)
    Application of arthroscope and postoperative functional exercises in diagnosis and treatment of knee joint diseases(兰玉平 殷光义 等)
    Effect of rehabilitation exercises on urinary function of incontinence after per urethra prostate opertation(谢小燕)
    The early enteral feeding and rehabilitation of severely burned patients(邢德荣)
    “X” plastic operation and postoperative rehabilitative treatment of hand proximal interphalangeal joint flexion contraction deformity(杨国华 安宇 等)
    Rehabilitation treatment of ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus(史桂秋 尹中华)
    Effect of health education in treatment of cervical spondylopathy by blocking of nerve ganglion(张洪梅)
    The ultrasonic wave treatment of 116 disorders of temporomandibular joint(徐文华 黄昊红 等)
    Health education and rehabilitation measures of patients with osteoporosis(王彦香 米立新)
    Reconstruction of trachea—esophagus vocalization by tunnel method in 12 cases(黄维平 闫玉纪 等)
    癌症治疗功能评价系统——乳腺癌生存质量测评量表(李莹 宋黎君)
    《中国临床康复》封面

    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

    社  长:王莉莎

    主  编:刘昆

    地  址:沈阳1200邮政信箱

    邮政编码:110004

    电  话:024-23384352 23394178

    电子邮件:[email protected]

    国际标准刊号:issn 1671-5926

    国内统一刊号:cn 21-1470/r

    邮发代号:8-587

    单  价:15.00

    定  价:780.00