前交叉韧带方位角变化的解剖学测量研究

目的:探讨前交叉韧带(anterior cruciate ligament,ACL)在膝关节不同屈曲角度时的方位角变化,为ACL损伤诊断和重建研究提供解剖学支持。方法:成人膝关节标本10具,解剖观察ACL形态,用Photoshop软件测量膝关节不同屈曲角度下ACL方位角变化。结果:0°、30°位膝关节中ACL胫骨角大于ACL股骨角,有显著性差异(P0.01);60°、90°位膝关节中的ACL胫骨角小于股骨角,有显著性差异(P0.01)。膝关节0°、30°、60°、90°ACL胫骨角由大渐小,各角度间均有显著性差异(均P0.01)。膝关节0°和30°的ACL股骨角比60°和90°时小,有显著性差异(均P0.01),0°与30°间无显著性差异(P0.05),60°小于90°,有显著性差异(P0.01)。结论:ACL于膝关节0°和30°位时,后外侧束(posterolateral bundle,PLB)发挥主要作用,ACL诊断或重建主要参考胫骨角;60°、90°时ACL前内侧束(anteromedial bundle,AMB)发挥主要作用,ACL诊断或重建主要参考股骨角。ACL方位角可作为ACL损伤诊断和手术重建的重要参考。     

前交叉韧带不同断裂程度对髌骨内外侧关节面的生物力学影响

目的:探讨前交叉韧带(ACL)完全断裂和部分断裂对髌骨内外侧关节面生物力学的影响.方法:10例新鲜正常成人膝关节标本作为ACL完整组,在200N轴向载荷下,测试膝关节0°、30°、60°、90°髌骨内外侧关节面应变,测试完毕后随机将标本造模成前内侧束(AMB)切断组和后外侧束(PLB)切断组,各5例,在上述条件下测试,再将ACL中下1/3全切作为全切组进行测试.结果:膝伸直0°位各组应变无显著性差异(P＞0.05),膝屈曲30°、60°、90°各组间均有显著性差异(P＜0.05),其应变变化趋势为ACL完整组＞PLB切断组＞AMB切断组＞全切组.且髌骨内侧面应变小于髌骨外侧面应变(P＜0.05).结论:ACL完全断裂,在不同栽荷和角度下,对髌骨内外侧关节面的应变均有影响.ACL部分断裂在膝关节屈曲30°、60°、90°位可引起髌骨内外侧生物力学改变.ACL完全断裂,髌骨外侧应变高于髌骨内侧应变,其意义尚需进一步探讨.     

前交叉韧带不同断裂程度对内侧半月板后角生物力学特性的影响

目的:探讨前交叉韧带(ACL)断裂对内侧半月板后角的生物力学特性影响.方法:12例新鲜正常成人膝关节标本作为ACL完整组,在200N轴向载荷下,测试膝关节0°、30°、60°、90°内侧半月板后角应变,测试完毕后随机将标本造模成前内侧束(AMB)断裂组和后外侧束(PLB)断裂组,各6例,在上述条件下测试,再将标本的ACL中下1/3全部切断作为全断组进行测试.结果:膝伸直0°、屈曲30°,全断组后角应变大于其它各组(p＜0.01),PLB断裂组后角应变大于完整组、AMB断裂组(p＜0.01),AMB断裂组与完整组无显著性差异(p＞0.05);膝屈曲60°,全断组后角应变大于PLB断裂组、完整组(p＜0.05).与AMB断裂组无显著性差异(p＞0.05),AMB断裂组后角应变大于PLB断裂组、完整组(p＜0.05),PLB断裂组与完整组无显著性差异(p＞0.05);膝90°,全断组后角应变大于其它各组(p＜0.05),完整组、AMB断裂组、PLB断裂组组间均无显著性差异(p＞0.05).结论:(1)ACL完全断裂,在膝关节各角度对内侧半月板后角应变均有较大影响,为ACL完全断裂早期修复提供了理论依据.(2)AMB断裂在膝屈曲位(60°)引起内侧半月板后角生物力学改变;PLB断裂在膝0°、30°引起内侧半月板后角生物力学变化,其意义尚需进一步探讨.     

应用无内固定装置技术双束双隧道重建前交叉韧带疗效分析

目的：探讨应用无内固定装置技术双束双隧道重建前交叉韧带（ACL）的治疗效果。方法：2006年1月至2008年1月,我科应用无内固定装置技术双束重建ACL损伤患者33例,男31例,女2例。患者排除手术禁忌后,分别在关节镜下采用双股半腱肌腱重建前内侧束,双股股薄肌腱重建后外侧束。韧带采用无内固定装置固定,股骨端行悬吊固定,胫骨端行拴桩固定。术后1~3周内指导患者在支具保护下进行康复训练,并逐渐提高训练强度。结果：术后切口均一期愈合,无并发症。病例随访时间24~48个月,平均36个月。术后12月时：Lysholm评分由术前的52.2±2.5,升至96.4±7.2分,IKDC评分55.3±3.7分,升至94.1±5.3分,其中A级19例,B级：11例。术前与术后Lysholm评分及IKDC评分有显著差别（P〉0.05）。结论：采用无内固定装置双束ACL重建方法能够较好的平衡患者前内侧束和后外侧束张力,并有利于保留ACL韧带残余结构、节约经费,具有令人满意的临床效果。     

应用无内固定装置技术双束双隧道重建前交叉韧带疗效分析

目的:探讨应用无内固定装置技术双束双隧道重建前交叉韧带(ACL)的治疗效果.方法:2006年1月至2008年1月,我科应用无内固定装置技术双束重建ACL损伤患者33例,男31例,女2例.患者排除手术禁忌后,分别在关节镜下采用双股半腱肌腱重建前内侧束,双股股薄肌腱重建后外侧束.韧带采用无内固定装置固定,股骨端行悬吊固定,胫骨端行拴桩固定.术后1～3周内指导患者在支具保护下进行康复训练,并逐渐提高训练强度.结果:术后切口均一期愈合,无并发症.病例随访时间24～48个月,平均36个月.术后12月时:Lysholm评分由术前的52.2±2.5,升至96.4±7.2分,IKDC评分55.3±3.7分,升至94.1±5.3分,其中A级19例,B级:11例.术前与术后Lysholm评分及IKDC评分有显著差别(P＞0.05).结论:采用无内固定装置双束ACL重建方法能够较好的平衡患者前内侧束和后外侧束张力,并有利于保留ACL韧带残余结构、节约经费,具有令人满意的临床效果.     

全膝关节置换术假体的三维有限元生物力学分析

分析基于MRI图像数据建立的膝关节有限元模型,并采用人工膝关节置换术对假体进行匹配,通过有限元法对匹配假体接触关节表面进行应力变化分析,为人工关节假体进一步研究提供理论依据。采用MRI对1名正常男性青年双膝关节进行扫描并获取二维图像数据,根据MRI扫描数据建立膝关节三维模型;根据实际假体模型经过逆向工程技术建立膝置换假体模型,在截骨的膝关节三维模型上装配置换假体,最终构建三维有限元模型,并进行相关的生物力学分析。进行置换术后膝关节在垂直受力的0°~90°屈曲运动中,相对于胫骨,内股骨滚动并向后方发生了滑动外旋;膝关节在90°~120°范围內侧髁向内后方滑动,并且外侧髁向上抬离处于内旋状态。在屈曲运动过程中,膝关节随着度数增加,聚乙烯垫片内侧后方出现应力集中情况,约为120°时垫片后缘产生较大的应力峰值;基于MRI图像扫描并通过有限元法建立膝关节三维模型,用于膝关节置换后生物力学分析,为进一步人工关节假体研究提供相应理论依据。     

股四头肌腱双束重建前交叉韧带的生物力学特性研究

目的：探讨股四头肌腱的生物力学特性,为其能否应用于临床前交叉韧带（ACL）重建提供实验依据。方法：取32例新鲜尸体的1cm宽股四头肌腱,按其解剖结构分为两束：股直肌、股内、外侧肌腱合为A束,股中间肌腱为B束,用游标卡尺测量两束的宽度及厚度,然后将两束置于电子万能试验机上分别测其生物力学指标。结果：A束厚度为4.39±1.72mm,宽度为8.19±1.18mm,生物力学强度为685.67±227.09N,抗拉强度为17.00±3.48Mpa;B束厚度为3.06±1.47mm,宽度为7.10±2.03mm,生物力学强度为435.04±205.80N,抗拉强度为13.16±4.02Mpa。A束生物力学强度与ACL比较,差异有统计学意义（p〈0.05）;B束生物力学强度与ACL比较,差异有统计学意义（p〈0.05）。结论：股四头肌腱的生物力学性能不能满足ACL双束重建的要求,其在临床上应用于ACL双束重建的价值有待于进一步的深入研究。     

III度膝关节内侧副韧带损伤缝合锚重建术后异位骨化8例临床分析

目的:分析8例III度膝关节内侧副韧带损伤的患者行缝合锚重建术后异位骨化发生与损伤的关系。方法:回顾性收集8例Ⅲ度膝关节内侧副韧带损伤行缝合锚重建术后发生异位骨化的患者,对其临床一般资料、损伤程度及部位、膝关节活动度及异位骨化程度等进行分析。结果:8位中Ⅰ度异位骨化4例,膝关节活动度73.75°~176.25°,平均125°,Ⅱ°异位骨化4例,膝关节活动度78.75°~157.25°,平均117.4°。在发生内侧副韧带异位骨化的8名患者中,仅有1名为单纯内侧副韧带损伤导致,其余7名患者中5名合并前叉或前、后叉韧带损伤,1例伴有胫骨髁间棘的撕脱骨折,1例合并胫骨平台骨折,4例合并胫骨或股骨髁骨折。结论:膝关节内侧异位骨化是异位骨化的好发部位,其发生与膝关节多发韧带损伤有关。     

股四头肌腱双束重建前交叉韧带的生物力学特性研究

目的:探讨股四头肌腱的生物力学特性,为其能否应用于临床前交叉韧带(ACL)重建提供实验依据.方法:取32例新鲜尸体的1cm宽股四头肌腱,按其解剖结构分为两柬:股直肌、股内、外侧肌腱舍为A束,股中问肌腱为B束,用游标卡尺测量两束的宽度及厚度,然后将两束置于电子万能试验机上分别测其生物力学指标.结果:A 束厚度为4.39±1.72mm,宽度为8.19±1.18mm,生物力学强度为685.67±227.09N,抗拉强度为17.00±3.48Mpa;B束厚度为3.06±1.47mm,宽度为7.10±2.03mm,生物力学强度为435.04±205.80N,抗拉强度为13.16±4.02Mpa.A束生物力学强度与ACL比较,差异有统计学意义(p<0.05);B束生物力学强度与ACL比较,差异有统计学意义(p<0.05).结论:股四头肌腱的生物力学性能不能满足ACL双束重建的要求,其在临床上应用于ACL双束重建的价值有待于进一步的深入研究.

Abstract：

Objective: To investigate the biomechanics of the quadrieeps tendon and to provide theoretical basis for double-bundle reeonstruction of anterior cruciate iigament(ACL). Methods: 32 quadriceps tendons (width lena) taken from fresh cadaver were dissected into 2 bundles according to the anatomy, one bundle including rectus femoris, vastus medialis and vastus lateralis was named A bundle and the other was named B bundle. The width and thickness of the A and B bundle were detected respectively with a Vernier caliper and the biomechanics were determined by WDW-30 election universal testing machine. Results: The thickness, width, ultimate load and ultimate tensile strength of bundle A were 4.39± 1.72mm, 8.19± 1.18mm, 685.67± 227.09 N and 17.00± 3.48 Mpa respectively, while for bundle B,which were 3.06± 1.47 ram, 7.10± 2.03mm: 435.04±205.80 N and 13.16± 4.02 Mpa. There was difference between bundle A and the ACL (p<0.05). Conclusion: The ultimate load ofbundle A was much lower than the the ACL and bundle Bwas also lower than the ACL.     

关节镜下多种移植物联合重建膝关节前、后交叉韧带

目的:评估关节镜下膝关节前交叉韧带(ACL)与后交叉韧带(PCL)同时重建的技术和临床效果。方法:自2003年6月～2009年10月,27例病人(28膝)经MRI检查及关节镜检查证实ACL和PCL均断裂,其中9膝伴内侧副韧带损伤(MCL),8膝伴后外侧角损伤(PLC),5膝伴内侧半月板破裂,4膝伴外侧半月板损伤。27例患者于伤后3～10周在关节镜下行膝关节前、后交叉韧带联合重建。结果:本组术后早期均未发生严重并发症。术后随访12～88个月,平均(42.67±3.34)个月,Lysholm膝关节功能评分为78～93分,平均(86.67±5.21)分。国际膝关节文件编制委员会(IKDC)综合评定由术前显著异常(D级)28膝,改进为随访时正常(A级)9膝、接近正常(B级)16膝、异常(C级)3膝。结论:关节镜下膝关节前交叉韧带(ACL)与后交叉韧带(PCL)同时重建创伤小、手术操作精细,术后膝关节功能恢复满意。     

Characteristics of the membranes of the pellicle of the ciliatePseudomicrothorax dubius

Summary The membranes of the pellicle of the ciliatePseudomicrothorax dubius are investigated using thin section electron microscopy and freeze-fracture replicas. The plasma membrane is covered by a surface coat and is connected to the outer alveolar membrane by short, sometimes branched, bridges. The inner alveolar membrane is coated on both sides. The epiplasm lies in intimate contact with the cytoplasmic surface of this membrane, and there is a corresponding deposit on the other surface. This deposit is regularly striated.The epiplasmic layer and the alveoli are interrupted at sites of cytotic activity,e.g., the attachment sites of trichocysts, the cytoproct, and the parasomal sacs. The striated deposit ends where the epiplasm ends, indicating a direct relationship between these two epimembranous layers.There is a deposit along the sides of the first part of the tip of the trichocysts, and in this region the trichocyst membrane is free of intramembranous particles.The membrane of the parasomal sacs has a coat on both surfaces. That on the extraplasmic surface is similar to the surface coat of the plasma membrane. The origin of the cytoplasmic coat is unknown. The cytotic activity of these sacs is indicated by their highly irregular profiles.     

The early development of the tail and the transformation of the shape of the nucleus of the spermatid of the domestic fowl,Gallus gallus

Summary The differentiation of the spermatid, especially in reference to the formation of the flagellum, and transformation of the shape of the nucleus was investigated in the domestic fowl.In the early stage of the spermatid, a prominent Golgi apparatus appears around the centrioles. The Golgi vesicles then surround the axial-filament complex which develops from the distal centriole. These vesicles fuse to form continuous membrane at the earliest stage of flagellar formation, and in the succeeding stage Golgi lamellae are attached to the plasma membrane of the developing flagellum. From these observations, it is assumed that Golgi apparatus may be a source of the membrane system of the flagellum.The microtubules distributed around the nucleus form the circular manchette. The anterior region of the nucleus with the manchette is cylindrical in shape and the posterior region without it remains irregular in shape. When the circular manchette has been completed, the whole nucleus acquires a slender cylindrical shape. The circular manchette then changes into the longitudinal manchette. The nuclei of spermatids without a longitudinal manchette are abnormal in shape. In view of these observations it is assumed that the nuclear shaping of the spermatid may be accomplished by circular manchette and the maintenance of shape of the elongated nucleus by longitudinal manchette.The authors wish to thank Mr. Takayuki Mori for his helpful suggestions and technical advices     

Characterization of the composition of the aqueous humor and the vitreous body of the eye of the frog Rana temporaria L

This study aimed to analyze the aqueous humor (AH) and the vitreous body (VB) of the eye of the adult frog Rana temporaria L. as a representative species of amphibians, which lead a semi-terrestrial life. The presence of collagen, albumin, uric acid and electron donors was shown in both media; however, there are slight differences in their concentrations. To determine collagen, a spectral-fluorescent probe, cyanine dye, was used. The presence of collagen in AH of the frog was found at the first time. The total content of electron donors (ascorbic and uric acids, tryptophan, and tyrosine) in VB and HA was roughly estimated at ~ 1.5 × 10^− 4 mol/L. Both VB and AH absorb light in similar UV regions. The total protein and albumin contents in AH were found to be somewhat higher than those in VB. The uric acid content was at an equally low level in both intraocular media. It is supposed that the similarity of VB and AH compositions shown in this work is due to some exchange between VB and AH contents in the course of accommodation. The role of intraocular fluids in physiological functions of the eye and in protecting the retina against UV light is discussed.