The influence of limb alignment and transfemoral amputation technique on muscle capacity during gait

Many factors influence successful outcomes following transfemoral amputation. One factor is surgical technique. In this study, the influence of limb alignment and surgical technique on a muscle’s capacity to generate force was examined using musculoskeletal modeling. Non-amputee and transfemoral amputee models were analyzed while hip adduction, femur length, and reattached muscle wrap position, tension and stabilization technique were systematically varied. With muscle tension preserved, wrap position and femur length had little influence on muscle capacity. However, limb alignment, muscle tension and stabilization technique notably influenced muscle capacity. Overall, myodesis stabilization provided greater muscle balance and function than myoplasty stabilization.     

Autofluorescence imaging for recurrence detection in skin cancer postoperative scars

This clinical study is a first attempt to use autofluorescence for recurrence diagnosis of skin cancer in postoperative scars. The proposed diagnostic parameter is based on a reduction in scar autofluorescence, evaluated in the green spectral channel. The validity of the method has been tested on 110 postoperative scars from 56 patients suspected of non‐melanoma skin cancer, with eight patients (13 scars) available for the repeated examination. The recurrence diagnosis within a scar has been made after two subsequent autofluorescence check‐ups, representing the temporal difference between the scar autofluorescence amplitudes as a vector. The recognition of recurrence has been discussed to represent the significant deviations from the value of vector angle θ. This new autofluorescence‐based method can be easily integrated into the postoperative monitoring of surgical scars and can help diagnose the recurrence of skin cancer from the early stage of scar development.     

EXTERNAL MORPHOLOGY AND PIGMENTATION OF THE VAQUITA, PHOCOENA SINUS (CETACEA: MAMMALIA)

The vaquita, Phocoena sinus , is a porpoise in the family Phocoenidae that lives only in the Gulf of California. The external appearance of P. sinus was unknown until 13 fresh specimens were recently examined. The most obvious morphological feature distinguishing P. sinus from its two congeners is the proportionately higher dorsal fin. The most striking features of the pigmentation pattern are the large black eye patches and the black upper and lower lip patches. In both areas, the pigmentation contrasts sharply with the surrounding light gray coloration. The total lengths of the specimens ranged from 70.3 cm (a neonate) to 143.5 cm (an adult female).     

Oxygen-derived free radicals and hemolysis during open heart surgery

Reperfusion injury occurs during open-heart surgery after prolonged cardioplegic arrest. Cardiopulmonary bypass also is known to cause hemolysis. Since reperfusion of ischemic myocardium is associated with the generation of oxygen free radicals, and since free radicals can attack a protein molecule, it seems reasonable to assume that hemolysis might be the consequence of free radical attack on hemoglobin protein. The results of this study demonstrated that reperfusion following ischemic arrest caused an increase in free hemoglobin and free heme concentrations, simultaneously releasing free iron and generating hydroxyl radicals. In vitro studies using pure hemoglobin indicated that superoxide anion generated by the action of xanthine oxidase on xanthine could release iron from the heme ring and cause deoxygenation of oxyhemoglobin into ferrihemoglobin. This study further demonstrated that before the release of iron from the heme nucleus, oxyhemoglobin underwent deoxygenation to ferrihemoglobin. The released iron can catalyze the Fenton reaction, leading to the formation of cytotoxic hydroxyl radical (OH·). In fact, the formation of OH. in conjunction with hemolysis occurs during cardiac surgery, and when viewed in the light of the in vitro results, it seems likely that oxygen-derived free radicals may cause hemolysis during cardiopulmonary bypass and simultaneously release iron from the heme ring, which can catalyze the formation of OH·.     

刺激家兔颈交感神经对颈动脉窦反射的影响

在36只麻醉家兔观察了电刺激颈交感神经(CSN)对颈动脉窦压力感受器(CSB)活动的影响。所得结果如下:(1)电刺激 CSN 可使夹闭颈动脉引起的加压反射消失或倒转,△BP 从刺激前的 39.5±3.6mmHg 变为刺激时的-0.31±5.4mmHg(P<0.001)。(2)在电刺激CSN 时,静注新福林所诱发的颈动脉窦压力感受器-心率反射增强,表现为反射性心率减慢较刺激前更为明显。(3)在以50—200mmHg 的压力充胀两侧颈动脉窦的条件下,刺激 CSN 引起窦内压与平均动脉压的关系曲线下移,与刺激前曲线相比有明显差异(P<0.01)。(4)切断 CSN 后,动脉血压有所升高,提示 CSN 对 CSB 活动有紧张性调节作用。以上结果比较明确地表明家兔 CSN 对 CSB 活动有调节作用。此作用可能是 CSN 作用于窦壁平滑肌而间接引起的。     

颈动脉窦内压的变化速率对反射性降压效应的影响

在成年狗身上制备右侧孤离颈动脉窦,借助灌流装置用饱和氧的任氏液对其进行灌流。灌流压为搏动性的。通过改变每搏泵出量、灌流管道的阻力和弹性来调节灌流压及其变化速率。用多导生理记录仪同步记录股动脉血压、窦内灌流压及其变化速率。本文主要观察窦内压的变化速率对降压反射的影响。在8只狗身上共进行了93次实验。结果表明,在窦内压相同的情况下,灌流压的上升速率愈快,降压效应愈明显,而其下降速率则无显著作用。已有资料证明搏动性窦内压所引起的降压效应较非搏动性压力更为明显。由此可见,狗的颈动脉窦压力感受器不仅对搏动性压力而且对其上升的变化速率也很敏感。     

颈动脉窦区注入枸橼酸钠抑制家兔呼吸的机制

向颈总动脉头端注入枸橼酸钠能使大多数家兔发生呼气性呼吸暂停和呼吸频率变慢。此呼吸抑制效应可被地卡因麻醉颈动脉窦区所消除。切断窦神经不能阻断枸橼酸钠对呼吸的抑制。切断迷走神经窦支则使半数以上家兔的呼吸抑制减弱或消失,而在结状神经节上方切断迷走神经能阻断大多数家兔的呼吸抑制。结果提示,迷走神经窦支是颈动脉窦区感受器传入通路之一,向颈动脉窦区注入枸橼酸钠对呼吸的抑制主要是通过迷走神经传入引起的。     

Scanning Electron Microscopy of Xiphinema,Longidorus, and Californidorus Stylet Morphology

Stylet ultrastructure of five Xiphinema, four Longidorus, and three Californidorus species was compared by scanning electron microscopy. Morphological differences were seen in the odontophores and odontostyle bases between the genera and some of the species. All Xiphinema studied had well-developed odontophore flanges; the Longidorus species lacked flanges, except for weakly developed ones in L. diadecturus; and none of the Californidorus had flanges. Three sinuses were present in the odontophores of all species. The sinuses varied in length depending upon species. In Xiphinema and Californidorus the odontostyle bases had distinct overlapping collars, but in Longidorus the collars were absent except for L. diadecturus. The odontostyle-odontophore junction from a lateral view appeared as a slanted transverse line in all the species, but in a dorsal view of Xiphinema and Californidorus it was V-shaped. Dorsal longitudinal seams of the odontostyle and odontophore were observed in all the species. The dorsally located odontostyle aperture was ca. 1 μm from the anterior end in all species, except in one Longidorus sp. it was ca. 4 μm from the end.     

Nitric oxide synthase in the rat carotid body and carotid sinus

The participation of nitric oxide synthase (NOS) in the innervation of the rat carotid body and carotid sinus was investigated by means of NADPH-diaphorase histochemistry and NOS immunohistochemistry using antisera raised against purified neuronal NOS and a synthetic tridecapeptide. NOS was detected in 23% of neurons at the periphery of the carotid bodies. Some negative neurons were surrounded by NOS-positive terminals. NOS-containing varicose nerve fibres innervated the arterial vascular bed and, to a lesser extent, the islands of glomus cells. These fibres persisted after transection of the carotid sinus nerve and are probably derived from intrinsic neurons. Large NOS-positive axonal swellings in the wall of the carotid sinus were absent after transection of the sinus nerve, indicating their sensory origin. The results suggest a neuronal nitrergic control of blood flow, neuronal activity and chemoreception in the carotid body, and an intrinsic role of NO in the process of arterial baroreception.     

经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症疗效对比的回顾性研究

摘要 目的：对比经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症（LDH）的疗效。方法：回顾性分析2018年5月至2020年5月我院收治的80例单节段LDH患者的临床资料。患者均接受经皮椎间孔镜手术,根据手术入路的不同,分为经椎间孔入路（PETD）组和经椎板间入路（PEID）组,每组均40例。比较两组的手术相关指标、术后恢复指标、手术前后的Oswestry功能障碍指数（ODI）和视觉模拟评分法（VAS）评分,以及术后并发症情况。结果：PEID组的手术时间短于PETD组,X线透视次数少于PETD组,差异均有统计学意义（P<0.05）。两组的术中出血量相比,差异无统计学意义（P>0.05）。PETD组的术后卧床时间短于PEID组,差异有统计学意义（P<0.05）。两组的术后1 d直腿抬高试验角度、住院时间、复发率相比,差异无统计学意义（P>0.05）。两组患者术后1 d、术后3个月、术后12个月的ODI评分、VAS评分均低于术前,且呈降低趋势（P<0.05）;同一时间点两组间ODI评分、VAS评分比较,差异无统计学意义（P>0.05）。两组的并发症发生率相比,差异无统计学意义（P>0.05）。结论：PETD和PEID经皮椎间孔镜手术治疗单节段LDH总体疗效和安全性接近,PETD可缩短术后卧床时间,PEID的操作难度更低、可减少手术时间和X线透视次数。临床中应视患者实际情况选择合适的入路。