一期后路半椎体切除短节段内固定与一期前路半椎体切除短节段内固定治疗先天性半椎体畸形的疗效对比

目的：对比一期后路半椎体切除短节段植骨融合内固定术与一期前路半椎体切除短节段植骨融合内固定术治疗先天性半椎体畸形的疗效。方法：抽取兰州军区兰州总医院骨科中心脊柱外科46例住院手术治疗先天性半椎体畸形的患者,随机化分为2组,每组23例,分别行一期后路半椎体切除短节段植骨融合内固定术和一期前路半椎体切除短节段植骨融合内固定术,观察比较两纽的手术时间、出血量、术后住院时间、术前和术后6个月侧凸cobb角、后凸cobb角及矫正率。结果：两组间的手术时间、出血量、术后住院时间、术后6个月后凸cobb角及后凸矫正率对比差异有统计学意义。结论：一期后路半椎体切除短节段植骨融合内固定术在后凸畸形矫正方面优于一期前路半椎体切除短节段植骨融合内固定术,且其手术创伤较小、术后恢复较快。     

关节镜下前交叉韧带重建术的手术时机对患者膝关节功能恢复的影响

目的:研究关节镜下前交叉韧带(ACL)重建术的手术时机对患者膝关节功能恢复的影响。方法:选取2016年1月至2017年8月我院收治的膝关节ACL损伤患者65例为研究对象,所有患者均接受关节镜下ACL重建术治疗,并按照患者受伤至接受手术的时间分为研究组(n=35,受伤至接受手术的时间≤3周)和对照组(n=30,受伤至接受手术的时间3周),术后对患者进行为期6个月的随访,对比两组患者术前和术后6个月的膝关节活动度、膝关节功能以及ACL恢复情况,并比较随访期间两组并发症发生情况。结果:术前,两组膝关节活动度、国际膝关节文献委员会膝关节评估表(IKDC)和Lysholm膝关节评分比较差异无统计学意义(P0.05),术后6个月,两组膝关节活动度、IKDC评分和Lysholm膝关节评分均较术前升高,且研究组高于对照组,差异有统计学意义(P0.05)。术前与术后6个月,两组前抽屉(ADT)试验和Lachman试验阴性率比较差异无统计学意义(P0.05),但与术前比较,术后6个月两组ADT试验和Lachman试验阴性率均升高,差异有统计学意义(P0.05)。与对照组比较,研究组并发症总发生率降低,差异有统计学意义(P0.05)。结论:膝关节ACL损伤患者在不同时间内接受关节镜下ACL重建术治疗均具有较好的效果,但是在受伤后3周内接受手术对患者膝关节功能恢复效果更明显,同时并发症发生率也相对更低。     

Three-dimensional in vivo kinematics and finite helical axis variables of the ovine stifle joint following partial anterior cruciate ligament transection

Partial anterior cruciate ligament (p-ACL) rupture is a common injury, but the impact of a p-ACL injury on in vivo joint kinematics has yet to be determined in an animal model. The in vivo kinematics of the ovine stifle joint were assessed during ‘normal’ gait, and at 20 and 40 weeks after p-ACL transection (Tx). Gross morphological scoring of the knee was conducted. p-ACL Tx creates significant progressive post-traumatic osteoarthritis (PTOA)-like damage by 40 weeks. Statistically significant increases for flexion angles at hoof-strike (HS) and mid-stance (MST) were seen at 20 weeks post p-ACL Tx and the HS and hoof-off (HO) points at 40 weeks post p-ACL-Tx, therefore increased flexion angles occurred during stance phase. Statistically significant increases in posterior tibial shift at the mid-flexion (MF) and mid-extension (ME) points were seen during the swing phase of the gait cycle at 40 weeks post p-ACL Tx. Correlation analysis showed a strong and significant correlation between kinematic changes (instabilities) and gross morphological score in the inferior-superior direction at 40 weeks post p-ACL Tx at MST, HO, and MF. Further, there was a significant correlation between change in gross morphological combined score (ΔGCS) and the change in location of the helical axis in the anterior direction (ΔsAP) after p-ACL Tx for all points analyzed through the gait cycle. This study quantified in vivo joint kinematics before and after p-ACL Tx knee injury during gait, and demonstrated that a p-ACL knee injury leads to both PTOA-like damage and kinematic changes.     

A bivariate approach to the widening of the frontal lobes in the genus Homo

Within the genus Homo, the most encephalized taxa (Neandertals and modern humans) show relatively wider frontal lobes than either Homo erectus or australopithecines. The present analysis considers whether these changes are associated with a single size-based or allometric pattern (positive allometry of the width of the anterior endocranial fossa) or with a more specific and non-allometric pattern. The relationship between hemispheric length, maximum endocranial width, and frontal width at Broca's area was investigated in extant and extinct humans. Our results do not support positive allometry for the frontal lobe's width in relation to the main endocranial diameters within modern humans (Homo sapiens). Also, the correlation between frontal width and hemispheric length is lower than the correlation between frontal width and parieto-temporal width. When compared with the australopithecines, the genus Homo could have experienced a non-allometric widening of the brain at the temporo-parietal areas, which is most evident in Neandertals. Modern humans and Neandertals also display a non-allometric widening of the anterior endocranial fossa at the Broca's cap when compared with early hominids, again more prominent in the latter group. Taking into account the contrast between the intra-specific patterns and the between-species differences, the relative widening of the anterior fossa can be interpreted as a definite evolutionary character instead of a passive consequence of brain size increase. This expansion is most likely associated with correspondent increments of the underlying neural mass, or at least with a geometrical reallocation of the frontal cortical volumes. Although different structural changes of the cranial architecture can be related to such variations, the widening of the frontal areas is nonetheless particularly interesting when some neural functions (like language or working memory, decision processing, etc.) and related fronto-parietal cortico-cortical connections are taken into account.     

The Bacterial Peptide Pheromone Plantaricin A Permeabilizes Cancerous, but not Normal, Rat Pituitary Cells and Differentiates between the Outer and Inner Membrane Leaflet

Plantaricin A (PlnA) is a 26-mer peptide pheromone with membrane-permeabilizing, strain-specific antibacterial activity, produced by Lactobacillus plantarum C11. We investigated the membrane-permeabilizing effects of PlnA on cultured cancerous and normal rat anterior pituitary cells using patch-clamp techniques and microfluorometry (fura-2). Cancerous cells displayed massive permeabilization within 5 s after exposure to 10–100 μm PlnA. The membrane depolarized to nearly 0 mV, and the membrane resistance decreased to a mere fraction of the initial value after less than 1 min. In outside-out membrane patches, 10 μm PlnA induced membrane currents reversing at 0 mV, which is compatible with an unspecific conductance increase. The d and l forms of the peptide had similar potency, indicating a nonchiral mechanism for the membrane-permeabilizing effect. Surprisingly, inside-out patches were insensitive to 1 mm PlnA. Primary cultures of normal rat anterior pituitary cells were also insensitive to the peptide. Thus, PlnA differentiates between plasma membranes and membrane leaflets. Microfluorometric recordings of [Ca²⁺] _i and cytosolic concentration of fluorochrome verified the rapid permeabilizing effect of PlnA on cancerous cells and the insensitivity of normal pituitary cells.     

Neuronal Types in the Human Anterior Ventral Thalamic Nucleus: A Golgi Study

Neurons in the anterior ventral (AV) thalamic nucleus of human adults were impregnated by Golgi-Kopsch impregnation method. Results showed that at least three morphological types of neurons could be recognized in the human AV thalamic nucleus. Type I neurons were medium to large with rich dendritic arborization. Both tufted and radiating dendritic branching patterns were seen in almost every neuron of this type. Only the initial axonal segments of these cells were impregnated suggesting that these axons were heavily myelinated. Type II neurons were medium in size with poor to moderate dendritic arborization. Many of these cells possess a few dendritic grape-like appendages. Long segments (up to 300 μm) of their axons were impregnated suggesting that these axons were either unmyelinated or thinly myelinated. These axons change their direction and form loops very often. No local branches were seen for these axons suggesting that they could be projection axons. Type III neurons were small with only one or two dendrites with poor arborization. No axons for these cells were seen in this study. The three neuronal types in the human AV thalamic nucleus were compared with neuronal types already described in other thalamic nuclei of human and non-human species. The results of this study might provide a morphological basis for further electrophysiological and / or pathological studies.     

Extramuscular myofascial force transmission also occurs between synergistic muscles and antagonistic muscles

The purpose of the present study was to test the hypothesis that myofascial force transmission may not be limited by compartmental boundaries of a muscle group to synergists. Muscles of the anterior tibial compartment in rat hindlimb as well as of the neighbouring peroneal compartment (antagonistic muscles) were excited maximally. Length–force data, based on proximal lengthening, of EDL, as well as distal lengthening of the tibial muscles (TA + EHL) and the peroneal muscle group (PER) were collected independently, while keeping the other two muscle groups at a constant muscle–tendon complex length. Simultaneously measured, distal and proximal EDL active forces were found to differ significantly throughout the experiment. The magnitude of this difference and its sign was affected after proximal lengthening of EDL itself, but also of the tibial muscle complex and of the peroneal muscle complex. Proximal lengthening of EDL predominantly affected its synergistic muscles within the anterior crural compartment (force decrease <4%). Lengthening of either TA or PER caused a decrease in distal EDL isometric force (by 5–6% of initial force). It is concluded also that mechanisms for mechanical intermuscular interaction extend beyond the limits of muscle compartments in the rat hindlimb. Even antagonistic muscles should not be considered fully independent units of muscular function.

Particular, strong mechanical interaction was found between antagonistic tibial anterior muscle and peroneal muscle complexes: Lengthening of the peroneal complex caused tibial complex force to decrease by approximately 25%, whereas for the reverse a 30% force decrease was found.     

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MRJ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（mDC）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。