超声定位穿静脉结扎对下肢静脉性溃疡术后愈合影响的临床研究

目的:观察下肢静脉性溃疡患者穿静脉功能不全情况,探讨超声定位下肢穿静脉结扎对下肢静脉性溃疡术后疗效的影响。方法:40例大隐静脉曲张患者随机分成两组:A组采用大隐静脉高位结扎、静脉腔内微波射频闭合术及超声定位穿静脉结扎治疗,B组采用大隐静脉高位结扎和静脉腔内微波射频闭合术治疗。观察两组患者治疗后静脉性溃疡的愈合时间、复发率及瓣膜功能不全穿静脉数量部位,并比较两组患者临床预后评分。结果:术前两组瓣膜功能不全穿静脉数量分别是47条和44条,两组比较差异无统计学意义(P=0.5520)。术后两组愈合时间分别是(7.5±4.389)周和(11.6±6.489)周,两组比较差异具有统计学意义(P=0.048)。两组临床预后评分分别为(2.3±0.6)分和(1.1±1.5)分,两组比较差异具有统计学意义(P=0.042)。结论:多普勒超声可有效检测定位瓣膜功能不全的下肢穿静脉,在超声定位下行大隐静脉高位结扎、静脉腔内微波射频闭合术联合穿静脉结扎治疗下肢静脉性溃疡的疗效优于穿静脉不结扎。     

聚桂醇在治疗下肢静脉曲张中初步临床应用

目的:探讨聚桂醇在治疗下肢大隐静脉曲张中的应用价值。方法:回顾性分析2013年9月-2015年9月医院确诊的下肢大隐静脉曲张患者75例(75条患肢)病例资料,根据治疗方案分为两组,33例(33条患肢)超声引导下注射聚桂醇泡沫硬化剂作为聚桂醇组,42例(42条患肢)行大隐静脉高位结扎+剥脱术作为手术组,记录手术时间、术中出血量、下床活动时间、住院时间、治疗费用及术后并发症发生率,门诊随访术后6、12个月,记录复发率。结果:聚桂醇组手术时间、下床活动时间均短于手术组,术中出血量、住院费用少于手术组,差异有统计学意义(P0.05);聚桂醇组皮下血肿、皮肤麻木感发生率明显低于手术组,差异有统计学意义(P0.05);聚桂醇组12个月复发率为12.12%低于手术组的33.33%,差异有统计学意义(P0.05)。结论:聚桂醇泡沫硬化剂注射是治疗下肢大隐静脉曲张的可选疗法。     

Capacities of ultrasound study in a follow-up of patients with lower extremity varicose veins after phlebectomy

The study was undertaken to estimate the capacities of triplex ultrasound angioscanning in patients with lower extremity varicose veins in the late period after phlebectomy. Seventy patients operated on for the underlying disease were examined. According to the duration of the underlying disease, all the patients were divided into 4 groups: 1) 4 (5.7%) patients had a 5-year history of lower limb varicose veins; 2) 16 (22.9%) had a 5-to-15-year history; 3) 42 (60%) had a 15-to-25-year history; 4) 8 (11.4%) had a more than 25-year history. The ultrasonic marker of recurrent lower limb varicose veins was the re-emergence of dilated saphenous and perforating veins, as well as valve apparatus failure in the operated leg. In groups 1, 2, and 3, a recurrence of the underlying disease was detected just 2 years after surgical treatment. Good results could be obtained with multimodality treatment: phlebosclerotherapy at early stages of the disease, followed by phlebectomy, or multiple phlebosclerotherapy from the earliest stages. Ultrasound study (USS) is the most rational method for screening diagnosis in case of abnormal veins of the lower extremities in the postoperative period. USS carried out at early disease stages and in the postoperative period permits prevention of recurrent lower limb varicose veins.     

超声下腔内激光消融联合点式剥脱治疗大隐静脉曲张的效果和安全性观察

摘要 目的：探讨超声下腔内激光消融联合点式剥脱治疗大隐静脉曲张的效果和安全性观察。方法：选取我院血管外科在2019年1月到2021年12月收治的140例大隐静脉曲张患者作为研究对象。将所有患者依照住院号单双号进行分组,分为联合组与对照组,每组70例。对照组采用常规高位结扎联合抽剥术进行治疗,联合组采用超声下腔内激光消融联合点式剥脱进行治疗。对比两组手术指标、临床疗效、术前术后下肢深静脉瓣膜功能变化以及术后并发症的发生率。结果：联合组的手术耗时较对照组高,术中出血量、切口个数及住院时间均较对照组低（P<0.05）;两组临床疗效分布对比有明显差异,且联合组显效率高于对照组（P<0.05）;术后3个月两组VCT均有缩短,Vmax均有提升,且联合组术后3个月VCT较对照组短,Vmax较对照组高（P<0.05）;联合组术后并发症较对照组低（P<0.05）。结论：对大隐静脉曲张患者采用超声下腔内激光消融联合点式剥脱方法治疗,与常规手术相比疗效更佳,且能够明显改善患者下肢静脉瓣膜功能,安全性高。     

Effect of Hydroxyethylrutosides on Blood Oxygen Levels and Venous Insufficiency Symptoms in Varicose Veins

Oxygen levels (tension, saturation, and content) in blood from varicose leg veins were found to be significantly lower than those in blood from normal leg veins at the same site on the limb under the same laboratory conditions. Treatment with hydroxyethylrutosides significantly increased the oxygen levels in blood from varicose veins, and this was associated with an improvement in leg symptoms attributable to venous insufficiency. Hydroxyethylrutosides have been shown to have a beneficial effect on capillary dysfunction in venous stasis.     

Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women

The purpose of this study was to investigate the effects of Swiss-ball core strength training on trunk extensor (abdominal)/flexor (lower back) and lower limb extensor (quadriceps)/flexor (hamstring) muscular strength, abdominal, lower back and leg endurance, flexibility and dynamic balance in sedentary women (n = 21; age = 34 ± 8.09; height = 1.63 ± 6.91 cm; weight = 64 ± 8.69 kg) trained for 45 minutes, 3 d·wk-1 for 12 weeks. Results of multivariate analysis revealed significant difference (p ≤ 0.05) between pre and postmeasures of 60 and 90° s trunk flexion/extension, 60 and 240° s-1 lower limb flexion/extension (Biodex Isokinetic Dynamometer), abdominal endurance (curl-up test), lower back muscular endurance (modified Sorensen test), lower limb endurance (repetitive squat test), lower back flexibility (sit and reach test), and dynamic balance (functional reach test). The results support the fact that Swiss-ball core strength training exercises can be used to provide improvement in the aforementioned measures in sedentary women. In conclusion, this study provides practical implications for sedentary individuals, physiotherapists, strength and conditioning specialists who can benefit from core strength training with Swiss balls.     

应用新型静脉剥脱导管单次与分次手术治疗双下肢单纯性静脉曲张的疗 效对比

目的:对比分析应用新型静脉剥脱导管单次与分次手术治疗双下肢单纯性静脉曲张的疗效.方法:采用严格的纳入和排除标准选取我院2007年8月至2010年8月收治的双下肢单纯性静脉曲张患者53例,以接受采用法国Gamida公司新型静脉剥脱导管的大隐静脉高位结扎加剥脱手术次数不同分为两组.单次手术组:(28例)患者一次性接受双侧手术;分次手术组:(25例)患者接受单侧手术,1月后再入院接受对侧手术.结果:分次手术组两次手术时间总和较单次手术组手术时间长(P=0.034),而两组在术中失血量上无明显差异(P=0.550).两组临床治愈率及出现并发症的几率相当(P＞0.05),但分次手术组的住院时间及住院费用均明显高于单次手术组(P＜0.001).结论:应用新型静脉剥脱导管单次手术剥脱双下肢单纯性静脉曲张的疗效与分次手术相当,但在经济方面单次手术显示出明显的优势,值得推广.     

The influence of geographic variations on the muscular activity in selected sports movements

Surface EMG (SEMG) has been used frequently to study motion techniques or skills, body positions, material or equipment used, training-methodology and learning processes in sports and ergonomics. Little if any information is available on the effect of the geographical environment on the neuromuscular control of an athlete or workman during his/her performance or effort.

Motions were chosen in Alpine skiing and cycling.

Thirty-one certified ski instructors and twelve professional road cyclists participated in the study of geographical variance and its impact on muscle activity.

SEMG was measured from the agonists and antagonists of the upper- and lower limb. Skiers were measured on downhill slopes ranging from 19 to 51% while the cyclists performed with different saddle positions on 2, 7 and 12% slope inclinations, respectively.

Verification of the variation of muscular intensity (IEMG) over the slope inclination during a simulated giant slalom indicated that the muscular activity increased with increasing slope angle and decreased with decreasing slope angle, while heart rate measured with short-range radio telemetry increased at a constant rate between start and finish independent of the geographical variations.

In a direct descent on different slopes % levels the integrated EMG is well related to the inclination (r=0.82) confirming the findings of the giant slalom.

In cycling we found that, regardless of the pelvis position, the muscular intensity of lower limb muscles increased with increasing slope inclination, while the muscular intensity of the arms decreased with the same increasing slope inclination. In addition the decreased intensity of the arm muscles remained significantly higher with the pelvis (saddle) fully forward.

The geography of the terrain did influence the neuromuscular work and therewith probably the performance also. The influence however, varies with specific circumstances and is coupled with items of variability of the equipment used and the body regions involved.     

改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的临床疗效

目的:探究改良曲张静脉点式剥除术在治疗中老年下肢静脉曲张的临床疗效。方法:收集我院已确诊为下肢静脉曲张的中老年患者37例,分成实验组与对照组。对照组18例行传统曲张静脉点式剥除术,实验组19例行改良曲张静脉点式剥除术。对比两组患者手术后的下肢静脉曲张的治疗效果。结果:实验组有效率(94.7%)显著高于对照组(72.2%),差异具有统计学意义(P0.05);与对照组相比,实验组患者手术时间较短、术中出血量较少、下床活动时间较早,术后并发症总治愈率较高,复发率、术后并发症发生率较低,其差异均有统计学意义(P0.05)。结论:采用改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的患者能够更彻底的剥除曲张额静脉,有效的改善患肢症状,明显降低复发率。     

Use of maternal information for QTL detection in a (grand)daughter design

In a (grand)daughter design, maternal information is often neglected because the number of progeny per dam is limited. The number of dams per maternal grandsire (MGS), however, could be large enough to contribute to QTL detection. But dams and MGS usually are not genotyped, there are two recombination opportunities between the MGS and the progeny, and at a given location, only half the progeny receive a MGS chromosomal segment. A 3-step procedure was developed to estimate: (1) the marker phenotypes probabilities of the MGS; (2) the probability of each possible MGS haplotype; (3) the probabilities that the progeny receives either the first, or second MGS segment, or a maternal grandam segment. These probabilities were used for QTL detection in a linear model including the effects of sire, MGS, paternal QTL, MGS QTL and maternal grandam QTL. Including the grandam QTL effect makes it possible to detect QTL in the grandam population, even when MGS are not informative. The detection power, studied by simulation, was rather high, provided that MGS family size was greater than 50. Using maternal information in the French dairy cattle granddaughter design made it possible to detect 23 additional QTL genomewise significant.     

Effects of acetylcholine and other vasodilatory substances in the vascular bed of skeletal muscles during and after muscular contractions.

In dogs and cats perfusion pressure or femoral venous outflow and changes in the volume of the hind limb were measured. The influence of muscular contractions on the effects of acetylcholine, histamine, isoprenaline and papaverine in the vascular bed of the limb was investigated. It was found that after muscular excerise the effects of i. a. injection of acetylcholine into the isolated limb were markedly potentiated, whereas the effects of histamine and isoprenaline were diminished.     

Skeletal indicators of subsistence patterns and activity régime in the Mesolithic sample from Grotta dell’Uzzo (Trapani,Sicily): a case study

The skeletal sample from Grotta dell’Uzzo, Sicily (2 adult females and 5 adult males) was compared to a number of more representative population samples from Western Europe and the Mediterranean Basin. The majority of these were from Italian pre- and protohistoric sites. The research protocol analyzed skeletal indicators of labour activity and sexual division of labour (body size and proportions, sexual dimorphism, limb lateralization, bone robustness, the development of muscular attachments, accessory articular facets, signs of muscular hyperfunction). Sexual dimorphism and limb lateralization showed some regular patterns of possible general significance in all the samples examined here. A general pattern of gracilization and de-specialization of physical activity is observed in the Mesolithic as compared to the Upper Palaeolithic samples. The main features of the Mesolithic samples are: a reduction of body size and bone robustness, a lower degree of sexual dimorphism and limb bone asymmetry, a reduction of the mechanical stress on the lower limbs indicated by less pronounced muscular attachments and reduced talar flattening. This trend is reversed towards the Neolithic period. The main features of these variations are discussed in relation to economic and environmental changes. The Uzzo sample fits well into the general picture of the Western European Mesolithic, although showing some intermediate features between the Mesolithic and the Neolithic samples. This paper is dedicated to the memory of the late Roland Menk, who made significant contribution to our understanding of the Mesolithic transition.     

Functional architecture of the splenic vein in the adult human

The spatial arrangement of the muscular, elastic and collagenous fibers was examined in 20 splenic veins of adult humans. Histologic and panorganographic sections were stained by the following methods: azan, resorcinfuchsin (Weigert), Verhoeff-van Gieson's stain and Masson's trichrome. Unstained sections were examined under polarized light. The results show that the muscular and collagenous fibers of the splenic vein exhibit an elongated spiral arrangement with no polarization. The elastic fibers form a threedimensional network disposed predominantly in a longitudinal direction. Hemodynamics are discussed based on the spatial structure of the muscular, elastic and collagenous elements of the vein wall and its relationship with the circulatory functions of the spleen.     

Mucus transport in a miniaturized simulated cough machine: effect of constriction and serous layer simulant

The transport of mucus gel simulant (MGS) in a constricted simulated cough machine, using blood plasma as a serous layer simulant (SLS), was investigated. MGS was prepared from locust bean gum solutions crosslinked with varying amounts of added borate to produce gels of varying spinnability (filance). The model trachea was a plexiglass channel of rectangular cross-section with the plane bottom surface. The upper surface included a sinusoidal protrusion which provided a flow convergence with minimum gaps of 6, 4 and 2 mm. Experiments for mucus transport were conducted for these minimum gaps, as well as for the non-convergent case (12 mm gap). Miniaturization of sample quantity was achieved by keeping the MGS layer depth constant (0.5 or 1 mm) but reducing the zone of loading from 13.4 cm to 1 cm, thus reducing the sample requirement to as little as 0.2 ml. MGS transport was determined as the minimum displacement of a line of marker dye placed in the MGS layer at the point of minimum constriction gap. It was shown that in all cases (dry as well as with SLS), MGS transport increased as the minimum constriction gap between the plane and the convergent top surface decreased. This increase was further enhanced if an SLS of lesser viscosity was used. It was also found that the transport of MGS increased as the depth of MGS layer increased or as the filance decreased in both non-constricted and constricted cases. The relationship between MGS transport and filance was maintained even in the presence of an SLS layer.     

Altered activity of signaling pathways in diaphragm and tibialis anterior muscle of dystrophic mice

Duchenne muscular dystrophy is a musculoskeletal disease caused by mutations in the dystrophin gene. The purpose of this study was to use the mouse model of muscular dystrophy (mdx) to determine if the progression of the dystrophic phenotype in the diaphragm (costal) versus limb skeletal muscle (tibialis anterior) is associated with specific changes in extracellular regulated kinase (ERK1/2), p70 S6 kinase (p70(S6k)), or p38 signaling pathways. The studies detected that consistent with an earlier dystrophic phenotype, phosphorylation of p70(S6k) is elevated by 40% in the diaphragm with no change in limb muscle. In addition, phosphorylation of p38 kinase was decreased by 33% in the mdx diaphragm muscle. Levels of ERK1/2 as well as phosphorylation states were elevated in the diaphragm and limb muscle of mdx mice compared with age-matched control muscles. These results indicate that distinct signaling pathways are differentially activated in skeletal muscle of mdx mice. The specificity of these responses, particularly in the diaphragm, provides insight for potential targets for blunting the progression of the muscular dystrophy phenotype.     

Technique of definition and diagnostic criteria of a state of blood flow of pelvis minor in woman with pelvis minor varicosis

The aim of the research: the examination of the state of woven blood flow in women with pelvis minor varicosis. The study of woven blood flow by the method of radioisotope clearance in 72 women of reproductive age is carry ouied. In patients with the varicose expansion of the veins of pelvis minor was revealed significant reduction in the indices of blood flow in the organs of pelvis minor, which plays the leading part in the genesis of painful sidroma.     

Leg and Joint Stiffness in Children with Spastic Diplegic Cerebral Palsy during Level Walking

Individual joint deviations are often identified in the analysis of cerebral palsy (CP) gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient) of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.     

2 types of dynamics of filling of veins in the extremities during obstruction of venous outflow

The method of venous occlusion plethysmography improved by introduction of differential and logarithmic-computing signal amplifiers was used to study the time course of blood inflow to the limbs in 35 healthy individuals and 115 patients with diseases of lower limb veins. Two types of the time course of the vein blood content were defined. With type I the volume velocity (VV) of blood supply to the segment under study decreases, whereas with type II the VV first decreases and then remains unchanged for a long time. Type I occurs in 76% of healthy individuals, type II in 74% of patients. With type II the increment of the vein capacity is significantly reduced in both healthy individuals and in patients with varicose veins. Moreover, in healthy individuals, the VV, the time of constant venous volume attainment, and the rate of blood outflow from veins (after occlusion removal) significantly differ as well in types I and II. Both types of the blood content remain unchanged while both applying the functional tests and during examinations at varying times. It is assumed that type II blood content is determined by greater rigidity of the venous vessels.