首例圈养大熊猫难产的治疗与原因分析

2004年8月,成都大熊猫繁育研究基地1只雌性大熊猫发生难产,临床表现以阵缩及努责匮乏为主要特征,经过B超检查、药物辅助治疗等一系列保守措施后,胎儿于4天后排出。鉴于大熊猫难产病例在国内外至今未见报道,现将该病的临床特点、诊断和处治情况介绍如下。     

徒手转胎纠正128 例头位难产的临床效果观察

目的:探讨应用徒手转胎术纠正头位难产的临床效果,为提高经阴道分娩的成功率提供参考。方法:选取2014年6月-2015年12月我院收治的128例头位难产患者作为研究对象,随机为研究组和对照组,每组64例。对照组在第二产程初期采用胎头吸引术,研究组患者通过徒手旋转胎头术调整胎头方位。观察并比较两组产后出血量、第二产程时间及新生儿神经行为测定(NBNA)评分。结果:研究组患者阴道自然分娩成功率(95.31%)高于对照组(73.44%),差异有统计学意义(P0.05);研究组产后出血量和第二产程时间均显著低于对照组,差异具有统计学意义(P0.05);研究组新生儿NBNA评分高于对照组,但两组之间比较,差异无统计学意义(P0.05)。结论:徒手转胎术与胎头吸引术两种干预方式对新生儿行为神经的影响无明显区别,但徒手转胎术可以有效缩短头位难产产妇的产程,并能显著提高阴道分娩率,有益于母婴的预后,值得临床推广应用。     

中国广肩小蜂-新属及-新纪录属（膜翅目，广肩小蜂科）

研究了广肩小蜂科1新属丽广肩小蜂属Chryseurytoma Chen et Huang,描述1新种绿丽广肩小蜂Chryseurytoma viridis Chen et Huang,sp．nov．及中国1新纪录属刺盾广肩小蜂Acantheurytoma Cameron。新种绿丽广肩小蜂Chryseurytoma viridis Chen et Huang,sp．nov．的主要特征为：额无前眶脊;前足基节无纵槽;前单眼位于触角洼之上;胸部明显隆起;前胸背板前缘无脊;盾纵沟伸至中胸盾片3/4;触角除棒节褐色外其余为黄色;柄后腹长为宽的3.2倍。模式标本保存于中国科学院动物研究所动物标本馆。     

DGGE和RFLP方法分析桑粒肩天牛幼虫肠道微生物多样性

昆虫是一个复杂的微生态系统,这些微生物对宿主发育,营养物质的消化吸收和防御方面起着重要的作用。利用DGGE和RFLP指纹图谱的方法初步研究桑粒肩天牛幼虫肠道微生态系统。对肠道微生物16S rDNA V3区进行DGGE分离,得到24个不同位置的条带。DGGE图谱亦显示了肠道微生物的季节变化,夏季较冬季菌群丰富。各月DNA样品混合并扩增16S rDNA全长序列,构建16S rDNA克隆文库。用Msp I、Rsa I对文库中175个随机阳性克隆的质粒DNA进行限制性酶切。酶切图谱聚类分析结果显示175个克隆被归为60个不同的类群,这一结果显示桑粒肩天牛幼虫肠道微生物非常丰富。因此,这2种方法都能有效的反应肠道微生物多样性状况,且RFLP比DGGE具有更好的分辨率。结合使用这2种方法,初步反应了桑天牛肠道微生物多样性信息。     

光肩星天牛两型种群表型多样性分析

【目的】光肩星天牛Anoplophora glabripennis(Motschulsky)是国内最重要的林木蛀干害虫之一,在中国分布范围较广。近年来,形态学以及分子生物学的研究表明,光肩星天牛与黄斑星天牛A.nobilis(Ganglbauer)很可能是同一种的不同型。定量研究光肩星天牛两型的差异与表型多样性。【方法】作者以光肩星天牛的20个地理种群的光肩星天牛分布区为研究对象,采用巢式方差分析和聚类分析对其头长、头后缘宽、前胸后缘宽等13个表型性状进行多样性分析。【结果】表型特征在群体间与群体内均存在着广泛的变异,13个性状的平均表型分化系数为11.78%,群体内变异是其表型性状变异的主要来源;后翅长度与经度呈极显著负相关,与海拔极显著正相关以及与年降水量呈显著负相关。体长与鞘翅斑纹颜色与海拔高度分别呈显著正相关和负相关关系;在不同地理种群中,鞘翅斑纹颜色的分化系数达到最大,为50.53%;而以鞘翅斑纹颜色分类的两型差异显示各性状的表型分化系数均大幅度降低。【结论】本研究首次将鞘翅斑纹的颜色进行数字化处理,并进行分类,结果显示各个颜色类群的分化系数均大幅度减小,说明颜色类群之间的分化要小于地理隔离所造成的差异,进一步验证了光肩星天牛与黄斑星天牛为同一种的不同型。     

肩袖间隙影像解剖及常见病变的研究进展

肩袖间隙在解剖学上是肩关节的一个复合区域,在维持肩关节稳定性和保护肱二头肌长头肌腱功能起重要作用。对肩袖间隙解剖结构及功能的深入认识有助于肩袖间隙损伤性病变、挛缩性病变等的及时诊断和合理治疗。影像学检查尤其是磁共振逐步成为肩袖间隙疾病最主要的检查方法,包括常规扫描、直接及间接性磁共振肩关节造影、增强扫描等。本文将就肩袖间隙的影像解剖及常见病变的相关研究进行综述。     

杨树粒肩天牛的生物学特性

杨树粒肩天牛在福建省2a发生1代;老熟幼虫在第2年4月下旬至5月初开始化蛹,成虫出现期始于5月底6月初,6月中下旬到7月上旬为盛发期,9月上旬只见个别成虫;产卵期始于6月中旬,6月下旬至7月中旬为产卵高峰期;幼虫孵化期为6月下旬到8月中旬,7月上中旬为为盛发期;幼虫不越冬。杨树粒肩天牛成虫为补充营养所取食的树种较集中,主要是构树与桑树。杨树粒肩天牛幼虫对杨树危害严重,但成虫却不喜欢取食杨树,用杨树饲养的粒肩天牛成虫寿命很短,仅3-19d,不产卵;而以桑树为补充营养的雌成虫的平均寿命为55d、雄26.5d;以构树为补充营养的雌成虫的平均寿命为78d、雄45.5d,补充桑树与构树的粒肩天牛成虫均可正常产卵。雌雄成虫一生可多次交尾。雌虫有多次产卵现象,单雌每天产卵数量1-12粒不等。     

杨树粒肩天牛幼虫林间化学防治试验

选用3种化学药剂应用不同的施药方法对杨树粒肩天牛幼虫进行林间药效试验,结果表明,采用虫道注射与毒签两种施药方法林间防治粒肩天牛幼虫都具有良好的防治效果,15d后防治效果达71.44～97.54%,可在生产中推广应用。     

运动疗法结合针刺治疗颈肩综合征的临床效果

目的 探讨运动疗法结合针刺在颈肩综合征的临床应用效果. 方法 选择2018年1月～2021年6月我院治疗的60例颈肩综合征患者为研究对象,按照随机数字表法分为两组,每组30例.对照组采用针刺治疗,观察组在对照组的基础上加用运动疗法治疗,比较两组患者的治疗效果以及治疗前后疼痛程度、颈椎功能变化情况. 结果 观察组的治疗总...     

Neonatal Injury at Cephalic Vaginal Delivery: A Retrospective Analysis of Extent of Association with Shoulder Dystocia

Purpose

To describe the risk factors and labor characteristics of Clavicular fracture (CF) and brachial plexus injury (BPI); and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia.

Methods

This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300) was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia.

Results

During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2%) sustained permanent injury, whereas one neonate (4.5%) with BPI following shoulder dystocia sustained permanent injury (p = 0.34).

Conclusion

BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae.     

肌内效贴联合经皮神经电刺激对脑卒中后偏瘫肩痛患者肩关节疼痛、肩关节功能和血液流变学的影响

摘要 目的：探讨肌内效贴联合经皮神经电刺激（TENS）对脑卒中后偏瘫肩痛患者肩关节疼痛、肩关节功能和血液流变学的影响。方法：选取2019年5月~2022年1月期间江苏省人民医院收治的脑卒中后偏瘫肩痛患者100例,根据随机数字表法将其分为对照组（n=50）和研究组（n=50）,在常规康复训练的基础上,对照组接受肌内效贴干预,研究组接受肌内效贴联合TENS干预。对比两组视觉模拟评分法（VAS）评分、上肢Fugl-Meyer运动功能评定量表（FMA）、改良Barthel指数（MBI）、Constant-Murley肩关节功能评分量表（CMS）评分、血液流变学指标、肩关节功能变化情况。结果：研究组干预后VAS评分低于同期对照组（P<0.05）。研究组干预后FMA、MBI、CMS评分高于同期对照组（P<0.05）。研究组干预后血浆黏度、纤维蛋白原、全血黏度、红细胞压积均低于同期对照组（P<0.05）。研究组干预后患侧肩关节的外旋、前屈、外展的主动/被动活动度（AROM/PROM）均大于对照组同期（P<0.05）。结论：肌内效贴联合TENS应用于脑卒中后偏瘫肩痛患者,可有效改善肩关节疼痛、肩关节功能和血液流变学。     

中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析

摘要 目的：探究分析中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析。方法：采用便利抽样法,随机抽取2020年9月至2022年9月期间于我院门诊就诊的2010名中老年患者作为调查对象,对患者进行筛查、复查、确诊、随访等。并对所搜集信息进行疼痛及肩关节功能恢复单因素与多因素Logistic回归分析。结果：单因素分析显示,年龄（x²=15.274, P＜0.001）、性别（x²=10.401, P=0.001）、病程（x²=16.410, P＜0.001）和是否进行功能锻炼（x²=6.293, P=0.012）为影响中老年肩痛患者肩关节功能恢复的主要因素;年龄≥70岁（OR=1.292, 95%CI 0.953-1.750）、女性（OR=1.672, 95%CI 1.348-2.074）、病程＞1个月（OR=1.470, 95%CI 1.021-2.116）和未进行功能锻炼（OR=1.844, 95%CI 1.175-2.894）为影响中老年肩痛患者肩关节功能恢复的独立危险因素。结论：年龄≥70岁、女性、病程＞1个月和未进行功能锻炼为影响中老年肩痛患者肩关节功能恢复的独立危险因素,根据上述因素尽早快速甄别高风险患者,及早给予合理有效的康复治疗措施,可显著改善肩痛患者肩关节功能的预后。     

Shoulder labral pathomechanics with rotator cuff tears

Rotator cuff tears (RCTs), the most common injury of the shoulder, are often accompanied by tears in the superior glenoid labrum. We evaluated whether superior humeral head (HH) motion secondary to RCTs and loading of the long head of the biceps tendon (LHBT) are implicated in the development of this associated superior labral pathology. Additionally, we determined the efficacy of a finite element model (FEM) for predicting the mechanics of the labrum. The HH was oriented at 30° of glenohumeral abduction and neutral rotation with 50 N compressive force. Loads of 0 N or 22 N were applied to the LHBT. The HH was translated superiorly by 5 mm to simulate superior instability caused by RCTs. Superior displacement of the labrum was affected by translation of the HH (P<0.0001), position along the labrum (P<0.0001), and interaction between the location on the labrum and LHBT tension (P<0.05). The displacements predicted by the FEM were compared with mechanical tests from 6 cadaveric specimens and all were within 1 SD of the mean. A hyperelastic constitutive law for the labrum was a better predictor of labral behavior than the elastic law and insensitive to ±1 SD variations in material properties. Peak strains were observed at the glenoid–labrum interface below the LHBT attachment consistent with the common location of labral pathology. These results suggest that pathomechanics of the shoulder secondary to RCTs (e.g., superior HH translation) and LHBT loading play significant roles in the pathologic changes seen in the superior labrum.     

Shoulder complex kinematics pre- and post- rotator cuff repair

This study investigated shoulder complex joint kinematics and functional outcomes before and after full-thickness supraspinatus rotator cuff repair. Nine adults (mean age 63.4 ± 6.2 years) participated in three test sessions: 0–12 weeks pre-operatively, 9–12 weeks, and 22–30 weeks post-operatively. Upper extremity kinematics of the surgical arm’s glenohumeral, acromioclavicular, sternoclavicular and thoracohumeral joints over the duration of a hair combing task were quantified with motion analysis using inverse kinematics. The UCLA Shoulder Rating and Simple Shoulder Test shoulder health outcomes were administered at each session to determine patients’ perceived function of their surgical shoulder. Results indicated multiple significant increases over time among the three joints comprising the shoulder complex in the coronal and transverse planes, despite no increases in thoracohumeral motion, and suggest that thoracohumeral motion alone does not provide a comprehensive assessment. Interestingly, more significant increases were observed at the 6-month evaluation than the 3-month evaluation, which is not aligned with the standard rehabilitation endpoint. Thus, our findings suggest that clinicians should evaluate all joints of the shoulder complex during longer-term rehabilitation assessment. Ultimately, knowledge of patients’ pre-operative and post-operative shoulder complex kinematics may help to improve rehabilitation to promote improved patient outcomes.     

Shoulder muscle load and muscle fatigue among industrial sewing-machine operators

Physiological responses to physical work were assessed for 29 female industrial sewing-machine operators during an 8-h working day under ordinary working conditions. During sewing-machine work, the average (left and right) static load in the trapezius muscle was 9% of the maximal electromyogram (EMG) amplitude (% EMG_max), while the average mean load was 15% EMG_max, and the average peak load was 23% EMG_max. The static load level was unrelated to the muscle strength of the sewing-machine operators, which for the group as a whole was within the normal range. The load levels remained unchanged during the working day, while changes in the EMG mean power frequency and zero crossing frequency rate occurred, both indicating the development of muscle fatigue in left and right trapezius muscle during the working day. In line with this, the rating of perceived exertion in the shoulder and neck region increased during. the working day. Dividing the group of sewing-machine operators into two groups, those with the highest frequency and those with the lowest frequency of shoulder/neck troubles showed that the former group had significantly lower muscle strength, despite the fact that no differences in the surface EMG during sewing were found between the two groups. It was concluded that industrial sewing-machine work involves a pattern of shoulder muscle activity which induces fatiguing processes in the shoulder and neck regions. Furthermore, since the static shoulder muscle load was independent of muscle strength, factors other than working posture may be of significance for the static shoulder muscle load.     

Shoulder biomechanics of RC repair and Instability: A systematic review of cadaveric methodology

BackgroundNumerous biomechanical studies have addressed normal shoulder function and the factors that affect it. While these investigations include a mix of in-vivo clinical reports, ex-vivo cadaveric studies, and computer-based simulations, each has its own strengths and limitations. A robust methodology is essential in cadaveric work but does not always come easily. Precise quantitative measurements are difficult in in-vivo studies, and simulation studies require validation steps. This review focuses on ex-vivo cadaveric studies to emphasize the best research methodologies available to simulate physiologically and clinically relevant shoulder motion.MethodsA PubMed and Web of Science search was conducted in March 2017 (and updated in May 2018) to identify the cadaveric studies focused on the shoulder and its function. The key words for this search included rotator cuff (RC) injuries, RC surgery, and their synonyms. The protocol of the study was registered on PROSPERO and is accessible at CRD42017068873.ResultsThirty one studies consisting of 167 specimens with various biomechanical methods met our inclusion criteria. All studies were level V cadaveric studies. Cadaveric biomechanical models are widely used to study shoulder instability and RC repair. These models are commonly limited to the glenohumeral joint by a fixed scapula, passively and discretely move the humerus, and statically load the RC without regard for the integrity of the glenohumeral capsule.ConclusionAll studies captured in this review evaluated shoulder biomechanics. Recent studies in patients suggest that some assumptions made in this space may not fully characterize motion of the human shoulder. With reproducible scapular positioning, dynamic RC activation, and preservation of glenohumeral capsule integrity, cadaveric studies can facilitate proper validation for simulation models and broaden our understanding of the shoulder environment during motion in healthy and disease states.     

Effects of Kinesio taping on scapular kinematics of overhead athletes following muscle fatigue

Scapular kinematics alterations have been found following muscle fatigue. Considering the importance of the lower trapezius in coordinated scapular movement, this study aimed to investigate the effects of elastic taping (Kinesio taping, KT) for muscle facilitation on scapular kinematics of healthy overhead athletes following muscle fatigue. Twenty-eight athletes were evaluated in a crossover, single-blind, randomized design, in three sessions: control (no taping), KT (KT with tension) and sham (KT without tension). Scapular tridimensional kinematics and EMG of clavicular and acromial portions of upper trapezius, lower trapezius and serratus anterior were evaluated during arm elevation and lowering, before and after a fatigue protocol involving repetitive throwing. Median power frequency decline of serratus anterior was significantly lower in KT session compared to sham, possibly indicating lower muscle fatigue. However, the effects of muscle fatigue on scapular kinematics were not altered by taping conditions. Although significant changes were found in scapular kinematics following muscle fatigue, they were small and not considered relevant. It was concluded that healthy overhead athletes seem to present an adaptive mechanism that avoids the disruption of scapular movement pattern following muscle fatigue. Therefore, these athletes do not benefit from the use of KT to assist scapular movement under the conditions tested.     

单胎头位初产妇产程图分析

目的：探讨存在难产因素初产妇产程图的临床意义。方法：对2009年6月至2010年6月在济南军区总医院住院分娩的326例单胎头位初产妇的产程图进行回顾性分析。结果：产程图异常组中难产因素的构成比和剖宫产率均高于产程图正常组;存在难产因素的组别（胎方位异常组、宫缩乏力组、巨大儿组）产程中各阶段时限均较正常产妇组长,宫颈扩张速度均较正常组慢,胎头位置均高于正常组,以上差异均有统计学意义（P〈0．05）。结论：在产程中对产程图中各阶段时限、宫颈扩张速度及胎头位置等指标进行监测,来预测和及时发现头位难产因素的存在,及时给予处理,改善母儿预后。