两种不同内固定手术对髌骨骨折患者术后膝关节功能恢复的影响

目的:探讨两种不同的手术方式(钛制空心钉结合张力带内固定手术)对髌骨骨折患者的临床疗效和安全性比较。方法:选择2016年6月-2017年10月治疗的髌骨骨折患者72例作为对象,使用随机数字表,随机分为对照组(n=36)和观察组(n=36)。对照组给予常规的克氏针张力带内固定进行手术,观察组则使用空心钉张力带进行固定。治疗后对患者效果进行统计和评估,比较两组患者的术后骨折的愈合时间,功能恢复(最大屈曲角度),髌骨评分以及并发症等指标。结果:根据不同的治疗方式后,观察组(空心钉张力带固定组)在骨折的愈合时间,功能恢复,髌骨评分以及并发症等比较指标中较对照组均有显著优势,其结果具备统计学意义(P<0.05)。结论:将钛制空心钉结合张力带内固定手术用于髌骨骨折与传统的克氏针张力带固定方法相比较,具有操作简便,骨折愈合率高,功能恢复确实,并发症发生率低等诸多优点,值得在临床中进一步推广应用。     

A clinical surrogate model for proof of efficacy of external phytomedicines for muscle pain. Results of a randomized,placebo-controlled clinical study in volunteers with muscle pain due to physical training

PurposeSurrogate models have been postulated for (re-)registration of external remedies for pain, whose active substances are in accordance to monographs. In a new human model, we investigated an ointment consisting of high dosed herbal ingredients.MethodsWe conducted a clinical study in 32 healthy volunteers. Four muscle regions were treated with the ointments (verum on the one side and placebo on the other) in a randomized and doubleblinded manner immediately after a standardized physical exercise with individual intensity, as well as after 1, 2 and 24 h. Acute muscle pain and muscle tension for each region was documented repeatedly during the following two days by visual analogue scale (VAS). Primary outcome parameter was the difference of pain during the follow up given as area under the curve (AUC) of VAS for corresponding right and left regions, treated with verum or placebo. Also the difference of muscle tension was documented and evaluated in an analogous way.Results30 out of 32 included patients finished the study, but developed only moderate muscle pain, with highest pain scores for extension muscles of the arm. There was less pain in the course for the verum in 3 of the 4 regions, the mean difference of individual AUCs was at highest for the extension (triceps) muscles of the arm, but between-group differences failed significance. Feeling of muscle tension was higher than that of pain, with smaller mean AUCs of verum in all 4 regions; the differences were significant in total (p<0.02) and in 2 of 4 single regions.ConclusionsPhysical exercise was not intensive enough to exert clear symptoms. Our volunteers with sportive background seem not to show severe symptoms of muscle pain and muscle tension even after an intensive training. Despite low levels of symptoms, verum showed better courses of muscle tension and muscle pain. For future studies it seems better not to use volunteers with sportive background but totally untrained persons in order to achieve pronounced symptoms. The model is feasible, sensitive, inexpensive and is much more clinically relevant than those, focusing on perfusion parameters of skin.     

两种内固定方法治疗髌骨骨折术后关节面对合情况的比较

目的：比较改良张力带钢丝内固定和传统张力带钢丝内固定治疗髌骨横行骨折术后关节面对合的效果。方法：2007年3月至2011年9月,分别采用胥氏张力带钢丝内固定和改良张力带钢丝内固定且随访超过1年的髌骨横行骨折的患者64例,术中分别采用胥氏张力带钢丝内固定和改良张力带钢丝内固定治疗,随访时行膝关节X线摄片检查,观察关节面对合情况,比较两种治疗方法所致关节面台阶样错位是否大于2mm的差异。结果：64例患者均获得随访,随访时间8~18个月,平均13.2个月,骨折端均愈合,两组Lysholm评分比较无统计学意义（P=0.665）;胥氏张力带钢丝内固定组和改良张力带钢丝内固定组分贝出现1例（3.1%）和7例（21.9%）关节面台阶征,两组关节面台阶征的发生率比较差异有统计学意义（P=0.036）。结论：胥氏张力带钢丝固定法使髌骨骨折术后固定作用加强,关节面对合更好,能有效预防因台阶征引起的创伤性关节炎的发生。     

A therapeutic alternative for tension headache in children: treatment and 1-year follow-up results

Ten young subjects, ranging in age from 12 to 15 years, suffering from tension headache were treated by electromyographic biofeedback (EMG-BFB) twice a week for 12 sessions. The Pain Total Index (PTI) was recorded every month from the beginning to the end of the treatment. At the end of the treatment the PTI decreased significantly in all our patients and, at the same time, the muscular tension values also decreased. This result supports the hypothesis of a correlation between clinical symptom and muscular tension level. We saw our patients for follow-up sessions, and the clinical improvement was confirmed to 1 year from the completion of the treatment; however, the muscular tension values were increased with respect to the last-session values.     

A therapeutic alternative for tension headache in children: Treatment and 1-year follow-up results

Ten young subjects, ranging in age from 12 to 15 years, suffering from tension headache were treated by electromyographic biofeedback (EMG-BFB) twice a week for 12 sessions. The Pain Total Index (PTI) was recorded every month from the beginning to the end of the treatment. At the end of the treatment the PTI decreased significantly in all our patients and, at the same time, the muscular tension values also decreased. This result supports the hypothesis of a correlation between clinical symptom and muscular tension level. We saw our patients for follow-up sessions, and the clinical improvement was confirmed to 1 year from the completion of the treatment; however, the muscular tension values were increased with respect to the last-session values.     

Deficient Discrimination of EMG Levels and Overestimation of Perceived Tension in Chronic Pain Patients

Twenty chronic low back pain patients (CBP), twenty tension headache (THA) patients, and twenty healthy controls (HC) participated in a tension production task where subjects had to attain four levels (4, 8, 12, 16 V) of muscle tension at the m. frontalis and the m. erector spinae. Ratings of perceived tension, pain, and aversiveness as well as EMG, heart rate, and skin conductance levels were recorded. Signal detection and correlational methods revealed that the patients were deficient in muscle tension discrimination at high tension levels in both muscles. They generally overestimated low and underestimated high levels of muscle tension, especially in the CBP group. At low muscle tension levels, both healthy controls and patients showed deficient discrimination ability. Perceived muscle tension, aversiveness, and pain ratings during the tasks were higher in the patient groups. These data confirm and clarify previous reports of deficient tension perception and show concurrent overestimation of bodily symptoms in chronic musculoskeletal pain patients.     

Effects of oxygen tension and humidity on the preimplantation development of mouse embryos produced by in vitro fertilization: analysis using a non-humidifying incubator with time-lapse cinematography

To examine the effects of oxygen tension and humidity on early embryonic development, the preimplantation development of mouse embryos produced by in vitro fertilization was assessed by time-lapse cinematography to evaluate morphokinetic development with higher precision. Zygotes were produced from spermatozoa and oocytes from ICR mice and cultured in KSOM under low or high oxygen tension in a non-humidified incubator with time-lapse cinematography (CCM-iBIS). The developmental rates of embryos to the 4-cell and blastocyst stages under lower oxygen tension in CCM-iBIS were significantly higher than those under higher oxygen tension in CCM-iBIS. Ninety-six hours after insemination, a large number of embryos cultured under low oxygen tension developed to the hatching blastocyst stage. Embryonic development was more synchronized under lower oxygen tension. Non-humidified cultures did not affect embryonic development. On average, mouse embryos cultured at lower oxygen tension reached 2-cell at 18 h, 3-cell at 39 h, 4-cell at 40 h, initiation of compaction at 58 h, morula at 69 h, and blastocyst at 82 h after insemination. In conclusion, lower oxygen tension better supports preimplantation development of mouse embryos fertilized in vitro, and non-humidified culture conditions do not influence the embryonic development in vitro.     

TREATMENT OF PAIN AND NEUROMUSCULAR TENSION—A Report on Intravenous Use of Tetracaine in 365 Cases

Three hundred and sixty-five patients were given tetracaine intravenously for various types of pain and neuromuscular tension. In the treatment of pain, myositis, muscle spasm, and visceral spasm most patients were relieved. Best results were obtained in syndromes in which pain was associated with muscle spasm, such as in pain in the lower part of the back and scalenus anticus syndromes. The effects of tetracaine intravenously are those of analgesia, vasodilatation, and relaxation of spastic muscle. Sixty-five of the patients were treated for neuromuscular tension, and there was good relaxation and increased comfort. Alcoholics were relieved of some of the tension symptoms and may have been helped to resist the desire to drink. Of 14 patients with premenstrual tension, 13 had complete relief. Eight patients with mixed anxiety and tension states also responded well.Toxic and allergic reactions were negligible, and other side effects were infrequent and of no consequence.     

Treatment of pain and neuromuscular tension; a report on intravenous use of tetracaine in 365 cases

Three hundred and sixty-five patients were given tetracaine intravenously for various types of pain and neuromuscular tension. In the treatment of pain, myositis, muscle spasm, and visceral spasm most patients were relieved. Best results were obtained in syndromes in which pain was associated with muscle spasm, such as in pain in the lower part of the back and scalenus anticus syndromes. The effects of tetracaine intravenously are those of analgesia, vasodilatation, and relaxation of spastic muscle. Sixty-five of the patients were treated for neuromuscular tension, and there was good relaxation and increased comfort. Alcoholics were relieved of some of the tension symptoms and may have been helped to resist the desire to drink. Of 14 patients with premenstrual tension, 13 had complete relief. Eight patients with mixed anxiety and tension states also responded well. Toxic and allergic reactions were negligible, and other side effects were infrequent and of no consequence.     

胫前减张切口结合锁定加压钢板内固定治疗老年胫腓骨远端骨折的疗效

目的:探讨胫前减张切口结合锁定加压钢板(LCP)内固定治疗老年胫腓骨远端骨折的临床效果。方法:选择2014年3月-2015年3月本院收治的老年胫腓骨远端骨折患者100例,根据手术方式不同分为减张组和内固定组。减张组行胫前减张切口结合锁定加压钢板内固定术,内固定组行锁定加压钢板内固定术。观察并比较两组患者的手术时间、术中出血量、住院时间、骨折愈合时间、并发症的发生率以及AOFAS评分。结果:两组手术时间、术中出血量及住院时间比较,差异无统计学意义(P0.05);减张组患者骨折愈合时间短于内固定组,并发症的发生率低于内固定组,差异具有统计学意义(P0.05);两组患者AOFAS评分比较,差异无统计学意义(P0.05)。减张组患者的手术优良率高于内固定组,差异具有统计学意义(P0.05)。结论:胫前减张切口结合LCP内固定治疗老年胫腓骨远端骨折的临床效果显著,值得推广应用。     

The effect of electrode placement on frontalis EMG measurement in headache patients

Comparisons were made between frontalis EMG surface recordings concurrently taken from horizontal, right vertical, and left vertical electrode placement configurations. Six migraine and seven tension headache patients were used as subjects. Results showed that, in general, a positive correlation existed between recordings from the three placements for both migraine and tension subjects as a group. However, marked individual differences were noted. It was concluded that electrode placement can be quite important in measuring changes in frontalis muscle tension for headache patients.     

1株耐高温生物表面活性剂产生菌的特性研究

研究了耐高温生物表面活性剂产生菌ZY-3的生理生化特性,并通过测定发酵液的菌体密度、表面张力和乳化活性等指标,研究不同碳源和初始pH对菌株ZY-3生长和产生物表面活性剂的影响,同时对其所产生物表面活性剂进行了初步分离和性质分析。菌株ZY-3被初步鉴定为芽胞杆菌属(Bacillus),具有产酸、不产H_2S、还原硝酸盐等特性。在以淀粉为碳源、初始pH 6.0的培养基中发酵,产生物表面活性剂多且稳定;在种子培养基和发酵培养基中都有淀粉的条件下,菌体生长较多,降低表面张力和乳化的作用均较强,所产生物表面活性剂可以使发酵液的表面张力从72.1 mN/m降到53.1 mN/m,乳化活性从0升高到24%。初步判断产物为糖脂类阴离子表面活性剂。     

离体子宫张力测定在药物生殖毒性研究中的应用

目的:建立药物生殖毒性研究中孕鼠离体子宫平滑肌张力的测定方法。方法:SD大鼠于妊娠第6~15天(GD6-15)给予受试物,在妊娠第20天(GD20)取子宫平滑肌,分别给予不同浓度缩宫素和硫酸镁溶液刺激,选择试验的最佳条件。在此基础上,测定不同剂量组孕鼠离体子宫平滑肌张力的变化情况,采用RM-6240BD多道生理信号采集处理系统分析数据,统计结果。结果:选择0.007 U/m L缩宫素、0.008 mol/m L硫酸镁为最佳刺激浓度。随着受试物剂量的增加,加入缩宫素后,各组妊娠子宫平滑肌的频率和张力均呈逐渐上升的趋势,而加入硫酸镁后,各剂量组妊娠子宫平滑肌的活动幅度、频率和张力均呈现降低的趋势,但各剂量组与溶媒对照组相比均未见明显差异(P0.05)。结论:本研究建立了孕鼠离体子宫平滑肌张力的测定方法,该方法可以更好的反映受试物对孕鼠子宫肌的毒性作用,更加全面的评价受试物的生殖毒性。     

空心钉张力带钢丝联合内固定治疗髌骨骨折的临床疗效

目的:探讨空心钉张力带钢丝联合应用内固定在髌骨骨折患者中的临床疗效及安全性。方法:收集于我院就诊的150例髌骨骨折患者,随机分为实验组和对照组,各75例。对照组患者行钢丝环扎内固定术,实验组患者给予空心钉张力带钢丝内固定术。观察并比较两组患者骨折愈合时间、手术时间、临床治疗优良率以及患者的并发症的发生情况。结果:与对照组相比,实验组患者的骨折愈合时间显著缩短,但手术时间较长,治疗优良率较高,并发症发生率较低,差异均具有统计学意义(P0.05)。结论:与钢丝环扎内固定术比较,空心钉张力带钢丝联合应用治疗髌骨骨折的临床疗效较好,安全性更高。     

Production of biosurfactants by Cladosporium resinae

Summary Cladosporium resinae produces extracellular biosurfactants when growing in a hydrocarbon source such as the jet fuel JP8. This production of biosurfactants was observed by the reduction of the surface tension of the aqueous phase of growing medium, and by the increase in emulsion and foaming properties. A partial purification by collapsed foam gave better physical properties by decreasing surface tension and increasing foaming power and stabilization of emulsions. Surface active substances were purified by reversed phase chromatography. Six compounds representing over 75% of fraction containing surface activity were present. This fraction gave an improvement of all surface properties.     

Precipitating and relieving factors of migraine versus tension type headache

ABSTRACT: BACKGROUND: To determine the differences of precipitating and relieving factors between migraine and tension type headache METHODS: This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. RESULTS: In this study, the female patients predominated (67%). Most of the patients were within 21--30 years age group (58.6%). About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH) patients. But significant difference was demonstrated for fatigue (p < 0.05), sleep deprivation (p < 0.05), sunlight (p < 0.01) and food (p < 0.05), which were common among migraineurs. In consideration of relieving factors of pain, different maneuvers were commonly tried by migraineurs and significant difference were observed for both analgesic drug and massage (p < 0.05), which relieved migraine headache. But maneuvers like sleep, rest and posture were used by both groups. CONCLUSION: The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.     

The effectiveness of EMG biofeedback training in low back pain

Eighteen patients with chronic low back pain(lbp) of muscle tension origin were given an EMG biofeedback training. Compared to seven controls they showed a significant decrease during training in muscle tension and subsequently in pain. However, at follow-up EMG levels dropped to the initial(high) level. Pain scores of patients with high pain decrements during training showed further improvement during follow-up, which was not the case with patients showing less substantial improvement. The importance of cognitions was discussed.We wish to express our thanks to Marijke Höweler-van Dalen for supervising this investigation, to Arnold Goedhart for statistical advice, to Dr. Orlebeke for his critical remarks, and to Dr. Penders for referring the patients in Amsterdam. We are particularly indebted to the general practitioners Paul Kreutzer and Jan Huls for referring the Andijk patients. Without their support this investigation would not have been possible.     

Discrimination of muscle tension in chronic pain patients and healthy controls.

The purpose of this study was to assess the perception of muscle tension in chronic pain patients and healthy controls. Twenty chronic back pain patients, 20 patients who suffered from temporomandibular pain and dysfunction, and 20 healthy controls were instructed to produce eight different levels of muscle contraction in either the m. masseter or the m. erector spinae. Each level was produced three times; trials were presented in random order. Analyses of the accuracy and the sensitivity of discrimination of muscle tension levels revealed that the patients were less able to perceive muscle contraction levels correctly and that they underestimated their actual levels of muscle tension. Patients and controls did not differ in the extent to which they contracted muscles not involved in the task. Patients suffering from musculoskeletal disorders seem to display a genuine deficit in discrimination of muscle tension that is related to neither local physiological changes at the site of pain, lack of motivation, in-attention, nor fatigue.     

The development of an improved physical surrogate model of the human spinal cord—Tension and transverse compression

To prevent spinal cord injury, optimize treatments for it, and better understand spinal cord pathologies such as spondylotic myelopathy, the interaction between the spinal column and the spinal cord during injury and pathology must be understood. The spinal cord is a complex and very soft tissue that changes properties rapidly after death and is difficult to model. Our objective was to develop a physical surrogate spinal cord with material properties closely corresponding to the in vivo human spinal cord that would be suitable for studying spinal cord injury under a variety of injurious conditions. Appropriate target material properties were identified from published studies and several candidate surrogate materials were screened, under uniaxial tension, in a materials testing machine. QM Skin 30, a silicone elastomer, was identified as the most appropriate material. Spinal cords manufactured from QM Skin 30 were tested under uniaxial tension and transverse compression. Rectangular specimens of QM Skin 30 were also tested under uniform compression. QM Skin 30 produced surrogate cords with a Young's modulus in tension and compression approximately matching values reported for in vivo animal spinal cords (0.25 and 0.20 MPa, respectively). The tensile and compressive Young's modulus and the behavior of the surrogate cord simulated the nonlinear behavior of the in vivo spinal cord.