驻极体及川芎对神经肌肉移植体功能恢复的影响

以２８只成年家狗为实验动物，做吻合血管神经的游离股直肌原位移植，同时予以局部驻极体和全身川芎治疗，旨在观察其对移植肌肉功能恢复的影响。结果显示：治疗后的移植肌，其电生理指标有明显改善，肌力提高约１７％；肌纤维数量增多；肌纤维间神经纤维多，毛细血管丰富。     

驻极体及川芎对神经肌肉移植体功能恢复的影响

以２８只成年家狗为实验动物，做吻全血管神经的游离股直肌原位移植，同时予以局部驻极体和全身川芎治疗，旨在观察其对移植肌肉功能恢复的影响。结果显示：治疗后的移植肌，其电生理指标有明显改善，肌力提高约１７％，肌纤维数量增多；肌纤维间神经纤维多，毛细血管丰富。     

聚集蛋白基因转染促进移植肌肉功能恢复的实验研究

目的 研究转染神经源性聚集蛋白基因对游离移植肌肉功能恢复的影响。方法 选大鼠股薄肌原位移植模型，按移植术后即刻肌肉内注射溶液的不同分为pCS2＋．-agrin基因转染实验组。pCS2＋空质粒组以及生理盐水注射组，后两组作为手术对照组，基因电转染术后不同时间检测各组肌肉收缩功能、神经源性agrin蛋白表达，以及终板区烟碱型乙酰胆碱受体（nAChR）数量的变化。结果 术后早期agrin基因转染组肌肉功能恢复明显优于空质粒转染组以及生理盐水注射组（4、5、10周，P〈0．05），但术后晚期15及20周时各组肌肉功能间差异无统计学意义。免疫组化显示agrin基因转染后，术后1周到5周，有大量棕黄色抗原抗体复合物沉积在终板及其邻近区域，但到第10周时表达明显减少，接近对照组水平。agrin基因转染组终板区的nAChR数量在各个时间点均高于实验对照组。结论 移植肌肉终板区转染神经源性agrin基因，促进了移植肌肉早期功能的恢复。     

川芎制剂对肾脏病治疗的现状

川芎制剂 (主要为川芎嗪及阿魏酸类 )现已广泛应用于临床。其清除氧自由基及抗内皮素对血管内皮的双重保护作用 ,对肾脏疾病的防治具有重要意义。本文对近年来有关研究作一简述。　　 1　对肾小球疾病的治疗作用在 10年前华西医科大学肾内科用阿魏酸哌嗪片口服治疗 35例肾病综合征Ⅱ型 ,取得满意疗效 ,治疗 1月后 2 4ｈ尿蛋白定量、血肌酐 (Ｓｃｒ)、肌酐清除率 (Ｃｃｒ)、胆固醇 (ＣＨ)、血浆白蛋白等指标均较对照组明显好转 (Ｐ <0 .0 1) ,其完全缓解 2 2 .86 % ,基本缓解 2 5 .71% ,部分缓解 4 2 .86 % ,显效率 91.4 3% ,而对照组显效率…     

肌肉缺损肌皮瓣移植功能重建临床效果

因创伤、火器伤、肿瘤切除及某些神经系统疾病或损伤等所致肌肉缺损或肢体肌肉功能丧失，均可行肌皮瓣移植重建功能。肌皮瓣具有皮瓣和肌瓣两者兼有的优点，尤其是带血管神经蒂肌皮瓣，既能作为肌肉填充深在缺损，使其产生动力效应，修复因肌肉缺损而带来的功能障碍，还能...     

功能性游离肌肉移植重建肢体功能的研究进展

本文对功能性游离肌肉移植重建肢体功能的研究、应用和进展的诸多方面进行综述。包括肌肉移植后的组织、形态结构、电生理变化;供肌的选择,常用供肌的特点;内窥镜下切取供肌的进展,与传统切取方法比较所具有的优点及缺点;术中肌肉的固定和张力的调节,动力神经的选择、吻合;目前该手术在临床上的主要适应证;并分析了面临的一些问题、挑战及前景。     

神经肌肉阻滞恢复标准的再探讨

７０年代中期将神经肌肉阻滞恢复标准的安全范围界定为四次成串比值（ＴＲ）０．７左右。此外,肌松药残余作用所致的并发症仍时有发生。近年来有学者就此进行临床研究,提出将Ａｌｉ等所界定的ＴＲ０．７修改为≥９。本文主要综述神经肌肉阻滞恢复至ＴＲ０．７时所存在的缺陷及修改为≥０．９的依据,供临床借鉴与参考。     

胚胎运动神经元移植对失神经肌肉影响的实验研究

目的探讨胚胎运动神经元移植至入肌点前支配神经内对失神经肌肉萎缩的影响.方法取20只健康SD大鼠建立失神经腓肠肌动物模型,随机分移植组和对照组(每组10只);将胚胎14～18d的SD鼠胚脊髓前角运动神经元的活细胞悬液注入移植组切断的胫神经远端,对照组注射等量的生理盐水.手术后第3个月,进行腓肠肌肌力、肌湿重测定,组织和免疫化学检查以及胫神经纤维计数,并作图像分析.结果种植入胫神经内的鼠胚胎运动神经元能够存活.移植组腓肠肌肌力和肌湿重恢复率高于对照组,差异有显著性(P＜0.01);肌纤维横截面积恢复率高于对照组,差异有显著性(P＜0.05),且I型、Ⅱ型纤维面积均优于对照组(P＜0.05);肌动蛋白的相对含量移植组高于对照组,差异有显著性(P＜0.05);移植组运动终板结构清晰,而对照组大部分运动终板崩解,两组运动终板恢复率比较,差异有显著性(P＜0.05);移植组神经纤维再生率为0.661±0.149,高于对照组的0.463±0.109,差异有显著性(P＜0.01).结论胚胎运动神经元移植至外周神经内,便于靶组织获得神经营养,能延缓失神经肌肉的萎缩,并可提高其功能的恢复.     

FEP驻极体薄膜对创面愈合的影响

目的观察-700V、-400V 之驻极体薄膜(聚氟化乙丙烯共聚物薄膜)对创面愈合的影响。方法以凡士林纱布对照,分别覆盖在36个浅Ⅱ度创面上,术后1,2,3,5,7天,通过肉眼观察创面愈合,光镜下观察上皮细胞生长情况,测定创面上皮细胞 DNA 含量及利用微机计算创面面积缩小率。结果从术后第3天开始,贴有驻极体薄膜之创面 DNA 含量明显高于凡士林组,光镜下显示其表皮生长旺盛,其面积缩小率亦明显高于凡士林组,其中以-700v 效果更佳。结论驻极体能够促进创面的愈合。     

FEP驻极体薄膜对创面愈合的影响

目的观察－７００Ｖ、－４００Ｖ之驻极体薄膜（聚氟化乙丙烯共聚物薄膜）对创面愈合的影响。方法以凡士林纱布对照，分别覆盖在３６个浅Ⅱ度创面上，术后１，２，３，５，７天，通过肉眼观察创面愈合，光镜下观察上皮细胞生长情况，测定创面上皮细胞ＤＮＡ含量及利用微机计算创面面积缩小率。结果从术后第３天开始，贴有驻极体薄膜之创面ＤＮＡ含量明显高于凡士林组，光镜下显示其表皮生长旺盛，其面积缩小率亦明显高于凡士林组，其中以－７００ｖ效果更佳。结论驻极体能够促进创面的愈合。     

驻极体对金黄色葡萄球菌感染创面影响的实验研究

采用兔背创面模型，观察驻极体对金黄色葡萄球菌感染创面的影响。于兔背上接种金黄色葡萄球菌液（１０６／ｍｌ），将４０个创面分成两组，对照组贴上凡士林油纱布，治疗组贴上－１５００ｖ驻极体薄膜。于术后第１、２、３、５、７、１０天进行肉眼观察、痂下组织细菌定量计算及组织学检查。结果发现：从术后第３天开始，治疗组含菌量日益减少，创面开始有上皮细胞生长，至第７天，上皮细胞生长旺盛。对照组含菌量日趋增多，且无上皮细胞生长。     

Effects of fast functional electrical stimulation gait training on mechanical recovery in poststroke gait

Stroke leads to gait impairments that can negatively influence quality of life. Functional electrical stimulation (FES) applied during fast walking (FastFES) is an effective gait rehabilitation strategy that can lead to improvements in gait performance, walking speed and endurance, balance, activity, and participation poststroke. The effect of FastFES gait training on mechanical energy utilization is not well understood. The objective of this study was to test the effects of 12 weeks of FastFES gait training on mechanical recovery indices of poststroke gait. Kinematic data were collected from 11 stroke survivors before and after 12 weeks of FastFES training. Mechanical recovery was calculated from the positive changes in vertical, anterior-posterior, and medial-lateral components of center of mass energy. The average mechanical recovery increased from 34.5% before training to 40.0% after training. The increase was statistically significant (P = 0.014). The average self-selected walking speed increased from 0.4 m/s to 0.7 m/s after the 12-week FastFES training. The results indicate that the subjects were better able to generate and utilize the external mechanical energy of walking after FastFES gait training. FastFES gait training has the capacity to increase the gait speed, improve the mechanical recovery, and reduce the mechanical energy expenditure of stroke survivors when they walk.     

手术相关因素对全膝关节置换术后功能恢复的影响

全膝关节置换术后功能恢复的结果受多种手术相关因素影响,本文分析总结不同手术相关因素对术后功能恢复的影响机制,认为股骨后髁偏心距、胫骨平台后倾角、关节线高度变化、髌骨关节填塞及假体类型均可能影响术后功能恢复结果,且不同因素间同样存在联系。本文拟通过对各因素影响机制的阐述与分析,协助临床医生制定更优的术前计划,精准的术中决策以及个体化的术后康复计划。     

Patterns and predictors of hand functional recovery following pediatric burn injuries: Prospective cohort study

PurposeTo describe the pattern of hand functional recovery in the first six months following the discharge of children with burn injury, and to identify the predictors affecting this recovery.Materials and methodsThis was a prospective, comparative, follow-up cohort study in which hand functional outcome, was assessed during 9 months follow-up on 37 children with burn injuries involving the upper extremity with total body service area (TBSA<35%). Thirty-six matched healthy children were participated to compare the differences between children with burn and healthy children regarding the hand functional outcome. Hand function assessments included total active motion (TAM), grip strength and Jebsen Hand Function Test (JHFT) were conducted at hospital discharge, 3, and 6 months follow-up after discharge.ResultsWe found a trend towards an increase in the TAM scores over time (P<0.001), and were excellent in 5.41%, at discharge and increased to 18.92% and 40.54% at 3 and 6-month following discharge. The hand grip strength and JHFT showed significant improvement over time after 6 months (P<0.001). Regression analysis revealed that time to surgery, engagement in rehabilitation services, hand dominance, age and TBSA were the predictors of hand functional recovery and accounted 74% for TAM, 0.79 and 0.86 for total JHFT scores and grip strength.Conclusionsthe TAM, grip strength and JHFT were significantly improved after 3-month and these improvements were more evident at 6-month following discharge. Identification of the predictors may help therapists in the development of an effective rehabilitation programs.     

Free muscle graft pharyngoplasty with palatal retroposition in the treatment of velopharyngeal incompetence

Summary The use of free skeletal muscle autografts in combination with a V-Y push back to the soft palate, in the treatment of velopharyngeal incompetence in 6 patients is reported. This pharyngoplasty offers a reconstruction of the anatomical elements of the region, and enhancement of the physiological functions of the velopharyngeal sphincter in speech production. Of the 6 patients treated, 4 were restored to essentially normal speech, and 2 salvage cases were improved; in all cases however, the anatomical mechanism for speech production was effectively augmented.