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PARTICIPANTS: Totally 3 cases of children idiopathic multiple contracture, 2 cases of idiopathic clubfoot in children aged more than 10 years old without treatment and 6 cases of postoperative recurrent idiopathic clubfoot were admitted by the Department of Orthopedics of Nanjing Children' s Hospital Affiliated to Nanjing Medical University during 1999 to 2000. All cases manifested abnormal ankylosis and shortening deformity in foot.

对象:1990/2000南京医科大学附属南京儿童医院骨科共收治儿童先天性多发性关节挛缩症3例、未经任何治疗10岁以上的大年龄儿童先天性马蹄内翻足2例、先天性马蹄内翻足术后复发6例,全部病例均表现为足畸形僵硬和短足畸形。

The peak of the bulge accorded with the vertical line through the posterior convexity of superior articular surface of atlas. The superimpose rate of the vertical line with the M line were 48% to left and 65% to right. The surplus existed in l~2mm to lateral of M line. The exit point of screw was the median point of vertical line on the anterior cortex of lateral mass. The superimpose rate of BB line the line linked with the

寰椎后结节中点及上关节突后凸尖下的骨质弧形隆起的顶点可作为寰椎椎弓根螺钉进钉点的准确标志,上关节突后凸尖及横突尖可作为寰椎椎弓根进钉点的大体标志;沿寰椎椎弓根轴线进钉较为安全,内倾17°,仰角变异大,出钉参照前结节顶点;椎动脉沟中外的厚度及进钉点处寰椎后弓的高度是寰椎椎弓根螺钉固定的主要限制性因素。

Two component design total ankle replacement is based on restricted type design to prevent dislocation ,and make syndesmosis union to enlarge tibia component contact area and stability. Three component design total ankle replacement is based on unrestricted type design. Components are mimic to anatomic shape ,and congruent polyethylene insert was also characterized. Successful total ankle replacement depends on reasonable prosthesis design and rational contact stress .

二件式人工踝关节,其设计理念,在於以高限制型设计,避免脱位之产生,并以胫骨腓骨骨联合扩大胫骨元件的接触面积与稳定度;三件式人工踝关节,主张以非限制型设计,近於解剖形状之元件,以及与关节面一致构形的聚乙烯内衬为其特点成功的全踝人工关节置换术仰赖合理的踝关节设计以及合理的接触压力。

The results suggest that drug synovectomy may be one mechanism about intra-articular corticosteroid therapy in TMD, and this therapy could lead to progressive degradation and destruction of the articular cartilage.

糖皮质激素通过药物性的滑膜切除是治疗TMD关节源性疼痛的一个可能的作用机制;②一次性的关节腔内注射治疗剂量的糖皮质激素可以导致软骨基质的丢失和软骨的破坏。

Conn and Parker8 examined 375 patients with nondisplaced intracapsular fractures treated with internal fixation.

Conn和Parker研究了内固定治疗的375个无移位关节囊内骨折。

TyPe II collagen induced arthritisln the rat ank1e joint andoVathumin as antigen induced arthritis WA in the rabbit knee joint wereestab1ish2 Qualitative evaluation of me in skin, muscle, synovium, cedilagearound joint and blood was performed by OMA3 The CIA rats were treated on day 7 after hind paw swelling and erythemaAnimals were injected intravenously with ase at a dose of 10mg/kg,tWenty minuots 1ater, one ankle of the rats random1y assigned was exPosedlaser irradiation at l00J/cm fOr l000 seconds, and another ankle wasM grouP wihout laser The other two groups is unmanipulatedcontrol group and untreated CIA group Bimaleolar ankle widthmeasuremellts were taken in all animals every tWo days using amicrometer The histopathology of the ank1e Joint was assessed at day 21after disease onset4 The pro1iferating cell nuclear antigen WCNA of CIA treated by PDT andthe HMME group without laser was doterdrined by immunohistochemiStry5 The AfA rabbits were treated on day 7 after knee swelling and erythemaThe theraPy invo1ved lntravenous injection of l0mg/kg HMME, fOl1owedby 20 minues period in dim light, and transdermal light treatment with\l00 J/cm2 fOr l000 seconds The inner sides of the treated Anees wereirradiated at first, and then the outer side did 24 hours later, the synovialtissue of the Anees joint were removed and in situ cel1 aPoptosis wasdetCCted With tednal deoxync1eotidyl transferase-mediated dUTP nickend labelingR6suIt8:l The pathologic changes of CIA and AIA include subsynovial inflammation,opovial hyPerplasia, pannus formation, cartilage and bone destructionresemble RA.2 The studies demonstrated that there are different uptake of HMME withinskin, muscle, synovium, cartilage and b1ood, and the synovium cou1draPidly uPtake more ase than skin and cartilage at the firSt 30 minuesaller intravenous injection of HMME3 The bimaleolar anke width had no different among PDT treated group,H group withollt 1aser and untreated CIA group But hlstologicalevaluation showed statiStical1y significallt reductions in synovialhyperplasia, pannus formation and cart1lage reosion, bone destruction andtotal score in PDT treated group4 Image analysis showed that the ratlo bforeen the areas of the coufltedobect to that of the entire area in PDTtreated grOup is lower than that in conirol group, but the integrated oPticaldensity had no different between the two groups5 Imape analysis showed that the ratio between the area of the countedobject to that of the e

治疗组在大鼠出现踝关节红肿后1周,炎症达到高峰时进行PDT治疗。随机治疗大鼠一侧的踝关节,另。2。一一侧作单纯HMME 对照。治疗方法是大鼠麻醉后尾静脉注入 HMME10ngkg,20分钟后踝关节照光,激光波长627.sum,功率密度 100mwcm',照射时间1000秒,能量密度100)/。治疗后避光喂养72 小时。隔日一次测量大鼠的踝关节左右横径,治疗后两周取关节进行病理d 观察。 4。大鼠CIA模型用上述方法进行PDT治疗后,治疗组和单纯HMME 组用兔疫组化SP法检测石蜡切片的核增殖抗原。 5。兔AIA模型在关节炎出现第七天进行PDT治疗,随机治疗一侧膝关节,另一侧作自身对照。兔耳静脉注入I'arrainrelomg/Kg,20分钟后,膝关节用金蒸气激光照射,激光能量密度100)儿旷。24 /J'时后取膝关节滑膜作病理检查,并用脱氧核昔酸末端转移酶介导的缺口末端标记法原位检测凋亡细胞。结果: 1。模型观察:CIA大鼠炎症高峰期滑膜下炎细胞浸润明显,滑膜细胞明显增殖,炎症达到高峰后二周,血管缀形成,并侵蚀和破坏软骨和骨, CIA模型病理改变与人类RA相似。兔AIA模型膝关节滑膜病理可见滑膜细胞增生,滑膜下炎细胞浸润,也与人类RA滑膜改变相似。 2。关节周围组织中光敏剂含量的测定结果表明,各组织对HMME 的吸收速度和吸收量不同,荧光值一时间曲线不同,滑膜组织比皮肤和软骨对 HMME的吸收多,在 2 0分钟时即有明显差异。 3.PDT对CIA模型的治疗结果表明:PDT治疗后关节炎组、单纯 HMME组和治疗组踝关节左右横径统计学检验差异没有显著性,但病理评分PDT治疗组滑膜增生、血管资形成及软骨破坏、骨破坏和总分比关节炎对照组和HMME对照组好,统计学检验差异有显著性。。3_军医进修学院硕士学位论文中文摘要 4.PDT治疗组PCNA阳性细胞较对照组少,图像分析结果表明面密度(阳性染色的面积总和与统计视野面积的比值)治疗组小于对照组,统计学检验差异有显著性。。 5.PDT治疗组凋亡阳性细胞较对照组明显增多,图像分析结果单位视野内阳性细胞数和面密度PDT治疗组高于对照组,统计学检验差异有显著性。凋亡细胞核直径PDT治疗组较小,与对照组相比,统计学检验差异有显著性。结论:二。CIA、AIA的病理改变类似人类RA,可作为研究RA病因、发病机制、检查及治疗方法的模型。 2。各组织对HMME的吸收速度和吸收量不同,滑膜组织比皮。

METHODS: Puncture with the needle retaining in the cavity of knee of normal adult corpse without effusion or pneumatosis was performed, and 1, 5, 10, 15, 20, 30, 40 mL contrast-medium was injected into the cavity. Coronal section, vertical plane and transect were scanned with T2WI, 4 mm thickness and 1 mm interval by MRI.

对10件无积液、积气、结构正常的成人尸体膝关节腔内穿刺留针,通过穿刺针向关节腔内依次注入1,5,10,15,20,30,40 mL对比剂,分别于每次注射后行冠状面、矢状面、横断面T2WI,厚度4 mm,间距1 mm,MRI扫描。

Methods From March 1994 to December 2002, on the basis of the ordinary operative method, Pemberton method was improved for 48 cases of DDH 49 articulatio coxae which had superficial and small acetabula but big heads of femur. Osteotomy points were moved higher to enlarge area of bone flap turned over. A piece of full thickness ilium including periosteum was removed as a free bony graft. Capsula articularis growing thicker was made into 2 layers, of which the inner layer was used to tighten articularis and the outer layer was used to stabilize bone flap.

1994年3月~2002年12月,对DDH髋臼浅而小、股骨头大的48例49个髋关节,在通常术式的基础上,对Pemberton截骨术式进行改良,将截骨点上移,扩大翻转骨瓣面积;取髂骨全层骨板连带附着的骨膜植骨;增厚的关节囊制成两层,内层紧缩关节,外层稳定骨瓣。

Methods Fortythree cases of Itraarticular Fracture of the Calcaneus(46 feet) were treated with limited internal fixation with small incision and artificial bone implantation from June 2003 to June 2007.There were 34 male(37 feet) and 9 female(9 feet). Small incision was used extracalcaneus,collapsed facies articularis posterior calcanei after reduction,air containing space of Calcaneus were fiiled with hydroxyapatite ceramic artificial bone.

2003年6月—2007年6月作者采用微创小切口有限内固定联合人工骨植入的方法对43例46足跟骨关节内骨折进行治疗,其中男34例37足,女9例9足,术中运用跟骨外侧横行小切口,塌陷的跟骨后关节面复位后选用羟基磷灰石人工骨材料填充跟骨内空腔然后克氏针及螺钉固定。

Main factors influencing the joint lockup performance are determined by experiments and analysis, and the basic relationship between the lockup performance of robot joints and the influencing factors, including piston diameter, cavity diameter, material of friction ring, friction ring average diameter and viscosity of hydraulic oil, is obtained.

通过相关的实验研究及分析,确定了影响机器人关节锁紧能力的主要因素,获得了机器人关节锁紧能力与活塞尺寸、内腔尺寸、摩擦环材料和尺寸及液压油粘度等影响因素的基本关系。

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