关节内的

The static model of torsion joint is based on that of bending joint. The effects of structure parameters inside air pressure, initial angle, rube average radius, rube shell thickness on the turning angle are analyzed and the following conclusions are drawn: the relationship between the angle of torsion joint and the inside air pressure is basically linear, the angle of torsion joint increases with the initial angle and rube average radius, the angle of torsion joint decreases while the rube shell thickness increases. The kinetic equation is built for torsion joint. Simulating experiment implies that the time of inflating and deflating process is extremely shorter than that of kinetic process. So the pneumatic process can be ignored in actual system design and control. The factors that affect the dynamic features of torsion joint, such as shell thickness of rubber tube, average radius, initial angle, connector's outlet area, moment of inertia and viscous damping coefficient, are analyzed and the following conclusions are drawn: the change of rube shell thickness has no effects on the dynamic process of FPA inside air pressure while greatly affects the turning angle of torsion joint; when the rube shell thickness is small, the torsion joint has a bigger turning angle, no overshoot and long risetime, when the shell thickness is big, the turning angle of torsion joint is small, but has high response speed, overshoot and low shock; when the rube average radius increases, the turning angle of torsion joint increases and the overshoot increases too; when the initial angle of torsion joint is big, the turning joint is big, the overshoot is small and shock is low, but the risetime is big; the connector's outlet area affects the dynamic process of FPA inside air pressure greatly, but has no effects on the dynamic process of turning angle; moment of inertia and viscous damping coefficient have no effects on the dynamic process of FPA inside air pressure, but affect the dynamic process of turning angle greatly.

在弯曲关节模型推导的基础上，建立扭转关节的静态模型，并分析了扭转关节内腔压力，初始转角，橡胶管平均半径，橡胶管壁厚等参数对关节转角的影响，得出扭转关节的转动角度与充入FPA内腔的压缩气体压力之间基本呈线性关系，扭转关节的转角随初始角度和橡胶管平均半径的增大而增大，扭转关节的转角随橡胶管壁厚的增大而减小的结论；建立了扭转关节的动力学方程，仿真实验表明FPA的充放气过程与扭转关节的动力学过程相比时间极短，在实际系统设计和控制过程中可以忽略不计；分析讨论橡胶管壁厚，平均半径，初始角度，气体节流口面积，转动惯量，粘性阻尼系数等因素对扭转关节动态特性的影响，得出橡胶管初始壁厚的变化对扭转关节FPA内腔压力的动态响应几乎没有影响而对关节转角的响应曲线影响比较明显，壁厚较小时，关节可以得到较大的转角，并且转角的响应曲线没有超调，但上升时间长，壁厚较大时，关节转角变小，响应加快，但是有超调和轻微振荡现象，橡胶管平均半径越大，得到的关节转角越大，但是转角响应的超调量也随之增大，FPA的初始角度越大，关节的转角越大，并且超调量减小，振荡减弱，但是上升时间增大，管接头出口面积的大小对关节FPA内腔压力的建立过程影响较大，但对关节转角的动态响应几乎没有影响，转动惯量和粘性阻尼系数对FPA内腔压力的动态过程几乎没有影响而对扭转关节转角有较大影响等结论。

The right and left TMJ were removed from the animals, and all the specimens were observed. 3 days later, we could find that all TMJ components showed signs of injury. The synovial membrane was torn up and the cartilage of the condylar process and glenoid fossa was destructed.

伤后3天可出现关节滑膜撕裂、颞骨和髁突骨质破坏、关节腔内积血，关节盘以及关节附着的断裂等改变；7天后，关节积血少见。2周后可见关节内明显的破坏性改变，关节腔内还可有渗出液存在。

This is a kind of new and practical biomechanical research method. It more directly and really express the intra-articular stress change.

本方法是一种新的可行的生物力学研究方法，更直接更实际地反映关节内的应力变化。

Afterwards, releases were carried on by the sequences: suprapatellar bursa; medial and lateral channel; medial and lateral patellar retinaculum; patella/femoral joint; condyloid socket; medial and lateral chamber; adhesion between femoral and quadriceps.

方法］釆用膝前内、前外及骸骨内上、外上4个5~10mm切口，先松解、扩张髌上囊创造出进入关节镜的空间，依照髌上囊→内、外侧沟→髌骨内、外侧支持带→髌股关节→髁间窝→膝关节内侧室→外侧室→股骨与股四头肌之间的粘连顺序进行松解。

Abstract］ objective to provide the experience on treatment with the internal fixation to the fractures combined with/without dislocation on peripheral amphiarthrodial joint.methods from january 2000 to january 2005,62 cases were follow-up visited and evaluated on imageology,imaging,joint function and complication,et al.results serveral problems were observed on these cases.first,when the internal fixation were pulled out,some of the patients were observed the disturbance,even loss on joint function,and their quality of life were limmited.second,some internal fixations had been broken before they were pull out.conclusion we should sufficiently allow for not only the stabilization and the union of the fracture,but also degrade the complication to minimum limit and maximally recover the joint function.

目的 通过对微动关节周围骨折和合并关节脱位的内固定治疗后的疗效分析，进而为临床治疗提供经验。方法对2000年1月～2005年1月期间62例患者进行随访，并从影像学及关节功能、并发症等方面进行评估。结果治疗该类创伤病例存在着以下几个问题：（1）部分患者的关节功能在内固定解除术后，存在着不同程度的功能障碍，甚至丧失而影响到患者的生活质量。（2）并发内固定断裂情况时有发生。结论治疗微动关节周围骨折尤其在合并有关节脱位时，应充分考虑到既要修复因创伤引起的骨折使其愈合并使该关节稳定，又应该最大限度地恢复关节功能，并将并发症降低到最小限度。

Abstract］ objective to provide the experience on treatment with the internal fixation to the fractures combined with/without dislocation on peripheral amphiarthrodial joint.methods from january 2000 to january 2005,62 cases were follow-up visited and evaluated on imageology,imaging,joint function and complication,et al.results serveral problems were observed on these cases.first,when the internal fixation were pulled out,some of the patients were observed the disturbance,even loss on joint function,and their quality of life were limmited.second,some internal fixations had been broken before they were pull out.conclusion we should sufficiently allow for not only the stabilization and the union of the fracture,but also degrade the complication to minimum limit and maximally recover the joint function.

作者：洪洋，陈峥嵘，董有海，钱光，杨群，程根祥目的通过对微动关节周围骨折和合并关节脱位的内固定治疗后的疗效分析，进而为临床治疗提供经验。方法对2000年1月～2005年1月期间62例患者进行随访，并从影像学及关节功能、并发症等方面进行评估。结果治疗该类创伤病例存在着以下几个问题：（1）部分患者的关节功能在内固定解除术后，存在着不同程度的功能障碍，甚至丧失而影响到患者的生活质量。（2）并发内固定断裂情况时有发生。结论治疗微动关节周围骨折尤其在合并有关节脱位时，应充分考虑到既要修复因创伤引起的骨折使其愈合并使该关节稳定，又应该最大限度地恢复关节功能，并将并发症降低到最小限度。

In the four placebo-controlled studies evaluating radiofrequency denervation outcomes in patients with "confirmed"l-z joint pain, the only study that screened patients with MBB demonstrated positive outcomes,157versus only one of three that used diagnostic intraarticularin jections.158–160 Ultrasound-guided medial branchand intraarticular blocks have also been demonstrated to provide comparable accuracy to fluoroscopically guided injections, although they may be less likely to detect low-volume intravascular uptake and are less accurate in obese patients.161–164 Because MBB are technically easier to perform than intraarticular injections and involve anesthetization of the nerves to be lesioned, it seems more logical to use these blocks as a prognostic tool before radiofrequency denervation.

在四个设有安慰剂对照的对于&确诊&小关节疼痛的患者行射频神经消融后的结果的研究中，唯一一个用MBB筛选研究对象的实验表现出阳性结果，而其他3个用关节内注射筛选的实验中只有1个表现出阳性。超声介导下的内侧支关节囊内阻滞被证实较透视介导更精确，虽然其血管内吸收剂量较低且在肥胖的患者中精确性较差。由于MBB较之关节内注射技术上更简单，且能对受损神经进行麻醉，利用这种阻滞作为神经射频消融前的诊断方法较为合理。

These include inflammatory arthritides such as rheumatoid arthritis, ankylosing spondylitis and reactive arthritis,99 101 synovial impingement,meniscoid entrapment, chondromalacia facetae, pseudogout,synovial inflammation, villonodular synovitis, and acute and chronic infection.102 106 Intrafacetal synovial cysts can be a source of pain because of distension and pressure on adjacent pain-generating structures, calcification,and asymmetrical facet hypertrophy.107 110 In a retrospective review of MRI scans in 303 consecutive patients with LBP, Doyle and Merrilees111 found that9.5% had facet joint synovial cysts, the large majority of which were located posteriorly.

包括炎症性关节炎如类风湿性关节炎，强直性脊柱炎及反应性关节炎等，还有滑液撞击，关节软骨版卡压，关节面软骨软化，假性痛风，滑液炎症，绒毛结节性滑膜炎和急慢性感染。小关节内滑囊囊肿可由于拉伸和压缩临近的疼痛发生结构，骨化及不对称关节增生等原因引起疼痛。在一项303例连续患者的MRI研究中，Doyle 和 Merrilees发现其中9.5%存在小关节囊肿，大部分发生于关节囊后部。

Whatever methods you chose, the destruction of the TMJ was also found. At 3 days posttrauma hemarthrosis could be seen in most of the joints of both groups. Fibrous effusion was seen in a joint of surgery treatment group at 1 month posttrauma. 3 months later, fibrous ankylosis was found in the conservative treatment group.

不管采用哪种治疗方法，关节结构的破坏性改变自始至终都存在，早期都出现关节积血及关节结构的破坏；2周后可有关节盘不规则破坏，甚至完全崩解，关节腔内出现渗出液。1月时，可见固定组动物的关节腔内有纤维性渗出。3月时绝大多数关节结构基本存在，但可见有许多裂隙或囊样变，不固定组内有一动物的关节内出现了纤维性关节强直的表现。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

For a big chunk of credit-card losses; the number of filings (and thus charge-off rates) would be rising again, whether

年美国个人破产法的一个改动使得破产登记急速下降，而后引起了信用卡大规模的亏损。

Eph. 4:23 And that you be renewed in the spirit of your mind

弗四23 而在你们心思的灵里得以更新