膝关节

Intelligent artificial leg consists of knuckle, an executive mechanism, an anklebone, a foot and an intelligent controller. The executive mechanism controls the bent and stretchs movement of knuckle and the pendular movement of calf. The key components of the intelligent artificial leg are the executive mechanism and the intelligent controller.

智能人工腿主要由膝关节、控制膝关节屈伸运动及小腿摆动的执行机构、踝关节、脚以及智能控制器等组成，其最关键部件是控制膝关节屈伸运动及小腿摆动的执行机构和智能控制器。

OBJECTIVE: To study the therapeutic effect of treating knee arthropathy with total knee arthroplasty using rotating-platform knee prosthesis.

摘要目的：观察采用旋转平台膝关节假体行人工膝关节置换治疗膝关节疾病的疗效。

concluded from the experiment is that the effect of postoperative function exercise of knee joint starts from the time of recovery of anesthesia is better than those in later time with less adhesion of knee and reduced proliferation of cicatrization tissue; it may facilitate the recovery of knee function by maximum.

通过动物实验，我们发现：在膝关节手术后，麻醉消退后即刻开始功能锻炼，确能较术后24 h和72 h才开始锻炼在减轻膝关节的粘连，减少关节内瘢痕组织增生，最大限度地恢复膝关节的功能等方面有着明显的优点。

Material and MethodsRA Rabbit Model group: 15 early RA rabbits of the same weight and variety Control group:10 normal rabbits of the same weight and varietyMethods of making RA rabbit model:elect 15 normal rabbits of the same weight and variety, dissolve Ovalbumin in 0.9% sodium chloride solution, to make the solution of 20mg/ml concengtration, blend the same quantity of complete Freund′s Adjuvant equably ,inject the mixed solution into endermic tissue of the rabbit′s scapular section, making the rabbits allergic, inject 1 ml of the mixed solution to one rabbit every time, inject 1 ml of the mixed solution in 5 different places of the rabbit′s scapular section, inject the rabbit one time every week,inject 3 weeks continuously,it turned out to be that the rabbits will be allergic, inject Ovalbumin blent with the 0.9% sodium chloride solution into the knee joint cavity of the rabbits in the fourth week, 5 mg Ovalbumin every knee joint cavity,two knees of every rabbit of the 15 rabbits are both injected,the arthrosis diameter and the exterior temperature of the knees will be added obviously in 24 hours,and they will drop gradually,at the time of the 14th or 21th day, the arthrosis diameter and the exterior temperature of the knees will get to the balance time,the incidence rate of RA is 100%.after the RA model succeeds,it is the early time of RA from the first week to the fourth week,after the fourth week,it is the late time of RA, the cartilage of the femoral condyle and the subchondral bone cortices will be changed unrecoverily.

资料与方法RA模型组：早期RA家兔模型15只，品种及体重接近。对照组：正常家兔10只，品种及体重接近。RA家兔模型制作方法：选取15只成年家兔，体重、品种接近，将卵蛋白溶解于生理盐水，配成浓度为20mg/ml的溶液，与等量完全弗氏佐剂混匀，注入家兔肩胛区皮下致敏，每只家兔每次注射1ml，于肩胛区5个不同区域注射，每周一次，连续注射3周而致敏，第4周向膝关节腔注射卵蛋白生理盐水溶液，每只关节腔注射5mg卵蛋白，15只家兔膝关节全部注射，24h内此关节直径和表面温度大幅度上升，以后缓慢下降，至14～21d达到平台期，发病率达100%。造模成功后第1～4周为早期改变，第4周以后出现不可逆的关节软骨及骨破坏。采用高频超声对RA模型组与对照组的膝关节髌上囊液体厚度、滑膜及股骨髁软骨厚度及软骨下骨皮质的回声情况进行对比观察。结果RA组模型组膝关节髌上囊积液及滑膜的厚度明显厚于对照组，其股骨髁软骨的厚度与对照组相比无明显差异，其软骨下骨皮质与对照组相比无明显改变。

Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred.

反复的微创伤和过度使用膝关节在膝关节的以下病损的发生中起到重要作用：Hoffa氏脂肪垫、膝关节伸膝装置、膝关节内侧和外侧限制结构或软骨表面，然而，活动的增加或改变常常为诱发因素。

［Objective］To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value［Method］A total of 14 cases of pigmented villonodular synovitis of the knee were treated from January 2000 to July 2003Intraarticular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequency was performed on all these 14 cases,and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee,13 patients were followed up for 10~45 months,and were evaluated for range of motion,pain,swelling effusion［Result］Thirteen cases according to the International Knee Documentation Committeecriteria,subjective knee score was (587+64) and (865 ±57) respectively before surgery and at the last followup［Conclusion］In case of pigmented villonodular synovitis of the knee joint,arthroscopical synovectomy can make good surgical results,and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee

作者：王晓旭，廖瑛，黄华扬，席雅文，李朝旭，韩志关节镜；放射治疗；膝关节；滑膜炎；色素绒毛结节性摘要：［目的］探讨采用关节镜结合放射治疗膝关节色素沉着绒毛结节性滑膜炎的方法及其临床应用价值。［方法］2000年1月～2003年7月，共收治14例膝关节色素沉着绒毛结节性滑膜炎患者，采用关节镜下常规器械加双极射频进行关节内病变切除，术后弥漫性色素沉着绒毛结节性滑膜炎辅以放疗，13例通过10~45个月的随访，了解患膝活动度、疼痛、肿胀情况。［结果］13例随访患者，术前国际膝关节评分委员会膝关节功能主观评分为（587±64）分，最后随访时，IKDC膝关节功能主观评分为（865±57）分。［结论］通过关节镜能完成膝关节色素沉着绒毛结节性滑膜炎滑膜较彻底切除，对弥漫性膝关节色素沉着绒毛结节性滑膜炎辅以术后放疗是一种有效方法。

Using the following methods to treat one patient of congenital absence of the tibia with fork-shaped lower femur, the caput fibulae forming unstable knee joint, and concomitant knee flexion 95 degree.

方法1例先天性右胫骨完全缺如，股骨下端呈叉状，腓骨头与股骨下端形成不稳定的膝关节，伴屈膝畸形95 ，于1岁半实施股骨下端修整术，5岁和8岁时分两期安装Ilizarov膝关节牵伸器，牵拉矫正屈膝畸形达到伸膝0 位，使腓骨头与股骨下端成膝关节，拆牵伸器后装配能稳定膝关节的下肢补高矫形器行走。

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。

Comprehensive rehabilitative training was essential to maximum recovery of knee joint function including various agonistic muscle training plus extending and flexing power of knee joint; continuous passive training of motion of knee joint in early period plus motion of joint; proprioceptive sensation training in amelioration of motor controllability, postural rectification and balance-keep capability and gait training in correction of abnormal gait.

为最大限度的恢复膝关节功能，综合的康复训练必不可少：包括各种主动肌力训练增加膝关节伸、屈肌力；早期持续被动的膝关节活动度训练增加关节活动度；本体感觉训练改善膝关节的运动控制能力、姿势校正及平衡维持能力；行走步态训练矫正异常行走步态。

The mobile bearing design has no advantages in postoperative range of motion, pain relief and knee function relative to fixed bearing design.

活动衬垫型膝关节假体置换后在膝关节活动度、疼痛缓解以及膝关节功能方面与固定衬垫型膝关节假体相比并没有显著性优势。

The absorption and distribution of chromium were studied in ryeusing nutrient culture technique and pot experiment.

采用不同浓度K2CrO4(0，0.4，0.8和1.2 mmol/L)的Hoagland营养液处理黑麦幼苗，测定铬在黑麦体内的亚细胞分布、铬化学形态及不同部位的积累。

By analyzing theory foundation of mathematical morphology in the digital image processing, researching morphology arithmetic of the binary Image, discussing two basic forms for the least structure element: dilation and erosion.

通过分析数学形态学在图像中的理论基础，研究二值图像的形态分析算法，探讨最小结构元素的两种基本形态：膨胀和腐蚀；分析了数学形态学复杂算法的基本原理，把数学形态学的部分并行处理理念引入到家实际应用中。