Lower rotating point nutrient vessels of sural nerve flap with distant pedicled repairing soft tissue defect of foot and ankle

To explore lower rotating potint nutrient vessels of sural nerve flap with distant pedicled repairing the soft tissue defect of foot and ankle.Methods Lay a foundation of anatomic studying from february 2003 to March 2004,using lower rotating point nutrient vessels of sural nerve flap with distant pedicled repairing the soft tissue defect of foot and ankle in 11 cases.Cause of injuring:traffic accident 7 cases,crushing 1 case,saw injury 1 case,skin cancer 1 case,chronic ulcer 1 case.Areas:foot heel 6 cases,shank lower section 2 cases,heel tendon 2 cases,the distant back of the foot 1 case.Using the flap axis point was 1～3 cm above the pin of the external heel,average 2 cm.The scope of the flap was 6.0 cm×8.0 cm～12.0 cm～18.0 cm.Results All sural nerve flaps were alive.Of them,2 cases have distant part necrosis,accompanying with subcutaneous tissue,1 case heels after change dressings,another heels after skin grafting.All case can walk as usual,the flap was wear-resisting and keenly feel.Conclusion Lower rotating point nutrient vessels of sural nerve flap,donner area was fine,available area was large,skin in the pink,easy grafting,without main blood vessel damage,survival rate high,it is a good donner area in repairing around heel,foot and shank lower section.7 refs,1 tab.

OBSERVATION ON THERAPEUTIC EFFECTS OF ACUTE SPRAIN OF SOFT TISSUE TREATED BY ACUPUNCTURE AT PRESSURE PAIN POINTS

In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6％ and the total effective rate was 94.3％.Also,its mechanisms werestudied preliminarily.The present therapy is simple,convenient,easy to operate and it producesrapidly desired effects with a higher cure rate,so it is suited to be popularized clinically.

TREATMENT OF SOFT TISSUE INJURY BY PUNCTURING CLEFT-POINTS

Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft) points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft point group (264 cases) and Ashi point group (control group, 71 cases) randomly. In Cleft point group, the 16 Cleft points were used in combination with Ahshi points. In control group, only local Ahshi points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed. Results: Results showed that the therapeutic effect of cleft point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi point.

IgG4-Related Disease Presenting as a Soft Tissue Tumor Affecting Skeletal Muscle: A Case Report

Background: IgG4-related disease is a systemic lymphoproliferative syndrome that shows IgG4-producing plasma cell expansion in affected organs with fibrotic or sclerotic changes. The lacrimal glands, salivary glands and pancreas are typically affected. We report a case of IgG4-related disease presenting a soft tissue tumor affecting skeletal muscle. Case Report: A 32-year-old man presented a soft tissue mass in his left arm. Magnetic resonance imaging revealed a spindle like, peripheral mass, in the lateral head of the triceps of his left arm. Tru-Cut Biopsy provided the diagnosis of IgG4-related disease affecting skeletal muscle. Glucocorticoid treatment was effective. Conclusion: To our knowledge, this is the first reported case of IgG4-related disease affecting skeletal muscle and presenting a soft tissue mass.

Skeletal muscle metastasis with bone metaplasia from colon cancer:A case report and review of the literature

BACKGROUND Colon cancer is a common malignant disease of the gastrointestinal tract and usually occurs at the junction of the rectum and sigmoid colon.Lymphatic and hematogenous metastases occur frequently in colon cancer and the most common metastatic sites include the liver,lung,peritoneum,bone,and lymph nodes.As a manifestation of advanced tumor spread and metastasis,soft tissue metastasis,especially skeletal muscle metastasis with bone metaplasia caused by colon cancer,is rare,accounting for less than 1%of metastases.CASE SUMMARY A 43-year-old male patient developed skeletal muscle metastasis with bone metaplasia of the right proximal thigh 5 mo after colon cancer was diagnosed.The patient was admitted to the hospital because of pain caused by a local mass on his right thigh.Positron emission tomography-computed tomography showed many enlarged lymph nodes around the abdominal aorta but no signs of lung or liver metastases.Color ultrasound revealed a mass located in the skeletal muscle and the results of histological biopsy revealed a poorly differentiated adenocarcinoma suspected to be distant metastases from colon cancer.Immunohistochemistry showed small woven bone components that were considered to be ossified.CONCLUSION This case reminds us that for patients with advanced colorectal tumors,we should be alert to the possibility of unconventional metastasis.

Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome

BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.

Andrews六要素指导下不同治疗方案对骨性Ⅱ类患者审美评价的影响

目的评价依据Andrews六要素制定的不同治疗方案对骨性Ⅱ类患者侧貌美观的影响,并研究正畸医生与非专业人员审美评价的差异。方法选取一名符合实验标准的骨性Ⅱ类患者作为研究对象,使用Dolphin Imaging导入试验对象头颅侧位片,与侧貌照片进行重叠,以Andrews六要素理论为指导制定正畸掩饰性治疗方案、正畸代偿结合颏成形方案及正畸-正颌方案,得到相应的侧貌彩图后用Photoshop转变成侧貌剪影图,选取正畸医生和非专业人员根据Likert量表对6张剪影图进行评分。结果两组评分者均认为根据Andrews六要素制定的正畸正颌双颌手术方案侧貌最美观,正畸代偿结合颏成形方案中颏部前移8 mm次之。在专业组中,原始侧貌得分明显低于非专业组,而双颌手术侧貌得分明显高于非专业组。结论对于下颌后缩的骨性Ⅱ类患者,根据Andrews六要素制定的正畸正颌双颌手术方案是最佳治疗方式,而在正畸代偿辅以颏成形术方案中,通过Andrews六要素制定的颏部前移量最有利于患者改善侧貌美观。专业组与非专业组之间存在审美差异。

SanderⅢ矫治器治疗早期骨性Ⅲ类错[牙合]后软、硬组织变化及垂直向相关性

目的:探讨SanderⅢ矫治器矫治早期骨性Ⅲ类错[牙合]后软、硬组织变化和垂直向相关性。方法:选择32例拟行SanderⅢ矫治器矫治的早期骨性Ⅲ类错[牙合]患者,观察矫治前、矫治12个月后软、硬组织变化,分析软组织与垂直向的相关性。采用SPSS 25.0软件包对数据进行统计学分析。结果:矫治12个月后SNB缩小(P<0.05),ANB、A-PTV、Go-Me增加(P<0.05),软组织指标LL-LI增加(P<0.05),LL-EP减少(P<0.05),矫治后L1/MP缩小(P<0.05),U1E-PTV增加(P<0.05)。相关性分析显示,UL-UI与倾斜角、U1E-PP、U6E-PP呈正相关(P<0.05),LL-LI与倾斜角、U1E-PP、U6E-PP呈负相关(P<0.05),Sn-UL/FH与U6E-PP呈正相关(P<0.05)。结论:SanderⅢ矫治器可有效矫正早期骨性Ⅲ类错[牙合]患者软、硬组织畸形,唇部形态随硬组织骨性关系改善而趋于协调,软组织指标与硬组织垂直向关系密切。

治伤巴布剂对大鼠急性软组织损伤模型骨骼肌中AQP-3表达的影响

目的:观察治伤巴布剂对大鼠急性软组织损伤模型骨骼肌中水通道蛋白3(AQP-3)表达的影响。方法:SD大鼠54只,随机分成3组,造模前1 d使用10%的硫化钠对每只大鼠左后肢大腿外侧区域进行脱毛处理。正常对照组:仅在左后肢大腿外侧进行脱毛处理,并标记打击范围,不予打击造模;模型组:使用软组织打击器在脱毛区标记范围内予以打击建立急性软组织损伤肿胀的模型,不给任何药物处理;药物处理组:急性软组织损伤肿胀模型建立后立即在局部予治伤巴布剂外敷,另予胶布加强固定。造模后1 h,6 h,1 d,3 d,5 d,7 d六个时间点处死动物,每组每个时相点3只,在标记的区域切取肌肉组织,采用干湿比重法测定骨骼肌组织的含水量,应用实时荧光定量PCR、Western印迹法检测AQP-3 mRNA及蛋白的表达水平,并行相关分析。结果:检测的六个时间点中,模型组和药物处理组的肌肉组织含水量均高于正常对照组(P<0.05),在3,5,7 d三个时间点,药物处理组的含水量低于模型组(P<0.01);药物处理组、模型组的AQP-3 mRNA及蛋白表达水平均高于正常对照组,且药物处理组高于模型组(P<0.01)。结论:治伤巴布剂具有减轻急性软组织肿胀的作用,从而加速急性软组织损伤后修复的进程。

成人骨性Ⅲ类错(牙合)患者软组织侧貌形态Holdaway分析

目的研究成人骨性Ⅲ类错(牙合)畸形患者的软组织侧貌形态。方法选取53例(女32例,男21例)成人骨性Ⅲ类患者及53例成人骨性Ⅰ类患者治疗前的CBCT数据,利用Dolphin imaging 11.0软件重建头颅侧位片,采用Holdaway软组织测量方法进行头影测量分析,测量结果按不同性别及不同矢状向骨面型进行比较,用SPSS 20.0软件进行单因素方差分析。结果成人骨性Ⅲ类患者与骨性Ⅰ类患者相比,骨性Ⅲ类患者的面中1/3凹陷明显(A点突度、Sn-H线)、上唇前突(上唇沟深度、上唇紧张度)、下唇前突(LL-H线)、颏部前突、颏唇沟变浅(软组织面角、H角、颏唇沟深度、颏部厚度)。成人骨性Ⅲ类患者不同性别间的软组织侧貌形态差异主要集中在软组织面角、上唇沟深度及上唇紧张度,其余指标无明显差异,显示出女性患者具有较好的软组织代偿。结论由于成人骨性Ⅲ类患者上下颌骨间存在明显的矢状向不协调,因此与骨性I类患者相比,其软组织侧貌有着显著不同的特点。

治伤巴布剂对大鼠创伤性软组织肿胀模型骨骼肌中AQP-1表达的影响

目的:观察治伤巴布剂对大鼠急性软组织损伤模型骨骼肌中AQP-1表达的影响。方法:SD大鼠54只,随机分成3组,分别为正常对照组、模型组和药物处理组。造模后1 h、6 h、1 d、3 d、5 d、7 d 6个时相点处死动物,每组每个时相点3只,在标记的区域内肌肉组织取材,采用干湿比重法测定骨骼肌组织的含水量,应用Western Blot、qPCR法检测AQP-1蛋白及基因的表达水平,并进行相关分析。结果:检测的6个时相点中,模型组和药物处理组的肌肉组织含水量均高于正常对照组,在3 d、5d、7 d 3个时相点,药物处理组的含水量低于模型组,药物处理组、模型组的AQP-1蛋白及基因表达水平均高于正常对照组,而药物处理组与模型组相比,差异具有统计学意义。结论:治伤巴布剂具有减轻急性软组织肿胀的作用,从而加速急性软组织损伤后修复的进程。

针刺对骨骼肌顿挫伤模型兔CaN/NFAT信号通路的影响

目的:观察针刺对兔骨骼肌钝挫伤后组织超微结构和CaN/NFAT信号通路的影响,探讨该通路在骨骼肌损伤修复中的作用机制。方法:30只家兔,雌雄各半,随机分为空白组、模型组、环孢素A(CsA)组、针刺组、针刺合并CsA组。采用重物自由落体撞击法造成急性骨骼肌钝挫伤模型。针刺组于造模24 h后采用毫针斜刺腓肠肌全肌束的方法干预,CsA组于造模前3天按每天每只兔9.25mg/kg CsA进行注射,针刺合并CsA组进行针刺合并CsA干预。采用Western blot法检测CaN和NFAT蛋白表达量。结果:电镜下针刺组肌丝总体排列整齐,肌节未见明显肿胀,Z线、M线清晰;模型组、CsA组和针刺合并CsA组均有不同程度的肌原纤维断裂、溶解,Z线、M线有不同程度的溶解断裂。与空白组相比,各组CaN蛋白表达量均显著升高(P<0.05或P<0.01),模型组、针刺组和针刺合并CsA组NFAT蛋白表达显著升高(P<0.05);与模型组相比,针刺组CaN和NFAT蛋白表达量显著升高(P<0.05);与CsA组相比,针刺组与针刺合并CsA组CaN和NFAT蛋白表达量显著升高(P<0.05)。结论:针刺可有效改善急性钝挫伤模型兔超微结构的损伤;急性软组织顿挫伤可使兔骨骼肌CaN、NFAT1蛋白表达升高;针刺可激活CaN/NFAT信号通路,促进骨骼肌的再生修复。

不同前磨牙拔除模式对安氏Ⅰ类病例软硬组织A点影响的研究

目的比较拔除第一、第二前磨牙矫治安氏Ⅰ类错病例治疗前后软硬组织A点的变化。方法选择50例安氏Ⅰ类(骨性Ⅰ类)临界病例为样本,其中拔4个第一前磨牙和4个第二前磨牙病例各25例,按性别、年龄、骨面型、拥挤度严格配对,对治疗前后的头颅侧位X线片软硬组织的14项指标进行测量。统计学分析方法采用组内配对t检验、组间成组t检验及相关分析。结果①在相对X、Y轴的绝对值测量中,治疗前2组无统计学差异;治疗前后的各点第一前磨牙拔除组在垂直方向上的变化存在显著性差异(P<0.05),而拔除第二前磨牙组在水平方向上的变化更明显。②在软组织角度和线距的测量项目中,治疗前的上唇翻卷度、上唇倾角第一前磨牙拔除组均小于第二前磨牙拔除组;治疗后2组均出现上唇倾角、上唇到E线的距离增加;但2组在各项测量项目的变化上没有组间差别。③在硬组织角度和线距的测量项目中,治疗前第一前磨牙拔除组的颌凸角较大;治疗后2组各测量值均减少,但2组无组间差异。④相关分析:统计结果显示第一、第二前磨牙拔除组软硬组织A点的变化均呈正相关关系(P<0.01)。结论拔除第一和第二前磨牙软硬组织A点均有明显改变,两种拔牙模式之间没有统计学差别。

大鼠急性软组织损伤模型骨骼肌中AQP-3的表达变化

目的观察大鼠急性软组织损伤模型骨骼肌中AQP-3的表达变化及与骨骼肌肿胀的关系。方法SD大鼠36只,随机分成两组,造模前1 d使用10%的硫化钠对每只大鼠左后肢大腿外侧区域进行脱毛处理。正常对照组:仅在左后肢大腿外侧进行脱毛处理,并标记打击范围,不予打击造模;模型组:使用软组织打击器在脱毛区标记范围内予以打击建立急性软组织损伤肿胀的模型,不给任何药物处理。造模后1 h、6 h、1 d、3 d、5d、7 d六个时相点处死动物,每组每个时相点3只,在标记的区域内肌肉组织取材,应用实时荧光定量PCR、Western blot检测AQP-3的表达水平,行相关分析。结果在3 d、5 d、7 d三个时相点,模型组的AQP-3表达水平均高于正常对照组(P<0.05)。结论骨骼肌肿胀状态下AQP-3表达上调,提示AQP-3可能参与了急性软组织损伤后肿胀消退的过程,加速了损伤组织修复的进程。

替牙期骨性Angle Ⅲ类错患者颅面部软组织形态研究

选择替牙期骨性 Angle 类错牙合患者 3 8例作为研究样本 ,另选相应年龄的替牙期正常牙合儿童 40例作为对照组 ,拍摄正中牙合位的 X线头颅定位侧位片 ,利用 X线头影测量分析软件进行结果分析 ,选取与 Angle 类错牙合有关的测量项目 2 7项 ,得出两组软组织各测量值 ,比较替牙期骨性 Angle 类错牙合和正常牙合的颅颌面部软组织形态差异。分析替牙期骨性 Angle 类错牙合的软组织形态 ,并探讨其与相应硬组织构形上的关系和发育规律。结果 :软组织线距测量男性有 13项 ,女性有 12项 ,两组间有显著差异。软组织角度测量 9项均有显著差异。认为面部软组织侧貌基本反映了硬组织的骨骼构形 ,软组织在不同的部位有不同的改变 ,部分软组织代偿可掩盖骨骼的畸形 。

上颌前方牵引矫治骨性Ⅲ类错软硬组织A点和B点矢状向垂直向的变化及其相关性研究

目的:探讨上颌前方牵引矫治骨性Ⅲ类错软硬组织A点和B点矢状向垂直向的变化及其相关性。方法:选择20例骨性Ⅲ类错患者,采用上颌前方牵引结合快速扩弓进行矫治,对治疗前后的软硬组织头影测量值进行配对t检验、直线相关分析。结果:在矢状向上,硬组织点A与软组织点A(sA)前移的比例为1∶0.87,硬组织点B与软组织点B(sB)后退的比例为1∶0.96;在垂直向上,A与sA和B与sB分别下移的比例分别为1∶1.09和1∶1.21。A与sA(矢状向r=0.612,垂直向r=0.459,P<0.01)、B与sB(矢状向r=0.885,垂直向r=0.689,P<0.01)的移动呈现密切的正相关关系,唇部形态随着软硬组织A、B点的变化而趋于协调。结论:上颌前方牵引矫治骨性Ⅲ类错软硬组织A点和B点在矢状向垂直向的变化呈正相关,且下颌的反应较上颌更加明显。

正畸正颌联合矫治骨性Ⅲ类错软硬组织稳定性的Meta分析

目的:采用Meta分析方法评价正畸正颌联合矫治骨性Ⅲ类错软硬组织的稳定性。方法:计算机检索Cochrane Library、PubM ed、Medline、CNKI、万方等中外文数据库中符合要求的随机对照试验、半随机对照试验、临床病例对照试验的文献,检索日期截止2013-12-31。按照纳入、排除标准,由2名经过系统评价专业培训的研究者对纳入文献进行严格的质量评价,提取中、高等质量文献的数据资料。然后采用RevM an 5.2软件进行Meta分析。结果:最终纳入4篇文献,共178例患者,均为临床病例对照试验(CCT)。Meta分析结果示:硬组织稳定性:SNA(WMD=-0.58,95%CI[-1.18,0.02])、SNB(WMD=0.25,95%CI[-0.42,0.91])、ANB(WMD=-0.70,95%CI[-1.44,0.04])、MP-SN(WMD=0.39,95%CI[-0.25,1.04]),术后与术后3年差异无统计学意义,A点保持相对稳定位置,B点较术后有复发;软组织稳定性:术后与术后3年患者的软组织总体上保持稳定,仅下唇突度术后3年有所增大,显示其有一定的复发。结论:骨性Ⅲ类错患者经正畸联合双颌手术治疗后,软硬组织基本保持了长期的稳定性,仅下颌有一定的向前复发,下唇突度有所增大。

不同拔牙模式对安氏Ⅰ类错牙合患者软硬组织A、B点的影响

目的:探讨不同拔牙模式对安氏Ⅰ类错牙合患者软硬组织A、B点的影响。方法:选取安氏Ⅰ类错牙合患者164例,采用随机数字表法分为实验组与对照组,每组82例。实验组患者拔除4颗第一前磨牙,对照组患者拔除4颗第二前磨牙,拔除后两组患者均不使用任何辅助矫正器或支抗装置。比较两组患者矫治前后软硬组织A、B点指标及软组织变化。结果:与矫治前比较,矫治后两组患者A’-Y、B’-Y、UL-Y及LL-Y测量值均明显减少(P<0.01),且实验组明显小于对照组(P<0.01)。与矫治前比较,矫治后对照组患者上下唇倾角及实验组患者鼻唇角、上下唇倾角、上唇翻卷度测量值均明显增加(P<0.01),且实验组鼻唇角、颏唇角、下唇倾角及上下唇翻卷度测量值明显大于对照组(P<0.01)。结论:不同拔牙模式对安氏Ⅰ类错牙合患者上下唇凹点及上下唇突点相对X/Y轴移动距离的影响不同,拔除第一前磨牙对患者上下唇凹点/突点相对Y轴的距离及鼻唇角、下唇倾角、上下唇翻卷度的影响大于拔除第二前磨牙。

Patient-specific modeling of facial soft tissue based on radial basis functions transformations of a standard three-dimensional finite element model

Background An important purpose of orthodontic treatment is to gain the harmonic soft tissue profile. This article describes a novel way to build patient-specific models of facial soft tissues by transforming a standard finite element （FE） model into one that has two stages： a first transformation and a second transformation, so as to evaluate the facial soft tissue changes after orthodontic treatment for individual patients. Methods The radial basis functions （RBFs） interpolation method was used to transform the standard FE model into a patient-specific one based on landmark points. A combined strategy for selecting landmark points was developed in this study： manually for the first transformation and automatically for the second transformation. Four typical patients were chosen to validate the effectiveness of this transformation method. Results The results showed good similarity between the transformed FE models and the computed tomography （CT） models. The absolute values of average deviations were in the range of 0.375-0.700 mm at the lip-mouth region after the first transformation, and they decreased to a range of 0.116-0.286 mm after the second transformation. Conclusions The modeling results show that the second transformation resulted in enhanced accuracy compared to the first transformation. Because of these results, a third transformation is usually not necessary.

Twin-block在骨性Ⅱ类错[牙合]下颌后缩患儿中的应用

目的:探讨Twin-block在骨性Ⅱ类错[牙合]下颌后缩患儿中的应用效果。方法:选取2019年1月-2021年1月笔者医院接收的84例骨性Ⅱ类错[牙合]下颌后缩患儿设置为研究对象,按随机抽签法分为对照组、研究组,各42例,对照组采用直丝弓矫治器,研究组采用Twin-block矫治器。比较两组治疗前后咀嚼功能、牙齿咬合力、下颌骨变化、软组织面型变化、上气道矢状径,并统计家属治疗满意度。结果:治疗后,研究组咀嚼功能、牙齿咬合力、下颌骨变化指标、软组织面型变化指标均优于对照组(P<0.05);治疗后,研究组上气道矢状径高于对照组(P<0.05);研究组家属治疗满意度(95.24%)明显高于对照组(73.81%)(P<0.05)。结论:Twin-block应用于骨性Ⅱ类错[牙合]下颌后缩患儿治疗中,能改善咀嚼功能,增强牙齿咬合力,促进下颌骨生长,提高面型美观度,扩大上气道矢状径,利于改善呼吸功能,获得家属对治疗效果的高度评价。