Effect of Purified Paper Wasp Ropalidia marginata Venom Toxin Enzyme Activity in Blood Serum, Liver, and Gastrocnemius Muscle of Albino Mice

In the present, investigation effects of sub-lethal dose of purified paper wasp Ropalidia marginata venom toxins were evaluated on important metabolic enzymes i.e. ALP ACP, GPT, GOT, LDH, and AchE enzyme activity in serum, liver, and gastrocnemius muscles of albino mice. Alkaline phosphatase was found to be increased up to 119.9% at the 6th hr of the toxin injection in comparison to control. This elevation may be due to cytolysis. Maximum increase i.e., 153.33% level of glutamate pyruvate transaminase (GPT) was found at 6 hrs of 40% of 24-h LD50 treatment while it was found to be 151.1% at 6 hrs of 24 hr 80% of LD50, venom injection. A significant elevation was observed in LDH activity in serum, liver, and muscles, while the activity of AchE was decreased in serum, liver, and gastrocnemius muscles of albino mice after injecting the sub-lethal dose of Ropalidia marginata venom. This increase in the activity of LDH produces liver damage, massive disintegration and necrosis of hepatic cells. This elevation in LDH level led to a significant increase in the glucose catabolism and elevated oxidative stress in muscle and liver cells. It also displays insufficient oxygen supply and consequently leads to cell death. In experimental animals, venom toxin treatment decreased AchE level, and animals showed muscular paralysis. When mice were treated with 40% and 80% of 24-h LD50 of purified venom caused a significant (p < 0.05) elevation in the level of ACP, GOT, GPT, and LDH while the reduction in ALP and AChE level. Present study will be useful in the development of prototypes for study of pharmacological and therapeutic effects of various venom toxins. For this purpose structure activity relationship of enzyme and venom toxin, its due interaction to various metabolic enzymes and receptors must be explored.

Small Cell Lymphoma of the Gastrocnemius Muscle: A Case Report

Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in Mali and to do a review of the literature. Clinical Observation: It was about a 34-year-old woman who consulted 3 months after the onset of symptoms for swelling and pain in the left calf. On clinical examination there was a hard, painful and warm mass in the left calf, with paresthesias in the tibial nerve territory associated with partial functional impotence of the leg. The ultrasound revealed a hyper echogenic and heterogeneous non-vascularized mass of the left gastrocnemius muscle measuring 65 × 45 × 40 mm non-vascularized on color Doppler and pulsed in favor of myositis. Magnetic resonance imaging (MRI) concluded in a well-limited heterogeneous cystic mass in the left gastrocnemius muscle respecting the bone of benign appearance: remodeled Baker’s cyst? Considering the radioclinical unconformity, thoraco-abdominal CT was performed and revealed pulmonary metastasis. The biopsy carried out concluded with a small cell lymphoma of the gastrocnemial muscle. Marginal resection was performed associated with adjuvant chemotherapy. The advancement at 9 months was satisfactory.

Histochemical pattern of gastrocnemius muscle in fluoride toxicity syndrome

Objective:To evaluate the effect of sodium fluoride(NaF) on cytochemical distribution of proteins,DNA,and RNA in the gastrocnemius muscle of rat in experimental fluorosis.Methods: Young Sprague Dawley albino rats were administered with NaF at 30,45,and 75 mg/kg bw/ day subcutaneously for 15 and 30 days,respectively.The control animals were given the vehicle(1cc deionized double distilled water/kg bw/day).Results:In the first phase of 15 days experimentation,the gastrocnemius muscle of rats intoxicated with NaF at 30,45,and 75 mg /kg bw/ day showed decline in proteins including a amino acids as compared to control. In the second phase of 30 days experimentation,the muscle fibers of rat showed elevation in sarcolemmal and sarcoplasmic proteins in 30 mg NaF dose group,and angulated fibers exhibited increase in sarcolemmal proteins in 45 mg NaF group.The marginal regions of angular and rim fibers showed deeply stained rings of sarcoplasmic proteins whereas the split fibers were faindy stained in rats treated with NaF at 75 mg/kg bw/day for 30 days.In rats treated with NaF at 30 mg/kg bw/day for 15 days,the hypertrophied peripheral muscle fibers contained more DNA,however the atrophied fibers had more RNA.In 45 mg NaF group,RNA was located in sarcolemmal regions,while DNA content decreased as compared to control.In 75 mg NaF group,the muscle fibers had dark and light staining regions of DNA and RNA.In the 30 days of experimentation,the DNA level decreased whereas RNA content increased in the gastrocnemius muscle fibers of the rat treated with NaF at 30 mg/kg bw/day.In treatment group with NaF at 45 mg/kg bw/day,the RNA content slighdy declined in comparison to control,in all treatments for 15 days as well as in treatment group with NaF at 30 mg/kg bw/day for 30 days whereas the amount of DNA slightly increased as compared to treatment group with NaF at 75 mg/kg bw/day for 15 days.The highest dose group revealed elevated amount of RNA whereas DNA content remained stable.Conclusions:The findings of present study demonstrate that certain concentrations of fluoride can induce muscle lesions and damage DNA,RNA,and protein in muscle cells and excessive intake and accumulation of fluoride is therefore a serious risk factor for muscular abnormalities in fluorosis.

A new linearly-combined bi-exponential model for kinetic analysis of the isometric relaxation process of Bufo gastrocnemius under electric stimulation in vitro

There was a slow-relaxing tail of skeletal muscles in vitro upon the inhibition of Ca2+-pump by cyclopiazonic acid (CPA). Herein, a new linearly-combined bi-exponential model to resolve this slow-relaxing tail from the fast-relaxing phase was investigated for kinetic analysis of the isometric relaxation process of Bufo gastrocnemius in vitro, in comparison to the single exponential model and the classical bi-exponential model. During repetitive stimulations at a 2-s interval by square pulses of a 2-ms duration at 12 V direct currency (DC), the isometric tension of Bufo gastrocnemius was recorded at 100 Hz. The relaxation curve with tensions falling from 90% of the peak to the 15th datum before next stimulation was analyzed by three exponential models using a program in MATLAB 6.5. Both the goodness of fit and the distribution of the residuals for the best fitting sup- ported the comparable validity of this new bi-exponential model for kinetic analysis of the relaxation process of the control muscles. After CPA treatment, however, this new bi-exponential model showed an obvious statistical superiority for kinetic analysis of the muscle relaxation process, and it gave the estimated rest tension consistent to that by experimentation, whereas both the classical bi-exponential model and the single exponential model gave biased rest tensions. Moreover, after the treatment of muscles by CPA, both the single exponential model and the classical bi-exponential model yielded lowered relaxation rates, nevertheless, this new bi-exponential model had relaxation rates of negligible changes except much higher rest tensions. These results suggest that this novel linearly-combined bi-exponential model is desirable for kinetic analysis of the relaxation process of muscles with altered Ca2+-pumping activity.

THE MECHANISM OF CEREBRAL EVOKED POTENTIALS BY REPETITIVE MAGNETIC STIMULATION OF GASTROCNEMIUS MUSCLE IN DUCHENNE MUSCULAR DYSTROPHY

Objective. To study the features and mechanism of the cerebral evoked potentials by repetitive stimulation of calf muscle in Duchenne muscular dystrophy (DMD) patients with obvious muscular dystrophy and psuedohypertrophy. Methods. Cerebral evoked potentials by stimulation of calf muscles and somatosensory evoked potentials (SEPs) by the stimulation of posterior tibial nerves at ankle were measured in 10 patients with DMD and 10 normal controls matched with gender and age. The intensity of the magnetic stimulation was at 30％ of maximal output (2.1 Tesla, MagPro magnetic stimulator, Dantec) and the frequency was 1 Hz. The low intensity of magnetic stimulation was just sufficient to produce a contraction of the muscle belly underneath the coil. Recording electrode was placed at 2 cm posterior to the Cz, reference to Fpz. The latencies of N33, P38, N48 and P55 and amplitude (P38－ N48) were recorded. SEPs were recorded by routine methods. Results. In normal subjects, the amplitudes of cerebral evoked potentials by magnetic stimulation of calf muscle was 40％ lower than that by electrical stimulation of the posterior tibial nerves at ankle. The latency of P38 was 2.9± 2.1 ms longer compared with electrical stimulation of the posterior tibial nerves at ankle. In 6 patients, P38 latency from magnetic stimulation was remarkably prolonged (P< 0.01), and in 4 patients, there was no remarkable response. SEPs evoked by electrical stimulation were normal in all of the patients. Conclusion. DMD is an available model for the study of mechanism of cerebral evoked potentials by magnetic stimulating muscle. We can conclude that the responses from magnetic stimulation were produced by muscle input. The abnormal responses in patients may relate to decreased input of muscle by stimulating dystrophic and psedohypertrophic muscle.

Crohn's disease-related'gastrocnemius myalgia syndrome'successfully treated with infliximab:A case report

BACKGROUND Extra-intestinal manifestations in inflammatory bowel diseases(IBD)are frequent and involve virtually all organs.Conversely,the clinical characteristics and course of inflammatory myopathies in IBD remain poorly described and mostly related to orbital myositis.Moreover,alternative therapeutic strategies in non-responder patients to corticosteroid therapy must still be clarified.CASE SUMMARY A 33-year-old woman with a history of unclassified colitis presented with acute bilateral calf pain.On admission,her clinical and biological examinations were non-specific.However,magnetic resonance imaging showed bilateral inflammatory changes in gastrocnemius muscles suggestive of myositis.Muscle biopsy confirmed the diagnosis of myositis and demonstrated an inflammatory infiltrate mainly located in the perimysial compartment including lympho-plasmocytic cells with the formation of several granulomatous structures while the endomysium was relatively spared.The combined clinical,biological and histomyopathological findings were concordant with the diagnosis of‘gastrocnemius myalgia syndrome’(GMS),a rare disorder associated with Crohn’s disease(CD).Ileocolonoscopy confirmed CD diagnosis and systemic corticosteroids(CS)therapy was started,resulting in a rapid clinical improvement.During CS tapering,however,she experienced a relapse of GMS together with a severe active ileocolitis.Infliximab was started and allowed a sustained remission of both conditions at the latest follow-up(20 mo).CONCLUSION The GMS represent a rare CD-associated inflammatory myopathy for which anti-tumour necrosis factor-αtherapy might be considered as an effective therapeutic option.

The Effect of Stretching Hamstring, Gastrocnemius, Iliopsoas and Back Muscles on Pain and Functional Activities in Patients with Chronic Low Back Pain: A Randomized Clinical Trial

A back pain lasting more than 12 weeks has been defined as a chronic low back pain (LBP) [1]. More than half of people suffer from LBP [1]. The purpose of this study was to examine the effect of gastrocnemius muscle stretching in the treatment of chronic low back pain. Methods: Forty patients with chronic low back pain, ages ranging from 25 to 40 years, were recruited and divided randomly into two groups. The control group followed a physical therapy program that included stretching exercises for back, hamstring and iliopsoas muscles. Strengthening exercises for abdominal muscle and postural instructions for activities of daily living were also performed. The experimental group followed the same control-group exercises with the addition of stretching exercises for gastrocnemius muscles. The interventions for both groups consisted of three sessions per week for six weeks, each session lasting for an hour. The outcome measures were visual analog scale (VAS) for pain severity, modified fingertip to floor (FTF) for range of motion (ROM) of trunk flexion, Oswestry Disability Index (ODI), and loading X-ray to detect lumbosacral angle. Results: There was no significant difference between groups at baseline characteristics. At final follow up, the two groups were significantly different in all outcome measures in terms of pain (p p p p < 0.01). Conclusion: Gastrocnemius manual stretching exercise is more beneficial in reducing pain and improving functions for patients with chronic low back pain when adding to stretching exercises for hamstring, iliopsoas, and back muscles, and strengthening exercise for abdominal muscles.

Return to physical activity after gastrocnemius recession

AIM To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession(EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36(SF-36), American Orthopedic Foot and Ankle Society(AOFAS) Hindfoot score and modified Olerud and Molander(O and M) scores respectively. Patient's satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value < 0.05 was considered statistically significant.RESULTS Ninety-one percent(n = 42) of all patients returned to their preoperative level of physical activity after EGR. The mean time for return to physical activity was 7.5(2-24) mo. Ninety-eight percent(n = 45) of all patients were able to return to their preoperative employment status, with a mean time of 3.6(1-12) mo. Ninety-six percent(n = 23) of all patients with an activity score > 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86%(n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale.CONCLUSION The majority of patients were able to return to their pre-operative level of sporting activity after EGR.

The Effect of Internal Heat Acupuncture on the Tolerance Time of Plantar Hot Plate and Pain Threshold of Gastrocnemius Muscle in Rats with Chronic Myofascial Pain Syndrome

Objective:To investigate the effect of internal heat acupuncture on the tolerance time of plantar hot plate and the pain threshold of gastrocnemius in rats with chronic myofascial pain syndrome(MPS).Methods:A total of 80 adult Wistar rats were randomly selected to establish chronic MPS rat models,and randomly divided into four groups:control group,acupuncture group,internal heat acupuncture group A,and internal heat acupuncture group B,with 20 rats in each group.The rats in the control group were not given any treatment,and the rats in the acupuncture group were only given acupuncture treatment.The rats in group A were treated with internal heat acupuncture(needle heating up to 42℃),and the rats in group B were treated with internal heat acupuncture(needle heating up to 44℃).The tolerance time of plantar hot plate,the pain threshold of gastrocnemius muscle and the level of tumor necrosis factor-α(TNF-α)were observed and compared before modeling,1 d before treatment,and 1,7 and 14 d after treatment.Results:There were significant differences in hot plate tolerance time,time and interaction among the four groups(P<0.05),as well as in gastrocnemius tenderness threshold,time and interaction among the four groups(P<0.05),and there were also significant differences in TNF-αlevel among the three groups(P>0.05).There were significant differences in the number of electric shocks,time and interaction among the four groups(P<0.05).Conclusion:In contrast to conventional acupuncture treatment,internal heat acupuncture demonstrates greater efficacy in extending the tolerance duration of hot plate exposure and enhancing the pain threshold of the gastrocnemius muscle in rats afflicted with myofascial pain syndrome.Additionally,it accelerates the amelioration of inflammatory markers and motor function.However,it is important to note that the therapeutic impact of internal heat acupuncture may be influenced by its temperature,with 44℃being the most effective in this research.

电针对运动大鼠腓肠肌组织代谢酶及自噬基因表达的影响

背景:急性运动易引起机体内骨骼肌组织损伤和体内脂代谢紊乱,但急性运动联合电针调控机体内代谢和自噬通路的机制尚不明确。目的:观察电针“足三里”和“环跳”穴对急性运动大鼠骨骼肌代谢酶及自噬水平的变化。方法:将50只雄性SD大鼠随机分为安静对照组(10只)、模型组(20只)、逆电针组(20只),后两组设2个时相点,即运动后即刻和运动后3 h组,每个时相点10只大鼠。后两组进行适应性跑台运动训练后,进行急性运动训练,逆电针组大鼠于每天跑台训练前先介入电针治疗(参数为电针大鼠两侧“足三里”和“环跳”穴,连续波、频率2 Hz、强度2 mA、留针30 min、1次/d、连续7 d),电针后休息10 min再进行急性运动。分别于运动后即刻和运动后3 h麻醉取大鼠双侧腓肠肌组织,苏木精-伊红染色观察大鼠骨骼肌组织病理学变化;ELISA法检测大鼠骨骼肌组织肝脂酶、脂肪酸合成酶、激素敏感脂肪酶、肉碱棕榈酰转移酶1活性;免疫组织化学和Western Blot法检测自噬基因表达变化。结果与结论:①苏木精-伊红染色后模型组大鼠运动后即刻和运动后3 h腓肠肌纤维排列出现紊乱、肿胀、破裂;逆电针组大鼠运动后即刻和运动后3 h腓肠肌纤维排列紧密,肿胀和破裂的细胞大为减少,与安静对照组比较无明显性差异;②模型组和逆电针组运动后3 h的肝脂酶和脂肪酸合成酶活性均低于安静对照组(P<0.05或P<0.01);模型组和逆电针组大鼠运动后3 h的脂蛋白酯酶、激素敏感脂肪酶和肉碱棕榈酰转移酶1活性高于安静对照组(P<0.05或P<0.01),激素敏感脂肪酶和肉碱棕榈酰转移酶1活性在逆电针组运动后即刻高于模型组同期(P<0.05);与模型组运动后3 h相比,逆电针组运动后3 h脂蛋白酯酶活性升高(P<0.05),激素敏感脂肪酶活性降低(P<0.01);③免疫组织化学结果显示,P62、自噬相关基因5和自噬相关基因7表达在模型组大鼠运动后即刻和运动后3 h及逆电针组运动后即刻均高于安静对照组(P<0.05或P<0.01),其中运动后即刻和运动后3 h逆电针组大鼠P62及自噬相关基因7表达均低于模型组(P<0.05);④Western Blot结果显示,运动后即刻逆电针组大鼠P62和自噬相关基因7蛋白表达均低于模型组(P<0.05);Parkin蛋白表达在模型组大鼠运动后即刻和运动后3 h均高于安静对照组(P<0.05),逆电针组大鼠运动后即刻和运动后3 h均低于模型组(P<0.05);⑤提示急性运动引起大鼠腓肠肌纤维排列出现紊乱、肿胀、破裂,电针两侧“足三里”和“环跳”穴可改善大鼠骨骼肌脂代谢水平及调控自噬细胞,防止急性运动引起大鼠机体内脂代谢紊乱和腓肠肌组织的损伤,其机制可能与调控自噬相关因子P62、自噬相关基因5、自噬相关基因7、Parkin蛋白表达来促进大鼠骨骼肌细胞自噬的发生或调节细胞自噬通路密切相关。

足踝手术后连续腓肠肌平面阻滞的镇痛效果

目的 探索连续腓肠肌平面阻滞镇痛用于足踝部手术患者术后镇痛效果。方法选择全麻下行足踝部择期手术患者42例,男19例,女23例,年龄18~64岁,BMI 18~28 kg/m^(2),ASAⅠ—Ⅲ级。将患者随机分为两组:连续腓肠肌平面阻滞镇痛组(CN组)和患者自控静脉镇痛(PCIA)组(Ⅰ组),每组21例。CN组术毕行连续腓肠肌平面阻滞镇痛,配方为0.125%罗哌卡因300 ml,背景剂量为3 ml/h,单次给药剂量为8 ml,锁定时间为25 min。Ⅰ组术毕使用羟考酮PCIA,配方为羟考酮30 mg、托烷司琼6 mg加生理盐水至150 ml,输注速度0.5 ml/h,单次追加剂量5 ml。观察两组术后0~16、16~24、24~48、0~48 h时段静息和活动时NRS评分曲线下面积(AUC),1、8、16、24、32、48 h静息和活动时NRS评分,CN组术后胫神经和腓总神经运动功能恢复时间、羟考酮滴定量、术后48 h内补救镇痛药物的吗啡当量累计使用量、补救镇痛次数、补救镇痛率、首次下床活动时间、术后恶心呕吐的发生情况和患者满意度评分。结果 与Ⅰ组比较,CN组0~16、16~24、24~48、0~48 h静息和活动时NRS评分AUC明显降低(P<0.01),术后1、8、16、24、32、48 h NRS评分明显降低(P<0.01),CN组16 h有10例(50%)患者腓总神经运动功能恢复,24 h有17例(85%)患者腓总神经运动功能恢复,32~48 h所有患者腓总神经运动功能恢复,48 h内所有患者胫神经运动功能正常。与Ⅰ组比较,CN组吗啡当量累计使用量和补救镇痛次数明显减少(P<0.01),补救镇痛率明显降低(P<0.01),患者满意度评分明显升高(P<0.01)。两组羟考酮滴定量、首次下床活动时间,恶心呕吐发生率差异无统计学意义。结论 超声引导下连续腓肠肌平面阻滞可以实现胫神经运动和感觉阻滞分离,可在足踝手术后提供良好且持续的镇痛效果。

基于数据挖掘技术探讨针灸治疗腓肠肌痉挛理法方穴术

目的:采用数据挖掘技术总结针灸治疗腓肠肌痉挛取穴、刺灸方法的规律,探讨针灸治疗腓肠肌痉挛的理法方穴术。方法:检索中国知网、万方数据知识服务平台、维普期刊全文数据库和中国生物医学文献数据库针灸治疗腓肠肌痉挛的临床研究文献,建立腓肠肌痉挛处方数据库,运用SPSS Statistics25.0及SPSS modeler18.3软件对数据进行统计描述、关联规则与聚类分析。结果:共纳入85篇文献,涉及32个腧穴、11种刺灸法。理:外感风寒湿邪气壅阻经脉,气血运行不畅;在内则为气血亏虚或久病致虚、筋失濡养。法:舒筋通络、调和气血和平衡阴阳。方、穴:舒筋通络循膀胱经取穴选用承山、承筋和委中辅以胆经阳陵泉;调和气血从足阳明胃经与足太阴脾经论治取足三里、三阴交;平衡阴阳取肢体上部腧穴;特定穴以下合穴、合穴和八会穴为主,关联规则分析显示承山-承筋为支持度最高的穴对。通过对使用频数≥5的腧穴进行聚类分析,可将腧穴分为3类。术:以针刺、穴位注射、温针灸和电针应用最多。结论:对文献数据进行分析以探讨针灸治疗腓肠肌痉挛的理法方穴术,为临床治疗腓肠肌痉挛提供指导。

理筋手法减轻兔损伤骨骼肌纤维化的作用机制

背景:理筋手法能够减少纤维化瘢痕增生,促进骨骼肌修复。但不恰当的激活Wnt/β-catenin信号通路,能加剧损伤骨骼肌纤维化,对骨骼肌修复过程产生不利影响。开展理筋手法对Wnt/β-catenin信号通路的调控作用研究,有利于阐述理筋手法减少纤维化瘢痕增生、促进骨骼肌损伤修复的相关机制。目的:探讨理筋手法促进兔骨骼肌损伤修复的作用机制。方法:45只普通级健康成年日本大耳兔随机分为空白组、模型组和理筋组,每组15只。模型组和理筋组均进行腓肠肌打击造模,理筋组于造模后第3天开始进行理筋手法治疗,1次/d,15 min/次。各组在造模后第7,14,21天分别取5只进行取材。苏木精-伊红染色观察腓肠肌一般形态结构,Masson染色观察腓肠肌胶原纤维含量,Western blot检测腓肠肌Wnt3a、β-catenin、GSK3β、p-GSK3β、TCF、Ⅰ型胶原蛋白、Ⅲ型胶原蛋白表达,RT-PCR检测腓肠肌Wnt3a、β-catenin、TCF mRNA表达,免疫荧光法检测腓肠肌β-catenin的表达,免疫组化法检测腓肠肌Ⅰ型胶原蛋白、Ⅲ型胶原蛋白的表达。结果与结论:①苏木精-伊红染色及Masson染色结果显示:与模型组比较,理筋组各观察点炎性细胞浸润减少,胶原纤维量减少(P<0.001),肌纤维逐渐愈合;②Western blot结果显示:与模型组比较,理筋组各观察点Wnt3a、β-catenin、TCF、Ⅰ型胶原蛋白、Ⅲ型胶原蛋白的蛋白表达量均显著降低(P<0.05),而p-GSK3β/GSK3β比值较模型组则明显升高(P<0.05);③RT-PCR结果显示:与模型组比较,理筋组各观察点Wnt3a、β-catenin、TCF的mRNA表达量均显著降低(P<0.001);④免疫荧光结果显示:与模型组比较,理筋组各观察点β-catenin核表达荧光强度明显降低,且逐渐与空白组相近(P<0.001);⑤免疫组化结果显示:理筋组各观察点Ⅰ型胶原蛋白、Ⅲ型胶原蛋白的表达量相较于模型组均显著降低(P<0.01)。结果表明:理筋手法能够抑制Wnt/β-catenin信号通路的异常激活,减少纤维化瘢痕增生,从而达到促进损伤骨骼肌修复的目的。

腓肠肌内侧头腱膜松解和体外冲击波治疗跖筋膜炎疗效对比研究

目的比较腓肠肌内侧头腱膜松解术与体外冲击波对慢性跖筋膜炎的治疗效果。方法采用前瞻性随机对照研究,选取2021年8月至2023年9月北京京煤集团总医院收治的100例单侧慢性跖筋膜炎患者作为研究对象,采用随机数字表法将其分为腱膜松解组与体外冲击波组,每组50例。腱膜松解组采用腓肠肌内侧头腱膜松解术治疗,体外冲击波组接受体外冲击波治疗。比较2组患者治疗前、后视觉模拟评分(VAS)、踝关节背伸角度(ROM)、美国骨科足踝外科协会踝-后足评分(AOFAS)、足底筋膜厚度以及平衡能力。结果治疗后,腱膜松解组VAS评分明显低于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组踝关节背伸ROM大于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组AOFAS评分高于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组的足底筋膜厚度低于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组前侧的星偏移平衡测试法(star excursion balance test,SEBT)检测结果与体外冲击波组比较,差异无统计学意义(P>0.05);其余方向检测结果相较于体外冲击波组均增加(P<0.05)。结论相较于体外冲击波治疗,腓肠肌内侧头腱膜松解术能有效缓解患者疼痛程度、扩大其ROM,改善踝关节功能,降低足底筋膜厚度,提高平衡能力。

悬吊运动训练对痉挛型脑瘫患儿肌张力和运动功能的影响

目的 分析使用悬吊训练如何影响痉挛型脑瘫患儿肌肉张力和运动功能。方法 以徐州医科大学第二临床医学院在2021年1月-2023年1月接收的60例痉挛型脑瘫患儿为样本,根据不同的治疗方法分为观察组和对照组,各30例。其中对照组进行常规康复训练,观察组在常规康复训练的基础上增加悬吊运动训练,2组均干预3个月。分别在治疗前和治疗后,通过改良Ashworth 痉挛量表评价张力,利用粗大运动功能评估量表(GMFM-88)以及精细运动功能评估量表(FMFM)对患儿的运动功能进行比较;同时日常生活活动能力量表(ADL)评价其生活自理能力。结果 观察组治疗后痉挛程度较对照组降低,GMFM-88、FMFM评分和关节活动度增加,且日常生活活动能力比对照组明显提高,差异有统计学意义(P<0.05)。结论 痉挛型脑瘫患儿通过悬吊运动训练可以减轻痉挛,并提高运动能力。

Comparison of Electroacupuncture and Body Acupuncture on Gastrocnemius Muscle Tone in Children with Spastic Cerebral Palsy: A Single Blinded, Randomized Controlled Pilot Trial

Objective:To compare the immediate effects of electroacupuncture(EA)and body acupuncture(BA)on gastrocnemius muscle tone in children with spastic cerebral palsy(CP).Methods:Children with spastic CP,age from 24 to 60 months,who all received rehabilitation treatment in the Department of Developmental and Behavioral Pediatrics,the First Hospital of Jilin University from April 2016 to May 2017 were enrolled in this trial and assigned to EA group and BA group through a random number table.Both EA and BA therapies were performed on acupoints of Zusanli(ST 36),Shangjuxu(ST 37),Sanyinjiao(SP 6),and Xuanzhong(GB 39)for 30 min once.The root mean square(RMS),integrated electromyogram(iEMG)of the gastrocnemius of surface electromyography(sEMG),and Modified Tardieu Scale(MTS)of the two groups were evaluated before and after treatment.All adverse events were accurately recorded.Results:Thirty-six children with spastic CP completed the study(18 cases and 32 legs in the EA group;18 cases and 31 legs in the BA group).There was no significant difference in RMS,iEMG and MTS between the two groups before treatment(P>0.05).After treatment,compared with before treatment,RMS and iEMG significantly reduced and MTS(R2–R1)significantly increased in both EA and BA groups(P<0.05),and EA was more effective than BA in RMS and MTS(P<0.05).However,the iEMG between the two groups were not statistically significant after treatment(P>0.05).There was no serious adverse event during this clinical trial.Conclusion:Both EA and BA could significantly relieve the gastrocnemius muscle tone in spastic CP,and EA was more effective than BA.

围手术期护理在腓肠肌岛状穿支肌皮瓣修复胫骨远端骨折伴骨外露中的应用效果

目的:分析围手术期护理在腓肠肌岛状穿支肌皮瓣修复胫骨远端骨折伴骨外露中的应用效果。方法:选择2021年1月—2023年2月高州市人民医院收治的20例胫骨远端骨折伴骨外露患者,入院均提供腓肠肌岛状穿支肌皮瓣修复治疗,采用随机抽签法分为两组,各10例。对照组接受常规护理,观察组接受围手术期护理。对比两组术后皮瓣成活率、疼痛评分、踝关节功能及护理满意度。结果:研究组的皮瓣成活率高于对照组,但两组对比差异无统计学意义(P>0.05);术后1 d、术后3 d及随访2周,研究组的疼痛评分均明显低于对照组,差异有统计学意义(P<0.05);术后7 d、随访1个月、随访3个月,研究组的踝关节功能评分均明显高于对照组,差异有统计学意义(P<0.05);研究组的护理满意度明显高于对照组,差异有统计学意义(P<0.05)。结论:围手术期护理应用于腓肠肌岛状穿支肌皮瓣修复治疗的胫骨远端骨折伴骨外露患者,皮瓣成活率好,且可减轻疼痛,提高踝关节功能,提升护理满意度。

火针点刺治疗老年人腓肠肌痉挛的随机对照研究

目的:探讨火针点刺治疗老年人夜间腓肠肌痉挛的临床疗效。方法:研究纳入80例老年腓肠肌痉挛患者,随机分为观察组(n=39)和对照组(n=38)。观察组采用火针点刺治疗,对照组采用Park针治疗。2组均每周治疗3次,3次为1个疗程,共治疗3个疗程。比较2组患者症状、体征以及失眠改善情况。结果:观察组总有效率为97.44%,对照组总有效率为57.89%,2组比较差异有明显统计学意义(P<0.001)。2组治疗1周、2周、3周后的症状分级积分、体征分级积分、失眠严重指数、炎症细胞因子、氧化应激等指标均较治疗前及前一治疗时间点改善(P<0.05),且观察组上述指标的改善程度均优于对照组(P<0.01)。结论:火针点刺治疗能有效缓解老年人夜间腓肠肌痉挛状态,改善睡眠,提高抗氧化应激能力,减轻炎症损伤,可以在临床上广泛推广。

Bi-pedicled V-Y gastrocnemius myocutaneous flap for repairing Achilles tendon and overlying skin defect： the anatomic basis and clinical application

Objective： To study the anatomic basis of the bipedicled V-Y gastrocnemins myocutaneons flap for repairing the composite Achilles tendon defect. Methods ： The pedicle anatomy of the bi-pedicled V-Y gastrocnemins myocutaneons flap was examined on 30 cadaver specimens. The sliding distances of the flap were measured at different knee flexion degrees. The bi-pedicled V-Y gastrocnemins myocutaneons flap was applied in 12 cases of Achilles tendon defect with simultaneous skin and soft tissue defect. Results： The surai arteries could be classified into four types. After cutting off the gastrocnemins origin with a ＂ Z-shaped＂ incision, the sliding distance of the flap reached （3. 7 ± 0. 5） cm when the knee flexed 0° ,（4.9 ± 0.7） cm when the knee flexed 30°, （ 6. 7 ±0.7 ） cm when the knee flexed 60°and （9.2 ±0.9） cm when the knee flexed 90°. All the defects healed. The patients recovered ambulation with satisfactory knee and ankle function. The follow-up was 4 months -12 years. Conclusions： Different sural artery types should be noticed during the harvest of the bi-pedicled V-Y gastrocnemins myocutaneons flap. With 90° knee flexion, this flap is suitable for one-stage repair of composite Achilles tendon defect within 9.2 cm ± 0.9 cm.

以腓肠肌内侧头动脉供血的游离股前外侧皮瓣修复小腿复杂创面的临床研究

目的探讨以腓肠肌内侧头动脉为受区供血动脉的游离股前外侧皮瓣修复小腿复杂创面的手术方法及临床疗效。方法回顾性分析2020年10月—2022年9月苏州瑞华骨科医院收治的11例小腿复杂创面患者的临床资料。患者均存在小腿大面积皮肤及皮下软组织缺损,均接受游离对侧大腿股前外侧皮瓣修复,受区以腓肠肌内侧头动脉为供血动脉,供区皮肤直接缝合。结果11例患者11块游离皮瓣均成活,供区、受区创面均Ⅰ期愈合。出院后患者均获随访,随访时间12~35个月。术后12个月随访结果显示,所有患者创面愈合良好,皮瓣外观、弹性良好;所有患者恢复正常膝、踝关节功能,具有自主生活能力;供区伤口愈合良好,无明显瘢痕增生。末次随访时,皮瓣感觉功能评定为S 3级者2例、S 2级者9例;患肢功能评分达优者5例、良者6例,优良率高达100%。结论腓肠肌内侧头动脉血管口径适于吻合、位置恒定,以该动脉供血的游离股前外侧皮瓣修复小腿严重创面,可有效覆盖软组织缺损,并避免损伤小腿残留主干血管,疗效满意。