摔跤、柔道运动员膝关节半月板 损伤的超声诊断技术探讨

探讨实时、动态的超声方法诊断半月板损伤的价值。方法：对52名摔跤、柔道运动员采用旋转和拉动手法活动膝关节，同时应用实时、动态的超声检测方法观察膝关节半月板的形态。结果：采用拉、挤、旋转等动作的同时实时、动态进行超声检查提高了半月板诊断的准确率、敏感率。结论：实时、动态的超声技术不失为临床诊断半月板损伤的优选检查方法，值得加以推广。     

膝关节半月板的构造

本文从半月板的一般形态、韧带论述了半月板的大体构造,其中介绍了作者对兔外侧、内侧半月板各部厚度进行测量研究的结果。既对兔的半月板实验手术有一定参考价值,又可为研究中国人外侧半月板损伤率高的原因和临床治疗提供资料。     

运动员的半月板损伤(综述)

半月板损伤是某些体育项目,如足球、排球、篮球及体操等常见的运动损伤。损伤发生后往往影响运动员的运动能力和成绩,危害运动员的身体健康。因此,做为一名教练员、运动员及随队医务人员等能够很好地掌握运动员半月板损伤的有关理论,以减少运动员半月板损伤的发生,延长运动员的运动寿命。本文对运动员半月板损伤的发生、生物力学改变、临床诊断和治疗、康复训练和比赛以及预防等方面进行了详细的阐述。     

半月板全切除术远期疗效及其影响因素观察

研究目的：研究半月板全切除术远期疗效及其影响因素;研究方法：对98例半月板全切除术患者的远期疗效及其影响因素进行随诊观察,术后随诊时间10年至40年,平均20年;主要结果和结论：全部患者主观满意率为77．5％,统计学分析表明远期疗效与术后随诊时间长短有显著相关性。44例患者行x线检查,95．5％的患者膝关节出现明显退行性改变,其综合评定结果优良率为29．5％。作者认为,半月板具有十分重要的生物力学功能,半月板全切除术将导致骨性关节炎的发生;建议：对半月板损伤应尽早做出诊断并进行治疗,尽可能避免半月板全切除术。     

兔膝关节半月板神经分布的研究

本文首次报导了在兔内侧半月板中神经分布的情况,发现在半月板的不同部位(半月板体的外侧、中间和内侧三分之一;前角、后角)均有神经纤维及神经终末.这对于有关内容及损伤半月板的修复有重要意义.     

膝关节半月板损伤的中医针灸治疗

本文通过查阅文献资料和临床资料统计,对膝关节半月板损伤的病理机理、临床症状、病理分型等方面进行了分析,并通过中医针灸和推拿手法对此病患的治疗结果统计研究后发现：中医针灸和推拿对急慢性膝关节半月板损伤均有很好的疗效,且副作用小,费用低等优点,值得推广。     

试谈运动员膝关节半月板损伤的预防、诊断与治疗

半月板损伤是很多接触性运动项目中，损伤率较高的一种，这种损伤虽然不会导致结束运动生涯．但对运动训练的连续和运动寿命的延长是有一定影响的，往往在训练中出现了半月板损伤，轻者要休息治疗1-2周，重者4-8周，有的必须要手术才可修复，而且新的半月板在训练中又很易撕裂，所以为了避免损伤反复而形成进行性变，教练员在制定训练计划时很难有连续性，队伍的整体配合也受到了制约，所以半月板损伤确实是教练员、运动员很难解决的问题，作者就随运动队医务工作的过程中就发现常见的运动员半月板损伤，谈一谈，预防诊断与治疗，渴望对易出现该损伤的运动项目引起重视，使常见的损伤逐渐减少或不在发生。     

人胎儿半月板形态结构的电镜(TEM、SEM)观察

本文采用透射电镜和扫描电镜的方法,对胎儿(胎龄为4—8个月)时期的膝关节半月板的形态结构进行了观察,获得有关胎儿时期半月板表面的被覆物、细胞及胶原纤维的丰富材料.     

谈武术运动员膝关节半月板损伤的预防、诊断与治疗

半月板损伤是很多接触性运动项目中损伤率较高的一种,这种损伤虽然不会导致结束运动生涯,但对运动训练的连续和运动寿命的延长有一定的影响。特别是教练员在制定训练计划时很难有连续性,队伍的整体配合也受到了制约,所以半月板损伤确实是运动队教训员运动员很难解决的问题,文章对武术运动员膝关节半月板损伤的预防诊断与分析进行了分析研究,以使常见的损伤逐渐减少见或不再发生。     

人体内、外侧半月板生物材料力学特征及比较的实验研究

目的:通过对人体膝关节内侧半月板与外侧半月板多部位、多切面的力学实验,研究其生物材料力学的特征,对比其差异,有助于分析该结构发生损伤的机理,为损伤后的治疗、修复、人工材料置换等提供实验参考依据.方法:取右侧膝关节无病变,年龄在20～45岁之间的成年男性内、外侧半月板各6块.将半月板分为前角、体部和后角3部分,再对前角与后角进行水平面、额状面冰冻切片,体部进行水平面、矢状面冰冻切片,制作成标准试件.使用上海大学力学实验中心“生物材料力学性能测试系统”完成“一维拉伸试验”和“应力松弛试验”.实验数据经统计学处理,进行:1)内、外侧半月板前角额状面及水平面比较;2)内、外侧半月板后角额状面及水平面比较;3)内、外侧半月板体部矢状面及水平面比较.结果:1)内、外侧半月板瞬时弹性响应比较,前者的前、后角均显著大于后者,前者的体部显著小于后者(P≤0.05);2)内、外侧半月板各部位、各切面应力松弛率比较均无显著性差异(P＞0.05);3)外侧半月板不同部位、不同切面中有4项抗拉伸能力指标显著低于内侧半月板(P≤0.05).结论:1)外侧半月板前角与后角、内侧半月板体部粘弹性较差,抵抗瞬时外力的能力较弱,从生物材料的角度看可能在承受突然较强的负荷时容易发生损伤;2)内、外侧半月板各部位、各切面调整负荷的能力基本相同,运动时若注意关节运动幅度适度、准备活动充分,应能够避免因负荷不均造成的损伤;3)外侧半月板较内侧半月板抗拉伸能力弱,可能是其急慢性损伤更为多见的生物材料力学原因之一.     

超声和CT对胆囊癌的诊断价值

目的评价超声和CT对原发性胆囊癌的诊断价值。方法回顾性分析了155例经手术证实的胆囊癌的超声和CT检查资料,对超声和CT征象进行归纳总结。结果术前133例行B超检查,诊断符合率为57.9%(77/133);89例行CT检查,诊断符合率为70.8%(63/89)。结论超声和CT对胆囊癌的诊断有一定价值。疑似胆囊癌或进行胆囊癌临床分期时,CT较超声价值更大。     

The role of ultrasonography in the diagnosis of anterior cruciate ligament injury: A systematic review and meta-analysis

To evaluate the value of ultrasonography in the diagnosis of anterior cruciate ligament injury (ACL injury) by conducting a systematic review and meta-analysis. A literature search was carried out in the Cochrane Library, Embase, Pubmed databases and included studies prior to April 2017. Based on inclusion and exclusion criteria, studies evaluating ultrasound to diagnose ACL injury were selected. MRI, arthroscopy and clinical-follow were considered the reference standards. The diagnostic accuracy of ultrasound was assessed using a combination of sensitivity, specificity, likelihood ratio (LR), post-test probability, diagnostic odds ratio (DOR) and by summarizing the area under the receiver operating characteristic (SROC) curve. A total of 4 studies involving 246 patients were eventually included in the analysis. In these four studies, the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, post-test probability and DOR were 90.0% (95% CI: 77–96), 97% (95% CI: 90–99), 31.08 (95% CI: 8.75–110.41), 0.11 (95% CI: 0.05–0.24), 89% (3%) and 288.81 (95% CI: 78.51–1062.48), respectively. The area under the SROC curve was 0.98 (95% CI: 0.97–0.99). Our meta-analysis showed that ultrasound can play an important role in the diagnosis of ACL injury. Because of its high sensitivity, high specificity and high diagnostic ability, ultrasound should be a part of the standard diagnostic work-up of an ACL injury.     

Anorexia athletica in pre-professional ballet dancers

Competitive sport has been under increasing discussion as a possible favourable factor in the development of eating disorders among children and adolescents. The aim of this study was to determine the frequency of sport-specific eating disorders, in line with the concept of anorexia athletica. This prospective field study included one experimental group and two control groups (disease and healthy). Fifty-two pre-professional ballet dancers aged 13-20 years were tested for clinical eating disorders, anorexia athletica criteria, eating disorder related psychopathology and self-concept, and were compared with 52 patients with anorexia nervosa and 44 non-athletic controls of the same age. The study was conducted using semi-structured interviews as well as self-report questionnaires. A clinical eating disorder diagnosis was made in 1.9% of the ballet dancers versus 0% of the high school students; anorexia athletica was diagnosed in 5.8% of the dancers versus 2.3% of the students. Ballet dancers scored lower than patients with anorexia nervosa with regard to eating disorder related psychopathology and higher than the patients with regard to self-concept. We conclude that more sensitive tools to differentiate between sport-specific (eating) patterns, anorexia athletica and clinically relevant eating disorders are needed, especially for aesthetic sports such as ballet. It remains an important goal to identify athletes with symptoms of anorexia athletica irrespective of their physique and/or sport.     

Anorexia athletica in pre-professional ballet dancers

Abstract

Competitive sport has been under increasing discussion as a possible favourable factor in the development of eating disorders among children and adolescents. The aim of this study was to determine the frequency of sport-specific eating disorders, in line with the concept of anorexia athletica. This prospective field study included one experimental group and two control groups (disease and healthy). Fifty-two pre-professional ballet dancers aged 13–20 years were tested for clinical eating disorders, anorexia athletica criteria, eating disorder related psychopathology and self-concept, and were compared with 52 patients with anorexia nervosa and 44 non-athletic controls of the same age. The study was conducted using semi-structured interviews as well as self-report questionnaires. A clinical eating disorder diagnosis was made in 1.9% of the ballet dancers versus 0% of the high school students; anorexia athletica was diagnosed in 5.8% of the dancers versus 2.3% of the students. Ballet dancers scored lower than patients with anorexia nervosa with regard to eating disorder related psychopathology and higher than the patients with regard to self-concept. We conclude that more sensitive tools to differentiate between sport-specific (eating) patterns, anorexia athletica and clinically relevant eating disorders are needed, especially for aesthetic sports such as ballet. It remains an important goal to identify athletes with symptoms of anorexia athletica irrespective of their physique and/or sport.     

日常生活中可穿戴设备测量步态参数的有效性

定量步态分析对于寻找病理、损伤或其他步态特征至关重要,是重要的临床工具,常用于步态异常的诊断和治疗,为外科手术提供信息,评估治疗效果。本世纪以来,随着电子元件小型化的进步,促进了可穿戴设备在研究和临床上的应用。目的是为了阐明可穿戴设备在日常生活中,检测健康年轻人、老人和一些病理患者步态特征的有效性。对于健康年轻人、老人和亨廷顿病患者、帕金森患者以及中风患者而言,可穿戴设备能够有效地检测他们的日常步态特征,进而通过分析其步态特征获得身体状况的相关信息,达到纠正不健康步态或者预防疾病的目的。     

外用中药分期治疗踝关节扭伤的临床研究

对200例踝关节扭伤的患者以外用中药进行分期治疗,临床治愈率达89%.认为此方法能发挥中医辨证施治的优势,取得良好疗效,同时强调初诊时仔细询问病史及检查体征具有重要意义,以及过早下地行走对远期治疗效果会产生不良影响.     

Determination of the predictive clinical parameters to diagnose chronic exertional compartment syndrome

Chronic exertional compartment syndrome (CECS) is characterized by pain occurring during physical activity. As clinical examination is not sufficient to diagnose it, intracompartmental pressure (ICP) measure is used for CECS confirmation. Numerous clinical signs are reported but their diagnosis predictive ability has never been studied. We aimed to determine if the 12 classically reported clinical signs are predictive of CECS. We performed a single-centre retrospective cohort study on patients referred for CECS suspicion. Patients were asked to run on a treadmill. When pain occurred, post-exercise ICP was performed. We diagnosed CECS if the ICP was ≥30?mmHg and used a logistic regression to calculate the predictive value of clinical signs. One hundred twenty-five patients were evaluated. Ninety-six had CECS and 29 did not, according to the ICP 30?mmHg cut-off. Anterior and lateral compartments were the most frequently affected. After exercise, mean ICP was 58.6?mmHg?±?20.5 in the group with CECS versus 20.9?mmHg?±?4 in the group without (p?p?p?相似文献   

代谢综合征与运动干预对中心性肥胖影响的研究进展

代谢综合征（metabolicsyndrome,MS）是一系列代谢异常成分在同一个体聚集的临床综合症状,中心性肥胖是其重要的发病危险因素和临床表现之一。此外,有诸多研究显示中心性肥胖还是胰岛素抵抗（insulinresistance,IR）的一个重要发病基础。中心性肥胖症患者实施运动干预,对MS、IR有着显著的影响。本文通过文献资料法就中心性肥胖的危害和运动干预对中心性肥胖的影响进行综述。     

骨骼肌衰减症与运动干预研究进展

肌肉衰减症是指具有渐进性、全身性的骨骼肌质量和力量丢失为特征的综合症状,该综合征状伴有身体活动能力丧失,生活质量下降甚至死亡等严重后果的风险。骨骼肌质量和功能降低（肌肉力量下降和/或身体活动能力下降）是评判骨骼肌衰减症的临床诊断标准。有氧运动、尤其是抗阻训练和快速力量训练是改善老年人骨骼肌力量和身体活动能力的有效方法。本文综述了骨骼肌衰减的定义和临床诊断标准,以及运动干预的研究成果,以期为国内骨骼肌衰减症的基础研究和临床应用研究提供借鉴和参考。     

Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases

BackgroundChronic ankle instability (CAI) is a common sequela following an acute lateral ankle sprain (LAS). To treat an acute LAS more effectively and efficiently, it is important to identify patients at substantial risk for developing CAI. This study identifies magnetic resonance imaging (MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.MethodsAll patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1, 2017 to December 1, 2019 were identified. Data were collected using the Cumberland Ankle Instability Tool at final follow-up. Demographic and other related clinical variables, including age, sex, body mass index, and treatment were also recorded. Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.ResultsA total 131 out of 362 patients with a mean follow-up of 3.0 ± 0.6 years (mean ± SD; 2.0–4.1 years) developed CAI after first-episode LAS. According to multivariable regression, development of CAI after first-episode LAS was associated with 5 prognostic factors: age (odds ratio (OR) = 0.96, 95% confidence interval (95%CI): 0.93–1.00, p = 0.032); body mass index (OR = 1.09, 95%CI: 1.02–1.17, p = 0.009); posterior talofibular ligament injury (OR = 2.17, 95%CI: 1.05–4.48, p = 0.035); large bone marrow lesion of the talus (OR = 2.69, 95%CI: 1.30–5.58, p = 0.008), and Grade 2 effusion of the tibiotalar joint (OR = 2.61, 95%CI: 1.39–4.89, p = 0.003). When patients had at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, or inversion tilt test, they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.ConclusionMRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, and inversion tilt test. Further prospective and large-scale studies are necessary for validation.