Emergency contraception in Beijing

ＥｍｅｒｇｅｎｃｙｃｏｎｔｒａｃｅｐｔｉｏｎｉｎＢｅｉｊｉｎｇＷｅｎｇＬｉｊｕ（翁梨驹），ＨａｎＸｕｅｊｕｎ（韩学军），ＨｕＪｉｎｇ（胡静），ＷｕＳｈａｎｇｃｈｕｎ（吴尚纯）ＩｎｔｒｏｄｕｃｔｉｏｎＴｈｅａｃｈｉｅｖｅｒｎｅｎｔｏｆｆａｍｉｌｙｐｌａ...     

芬太尼对大鼠全心缺血/再灌注损伤及心律失常的影响

心肌缺血／再灌注损伤及心律失常是围麻醉期的一种病理生理变化。本研究采用Ｌａｎｇｅｎｄｏｒｆｆ心脏离休灌注模型和大鼠在体、离体局部心肌缺血／再灌注心律失常模型，系统观察芬太尼对其的影响。材料与方法再灌注损伤模型　采用Ｌａｎｇｅｎ－ｄｏｒｆｆ心脏离体灌注模型及Ｍａｃｌａｂ记录系统，将３０只ＳＤ大鼠随机分为对照组（Ｃ组）和两芬太尼组（Ｆ１及Ｆ２组）。３％戊巴比妥钠３０ｎｇ·ｍｌ－１、肝素５００Ｕ·ｋｇ－１腹腔麻醉，１０分钟后开胸取心迅速投入（０～４）℃Ｋ－Ｈ液中停搏，经主动脉插管行非循环式Ｌａｎｇｅｎ…     

Cnaical significance of changes in cortital and trabeular bone density after menopause

ＣｎａｉｃａｌｓｉｇｎｉｆｉｃａｎｃｅｏｆｃｈａｎｇｅｓｉｎｃｏｒｔｉｔａｌａｎｄｔｒａｂｅｕｌａｒｂｏｎｅｄｅｎｓｉｔｙａｆｔｅｒｍｅｎｏｐａｕｓｅＬｉｎＳｈｏｕ一ｑｉｎｇ（林守清），ｚｈａｎｇＴａｏ（张涛），ＨｅＦａｎｇ－ｒａｎｇ（何方方），ｘｕ...     

儿童腰背痛（Back Pain in Children）

儿童特别是少年（Ｐｒｅ－ａｄｏｌｅｓｃｅｎｔｓ）期腰背痛持续１～２周以上者,常是由于器质性（ｏｒｇａｎｉｃ）原因所引起,与成人多是机械性（ｍｅｃｈａｎｉｃａｌ）或精神因素（ｐｓｙｃｈｏｌｏｇｉｃａｌ）所致者不同。Ｈｅｎｓｉｎｇｅｒ研究了１００例骨骼...     

An androgen induced hyperinsulinemic and hyperandrogenic anovulatory rat model

ＡｎａｎｄｒｏｇｅｎｉｎｄｕｃｅｄｈｙｐｅｒｉｎｓｕｌｉｎｅｍｉｃａｎｄｈｙｐｅｒａｎｄｒｏｇｅｎｉｃａｎｏｖｕｌａｔｏｒｙｒａｔｍｏｄｅｌＹｕＪｉｎ（俞谨），ＹａｎｇＳｈｕｐｉｎｇ（杨淑萍），ＺｈａｎｇＹｕｅｐｉｎｇ（张月萍）ＷｅｉＭｅｉｊｕａｎ（...     

锁骨骨折复位固定器治疗锁骨骨折39例

锁骨骨折复位固定器治疗锁骨骨折３９例福建省永定县医院（３６４１００）林爵荣，陈础Ｔｈｉｒｔｙｎｉｎｅｃａｓｅｓｏｆｆｒａｃｔｕｒｅｏｆｃｌａｖｉｃｌｅｔｒｅａｔｅｄｗｉｔｈｆｉｘａｔｏｒ￥ＬｉｎＪｕｅ－ｒｏｎｇ（林爵荣）Ｃｈｅｎｃｈｕ（陈础）（Ｙｏｎ...     

原癌基因c-jun、c-fos 在小鼠胚泡着床前后的表达

为了解胚泡着床前后ｃ ｊｕｎ、ｃ ｆｏｓ表达的动态变化。采用逆转录聚合酶链反应方法检测小鼠子宫内膜原癌基因ｃ ｊｕｎ、ｃ ｆｏｓ的表达。结果表明：（１）小鼠正常内膜有一定的ｃ ｊｕｎ、ｃ ｆｏｓ基因的表达；（２）胚泡着床前（孕３天）的内膜ｃ ｊｕｎ、ｃ ｆｏｓ基因的表达明显高于正常内膜（Ｐ＜０．００１）；（３）着床后，孕５与孕７天内膜ｃ ｆｏｓ、ｃ ｊｕｎ基因的表达低于着床前，至孕７天已低于正常水平（Ｐ＜０．００１）。提示原癌基因ｃ ｊｕｎ、ｃ ｆｏｓ与小鼠胚泡着床有关。     

Evidence of progesterone receptor mRNA in endothelial cells

ＥｖｉｄｅｎｃｅｏｆｐｒｏｇｅｓｔｅｒｏｎｅｒｅｃｅｐｔｏｒｍＲＮＡｉｎｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｓＬｕｏＨｏｎｇｚｈｉ（罗宏志），ＷａｎｇＨｏｎｇｙｉ（王弘毅），ＬｉｕＷｅｉ（刘伟），ＣｈｅｎｇＪｉｅ（程捷），ＺｈａｏＸｉａｏｄｏｎｇ（赵小东）...     

Two－year experience of providing emergency contraception service in Tianjin China

Ｔｗｏ－ｙｅａｒｅｘｐｅｒｉｅｎｃｅｏｆｐｒｏｖｉｄｉｎｇｅｍｅｒｇｅｎｃｙｃｏｎｔｒａｃｅｐｔｉｏｎｓｅｒｖｉｃｅｉｎＴｉａｎｊｉｎ　ＣｈｉｎａＣｈｅｎｇＷｅｉｙｕ（程渭玉），ＰｅｎｇＤｕｎｒｅｎ（彭敦仁）Ｏｂｊｅｃｔｉｖｅｓ：Ｔｏｐｒｏｖｉｄｅｔ...     

The in vivo model of cross－species rabbit anterior eye chamber of human endometrium

Ｔｈｅｉｎｖｉｖｏｍｏｄｅｌｏｆｃｒｏｓｓ－ｓｐｅｃｉｅｓｒａｂｂｉｔａｎｔｅｒｉｏｒｅｙｅｃｈａｍｂｅｒｏｆｈｕｍａｎｅｎｄｏｍｅｔｒｉｕｍＷｕＹａｎｗａｎ（吴燕婉），ＹｕａｎＤｏｎｇ（袁冬），ＳｈｉＸｉｎｑｕａｎ（石心泉），ＸｉｎｇＺｈｉｊｕｎ（...     

颈胸椎连接段骨折脱位的治疗

目的探讨前路手术在颈胸椎连接段骨折脱位的应用价值。方法自1997年以来共收治21例颈胸椎连接段骨折脱位的患者，受伤至手术时间24小时内4例、2～7天9例、8～14天3例、4周以内5例，均为骨折脱位，其中C6、7 7例，C7 9例，T1 5例。均有不同程度脊髓损伤，按Frankel分级，A级3例、B级6例、C级9例、D级3例。手术行前方入路，骨折椎体大部分切除彻底减压，自体髂骨块植骨融合，并使用前路颈椎带锁钢板内固定。结果全组21例，除因合并肺部感染死亡1例外，20例均获随访，随访时间8个月～3年，平均21个月，植骨全部融合，术后脊髓神经功能有不同程度恢复，其中A级2例、C级1例、D级9例、E级8例，脊柱序列正常，无内固定失败。结论前路手术操作简便，并发症少，骨折脱位复位满意，节段稳定性好，是治疗颈胸椎连接段骨折脱位的一种较好方法。     

Intrathoracic carotid bifurcation in Klippel-Feil syndrome

Intrathoracic carotid bifurcation is rare with only five other cases reported. This anatomic variant with posteromedial origin of the internal carotid artery (ICA) appears to be part of the Klippel-Feil syndrome, a rare congenital defect characterized by fusion of the cervical vertebrae. Caution is advised when planning thoracic and cervical vascular procedures. Angiography carries higher risk of unintentional ICA catheterization due to the short common carotid artery length. The intrathoracic location of the carotid bifurcation makes endarterectomy difficult and patients may do better with carotid artery stenting. Ultrasound can be confusing in these patients and MRA may be preferable.     

消瘀散外敷配合导引治疗颈椎病临床观察

目的：探讨消瘀散外敷配合导引治疗颈椎病的临床疗效,为颈椎病的治疗寻找新途径。方法：从2007年5月至2008年4月,共治疗颈椎病患者63例,按随机数字表单双数随机分为两组,治疗组33例,男21例,女12例,年龄20～49岁,平均（30．60±7．89）岁,用消瘀散外敷配合导引治疗;对照组30例,男16例,女14例,年龄20～49岁,平均（32．43±8．00）岁,用扶他林缓释片治疗。治疗前后对患者颈部疼痛、压痛和颈椎活动度进行观察。结果：治疗组治疗前后各项指标比较（疼痛、压痛、活动度）,差异均有统计学意义（P〈0．001）。对照组治疗前后各项指标比较（疼痛、压痛、活动度）,差异均有统计学意义（P〈0．001）。两种治疗方法均能改善颈部疼痛、压痛和颈椎活动度。结论：消瘀散外敷配合导引治疗颈椎病,能明显改善颈部疼痛、压痛和颈椎活动障碍,纠正颈椎动力性平衡失调。     

椎小关节综合征的CT表现

目的评价CT对椎小关节综合征的诊断价值。方法回顾性分析426例椎小关节综合征患者的CT表现。男性265例,女性161例,平均年龄53(36~72)岁。颈椎63例,胸椎11例,腰椎352例。结果单纯小关节病54例,余372例均合并其他椎关节疾病。颈椎、胸椎小关节病CT表现特点以椎小关节突的增生肥大(67例,90.54%)、硬化(53例,71.62%)、关节间隙变窄(47例,63.51%)和关节周围韧带骨化(48例,64.86%)为主征。腰椎小关节病的CT表现复杂,综合有:小关节突肥大、增生、骨桥形成306例(86.93%),小关节间隙狭窄或消失185例(52.56%),骨质关节面下有囊状破坏130例(36.93%),关节囊及周围组织钙化226例(64.20%),椎小关节间隙增宽或两侧不对称时有椎体滑脱改变36例(10.23%),关节腔“真空”征82例(23.30%);以多种影像并存为特点。结论CT可充分地显示椎小关节的解剖结构和病理改变,为小关节病的诊断提供了可靠的影像学根据。     

计算机辅助颈椎椎弓根螺钉置入参数的获取

目的探讨利用CT三维重建技术模拟颈椎椎弓根螺钉置入的方法,以获得预置螺钉的椎弓根三维定量解剖数据及置钉参数。方法将颈椎16排CT扫描的数据导入Mimics8．1软件中,进行颈椎CT三维重建,在三维图像上构建一圆柱体来模拟椎弓根螺钉,并置入颈椎椎弓根内,然后测量各项置钉参数。结果应用CT三维重建技术可以获得清晰的颈椎三维图像,使用软件测量功能可精确地获取预置螺钉的椎弓根解剖数据（椎弓根宽度和轴线长度）和置钉参数（置钉的α角、β角以及置钉α角安全范围）。结论通过CT三维重建技术获取椎弓根螺钉置入个体化三维数据,为术中实施颈椎椎弓根螺钉置入提供依据,是颈椎椎弓根螺钉置入安全性研究的一种可靠方法。     

Spinal tuberculosis in a developed country. A review of 26 cases with special emphasis on abscesses and neurologic complications

A retrospective study of 26 cases was analyzed to review the sometimes unfamiliar clinical appearance and outcome of Pott's disease. Swiss nationals (46%) were older than patients from Mediterranean or developing countries (mean age, 69 versus 29 years). The number of vertebrae initially involved was 2.2. Localization was lumbar in ten cases, thoracic and lumbar in two, and thoracic or cervical in 14. Abscesses were present in 15 (57%) subjects and appeared during treatment in 20% of these cases. They were twice as frequent in non-Swiss patients. Three patients had surgery because of progression of the abscess under treatment. Ten cases needed single or multiple aspirations. Three of six lumbar abscesses were initially visualized only by computed tomography. Neurologic complications occurred in 12 (46%) patients, 11 of whom had cervical or thoracic vertebrae involved. In four cases (33%), the neurologic deficit developed during the first two months of treatment. Three patients had laminectomies, two without any benefit. Outcome was favorable for 11 of 12 patients without any difference between conservative treatment and surgery. Neurologic symptoms are in most cases related to radicular and medullary inflammation, with arachnoiditis and without compression. The possible benefit of steroids seems promising enough to warrant further investigation.     

Birth injuries of the spine

Results of treatment of 204 children with labour traumas of the vertebral column are presented. Among the 204 patients there were 151 neonates, 28 infants and 25 patients with consequences of labour trauma. The cervical part is traumatized most frequently. Injury of the cervical vertebrae was diagnozed in 154 patients, of lumbar vertebrae in 18 patients. One child has an injury of the cervical and thoracic vertebra. In 41 patients there were ischemias in the vertebrobasilar area. An associated labour trauma of the vertebral column was diagnozed in 36% of the cases. Results of treatment were followed-up in 174 patients. Good results were obtained in 133 patients (76%). Satisfactory results were noted in 36 children (20%). Five patients died. Early and complex treatment gave good results in 93% of the cases.     

内固定应用于脊柱结核治疗的安全性探讨

目的 探讨内固定应用于脊柱结核治疗的安全有效性.方法 1985年4月至2005年5月,51例脊柱结核患者行一期或二期病灶清除、植骨及前路或后路钉棒系统内固定术,男25例,女26例;年龄2～80岁,平均44.8岁.病灶分布:C3～S1,其中颈椎6例,胸椎19例,胸腰段16例,腰骶椎10例.单节段6例,双节段30例,三节段11例,四节段及以上4例.神经功能按Frankel分级:B级2例,C级8例,D级36例,E级5例.所有患者术前均行至少两周的抗结核治疗.手术清除脓液,刮除干酪样坏死物,摘除椎间盘,用骨刀切除坏死骨质直至有正常血运的骨组织.使用内固定Luque 6例,Z-plate 3例,TSRH 8例,Ventrofix 5例,Kenada 4例,Moss-Miami 5例,Isola 6例,CDH 3例,Caspaz 2例,C-D 2例,Zielke、Dick、Oriell、Ozion、Zephir、Tenor、USS各1例.术后继续三联抗结核治疗1年.结果 术后患者腰背部疼痛明显缓解,术前有神经损害的患者术后均有不同程度的恢复.1例术后复发.经清创及调整药物治疗后未再复发.1例胸椎结核术后伤口延迟愈合,出现脓肿窦道,经长期换药后愈合.1例T10椎体结核,术前双下肢肌力3级,术后降为0级,经保守治疗2周后双下肢肌力逐渐恢复至术前水平.所有患者均获得随访,随访时间3.2～23.5年,平均813年.所有患者植骨均融合.24例术前伴后凸畸形的患者,后凸角从入院时平均34.17°矫正至术后平均10.45°,末次随访矫形平均丢失3.2°.结论 内固定应用于脊柱结核的治疗安全、有效.     

老年脊柱结核的手术治疗

目的 探讨老年脊柱结核患者的围手术期特点、手术入路及手术治疗效果.方法 回顾性分析2002年4月至2007年5月收治的45例老年胸腰椎结核患者的临床资料.男26例,女19例;平均年龄为67(61～78)岁.单个椎体破坏8例,两个椎体破坏27例,三个或三个以上椎体破坏10例.病程1～8个月,平均4.5个月.部位:胸椎(T2～T10)9例,胸腰段(T11～2)14例,腰椎(L3、L4)16例,腰骶段(L5、S1)6例.Frankel分级:B级7例,C级21例,D级11例,E级6例.45例患者均合并一种或多种其他疾病,其中21例合并心脑血管疾病,10例合并糖尿病.术前对这些患者进行合理治疗,术后随访.术前均行抗结核治疗2～3周.T2～T7椎体结核采用经后路病灶清除植骨融合、后路钉-棒系统内固定术,腰骶段椎体结核采用后路椎弓根螺钉固定加前路结核病灶清除髂骨植骨融合术,其余采用一期前路结核病灶清除加植骨内固定手术.45例患者均获得随访,随访时间24～40个月,平均28.5个月.结果 所有患者术中及住院期间无死亡及严重并发症发生.44例治愈,1例复发.植骨于12～18个月内均获融合.Frankel分级明显改善,B级1例,C级6例,D级11例,E级27例.结论 围手术期对并存疾病进行有效处理后,老年脊柱结核患者可以耐受手术治疗.如手术入路选择合理,病灶清除、内固定并植骨融合术可以提供足够的稳定性和较好的疗效.

Abstract：

Objective To discuss perioperative features, operative approach and surgical effects of spinal tuberculosis in older patients. Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal tuberculosis ranging in age from 61 to 78 years (average, 67 years). The lesion was located in thoracic vertebrae in 9 patients, thoracolumbar vertebrae in 14, lumbar in 16, and lumbosacral in 6. Preoperative Frankel grades were B in 7 cases, C in 21, D in 11 and E in 6. Among them, 21 had cardio-cerebrovascular disease, 10 had diabetes mellitus. With preoperative medicine and chemotherapy for 2-3 weeks, all patients were treated surgically. The surgical procedures included: 1) Posterior focus debridement, bone grafting and one-stage posterior transpedicular screw system fixation in thoracic vertebrae (T2-T7). 2) Anterior debridement, bone grafting and one-stage posterior transpedicular instrumental fixation in lumbosacral vertebrae (L5-S1). 3) Anterior focus elimination, bone grafting and one-stage anterior plate fixation in the other vertebrae. Results Forty-five patients were followed up for 24 to 40 months, with the average of 28.5 months. No severe complication occurred during and after operation. Forty-four cases had recovered and 1 recurred. Spinal fusion occurred 12-18 months after operation. Frankel neurological grades improved significantly. Conclusion With the effective management of comorbidities in perioperative period,the elderly could tolerate surgical treatment. The appropriate approaches, thorough debridement and reasonable bone grafting with internal fixation are key to therapeutic success.     

后路减压椎弓根钉内固定治疗胸腰椎骨折伴不全瘫

目的探讨经后路减压椎弓根钉内固定手术治疗胸腰椎骨折合并不全瘫的术后神经功能恢复效果。方法回顾性分析2005年1月到2006年1月收治的胸腰椎骨折脱位合并不全瘫病例共30例,其中男性21例,女性9例。神经损伤按照ASIA分级,B级10例,C级12例,D级8例。所有病例均采用后路椎弓根钉短节段固定减压手术。结果所有病例均得到有效随访,平均28.3个月,脊柱后凸角度（Cobb′s角）由术前的（24.3±4.6）°平均恢复到（3.6±1.2）°;伤椎椎体前缘高度恢复率由术前（35.8±5.3）%平均恢复到（90.2±3.8）%;椎管占有率由手术前平均（58.3±10.7）%恢复至术后平均（8.4±1.7）%。神经功能ASIA分级术后随访部分有明显改善。Dennis工作评分：11例患者可以再次获得稳定工作。结论后路减压椎弓根内固定手术治疗胸腰段骨折固定确实,且手术后对于神经恢复有良好改善,能使部分患者恢复工作。