累及椎板型颈椎棘突骨折有限元模型的建立和分析

目的建立累及椎板型颈椎棘突骨折有限元模型（累及椎板型颈椎棘突骨折模型）并行活动度及应力分析,明确此型骨折对颈椎稳定性的影响。方法采集男性健康志愿者颈椎CT数据,运用有限元软件构建颈椎（C0~T1）全节段模型（正常颈椎模型）,并与文献报道数据进行对比验证,正常颈椎模型活动度通过比较验证后,在正常颈椎模型基础上建立C7累及椎板型颈椎棘突骨折模型,测量C7累及椎板型颈椎棘突骨折模型在前屈、后伸、左右侧弯和左右旋转6种工况下的活动度,与正常颈椎模型进行比较,测量颈椎骨性结构及韧带的生物应力变化。结果建立的正常颈椎模型同文献报道的颈椎活动度比较符合有限元建模标准,在正常颈椎模型上结合临床骨折病例建立的累及椎板型颈椎棘突骨折模型外观逼真,活动度比较结果显示：在C6~7节段,骨折模型的前屈、侧弯及旋转活动度比正常模型减小（减少0.24°~1.60°）,而后伸活动度略微增大（增加0.30°）;在C7~T1节段,除后伸活动外,其余活动度均比正常模型要大（增加0.91°~3.53°）,且活动度变化范围较为明显（单侧旋转活动度增加36.7%）;其余节段两个模型活动度相差无几。累及椎板型颈椎棘突骨折模型在侧弯及旋转工况下应力值较正常模型相对升高。结论累及椎板型颈椎棘突骨折模型能较好地模拟临床实际骨折病例,C7累及椎板型棘突骨折模型有限元分析提示骨折局部稳定性变差,预示颈椎不稳发生,一旦发现颈椎不稳或神经损伤,需及时手术治疗。     

颈前路融合手术对相邻节段影响的有限元分析

目的：通过有限元分析比较正常人体下颈椎、颈前路椎间盘切除植骨融合术（ACDF）后及颈前路椎体次全切植骨融合术（ACCF）后活动度（ROM）和相邻节段椎间盘及关节突关节的应力变化。方法建立正常人体下颈椎三维有限元模型。通过与已发表的关于颈椎ROM的文献相对比,验证该模型的有效性。模型验证成功后,建立下颈椎ACDF、ACCF模型,并对比正常颈椎、ACDF及ACCF术后ROM和相邻节段椎间盘及关节突关节的应力变化。结果所建立的下颈椎三维有限元模型在各个方向上的ROM与已发表研究所测得的ROM数值基本吻合,验证了模型的有效性。ACDF和ACCF术后总体ROM和融合节段ROM显著低于正常下颈椎。ACDF及ACCF术后相邻节段各个方向的ROM显著高于正常下颈椎。ACDF、ACCF术后相邻节段椎间盘及关节突关节应力峰值在各个运动方向上高于正常下颈椎组。结论颈椎融合术后总体ROM减少、相邻节段ROM增加,并且相邻节段椎间盘及关节突关节应力峰值升高,显著改变了颈椎的正常生理特性。     

寰枕融合伴寰枢椎脱位的三维非线性有限元模型的建立和分析

目的 使用有限元技术建立正常寰枕枢椎三维非线性有限元模型及寰枕融合伴寰枢椎脱位三维非线性有限元模型,为上颈椎临床研究提供生物力学方法.方法 对1例27岁男性志愿者CT数据进行有限元分析,建立正常寰枕枢椎三维非线性有限元模型(正常模型).对1例35岁寰枕融合伴寰枢椎脱位男性患者CT数据进行有限元分析,使用计算机模拟其在高...     

下颈椎前路椎弓根螺钉固定系统的有限元法生物力学特性研究

目的探讨下颈椎前路椎弓根螺钉固定系统的有限元法生物力学特性研究效果。方法应用有限元法对两种内固定物治疗脊柱骨折的疗效进行比较。应用Mimics、SolidWorks、Abaqus等软件建立脊柱骨折的三维有限元模型并分别置入两种不同的治疗方式。其一为模拟采用颈椎前路椎体螺钉钛板系统治疗,其二为下颈椎前路椎弓根螺钉固定系统。计算三维有限元模型的生物力学指标,包括75N轴压力、前屈、左侧屈、后伸等应力值进行比较。结果颈椎前路椎体螺钉钛板系统在75N轴压力、前屈、左侧屈、后伸等最大应力值均明显大于对照组,对比差异有统计学意义(P0.05)。结论下颈椎前路椎弓根螺钉固定系统在75N轴压力、前屈、左侧屈、后伸、右侧区的生物力学强度均优于常规的颈椎前路椎体螺钉钛板系统,其可提供更多的应力,值得临床推广和广泛应用。     

现实与虚拟互动的第3～7颈椎应力分析比较

目的:应用三维有限元方法建立第3~7颈椎有限元模型;分析直立时3~7颈椎不同部位的应力分布;进行定量生物力学与三维有限元模型比较;以期应用于临床实验研究。方法:采用UnigraphicsV18.0软件建立3~7颈椎的实体模型并划分单元,在1.8Nm作用力下,观察节段运动与力-位移反应。结果:分析结果证明其在仿真分析中是可行的。通过进行定量生物力学与三维有限元比较的统计学分析,未见显著性差异。结论:该方法适用于重建人体骨骼结构的有限元模型,所得结果较为合理,几何外形和材料特性均较满意,所得结果与实验检验结果基本吻合,所建立的3~7颈椎三维有限元模型可以模拟颈椎生物力学实验。希望在应用于临床与实验的过程中进一步修改和完善。     

颈椎三维有限元模型的建立与应用

目的建立颈椎的三维有限元模型(C4/5/6),以用于临床试验研究。方法根据条件选取健康成年男性志愿者,通过CT扫描,得到颈椎的连续断层数据图片,通过医学三维重建软件Materialise Mimics、作图软件Uni-graphics NX、有限元分析软件ANSYS 8.1构建出颈椎的三维有限元模型,进行边界设定,在模型上加载45N的预载荷,再加以2.0 N.M的纯力矩模拟脊柱的前屈、后伸、左右侧曲、旋转的生理活动,观察正常FSU(C4/5)的运动与受力,并与体外实物生物力学实验结果比较。结果C4/5三维有限元模型的运动范围与体外实体实验结果在统计学上没有显著差异(P<0.01)。结论建立的颈椎有限元模型可以模拟颈椎的生物力学特性。     

上颈椎运动节段数字模型建立及三维可视化研究

目的:寻求连续CT断层图像重建上颈椎运动节段数字模型及三维可视化的方法。方法:基于上颈椎连续薄层CT图像,运用Mimics10.01软件重建上颈椎运动节段骨性和各种软组织结构,并导入有限元分析Ansys10中初步进行有限元分析验证。结果:成功建立上颈椎运动节段三维数字模型并实现可视化。模型包括:C0~3骨性结构并区分皮质骨与松质骨、C1~3关节软骨盘、C2,3椎间盘和6种韧带结构。上颈椎有限元模型初步验证结果与体外生物力学实验和临床结果相符,可进一步行各种上颈椎有限元分析。结论:Mimics软件基于薄层CT图像建立上颈椎有限元模型提供了一个更为快捷精确的方法,所建模型逼真,几何相似性好,为研究上颈椎的生物力学性状创造了条件。     

下颈椎不稳症97例临床分析

目的:探讨下颈椎不稳症的诊断标准及治疗方法。方法:对颈椎牵引等综合疗法治疗的97例下颈椎不稳症病例的临床表现、诊断标准进行分析。结果:本组病例临床表现为肩臂部疼痛、头痛、头晕、恶心呕吐、手部麻木、斜方肌、提肩胛肌压痛等.影像学检查表现为颈椎椎间隙狭窄、骨赘形成、生理弯曲消失、椎体间位移大于等于3.5mm或椎体间位移1mm-3mm呈阶梯样改变。随访71例,优良率为90%。结论:下颈椎不稳症临床上十分常见,临床表现比较复杂且无特征性。除按White标准诊断下颈椎不稳定外,补充诊断标准为过伸过屈侧位X线片椎体间位移之和1mm-3mm,并呈阶梯样改变者。诊断下颈椎不稳症的标准:①除外内科、耳鼻喉科疾病:②有临床症状,符合White诊断标准;④补充诊断标准是有·临床症状,影像学符合下颈椎不稳定的补充诊断标准。治疗上除休息、枕领带牵引、配合药物治疗外,应用便携式颈椎牵引器牵引等门诊治疗是值得推荐的治疗方法。     

颅颈交界区畸形寰枢外侧关节生物力学稳定性的有限元分析

目的：利用有限元法分析颅颈交界区畸形（CJVM ）寰枢椎外侧关节生物力学变化。方法获取1例CJVM 枕骨和颈椎的CT扫描图像,利用三维造型和有限元软件建立颅颈交界区的三维有限元模型。施加生理载荷和边界条件,通过比较该模型与正常模型活动度的差异结合临床观察经验,验证模型的有效性,同时分析寰枢椎外侧关节应力分布。结果建立几何精度较高和参数设定可靠的CJVM有限元模型,通过模型发现各节段的活动度与相关尸体实验和有限元模型数据的结果相比总体呈偏小趋势,与一般CJVM患者临床实际运动表现相符合。获得了不同生理状况下畸形有限元模型寰枢椎外侧关节面的应力分布情况,可以合理解释寰枢外侧关节结构变异及其在维持寰枢椎之间稳定的重要作用。结论 CJVM 患者寰枢外侧关节结构发生变异,其生物力学稳定性对于术前的诊断和术中治疗操作具有一定价值。     

下颈椎不稳症97例临床分析

目的：探讨下颈椎不稳症的诊断标准及治疗方法.方法：对颈椎牵引等综合疗法治疗的97例下颈椎不稳症病例的临床表现、诊断标准进行分析.结果：本组病例临床表现为肩臂部疼痛、头痛、头晕、恶心呕吐、手部麻木、斜方肌、提肩胛肌压痛等.影像学检查表现为颈椎椎间隙狭窄、骨赘形成、生理弯曲消失、椎体间位移大于等于3.5mm或椎体间位移1mm～3mm呈阶梯样改变.随访71例,优良率为90%.结论：下颈椎不稳症临床上十分常见,临床表现比较复杂且无特征性.除按White标准诊断下颈椎不稳定外,补充诊断标准为过伸过屈侧位X线片椎体间位移之和1mm～3mm,并呈阶梯样改变者.诊断下颈椎不稳症的标准：①除外内科、耳鼻喉科疾病;②有临床症状,符合White诊断标准;③补充诊断标准是有临床症状,影像学符合下颈椎不稳定的补充诊断标准.治疗上除休息、枕领带牵引、配合药物治疗外,应用便携式颈椎牵引器牵引等门诊治疗是值得推荐的治疗方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.