后路减压椎间融合内固定治疗复发性腰椎间盘突出症

目的 探讨复发性腰椎间盘突出症的原因和后路椎弓根螺钉固定及椎间融合术治疗的临床效果.方法 2006年12月～2012年12月对35例复发性腰椎间盘突出症患者应用后路椎板扩大切除减压椎间植骨融合内固定手术治疗,其中30例得到随访,手术前后采用视觉模拟评分法（VAS）评估患者术前及术后第1、14天与末次随访的疼痛程度.结果 术后随访时间6～36个月,所有患者腰腿病症状均得到有效缓解.术前腰腿痛VAS评分为（8.34±1.56）分,术后VAS评分第1天为（4.12±1.26）分,14天为（2.23±1.12）分,末次随访为（1.56±1.13）分.所有患者的VAS评分术后明显低于术前,差异有统计学意义（P＜0.05）;术后第14天及末次随访时VAS评分明显低于术后第1天,差异有统计学意义（P＜0.05）.术后第14天及末次随访时VAS评分差异无统计学意义（P＞0.05）.结论 手术技术不当,术后锻炼不当,术后病变节段的退变,是复发的主要原因.再次手术减压联合椎间固定融合治疗复发性腰椎间盘突出症疗效肯定,可作为治疗腰椎间盘突出症的一种选择方法.     

腰椎间盘突出症内镜手术临床治疗分析

目的探讨内窥镜下椎间盘切除术治疗腰椎间盘突出症的手术技术和临床疗效。方法回顾性分析2007年1月～2008年1月间共收治40例外侧型腰椎间盘突出症患者,在内窥镜直视下行突出髓核组织切除术。结果内窥镜下椎间盘切除术平均手术时间70min,出血5ml～20ml,平均术后下床时间36h,平均住院时间5（d3～10d）。随访时间12个月,下肢坐骨神经痛VAS评分术前为（8.5±1.2）分,术后3d时为（3.5±1.4）分,末次随访时为（1.5±1.1）分;术前、术后结果进行配对t检验有显著性差异（P〈0.01）。MacNab标准临床效果评定结果为优30例,良6例,可4例,优良率90%。结论经皮内窥镜下椎间盘切除术创伤小、出血少、视野清晰、操作精细、术后恢复快、手术效果优良,是治疗外侧型腰椎间盘突出的优选术式。     

椎间孔入路微创手术与椎板开窗治疗复发性腰椎间盘突出症的效果比较

目的 经皮椎间孔镜微创治疗复发性腰椎间盘突出症的效果。方法 回顾性分析2010年6月~2015年11月行微创椎间孔镜下椎间盘髓核切除术和传统椎板扩大开窗髓核摘除术治疗的腰椎间盘突出术后复发患者的病历资料,统计描述病人的性别、年龄、复发节段,比较两种术式在手术时间、术中失血量、术后卧床时间和住院时间的差异; 随访6个月以上,采用疼痛视觉模拟评分(VAS)及疗效优良率(Macnab标准)比较两种手术方式的临床疗效。结果 两组病人手术时间和住院时间比较,差异无统计学意义(P>0.05); 两组病人术中失血量和术后卧床时间比较,差异有统计学意义(P<0.05); 两组病人术后6个月VAS评分的降低率、疗效优良率比较,差异均有统计学意义(P<0.05)。结论经皮椎间孔镜微创治疗复发性腰椎间盘突出术中出血少,恢复快,临床疗效良好。     

微创与开放手术治疗腰椎间盘突出症的疗效对比

目的比较微创手术与常规开放手术治疗腰椎间盘突出症的临床疗效。方法108例腰椎间盘突出症患者随机分为微创手术组58例和常规开放手术组50例。微创手术组采用椎间盘镜腰椎间盘髓核摘除术,常规开放手术组采用椎板间开窗和腰椎间盘髓核摘除术。比较两组的手术时间、出血量和住院日,并对一年后的疗效进行随访。结果微创手术组较常规开放手术组手术时间短、失血量大和住院日长,差异均有统计学意义（均P〈0．05）;术后随访1年,微创手术组优良率（82．76％）与常规开放手术组优良率（82．00％）比较差异无统计学意义（P〉0．05）。结论微创手术与常规开放手术对腰椎间盘突出症的治疗疗效均较好,但微创手术创伤较小,同时对术者的要求也更高。     

经皮微创治疗腰椎间盘突出症80例临床分析

目的：探讨经皮微创治疗腰椎间盘突出症80例的疗效。方法：选取本院2010年1月-2013年1月诊治的80例腰椎间盘突出症患者,选用21g注射针,医用纯氧,500mA带影像增强系统X光机,SYZ-2000型三氧治疗仪,医用电动负压吸引器,R-2000B型射频控温热凝器。所有患者都采用经皮微创治疗。结果：全部患者均进行随访,时间0．5～4年,平均19个月。椎体愈合时间为4．5个月～1年,平均9个月。VAS评分术前（6．12±1．28）分,术后2周（3．20±0．12）分,1年后（2．91±1．30）分,术后2周和1年与术前VAS得分比较差异均有统计学意义（P〈0．05）,术后2周与1年VAS评分比较差异无统计学意义（P〉0．05k手术治疗2周后,优60例,良lO例,可8例,差2例,优良率为87．5％（70／80）。术后1年优70例,良7例,可3例,差0例,优良率为96．25％（77／80）,疗效为优良的患者基本都达到骨融合。术后2周与1年后优良率比较差异无统计学意义（P〉0．05）。结论：经皮微创治疗腰椎间盘突出症效果较好,也为治疗腰椎间盘突出症开辟了一条实用而又安全的新途径,值得大力推广。     

复发性腰椎间盘突出症再手术临床分析

目的 探讨复发性腰椎间盘突出症的原因和治疗方法 .方法 该院自2002年1月～2008年1月共手术治疗复发性腰椎间盘突出症39例,均获得随访,平均随访时间(14.4±1.2)个月.按Nakano标准进行术后疗效评定.结果 优24例,良12例,尚可2例,差1例,优良率92.3%.结论 初次手术处理不当以及术后腰椎局部生物力学的改变是腰椎间盘突出复发的主要原因.再次手术治疗复发性腰椎间盘突出症,在同时解决减压和稳定两个问题后,可获得良好的效果.     

经皮椎间孔镜与显微内窥镜治疗腰椎间盘突出症的前瞻性随机对照研究

目的 比较经皮椎问孔镜(percutaneous transforaminal endoscopic discectomy,PTED)和显微内窥镜(microendo-scopic discectomy,MED)在腰椎间盘切除术中的临床疗效.方法 采用前瞻性随机对照研究的方法,将2007年12月至2008年6月术前确诊为单节段腰椎间盘突出症的60例患者,随机分为PTED组和MED组,各30例.手术效果按照Oswestry功能障碍指数(Oswestry disability index,ODI)、疼痛视觉类比评分(visual analogue scale,VAS)和改良的Macnab标准评定.结果 所有病例均顺利完成手术.两组病例的椎间盘突出类型、手术时间、术后随访时间及并发症的发生率均无明显差异,但PTED组平均手术失血(7±2)ml,术后卧床1 d.MED组平均手术失血(48±13)ml,术后卧床3～5 d(平均4.2 d).按照改良的MacNab法评定优良率分别为90%和93%,两组无显著性差异(P>0.05).PTED组和MED组术后ODI、VAS与术前比较,均明显改善(P<0.05).结论 PTED和MED两种微创术式治疗腰椎间盘突出症的短期疗效均满意.在严格选择手术适应证的情况下,PTED具有切口小、出血少、创伤小和术后恢复快等微创优势,是一种安全有效的微创手术方法.     

经皮穿刺低温等离子消融术治疗腰椎间盘突出症的临床研究

目的探讨经皮穿刺低温等离子射频消融髓核成形术治疗腰椎间盘突出症的可行性及临床疗效。方法回顾分析2009-01～2010-10收治的47例腰椎间盘突出症患者,采用经皮穿刺低温等离子射频消融髓核成形术进行治疗,计算手术时间、出血量、住院时间。在术前、术后1h、1d、2d、3d、3个月、1年时采用疼痛VAS和ODI评分标准进行评定。术后3个月和1年随访临床疗效结果判定参考改良Macnab标准。结果本组患者手术时间（20±10）min,出血量（4±1）ml,住院时间（4±1）d,随访时间（15±2）个月。手术前、后VAS和ODI评分比较差异具有统计学意义（P〈0．05）。结论经皮穿刺低温等离子射频消融髓核成形术治疗腰椎间盘突出症具有操作简便、安全、疗效好的优点。     

经皮椎间孔镜微创手术治疗复发性腰椎间盘突出症疗效观察

目的分析经皮椎间孔镜下微创手术治疗复发性腰椎间盘突出症的近期临床疗效。方法 21例复发性腰椎间盘突出症患者采取局部麻醉下后外侧入路经皮椎间孔内窥镜下手术摘除髓核、减压神经根。术后随访患者症状的改善情况。采用功能障碍指数(ODI)、视觉模拟评分(VAS)和改良的MacNab标准评定手术疗效。结果所有患者均顺利完成手术及随访,平均手术出血量(7.2±2.1)mL,手术时间(63.7±9.2)min,未发生硬脊膜破裂、脑脊液漏、神经根断裂等严重并发症。随访4¹9个月,平均(12.4±2.1)个月,术后ODI、VAS与术前比较均显著改善(P<0.05),术后末次随访按照改良的MacNab法评定疗效,优12例,良6例,可3例,优良率为85.7%。结论在严格把握手术适应证的前提下,经皮椎间孔内窥镜下手术治疗复发性腰椎间盘突出症临床疗效可靠,而且该术式不需要处理后方硬膜神经根的瘢痕组织,不破坏脊柱稳定性,具有创伤小、手术时间短、并发症少等优点。     

MED治疗复发性腰椎间盘突出症的体会

目的 探讨腰椎后路椎间盘镜髓核摘除术治疗复发型腰椎间盘突出症的疗效.方法 使用椎间盘镜手术系统（MED）对复发性腰突症8例患者,结合初次手术情况,采取MED手术.结果 8例患者手术经过顺利, 无转为开放手术病例.手术时间 55-140min, 平均68min 术中失血量50-180ml, 平均 80ml.3例患者发生脑脊液漏, 由于撕裂口小未予修补, 局部明胶海绵压迫, 严密逐层缝合, 3 d后脑脊液漏停止.无神经损伤、感染等并发症, 手术切口均Ⅰ期愈合.随访5-28个月, 平均15个月.按改良Macnab标准评价临床效果, 优5例, 良2例,可1例.结论 在严格的术前影像学诊断和熟练掌握手术原则及技巧的前提下,应用椎间盘镜治疗腰椎间盘突出症术后复发是可行的.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.