AF钉治疗胸腰段爆裂骨折疗效分析

目的探讨使用AF钉内固定治疗胸腰段爆裂骨折的临床效果。方法回顾分析应用AF钉治疗的胸腰段爆裂骨折46例,比较术前、术后椎体前后缘高度、Cobbs角、椎管狭窄程度及随诊时的症状恢复情况。结果平均随访18个月,46例患者伤椎椎体平均高度比、Cobbs角及CT片显示椎体后突骨块占椎管前后径的比例分别是术前0.48,31.5°,0.46;术后0.91,7.6°,0.11。在随访时伤椎椎体高度比和Cobbs角均有不同程度的丧失。结论AF钉内固定是治疗胸腰段爆裂骨折的有效方法,但后期仍存在复位丢失及内固定物折断等问题,经椎管伤椎椎体植骨可有效防止后期并发症发生。     

AF内固定系统治疗胸腰椎爆裂骨折

目的探讨AF内固定系统在治疗胸腰椎爆裂骨折中的作用和价值.方法对43例胸腰椎爆裂骨折的患者行后路常规椎弓根内固定,骨折复位后椎管减压,观察术前、术后椎体高度及Cobb's角改变.结果术前平均椎体前缘高度为47.8%,术后平均椎体高度为94.9%,术前cobb's角平均27.2°,术后平均4.3°.结论作者认为AF系统固定可靠,又具有良好的撑开作用,对有骨折突入椎管内的爆裂型骨折,骨折块还纳复位以及椎体前、后缘高度恢复可获得满意的效果,但抗扭转能力差.     

AF内固定系统治疗胸腰椎骨折的临床研究

目的探讨AF内固定系统治疗胸腰椎骨折的方法和临床疗效。方法回顾分析56例应用AF内固定系统治疗的胸腰椎骨折患者手术前后的临床体征、X线片和CT片。结果56例患者椎体前缘高度由术前47.8%恢复至96.8%,椎体后缘(中柱)高度由术前76.8%恢复至98.8%,Cobb's角由术前平均22.8°恢复至术后6.0°,平均随诊20个月,瘫痪恢复按ASIA分级:A级中6例无变化,余50例均提高1~2级。结论AF内固定系统操作简单,固定牢靠,调节方便,复位准确,疗效确切,是治疗胸腰椎骨折的良好内固定器械。     

AF系统内固定治疗胸腰椎爆裂型骨折

目的 :评价AF系统内固定治疗胸腰椎爆裂型骨折的效果。方法 :分析AF系统内固定治疗 4 4例胸腰椎爆裂型骨折。患者术前、术后和随诊的临床表现、X线片和CT。平均随诊 32个月。结果 :4 4例患者伤椎体前后缘平均高度从术前的 5 0 .3%和 75 .1 %恢复为术后 92 .2 %和 96 .7% ,Cobb角从术前 1 7.6°恢复为术后平均 1°。结论 :AF系统内固定是治疗胸腰椎爆裂型骨折的有效方法。其手术创伤小 ,出血少 ,并发症少 ,术后恢复好的特点 ,具有复位确切 ,固定可靠 ,操作简单的优点     

AF系统内固定治疗胸腰段椎体骨折48例

目的:探讨AF系统内固定治疗胸腰段椎体骨折的效果。方法:采用AF系统内固定治疗胸腰段椎体骨折48例,9例经椎弓根植骨,其中3例用加长AF跨双椎体固定。39例行横突及关节突部自体植骨。结果:45例获随访11～36个月,平均23个月。椎体前缘高度由术前平均48.5%恢复到88%,Cobb角由术前平均34°矫正到术后平均10°,经过随访,截瘫患者Frankel分级均有明显提高,其中A-B级2例,B-C级4例,B-D级3例,C-D级5例,C-E级1例,D-E级4例。结论:AF内固定系统具有短节段三维空间内多重矫正力的灵活性和维持解剖复位的坚固性、强大的轴向撑开力,而且结构简单、操作方便。     

AF钉系统治疗胸腰椎骨折

目的:评价AF系统治疗胸腰椎骨折的疗效,总结手术失误的经验。方法:对比54例患者手术前后X线片、电子计算机体层扫描(CT)、磁共振成像(MRI)以及ASIA评分,进 行综合评价。结果:47例患者获得连续随访,随访时间6至30个月,Cobb’角由术前平均24.5°恢复到术后平均 5.5°。椎体前缘高度由术前平均53％,恢复到术后91％。神经损伤ASIA分级平均提高1～3级。并发症发生率约为19.1％。结论:AF系统能够获得满意复位与固定效果,提高手术技术是减少并发症的关键。     

老年性骨质疏松合并腰椎骨折的手术治疗

目的 :总结AF钉治疗老年性骨质疏松合并腰椎骨折的经验。方法 :回顾性分析 13 7例老年性骨质疏松合并腰椎骨折患者采用AF钉内固定治疗 ,临床评价手术前后椎体的复位固定情况和神经功能。结果 :随访 6个月～ 2年 ,全部骨折 10～ 18周愈合 ,平均愈合时间 12周 ,AF内固定无断裂、松动、无椎体再压缩等并发症。椎体高度恢复 ,Cobb角由术前平均 2 0 6°恢复到 3 2° ,远期椎体高度无丢失 ,无严重腰痛和下肢痛。 2 5例伴有脊髓神经损伤的患者ASIA评级平均提高 1～ 2级。结论 :采用AF钉治疗老年性骨质疏松合并腰椎骨折 ,能有效缓解疼痛 ,具有良好的复位和固定作用 ,术后椎体高度维持好 ,可减少腰椎骨折并发症。我们认为AF钉是治疗老年性骨质疏松合并腰椎骨折理想的内固定器械     

后路半椎体切除治疗先天性脊柱侧凸

目的探讨后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸的临床效果。方法采用一期后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸畸形15例。术中咬除半椎体的后部附属结构,沿椎弓根外侧壁剥离至椎体前缘,切除半椎体、上下椎间盘及邻近椎体的软骨面,通过内固定器械凸侧加压闭合畸形椎切除后所致的间隙,矫正脊柱畸形。术后定期门诊复诊,观察脊柱融合、畸形矫正率和内固定稳定情况。结果本组15例均获得随访,随访时间12~36个月,平均24个月。术前侧凸Cobb角35°~78°,平均57°,术后Cobb角15°~36°,平均25°,矫正率54%;术前后凸Cobb角22°~65°,平均45°,术后后凸Cobb角8°~36°,平均18°,矫正率60%。术后未发现脊髓、神经损伤,无内固定松动,无切口感染。结论后路半椎体切除、器械矫正内固定治疗先天性脊柱侧凸是一种安全、有效的矫正方法。     

AF治疗胸腰椎骨折49例分析

目的：探讨AF内固定治疗胸腰椎骨折的策略。方法：回顾性分析2002年1月至2008年4月手术AF内固定治疗胸腰椎骨折患者49例,男32例,女17例,年龄17～62岁,平均37．6岁。受伤节段为T11～L4。侧位X线片示骨折椎体楔形变。骨折椎体高度压缩程度为1／4～3／4。结果：全部病例随访6个月～6年5个月,平均26个月,椎体前后缘高度分别由术前平均36．5％和80％恢复到术后平均93．2％和98．2％,Cobbg角由术前平均24。恢复到术后平均2．3°,脊髓损伤患者按Frankel分级,除4例A级无明显改善外,其余病例均有明显改善,平均改善1级以上。结论：AF内固定治疗胸腰椎骨折的疗效是肯定的。是否减压和植骨要看病情及每个医疗人员的习惯。     

AF椎弓根内固定系统治疗胸腰椎骨折13例报告

目的探讨ＡＦ椎弓根螺钉内固定系统治疗胸腰椎骨折的疗效。方法对１３例应用ＡＦ椎弓根内固定系统治疗胸腰椎骨折患者进行回顾性分析。结果１３例患者术前椎体前缘平均压缩５６％,术后平均７％,椎体后缘术前平均压缩８％,术后平均３％。Ｃｏｂｂ＇ｓ角由术前的平均２３°,恢复至术后２．１°。平均随访１年８个月,神经系统功能评定（ＡＳＩＡ法）：除Ａ级１例外,余１２例均提高１～３级。结论ＡＦ椎弓根内固定系统能达到理想复位和固定,并对椎管有一定减压作用,是一种治疗胸腰椎短节段骨折的最佳方法。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…