宫颈粘液电导率在月经周期中的变化规律

采用电化学分析方法,在月经周期中连续测定宫颈粘液的电导率,分析电导率变化规律与排卵期的相关性,此法确认的排卵期与实际排卵期一致,由此为自然避孕提供新途径。     

经皮椎板关节突螺钉固定的应用解剖及影像学研究

[目的]为经皮椎板关节突螺钉的器械设计及临床应用提供解剖学依据。[方法]利用30例干燥腰椎标本，用游标卡尺及量角器测量腰椎椎板上缘及下缘的厚度，椎板关节突螺钉的长度。通过影像学测量椎板的内倾角和下倾角。[结果]椎板的上缘薄而下缘厚。从L1～5椎板的厚度、螺钉的长度及从内倾角逐渐增加，而下倾角逐渐减小。[结论]上缘的厚度太薄不适合螺钉的放置。从L1～5使用4．5mm的皮质骨螺钉固定是安全的，但应该在椎板的下缘置人。注意下倾角和内倾角的变化。设计的瞄准器应该具有调节角度的装置。     

椎动脉型颈椎病患者中缩血管活性肽类物质的变化及意义

目的　探索缩血管活性肽类物质在椎动脉型颈椎病发病时的变化情况及病理意义。方法　椎动脉型颈椎病治疗组 30例 ,正常组 30例 ,椎动脉型颈椎病患者均采用中医手法治疗。正常组和治疗组患者分别在治疗前和治疗后空腹取静脉血进行神经肽类物质NPY、ET、CGRP、ANP放射免疫检测。结果　治疗前椎动脉型颈椎病患者的血浆NPY、ET、ANP明显高于正常组 ,而CGRP的含量则低于正常组 (P <0 0 5) ;经过治疗后患者的血浆NPY、ET、ANP含量降低 ,CGRP的含量升高 ,与治疗前比较具有显著性差异 (P <0 0 5)。结论　缩血管活性肽类物质在椎动脉型颈椎病发病时可能起重要的神经 体液调节作用     

颈椎骨折类型与脊髓损伤关系之临床观察

通过对９２例颈椎骨折病例的分析，发现屈曲型损伤最多见（５３％），其次为过伸型（２６％），压缩型（２１％）。屈曲型和压缩型多见于年轻人，而屈曲损伤导致的脱位及过伸型则多见于年龄较大者。爆裂骨折引起的神经损害最重，其次为屈曲型、过伸型及压缩（非爆裂）骨折。神经功能改善率以爆裂型骨折最差，死亡率亦最高，以压缩（非爆裂型）骨折最好，其次为过伸型及屈曲型。文内对各型的特点进行了详细讨论。     

Long-term follow-up by video of cervical dystonia treated with botulinum toxin

We have analysed video recordings of 21 patients with cervical dystonia treated with botulinum toxin. Fourteen patients have a record both of their response shortly after injections were commenced and between four years five months and six years seven months later. Our analysis shows that the long term outcome is often better than the initial response. We suggest that chronic treatment with botulinum toxin allows different muscles to those initially injected to be identified as contributors to the dystonia. Subsequent injection of these muscles leads to further improvement. It implies that cervical dystonia is a more widespread disorder of motor control, rather than simply limited to a few muscles.     

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity,reproductive factors,and venereal infections

Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n=614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.Drs Kjaer, Engholm, and Lynge are with the Danish Cancer Registry. Dr Dahl is with the Department of Surgery, Slagelse Hospital, Denmark. Dr Bock is with the Department of Gynecology, Rigshospitalet, Copenhagen, Denmark. Dr Jensen, formerly with the Danish Cancer Registry, is deceased. Address correspondence to Dr Kjaer, Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Rosenvengets Hovedvej 35, Box 839, Copenhagen. Denmark. The Danish Cancer Society supported this study through grants.     

尺骨鹰嘴骨折皮质骨加压螺钉固定的实验研究及临床应用

比较尺骨鹰嘴骨折加压螺钉与常用的4种内固定的强度,为临床选择内固定方法提供实验依据。用22具新鲜尸体肘关节做成横型、斜形和粉碎形鹰嘴骨折模型。用5种内固定后置于MD—10E万能电子力学试验机上,测定骨折处的位移与压力的关系;结果:钢丝内固定强度最小,钩钢板最大。髓内加压螺钉固定欠可靠。横形骨折皮质骨加压螺钉与张力带钢丝比较,统计学上无显著差异(P〉0.05),斜形骨折皮质骨加压螺丝钉强于张力带钢丝(P〈0.01)。粉碎形骨折使用钩钢板尤佳(P〈0.01)。临床应用24例中,22例平均随访14个月。骨折全部愈合,优良率达90.91％;认为皮质骨加压螺丝钉治疗横、斜形尺骨鹰嘴骨折,创伤小,操作简便,固定确切,是一种安全可靠的方法。     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

颈椎髓外硬膜下结核瘤1例

患者,男,38岁,以颈项部疼痛1个月,突发左上肢麻木无力3d入院。1个月前,无明显诱因,出现颈部疼痛,无双上肢感觉障碍,无活动受限,无头晕头痛,就诊于当地医院(具体治疗不详),症状无改善。3d前突然出现左上肢麻木无力,右上肢麻木感,排尿无力。既往:3年前无明显诱因出现颈部皮肤溃烂