腰椎节段形态对峡部、小关节应力及小关节接触力影响的有限元分析

目的:探讨腰椎形态结构变化对峡部裂性滑脱及小关节退变的作用和意义。方法:采用改良的“非种子区域分割方法”及非平行“最佳切割平面”等一系列新型计算机辅助设计(CAD)方法精确建立包括椎间盘高度、腰椎小关节角、椎间盘前凸角改变的L4~L5活动节段有限元模型;在2700N轴向压缩载荷条件下,分别对各有限元模型的峡部、小关节应力、小关节接触力以及椎间盘负载进行测试。结果:压缩载荷下,腰椎活动节段峡部、小关节等效应力及小关节接触力随椎间盘高度的减小而减小,随小关节角的增大而增加,随椎间盘前凸角的增加而减小。结论:椎间盘高度、腰椎小关节角、椎间盘前凸角等形态结构变化对腰椎节段有限元模型的峡部、小关节应力及小关节接触力有明显的影响。提示腰椎峡部应力性骨折及小关节退变的发生与椎间盘高度、腰椎小关节角、椎间盘前凸角等解剖形态因素有关。     

Comparison between a swim-up and a Percoll gradient technique for the separation of human spermatozoa

Two methods of separating human sperm were compared using twenty-two semen samples. The sperm were separated by a swim-up technique or by self-migration on a Percoll gradient followed by medium change. After separation, the sperm obtained were assessed for progressive motility, ATP content, energy charge index ([ATP + 0.5 ADP]/[ATP + ADP + AMP]) and morphology. In general, and especially for semen samples containing less than 20 X 10(6) sperm/ml, separation by Percoll gradient selected sperm that were superior to those separated by the swim-up technique. The relatively high energy charge index (greater than 0.8) showed that the sperm tolerated the separation conditions well. It is suggested that self-migration on a Percoll gradient should prove useful for obtaining sperm of high quality.     

免疫组化法检测非甲-非庚型肝炎患者肝组织中输血传播病毒

目的　检测非甲-非庚型肝炎患者肝组织输血传播病毒(TTV)感染状况,TTV感染与肝组织炎症程度 及与血液学指标的相关性。方法　应用免疫组织化学法检测52例非甲-非庚型肝炎患者肝组织中TTV,并经原位 杂交证实;对TTV阳性和阴性组的血液学生化指标,诸如血清丙氨酸转氨酶(ALT)、血清天冬氨酸转氨酶(AST)、血 清总胆红素(TBIL)、白蛋白(ALB)、γ 球蛋白(γ G)、凝血酶原活动度(PTA)及组织学活动指数(HAI)进行了比较。 结果　非甲-非庚型肝炎患者肝组织中TTV抗原(TTVAg)阳性15例,检出率为28.8%;阳性物质主要定位于肝细 胞浆内,呈棕黄色细小颗粒,偶见肝细胞核内有表达;TTV阳性表达细胞呈单个、散在或片簇状分布;TTVAg阳性的 组织切片经苏木素-伊红(HE)染色后,可观察到病毒性肝炎的一些病理变化,如肝细胞胞浆疏松化、气球样变、嗜酸 样变、灶性坏死、凋亡、小叶内及汇管区炎细胞浸润;从15例TTVAg阳性病例中任选10例进行TTV DNA原位杂交 检测,结果8例阳性,二者符合率80.0%;同时对5例免疫组化TTVAg阴性肝组织进行TTV DNA原位杂交检测,结 果5例均为阴性,二者符合率100%;TTVAg阳性组ALT、AST、TBIL、γ G均值均高于TTVAg阴性组,ALB、PTA 均值均低于TTVAg阴性组,但两组比较差异无统计学意义(P>0.0     

Prognostic index to identify patients who may not benefit from whole brain radiotherapy for multiple brain metastases from lung cancer

Palliative whole brain radiotherapy (WBRT) is often recommended in the management of multiple brain metastases. Allowing for WBRT waiting time, duration of the WBRT course and time to clinical response, it may take 6 weeks from the point of initial assessment for a benefit from WBRT to manifest. Patients who die within 6 weeks (‘early death’) may not benefit from WBRT and may instead experience a decline in quality of life. This study aimed to develop a prognostic index (PI) that identifies the subset of patients with lung cancer with multiple brain metastases who may not benefit from WBRT because of ‘early death’. The medical records of patients with lung cancer who had WBRT recommended for multiple brain metastases over a 10-year period were retrospectively reviewed. Patients were classified as either having died within 6 weeks or having lived beyond 6 weeks. Potential prognostic indicators were evaluated for correlation with ‘early death’. A PI was constructed by modelling the survival classification to determine the contribution of these factors towards shortened survival. Of the 275 patients recommended WBRT, 64 (23.22%) died within 6 weeks. The main prognostic factor predicting early death was Eastern Cooperative Oncology Group (ECOG) status >2. Patients with a high PI score (>13) were at higher risk of ‘early death’. Twenty-three per cent of patients died prior to benefit from WBRT. ECOG status was the most predictive for ‘early death’. Other factors may also contribute towards a poor outcome. With further refinement and validation, the PI could be a valuable clinical decision tool.     

腰椎后路非融合固定系统的临床应用

复习腰椎后路非融合固定系统的设计原理、临床应用及治疗效果等相关文献,与传统的脊柱融合术相比,应用非融合系统可获得很好的疗效,并可以减少邻近节段退变的发生率。     

中医综合疗法治疗腰椎间盘突出症的临床观察

目的：观察中医综合治疗方式对腰椎闻盘突出症的临床治疗效果。方法：对近两年我院329例住院腰椎闻盘突出症患者进行针欠、推拿、牵引、中药等综合治疗。结果：治疗329例，显效108例，好转184例，无效37例，总有效率88．75％。结论：采用中医综合疗法治疗腰椎间盘突出症绝大部分病例明显有效，需要手术治疗的只占很小部分，保守疗法应该是腰椎间盘突出症首选的治疗方法。     

Body mass index and age affect Three-Factor Eating Questionnaire scores in male subjects

This cross-sectional analysis evaluated the effect of age and body mass index (BMI) on Three-Factor Eating Questionnaire scores in males. Subjects (n = 60) were recruited according to BMI status. Each completed the 51-item Three-Factor Eating Questionnaire. The group was split at the median age to produce a “younger” and “older” group for statistical analysis. A 2-way between-groups analysis of variance revealed a significant main effect of BMI on disinhibition (P = .003) and hunger (P = .041) with higher levels found in overweight males compared to healthy-weight counterparts. A significant main effect of age on hunger (P = .046) demonstrated older males were less susceptible to hunger than younger males. These insights provide a better understanding of eating behavior across the male life cycle and may assist health professionals to better guide men in weight management in the light of rising overweight/obesity.     

电针对围绝经期综合征患者Kupperman评分的效应

目的观察电针对围绝经期综合征患者Kupperman评分的效应并分析其可能的作用途径。方法将110例患者随机分为关元组（关元、三阴交）、内关组（内关、足三里）,观察治疗前后Kupperman指数（MI）,分析电针效应及其对各项症状的影响。结果电针治疗1星期后两组MI即较初始下降,并随治疗时间的延长逐周递减,差异有统计学意义（P〈0.01）;电针能显著降低Kupperman指数（P〈0.01）,4星期后关元组评分下降52.6%,内关组下降47.4%,有效率分别为93.6%、85.7%;电针能明显改善围绝经期综合征各类症状（P〈0.05）,各项症状的起效时间从治疗后1星期至4星期不等。但两组间差异不明显（P〉0.05）。结论电针两组精简穴位均能明显降低Kupperman评分,改善围绝经期综合征各类临床症状。     

对诊断PADAM的游离睾酮指数的评估

目的 评价诊断中老年男子部分雄激素缺乏综合征（PADAM）的游离睾酮指数（FTI）.方法 对129例45岁以上健康男性的FTI进行年龄相关分析.以推算的游离睾酮（CFT）值为依据,对FTI进行有效性检验.结果 男子在中老年期FTI与增龄呈明显的负相关.FTI敏感性97.78%,特异性58.33%.结论 计算简单的FTI可用于PADAM病人的筛选和随访,尤其对70岁以上男子是血清FT较为有效的参数.     

Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine

A prospective longitudinal study was performed to evaluate the vertebral body replacement system Synex associated with posterior fixation in unstable burst fractures of the lumbar and thoracic spine. Within 24 months, we treated 28 patients (average age, 41 years; range, 22–64 years; 14 women, 14 men) with acute unstable burst fractures without osteoporosis of the thoracolumbar region (n=16) and the thoracic (n=3) as well as the lumbar (n=9) spine in two stages (primary dorsal transpedicular stabilization and secondary vertebral body replacement). The complications were analyzed and the postoperative follow-up result was evaluated regarding stability, bone fusion, correction loss, pain and neurological status. One patient showed a transient irritation of the lumbosacral plexus and one patient had a superficial wound infection (complication rate, 7.1%). At the follow-up examination (mean follow-up, 13 months) only in two cases a minimal loss of correction (<5°) was measured. Radiologically, 27 patients showed secure bone fusions and all patients had stability of the osteosynthesis. Most of the patients stated no or just slight pain at follow-up. Only two patients with pain to a medium degree had to take painkillers. The vertebral body replacement system Synex seems to be a good alternative for vertebral body replacement in unstable burst fractures of the thoracic and lumbar spine since at present follow-up it shows a high rate of bone fusion and minimal loss of correction.