颈椎损伤合并截瘫100例总结

本文回顾我院20年来所收治的100例颈椎损伤合并截瘫伤员,试图对诊断和处理方法上若干主要问题提出探讨。     

Intracranial trajectories of sympathetic nerve fibers originating in the superior cervical ganglion in the rat: WGA-HRP anterograde labeling study

Intracranial trajectories of sympathetic nerve fibers originating in the superior cervical ganglion (SCG) in the rat were investigated by means of anterograde labeling following the injection of wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) into the unilateral SCG. The trajectory of the sympathetic fiber innervating the pineal gland and its continuing structures was found advancing along the abducent nerve, through the cavernous plexus, then along the trochlear nerve. Labeled sympathetic fibers showed two patterns of distribution in the blood vessels on the basal surface of the brain. The sympathetic fibers originating in the unilateral SCG were intermingled with those fibers from the contralateral SCG in the pineal gland, its continuing structures and the choroid plexus of the third ventricle as well as in the cerebral blood vessels.     

宫颈癌细胞增殖和DNA倍体与放射敏感性的关系

为研究宫颈癌细胞增殖参数 S期比例 (SPF)、增殖指数 (PI)和 DNA倍体与宫颈癌放射敏感性的关系 ,探讨它们在预测宫颈癌放射敏感性中的价值。对 4 7例宫颈癌患者放疗前行宫颈癌组织取材 ,进行流式细胞术分析 ,在放疗过程中每周测量 1次宫颈局部瘤床的大小 ,计算肿瘤消退 1/ 2所需照射剂量 (D0 .5 ) ,研究 SPF、PI和 DNA倍体与D0 .5之间的关系。结果显示 :SPF与 D0 .5呈正相关 (r=0 .6 0 4 ,P<0 .0 1) ,PI与 D0 .5无明显关系 ,DNA倍体对 D0 .5的影响有显著性意义 (P<0 .0 5 )。提示 :宫颈癌细胞放疗前 SPF和 DNA倍体与放射敏感性有关 ,该两项指标有可能成为宫颈癌放射敏感性的预测指标     

Value of polydirectional tomography in the assessment of the postoperative spine after anterior decompression and vertebral body autografting

With the growing number of orthopedic reconstructive spinal procedures, the use of bone grafting has steadily increased in the past decade. An understanding of the biology of bone grafting is essential for both the clinician and radiologist. Despite the advent of computed tomography and magnetic resonance imaging, conventional polydirectional tomography remains an important tool in the evaluation of vertebral body autografts. Trispiral or hypocycloidal tomography plays a valuable role in the assessment of bone graft fusion and possible complications, especially in the presence of metallic fixation devices. We present our imaging experience derived from 375 patients with cervical, thoracic, or lumbar anterior spinal fusion. True graft complications occurred in 27 patients (7%) and consisted of fracture (4%), malpositioning (3%), and infection (<1%).     

Automated assessment of cervical dystonia.

We developed an automated and objective method to measure posture and voluntary movements in patients with cervical dystonia using Fastrack, an electromagnetic system consisting of a stationary transmitter station and four sensors. The junction lines between the sensors attached to the head produced geometrical figures on which the corresponding aspects of the head were superimposed. The head position in the space was reconstructed and observed from axial, sagittal, and coronal planes. Four patients with cervical dystonia and 6 healthy subjects were studied. Each patient was representative of one of the typical patterns of cervical dystonia. The study allowed the authors to collect quantitative data on posture and range of motion of the head. This pilot study demonstrates the efficacy of the Fastrack system to objectively measure the head position in cervical dystonia patients.     

胃肠富集kruppel因子GKLF在宫颈鳞癌中的表达及意义

目的　探讨胃肠富集kruppel因子 (GKLF)在宫颈鳞癌组织及正常宫颈组织中的表达及意义。方法　应用半定量的逆转录聚合酶链式反应 (RT -PCR)方法检测 32例宫颈鳞癌组织 (研究组 )中GKLFmRNA的表达强度 ,以 10例正常宫颈组织作为对照 (对照组 )。结果　GKLFmRNA在正常宫颈组织中的表达强度为 0 .76± 0 .15 ,而在宫颈鳞癌中的相对表达强度为 0 .4 2± 0 .19,与正常宫颈组织相比较 ,宫颈鳞癌组织中GKLFmRNA的表达丰度较低 (P <0 .0 5 )。而且临床分期愈晚 ,GKLFmRNA的表达强度愈低 ,差异有显著性 (P <0 .0 5 )。随着病理分级增高 ,GKLFmRNA的表达强度逐渐降低 ,差异有显著性 (P <0 .0 5 )。结论　宫颈鳞癌组织中GKLF表达下调 ,而且GKLFmRNA的表达与宫颈癌的临床分期和病理分级呈负相关 ,提示GKLF可能参与了宫颈癌的发生或进展过程     

凋亡相关蛋白Apr-2的克隆、测序及初步表达

目的: 从HL-60细胞凋亡模型中克隆凋亡相关蛋白Apr-2编码区基因,并对其进行表达,为进一步研究Apr-2的结构功能及多克隆抗体的制备奠定基础.方法: 建立HL-60细胞凋亡模型,提取HL-60凋亡细胞总RNA,以RT-PCR方法获取Apr-2 cDNA编码区全序列,将其与PGEM-T Easy载体连接,转化E.coli DH5α,构建重组克隆载体PGEM-TEasy/apr-2,测序正确后,将目的片段亚克隆入PGEX-4T-2原核表达载体,并转化大肠杆菌, IPTG诱导重组蛋白质表达,分析蛋白质在细菌中的表达分布,进行凝胶自动扫描分析. 结果:序列分析表明,与GenBank中已登录的Apr-2 cDNA编码区序列比较,完全一致.表达的融合蛋白占菌体总蛋白质的40%以上,主要以包涵体的形式存在. 结论:成功的获得了细胞凋亡模型HL-60中Apr-2 cDNA编码区的克隆及其融合蛋白表达产物.     

后路肿瘤摘除固定融合一期手术治疗颈椎椎管内肿瘤

目的探讨经后路全椎板切除摘除椎管内肿瘤,同时行颈椎侧块或椎弓根内固定植骨融合治疗颈椎椎管内肿瘤的临床疗效. 方法采用该手术方法治疗颈椎椎管内肿瘤8例. 结果所有患者术后早期(3周以内)可下床活动,无一例出现眩晕、颈痛、头痛等颈椎不稳的表现.随访6个月～2年未见后凸畸形发生,颈椎活动不受限制,内固定物无松动断裂. 结论经后路全椎板切除同时行经颈椎侧块或椎弓根内固定植骨融合治疗颈椎管内肿瘤,能够维持手术后颈椎的稳定性,防止远期后凸畸形的发生.     

经关节突入路椎间融合椎弓根固定治疗峡部裂性腰椎滑脱

目的 评价经关节突入路手术治疗峡部裂性腰椎滑脱的应用价值。方法 2000年 9月 ~2003年 5月我院手术治疗峡部裂性腰椎滑脱患者 83例,随访患者 81例,年龄(55. 25±19. 21)岁,随访时间 (1. 68±0. 93)年。按照不同的手术入路方法分为两组,Ⅰ组经关节突入路,椎间融合椎弓根固定;Ⅱ组经椎板切除入路,椎间融合椎弓根固定。按各组术中的临床出血量、手术时间、术前和术后JOA评分等数据经SPSS11. 5统计软件处理数据。结果　术后采用Stauffer Coventry下腰椎术后疗效评定标准:临床优良率分别为 87%与 75%;术后神经功能改善率分别为 87. 81%与62. 88%。术后均无螺钉松动、断裂或者滑脱加重等并发症,有 3例假关节形成。结论　在峡部裂性腰椎滑脱的患者的手术治疗中,经关节突入路椎间融合椎弓根固定技术具有良好的临床效果。