经皮椎体成形术治疗骨质疏松性椎体骨折疗效观察

目的探讨经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效及应用价值。方法36例骨质疏松性压缩性骨折患者45个椎体，在C型臂X线透视下，取俯卧位，经皮穿刺，在病椎注入聚甲基丙烯酸甲酯。术前及术后3d进行疼痛视觉类比评分（VAS评分），并进行统计学分析。结果治疗后36例患者疼痛较治疗前有明显好转，VAS评分差异有统计学意义（P〈0．001）；活动能力也有不同程度改善；部分椎体的前缘和椎体中部高度有一定恢复。结论经皮椎体成形术治疗骨质疏松性椎体压缩骨折止痛效果明显，能很快改善患者的活动能力，早期下床活动。该手术属微创手术，在骨科临床有一定的应用前景。     

如何预防经皮椎体成形术并发症的临床研究

目的总结经皮椎体成形术（PVP）治疗老年性椎体压缩性骨折的临床效果，探讨在治疗过程中的并发症及注意事项。方法2004年12月至2007年2月开展pvp治疗老年性椎体压缩性骨折42例，男16例，女26例；年龄最小58岁，最大86岁。手术均在C臂X光机监视下完成，术后密切观察及对症治疗。结果42例伤口均为工期愈合，术后腰背部疼痛症状大部分即解除，次日可下床行走。术后X线片复查椎体高度部分恢复，CT片见成形术后的椎体被骨水泥填充并固化。骨水泥外溢4例，其中1例骨水泥外溢到椎管腔，致左侧硬膜明显受压，神经根受伤，导致左下肢瘫痪，骨水泥取出后，左下肢肌力恢复到3级。平均随访10月以上，除1例骨水泥外溢到椎管腔外，41例患者椎体压缩性骨折处无疼痛。结论pvp治疗老年性压缩性骨折损伤小，在技术熟练的基础上治疗是安全的，效果满意，减少了老年性病人伤后长期卧床的并发症。     

The Art of Mammography With Respect to Positioning and Compression—A Swedish Perspective

In 2014, 8,023 women were diagnosed with breast cancer in Sweden. Screening mammography has been shown to reduce mortality in Sweden by 25%. Studies show that mammography examinations vary both in terms of positioning and compression affecting the image quality and the patient's experience of pain. Pain can affect participation in mammography screening. This study aims to describe how radiographers perceive the examination method used in mammography. The study was conducted using qualitative methods. Individual semistructured interviews were made with 13 radiographers working in six different mammography units. The material was analyzed by inductive manifest content analysis. Three main categories were identified: positioning of the patient, positioning of the detector, and compression. A fourth category, compliance, also emerged during the analysis work and was identified by the radiographers as being an important factor to be able to succeed with positioning and compression. The differences in the radiographer's methodology show that more research in technology relating to positioning and compression is needed for evidence-based guidelines.     

Functional testing in lumbar nerve root compression syndromes. An evaluation in patients with normal neurological findings

Summary A functional test using downhill walking was evaluated in relation to the myelopgraphical examination in 33 patients with a suspected lumbar nerve root compression syndrome despite normal neurological findings. Any changes of motor or reflex signs or of straight leg raising were accepted as test results. They were noted in a decision matrix and the positive and negative predictive value (PPV and NPV, respectively) calculated. The PPV of any deterioration of the neurological status resulting from the test as a sign of abnormal myelographical findings was calculated to be approximately 85 per cent, the corresponding NPVs being approximately 50 per cent. In its present form, this functional test is inadequate as a screening procedure in these patients.     

上肢神经卡压646例分析

目的 报道上肢神经卡压手术治疗的临床效果.方法 对646例上肢神经卡压患者行神经松解术或神经受损段切除重新吻合术,术后部分病例给予康复治疗.分析其临床特点、术中表现、治疗方法及预后效果.结果 术后405例经过6个月～3年随访.神经支配区麻木感消失、运动功能正常或接近正常252例,占全部随访病例的62.2%;神经支配区麻木感和运动功能较术前明显改善124例,占全部随访病例的30.6%;神经支配区麻木感和运动功能无改善或较术前加重29例,占全部随访病例的7.2%.经过规范性康复治疗134例中有121例获得随访,神经功能获得改善率为93%.结论 上肢神经卡压后,患肢感觉、运动功能丧失程度为手术方式提供参考,与神经恢复效果密切相关,应加强和重视术前对受损神经感觉、运动功能丧失程度的评估;术后系统的康复治疗对患肢畸形的发生有良好的预防作用,并且对神经功能的恢复具有促进作用.     

内镜图文网络数据采集处理系统

本文介绍医院内镜中心数字图文网络系统的数据采集及处理过程。     

Internal axonal cytoarchitecture is shaped locally by external compressive forces

The cross-sectional architecture of the axon and the area of its surrounding Schwann cell were quantified at selected histological regions along the length of avian myelinated axons. The number of neurofilaments (NFs), the density of NFs, axoplasmic area, and Schwann cell cross-sectional area were measured. These parameters were examined at Schmidt-Lanterman (S-L) clefts, at paranodal-nodal regions, and at regions of compact myelin Schwann cell nuclei. The results were then compared with the same parameters in adjacent compact myelinated regions of the same axons. At S-L clefts, paranodal-nodal regions, and Schwann cell nuclei, the axonal areas were smaller and the NF densities were higher than at compact myelinated regions. From other studies, it has been suggested that NF organization is responsive to local compressive forces — NF packing density tends to increase with increasing compression of the axon. We found that the NF packing densities were relatively small and the axon diameters were relatively large in the compact myelinated regions; this result suggests that in these axonal regions external constraints on axonal architecture are minimal. The higher NF packing densities and smaller axon diameters in the other histological regions suggest that external compressive effects on the axon increase in the following order: simple compact myelin < Schwann cell nucleus < S-L cleft < paranodal-nodal region. Ultrastructural comparisons of these 4 histological regions show that the Schwann cell cross-sectional areas differ reproducibly, and this is consistent with the idea that variations in the organization of extra-axonal elements that envelop the axon produce different amounts of physical constraint on the axon and that this can affect the amount of external pressure on the internal architecture of the axon.     

成都市农村老年人椎体压缩性骨折患病情况及其影响因素

目的　本文旨在调查成都地区农村老年人椎体骨折的流行病学情况及其影响因素。方法　以居住在成都地区具有正式户口 ,年龄在 5 0～ 89岁的农村人群为调查对象 ,进行随机抽样。对每名受试者行胸腰椎侧位摄片。若楔形指数 (椎体前缘 /后缘 )≤ 0 .8,即诊断为压缩性骨折 ,统计椎体骨折的患病情况。结果　成都地区农村老年人随年龄增加 ,椎体骨折的患病率逐渐增高 ,,椎体骨折以中胸段 (T6～ 8)及胸腰段交界区 (T11～L2 )最易发生 ,男性总体患病率2 7 9% ,女性总体患病率 17 75 % (P <0 0 5 ) ,男性椎体骨折在 6 0～ 6 9岁出现跳跃性增长。