腰椎间盘突出症合并椎管狭窄23 例治疗分析

目的探讨经后路椎间盘镜手术治疗合并腰椎管狭窄症的椎间盘突出症的临床应用。方法采用后路椎间盘镜进行单侧开窗减压术。通过术前标记腰椎正侧位片定位，于定位棘突间隙后正中偏患侧作长约1.5 cm小切口，逐级扩张后置入工作通道管，钻除部分椎板，置入内窥镜，于电视监视器下显露椎板、增生内聚的关节突、肥厚的黄韧带及突出的椎间盘髓核组织，彻底解除其对硬脊膜、神经根的压迫。结果本组共治疗合并腰椎管狭窄症的腰椎间盘突出症23例，平均随访7个月，按Prolo标准评定，治愈20例，有效2例，无效1例。结论本术式在严格掌握适应证前提下对合并腰椎管狭窄症的腰椎间盘突出症患者效果明显。     

椎管内神经鞘膜肿瘤的MRI

本文总结了椎管内神经鞘膜肿瘤的MRI表现并与病理结果进行了对照。MRI诊断准确率为82.6％。哑铃征及弄清脊髓与肿瘤的关系是MRI诊断椎管内神经鞘膜肿瘤的要点,本组病例哑铃征出现率为42.1％。但椎管内神经鞘膜肿瘤的MR信号变化与脊膜瘤和室管腆窟无法区分。     

脐血胆红素与新生儿黄疸的关系

对海拔1,100米地域出生的144例新生儿,进行了脐血胆红素及新生儿黄疸的研究。脐血胆红素与血清胆红素间差异非常显著(P<0.001)。生后4日内所有新生儿均出现了黄疸。脐血胆红素水平愈高,黄疸出现得愈早(P<0.001)。新生儿重症黄疸(血清胆红素≥205μmol/L)显然与脐血胆红素水平(≥40μtmol/L)有关(P<0.005)。以脐血胆红素预测新生儿重症黄疸,其敏感性为64.7%,特异性为75.6%。     

脐血单核细胞对VD大鼠认知功能及脑组织BDNF的影响

目的观察颈内动脉输注脐血单核细胞(Human cord blood mononuclear cells,HCMNCs)对血管性痴呆(Vascular dementia,VD)大鼠认知功能及脑组织脑源性神经营养因子(Brain-derivedneurotrophicfactor,BDNF)含量的影响。方法改良Pulsinellis四血管阻断法建立VD大鼠模型;体外分离HCMNCs,术后24h颈内动脉输注数量为3×106/0.5ml的BrdU标记细胞;利用穿梭箱系统和ELISA法检测注射HCMNCs后2、4、8周VD大鼠学习记忆能力以及脑组织BDNF含量的变化。结果模型组大鼠主动回避反应比率明显低于对照组(P<0.01),治疗组较模型组显著提高(P<0.01)。术后2周模型组大鼠脑组织BDNF含量较对照组明显增高(P<0.01),4周时达到高峰(P<0.01),8周时则明显下降,与2周时相比有显著性差异(P<0.05);颈内动脉输注HCMNCs后治疗组大鼠脑组织BDNF含量较模型组显著升高(P<0.01),4周时最高(P<0.01),8周时略有下降,但仍维持在较高水平,与4周时相比无显著性差异(P>0.05)。结论颈内动脉输注HCMNCs可显著改善VD大鼠学习记忆能力,增加VD大鼠脑组织BDNF含量,具有脑保护作用。     

转TrkC基因神经干细胞移植对脊髓损伤的治疗作用

目的 研究转酪氨酸激酶C（tyrosine kinase C，TrkC）基因神经干细胞（neural stem cells，NSCs）移植治疗脊髓损伤的作用。方法 60只SD大鼠随机分成正常对照组（A组）、脊髓半切组（B组）、NSCs移植组（C组）、NSCs移植＋神经营养素（NT）-3局部使用（D）组、转TrkC基WNSCs移植组（E组）和转TrkC基因NSCs移植＋NT-3局部使用组（F组），每组10只。脊髓损伤后第9天进行细胞移植。各组大鼠在细胞移植后2个月，行体感诱发电位（SEP）和运动诱发电位（MEP）检查以及脊髓运动功能（BBB）评分。结果 细胞移植后2个月SEP和MEP发生潜伏期和峰峰波幅以及右后肢BBB评分的恢复均以下组最佳，与其他各组比较，差异有统计学意义（P＜ 0．05，0．01）。结论在局部给予的NT-3作用下，转TrkC基因NSCs能较好地促进损伤脊髓功能的恢复。     

Time for sport and health to be formally linked in a positive way

Preventing sports injury has rarely been cited as an appropriate action to respond to the obesity epidemic, and in fact a recent letter has suggested that those playing sport are as responsible for their predicament as those who are obese. This opinion piece argues that it is time for better prevention and management of sports injury to be seen as part of the complex solution to preventing obesity, rather than being a self-inflicted problem that governments should continue to ignore.     

无水酒精阻滞大鼠腹腔神经丛后脊髓、孤束核C-FOS和NOS-1的表达

目的:通过免疫组化的方法研究无水酒精阻滞大鼠腹腔神经丛后脊髓和延髓孤束核内CFOS和NOS1的表达。材料和方法:对70只Wistar大鼠实施手术,建立实验动物模型。分5组于术后不同时间取得脊髓和延髓样本,并用标准方法对其进行CFOS和NOS1免疫组化染色,观察脊髓和延髓孤束核CFOS和NOS1的表达。结果:无水酒精阻滞后脊髓后角、延髓孤束核神经元细胞内均有CFOS和NOS1表达。结论:无水酒精阻滞腹腔神经丛后,短时间内脊髓后角和延髓孤束核内CFOS和NOS1表达阳性,表明FOS和NOS1与内脏信息在脊髓水平的传导有关。CFOS和NOS1参与了内脏信息在孤束核内的传导。     

Soma size and oxidative enzyme activity in normal and chronically stimulated motoneurones of the Cat''s spinal cord

In normal adult cats we measured the density of staining for the activity of succinate dehydrogenase (SDH staining) in ventral horn cells of different sizes. The measurements were restricted to that part of the lumbar ventral horn (L6-L7) which is known to contain motoneurones of the peroneal nerve. A statistically significant tendency was found for the SDH staining to be denser in smaller than in larger neurones within the size range of a motoneurones (soma diameter greater than 40 microns). These results are consistent with recently published evidence for ventral horn cells of rats and qualitatively similar relationships between size and SDH staining have also been observed among skeletal muscle fibres (confirmed for mixed muscle of cat in present study). In hindlimb muscles, size as well as SDH staining are known to be markedly activity-dependent. We tested whether this is the case for peroneal motoneurones as well by analyzing the effects of chronic nerve stimulation on the properties of neurones within the appropriate region of the ventral horn. Prior to the final acute experiment, these cats had been subjected to a left-side dorsal rhizotomy and hemispinalization. By aid of a portable mini-stimulator, the left-side common peroneal nerve was activated by repetitive pulses during 50% of total time per day (intra-activity rate: 10, 20 or 40 Hz). After 8 weeks of such treatment, cell sizes as well as the densities of SDH staining showed hardly any differences between peroneal ventral horn cells of the experimental and control sides of the spinal cord.(ABSTRACT TRUNCATED AT 250 WORDS)     

Spinal canal narrowing during simulated frontal impact

Between 23 and 70% of occupants involved in frontal impacts sustain cervical spine injuries, many with neurological involvement. It has been hypothesized that cervical spinal cord compression and injury may explain the variable neurological profile described by frontal impact victims. The goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to quantify canal pinch diameter (CPD) narrowing during frontal impact and to evaluate the potential for cord compression. The biofidelic model and a sled apparatus were used to simulate frontal impacts at 4, 6, 8, and 10 g horizontal accelerations of the T1 vertebra. The CPD was measured in the intact specimen in the neutral posture (neutral posture CPD), under static sagittal pure moments of 1.5 Nm (pre-impact CPD), during dynamic frontal impact (dynamic impact CPD), and again under static pure moments following each impact (post-impact CPD). Frontal impact caused significant (P<0.05) dynamic CPD narrowing at C0-dens, C2-C3, and C6-C7. The narrowest dynamic CPD was observed at C0-dens during the 10 g impact and was 25.9% narrower than the corresponding neutral posture CPD. Interpretation of the present results indicate that the neurological symptomatology reported by frontal impact victims is most likely not due to cervical spinal cord compression. Cord compression due to residual spinal instability is also not likely.     

足底深支或(和)第一跖背动脉逆行足背岛状皮瓣的临床应用

目的探索足部远端软组织缺损修复的较佳方法。方法采用足底深支或(和)第1跖背动脉逆行足背岛状皮瓣对6例足部远端软组织缺损创面进行修复。结果6例患者均一次性修复,软组织缺损最大面积8cm×6cm,术后随访1~4年,足部功能与外观均较满意。结论足底深支或(和)第1跖背动脉逆行足背岛状皮瓣血管解剖比较恒定,操作简单,是修复足远端软组织缺损的较好方法。