颈椎脱位的闭合复位

1985年5月～1996年3月,我们经治34例单纯颈椎脱位患者,30例行Crutchfield颅骨牵引闭合复位,20例成功,占66.6％。在成功组中,牵引重量最大为18kg,无一例出现神经损害加重。不全瘫均有不同程度恢复。尸体头颅标本测定,Crutchfield颅骨牵引承受的最大抗拨出力为60.3kg,在治疗颈椎脱位时,颅骨牵引是安全有效的闭合复位方法。     

DNA flow cytometry in stage IB and II cervical carcinoma

In a retrospective study the prognostic significance of nuclear DNA content was investigated, as measured by flow cytometry, of the tumor specimens from 212 women with nonpretreated FIGO stage IB and II cervical cancer. One-hundred and thirty cases (62%) were found to be diploid, whereas 82 (38%) were aneuploid. Univariate analysis of the follow-up data showed an increased relative risk (RR) for recurrence free survival (RFS) for stage II tumors (RR = 1.87, 95% CI: 1.13–3.10, P = 0.015) and for age (RR = 1.52, 95% CI: 0.66–3.52 and RR = 2.35, 95% CI: 1.19–4.65, P = 0.032). Ploidy showed a relative risk of 1.33 (95% CI: 0.83–2.13, NS). In addition, univariate analysis of overall survival (OS) revealed similar results. For the subgroup of patients with primary surgery ( n = 151), positive pelvic nodes (RR = 5.38, 95% CI: 2.70–10.71, P = 0.0001) and parametrial extension (RR = 2.53, 95% CI: 1.24–5.17, P = 0.011) were significant factors for OS after univariate analysis, the estimated effects on RFS were slightly smaller. Multivariate analysis of RFS for the whole study population showed age, histologic grade and stage with a slightly increased risk, but no effect was significant. Ploidy with an RR of 0.97 (95% CI: 0.58–1.62) seems to have no influence on prognosis. For the subgroup with primary surgery, ploidy again failed statistical significance with an RR of 1.20 (95% CI: 0.58–2.49). Our results suggest that abnormalities of the nuclear DNA content in this homogeneous group of patients are associated with clinical and morphological prognosticators, however, ploidy is not an independent prognostic factor for RFS, or for the whole study population or for the subgroup with primary surgery.     

对神经根型颈椎病CT扫描的价值探讨

对50例神经根型颈椎病的CT征象进行了分析,并与X线平片加以比较。认为CT不仅在神经根型颈椎病的诊断中具有独特作用,而且在确定手术方法和手术途径的选择上也很有意义。作者认为在CT机还没有普及的情况下,摄一张良好的钩椎关节放大斜位片或椎间孔断层片对诊断神经根型颈椎病应是首选的。CT和X线平片相结合,综合分析,更有价值。     

The lumbar and lumbosacral facet-syndrome. Diagnostic measures,surgical treatment and results in 119 patients

Summary The authors present their diagnostic and therapeutic protocol as well as the surgical outcome in a series of 119 patients with the lumbar facet syndrome.By use of different surgical techniques such as translaminar screw fixation (n=56), Louis plate fixation (n=36), Cotrel-Dubousset instrumentation (n=11) and soft system stabilization according to Graf (n=14) excellent, good, satisfactory, moderate and poor results were obtained in 78 (67%), 20 (17%), 14 (12%), 4 (3%), and 1 (1%) instances, respectively.     

Mivacurium in infants and children

Mivacurium is the only available short-acting nondepolarizing muscle relaxant in clinical use. It is a bis-quaternary benzylisoquinolinium ester hydrolysed by plasma-cholinesterase into inactive compounds. The ED₅₀ and ED₉₅ in children are about 50 μg·kg^?1 and 90 μg·kg^?1 respectively. In infants, they have a tendency to be lower. A standard intubating dose of 0.25 mg·kg^?1 causes complete neuromuscular depression in 1.5–2 min, recovery to 5% in 6–10 min, and complete recovery in 15–20 min. The recent tendency is to use 0.3 mg·kg^?1 to obtain better intubating conditions with slight prolongation of effect. Since the recovery profile of mivacurium is independent of the dose and duration, it is most suitable for administration by continuous infusion. The infusion requirement in children is 10–16 μg·kg^?1 min^?1, which is about twice that of adults. Cutaneous flushes from histamine release are commonly seen with the larger doses of mivacurium; however, the associated hypotensive effects are minimal and counteracted by the tracheal intubation. The duration of action of mivacurium is prolonged in patients with cholinesterase deficiency. Mivacurium's neuromuscular effects can be satisfactorily antagonized by edrophonium or neostigmine.     

活血化瘀法治疗髌骨软骨软化症的探讨

本文从髌骨软骨软化症的病因病理出发，阐述了活血化瘀疗法治疗髌骨软骨软化症的作用及其原理，列举了活血化瘀法在该病治疗中的具体运用，同时强调了在辨证施治基础上活血化瘀的重要性。     

Hemorrhagic fever with renal syndrome virus infection in livers studied by in situ hybridization and immunohistochemistry

ＨｅｍｏｒｒｈａｇｉｃｆｅｖｅｒｗｉｔｈｒｅｎａｌｓｙｎｄｒｏｍｅｖｉｒｕｓｉｎｆｅｃｔｉｏｎｉｎｌｉｖｅｒｓｓｔｕｄｉｅｄｂｙｉｎｓｉｔｕｈｙｂｒｉｄｉｚａｔｉｏｎａｎｄｉｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｓｔｒｙＹａｎｇＳｈｏｕｊｉｎｇ（杨守京）；Ｌ...     

宫腔镜电切术治疗宫颈肌瘤的临床应用

目的 :探讨应用宫腔镜电切术治疗宫颈肌瘤的临床应用价值。方法 :用宫腔镜电切术切除宫颈肌瘤3 7例 ,其中有蒂宫颈肌瘤 2 1例 ,无蒂内突型宫颈肌瘤 16例 ,术后随访 3～ 3 1个月。结果 :平均手术时间2 0 7min ,术中平均出血 2 0 5ml ,一次性治愈率达 10 0 % ,无 1例子宫穿孔、低钠血症、周围脏器损伤、感染及宫颈管粘连等并发症发生。结论 :治疗宫颈肌瘤首选宫腔镜电切术 ,它具有治愈率高、创伤小、恢复快、并发症少的特点。     

纤维组织粘合剂的实验研究

本文应用“冷沉淀”法制备纤维组织粘合剂。对纤维组织粘合剂中主要成份和含量进行了测定,并测定了主要理化性质,建立了动物实验模型,观察了实验兔对纤维粘合剂的反应。     

Anterior lumbar fusion using a hybrid interbody graft

Summary This is a radiographic report of 40 patients (20 men, 20 women) who underwent anterior lumbar interbody fusions (73 levels) utilizing a “hybrid” interbody graft composed of femoral cortical allograft (FCA) bone and iliac crest cancellous autograft bone. The average age at surgery was 38 years (range 17–64 years), and follow-up averaged 1.4 years (range 1.0–2.4 years). Nineteen of the patients had undergone previous lumbar surgery. Thirty-two patients (63 levels) underwent anterior fusion combined with some type of posterior fixation, and eight patients (10 levels) had no posterior fixation. Types of posterior fixation included: for 20 patients (36 levels) Steffee variable screw placement fixation, for 10 patients (23 levels) translaminar facet screws (TFS), for 1 patient (3 levels) Knodt rods and for 1 patient (1 level) facet screws. Based on the persistence of lucent lines at the graft-host interface, three patients (one level each) were felt to have non-unions at their latest follow-ups at 1.4, 1.5 and 2.0 years, respectively. Two of these patients had no posterior fixation, and the other had TFS fixation. The overall fusion rate was 96% (70 of 73 levels). The fusion rate for all levels treated with posterior fixation was 98% compared with 75% for those without fixation. Intervertebral disc heights (IVDH) were measured on all films and corrected for magnification with computer assistance. On average, the IVDH was increased postoperatively but returned to preoperative values at follow-up. IVDH loss was independent of the type of instrumentation used. No complications arose from the use of the hybrid graft. Incorporation of the allograft portion of the graft is slow and was felt to be complete in only 7 of the 73 levels at follow-up. We conclude that the hybrid interbody graft technique is a safe and reliable method for performing anterior lumbar interbody fusions and should be combined with some type of posterior fixation. Long-term follow-up will be required to assess the behaviour of the allograft until incorporation is complete.