椎间撑开解剖复位对于退变性腰椎滑脱症价值的前瞻性比较研究

目的:通过前瞻性研究评价椎间撑开解剖复位对于退变性腰椎滑脱症价值。方法:2006年1月~2009年12月,对56例退变性腰椎滑脱症(II度以上)患者均施行经后路椎体间融合术(poster ior lumbar interbody fusion,PLIF),但随机选择是否在术中进行解剖复位的操作,复位组30例,对照组26例,随访时比较两组病例的影像学、JOA功能障碍评分及并发症。结果:56例均获得13~46个月(平均32月)随访。复位组的影像学结果及最终融合率均优于对照组(P<0.01)。末次随访时,两组患者都有较高的JOA功能障碍评分,复位组略优于对照组(P<0.01)。复位组和对照组的并发症发生率分别为10%和23.1%。结论:经后路椎体间融合术治疗退变性腰椎滑脱症术中进行解剖复位可以获得更为理想的影像学结果、植骨融合及生活质量。     

血管淋巴样增生伴嗜酸性粒细胞增多症临床病理观察

目的：探讨血管淋巴样增生伴嗜酸性粒细胞增多症(angiolymphoid hyperplasia with eosinopilia, ALHE)的临床病理学特征、免疫组织化学染色(immunohistochemical stain,IHC)及鉴别诊断。方法：对3例ALHE进行临床病理分析及免疫组化研究,并进行文献复习。结果：2例ALHE为女性患者,1例为男性患者,病变位于头面部真皮内,组织形态以小到中等大小血管增生为主,血管内衬胞浆丰富的上皮样内皮细胞,血管周围见大量炎细胞浸润。免疫组化染色显示CD34、CD31、CD3阳性,CD20及CK阴性。结论：ALHE是一种少见的、良性的血管瘤,诊断主要依靠特征性组织学特点。     

泌尿外科腔镜术后尿源性脓毒血症的预后影响因素分析

目的:探讨影响泌尿外科腔镜手术后尿源性脓毒血症的预后因素,改善尿源性脓毒血症的预后.方法:回顾性分析57例泌尿外科腔镜手术后尿源性脓毒血症的患者资料,并按照严重程度分为低危组和高危组,比较按照临床资料特征、化验结果的区别.结果:在57例脓毒血症患者中,高危组24例,低危组33例,在性别构成(男/女)、术前尿路感染方面,高危组明显高于低危组,两组间差异有统计学意义.在手术方式方面,高危组患者中输尿管镜手术比例明显高于低危级,而经皮肾镜比例明显低于低危组,两组间差异有统计学意义.手术时间方面,高危组明显长于低危组,两组间差异有统计学意义.术后血白细胞、中性粒细胞、C反应蛋白、多脏器功能障碍发生率、血培养阳性率方面,高危组高于低危组,而术后至出现脓毒血症症状时间间隔(手术-感染时间)、血小板、血红蛋白、纤维蛋白原方面低于低危组,两组间差异有统计学意义.结论:男性、术前存在尿路感染、合并糖尿病、输尿管镜手术、手术时间过长是尿源性脓毒血症预后不良的因素;术后血中性粒细胞比例明显升高、C反应蛋白升高、发生多脏器功能障碍、血培养阳性、手术-感染时间短、血小板下降、血红蛋白下降、纤维蛋白原降低是预后不良的指标.     

Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

OBJECTIVE:To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group.METHODS:Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group.RESULTS:In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM) of C3–7 in all directions in the non-fusion group compared with the intact group (p>0.05), but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05). The ROM of adjacent segments (C₃₋₄, C₆₋₇) of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05). Significant differences in the C_4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C₄₋₆ ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01). The stability index ROM (SI-ROM) of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C₄₋₆ segment of the non-fusion group compared with the fusion group.CONCLUSION:An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be considered in future studies.     

In vivo anti-plasmodial activities and toxic impacts of lime extract of a combination of Picralima nitida,Alstonia boonei and Gongronema latifolium in mice infected with Chloroquine-sensitive Plasmodium berghei

Background

Lime extracts of powdered combination of seeds of Picralima nitida, stem bark of Alstonia boonei and leaves of Gongronema latifolium is a common remedy used in the treatment of malaria in South Western Nigeria.

Objective

To determine the antiplasmodial activities of the combined herbal extracts and its impact on the haematological, hepatological and renological parameters in mice.

Methods

The 4-day suppressive and curative tests were used to assess the antiplasmodial activities of the extract in mice infected with chloroquine-sensitive Plasmodium berghei at concentration of 200mg/kg, 400mg/kg and 800mg/kg body weight. The haematological parameters including red blood cells, white blood cells, packed cell volume and haemoglobin count were analysed with an auto analyser. The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were determined, while urea, protein and creatinine were analysed by standard procedural methods.

Results

The 4-day suppressive test revealed that the test extract achieved percentage suppression of 39.0%, 41.6% and 54.68% for the 200mg/kg, 400mg/kg and 800mg/kg concentration respectively. Additionally, the curative test achieved a high percentage suppression of 80.97%, 83.84% and 86.16% at the 200mg/kg, 400mg/kg and 800mg/kg concentration respectively. The extracts did not induce significant change on haematological parameters (P>0.05), while significant elevation in the values of the ALT and AST (P<0.05) was observed and elevation of creatinine (P<0.05) at 800mg/kg.

Conclusions

The results support the traditional use of the herbal combination in the treatment of malaria, however the liver cells were impacted by the extracts in bioassay conducted with mice.     

Does parents' socio-economic status matter in intentions of vaccinating against human papillomavirus for adolescent daughters?

BackgroundThe Human Papilloma Virus (HPV) vaccination provides substantial protection, and it is best to be taken before the age of twelve. Taiwan approved HPV vaccines since 2006. However, very few female adolescent have been vaccinated until now.ObjectivesTo examine whether the parents'' socio-economic status matters in deciding to purchase HPV vaccination for their daughters based on the theory of planned behavior.MethodA structured questionnaire to collect 394 responses from parents of adolescent girls in Taiwan. Data was coded to categorize relevant socio-economic classes, and was analyzed with SPSS.ResultsThe behavior intentions of parents with low (mean= 5.28) and high (5.01) socio-economic status are significantly stronger than the moderate (4.56) in deciding to purchase the HPV vaccination. Socio-economic factor has a slightly negative impact (B= -0.08), and attitude (0.68), subjective norms (0.16), and behavior control (0.32) have positive impacts on the parents'' intention.ConclusionMajor impacts on the decision to purchase an HPV vaccination for their adolescent was not due to the parents'' socio-economic status but the parent''s attitude. As the major predictor of a less complicated decision, attitudes toward the HPV vaccination should be reinforced through continuous communications between service providers and patient-advocate groups.     

慢性乙型肝炎患者病理舌苔与血清HBV DNA含量、肝脏HBcAg蛋白表达的关系

目的：通过对慢性乙型肝炎（CHB）患者病理舌苔与血清HBV DNA含量、肝脏HBcAg表达的研究,揭示CHB患者病理舌苔与病毒复制的关系,为临床宏观望舌诊病,以外揣内提供理论指导。方法：B超引导下肝脏穿刺,免疫组化法检测CHB患者肝脏HBcAg蛋白表达;荧光定量PCR（FQ-PCR）技术检测CHB患者血清HBV DNA含量。结果：①黄腻苔和白厚苔组CHB患者血清HBV DNA含量最高,与薄白苔组相比,差异有统计学意义（P〈0.05）。薄白苔组HBV DNA病毒复制以少量（〈105copies/ml）为主（P〈0.01）。②黄腻苔和白厚苔组CHB患者肝组织HBcAg阳性细胞率明显高于薄黄苔和薄白苔组（P〈0.01）,其肝细胞HBcAg分布形态以浆膜型和混合型为主（P〈0.05）;薄白苔组以单纯核型为主（P〈0.01）。结论：CHB患者其舌苔厚薄与病毒载量有一定关系,血清HBV DNA含量高者,肝脏HBcAg阳性细胞率亦较高。     

慢性神经根型颈椎病动物模型的建立

[目的]通过模拟慢性颈椎间盘退变及关节突关节双重退变,建立慢性神经根型颈椎病的动物模型。[方法]将48只SD大鼠分层随机分为两组:模型组、假手术组。观察大鼠行为学变化,并分别于术前1 d、术后29 d拍颈椎X线片侧位片,观察椎间盘退变的情况;术前1 h、术后29 d后分别测定右侧臂丛神经的感觉神经传导速度和运动神经传导速度;记录神经电生理变化。[结果]该模型可以出现明显椎间盘变化及神经功能传导损伤的变化。[结论]模拟慢性颈椎间盘退变及关节突关节双重退变的动物模型可以对神经根型颈椎病(慢性期)加以反映。