脊柱-骨盆矢状位参数与椎体压缩骨折预后的相关性

目的探讨脊柱-骨盆矢状位参数与椎体压缩骨折预后的相关性。方法 2013年3月至2018年3月,选择诊治的骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)患者258例,所有患者都给予经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗,记录所有患者的预后,测量脊柱-骨盆矢状位参数变化情况并进行相关性分析。结果所有患者都顺利完成手术,无术中术后严重并发症发生;手术时间为(67.20±10.33)min,术中出血量为(20.1±6.92)mL,术后住院时间为(6.20±0.67)d。术后1个月、术后3个月患者的Cobb角与Beck指数与术前1 d对比差异有统计学意义(P0.05),术后3个月的总有效率为94.2%。术后3个月患者PT、PI、LL值都显著低于术前1 d(P0.05)。Pearson相关分析显示患者的PT、PI、LL变化值与Cobb角、Beck指数、总有效率都有显著相关性(P0.05)。结论经皮椎体成形术治疗骨质疏松性椎体压缩骨折具有很好的应用有效性与安全性,手术前后脊柱-骨盆矢状位参数变化与患者预后有显著相关性。     

周期性牵张椎间盘纤维环细胞肌动蛋白骨架的重排

BACKGROUND: When the intervertebral disc is under stress, the hydraulic pressure generated inside the nucleus pulposus makes the annulus fibrosus extend outward and expand, and the annulus collagen fibers are stretched so that the extracellular matrix of annulus fibrosus cells is also under the pressure. In the intervertebral disc, aggrecan is the main component of proteoglycans, matrix metalloproteinase-2 is a major enzyme for extracellular matrix degradation, and tissue inhibitor of metalloproteinase is a multifunctional specific inhibition factor for matrix metalloproteinase activity. There is a mutual regulation between the latter two to keep the homeostasis between them. OBJECTIVE: To investigate the mechanism of cyclic tensile strain in the metabolism of intervertebral disc annulus matrix. METHODS: Rat anulus fibrosus cells were subjected to 2% or 10% cyclic tensile strain at 1.0 Hz for 2 and 12 hours using Flexcell4000 tension system. Then cells were collected and cultured in conditioned medium for gene and protein detection. Real-time quantitative PCR was used to detect mRNA expression of aggrecan, matrix metalloproteinases-2 and tissue inhibitor of metalloproteinase-2. Gelatin zymography was used to detect matrix metalloproteinases-2 activity. RESULTS AND CONCLUSION: The use of 2% cyclic tensile strain had no obvious effect on the stress fiber of actin cytoskeleton, whereas actin cytoskeleton was depolymerized in response to 10% cyclic tensile strain. The 2% cyclic tensile strain raised the expression of Aggrecan at 12 hours; whereas raised the matrix metalloproteinases-2 and tissue inhibitor of metalloproteinase-2 at 2 hours, both of which were in homeostasis; matrix metalloproteinases-2 activity had no significant changes. 10% cyclic tensile strain had no effect on the mRNA expression of Aggrecan. No matter stretching 2 or 12 hours, the matrix metalloproteinases-2 was up-regulated, and the tissue inhibitor of metalloproteinase-2 was down-regulated, both of which were not in balance. Moreover, the matrix metalloproteinases-2 activity was not significantly changed. These findings indicate that the mRNA expressions of Aggrecan, matrix metalloproteinases-2 and tissue inhibitor of metalloproteinase-2 alter in response to cyclic tensile strain in rat anulus fibrosus cells, and the tensile strain induces different mechano-responses in the actin cytoskeleton.      

固相萃取高效液相色谱法测定人血浆中齐多夫定浓度

 目的建立测定人血浆中齐多夫定浓度的固相萃取反相高效液相色谱测定法,为临床齐多夫定的药物浓度测定和药动学研究提供科学的分析技术.方法采用ZORBAX ODS色谱柱,以乙腈:20mmol/L的KH2PO4缓冲液(含10 mmol/L辛烷磺酸钠,pH 3.0)=25:75为流动相,阿普比妥为内标,流速1 ml/min,检测波长265 nm,进样量:20μl;血浆样品经固相萃取后直接进样.结果该法线性范围为50～2 000 ng/ml,回归方程为Y=196.2X+12.24,r=0.9996(n=6),最低检测浓度为12ng/ml,日内、日间相对标准差(Relative standard deviation,RSD)均小于5.0%.结论本法简便灵敏,专一性好,适用于临床齐多夫定血药浓度测定和人体药动学研究.     

抗凝药物致脑出血18例治疗体会

<正>近年来,由于抗凝药物(本文所指抗凝药物除特别说明外,均指广义上的抗凝药物)在心脏疾病和脑梗死治疗中的广泛应用,特别是在介入手术和人工心脏瓣膜移植后的大剂量应用,由其所引起的脑出血的病例也呈明显增多的趋势。     

开展药物咨询服务工作的体会

分析药物咨询服务的重要性,介绍工作要求,咨询内容,操作方法,案例分析。通过药物咨询服务,可以减少医疗差错,提高用药的合理性,安全性,有效性,改善患者用药的依从性。     

青蒿素及其衍生物的药理作用

青蒿素及其衍生物是我国科学工作者研究开发的一类抗疟疾新药,具有自主知识产权.由于青蒿素类药具有抗疟疾、抗孕、抗纤维化、抗血吸虫、抗弓形虫、抗心律失常和肿瘤细胞毒性等作用,并且有安全、高效、无耐药性等优点,备受国内外学者关注.但其作用机制、毒副作用和应用等方面有待更深入的研究.     

骨质疏松症的中药治疗进展

骨质疏松(osteoporosis)症是一种全身性代谢性骨骼疾病,以骨量减少,骨的微细结构破坏为特征,导致骨脆性增加,容易发生骨折,其发病率和死亡率都较高.现代医学认为骨质疏松症的病因与内分泌激素如雌激素、甲状腺素、降钙素含量的改变及钙代谢紊乱密切相关，其最常见的临床症状是不同程度、不同部位的骨骼及关节疼痛，常常伴随有腰腿乏力，     

中医药防治皮瓣修复术后血管危象的研究现状

分析近年来中医药防治皮瓣修复术后血管危象的相关文献,包括口服中药汤剂及中成药,对近年来中医药防治皮瓣修复术后血管危象的实验研究及临床应用现状进行综述。     

MAST Quadrant通道下减压椎弓根螺钉固定与传统后路腰椎融合手术治疗腰椎管狭窄症的效果对比

目的探讨MAST Quadrant通道结合椎弓根螺钉固定行椎管减压、椎间盘切除、椎间植骨融合、经皮椎弓根螺钉固定复位固定治疗腰椎管狭窄症的效果。方法将符合行腰椎后路椎间融合手术指征的腰椎管狭窄症患者随机分为通道组和对照组,各45例。比较两组患者的手术时间、术中出血量、住院时间、术后服止痛药时间、ODI评分、JOA评分的差异。结果术后切口均为Ⅰ期愈合;通道组患者手术时间显著长于对照组,术中出血量及住院时间显著低于对照组,差异有统计学意义(P0.05);术后6个月,两组患者椎间骨性融合均未见椎弓根螺钉固定松动、断裂或移位;通道组患者ODI评分、VAS评分显著低于对照组,JOA评分显著高于对照组,差异有统计学意义(P0.05)。结论在严格掌握手术适应证的情况下,经通道结合椎弓根螺钉固定系统行腰椎融合术是一种安全有效的通道方法。