18G穿刺针行经皮椎体成形术治疗颈椎恶性重度压缩骨折

目的研究利用18G血管穿刺针行经皮椎体成形术治疗颈椎恶性重度压缩骨折的可行性及疗效。方法 2006-2010年对10例颈椎恶性转移性病变所致的重度椎体压缩骨折（共12个椎体）行经皮椎体成形术。其中C4、C5椎体各3个,C6椎体4个,C7椎体2个。在DSA机透视引导下将18G穿刺针经皮穿刺进入靶椎体,后注入聚甲基丙烯酸甲酯骨水泥,术后随访1个月。结果术中穿刺和骨水泥注射技术成功率100%。每个椎体的骨水泥平均注射量为2.2ml（1.5～3.2ml）,所有患者的疼痛都得到了明显缓解。除4个椎体发生无症状的骨水泥渗漏外,无一例发生严重并发症。结论利用18G血管穿刺针行经皮椎体成形术是治疗颈椎恶性重度压缩骨折安全、有效的治疗方法 。     

经皮椎体成形术治疗颈椎转移瘤

目的评估经皮椎体成形术(PVP)3种路径治疗颈椎溶骨性转移瘤的疗效和安全性方法回顾性分析36例(57节椎体)经PVP治疗颈椎溶骨性转移瘤患者的临床资料。采用WHO标准和视觉模拟评分(VAS)评价患者临床疗效,并分析总结不同部位椎体3种手术入路的应用经验。结果3组穿刺路径分别是前外侧入路、侧方入路、经椎间盘入路。所有椎体穿刺和骨水泥注射技术成功率达100%。术后随访至少3个月,资料完整的32例患者中11例完全缓解(CR),20例部分缓解(PR)、1例术后轻度缓解(MR),0例无效(NR),临床治疗有效率(CR+PR)达96.87%。患者术前、术后24 h、1周和3个月的VAS评分差异有统计学意义(P<0.05)。17节椎体发生少量骨水泥渗漏(29.82%),但均无严重并发症。结论前外侧入路PVP治疗C4～C7溶骨性转移瘤方便安全、有效。侧方入路治疗Cl,经椎间盘入路治疗C2、C3椎体转移瘤亦安全可行。临床应根据具体情况合理选择手术入路。     

经皮椎体成形术治疗枢椎椎体转移瘤的穿刺途径及疗效初探

目的 探讨采用前外侧或后外侧入路穿刺椎体成形术(PVP)治疗枢椎转移瘤的安全性和疗效.方法 对10例枢椎椎体溶骨性转移瘤的患者行PVP,男8例,女2例.9例在X线透视引导下,采用前外侧入路穿刺与注射骨水泥,1例采用CT引导后外侧入路穿刺.结果 10例患者均为单侧穿刺,并均穿刺成功.注射骨水泥量为2～4 ml.患者术后当日CT复查显示骨水泥填充病灶均在70%以上.无穿刺途径出血或骨水泥外溢引起的有临床症状的并发症.术后7 d内疼痛完全缓解(CR)7例,部分缓解(PR)3例.术后1周内均去掉头托承重,下床活动.术后随访3～24个月,4个月死亡2例、8～11个月死亡3例、13～15个月死亡4例、1例术后第24个月仍存活,术后均无局部疼痛症状加重的表现.结论 采用前外侧入路或后外侧入路行PVP治疗枢椎转移瘤安全、有效.     

212例经皮穿刺椎体成形术的临床疗效及并发症处理

目的探讨经皮椎体成形术的临床疗效及并发症。方法对212例322个椎体行经皮椎体成形术治疗骨质疏松症所致椎体压缩性骨折及各类肿瘤的椎体转移瘤。术前行X线、CT检查，术中在C臂X线机定位下，经皮穿刺至病灶部位，将磷酸钙骨水泥（PCP）或骨水泥（PMMA）按粉剂与流体一定比例调制成糊状，注入病灶。结果386个椎体穿刺均成功，术后注射PMMA患者全部达到止痛效果，术后注射PCP患者平均10天疼痛缓解。18例发生并发症。结论经皮椎体成形术安全可行，创伤小、操作简单、并发症少，能有效缓解临床症状；适用于骨质疏松引起的椎体压缩性骨折及椎体的良恶性肿瘤，具有强化椎体，镇痛作用，有较高的临床应用价值。在严格适应症和规范细致的治疗下是安全可行的。     

骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折

目的探讨骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折的操作技术、临床疗效。方法2002～2004年间共计治疗了108例诉有严重疼痛的椎体压缩性骨折患者,其中骨质疏松性压缩性骨折85例,椎体恶性肿瘤31例。穿刺入路采用双侧椎弓根穿刺法,所有患者均在透视监视下双侧注射聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA),注射设备为骨水泥混合与注射一体化装置。术后随访患者6个月。结果共计注射116个椎体(腰椎69个,胸椎47个),双侧穿刺和骨水泥注射成功率100％,99例患者(91．7％)术后疼痛明显缓解,6个月内疼痛无复发95例(95．6％),9例患者(8．3％)术后疼痛无缓解。发生骨水泥外漏12例(11％),有临床症状5例(4．6％)。结论骨水泥混合与注射一体化装置行经皮椎体成形术创伤小、并发症少,而且止痛疗效显著,是一种非常有前景的治疗椎体压缩性骨折的介入手术方法。     

经皮椎体成形术治疗椎体转移瘤的临床应用

目的 探讨经皮椎体成形术(PVP)治疗椎体转移性肿瘤的骨水泥灌注量、灌注方法及临床疗效.方法 对150例共218个椎体行椎体成形术,其中胸椎73个椎体,腰椎138个椎体,骶椎7个椎体,共218个椎体.手术在DSA监视下进行.根据椎体形态、破坏范围及穿刺点位置选择进针途径.结果 150例218个椎体手术全部成功,手术成功率100%,胸椎注入骨水泥2～5 ml,平均3.5 ml;腰椎注入3～8 ml,平均5.5 ml;骶椎4～7 ml,平均5.5 ml.术后疼痛完全缓解134例,89.3%;部分缓解15例,10%;无效1例,0.7%.150例中渗漏至椎间盘12例,硬膜外囊10例,椎旁静脉丛3例,椎旁软组织4例,骨水泥外漏发生率13.3%.术中及术后均无并发症发生.结论 经皮椎体成形术(PVP)对缓解或消除由椎体转移性肿瘤引起的疼痛有明显的治疗效果,值得临床应用推广.     

OVCF经皮椎体后凸成形术后骨水泥渗漏的相关因素分析

目的 对骨质疏松性椎体压缩骨折经皮椎体后凸成形术后骨水泥渗漏的相关因素进行分析.方法 选取80例接受经皮椎体后凸成形术治疗的骨质疏松性椎体压缩骨折患者为研究对象.根据术后是否发生骨水泥渗漏分为渗漏组和无渗漏组,对发生骨水泥渗漏的相关因素进行分析.结果 80例共110个椎体行经皮椎体后凸成形术治疗,术后有11个椎体发生骨水泥渗漏.渗漏组和无渗漏组比较,术前椎体前中柱平均高度、术前Cobb角、骨水泥注入量、椎体周壁有无破坏等方面存在统计学差异（P＜0.05）.Logistic分析显示,术前椎体前中柱平均高度、术前Cobb角、骨水泥注入量、椎体周壁破坏为骨水泥渗漏重要因素.结论 术前椎体前中柱平均高度、术前Cobb角、骨水泥注入量、椎体周壁有无破坏等因素是影响术后骨水泥渗漏的重要原因.     

C形臂X线机与CT联合导向在经皮椎体成形术中的应用

目的探讨在移动式C形臂X线机与16排CT联合导向下,经皮椎体成形术中在治疗骨质疏松性椎体压缩骨折的操作方法及优势。方法将移动式C形臂X线机与16排CT置于同一机房,组成组合机。16排CT扫描病变椎体及相邻椎体,确定穿刺点及穿刺路径,评价术后椎体情况;移动式C形臂X线机实时透视监视注射聚乙烯吡咯烷酮(骨水泥)。结果在组合机引导下对12例单椎体压缩骨折的患者行经皮椎体成形术成功率100%,无并发症发生。结论移动式C形臂X线机与16排CT联合导向在经皮椎体成形术中的操作简便、定位准确、监视实时、导向安全,特别提高了L4椎体平面以上各椎体行椎体成形术的安全性。     

经皮椎体成形术治疗颈椎转移瘤的初步研究

目的应用椎体成形术(PVP)治疗颈椎转移瘤，观察其疗效，探讨椎体成形术治疗颈椎病变的操作技术。方法对11例颈椎单椎体转移瘤病变椎体行PVP治疗，均应用国产器械与骨水泥(聚甲基丙烯酸甲酯，PMMA)，其中C21例，C32例，C44例，C53例．C61例。在X线透视监测下经前外侧人路途径操作10例，在CT和X线透视联合监测下经后外侧人路途径行C2椎体成形术1例。PMMA在牙膏期向椎体内注射。于手术前后行CT检查对照。对患者随访7～12个月，观察临床疗效。结果11例穿刺全部成功，术后CT检查显示PMMA填充病灶均在50％以上。术后7d内11例患者均有不同程度的疼痛缓解：疼痛完全缓解(CR)6例，部分缓解(PR)5例。止痛效果在6个月内为7(7／10)例，在1年内为5(5／9)例。未发生由于穿刺途径出血或PMMA外溢出现临床症状的并发症。结论椎体成形术治疗颈椎转移瘤效果良好。     

经皮椎体成型术治疗椎体良、恶性肿瘤

目的　椎体良、恶性肿瘤一直是非常棘手的疾病 ,以往的治疗方法都有各自的不足 ,经皮椎体成型术的出现使椎体血管瘤的治疗产生突破性进展 ,本文总结用经皮椎体成型术治疗椎体良、恶性肿瘤的初步临床经验。方法　总结 7例椎体血管瘤和 11例椎体恶性肿瘤的治疗 ,17例采用单侧或双侧椎弓根入路 ,1例颈椎血管瘤采用颈椎前外侧入路。注射 15 2 0 %的骨水泥 ,使骨水泥在椎体内分布、铸形。结果　 18例治疗都获得成功 ,注射骨水泥 0 .5 7ml。 10例患者术后疼痛完全缓解 ,6例明显缓解 ;2例有所缓解 ;随访 1 9个月 ,无复发迹象。结论　采用经皮椎体成型术治疗椎体良、恶性肿瘤是一种小创伤、安全、有效的治疗手段。     

Investigation of Damage to Multilayer Optics in X-Ray Laser Cavities: W/C, WRe/C, WC/C, Stainless-Steel/C, and Cr3C2/C Mirrors

In many applications, multilayer mirrors are exposed to damaging fluences of x rays. In x-ray laser cavities intense optical and broad-band x radiation, from the x-ray laser plasma amplifier, can damage multilayer mirrors on time scales of hundreds of picoseconds. We describe experiments using short duration (500 ps) bursts of soft x rays from a laser produced gold plasma to damage multilayer mirrors designed to reflect wavelengths close to 45 ? at normal incidence. The effect of the damaging x-ray flux on normal incidence reflectivity was time resolved for W/C, WRe/C, WC/C, 303-stainless-steel/C, and Cr3C2/C multilayers. The damage thresholds of the different mirrors were compared, and the Cr3C2/C mirrors were found to be the most resilient. The outer layers of the multilayers were observed to expand slowly as x rays were absorbed, and a more rapid expansion then preceded the total loss of reflectivity, at temperatures well below the melting temperature of the mirror components. It is believed that the dominant expansion mechanism is a change in the amorphous carbon layers to a more graphitic structure. The data are fit quite well by a model that assumes expansion of up to 25% in the thickness of the outermost carbon layers, followed by intermixing of the hotter layers. The rapid expansion has been observed to occur in times from 40 to 150 ps and may be the fastest resolution to date of the phenomenon of graphitization. The integrated reflectivity of the mirrors was observed to increase by up to a factor of 2.5 as they damaged; this reflectivity increase may be consistent with a reduction in the layer roughness.     

MR and cryomicrotomy of C1 and C2 roots

Paramedian sagittal MR images and cryotome sections in four cadavers were correlated with eight clinical MR studies to analyze the appearance of the C1 and C2 nerve roots and adjacent tissue. The C2 nerve roots and anatomically related venous plexus were identified. The C1 root, although not visualized by MR, could be localized by its relation to the vertebral artery, C1 lateral mass, and posterior arch.     

Absorbed dose from 14C xylose and 14C mannose

Tissue distribution and excretion studies have been performed in rats and mice for up to 1 week after oral administration of 14C xylose and 14C mannose. The effective dose-equivalent is calculated to be 15 microSv/MBq for xylose and 120 microSv/MBq for mannose. Since there was no clearance of mannose during the period of the study, the effective dose-equivalent for mannose is almost entirely dependent upon the assumptions made about expected lifetime exposure.     

Hypertrophic anterior tubercles of C5 and C6 on CT

Summary Hypertrophy of the anterior tubercles of the transverse processes of the fifth and sixth cervical vertebrae is a rare congenital anomaly. We present the CT-appearance of this unusual variant.     

[C]Formaldehyde revisited: considerable concurrent [C]formic acid formation in the low-temperature conversion of [C]carbon dioxide into [C]formaldehyde

The reduction of [¹¹C]carbon dioxide with lithium aluminium hydride in diethyl ether at temperatures ranging from −56°C to 19°C was studied. In contrast to what others have reported, considerable amounts of [¹¹C]formic acid were found at all studied temperatures.     

Fullerenes (C60, C70) as Photosensitizers for PDT

Water-soluble C60 and C70 materials were prepared by complexation or conjugations with biocompatible polymers such as poly(vinylpyrrolidone) (PVP) and polyethylene glycol (PEG). The properties of these materials were tested by DNA cleavage test and ESR spin-trapping analyses for the formation of reactive oxygen species (ROS) generation under visible light irradiation.Due to their photoexcitation properties by the visible light in the longer wavelength region and in high quantum yields of ROS generation, fullerenes (C60 and C70) have been considered as good candidates for the photosensitizers in PDT [1]. In order to utilize these fullerenes in such a bioapplication, it is necessary to prepare water-soluble materials by forming complexes or conjugates with water-soluble moieties. In our initial study, we used PVP to form C60/PVP and C70/PVP complexes. Successfully obtained complexes were soluble in water and cleaved DNA under visible light irradiation especially in the presence of an electron donor (NADH). The ROS corresponding to this DNA cleavage was found to be superoxide radical anion (O2•–), while no generation of singlet oxygen (1O2) was found in these C60/PVP and C70/PVP complexes [2]. Alternatively, by the chemical conversion of C60 and C70 cores by 1,3-dipolar cycloaddition (Prato reaction) [3] and subsequent conjugation with PVP and PEG, highly water-soluble C60-PVP [4], C60-PEG [5], C70-PEG [6] conjugates were prepared. The Prato reactions of C60 and C70 occurred in site-selective manners, provided the monoadducts with tBu-ester groups. This adducts were reasonably soluble in many organic solvents and can easily be converted to acids to apply to many subsequent reactions. By amide conjugation reactions, PVP or PEG groups with well-defined molecular weights were attached to provide highly water-soluble conjugates [3-5]. In contrast to the results of C60/PVP or C70/PVP complexes, efficient 1O2 generation was observed from these conjugates dependent on the core (C60 or C70) and addition site in Prato reaction. This pathway dispersity was partially explained by the redox potential of the derivatives together with computational calculation [6].