AF内固定治疗胸腰椎骨折88例

目的 探讨AF椎弓根内固定系统治疗胸腰椎爆裂骨折的疗效.方法 应用AF经椎弓根内固定系统治疗胸腰椎爆裂骨折88例.结果 平均随访12个月.88例椎体前缘高度由术前平均48%恢复至平均92%.椎管内移位骨块复位率达90%.神经损伤的恢复按ASIA分级:A级中9例无变化,余79例均提高1～2级.结论 AF椎弓根内固定系统能达到满意复位固定及椎管有效减压,是一种治疗胸腰椎爆裂性骨折理想的方法.     

AF内固定治疗胸腰椎爆裂性骨折

目的 :观察和评估胸腰椎爆裂性骨折后路AF内固定撑开复位、间接减压的疗效。方法 :对 30例患者的临床资料进行回顾性分析。 30例患者均为胸腰椎爆裂性骨折 ,但MRI示后纵韧带仍完整。其中 2 2例伴脊髓损伤 ,按Frankel分级 ,A级 2例、B级 6例、C级 1 0例、D级 4例。 8例无神经压迫症状。治疗采用后路AF系统撑开复位内固定 ,结合横突间、椎板间植骨。术前及不同随访时间行CT检查 ,分别计算其伤椎椎体高度及椎管狭窄率 ,确定椎体高度及椎管横截面积的恢复程度 ,采用配对t检验方法进行统计学分析。结果 :30例术后平均随访 1 3.1个月 ,伤椎前、后高度及椎管矢状径均较术前有显著改善 (P <0 .0 1 )。 2 2例脊髓损伤患者中 ,神经功能恢复按Frankel分级评定 ,2 1例分别提高 1～ 3级 ,1例A级无变化。 2例AF钉断裂 ,余患者内固定稳定 ,未见椎体塌陷。结论 :AF系统治疗后纵韧带完整的胸腰椎爆裂性骨折 ,通过撑开复位 ,间接减压 ,能有效恢复椎体高度及椎管形态 ,以维持和增强脊柱稳定性     

AF钉治疗胸腰椎爆裂性骨折30例体会

目的:对AF钉治疗胸腰椎爆裂性骨折的效果进行探讨和分析。方法:对应用AF钉治疗胸腰椎爆裂性骨折的30例患者进行疗效的观察和随访。结果:平均随访15个月,30例患者椎体前缘高度恢复到平均92%。椎管内移位骨块复位率达96%。术后神经功能恢复情况:A级3例,B级9例,C级8例,D级4例,E级6例。术后6个月复查X片显示Cobb角丢失≤15°。结论:AF钉治疗胸腰椎爆裂性骨折能达到满意复位固定,并能有效减轻椎管压力,治疗效果比较理想,值得临床推广。     

AF系统治疗胸腰椎爆裂性骨折伴椎管狭窄

目的运用AF系统治疗胸腰椎爆裂性骨折伴椎管狭窄,并观察分析临床效果。方法采用AF系统治疗46例胸腰椎爆裂性骨折伴椎管狭窄,随访总结手术疗效。结果随访6-35个月,平均13个月,疗效满意,优良率84．6％。结论AF系统是治疗胸腰椎爆裂性骨折伴椎管狭窄较好的方法。具有操作简单,复位良好,固定安全可靠,椎体前缘高度恢复理想,Cobb’s角矫形充分的优点是值得推广运用的一种治疗胸腰椎爆裂性骨折伴椎管狭窄的方法。     

椎管环状减压治疗胸腰椎爆裂性骨折

目的探讨椎管环状减压治疗胸腰椎爆裂性骨折的方法和疗效。方法应用椎管环状减压、AF椎弓根螺钉系统固定及椎体后外侧植骨治疗胸腰椎爆裂性骨折32例。结果按美国脊髓损伤学会(Am erican sp inal in jury assoc iation,ASIA)神经损伤分级标准评定,27例不完全性损伤患者提高1-3级,5例完全性损伤患者部分神经功能有所恢复;术后伤椎高度和矢状面指数(sagital index,SI)有显著改善;螺钉位置全部良好,无折断、弯曲、松动现象。结论椎管环状减压、AF椎弓根螺钉系统及椎体后外侧植骨治疗胸腰椎爆裂性骨折有利于恢复神经功能和脊柱的生理弧度、稳定性。     

AF内固定系统治疗胸腰椎爆裂型骨折128例

目的评价AF椎弓根螺钉内固定系统治疗胸腰椎爆裂型骨折的效果。方法分析AF系统内固定治疗128例胸腰椎爆裂型骨折。观察患者手术前后椎体高度变化和椎管恢复情况。结果术后随访1-5年，128例患者椎体高度全部恢复108例，基本恢复17例，过度撑开3例。病例后凸畸形均纠正，椎体前缘高度由术前41％恢复到术后96％，椎体矢状面水平位移由术前平均31％纠正到术后6％。结论AF内固定治疗胸腰椎爆裂型骨折复位确切，固定可靠，是一种理想的治疗胸腰椎爆裂骨折的方法。     

AF内固定系统治疗胸腰椎爆裂型骨折疗效观察

目的:评价AF椎弓根螺钉内固定系统治疗胸腰椎爆裂型骨折的效果。方法:分析AF系统内固定治疗28例胸腰椎爆裂型骨折。观察患者手术前后椎体高度变化和椎管恢复情况。结果:术后随访1~4年,28例患者椎体高度全部恢复17例,基本恢复7例,过度撑开3例,1例椎体高度基本恢复,椎体侧方移位改善。所有病例后凸畸形均纠正。椎体前缘高度由术前41%恢复到术后的96%,椎体矢状面水平位移由术前平均31%纠正到术后6%。结论:AF内固定治疗胸腰椎爆裂骨折复位确切,固定可靠,是一种理想的治疗胸腰椎爆裂骨折的方法。     

AF系统内固定加人工骨植骨治疗胸腰椎爆裂性骨折

目的:探讨后路AF系统内固定加入工骨植骨治疗胸腰椎爆裂性骨折的临床疗效.方法:对62例胸腰椎爆裂性骨折患者行后路AF系统撑开复位内固定后行横突、关节突植入人工骨治疗.结果:经10个月～6年随访,椎体前缘平均高度由术前48%恢复到术后91%,植骨融合率96.8%.脊髓损伤的患者,术后神经功能按Frankel分级提高1～3级.结论:后路AF系统内固定加人工骨植骨操作简便,固定可靠,减小手术创伤,是一种治疗胸腰椎爆裂性骨折的有效方法.     

AF系统治疗胸腰椎爆裂骨折

目的研究AF系统治疗胸腰椎爆裂性骨折的疗效。方法利用后路切开减压＋AF系统内固定＋植骨术。结果用这种方法治疗的27例病例中，神经功能恢复接Frankel＇s分级评定，15例不全瘫者均有1—3级恢复，其中13例下肢肌力正常，7例全瘫者均有1—2级恢复。结论AF系统治疗胸腰椎爆裂性骨折因其具有操作简单，复住艮好，固定安全可靠，椎体前缘高度恢复理想，是当前一种理想的内固定器材。     

经椎弓根植骨AF内固定治疗胸腰椎爆裂性骨折18例

目的探讨经椎弓根植骨AF内固定治疗胸腰椎爆裂性骨折的方法和效果。方法对18例胸腰椎爆裂性骨折的患者行经椎弓根植骨AF内固定术,术前、术后及随访时测量椎体高度、后凸角,了解神经功能改变及腰背疼痛变化。结果随访6～36个月,无断钉及内固定物松动,椎体高度和后凸角无明显再丢失,神经功能及腰背疼痛明显改善。结论经椎弓根植骨AF内固定治疗胸腰椎爆裂性骨折可重建脊柱前中柱的稳定性,防止后期矫正角度及椎体高度的再丢失。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.