经皮椎体成形术/后凸成形术治疗骨质疏松性胸腰椎压缩性骨折

目的:评估经皮椎体成形术治疗多节段骨质疏松性胸腰椎压缩性骨折的临床疗效.方法:采用经皮椎体后凸成形术(PKP)或经皮椎体成形术(PVP)治疗多节段骨质疏松性胸腰椎压缩性骨折患者17例;比较手术前后椎体前柱及中柱高度以及Oswestry功能障碍指数(ODI)和疼痛视觉模拟评分(VAS)评分,根据Nakai标准分析手术疗效.结果:本组手术顺利,手术后椎体前柱及中柱高度均大于手术前,差异有统计学意义(P＜0.05).术后随访6～42个月.手术前后ODI和VAS评分较术前明显降低(P＜0.01),按Nakai标准评价:优9例,良5例,可2例,差1例,优良率82.35%(14/17).结论:经皮椎体后凸成形术或经皮椎体成形术治疗多节段骨质疏松性胸腰椎压缩性骨折创伤小,疗效满意.     

骨质疏松性压缩性骨折经皮椎体成形术治疗后非手术椎体再骨折发生情况及影响因素分析

目的探讨骨质疏松性压缩性骨折经皮椎体成形术治疗后非手术椎体再骨折发生情况及影响因素分析。方法选取我院治疗的138例骨质疏松压缩性骨折病例进行回顾性分析,据术后随访结果,将患者分为是否发生非手术椎体骨折分为非骨折组71例、骨折组67例。对可能会导致经皮椎体成形术治疗后非手术椎体再骨折情况的相关资料进行单因素比较,对造成影响的单因素进行多因素回归分析。结果 138例骨质疏松性压缩性骨折患者经皮椎体成形术治疗后有67例患者发生非手术椎体再骨折,发生率占据总人数的48.55%;经多因素分析显示,骨密度、骨折椎体部位(胸腰段)均是影响骨质疏松性压缩性骨折患者经皮椎体成形术治疗后发生非手术椎体骨折的独立危险因素(P0.001)。结论骨质疏松性压缩性骨折患者经皮椎体成形术治疗后发生非手术椎体再骨折的机率高,骨密度、骨折椎体部位是影响骨质疏松性压缩性骨折患者经皮椎体成形术治疗后发生非手术椎体骨折的危险因素。     

经皮椎体成形术治疗中老年性椎体骨折所致疼痛的临床探讨

目的:观察经皮椎体成形术(PVP)治疗中老年性骨质疏松性多个胸、腰椎骨折所致疼痛的疗效,探讨其治疗方法和止痛机制。方法:以自固化磷酸钙人工骨为充填材料,在CT监视定位下,经单侧椎弓根穿刺行经皮椎体成形术治疗31例椎体压缩性骨折的患者。结果:31例52个压缩性骨折椎体只需治疗35个,PMMA平均充填量为2.6ml,术中PMMA渗出者3例3个椎体,无并发症。术后所有患者疼痛明显减轻或消失,总有效率100%,显效率为77.4%。结论:少充填量,单侧椎弓根穿刺单椎体的PVP治疗能有效地缓解骨质疏松性胸、腰椎压缩性骨折引起的疼痛。     

椎体成形术治疗老年性骨质疏松椎体压缩性骨折疗效观察

目的观察经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折的临床疗效。方法采用经皮椎体成形术和经球囊扩张椎体成形术治疗老年骨质疏松性椎体压缩性骨折86例,观察并分析其临床效果。结果在所治疗的86例病例中,在术后6-48小时内均有腰背部疼痛的缓解,有12例13椎出现骨水泥渗漏,所有患者均无脊髓、神经根损伤及静脉栓塞、肺栓塞等并发症的产生。随访2-8个月,均未发现有新的骨折形成。结论椎体成形术对老年性骨质疏松性椎体压缩性骨折有良好的治疗效果。骨水泥渗漏是其主要并发症。     

高粘度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩性骨折患者的临床价值研究

目的 探讨高粘度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床价值.方法 选取2017年11月～2020年10月我院收治的80例骨质疏松性椎体压缩性骨折患者作为研究对象,根据术式不同分为对照组(传统骨水泥经皮椎体成形术)和实验组(高粘度骨水泥经皮椎体成形术),每组各40例.术后比较两组患者手术情况及VAS、OD...     

单侧入路椎体强化术治疗单节段骨质疏松性压缩性骨折2年随访

目的探讨单侧入路椎体强化术(包括经皮椎体成形术和经皮球囊扩张椎体后凸成形术)治疗骨质疏松性椎体压缩性骨折(Osteoporotic vertebral compression fractures,OVCFs)的长期效果。方法回顾我院自2007年1月~2011年10月应用单侧入路骨水泥充填椎体强化术治疗单节段椎体压缩性骨折共148例,所有患者均为骨质疏松性压缩性骨折。其中经皮椎体成形术(percutaneous vertebroplasty,PVP)64例,经皮球囊椎体后凸成形术(percutaneous Balloon Kyphoplasty,BKP)84例。随访分三个时间节点:术后2天,术后1个月,术后2年以上。前两个时间点使用视觉模拟评分(visual analogue scale,VAS)来评估近期治疗效果,术后2年使用Barthel指数及SF-36表来评估远期效果。结果 128例患者术后1个月内有效随访,89例患者术后2年仍有效随访,59例失访,9例死亡。未发现脊髓损伤及有症状的肺动脉栓塞,术中发生骨水泥渗漏23例,总渗漏率为15.5%。所有接受椎体强化术患者术前术后VAS评分差异有统计学意义(0.01)。BKP组与PVP组VAS评分及术后2年Barthel指数和SF-36表评分比较差异无统计学差异(0.05)。结论单侧入路骨水泥充填椎体强化术治疗单节段骨质疏松性椎体压缩性骨折,PVP以及BKP技术均可以取得很好的短期及长期临床效果,PVP和BKP的短期疗效和2年以上的长期效果之间无差异。     

椎体后凸成形术治疗老年胸腰椎压缩性骨折

目的：探讨球囊扩张椎体后凸成形术治疗老年胸腰椎压缩性骨折疗效.方法：采用经皮穿刺气囊扩张椎体后凸成形术治疗老年骨质疏松性胸腰椎骨折9例14个椎体.结果：9例患者后凸畸形平均矫正15.,其中8例患者术后疼痛即刻消失,另1例因终板部分破裂骨水泥入椎间隙,疼痛减轻.随访3～13个月,患者症状缓解,未见复发,椎体高度未见丢失.结论：经皮球囊扩张椎体后凸成形术是治疗老年性胸腰椎压缩性骨折的安全有效方法.     

经皮椎体成形骨水泥呈弥散型分布可减少邻近椎体再骨折的发生率北大核心

背景:经皮椎体成形是治疗骨质疏松性椎体压缩性骨折的有效治疗方法之一,骨水泥在椎体内的分布形态会对其临床疗效产生影响。目的:探讨经皮椎体成形治疗中骨水泥分布形态对骨质疏松性椎体压缩性骨折术后早期疗效的影响。方法:选择2017年1月至2019年6月山西医科大学第一医院收治的骨质疏松性椎体压缩性骨折患者132例,其中男52例,女80例,年龄(76.3±8.2)岁,经皮椎体成形治疗后根据X射线片上的骨水泥分布形态分为弥散不良组(n=54)和弥散分布组(n=78)。对比两组术后目测类比评分、伤椎椎体前缘高度及中线高度、局部后凸Cobb角与术后随访1年并发症的发生率。研究的实施符合山西医科大学第一医院对研究的相关伦理要求。结果与结论:(1)两组术后2 d、1个月、6个月的目测类比评分均低于术前(P <0.05);弥散不良组术后1个月的目测类比评分高于弥散分布组(P <0.05),两组间术后2 d、6个月的评分比较差异无显著性意义(P> 0.05);(2)两组术后的局部后凸Cobb角、椎体前缘及中间高度均较术前改善(P <0.05),两组间术后局部后凸Cobb角、椎体前缘及中间高度比较差异均无显著性意义(P> 0.05);(3)两组间骨水泥渗漏率比较差异无显著性意义(P> 0.05),弥散分布组邻近椎体再发骨折发生率低于弥散不良组(P <0.05);(4)结果表明,经皮椎体成形是骨质疏松性椎体压缩性骨折的有效治疗方法,骨水泥在椎体内的分布会影响手术效果,骨水泥分布弥散可以减少伤椎邻近椎体再发骨折的发生率。     

经皮椎体成形术与保守方法治疗脊柱骨质疏松骨折疗效分析

目的比较经皮椎体成形术（PVP）与保守治疗骨质疏松引起的椎体压缩性骨折的临床效果,探讨PVP的临床应用价值。方法选择2008年1月至2011年7月在我科治疗的骨质疏松性椎体压缩性骨折患者87例,其中PVP治疗42例（观察组）,保守治疗45例（对照组）,分析两组患者的治疗效果及并发症等情况。结果经比较发现,治疗前及治疗后半年,两组患者VAS和ODI评分差异无统计学意义（P〉0．05）;在治疗后第3天、1个月、3个月期间,观察组VAS和ODI评分显著低于同期的对照组患者（P〈0．05）。观察组中出现8例并发症,但均未出现脊髓及神经受压症状;对照组患者中出现褥疮1例,泌尿系感染1例,肺部感染1例。在随访的第5。6月中,观察组中有3例患者手术邻近的椎体出现压缩性骨折,对照组中有4例发生,组间比较差异不明显（P〉0．05）,无统计学意义。结论PVP对于近期疼痛缓解优于保守治疗,虽然PVP方式会出现骨水泥渗漏的并发症,但能有效避免了褥疮、感染等长期卧床的并发症。     

PVP、PKP治疗骨质疏松腰椎压缩性骨折的临床对比研究

目的:探讨经皮椎体成形术(Percutaneous vertebroplasty,PVP)、经皮椎体后凸成形术(Percutaneous kyphoplasty,PKP)治疗骨质疏松腰椎压缩性骨折的临床效果.方法:2018年6月～2020年2月本院收治的62例骨质疏松腰椎压缩性骨折患者,根据手术方式分为PVP组、PKP组,各31例.对比两组疼痛程度,治疗前后Cobb''s角、椎体前缘高度变化情况.结果:PVP组术后视觉模拟评分(Visual Analogue Scale/Score,VAS)低于PKP组(P<0.05);两组术后3d、6个月Cobb''s角度比较无差异(P>0.05),但PKP组术后3 d、6个月椎体前缘高度高于PVP组(P<0.05).两组并发症总发生率差异无统计学意义(P>0.05).结论:PVP术及PKP术治疗骨质疏松腰椎压缩性骨折各有优劣,临床可根据患者个人情况,选择手术方案.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.