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保留脊柱后方韧带复合体腰椎管扩大术的基础研究与临床应用 总被引:1,自引:0,他引:1
目的评价保留脊柱后方韧带复合体腰椎管扩大术临床疗效及生物力学特征。方法取8个新鲜腰骶椎标本,根据处理方法,分为3组。A组:8个完整腰骶椎标本进行生物力学测定;B组:A组测试后,切除L3-5 3个全椎板,保留后方韧带复合体,即为保留脊柱后方韧带复合体的腰椎管扩大术(改良术式);C组:B组测试后,将保留的韧带复合体切除,即为传统术式。3组均行轴向压缩实验、三点弯曲实验及扭转实验。2000年6月-2006年6月,收治309例腰椎管狭窄症患者,行保留脊柱后方韧带复合体腰椎管扩大术。其中男152例,女157例;年龄20~80岁,平均57.2岁。病程3个月~41年。单纯腰椎管狭窄症55例;腰椎管狭窄合并腰椎间盘突出症254例,其中合并L4、5椎间盘突出105例,L4~S1椎间盘突出56例,L5、S1椎间盘突出86例,L2、3高位腰椎间盘突出7例。术后采用JOA下腰痛手术疗效评分标准、患者手术满意度及影像学观察进行疗效评定。结果轴向压缩实验:前屈时,A、B组应变、应力、轴向位移均小于C组(P〈0.01);轴向刚度大于C组(P〈0.01)。后伸时,A、B、C3组间上述指标差异无统计学意义(P〉0.05)。三点弯曲实验:在相同弯矩下,挠度、倾角、弯曲刚度A、C组及B、C组比较,差异均有统计学意义(P〈0.01),A、B组间差异无统计学意义(P〉0.05)。扭转实验:相同扭角条件,B组承载的扭矩大于C组(P〈0.01);相同扭矩条件,B组扭角小于c组(P〈0.01),B组扭转刚度大于C组(P〈0.01)。临床应用结果:术中神经根牵拉伤7例;术后脑脊液漏5例,伤口感染4例,经处理后痊愈。309例均获随访,随访时间1~7年。根据JOA下腰痛评分标准,JOA评分平均改善率为86.0%;其中优163例,良112例,可34例,优良率89%。X线片未见椎体不稳。患者手术满意度为87%。结论保留脊柱后方韧带复合体腰椎管扩大术有利于保持脊柱的力学稳定性,疗效佳。 相似文献
3.
Human embryonic stem cells: research,ethics and policy 总被引:6,自引:0,他引:6
The use of human embryos for research on embryonic stem (ES) cells is currently high on the ethical and political agenda in many countries. Despite the potential benefit of using human ES cells in the treatment of disease, their use remains controversial because of their derivation from early embryos. Here, we address some of the ethical issues surrounding the use of human embryos and human ES cells in the context of state-of-the-art research on the development of stem cell based transplantation therapy. 相似文献
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In view of the promising developments in preclinical studies on the cryopreservation of human ovarian tissue offering this technology as a 'fertility insurance' to cancer patients can be justified. This commentary briefly discusses some of the ethical issues involved, including the doctors responsibility regarding the risk of the reintroduction of cancer, the pros and cons of both xenotransplantation and in vitro maturation, parental responsibility in consenting to fertility insurance for minors, and cryopreservation of ovarian tissue of younger, healthy women who wish to postpone fertility. 相似文献
7.
Jinlun Chen Xingyu Wang Jin Li Haitao Zhang Yijin Li Peng Deng Wenjun Feng Xinyu Qi Pengcheng Ye Jiahao Li Jianchun Zeng Yirong Zeng Jie Li Shuihua Xie 《Orthopaedic Surgery》2022,14(12):3378
ObjectiveThe treatment of chronic osteomyelitis (COM) is extremely challenging for physicians and patients. It is of great significance to explore the research status, development trend and future research hotspots in the field of COM to promote the development of this field. This study is aimed to explore the global research status of COM and predict its future research hotspots based on bibliometric and visualized analysis.MethodsWeb of Science core collection database was used to search the related literature of COM from 1994 to 2020. All data were imported into Microsoft Excel 2019 for collation. Additionally, the literature quality of countries, authors, journals, and institutions is evaluated. The VOS viewer software was used for conducting co‐analysis, co‐citation analysis, and keyword co‐occurrence analysis of literature to analyze the global status and predict the future hotspots of the COM field.ResultsA total of 726 articles were retrieved in this study. The number of global publications shows a trend of wave growth, but the increase is not significant. It is expected that the number of COM articles will remain at more than 50 per year in the next decade. The COM literature published in the United States (Publications = 160, H index = 37, average citations per item = 28.63) is of the highest quality. Girschick HJ (Publications = 16, H index = 14, average citations per item = 52.25) is the most contributed scholar in the field of COM. UNIV IOWA (Publications = 15, H index = 11, average citations per item = 57.27) and UNIV WURZBURG (Publications = 18, H index = 15, average citations per item = 47.5) are influential institutions in the field of COM. The results of co‐occurrence analysis show that the field of COM can be roughly divided into the following five modules: COM surgical research, COM basic research, COM diagnosis‐related research, chronic recurrent multifocal osteomyelitis (CRMO)‐related research, risk factors of COM. Risk factors of COM are the module with the highest concentration of hot words.ConclusionCOM‐related research will continue to develop further in the next decade. The diagnosis research and risk factors of COM are the most popular research modules in recent years. Some controversial or troubled issues including the efficacy of perforator flap and fascia flap covering soft tissue, searching exclusive detection methods for the diagnosis of COM and bisphosphonates and biological agents in the treatment of CRMO may lead to the development of the COM field. 相似文献
8.
Cis-acting sequences from a human surfactant protein gene confer pulmonary-specific gene expression in transgenic mice. 总被引:8,自引:2,他引:8
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T R Korfhagen S W Glasser S E Wert M D Bruno C C Daugherty J D McNeish J L Stock S S Potter J A Whitsett 《Proceedings of the National Academy of Sciences of the United States of America》1990,87(16):6122-6126
Pulmonary surfactant is produced in late gestation by developing type II epithelial cells lining the alveolar epithelium of the lung. Lack of surfactant at birth is associated with respiratory distress syndrome in premature infants. Surfactant protein C (SP-C) is a highly hydrophobic peptide isolated from pulmonary tissue that enhances the biophysical activity of surfactant phospholipids. Like surfactant phospholipid, SP-C is produced by epithelial cells in the distal respiratory epithelium, and its expression increases during the latter part of gestation. A chimeric gene containing 3.6 kilobases of the promoter and 5'-flanking sequences of the human SP-C gene was used to express diphtheria toxin A. The SP-C-diphtheria toxin A fusion gene was injected into fertilized mouse eggs to produce transgenic mice. Affected mice developed respiratory failure in the immediate postnatal period. Morphologic analysis of lungs from affected pups showed variable but severe cellular injury confined to pulmonary tissues. Ultrastructural changes consistent with cell death and injury were prominent in the distal respiratory epithelium. Proximal components of the tracheobronchial tree were not severely affected. Transgenic animals were of normal size at birth, and structural abnormalities were not detected in nonpulmonary tissues. Lung-specific diphtheria toxin A expression controlled by the human SP-C gene injured type II epithelial cells and caused extensive necrosis of the distal respiratory epithelium. The absence of type I epithelial cells in the most severely affected transgenic animals supports the concept that developing type II cells serve as precursors to type I epithelial cells. 相似文献
9.
Can Zhao Jiao Li Qing Cun Yijin Tao Wenyan Yang Sean Tighe Yingting Zhu Hua Zhong 《Medicine》2021,100(2)
To investigate the impact of different types of binocular integrated visual field defects on the quality of life in glaucoma.Ninety-six patients with primary glaucoma were divided into 5 groups with 25, 24, 11, 15, and 21 patients according to types of the binocular integrated visual field (BVF) defects. The criteria for BVF grouping included mild visual field defect in binocular eyes, mild visual field defect in 1 eye and moderate or advanced defect in the other, moderate and non-overlapping visual field defect in both eyes, overlapping and moderate visual field defect in binocular eyes, and severe defect in both eyes, respectively. The visual field (VF) evaluation was based on H-P-A visual field grading system. Visual acuity, visual field tests and Glaucoma Quality of Life-15 Questionnaire (GQL-15) were performed for enrolled patients, and binocular visual field results were integrated. The changes and correlations of the Visual field index values and quality of life scores were compared among the 5 groups. The main factors affecting the quality of life in glaucoma were analyzed by multiple regression analysis.The best binocular integrated visual field index (BVFI) and optimal quality of life were observed in group A. The BVFI of group B was better than that of group C or group D, but the peripheral vision glare and dark adaptation were worse. No significant difference was noted between group C and group D in terms of BVFI. However, the glare and dark adaptation in group C were better than that in group D. The BVFI was the lowest and the quality of life was the worst in group E. In all, BVFI and decibels (dB) values were negatively correlated with GQL-15 scores and positively correlated with patients’ quality of life.Binocular integrated visual field accurately reflects the visual function in glaucoma. Higher binocular integrated visual field indices represent a better quality of life for patients with glaucoma. Mild to moderate synchronous or complementary binocular VF defects had a slight effect on the quality of life, while severe and non-compensated VF loss significantly impacts on quality of life in glaucoma patients. 相似文献
10.
Qiaoshi Zeng Yu Lin Yijin Liu Zhidan Zeng Crystal Y. Shi Bo Zhang Hongbo Lou Stanislav V. Sinogeikin Yoshio Kono Curtis Kenney-Benson Changyong Park Wenge Yang Weihua Wang Hongwei Sheng Ho-kwang Mao Wendy L. Mao 《Proceedings of the National Academy of Sciences of the United States of America》2016,113(7):1714-1718
Metallic glass (MG) is an important new category of materials, but very few rigorous laws are currently known for defining its “disordered” structure. Recently we found that under compression, the volume (V) of an MG changes precisely to the 2.5 power of its principal diffraction peak position (1/q1). In the present study, we find that this 2.5 power law holds even through the first-order polyamorphic transition of a Ce68Al10Cu20Co2 MG. This transition is, in effect, the equivalent of a continuous “composition” change of 4f-localized “big Ce” to 4f-itinerant “small Ce,” indicating the 2.5 power law is general for tuning with composition. The exactness and universality imply that the 2.5 power law may be a general rule defining the structure of MGs.Metallic glasses (MGs) possess many unique and superior properties, such as extremely high strength, hardness, and corrosion resistance, etc., making them promising metallic materials with widespread applications (1, 2). Thousands of MGs with a wide range of compositions and properties have been synthesized over the past decades. However, so far the development of MGs is mainly based on tedious composition mapping in multicomponent space to pinpoint the combination of elements with optimized glass-forming ability (GFA). This method for development of MGs is a time- and resource-intensive strategy of trial and error which highlights the need for the guidance of a general theory (2, 3). Intensive research effort has been devoted to finding general rules in various MGs to understand the fundamentals and to guide the development of new MGs (4, 5). Quantitative correlations between their properties have been observed. For instance, compressive yield strength and elastic moduli of MGs are found to be intimately connected with their glass transition temperature Tg (6–10), and the ductility, fragility (11, 12), and Poisson’s ratio of MGs are closely related (13–16). The extensive correlations in properties suggest that the disordered MGs may share general rules in their structure. To clarify this scenario, detailed and accurate structural information spanning short range to long range is required. However, the current experimental probes and theories are limited to local structure in MGs (17). Therefore, understanding how the atoms efficiently fill up the 3D space and how this controls the bulk properties of MGs remains a long-standing theoretical challenge (18–23). To date, few general and exact rules regarding structure–property relationships have been established in MGs (23).Encouraging progress on understanding structure–property relationships in MGs has recently been made through the discoveries of the noncubic (2.3 or 2.5) power laws that correlate the principal diffraction peak (PDP) position q1 with the bulk density ρ or average atomic volume, Va, i.e., ρ∝(q1)D or Va∝(1/q1)D, where D equals ∼2.3 with varying the composition of MGs at ambient pressure (19) or ∼2.5 for tuning the density of MGs with pressure (22, 24). Whereas composition and pressure show similar exponents in the power laws in MGs, composition and pressure are two independent variables for controlling the density (volume) of materials; they usually have dramatically different effects on MGs. For example, pressure is thought to cause only elastic densification in MGs without obvious structural change because of their already densely packed structure; the structure and properties of MGs are very sensitive to even minor compositional variations (25, 26). In addition, to achieve composition change, different samples usually have to be synthesized. And, many other variables are thought to be inevitably involved, making the compositional change complex (23). Therefore, some basic questions have been perplexing to the glass community: Why do “complex” compositional and “simple” pressure power laws show similar exponents? Is there any connection between them? These questions remain unanswered and have been the major obstacle in understanding the nature of these noncubic power laws.To address these questions, a systematic study in the 2D pressure-composition space seems to be required. However, the consistency of the data in this kind of study will be questionable. Alternatively, in the present study, we choose the polyamorphous Ce68Al10Cu20Co2 MG as a model system. It is well known that Ce-based MG systems show a polyamorphic transition between ∼2 GPa and ∼5 GPa caused by the pressure-induced 4f electron localized-to-itinerant transition (27, 28). During this polyamorphic transition, both the atomic size and the electronegativity of Ce are significantly changed (29). Composition tuning in MGs mainly means the variation of atomic size and electronegativity of components, which controls the formation of MGs (30). Therefore, although nothing changes in the nucleus, for MGs this pressure-induced polyamorphic transition is equivalent to a continuous “composition” change with the 4f-localized “big Ce” gradually substituted by 4f-itinerant “small Ce.” As a result, we are able to vary both pressure and composition of a MG in a well-controlled way for the first time, to our knowledge. 相似文献