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目的:分析不同载荷对C4~5椎间孔孔径变化的影响。方法:实验于2006-01/2006-05在湘南学院附属医院进行。成人新鲜尸体颈椎标本10具(自愿捐献或家属同意),节段包括C3~T1,剔除肌肉组织,保留椎间盘、韧带和关节囊结构的完整。分别测量椎间盘完整、椎间盘髓核摘除、颈人工椎间盘置换和前路钢板植骨内固定4种状态下,加压速度为5mm/min时,25,50,75,100,125和150N的分级轴向载荷加载于标本时C4~5上下径、上前后径、下前后径以及椎间孔面积的变化。结果:①轴向加载25N时,C4~5椎间孔面积椎间盘髓核摘除标本小于完整椎间盘、颈人工椎间盘置换和前路钢板植骨内固定标本[(57.26±17.65),(65.81±16.83),(75.37±17.75),(66.21±16.50)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。②轴向加载50N时,C4~5椎间孔面积椎间盘髓核摘除标本小于其他3组[(57.13±17.64),(65.72±16.85),(75.35±17.75),(66.11±16.46)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。③轴向加载75N时,上下径:C4~5椎间孔面积椎间盘髓核摘除标本小于其他3组[(55.26±17.66),(64.80±16.85),(73.32±17.74),(65.21±16.48)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。④轴向加载100N时,上下径:C4~5椎间孔面积椎间盘髓核摘除标本小于其他3组[(53.22±17.66),(63.81±16.83),(71.35±17.76),(65.27±16.46)mm2,P<0.05]。⑤轴向加载125N时,C4~5椎间孔面积椎间盘髓核摘除标本小于其他3组[(51.25±17.64),(62.82±16.83),(69.25±17.74),(65.25±16.43)mm2,P<0.05]。⑥椎间孔面积:轴向加载150N时,C4~5椎间孔面积椎间盘髓核摘除标本小于其他3组[(49.16±17.65),(61.84±16.86),(67.15±17.73),(65.24±16.42)mm2,P<0.05]结论:颈椎间盘髓核摘除后C4~5椎间孔有效空间明显减少。 相似文献
23.
Finding meaning in the death of a loved one is thought to be extremely traumatic when the circumstances surrounding the death is perceived to be due to negligence, is intentional, and when the deceased suffered extreme pain and bodily harm immediately prior to death. We addressed this assumption by obtaining personal narratives and empirical data from 138 parents 4, 12, 24, and 60 months after an adolescent's or young adult child's death by accident, suicide, or homicide. Using the Janoff-Bulman and Frantz's(1997) framework ofmeaning-as-comprehensibility and meaning-as-significance, the purposes were to identify the time course to find meaning, present parents' personal narratives describing finding meaning in their experiences, identify predictors of finding meaning, and compare parents who found meaning versus those who did not on five health and adjustment outcomes. The results showed that by 12 months postdeath, only 12% of the study sample had found meaning in a child's death. By 60 months postdeath, 57% of the parents had found meaning but 43% had not. Significant predictors of finding meaning 5 years postdeath were the use of religious coping and support group attendance. Parents who attended abereavement support group were 4 times more likely to find meaning than parents who did not attend. Parents who found meaning in the deaths of their children reported significantly lower scores on mental distress, higher marital satisfaction, and better physical health than parents who were unable to find meaning. Recommendations for future research are made. 相似文献
24.
Daniel WH Mang Gunter P Siegmund Jean-Sébastien Blouin 《The Journal of the Canadian Chiropractic Association》2014,58(2):109-118
Whiplash injuries are the most common injuries following rear-end collisions. During a rear-end collision, the human muscle response consists of both a postural and a startle response that may exacerbate injury. However, most previous studies only assessed the presence of startle using data collected from the neck muscles and head/neck kinematics. The startle response also evokes a descending pattern of muscle recruitment and changes in autonomic activity. Here we examined the recruitment of axial and appendicular muscles along with autonomic responses to confirm whether these other features of a startle response were present during the first exposure to a whiplash perturbation. Ten subjects experienced a single whiplash perturbation while recording electromyography, electrocardiogram, and electrodermal responses. All subjects exhibited a descending pattern of muscle recruitment, and increasing heart rate and electrodermal responses following the collision. Our results provide further support that the startle response is a component of the response to whiplash collisions. 相似文献
25.
26.
B. J. ORMSTON L. ALEXANDER D. C. EVERED F. CLARK T. BIRD D. APPLETON R. HALL 《Clinical endocrinology》1973,2(4):369-376
Thirty-four patients with ophthalmic Graves' disease were investigated by routine thyroid function tests, by measurement of the serum thyroid-stimulating hormone (TSH) response to thyrotrophin-releasing hormone (TRH) and by measurement of the serum triiodothyronine (T3) levels. The patients could be divided into four groups according to their response to TRH—normal, impaired, absent and exaggerated. Those with normal responses had routine thyroid function tests and serum T3 levels which in general did not differ from normal control values. Those with impaired and with absent responses showed routine thyroid function tests which approached the hyperthyroid range together with significant elevation of serum T3 levels. It is suggested that they might represent examples of ‘subclinical T3 thyrotoxicosis’. Patients with exaggerated responses had routine thyroid function tests near the lower end of the normal range and could be regarded as suffering from ‘subclinical hypothyroidism’. There was a good correlation between a normal TRH response and normal thyroid suppressibility by T3, and between impaired and absent responses and impaired thyroid suppressibility. It is evident that the TRH test which is safer, shorter and more convenient, can replace the T3 suppression test in routine clinical practice. The response to TRH also provided information on the activity of the eye signs, a normal response was associated with improving eye signs whereas impaired, absent or exaggerated responses were associated with static signs or actual deterioration. The TRH test is of value in the diagnosis of unilateral exophthalmos since about three-quarters of the patients in this series showed some abnormality. The wide range of TRH response and of circulating thyroid hormone levels is to be expected since the thyroid is not subject to the normal finely-balanced negative feed-back mechanism via TSH. 相似文献
27.
HYPERPROLACTINAEMIA AFTER EXTERNAL IRRADIATION FOR ACROMEGALY 总被引:1,自引:0,他引:1
The progress of twelve patients who received external irradiation of the pituitary as sole treatment for acromegaly was reviewed. In all cases a fall in serum GH was achieved and no patient developed hypopituitarism. Three had mild hyperprolactinaemia before therapy. In all twelve cases, PRL levels rose after treatment, in five entering the hyperprolactinaemic range. It is suggested that the most likely cause is interference with the supply of prolactin release inhibiting factor (PIF) by the effects of irradiation on the hypothalamus. 相似文献
28.
Tom De Beule T Boulanger S Heye WJ van Rooij WH van Zwam L Stockx 《Interventional neuroradiology》2021,27(1):51
Background and purposeFlow diverters are increasingly used to treat intracranial aneurysms. We report the safety and efficacy of the p64 flow diverter, a resheathable and detachable device for intracranial aneurysms.Materials and methodsWe retrospectively reviewed 108 patients with 109 aneurysms treated with the p64 between March 2014 and July 2019. There were 87 women and 21 men, mean age 57 years. Of 109 aneurysms, 74 were discovered incidentally, 12 were symptomatic, 18 were previously treated, and five were ruptured dissection aneurysms. A total of 10 aneurysms were located in the posterior circulation. The mean aneurysm or remnant size was 8.1 mm.ResultsHemorrhage by perforation with the distal guidewire occurred in two patients with permanent neurological deficits in one. In one patient, acute in-stent occlusion caused infarction with a permanent deficit. Permanent morbidity was 1.9% (2 of 108, 95%CI 0.1–6.9%); there was no mortality. During follow-up, three in-stent occlusions occurred, all asymptomatic. There were no delayed hemorrhagic complications. At six months, 77 of 96 aneurysms (80.2%) were completely occluded, and at last follow-up, this increased to 93 of 96 aneurysms (96.9%). In-stent stenosis at any degree occurred in 11 patients, progressing to asymptomatic complete occlusion in one. In the other patients, stenosis resolved or improved at further follow-up.ConclusionThe p64 offers an effective and safe treatment option. Aneurysm occlusion rate was 97% at last follow-up, mostly achieved with a single device. There were no delayed hemorrhagic complications. Delayed in-stent stenosis infrequently progresses to occlusion but remains a matter of concern. 相似文献
29.
Summary. Peripheral blood stem cell autografts for the treatment of chronic myeloid leukaemia (CML) are currently under evaluation. A patient with CML received intensive chemotherapy followed by granulocyte colony-stimulating factor prior to the collection of peripheral blood derived stem cells. He developed unusually severe, and fatal, hypophosphataemia and this coincided with the rapid rise of his peripheral blood white cell count. The hypophosphataemia was considered to be due to a combination of severe anorexia, sepsis and the rapid growth factor-stimulated myeloid regeneration in CML. 相似文献
30.
C. BARNES D. LILLICRAP† J. PAZMINO-CANIZARES‡ V. S. BLANCHETTE A. M. STAIN§ D. CLARK C. HENSMEN† M. CARCAO 《Haemophilia》2006,12(S4):40-49
Summary. Understanding the pharmacokinetics (PK) of factor VIII (FVIII) is important in the management of patients with haemophilia A. We studied the PK of FVIII in order to determine aetiological factors contributing to PK variability of FVIII in children.
Twenty children with haemophilia A (mean age 12.8 years) were administered a single bolus of 50 U kg−1 of recombinant FVIII (rFVIII; Kogenate-FS® , Bayer).
The mean incremental FVIII recovery was 1.87 (U mL−1 )/(U kg−1 ) (range: 1.25–2.76) and the mean FVIII half-life was 10.7 h (range: 7.8–15.3). FVIII recovery was positively correlated with body surface area (BSA; P = 0.04). FVIII half-life was positively correlated with preinfusion levels of von Willebrand factor antigen (VWF:Ag) ( P = 0.0001) and was reduced in patients ( n = 6) with very low FVIII inhibitor titres (<0.5 BU) vs. those ( n = 14) with negative inhibitor titres ( P = 0.06).
These observations suggest that (i) young children with haemophilia in comparison with adults have a low recovery of FVIII and that this might be explained by differences in body composition (BSA, plasma volume), (ii) levels of VWF:Ag may explain some of the differences in the half-life and clearance of FVIII and (iii) very low inhibitor titres, previously regarded as clinically insignificant, may actually be significant and should be evaluated in the context of PK studies. 相似文献
Twenty children with haemophilia A (mean age 12.8 years) were administered a single bolus of 50 U kg
The mean incremental FVIII recovery was 1.87 (U mL
These observations suggest that (i) young children with haemophilia in comparison with adults have a low recovery of FVIII and that this might be explained by differences in body composition (BSA, plasma volume), (ii) levels of VWF:Ag may explain some of the differences in the half-life and clearance of FVIII and (iii) very low inhibitor titres, previously regarded as clinically insignificant, may actually be significant and should be evaluated in the context of PK studies. 相似文献