经皮椎体成形术后椎体感染的手术治疗

经皮椎体成形术（percutaneous vertebroplasty，PVP）因其操作简单、疼痛缓解快，已广泛用于治疗椎体压缩性骨折、多发性骨髓瘤、椎体转移性病变和血管瘤引起的疼痛。尤其在治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）上取得了显著的疗效。然而，随着PVP的应用越来越多，随之而来的并发症（包括骨水泥渗漏、神经压迫、再骨折、感染以及骨水泥栓塞等）也显著增多。在这些并发症中，PVP术后椎体感染发生率低，治疗经验有限，并无统一的治疗标准，且其发生后是否需要手术以及手术方式的选择仍存在争议。2016年1月~2020年1月我院手术治疗9例PVP术后椎体感染的患者，总结如下。     

低分子肝素超氧化物歧化酶结合物对白细胞介素6转基因小鼠局灶性脑缺血模型星形胶质细胞的影响

BACKGROUND： Studies have shown that low molecular weight heparin-superoxide dismutase conjugate exhibits a remarkable neuroprotective effect.
OBJECTIVE： To investigate the effect of low molecular weight heparin-superoxide dismutase conjugate on astrocytes in an interleukin-6 （IL-6） overexpressing mice following local cerebral ischemia.
DESIGN, TIME AND SETTING： Randomized, cytological, controlled, animal study was performed in the Department of Physiology and Neuroscience, Neurology and Biochemistry and Molecular Biology, Medical University of South Carolina from January 2005 to March 2005.
MATERIALS： Nine IL-6 transgenic mice, irrespective of gender, were randomly divided into three groups： sham-operated, model, and treatment, with three mice in each group. With exception of the sham-operated group, right middle cerebral artery occlusion was induced in the mice. Expression of glial fibrillary acidic protein, an astrocyte marker, was determined by immunohistochemistry. Low molecular weight heparin-superoxide dismutase conjugate was purchased from Biochemistry and Biotechnique Institute, Shandong University.
METHODS： Two minutes prior to ischemia induction, 0.5 mL/kg saline or 20 000 U/kg low molecular weight heparin-superoxide dismutase conjugate were administrated via the femoral artery in the model group and treatment group, respectively. The sham-operated group underwent the same protocols, with the exception of occlusion and treatment.
MAIN OUTCOME MEASURES： The number of glial fibrillary acidic protein-positive cells was quantified under light microscopy （x200）.
RESULTS： In the sham-operated group, there were a large number of astrocytes in the IL-6 transgenic mice. However, the cell bodies were small, and the branches were few and thin. The number of astrocytes in the model group was remarkably less than the sham-operated group. Compared to the model and sham-operated groups, the number of astrocytes significantly increased, and the cell body became larger, following treatment with low molecular weight heparin-superoxide dismutase conjugate. Astrocytes exhibited hypertrophy and hyperplasia, and the processes became longer and thicker.
CONCLUSION： The low molecular weight heparin-superoxide dismutase conjugate may provide neuroprotection through astrocytic activation at the super-early stage of cerebral ischemia and reperfusion.     

硬膜外腔应用吗啡超前镇痛的临床意义

目的：探讨硬膜外腔应用吗啡超前镇痛的临床意义,方法选择硬膜外阻滞行腹部手术患６９例,随机分成两组,均经硬膜外导管注入用生理盐水稀释至５ｍＬ的吗啡２ｍｇ,Ⅰ组术毕缝皮瓣,Ⅱ组于术后阻滞消退后,结果两组镇痛作用时间和节段数相仿,镇痛效果优,良率均为１００．０％。两组术后４８ｈ内镇痛药应用率和恶心、呕吐、瘙羊的发生率相似。尿潴留发生率Ⅰ组为４２．１％,Ⅱ组为１２．９％（Ｐ〈０．０５）。结论应用吗啡行超     

亚急性脊髓联合变性的诊断

为探讨亚急性脊髓联合变性(SCD)的早期诊断方法，我们对9例SCD的诊断方法及结果进行分析。现报告如下。     

后路长节段固定联合伤椎打压植骨与联合伤椎骨水泥强化治疗Ⅲ期Kümmell病的疗效比较

目的比较后路长节段固定联合伤椎打压植骨与联合伤椎骨水泥强化治疗Ⅲ期Kümmell病的疗效。方法采用回顾性队列研究分析2016年1月至2020年12月郑州市骨科医院收治的38例Ⅲ期Kümmell病患者临床资料, 其中男8例, 女30例;年龄59～81岁[(68.9±4.9)岁]。骨折椎体:T8 1例, T11 9例, T12 10例, L1 8例, L2 10例。17例行后路长节段固定联合伤椎椎弓根打压植骨术治疗(打压植骨组), 21例行后路长节段固定联合伤椎骨水泥强化术治疗(骨水泥组)。比较两组手术时间、术中出血量;术前、术后1周、术后3个月及末次随访时视觉模拟评分(VAS)、日本骨科学会(JOA)评分、后凸Cobb角;末次随访时骨性愈合情况;并发症发生率。结果患者均获随访24～35个月[(28.7±2.9)个月]。打压植骨组手术时间为(150.7±25.4)min, 术中出血量为(285.3±48.6)ml;骨水泥组分别为(132.0±21.1)min和(251.4±44.8)ml(P均<0.05)。术前两组VAS、JOA评分及后凸Cobb角差异无统计学意义(P均>0.0...     

基底动脉尖综合征25例临床分析

基底动脉尖综合征（top of the basilar syndrom，TOBS）为基底动脉顶端血液循环障碍所引起的一组临床综合征，这是一种特殊类型的缺血性脑于血管病，也是神经内科的急危重症之一。Caplan首先报道，国内自1991年以来陆续有报道，近年来随着临床医师对此病的认识加深以及影像学（特别16排和64排CT及MRI）的进展，确诊TOBS病例增多，现将我院收治的25例TOBS分析如下。     

降压不当诱发老年脑梗塞12例报告

降压不当诱发老年脑梗塞１２例报告山东铝业公司医院（２５５０６９）王庆德，张东庆高血压是脑血管病的危险因素，有效的降压治疗可以明显改善高血压病人的预后，但降压不当会严重影响脑血流，诱发脑梗塞［１～３］。本文报告１２例因降压治疗诱发的老年脑使塞，旨在引起...     

降压过快诱发大面积脑梗塞1例报告

女,58岁。因头痛头晕3个月就诊。既往体健。查体;血压26.6/12.0千帕。眼底为动脉硬化Ⅱ级,余无异常。诊断高血压病(Ⅱ期)。给予复方降压片(2片日3次),治疗2天无效再诊。测血压29/12千帕。加服硝苯地平(10毫克日3次)约8小时(服硝苯地平共20毫克)后头晕加重,并反复发作左侧上下肢活动不灵4次,每次持续3～5分钟(此时曾测血压17/10千帕),约12小时后左上下肢活动失灵,不能言语,并     

胆囊结石碎石标准及影响碎石因素的探讨—(附122例分析)

本文分析了122例胆囊结石体外冲击波碎石术(E8WL)。依据胆囊管及Vater氏壶腹部的出口解剖,提出解剖性碎石的概念,及碎石标准分类。分析影响碎石因素。提出解剖性碎石是排石的先决条件。并对ESWL治疗胆结石前景进行初步探讨。     

体外震波碎石治疗胆囊结石所致并发症及处理

我院自1988年12月至1990年1月。应用液电式BD8828型体外震波碎石机治疗胆囊结石155例,本文就治疗中并发症的产生机理及处理探讨如下。临床资料本组155例,年龄21～79岁,男56例(36.1%),女99例(63.9%)。单发结石119例,多发结石31例,最大结石3.5×2.3cm。复碎22例(14.2%),震