腰椎退变性后凸截骨矫形内固定后矢状面的平衡变化

BACKGROUND: At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters following corrective osteotomy for lumbar degenerative kyphosis have not been reported. OBJECTIVE: To evaluate postoperative changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis. METHODS: We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final follow-up. RESULTS AND CONCLUSION: (1) There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle (P < 0.05). (2) There were significant differences between postoperative and last follow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis (P < 0.05). (3) Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation (r=-0.610, P < 0.001). Thoracic kyphosis was positively correlated with lumbar lordosis (r=0.598, P < 0.001). (4) Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.      

保留双侧半棘肌改良单开门椎管扩大钢板置入：减少轴性症状及颈椎曲度丢失

BACKGROUND: Cervical single-door laminoplasty for chronic compressive myelopathy has obtained exact effects. To reduce the occurrence of related complications, different doctors have proposed different improvement programs, and have achieved a certain effect, but the effect on postoperative complications is not very well. OBJECTIVE: To evaluate the effect of modified open-door laminoplasty with steel implantation and preservation of bilateral semispinalis. METHODS: We retrospectively analyzed the data of 30 cases of multilevel cervical spondyiotic myelopathy who underwent modified open-door laminoplasty from October 2013 to March 2014. Internal fixation material was Centerpiece titanium plate fixation system. Visual Analogue Scale score, Japanese Orthopaedic Association score (17-score method), neck disability index, range of motion of cervical vertebra, and cervical curvature were compared before treatment and during follow-up. Axial symptom severity was assessed after treatment. RESULTS AND CONCLUSION: The patients were followed up for 12-24 months. No complications appeared during repair, including postoperative spinal cord injury, cerebrospinal fluid leakage, infection or C5 nerve root palsy. Only one patient suffered from axial pain, but there was no need for oral medication. The improvement rate of Japanese Orthopaedic Association score was (76.96±17.61)%. Neck disability index decreased from 12.29±3.82 preoperatively to 8.24±2.86 in final follow-up. Range of motion of cervical vertebra (47.41±17.33)° in final follow-up, accounting for (93.0±4.2)% of preoperative data. Cervical curvature decreased from (13.47±10.54)° preoperatively to (12.88±8.56)° in final follow-up. These findings confirm that modified open-door laminoplasty with preservation of bilateral semispinalis can reserve cervical rear structure to maximum extent, is conducive to early functional exercise after rehabilitation, and reduces the incidence of axial symptoms and loss of cervical curvature.       

崂山区农村居民患病住院状况及影响因素分析

目的：了解青岛市崂山区农村居民的住院状况及影响因素。方法：采取分层与随机抽样相结合的方法，对青岛市崂山区12个村（居委会）的7482人进行问卷调查。结果：崂山区农村居民的住院率为40．10‰；76．57％的病人住在市级及以上医院，因病住院者占67．82％；居民住院率与年龄、文化水平、职业、婚姻状况、是否患有慢性病及就诊距离等因素有关。结论：青岛市崂山区农村居民住院服务的利用率较高，受多种因素的影响，应重视高年龄组人群的卫生保健和慢性疾病的防治工作。     

高值血清肌酸激酶稀释物的选择

我们发现应用灭活血清稀释高活性CK 值的结果优于临床常用的生理盐水稀释液.首先,将混合血清置56℃水浴箱30分钟,经此灭活CK 值为0～1U/L.CK 测定按试剂盒说明操作(中生公司),仪器为cobas MIRAs.因超出线性范围的高CK 活性无法测得实际值.因此要说明应用不同稀释液稀释后的值与实际值的相符程度,我们采用线性范围之内的高CK 活性血清,结果见附表.     

高热惊厥脑电图的临床意义

高热惊厥脑电图的临床意义盛军（陕西省郑州铁路局西安中心医院７１００５４）惊厥是婴幼儿最多见的急性症状，６０％以上由上呼吸道感染导致高热惊厥。发作时以阵挛、强直居多，少数为肌张力低下，脑电图常显示各种异常表现。一般资料近年我院收治２３例，女９例、男１４...     

强化思想政治工作 打造医院特色文化品牌

思想思想政治工作是党的生命线,“八荣八耻”是倡导时代新风的“正衣镜”,是党密切联系群众的纽带和桥梁,是永葆先进性、增强凝聚力、提升战斗力的思想保证。通过强有力的思想政治工作和丰富多彩的创新实践,培养和造就一支德艺双馨的员工队伍,积极打造医院特色文化品牌。     

下腰椎后路手术硬脊膜损伤和脑脊液漏的防治

目的:探讨下腰椎手术合并硬脊膜损伤及脑脊液漏的处理方法。方法:24例硬脊膜损伤患者术中给予不同的修复,其中术后10例脑脊液漏患者进行蛛网膜下腔引流。结果:24例患者均痊愈出院,无一例发生脑脊髓炎和脑脊液囊肿等并发症。结论:硬脊膜损伤根据不同程度给予相应的修复是首选方法,持续蛛网膜下腔置管引流是治疗脑脊液漏的有效方法。     

肺炎球菌外膜蛋白A的分离纯化及免疫原性

培养肺炎球菌FY06，采用表面活性剂从菌泥抽提外膜蛋白，依次用硫酸铵盐析法和DEAE-纤维素离子交换法对肺炎球菌外膜蛋白进行分离和纯化。免疫原性实验表明：所制备的外膜蛋白A具有优良的免疫原性，对5种血清型肺炎球菌均有较广泛的交叉免疫效果。可作为新．代的肺炎球菌疫苗成分。     

5-HT3受体拮抗剂所致便秘中医诊治思路与方法

目的：研究中医治疗5-HT3受体拮抗剂所致便秘的思路与方法。方法：通过对肿瘤化疗病人因应用5-HT3受体拮抗剂而出现的不良反应-便秘的症状、舌象、脉象进行辨证分析,得出辨证结论,分析治疗方法。结果：5-HT3受体拮抗剂所致便秘中医辨证为阴虚燥结,治以滋阴通腑泻热,方药选用增液承气汤。结论：增液承气汤是治疗5-HT3受体拮抗剂所致便秘的有效方剂,而且能提高5-HT3受体拮抗剂的止吐效果。     

后路经顶椎楔形截骨矫形治疗重度僵硬性特发性脊柱侧凸

目的：评价后路经顶椎楔形截骨治疗重度僵硬性特发性脊柱侧凸的疗效及安全性。方法回顾性分析1998年9月-2012年12月收治的17例重度僵硬性特发性脊柱侧凸患者的临床资料,其中男5例,女12例;年龄14~24岁,平均18.6岁;LenkeⅡ型3例,Ⅲ型4例,Ⅳ型4例,Ⅵ型6例。均行后路经顶椎楔形截骨矫形固定融合术。术前、术后及随访时拍摄站立位全脊柱X线片,测量冠状面、矢状面侧凸Cobb角及躯干矢状面偏移距离,记录脊柱融合固定节段和融合情况。结果均获得随访12~84个月,平均47.6个月。融合固定节段为11~16节椎体,平均14节。末次随访冠状面Cobb角由术前平均102.2°,矫正至39.4°,矫正率为61.4%;矢状面Cobb角由术前平均49.5°,矫正至8.6°,矫正率为82.6%;躯干冠状偏移距离由术前平均-29.8 mm,矫正至-3.5 mm,平均矫正26 mm。围手术期并发症主要包括胸膜破裂4例,胃肠道功能紊乱2例。结论对重度僵硬性特发性脊柱侧凸采取后路经顶椎楔形截骨矫形及内固定是较为安全、有效的方法。