急诊经皮撬拨复位克氏针内固定治疗SandersⅡ型跟骨骨折（附23例病例报告）

目的观察急诊经皮撬拨复位克氏针内固定治疗SandersⅡ型跟骨骨折的疗效,探讨SandersⅡ型跟骨骨折的治疗方案。方法选取2004年6月～2008年6月我院收治的23例跟骨骨折患者为研究对象,在X线监视下进行,采用经皮撬拨复位克氏针内固定治疗,术后以石膏管型外固定。结果所有患者获得12～36个月（平均19.5个月）随访。术后平均骨折愈合时间为10周。术后X线照片检查示Bhler角、Gissane角、跟骨外形基本恢复正常。结论急诊经皮撬拨复位克氏针内固定治疗SandersⅡ型跟骨骨折,具有操作简单、疗效可靠、创伤小、并发症少及恢复快等优点。     

双媒介间接电解氧化法合成醋酸可的松

在相转移试剂（Ｂｕ_４Ｎ~＋）存在下，以Ａｇ~＋／Ａｇ~（２＋）－Ｃｒ~（３＋）／Ｃｒ_２Ｏ_７~（２－）为双媒介，间接电解氧化表氢可的松醋酸酯生成醋酸可的松，化学收率为９４．３％，电流效率为７６．５％，同时阳极电解液可重复使用。     

Reduction of peristaltic artifacts on magnetic resonance imaging of the abdomen: a comparative evaluation of three drugs

Background: Peristaltic motion is an omnipresent source of degradation in abdominal magnetic resonance (MR) imaging by blurring images and producing ghost artifacts that can mask or mimic lesions. The objective of this study was to select an effective and easy-to-administer drug to provide consistent reduction of peristaltic motion artifacts on MR images. Methods: One hundred forty-eight adult patients with MR examinations of the abdomen were enrolled in a prospective, single-blind comparative study. Four groups were defined: (a) no-drug control group (n = 35), (b) 1 mg of intravenous (IV) glucagon (n = 19), (c) 20 mg of IV butylscopolamine (n = 28), and (d) 20 mg of oral dicyclomine (n = 66). All patients received high-density barium sulphate as a negative oral contrast medium. Quantitative image analysis was performed with operator-defined region-of-interest measurements of signal intensity. Gastrointestinal noise was measured outside the patient at the posterior part of the left hemiabdomen along the phase-encoding direction on a short inversion time inversion recovery (STIR) sequence. Results: Treatment groups showed reduced gastrointestinal noise (p < 0.01). When compared with the control group, IV butylscopolamine (p < 0.05) and oral dicyclomine (p < 0.05) significantly reduced gastrointestinal noise, whereas glucagon did not. Conclusion: Anticholinergic drugs significantly reduced the intensity of ghost artifacts on MR imaging of the abdomen. Twenty milligrams of oral dicyclomine is an effective and safe alternative to more expensive and parenterally administered drugs such as glucagon and butylscopolamine. Received: 22 November 1994/Accepted after revision: 14 March 1995     

Histochemical evaluation of the coagulation depth after argon laser impact on a port-wine stain.

A two-step excisional treatment of a port-wine stain (PWS) on the back of a 43-yr-old female patient was performed. Immediately before the first surgical treatment, two corresponding series of argon laser impacts were performed, each on one PWS half. Different laser parameters with irradiances ranging from 95 to 382 W/cm2 and energy fluences ranging from 19 to 114,6 J/cm2 were used. Laser spots on the first part ot be excised were biopsied 10 min after laser treatment and prepared for histochemical analysis by staining with nitro blue tetrazolium chloride (NBTC). Reduction of this redox dye by nicotinamide adenine dinucleotide diaphorase (NADH-diaphorase) leads on frozen tissue sections to an intense blue precipitate. The activity of NADH-diaphorase subsides immediately upon cell damage. All vital epidermal and dermal cells presented a dense blue granular pigment in their cytoplasm, sparing the nuclei. Laser induced arc-shaped epidermal and dermal necrosis did not stain, showing a clear demarcation from surrounding vital tissue. The depth of the thermal injury ranged from 0.28 to 0.45 mm; it did not correlate with the chosen fluences. With these penetration depths, the vast majority of PWS vessels was affected. Assessment of the remaining part of the PWS 8 months later yielded blanching of all laser-treated areas. With the NBTC method, an accurate definition of laser-induced tissue damage is feasible. It could be shown that the exposure time is the most relevant parameter influencing the penetration depth.     

Another option to treat Kümmell’s disease with cord compression

The efficiency of short-segment fixation with transpedicle body augmenter (a titanium spacer with bone-ingrowth porous surface, TpBA) to treat Kümmell's disease with cord compression (stage III) was retrospectively evaluated. No laminectomy or instrumentation reduction was done. Inclusion criteria included Frankel CDE, single-level within T10-L2. FU rate was 88%, i.e. 21 cases were included. Frankel function classification was 6E9D6C. Mean age was 72+/-8 years. F:M was 16:5. FU period was 48 M (range, 30-76 M). The hospitalization was 4.5+/-2.2 days; operation time, 70.4+/-17.2 min; blood loss, 150+/-72 cc. Final Frankel class was 20E1D. Complications included two superficial infection and one pneumonia. Body height and kyphosis were all corrected significantly and well preserved at the final visit. No TpBA dislodgement or implant failure was noted; however, three cases developed new compression fractures. The clinical outcome showed 81% with P1 or P2 by Denis pain scale. This method can decompress spinal canal, maintain kyphosis correction and vertebral restoration, prevent implant failure, and attain good clinical results.     

股骨近端解剖型钢板治疗股骨粗隆下不稳定性骨折

目的:探讨股骨近端解剖型钢板治疗股骨粗隆下不稳定骨折的临床价值.方法:自2001年1月～2003年6月采用切开复位、股骨近端解剖型钢板内固定治疗股骨粗隆下不稳定骨折23例.根据术前术后X线片及术后髋关节功能、站立及行走等恢复情况评价内固定效果.结果:17例获得随访,随访时间6个月～3年,根据黄公怡评定标准,优9例,良6例,差2例.结论:股骨近端解剖型钢板治疗高位股骨粗隆下不稳定骨折具有安全可靠、能允许术后早期部分负重等特点,是治疗高位股骨粗隆下骨折的理想选择.     

Optimization of the protrusion shape for a couette-type flow

A study is made of the longitudinal 2D viscous steady flow and heat flux between two plates. Optimal shape design problems are solved in explicit form and shown to have unique global extrema. Conformal mappings are used to bring the problems into a fixed domain and solve them as Dirichlet boundary value problems in the form of Cauchy integrals and series expansions. For the simplest problem statement the optimum is shown to coincide with the well-known concrete dam outline of constant hydraulic gradient.     

Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries

We present a three-dimensional anatomical computer model of the terminal branches of the posterior cerebral artery and circle of Willis, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries. This can help to identify the arteries in conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can be matched with CT, MR und PET images to indicate the areas of extension of the individual branches, allowing neuromorphological and functional correlations.     

解剖型钢板固定干骺部骨折评价(附98例报告)

目的：探索MAY解剖型钢板在干骺部骨折治疗中的应用。方法：通过对98例干骺部骨折采用MAY解剖型钢板固定的评析，评价该手术的优越性。结果：MAY解剖型钢板在干骺部骨折治疗中疗效满意。结论：MAY解剖型钢板是根据骨骼的特定部位的解剖形态制作的，与干骺部骨轮廊相匹配，因而手术操作极为方便，创伤小，固定骨折稳定性好，有利于骨折愈合和功能锻炼，是干骺部骨折理想的内固定材料。     

An unusual reduction technique prior to surgical treatment for traumatic spondylolisthesis in the lower cervical spine

Traumatic spondylolisthesis in the lower cervical spine is rare and only a few cases have been reported. We present a 56-year-old man who had severe C6-C7 spondylolisthesis without major neurological complications, caused by a traffic accident. Plain CT images showed a pedicular fracture on the right side and a laminar fracture on the left side at C6, but magnetic resonance images revealed no spinal cord compression. Application of a halo brace and maintaining the neck in slight flexion without traction resulted in reduction of the spondylolisthesis to nearly normal alignment. Anterior fusion using an autogeneous bone graft and a plate was easily performed without loss of correction. We suggest that preoperative reduction using a halo brace in slight flexion without longitudinal skull traction is useful and effective for severe traumatic spondylolisthesis in the lower cervical spine.