The design of a cervical vertebra titanium plate-interbody fusion cage

Objective： To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods： Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results： As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion： Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.     

Evaluation of PTEN expression in cervical adenocarcinoma by tissue microarray

PTEN, a tumor suppressor gene, appears to negatively control the phosphoinositide 3-kinase signaling pathway for regulation of cell proliferation and cell survival. Somatic PTEN mutations are involved in a variety of tumors, including endometrial carcinomas, where PTEN expression is diminished. We examined expression of PTEN in a series of cervical adenocarcinomas and precursors, using tissue microarray (TMA) technology. TMA blocks were constructed using paraffin-embedded, formalin-fixed tissues from 273 samples derived from 16 normal cervical biopsies, 119 cases of invasive adenocarcinoma, and 20 high-grade cervical glandular intraepithelial neoplasia (CGIN). Fresh 3-mum sections were cut and immunostained with PTEN, and expression was correlated with clinicopathologic variables, including histologic subtypes of adenocarcinoma. In 137 patients, PTEN expression was positive in 121 (88%). The intensity and distribution of PTEN staining in the tumor tissue were more heterogeneous than those observed in the normal tissues. There were no significant differences in distribution or intensity of PTEN expression between adenocarcinoma in situ and subtypes of invasive adenocarcinoma. Our findings show that unlike the case in most endometrial carcinomas, PTEN expression is retained during the process of carcinogenesis in the glandular cervix. There is, however, evidence of altered distribution and intensity of PTEN expression in cervical adenocarcinoma cells.     

Immunohistochemical characterization of endocervical papillary serous carcinoma

Abstract.   Nofech-Mozes S, Rasty G, Ismiil N, Covens A, Khalifa MA. Immunohistochemical characterization of endocervical papillary serous carcinoma. Int J Gynecol Cancer 2006; 16(Suppl. 1): 286–292.
Endocervical adenocarcinomas are rare and aggressive neoplasms. Papillary serous endocervical adenocarcinomas are the rarest form of endocervical adenocarcinomas. This tumor exhibits morphologic similarities to its counterparts commonly seen in the endometrium, fallopian tubes, ovaries, and peritoneum, which are known to have an aggressive behavior. Because of the rarity of this tumor, little is known about its immunophenotyping. In this study, we included ten cases of papillary serous carcinomas arising from the uterine cervix (PSCC) diagnosed in the absence of a primary endometrial malignancy. We studied their immunohistochemical profile, using a panel of antibodies against Ki67, bcl-2, p53, carcinoembryonic antigen (CEA), and CD10, and compared them to 20 consecutive cases of cervical adenocarcinoma of conventional cell subtypes (CAC) (15 mucinous, 3 adenosquamous, and 2 endometrioid). Immunostaining was recorded semiquantitatively. Patients with PSCC ranged in age from 27 to 79 years (mean = 51.6 ± 19.1), while the conventional cell subtypes control group were 28–90 years old (mean = 47.5 ± 16.9). Only p53 and CEA immunostaining significantly correlated with the PSCC morphology ( P = 0.001 and P = 0.016, respectively) as shown by Cochran–Mantel–Haenszel Statistics (Modified Ridit Scores). PSCC is a distinctive immunophenotypic subtype of endocervical adenocarcinoma with significantly higher p53 and lower CEA reactivity than other more common histologic subtypes.     

脊髓型颈椎病患者三维有限元模型的构建与生物力学分析

目的：构建颈部三维有限元模型(finite element model,FEM),初步分析脊髓型颈椎病(cervical spondylotic myelopathy,CSM)患者与对照者颈部生物力学的差异,为CSM发病机制的研究提供生物力学依据。方法：以1名CSM患者作为力学模拟实验对象进行三维CT扫描,并构建颈部三维FEM依照患者的年龄、性别、身高、体重等参数选取本团队已有的健康颈部三维FEM作为对照,比较患者和对照者在颈椎正常受力情况下椎体、椎间盘、韧带及脊髓的应力差异,以及后仰伸运动后最大应力的差异。结果：成功构建CSM患者及对照者FEM模型,并进行力学分析,CSM患者颈椎椎体受力差异C5~C6节段最明显,对照者和患者的最大应力部位均在椎体前缘,CSM患者椎体前缘的最大应力小于对照者;CSM患者椎间盘应力分布不均匀,最大应力部位集中在椎间盘底部后缘的两侧;CSM患者各韧带的应力分布不均匀,其中后纵韧带应力最大。CSM患者颈椎在后仰伸运动时范围受限。结论：CSM患者相对于对照者可能存在颈部椎体、椎间盘及韧带受力平衡的改变和颈椎运动范围的受限,这可能与CSM力学发病机制相关。     

颈部肿块性质与年龄和性别关系的研究

目的研究颈部肿块性质与年龄和性别的关系,以期提高颈部肿块的诊断水平。方法回顾性分析2000年1月至2006年1月经病理确诊颈部肿块病例2136例。根据肿块的性质分为先天性、良性、恶性肿块。按年龄段分为四组:0～19岁,20～39岁,40～59岁,≥60岁。统计各年龄组三种性质肿块的构成比及不同年龄组、不同性别三种性质肿块的构成比。结果三种性质肿块在不同年龄组构成比均差异有统计学意义(P<0.01)。先天性肿块多见于20岁以下,各年龄组男女无差异;良性肿块多见于20～39岁,男女构成比差异有统计学意义(P<0.05),女性多于男性,其余三组中男女无差异(P>0.05);恶性肿块多见于40岁以上,男女构成比相比在0～19岁差异无统计学意义(P>0.05),在其余三组差异有统计学意义(P<0.01),男性多于女性。结论颈部肿块性质与年龄和性别存在着明显的关系,年龄和性别对颈部肿块的诊断有很大的帮助,临床上诊断颈部肿块时应考虑年龄和性别的因素。     

宫颈癌全子宫切除术后发生毛细血管渗漏综合征 1例

目的探讨宫颈癌病人术后发生毛细血管渗漏综合征( capillary leakage syndrome,CLS)的病因、临床表现及处理措施,为临床医师提供可靠经验,提高此类疾病诊治水平。方法分析 1例 2022年 7月于潍坊医学院附属医院术前诊断为子宫颈原位癌而术后病理为浸润性宫颈癌的病人术后发生 CLS的过程及诊疗经过,结合相关文献报道,总结宫颈癌病人术后发生 CLS的机制及处理措施。结果病人术中生命体征平稳,手术结束恢复体位时出现血压下降,给予去甲肾上腺素升压,待血压升至 100/60 mmHg返回病房后陆续出现胸闷、憋气及双下肢中度水肿,行 CT检查提示大量胸腹腔积液,给予地塞米松、羟乙基淀粉、血浆及人血白蛋白改善毛细血管通透性,补充血容量,限制性补液并间断性给予利尿剂等处理,经过积极治疗后病人病情好转。结论针对宫颈癌术后的病人,医务人员需严密观察,对胸闷、憋气、双下肢水肿等症状提高警惕,首先排除是否出现 CLS,一旦确诊立即给予相应的处理。     

面颈部静脉畸形的综合治疗

目的:探讨多种方法综合治疗口腔及面颈部大面积静脉畸形的临床效果。方法:根据患者的年龄、病变部位、病变大小制订个体化治疗方案,采用多种药物联合注射,结合病变周围环形缝扎、激光、手术等方法综合治疗口腔颌面部大面积静脉畸形134例。结果:134例中治疗效果优79例(58.96%),良45例(33.58%),显效10例(7.46%),差0例。结论:采用多种方法综合治疗口腔颌面部大面积静脉畸形,对提高疗效、改善面部形态、维持局部功能、减少不良反应具有重要意义。     

青少年颈椎病的病因病机及预防

青少年颈椎病很少有人研究，笔者在临床中发现高中学生中时有颈椎病发生，比例约占学生总数１５．７９％，年龄均在１５—１９岁间。通过对５００余名高中、小学生的坐姿、睡姿调查发现：学生从小学一年级就开始的铅笔习字和枕高不合标准—使坐姿、睡姿改变—迫使颈椎生理弧度改变—颈部生物力学早期综合性失衡—颈部解剖学、组织学改变—最终出现病理学改变—颈椎病发生。Ｘ线平片证实：学生颈椎病主要是颈椎曲度值改变，与增生关系不大。并针对青少年颈椎病出现的病因病机，提出了一套保健措施，自编《青少年颈部保健操》。希望引起学校、家长、教育、卫生等对青少年颈椎病预防的重视     

青光眼与颈椎病的眼部表现特点关系探讨

目的:对一组症状,体征表现极相似于青光眼但非青光眼所致的颈椎病患者进行分析诊断,并作治疗探讨。方法:我院1993/2003-10间一组症状相似的颈椎病患者37例,分析其症状及体征特征,并与青光眼相鉴别。结果:通过此组患者症状体征分析,提醒相关医师掌握这些知识,对此组患者进行正确诊断和治疗。结论:该组患者是一组特殊类型的眼科患者,可暂称其为缺血性视疲劳。