胸腰椎骨折伴脊髓损伤前后路手术适应证的选择

目的 通过107例胸腰椎骨折伴脊髓损伤病例的治疗,探讨前、后路手术适应证的选择。方法 31例经前路减压植骨,采用Z-Plate等内固定。76例经后路采用短节段椎弓根钉内固定。结果 两组均获得了满意的疗效。结论 选择前或后路手术,应综合考虑脊髓损伤程度、手术时机与技巧、骨折的部位、骨折类型和影像结果等,才能确实做到减压、恢复脊柱序列和坚强固定的目的。     

浅析排球运动损伤的发生与预防

[目的]分析排球运动中损伤的发生原因,研究预防和简单的治疗方法。[方法]文献资料法和专家访谈法。[结果]技术不定型、大负荷训练和比赛中的意外情况是损伤发生的主要原因。[结论]随着世界排球运动的飞速发展,各队之间的水平差异越来越小。想取得好的成绩就需要科学的大运动量训练,在训练水平和成绩上升的同时,伤病成了困扰排球队伍的负面因素,直接会影响集体成绩的提高。因此,排球运动中各种损伤的预防和治疗也成为排球科研解决的关键问题。     

Plain radiographic findings in anterior cruciate ligament injury and repair

Although magnetic resonance imaging is the most accurate imaging method of evaluating the anterior cruciate ligament, several plain radiographic signs suggestive of anterior cruciate ligament injury have been described. Plain radiographs also play an important role in evaluating anterior cruciate ligament reconstruction.     

Population-based study of emergency department admissions and deaths from injuries in Barcelona,Spain: Incidence,causes and severity

The aim of this study was to estimate the incidence of morbidity and mortality due to injuries in the population over the age of 14 years in Barcelona, Spain. Injury distribution according to sex, age, external cause, place of occurrence of the injury and severity was also obtained. A one-year survey was conducted in the emergency departments of the six main hospitals in Barcelona, based on a multistage sampling. Information was collected prospectively in emergency services by specially trained non-staff interviewers. Mortality data were drawn from death certificates. The incidence rate was 74.7 injury cases per 1,000 person-years over 14 years of age, higher in males than in females. Injury rates were highest in the youngest age-group and progressively lower until people over 75 years of age. Main external causes of injury were falls, being struck or caught by objects, and traffic-related injuries. The leading specific causes of injury mortality were traffic injuries, suicides and poisonings. While the overall admission incidence was 3.34 cases per 1,000 inhabitants, the proportion of hospitalized cases was 45.0 per 1,000 injury cases admitted to emergency rooms, higher for females, for traffic injuries and in the elderly population. Ninety-six percent of injury cases had an ISS value of 8 or less, mean ISS being highest for traffic injuries and falls. Injury morbidity and mortality amongst residents of Barcelona follow sex, age and cause of injury patterns which are, overall, comparable to those observed in other industrialized countries, suggesting that similar etiologic factors might be operating in those areas. The results should enable the orientation of injury prevention policies in the urban environment targeted on the young and the elderly population.     

Experimental models of colorectal cancer

PURPOSE: A review ofin vivo andin vitro models of colorectal cancer is presented. METHODS: A retrospective literature review was performed with reference to CD-ROM Medline and Index Medicus. RESULTS: A comparison of the advantages and disadvantages of the models is presented in addition to a summary of individual model methodology and applications. CONCLUSIONS: Such models are a useful adjunct for surgical research in colorectal oncology.Mr. Banerjee is in receipt of support from the Yorkshire Cancer Research Organization.     

Patterns of calcifications and cholangiographic findings in hepatobiliary tuberculosis

The radiologic findings on conventional examinations (plain films and cholangiograms) in a large group of patients with proven hepatobiliary tuberculosis are reviewed. The plain film findings of large chalky and confluent hepatic calcifications or nodal-type calcifications along the course of the common bile duct are suggestive of hepatobiliary tuberculosis. Small, discrete, scattered calcifications may be mimicked by histoplasmosis but can be differentiated from hepatobiliary tuberculosis. Obstructing defects seen on cholangiography are indicative of tuberculosis when adjacent calcifications are present. The patterns of liver calcifications could provide a clue to the diagnosis of hepatobiliary tuberculosis and its differentiation from liver calcifications of various other etiologies.     

Sodium bicarbonate secretion indicated by ultrastructural cytochemical localization of HCO3 −, Cl−, and Na+ ions on rat bile duct brush cells

Brush cells are widely distributed in the digestive and respiratory apparatus, but their function is still unknown. Because brush cells (BC) are found in organs secreting NaHCO₃, it was hypothesized that these cells may secrete NaHCO₃. To test this possibility, rat common bile duct epithelia were examined by ultrastructural cytochemical methods for localizing HCO₃⁻, Cl⁻, and Na⁺ ions. All three ion precipitates were few in or on BCs of rats without stimulation. Lead carbonate precipitates, which localized HCO₃⁻ ions by the lead nitrate-osmium method, increased markedly on the surface of the microvilli (MV) of BCs after secretin or meal stimulation, but similar precipitates were few on the luminal surface of principal cells (PCs). Silver chloride precipitates, which indicate the presence of Cl⁻ ions by the silver-osmium method, increased in the apical cytoplasm and in MV of BCs after secretin or meal stimulation, but they were few in PCs. Sodium pyroantimonate precipitates, which localize Na⁺ ions by the potassium pyroantimonate-osmium method, increased on the surface of the MV, along the basolateral membrane, and in the apical cytoplasm of BCs after secretin or meal stimulation, but they were few in PCs. These results strongly suggest that BCs may be a significant source of NaHCO₃ secretion.     

Force deficits after stretches of activated rat muscle-tendon complex with reduced collagen cross-linking

The forces produced during stretches of passive and activated muscles, and isometric force deficits after stretching of activated muscles were examined in rat plantor flexor muscle-tendon complexes with reduced collagen cross-links (pyridinoline). Female Sprague-Dawley rats (n=6, age 87 days) were injected twice daily for 43 days with β-aminopropionitrile (BAPN, 333 mg/kg/day i.p.), an inhibitor of lysyl oxidase, which is responsible for the production of collagen cross-links. The relative weights of the plantar flexor muscles were similar for BAPN and saline-injected (control, C) rats (n=6). Pyridinoline was lower in the tendon (22.9%), and in the plantaris (17.1%), and soleus (7.4%) muscles (P<0.05), with no changes observed in collagen content (hydroxyproline), as determined by high-pressure liquid chromatography. At an ankle position of 90°, groups had similar forces at 5, 10, 20, 40, 60 and 80 Hz before stretching. Forces at 40° with stretches of the passive muscles (five times from 90° to 40°) were lower for all stretches in BAPN-injected rats (P<0.05). Isometric force deficits resulting from stretches of activated muscles (80 Hz, 20 times from 90° to 40°, rest intervals 3 min) followed similar courses for BAPN-injected and C rats, and were 51.1 (2.4)% (C) and 54.7 (4.6)% (BAPN) before the last stretch. After 1 h of rest, isometric force deficits were 26% and 29% larger at 10 Hz and 5 Hz, respectively, in BAPN-treated rats (P<0.05). The reduction in BAPN-injected collagen cross-linking of the skeletal muscle-tendon complex reduced the forces produced during stretches without muscle stimulation (i.e. passive stretch), and stretching of activated muscles produced larger isometric force deficits only at low stimulation frequencies. Electronic Publication     

冲击波致伤作用实验研究进展

原发冲击伤是爆炸产生的冲击波直接作用于生物体而引起的。各种生物激波管和其它冲击波发生装置的研制大大促进了冲击波致伤作用的实验研究的开展。通过将多种动物、离体器官以及培养的细胞暴露于冲击波,获得了大量的原发冲击伤实验研究结果。作者在简述冲击波的基本物理学特征的基础上,着重概括了生物激波管研制和原发冲击伤实验研究方法及其主要进展。     

医源性血管损伤的预防和术中处理

目的：总结手术中发生医源性血管损伤的处理经验。方法：10例在外科手术中损伤血管的患者,其中门静脉,下腔静脉、髂总静脉损伤各2例,股总静脉、颈总动脉、腋静脉、腘动脉损伤各1例。行血管修补术5例,行端-端吻合术1例,自体静脉移植术1例,人工血管移植1例,钳夹止血1例,血管结扎1例。结果：本组痊愈8例;死亡2例,其中下腔静脉损伤止血失败死亡1例,颈总动脉损伤结扎死亡1例。结论：医源性血管损伤重在预防,一旦发生血管损伤,迅速有效地控制出血是手术成功的关键,血管修补或吻合术疗效良好。