特发性颈椎后凸畸形的手术治疗

目的 :明确颈椎前路手术治疗特发性颈椎后凸畸形的可行性和局限性。方法 :本文对 14例颈椎特发性后凸畸形患者采取手术方法进行治疗 ,所有患者均采用颈椎前路椎间盘切除减压 ,椎间隙植骨和前路钢板内固定。结果 :手术后患者临床体征明显改善 ,颈椎后凸畸形由手术前平均 -15 6°矫正为手术后平均 -6 4° ,矫正效果明显 ;手术后患者的短期随访表明颈椎矫正度数在随访中没有丢失。结论 :前路手术 ,延长颈椎前柱能够矫正颈椎的后凸畸形 ,改善临床症状和体征     

兔颈椎终板胶原结构变化对运动节段力学性能的影响

目的 通过测定兔退变颈椎运动节段力学参数的改变,观测其软骨终板胶原的超微结构变化,为退变的椎间盘显现异常力学特性作材料结构上的探讨。方法 将24只家兔随机分为对照组和模型组,模型组家兔保持45°低屈曲位5 h/d,取C5,6、C6,7进行生物力学测定,同时电镜观察终板胶原组织结构改变,总结分析终板材料的结构变化对运动节段力学性能的影响。结果 模型组终板抗扭强度、抗压强度、断裂时的最大形变都低于对照组,胶原排列从有序、致密、规整到紊乱、松散、溶解,并随造模进程的深入而加剧。结论 长时间的应力不均状态,造成椎间盘终板材料力学特性改变;终板胶原结构改变是颈椎间盘生物力学性能减退的原因之一。     

子宫颈癌226例临床病理分析

目的：探讨宫颈癌的临床、病理特点、诊治方法及预后因素。方法：收集1996年1月至2001年1月226例宫颈癌患者进行回顾性分析。结果：平均患病年龄为48．18岁。130例患者为阴道流血，70例为阴道流液，25例下腹疼痛，l例精神减退、贫血、浮肿。病理分期：Ⅰ期病例数为169例(75％)；Ⅱ期病例数为3l例(13．72％)；Ⅲ期病例数为23例(10．18％)；Ⅳ期病例数为3例(1．1％)。比较2l例宫颈鳞癌与宫颈腺癌的转移，显示后者的腹主动脉旁淋巴结转移、肾上腺转移、子宫转移、胸水形成明显高于前者。结论：重视宫颈癌发病相关因素及临床症状，争取早期诊断，严格手术病理分期，选择适当治疗方案。     

宫颈粘液电导率在月经周期中的变化规律

采用电化学分析方法,在月经周期中连续测定宫颈粘液的电导率,分析电导率变化规律与排卵期的相关性,此法确认的排卵期与实际排卵期一致,由此为自然避孕提供新途径。     

椎动脉型颈椎病患者中缩血管活性肽类物质的变化及意义

目的　探索缩血管活性肽类物质在椎动脉型颈椎病发病时的变化情况及病理意义。方法　椎动脉型颈椎病治疗组 30例 ,正常组 30例 ,椎动脉型颈椎病患者均采用中医手法治疗。正常组和治疗组患者分别在治疗前和治疗后空腹取静脉血进行神经肽类物质NPY、ET、CGRP、ANP放射免疫检测。结果　治疗前椎动脉型颈椎病患者的血浆NPY、ET、ANP明显高于正常组 ,而CGRP的含量则低于正常组 (P <0 0 5) ;经过治疗后患者的血浆NPY、ET、ANP含量降低 ,CGRP的含量升高 ,与治疗前比较具有显著性差异 (P <0 0 5)。结论　缩血管活性肽类物质在椎动脉型颈椎病发病时可能起重要的神经 体液调节作用     

颈椎骨折类型与脊髓损伤关系之临床观察

通过对９２例颈椎骨折病例的分析，发现屈曲型损伤最多见（５３％），其次为过伸型（２６％），压缩型（２１％）。屈曲型和压缩型多见于年轻人，而屈曲损伤导致的脱位及过伸型则多见于年龄较大者。爆裂骨折引起的神经损害最重，其次为屈曲型、过伸型及压缩（非爆裂）骨折。神经功能改善率以爆裂型骨折最差，死亡率亦最高，以压缩（非爆裂型）骨折最好，其次为过伸型及屈曲型。文内对各型的特点进行了详细讨论。     

Long-term follow-up by video of cervical dystonia treated with botulinum toxin

We have analysed video recordings of 21 patients with cervical dystonia treated with botulinum toxin. Fourteen patients have a record both of their response shortly after injections were commenced and between four years five months and six years seven months later. Our analysis shows that the long term outcome is often better than the initial response. We suggest that chronic treatment with botulinum toxin allows different muscles to those initially injected to be identified as contributors to the dystonia. Subsequent injection of these muscles leads to further improvement. It implies that cervical dystonia is a more widespread disorder of motor control, rather than simply limited to a few muscles.     

对神经根型颈椎病CT扫描的价值探讨

对50例神经根型颈椎病的CT征象进行了分析,并与X线平片加以比较。认为CT不仅在神经根型颈椎病的诊断中具有独特作用,而且在确定手术方法和手术途径的选择上也很有意义。作者认为在CT机还没有普及的情况下,摄一张良好的钩椎关节放大斜位片或椎间孔断层片对诊断神经根型颈椎病应是首选的。CT和X线平片相结合,综合分析,更有价值。     

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity,reproductive factors,and venereal infections

Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n=614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.Drs Kjaer, Engholm, and Lynge are with the Danish Cancer Registry. Dr Dahl is with the Department of Surgery, Slagelse Hospital, Denmark. Dr Bock is with the Department of Gynecology, Rigshospitalet, Copenhagen, Denmark. Dr Jensen, formerly with the Danish Cancer Registry, is deceased. Address correspondence to Dr Kjaer, Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Rosenvengets Hovedvej 35, Box 839, Copenhagen. Denmark. The Danish Cancer Society supported this study through grants.