CT重建椎弓根轴线投影点定位研究

目的:建立椎弓根螺钉最佳入钉点,提高椎弓根螺钉内固定术的准确性和安全性。方法:高速螺旋CT共扫描检查40例国人的200个L1~L5脊椎。重建后测量400个椎弓根的入点坐标(x,y),即椎弓根轴线在椎骨后表面的投影点与后正中线的距离(x)及与横突中线的垂直距离(y)。结果:x坐标从L1~L5逐渐增大,男性大于女性(P<0.05);y坐标从L1到L4逐渐下移,在L4与横突中线接近重叠,但L5突然上升,与L2节段水平相当,L1~L5y坐标基本上都在横突中线以上,但每组数据变异较大。就y坐标而言,椎弓根轴线投影点与传统入点比较均有差异。结论:横突中线是椎弓根螺钉置入的重要参照标志,但椎弓根轴线投影点并不在横突中线上,不同个体、节段之间y坐标存在的较大差异是高误置率发生的重要原因。对个体而言,术前常规通过CT测量椎弓根轴线在椎骨后表面的投影点数据对椎弓根螺钉的置入有重要指导意义。     

胸腰段椎间盘突出症诊断的临床研究

目的探讨胸腰段椎间盘突出症临床表现的特点与规律，提高胸腰段椎间盘突出症的诊断水平。方法回顾性分析1995年9月～2004年1月我院经X线、CT、MRI及手术证实的胸腰段椎间盘突出症65例的临床资料，并将其分为低位胸椎组（T10-T12L1）43例，高位腰椎组（L1-2-L2-3）16例，多节段突出组6例。结果躯体感觉障碍89．2％（58／65）和下肢无力83．1％（54／65）是最多见的症状。9．2％（6／65）表现为上运动神经元损害，47．7％（31／65）表现为下运动神经元损害，43．1％（28／65）表现为上、下运动神经元混合性损害。仅3例为单根神经根损害，其余表现为多根神经或马尾神经的损害。腰背痛44．6％（29／65）和下肢无力40．0％（26／65）是最常见的首发症状。低位胸椎间盘突出以混合性运动神经元损害为主，占58．1％（25／43），易导致行走障碍、足下垂、下肢肌张力升高和病理征阳性；而高位腰椎间盘突出则以下运动神经元损害为主，占93．8％（15／16），易造成腰背、下肢疼痛及马尾神经损害。结论胸腰段椎间盘突出症的症状广泛、体征多样，当临床上存在以下情况时应高度怀疑胸腰段椎间盘突出症：①大腿前方、外侧或腹股沟部位出现感觉障碍者；②下肢无力，股四头肌，胫前肌肌力减退者（如足下垂）；③下肢运动或感觉障碍范围广泛、不规则，缺乏根性分布特征者；④上、下运动神经元损害同时存在，或虽表现为下运动神经元损害，但难以用低位腰椎间盘突出症解释者。     

腰椎间盘突出症早期手术并发症的回顾性分析

腰椎间盘突出是腰腿痛的主要原因,因患病率高,手术开展较为普及,关于其手术后并发症的相关报导也逐渐增多。为了进一步了解这些并发症的发生原因,我们将1993年2月至2004年12月手术治疗腰椎间盘突出症768例中所发生的74例早期并发症进行回顾性分析,针对手术的危险因素提出相应的     

经皮椎板关节突螺钉固定的应用解剖及影像学研究

[目的]为经皮椎板关节突螺钉的器械设计及临床应用提供解剖学依据。[方法]利用30例干燥腰椎标本，用游标卡尺及量角器测量腰椎椎板上缘及下缘的厚度，椎板关节突螺钉的长度。通过影像学测量椎板的内倾角和下倾角。[结果]椎板的上缘薄而下缘厚。从L1～5椎板的厚度、螺钉的长度及从内倾角逐渐增加，而下倾角逐渐减小。[结论]上缘的厚度太薄不适合螺钉的放置。从L1～5使用4．5mm的皮质骨螺钉固定是安全的，但应该在椎板的下缘置人。注意下倾角和内倾角的变化。设计的瞄准器应该具有调节角度的装置。     

Imaging of activated microglia with PET and [11C]PK 11195 in corticobasal degeneration.

Positron emission tomography (PET) using [(11)C]PK 11195, a ligand for peripheral benzodiazepine receptor binding sites, offers the opportunity to image activated microglia in vivo. This tool may therefore be used to display the occurrence of microglial activation in the course of neurodegeneration. A patient with the clinical diagnosis of corticobasal degeneration (CBD) and left-sided symptoms was studied using fluorodeoxyglucose (FDG) and [(11)C]PK 11195 PET. We found a marked right hemispheric hypometabolism and asymmetric microglial activation in corresponding areas of the basal ganglia and right temporal and parietal cortex. [(11)C]PK 11195 PET suggests involvement of microglial activation in the pathogenesis of CBD.     

腰椎间盘突出症治疗方法与肌电图变化的相关性研究

腰椎间盘突出症(lumbar disc herniation，LDH)是导致腰腿痛的主要病因，本研究对具有典型临床症状、相应体征及MR或CT等影像学资料确诊的LDH，采用规范化非手术治疗，经规范化保守治疗无效者选用手术治疗，治疗前后均行肌电图(elec-tromyograptly，EMG)检查，旨在探讨肌电图变化与治     

经皮弧式椎间盘切除器械治疗腰5骶1椎间盘突出症初步报告

采用经皮弧式椎间盘切除器械治疗Ｌ_５～Ｓ_１椎间盘突出症２２例，２１例成功。术后优良率为８６．４％。该器械能够避开髂嵴阻挡进入Ｌ_５～Ｓ_１椎间隙，并增加椎间盘切除量，提高经皮Ｌ_５～Ｓ_１椎间盘切除成功率。定位正确是成功的关键。     

The biomechanics of vibration and low back pain

This work is a review of the mechanical factors related to low back pain production in a vibration environment. The sitting posture is an extreme orientation for the lumbar intervertebral disc that 1) increases its internal pressure, 2) increases its anteroposterior shear flexibility, while: 3) decreasing its resistance to buckling instability and 4) stressing the posterior region of the disc. Vibration is an additional mechanical stressor. Several studies suggest that the following preventive measures be taken to reduce the risk of low back pain due to driving: 1) minimize the vibration reaching the driver, 2) avoid lifting or bending immediately following driving, and 3) walk around for a few minutes following driving. © 1993 Wiley-Liss, Inc.     

开式涡轮转盘塔的操作区域

考察了开式涡轮转盘塔(OTRDC)中的分散相滞留率和液泛特性。采用五种不同的液-液体系,在两种不同直径的塔中进行了实验。给出了估算分散相滞留率的关联式及无传质时临界转速的判据,进而大体上确认了OTRDC的操作区域。     

Immediate changes in subcellular structures of transplanted tumors following photodynamic and laser hyperthermic therapy

Background and Objective: To further understand the precise process of the tumor cell degeneration after photodynamic therapy (PDT), laser hyperthermic therapy (LH), and combined treatments using an Nd:YAG laser. It is important to examine initial morphological alteration of tumor cells after these treatments. Study Design/Materials and Methods: In this study, nude mice bearing HeLa cell tumors were treated with PDT, LH, and combined treatments of the two. Tumor tissues obtained immediately after these treatments were analyzed using electron microscopy and morphometry. Results: In the combined treatments, which produced more severe effects on tumor cells, morphological features of apoptosis such as cytoplasmic condensation, blebs, and apoptotic bodies appeared in the cells, although the typical alteration in the nuclear chromatin was not seen. Conclusion: Cytoplasmic alterations may proceed more rapidly than nuclear alterations in the cellular degeneration induced by the single or combined treatments of PDT and LH.