体重对腰椎后路开窗减压手术疗效的影响

目的对不同体重老年腰椎管狭窄患者行单纯腰椎后路开窗减压手术,并评价其治疗效果。方法回顾性分析1996年12月～2002年12月间145例因老年腰椎管狭窄而采用单纯腰椎后路开窗减压手术治疗患者的病例资料,结合问卷调查患者对手术的满意程度,比较不同体重患者住院期间及术后症状改善情况,评估手术疗效。结果不同体重患者术后腰腿疼痛明显缓解、日常生活质量改善,患者对手术的满意率达67.59%。而且患者的各种统计数据表明,不同体重组之间差异无显著性意义(P>0.05)。结论体重在一定程度上影响老年腰椎管狭窄患者的手术治疗结果。单纯腰椎后路开窗减压手术,可以达到较为理想的治疗效果。     

Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community-dwelling Japanese women 69 years of age and over

Introduction A few epidemiologic studies have comprehensively attempted to identify risk factors for low bone mineral density (BMD) in elderly Asian women. The purpose of this study was to identify demographic, lifestyle, and biochemical factors correlated with BMD in elderly Japanese women 69 years of age and over.Methods The study design was cross-sectional. The subjects were 583 ambulatory women aged 69 years and over, and their average age was 74.3 (SD 4.4) years. Predictor variables were age, reproductive history, anthropometric indices, grip strength, calcium intake, lifestyle information, and serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25(OH)₂D), osteocalcin (OC), and undercarboxylated osteocalcin (ucOC) values. The outcome variable was forearm BMD measured with a DTX-200 osteometer.Results Simple linear regression analyses showed that BMD was significantly positively associated with body height, weight, body mass index, grip strength, serum albumin concentration, and “housework,” and negatively associated with age, years since menopause, age at menarche, number of children, serum 1,25(OH)₂D concentration, serum OC concentration, and ucOC concentration. The stepwise multiple regression analysis showed that weight (β=0.00316, SE=0.00028, R²=0.180), age (β=−0.00321, SE=0.00050, R²=0.108), log-transformed serum OC (β=−0.0445, SE=0.0064, R²=0.053), log-transformed serum 1,25(OH)₂D (β=−0.0401, SE=0.0074, R²=0.050), “farmwork” (β=0.00904, SE=0.00426, R²=0.005), and serum 25(OH)D concentration (β=0.000281, SE=0.000120, R²=0.003) were significantly associated with BMD.Conclusion It was concluded that body weight is a major predictor of forearm BMD among the factors measured in this study in independent Japanese women 69 years of age and over and that serum 1,25(OH)₂D concentration may be associated with cortical BMD. Maintenance of body weight is very important for maintaining BMD in this population, unless a large weight aggravates obesity-related diseases. A follow-up study is needed to confirm these findings.     

体重指数对全膝关节置换术后功能的影响

目的回顾性分析体重指数(BMI)对骨关节炎(OA)患者全膝关节置换术(TKA)后功能的影响.方法由同一组医生使用同一种假体对320例(520膝)骨关节炎患者行全膝关节置换.按体重指数分为4组非肥胖组(BMI＜25.0 kg/m2)、超重组(BMI 25.1～27.0 kg/m2)、肥胖组(BMI 27.1～30.0kg/m2)和病理性肥胖组(BMI＞30.0 kg/m2),分别记录术前及随访时HSS膝评分、功能评分、膝关节最大屈曲、伸直度数和并发症.结果术前超重组、肥胖组和病理性肥胖组功能评分较非肥胖组低(P＜0.05),但膝评分差异无显著性.通过平均28.3个月的随访,无论膝评分和功能评分各组术后均明显提高,各组提高的幅度比较差异无显著性.虽然超重组、肥胖组和病理性肥胖组术后最大屈曲、伸直度数较非肥胖组小,但是改善幅度仍相当,差异无显著性(P＞0.05).肥胖组和病理性肥胖组围手术期并发症明显增高(P＜0.05),在总共93例(181膝)中,有14膝(9.2%)出现伤口并发症,其中1膝(0.5%)感染,感染发生于术后10周内,与伤口并发症有关;2膝(1.3%)内侧副韧带损伤.超重组166例(258膝)中有6膝(2.3%)出现伤口并发症,无感染及内侧副韧带损伤病例.非肥胖组61例(81膝)中有1膝(1%)出现伤口并发症,无感染及内侧副韧带损伤病例.结论TKR是进展期OA患者有效的治疗措施,肥胖并不是膝关节置换手术的障碍.但围手术期并发症增多,包括伤口愈合、感染、内侧副韧带损伤,应注意伤口缝合技术和保护内侧副韧带.     

月经初潮与骨龄及发育指标研究

本文研究了兰州市区6～17周岁女生360人的骨龄、身高、体重、胸围等项发育指标与月经初潮的关系,结果表明:已来潮女生各种发育指标均高于同龄未来潮者(P<0.01)。未来潮比已来潮者骨龄相差1.1岁,身高相差7.21cm,体重相差5.46kg,胸围相差3.65cm。平均初潮骨龄为13.45岁,初潮骨龄标准误差、最大-最小值及变异系数均小于生物年龄,说明初潮与骨龄关系最密切,用骨龄估计月经初潮最为准确可靠。初潮一般在拇籽骨出现15.7月内来潮。     

Care of the child in a body cast

Caring for a child in a body cast is a stressful situation for most families and many families state they do not receive adequate information on how to care for their child. This paper presents a comprehensive guide on caring for a child in a body cast. It examines the physical care issues, transportation and cast care. An instrument for assessing the family’s ability to cope with caring for a child in a body cast is described, and further resources for parents and nurses are presented.     

成都市中老年健身女性体成分指标与骨密度和骨代谢指标的相关性研究

目的探讨体重、体重指数(BMI)等体成分指标对中老年健身运动女性骨密度的影响及体成分指标与骨代谢指标、骨密度指标的关系。方法94例成都市城区健身运动女性根据BMI不同分为三组:低体重组(BMI≤20kg/m2)、正常体重组(20kg/m225kg/m2),采用Osteospace超声骨密度仪测定跟骨的BUA、SOS、STI骨密度指标;全自动生化分析仪测定血清AKP含量;应用放射免疫法测定血清hCT、BGP、IL-6、E2、TNF含量。应用方差分析和偏相关方法进行统计学处理。结果不同BMI组的体重、体重指数、瘦体重和体脂百分比差异显著,低体重组T-score与正常体重组、超重组比较有极显著差异;低体重组SOS、STI骨密度指标显著低于正常体重组;BUA、SOS、STI骨密度指标与体重、体重指数、瘦体重和体脂百分比呈正相关,与hCT、IL-6、TNF、BGP、AKP呈正相关,与E2呈负相关。低体重组骨量减少、骨质疏松发生率最高。结论体重、体重指数等体成分指标是影响中老年健身运动女性BMD的重要因素,保持体重有利于防止骨丢失和预防骨质疏松发生。     

先天性心脏病导管介入治疗对小儿生长发育和内分泌功能的影响

目的　了解先天性心脏病 (CHD)导管介入治疗对患儿生长发育和内分泌功能的影响。方法　测定 4 2例CHD患儿导管介入治疗前后的身高、体重和三碘甲状腺原氨酸 (T3)、甲状腺素 (T4 )、促甲状腺素 (TSH)、生长激素(HGH)。结果　治疗前后身高、体重的增长速度明显改善 ,而T3、T4、TSH、HGH无明显改变。结论　导管介入治疗能明显改善先心病患儿生长发育而不会影响患儿的内分泌功能     

体部表面线圈磁共振成像对肛瘘的术前诊断价值

目的:探讨体部表面线圈MRI对肛瘘的术前诊断价值。材料和方法:回顾性分析42例肛瘘患者,均于术前进行非增强MRI检查,将MRI结果与手术结果对照。结果:MRI诊断结果与手术结果一致,其中23例为括约肌间型,5例经括约肌型,5例括约肌上型,9例括约肌外型,所有病例中有12例可见肛周脓肿形成。结论:MRI作为一种安全、准确的肛瘘检查方法,对于肛瘘的术前诊断具有非常重要的价值。     

The effect of cooling on toe systolic pressures in subjects with and without Raynaud's syndrome in the lower extremities

Summary. The effect of changes in local and body temperature on the toe systolic pressures was studied in 20 subjects with and 30 without Raynaud's syndrome in the toes. The pressures were significantly lower in the group with Raynaud's syndrome under all experimental conditions (P < 0·01). The pressures were significantly lower during body cooling than during body warming in both groups (P < 0·01). The mean decrease with body cooling was 58 mmHg in the group with Raynaud's syndrome and 24 mmHg in the control subjects (P < 0·01). During body cooling pressures fell to less than 30 mmHg in 70% of subjects with Raynaud's syndrome and in 3% of the controls. Local cooling from 30 to 10°C during body cooling resulted in a significant mean decrease in pressure of over 40 mmHg in both groups (P < 0·01) and the pressure fell below 30 mmHg in over 90% of the group with and in 26% of those without Raynaud's attacks. The results indicate the importance of body cooling and local temperature in the mechanism of vasospasm in the toes. They are also relevant to the diagnosis of Raynaud's syndrome in the lower limbs and have implications for the testing of patients with arteriosclerotic occlusion since erroneously low pressure values could be obtained in tests when the feet are cold.     

Self-perception and action in infancy

By 2–3 months, infants engage in exploration of their own body as it moves and acts in the environment. They babble and touch their own body, attracted and actively involved in investigating the rich intermodal redundancies, temporal contingencies, and spatial congruence of self-perception. Recent research is presented, which investigats the spatial and temporal determinants of self-perception and action infancy. This research shows that, in the course of the first weeks of life, infants develop an ability to detect intermodal invariants and regularities in their sensorimotor experience, which specify themselves as separate entities agent in the environment. Recent observations on the detection of intermodal invariants regarding self-produced leg movements and auditory feedback of sucking by young infants are reported. These observations demonstrate that, early in development and long before mirror self-recognition, infants develop a perceptual ability to specify themselves. It is tentatively proposed that young infants’ propensity to engage in self-perception and systematic exploration of the perceptual consequences of their own action plays an important role in the intermodal calibration of the body and is probably at the origin of an early sense of self: the ecological self.