SKY椎体后凸成形术与PVP对骨质疏松多椎体压缩骨折责任椎体选择性治疗的比较

目的探讨SKY椎体后凸成形术与PVP对骨质疏松多椎体压缩骨折责任椎体选择性治疗的疗效对比,评价治疗骨质疏松多椎体压缩骨折责任椎体的有效方法。方法分别于术前、术后2周、术后6月、18个月进行疼痛强度视觉类比评分,观察患者的疼痛症状及生活治疗改善程度。结果 52例手术均成功完成,每个椎体的骨水泥灌注量为3-6mL。两组手术方法术前、术后VAS评分P值分别<0.05,余比较不具统计学意义,两组手术方法术前、术后SF-36评分P值分别<0.05,余比较不具统计学意义。结论无论是SKY椎体后凸成形术或PVP对骨质疏松多椎体压缩骨折选择性治疗均可取得良好的效果,相比PVP,SKY椎体后凸成形术更具优势,但价格昂贵,限制了它的使用。     

聚维酮在阿霉素诱导膀胱癌EJ细胞凋亡模型中的作用机制

目的:探讨聚维酮(PVP)在体外加阿霉素(ADM)后诱导EJ细胞发生凋亡的情况以及一些相关机制。方法:应用流式细胞仪(FCM)检测ADM诱导EJ细胞的凋亡率、PVP EJ细胞的凋亡率以及PVP ADM对EJ细胞的诱导凋亡率的情况。结果:PVP对ADM诱导膀胱癌EJ细胞凋亡无影响。结论:PVP在整个诱导过程中并没有协同作用,只起到粘附作用,使得药物停留在EJ细胞表面的作用时间延长,从而达到大量杀伤EJ细胞的作用。     

单侧与双侧椎弓根入路椎体成形术治疗高龄骨质疏松性椎体压缩骨折的临床疗效比较

目的探讨单侧与双侧椎弓根入路经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效及价值。方法回顾分析2007年12月～2011年2月我院56例获得6个月以上随访的女性骨质疏松性单个椎体压缩性骨折的临床资料,其中采用单侧椎弓根t入路经皮穿刺椎体成形术治疗30例,双侧椎弓根入路经皮穿刺椎体成形术治疗26例,比较2组患者手术时间、骨水泥填充量、X线照射次数及术后VAS评分。结果单侧组手术时间（25±6）min显著少于双侧组（45±5）rain（t=-13．426,P=0．011）。单侧组骨水泥渗漏率10．0％（3／30）,与双侧组3．8％（1／26）无显著差异（X^2=0．138,P=0．710）。单侧组术中X线曝光（10．5±2．5）次,显著少于双侧组（19．4±3．0）次（t=-12．110,P=0．000）。2组术后24h、术后6、12个月VAS评分无统计学差异（P〉0．05）。结论单侧与双侧椎弓根入路经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折均能取得良好效果。单侧穿刺方法手术时间短,X线暴露次数少;双侧入路穿刺方法手术操作相对简单。     

一期内固定结合椎体成形术治疗脊柱跳跃性骨折合并骨质疏松症

目的 评价后路一期内固定结合椎体成形术治疗脊柱跳跃性骨折临床效果.方法 对15例(33椎)脊柱跳跃性骨折患者行一期后路钉棒内固定结合椎休成形术.术前行MRI或CT检查,在骨折累及三柱节段或神经损伤处行内固定,视椎管占位情况决定是否减压,对椎体后壁完整椎体行椎体成形术.结果 患者均获随访,时间5~24个月.无感染,伤口均一期愈合;无内固定失败;无继发后凸畸形加重,无迟发神经损伤;有神经损伤的患者均不有同程度的恢复.结论 一期后路内固定结合椎体成形术是治疗脊柱跳跃性骨折合并骨质疏松症的安全有效的方法.     

牵引复位加经皮椎体成形术治疗骨质疏松性椎体骨折

目的探讨三维牵引床复位加经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的方法和效果。方法对36例骨质疏松性椎体压缩性骨折患行三维牵引床牵引复位加经皮椎体成形术治疗。结果全部随访，28例术后1d疼痛消失，8例术后即减轻，第3天消失，24例术后3d下床活动，12例术后5日下床活动，椎体压缩高度平均恢复16mm。随访12个月患恢复伤前生活，无疼痛，椎体高度无丢失．无并发症。结论三维牵引床牵引复位加经皮椎体成形术治疗骨质疏松性椎体压缩性骨折是安全、费用较低、效果良好的治疗方法。     

葛根素聚维酮K30固体分散体的制备及体外评价

目的:制备葛根素-聚维酮(PVP)K30固体分散体以提高葛根素的溶出速率。方法:以PVP K30为载体,采用溶剂法制备葛根素-PVP固体分散体,并优选葛根素和PVP K30的最佳比例。通过溶出试验、差示扫描量热法、红外光谱、X射线衍射等方法对固体分散体的性质进行评价。结果:以最佳比例(葛根素-PVP K30 1∶3)制备的固体分散体中葛根素的溶出速率是原料药的2倍;差示扫描量热法、红外光谱及X射线衍射结果表明固体分散体中葛根素以无定形形式存在,并可能与PVPK30有氢键形成。结论:采用溶剂法制备葛根素-PVP固体分散体可显著提高葛根素的溶出速率。     

经皮椎体成形术中椎体内压力的测定与分析

目的　从生物力学的角度来分析椎体成形术(PVP)中并发症发生的可能性缘由,并提出科学的预防性建议。方法　对16例具有脊柱椎体骨质疏松症临床诊断的老年尸体腰椎（14具）有椎体压缩性骨折的椎体（其椎体骨密度值T<-2.5）予以C-arm透视机的动态监测下达到临床评价要求的椎体成形术,采用unisensor AG公司生产的直径为2.0mm的微型压力传感器(5mv/bar)和Peekel Instruments GmbH生产的载频放大器及其附属配套软件－SignaSoft6000 (PICAS & SIGNALOG 6000)测定每个椎体的椎体成形术术中椎体内压力的动态变化,采用描述性的统计和非参数统计方法进行统计学上的描述和分析,并就并发症发生的可能性进行临床意义上的分析。结果　每个椎体的椎体成形术均达到临床评价要求,每次推杆（美国Kypho公司提供标准椎体成形术中Yamshi-Nadel套系中推注骨水泥入椎体的器具,每具推杆可容纳骨水泥约1.5mL）推注骨水泥入椎体时所产生的椎体内的压力P(下标 max)不是很高,多数在0.50 bar以下,其所导致的效应具有显著的统计学差异(P<0.01),而每次推杆推注骨水泥入椎体时的椎体内压力面积值P(下标 ares)也不是很高,多数在10.00 Unit以下,其所导致的效应具有显著的统计学差异(P<0.01),两者均呈偏态分布;而且,对每例椎体的第一、二、三、四杆之间两两予以统计学上的分析,在总体存在差异有统计学意义的基础上还发现除第一和二杆、第三和四杆之间外,其他各杆之间存在着差异(a<0.0083)。结论　对骨质疏松性腰椎椎体压缩性骨折行椎体成形术(PVP)时,其在推注骨水泥入病椎时一般3推杆（约4.5ml骨水泥）即可达到推注骨水泥的临床评价要求,已无必要予第四杆等再次将骨水泥推注入病椎,既不作无意义的行为,又减少发生手术并发症的风险。     

PVP/PVA水凝胶力学性能的分子动力学模拟

目的从分子微观角度研究复合材料的力学性能及其单组份间发生相互作用的本质。方法用分子动力学(molecular dynamics,MD)方法模拟研究聚乙烯毗咯烷酮(PVP)、聚乙烯醇(PVA)以及其混合体系PVP/PVA的力学性能、径向分布函数等性质。结果 PVP与PVA有机结合之后的混合体系PVP/PVA较纯PVP体系力学性能有了明显的提高,且复合材料的力学性能不受温度的影响;混合体系两单组份间的相互作用主要是通过PVP分子单元中的氧原子与PVA中的羟基形成较强的氢键作用。结论 MD分析结果从分子层面揭示PVP/PVA复合水凝胶组份间相互作用机理,其力学性能较单组份PVP水凝胶有较大提高且不受温度影响;为临床制备水凝胶假体组织及其理化性能研究提供了一种可靠的理论研究方法。     

GreenLight laser prostatectomy: a safe and effective treatment for bladder outlet obstruction by prostate cancer

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Although looked on as standard of care there is little published data on the use of “channel TURP” . Those case series that have been published show significant morbidity (in particular stress incontinence) and relatively long hospitalization compared to standard TURP. The use of vaprorising lasers in this patient group has not been addressed. GreenLight laser is a safe and efficacious treatment for bladder outflow obstruction in men with prostate cancer. Hospitalization is minimal (most were day cases) which we feel is important in men who are often in their last few months. We had no serious complications apart from a few patients with stress incontinence. The stress incontinence rate was dramatically lower than that reported in previous reported series of channel TURP – we are not however able to offer any obvious explanation for that finding.

OBJECTIVE

• ? To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer.

PATIENTS AND METHODS

• ? From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP.
• ? The patients’ hospital records were comprehensively reviewed to obtain preoperative, intra‐operative and postoperative data.
• ? Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer.

RESULTS

• ? Mean operating time was 42 min, mean post‐operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post‐operative catheter. Mean and median catheter times were 22 and 21.5 h respectively.
• ? Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention.
• ? At 3 months post‐operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%.
• ? Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post‐operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%).

CONCLUSION

• ? The present study is the first on PVP applied to patients with prostate cancer.
• ? It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate.