寰枢椎后路柔性固定的生物力学研究

目的分析细棒、PEEK棒固定对寰枢关节稳定性的影响。方法采用6具新鲜成人枕骨(occipital bone,Oc)~颈椎C4节段进行测试,模拟以下手术及固定状态:①完整状态;②损伤状态:枢椎齿状突II型骨折;③坚强固定:寰枢椎均采用普通椎弓根螺钉固定,直径3.5 mm钛棒连接;④PEEK棒:直径3.5 mm的PEEK棒连接;⑤细棒:直径2.0 mm钛棒连接。采用重复测量实验设计,在完整、损伤和不同的固定状态下,通过脊柱试验机对标本分别施加1.5 N·m的前屈/后伸、左/右侧弯和左/右轴向旋转的纯力偶矩。采用Optotrak三维运动测量系统连续采集标本运动,分析寰枢椎之间角度运动范围和中性区。结果采用直径3.5 mm的钛棒,2.0 mm的细棒以及3.5 mm的PEEK棒固定后,在前屈、后伸、侧弯和旋转方向上均显著减小了固定节段的运动范围(P<0.05)。直径3.5 mm和2.0 mm的棒固定后的运动范围,在各个方向上无显著性差异。PEEK棒固定的运动范围仅在侧弯方向上大于坚强固定(P=0.005),其他方向无显著性差异。3种固定方式在屈伸、侧弯和旋转方向上均显著减小了固定节段的中性区(P<0.05)。各种固定方式之间相比较,无显著性差异(P>0.05)。结论在寰枢关节采用直径2.0 mm的细棒固定,与坚强固定的稳定性相当。采用直径3.5 mm的PEEK棒固定,在前屈、后伸、旋转方向上与坚强固定的稳定性相当,在侧弯方向上弱于坚强固定。     

正念减压疗法对妊娠呕吐妇女负性情绪和生活质量的影响

目的 探析正念减压疗法对妊娠呕吐妇女负性情绪和生活质量的影响。 方法 将2017年5月-2018年5月在我院治疗的90例妊娠呕吐妇女纳入本研究,采用数字表法随机分成研究组和对照组,每组各45例。对照组接受宣教,研究组在对照组上实施正念减压疗法。分别于入组时、干预4周和干预8周采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、生活质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)进行评估,比较2组妊娠呕吐妇女负性情绪和生活质量。 结果 2组SAS、SDS评分及生活质量综合评定问卷总分在组间效应、时间效应及交互效应上差异具统计学意义。 结论 妊娠呕吐妇女进行正念减压疗法,能够显著减轻妊娠呕吐妇女负性情绪和提高生活质量,值得在临床上广泛应用。     

Bone growth patterns in Chinese children and adolescents: a 6-year follow-up study provides evidence for sexual dimorphism and tracking

Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up. Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences. Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at baseline and a 6-yr follow-up. Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”. Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr, but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs. Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores the importance that osteoporosis prevention should begin in childhood and adolescence. Fengxiu Ouyang and Binyan Wang contributed equally to this article. Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National Institute of Health and by the Food Allergy Project.     

改良开放性手术治疗巨大良性前列腺增生症

目的探讨巨大良性前列腺增生症的开放性手术治疗方法及效果。方法回顾分析16例巨大良性前列腺增生症,年龄61~88岁,平均74岁。作耻骨上经膀胱前列腺切除术。结果手术均成功;手术时间35~65min,出血量100~200mL,术后前列腺重量为200~520g,平均215g;膀胱冲洗2~3d,拔导尿管5~7d;术后3d再出血1例,经DSA同侧髂内血管栓塞止血成功,排尿困难1例,短期尿失禁1例,其余患者术后均排尿通畅,控尿良好。结论开放性手术治疗巨大良性前列腺增生症,其梗阻解除彻底,是一种合理的治疗方法。恰当的手术方法是提高疗效及降低并发症的关键。     

大鼠腹腔肥大细胞肿瘤坏死因子合成与释放的研究

应用免疫细胞化学技术及酶联免疫吸附试验（ELISA）对大鼠腹腔肥大细胞合成和释放肿瘤坏死因子（TNF）的状况进行了观测。结果:新鲜分离纯化的大鼠腹腔肥大细胞胞浆呈TNF蛋白阳性。单纯肥大细胞培养早期（2～4 h）,上清液中未能检测到TNF,随着培养时间延长,上清液中TNF含量增多;盐酸吗啡与肥大细胞共同培养2h时,上清液中出现可测TNF。四甲基偶氮唑盐（MTT）比色分析试验表明,肥大细胞培养上清液具体有TNF的抗肿瘤活性中。提示:大鼠腹腔肥大细胞能合成和释放TNF,盐酸吗啡能促进肥大细胞释放TNF。