椎弓根钉内固定治疗胸腰椎骨折

目的：探讨脊柱胸腰段骨折椎弓根钉内固定治疗效果。方法：临床收治脊柱胸腰段骨折72例，均采用后路减压，Dick或RF系统钉内固定手术治疗。比较手术前后骨折复位及神经功能恢复情况。结果：术后椎体高度完全或基本恢复占95．8％，神经功能有Frankel一级以上改善，不完全截瘫占90％，完全截瘫占53．1％。随访3—38个月，无螺钉折断、后退及脊柱矫正度丢失。结论：开放复位后路椎弓根钉内固定是治疗胸腰椎骨折的有效方法。     

An evaluation of stabilizing agents in competitive protein-binding assay for 25-hydroxyvitamin D

We have recently described a major variation from the normal levels of serum thyroxine-binding globulin in many Australian Aborigines [1]. Subsequently we presented evidence that affected individuals were widely distributed throughout Australia, that “low” values of thyroxine-binding globulin were not caused by environmental or health factors, but were inherited in an autosomal dominant fashion [2]. Refetoff [3] has shown that the cause of genetically determined low thyroxine-binding globulin levels in Caucasians is alteration in synthesis rate without any structural variation of the protein. Since however the “low” thyroxine-binding globulin of Aborigines is vastly more prevalent and genetically distinct from the X-linked type, we investigated the possibility that this may be a structural variant. Evidence suggestive of this includes results from heat inactivation, competitive binding of thyroxine to thyroxine-binding globulin to measure affinity, and use of a radioimmunoassay different from that used in the original work. The “low” thyroxine-binding globulin of Aborigines may be a protein with a structural variation at or near the binding site for thyroxine, resulting in lower affinity for thyroxine and hence “low” results with assay methods which depend upon the thyroxine binding site. Since the Australoid peoples, to whom Australian Aborigines are racially related, are distributed widely throughout the southern hemisphere it is important to establish whether this variant is found outside Australia in order to avoid the likelihood of misdiagnosis of thyroid disease in such subjects.     

Dick固定器治疗胸腰椎骨折影响因素的分析

通过对81例X线片进行Cobb角,钉杆角,螺钉角及CT片椎管矢径的测量。结果显示:钉杆角是复位的“关键角”.α校+β校≤174°对后凸Cobb角的矫正明显差(P〈0.01)。对椎体前柱的复位单靠器械杠杆的力量是不足的,且易引起弯钉,主要应依靠俯卧胸腰段过度背伸的力量,Dick固定可使椎管显著增大(P〈0.01)。但对有明显骨块突入椎管者行椎管前壁成形加Dick固定器固定有较好的效果。受伤10天后手术的患者,椎体的复位明显差(P〈0.01)。     

AF钉、Dick钉系统治疗胸腰椎骨折的临床比较研究

目的：比较AF钉系统与Dick钉系统治疗胸腰椎骨折的疗效.方法：对1995年5月-2005年5月期间122例胸腰椎骨折病人,应用Dick钉42例、AF钉80例,从手术时间、术中输血量、术后椎高恢复率、椎管容积恢复率、断钉率、神经功能恢复六个方面进行统计学比较.结果：两组平均随访14个月,术后椎高恢复率、椎管容积恢复率、手术时间、术中输血量,断钉率,AF钉组明显优于Dick钉组（P＜0.05）.两组病人在神经功能恢复方面比较无显著性差异.结论：AF钉系统较Dick钉具有更强大的轴向撑开力及椎体前方张开力,椎体前缘高度的恢复率更高,操作更简便,值得推广使用。     

Carotid Artery Function Is Restored in Subjects With Elevated Cardiovascular Disease Risk After a 12-Week Physical Activity Intervention

Sympathetic nervous system activation elicits carotid artery vasodilation in healthy subjects, yet vasoconstriction in those with cardiovascular disease (CVD). Whether carotid artery vasoconstriction can be reversed is currently unknown. Nineteen subjects with increased risk for CVD were referred to a 12-week physical activity intervention, and 12 participants with increased risk for CVD were recruited as a no treatment control group. Cardiorespiratory and vascular health measures were collected at baseline and 12 weeks. Results indicate that carotid artery vasoconstriction in response to sympathetic stimulation may be reversed in subjects at increased risk of CVD. These findings warrant further investigation.     

改良Dick钉固定治疗胸腰椎骨折(附25例报告)

目的　总结改良Dick钉固定治疗胸腰椎骨折的临床经验。方法　对椎体后缘移位轻的骨块 ,不需要减压 ,对椎体后缘骨块移位较重或有椎板粉碎骨折 ,则半椎板切除或全椎板切除 ,充分减压 ,在C型臂透视下 ,用改良Dick钉固定。结果　术后伤口 2周拆线 ,Ⅰ期愈合 ,均复位固定良好 ,随访 6个月～ 3年 ,瘫痪康复按ASIA分级 :完全瘫痪 4例中 ,2例无变化 ,1例恢复至B级 ,1例提高至C级 ;不全瘫痪中全部恢复至E级。结论　此手术操作简便 ,安装快捷 ,固定可靠 ,是治疗胸腰椎骨折的有效方法。     

角度Dick系统治疗爆裂型脊椎骨折

目的：总结角度Dick系统在治疗爆裂型脊椎骨折中对恢复椎体高度和椎管容积的作用。方法：采用角度Dick系统治疗胸腰椎爆型型骨折27例,通过术前、术后X线平片和CT扫描片观察、测量、对比椎体前后高度和椎管容积的恢复情况,结果：恢复椎体高度和椎间隙宽度达90％以上,椎管前后径增大最小0．4cm,最大1．0cm,随访10－16个月,神经症状改善有效率100％,不全瘫者全部恢复,完全瘫者部分恢复。结论：角度Dick钉在后路手术中可解决脊椎曲度和脊髓前方受压问题,损伤小、康复效果好。     

Dick氏钉内固定后矫形丢失分析

目的比较研究 Dick 氏钉内固定后矫形丢失情况。方法对使用 Dick 氏钉、AF 钉治疗胸腰椎骨折脱位52例随访对照分析。结果用 Dick 氏钉钉内固定组,由于万向关节的松动,远期手术矫正有明显丢失。结论 AF 系统与 Dick 氏钉相比结构更简单,使内植物在具备复位、固定功能的同时操作方便、有效。