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MED术中应用自制器械处理后纵韧带钙化及骨赘增生 总被引:1,自引:0,他引:1
目的探讨脊柱后路显微内镜(microendoscopic disectomy,MED)手术治疗腰椎间盘突出症合并后纵韧带钙化及椎体后缘骨赘增生的方法. 方法 MED手术中应用自制弧形纤维环刀和L形打入器治疗115例该类患者. 结果全组随访12~30个月,平均22个月,按MacNab标准:优、良109例,可5例,差1例,优良率94.8(109/115).未出现硬脊膜破裂及神经孙上,未发生椎间隙感染,无中转开放手术. 结论正确运用MED技术,配合采用自制器械及相应的改良方法,能较好地处理合并后纵韧带钙化及椎体后缘骨赘增生的难题,进一步扩大了手术适应证范围,提高了疗效及安全性. 相似文献
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内窥镜下治疗复发性腰椎间盘突出症 总被引:1,自引:0,他引:1
[目的]探讨对复发性腰突症患者行显微内窥镜下髓核切除术(microendoscopicdiscectomy,MED)治疗的可行性及有效性。[方法]19例有不同初次手术史,已明确诊断为复发性腰突症的患者接受MED手术。[结果]除1例术中改为开放式外,18例均在MED方式下完成手术。全部18例得到随访0.5~2.5a,平均随访1.5a。据Macnab评分,优为7例,良为9例,可为2例,差为0例,优良率88.89%。JOA评分由术前平均(9.61±3.40)分提高到末次随访时平均(26.17±2.60)分,有效率为86.32%。[结论]对于术前影像学上无明显腰椎不稳的复发性腰突症患者,只要遵循微创手术原则,掌握微创手术技巧,操作仔细,MED术也是治疗复发性腰突症较好的有效方法之一。 相似文献
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Pernille Mathiesen Tørring Martin Jakob Larsen Charlotte Brasch-Andersen Lotte Nylandsted Krogh Maria Kibæk Lone Laulund Niels Illum Ulrike Dunkhase-Heinl Antje Wiesener Bernt Popp Giuseppe Marangi Tina Duelund Hjortshøj Jakob Ek Ida Vogel Naja Becher Laura Roos Marcella Zollino Christina Ringmann Fagerberg 《European journal of medical genetics》2019,62(2):129-136
Introduction
MED13L-related intellectual disability is characterized by moderate intellectual disability (ID), speech impairment, and dysmorphic facial features. We present 8 patients with MED13L-related intellectual disability and review the literature for phenotypical and genetic aspects of previously described patients.Materials and methods
In the search for genetic aberrations in individuals with ID, two of the patients were identified by chromosomal microarray analysis, and five by exome sequencing. One of the individuals, suspected of MED13L-related intellectual disability, based on clinical features, was identified by Sanger sequencing.Results
All 8 individuals had de novo MED13L aberrations, including two intragenic microdeletions, two frameshift, three nonsense variants, and one missense variant. Phenotypically, they all had intellectual disability, speech and motor delay, and features of the mouth (open mouth appearance, macroglossia, and/or macrostomia). Two individuals were diagnosed with autism, and one had autistic features. One had complex congenital heart defect, and one had persistent foramen ovale. The literature was reviewed with respect to clinical and dysmorphic features, and genetic aberrations.Conclusions
Even if most clinical features of MED13L-related intellectual disability are rather non-specific, the syndrome may be suspected in some individuals based on the association of developmental delay, speech impairment, bulbous nasal tip, and macroglossia, macrostomia, or open mouth appearance. 相似文献5.
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目的 探讨椎间盘镜下治疗腰椎闻盘突出症的方法及疗效。方法 2001年11月至2003年2月采用椎间盘镜(MED)治疗32例、33个间隙腰椎间盘突出症,其中L4/5椎间盘突出症15例,L5/S1椎盘突出症18例。结果 所有病例均获3~12个月随访(平均6.5个月),优良率96.8%。结论 MED手术创伤小、出血少、术后恢复快、疗效满意。 相似文献
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Huang Z Dias R Jones T Liu S Styhler A Claveau D Otu F Ng K Laliberte F Zhang L Goetghebeur P Abraham WM Macdonald D Dubé D Gallant M Lacombe P Girard Y Young RN Turner MJ Nicholson DW Mancini JA 《Biochemical pharmacology》2007,73(12):1971-1981
Type 4 phosphodiesterases (PDE4) inhibitors are emerging therapeutics in the treatment of a number of chronic disorders including asthma, chronic obstructive pulmonary disease (COPD) and cognitive disorders. This study delineates the preclinical profile of L-454,560, which is a potent, competitive and preferential inhibitor of PDE4A, 4B, and 4D with IC50 values of 1.6, 0.5 and 1.2 nM, respectively. In contrast to the exclusive binding of cilomilast and the preferential binding of roflumilast to the PDE4 holoenzyme state (Mg2+-bound form), L-454,560 binds to both the apo-(Mg2+-free) and holoenzyme states of PDE4. The intrinsic enzyme potency for PDE4 inhibition by L-454,560 also results in an effective blockade of LPS-induced TNFalpha formation in whole blood (IC50 = 161 nM) and is comparable to the human whole blood potency of roflumilast. The cytokine profile of inhibition of L-454,560 is mainly a Th1 profile with significant inhibition of IFNgamma and no detectable inhibition of IL-13 formation up to 1 microM. L-454,560 was also found to be efficacious in two models of airway hyper-reactivity, the ovalbumin (OVA) sensitized and challenged guinea pig and the ascaris sensitized sheep model. Furthermore, L-454560 was also effective in improving performance in the delayed matching to position (DMTP) version of the Morris watermaze, at a dose removed from that associated with potential emesis. Therefore, L-454,560 is a novel PDE4 inhibitor with an overall in vivo efficacy profile at least comparable to roflumilast and clearly superior to cilomilast. 相似文献
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Consuming a Mediterranean-style diet (MED) is helpful for primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, few studies have compared mortality in ASCVD subjects with different degrees of adherence to the MED diet or have evaluated the contributions of individual diet components. We analyzed National Health and Nutrition Examination Survey (NHANES) participants with a history of coronary heart disease (CHD) or stroke (N = 2052) in a period from 1999 to 2010. Their individual vital status was linked to the National Death Index till the end of 2011. The level of adherence to the MED diet was quantified using a 9-point evaluation score (aMED score). Cox regression models were used to compare the different levels of adherence to the MED diet, and contributions of individual components of the MED diet on cardiovascular, cancer, and all-cause mortality. Among the 2052 subjects with CHD or stroke, 29.0% (596 of 2052) died after a median follow-up of 5.6 years. In Cox regression analysis, higher absolute aMED score (HR 0.798, p = 0.0079) or above median aMED score (score 4–9) (HR 0.646, p = 0.0013) was negatively associated with all-cause mortality. Among various components of the MED diet, intake of more whole grains or nuts was significantly associated with a lower all-cause mortality. In contrast, a higher aMED score was not associated with less cardiovascular mortality. In a secondary analysis that excluded deaths within 2 years of the NHANES study entry, the above median aMED score (score 4–9) was negatively associated with both all-cause and cardiovascular mortality. In conclusion, subjects with a history of CHD or stroke adhering better to the MED diet in the NHANES study had a lower all-cause mortality during follow-ups. Consuming more whole grains or nuts had a lower all-cause mortality. The protective effect of adherence to the MED diet on decreasing cardiovascular mortality was seen only after excluding those who died within first two years of the NHANES study entry. 相似文献