刃针治疗寰枢关节紊乱所致颈性眩晕临床研究

目的 观察刃针结合肌筋膜激痛点（myofascial trigger point,MTrP）原理治疗颈性眩晕的临床疗效。方法 将84例颈性眩晕患者随机分为治疗组42例,对照组42例。治疗组采用刃针结合MTrP原理治疗,对照组用毫针针刺颈夹脊穴为主治疗,两组治疗后均予龙氏正骨手法治疗,治疗2周后（共治疗5次）统计疗效。结果 治疗组临床疗效显著优于对照组（Z=-2.453, P<0.014）;在提高眩晕症状和功能评分及椎-基底动脉平均血流速度方面,以及在降低齿突生长性偏移（odontoid growth offset value,DO）、双侧齿突侧块间距差（bilateral odontoid lateral mass spacing difference, VBLADI）方面,治疗组显著优于对照组（P<0.05,或P<0.01）。结论 刃针结合MTrP原理治疗颈性眩晕在提高临床疗效、改善血流速度、缓解颈性眩晕症状及恢复功能等方面均有明显的优势。     

颈舒汤加减联合推拿康复治疗混合型颈椎病疗效观察

目的 观察中药内服联合推拿康复治疗混合型颈椎病疼痛和眩晕的临床疗效。方法 采用随机法将66例混合型颈椎病（颈痛、眩晕为主要症状）患者分为对照组和观察组,每组33例;两组患者均予以常规手法推拿、康复运动治疗,观察组在此基础上采用自拟中药汤剂颈舒汤加减内服联合治疗;分别于治疗前,治疗后3、7、10、14 d对两组患者进行疗效评估,采用视觉模拟量表（visual analogue scale,VAS）、颈性眩晕症状与功能评估量表（evaluation scale cervical vertigo,ESCV）对患者治疗前后疼痛、眩晕症状进行评分。结果 与同组治疗前比较,两组治疗3、7、10、14 d时VAS评分均显著降低（P＜0.05）,ESCV评分均显著增高（P<0.05）;治疗10、14 d时,观察组疼痛VAS评分显著低于对照组（P＜0.05）;治疗3、7、10、14 d时,观察组ESCV评分均显著高于对照组（P＜0.05）。观察组临床疗效优于对照组（P＜0.05）。结论 颈舒汤加减内服联合推拿康复治疗可有效缓解混合型颈椎病疼痛、眩晕症状,提高患者生活质量。     

CERVICAL CANCER PREVENTION: MANDATING THE HPV VACCINE AS A CONDITION OF SCHOOL ATTENDANCE

This Note advocates that states require all females entering the sixth grade to be vaccinated with the HPV vaccine Gardasil, as a means of preventing cervical cancer deaths in the United States. States that do pass such a mandate would receive federal funding to help disperse the cost of the expensive three‐dose vaccine, especially to those females most in need. Subject to each individual state's mandate, parents would be allowed to opt their children out of such a mandate for religious, medical, and/or philosophical reasons.     

Dissecting Thoracic Aortic Hematoma Masquerading as Blunt Force Injury of the Neck

Discoloration of the skin of the anterior and lateral neck may raise suspicion for blunt force injury, particularly cervical compression, in an unwitnessed death. We present a case of an elderly woman with an unwitnessed death at home which highlights an external examination finding of blue/purple discoloration of the skin of the neck and links this finding with those from internal examination at autopsy. Pertinent negatives include absence of conjunctival and mucosal petechiae, absence of cutaneous abrasions of the neck, and absence of contusions of the anterior neck musculature. This case illustrates a natural disease entity, spontaneous dissection of a thoracic aortic hematoma, masquerading as blunt force injury externally and highlights the importance of having an appropriate index of suspicion when triaging jurisdictional cases for postmortem examination to accurately determine cause and manner of death.     

服务型政府的类型探讨——兼论我国政府建设的取向

政府存在的最大正当性在于为社会提供良好的服务。服务型政府按照历时态可分为三种类型:宏观服务型政府、中观服务型政府和微观服务型政府。文章认为,我国目前的政府建设正处于由中观服务型政府向微观服务型政府过渡时期,因此,建立一个权力制约的法治政府以及促进公民社会的成长应该是我国社会主义服务型政府建设的努力方向。     

中国汉族人腰椎的性别差异

目的提供体质人类学的数据资料 ,建立中国汉族腰椎性别判别的方法。方法根据人体骨骼测量方法 ,测量 117付 (男 80 ,女 3 7付 ,年龄 17～ 90岁 )中国汉族人腰椎的 10项指标 ;选择性别差异显著的椎测量项目 ,建立腰椎及各腰椎的性别判别方程。结果第一至第五腰椎均有 5个以上的测量项目的数据存在显著意义的性别差异 (P<0 0 5 ) ;建立的 5个腰椎及各腰椎的性别判别方程 ,判别率在 69 4%～ 91 8% ,以 5个腰椎的多项指标的性别判别方程的准确率最高 (91 8% ) ,其次为第一腰椎 (84 5 % )和第二腰椎 (82 1% )。结论中国汉族人腰椎的性别差异以第一和第二腰椎明显 ,腰椎性别判定以多项指标的准确率高     

刃针短刺结合弥可保穴位注射治疗神经根型颈椎病80例

目的 观察刃针短刺结合弥可保穴位注射治疗神经根型颈椎病的疗效。方法 将156例神经根型颈椎病患者随机分为治疗组（80例）和对照组（76例）,治疗组采用刃针短刺结合弥可保穴位注射,对照组采用传统针刺法治疗,疗程15 d。观察两组治疗前后症状、体征积分,疼痛视觉模拟评分（visual analogue scale,VAS）分值,以及临床疗效。结果 治疗组治愈率及总有效率均显著高于对照组(P<0.05);与治疗前比较,两组治疗后症状、体征积分,疼痛VAS评分均显著减少(P<0.01);治疗后治疗组症状、体征积分及VAS评分显著低于对照组,治疗前后症状、体征积分差值及VAS评分差值显著高于对照组(P<0.01)。结论 刃针短刺结合弥可保穴位注射治疗神经根型颈椎病优于传统针刺法,临床值得推广应用。     

Suicidal Decapitation by Hanging—A Population‐based Study

A prospective study was undertaken at Forensic Science SA over a 15‐year period from July 2002 to June 2017 for all cases of adult (>18 years) suicidal hangings with decapitation. A total of 1446 cases of suicidal hangings were identified from a general population of approximately 1.5 million (1206 males—age range 18–97 years, average 42.6; and 240 females—age range 18–96 years, average 40.1). Only three cases of decapitation were found, all from long‐drop hangings; these consisted of three males (ages 32–55 years; average 45 years). Spinal transections had occurred between the first and second, second and third, and third and fourth cervical vertebrae, respectively. In this study, the number of suicidal hangings with decapitation represented only 0.2% of the total number of hangings. These events are therefore extremely rare, most likely due to most suicidal hangings occurring from relatively low levels in a domestic environment.     

17例颈椎外伤合并颈椎退行性病变的伤病关系分析

目的研究颈椎外伤合并颈椎退行性病变的法医学鉴定案件特点,探讨如何利用临床资料,法医学检查和影像学检查等对损伤和病变参与程度进行认定等问题。方法收集17例颈椎外伤合并颈椎退行性病变的法医学鉴定案例,对其年龄分布、损伤方式、损伤程度、影像学表现等进行分析,综合评定伤病关系。结果 17例案件以中老年为主。所有案例均存在椎间盘突出,损伤以过伸性损伤为主。按照影像学表现,将损伤程度和脊椎退变程度进行分级,综合计算伤病参与程度。结论颈椎外伤合并颈椎退行性病变的法医学鉴定案件应综合运用临床资料、法医学体格检查和影像学检查结果进行评定。     

A Method for Articulating and Displaying the Human Spine

Abstract:  An inexpensive and effective method for articulating a dry human spine is described. By constructing a Styrofoam™ spine tray, analysts can now accurately position and align each vertebra in correct anatomical order, allow for gaps because of missing vertebrae, and lay out the spine for documentation and photography. The spine tray provides analysts with a quick, easy, and professional quality method for aligning and orienting the human spine in the field and laboratory.