中药内服联合针刺及微波透药治疗宫颈癌术后顽固性尿潴留9例

目的 观察中药内服联合针刺及微波透药治疗宫颈癌术后顽固性尿潴留的疗效。方法 选择宫颈癌术后顽固性尿潴留患者共9例,所有患者均接受中药内服（补肾益气通利方加减）、针刺（取三阴交、足三里、关元、气海、中极等穴位）联合微波透药的综合方法, 治疗前和1个疗程（7 d）后分别观察膀胱残余尿量、中医症状积分,并观察自主排尿功能恢复时间及复发情况。结果 与治疗前比较,1个疗程后膀胱残余尿量明显减少（P＜0.05）,临床症状（排尿无力、小腹胀痛、腰膝酸软、倦怠乏力）积分均显著降低（P＜0.05）。患者自主排尿功能平均恢复时间为（16.22±6.12）d。随访结果显示没有患者复发。结论 中药内服联合针刺及微波透药的综合疗法对宫颈癌术后顽固性尿潴留具有较好的疗效。     

经伤椎置单向椎弓根螺钉结合十七味大活血胶囊治疗无神经损伤胸腰椎压缩性骨折疗效观察

目的 观察伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服在无神经损伤胸腰椎压缩性骨折治疗中的效果。方法 将67例无神经损伤胸腰椎骨折患者,根据患者最终选取的治疗方案分为对照组（n=45）和观察组（n=22）。对照组给予跨伤椎固定的基础上再经伤椎置入单向椎弓根螺钉固定,观察组在对照组的基础上使用自制十七味大活血胶囊口服。分别观察两组治疗前、治疗后1周、治疗后3个月椎前缘高度、椎中缘高度和后凸角度,视觉模拟量表（visual analogue scale,VAS）评分,日本骨科协会（Japanese Orthopaedic Association,JOA）评分。结果 与治疗前比较,两组治疗后1周、3个月椎前缘高度、椎中缘高度均明显增加（P＜0.05）,后凸角度均明显减小（P＜0.05）;观察组治疗后3个月椎前缘、椎中缘高度均明显高于对照组（P＜0.05）。与治疗前比较,两组治疗后VAS评分在治疗后1周、3个月均明显减少（P＜0.05）,JOA评分均明显增加（P＜0.05）。观察组治疗后VAS评分在治疗后1周、3个月均显著低于对照组（P＜0.05）,JOA评分明显高于对照组（P＜0.05）。结论 经伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服更利于伤椎前中柱交界处的复位,临床疗效更好。     

理筋正骨手法治疗颈型颈椎病临床观察

目的 观察理筋正骨手法结合运动锻炼治疗颈型颈椎病的临床疗效。方法 将60名颈型颈椎病患者随机分为治疗组和对照组,每组30例;治疗组采用理筋正骨手法结合运动锻炼,对照组采用牵引疗法联合运动锻炼;分别于治疗前后采用手持式压痛仪检测患者颈部疼痛部位压痛阈值,关节角度尺测量颈椎关节活动度,采集颈部肌肉表面肌电积分肌电值（integral electromyogram,iEMG）,计算颈椎前屈、后伸、侧屈的肌肉协同收缩率（co-contraction ratio,CCR）,采用颈部功能障碍指数（neck disability index,NDI）评价功能改善程度,并进行疗效评价。结果 与治疗前比较,两组患者治疗后疼痛减轻,颈椎活动度增加,颈部肌肉CCR下降,NDI降低（P＜0.05）;治疗组疼痛、颈椎关节活动度、颈部肌肉CCR、NDI改善程度均优于对照组（P＜0.05）。治疗组临床疗效优于对照组（P＜0.05）。结论 理筋正骨手法结合运动锻炼可有效减轻颈型颈椎病患者的疼痛,改善关节活动度,提高颈部肌肉协调性,改善患者颈椎功能,其疗效优于牵引疗法结合运动锻炼。     

淫羊藿对大鼠退变颈椎骨组织钙、磷代谢的影响

目的:观察淫羊藿对大鼠退变颈椎骨组织钙(Ca)、磷 (P)代谢的影响,探讨淫羊藿防治颈椎退变的机制.方法:6月龄SD大鼠,体质量(220±20)g,雌雄不拘,随机分为模型组20只,假手术对照组10只.通过切除动物C2-7棘上韧带、棘间韧带和分离椎旁两侧肌肉,建立颈椎退行性改变动物模型.在1,3个月末两个时间点拍摄颈椎X线片,证实模型复制成功后,将模型组分为淫羊藿组10只,9.0 g/L氯化钠注射液(NS)组10只,分别喂服淫羊藿水提液和NS 2个月,假手术对照组喂服NS,取大鼠颈椎骨组织和血清用全自动生化分析仪分别测定骨组织Ca、P含量和血清样本中Ca、P、碱性磷酸酶(ALP)水平.结果:淫羊藿组大鼠血清P及ALP水平较NS组和假手术对照组显著升高(P<0.05).3组血Ca水平无显著性差异.NS组颈椎骨组织Ca、P含量与假手术对照组相比较显著降低(P<0.01),淫羊藿组颈椎骨组织Ca、P含量与NS组相比较显著升高(P<0.01).结论:颈椎Ca、P含量减低,是颈椎退变的病理结果.淫羊藿可提高退变颈椎骨组织Ca、P含量,抑制颈椎退变.淫羊藿可降低退变颈椎组织ALP活性,具有抑制骨赘形成,减缓颈椎退变的作用.     

枢椎种族差异的初步研究

目的探讨枢椎椎骨在种族间是否存在差异。方法对黄种人已知确切性别的33例枢椎椎骨进行研究,测量枢椎椎骨的8项指标,所得数据与白种人进行比对。结果8项指标中,其中6项指标在男性种族间存在显著的种族差异、3项指标在女性种族间存在显著的种族差异。结论枢椎椎骨在种族方面存在一定差异,可以进行进一步的深入研究,本文对骨骼种族方面的鉴定研究有一定的借鉴意义。     

液基细胞学技术对减少临床医疗纠纷的应用价值

目的探讨液基细胞学技术对于减少临床医疗纠纷的价值。方法对1531例样本分别用液基细胞学方法和传统巴氏涂片技术进行宫颈细胞学涂片制作,其中液基细胞学方法分别用新柏氏耗材和昂佰氏耗材;涂片根据TBS 2001标准进行诊断;细胞学诊断为LSIL以上病变(包括LSIL、HSIL、SCC和AC)者组织活检进行组织学诊断;应用SPSS11.0软件进行数据分析。结果液基细胞学方法同传统巴氏方法相比,在标本满意度、敏感度、特异度和准确性、假阴性率和误诊率等方面有显著统计学差异(P<0.05),新柏氏和昂佰氏获得结果之间无明显差异。结论液基细胞学技术可以有效提高宫颈癌普查的诊断水平,从而有效防止和减少医疗纠纷的发生;昂佰氏耗材可以替代新柏氏耗材进行液基细胞学检查。     

Integrating Growth Variability of the Ilium,Fifth Lumbar Vertebra,and Clavicle with Multivariate Adaptive Regression Splines Models for Subadult Age Estimation

Subadult age estimation should rely on sampling and statistical protocols capturing development variability for more accurate age estimates. In this perspective, measurements were taken on the fifth lumbar vertebrae and/or clavicles of 534 French males and females aged 0–19 years and the ilia of 244 males and females aged 0–12 years. These variables were fitted in nonparametric multivariate adaptive regression splines (MARS) models with 95% prediction intervals (PIs) of age. The models were tested on two independent samples from Marseille and the Luis Lopes reference collection from Lisbon. Models using ilium width and module, maximum clavicle length, and lateral vertebral body heights were more than 92% accurate. Precision was lower for postpubertal individuals. Integrating punctual nonlinearities of the relationship between age and the variables and dynamic prediction intervals incorporated the normal increase in interindividual growth variability (heteroscedasticity of variance) with age for more biologically accurate predictions.     

A Novel Method for Removing a Spinal Cord with Attached Cervical Ganglia from a Pediatric Decedent

A diagnosis of child abuse is dependent on a comprehensive and accurate assessment of injury in the context of a thorough investigation. However, signatures of trauma are often subtle and interpretation can be very difficult. Recently, researchers have refocused their attention from the head to the neck in search of traumatic signatures of abusive head trauma. HCIFS has developed a technique to remove the cervical spinal cord with the ganglia attached that is less destructive and more time and cost efficient than alternative methods previously published. Once removed, the dorsal nerve roots and ganglia are evaluated for the presence of hemorrhage. The authors performed a small pilot study using the novel method to evaluate 20 decedents with a history of blunt force trauma and eight without a traumatic history. Fifteen of the traumatic deaths and two of the nontraumatic deaths were found to have dorsal nerve root and/or ganglia hemorrhage.     

Determination of sex for the 12th thoracic vertebra by morphometry of three-dimensional reconstructed vertebral models

Thirty-three linear measurements and two ratios were derived from 102 12th thoracic vertebrae of the Digital Korean database at the Catholic Institute for Applied Anatomy. Of 35 linear traits, 23 were sexually dimorphic. We created 23 discriminant function equations that predicted sex with 62.7-85.3% accuracy. The analysis using combinations of two factors gave higher accuracies: most equations with accuracies over 80% included at least one measurement involving the coronal diameter of the vertebral endplate. Using stepwise method of discriminant function analysis, three variables predicted sex with 90.0% accuracy: the coronal diameter of the superior endplate of the vertebral body, the ratio of anterior to middle height of the body, and the length of the left mammillary process and pedicle. Coronal dimensions of the vertebral body represented the major sex difference. These equations will help forensic discrimination of the sex of this vertebra among Koreans.     

内热针治疗颈型颈椎病疗效观察

目的 观察内热针与电针治疗颈型颈椎病的近、远期疗效。方法 将80例颈型颈椎病患者随机分为治疗组和对照组,每组40例,治疗组给予内热针治疗（每周1次）,对照组给予电针治疗（每周5次）,两组均治疗2周,治疗前、治疗2周结束时、治疗结束2个月随访时,分别观察患者的视觉模拟评分（visual analogue scale,VAS）、颈痛量表（Northwick park neck pain questionnaire, NPQ）评分。结果 两组治疗前VAS、NPQ评分比较,差异均无统计学意义（P＞0.05）。与治疗前相比,两组治疗后各观察时间点两项评分均有改善（P＜0.05）;且治疗组在各观察时间点两项评分改善程度均优于对照组（P＜0.05）。结论 内热针与电针治疗颈型颈椎病均有较好的近期与远期疗效,且内热针优于电针。