推拿治疗椎动脉型颈椎病的时效性研究

目的 探讨推拿治疗时间对椎动脉型颈椎病（cervical spondylosis of vertebral artery,CSA）的影响。方法 选取符合纳入标准的CSA患者90例,按随机数字表法随机分为推拿10 min组、推拿20 min组和推拿30 min组,行常规推拿手法治疗,比较治疗前后所有患者临床疗效、颈椎功能评分以及经颅多普勒（transcranial Doppler,TCD）超声检测情况。结果 3组患者临床疗效的分布比较,差异均具有统计学意义（P<0.05）,推拿20 min组和30 min组临床疗效均明显优于10 min组。推拿10 min组治疗前后颈椎功能评分比较,差异无统计学意义（P＞0.05）,而推拿20 min组和30 min组治疗后颈椎功能评分均较治疗前明显改善（P＜0.05）。推拿20 min、30 min组较10 min组颈椎功能评分改善程度更加明显（P＜0.05）;推拿20 min组和30 min组相比较,颈椎功能评分改善程度差异无统计学意义（P＞0.05）。3组患者治疗前后相比,两侧椎动脉的血流速度均有明显改善（P＜0.05）;与推拿10 min组比较,推拿20 min、30 min组治疗后两侧椎动脉的血流速度改善更加明显（P＜0.05）,推拿20 min和30 min组比较,治疗后两侧椎动脉血流速度的改善程度无统计学意义（P＞0.05）。结论 推拿治疗CSA具有时间累积效应,随着推拿时间的延长,疗效提高,但是到达一定时间疗效不再增加;推拿治疗时间的选择在20 min左右为最佳。     

李业甫筋骨并举整脊法治疗颈性眩晕临床疗效观察

目的 观察李业甫筋骨并举整脊法治疗颈性眩晕的临床疗效.方法 将80例颈性眩晕患者按照随机数字表法分为对照组和观察组,每组40例.对照组患者采用常规推拿治疗,观察组患者采用常规推拿结合李业甫筋骨并举整脊法治疗.比较两组患者临床疗效,治疗前后颈性眩晕症状与功能评分、眩晕残障程度评定量表(dizziness handicap inventory,DHI)评分及椎-基底动脉血流速度.结果 两组患者临床疗效比较,差异有统计学意义(P<0.05),观察组的治疗效果优于对照组.两组治疗后颈性眩晕症状与功能评分均显著升高,DHI评分均显著降低(P<0.05),且观察组改善程度显著优于对照组(P<0.05).两组治疗后左侧椎动脉、右侧椎动脉、基底动脉平均血流速度均有所增加(P<0.05),且观察组改善程度优于对照组(P<0.05).结论 李业甫筋骨并举整脊法可以有效调节椎-基底动脉血流速度以减轻患者的眩晕症状.     

Two consecutive fatal cases of acute myocardial infarction caused by free floating thrombus in the ascending aorta and review of literature

Free floating thrombus in the ascending aorta is an uncommon source of acute myocardial infarction. We report on two cases of young women who died of acute myocardial infarction caused by a free floating thrombus in the sinus of Valsalva obstructing the coronary arteries' ostia. The first case reports on a 30-year-old pregnant woman who anamnestically had episodes with short loss of consciousness and weakness. The second case presents a 37-year-old woman suffering from multiple sclerosis with no previous history of thrombotic events. The review of literature revealed a predominance of women (eight females and three males). Interestingly, the coronary arteries bear no preference concerning the right (RCA) or left coronary artery (LCA) being more often occluded by a free floating thrombus. Especially, younger women (mean age 45.5 years, range 30-59 years) with no history of cardiac symptoms and without atherosclerotic changes seem to be predispositioned. The hypothesis that thrombus formation in cases without plaque disruption may depend on an endothelial erosion which seems to be more common in younger women and promoted by a hyperthrombogenic state is supported by our two cases. A comprehensive literature search revealed, that these are the first two reports on a free floating thrombus being the cause of fatal acute myocardial infarction in a pregnant woman, respectively, a woman suffering from multiple sclerosis.     

Identification of unknown bodies by using CT images of frontal sinus

The aim of the study was to define a simple system for the identification of unknown bodies by using CT images of frontal sinus and to discuss whether it was worth to add measurements to the system or not. The system was including simple features as F (presence or absence of frontal sinus), S (intersinus and intrasinus septum) and S (scalloping), and named as FSS system. Measurements selected for the study were width, height, anteroposterior length, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit. The study was conducted retrospectively on the paranasal CT scans of 100 cases (38 male and 62 female) who had no apparent sinonasal pathology. All the features and measurements were coded according to the system defined by the authors for each case and coded formulas were compared. At least 93% of the formulas could be eliminated for a case by using FSS system. The rate of success was increased to 98% by adding measurements. Contrary to objective criteria of FSS system, measurements were prone to bias. Therefore, in practice success rate would be expected to be lower than calculated. In the study population, instead of making 100 measurements, eliminating the most of the cases with FSS system and later discriminating the rest by pattern matching was seen logical.     

Schmorl's nodes in an American military population: frequency, formation, and etiology

This research investigates the frequency of Schmorl's nodes in differing populations, with new data from a skeletal sample from the Central Identification Laboratory (CIL) at the Joint Prisoner of War/Missing in Action Accounting Command, while also reviewing the etiology of Schmorl's node formation. Processes implicated in Schmorl's node formation include trauma, old age, disease, intrinsic abnormalities, and biomechanical factors, and they correlate with Schmorl's node formation to varying degrees. A survey of research from the anthropology and medical literature revealed Schmorl's node population frequencies ranging from 8 to 80%. The current study consists of two samples, one derived from CIL case reports and one analyzing skeletal remains. The case report sample yielded a Schmorl's node frequency of 19.8%. The examined sample yielded a frequency of 73.7%. The disparate frequencies reported are likely due mainly to differences in completeness and observability. It is likely that trauma was a major factor in the formation of Schmorl's nodes in the CIL study.     

Spontaneous Coronary Artery Dissection: Case Report and Literature Review

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35‐year‐old pregnant female who presented with an acute antero‐lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.     

双峰驼肾动脉血管分布的铸型观察

运用管道铸型技术以及扫描电镜技术对双峰驼肾动脉血管进行了系统观察。结果显示,双峰驼肾动脉在入肾门前约4~8 cm处分为背干和腹干,入肾后在肾窦内相继形成肾段动脉。左右两肾段动脉的分支分布各有特点,各段动脉分支延伸至肾的皮髓交界处,形成弓形动脉;弓形动脉是叶间动脉的延续,并不与肾表面相平行;肾血管球以及出、入球微动脉因分布区域的不同,形态结构也不尽一致。表明,双峰驼肾各段动脉分布的规律性强,段动脉分支之间没有吻合支存在;肾各部位的血管球随分布区域的不同,其形态结构也呈现一定的变化。     

急性热应激对肉鸡股动脉压等生理指标的影响

通过对 30只 2 5日龄常温饲养的商品代雄性AA肉鸡 ,置于 4 2 .0℃± 0 .5℃控温小木箱中 ,给予高温刺激 ,并进行肉鸡股动脉压等指标的动态检测 ,探讨了肉鸡热应激发生发展的规律。结果显示 ,热暴露第 10min时平均股动脉压 (mFAP)显著下降 (P <0 .0 5 ) ,第 15～ 5 0min时平均股动脉压极显著下降 (P <0 .0 1) ,第 30min时股动脉收缩压最大变化速率 ( dp/dtmax)极显著升高(P <0 .0 1) ,第 5 0min时极显著降低 (P <0 .0 1) ;第 2 0min时股动脉舒张压最大变化速率(︱ -dp/dtmax︱ )极显著升高 (P <0 .0 1) ,第 4 0min时显著降低 (P <0 .0 5 ) ,第 5 0min时极显著降低 (P <0 .0 1)。平均股动脉压与呼吸频率、心率呈极显著正相关 (P <0 .0 1,n =4 5 ) ,相关系数分别为 0 .4 6 4和 0 .4 70 ;与体温呈极显著负相关 (P <0 .0 1,n =4 5 ) ,相关系数为 - 0 .790。证实 ,肉鸡的股动脉压在短时间内极显著下降 ,可能为高温条件下肉鸡死亡的主要原因。     

垂体后叶素致冠状动脉痉挛症的实验病理学研究

作者通过大鼠舌下静脉注射垂体后叶素致冠状动脉痉挛,运用组织学、酶组织化学及电镜技术研究冠状动脉痉挛症引起心肌急性缺血的形态学变化特点,同时对大鼠心肌自溶性变化与上述结果进行了分析比较,认为心肌纤维磷钨酸苏木素(PTAH)染色出现不规则横带且伴有心肌间质小血管壁腺苷三磷酸酶(ATPase)活性下降,有助于冠状动脉痉挛症引起心肌缺血的诊断。     

Death Due to an Unusual Angio‐Seal‐Related Complication: Case Report and Literature Review

Angio‐SealTM is a vascular closure device (VCD) that can be applied to the femoral artery following cardiac catheterization to achieve hemostasis. Although it has been demonstrated to be superior to conventional manual pressure and to reduce time to hemostasis and patient ambulation, the use of this VCD is not without its complications. In this report, we describe the case of a 55‐year‐old man who died due to an extremely rare event that occurred several hours after the deployment of an Angio‐SealTM VCD: acute complete transverse laceration of the femoral artery that occurred because of the particular fragility of the vessel due to an unrecognized and asymptomatic arteriosclerotic disease. Few data are available in the literature about the incidence of such events, and much more remains to be done to determine how to prevent and manage its occurrence.