退变性腰椎滑脱患者脊柱-骨盆矢状位参数及小关节的研究

目的:探讨退变性腰椎滑脱患者脊柱-骨盆矢状位参数和腰椎小关节的特点,分析退变性滑脱的发生发展机制。方法:从2014年1月份到2015年12月份,于我科收集L4-5节段退变性腰椎滑脱的患者,作为DS组,共46例患者。根据年龄和性别匹配原则,纳入46例L4-5节段椎管狭窄的患者,作为DSS组。通过影像学资料测量评估两组病例的如下参数:PI、PT、SS、LL、TK、SVA、小关节方向、小关节不对称性、小关节退变分级和滑脱程度。比较两组患者参数的差异。对退变性腰椎滑脱患者小关节方向与其他参数进行相关性分析,并根据小关节方向不同将滑脱患者,分为小关节矢状化程度重的A组和矢状化轻度相对较轻的B组。对比分析两组病例相关参数的差异。结果:DS组小关节退变分级高于DSS组(P=0.045)。DS组PI和PT大于DSS组(P0.001),小关节角度小于DSS组(P=0.004),两组小关节不对称程度没有统计学差异(P=0.483)。DS组小关节方向与PI、LL、PT、滑脱程度和小关节退变程度呈现显著负相关(P0.05)。A组小关节退变分级高于B组(P=0.037),PI、PT和滑脱程度均显著大于B组(P0.05)。结论:退变性腰椎滑脱患者小关节矢状化程度和退变较重,PI较大,大PI和小关节矢状化是退变性腰椎滑脱发生发展的重要因素。     

TLIF与PLIF对退行性腰椎滑脱合并腰椎管狭窄患者临床疗效及安全性比较

目的:比较经椎间孔椎体间融合术(transforaminal lumbar interbody fusion,TLIF)与经后路椎体间融合术(posterior lumbar interbody fusion,PLIF)对退行性腰椎滑脱合并腰椎管狭窄患者临床疗效及安全性。方法:选择2013年6月到2015年6月我院收治的90例退行性腰椎滑脱合并腰椎管狭窄患者,随机分为TLIF组和PLIF组,各45例。TLIF组患者给予TLIF治疗,PLIF组患者给予PLIF治疗。记录并比较两组患者手术时间、术中失血量、术后引流量及术后卧床时间。评价并比较两组患者治疗前后视觉疼痛评分(visual analogue scale,VAS)和Oswestry功能不良指数(oswestry disability index,ODI)。记录并比较两组患者治疗后神经根损伤、感染、硬膜囊破裂等并发症发生情况。结果:TLIF组患者的手术时间、术中失血量、术后引流量及术后卧床时间均明显小于PLIF组,均具有显著性差异(P0.05)。治疗前,两组患者VAS、ODI评分,相比均无显著性差异(P0.05);治疗后,两组患者VAS、ODI评分均明显小于治疗前,且TLIF组患者的VAS、ODI评分均明显小于PLIF组,均具有显著性差异(P0.05)。TLIF组患者的并发症发生率明显低于PLIF组,均具有显著性差异(X~2=3.873,P=0.049)。结论:相比于PLIF,TLIF治疗退行性腰椎滑脱合并腰椎管狭窄患者的临床疗效显著,有助于腰椎功能的恢复,并发症发生率较低,值得在临床上推广应用。     

腰椎多节段退变性滑脱的手术治疗

目的:研讨腰椎多节段退变性滑脱手术减压和植骨融合方式与疗效的关系。方法:20例腰椎多节段退变性滑脱患者行后路椎弓根螺钉复位内固定后,采用椎管减压、神经根松解,行椎间植骨和后外侧植骨融合术,采用日本整形外科学会(JOA)下腰痛评分标准评价疗效。结果:获得连续随访者18例,随访时间9月～3年,平均24个月,优良率90%。结论:可靠的内固定、复位,神经根松解,椎间植骨融合治疗腰椎多节段退变性滑脱效果满意,充分的神经根松解是手术治疗的关键。     

成人退行性腰椎侧弯合并滑脱的手术治疗

目的:探讨退行性腰椎侧弯合并滑脱的手术方法和临床疗效.方法:25例适应证患者行后路椎弓根螺钉内固定复位矫形后,采用椎管减压、神经根松解,行椎间植骨和后外侧植骨融合术,术后测量退变性脊柱侧弯的矫正效果,依照日本整形外科学会(JOA)下腰痛评分,观察腰腿疼痛改善情况.结果:全部病例获得随访,随访时间6月～3年,平均20个月,术后平均侧弯矫正率58.7%,疼痛改善优良率80%.结论:椎弓根固定系统结合椎间及后外侧植骨融合术是治疗退行性腰椎侧弯合并滑脱的有效方法.应重视术中神经根减压,矫正腰椎侧弯,恢复腰椎力学平衡,有助于提高远期疗效.     

经后路椎体间融合术与经椎间孔椎体间融合术治疗老年退行性 腰椎滑脱合并腰椎管狭窄的疗效

目的：研究经后路椎体间融合术（PLIF）与经椎间孔椎体间融合术（TLIF）治疗老年退行性腰椎滑脱合并腰椎管狭窄症的临 床疗效。方法：选取2011 年12 月到2014 年12 月我院收治的老年退行性腰椎滑脱合并腰椎管狭窄症患者40 例,根据手术方式 将患者分为PLIF组和TLIF组,比较两组手术时间、术中出血量、术后引流量、术后卧床时间、视觉疼痛评分（VAS）、Oswestry功能 不良指数（ODI）以及并发症的发生率。结果：TLIF组术中出血量、术后引流量及术后卧床时间均显著优于PLIT 组,差异具有统计 学意义（P＜ 0.05）;两组手术时间差异无统计学意义（P＞0.05）;两组术后半年VAS评分及ODI评分均显著优于手术前,差异具有 统计学意义（P＜0.05）;但两组之间比较,差异无统计学意义（P＞0.05）;TLIF 组并发症发生率显著低于PLIF 组,差异具有统计学 意义（P＜ 0.05）。结论：TLIF治疗老年退行性腰椎滑脱合并腰椎管狭窄症具有较好的临床疗效,且术后并发症较少。     

人退变椎间盘软骨终板干细胞多向分化的研究

目的:为了分离和鉴定人退变椎间盘软骨终板干细胞。方法:收集因腰椎间盘退变性疾病行腰椎间盘摘除术并植骨融合的标本。在解剖显微镜下清理软骨终板组织,并消化软骨终板,提取软骨终板细胞。获得的软骨终板细胞经过琼脂糖三维筛选系统培养后,选取细胞克隆团并进行体外扩增,扩增后的细胞行流式细胞术检测干细胞标志物证实退变软骨终板中存在干细胞。结果:共聚焦免疫荧光提示退变椎间盘软骨终板组织中存在干细胞标志物STRO1、CD105、CD73、CD90阳性的细胞。经琼脂糖三维培养基筛选的CESCs在免疫表型上符合干细胞标准。结论:在人退变椎间盘的软骨终板中存在具有多向分化潜能的干细胞。     

人退变椎间盘软骨终板干细胞多向分化的研究

目的：为了分离和鉴定人退变椎间盘软骨终板干细胞。方法：收集因腰椎间盘退变性疾病行腰椎间盘摘除术并植骨融合的标本。在解剖显微镜下清理软骨终板组织,并消化软骨终板,提取软骨终板细胞。获得的软骨终板细胞经过琼脂糖三维筛选系统培养后,选取细胞克隆团并进行体外扩增,扩增后的细胞行流式细胞术检测干细胞标志物证实退变软骨终板中存在干细胞。结果：共聚焦免疫荧光提示退变椎间盘软骨终板组织中存在干细胞标志物STR01、CDl05、CD73、CD90阳性的细胞。经琼脂糖三维培养基筛选的CESCs在免疫表型上符合干细胞标准。结论：在人退变椎间盘的软骨终板中存在具有多向分化潜能的干细胞。     

椎弓根内固定联合椎体间植骨融合术治疗退行性腰椎滑脱症的临床探讨

目的:探讨椎弓根内固定联合椎体间植骨融合术治疗退行性腰椎滑脱症的临床效果。方法:回顾性分析我院2012年3月至2014年3月收治的30例采用椎弓根内固定联合椎体间植骨融合术治疗的退行性腰椎滑脱症患者临床资料,观察患者对手术效果的满意度,并对症状进行JOA评分。比较患者术前术后的腰椎X线的影像学变化,观察术后临近节段的退变发生率与影像的融合率。结果:术后随访1-3年发现患者JOA评分的平均改善率为(73.81±16.12)%,术后滑脱率与椎间高度均有明显改善,与术前比较差异具有统计学意义(P0.05)。术后影像学显示植骨融合A级15例,B级12例,C级3例,融合优良率为90%。结论:椎弓根内固定联合椎体间植骨融合术对退行性腰椎滑脱症具有显著的临床效果,不仅可以缓解疼痛,改善功能评分,而且使患者影像学变化恢复正常生理形态,是理想的手术方法之一。     

退行性腰椎滑脱临近节段椎间盘退变和关节突关节角度相关研究

目的:探讨退行性腰椎滑脱(DLS)临近节段椎间盘退变程度和关节突关节角度之间的关系。方法:选取我院2012年6月至2016年6月收治的120例DLS患者作为DLS组,另外选取来我院接受体检的健康者120例作为对照组,选择CT进行关节突关节角和腰椎滑脱度的测量,使用MRI的T2像对椎间盘进行Pfirrmann退变分级。结果:DLS组的各节段关节突关节角度均小于对照组(P0.05);DLS组不同滑脱程度的L2/3、L3/4、L5/S1节段关节突关节角度的比较,差异无统计学意义(P0.05);DLS组L2/3、L3/4、L5/S1节段不同椎间盘退变等级间的滑脱程度无显著性差异(P0.05)。L2/3和L3/4节段不同椎间盘退变程度间关节突关节角度差无显著性差异(P0.05),L5/S1节段不同椎间盘退变程度间关节突关节角度差有统计学差异(P0.05)。结论:退行性腰椎滑脱临近节段关节突关节角度明显小于正常人,且临近节段关节突关节的角度并未随着腰椎滑脱程度的加重而改变,退行性腰椎滑脱患者滑脱临近节段椎间盘退变与关节突关节的矢状化程度无关,但L5/S1关节突关节角度不对称性会影响到同节段椎间盘退变程度。     

中药熨疗腰椎骨性关节炎的护理

腰椎骨性关节炎(Lumbar osteoarthritls,LOA)是指以腰椎小关节肥大变性等病理改变引起的以腰痛为主要表现的临床病症.临床上又称为腰椎退行性关节病、腰椎增生性关节炎及老年性腰椎关节炎等,其病理特点为关节软骨变性、破坏,软骨下骨硬化,关节边缘和软骨下骨反应性增生,骨赘形成.     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

医疗机构合理用药评价模型的构建研究

目的 针对医疗机构的合理用药水平进行评价研究。方法 根据医疗机构合理用药的具体要求,构建医疗机构合理用药评价指标体系,采用基于模糊群决策的方法和多指标评价分析法构建医疗机构合理用药评价模型。结果 构建了基于模糊群决策的医疗机构合理用药评价模型,并通过实例分析证明了评价模型的可行性。结论 建立的基于模糊群决策的医疗机构合理用药评价模型能够对医疗机构的合理用药水平进行科学评价,为提高医疗机构合理用药水平奠定基础。     

The mechanism of hatching of eggs of Haemonchus contortus

Fluid collected from hatching eggs of Haemonchus contortus contained a lipase which hydrolysed 2-naphthyl laurate (about 0·7 μmol naphthol freed /h/10⁶ eggs). The fluid also hydrolysed l-leucinamide (about 2·3 μmol leucine freed/h/10⁶ eggs). The fluid when added to normal or heated eggs caused ‘hatching’. ‘Hatching’ also occurred in exsheathing fluid from infective juveniles and in a preparation of pancreatic lipase containing leucine aminopeptidase. A purified mammalian leucine aminopeptidase in combination with several different lipases did not attack egg shells.The ‘spontaneous’ hatching of eggs of H. contortus was strongly inhibited by 1,10-phenanthroline, 10^?3M, and this inhibition was reversed by Zn²⁺. However, the inhibition of ‘hatching’ of eggs in externally applied hatching fluid, or the hydrolysis of leucinamide in hatching fluid was generally less marked.