国人颈椎横突孔的形态观察与测量

本文作者用精密度为0.02毫米的游标卡尺对东北地区出土的100副成套颈椎,1200个颈椎横突孔的诸径进行了测量,得到了一系列数据,并对颈椎横突孔的形状(将它分为五型)及一些特异颈椎进行了观察,根据这些材料探讨了横突孔与椎动脉的关系。     

颈椎骨折颅骨牵引规范化体位护理的探讨

颈椎骨折是由外力突然作用于患者的颈部而引起,重者可致颈髓损伤。颅骨牵引适用于颈椎骨折和脱位患者,但颅骨牵引术后需要长期卧床,并且骨钉置于颅骨两侧,为保持有效牵引,头颈部不能随意活动,处于绝对被迫卧位[1],故颈椎骨折颅骨牵引病人的体位护理相当重要,若翻身操作不当,可使病情加重,甚至迅速死亡[2]。我院于2010年7月～2011年7月收治颈椎骨折并进行颅骨牵引的患者28例,经规范化的体位护理,取得满意效果,现报告如下。     

颈椎骨折脱位并发高位截瘫的护理

颈椎外伤合并高位脊髓损伤伴截瘫是一种严重的致残性损伤,伤情常较严重而复杂,往往给患者造成致命的身心创伤甚至终生残疾,使患者丧失全部或部分生活自理能力,还会继发其他并发症,因此,护理工作显得特别重要。近年来,我科收治颈椎骨折脱位并发高位截瘫患者28例,现将护理体会总结如下。     

单节段颈椎人工椎间盘置换术治疗颈椎病的临床研究

目的:探讨单节段颈椎人工椎间盘置换术(CDA)治疗颈椎病的临床效果。方法:选择2013年5月到2015年5月在我院收治的80例颈椎病患者,按手术方式不同分为颈椎人工椎间盘置换组(CDA组)和前路颈椎减压融合组(ACDF组),各40例。两组患者均于术前、术后3个月、术后6个月及术后1年进行末期随访时,采用颈椎功能障碍指数(NDI)评价患者颈部功能,采用颈痛视觉模拟评分(VAS)和上肢痛VAS评价患者颈部疼痛,采用X线片在过伸和过屈位测量患者术前和术后手术节段相邻节段的活动度。结果:两组患者术后3个月、6个月及术后1年时的NDI评分、颈痛VAS及上肢痛VAS均明显低于术前,差异具有统计学意义(P0.05),然而两组间比较差异无统计学意义(P0.05)。CDA组患者术后3个月、6个月及术后1年时的手术相邻上节段活动度和手术相邻下节段活动度与术前比较差异无统计学意义(P0.05),而ACDF组患者术后3个月、6个月及术后1年时均明显高于术前及同期CDA组,差异具有统计学意义(P0.05)。结论:单节段CDA治疗颈椎病的临床疗效与ACDF相近,另外其不会引起手术相邻节段活动度的增加,值得在临床上推广应用。     

双开门术后对颈椎稳定性及抗疲劳性的影响

目的:比较不同节段的双开门术后的三维稳定性及抗疲劳性,为改进手术方式提供生物力学依据。方法:新鲜成人颈椎标本16例(男、女各8例),随机分为4组,A组4例,B组5例,C组4例,D组三例;A组无特殊处理,B组对五例分别行C3、C4、C5、C6、C7各一个节段的双开门,C组对四例分别行C34、C45、C56、C67各两个节段的双开门,D组对三例分别行C345、C456、C567三个节段的双开门,各组棘突开口间距均为5mm。标本进行生物力学测试,标本进行生物力学测试,获得三维稳定性和抗疲劳数据,采用独立样本t检验及配对样本t检验。结果:A、B、C、D组的颈椎活动范围有明显的统计学差异(P0.05),各组在疲劳测试前后各个方向的运动范围有显著差异(P0.05)。结论:不同节段的双开门对椎体稳定性的影响不同,其双开门节段越多,对椎体的稳定性影响越大。     

离子治疗仪治疗颈椎增生76例疗效观察

作者以自制的离子治疗仪治疗颈椎增生78例疗效甚佳,现报告如下。 一般资料: 78例中男63例,女15例,年龄36～64岁,61例经X光拍片确诊为颈椎增生。因增生发作时至严重头晕欲吐不能作任何活动的4例;引起一边或两边头痛的31例;至上肢酸软无力的17例;引起肩周酸软的8例;仅颈部酸软的18例。经确诊增生已10年以上的2例;发现增生2周内的5例;71例为增生3周至4年不等。     

犬颈椎小关节脱位动物模型制作过程中的护理

为探讨犬颈椎小关节脱位动物模型制作过程中的护理特点,对20只犬建立颈椎小关节脱位模型,并于手术前积极准备,术中主动配合,术后及撞击伤后细致护理,密切观察.结果动物术后3日存活率达80%,满足了实验要求.认为术前不必禁食,术中可不作气管插管,术后保暖十分重要.     

核心稳定训练联合五禽戏对颈型颈椎病患者颈椎疼痛、颈椎功能和生活质量的影响

目的:观察核心稳定训练联合五禽戏对颈型颈椎病(NTCS)患者颈椎疼痛、颈椎功能和生活质量的影响。方法:选取NTCS患者80例,按随机数字表法分为对照组(核心稳定训练)和研究组(核心稳定训练联合五禽戏)各40例。对比两组疗效、颈椎疼痛、颈椎功能和生活质量。结果:研究组的临床总有效率高于对照组(P<0.05)。两组干预1个月、2个月后、3个月后颈部视觉模拟评分法(VAS)评分逐渐下降,且研究组的下降程度大于对照组(P<0.05)。两组干预3个月后颈椎功能障碍指数(NDI)评分下降,且研究组的下降程度大于对照组(P<0.05),颈椎前屈、后伸、左旋、右旋活动度升高,且研究组的升高程度大于对照组(P<0.05)。两组干预3个月后SF-36各维度评分均较干预前升高,且研究组的升高程度大于对照组(P<0.05)。结论:NTCS患者采用五禽戏、核心稳定训练联合干预,可有效缓解颈椎疼痛,促进颈椎功能恢复,提高患者生活质量,疗效明确。     

家兔减压神经颈部变异的几种新类型

用解剖学方法结合电生理学方法鉴别减压神经形态上的变异。在35只纯种青紫蓝家兔中,减压神经颈部有形态变异者达23只(占65.71％)20种,观察到减压神经变异的三种新类型:减压神经三分支型、“无”减压神经型和减压迷走交感干型;至于减压神经的起点,以起于喉前神经者居多。     

CINERADIOGRAPHIC STUDIES OF THE NORMAL CERVICAL SPINE

By considering the cervical spine as several segments with relatively different motions, an understanding of the total possible motions of the cervical spine can be more easily attained.Reversal of the cervical lordosis is a normal part of the flexion action and can result from positioning of the patient for radiographic studies.The effect of standing or sitting postures, and methods of initiating flexion of the neck should be considered in the evaluation of routine flexion and extension studies.Evaluation of individual cervical segments may be accomplished by the use of different methods of initiating flexion.     

Can one angle be simply subtracted from another to determine range of motion in three-dimensional motion analysis?

To determine the range of motion of a joint between an initial orientation and a final orientation, it is convenient to subtract initial joint angles from final joint angles, a method referred to as the vectorial approach. However, for three-dimensional movements, the vectorial approach is not mathematically correct. To determine the joint range of motion, the rotation matrix between the two orientations should be calculated, and angles describing the range of motion should be extracted from this matrix, a method referred to as the matrical approach. As the matrical approach is less straightforward to implement, it is of interest to identify situations in which the vectorial approach leads to insubstantial errors. In this study, the vectorial approach was compared to the matrical approach, and theoretical justification was given for situations in which the vectorial approach can reasonably be used. The main findings are that the vectorial approach can be used if (1) the motion is planar (Woltring HJ. 1994. 3-D attitude representation of human joints: a standardization proposal. J Biomech 27(12): 1399–1414), (2) the angles between the final and the initial orientation are small (Woltring HJ. 1991. Representation and calculation of 3-D joint movement. Hum Mov Sci 10(5): 603–616), (3) the angles between the initial orientation of the distal segment and the proximal segment are small and finally (4) when only one large angle occurs between the initial orientation of the distal segment and the proximal segment and the angle sequence is chosen in such a way that this large angle occurs on the first axis of rotation. These findings provide specific criteria to consider when choosing the angle sequence to use for movement analysis.     

THE EFFECT OF DEPRIVATION OF GLUCOSE ON THE ULTRASTRUCTURE AND FUNCTION OF THE SUPERIOR CERVICAL GANGLION OF THE RAT IN VITRO

The superior cervical sympathetic ganglion of the rat kept in vitro in a bicarbonate-buffered Krebs' solution retains its capacity for synaptic transmission and axonal conduction during more than 36 hr. After glucose withdrawal, synaptic transmission is lost in 2½ hr and this loss is irreversible; on the other hand, axonal conduction can still be measured on the postganglionic nerve for more than 24 hr after glucose deprivation. Electrophysiological measurements as well as electron microscope studies revealed specific changes at the level of the presynaptic terminal processes, while the ganglion cells and the satellite cells remained relatively unaltered. The presynaptic lesion due to lack of glucose can be prevented by keeping the preparation in vitro at 6°C. This strongly suggests that this lesion results from a major disturbance of the metabolism of the presynaptic fibers.     

Morphofunctional peculiarities of the transverse processes of the axis, considerations on their pathogenetic significance.

The transverse process C2 plays an important role in the stabilization of the vertebral unit C2/C3 and the protection of the vertebral artery and the cervical spinal cord. The anatomical disposition of the transverse processes C2 and especially the lateral processes may be different from one subject to another. Certain anatomical variants of the transverse process can exert a negative effect on the stabilizing and protective function of the same. Our observations suggest that a maldevelopment or a lesion of the transverse process of the axis may induce extra stresses in the vertebral unit C2/C3 with subsequent development of a zygapophyseal arthrosis at this level. Any zygapophyseal arthrosis (uni- or bilaterally) should lead us to think of this possibility too.     

四川盆地一新蛇颈龙

本文记述了蛇颈龙一新属种——杨氏壁山上龙(Bishanopliosaurus youngi gen.et sp.nov.)。它的形态特征与欧洲里阿斯[Lias]期的 Rhomaleosaurus 的相似。因此可以推测产壁山上龙的地层——自流井组的东岳庙段的时代为早侏罗世。     

Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine

The facet joint contributes to the normal biomechanical function of the spine by transmitting loads and limiting motions via articular contact. However, little is known about the contact pressure response for this joint. Such information can provide a quantitative measure of the facet joint's local environment. The objective of this study was to measure facet pressure during physiologic bending in the cervical spine, using a joint capsule-sparing technique. Flexion and extension bending moments were applied to six human cadaveric cervical spines. Global motions (C2-T1) were defined using infra-red cameras to track markers on each vertebra. Contact pressure in the C5-C6 facet was also measured using a tip-mounted pressure transducer inserted into the joint space through a hole in the postero-inferior region of the C5 lateral mass. Facet contact pressure increased by 67.6 ± 26.9 kPa under a 2.4 Nm extension moment and decreased by 10.3 ± 9.7 kPa under a 2.7 Nm flexion moment. The mean rotation of the overall cervical specimen motion segments was 9.6 ± 0.8° and was 1.6 ± 0.7° for the C5-C6 joint, respectively, for extension. The change in pressure during extension was linearly related to both the change in moment (51.4 ± 42.6 kPa/Nm) and the change in C5-C6 angle (18.0 ± 108.9 kPa/deg). Contact pressure in the inferior region of the cervical facet joint increases during extension as the articular surfaces come in contact, and decreases in flexion as the joint opens, similar to reports in the lumbar spine despite the difference in facet orientation in those spinal regions. Joint contact pressure is linearly related to both sagittal moment and spinal rotation. Cartilage degeneration and the presence of meniscoids may account for the variation in the pressure profiles measured during physiologic sagittal bending. This study shows that cervical facet contact pressure can be directly measured with minimal disruption to the joint and is the first to provide local pressure values for the cervical joint in a cadaveric model.     

大鼠心内神经元至颈上神经节的分支投射研究

应用CB－HRP逆行追踪法研究了大鼠心内神经元至颈上神经节的分支投射。将CB－HRP注入大鼠颈上神经节内,在心脏壁内神经节见到CB－HRP标记细胞,这些细胞为中小型梭形或园形,多位于心房后壁。结果表明心内神经元有分支投射到颈上神经节,并对此进行了讨论。     

On the estimation of joint kinematics during gait.

In gait analysis, the concepts of Euler and helical (screw) angles are used to define the three-dimensional relative joint angular motion of lower extremities. Reliable estimation of joint angular motion depends on the accurate definition and construction of embedded axes within each body segment. In this paper, using sensitivity analysis, we quantify the effects of uncertainties in the definition and construction of embedded axes on the estimation of joint angular motion during gait. Using representative hip and knee motion data from normal subjects and cerebral palsy patients, the flexion-extension axis is analytically perturbed +/- 15 degrees in 5 degrees steps from a reference position, and the joint angles are recomputed for both Euler and helical angle definitions. For the Euler model, hip and knee flexion angles are relatively unaffected while the ab/adduction and rotation angles are significantly affected throughout the gait cycle. An error of 15 degrees in the definition of flexion-extension axis gives rise to maximum errors of 8 and 12 degrees for the ab/adduction angle, and 10-15 degrees for the rotation angles at the hip and knee, respectively. Furthermore, the magnitude of errors in ab/adduction and rotation angles are a function of the flexion angle. The errors for the ab/adduction angles increase with increasing flexion angle and for the rotation angle, decrease with increasing flexion angle. In cerebral palsy patients with flexed knee pattern of gait, this will result in distorted estimation of ab/adduction and rotation. For the helical model, similar results are obtained for the helical angle and associated direction cosines.(ABSTRACT TRUNCATED AT 250 WORDS)     

VIABILITY OF THE CERVICAL EPITHELIUM DURING CARCINOGENESIS IN MICE

Autoradiograms of histological specimens from the cervix of seventy-five mice were analysed after in vivo injection with an RNA precursor. All nucleated, non-pyknotic cells and some mitotic figures were labelled, which suggested that the tissue was metabolically active (i.e. viable). Only the uppermost epithelial pyknotic cells were devitalized, as deduced by the morphological appearance of the cells and by the absence of label. The viability of the whole epithelium suggests that the previously reported focal distribution of proliferating and non-proliferating areas in the cervical epithelium of mice is a genuine phenomenon.