一期前路病灶清除植骨内固定治疗胸腰椎结核

目的探讨前路一期病灶清除、植骨、前路内固定手术治疗胸腰椎结核的疗效。方法 2010~2013年我院对42例胸腰椎结核患者进行一期病灶清除植骨前路内固定,病变节段:T5~T108例,T11~L129例,L2~L45例。其中病变累及1个椎体29例,累及2个椎体10例,跳跃型和累及3个椎体3例。累及1个椎体者应用Z-PlateⅡ钛板内固定,累及2个椎体或上胸椎结核者则选用钉-棒系统(CDH M8)固定。术后抗结核治疗不少于9个月。结果 42例患者均得到随访,随访时间6个月~4年,平均2.6年。手术切口均1期愈合,术后全身症状及局部疼痛消失,神经症状有不同程度恢复,所有病灶愈合,其中39例患者植骨融合,内固定牢固;3例患者因过早进行重体力劳动导致螺钉松动,植骨块塌陷,再次出现后凸畸形,经再次手术后治愈。结论一期病灶清除植骨内固定手术结合规范药物抗痨治疗胸腰椎结核的临床疗效显著、可靠。     

一期后外侧入路病灶清除植骨融合治疗老年胸椎结核

目的:探讨一期后外侧入路病灶清除植骨融合治疗老年胸椎结核的效果,为临床治疗提供依据.方法:选择2009年1月～2010年12月我院确诊的老年胸椎结核患者38例,根据手术方法不同,一期后外侧入路病灶清除植骨融合治疗老年胸椎结核为观察组;一期前路病灶清除植骨融合治疗老年胸椎结核为对照组,比较两组的治疗效果.结果:治愈率为94.74％.观察组手术时间(t=5.003,P＜0.05)、术中出血量(t=3.908,P＜0.05)及住院时间(t=4.331,P＜0.05)与对照组比较,差异均有统计学意义.观察组术前Cobb's角与对照组比较,t=1.235,P＞0.05,两组合差异无统计学意义.观察组术后Cobb's角与对照组比较,t=1.993,P＜0.05,两组术后Cobb's角差异无统计学意义.末次随访观察组Cobb's角与对照组比较,t=3.001,P＜0.05,两组合差异有统计学意义.结论:采用一期后外侧入路病灶清除植骨融合治疗老年胸椎结核创伤小,减少出血量,减低住院时间,且效果良好,能提高术后患者的生活质量.     

一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核临床效果观察

目的：探究一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核临床效果。方法：回顾性分析我院2007年1月-2010年12月收治下腰椎结核老年患者共84例,分别设立实验组和对照组。实验组42例采用后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核,对照组42例采用前路病灶清除。分别对两组一期治疗后临床效果进行观察,对患者术后腰椎局部前凸角、Oswestry障碍指数（ODI）及脊髓损伤神经功能分级标准（ASIA）分级进行客观评定。结果：实验组一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核,术后腰椎局部前凸角为（8．22±1．67）°,明显优于对照组患者术后腰椎局部前凸角为（5．02±1．93）°,（P〉0．05）;实验组患者术后ODI为（21．25±3．75）％,对照组ODI为（35．72±4．15）％,实验组疗效优于对照组（P〈0．05）;实验组患者术后ASIA分级全部转化为E级。而对照组仍有7人为D级。结论：一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核具有显著的临床效果,应进一步临床推广。     

一期前路病灶清除植骨融合内固定术治疗短节段腰椎结核

目的:对比观察一期前路病灶清除减压植骨融合内固定术与分期前后路联合手术针对短节段腰椎结核的疗效.方法:抽取兰州军区兰州总医院骨科中心脊柱外科30例住院治疗短节段腰椎结核的患者,随机化分为两组,每组15例,分别施行一期前路病灶清除减压植骨融合内固定术和分期前后联合手术,观察比较两组术前、术后6个月、12个月、18个月Frankle神经功能分级,术后12个月及18个月Birdwell植骨融合分级.结果:试验组及对照组术前、术后6个月Frankle分级差异有统计学意义(P＜0.05).两组间术后6个月,术后12个月Frankle分级差异无统计学意义(P＞0.05).两组间术后18个月Frankle分级差异有统计学意义(P＜0.05).两组间术后12个月Birdwell分级差异无统计学意义(P＞0.05),而两组间术后18个月Birdwell分级差异有统计学意义(P＜0.05).随访期间,对照组有两例发生断钉.结论:一期前路病灶清除、植骨融合内固定术治疗脊柱结核,病灶清除彻底、融合率高,远期效果良好,复发率低并能够最大限度恢复脊柱生物力学稳定性.具有重要的临床应用价值.     

两种植骨方式在胸腰椎结核手术中的应用

目的:比较不同植骨方式治疗胸腰椎结核的手术效果,探讨颗粒自体骨与块状自体骨两种植骨方式在治疗胸腰椎结核的临床疗效。方法:2008年1月至2010年12月期间在我院手术治疗的胸腰椎结核患者132例,其中采用块状自体骨进行骨移植的患者60例,采用颗粒状自体骨进行骨移植的患者72例,随机从两种植骨方式中各抽取20例患者进行回顾性分析,对两组患者术中出血量、住院时间、术后神经功能改善情况、植骨融合情况、后凸畸形矫正状况进行对比。结果:所有患者均一期愈合,无全身并发症,两组患者随访12~36个月,平均18个月,影像学提示内固定位置良好,无松动及断裂,结核病灶无复发。块状骨组术后6个月随访植骨融合率15%(3/20)术后9个月融合率45%(9/20),术后12个月融合率95%(19/20)。颗粒骨组术后6个月随访植骨融合率45%(9/20)术后9个月融合率80%(16/20),术后12个月融合率100%。块状骨组术前Cobb角为29.8°±5.0°,术后Cobb角为14.7°±2.5°,末次随访Cobb角为16.0°±2.9°。颗粒骨组术前Cobb角为30.9±7.6°,术后Cobb角为15.6°±3.8°,末次随访Cobb角为16.7°±3.8°,两组病人术后cobb角较术前有明显矫正,末次随访无明显丢失,两组比较无显著性差异(P0.05)。颗粒骨组术中出血量明显少于块状骨组,两组比较有统计学意义(P0.05)。住院时间两组比较无显著性差异(P0.05)。结论:颗粒状自体骨与块状自体骨相比在胸腰椎结核手术中植入方便,出血量少,植骨融合时间短,融合率高,是胸腰椎结核植骨的理想选择。     

椎弓根螺钉用于植骨融合术治疗胸腰椎结核的临床研究

目的:探讨椎弓根内固定联合植骨融合术治疗胸腰椎结核的临床效果。方法:回顾性分析2013年5月至2014年5月在我院接受治疗的50例胸腰椎结核患者的临床资料,结合影像资料评价患者手术前后的红细胞沉降率、后凸畸形矫正情况、Frankel分级及术后并发症的发生情况等。结果:所有患者术后病理均证实为脊柱结核,术中27例植入大块自体髂骨,23例植入自体肋骨捆绑植骨。24例采用椎体侧前方钉棒内固定,26例采用后路椎弓根螺钉系统内固定。术中未出现脊髓、神经、血管损伤及血气胸等并发症。患者术后红细胞沉降率获得改善,差异具有统计学意义(P0.05)。术后Cobb角明显获得矫正,差异具有统计学意义(P0.05)。患者术后脊柱损伤程度明显改善,差异具有统计学意义(P0.05)。结论:椎弓根内固定联合椎体间植骨融合术治疗胸腰椎结核具有良好的临床效果,不仅可以改善红细胞沉降率,而且可以矫正患者脊柱后凸畸形,值得临床推广应用。     

胸腰椎结核患者手术前后的护理

脊柱结核占全身关节结核的首位,而腰椎结核最常见,其次为胸椎、颈椎.我科2004年5月至2007年8月对36例胸腰椎结核患者进行了病灶清除、椎体减压及植骨融合内固定术.经给予精心护理,疗效满意.现总结如下.     

不同植骨融合方法治疗退行性腰椎滑脱症的疗效评价

目的:比较Cage植骨和椎体间骨粒直接植骨两种植骨融合方法治疗退行性腰椎滑脱症的疗效.方法:我科自2004年9月至2006年10月采用腰椎滑脱复位系统(Spondylolisthesis reduction system,SRS)共治疗40例退行性腰椎滑脱症,分成A,B两组,其中A组19例行Cage植骨,B组21例行椎体阃骨粒直接植骨,按侯树勋等[1]的疗效评定标准比较术后两组的临床疗效,同时比较两组手术时间,术中术后出血量,平均融合率,术后椎间隙高度变化.结果:两组手术时间、术中术后出血量、平均椎间隙高度变化差异有显著性;40例患者获得10月-3年(平均1.9年)随访,两组临床症状术后有明显改善,临床症状改善率、融合率差异无显著性.两组都无症状加重,无内固定松动或断裂发生.结论:SRS治疗腰椎滑脱症时,采用Cage植骨与椎体间骨粒直接植骨其融合率和临床优良率无显著性差异.椎体间骨粒直接植骨手术操作更简便,手术时间更短(P=0.000),术中术后出血量更少(p=0.000).     

椎体加椎间植骨融合术在腰椎爆裂性骨折患者中的应用效果与安全性探究

目的:探讨椎体加椎间植骨融合术在治疗腰椎爆裂性骨折患者中的临床效果及安全性。方法:选取2016年12月～2017年10月我院骨科收治的腰椎爆裂性骨折患者90例,按照手术方式将患者分成研究组和对照组,每组45例。研究组给予后路内固定术联合椎体加椎间植骨术治疗,对照组给予后路内固定术联合后外侧植骨术治疗。比较两组患者的手术时间、手术出血量以及术后3个月和12个月的椎体Cobb角、患者术后骨折愈合情况、内固定有效情况。结果:研究组手术时间、术中出血量、术后3个月和12个月椎体Cobb角明显短于或低于对照组,但骨折愈合率、内固定有效率显著高于对照组,组间差异均有统计学意义(P0.05)。结论:椎体加椎间植骨融合术治疗腰椎爆裂性骨折的临床综合效果显著优于后路内固定术联合后外侧植骨术治疗,且安全性较好。     

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。     

Distribution of N,P, K,Ca, Mg,S, Zn,Fe, Mn and Cu in groundnut

Summary Concentration of N, P, K, Ca, Mg and S in summer groundnut crop was higher than in kharif while Zn, Fe, Mn and Cu contents were higher in summer crop. Kernel's N, P and Zn; Leaflet's Ca and Mn; Stem's K and Fe; Root's S and Cu and Petiole's Mg contents were highest. Shell's N, P, K, Mg, S, Zn and Cu; Kernel's Ca, Fe and Mn contents were the least. N, P, K, S, Zn and Cu concentrations decreased linearly as the crop grew. Ca, Mg, Fe and Mn concentrations did not display any distinct pattern. Ca concentration was positively correlated with pod yield in both the seasons.     

Simultaneous measurement of the trace elements Al, As, B, Be, Cd, Co, Cu, Fe, Li, Mn, Mo, Ni, Rb, Se, Sr, and Zn in human serum and their reference ranges by ICP-MS

The goal of this article was to establish reference ranges of the concentration of trace elements in human serum and to compare these results with those reported by other authors. We describe the sample preparation and measurement conditions that allow the rapid, precise, and accurate determination of Al, As, B, Be, Cd, Co, Cu, Fe, Li, Mn, Mo, Ni, Rb, Se, Sr, and Zn in human serum samples (n=110) by inductively coupled plasma-mass spectrometry (ICP-MS). Accuracy and precision were determined by analyzing three reconstituted reference serum samples by comparison with other methods and by the standard addition procedure. The advantages of the ICP-MS method include short time of analysis of the elements mentioned, low detection limit, high precision, and high accuracy. Disadventages include a high risk of contamination due to the presence of some of the elements of interest in the environment, the relatively delicate sample handling, and the high cost of the equipment.     

Reference values for the concentrations of As,Cd, Co,Cr, Cu,Fe, I,Hg, Mn,Mo, Ni,Pb, Se,and Zn in selected human tissues and body fluids

This report attempts to formulate reference ranges of elemental concentrations for 15 trace elements in selected human tissues and body fluids. A set of samples consisting of whole blood, blood serum, urine, milk, liver, and hair were chosen and considered for 15 elements of biological significance: As, Cd, Co, Cr, Cu, F, Fe, I, Hg, Mn, Mo, Ni, Pb, Se, and Zn. The results represent wholly or partially data received from 40 countries of the global regions of Africa, Asia, Europe, North, South, and Central America, Australia, and New Zealand. This survey, even if qualitative, has been useful in demonstrating certain trends of trace-element scenarios around the world. It is of course recognized that both diet and environment exert a strong influence on the distribution pattern of several elements, such as As, Cd, Mn, Pb, Se, and Zn. A limited comparison of the available information on soil status of different countries reflected some interesting associations for elements, such as Mn and Zn. Importantly, this study revealed that only a few countries were in a position to identify a reasonable amount of data on samples requested for this project. Regretably, for a number of countries, any dependable data for even such essential elements as Cu, Fe, and Zn were not available. In view of the nutritional importance of many elements, the time is ripe for concerted efforts by intergovernmental agencies to initiate investigations or commission task forces/projects to generate reliable reference data for selected global regions, which sadly lack data of any kind at present.     

Monovalent Cation Permeation through the Connexin40 Gap Junction Channel : Cs,Rb, K,Na, Li,TEA, TMA,TBA, and Effects of Anions Br,Cl, F,Acetate, Aspartate,Glutamate, and NO3

The unitary conductances and permeability sequences of the rat connexin40 (rCx40) gap junction channels to seven monovalent cations and anions were studied in rCx40-transfected neuroblastoma 2A (N2A) cell pairs using the dual whole cell recording technique. Chloride salt cation substitutions (115 mM principal salt) resulted in the following junctional maximal single channel current-voltage relationship slope conductances (γ_j in pS): CsCl (153), RbCl (148), KCl (142), NaCl (115), LiCl (86), TMACl (71), TEACl (63). Reversible block of the rCx40 channel was observed with TBA. Potassium anion salt γ_j are: Kglutamate (160), Kacetate (160), Kaspartate (158), KNO₃ (157), KF (148), KCl (142), and KBr (132). Ion selectivity was verified by measuring reversal potentials for current in rCx40 gap junction channels with asymmetric salt solutions in the two electrodes and using the Goldman-Hodgkin-Katz equation to calculate relative permeabilities. The permeabilities relative to Li⁺ are: Cs⁺ (1.38), Rb⁺ (1.32), K⁺ (1.31), Na⁺ (1.16), TMA⁺ (0.53), TEA⁺ (0.45), TBA⁺ (0.03), Cl⁻ (0.19), glutamate⁻ (0.04), and NO₃− (0.14), assuming that the monovalent anions permeate the channel by forming ion pairs with permeant monovalent cations within the pore thereby causing proportionate decreases in the channel conductance. This hypothesis can account for why the predicted increasing conductances with increasing ion mobilities in an essentially aqueous channel were not observed for anions in the rCx40 channel. The rCx40 effective channel radius is estimated to be 6.6 Å from a theoretical fit of the relationship of relative permeability and cation radius.     

Crystal structure, detonation performance, and thermal stability of a new polynitro cage compound: 2, 4, 6, 8, 10, 12, 13, 14, 15-nonanitro-2, 4, 6, 8, 10, 12, 13, 14, 15-nonaazaheptacyclo [5.5.1.13, 11. 15, 9] pentadecane

A new polynitro cage compound 2, 4, 6, 8, 10, 12, 13, 14, 15-nonanitro-2, 4, 6, 8, 10, 12, 13, 14, 15-nonaazaheptcyclo [5.5.1.1(3,11).1(5,9)] pentadecane (NNNAHP) was designed in the present work. Its molecular structure was optimized at the B3LYP/6-31 G(d,p) level of density functional theory (DFT) and crystal structure was predicted using the Compass and Dreiding force fields and refined by DFT GGA-RPBE method. The obtained crystal structure of NNNAHP belongs to the P-1 space group and the lattice parameters are a = 9.99 ?, b = 10.78 ?, c = 9.99 ?, α = 90.01°, β = 120.01°, γ = 90.00°, and Z = 2, respectively. Based on the optimized crystal structure, the band gap, density of state, thermodynamic properties, infrared spectrum, strain energy, detonation characteristics, and thermal stability were predicted. Calculation results show that NNNAHP has detonation properties close to those of CL-20 and is a high energy density compound with moderate stability.     

Relations of the Al,B, Ba,Br, Ca,Cl, Cu,Fe, K,Li, Mg,Mn, Na,P, S,Si, Sr,and Zn mass fractions to morphometric parameters in pediatric and nonhyperplastic young adult prostate glands

The variation with age of the 18 trace element mass fractions and some histological characteristics of intact prostate glands of 50 subjects aged 0–30 years was investigated by instrumental neutron activation analysis, inductively coupled plasma atomic emission spectrometry, and a quantitative morphometric analysis. Mean values ± standard error of the mean (M ± SΕΜ) for the mass fractions (in milligrams per kilogram wet tissue) of these trace elements in pre-puberty were: Al 28.5 ± 9.0, B 0.40 ± 0.11, Ba 1.48 ± 0.44, Br 10.5 ± 1.5, Ca 241 ± 30, Cl 3,203 ± 278, Cu 3.51 ± 0.89, Fe 33.7 ± 4.1, K 2,364 ± 145, Li 0.020 ± 0.004, Mg 153 ± 23, Mn 0.46 ± 0.06, Na 2,286 ± 130, P 1,391 ± 100, S 1,698 ± 132, Si 62 ± 11, Sr 0.38 ± 0.08, and Zn 27.6 ± 2.3. During puberty and postpuberty, when there is a significant increase in circulating androgens, the mean values were: Al 7.2 ± 1.4, B 0.21 ± 0.05, Ba 0.25 ± 0.06, Br 5.8 ± 1.0, Ca 433 ± 81, Cl 2,314 ± 201, Cu 1.77 ± 0.13, Fe 20.9 ± 1.6, K 2,585 ± 118, Li 0.0088 ± 0.0014, Mg 232 ± 27, Mn 0.34 ± 0.04, Na 1,875 ± 107, P 1,403 ± 98, S 1,673 ± 73, Si 22.2 ± 3.1, Sr 0.22 ± 0.03, and Zn 93.3 ± 8.9. Mean values (M ± SΕΜ) of percent volumes (%) of the stroma, epithelium and lumen in the prostate before puberty were 73.4 ± 2.6, 20.4 ± 1.7, and 4.45 ± 0.94, respectively, versus 46.5 ± 2.5, 38.5 ± 1.9, and 14.9 ± 1.2 during puberty and postpuberty. This work’s results confirm that the Zn mass fraction in prostate tissue is an androgen-dependent parameter. For the first time it has been demonstrated that the glandular lumen is a main pool of Ca, Mg, and Zn accumulation and that the stroma is a main pool of Al, B, Ba, Br, Cl, Cu, Fe, Mn, Na, and Si accumulation in the normal human prostate, for the age range 0–30 years. It was concluded that the Ca, Mg, and Zn binds tightly within the prostatic fluid, because the volume of glandular lumen reflects the volume of prostatic fluid.     

Reliability of Analyses of Hg,Fe, Ca,K, P,pH, Alkalinity,Conductivity, Hardness and Colour from Lakes

The aim of this report has been to present results concerning analytical quality controls of Hg analysis of fish and sediment, analyses of Fe, Ca, total-P, K, pH, alkalinity, conductivity, colour and hardness (Ca + Mg) of lake water samples. Despite the fact that these are standard parameters in many regular water control programs, there are major differences in the reliability with which these parameters can be determined. The focus here is on an overall inter-laboratory comparison between the parameters. Six laboratories have been involved in the analysis. Selected results: pH gives the lowest (average) relative standard deviation (error), about 2 %; conductivity gives an error of about 5–7 %; alkalinity yields an average error of as much as 13–25 %, which is the largest among the parameters studied here; colour also gives a high error, 9–15 %; hardness gives a relative standard deviation of about 6–7 %. Of the other parameters (i. e., Hg, Fe, Ca and P), Hg gives the best reliability and Fe and P the lowest. To have knowledge of the reliability of the analytical data is of paramount importance in most control programs and research projects.     

Competitive inhibition and selectivity enhancement by Ca in the uptake of inorganic elements (Be, Na, Mg, K, Ca, Sc, Mn, Co, Zn, Se, Rb, Sr, Y, Zr, Ce, Pm, Gd, Hf) by carrot (Daucus carota cv. U.S. harumakigosun)

We investigated the uptake of inorganic elements (Be, Na, Mg, K, Ca, Sc, Mn, Co, Zn, Se, Rb, Sr, Y, Zr, Ce, Pm, Gd, and Hf) and the effect of Ca on their uptake in carrots (Daucus carota cv. U.S. harumakigosun) by the radioactive multitracer technique. The experimental results suggested that Na, Mg, K, and Rb competed for the functional groups outside the cells in roots with Ca but not for the transporter-binding sites on the plasma membrrane of the root cortex cells. In contrast, Y, Ce, Pm, and Gd competed with Ca for the transporters on the plasma membrane. The selectivity, which was defined as the value obtained by dividing the concentration ratio of an elemental pair, K/Na, Rb/Na, Be/Sr, and Mg/Sr, in the presence of 0.2 and 2 ppm Ca by that of the corresponding elemental pair in the absence of Ca in the solution was estimated. The selectivity of K and Rb in roots was increased in the presence of Ca. The selectivity of Be in roots was not affected, whereas the selectivity of Mg was increased by Ca. These observations suggest that the presence of Ca in the uptake solution enhances the selectivity in the uptake of metabolically important elements against unwanted elements.     

The Effect of Age and Gender on Al, B, Ba, Ca, Cu, Fe, K, Li, Mg, Mn, Na, P, S, Sr, V, and Zn Contents in Rib Bone of Healthy Humans

The effect of age and gender on major, minor, and trace element contents in the intact rib bone of 80 relatively healthy 15–55-year-old women and men was investigated. Contents or upper limit of contents of 16 chemical elements in the rib bone were determined by inductively coupled plasma atomic emission spectrometry (ICP-AES). Mean values (M?±?SΕΜ) for the mass fraction of Ba, Ca, Cu, Fe, K, Li, Mg, Na, P, S, Sr, and Zn (milligram per kilogram of dry bone) were as follows: 2.54?±?0.16, 171,400?±?4,050, 1.35?±?0.22, 140?±?11, 1,874?±?71, 0.049?±?0.011, 2,139?±?38, 5,378?±?88, 75,140?±?1,660, 1,881?±?51, 291?±?20, and 92.8?±?1.5, respectively. The upper limits of contents of Al, B, Mn, and V were <7.20, <0.65, <0.36, and <0.03, respectively. Statistically significant tendency for the Ca, Mg, and P content to decrease with age was found in the human rib bone, regardless of gender. The mass fraction of Fe in the male rib bone increases with age. It was shown that higher Ca, Mg, Na, P, and Sr mass fractions as well as lower Fe content were typical of female ribs as compared to those in male ribs.