助攻微螺钉种植体矫治先天缺牙所至中线偏斜一例

1临床资料 1．1病例介绍：某女，19岁，因左上颌侧牙齿缺失，上前牙间隙，上中线偏斜，要求正畸治疗。     

中心体相关蛋白激酶2和环氧合酶2在前列腺癌组织的表达及其临床意义

目的 探讨中心体相关蛋白激酶2(NEK2)和环氧合酶2(COX2)在前列腺癌组织的表达及两者与前列腺癌临床病理参数的关系.方法 选取广东医科大学附属医院2013年2月至2019年9月收治的77例前列腺癌组织标本和27例前列腺增生组织标本作为研究对象,应用免疫组织化学法检测两者组织中NEK2和COX2的表达水平,结合临床...     

中心体相关蛋白激酶2和高迁移率蛋白A2在乳腺癌组织中的表达及其临床意义

目的 探讨中心体相关蛋白激酶2(NEK2)和高迁移率蛋白A2 (HMGA2)在乳腺癌组织中的表达水平及其临床意义.方法 收集东阳市妇幼保健院2011年1月至2019年6月收治的79例乳腺癌组织和癌旁组织标本应用免疫组织化学法检测NEK2和HMGA2的表达水平,组间比较采用x2检验.结果 乳腺癌组织中的NEK2表达率为7...     

AT丰富结合域1A和中心体相关蛋白激酶2在肝癌组织的表达及其临床意义

目的:探讨AT丰富结合域1A(ARID1A)和中心体相关蛋白激酶2(NEK2)在原发性肝癌(PLC)组织中表达及其临床意义。方法:收集收集山西医科大学第二医院2015年1月至2020年12月经病理确诊的79例PLC组织标本、38例肝硬化组织标本和22例正常肝组织标本,采用免疫组织化学方法检测上述组织中ARID1A和NE...     

硬腭骨膜下种植体修复单侧无牙上颌骨缺损中基台设计的有限元分析

目的：对支持单侧上颌赝复体的硬腭骨膜下种植体基台数量及分布进行优化设计。方法：建立目标三维有限元模型，分别对6、5、4、3、2个基台共15种设计方案进行双侧加载测试，对比观测其健侧颌骨6个不同部位骨皮质内最大von Mises应力。用简化模型计算各类设计中健侧基台上的最大脱位力。结果：5基台与6基台设计骨应力反应无明显差异；4基台设计中Ⅳ b、3基台设计中Ⅲa、2基台设计中Ⅱa方案在同组方案中骨应力反应最佳，前二者甚至接近6基台设计。各类设计中健侧分布靠前的基台上产生的脱位力较大，反之较小。结论：Ⅳ b和Ⅲa是此类骨膜下种植体较理想的基台设计方案。     

中心体相关蛋白激酶2和细丝蛋白A在胃癌组织的表达及其临床意义

目的探讨中心体相关蛋白激酶2(NEK2)和细丝蛋白A(FLNa)的表达与胃癌患者临床特征及预后之间的关系。方法以2017年10月至2022年12月烟台市烟台山医院收治的108例胃癌患者组织标本作为研究对象, 采用免疫组织化学方法检测上述胃癌组织和癌旁组织中NEK2和FLNa表达水平, 结合临床资料, 应用χ2检验进行分析。结果胃癌组织中NEK2表达率为62.96%(68/108), 明显高于癌旁组织中NEK2表达率[11.11%(12/108)], 差异有统计学意义(χ2=62.259, P<0.01)。胃癌组织中FLNa表达率为30.56%(33/108), 明显低于癌旁组织中FLNa表达率[80.56%(87/108)], 差异有统计学意义(χ2=54.675, P<0.01)。NEK2表达水平与胃癌患者组织学分化程度、TNM分期(TNM stage, tumor node metastasis stage)、淋巴结转移、肿瘤大小明显相关(χ2=4.723、6.632、4.246、7.021, P<0.05), NEK2表达水平与胃癌患者年龄、性别无相关(χ2=0...     

成髓细胞瘤转录因子第2亚型和中心体相关蛋白激酶2在结直肠组织的表达及其临床意义

目的探讨成髓细胞瘤转录因子第2亚型(MYBL2)和中心体相关蛋白激酶2(NEK2)表达与结直肠癌临床特征和预后的关系。方法收集大庆龙南医院(齐齐哈尔医学院第五附属医院)和广东医科大学附属医院2019年1月至2022年12月经病理学检查确诊的108例结直肠癌组织标本和对应癌旁组织标本, 采用免疫组织化学法检测组织中MYBL2和NEK2表达, 采用χ2检验分析MYBL2和NEK2的表达与结直肠癌临床病理特征的关系。结果结直肠癌组织和对应癌旁组织中MYBL2表达率分别为74.07%(80/108)、12.96%(14/108), 两者差异有统计学意义(χ2=82.045, P<0.01)。MYBL2表达水平与结直肠癌患者淋巴结转移、浸润深度、组织学分化程度、TNM分期明显相关(χ2=5.839、7.036、4.304、6.895, P<0.05), MYBL2表达水平与结直肠癌患者性别、年龄、肿瘤部位无相关(χ2=0.039、0.045、0.005, P>0.05)。结直肠癌组织和对应癌旁组织中NEK2表达率分别为65.74%(71/108)、32.41%(35/108),...     

The clinical significance of gallstones and their radiological investigation

The symptoms of 122 patients with gallstones were correlated with the radiological findings. No specific indigestion was present which could be termed 'flatulent dyspepsia'. Sensitivity to fatty foods occurred in 69 per cent, heartburn in 42 per cent, regurgitation of of acidtasting or bitter fluid to the mouth in 31 per cent and increased passage of flatus from the stomach upwards in 38 per cent. If the gallbladder concentrated contrast medium or an oral cholecystogram but did not contract after a fatty meal, the patients suffered less heartburn than if the gall bladder functioned normally. However, since surgeons rarely perform a cholecystectomy for flatulent dyspepsia alone, knowlege of gallbladder function may be unnecessary.     

Diurnal changes in spinal mechanics and their clinical significance

Diurnal changes in the loads acting on the spine affect the water content and height of the intervertebral discs. We have reviewed the effects of these changes on spinal mechanics, and their possible clinical significance. Cadaveric lumbar spines subjected to periods of creep loading show a disc height change similar to the physiological change. As a result intervertebral discs bulge more, become stiffer in compression and more flexible in bending. Disc tissue becomes more elastic as its water content falls, and its affinity for water increases. Disc prolapse becomes more difficult. The neural arch and associated ligaments resist an increasing proportion of the compressive and bending stresses acting on the spine. Observations on living people show that these changes are not fully compensated for by modified muscle activity. We conclude that different spinal structures are more heavily loaded at different times of the day. Therefore, the time of onset of symptoms and signs, and any diurnal variation in their severity, may help us understand more about the pathophysiology of low back pain and sciatica.     

Residual fibrous formations after hydatidectomy and their clinical significance

After radical hydatidectomies in the organ still remains a fibrous cyst capsule in which the maternal chitinous membrane has signs of destruction (the second phase of vital activity). Germinal elements capable to transform in cyst-satellites can be introduced into the fibrous cyst capsule. Most cyst-satellites while growing break inside the initial cyst. The residual fibrous cyst capsule which is in the second phase should be considered as a risk factor of recurrence and so hydatidectomy must be followed by intraoperative ultrasound scanning of the peri-parasitogenic space for a detection of cyst-satellites as well as by anti-recurrence courses of medication at the postoperative period. In the USI the area of localization of the residual fibrous capsule is visualized as polymorphous focal structures which can be classified as: an unechogenic focus (a residual cavity); heterogeneity of the echo-structure with minimal unechogenic foci; heterogeneity of the echo-structure with prevailing unechogenic foci (a mixed type structure); hyperechogenic focus (focal fibrosis). The optimal strategy of management of the postoperative period can be worked out by using USI in the field of liquidation of the residual cavity and by getting an exact character of its echo-tomoscopic picture.     

The mechanical response of the neural arch of the lumbosacral vertebra and its clinical significance

Summary To investigate the effect of mechanical stresses in the aetiology of spondylolisthesis a study of the behaviour of the lumbar spine under load has been carried out. The loading tests on the lumbo-sacral segment, both with and without the dorsal elements present, showed that generally the disc only transmitted axial loads whereas transverse loads are resisted by the dorsal processes.Only after simulating a spina bifida, by splitting the lamina, was it possible to initiate a fracture in the isthmus by means of force applied in the transverse direction.Measurement of the stress behaviour in the neural arch shows that with transverse loading alone the pedicle can be just as heavily stressed as the pars interarticularis. Strain gauge measurements were performed on a macerated fifth lumbar vertebra to determine the manner in which loading forces must act to provide the greatest effect upon the region of the pars interarticularis. This was found to occur with vertical loading of the hyperextended spine. The vulnerability of the vertebra under these conditions was confirmed with further tests upon fresh cadaver specimens when it was found that the pars interarticularis of the fifth lumbar vertebra, when impinged upon by the caudal joint edges of the fourth lumbar vertebra, could be fractured with a vertically applied load of about 200 kp.

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Résumé Pour apprécier la part des facteurs mécaniques dans l'étiologie du spondylolisthésis les auteurs ont étudié le comportement de la colonne lombaire en charge. Les tests de charge sur le segment lombo-sacré, comportant ou non ses éléments postérieurs, ont montré qu'en général le disque ne transmet que les forces axiales tandis que les forces de cisaillement sont transmises par les éléments postérieurs.Ce n'est qu'après avoir créé artificiellement un Spina bifida, par laminectomie, qu'il a été possible de produire une fracture de l'isthme, en appliquant une force dans une direction transversale.La mesure de la transmission des forces dans l'arc postérieur montre qu'une charge transversale isolée retentit tout autant sur le pédicule que sur la région inter-articulaire. Des mesures pratiquées à l'aide de jauges de contrainte sur une 5ème vertèbre lombaire ont montré qu'une charge verticale sur la charnière lombo-sacrée en hyperextension peut produire une fracture de l'isthme. Des expériences identiques réalisées sur des colonnes lombaires de cadavres frais ont confirmé ces résultats: lorsque la partie interarticulaire de la 5ème lombaire est mise sous tension par le processus articulaire inférieur de la 4ème lombaire, une force verticale de 200 kgs suffit pour provoquer une fracture.

     

The frequency and clinical significance of congenital defects of the posterior and anterior arch of the atlas

OBJECT: In this study the authors investigated the anatomical, clinical, and imaging features as well as incidence of congenital defects of the C-1 arch. METHODS: The records of 1104 patients who presented with various medical problems during the time between January 2006 and December 2006 were reviewed retrospectively. The craniocervical computed tomography (CT) scans obtained in these patients were evaluated to define the incidence of congenital defects of the posterior arch of C-1. In addition, 166 dried C-1 specimens and 84 fresh human cadaveric cervical spine segments were evaluated for anomalies of the C-1 arch. RESULTS: Altogether, 40 anomalies (2.95%) were found in 1354 evaluated cases. Of the 1104 patients in whom CT scans were acquired, 37 (3.35%) had congenital defects of the posterior arch of the atlas. The incidence of each anomaly was as follows: Type A, 29 (2.6%); Type B, six (0.54%); and Type E, two (0.18%). There were no Type C or D defects. One patient (0.09%) had an anterior arch cleft. None of the reviewed patients had neurological deficits or required surgical intervention for their anomalies. Three cases of Type A posterior arch anomalies were present in the cadaveric specimens. CONCLUSIONS: Most congenital anomalies of the atlantal arch are found incidentally in asymptomatic patients. Congenital defects of the posterior arch are more common than defects of the anterior arch.