寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

寰枢椎后路三种组合固定技术治疗寰枢关节不稳的临床评估

Objective To assess clinical curative effect of three types of combined posterior atlantoaxial internal fixation techniques in treatment of atlantoaxial instability. Methods The study involved 68 patients with atlantoaxial instability treated with different fixation techniques from August 2002 to March 2008. ( 1 ) Transpedicular fixation was performed in 32 patients including 20 patients with Anderson Ⅱ odontoid fractures (seven with old odontoid fracture and 13 with fresh fractures), six with type Anderson Ⅲ fresh odontoid fractures, four with disrupt of transverse ligament of the atlas and two with congenital loose odontoid process combined with atlantoaxial instability. (2) Transpedicular internal fixation with screws of atlas incorporating C2 laminar screws was performed in 20 patients with upper cervical injury including eight with type Ⅱ odontoid process fractures combined with atlantoaxial backward dislocation,four with type Ⅱ odontoid process fractures combined with atlantoaxial forward dislocation, two with nonunion of odontoid process fractures, three with type Ⅲ odontoid process fractures combined with atlantoaxial unsteadiness and three with atlantoaxial dislocation combined with disrupt of transverse ligament of atlas. (3)A total of 16 patients with traumatic atlantoaxial instability, reducible atlantoaxial dislocation and irreducible atlantoaxial dislocation were treated with four-point internal fixation technique using autologous iliac bone grafts. Results (1) A total of 120 screws were implanted in 32 patients, with no spinal cord or vertebral artery injury after surgery. Atlas lateral mass fixation was adopted in three patients because of broken posterior arch of the atlas. Postoperative CT showed that two screws were inserted into the vertebral artery hole and that one screw was inserted medially into the spinal canal and caused medial correx rupture, but both with no clinical symptoms. All 32 patients were followed up for 6-42 months ( average 26 months), which showed solid fusion in all patients. The postoperative JOA scores ranged from 13.2 points to 16.8 points (average 14. 8 points). (2) Thirty-two screws were implanted in 20 patients,with no spinal cord or vertebral artery injury. The patients were followed up for mean six months ( range 6-14 months). Postoperative X-ray showed sound bone fusion, with no cervical instability, loosening or breakage of the screws. (3) The symptoms of all the patients were improved at different degrees, with no neurological deterioration or severe complications, such as nerve blood vessel injury. All 16 patients were followed up for 8-26 months ( average 16 months), which showed bony fusion in all patients at 3-6 months after surgery. The spinal cord function was improved markedly in five patients, good in eight, mild in two but unchanged in one. Conclusions Three types of combined posterior atlantoaxial internal fixation techniques have advantages of rigid, short-segmental and three-dimensional fixation and hence are effective methods for treatment of upper cervical injuries. The combination mode can be varied according to specific condition of the patients.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

海马头部浅沟消失对海马硬化诊断价值的探讨

目的　探讨海马头部浅沟消失对海马硬化的诊断价值。方法　对 18例经组织学检查证实的海马硬化患者的MRI检查资料和 18例年龄相匹配的对照组进行回顾性分析 ,观察海马头部浅沟的显示情况、海马头部大小和信号改变。结果　 18例海马硬化患者中 ,16例硬化侧海马头部浅沟消失 ,1例硬化侧海马头部浅沟明显变浅 ,几乎消失 ,1例硬化侧海马头部浅沟存在。硬化侧海马头部均有萎缩 ,并在T2 WI和液体衰减恢复 (FLAIR)成像呈高信号。海马头部浅沟消失对海马硬化诊断的敏感性为 88.9% ,特异性为 10 0 %。结论　海马头部浅沟消失是诊断海马硬化的一个可靠征象 ,结合患侧海马有萎缩性改变和T2 加权成像信号增高 ,可肯定诊断海马硬化。     

肝癌转移机制研究进展

肝癌细胞的侵袭和转移是肝癌治疗失败和患者致死的主要原因，因此，了解肝癌侵袭转移的相关机制十分重要。肿瘤转移是一个多步骤的复杂的生物学过程，多个因素参与了肿瘤转移的调控，癌基因的表达上调、抑癌基因的失活、免疫基因的失调、肿瘤细胞间粘附作用的丧失、新生血管的形成、蛋白水解酶的合成、细胞的迁移能力增强、肿瘤细胞和基底膜的粘附等等，都是促进肿瘤转移复发的重要因素。     

跟骨骨折临床治疗探讨

目的：探讨跟骨骨折的分型与临床治疗措施的选择。方法：自2002年1月-2008年1月，选择我科收治的跟骨骨折患者中的100例，分为手术组与非手术组，其中非手术组50例，手术组50例；男85例，女15例。结果：手术治疗组患者术后跟部疼痛不适、行走受限较非手术组明显轻。结论：手术治疗能大限度恢复跟骨的解剖结构，减少跟骨骨折所致的并发症。