Acute transverse myelitis in the emergency department: A case report and review of the literature

Acute transverse myelitis (ATM) is a neurologic condition that presents with bilateral lower extremity weakness and sensory loss associated with bowel and bladder dysfunction. Whereas the time of onset may be hours to days, the time to either partial or complete recovery may require months. The etiology is varied and may be idiopathic. Laboratory and radiographic evaluation may be nonrevealing. Corticosteriods have been used for treatment, but their efficacy is controversial. As illustrated by this case report, the essential aspect of the initial management of ATM is the elimination of potentially treatable causes.     

义齿用Ti-6Al-7Nb合金铸件挠度的研究

目的：通过对相同长度、宽度、不同厚度的Ti-6Al-7Nb合金铸件挠度的测量,观察铸件厚度与挠度的关系,为确定Ti-6Al-7Nb合金铸造义齿基托的适合厚度提供实验依据。方法：参照ISO关于义齿基托材料挠度的标准,测量不同厚度Ti-6Al-7Nb合金铸件的挠度,并与纯钛、Ti-6Al-4V合金及Co-Cr合金对比。结果：Ti-6Al-7Nb合金、纯钛及Ti-6Al-4V合金铸件的厚度在0.65mm时可以达到义齿基托挠度的标准;Co-Cr合金在0.57mm时可达到标准要求。结论：在临床制作Ti-6Al-7Nb合金义齿基托时,厚度应不低于0.65mm。     

Effects of Polyethyleneglycol Chain Length and Phospholipid Acyl Chain Composition on the Interaction of Polyethyleneglycol-phospholipid Conjugates with Phospholipid: Implications in Liposomal Drug Delivery

Purpose. The purpose of this study was to investigate polyethyleneglycol(PEG)-phosphatidylethanolamine(PE) conjugate interaction with phospholipid bilayers, in an attempt to explain the dependence of liposome circulation time on formulation. Methods. Differential scanning calorimetry, electron microscopy, dynamic light scattering and NMR were the major methods used in the study. Results. Mixtures of PEG-phospholipid conjugates and phosphatidylcholine existed in three different physical states: a lamellar phase with components exhibiting some miscibility, a lamellar phase with components phase separated, and mixed micelles. Beyond 7 mol% of PEG(l,000–3,000)-dipalmitoyl phosphatidylethanolamine (DPPE), and 11 mol% PEG(5,000)-DPPE in dipalmitoyl phosphatidylcholine (DPPC), a strong tendency towards mixed micelle formation was observed. All concentrations of PEG(12,000)-DPPE and PEG(5,000)-DPPE beyond 8 mol% formed phase separated lamellae with phosphatidylcholine. Decreasing the acyl chain length from C_16:0 to C_14:0 caused a decrease in tendency towards micelle formation and phase separation. These tendencies increased upon increasing acyl chain length to C_18:0. Phase separation was at least partly due to PEG chain-chain interaction. This was supported by an increased fraction of PEG chains exhibiting a fast NMR transverse relaxation in DPPC/PEG(5,000)-DPPE mixtures as compared to that in distearoyl phosphatidylcholine (DSPC)/PEG(5,000)-dioleoyl-PE (DOPE). Conclusions. These phenomena are discussed in relation to both bilayer and steric stabilization of liposomes, and the lack of prolonged circulation with certain formulations is discussed.     

颈椎间管壁骨质增生的观察及其意义

在甘肃地区出土的成人颈椎骨骼标本390套(2730块)上,观测了钩椎关节、椎间关节、横突孔和椎体后缘的骨质增生,出现率高达22.5%。增生骨唇占据椎间管、横突孔和椎管的情况分轻、中、重三度.     

The anatomical basis of the osteo-musculo-cutaneous trapezius flap in mandibular reconstruction

The osteo-musculo-cutaneous trapezius flap has seen its indications in mandibular reconstruction reduced since the appearance of micro-anastomotic flaps. However, it may still be useful when the patient has marked atheroma contraindicating a free flap. While the arterial supply of this flap is well known, the same is not true for its venous drainage. The preservation of the accessory nerve and its limits in mandibular reconstruction has been little studied. We carried out a study on 30 subjects (60 cadaveric dissections of trapezius flaps) in order to address these questions. The study has been completed by a surgical series of five patients. The cadaveric study allowed demonstration of the variability of venous drainage of this flap, which depended on the external jugular vein in 80% of cases, the subclavian vein in 12% of cases and on both veins in about 8% of cases. The accessory nerve in one third of cases passed through the middle of the arteriovenous pedicle making its preservation impossible. The segment of the scapular spine allowed reconstruction of about 9 cm of mandible including the mental protuberance in 95% of cases. The surgical study confirmed the data of the cadaveric study and showed the value of this flap when free flaps are contraindicated.     

Localization of motoneurons innervating the muscle of the hard palate in the rat: A horseradish peroxidase study

Using the horseradish peroxidase-technique, the myotopical arrangement of motoneurons innervating the transverse palatine muscle in the rat was studied. It appears that this muscle is innervated by axons from cells located in the ipsilateral intermediate subnucleus of the facial motor nucleus. By nerve transection and electrophysiological experiments it is shown that the transverse palatine muscle is innervated by the inferior as well as the superior buccolabial branch of the facial nerve.     

如何正确理解T_1T_2的不同

本文针对学生在学习核磁共振的过程中 ,在理解纵向弛豫时间T1和横向弛豫时间T2 时经常提出的疑问 ,建构两个物理模型 ,以便于学生能深刻理解T1、T2 的物理学 ,生物学意义 ,为读释图像 ,挖掘生物信息奠定更牢固的理论基础。     

侧脑室计算机三维重建及理论分析

目的 :建立便于推广、功能齐全、价廉的三维医学图像重建系统及进行三维重建。方法 :利用目前较先进的数码摄片技术和自行编制的软件系统 ,对层距 1.0 mm的人体头部断面共 2 4 0层进行侧脑室的三维重建 ,同时对头部整体行三维重建以其进行相对定位和比较。结果 :重建后的侧脑室可和头部进行参照显示 ,行旋转、透明处理和不同方向的任意剖割。结论 :较以 CT、MRI断面图像重建的模型增加了轮廓的准确性和器官内组织的鲜明色彩     

The Effect of Functional Pelvic Tilt on the Three-Dimensional Acetabular Cup Orientation in Total Hip Arthroplasty Dislocations

BackgroundAnterior and posterior pelvic tilt appears to play a role in total hip arthroplasty (THA) stability. When changing from the standing to the sitting position, the pelvis typically rotates posteriorly while the hips flex and this affects the femoro-acetabular positions. This case-control study compares changes in 3-D acetabular cup orientation during functional pelvic tilt between posterior THA dislocations vs stable THAs.MethodsStanding and sitting 3-D cup orientation was compared between fifteen posterior dislocations vs 233 prospectively followed stable THAs. 3-D cup orientation was calculated using previously validated trigonometric algorithms on biplanar radiographs. Those algorithms combine the angles in the three anatomical planes (coronal inclination, transverse version, and sagittal ante-inclination) in the standing position with the change in sagittal pelvic tilt from standing to sitting to calculate the 3-D orientation in the sitting position.ResultsThe standing cup orientation of the dislocated THAs was only characterized by a lower coronal inclination (P = .039). Compared with the controls, from standing to sitting, they showed less posterior pelvic tilt (P < .001). This led to a significant lower coronal inclination (P < .001) and sagittal ante-inclination (P < .001) in the sitting position but similar transverse version (P = .366).ConclusionsComparing posterior THA dislocations to stable THAs, there is a lower increase of all three orientation angles from standing to sitting. This leads to a decreased sitting coronal inclination and sagittal ante-inclination which may lead to an increased risk of impingement ensued by THA instability. By contrast, the transverse version was not significantly different in both positions. This confirms the importance of biplanar data on functional cup orientation.Level of EvidenceDiagnostic, Level III.     

伴颈5/6椎间孔狭窄神经根型颈椎病影像学特点及临床意义

目的 观测伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔形态及三维空间下的各相关径值,分析并探讨其临床意义。方法 随机选取492例伴C5/C6椎间孔狭窄,在上海长征医院于2014年9月至2019年7月期间行手术治疗的神经根型颈椎病患者,行颈椎正侧位X线、颈椎CT、颈椎磁共振等检查,数字骨科系统重建后观测椎间孔形态并测量最佳投射角度下的纵径、上前后径、下前后径、横截面积、椎间隙高度等径值并对其进行统计学处理,比较病例组与正常成人组C5/C6椎间孔之间、病例组病变椎间孔与对侧椎间孔以及病例组中男女患者之间的差异。结果 病例组C5/C6椎间孔形态因骨赘增生等,以纺锤形、不规则形为主,病例组C5/C6椎间孔横径均值、纵径、横截面积、椎间隙平均高度分别为（5.81±1.40）mm、（10.45±1.70）mm、（50.02±15.46）mm2、（4.99±0.89）mm,均比正常成人组减小,且差异有统计学意义（P<0.01）;男女间比较差异无统计学意义（P>0.05）。结论 伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔的形态发生改变,导致椎间孔的横径均值及横截面积值均明显减小;椎间孔的横径在诊断颈椎间孔狭窄方面敏感性及特异性高;术中减压时应更加注重椎间孔横径的有效扩大,以提高手术效果。