治脊法为主治疗肠易激综合征40例临床观察

肠易激综合征(irritable bowel syndrome,IBS)是胃肠道最常见的功能性疾病,约占人群的15%,消化道门诊的1/3～1/2,临床以腹痛、腹胀、大便习惯改变等症状为主要表现,目前对其病因尚不十分清楚,也缺乏特效的治疗方法.

治脊疗法治疗颈性失眠76例

1临床资料 本组76例中，男40例，女36例；年龄最大68岁，最小20岁，其中35岁以上者占80％；病程最短1天，最长10年。住院病例18例，门诊病例58例。临床主要症状体征：颈部活动受限，局部疼痛或疼痛不明显。常失眠、多梦、心烦、易于冲动等情志症状：可见枕部疼痛、头晕头沉、胃纳不佳、神经过敏，精神疲劳等类似神经衰弱症状，伴记忆力减退。注意力不集中等。失眠与头、颈姿势的改变有明显的关系。

龙氏治脊疗法结合中药定向透入治疗腰椎间盘突出症的护理干预效果研究

目的探讨龙氏治脊疗法结合中药定向透入治疗腰椎间盘突出症患者的护理干预效果。方法选取我院收治的120例腰椎间盘突出症患者随机分为两组各60例。对照组采用常规治疗和护理,研究组采用龙氏治脊疗法结合中药定向透入治疗和护理干预。比较两组患者的VAS评分、QOL评分及护理满意度。结果治疗前,两组患者的VAS评分和QOL评分比较均无统计学差异(P>0.05);治疗后1周、4周,研究组的VAS评分均低于对照组,QOL评分均高于对照组,差异有统计学意义(P<0.05)。研究组的护理满意度为93.33%,高于对照组的80.00%(P<0.05)。结论护理干预对龙氏治脊疗法结合中药定向透入治疗的腰椎间盘突出症患者的效果显著,可减轻患者的疼痛感,提高其生存质量和护理满意度,维持良好的护患关系。

Multilevel cervical spondylotic myelopathy treated by anterior cervical decompression in subsection and autograft fusion

Objective：To investigate a novel surgical method for multilevel cervical spondylotic myelopathy （CSM）. Methods： Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively. All patients experienced anterior cervical decompression surgery in subsection, autograft fusion and internal fixation. Preoperative, immediate postoperative and follow-up image data, X-rays and semi-quantitative Japanese orthopaedics association （JOA） scores were used to evaluate the restoration of lordosis （Cobb＇s angle）, intervertebral heights, the stability of the cervical spine and the improvement of neurological impairment. Results： Preoperative symptoms were markedly alleviated or disappeared in most of the patients. According to the JOA scores, the ratio of improvement in neurological function was 72. 2%, including excellent in 9 cases （42.9%）, good in 7 cases （33.3%）, fair in 3 cases （14.3%） and poor in 2 cases （9.5%）. Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine （P〈0. 01）. There is no evidence of instrument failure during the mean follow-up period of 14. 2 months （9-24 months, P〉0. 01）. Conclusion：Anterior cervical decompression in subsection, autograft fusion and internal fixation is a rational effective method for the surgical treatment of multilevel CSM.

Application of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis

Objective： To determine the effectiveness of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis in 24 patients with a 2-year minimum follow-up. Methods： 24 patients who underwent operations between September 2002 and November 2003 were evaluated for curve correction, spinal balance, and complications. Age at surgery averaged 13.8 years （range from 10 to 20）. The spinal deformities were evaluated by Cobb method with anteroposterior and lateral bending radiographs. All patients were right thoracic curves. Posterior instrumentation （Moss-Miami transpedicular system） was used. The transpedicular screws were placed between T2 and L2. All the patients were assessed both clinically and radiographically. Follow-up averaged 2.8 years. Results： There was an average correction of 72% of the primary curve （pre-operation standing average 54 degrees （range from 40 to 67 degrees）, post-operation average 15.2 degrees （range from 2 to 27 degrees）, at last examination average 16.1 degrees （range from 2 to 30 degrees）. Infection and neurological complications were not noted. No major complications were observed. Conclusions： Frontal and sagittal thoracic curve correction of thoracic scoliosis can be satisfactorily obtained using Moss Miami transpedicular instrumentation. It seems that control of the three columns of the spine by the transpedicular screws offers sufficient apical translation and coronal realignment.

Safety control strategy for vertebral lamina milling task

Vertebral lamina milling task is one of the high-risk operations in spinal surgeries. The operation is to remove part of vertebral lamina and release the pressure on the spinal nerve. Because many important vessels and nerves are under the vertebral lamina, any incorrect operation may cause irreparable damage to patients. To improve the safety of lamina milling task, a fuzzy force control strategy is proposed in this paper. Primary experiments have been conducted on bone samples from different animals. The results show that, with the fuzzy force control strategy, the bone milling system can recognize all surgery states and halt the tool at the proper location, achieving satisfactory surgery performance.

Relationship belween Gene Expression of bFGF and Prolifercrtive Activity in Meningioma

OBJECTIVE To study the relationship between bFGF gene expression and proliferative activity in meningiomas. METHODS Thirty-seven samples of meningioma were examed using Northern hybridization for bFGF-gene expression and immunohistochemi- stry for bFGF protein expression and the Ki-67LI. RESULTS bFGF mRNA was detected in 22 meningiomas of Grade Ⅰ and in all samples of Grade Ⅱ and Ⅲ. Six of the Grade Ⅰ tumors were negative, giving an overall positive rate of 83.8 % for bFGF mRNA. Autoradiography was conducted using a thin scaning apparatus, bFGF mRNA expression compared to that for β-actin was 0.34±0.06 for Grade Ⅰ tumors compared to 0.82±0.12 for Grade Ⅱ and Ⅲ tumors. The difference was highly significant （P〈0.001）. The results of immunohistochemistry showed that the number of the positive cells for the bFGF protein was 29.7±7.6% in Grade Ⅰ tumors and 63.2±11.7 % in Grade Ⅱ plus Ⅲ, resulting in a significant difference between them （P〈0.001） . The Ki-67LI was found to be 2.8±1.1% in Grade Ⅰ and 6.5±1.3 % in Grade Ⅱ plus Ⅲ. The former was significantly lower than the later （P〈0.001）. CONCLUSION The expression of bFGF was correlated well with the malignancy of the meningiomas.

Pedicle screw fixation against burst fracture of thoracolumbar vertebrae

Objective： To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods： A total of 48 cases （31 males and 17 females, aged from 18-72 years, mean： 41.3 years ） with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004. According to the AO classification of thoracolumbar vertebrae fracture, there are 36 cases of Type A, 9 of Type B and 3 of Type C. Results： All patients were followed up for 6-25 months （average 12 months ）, no secondary nerve root injury, spinal cord injury, loosening or breakage of pedicle screw were observed. The nerve function of 29 patients with cauda eqnina nerve injury was restored to different degrees. The vertebral body height returned to normal level and posterior process angle was rectified after operation. Conclusions： The vertebral pedicle screw internal fixation was technologically applicable, which can efficiently reposition and stablize the bursting fractured vertabrae, indirectly decompress canalis spinalis, maintain spine stablity, scatter stress of screw system, reduce the risk of loosening or breakage of screw and loss of vertebral height, and prevent the formation of posterior convex after operation.

Comparison of therapeutic effect between percutaneous kyphoplasty and pedicle screw system on vertebral compression fracture

Objective： To compare the clinical efficacy of percutaneous kyphoplasty （PKP） with pedicle screw system （PS） in the treatment of vertebral compression fracture （VCF） . Methods： Eighty-six patients with VCF were treated either by PKP （ Group A, n ffi 30） ） or PS （ Group B, n ffi 56）. The anterior, intermediate, and posterior heights of the vertebrae body , visual analogue pain scale （VAS） before and after operation, the duration of operation, and amount of blood loss between two groups were compared. Results ： No statistical difference was noted regarding the vertebral height between two groups. Significant difference was seen in VAS, duration of operation and amount of blood loss between the two groups （P 〈0. 01 ）. Conclusions： Percutaneous kyphoplasty has the similar therapeutic efficacy with pedicle screw system in treatment of VCF with a mininlal invasion, less operation time and blood loss. For those with posterior wall destruction, PS is deemed favorable.

Clinical efficacy observation of spine subtle adjusting manipulation for postpartum low back pain

Objective To explore the clinical efficacy of spine subtle adjusting manipulation for postpartum low back pain(PLBP).Methods A total of 76 patients with PLBP were randomized into a control group and a treatment group,with 38 cases in each group.The control group was treated with core muscle strengthening exercises,and the treatment group was treated with spine subtle adjusting manipulation.After 3 weeks of treatment,the clinical efficacy was observed,and the visual analog scale(VAS)score and Oswestry disability index(ODI),and the changes of lumbar Cobb angle and pelvic rotation were compared between the two groups.Results The total effective rate of the treatment group was 92.1%,and that of the control group was 78.9%.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score and ODI in both groups decreased,and the intra-group differences were all statistically significant(P<0.05).There were no intra-group statistical differences in the lumbar Cobb angle or pelvic rotation in the two groups(P>0.05).After treatment,there were no statistical differences in the lumbar Cobb angle or pelvic rotation between the two groups(P>0.05);the VAS score and ODI in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Spine subtle adjusting manipulation can effectively relieve the pain for patients with PLBP,and improve their daily activity function.

Immunofluorescence laser confocal expression and localization study of rat nerve growth guidance cues Netrin-1 and Slit2 after spinal cord injury

Objective： To observe the expression and distribution of adult rat axon guidance cues Netrin- 1 and Slit2 at different time points after spinal cord injury and to investigate the guidance mechanism of regenerated axons. Methods： Twenty adult Sprague Dawley （SD） rats were divided randomly into five groups with 4 in each. Four groups of them were used to make Allen＇s spinal cord punch models and we took materials randomly from one of them on the 2nd, 4th, 7th and 14th day respectively after operation. The left one group was taken as the control group. Immun- ofluorescence laser confocal scan was used to examine the co-expression and localization of Netrin- 1 and Slit2 proteinsin the injured site of the spinal cord. Results： Within two weeks after SCI, the expression of Netrin- 1 and Slit2 proteins increased temporarily and there was co-expression of them on the neuron plasma membrane. Conclusions： Synchronous high expression and co-expression of axon attractant Netrin-1 and repellent Slit2 are found in the adult rat injured spinal cord in the damaged local and vicinity parts, and probably, they act as the key regulators of axon guidance regeneration.

Comparison of therapeutic effect between percutaneous vertebroplasty and kyphoplasty on vertebral compression fracture

Objective： To compare the clinical efficacy of percutaneous vertebroplasty （PVP） with percutaneous kyphoplasty （PKP） in the treatment of vertebral compression fracture （VCF）. Methods： Ninety-eight patients with VCF were treated by PVP （n = 42 ） or PKP （n = 56 ）. The anterior midline and posterior heights of vertebrae body, preoperative and postoperative visual analogue scale （VAS）, operation time and amount of blood loss were compared between 2 groups. Results： There was statistical difference in vertebral height between two groups （ P 〈 0. 01 ）. No significant difference was seen in VAS, operation time and blood loss between two groups （ P 〈 0.05 ）. Conclusions： PKP and PVP have the similar therapeutic efficacy in treatment of VCF with minimal invasion, less operation time and blood loss. However, PKP is superior in the recovery of vertebral height.

The clinical characteristics and therapy of syndrome of craniocerebral- cervical vertebral injury

Objective: To explore the clinical characteristics and new treatment for syndrome of craniocerebral-cervical vertebral injury. Methods: The clinical data of 52 patients with head injury accompanied by neck injury were analyzed retrospectively. Results: Craniocerebral injury could result in damage to cervical vertebrae, muscles, vessels and nerves, and even cause vertebral artery injury, which may lead to insufficient blood-supply of vertebral-basal artery. All patients were treated with cervical vertebral traction and the results were good. Conclusions: Acute craniocerebral injury with symptom of insufficient blood-supply of vertebral-basal artery, evident neurosis and atlas-axis half-dislocation in X-ray should be treated by cervical vertebral traction, which will yield better outcome.

Spinal cord injuries from road traffic crashes in southeastern Iran

Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods ： In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results： Among 64 patients with SCI, 38 patients （59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average） were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases （68.4%） and 12 cases （31.6%）, respectively. And 31patients （81. 6%） had complete SCI. Conus medularis （T12-L2 ） was the most affected level. Conclusions： Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.

Effect of human neural progenitor cells on injured spinal cord

To study whether human neural progenitor cells can differentiate into neural cells in vivo and improve the recovery of injured spinal cord in rats. Methods： Human neural progenitor cells were transplanted into the injured spinal cord and the functional recovery of the rats with spinal cord contusion injury was evaluated with Basso-Beattie-Bresnahan （ BBB ） locomotor scale and motor evoked potentials. Additionally, the differentiation of human neural progenitor cells was shown by immunocytochemistry. Results： Human neural progenitor cells developed into functional cells in the injured spinal cord and improved the recovery of injured spinal cord in both locomotor scores and electrophysiological parameters in rats. Conclusions ： Human neural progenitor cells can treat injured spinal cord, which may provide a new cell source for research of clinical application.

Effect of allograft compound vertebra on vertebral reconstruction in rabbits

Objective ： To study the effect of allograft compound vertebra on vertebral reconstruction in rabbits so as to provide biomechanical direction for manufacturing and selecting vertebral reconstruction materials. Methods： Twenty-five healthy New Zealand white rabbits were divided randomly into three groups： normal group （ Group A, n = 5 ） ,iliac bone graft group （ Group B, n = 10） and allograft compound vertebra group （ Group C, n = 10）. After C4 was resected, iliac bone implantation and allograft bone cage transplantation were fulfilled in Group B and Group C, respectively. Every 5 rabbits from Group B and Group C were selected to test the biomechanical strength and biological activity one and two months postoperatively. Results： No significant statistical difference was found between Group A and Group C one and two monthspostoperatively （ P 〉 0.05 ）. The biomechanical strength of Group B was much weaker than that of Group A and Group C one month postoperatively （P 〈 0.05 ）, but at two months postoperatively, no statistical difference was found among the three groups. The biological activity and vertebral moulding ability of Group C were better than those of Group B at one and two months postoperatively. Conclusions： Compound vertebra, which is made up of allograft cortical bone cage and autogenous cancellous bone, shows instantaneous and permanent biomechanical stability and biological activity, therefore, it is an ideal material for vertebral reconstruction.

Tuina plus Traction for Cervical Distortion in Teenagers:A Report of 40 Cases

Objective： To observe the clinical effect of tuina plus traction for cervical distortion in teenagers. Methods： Tuina plus traction was applied to 40 teenagers with cervical distortion once every other day, and 10 days make up 1 treatment course. The therapeutic effect was evaluated after 2 courses. Result： Significant changes occurred after the treatment： 15 cases got correction, 20 cases got substantial improvement and 5 cases got certain improvement. Conclusion： Tuina plus traction works effectively for abnormal cervical physiological curve in teenagers.