节段性神经肌肉疗法治疗肌筋膜痛综合征临床疗效观察

目的:观察节段性神经肌肉疗法(Segmental Neuromyotherapy,SNMT)治疗肌筋膜痛综合征的疗效。方法:选取36例肌筋膜痛综合征患者,所有患者进行SNMT治疗。每例患者在SNMT治疗前、后及治疗后1个月、3个月进行0～10数字分级量表(Numeric Rating Scale,NRS)评定。结果:SNMT治疗前NRS评分平均为8.12±1.21分,治疗后即刻降至3.62±1.64分,与治疗前比有显著性差异(P=0.000);治疗后1个月为3.36±1.78分,与治疗前比有显著性差异(P=0.044);治疗后3个月为3.28±1.42分,与治疗前比有显著性差异(P=0.044)。结论:SNMT对肌筋膜痛综合征所致神经肌肉骨骼性疼痛具有明显改善作用,疗效持久。     

Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele in a child

Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare. We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia. Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord. A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1. The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved. Arachnoid cyst was confirmed by histological examination. The patient recovered well postoperatively. This is the second report of such a case in the world according to the available literature. The take-home message for our case is that the surgical approach should be individualized, depending on the size and location.     

北宋中后期四川铁钱币值和流通地区的变化

北宋中后期四川铁钱币值的变化,主要受到两个因素的影响：即铁线成为交子的准备金及陕西地区铸造铁线的冲击。由于交子发行额度的变化以及陕西铁线的不断贬值,四川铁线的币值不断波动,宋政府采用暂停铸造铁线、禁止陕西铁钱进入四川流通以及稳定交子发行数额的措施,使四川钱钱的币值在北宋中后期仍然基本得到稳定。     

Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury

Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Spragne-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day l, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.     

碱性成纤维细胞生长因子（bFGF）对脊髓损伤的恢复作用

脊髓损伤（spinal cord injury,SCI）是中枢神经系统的严重损伤,是一种严重威胁人类生命健康的疾患。碱性成纤维细胞生长因子是一种对神经细胞起重要调节作用的蛋白质,对脊髓损伤具有重要的修复作用。文章就碱性成纤维细胞生长因子在脊髓损伤中的作用机制予以综述。     

Unilateral hemilaminectomy for patients with intradural extramedullary tumors

A modified hemilaminectomy was introduced in an attempt to explore the operative techniques and the values of the limited approach to spinal cord tumors. Forty-five consecutive patients with intradural extramedullary lesions, who underwent modified hemilaminectomy, were studied retrospectively. The intraspinal tumors were removed via the limited bone window with a 3.3-cm mean length (range: 2.0–6.5 cm) and a 1.2-cm mean width (range: 0.6–1.5 cm), in which the inner parts of the medial and lateral laminae were mostly undercut for wider view. Spinal lesions were cervical in 21 cases, thoracic in 12 cases, lumbar in 10 cases, and multiple in 2 cases. Forty-three cases were completely excised via hemilaminectomy alone. Two subjects with dumbbell neurinoma underwent two-stage tumor removal via anterolateral cervical approach following hemilaminectomy. With respect to neurological status, the percentage of good Frankel scale (D+E grade) was markedly improved from 22.2% on admission to 93.3% at follow-up. At the median 26-month follow-up evaluation by magnetic resonance imaging (MRI), none of the subjects showed spinal deformity or instability. By preserving musculoligamentous attachments and posterior bony elements as much as possible, the modified approach is minimally invasive and may be routinely used to remove intradural and extramedullary tumors, especially in patients with meningiomas and neurinomas.