后颈

Material and Methods:From March,2008 to January,2009,250 patients(146 Males and 104 Females,ranged from 18 to 82 years old,mean age was 48 years old) enrolled in the First Affiliated Hospital of Kunming Medical College were performed dual energy scan(Group A,200 patients) and Neuro-DSA scan(Group B,50 patients) using DSCT.The patients were randomly divided into Group A and Group B.Regarding to the justification of scan protocol,100 patients in Group A were selected as sub-group to explore the scan protocol.The image quality Was analyzed both in four categories(4.0/60、4.5/60、4.0/70、4.5/70) of flow rate and total amount of contrast-enhanced material and in three categories(100—150HU、150—200HU、200-250HU) of CT value of left common carotid artery.The comparison of two scan approach was based on image quality,radiation does, postprocessing methods,time of scanning and subtraction and data storage amount.To validate the diagnostic capability of DE-CTA virtual unenhanced images,100 patients in Group A were undergoing head scan both in routine non-contrast program and DE-CTA virtual unenhanced program.Mean CT values,signal-to-noise ratio,image quality,sensitivity of lesion identification,and radiation does were applied to comparison.According to diagnostic results of dual energy of cerebral arterial angiography,62 patients out of 200 patients in Group A were confirmed with cerebral vessel lesions,the results were complied with DSA findings(the time between the two methods were within 1 week).

材料与方法收集2008年3月到2009年1月间在昆明医学院第一附属医院行DSCT CTA检查者250例(男性146例，女性104例，年龄范围18-82岁，平均48岁)，随机分为A、B两组，A组200例行双能量头颅CTA扫描；B组50例行Neuro-DSA扫描。A组前100例按对比剂不同流率和总量分为4组(4.0/60、4.5/60、4.0/70、4.5/70)对图像质量比较；按触发时左颈总动脉内平均CT位分3组(100—150HU、150—200HU、200-250HU)，比较图像质量的差异；对A、B两组血管图像质量、辐射剂量、后处理的方法、扫描和后处理时间及数据的容量进行比较分析；A组中前100例行常规与DE-CTA虚拟平扫的平均CT值、信号噪声比、图像质量、病灶显示情况、辐射剂量的比较分析；A组中行DSA检查62例(两种方法间隔时间均1周内)，比较两种检查方法诊断结果是否符合，并对其中24例动脉瘤行动脉瘤部位、数目、形态、瘤颈显示程度、瘤颈大小及瘤体长径和短径的比较研究。

RESULTS: The imaging features of CBT were masses located at the bifurcation of the carotid artery, with abundant blood supply in the tumor, the internal and external carotid arteries shifted, the bifurcation of the carotid artery increased like goldcup in DSA. The imaging features of the neurilemmoma were masses located behind the bifurcation of the carotid artery, and the carotid bifurcation was normal, no blood supply in the tumor, but carotid arteries shifted.

结果：颈动脉体瘤的CDFI和DSA特征为：颈总动脉分权处单发性肿块，并与其紧密相连，瘤体内血流极为丰富，瘤体使颈外动脉向前内移位、颈内动脉向后外移位，颈内、外动脉分权角度增大明显，DSA呈高脚杯状改变；神经鞘瘤紧邻颈动脉，颈总动脉分权处角度无改变，瘤体内血流信号不丰富，瘤体使颈动脉向前、外移位。

After two experienced doctors of Traditional Chinese Medicine who knew nothing affirmed the pulse is wiry pulse, we used sphygmograph to note the sphygmogram of carotid. Then after the rabbits breathed calmly, two experienced doctors of Traditional Chinese Medicine who knew nothing affirmed the pulse was the normal pulse ,we noted the the sphygmogram of carotid under the same pulse-taking pressure. After classifying the parameters in the sphygmogram of carotid, we analyzed them by time domain.

2.2 给予家兔疼痛性刺激建立弦脉模型在非麻醉状态下将家兔行颈部手术，暴露颈动脉，经两名有经验的中医师双盲取脉，使用脉图仪记录颈动脉脉图，待家兔呼吸平稳后再由两名有经验的中医师双盲取脉，确认为平脉后在同样的取脉压力下记录颈动脉脉图，对脉图参数进行分类后做时域分析。

To detect effects on apoptosis of cortex neuron in DHCA rats, the rat model of occluding bilateral common carotid artery in the deep hypothermic (21C) rats had been established, and flow cytometry, TUNEL, electron microscope, immunohistochemistry and RT-PCR had been studied.: part I: To establish a new rat model of cerebral ischemia/protect during DHCA: 20 SD rats were used in the experiment, little animal respirator was to assist anesthetized rat's respiration after tracheal cannula, artery press through artery spile in femoral artery, electrocardiograph, temperature, blood saturation of O2 (SaO2) and arterial blood gases were monitored during the whole experiment, blood flow of bilateral common carotid artery of rat were occluded about 60 minute when its temperature was reduced to 21 C by ice, then normal temperature was resumed.

本研究采用大鼠深低温颈总动脉阻断模型，应用流式细胞仪、电镜、原位缺口末端标记法、免疫组化法和RT-PCR技术分别检测深低温脑缺血对皮层神经细胞调亡的影响方法：第一部分深低温停循环脑保护大鼠模型的建立：SD大鼠20只，麻醉后气管插管辅助呼吸，用冰块将大鼠的体温降至(21±1)℃，阻断双侧颈总动脉，记录体温、心率、血压、血氧饱和度和血气分析，60分钟后恢复颈总动脉血流，用Longa等的5级评分标准评定4小时和24小时后大鼠神经系统损伤情况。

Methods The skeletal muscle stem cells were enzymatically isolated with collagen and dispase, and then purified by different adhesion time from 6 female SD rats. The purified cells were transinfected with adenovirus carrying lac-Z gene, and injected into the bladder neck of 6 autologous and 4 allogeneic rats. Tissues of blader neck and ureter were obtained in sacrified rats after 5 and 15 days, histological examination and X-gal staining were performed.

采用混合酶消化及反复差速贴壁法分离、纯化培养SD大鼠骨骼肌干细胞，然后用携带lac-Z基因的腺病毒载体转染肌干细胞，待转染成功后将携带lac-Z基因的骨骼肌干细胞注射于自体和同种异体的膀胱颈及后尿道周围，分别于注射后5、15d，处死大鼠取出膀胱颈及后尿道，行组织学检查及X-gal染色。

METHODS: Rabbit models of autogenous vein graft were generated in both groups. After anaesthesia, a median incision was made at the neck to dissociate external jugular vein and common carotid artery of the left side. Following blood flow was blocked at the upper and down sides of the common carotid artery, blood vessels were transected to collect 4.0-5.0 cm external jugular vein at the left side, and placed among the common carotid artery at the same side after inversion. End-to-end anastomosis was performed using discontinuous ecstrophy.

两组兔均建立自体静脉移植模型，麻醉后颈前正中切口，游离出左侧颈外静脉及颈总动脉，在颈总动脉的上下两端阻断血流后，横断血管，取左侧的颈外静脉4.0~5.0cm，上下倒向后置于同侧颈总动脉之间，采用间断外翻法行端端吻合。

Objective To observe the clinical efficacy of treatment in acute cerebral infarction by Safflower injection via carotid artery infusion.Methods 100cases were randomized into treatment group in which50cases were treated with Safflower injection via carotid artery infusion,added Safflower injection20ml into0.9%sodium chloride injection60ml with the4ml/min velocity,once a day;control group in which50cases were treated with venous drip of Safflower injection,added Safflower injection20ml into0.9%sodium chloride injection500ml.After therapy,the curative effect、myodynamia and hemorrheology were compared between the two groups.

目的 探讨颈动脉灌注红花注射液治疗急性脑梗死的临床疗效方法将100例脑梗死患者随机分红花注射液颈动脉灌注组50例和红花注射液静脉滴注组50例，治疗组：于0.9%氯化钠注射液60ml中加入红花注射液20ml，以4ml/min的滴速经颈动脉灌注；对照组：以红花注射液20ml加入0.9%氯化钠注射液500ml中静滴，20天后对两组疗效进行分析并观察治疗后肢体肌力及血液流变学变化。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

Then,the left external carotid artery of 40 adult New Zealand White rabbits were ligated,which reduced the pulsatile shear stress of left common carotid significantly (for example, mean=21.16 ± 7.17 vs 3.13±2.28 dynes/cm2, p=2.176E-21)and did not change the pulsatile shear stress of right common carotid significantly.

结果左颈外动脉结扎后即刻兔的左颈总动脉形成脉动低切应力以τ_(mean为例，从21.16±7.17dynes/cm~2降至3.13±2.28dynes/cm~2，p=2.176E-21，并一直持续至结扎12周后；而右颈总动脉脉动切应力始终无显著变化。

If these abnormities were laid according as frequency among 2-6 months,reflex abnormities are knee tendon reflex, palmar grasp reflex,...

其中 2— 6个月组，4个方面的异常项目按出现多少分别排列为：①反射异常：膝反射、手持握反射、巴氏征、非对称性颈肢反射、踝阵挛、坐位平衡反应、踏步反射、交叉伸展反射、紧张性迷路反射、躯干侧弯反射、拥抱反射；②姿势异常：仰卧翻成侧卧头后仰≥ 15°、立位悬垂、平卧颈后空隙≥1cm、俯卧悬垂、侧位悬垂、拉起、紧张性头偏斜、自发姿势异常；③肌张力异常：足背屈角、上肢围颈、手握拳、扶立足跟抬起≥ 3 0°、拇指交叉达掌心、窝角、内收角、跟耳角；④其他异常：头围≤ x -2s、斜视、主动运动减少/异常、听觉异常、视觉异常、眼颤、癫痫。

She gently rebuff ed him, but agreed that they could be friends

她婉言拒绝了，但同意作为朋友相处。

If in the penal farm, you were sure to be criticized.

要是在劳改农场，你等着挨绳子吧！