微创减压治疗腰椎侧隐窝狭窄症21例观察

目的：探讨微创减压治疗腰椎侧隐窝狭窄症疗效及手术减压范围。方法：46例单纯性腰椎侧隐窝狭窄症病人随机分为2组，一组采用小切口椎板开窗潜行侧隐窝减压(微创减压)治疗，另外一组行全椎板或半椎板切除减压(常规减压)治疗。结果：46例获平均32个月随访，微创减压组优良率为90．5％，平均每一节段手术时间为62min，出血量为168mL，术后住院时间为240h。常规减压组优良率为88．5％，平均每一节段手术时间为88min，出血量为293mL，术后住院时间为408h。经统计学处理，两组间近期疗效无显差异，在减少创伤促进康复方面，微创减压组优于常规减压组。结论：与椎板切除完全减压相比，微创椎板开窗潜行有限减压治疗腰椎侧隐窝狭窄症，虽近期临床疗效没有显差别，但减少了组织剥离及术后疤痕形成和粘连，具有损伤小，恢复快，下地早等优点，对年老患尤为适合。     

甲泼尼龙琥珀酸钠在颈、胸椎围手术期的应用研究

目的探讨大剂量甲泼尼龙琥珀酸钠（甲强龙）在严重颈、胸椎管狭窄伴有脊髓损伤患者围手术期应用的价值。方法选取有严重颈、胸椎管狭窄脊髓受压的患者50例,随机分为治疗组和对照组,每组25例,采用单盲法。治疗组术前30min给于5％葡萄糖盐水250mg加甲强龙1000mg快速静滴;对照组术前只给予5％葡萄糖盐水静滴。脊髓型颈椎病的患者,采取前路椎间盘摘除加椎体次全切除减压,同时给予植骨内固定;胸椎黄韧带钙化症的患者只作后路全椎板切除减压。结果术后JOA评分,治疗组为（11．9±3．2）分（改善率49．5％）,对照组为（9．1±2．1）分（改善率16．8％）,两组相比差异有统计学意义（P〈0．01）。结论围手术期大剂量使用甲强龙在伴有严重脊髓压迫的颈、胸椎管狭窄症的患者减压治疗中具有明显改善神经功能的作用。可有效地预防由于手术所造成的神经刺激症状,增加手术的安全性,减少并发症。     

腰椎间盘突出并发侧隐窝狭窄的诊断和治疗（附48例分析）

４８例腰椎间盘突出并发侧隐窝狭窄均行手术治疗,其中２５例经椎板间开窗术,１９例经半椎板切除术,４例经全椎板切除术。术后随访３７例,其中优２２例,占５９．５％,良１１例,占２９．７％,优良率为８９．２％。笔者认为本病确诊需靠脊髓造影ＣＴ检查;手术以椎板间开窗、半椎板切除为主。如此手术创伤小,脊柱稳定性不受损,术后功能恢复快。     

椎板间隙开窗显露手术治疗腰椎间盘突出症

为探讨椎板间隙开窗显露手术治疗腰椎间盘突出症的临床应用价值及适应证。采用椎板间隙开窗显露方法对58例腰椎间盘突出症进行髓核摘除及神经根通道清理。经随访6～36个月者共56例，其中优48例，良5例，可2例，差1例。认为本法手术治疗腰椎间盘突出症能保证充分显露，完全去除病变，使硬脊膜及神经根在彻底减压的基础上，尽量减少手术损伤和手术对脊柱稳定性的影响，经临床观察疗效满意，并发症少，术后恢复快，适用于单节段腰椎间盘突出症或合并相同节段同侧神经根通道狭窄者。     

小切口双L截骨治疗退行性腰椎管狭窄症(摘要)

采用小切口双L截骨治疗退行性腰椎管狭窄症 12 8例。该手术方法是根据退行性腰椎管狭窄症发病特点和狭窄区域 ,介于半椎板切降和椎板间开窗之间的一种有限减压方式。着重于关节突、侧隐窝、神经根、椎间盘等部位的显露 ,达到取除病变 ,缓解症状 ,保留稳定结构 ,减少并发症的目的。适用于单侧单间隙狭窄症的减压 ,具有显露清楚 ,创伤小 ,术后反应轻 ,恢复快 ,并发症少等优点。本组疗效随访结果 ,优良率为 94 5%。     

腰间盘突出症的手术与非手术治疗

目的 探讨腰间盘突出症的手术与非手术治疗。方法 对200例腰间盘突出症的治疗进行回顾。非手术治疗132例,采用卧床骨盆牵引加药物治疗,辅以理疗等。手术治疗68例,采取开窗、半椎板切除、对年龄较大、考虑有椎管狭窄或中央型腰间盘突出较大者采用全椎板切除。结果 非手术治疗效果优良者97例,占74％。手术治疗组全部达到优良标准。结论 非手术治疗是腰间盘突出症的最基本治疗方法,可以获得很好的效果。在手术治疗时应严格选择手术适应症,尽量选择对脊柱稳定性影响小的手术方法。     

腰椎间盘突出并腰椎管狭窄症采用椎间孔镜技术与骨科开放手术治疗的临床对比研究

研究在腰椎间盘突出合并腰椎管狭窄症患者临床治疗中,采用椎间孔镜技术和骨科开放手术治疗的临床疗效。择取2017年2月-2018年3月期间入合水县人民医院治疗的腰椎间盘突出合并腰椎管狭窄症患者82例;抽取41例,采用骨科开放式治疗,为对照组,另41例采用椎间孔镜技术进行治疗,为治疗组。对两组患者治疗的手术时间、出血量、住院时间、术后切口VAS评分以及术后6个月JOA评分进行分析对比。手术后治疗组患者在手术时间、出血量、住院时间,术后切口VAS评分以及术后6个月JOA评分等方面均显著优于对照组,且存在明显差异。在腰椎间盘突出并腰椎管狭窄症患者治疗中采用椎间孔镜技术,可有效减少患者手术创伤,提高手术的安全性。     

全椎板切除并神经通道松解治疗腰椎管狭窄68例分析

自1990年以来，我科收治68例腰椎管狭窄症，全部病例行椎板切除，与部分神经通道松解，优良率87 ．2％．作者认为，彻底解决椎管狭窄与神经通道的狭窄，是取得手术治疗成功的关键。     

颈椎单开门椎管扩大成形术中重建伸肌附着点及保留C7棘突开槽式减压的临床疗效观察

观察颈椎单开门椎管扩大成形术中重建伸肌附着点及保留C7棘突开槽式减压在治疗脊髓性颈椎病的临床疗效。2017年01月～2018年07月有81例多节段脊髓型颈椎病患者在我院接受单开门椎管扩大成形术治疗,其中70例获得完整临床随访。根据手术方法将其分为两组：观察组(37例),单开门术中采用伸肌附着点重建和保留C7棘突开槽式减压治疗;对照组(33例),行常规单开门椎管成形钛板固定术治疗。记录手术时间及术中出血量,观察术后患者神经功能改善、颈椎曲度指数(cervical curvature index,CCI)改变、颈后肌群横截面积变化及轴性症状(axial symptoms,AS)的发生情况。结果表明：观察组在手术时间及术中出血量上明显高于对照组(P<0.05);在椎板开门角度及脊髓漂移距离上,两组比较无显著统计学差异(P>0.05);术后两组患者的JOA评分较术前有显著升高(P<0.05),两组在神经功能恢复率上无显著统计学差异(P>0.05)。观察组在CCI及颈后肌群横截面积上与术前比较无显著统计学差异(P>0.05),对照组的上述数值较术前明显减小(P<0.05)。观察组轴性症状发生率为8.1%(3/37),对照组为21.2%(7/33),具有显著统计学差异(P<0.05)。可见,在单开门椎管成形术中,重建伸肌附着点及保留C7棘突开槽式减压会增加手术时间,但术式的改进可以更好的维持颈椎曲度,减轻颈后肌群萎缩并降低术后轴性症状的发生。     

颈椎后路单开门手术方式改进的临床应用

目的探讨颈椎后路单开门手术椎板开门、开槽的方法和效果。方法对18例脊髓型颈椎病和无骨折脱位型颈脊髓损伤的病人行后路单开门手术，选用高速电磨钻并配锥形钻头和细柱形钻头行椎板开槽、开门。结果18例椎板开门均成功，绞链侧均呈青枝样骨折对合，未见完全折断移位，术中未出现脊髓、神经根损伤等并发症。所有患者都获随访，随访时问平均13个月（5-12个月）。随访时颈椎动力位摄片，未发现颈椎节段性不稳定，CT检查减压的各节段椎管矢状径均较术前明显增大。结论使用高速电磨钻配锥形钻头和细柱形钻头行椎板开槽、开门，方法简单，操作方便，安全，可缩短手术时间，降低并发症发生。     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.     

Achieving Unusual States of Matter Under High Pressure

正The periodicity of the elements and the non-reactivity of the inner-shell electrons are two related principles of chemistry,rooted in the atomic shell structure.Within compounds,Group I elements,for example,invariably assume the+1 oxidation state,and their chemical properties differ completely from those of the p-block elements.These general rules govern our understanding of chemical structures and reactions.Using first principles calcula-     

Exchange-Correlation and Electronic Excitation Energies from Pairing Matrix Fluctuations

We have developed an adiabatic connection to formulate the ground-state exchange-correlation energy in terms of pairing matrix linear fluctuations.This formulation of the exchange-correlation energy opens a new channel for density functional approximations based on the many-body perturbation theory.We illustrate the potential of such approaches with an approximation based on the particle-particle Random Phase Approximation(pp-RPA).This re-     

Density Functional Theory for the Response of Periodic Systems to Electric Fields Based on the Vector Potential Approach

正The electronic and nuclear(structural/vibrational)response of 1D-3D nanoscale systems to electric fields gives rise to a host of optical,mechanical,spectral,etc.properties that are of high theoretical and applied interest.Due to the computational difficulty of treating such large systems it is convenient to model them as infinite and periodic(at least,in first approximation).The fundamental theoretical/computational problem in doing so is that     

On the Thermodynamic Limit for Responses to Static Electromagnetic Fields

For molecular systems,the quantum-mechanical treatment of their responses to static electromagnetic fields usually employs a scalar-potential treatment of the electric field and a vector-potential treatment of the magnetic field.Although the potential for each field separately is associated with the choice of an(unphysical)origin,the precise choice of the origin for the electrostatic field has little consequences for the results.This is different for the     

An affordable accurate evaluation of the binding conformations predicted by molecular docking studies in bio-system

Franck-Condon factors bridge the gap between theoretical modeling and experimental observations for molecular electronic spectroscopy and electron transfer.Under the displaced harmonic oscillator approximation,multidimensional Franck-Condon factors are decomposed into a product of many one-dimensional(1D)Franck-Condon(FC)factors,and each 1D-FC factor is associated with one Huang-Rhys factor that determines the leading contribution of     

Call for Papers

<正>"The Journal of Shanghai Normal University:Mathematics"is published by Shanghai Normal University as regular issues of The Journal of Shanghai Normal University each year from 2014 in English.The editors-in-chief of the issues are professors Yuhao Cong and Maoan Han.The Journal of Shanghai Normal University was started in 1958 with