ABSTRACT
[Objective]To discuss the changes and clinical significance of microcirculation in lower limbs in patients with lumbar canal stenosis under different circumstances.[Method]Prospectively,randomly,the nail fold microcirculation of the big toe in 50 patients were investigated with WX-6 microcirculation instrument before and after operation at 7~10 days and 3~6 months.The averages were compared with that of 30 healthy persons with q test.Two groups were defined according to the claudication distance as 0～100 meter and 300～400 meter and tested.The averages were analyzed with t test.[Result]There were statistically significant differences between the patients group and the healthy group and before and after surgery(P0.05).The most significant change was the form of blood flow.[Conclusion]The dysfunction of sympathetic nerve resulting from lumbar canal stenosis will impair the microcirculation of lower limbs and aggravate intermittent claudication.The operation will improve the microcirculation and alleviate the symptoms significantly.The microcirculation test in lower limbs can serve as an objective method for the preoperative diagnosis and postoperative assessment for therapeutic efficacy.
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Objective To investigate the gene expression of interleukin-1 alpha (IL-1?) in degenerative cervical intervertebral discs and its significance. Methods The specimens of the cervical intervertebral discs were harvested from 12 patients with cervical disc herniation (CDH) and 16 patients with cervical spondylotic myelopathy (CSM) in surgical operations, and categorized according to the MRI disc degeneration classification. The specimens of 8 normal cervical intervertebral discs from fresh corpses were harvested as control group. The expression of IL-1? mRNA was detected by in situ hybridization histochemistry (ISHH) and the difference and change characteristics of IL-1? mRNA expression were compared among groups and each grades. Results The expression of IL-1? mRNA was obviously stronger in CDH and CSM groups than in the control group and stronger in discs of grades Ⅲ and Ⅳ than gradesⅠ and Ⅱ. Conclusion The gene expression of IL-1? was strengthened in degenerative cervical intevertebral discs and the more serious the degeneration, the stronger the gene expression. IL-1? may play an important role in the degeneration of cervical intervertebral discs.
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Objective To discuss the diagnostic value of parasagittal reconstruction CT for the lumbar intervertebral foraminal stenosis.Methods From Jan.2003 to Apr.2004,15 suspected cases with lumbar intervertebral foraminal stenosis based on the routine clinical and radiologic examinations were diagnosed by means of the CT parasagittal reconstruction and operated on .Results All showed L_(4~5) or L_5~S_1 foraminal stenosis,2 cases far lateral disc protruded,8 cases the vertebral endplate posteriolateral spurs extruded into foramina,1 spondylolisthesis pseudoarthrosis pressed,4 cases had the narrow intervertebral space along with the flavum ligament hypertrophy and facet superioanterio subluxation. 7 cases showed horizontal stenosis and 8 cases showed vertical stenosis.6 cases wereⅡ?,9 cases were Ⅲ?. Conclusion The parasagittal reconstruction CT for the lumbar foraminal stenosis can compensate for the drawbacks of the routine axial CT, show more clearly and vividly and guide the operations more accurately.
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Objective To evaluate routine MR examination of the knee in diagnosing bucket-handle tears of the menisci.Methods The characteristic MRI findings of bucket-handle tear of menisci proved by arthroscopy in 38 cases were analysed.Results The fragments of bucket-handle tears mesially displaced and meniscus deficiency or part deficiency were showed in 30 cases.Five cases showed Ⅲ degree high signal intensity of meniscal tears.Three cases had no abnormal finidngs.Conclusion The MRI characteristic features of bucket-handle tears of the menisci are the fragment of bucket-handle tears mesially displaced and the deficience of the menisci.When the fragments teared had no mesially displace,only show Ⅲ degree high signal intensity in meniscal tears,and those tears extend to the up and lower surface of menisci.