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双侧经皮椎体后凸成形术对骨质疏松性椎体爆裂骨折的安全性及疗效评价 被引量:11
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作者 庞大明 杨晋才 +2 位作者 高海峰 范哲轩 尹鹏 《中华医学杂志》 CAS CSCD 北大核心 2022年第35期2793-2798,共6页
目的探讨双侧经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体爆裂骨折的安全性以及临床疗效。方法将2021年1至7月于北京朝阳医院接受双侧PKP治疗的骨质疏松性胸腰椎爆裂性骨折患者纳入本前瞻性研究。共纳入28例患者28个椎体,其中男10例,女1... 目的探讨双侧经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体爆裂骨折的安全性以及临床疗效。方法将2021年1至7月于北京朝阳医院接受双侧PKP治疗的骨质疏松性胸腰椎爆裂性骨折患者纳入本前瞻性研究。共纳入28例患者28个椎体,其中男10例,女18例,中位年龄73.6岁(56.0~87.0岁)。患者术前拍摄正侧位X线片、骨密度、CT三维重建扫描和磁共振脂肪抑制序列扫描并进行观察,明确骨折部位及椎体后壁情况,进一步确定诊断。术后第1天及末次随访时拍摄正侧位X线片、CT三维重建扫描,观察骨水泥渗漏情况,通过X线片测量,比较术前、术后伤椎上位椎体上终板和下位椎体下终板后凸角度(KA)、伤椎椎体前缘高度(HAW)、伤椎椎体后缘高度(HPW)等指标变化情况。同时比较患者术前、术后疼痛视觉模拟评分(VAS)以及Oswestry功能障碍指数(ODI)情况,对手术临床疗效进行评估。结果所有患者均获随访,随访时间(12.2±6.0)个月。术前HAW为(21.2±2.4)mm,术后HAW为(22.5±2.0)mm,差异有统计学意义(P<0.05),末次随访时HAW为(18.9±1.6)mm,低于术后(P<0.05)。术后HPW也较术前明显矫正(P<0.05)。末次随访时HPW与术后比较差异无统计学意义[(27.2±1.3)mm比(27.5±1.6)mm,P>0.05]。术前KA为18.8°±1.3°,术后KA为14.2°±1.5°,术后KA明显矫正(P<0.05),末次随访时KA为17.6°±1.4°,较术后增大,差异具有统计学意义(P<0.05)。5例发现骨水泥渗漏,1例发现邻近椎体骨折。术后第1天、末次随访时疼痛VAS评分及ODI均较术前降低,差异均有统计学意义(均P<0.05)。结论双侧PKP治疗骨质疏松性椎体爆裂骨折治疗效果肯定且安全可靠,仔细评估术前影像学资料,精准的穿刺及把握骨水泥推注时机是保证手术成功的关键因素。 展开更多
关键词 骨质疏松 椎体爆裂骨折 双侧经皮椎体后凸成形术 安全性 临床疗效
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Ecogeographical variation of 12 morphological traits within Pinus tabulaeformis: the effects of environmental factors and demographic histories
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作者 Mingfei Ji Jianming Deng +6 位作者 Buqing Yao Renfei Chen zhexuan fan Jiawei Guan Xiaowei Li fan Wu Karl J.Niklas 《Journal of Plant Ecology》 SCIE CSCD 2017年第2期386-396,共11页
Aims More data are needed about how genetic variation(GV)and envi-ronmental factors influence phenotypic variation within the natural populations of long-lived species with broad geographic distribu-tions.To fill this... Aims More data are needed about how genetic variation(GV)and envi-ronmental factors influence phenotypic variation within the natural populations of long-lived species with broad geographic distribu-tions.To fill this gap,we examined the correlations among envi-ronmental factors and phenotypic variation within and among 13 natural populations of Pinus tabulaeformis consisting of four demo-graphically distinct groups within the entire distributional range.Methods Using the Akaike’s information Criterion(AiC)model,we measured 12 morphological traits and constructed alternative candidate models for the relationships between each morphological trait and key climatic variables and genetic groups.We then compared the AiC weight for each candidate model to identify the best approximating model for ecogeographical variation of P.tabulaeformis.The partitioning of vari-ance was assessed subsequently by evaluating the independent vari-ables of the selected best models using partial redundancy analysis.Important Findings Significant phenotypic variation of the morphological traits was observed both within individual populations and among populations.Variation partition analyses showed that most of the phenotypic variation was co-determined by both GV and climatic factors.GV accounted for the largest proportion of reproductive trait variation,whereas local key climatic factors(i.e.actual evapotranspiration,AET)accounted for the largest proportion of phenotypic variation in the remaining investigated traits.Our results indicate that both genetic divergence and key environmental factors affect the phenotypic variation observed among populations of this species,and that reproductive and vegetative traits adaptively respond differently with respect to local environmental conditions.This partitioning of factors can inform those making predictions about phenotypic variation in response to future changes in climatic conditions(particularly those affecting AET). 展开更多
关键词 Akaike’s Information Criterion environmental factors genetic variation information-theoretic approach phenotypic variation
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