背景:单纯斜外侧腰椎椎间融合的临床应用受患者骨密度影响较大,但该手术适应的骨密度目前国内外均无相关研究的报道.目的:比较不同骨密度下单纯斜外侧腰椎椎间融合模型的生物力学性能.方法:以健康成年男性志愿者的CT数据为基础,建立L3-S1正常对照有限元模型(M0组)、正常骨密度(T值>-1.0 SD)L4-5单纯斜外侧腰椎椎间融合有限元模型(M1组)、骨量减少(-2.5 SD-2.5 SD的患者行单纯斜外侧腰椎椎间融合手术可以改善生物力学稳定性.

目的 探讨乳腺癌钼靶X线恶性钙化征象与雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2 (HER-2)、增殖细胞核抗原Ki-67表达的关系.方法 选择初诊乳腺癌患者81例,术前均接受乳腺钼靶X线检查,根据有无恶性钙化征象分为有恶性钙化组36例、无恶性钙化组45例.取两组手术切除的乳腺癌组织,采用免疫组化SP法检测ER、PR、HER-2、Ki-67表达.结果 有恶性钙化组ER、PR阳性表达率均低于无恶性钙化组,而HER-2、Ki-67阳性表达率均高于无恶性钙化组(P均＜0.05).结论 乳腺癌钼靶X线恶性钙化征象可在一定程度上反映肿瘤ER、PR、HER-2、Ki-67表达情况,这为乳腺癌术前辅助内分泌治疗和预后判断提供了更多有价值的参考信息.

OBJECTIVE:To use computed tomography angiography to evaluate the regional anatomy of the lumbar segmental arteries (LAs) associated with the surgical field in oblique lateral interbody fusion (OLIF). METHODS:Computed tomography angiography images from 50 patients were reviewed. In the sagittal plane, distances from the LA to the upper and inferior edges of the vertebral body were measured in the anterior quarter of the anterior and median lines of the intervertebral disc (IVD). LAs were classified as types I-IV based on the zone in which they passed through the vertebral body. RESULTS:The LA branch angles were acute (<90°) at L1-L3 and blunt (>90°) at L4-L5. The average distances from the LA to the upper and inferior edges of the vertebral body in the anterior quarter position revealed that La1.2 > Lb1.2 and Lb3.4.5 > La3.4.5. For the IVD of L1-L2, Lb1 < La2; IVD of L2-L3, Lb2 < La3; IVD of L3-L4, Lb3 > La4; IVD of L4-L5, Lb4 > La5. In zone I, the most frequent LA type was type IV at L1 (n = 41; 85.4%) and L2 (n = 42; 84.0%), type III at L3 (n = 20; 40.0%), and type II at L4 (n = 36; 80.0%) and L5 (n = 5; 83.3%). In zone II, the most frequent LA type was type III at L1 (n = 38; 79.2%), L2 (n = 39; 78.0%), L3 (n = 43; 86.0%), and L4 (n = 28; 62.2%), whereas type II was the most frequent LA type at L5 (n = 5; 83.3%). In zone III, type III was the most frequent LA type at L1-L4. In zone IV, type IV was the most frequent LA type at L3 (n = 44; 88.0%), L4 (n = 42; 93.3%), and L5 (n = 6; 100%). CONCLUSIONS:The risk of LA injury during OLIF is the least when the cage is placed in zones II and III. Care is required during OLIF in zone IV of L3-L5. The fixation pin should be fixed on the upper edge of the lower vertebral body at L1-L2 and L2-L3, and on the lower edge of the upper vertebral body at L3-L4 and L4-L5.