目的 探讨C3椎板切除、保留C7棘突的改良椎管成形术治疗颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)的临床疗效,并分析该术式减少轴性疼痛的机制.方法 2014年2月至2016年3月共收治OPLL患者133例,按...目的 探讨C3椎板切除、保留C7棘突的改良椎管成形术治疗颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)的临床疗效,并分析该术式减少轴性疼痛的机制.方法 2014年2月至2016年3月共收治OPLL患者133例,按纳入及排除标准共纳入42例.采用病例对照研究的方法,改良手术组22例,男13例,女9例;年龄39~77岁,平均(56.2±9.75)岁;采用C3椎板切除、C4~C6椎板单开门、C7椎板上半部分切除保留C7棘突的改良椎管成形术治疗.同期采用标准单开门椎管扩大成形术(标准手术组)患者20例,即C3~C7椎板单开门减压术治疗,男12例,女8例;年龄41~75岁,平均(53.7±8.23)岁.临床疗效评价采用日本骨科协会(Japanese Orthopaedic Association Scores,JOA)评分、颈椎功能障碍指数(neck disability index,NDI)及切口疼痛视觉模拟评分(visual analogue scale,VAS),影像学疗效评价采用颈椎生理曲度及活动度,记录两组患者术后轴性症状发生率及其他术后并发症.结果 42例患者均得到随访,随访时间15~29个月,平均(22.9±4.5)个月.两组患者术前各项指标的差异均无统计学意义,术后及随访时两组患者的JOA评分及NDI均较术前明显好转;末次随访时两组患者JOA评分的差异无统计学意义,而改良手术组患者NDI平均为6.56%±4.78%,优于标准手术组9.25%±7.63%.改良手术组术后第1天切口疼痛VAS评分低于标准手术组,此后随访期间两组VAS评分的差异均无统计学意义.改良手术组术后颈椎曲度平均为12.32°±8.26°,标准手术组为11.56°±8.05°,两组的差异无统计学意义.改良手术组术后颈椎活动度平均为39.68°±5.52°,标准手术组为33.51°±7.39°,差异有统计学意义.8例(19%)患者术后轴性症状加重或新出现轴性症状,改良手术组3例(13.6%),标准手术组5例(30%),两组间差异无统计学意义.随访期间无脑脊液漏、脊髓损伤、切口感染、椎板塌陷、术后再关门、内固定�展开更多
It is a great challenge to develop highly active oxygen evolution reaction(OER)electrocatalysts with superior durability.In this study,a NiFe layered double hydroxidedecorated phosphide(NiFe LDH@CoP/NiP_(3))was constr...It is a great challenge to develop highly active oxygen evolution reaction(OER)electrocatalysts with superior durability.In this study,a NiFe layered double hydroxidedecorated phosphide(NiFe LDH@CoP/NiP_(3))was constructed to display satisfactory OER activity and good stability for water splitting in alkaline media.At an overpotential of 300 mV,NiFe LDH@CoP/NiP_(3) achieved a current density of 82 mA cm^(-2) for the OER,which was 9.1 and 2.3 times that of CoP/NiP_(3) and NiFe LDH,respectively.Moreover,the reconstruction behavior,during which oxyhydroxides formed,was studied by a combination of X-ray photoelectron spectroscopy,Raman spectroscopy,and scanning electron microscopy.A synergistic effect between NiFe LDH and CoP/NiP_(3) was also observed for the hydrogen evolution reaction.Furthermore,when NiFe LDH@CoP/NiP_(3) acted as both the cathode and anode for overall water splitting,a high current density of 100 mA cm^(-2) was maintained for more than 275 h.In addition,under Xe light irradiation,a solar-to-hydrogen efficiency of 9.89% was achieved for solar-driven water splitting.This work presents the coupling of different active compositions,and can provide a reference for designing bifunctional electrocatalysts.展开更多
基金financially supported by Hunan Provincial Science and Technology Plan Project(2017TP1001 and2020JJ4710)the National Key R&D Program of China(2018YFB0704100)the State Key Laboratory Fund。
文摘It is a great challenge to develop highly active oxygen evolution reaction(OER)electrocatalysts with superior durability.In this study,a NiFe layered double hydroxidedecorated phosphide(NiFe LDH@CoP/NiP_(3))was constructed to display satisfactory OER activity and good stability for water splitting in alkaline media.At an overpotential of 300 mV,NiFe LDH@CoP/NiP_(3) achieved a current density of 82 mA cm^(-2) for the OER,which was 9.1 and 2.3 times that of CoP/NiP_(3) and NiFe LDH,respectively.Moreover,the reconstruction behavior,during which oxyhydroxides formed,was studied by a combination of X-ray photoelectron spectroscopy,Raman spectroscopy,and scanning electron microscopy.A synergistic effect between NiFe LDH and CoP/NiP_(3) was also observed for the hydrogen evolution reaction.Furthermore,when NiFe LDH@CoP/NiP_(3) acted as both the cathode and anode for overall water splitting,a high current density of 100 mA cm^(-2) was maintained for more than 275 h.In addition,under Xe light irradiation,a solar-to-hydrogen efficiency of 9.89% was achieved for solar-driven water splitting.This work presents the coupling of different active compositions,and can provide a reference for designing bifunctional electrocatalysts.
