目的:探讨椎板分区切除法脊髓减压内固定术在治疗胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,T-OLF)的疗效性及安全性。方法:回顾性分析58例T-OLF病人的临床资料,根据手术方法将其分为:A组(25例),根据黄韧带的...目的:探讨椎板分区切除法脊髓减压内固定术在治疗胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,T-OLF)的疗效性及安全性。方法:回顾性分析58例T-OLF病人的临床资料,根据手术方法将其分为:A组(25例),根据黄韧带的解剖学特点及与椎板的毗邻关系,在椎板后方进行区域划分后,采用椎板分区减压、逐节切除、脊髓减压内固定术治疗;B组(21例),采用椎板分层薄化法减压内固定术治疗。记录2组手术时间、出血量及并发症发生情况,观察术后病人神经功能恢复及局部后凸角变化情况。结果:2组手术时间和术中出血量差异均无统计学意义(P>0.05)。2组术后JOA评分均较术前有明显升高(P<0.05);A组神经功能改善率(72.2±14.8)%,B组为(73.1±15.2)%,差异无统计学意义(P>0.05)。2组术后局部Cobb角均较术前有明显改善(P<0.01),不同时间点组间比较差异均无统计学意义(P>0.05)。A组病人脑脊液漏发生率12.00%与B组的23.80%差异有统计学意义(P<0.05)。结论:椎板分区切除法脊髓减压内固定可减少椎管内侵袭性操作,硬膜撕裂的发生率低,安全性相对高,内固定植入有利于术后胸椎稳定性更好维持。展开更多
Motivated by the observation that firms invest in carbon emissions reduction to decrease the cost of carbon tax as governments in numerous countries increasingly implement carbon tax to improve the environment,and bro...Motivated by the observation that firms invest in carbon emissions reduction to decrease the cost of carbon tax as governments in numerous countries increasingly implement carbon tax to improve the environment,and broad researcher and practitioner agreement that carbon tax implementation always benefits the environment.However,we find that a carbon tax may actually hurt the environment based on a stylized game model with a better-informed retailer(one who controls the demand information sharing with the manufacturer)and a manufacturer.In particular,we find that the carbon emissions reduction may harm the environment if the carbon tax is moderate or both the carbon tax and the demand fluctuation are high.We further reveal free-riding behavior by the retailer,who may enjoy more profit sharing from the supply chain in the presence of carbon emissions reduction.Based on these observations,we argue that a carbon tax does not always benefit the environment when a manufacturer who receives demand information from the retailer responds better to market uncertainty.展开更多
文摘目的:探讨椎板分区切除法脊髓减压内固定术在治疗胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,T-OLF)的疗效性及安全性。方法:回顾性分析58例T-OLF病人的临床资料,根据手术方法将其分为:A组(25例),根据黄韧带的解剖学特点及与椎板的毗邻关系,在椎板后方进行区域划分后,采用椎板分区减压、逐节切除、脊髓减压内固定术治疗;B组(21例),采用椎板分层薄化法减压内固定术治疗。记录2组手术时间、出血量及并发症发生情况,观察术后病人神经功能恢复及局部后凸角变化情况。结果:2组手术时间和术中出血量差异均无统计学意义(P>0.05)。2组术后JOA评分均较术前有明显升高(P<0.05);A组神经功能改善率(72.2±14.8)%,B组为(73.1±15.2)%,差异无统计学意义(P>0.05)。2组术后局部Cobb角均较术前有明显改善(P<0.01),不同时间点组间比较差异均无统计学意义(P>0.05)。A组病人脑脊液漏发生率12.00%与B组的23.80%差异有统计学意义(P<0.05)。结论:椎板分区切除法脊髓减压内固定可减少椎管内侵袭性操作,硬膜撕裂的发生率低,安全性相对高,内固定植入有利于术后胸椎稳定性更好维持。
基金This paper was supported by the National Natural Science Foundation of China(71672153).
文摘Motivated by the observation that firms invest in carbon emissions reduction to decrease the cost of carbon tax as governments in numerous countries increasingly implement carbon tax to improve the environment,and broad researcher and practitioner agreement that carbon tax implementation always benefits the environment.However,we find that a carbon tax may actually hurt the environment based on a stylized game model with a better-informed retailer(one who controls the demand information sharing with the manufacturer)and a manufacturer.In particular,we find that the carbon emissions reduction may harm the environment if the carbon tax is moderate or both the carbon tax and the demand fluctuation are high.We further reveal free-riding behavior by the retailer,who may enjoy more profit sharing from the supply chain in the presence of carbon emissions reduction.Based on these observations,we argue that a carbon tax does not always benefit the environment when a manufacturer who receives demand information from the retailer responds better to market uncertainty.
