骨密度测量仪的研制与临床应用

1986年11月～1987年9月,联合研制了GMY—Ⅰ型γ光子吸收扫描骨密度测量仪。通过1699例正常人的临床应用,证明该类仪器具有操作简便、灵敏度高、速度快、安全性能好、对被检对象无损伤及价格较便宜等优点。本文介绍了该仪器的技术原理及测试方法,并提供了20～60岁正常成年人男女两性不同年龄组骨盐含量及骨密度正常值。     

骨髓水肿综合征与股骨头缺血性坏死

目的探讨骨髓水肿综合征(bone marrow edema syndrome,BMES)与股骨头缺血性坏死(avascular necrosis of femoral head,ANFH)的差异。方法广泛查阅国内外关于ANFH及BMES研究的相关文献,进行回顾及综合分析。结果 BMES与ANFH在病理、发病机制、临床表现、治疗方法及预后等方面存在不同。结论 BMES与ANFH是两种不同性质的疾病,微骨折可能是骨髓水肿出现的原因。     

进一步提高股骨头坏死保存自身关节的疗效

对股骨头坏死患者,特别是早、中期的中青年患者,选择保存自身关节（joint—preserving）治疗的必要性和可能性已为多数骨科医师接受。目前面临最大的困难是如何进一步提高此种疗法的临床效果。本期集中刊登数篇临床经验、基础研究及综述等,目的是希望在更大范围内普及相关知识,使更多的骨科医师参与,以达共同进步。     

膝关节骨关节炎：以循证医学为基础的诊断和治疗选择

膝关节骨关节为中老年常见骨科疾病,依据临床症状和影像学检查可确诊.诊断和治疗选择应依赖循证医学证据,根据疾病的分期与分级,分别行生活方式调整、药物治疗及手术治疗.各种治疗各有其适应证,合理选择才能获最佳疗效和最小并发症.     

不同取血方式对分离骨髓单核细胞浓度的影响

150例行髓芯减压加自体干细胞移植股骨头坏死患者按侧别分为单侧和双侧髂骨取血两组,按取血量再分为3个亚组（200、300和400ml组）,并于取髂骨血前、后行单核细胞记数。单侧髂骨取血200、300和400ml组分离后单核细胞记数分别为（3．11±1．42）×10^10／L、（2．62±1．31）×10^10／L和（2．13±0．91）×10^10／L,取血400ml组单核细胞记数显著低于取血200ml组（t=5．118,P〈0．01）;双侧髂骨取血200、300和400ml组分离后单核细胞计数分别为（4．51±2．21）×10^10／L、（3．89±2．06）×10^10／L和（2．98±1．39）×10^10/L,取血400ml组单核细胞记数显著低于取血200ml组（t=6．446,P〈0．01）;双侧髂骨取血200、300和400ml分离后单核细胞浓度明显高于单侧取血,且差异有统计学意义（t=3．119,P〈0．01;t=5．544,P〈0．01;t=2．207,P〈0．05）。提示髂骨取血所分离单核细胞浓度受不同取血方式影响：双侧高于单侧;随着取血剂量增加,分离单核细胞浓度降低。     

软骨延迟增强核磁成像法检测Ⅱ期、Ⅲ期股骨头坏死软骨改变

目的 运用软骨延迟增强核磁成像法检测Ⅱ期、Ⅲ期股骨头坏死的软骨改变,研究股骨头坏死塌陷前后软骨的改变规律.方法 采用软骨延迟增强核磁成像技术,对每名受试者进行钆增强延迟核磁共振扫描,应用MATLAB和Mrimapper软件进行数据处理,分别获得股骨头软骨感兴趣区的TIGd数据.样本为成人激素性股骨头坏死国际骨坏死与循环协会(ARCO)分期Ⅱ期、Ⅲ期患者和健康志愿者,分为3组,A组:ARCO Ⅱ期,11髋;B组:ARCO Ⅲ期,13髋;C组:健康对照组为无髋关节疾病的健康正常成年人,10髋.结果 A组T1Gd值为420±60,B组T1Gd值为361±54,C组T1Gd值为538±26,A组、B组患者T1Gd值与C组相比差异均有统计学意义(均P＜0.01).股骨头坏死塌陷后期T1Gd值较塌陷前T1Gd值低14%,差异有统计学意义(P＜0.01).结论 股骨头坏死塌陷前的ARCO Ⅱ期股骨头关节软骨已经发生代谢变化,塌陷后ARCO Ⅲ期更加明显,说明骨坏死塌陷前期即影响关节关节软骨的代谢功能,并随坏死程度的加重而加重.

Abstract：

Objective To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages Ⅱ and Ⅲ and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse. Methods The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageⅡ; Group B,13 hips, stage Ⅲ; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed. Results The values of T1Gd were 420 ±60 (Group A) ,361 ±54(Group B) and 538 ±26 (Group C) respectively. There was a significant difference among three groups.The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of T1Gd of Group B was 14% lower than those of Group A. And the difference was significant statistically. Conclusion Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.     

Cartilage changes of femoral head osteonecrosis in stage Ⅱ and Ⅲ as detected by dGEMRIC

Objective To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages Ⅱ and Ⅲ and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse. Methods The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageⅡ; Group B,13 hips, stage Ⅲ; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed. Results The values of T1Gd were 420 ±60 (Group A) ,361 ±54(Group B) and 538 ±26 (Group C) respectively. There was a significant difference among three groups.The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of T1Gd of Group B was 14% lower than those of Group A. And the difference was significant statistically. Conclusion Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.     

骨组织工程支架材料表面修饰的试验研究

观察骨髓基质细胞 (BMSC)在吸附了多聚赖氨酸 (Poly -L -Lysine,PLL)的羟基磷灰石 (HA)上的生长情况。探讨改进材料表面活性 ,促进种子细胞黏附和生长的方法。利用组织工程学的方法 ,将体外培养的BMSC种植于吸附了多聚赖氨酸的HA上 ,立体培养一周 ,用环境扫描电镜和倒置相差显微镜观察细胞的生长情况。结果表明 ,细胞在体外可以立体培养成活 ,吸附了多聚赖氨酸的HA上细胞较多。多聚赖氨酸可以改善HA的表面活性 ,促进细胞的黏附和生长。     

我国北方地区颈肩痛病人中颈椎后纵韧带骨化症发病率调查

颈椎后纵韧带骨化症1838年由Ｋｅｙ首先报道,60年代以后,有关本病的研究报告相继发表。日本报告本病的发病率为2%～3%,高于美国、德国、意大利、菲律宾、新加坡和韩国〔1～6〕。1975年被日本厚生省定为特定疾患,从流行病、遗传、病因、生化等方面进行了较多的研究工作。本病在我国的确切发病率尚不清楚,1994年1月至1997年10月,我们联合东北、华北、西北地区六家医院的骨科医生,对以颈肩痛为主诉的门诊及住院病人进行颈椎后纵韧带骨化症调查,报告如下。1　调查对象与方法北京中日友好医院、内蒙古医学院第二附属医院、内蒙古巴盟医院、白求恩…