不同程度脊髓背侧压迫损伤模型大鼠脊髓损伤致伤器的设计

背景：随着对脊髓损伤研究的不断深入,国内外学者不断设计出各种脊髓损伤模型,主要包括脊髓挫伤、重物坠击、脊髓压迫、化学灼伤、放射性损伤及激素横断半横断损伤等,然而各种制备方法都存在一定的局限。 目的：设计脊髓损伤致伤器并建立不同程度脊髓损伤动物模型。 方法：实验自行设计包括致伤部件及传动装置的脊髓损伤致伤器,利用不同致伤质量m1=10 g,m2=20 g,m3=30 g及时间T1=3 s,T2=5 s,造成不同质量×时间暨不同程度SD大鼠脊髓背侧压迫损伤,分为m1T1,m2T1,m3T1,m1T2,m2T2,m3T2共6组,并设假手术组进行对照。 结果与结论：造模后各实验组BBB评分均低于假手术组(P < 0.01),m1T1组与其他各实验组相比差异有显著性意义(P < 0.01),建模后8周m1T2组BBB评分高于与m2T2组及m3T2组(P < 0.05)。建模后8周各组体感诱发电位和运动诱发电位潜伏期明显长于假手术组(P < 0.01)。除了m1T1组与m1T2组外,其他各组间建模后体感诱发电位潜伏期均明显延长(P < 0.05)。所有组建模后运动诱发电位潜伏期均明显延长(P < 0.05)。结果证实,实验所设计的脊髓损伤致伤器可制备出不同程度的脊髓背侧压迫损伤动物模型。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

改良Rao穿破分级评估胸腰椎椎弓根螺钉的准确性及其临床意义

目的 探讨改良Rao穿破分级评估胸腰椎椎弓根螺钉的准确性及其临床意义。方法 采用改良Rao穿破分级标准,对2010年1月至2017年6月我科收治的经胸腰椎开放后路椎弓根置钉术治疗的40例胸腰椎病变病人的术后CT影像资料进行回顾性分析。收集病人的一般资料、并发症情况,并对术后各椎弓根螺钉发生穿透的方向和程度进行统计,分析各椎弓根螺钉的穿透率。结果 共置入254枚螺钉,其中33枚螺钉穿出,置钉总准确率为87.01%（221/254）。L₅的置钉准确性最低,仅为78.26%（36/46）,且其A、D型的穿透率和2级及以上的穿透率明显高于其他椎体。畸形椎弓根的穿透率明显高于退行性变与骨折,差异均具有统计学意义（P均＜0.05）。结论 改良Rao穿破分级更加精准、实用,胸腰椎畸形的椎弓根穿透率明显高于退行性变和骨折,而L₅节段2级及以上穿透率均明显高于其他胸腰椎,临床上应引起足够重视。     

膝关节前外侧韧带的研究进展

目的 总结膝关节前外侧韧带的研究进展。方法 在中国知网、万方数据、中国生物医学文献数据库和PubMed数据库,分别以“膝关节”“前外侧韧带”“前外侧关节囊”“Segond骨折”为关键词,检索1980年1月—2015年10月与膝关节前外侧韧带的解剖学、组织学、生物力学及其损伤的临床诊断和外科治疗有关的文献进行分析总结。结果 前外侧韧带近端起源于股骨外侧髁腘肌腱止点附近,远端止于Gerdy结节外侧,经组织学研究显示前外侧韧带符合韧带组织的特征。前外侧韧带对维持膝关节内旋稳定有重要作用。前外侧韧带损伤应该早期诊断、早期治疗。其诊断不仅依靠影像学检查,还要结合临床查体;手术方式一般为关节外肌腱固定。结论 前外侧韧带是与Segond骨折相关的韧带结构,有助于维持膝关节内旋稳定性。目前对其损伤后的手术治疗方式尚无统一定论,有待进一步深入研究。     

早期激素性股骨头坏死过程中细胞色素c的作用

BACKGROUND: Studies have shown that apoptosis is closely related to the pathogenesis of steroid-induced femoral head necrosis. The release of cytochrome c plays a very important role in the process of apoptosis. OBJECTIVE: To observe the effects of cytochrome c on early steroid-induced femoral head necrosis. METHODS: Twenty-four healthy adult male New Zealand rabbits at 5 months old were randomly divided into model group and control group (n=12 per group). Models of early steroid-induced femoral head necrosis were established by intragluteal injection of hormone combined with ear vein injection of horse serum. In the control group, rabbits were given ear vein injection of the same amount of physiological saline. At 2, 4 and 6 weeks after model establishment, histopathological changes of bilateral femoral head were observed by optical microscope, and the ratio of empty lacuna was calculated. Apoptosis of osteocytes was determined by TUNEL assay, and apoptotic index was calculated. Immunohistochemical method was used to determine cytochrome c and to calculate cytochrome c-positive expression rate. RESULTS AND CONCLUSION: (1) The ratio of empty lacuna and apoptotic index: The model of early steroid-induced femoral head necrosis was successfully established in the experiment. Compared with the control group, ratio of empty lacuna, apoptotic index and expression rate of cytochrome c in osteocytes were significantly higher in the model group (P < 0.05 or P < 0.01). (2) Correlation analysis: Ratio of empty lacuna was significantly positively associated with apoptotic index at various time points in the model group (r=0.856, P < 0.01). Expression rate of cytochrome c was significantly positively associated with apoptotic index at various time points in the model group (r=0.824, P < 0.01). (3) These findings confirm that cytochrome c-involved apoptosis of osteocytes may play an important role in steroid-induced femoral head necrosis. Expression rate of cytochrome c in osteocytes is remarkably positively associated with the occurrence of steroid-induced femoral head necrosis in rabbits. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

纤毛相关疾病：细胞学机制及转化应用进展

BACKGROUND: Cilium is an antenna-like organelle that plays a vital role in all organs generation and maintenance. Ciliopathies refer to multisystem diseases caused by disorders of the cilia structure and function. OBJECTIVE: To introduce current understanding of the structure and function of the cilium, with a focus on the study progress of ciliopathies. METHODS: PubMed database was searched by computer using the keywords of “primary cilium, motion cilium, ciliopathy”. Totally 371 relevant articles published from 1959 to 2015 were retrieved. After excluding repetitive and irrelevant articles, we enrolled 32 English literatures regarding cilia structure, function and ciliopathies in accordance with the inclusion criteria. RESULTS AND CONCLUSION: Ciliopathies almost involve every system of the human body, such as the brain, eyes, liver, kidney, bone and reproductive system. Most ciliopathies are related to human developmental or degenerative diseases, which characterized by wide-ranging clinical and genetic heterogeneity, such as primary ciliary dyskinesia, ploycystic kidney disease, infertility, blindness and tumor. In view of the medical importance of the cilium, scholars have devoted to studying the underlying cellular mechanisms. These in turn have revealed that ciliopathies are not only caused by defective assembly of the cilium, but also by impaired ciliary signaling. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

微载体参与软骨损伤修复的研究进展

<正>关节软骨是一种光滑、无血管、无神经结构的粘弹性组织^[1],其覆盖骨端并参与维持关节的运动,抑制运动负荷下的关节疼痛和炎症。软骨结构的自我修复能力有限,再生能力极差,最终会导致骨性关节炎等退行性疾病^[2]。早期关节软骨损伤可选择非手术治疗,如关节内注射药物及细胞治疗,但是只能暂时缓解疼痛,并不能逆转缺损部位软骨的持续退化。     

局部浸润治疗肱骨髁上骨折闭合复位经皮克氏针固定术后疼痛的效果

目的:评估Gartland Ⅲ型儿童肱骨髁上骨折闭合复位经皮克氏针固定术后采用0. 25%左旋布比卡因局部浸润治疗术后疼痛的效果。方法:将2018年6月至2020年5月在内蒙古医科大学第二附属医院就诊的183例Gartland Ⅲ型肱骨髁上骨折患儿作为研究对象。术前排除37例可能影响术后疼痛测量的患儿,排除2例手术时间...     

延误1周以上伴骨痂生成且有移位的儿童肱骨髁上骨折的治疗研究

目的探讨延误1周以上伴骨痂生成且有移位的儿童肱骨髁上骨折的治疗策略。方法回顾性分析2011年1月至2021年1月内蒙古医科大学第二附属医院儿童骨科医学中心收治的36例延误1周以上伴骨痂生成且有移位的儿童肱骨髁上骨折的患者资料。男22例, 女14例;年龄为(6.7±2.7)岁, 范围值为2.3～12.8岁;骨折均为Gartland Ⅲ型。根据治疗方式不同将患儿分为2组:闭合复位经皮克氏针固定(CRPP)组15例(单纯采用CRPP治疗)和杠杆组21例(经肘后克氏针撬拨"杠杆技术"辅助CRPP治疗)。比较两组患儿手术时间、透视次数、复位质量和肘关节运动范围恢复时间, 末次随访时的肘关节活动度、疼痛视觉模拟评分(VAS)和Mayo肘关节功能评分(MEPS), 观察并发症发生情况。结果两组患儿术前一般资料比较差异均无统计学意义(P>0.05), 具有可比性。所有患儿术后随访(26.2±16.3)个月(范围值为6～96个月), 均获可接受的复位, 术后4～6周骨折临床愈合。杠杆组手术时间[(28.2±6.8)min]和透视次数[(27.0±6.0)次]均少于CRPP组[(40.8±10.8)...     

舒适护理在手足创伤患者中的应用体会

舒适护理是一种整体的、个体化的、创造性的、有效的护理模式。其强调通过护理人员、患者、治疗环境及社会的整体性配合,使患者在生理与心理两个方面均达到愉悦,尽可能地消除或降低患者出现各种不良情绪[1]。近年来我科对手足外伤患者实施了舒适护理并取得良好效果。现报告如下。1临床资料2012年5月至2013年5月我院收治的手足外伤患者452例,男317例、女135例,年龄6-56岁、平均33.2岁。     

外侧半月板月国肌腱裂孔区损伤的诊疗进展

<正>半月板是一种位于股骨髁和胫骨平台之间新月形纤维软骨,共同覆盖胫骨平台关节面约70%^[1]。其主要成分是水(72%)和胶原(22%)、糖胺聚糖、DNA、黏附糖蛋白和弹性蛋白等^[2]。内侧半月板呈C型,与外周关节囊相连接;外侧半月板呈O形,在月国肌腱裂孔处外侧半月板与关节囊没有连接,因此,外侧半月板比内侧半月板活动度更大,在某些情况下也更容易损伤。外侧半月板月国肌腱裂孔区因其解剖结构特殊性,损伤后愈合率较低,被视为难以修复的区域,