Genetic polymorphisms of interleukin-1β (?511C/T) and interleukin-1 receptor antagonist (86-bpVNTR) in susceptibility to knee osteoarthritis in a Chinese Han population

Osteoarthritis (OA) is a multifactorial disorder in which genetic factors act as important contributors to its onset and progression. Associations between genetic polymorphisms of the interleukin-1 (IL-1) gene cluster and OA susceptibility have been studied continuously in different ethnic groups, yielding controversial results. This study investigated the association of interleukin-1β (−511C/T) and interleukin-1 receptor antagonist (86-bp VNTR) polymorphisms with knee OA susceptibility in a Chinese Han population. A case–control association study was conducted. The two polymorphisms were genotyped in 453 patients who had primary symptomatic knee OA with radiographic confirmation and in 487 matched controls. Allelic and genotypic frequencies and haplotype distribution were compared between OA and control subjects. For either of the two loci, no significant difference was detected in genotype or allele distribution between knee OA and control groups (all P > 0.05). The haplotype distribution of the two loci showed no difference between the two groups, either. Furthermore, no association between the genotype of the −511 and VNTR polymorphisms and the clinical variables, age, sex, body mass index and Kellgren/Lawrence score was observed in OA patients. The genetic polymorphisms of interleukin-1β and interleukin-1 receptor antagonist are not risk factors for OA etiology in Han Chinese. H. Ni and D. Shi contributed equally to this work.     

单钉固定股骨颈骨折的应力分析

本文对单钉同定股骨颈骨折的模型进行应力计算,考虑中空钉和股骨之间的接触以及摩擦作用,分析了不同摩擦系数的影响.有限元计算结果表明:摩擦系数对计算结果有一定的影响,采用不同的摩擦系数,计算结果最大相差7.16%;中空钉和股骨之间按接触计算,计算的结果更精确;如果是进行定性的分析,为了节省计算时间,可以用节点位移耦合代替接触,二者计算结果最大相差8.58%.     

血管内皮祖细胞研究进展

血管内皮祖细胞(EPC)是血管内皮细胞的前体细胞,主要来源于脐静脉血、成人外周血和骨髓,不仅参与胚胎血管形成,而且在出生后的血管生成过程中有很强的促进作用.EPC在血管损伤修复中起重要作用,为缺血性疾病的治疗提供了值得探索的新途径.以下就EPC在缺血心肌、缺血肢体、损伤角膜修复中的血管生成作用作一综述.     

髋部骨折患者的肌少症相关危险因素分析

目的:探讨肌少症在髋部骨折患者中的发生率及相关风险因素。方法:自2013年5月至2017年1月收治髋部骨折患者187例,男99例,女88例;年龄50～95(77.40±10.58)岁。观察分析患者的一般情况、四肢骨骼肌质量指数(ASMI)、脂肪总量、骨矿含量(BMC)、身体质量指数(BMI),握力、术前血维生素D、血白蛋白、美国麻醉医师协会分级评分(ASA)及NMS运动评分。根据握力和ASMI,将患者并分为肌少症组与非肌少症组,采用单因素及多因素分析统计分析。结果:符合肌少症诊断的患者99例(52.9%),与非肌少症组相比,肌少症的发生与高龄、高ASA、低脂肪总量、低骨矿含量、低BMI,低白蛋白、低NMS评分相关,随后进行的二元Logistic回归分析提示高龄(OR=1.804,P=0.048),高ASA评分(OR=3.052,P=0.001),低脂肪总量(OR=0.843,P=0.006),低骨矿含量(OR=0.203,P=0.026)是髋部骨折患者肌少症发生的相关因素。结论:高龄、高ASA评分、低脂肪总量、低骨矿含量可能是髋部骨折患者肌少症的相关危险因素     

颈椎生理弯曲的弧度法测量及临床意义

目的 :为临床颈椎功能评定建立参考指标并为颈椎椎体间融合器的研制和应用提供依据。方法 :采用计算机图像处理技术 ,对 3 78例正常人体颈椎中间位侧位片弦、弧长度进行测量 ,通过二元一次方程求解计算出正常颈椎生理曲度。结果 :男女颈椎生理曲度平均值为 ( 3 4.5 7± 5 .2 6)° ,95 %的正常值范围为 2 4.2 7°～ 44 .88° ,男女组之间无统计学差别 (P >0 .0 5 )。低年龄组 ( 11～ 3 0岁 )颈曲较大 ,随年龄增长颈曲减小 ;3 1～ 60岁之间男女颈曲呈波动变化 ;高龄组 ( 60岁以上 )颈曲随年龄的增加又有增大趋势。结论 :人体生理颈曲与年龄存在相关性 ,但非线性相关 ;颈曲的变化是颈椎基础力学失衡的结果 ,维持和恢复颈椎生理曲度对预防和治疗颈椎疾患有积极作用     

无脊髓损伤的陈旧性下颈椎骨折脱位的外科治疗

目的：探讨无脊髓损伤的陈旧性下颈椎骨折脱位的手术治疗方法。方法：对9例无脊髓损伤的陈旧性下颈椎骨折或者骨折脱位患者,采用经前路伤椎椎体次全切除减压、复位、自体髂骨植骨融合及Orion^TM钢板固定或采用一期前后路联合手术切开复位,椎间融合加Orion^TM钢板固定融合的方法进行手术治疗。结果：术后全部病例经随访观察,症状获得改善,7例完全恢复,2例残留手指麻木。术后6个月全部返回工作岗位。颈椎椎间高度、生理曲度维持良好,无内固定失败等并发症。结论：对于无脊髓损伤的陈旧性下颈椎骨折脱位宜采用一期前后路联合手术切开复位、椎间融合加钢板内固定的方法,最大限度保留活动节段,恢复颈椎椎间高度和生理曲度,重建颈椎即刻稳定性;对于无脱位的骨折宜采用单纯前路手术,除可达到减压、复位、恢复椎间高度和生理曲度外,更重要的是可重建颈椎即刻稳定性,对防止继发性脊髓损伤有极其重要的作用。     

CPM及透明质酸钠在髌骨骨折治疗中的临床价值

目的：探讨CPM及透明质酸钠在髌骨骨折治疗中的临床应用价值。方法：对62例髌骨骨折患者术中、术后使用透明质酸钠并应用CPM康复机进行功能锻炼,观察其疗效。结果：所有患者切口均一期愈合,术后反应轻,关节活动好。临床疗效优良率为98．4％。结论：CPM及透明质酸钠关节内注射能够减轻术后疼痛,促进软骨修复,改善关节功能,防止创伤性骨炎的发生。     

Preliminary study of 3T 1H MR spectroscopy in bone and soft tissue tumors

Background Magnetic resonance spectroscopy （MRS） is one method that can examine noninvasively the alive specimen of the organ, metabolism of the organ and cell, and the biochemistry change. MRS provides the biochemistry information that may be used to diagnose tumors or differentiate the malignant tumor from benign. The objective of this study is to investigate the benign and malignant bone and soft tissue tumors by 1H-MR spectroscopy （^1H-MRS） on a 3 Tesla MR scanner, then to assess the usefulness of ^1H-MRS in diagnosing bone and soft tissue tumors and distinguishing benign from malignant tumors.
Methods Fifty-six patients with bone and soft tissue tumors proved clinically and pathologically were examined with ^1H-MRS. ^1H-MRS was performed to study malignant musculoskeletal tumors, benign tumors and normal muscle adjacent to lesions to analyze the characteristics, and single-voxel point-resolved spectroscopy sequence was used. Proton brain exam-single voxel of ^1H-MRS which directly appeared in the spectrum, was observed to find the peak height of choline compounds （Cho） opposite to the creatine （Cr）, and whether there was a Cho peak. Metabolite values were calculated automatically from the area under each metabolite peak by the Functool 3.1 software. Metabolite ratios of Cho/Cr were manually calculated. Then according to the results, it was judged whether there existed benign or malignant tumors. The Kappa statistical test was used to analyze the MRS results, the histopathology data and the surgical situation. Statistics processing was performed using the software packaqe SPSS11.5 for Windows.
Results ^1H-MRS spectra style of bone and soft tissue tumors was different from that of normal muscle, and differences also existed between benign and malignant tumors. Choline level in malignant tumor was markedly higher than that in benign tumors. Cho/Cr in malignant tumor was higher than in benign tumor significantly （P〈0.05）. The true positive rate of bone and soft tissue between benign and malignant tumors was 34/36, the true negative rate was 15/18, the false positive rate was 3/18 and the false negative rate was 2/36. Therefore in the group, sensitivity of the ^1H-MRS was 94% （34/36）, specificity was 83% （15/18）, positive predictive value was 92% （34/37）, negative predictive value was 88% （15/17） and the accuracy rate was 91% （49/54）. The MRS results and the histopathology inspection conclusions had very good uniformity. The K value was 0.76±0.10 （P 〈0.01）.
Conclusions The increase of Cho level measured by ^1H-MRS is related to the bone and soft tissue malignant tumor. Cho/Cr in malignant tumor was higher than in benign tumor, so they will play a vital role in the diagnosis and differential diagnosis of bone and soft tissue tumors.     

全髋关节置换术治疗强直性脊柱炎髋关节病变

目的探讨全髋关节置换术治疗强直性脊柱炎髋关节病变的效果。方法对20例(27髋)强直性脊柱炎髋关节病变患者行人工全髋关节置换手术。置换前患者日常活动均明显受限,其中需要使用助行器7例,生活完全不能自理4例,8例(11髋)关节强直。比较手术前后髋关节Harris评分和关节活动度及术后并发症。1例患者后期行脊柱后凸矫形术。结果全部病例获得随访,平均随访时间4.2年(1.2~7.8年)。最后一次随访,23髋(85.2%)疼痛完全消失;仅有1例仍需双拐辅助行走,其余患者均可不扶拐行走,步态正常。术前Harris评分平均14.9分,髋关节活动度平均40°。术后Harris评分平均82.9分,其中优8髋,良10髋,可7髋,差2髋,优良率74.1%;髋关节活动度平均190.5°;髋关节Harris评分及关节活动度均显著高于置换前(P0.05)。4髋(7.4%)出现异位骨化,分别为Brooker分级Ⅰ、Ⅱ级。假体无菌性松动1例。结论全髋关节置换术是治疗强直性脊柱炎髋关节病变的有效手段,可以缓解关节疼痛,恢复关节功能,改善患者生活质量。     

Roseomonas Spinal Epidural Abscess Complicating Instrumented Posterior Lumbar Interbody Fusion

The first case of a spinal epidural abscess caused by Roseomonas mucosa following instrumented posterior lumbar fusion is presented. Although rare, because of its highly resistant profile, Roseomonas species should be included in the differential diagnosis of epidural abscesses in both immunocompromised and immunocompetent hosts.