Editorial Commentary: Stabilize the Patella to Achieve Functional Gain but Don’t Neglect the Cartilage That May Cause Long-Term Pain! Trochlear Dysplasia Plays a Role in Both

While trochlear dysplasia is commonly discussed as a major risk factor for recurrent patellar instability, it also has a strong relationship with the development of patellofemoral cartilage lesions. Patellofemoral instability frequently occurs in teens and young adults, and the high prevalence of associated cartilage damage unfortunately sets patients up for the progression of degenerative changes of the patellofemoral joint at an early age. The judicious use of magnetic resonance imaging can help identify the presence of chondral lesions, allowing for urgent management of associated osteochondral fractures or open discussions and patient education about the possibility of performing a cartilage restoration procedure concurrently with patellar stabilization surgery. The location and presence of patellofemoral chondral lesions should be considered when contemplating the concurrent use of tibial tubercle osteotomy as part of the patellar stabilization procedure.     

肌骨共病视阈下肌骨共减综合症的生物学机制探究

肌少症和骨质疏松症为常见的衰老性疾病,肌骨共病为肌骨共减综合症提供新的研究基础。肌肉分泌IGF-1、MSTN、OG、OCN、FAM5C、Irisin、FGF-2、IL-6、IL-7、IL-15和MMP-2调节肌骨共减综合症视阈下骨骼质量;骨骼分泌IGF-1、SOST、VEGF、OCN、MGF和HGF调节肌骨共减综合症视阈下肌肉质量。本文将通过探析和梳理肌少症、骨质疏松症的流行病学和生理功能特点,为共病视阈下肌骨共减综合症提供新的导向。     

夹闭大鼠双侧颈总动脉对胃运动的影响

采用动脉夹夹闭大鼠双侧颈总动脉,胃内放置水囊记录胃运动的方法,观察了脑供血不足对胃运动的影响。结果表明:(1)夹闭30 min过程中,最初2 min内的胃运动指标(收缩频率、总收缩时程、总收缩幅度、胃运动指数)较夹闭前2 min内抑制显著;夹闭第28~30 min(即松开动脉夹前2 min内)的胃运动各项指标较夹闭前2 min均无显著差异。(2)松开动脉夹30 min过程中,松开后最初2 min内与松开前2 min内相比,胃运动抑制显著;但松开后第28~30 min的胃运动与松开前2 min内的胃运动相比,无显著差异。这些结果说明:夹闭双侧颈总动脉造成脑局部供血不足初期,对胃运动有抑制作用,但随着结扎时间的延长,这种抑制作用逐渐消除,可能是椎-基底动脉环起了代偿作用。     

正常体重者与超重、肥胖患者体内C反应蛋白水平的观察研究

目的研究C反应蛋白与肥胖的关系。方法本文通过测量试验组(肥胖)与对照组(正常体重)的各项人体参数和C反应蛋白(CRP)浓度然后进行分析。结果C反应蛋白与体重指数、总胆固醇、TG正相关,与HDL-C、LDL-C等指数关系不明显。结论C反应蛋白与中心性肥胖关系密切,与肥胖具有相关性。     

羞怯对网络交往的影响:自我意识的中介作用

目的:考察自我意识在大学生羞怯与网络交往关系中的中介作用。方法:采用大学生羞怯量表、自我意识量表和大学生网络交往问卷对781名大学生进行考察。结果:1羞怯与自我意识、网络交往总分显著正相关(r=0.483,0.260;P0.01);自我意识与网络交往总分显著正相关(r=0.261,P0.01);2羞怯通过自我意识的完全中介效应(△χ~2=5.43,△df=1,△χ~2/△df=5.436.63)对大学生网络交往产生影响,羞怯对大学生网络交往没有直接效应。结论:自我意识在大学生羞怯与网络交往关系中起到中介作用。     

Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures

BackgroundFew reports on external fixation to treat displaced midshaft clavicular fractures exist. We sought to compare the clinical effects of external fixation, plate fixation, and nonoperative treatment for treating displaced midshaft clavicular fractures in adults.Material and methodsEighty-nine patients with a displaced midshaft fracture of the clavicle were selected (according to inclusion criteria) for a retrospective analysis and assigned to either operative treatment with external fixation (29 patients), plate fixation (30 patients) or nonoperative treatment with a sling (30 patients). The average follow-up period is 32 months. Outcome analysis included: Constant shoulder score (CSS); disabilities of the arm, shoulder and hand score (DASH); nonunion rate; satisfaction of shoulder appearance.ResultsEighty-five cases were successfully followed up. No significant difference was observed between external fixation and plate fixation (p > 0.05 and p = 0.132, respectively). The operative groups achieved better effects (p < 0.001) compared to the nonoperative treatment. The healing time of the three groups were: 10.4 ± 2.3 weeks for external fixation; 12.1 ± 2.5 weeks for plate fixation; and 15.7 ± 2.2 weeks for nonoperative treatment. In the follow-up, patients in the external fixation group (96%) and plate fixation group (93%) were more likely to be satisfied with the appearance of the shoulder than were those in the nonoperative group (77%).ConclusionThe external fixation and plate fixation are overall better than the nonoperative treatment. As to choose between the two, it depends on the local soft tissue condition, surgeon's techniques, communication between doctor and patients and so on.