骨盆骨折微创治疗的研究进展

骨盆骨折的手术治疗方式中,切开复位内固定为目前最常用的治疗方式,现今临床上常用微创手术对骨盆骨折进行治疗,在进行微创手术前往往需要对骨盆进行闭合复位 [1-2].临床上常通过手法复位或外支架牵引复位进行闭合复位.复位效果一般按照 Pastor 等 [3] 和 Matta [4] 的影像学复位标准对其进行评分,优:移位 ...     

下胫腓联合损伤手术治疗进展

下胫腓联合损伤常伴有踝关节骨折,亦可发生在无骨折的情况下,但病史及体格检查通常缺乏特异性,漏诊或误诊可能导致患者踝关节功能受损。下胫腓联合损伤分型方法不一,可按需运用。诊断下胫腓联合损伤的辅助检查有下胫腓联合分离试验、外旋试验、挤压试验、腓骨横移试验和影像学检查,关节镜为诊断下胫腓联合损伤时极为重要的检查方法,尤其在评估固定术后慢性踝关节疼痛方面。急性单纯下胫腓联合损伤可保守治疗,但严重下胫腓联合损伤推荐手术治疗。下胫腓联合损伤的手术方式可分为静态固定、弹性固定、下胫腓钩固定和韧带重建,这些方法各有其适应证及优缺点。该文对下胫腓联合损伤手术治疗进展作一综述。     

腓肠神经营养血管远端蒂皮瓣结合抗生素硫酸钙治疗跟骨慢性骨髓炎

背景:跟骨慢性骨髓炎是跟骨骨折术后发生的较为严重的并发症之一,其发生率日益增加,且处理较为棘手.目的:探讨应用腓肠神经营养血管远端蒂皮瓣及抗生素硫酸钙治疗跟骨慢性骨髓炎的方法和疗效.方法:回顾性研究2016年1月至2019年10月治疗的19例跟骨骨折所致跟骨慢性骨髓炎患者,男11例,女8例;年龄35～65岁,平均(45...     

间充质干细胞在器官移植中的应用研究进展

器官移植是终末期器官功能衰竭的有效治疗方法。然而, 移植受体需长期使用免疫抑制剂以降低器官移植免疫排斥反应。间充质干细胞(MSC)具有独特的免疫学特性, 有望在器官移植中发挥重要作用。本文总结了MSC的免疫学特性, 并就其在器官移植中减轻免疫排斥反应、诱导免疫耐受、促进组织修复、诱导新生血管形成以及在异种器官移植中的作用等方面的研究进展进行了简述, 以期为MSC应用于器官移植提供参考。     

单边外固定支架骨搬运治疗大段跖骨缺损

背景:大段跖骨缺损由足部创伤、感染等原因导致,其发生率日益增加,且处理较为棘手,其治疗亟待解决.目的:探讨应用单边外固定支架骨搬运治疗大段跖骨缺损的临床疗效.方法:回顾性分析2015年1月至2018年10月收治的8例大段跖骨缺损患者.均采用单边外固定支架进行跖骨骨搬运治疗,根据骨痂直径率(CDR值)及时调整牵拉速度.记...     

三维打印双相磁性纳米复合支架材料的性能测定

目的研究制备出一种新型双相磁性纳米复合支架材料(PLGA/Col-I-PLGA/n-HA/Fe_2O_3),通过各项生物学性能检测,评价并探讨其作为骨组织工程支架的可行性。方法通过低温快速成型方法制备双相磁性纳米复合支架材料(PLGA/Col-I-PLGA/n-HA/Fe_2O_3),采用电子试验机检测支架材料的抗弯,抗压,弹性模量评价其力学性能,通过电镜观察支架材料超微结构;以介质(乙醇)浸泡法测定支架材料的孔隙率,将支架材料与骨髓间充质干细胞复合共培养,检测其生物相容性。结果双相磁性纳米复合支架材料力学检测结果显示其具有良好的力学性能,电镜观察结果显示上下两层孔径均匀分布,上层软骨相孔径较小,中间连续相良好融合,孔径及孔隙率检测结果显示软骨层支架的孔径为189um,孔隙率86.5%。骨层支架的孔径为364um,孔隙率77.1%,符合双层支架材料的设计要求。双相磁性纳米复合支架材料与骨髓间充质干细胞共培养,结果显示骨髓间充质干细胞的增殖效果很好,能更好的促进分化为目的细胞,说明双相磁性纳米复合支架材料具有良好的生物相容性。结论双相磁性纳米复合支架材料(PLGA/Col-I-PLGA/n-HA/Fe_2O_3)有很好的力学性能和生物相容性,孔径及孔隙率达到细胞粘附生长的要求,与正常的关节软骨及软骨下骨生理结构更加接近,有望可以更好的修复骨关节炎或者外伤等疾病带来的软骨和软骨下骨损伤。     

非手术治疗老年肱骨外科颈骨折效果分析

目的比较手法复位与手术内固定治疗肱骨外科颈骨的效果,为今后临床治疗提供依据。方法比较两组不同治疗方式的患者治疗后的效果评价、愈合时间及并发症发生情况。结果手法复位组有效率为96.7%,手术内固定组有效率为98.2%,两组疗效的分布差异无统计学意义(P0.05);手法复位组的愈合平均为(50.1±12.9)d;手术内固定组愈合时间平均为(63.4±17.3)d,两组的愈合时间差异具有统计学意义(t=3.406,P0.01);经过治疗后随访,手法复位组并发症发生率为8.3%,手术内固定组并发症发生率为7.1%,两组患者治疗后并发症发生率的差异无统计学意义(χ2=1.003,P0.05)。结论手法复位组治疗肱骨外科颈骨折的效果优于手术内固定。     

聚乙烯醇/壳聚糖多孔水凝胶复合骨髓间充质干细胞修复膝关节软骨缺损北大核心

BACKGROUND: By mixing technology, various materials are mixed and complemented each other to enhance heat sensitivity, mechanical properties, viscoelasticity of the materials and improve their biocompatibility, biodegradability and other biomedical properties. OBJECTIVE: To prepare polyvinyl alcohol (PVA)/chitosan (CS) porous hydrogel and to observe its effects on the repair of articular cartilage defects. METHODS: PVA, CS and polysorbate-80 were used as raw materials to prepare the hydrogels at the PVA/CS ratio of 5:5, 6:4, 7:3, 8:2 and 9:1 by freezing-thawing cycle and emulsification-frost-ice phase separation, and the physical and chemical properties, mechanical properties, and biocompatibility of the hydrogels were detected to find out the best PVA/CS ratio. Eighteen New Zealand rabbits were enrolled to make models of bilateral articular cartilage defects, and then randomized into three groups: blank control group; control group; experimental group. The prepared hydrogel was compounded with rabbit bone marrow mesenchymal stem cells (BMSCs) and then implanted into the rabbit articular cartilage defect in the experimental group, the PVA/CS hydrogel was implanted in the control group, and nothing was implanted in the blank control group. After 12 weeks, the animals were killed and the repairing effect was observed by gross observation and histological examination. RESULTS AND CONCLUSION: The PVA/CS porous composite hydrogel was successfully prepared, and PVA:CS=6:4 was the best in the presence of good mechanical properties, stable physical and chemical properties, and water content ≥ 90%. In additional, scanning electron microscopy showed a porous network structure, with the porosity ≥ 90%. The results of cell counting kit-8 assay and the results of cell death and survival showed that the hydrogel was non-cytotoxic and beneficial to the cell proliferation. In the blank control group, knee articular cartilage defects were not repaired within 12 weeks after surgery, showing significant granulation tissue filling. In the control group, knee articular cartilage defects were full of cartilage-like tissues with no smooth surface, but there were a great amount of chondrocyte-like cells. In the experimental group, knee articular cartilage defects were well repaired and full of a great amount of chondrocytes with the smooth surface. To conclude, the PVA/CS porous composite hydrogel could repair articular cartilage defects as an ideal tissue-engineered cartilage material. [ABSTRACT FROM AUTHOR]