胫骨结节骨膜软骨瘤1例

患儿,男,６岁半,因左膝下方硬性隆起渐增大３年入院。３年前无明显诱因出现左胫骨结节部位增大,轻微压痛,不发热,活动基本不受影响,Ｘ线片示左胫骨结节骨皮质出现压迹样凹陷,近１年增长加快。入院查体：左胫骨结节明显增大隆起,形成硬性包块,表面皮肤无红肿及血...     

HD-MTX使用后推迟解救时间的毒性反应观察

目的 探讨应用ＨＤ－ＭＴＸ后推迟解救时间的安全性方法 恶性骨肿瘤患者１６例,按综合治疗方案进行术前术后化疗,其中ＭＴＸ用量按１０ｇ／ｍ＾２计算。分别于ＭＴＸ注射完毕后６ｈ、１８￣２０ｈ始给予甲酰四氢叶酸钙（ＣＦ）,观察两组解救方法的毒性反应。结果 晚解救的毒性得于早解救,但两组间只有一过性谷丙转氨酶升高差异有显著性。结论应用大剂量ＭＴＸ后,早期小剂量ＣＦ解救及较大剂量ＣＦ晚解救都是安全的,均无不可     

The results of cementless Zweymüller hip system: 5 to 11 years follow-up study

Objective To analyze the intermediate-term results associated with the use of Zweymüller hip system. Methods Review the 116 cases (142 hips) who were treated with total hip replacement from 1996 to 2002 by a single surgeon using cementless Zweymüller hip systems. Results Sixty-one cases (77 hips) were followed up, 50 cases (64 hips) were evaluated both clinically and radiographically while 5 cases (6 hips) and 6 cases (7 hips) were only evaluated clinically and radiographically respectively. The average follow-up period was 7.3 years(range 5 to 11 years). The mean preoperative Harris Hip Score was 46 while the mean postoperative Harris Hip Score was 93. Distal cortical hypertrophy and medullary sclerosis were observed in 30 hips(42.3%) and 33 hips(46.5%) respectively. Heterotopic ossification arose in 45 hips (63.4%). Radiolucent lines occured in 27 stems(38.0%) but in no cups. Radiolucent lines were mosdy observed in Gruen zones 1. Osteolysis occured in 7 cups (9.9%) and 18 stems (25.4%). Osteolysis was mostly observed in Delee Zone 3 and Green zone 7. In the distal Gruen zones 3, 4 and 5, no radiolucent line or osteolysis was observed. No hips had been revised, 3 cups needed revision surgery because of aseptic loosening. Conclusion The 5-11 years follow-up results are satisfactory, but osteolysis is common     

噬菌体呈现技术研制特异性人抗骨肉瘤干扰素

目的利用噬菌体表面呈现技术研制高活性、特异性抗骨肉瘤干扰素。方法将干扰素IFNαlc／86DDNA插入噬菌体质粒载体pCANTAB5E,并构建噬菌体IFNαlc／86DAB环突变文库;通过在OS732细胞上竞争性亲合洗脱、MTT法对比检测抗肿瘤活性,筛选针对OS732细胞的高活性噬菌体-IFN突变体。结果获得2个噬菌体-IFN突变体,其抗OS732细胞增殖活性较突变母体分别提高4和16倍。结论αl型干扰素可在噬菌体表面正确折叠表达。这一技术可用于研制高活性特异性IFN。     

几种重组干扰素单独及联用阿霉素对骨肉瘤细胞的毒性研究

目的体外评价几种国产干扰素联合阿霉素的抗骨肉瘤活性及其协同效应。方法采用MTT比色法,体外对比检测阿霉素及几种国内临床常用重组干扰素（rhIFNα2a、rhIFNα1b、rhIFNα1c、rhIFNβ和rhIFNγ）的抗骨肉瘤细胞增殖活性。分别将几种干扰素与阿霉素联合用药,对比检测其抗骨肉瘤的协同作用。结果rhIFNα2a为5×104IU/L、rhIFNα1b为3.75×105IU／L、thIFNalc为1.25×105IU／L、rhIFNβ为5×105IU／L时,细胞生长抑制率均达到50％：rhIFNγ对0S732细胞生长无明显抑制作用;rhIFNα1c与ADM合用时有明显的协同增强效应。结论rhIFNα2a、rhIFNa1b、rhIFNβ、rhIFNαlc对骨肉瘤细胞的生长有明显的抑制作用,其中以rhIFNα2a和rhIFNα1c作用最为明显;上述4种IFNs与阿霉素合用均呈协同增强效应;rhIFNγ在体外对骨肉瘤细胞无明显抑制作用。     

胸椎复发性附件滑膜肉瘤1例报告

滑膜肉瘤是恶性程度较高的软组织恶性肿瘤，源于关节、滑膜及腱鞘滑膜组织。发病部位以四肢的大关节为多，但发生于脊柱十分罕见。2006年1月收治1例T，附件滑膜肉瘤患者，报告如下。     

Modulation of transforming growth factor β to platelet-derived growth factor receptor-a of human osteoblasts

ｅｔｈｏｄｓ　Ｔｈｅｏｓｔｅｏｂｌａｓｔｓｗｅｒｅｉｓｏｌａｔｅｄｆｒｏｍｈｕｍａｎｆｅｔａｌｃａｌｖａｒｉａ .Ｔｈｅｐｅｒｃｅｎｔａｇｅｏｆｃｅｌｌｉｎｃｒｅａｓｅ(ＰＣＩ)ｉｎｅｖｅｒｙ 4ｈｏｕｒｓｗａｓｃａｌｃｕｌａｔｅｄｔｏｄｅｍｏｎｓｔｒａｔｅｔｈｅｐｒｏｌｉｆｅｒａｔｉｏｎｏｆｏｓｔｅｏｂｌａｓｔｓａｆｆｅｃｔｅｄｂｙＰＤＧＦ -ＡＡａｎｄＴＧＦβ .ＴｈｅｏｓｔｅｏｂｌａｓｔｓｗｅｒｅｃｕｌｔｕｒｅｄｗｉｔｈＴＧＦβｆｏｒ 2 4ｈｏｕｒｓａｎｄｗｉｔｈＰＤＧＦ -ＡＡｆｏｒａｎｏｔｈｅｒ 2 4…     

强直性脊柱炎髋关节骨性强直的功能重建

目的探讨强直性脊柱炎合并双侧髋关节骨性强直时的全髋关节置换方法及其注意事项。方法对17例24～52岁强直性脊柱炎患者骨性强直的34侧髋关节行Zweimüller非骨水泥型全髋关节置换手术。髋关节强直在屈曲0°～100°(平均37°),其中超过90°强直者3例6髋。术前需助行器者7例。生活不能完全自理者9例。所有患者均在一次性经口腔(10例)或鼻腔(7例)气管插管麻醉下完成双侧手术。3例患者后期行脊柱后凸畸形矫正术。结果患者髋关节活动度由术前的0°改善为术后复查时的屈伸平均77°(55°～120°),屈伸、收展、内外旋总活动度平均为150°(105°～230°)。术中有1例因股骨颈截骨造成髋臼后壁缺损,经修补后恢复。术后近期无神经血管损伤、关节脱位、感染等并发症发生,随访18～47个月无假体松动、移位。除2例3髋长时间行走有轻微疼痛外,其余患者无疼痛,患者的生活质量明显提高,1例患者仍需助行器。结论手术技术熟练者可一次顺利完成强直性脊柱炎双髋骨性强直的双侧髋关节置换术,采用Watson-Jones入路可在完成骨性强直的髋关节置换的同时完成髋关节前方的软组织松解;术中注意神经、血管的保护可顺利完成90°以上屈曲骨性强直畸形髋关节的置换;术后康复的重点是锻炼患者的肌力和肌肉活动的协调性;采用自体血回输可以     

The results of cementless Zweymüller hip system: 5 to 11 years follow-up study

Objective To analyze the intermediate-term results associated with the use of Zweymüller hip system. Methods Review the 116 cases (142 hips) who were treated with total hip replacement from 1996 to 2002 by a single surgeon using cementless Zweymüller hip systems. Results Sixty-one cases (77 hips) were followed up, 50 cases (64 hips) were evaluated both clinically and radiographically while 5 cases (6 hips) and 6 cases (7 hips) were only evaluated clinically and radiographically respectively. The average follow-up period was 7.3 years(range 5 to 11 years). The mean preoperative Harris Hip Score was 46 while the mean postoperative Harris Hip Score was 93. Distal cortical hypertrophy and medullary sclerosis were observed in 30 hips(42.3%) and 33 hips(46.5%) respectively. Heterotopic ossification arose in 45 hips (63.4%). Radiolucent lines occured in 27 stems(38.0%) but in no cups. Radiolucent lines were mosdy observed in Gruen zones 1. Osteolysis occured in 7 cups (9.9%) and 18 stems (25.4%). Osteolysis was mostly observed in Delee Zone 3 and Green zone 7. In the distal Gruen zones 3, 4 and 5, no radiolucent line or osteolysis was observed. No hips had been revised, 3 cups needed revision surgery because of aseptic loosening. Conclusion The 5-11 years follow-up results are satisfactory, but osteolysis is common     

不对称性臀肌挛缩致骨盆倾斜及双下肢不等长:1 35例治疗分析

目的探讨不对称性臀肌挛缩所致骨盆倾斜及双下肢不等长的病机、病理、临床表现及干预.方法对1992-06/1999-06南方医科大学附属南方医院收治的135例不对称性臀肌挛缩所致骨盆倾斜及双下肢不等长患者进行体检及手术治疗.结果患者年龄6～24岁,查体除有臀肌挛缩本身的体征外,尚有双下肢不等长、骨盆倾斜及脊柱腰段代偿性侧凸畸形,双侧下肢长度差距为0.5～6.2 cm,平均1.7 cm.而实际测量双侧大转子到内踝或髂前上棘到内踝的长度双侧相等.所有患者均行臀肌挛缩松解术,至术后2～4周,患者的外观畸形均基本消失,随访1年6个月～8年(平均4年8个月)畸形无复发.结论不对称性臀肌挛缩的挛缩带牵拉可造成骨盆倾斜、脊柱侧凸及双下肢不等长,挛缩不对称程度越高,畸形越严重.手术完全松解挛缩组织可解除畸形.臀肌挛缩所产生的畸形均为代偿性,治疗时不可矫正各畸形而忽略了臀肌挛缩的治疗.