丁丙诺啡透皮贴用于脊柱退变相关疼痛治疗中的临床效果分析

目的：探讨丁丙诺啡透皮贴在脊柱退变相关疼痛中的治疗作用。方法随机选择2015年1—12月该院进行脊柱退变相关疼痛治疗的患者100例,随机分为观察组和对照组各50例,对照组给予盐酸曲马多进行治疗,观察组给予丁丙诺啡透皮贴进行治疗,观察两组患者治疗前、治疗后24 h、72 h、7 d以及14 d静息状态和活动状态下疼痛变化情况以及治疗中不良反应发生情况。结果治疗后72 h、7 d、14 d,观察组在静息状态和活动状态下的VAS评分分别为(1.94±0.78)分、(2.52±0.84)分;(1.14±0.54)分、(1.85±0.77)分;(0.81±0.30)分、(1.52±0.64)分均明显低于对照组,且差异有统计学意义。两组患者不良反应发生率差异无统计学意义。结论丁丙诺啡透皮贴对于脊柱退变相关疼痛具有较好的治疗作用,且安全性高。     

硫酸钙人工骨复合培养骨髓间充质干细胞对骨诱导脊柱融合的影响

BACKGROUND: Biodegrable calcium sulfate artificial bone has a good biocompatibility, so it is used as a bone graft substitute in the treatment of spinal fusion. OBJECTIVE: To investigate the osteoinductive effects of the tissue-engineered bone made of bone marrow mesenchymal stem cells and calcium sulfate artificial bone in spinal fusion. METHODS: Bone marrow mesenchymal stem cells were cultured in vitro, and then combined with the calcium sulfate artificial bone. The composite material was observed under electron microscope. Totally 67 patients undergoing spinal fusion were enrolled, who were divided into control group (n=35) and observation group (n=32), receiving autologous iliac bone graft and autologous bone marrow mesenchymal stem cells combined with calcium sulfate transplantation, respectively. Subsequently, spinal fusion Lenke classification and low back outcome score were conducted. RESULTS AND CONCLUSION: Under electron microscope, the visible calcium sulfate artificial bone presented a good porous structure, on which bone marrow mesenchymal stem cells grew and adhered well. Slightly but insignificantly better outcomes in the spinal fusion through the use of the Lenke classification system were obtained in the observation group than the control group after surgery (P > 0.05). Besides, scores on low back outcomes in both two groups were significantly higher than baseline data (P < 0.05). These results suggest that the tissue-engineered bone made of calcium sulfate artificial bone as the scaffold and bone marrow mesenchymal stem cells as seed cells can exert a good osteoinduction in spinal fusion, and obtain ideal effects.     

人参皂苷Rg1干预小鼠巨大肩袖损伤后的肌肉退变

背景:肩袖肌退变(肌肉萎缩、纤维化和脂肪浸润)是肩袖撕裂后出现的常见问题,严重影响肩关节功能和手术预后。人参皂苷Rg1具有抗氧化、抗细胞凋亡、降血脂等生物效应,然而人参皂苷Rg1对肩袖损伤后肌肉退变的影响未见报道。目的:探讨人参皂苷Rg1对巨大肩袖损伤小鼠肌肉退变的影响。方法:将60只C57BL/6J小鼠随机分为假手术组、模型组、人参皂苷Rg1低剂量组、人参皂苷Rg1高剂量组,每组15只。假手术组小鼠切开右肩皮肤后缝合,其余3组小鼠均行右侧肩关节肩袖损伤造模,模拟巨大肩袖撕裂手术切断冈上肌肌腱和肩胛上神经压迫。术后假手术组和模型组腹腔注射生理盐水0.5 mL;人参皂苷Rg1低、高剂量组予以腹腔注射人参皂苷Rg130,60 mg/kg,1次/d,共注射6周。末次注射后次日予以步态分析评估小鼠肢体功能,安乐死后取术侧冈上肌测量肌肉萎缩率、肌肉收缩力,肌肉组织进行油红O染色、Masson染色,RT-PCR检测萎缩、纤维化、脂肪浸润相关基因的表达。结果与结论:①与模型组相比,人参皂苷Rg1低、高剂量组爪印面积、步长显著增加(P<0.05);②与模型组相比,人参皂苷Rg1低、高剂量组肌纤维横截面积、冈上肌收缩力显著增加(P<0.05),湿肌质量减少比率、脂肪浸润面积比率、胶原纤维面积比率显著下降(P<0.05);③与模型组相比,人参皂苷Rg1低、高剂量组肌肉组织中萎缩、纤维化和脂肪浸润相关基因的表达显著下降(P<0.05);④人参皂苷Rg1低、高剂量组爪印面积、冈上肌收缩力、肌纤维横截面积无统计学差异(P>0.05),人参皂苷Rg1高剂量组其他指标均优于低剂量组(P<0.05);⑤结果说明,人参皂苷Rg1能显著减轻小鼠巨大肩袖撕裂后肩袖肌萎缩、纤维化和脂肪浸润,并有利于肌肉力量及肢体功能的改善。     

自体髂骨植骨联合自体骨髓干细胞移植治疗骨折术后骨不连

BACKGROUND: Bone nonunion is a common complication in the orthopedic treatment, and its morbidity reached 5%-10%, which results in the long-term functional disturbance of the limbs, and even disability. Autogenous iliac crest graft has been commonly used to treat bone nonunion, but some limitations still exist. OBJECTIVE: To investigate the treatment outcomes of autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion after fracture surgery. METHODS: Clinical and follow-up data from 69 patients with bone nonunion were analyzed retrospectively. All patients were allotted to combination (n=37) and iliac (n=32) groups, followed by treated with autologous iliac crest graft combined with autologous bone marrow stem cell transplantation or  autologous crest graft, respectively. Afterwards, the hospitalization time, fracture healing time, bone mineral density and Fereadez-Esteve callus scores were detected and compared between groups. RESULTS AND CONCLUSION: The hospitalization time did not differ significantly between groups (P > 0.05). The fracture healing time in the combination group was significantly shortened compared with the iliac group (P < 0.05). The bone mineral density and Fereadez-Esteve callus scores in the combination group were significantly higher than those in the iliac group at 3 and 6 months after surgery (P < 0.05). The excellent and good rate of the affected limb function in the combination group was significantly higher than that in the iliac group (P < 0.05). These results suggest that autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion can accelerate fracture healing, promote porosis and improve the functional recovery of affected limbs. 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     

多维度胫骨结节参数预测髌骨不稳的临床价值研究

目的 本研究旨在通过测量多维度胫骨结节(TT)参数,评估多项TT参数在预测患者髌骨不稳的诊断效能。方法 选择2020年1月—2023年1月在宁波市杭州湾医院骨科门诊接受膝关节CT并确诊为髌骨不稳的患者为观察组,同时随机选取同期接受膝关节CT但排除髌骨不稳的患者作为对照组,各45例。统计患者资料并通过logistic回归及ROC曲线分析各项TT参数的临床诊断效能。结果 共纳入符合标准的患者90例,其中男性33例,女性57例。2组性别比较差异无统计学意义,观察组年龄相对较轻,差异有统计学意义(P<0.001)。Logistic回归分析显示,TT-TG、TT-RA、TT-TG/PL、TT-TG/PTL相关TT参数是预测髌骨不稳的有效指标。同时ROC曲线分析表明各项TT参数的诊断效能,其中TT-TG/PL的AUC值为0.826,TT-TG的AUC为0.816,TT-RA的AUC为0.761,TT-TG/PTL的AUC为0.769。结论 多维度TT参数如TT-TG、TT-RA、TT-TG/PL、TT-TG/PTL,在预测髌骨不稳方面具有良好的临床应用价值。鉴于单一量化指标可能无法全面评估髌...