脊柱骨母细胞瘤的临床研究进展

脊柱是骨母细胞瘤最常见的发病部位,主要侵及脊柱的附件结构,单发椎体少见。在组织学上该肿瘤并无恶性表现,但临床上常表现出很明显的侵袭性,甚至有恶变的可能。大多数患者存在疼痛症状,肿瘤侵犯压迫脊髓时会产生不同程度的神经损害。手术治疗是脊柱骨母细胞瘤最重要的治疗措施,肿瘤一经发现均应尽快手术切除,手术术式的选择应根据Enneking system分期,切除不彻底容易复发。目前放化疗在脊柱骨母细胞瘤的应用还存在争议,不建议作为骨母细胞瘤的常规治疗手段。     

亚油酸乙酯抑制钛颗粒诱导的炎症反应及其作用机制

BACKGROUND: Ethyl linoleate has been proved to attenuate the inflammatory-cytokines release induced by lipopolysaccharide, but whether it can inhibit titanium-induced osteolysis and the underlying mechanism remain unclear. OBJECTIVE: To observe the effect of ethyl linoleate on the expression of inflammatory-related factors induced by titanium particles and explore its mechanism. METHODS: Forty-eight Kunming mice were randomly divided into blank control, titanium, dimethylsulfoxide (DMSO) and experimental groups. The back air pouch Inflammatory models were established in the mice of the titanium, DMSO and experimental groups, in which the 200 µL menstruum of DMSO (0.5%) and 200 µL ethyl linoleate (0.5%) were respectively administered into the pouch of the mice at 12 hours. Mice in the blank control group received no intervention. Fourteen days later, the inflammatory cell infiltration in the skin was examined through hematoxylin-eosin staining; the expression levels of inhibitor κB-α, nuclear factor-κB, inducible nitric oxide synthase, cyclooxygenase-2, tumor necrosis factor-α and interleukin-6 as well as ERK, p-ERK, JNK, p-JNK, p38 and p-p38 in MAPK signaling pathways were evaluated by western blot assay. RESULTS AND CONCLUSION: In the titanium group and DMSO group, there were numerous inflammatory cells and vacuole-like necrotic tissues in the hair follicle lacuna of dermis and loose connective tissues of hypodermis. The experiment group showed significant reduction in inflammatory cell infiltration and vacuole-like necrosis. Compared with the blank control group, the expression levels of inducible nitric oxide synthase, cyclooxygenase-2, nuclear factor-κB, tumor necrosis factor-α, interleukin-6, ERK, JNK and p38 in the DMSO and titanium groups were significantly increased, while inhibitor κB-α significantly decreased (P < 0.05). Compared with the DMSO and titanium groups, there were significantly down-regulated levels of inducible nitric oxide synthase, cyclooxygenase-2, nuclear factor-κB, tumor necrosis factor-α, interleukin-6, ERK, JNK and p38, and up-regulated inhibitor κB-α level in the experimental group (P < 0.05). In conclusion, ethyl linoleate can remarkably suppress the expressions of titanium-induced inflammatory factors associated with the inhibition of nuclear factor-κB and MAPK signaling pathway activation.     

颈前路减压零切迹颈椎融合器融合术的舒适护理

[目的]探讨颈前路减压零切迹颈椎融合器(ROI-C)融合术的舒适护理。[方法]选择行ROI-C融合术病人25例,回顾病人的舒适护理经验,并采用日本矫形外科学会(JOA)制定的17分评分标准及视觉疼痛模拟评分(VAS)法对病人术后神经功能改善情况和疼痛缓解程度进行比较。[结果]干预后所有病人JOA及VAS评分均较术前有明显改善,差异有统计学意义(P0.05)。[结论]ROI-C融合术配合科学合理的舒适护理方法能够有效提高病人的临床治疗效果,减少术后并发症,保证病人舒适渡过围术期,促进疾病康复。