中药接骨丸促进肾虚骨折愈合的生物化学研究

目的 研究中药接骨丸对肾虚骨折愈合的治疗作用。方法 ２４只种兔造成桡骨中段０．７ｃｍ缺损并分成三组,对照组和用药组用强的松造成家兔肾虚模型,空白组不用激素。用药组口服中药接骨丸,另两组自然饮食,术后第３、６周取材,观察中药接骨丸对肾虚模型动物骨折修复的影响。结果 对照组动物骨痂修复指标均抵于空白组和用药组,中药接骨丸有拮抗强的松、抑制骨折修复的作用,表现在实验组动物的修复骨痂的骨矿含量、骨密度、骨     

中医治疗骨折的方剂研究

选择恰当的方剂是中医治疗骨折的一个重要方面。本文仅将治疗骨折常用的并有代表性的方剂介绍如下。1　治疗骨折常用的主要代表性方剂作用于骨,促使骨痂形成快、骨代谢旺盛、骨质加快生长的主要代表方剂有:七厘散、接骨丹、续骨活血汤、和营续骨汤、飞龙夺命丹、紫金丹、?..     

苯妥英促进骨折愈合的临床观察

目的　观察苯妥英对骨折愈合的促进作用。方法　选择40 例胫腓骨闭合性骨折患者,随机分为两组,治疗组用苯妥英和接骨丹口服,对照组仅用接骨丹口服。术后分期观察一般情况,纵向叩击痛,骨折临床愈合时间,X线片骨痂生长情况。结果　全部患者骨折均在伤后3个月内愈合,但治疗组纵向叩击痛、临床愈合时间及X线片骨痂生长均明显优于对照组。结论　口服苯妥英有明显的促进骨折愈合的作用。由于中成药接骨丹含有钙成分,避免了单用苯妥英使血钙降低的可能性     

无名异冲剂在骨折愈合中对DNA和BMP含量影响的实验研究

目的探讨无名异冲剂治疗骨折的作用机理。方法新西兰家兔５５只造成双侧桡骨３ｍｍ缺损的骨折后随机分为用药组和对照组,于术后１、２、３、４、５周取骨痂制成石蜡切片,以Ｆｅｕｌｇｅｎ反应和免疫组化技术分别显示ＤＮＡ和ＢＭＰ,进行图像定量分析。结果在骨折愈合过程中,骨痂中骨折修复细胞ＤＮＡ指数和骨痂局部ＢＭＰ含量的总体变化趋势两组相同;用药组第１、２周骨痂ＤＮＡ指数和ＢＭＰ含量明显高于同期的对照组（Ｐ＜００１）;用药组ＢＭＰ高峰出现在第２周,对照组出现在第３周。结论无名剂冲剂能促进骨折修复细胞的增殖,增加成骨细胞的活性,诱导ＢＭＰ合成,加速骨折愈合。     

接骨续筋丸影响骨折愈合过程的临床研究

目的:观察接骨续筋丸治疗骨折后骨痂质量及血清碱性磷酸酶(ALP)、血清生长激素(GH)的变化,探讨接骨续筋丸对骨痂改造塑形期的影响。方法:将68例入选病例(男41例,女27例;年龄28~64岁)按随机数字表分为治疗组35例和对照组33例。对治疗组采用接骨续筋丸治疗,对照组采用依普黄酮和钙片治疗,比较两组治疗前后骨痂X线评分、骨痂BMD、血清ALP及GH的改变及两组临床疗效的差异。结果:治疗后治疗组与对照组比较,骨痂BMD、血清ALP差异有显著性意义(P<0.01),骨痂X线评分、血清GH、两组总有效率比较有统计学差异(P<0.05)。结论:接骨续筋丸对骨折后骨痂改造塑形期愈合有促进作用。     

消瘀接骨散促进骨折愈合的实验研究

目的 验证消瘀接骨散促进骨折愈合的疗效和探讨其治疗机理。方法 选用４０只健康雄性家兔,做双侧桡骨中、下１／３人工骨折模型,随机分为实验组外敷消瘀接骨散和对照组不敷药,术后７天、１４天、２２天和３２天分别处死动物,取桡骨标本Ｘ线片检查、作生物力学测试和称取骨痂干重。结果 实验组的Ｘ线平片显示骨折修复优于对照组,而且生物力学性能和骨痂干重均显著高于对照组（Ｐ〈０．０５或Ｐ〈０．０１）。结论 消瘀接骨散能缩短骨折愈合过程和提高骨折愈合质量。     

动态压应力对骨折愈合时骨痂矿化过程的影响

[目的]探讨持续动态压应力对实验性骨折愈合时骨折间隙内骨痂矿化过程的影响。[方法]新西兰兔肱骨干横断截骨，试验组以天鹅记忆接骨器内固定，对照组以4孔加压钢板内固定。分别于术后第2、3、4、8、12周时，在骨折间隙取材，并于术后1、2、3、4、8、12周时抽取血标本，经比色法测定骨痂钙、磷元素含量及血中骨特异性碱性磷酸酶的活性。[结果]试验组和对照组骨折间隙内骨痂钙、磷元素的含量均逐渐升高；血中骨特异性碱性磷酸酶的活性分别于术后4、8周升至峰值，随后缓慢下降。术后3～4周时试验组以上指标均明显高于对照组。[结论]天鹅记忆接骨器产生的持续动态压应力可能促进了骨痂的矿化和软骨内成骨。     

高压氧对小鼠胫骨骨折愈合过程中骨生物力学特性及胶原蛋白含量的影响

目的 探讨高压氧对小鼠胫骨骨折愈合过程中骨生物力学特性及胶原蛋白含量的影响.方法 采用简单随机抽样法将216 只昆明小鼠随机分为对照组（108 只）和高压氧组（108 只）,建立胫骨骨折模型.高压氧组予以高压氧治疗,对照组不予高压氧治疗.分别于骨折后1、2、3、4 周取材,取材前通过行为学评分和斜板实验评价两组小鼠的行为学特征,观察取材后胫骨的一般生物学特征,检测胫骨标本的抗扭力和抗折力,测定胫骨骨痂组织的胶原蛋白含量,同时采用改良Masson 染色对骨痂组织中的胶原蛋白进行组织学观察.结果 与对照组相比,高压氧组小鼠骨折后1、2 周行为学评分降低;2、3、4 周斜板实验坡度升高（P ＜0.05）.骨折后1周高压氧组小鼠右侧胫骨宽度（骨痂处）、胫骨抗折力均大于对照组,两组比较,差异有统计学意义（P ＜0.05）;骨折后2 周高压氧组小鼠右侧胫骨抗扭力高于对照组,骨折后1、2、3 周右侧与左侧胫骨抗扭力比值以及两侧胫骨抗折力比值均高于对照组,两组比较,差异有统计学意义（P ＜0.05）;高压氧组小鼠骨折后1、2、3、4 周骨痂胶原纤维含量高于对照组（P ＜0.05）,且高压氧组改良Masson染色出现较多的蓝色反应.结论 在小鼠胫骨骨折的愈合过程中,高压氧治疗提高了骨痂组织中胶原蛋白的含量,增强了骨的生物力学性能,对骨折愈合起到促进作用.     

持续动态压应力对实验性骨折愈合的影响及相关信号转导通路研究

[目的]探讨持续动态压应力环境对实验性骨折愈合的影响及环氧化酶-2(cyclooxygenase,COX-2)、前列腺素E2(prostaglandin E2,PGE2)和环磷酸腺苷(cyclic adenosine monophosphate,cAMP)这一信号通路是否参与了该调控过程。[方法]120只新西兰兔行单侧肱骨干截骨,A、C两组以形状记忆接骨器内固定,B组以加压钢板固定,且术后C组以3 mg.kg-1.d-1的Celecoxib灌胃。术后定期在骨折间隙处取材并留取血清标本,用Real-time RT-PCR测定COX-1、COX-2基因转录水平,以放射免疫法测定PGE2、cAMP含量,观察愈合骨痂的组织学改变并检测血清中骨特异性碱性磷酸酶和骨钙素活性。[结果]各组COX-2转录水平以及PGE2、cAMP的含量均随愈合过程呈显著改变,且随内固定方式表现出明显差异。组织学和血清学结果则显示A组骨折间隙内软骨内成骨和编织骨痂的改建均领先于B组,而抑制形状记忆接骨器内固定下增高的COX-2活性后骨折愈合的组织学过程变缓,血中成骨特异性蛋白水平也明显下降。[结论]形状记忆接骨器产生的持续动态压应力环境可以促进软骨内成骨及随后的骨痂塑形,加速骨折愈合,而且该效应与COX-2、PGE2、cAMP这一信号转导通路密切相关。     

甲状旁腺激素联合降钙素对大鼠骨质疏松性骨折骨生长因子的影响

目的探讨甲状旁腺素联合降钙素对大鼠骨质疏松性骨折骨相关生长因子及骨折愈合的影响。方法75只雌性SD大鼠随机分为:假手术组、去势组、甲状旁腺素组、降钙素组、联合用药组,15只/组,首先构建去卵巢大鼠骨质疏松性骨折动物模型。观察并评估骨折愈合,测定骨痂BMD和BMC,检测血清BMP-2、VEGF、TGF-β、IGF-1水平和骨痂蛋白表达,观察骨痂形态结构变化。结果去势组较假手术组骨折愈合评分、骨痂BMD和BMC、血清BMP-2、VEGF、TGF-β、IGF-1水平和骨痂蛋白表达均显著降低(P均<0.05),而联合用药组较去势组上述指标均显著升高(P均<0.05)。去势组骨痂骨小梁明显减少,生长稀疏,排列紊乱,大量间充质干细胞及纤维软骨细胞,成骨细胞及微血管少见;联合用药组骨痂大量骨小梁,生长旺盛,互相交错网状,排列致密有序,可见较多成熟的骨细胞及成骨细胞。结论甲状旁腺素联合降钙素通过介导提高相关骨生长因子表达,提高骨质疏松性骨折骨密度和矿物含量,改善骨组织形态学,加快骨折愈合。     

家兔自体骨髓移植对骨痂中钙镁铜含量的影响

目的 探讨新骨的形成在骨髓移植术后2周尤为显著现象的机制。方法 用34只家兔剥除双侧桡骨骨膜3cm，截除剥离骨膜后的桡骨中段1cm，1小时后去除骨缺损区血肿，从股骨大转子处抽取1ml骨髓，随机注入一侧桡骨缺损区作为实侧，另一侧注入等量生理盐水作为对照侧，术后2、4、6、8周分批做放射学、组织学和骨痂中钙、镁、铜含量的检查。结果 骨髓移植有肯定的成骨效果，术后2周实验侧骨痂中镁、铜及术后4周镁含量高于对照侧（P＜0．01）。结论 铜和镁在骨髓移植促进骨缺损愈合早期可能具有重要作用，移植术后的2周内补充铜和镁有可能提高骨髓移植的成骨能力。     

Changes in basic metabolic elements associated with the degeneration and ossification of ligamenta flava

OBJECTIVE: To determine the association between levels of basic metabolic elements and degeneration and ossification of the ligamentum flavum (LF). SUBJECTS: Fourteen consecutive patients with degenerative lumbar stenosis, 11 with ossification of the thoracic ligamenta flava, and 11 control subjects. METHODS: The basic elements of calcium (Ca), phosphorus (P), magnesium (Mg), zinc (Zn), copper (Cu), manganese (Mn), molybdenum (Mo), and fluoride (F) in the specimens were measured using atomic absorption spectrometry, the phosphomolybdic blue method, and a fluoride-selected electrode. RESULTS: Ca content and the ratio of Ca/Mg in the LF specimens increased significantly in the sequence of control, degeneration, and ossification groups. Compared with values for the control group, the Zn, Mn, and Mo contents in the ossification and degeneration groups were significantly lower (P < 0.01); in contrast, Cu content was significantly higher (P < 0.01). As to F, its content in the specimens of the ossification group was much higher than those in the degeneration and control groups (P < 0.01); the F content in the ligamenta flava and sera from patients with fluorosis was also significantly higher than in those from patients without fluorosis (P < 0.01). Compared with the control group, there were no differences in the F content in serum from patients without fluorosis; however, the F content in ligamenta flava specimens from patients without fluorosis was significantly higher (P < 0.01). CONCLUSIONS: There are trends in the contents of basic metabolic elements in the degeneration and ossification of ligamenta flava. These basic metabolic elements may play an important role in this process.     

不同烧伤面积血清、尿、水泡液中Zn、Cu、Fe、Ca、Mg的动态比较

为探讨烧协病人伤后血清、尿和水泡液中 Zn、Cu、Fe、Ca、Mg 的含量,观察了106例烧伤病人(L 组烧伤≥30%,TBSA,57例;S 组烧伤<30%TBSA,49例)伤后1,2,3,7,14,21,28天血清、尿和水泡液中 Zn、Cu、Fe、Ca、Mg 的动态变化。发现除血清 Fe 第1天高于正常值外,其它各元素都减低,L 组比 S 组减低明显。尿 Zn、Cu、Fe 排出明显增多,尿 Ca、Mg 排出减少。水泡液 Zn、Fe、Ca 与血清正常值近似,Cu、Mg 略低于血清正常值。说明烧伤后血 Zn、Cu、Fe、Ca、Mg 的降低与从尿液及创面丢失有关。     

不同烧伤面积血清,尿,水泡液中Zn,Cu,Fe,Ca,Mg的动态…

对探讨烧伤病人伤后血清，尿和水泡液中Ｚｎ，Ｃｕ，Ｆｅ，Ｃａ，Ｍｇ的含量，观察了１０６例烧伤病人（Ｌ组烧伤≥３０％，ＴＢＳＡ，５７例，Ｓ组烧伤〈３０％ＴＢＳＡ，４９例）伤后１，２，３，７，１４，２１，２８天血清，尿和水泡液中Ｚｎ，Ｃｕ，Ｆｅ，Ｃａ，Ｍｇ的动态变化，发现除血清Ｆｅ第１天高于正常值外，其它各元素都减低，Ｌ组比Ｓ组减低明显，尿Ｚｎ，Ｃｕ，Ｆｅ排出明显增多，尿Ｃａ，Ｍｇ排出减少，水泡液Ｚｎ，     

胃癌周围淋巴结微量元素变化的研究

目的 研究胃癌组织和癌旁淋巴结微量元素的变化及与胃癌淋巴结转移的关系。方法对40例胃癌患者的胃癌组织、癌转移及无癌转移淋巴结组织进行铁（Fe）、镁（Mg）、锰（Mn）、钙（Ca）、铜（Cu）、锌（Zn）、硒（Se）7种微量元素的测定并进行分析比较。结果胃癌组织、癌转移与无癌转移淋巴结组织中Fe、Mg、Mn、Ca含量比较，差异无统计学意义（P=0．372-0．741，均P〉0．0S）；胃癌组织与癌转移淋巴结的7种微量元素相比，差异无统计学意义（P=0．15—0．59，均P〉0．0S）；癌转移淋巴结与无癌转移淋巴结的微量元素比较，Zn、Se明显下降，Cu及Cu／Zn上升，差异有统计学意义（P=0．001-0．009，均P〈0．01）；癌转移淋巴结中N2站的Zn含量低于N1站Zn，差异有统计学意义（P=0．027）；肠型胃癌中癌转移淋巴结7种微量元素与弥漫型胃癌中癌转移淋巴结比较，差异均无统计学意义（P=0．149-0．758，均P〉0．05）。结论胃癌淋巴结转移过程中伴有体内微量元素的变化；Zn、Cu、Se含量的变化可能与胃癌淋巴结转移机制有关。     

Determination of multiple chemical elements in CSF in Parkinson disease after intracerebral autotransplantation of the adrenal medulla]

The contents of indispensable major elements sodium (Na), phosphorus (P), calcium (Ca), magnesium (Mg), trace elements iron (Fe), copper (Cu), nickel (Ni), zinc (Zn), strontium (Sr), vanadium (V), chromium (Cr), manganese (Mn), molybdenum (Mo), and other elements lead (Pb), silicon (Si), aluminium (Al), titanium (Ti), barium (Ba), lanthanum (La), cadmium (Yb), cerium (Ce), scandium (Sc), silver (Ag), in cerebrospinal fluid (CSF) were measured in 13 patients suffering from Parkinson disease before and after autotransplantation of adrenal medulla. It was found that while the patients' objective symptoms were relieved and the contents of monoamine transmitters were changed, the contents of P, V, Co, Cr, in CSF increased significantly (P less than 0.05 or 0.01) at the first, 2nd, 4th, 6th, and 8th week, the contents of Mn in CSF also increased significantly at the first 4th week (P less than 0.05) but decreased significantly at the 8th week the contents of Zn in CSF increased significantly (P less than 0.05) at the 2nd week; Mo increased significantly (P less than 0.05 or 0.01) at the 4th and 8th week B increased significantly (P less than 0.05) at the first week; the contents of Ca, Na, Sr, Ba, Al, Ti, La, Ce, Yb, Sc, Ag in CSF increased significantly (P less than 0.05 or 0.01) at the 8th week, Mg, Fe, Cu Ni, Pb, Si, Cd remained unchanged after operation. The results suggest that the contents of these chemical elements can be affected by this kind of operation, indicating that these elements are involved in the pathogenesis of Parkinsonism.     

不同烧伤面积血清、尿、水泡液中Zn、Cu、Fe、Ca、Mg的动态比较

为探讨烧伤病人伤后血清、尿和水泡液中Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的含量，观察了１０６例烧伤病人（Ｌ组烧伤≥３０％ＴＢＳＡ，５７例；Ｓ组烧伤＜３０％ＴＢＳＡ，４９例）伤后１，２，３，７，１４，２１，２８天血清、尿和水泡液中Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的动态变化。发现除血清Ｆｅ第１天高于正常值外，其它各元素都减低，Ｌ组比Ｓ组减低明显。尿Ｚｎ、Ｃｕ、Ｆｅ排出明显增多，尿Ｃａ、Ｍｇ排出减少。水泡液Ｚｎ、Ｆｅ、Ｃａ与血清正常值近似，Ｃｕ、Ｍｇ略低于血清正常值。说明烧伤后血Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的降低与从尿液及创面丢失有关。     

Changes in Basic Metabolic Elements Associated With the Degeneration and Ossification of Ligamenta Flava

Abstract

Objective: To determine the association between levels of basic metabolic elements and degeneration and ossification of the ligamentum flavum (LF).

Subjects: Fourteen consecutive patients with degenerative lumbar stenosis, 11 with ossification of the thoracic ligamenta flava, and 11 control subjects.

Methods: The basic elements of calcium (Ca), phosphorus (P), magnesium (Mg), zinc (Zn), copper (Cu), manganese (Mn), molybdenum (Mo), and fluoride (F) in the specimens were measured using atomic absorption spectrometry, the phosphomolybdic blue method, and a fluoride-selected electrode.

Results: Ca content and the ratio of Ca/Mg in the LF specimens increased significantly in the sequence of control, degeneration, and ossification groups. Compared with values for the control group, the Zn, Mn, and Mo contents in the ossification and degeneration groups were significantly lower (P < 0.01 ); in contrast, Cu content was significantly higher (P < 0.01 ). As to F, its content in the specimens of the ossification group was much higher than those in the degeneration and control groups (P < 0.01); the F content in the ligamenta flava and sera from patients with fluorosis was also significantly higher than in those from patients without fluorosis (P < 0.01). Compared with the control group, there were no differences in the F content in serum from patients without fluorosis; however, the F content in ligamenta flava specimens from patients without fluorosis was significantly higher (P < 0.01).

Conclusions: There are trends in the contents of basic metabolic elements in the degeneration and ossification of ligamenta flava. These basic metabolic elements may play an important role in this process.     

骨质疏松症大鼠骨组织中微量元素含量的变化

目的探讨骨质疏松症与骨组织中微量元素含量的变化关系。方法用切除双侧卵巢制作大鼠骨质疏松症动物模型，用ICP电偶合等离子体发射光谱法测定实验组和对照组相关元素含量。结果实验组大鼠骨组织中的锌、锰、铜、铁的含量明显低于对照组锌、锰、铜、铁的含量。结论骨组织中锌、锰、铜、铁的含量明显减少是导致骨质疏松症发生的病因之一。     

Determination of callus quantity in 4-week-old fractures of the rat tibia

In clinical practice the quantity of fracture callus is usually estimated on the basis of radiographs. In experimental studies on fracture healing, more exact chemical measurements (total protein, DNA, and mineral contents) have been used to quantitate the amount of callus. It is not known, however, how these two parameters correlate with each other. In this study we used different (radiographic, histomorphometric, and chemical) methods to evaluate the quantity of fracture callus in 4-week-old tibial fractures of rats stabilized by intramedullary nailing. The wet and dry weights and the nitrogen, collagen, calcium, phosphorus, and DNA contents of the calluses showed no correlation with the radiographic size of the calluses. There was a strong correlation (p less than 0.001), however, between radiographic and histomorphometric callus sizes. The mass of callus and the chemically defined parameters of callus production thus indicate different properties of the healing bone.