愈伤灵胶囊配合动力髋螺钉治疗股骨转子间骨折观察

目的应用愈伤灵胶囊配合动力髋螺钉(DHS)治疗股骨转子间骨折,以加速骨折愈合、减少由于手术刺激引起的并发症和潜在疾病。方法2003年3月~2007年3月,我院应用愈伤灵胶囊配合DHS治疗股骨转子间骨折103例,术后3天开始用愈伤灵胶囊并对其疗效进行随访。结果103例患者获随访1~3年(平均1.5年),无髋部疼痛,无畸形,无延迟愈合,3例发生下肢深静脉血栓。愈合时间6~10周(平均7.9周),关节功能优76例,良27例,优良率达96.8%。结论愈伤灵胶囊配合DHS手术治疗转子间骨折愈合快,肢体功能恢复好,卧床时间短,并发症少,是理想的中西医结合治疗骨折的方法。     

人工骨和自体骨植骨治疗胫骨平台骨折临床比较研究

目的 比较研究人工骨和自体骨植骨治疗胫骨平台骨折的临床疗效.方法 对33例胫骨平台Ⅱ、Ⅲ型骨折行切开复位后,18例行人工骨(β-TCP)植骨钛板内固定,15例行自体骨植骨钛板内固定.随访12～24个月,根据Merchant评分评价关节功能恢复情况,根据X线表现评价胫骨平台术后塌陷情况.结果 两组术后关节功能恢复按Merchant评分无显著性差异(P＞0.05).胫骨平台术后再塌陷＞2 mm的患者自体骨组有13例,占本组患者总数的86.7%,人工骨组12例,占66.7%,两组比较无显著性差异(P＞0.05).自体骨组胫骨平台术后再塌陷发生时间多在术后2周至12周,而人工骨组再塌陷时间多在术后6周至6个月,后者发生再塌陷时间较前者明显延迟.结论 人工骨植骨钛板内固定在预防平台骨折术后关节再塌陷较自体骨植骨具有优势.     

微小颗粒骨、微创治疗四肢骨折延迟愈合、不愈合30例

目的探讨运用微创植骨治疗四肢骨折延迟愈合、不愈合、分析其疗效。方法原固定牢固的可继续使用;松动者。必须更换。运用椎间盘镜,对骨折不愈合断端磨除骨折端纤维及硬化骨质,将自体松质骨剪碎闭合植入骨折端。结果30例患者随访6个月以上,骨折全部骨性愈合,愈合时间平均3．8个月。结论微创治疗四肢骨折创伤小,保护断端残留血运,微小颗粒骨诱导成骨作用强,有利于骨折的愈合,是治疗四肢骨折延迟愈合、不愈合的一种较好方法。     

189例健康人群CK、LDH和ALP的测值分析

目的：对比分析我地区189例男女健康人群的空腹血清肌酸肌酶（CK）、乳酸脱氢酶（LDH）和碱性磷酸酶（ALP）的不同的值。方法：采用血清流行病的方法检测我单位健康体检人员189例的空腹血清标本CK、LDH和ALP的值，并进行统计分析。结果：健康体检人员男、女的CK值（P〈0．05）有差别，LDH和ALP男女的值差异无统计学意义。结论：健康男女人群的CK值、范围是不同的。     

跟骨骨折的治疗

目的探讨跟骨骨折手术治疗的效果。方法47例（52足）跟骨骨折患者,采用跟骨外侧切口,皮瓣“不接触”牵开术显露骨折复位,跟骨解剖钢板内固定,术后配合中药治疗。结果术后43例（50足）随访9—32个月,按门振武拟定标准评定,优18例（22足）,良20例（22）,劣5例（6足）,优良率88％。结论粉碎性跟骨骨折手术切开复位解剖钢板内固定为一种理想治疗方法,但应注意手术时机的选择,术后配合中药治疗可提高疗效。     

可吸收螺钉治疗距骨骨折的疗效观察

目的：观察可吸收螺钉治疗距骨骨折患者的疗效。方法选取2011年1月至2013年6月在我院接受治疗的22例距骨骨折患者为研究对象,所有患者均采用手术切开复位及可吸收螺钉内固定治疗。术后进行规律的功能锻炼,定期随访及复查。结果22例患者均顺利接受手术治疗,术后均接受随访,随访时间6个月-24个月,平均（14.6±5.3）个月;1例患者出现距骨缺血性坏死,给予理疗及功能锻炼后自行恢复;1例患者出现创伤性关节炎,给予对症治疗后痊愈。AOFAS评分结果为优14例,良6例,可1例,差1例,总体优良率为90.9%（20/22）。结论可吸收螺钉治疗距骨骨折临床效果显著,组织相容性好,并发症少,无需二次手术,值得推广应用。     

老年骨折患者血清铁蛋白、微量元素、骨密度及其营养状况分析

目的 探讨老年骨折患者血清铁蛋白、微量元素、骨密度及其营养状况分析.方法 以2017年1月至2019年12月株洲市某医院诊治的≥60岁骨折患者为研究对象作为病例组,按相同性别、年龄相差0.5岁以内的要求在同医院体检部进行健康体检的近1年内未发生过骨折的≥60岁居民作为对照组,收集病例组和对照组人群的基本情况及营养状态、...     

复方丹参合剂对去卵巢大鼠骨大小和骨量的影响

用测定骨大小和骨量的方法,观察复方丹参合剂(compound Danshen mixture,CDM)对去卵巢大鼠骨大小和骨量的影响。将健康4月龄雌性SD大鼠32只随机分成4组:正常对照组、假去卵巢组、去卵巢组、去卵巢+CDM组。去卵巢+CDM组大鼠于去卵巢手术后第2天开始给予CDM溶液灌胃,10 ml/(kg·d),持续11周。结果表明,去卵巢大鼠骨直径、骨体积、骨湿重、骨湿重/体重、骨干重、骨干重/体重、骨干重/骨体积等指标均低于假去卵巢组。去卵巢大鼠给予复方丹参合剂溶液灌胃后,骨直径、骨体积、骨湿重、骨湿重/体重、骨干重、骨干重/体重、骨干重/骨体积等指标均较去卵巢组增加。提示复方丹参合剂有利于改善去卵巢大鼠的骨大小和骨量。     

螺丝钉内固定与骨牵引治疗股骨颈骨折疗效观察

目的通过对比空心加压螺丝钉内固定与骨牵引治疗股骨颈骨折的四项临床指标,评估两种治疗方法的优劣,为临床治疗及护理提供选择的依据。方法将1994~2001采用骨牵引方法治疗股骨颈骨折的97例设为A组,将2003~2006年空心加压螺丝钉的32例设为B组,对两组的骨折愈合时间,关节屈髋活动到达90°的时间,下床负重时间,并发症等四个方面进行对比。结果A组四项指标分别为:8±0.5周,56±8.4 d,65±6.3 d,43例。B组四项指标分别为:8±0.3周,20±5.5 d46±7.5 d,7例。结论表明在功能康复及预防并发症方面空心加压螺丝钉治疗股骨颈骨折有较大优势。     

4种血清酶在三硝基甲苯染毒致大鼠肝损伤中的变化及意义

[目的]观察三硝基甲苯(TNT)染毒致大鼠肝损伤时血清乳酸脱氢酶(LDH)、谷氨酸氨基移换酶(ALT)、天门冬酸氨基移换酶(AST)和碱性磷酸酶(ALP)的活力变化情况,并探讨其意义。[方法]以50、100和200mg/kg体重剂量的TNT对大鼠每天一次经口染毒,分别于染毒2、4、6和8周后处死,测定血和肝组织TNT代谢产物2,6-二硝基-4-氨基甲苯(DNAT)水平、血靛青绿(ICG)10min滞留率(ICG_(R10))和血清LDH、ALT、AST、ALP的变化情况。[结果]TNT染毒大鼠血和肝组织DNAT均比对照组有明显升高,TNT染毒剂量与大鼠血清或肝组织DNAT呈显著性相关(P<0.01),血清与肝组织DNAT呈显著性相关(P<0.01);各TNT染毒组大鼠血清ICG_(R10)明显高于对照组。TNT高剂量染毒组大鼠血清LDH、ALT、AST和ALP活力有所降低,其他剂量组与对照组相比未见显著性变化;血清或肝组织DNAT与血清LDH呈显著性负相关(P<0.05或0.01),与ALT、AST和ALP均负相关,但未见显著性(P>0.05)。[结论]血清LDH、ALT、AST和ALP指标对TNT染毒诱导的大鼠肝损伤的反应并不敏感,似与TNT代谢产物DNAT对血清4种酶活力可能具有的一定抑制作用有关。     

1350例骨折病人骨密度检测分析

目的检测分析武威地区骨折病人骨密度,以获得当地人群骨密度数据,并探讨骨折的危险性。方法 2008年10月～2009年9月所有骨折住院的当地病人1350例,其中30岁以下339例,30岁以上1011例;城镇人口415例,农村人口935例,均在刚入院时进行骨密度检测,对测定结果按以上分组进行统计分析。结果男性30岁以上骨密度异常者为68.30%,30岁以下为18.30%,女性30岁以上骨密度异常者为77.00%,30岁以下为13.41%,P均〈0.01;农村人口与城镇人口骨密度异常者比例分别为83.53%和83.86%,P〈0.05。结论 30岁以上人群骨密异常者显著高于30岁以下人群,骨折病人不论城市、农村人口,骨密度异常者均较高,骨折的发生有一定的必然性。     

职业接触低浓度混苯对健康的影响

目的观察低浓度混苯对作业人员健康的影响.方法.观察118名从事混苯作业人员,对照119名条件相当非接触混苯的行政人员健康状况.结果低浓度混苯接触组头晕、头痛、记忆力下降、月经紊乱以及鼻炎、咽炎、皮炎发病率明显高于对照组,发病者专业工龄无明显差异.结论职业接触低浓度混苯可损害神经系统、生殖系统、皮肤黏膜.     

Influence of Obesity on Bone Turnover Markers and Fracture Risk in Postmenopausal Women

Background and aims: The relationship between obesity and bone metabolism is controversial. In recent decades, the protective role of obesity in the development of osteoporosis is questioned. The aims of this study are the following: to evaluate the differences in bone turnover markers between postmenopausal women with and without obesity and to compare the risk of fracture at five years between these groups. Methods: An observational longitudinal prospective cohort study of postmenopausal women with obesity (O) (body mass index (BMI) > 30 kg/m²) and non-obesity (NoO) (BMI < 30 kg/m²) is designed. 250 postmenopausal women are included in the study (NoO: 124 (49.6%) and O: 126 (50.4%)). It measures epidemiological variables, dietary variables (calcium intake, vitamin D intake, smoking, alcohol consumption, and physical activity), biochemicals (β-crosslap, type I procollagen amino-terminal peptide (P1NP), 25OH-vitamin D, and parathyroid hormone (PTH)), anthropometric variables, and fracture data five years after the start of the study. The mean age is 56.17 (3.91) years. Women with obesity showed lower levels of vitamin D (O: 17.27 (7.85) ng/mL, NoO: 24.51 (9.60) ng/mL; p < 0.01), and higher levels of PTH (O: 53.24 (38.44–65.96) pg/mL, NoO: 35.24 (25.36–42.40) pg/mL; p < 0.01). Regarding the bone formation marker (P1NP), it was found to be high in women without obesity, O: 45.46 (34.39–55.16) ng/mL, NoO: 56.74 (45.34–70.74) ng/mL; p < 0.01; the bone resorption marker (β-crosslap) was found to be high in women with obesity, being significant in those older than 59 years (O: 0.39 (0.14) ng/mL, NoO 0.24 (0.09) ng/mL; p < 0.05). No differences are observed in the risk of fracture at 5 years based on BMI (OR = 0.90 (95%CI 0.30–2.72); p = 0.85). Conclusions: Postmenopausal women with obesity showed lower levels of bone formation markers; older women with obesity showed higher markers of bone resorption.     

Experimental Testing of the Action of Vitamin D and Silicon Chelates in Bone Fracture Healing and Bone Turnover in Mice and Rats

This study presents findings on the biological action of an integrated supplement containing the following components involved in osteogenesis and mineralization: vitamin D and silicon in the bioavailable and soluble form. A hypothesis that these components potentiate one another’s action and make calcium absorption by the body more efficient was tested. Biological tests of the effect of vitamin D and silicon chelates on bone fracture healing and bone turnover were conducted using ICR mice and albino Wistar rats. Radiographic and biochemical studies show that the supplement simultaneously containing silicon chelates and vitamin D stimulates bone tissue regeneration upon mechanical defects and accelerates differentiation of osteogenic cells, regeneration of spongy and compact bones, and restoration of bone structure due to activation of osteoblast performance. Bone structure restoration was accompanied by less damage to skeletal bones, apparently due to better absorption of calcium from food. The studied supplement has a similar effect when used to manage physiologically induced decalcification, thus holding potential for the treatment of osteomalacia during pregnancy or occupational diseases (e.g., for managing bone decalcification in astronauts).     

止血合剂治疗急性上消化道出血的临床观察及护理

目的探讨止血合剂及针对性护理措施对急性上消化道出血的临床疗效。方法将84例急性上消化道出血患者随机分为治疗组和对照组,在常规西药治疗的基础上,治疗组给予止血合剂口服或胃管注入,对照组予正肾冰盐水口服或胃管注入,并同时给予两组针对性护理措施,观察两组患者止血时间和大便潜血转阴时间,对比二者对急性上消化道出血的临床疗效。结果止血合剂治疗组在止血时间和大便潜血转阴时间方面治疗组明显优于正肾冰盐水对照组(P<0.05);止血合剂对急性上消化道出血的总体疗效明显优于正肾冰盐水(P<0.05),且两组予针对性护理措施可明显提高临床疗效。结论止血合剂治疗急性上消化道出血疗效确切,针对性护理措施可提高治疗效果,值得临床进一步推广应用。     

止血合剂治疗急性上消化道出血的临床观察及护理

目的探讨止血合剂及针对性护理措施对急性上消化道出血的临床疗效。方法将84例急性上消化道出血患者随机分为治疗组和对照组,在常规西药治疗的基础上。治疗组给予止血合剂口服或胃管注入,对照组予正肾冰盐水口服或胃管注入,并同时给予两组针对性护理措施,观察两组患者止血时间和大便潜血转阴时间,对比二者对急性上消化道出血的临床疗效。结果止血合剂治疗组在止血时间和大便潜血转阴时间方面治疗组明显优于正肾冰盐水对照组（P〈O．05）;止血合剂对急性上消化道出血的总体疗效明显优于正肾冰盐水（P〈0．05）,且两组予针对性护理措施可明显提高临床疗效。结论止血合剂治疗急性上消化道出血疗效确切,针对性护理措施可提高治疗效果,值得临床进一步推广应用。     

补充钙、维生素D及镁、锌、铜对大鼠骨密度和骨强度的影响

目的观察在补充钙、维生素D的同时补充镁、锌、铜对大鼠骨密度和骨强度的影响。方法30只初始体重65～75g的清洁级断乳Wistar雄性大鼠,根据体重随机分为3组,即低钙饲料对照组、受试物低剂量实验组和高剂量实验组,每组10只。实验周期为12周。测定右侧股骨长度、重量、股骨骨密度及骨钙含量,左侧股骨最大载荷、最大挠度、弹性能量吸收、最大应力、弹性模量。结果低、高剂量实验组大鼠的股骨重量、股骨远心端和股骨中点的骨密度、股骨钙含量、股骨的最大载荷和弹性能量吸收均显著高于低钙对照组(P<0.05)。结论补充钙、维生素D及镁、锌、铜能明显增强大鼠股骨的骨密度、骨强度,提示对延缓骨骼的老化有一定的作用。     

Modified Serum ALP Values and Timing of Apparition of Knee Epiphyseal Ossification Centers in Preterm Infants with Cholestasis and Risk of Concomitant Metabolic Bone Disease of Prematurity

The usefulness of serum alkaline phosphatase (ALP) and phosphorous in screening and monitoring of metabolic bone disease of prematurity (MBDP) still has some limitations, especially in preterm infants with concomitant conditions such as cholestasis. We aimed to assess a modification of serum ALP (M-ALP) as a biomarker for MBDP in preterm infants, and the use of ultrasound monitoring for the apparition of knee ossification centers as marker of bone mineralization. Biochemical and clinical registers were taken from 94 preterm newborns <32 weeks. A significant correlation existed between serum ALP and direct bilirubin (DB), expressed by the regression equation: M-ALP (IU/L) = 302.1 + 96.9 (DB (mg/dL)). The ratio ALP/M-ALP > 1 was demonstrated to be more specific (87.5%) in the diagnosis of MBDP than the cut-off value of serum ALP > 500 IU/L (62.5%). ALP/M-ALP > 1 showed 100% sensitivity and specificity for the diagnosis of MBDP, and a good correlation with specific bone ALP (B-ALP). Patients with the knee nucleus by post-menstrual week 37 had lower B-ALP compared to patients with no nucleus, and no patients with MBDP presented the nucleus by the 40th week. In the absence of reliable specific B-ALP, reinterpreting serum ALP values by M-ALP plus monitoring of knee ossification centers contribute to better management of MBDP in preterm infants with cholestasis.     

带旋髂深血管蒂髂骨瓣植骨加压螺钉治疗创伤性股骨颈骨折

目的探讨用带旋髂深血管蒂髂骨瓣植骨加压锣钉治疗创伤性股骨颈骨折的疗法。方法采用经髂关节改良Smith-Petersen氏入路,取旋髂深血管蒂髂骨瓣植骨加压锣钉内固定治疗创伤性股骨颈骨折48例。结果术后随访43例,随访时间8个月～8年。38例愈合,患侧髂关节功能恢复良好,5例出现股骨头缺血性坏死。结论带旋髂深血管蒂髂骨瓣植骨加压锣钉治疗创伤性股骨颈骨折,能促进股骨颈骨折愈合,是治疗创伤性股骨颈骨折的有效方法。