药物防治激素性股骨头坏死的研究进展

随着激素性股骨头坏死发病机制研究的深入，使药物防治激素性股骨头坏死成为可能。本文回顾了近年来一些国内外学者根据其发病机制进行的药物预防激素性股骨头坏死的研究，提出降脂、抗凝药联用不能完全预防激素性股骨头坏死的发生，激素性股骨头坏死是以脂肪代谢紊乱和血管内凝血为主要发病机制，其他一些病理机制共同作用的结果。     

骨细胞凋亡与股骨头坏死的相关研究

股骨头坏死又名缺血性股骨头坏死或无菌性股骨头坏死，主要发生于中青年人，发病年龄大多在30～59岁之间。本病发展到后期可导致股骨头塌陷并继发退变性关节炎，严重影响病人的正常生活，是一种致残率相当高的疾病。但令人遗憾的是该病确切的发病机制仍不清楚，已知与骨坏死相关的因素有150余种。     

成人股骨头坏死后塌陷的发病机理早期预测及防治进展

成人股骨头坏死 (ＡＮＦＨ)治疗困难 ,出现临床症状的主要原因 ,是股骨头坏死后塌陷〔1～ 3〕。本文就塌陷的发病机理、早期预测及防治方法方面的研究进展作一综述。1　发病机理成人股骨头坏死可分为创伤性和非创伤性两大类。前者主要见于股骨颈囊内骨折 ,髋关节脱位等 ;后者为激素滥用、酒精中毒等所致。尽管引起股骨头坏死的病因众多 ,其发病机制尚不十分清楚 ,但其共同特征都是血液循环障碍导致股骨头缺血、坏死 ,以及随之出现的修复反应 ,进而发生股骨头塌陷及髋关节退行性关节炎。缺血、坏死、塌陷是股骨头坏死的不同病理阶段 ,缺血是…     

股骨头坏死增强力学结构和防止塌陷的临床和实验研究进展

成人股骨头缺血性坏死(ANFH)是临床上常见的骨科疾病,最终可导致股骨头塌陷和髋关节破坏.目前,已知该病与许多疾病和危险因素有关,由于其发病机制复杂,真正的病因和发病机制尚未完全明了,根据不同的发病机制或者发病学说,临床中出现了众多的治疗方法.     

Legg-Calve-Perthes病的研究进展

Legg-Calve-Perthes的特点是儿童期的特发性股骨头骨骺骨化中心的缺血性坏死,又称股骨头骨骺骨软骨炎、儿童股骨头无菌性坏死、Legg-Calve-Perthes综合征.是骨科领域常见的疑难病之一,它严重危害儿童的身心健康,是儿童从婴儿期到学龄期间发生的股骨头骨骺与干骺端的缺血病变,其病因、病理较复杂,确切的发病机制和病理过程仍不明确.本文就该病的研究进展做一综述.……     

Legg-Calve-Perthes病的研究进展

Legg-Calve-Perthes的特点是儿童期的特发性股骨头骨骺骨化中心的缺血性坏死，又称股骨头骨骺骨软骨炎、儿童股骨头无菌性坏死、Legg-Calve-Perthes综合征。是骨科领域常见的疑难病之一，它严重危害儿童的身心健康，是儿童从婴儿期到学龄期间发生的股骨头骨骺与干骺端的缺血病变，其病因、病理较复杂，确切的发病机制和病理过程仍不明确。本文就该病的研究进展做一综述。     

基因治疗非创伤性股骨头坏死的研究进展

非创伤性股骨头坏死早期保守治疗方法甚多,但尚缺乏一种成熟有效的治疗方法。基因治疗非创伤性股骨头坏死是近年来新型的治疗方法,本文就该病的发病机制、分子生物学基础、外源性治疗基因与载体选择等方面研究的相关进展及存在问题展开综述,讨论了研究的有关问题及对策,并就研究前景进行了展望。     

股骨头血液供应与股骨头缺血性坏死研究进展(文献综述)

股骨头缺血性坏死是临床常见的疾病 ,其病因及发病机制不清。无论对于创伤性还是非创伤性股骨头缺血性坏死 ,股骨头血供受损被认为是引起坏死的主要因素。创伤对血管的直接损伤、关节囊内压的升高、脂肪栓塞、凝血机制的异常、骨内压的升高、血管的损害等多种因素均可使股骨头血供下降     

骨髓移植与股骨头缺血性坏死的治疗

股骨头缺血性坏死是一种致残性疾病,其发生与多种致病因素有关,除创伤性股骨头缺血坏死发病机理清楚外,非创伤性股骨头缺血性坏死发病机理并不完全明白,它可能有多种发病机制,例如血管的机械损伤 [1]、动脉的血栓和栓塞 [2]、静脉回流受阻 [3]、持续增高的骨内压 [4]等等。     

早期股骨头坏死的（Ficat Ⅰ、Ⅱ期，塌陷前）治疗

股骨头坏死是一种进行性破坏性疾病,病情进展常导致股骨头软骨下骨和关节面软骨的塌陷、继发骨关节炎。该病多发生于青壮年,平均发病年龄38岁。如果不采取积极的治疗．绝大多数患者最终都需要行全髋关节置换。而研究显示股骨头坏死行人工关节置换后其效果较因其他疾病行人工关节置换的效果要差。     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

下颌全牙弓后移量及最后界的测量

目的：研究下颌牙弓的有效后移量及找寻下颌牙弓移动的后界。方法：选取涉及拔除下颌第三磨牙或下颌第三磨牙缺失的病例18例（男6例,女12例）。采用种植支抗牵引下牙弓向远中,治疗完成时所有病例均明确到达下颌牙弓后界,即下颌第二磨牙远中到达下颌升支前缘软组织交界处。应用治疗前后的曲断片测量下颌第二磨牙远中到升支前缘的距离。结果：下颌第二磨牙后移量为（3.49±1.21）mm;治疗后磨牙后间隙的长度为（4.43±0.97）mm。结论：下颌牙弓可确定性地实现整体后移;最大后移量由磨牙后间隙的长度决定;其最后界止于下颌第二磨牙远中与下颌升支前缘软组织交界处。     

Preservation of the pylorus in resection of the head of the pancreas

Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.