骨科生物力学的研究进展

骨科生物力学的研究进展使得骨科学和复健医学等临床医学有了显著的进步，临床医师得以运用相关的技术和器械治疗罹患骨骼肌肉系统疾病的病患。近年来全球人口已趋向老龄化，此方面的研究需求更大。反观华人人口比例占全球人口绝大部分，但至今此方面研究仍以西方国家为领先，国人各领域的专业学者相当多，且各位学者的研究能力足以和欧美学者相比。为了切实解决国人骨骼肌肉系统方面疾病，需要更多华人骨科专家与生物力学专家投入此专业研究。本文概要叙述骨科生物力学的研究进展，希冀可吸引更多对骨科生物力学感兴趣的学者共同研究。     

骨科固定物与感染治疗新进展

感染作为骨科手术最常见和复杂的并发症，早已成为骨科医生所面临的极富挑战性的难题之一。资料显示：闭合性骨折的感染率（约1．5％）远较开放性骨折低3％～40％，约60％以上的开放性骨折在损伤时受到了细菌的污染。目前常用的处理开放性骨折的方法包括彻底清创、去除包括挫灭和失去活力的不健康组织、大量液体对伤口的冲洗、固定骨折以及软组织覆盖关闭创面等处理措施，以避免骨与软组织的感染。但是，尽管采取了上述积极的流程，仍有一部分患者发生了感染。正如AO组织于2006年第二届“固定物与感染”会议上指出：在10年内已有相当多的从微生物学、诊断学、组织病理学、临床治疗学等方面研究的进展，     

Conflict of interest in orthopaedic research

BACKGROUND: The expanding role of industrial support in biomedical research has resulted in both substantial interest and controversy in recent years. Our hypothesis was that, from 1985 to 2002, the role of industrial support in orthopaedic research increased, as documented by the research presented at the annual meetings of the American Academy of Orthopaedic Surgeons. METHODS: We analyzed the frequency and types of self-reported conflicts of interest for all presentations at the annual meetings of the American Academy of Orthopaedic Surgeons in 1985, 1988, 1992, 1997, 1999, and 2002. Conflicts of interest were recorded directly from the final program for each meeting analyzed. The analysis focused on the scientific presentations, Instructional Course Lectures, symposia, poster exhibits, and scientific exhibits. Information about specific types of support received by authors was first required in 1988. RESULTS: The incidence of conflicts of interest increased from 3% in 1985 to 39% in 2002 for scientific papers (p < 0.001); from 10% to 74%, respectively, for symposia (p < 0.001); from 22% to 60% for Instructional Course Lectures (p < 0.001); from 10% to 60% for scientific exhibits (p < 0.001); and from 9% in 1992 to 14% in 2002 for posters (p < 0.001). For presentations of all types, the incidence increased from 10% to 32% (p < 0.001). The types of conflict of interest also changed significantly from 1999 to 2002. In 1999, 73% of conflicts were documented as support directed to institutions and 27%, as support to individuals; in 2002, 57% were reported as support directed to institutions and 43%, as support to individuals (p < 0.01). CONCLUSIONS: The role of industrial support of orthopaedic research increased significantly between 1985 and 2002, as evidenced by the increase in the self-reported conflicts of interest for all types of presentations at the annual meetings of the American Academy of Orthopaedic Surgeons. In addition, the support directed to individuals, in contrast to that directed to institutions, increased significantly.     

骨科研究存在的问题与对策

骨科研究涵盖的范围相当广泛，只要是跟骨骼肌肉系统相关的研究都与骨科临床有直接关系。若以研究类型和使用工具来区分，骨科研究基本上包括人体或体内实验、体外实验、计算器模拟工具及临床随访资料等研究类型（图1），各类型又分为各个主题及方法。[第一段]