关节镜下Orthocord缝线固定治疗前交叉韧带胫骨止点撕脱骨折

目的 探讨前交叉韧带(ACL)胫骨止点撕脱骨折关节镜下治疗的方法及疗效.方法 对27例ACL胫骨止点撕脱骨折进行手术,关节镜下将骨折复位后,从胫骨结节内侧向骨折块的两侧钻取两个骨隧道,使用2号Orthocord缝线固定骨折.结果 本组均得到随访,平均12.3个月(7～24个月),X线片示骨折愈合良好.术后末次随访Lys...     

糖酵解与恶性肿瘤

大多数增殖快的恶性肿瘤细胞糖酵解活跃,经糖酵解获取能量多.恶性肿瘤糖酵解活跃与发生糖酵解的细胞结构和功能,以及催化糖酵解的酶有很大关系.恶性肿瘤糖酵解活跃还有促进细胞增殖和抑制细胞凋亡的作用.近年针对恶性肿瘤高糖酵解特点的研究取得了一些成果,该文就恶性肿瘤中糖酵解特点、糖酵解活跃的细胞结构和功能、糖酵解关键酶己糖激酶对...     

Promotion of chondrogenesis of marrow stromal stem cells by TGF-β3 fusion protein in vitro

The purpose of this study was to investigate the repair of the osteoarthritis（OA）-induced car- tilage injury by transfecting the new TGF-β3 fusion protein （LAP-MMP-mTGF-β3） with targeted ther- apy function into the bone marrow-derived mesenchymal stem cells （MSCs） in rats. The recombinant of plRES-EGFP-MMP was constructed by combination of DNA encoding MMP enzyme cutting site and eukaryotic expression vector plRES-EGFP. LAP and mTGF-β3 fragments were obtained from rat em- bryos by RT-PCR and inserted into the upstream and downstream of MMP from plRES-EGFP-MMP respectively, so as to construct the recombinant plasmid ofplRES-EGFP-LAP-MMP-mTGF-β3, plRES- EGFP-LAP-MMP-mTGF-β3 was transfected into rat MSCs. The genetically modified MSCs were cul- tured in medium with MMP-1 or not. The transfected MSCs were transplanted in the rat OA models. The OA animal models were surgically induced by anterior cruciate ligament transaction （ACLT）. The pathological changes were observed under a microscope by HE staining, Alcian blue, Safranin-fast Gre- en and graded by Mankin＇s scale, plRES-EGFP-LAP-MMP-mTGF-β3 was successfully constructed by means of enzyme cutting and sequencing, and the mTGF-β3 fusion protein （39 kD） was certified by Western blotting. Those genetically modified MSCs could differentiate into chondrocytes induced by MMP and secrete the relevant-matrix. The transfected MSCs could promote chondrogenesis and matrix production in rat OA models in vivo. It was concluded that a new fusion protein LAP-MMP-mTGF-β3 was constructed successfully by gene engineering, and could be used to repair the OA-induced cartilage injury.     

大转子截骨术治疗PipkinⅠ和Ⅱ型股骨头骨折疗效观察(英文)

目的评估大转子截骨术治疗PipkinⅠ和Ⅱ型股骨头骨折的中远期临床疗效。方法回顾分析采用大转子截骨术治疗股骨头骨折并髋关节后脱位患者23例,其中男性15例,女性8例,平均年龄44.1岁。临床疗效依据和d’Aubigne-Postel评分标准而确定。结果除1例患者因随访少于12个月而没有纳入研究外,余22例患者随访时间均不少于12个月。患者平均随访时间为23.5个月(最短12个月,最长36个月)。最后一次随访d’Aubigne-Postel的评分为13.41±4.0分;Thompson-Epstein的临床评价结果:8例优(36.4%),9例良(40.9%),3例一般(13.6%),2例差(9.1%),优良率为77.3%。患者术后无脱位发生,2例患者术后发生异位骨化,1例坐骨神经损伤患者术后6月后完全恢复正常,3例患者出现术后创伤性关节炎,其中1例术后1年因发生股骨头缺     

Targeted silencing of heparanase gene by small interfering RNA inhibits invasiveness and metastasis of osteosarcoma cells

The effects of targeted silencing of heparanase gene by small interfering RNA(siRNA) on invasiveness and metastasis of osteosarcoma cells(MG63 cells) were investigated in the present study.Two complementary oligonucleotide strands were synthesized and inserted into pGenesil-1 vector based on the mRNA sequence of heparanase gene.The expression vector containing short hairpin RNA(pGenesil-shRNA) was constructed successfully.MG63 cells were randomly allocated into 3 groups:blank group,empty vector(pGenesil) transfected group and expression vector(pGenesil-shRNA) transfected group.Under the induction of Lipofectamine 2000,the recombinants were transfected into MG63 cells.Heparanase gene expression level was detected by RT-PCR and Western blotting.Cell prolifera-tion was measured by MTT assay.Cell invasiveness and metastasis were examined by cell adhesion and Transwell-ECM assays.HUVECs migration assay was applied for the detection of angiogenesis.As compared with negative controls,the mRNA and protein expression levels of heparanase were down-regulated by 76.1%(P<0.01) and 75.3%(P<0.01) respectively in the pGenesil-shRNA transfected group.Meanwhile,the proliferation,adhesiveness,invasiveness and angiogenesis properties of MG63 cells were all significantly inhibited.It was suggested that targeted silencing of heparanase gene by siRNA could dramatically inhibit the invasiveness and metastasis of osteosarcoma cells.     

CT引导经皮穿刺骨活检在非典型脊柱感染性病变诊断中的价值

正脊柱感染性病变临床并不少见,发生率2/100000~([1]),且有渐增趋势,已经成为了一个全球性的健康问题~([2]),而早期的、非典型的脊柱感染与脊柱肿瘤不易鉴别。脊柱病变的诊断遵循临床表现、影像学检查、病理检查三结合原则,病理结果对诊断及后续治疗方案的确定不可或缺。而对于脊柱感染,除病理结果以外,病原学结果甚至更为重要。本     

表面置换珊瑚羟基磷灰石的表征及结构分析

目的 分析一种表面置换的珊瑚羟基磷灰石(SCHA)结构特征,寻找理想的骨修复材料.方法 海南天然滨珊瑚在特定温度和压力下部分水热反应,用扫描电镜(scanning electronic microscopy,SEM)、X射线色散谱(energy dispersive X-ray spectroscopy,EDX)、热失重分析(thermo gravimetric analyzer,TGA)的方法表征,分析SCHA孔径大小、计算羟基磷灰石和碳酸钙的成分比例.结果 SCHA表面为羟基磷灰石,里面为碳酸钙,保留原有的珊瑚贯穿多孔的三维结构,孔径大小为100～300μm.羟基磷灰石的比例为9.7%,厚度为30μm.结论 表面置换的珊瑚羟基磷灰石具有理想的贯穿多孔三维结构,是一种良好的骨组织工程支架材料.     

3D打印导板在肿瘤性长骨畸形胫骨截骨矫形中的应用

目的:探讨3D打印导板在肿瘤性长骨畸形胫骨截骨矫形中的临床应用。方法:回顾性分析2021年6月至2022年12月收治的52例肿瘤性长骨畸形患者的病历资料,所有患者均采用3D打印导板行截骨矫形内固定治疗。术前及术后1周拍摄下肢全长及膝关节负重正侧位X线片,测量负重线比率(WBL)、关节线相交角(JLCA)、胫骨近端内侧角(MPTA)、胫骨后倾角(PTS)。术前、术后6个月、术后1年采用Lysholm评分评估下肢功能。结果:所有患者下肢畸形均得到有效矫正。术后1周,WBL和MPTA较术前明显提升(t=-7.294,P<0.05;t=-4.153,P<0.05),JLCA较术前明显降低(t=-1.463,P<0.05),术前和术后PTS无明显变化(t=2.284,P>0.05)。术后6个月Lysholm评分较术前明显提高(t=-5.087,P<0.05),而术后6个月与术后1年Lysholm评分相比无明显变化(t=1.245,P>0.05)。结论:采用3D打印导板辅助肿瘤性长骨畸形截骨矫形,可有效纠正下肢力线,改善膝关节功能。     

LC3Ⅱ在骨肉瘤组织中的表达及自噬上调对其化疗敏感性的影响

目的:探讨微管相关蛋白1轻链3II(LC3II)在骨肉瘤组织中的表达,观察自噬上调对化疗药物顺铂敏感性的影响。方法:利用免疫组化技术,检测LC3II在28例骨肉瘤及19例正常骨组织中的表达;采用MTT比色法,应用雷帕霉素上调自噬,测定化疗药物DDP对骨肉瘤细胞的增殖抑制率。结果:骨肉瘤组织中LC3II阳性率为64.29%,正常骨组织中LC3II阳性率分别为94.73%,两者比较差异有统计学意义(P0.05)。MTT比色法显示骨肉瘤细胞增殖抑制率与DDP的浓度呈正相关,Spearman相关系数为0.989;Rapamycin+DDP组和DDP组的细胞增殖抑制率比较差异有统计学意义(P0.01)。结论:LC3II在骨肉瘤组织中的阳性表达低于正常骨组织,它的低表达与骨肉瘤的发生发展有关;Rapamycin+DDP组的细胞增殖抑制率明显低于DDP组,自噬的上调降低了骨肉瘤细胞对化疗药物DDP的敏感性。     

外固定器结合封闭负压引流技术治疗胫腓骨骨折术后感染

[目的]探讨外固定器结合封闭负压引流技术治疗胫腓骨骨折内固定术后感染的临床效果。[方法]自2004年6月~2008年6月,采用外固定器结合封闭负压引流技术治疗胫腓骨骨折内固定术后感染36例。[结果]36例中32例获得8~30个月平均14个月的随访,全部感染控制,无1例复发;骨折骨性愈合,骨折平均愈合时间约4.5个月;外固定拆除的平均时间为5个月。[结论]外固定器结合封闭负压引流技术简单、可靠、创伤小、功能恢复好,是一种治疗胫腓骨骨折内固定术后感染较好的方法。