Treatment of nonunions of humeral fractures with inter-locking intramedullary nailing

Objective： To introduce the experience of treating nonunions of humeral fractures with interlocking intramedullary nailing.
Methods： Twelve patients with humeral nonunions were treated with interlocking intramedullary nailing. The time interval between trauma and surgery was 10.5 months on average. Open reduction with anterograde approach was performed. Axial compression was specially applied to the fracture site with humeral nail holder after insertion of distal locked screws. Iliac bone grafting was added.
Results： The average follow-up period was 21 months （ranging 9-51 months）. All patients achieved osseous union 5.8 months after treatment on average. Eleven patients hadgood functions of the shoulder joints and the upper extremities. No patient experienced any permanent neurological deficit. Refracture of the original ununited region occurred in one patient after removal of the internal fixator one year later, but union was achieved after closed re-intramedullary nailing fixation.
Conclusion： Humeral interlocking intramedullary nailing is an effective alternative treatment for humeral nonunion.     

可注射支架修复骨关节炎动物模型软骨缺损

目的在严重骨关节炎环境下评价利用新型支架复合向软骨诱导的自体骨髓间充质干细胞（ABMSC）修复陈旧性软骨缺损的效果。方法建立新型兔OA模型42只，随机分成3组：自体骨髓间充质干细胞，纤维蛋白胶，透明质酸钠（CFH）组，髓腔钻孔（drilling，D）组，单纯支架（fibrin—hyaluronate，FH）组。CFH组：自体骨髓间质干细胞在分离培养并向软骨细胞方向诱导后，同纤维蛋白胶，透明质酸钠和氨甲苯酸混合制作可注射的细胞三维支架复合物，利用共推针具注入14只模型兔膝关节股骨髌沟部软骨缺损处;D组：膝关节股骨髌沟部软骨缺损底部作深达髓腔的钻孔治疗；FH组：单纯纤维蛋白胶、透明质酸钠和氨甲苯酸混合注入软骨缺损处。每组在术后第6周，12周、24周处死动物获取膝关节股骨髌沟部，标本进行组织学评分及统计分析。结果CFH组股骨髌沟部软骨包括新生软骨退变明显减慢。3组间各时间段组织学评分均有显著性差异（P〈0.01）。CFH组6周评分同12周和24周评分相比有显著性差异（P=0．025和0．032）。结论新型可注射支架复合ABMSC能够很好修复严重骨关节炎所致的陈旧软骨缺损。     

川芎嗪对骨肉瘤细胞株SaOS-2增殖及VEGF基因表达的影响

目的:探索川芎嗪对骨肉瘤细胞株SaOS-2增殖及血管内皮细胞生长因子(VEGF)基因表达的影响,为采用中医药治疗骨肉瘤奠定理论基础。方法:复苏人骨肉瘤细胞株SaOS-2,当细胞生长至融合时传代。实验分为空白对照组及5%、10%、15%川芎嗪干预组。采用CCK-8检测川芎嗪对细胞增殖的抑制情况;RT-PCR检测VEGF基因的表达。结果:CCK-8检测结果表明,在不同时间点、不同浓度的川芎嗪对SaOS-2细胞的生长均有抑制作用,并随着川芎嗪浓度的增高,其作用时间越长、抑制作用越明显(P<0.05);RT-PCR表明,川芎嗪各组之间没有明显有效的抑制VEGF基因的表达(P>0.05),但从数值上分析可发现随着川芎嗪浓度的增高,VEGF基因的表达呈降低的趋势。结论:川芎嗪可以有效地抑制骨肉瘤细胞株SaOS-2的增殖,但不能有效抑制VEGF的基因表达。