双侧锁定钢板治疗胫骨平台粉碎骨折

目的 探讨双侧锁定钢板治疗胫骨平台粉碎骨折的方法和疗效.方法对22例胫骨平台粉碎骨折患者行双侧锁定钢板内固定治疗.结果 22例均获随访,时间8～25个月.骨折均愈合,愈合时间6～16个月.膝关节功能按Iowa评分标准评定：优17例,良4例,可1例.结论 采用双侧锁定钢板治疗胫骨平台粉碎骨折固定牢靠,创伤小,并发症少,可早期功能锻炼,膝关节功能恢复良好,疗效满意.     

Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation

Purpose

The purpose of this study was to evaluate reconstruction of the medial patellofemoral ligament (MPFL) using the double-bundle anatomical or single-bundle isometric procedure with respect to the patients’ clinical outcomes.

Methods

In this retrospective study, we evaluated the clinical outcome of double-bundle anatomical versus single-bundle isometric reconstruction of the MPFL for patellar dislocation patients. Sixty-three patients were included in this study from August 2004 to January 2008. From August 2004 to September 2006, MPFL reconstruction using a single-bundle isometric technique was performed in 21 patients (26 knees). Since October 2006, the double-bundle anatomical reconstruction of the MPFL has been used as the routine surgical procedure. It was performed in 37 patients (44 knees). Fifty-eight patients (70 knees) could be followed up. According to the different techniques, we divided the patients into two groups: group D with double-bundle anatomical reconstruction (37 patients) and group S with single-bundle isometric reconstruction (21 patients). Clinical evaluation consisted of the number with a patellar re-dislocation, patellar apprehension sign, Kujala score, subjective questionnaire score, the patella lateral shift rate and patellar tilt angle measured by cross-sectional CT scan.

Results

According to the Kujala score and the subjective questionnaire score, the outcome of the double-bundle group was better than the outcome of the single-bundle group especially in the long-term. Patellar re-dislocation occurred in three patients in the group S, while no re-dislocation occurred in the group D. In total, 26.9 % of group S was considered to have patellar instability, compared to 4.54 % of the group D. After operation, the patellar tilt angle (PTA) and the patella lateral shift rate (PLSR) were restored to the normal range, with statistical significance (P < 0.05) compared to the preoperative state.

Conclusion

Single- and double-bundle reconstruction of the MPFL can both effectively restore patella stability and improve knee function. However, outcomes in the follow-up period showed that the double-bundle surgery procedure was much better than in single-bundle surgery.     

克氏针与微型骨锚钉治疗锤状指的疗效比较分析

目的 观察克氏针与微型骨锚钉分别治疗急性DoyleⅠ型锤状指的临床效果,并探讨其疗效差异.方法 随访2010年1月至2012年1月来我科就诊,并行手术治疗的Doyle Ⅰ a和Ⅰb型急性锤状指患者52例,其中27例行克氏针治疗(A组),25例行微型骨锚钉治疗(B组).记录患者的满意度和患指的活动度、疼痛度及并发症等情况,参照Crawford疗效评估标准对患者的恢复情况进行评定.统计分析克氏针组和微型骨锚钉组的疗效差异.结果 术后A组获得随访时间平均13.9(6～27)个月,B组平均12.0(6～ 22)个月.两组之间的满意度和患指活动度、疼痛度比较差异无统计学意义(P＞0.05).参照Crawford疗效评估标准:A组优7例、良6例、中9例、差5例,优良率为48.1％;B组优5例、良6例、中8例、差6例,优良率为44.0％.两组之间疗效等级分布和优良率比较差异无统计学意义(P＞0.05).B组线结外露并发症的发病率明显大于A组(P=0.031),而其余并发症及总并发症的发病率两组之间差异均无统计学意义(P＞0.05).结论 克氏针与微型骨锚钉治疗Doyle Ⅰ型急性锤状指损伤,疗效等级分布和优良率之间差异无统计学意义,微型骨锚钉使用后线结外露并发症的发病率明显较克氏针组多.     

三角吻合技术在全腹腔镜下胃远端癌根治术中的应用

目的 探讨三角吻合技术在全腹腔镜下胃远端癌根治术中的可行性和临床疗效.方法 回顾性分析2012年11-12月间福建医科大学附属协和医院实施的18例全腹腔镜胃远端癌根治术并残胃十二指肠吻合(三角吻合)病例的临床资料.三角吻合是完全在腹腔镜下应用直线切割闭合器完成残胃和十二指肠后壁的功能性端端吻合,再利用直线切割闭合器闭合共同开口后,吻合口内部的缝钉线呈现为三角形.结果 18例患者均成功施行全腹腔镜下胃远端癌淋巴结清扫(D1+或D2)及三角吻合.手术时间(156.3±38.5) min,三角吻合耗时(24.6±11.2) min.肿瘤距上切缘(5.8±2.4) cm,距下切缘(4.1±2.7) cm,上、下切缘病理结果均未见癌残留.术中出血量(70.7±43.8) ml,淋巴结清扫数目(32.4±12.0)枚/例.术后首次下床活动时间(1.8±0.9)d,肛门排气时间(3.1±1.2)d,进食流质时间(3.6±1.7)d,术后住院时间(9.6±2.5)d.术后1例患者出现乳糜瘘伴腹腔感染;全组均未出现吻合口出血、吻合口狭窄或吻合口瘘等吻合口相关并发症.结论 三角吻合技术应用于全腹腔镜下胃远端癌根治术是安全可行的,近期疗效满意.     

Correction: A novel biocompatible,simvastatin-loaded,bone-targeting lipid nanocarrier for treating osteoporosis more effectively

Correction for ‘A novel biocompatible, simvastatin-loaded, bone-targeting lipid nanocarrier for treating osteoporosis more effectively’ by Shan Tao et al., RSC Adv., 2020, 10, 20445–20459, DOI: 10.1039/D0RA00685H.

The authors regret that incorrect versions of Fig. 7, ​,99 and ​and1010 were included in the original article. The correct versions of Fig. 7, ​,99 and ​and1010 are presented below.Open in a separate windowFig. 7Histological analysis of organs from all experimental groups. H&E staining of heart, liver, spleen, lung, kidney, indicating the carrier has good biocompatibility. Scale bar = 50 μm.Open in a separate windowFig. 9Alkaline phosphatase (ALP) activity (arrows) and tartrate-resistant acid phosphatase (TRAP) assay results (arrowheads) of bone tissue sections. Scale bar = 50 μm. The ALP activity is much more high in SIM/LNPs and SIM/ASP₆-LNPs groups, while the TRAP activity is the opposite.Open in a separate windowFig. 10Histological assessment of bone formation in all experimental groups. (A) HE staining of femur bone. Scale bar = 50 μm. Histology of bone in the all experimental groups shows all ovariectomized groups had a higher amount of adipose tissue than Sham group. The trabecular bone is much more prominent in SIM/LNPs and SIM/ASP₆-LNPs groups. (B) Immunohistochemical staining for BMP-2 in typical newly-formed bone tissue (red arrows) and immunohistochemical staining for the osteogenic markers osteopontin (OPN, arrows) and osteocalcin (OCN, arrowheads). Scale bar = 50 μm. The BMP-2, OPN, OCN are much more prominent in SIM/LNPs and SIM/ASP₆-LNPs groups.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

髋关节置换术后股骨假体周围骨折的分型及治疗的研究进展

随着人工髋关节假体设计不断完善,人体髋关节置换术(THA)逐渐增多,医生必须面对股骨假体周围骨折并发症的治疗。术后股骨假体周围骨折一般是由创伤、患者老龄化等导致,复杂性更强,发生率逐渐增高。受到患者活动量和生存期的限制,在治疗中存在很多困难,术后股骨假体周围骨折治疗失败率也很高,严重威胁患者生命安全,因此在治疗中需要全面分析骨折类型,选择合理治疗方法,提高治疗效果。本文主要综述髋关节置换术后股骨假体周围骨折的治疗进展,为治疗提供参考。     

疏络化纤颗粒的质量标准研究

目的:建立疏络化纤颗粒的质量控制方法。方法:对制剂中的百合、灵芝、茜草、地龙、丹参采用薄层色谱(TLC)法进行定性鉴别;采用高效液相色谱(HPLC)法对制剂中的疏络化纤颗粒所含成分芍药苷进行含量测定,以C18柱为色谱柱,乙腈-0.1%磷酸水溶液(1486)为流动相,检测波长为230 nm。结果:用薄层鉴别百合、灵芝具有较好的专属性;在0.313~0.626μg范围内芍药苷与峰面积呈良好的线性关系,r2=0.9999,回收率均在95%与105%之间,RSD小于5%(n=6)。结论:所建立的方法专属性强,简便准确,该制剂标准可有效控制其质量。     

睾丸大细胞钙化性支持细胞瘤一例

患者男．25岁。双侧睾丸肿大半年余,伴咳嗽、咳痰和发热于2005年3月入院。体检：双侧睾丸上极均触及无痛性硬肿物,大小分别约1．5cm×1．5cm和0．5cm×0．2cm,可活动,与周围组织无粘连．既往无睾丸外伤史,无体态及毛发的改变。无明显内分泌疾病症状和体征。手术切除双侧睾丸肿物,病理检查：两块肿物组织境界清楚,直径分别约1．5cm和0．5cm。切面为黄白色带有分散的钙化点,切开时有沙砾感.未见包膜的浸润．也无出血和坏死灶。镜下观察：肿瘤内钙化十分显著,瘤细胞排列呈小梁状、小管状和实体性区域,呈巢状分布（图1）。间质部分为疏松的黏液样基质,部分为纤维性间质,伴有形状不规则的钙化灶（图2）。瘤细胞胞体和细胞核均较大,可见明显的核仁和丰富的嗜酸性胞质。胞质内可见不规则的深红染小体样结构。核分裂象罕见。瘤细胞问可见少量淋巴细胞浸润。未见包膜和血管浸润．也未见Reinke结晶和脂褐素沉积。免疫组织化学染色示瘤细胞S-100蛋白和α-抑制素弥漫强阳性（图3,4）,波形蛋白阳性。但平滑肌肌动蛋白（SMA）、细胞角蛋白（CK）、甲胎蛋白（AFP）、Ki-67阴性。     

海洋来源真菌Penicillium sp. wqh-572的次级代谢产物研究?

目的 研究浙江普陀岛海泥来源真菌Penicillium sp. wqh-572的次级代谢产物及其抑菌活性。方法 将菌株进行大规模发酵,乙酸乙酯萃取,采用小孔树脂MCI柱和半制备型高效液相色谱等分离纯化方法,通过核磁(₁H NMR和₁₃C NMR)和质谱(MS)等波谱分析方法,并与相关文献比较,鉴定化合物结构。结果 从该真菌发酵液的乙酸乙酯萃取相中分离得到6个化合物,鉴定结果分别为physcion (1)、emodin (2)、7-hydroxy-2-(2-hydroxypropyl)-5-methylchromone (3)、isorhodoptilometrin (4)、2-(2’, 4’, 6’-trihydroxyphenyc)-(7-hydroxy-5-methyc) chromone (5)及(Z)-N-(4-hydroxy styryl) formamide (6)。其中,其中化合物5为首次从青霉属真菌中分离得到。化合物1对3种植物病原菌均具有抑制作用。     

利用面板数据模型研究血脂对血压的影响

目的 利用面板数据模型,探讨血脂四项指标对血压的影响。 方法 收集社区居民连续5年的血脂、血压及身高、体重、腰围等体检数据,建立以血压为因变量,以血脂四项指标为自变量,以BMI和腰围为控制变量的面板数据模型,分析血脂水平变化对血压的影响。 结果 单因素模型中,影响收缩压的有甘油三酯、低密度脂蛋白;影响舒张压的有总胆固醇、甘油三酯、低密度脂蛋白。多因素模型中,影响收缩压的有高密度脂蛋白与低密度脂蛋白,影响舒张压的是低密度脂蛋白与甘油三酯,总胆固醇未能进入两个方程。 结论 血脂四项中,总胆固醇不能影响血压,甘油三酯增高会导致舒张压上升,高密度脂蛋白增高会降低收缩压,低密度脂蛋白增高会导致收缩压与舒张压的上升。居民膳食指南中,对于胆固醇的摄入,作出不再受限制的简单的建议是不够的,应该综合当前的研究结果,对脂肪的摄入提出更精准的推荐。