可吸收螺钉治疗股骨头骨折12例报告

目的 探讨应用可吸收螺钉治疗股骨头骨折的效果。方法 对12例股骨头骨折患使用可吸收螺钉行内固定治疗。结果 术后平均随访1．5年，患髋关节功能恢复良好，无骨折部位感染和股骨头坏死等并发症。结论 可吸收螺钉不需再次手术取出内固定，是股骨头骨折理想的内固定材料。     

Osteoclastogenesis in the nonadherent cell population of human bone marrow is inhibited by rhBMP-2 alone or together with rhVEGF.

During bone development and repair, angiogenesis, osteogenesis, and bone remodeling are closely associated processes that share some common mediators. In the present study nonadherent human bone marrow mononuclear cells under the induction of sRANKL and M-CSF, differentiated into osteoclasts with TRAP-positive staining, VNR expression, and Ca-P resorptive activity. The effects of various combinations of rhBMP-2 (0, 3, 30, and 300 ng/mL) and rhVEGF (0 and 25 ng/mL) on osteoclastogenesis potentials were examined in this experimental system. The percentages of TRAP-positive multiple nucleated cells represent osteoclast differentiation potential, and the percentages of resorptive areas in the Ca-P coated plates resemble osteoclast resorption capability. The presence of rhBMP-2 at 30 and 300 ng/mL showed inhibitory effects on osteoclast differentiation and their resorptive capability in the human osteoclast culture system. rhVEGF (25 ng/mL) enhanced the resorptive function of osteoclast whenever it was used alone or combined with 3 ng/mL rhBMP-2. However, rhVEGF-induced resorptive function was inhibited by 30 ng/mL and 300 ng/mL rhBMP-2 in a dose-dependent manner. Statistical analysis demonstrated that an interactive effect exists between rhBMP-2 and rhVEGF on human osteoclastogenesis. These findings suggested that an interactive regulation may exist between BMPs and VEGF signaling pathways during osteoclastogenesis; exact mechanisms are yet to be elucidated.     

臀上血管深上支的应用解剖

本文观察了52侧(男46,女6)成人尸体臀上动、静脉深上支进入髂嵴情况.臀上动、静脉深上支分为前、中、后支;本文测量了臀上动、静脉深上支的外径及各分支进入髂嵴的距离.臀上动、静脉深上支的分支在髂嵴前部及中部分布较多,前支的分支为3～8支,其中以4～6支者为多见,占78.8±5.5％;中支的分支1～4支,其中以2～3者为多见,占73.1±6.1％.因此,臀上动脉深上支作为游离髂骨移植术取髂嵴的前部和中部较宜.     

Bone remodeling during the development of osteoporosis in paraplegia

Summary Osteoporosis developing during the first weeks after the onset of traumatic paraplegia was studied with cortical and cancellous samples of iliac crest and tibia of 14 patients, and compared to normals. We used a procedure of bone particle fractionation (according to degree of mineralization) that allowed us to establish a profile reflecting the metabolic remodeling of bone and to analyze the organic matrix of the newly synthesized tissue. In paraplegics, we observed a large increase in the proportion of little calcified bone in the cortical as well as in the cancellous bone. Based on amino acid analyses, we found a decreased number of hydroxyproline residues in the newly synthesized organic matrix from paraplegia bone resulting either from an alteration of the prolyl hydroxylation or from the presence of an excess of noncollagen polypeptides. These results, together with previously published data reporting increased urinary hydroxylproline and calcium kinetic parameters, suggest an enhanced rate of skeletal remodeling in acute paraplegia. When investigated 2 years after injury, the patterns of distribution approach that of normal subjects.     

流式细胞术检测非小细胞肺癌患者骨髓微转移

目的　应用流式细胞术检测非小细胞肺癌患者骨髓中的微转移。方法　骨髓经Ficoll梯度离心分离单核细胞后,用细胞角蛋白 19(Cytokeratin, CK19)单克隆抗体染色,应用流式细胞仪检测。结果　检测了 96例肺癌患者骨髓,发现 25例患者骨髓中有微转移。20例肺良性病变患者、10例正常人骨髓均无微转移。肺癌患者阳性率与患者病理分期、分化程度和细胞组织学类型密切相关 (P<0. 05)。结论　应用流式细胞术检测非小细胞肺癌患者骨髓中的微转移,有助于肺癌的综合治疗。     

Thermal analysis of the bone surface induced by laser radiation

High energy laser has emerged to be an important surgical tool in medical technology. However, the application of laser energy to drill or cut a bone is still in an experimental state. In order to estimate the adequacy of laser heating of bone surface and at the same time minimize the damage to the bone tissue, we developed a mathematical model of the temperature distribution in bone due to laser irradiation. The thermal analysis shows that the temperature distribution depends on several parameters, including the density, the specific heat, and the thermal conductivity of the osseous tissue.     

Review of non‐positron emission tomography functional imaging of primary musculoskeletal tumours: Beyond the humble bone scan

Bone and soft tissue tumours are rare neoplasms. There are five major roles of imaging in the management of primary musculoskeletal tumours, that is, to differentiate between benignity and malignancy, to evaluate for local tumour extension, to screen for metastases, to judge the effect of chemotherapy, and to monitor for recurrence. To accomplish this, multiple modalities are required because no single examination is able to complete all these tasks. These modalities include plain radiography, CT, MRI, conventional nuclear medicine as well as positron emission tomography (PET) imaging. Elsewhere, PET imaging has been discussed at length, because it is likely to be superior in the assessment of bone and soft tissue tumours over conventional nuclear medicine procedures. However, conventional nuclear medicine may be of value when PET is unavailable. In this review, an overview of anatomical imaging will be given and the role of non‐PET functional imaging will be discussed in detail. A variety of illustrative cases will be presented.     

Benign giant cell tumor of bone with osteosarcomatous transformation (”dedifferentiated” primary malignant GCT): report of two cases

 It is not uncommon for sarcomatous transformation of giant cell tumor (GCT) of bone to occur after radiation, but rarely does malignant transformation occur spontaneously, with less than 15 cases reported up to 1995. Only four of these cases have been documented in detail. We report two additional cases of GCT of bone spontaneously transforming or ”dedifferentiating” into osteosarcoma without radiation therapy. The first case is absolutely unique and most interesting in that the dedifferentiation process occurred in one of multiple GCT lung metastases 6 years after successful eradication of a primary tibial tumor. The right lung was resected due to development of a large tumor, and at pathologic examination, demonstrated several small nodules of conventional GCT and a much larger, 14-cm mass composed of a mixture of GCT and high-grade osteosarcoma. The second case involved a physician, who had a large tumor in the sacrum with vague symptoms for 8 years. Open biopsy revealed conventional, benign GCT of bone with a secondary aneurysmal bone cyst. Complete curettage 2 weeks later revealed, in addition to areas of conventional, benign GCT a second component of very high grade osteosarcoma. Both patients died less than 1.5 years from diagnosis. This report of osteosarcomatous transformation of a conventional GCT of bone strengthens the theory that there is a mesenchymal cell line in GCT that may spontaneously tansform to sarcoma.     

骨感染病人TNF-α、IL-6和C反应蛋白的检测及临床意义

①目的　探讨骨感染病人肿瘤坏死因子α(TNF α)、白细胞介素 6 (IL 6 )和C反应蛋白 (CRP)水平的变化及意义。②方法　采用双抗体夹心ELISA法测定 30例骨感染病人及 2 5例正常人的血清TNF α、IL 6水平 ,采用散射比浊法测定CRP水平。③结果　骨感染病人血清中TNF α、IL 6及CRP含量均处于高水平状态 ,与健康人比较 ,差异有显著性 (t=2 .2 6～ 10 .6 7,P <0 .0 5、0 .0 1)。④结论　TNF α、IL 6及CRP是预测骨感染病人病情危重的重要指标之一 ,对临床有一定指导意义