少见的软组织内良性软骨母细胞瘤一例

患者,女,32岁。偶然发现左肘窝有一肿物,无外伤史。查体:左肘前有一肿块约3×5cm,质硬,不移动,无明显压痛,局部皮肤颜色、皮温及感觉正常。肘部伸直正常,屈曲较健侧略受限。 X线检查:于左肘关节之前略偏外方显示1.5×2.5大小边缘不甚规则略呈分叶两团块状钙化阴影,肿块中有多数班点状、索条状钙化,正侧位片未见直接与骨相连接征象,桡骨头骨质未见破坏、增生及局部骨膜反应(图1、2)。     

从筋的生理特点认识筋的损伤

中医所谓的筋是筋络、筋膜、筋腱、软骨的总称。是骨以外的皮、肉、筋、脉等组织的概括。结合现代医学解剖，相当于现代解剖学的四肢和躯干部位的软组织，主要包括肌腱、筋膜、关节囊、韧带、椎间盘、关节软骨盘等软组织。各种外来暴力或慢性劳损等原因所造成的筋的损伤，称筋伤，俗称伤筋，即现代医学所指的软组织损伤。筋的损伤实际上是因为不同原因导致了筋的相应生理特点发生改变，其机能和结构出现异常。因而认清筋的生理特点，分析筋的生理特点是否发生改变对于判断筋是否发生损伤及损伤的性质、种类具有重要的作用。     

耳屏软骨—软骨膜复合体在听力重建术中的应用

目的：探讨用耳屏软骨-软骨膜复合体行听力重建术的疗效。方法：用自体耳屏软骨-软骨膜复合体重建鼓膜和听骨链，并根据听骨链是否完整而采取了不同的术式。结果：48耳手术穿孔均一期愈合，术后随访18个月-5年半，未见再穿孔，术前，术后骨，气导间距分别为22.1dBHL和6.8dBHL，术后较术前平均缩小15.3dBHL。结论：耳屏软骨-软骨膜复合体是修复鼓膜大穿孔的理想材料，并能起到槌骨和/或砧骨的作用。     

髌骨开放性骨折的康复护理

髌骨开放性骨折通常是因受直接暴力打击、跌倒、压轧等原因引起的创伤性疾病 ,其发病率较高 ,若治疗和护理不当 ,易发生创口感染 ,出现创伤性关节炎、骨折畸形愈合或不愈合 ,为了使患者早日康复 ,除给予对症治疗外 ,还需要良好的康复护理配合 ,我们总结了对 10例髌骨开放性骨折患者所行系统的康复护理 ,现报告如下 :1　护理1 1　伤口的护理首先应正确辨认伤口损伤的程度及性质 ,严格进行无菌技术操作。如果处理不当发生感染 ,将会给病人造成肢体残疾等严重后果 ,遇到髌骨开放性骨折患者 ,首先必须做认真彻底的清创 ,用肥皂水或生理盐水由近…     

大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.     

关节滑膜软骨瘤病32例报告

关节滑膜软骨瘤病又称滑膜骨软瘤病〔1〕,是一种少见的慢性关节滑膜增殖性疾病。我院自 1 980年 1月至 2 0 0 2年 1月共收治关节滑膜软骨瘤病 32例 ,现报告如下。1　临床资料1 1　一般资料 :本组 32例 ,男性 2 2例 ,女性 1 0例 ,年龄最小 1 8岁 ,最大 5 2岁 ,平均年龄 4 3岁。从发病到入院时间最短 3个月 ,最长 1 6年 ,平均 3 2年 ,其中发病于膝关节 2 2例 (左膝 1 2例 ,右膝 1 0例 ) ;髋关节 8例 (左髋 4例 ,右髋 4例 ) ;右肩关节 1例 ,右肘关节 1例 ,1 3例有关节外伤史。临床均表现为关节间歇性疼痛、肿胀 ,1 2例活动时弹响、摩擦感 ,5例…     

西脉髌骨爪加粗线环扎治疗严重髌骨粉碎性骨折

自 2 0 0 0年 5月至 2 0 0 2年 7月 ,本院采用西脉髌骨爪加粗丝线环扎治疗严重粉碎性髌骨骨折 1 1例 ,疗效满意 ,报告如下。1　临床资料1 .1　一般资料 :本组 1 1例 ,男 7例 ,女 4例 ;年龄 2 1岁～ 62岁。骨折块最少 8块 ,最多 1 1块。致伤原因 :交通事故伤 6例 ,摔伤 4例 ,打击伤 1例。受伤至手术时间 5小时～ 2天。1 .2　手术方法 :硬膜外麻下仰卧位 ,作髌前纵“S”形切口 ,常规显露髌骨骨折端 ,断裂的韧带和两侧支持带 ,清除关节腔内、骨折间的血块 ,辨别碎骨的解剖关系 ,直视下复位 ,然后用 1 0号粗丝线沿髋骨周缘做上下两边半环形缝合…     

“软骨康”对损伤关节软骨修复机制的初探

我们用中药软骨康,对全层缺损的兔膝关节股骨髁关节软骨,进行三周治疗,取得较为满意的效果。实验结果表明,软骨康在促进成纤维细胞分泌大量胶原纤维,促进组织再生;对血管增生和扩张血管加速局部血循环以及提高滑膜的增生和活性,使其参与损伤组织的再建,均有独到作用。