应力松弛接骨板对骨几何形态和力学性能影响的实验观察

作者采用粘弹性材料制成垫圈置于接骨板螺孔与螺丝钉之间，构成应力松弛接骨板系统。实验证实，有垫与无垫接骨板在固定早期对模拟骨的应力遮挡作用相同，固定８周后垫圈出现明显变形和破坏，使有垫接骨板的应力遮挡率从第１０周起明显低于无垫接骨板。有垫接骨板固定的胫骨骨质疏松明显轻于无垫组，固定２０周后，有垫组的胫骨髓腔径明显小于无垫组，骨皮质厚度和胫骨抗弯强度均明显大于无垫组（Ｐ＜０．０５～０．０１）。说明应力松弛接骨板系统早期具有与坚强接骨板相同的固定作用，后期其应力遮挡效应可逐渐减小，避免严重的骨质疏松和骨力学性能下降。     

Can bone metabolism markers be adopted as an alternative to scintigraphic imaging in monitoring bone metastases from breast cancer?

Bone scintigraphy plays a major role in the diagnosis of bone metastases. The clinical utility of new biochemical markers of bone metabolism has recently been investigated in various bone diseases. This study evaluated the role of some bone metabolism markers in comparison with bone scan in the follow-up of breast cancer patients. We studied 149 patients with breast cancer, 33 (22%) of whom had bone metastases. IRMAs were used for the evaluation of blood levels of osteocalcin, bone alkaline phosphatase (BAP), the C-terminal propeptide of type I procollagen and the C-terminal cross-linked telopeptide of type I collagen (ICTP). Multivariate regression analysis showed that menopausal status (P=0.007) and metastatic bone lesions (P=0.001) affected bone marker levels. When considering post-menopausal women, the only subset in which bone metabolism marker behaviour could be reliably investigated, we found a high degree of overlap in marker distribution for scan-positive and scan-negative patients. Discrimination between scan-negative and scan-positive patients based on the above markers, taken singly or jointly, was assessed by means of logistic discriminant analysis. The best discrimination was achieved with BAP, closely followed by ICTP. BAP and ICTP together gave a slight improvement over the use of the two markers separately. However, even in this case the degree of discrimination was poor and its clinical utility was limited. In fact, to achieve a specificity of 95%, the sensitivity of the test was about 20%; conversely, with a sensitivity of 95%, the specificity was below 10%. In conclusion, based on our findings, we believe that blood levels of the investigated markers cannot replace bone scintigraphy in the follow-up of breast cancer patients for the early detection of bone metastases. Received 14 April and in revised form 5 July 1997     

自体骨髓多次注射治疗家兔骨缺损的实验研究

目的：观察骨髓多次注射的成骨性能。方法：利用家兔实验性骨缺损模型，通过大体、组织学观察，生物力学测定，评价骨髓不同移植次数促进骨缺损愈合的情况。结果：骨髓单次移植能够促进骨缺损的愈合，然而，骨髓二次移植组骨折愈合程度明显优于骨髓单次移植组，但骨髓三次移植组与骨髓二次移植组骨折愈合无明显差异。结论：在骨折愈合早期增加骨髓移植次数，能明显增强骨髓的成骨能力，加快骨折愈合     

Dietary Xylitol Retards the Ovariectomy-Induced Increase of Bone Turnover in Rats

The effects of 10% dietary xylitol supplementation in ovariectomized rats were studied on the degradation of bone organic and inorganic structures. The osseal concentrations of hydroxyproline, pyridinoline, and deoxypyridinoline were analyzed by high-performance liquid chromatography. Bone resorption was measured in [³H]tetracycline-prelabeled rats by urinary excretion of ³H, and by the amount of ³H preserved in bone. Bone trabeculation was measured by a computer image analyzer from sections stained by the method of von Kossa. The amount of collagen in bone organic fraction was lower in ovariectomized rats as compared with the sham-operated controls. This most likely is partly a consequence of an increased resorption, and partly a consequence of a higher proportion of immature periosteal bone in the ovariectomized animals, leading to a higher ratio of noncollagenous protein to collagen. The number of pyridinium crosslinks was lower in proportion, indicating no selective changes in the structure of collagen. Dietary xylitol significantly retarded the ovariectomy-associated decrease in the relative amount of collagen and the number of its mature crosslinks. Ovariectomy doubled the excretion of ³H and caused a significant decrease in the amount of ³H preserved in bone; both these changes were significantly retarded by the 10% dietary xylitol supplementation. Ovariectomy significantly decreased the volume of bone trabeculae, but this effect was also significantly inhibited by the xylitol supplementation in the diet. In conclusion, these findings suggest a dietary xylitol-induced normalizing effect on the rate of bone turnover in ovariectomized rats. Received: 12 February 1996 / Accepted: 20 August 1996     

手部创伤性骨关节缺损的处理

治疗手部骨关节缺损常采用植骨内固定、关节融合、关节成形及关节置换等方法．为总结经验，对１９８９年以来１０１例手部创伤性骨与关节缺损进行分析。单纯掌、指骨缺损３９例，行直接短缩对位，克氏针内固定６例，１例发主骨不连；对３３例缺损较大者用自体骨块植入克氏针交叉内固定，部分病例同时植人ＲＢＸ或异体骨粒，１０例发生延迟愈合，余全部正常愈合。骨与关节部分或完全缺损６２例，采用关节成形术４６例，其中以肋软骨移植效果最好，骨膜移植次之，筋膜衬垫或硅胶膜植入法较差；行关节融合术１１例．均达顺利融合；采用自体关节置换５例，均成活，术后关节活动度均＞７０°。我们认为：自体骨块植入克氏针交叉内固定，必要时植入ＲＢＸ骨粒．是治疗手部创伤性骨缺损的有效方法。关节缺损应按关节的重要性，分别采用关节融合术、关节成形术或关节置换术。     

The Domain of Hypertrophic Chondrocytes in Growth Plates Growing at Different Rates

In this study, we tested the hypotheses that (a) both the domain volume (volume of the cell and the matrix it has formed) and matrix volume of juxtametaphyseal hypertrophic chondrocytes in the growth plate is tightly controlled, and that (b) the domain volume of juxtametaphyseal hypertrophic chondrocytes is a strong determinant of the rate of bone length growth. We analyzed the rate of bone length growth (oxytetracycline labeling techniques) and nine stereologic and kinetic parameters related to the juxtametaphyseal chondrocytic domain in the proximal and distal radial and tibial growth plates of 21- and 35-day-old rats. The domain volume increased with increasing growth rates, independent of the location of the growth plate and the age of the animal. Within age groups, the matrix volume per cell increased with increasing growth rates, but an identical growth plate had the same matrix volume per cell in 21- and 35-day-old rats. The most suitable regression model (R ²= 0.992) to describe the rate of bone length growth included the mean volume of juxtametaphyseal hypertrophic chondrocytes and the mean rate of cell loss/cell proliferation. This relationship was independent of the location of the growth plate and the age of the animal. The data suggest that the domain volume of juxtametaphyseal hypertrophic chondrocytes, as well as the matrix volume produced per cell, may be tightly regulated. In addition, the volume of juxtametaphyseal hypertrophic chondrocytes and the rate of cell loss/rate of cell proliferation may play the most important role in the determination of the rate of bone length growth. Received: 2 December 1996 / Accepted: 24 March 1997     

Drawing the Boundaries: Exploring gender issues in young children's classifications of work using visual representations

This study examines young children's perceptions of work through a specific example. Reception class children at an inner city school were shown pictures of the same figure washing in four different contexts, ranging from housework to paid employment, in order to examine early classifications and conceptual systems relating to the concept of work and to ascertain whether these were gender related. Individual children varied in the complexity of their ideas, but the majority had not yet began to form hierarchical classifications of work which favour paid employment. There was evidence however that some children were beginning to devalue traditional women's work, suggesting that gender stereotypes are still prevalent amongst this age group, despite efforts by the educational system to counter this.     

骨形成蛋白(BMP)复合材料的实验研究

作者利用异种、同种、半脱钙骨基质明胶和羟基磷灰石四种材料植入20只大鼠肌肉内,通过光学显微镜观察比较了各种材料的吸收速度、抗原性和成骨情况。结果表明,异种骨基质明胶在植骨早期有轻度的排斥反应。羟基磷灰石不易被吸收,无诱导成骨作用。同种骨基质明胶适合作为较小骨缺损的骨形成蛋白复合材料,修复较大骨缺损,半脱钙骨基质明胶是较佳的复合材料。