锁骨骨折切开复位克氏针内固定30例疗效观察

对30例锁骨骨折病人采用切开复位克氏针内固定方法进行手术治疗,经3～12个月随访,全部治愈,无近、远期并发症。文中就锁骨的血液供应、能维持解剖复位和得到生理上的加压应力、上肢功能恢复快等疗效好的因素进行了讨论,对传统的手法复位“∞”绷带外固定的治疗方法和手术适应症提出了见解。认为采用手术治疗具有能达到解剖复位、康复周期短、操作简单、易于基层开展等优点。     

Comparative effect of cadmium on osteoblastic cells and osteoclastic cells

Cadmium(Cd) has been thought to disturb the bone metabolism directly. The mechanism for the bone lesion is unknown, however. To examine the effects of cadmium on bone metabolism, we compared its effects on osteoblasts and osteoclasts in vitro. We used an established cell line, MC3T3-E₁, as osteoblasts and tartrate resistant acid phosphatase (TRACP)-positive multi-nucleated cells (MNC) formed by a bone marrow culture system as osteoclasts. Alkaline phosphatase (ALP) activity was decreased by 10^–7 M Cd and DNA content and hydroxyproline content of osteoblastic cells were decreased by 10^–5 M Cd. Cadmium at 10^–7 M inhibited the osteoclastic cell formation from mouse bone marrow in the presence of 10^–8 M 1,25(OH)₂ vitamin D₃. A 100-fold higher concentration of zinc(Zn) simultaneously added to the cadmium-containing medium prevented the toxicity of cadmium to osteoclastic cells as observed in the culture of osteoblastic cells. These results indicate that both bone formation and bone resorption are inhibited by cadmium. The responses of osteoclasts and osteoblasts to cadmium in this culture system were the same and the responses of cadmium-damaged osteoblasts and osteoclasts to zinc were also similar. These results suggest that another mechanism by which cadmium could cause bone damage should be considered in addition to the specific induction of osteoclastic cells by Cd.     

论“筋主骨从”观念在慢性筋骨病损诊疗中的临床意义

生理状态下,筋附骨、骨撑筋,二者的自身结构和功能特点决定了筋与骨之间是筋主骨从的关系,这是维系筋骨和合的前提和根本。当直接或间接暴力作用下,筋骨系统遭受严重急性损伤时,治当筋骨并重;而对于慢性筋骨病损而言,其关键病理环节是筋出槽、骨错缝,治疗的重点应是筋伤,故而治则又当筋主骨从。在慢性筋骨病损中秉持"筋主骨从"的观念进行诊断与治疗,有助于早期发现病变、提高临床疗效,故而本文主要目的在于唤起中医骨伤科临床工作者对"筋伤"的高度重视。     

酒精性肝病常见临床综合征

酒精性肝病仅次于病毒性肝硬化已经成为终末期肝病的重要病因,但过量饮酒对身体造成的损伤并没有得到广泛关注,特别是一些中晚期的临床综合征,如马德龙综合征、假性布加综合症、酒精诱发的骨病、酒精戒断综合征等已经显现,临床上还不能得到准确认识和及时治疗,导致一些不可逆的损伤。通过介绍这4种综合征的临床表现、可能机制、治疗原则,旨在提高临床医师重视这些过量饮酒的信号,及早预防和阻止酒精性肝硬化的发生与发展;对于酒精戒断综合征的早期认识和及时有效的治疗,不仅能够减少误诊误治,还可减少重症监护状态下患者的病死率。