带锁髓内钉固定并植骨治疗陈旧性股骨干骨折

目的 评价带锁髓内钉并植骨治疗股骨干陈旧性骨折的临床疗效和优点。方法 对1996年2月～2003年11月收治的47例陈旧性股骨干骨折患者进行回顾性分析。其中植骨组28例，非植骨组19例。采用切开复位，带锁髓内钉扩髓，静力型固定，根据骨折部位生长情况改为动力型固定。结果 术后随访39例，随访lO～25个月，平均随访时间14．2个月。植骨组骨折愈合率为95．6％(22／23)，感染率为4．3％(1／23)，骨折平均愈合时间为6．3个月，非植骨组则分别为62.5%(10／16)，6．25％(1／16)和9．7个月。临近关节功能达正常，无感染、断钉等并发症。结论 带锁髓内钉静力固定能有效控制有害的剪应力，同时对骨折有一定的加压作用，可提供早期坚强的内固定，同时，植骨后骨折愈合快，并发症少，是治疗陈旧性骨折的理想方法。     

核素动态显像因子分析诊断股骨头缺血性坏死的应用初探

本文介绍了的核素动态显像因子分析成象原理与方法，并对１０例正常人和２８例成人股骨头缺血性坏死（ＡＦＨＩＮ）病人进行了放射性核素显像因子分析，结果表明：ＡＦＨＩＮ病人病变股骨的骨因子图像表现为明显浓聚，随病情加重股骨头头影像增大，且逐渐增浓。Ⅰ、Ⅱ期ＡＦＨＩＮ病人软组织因子图像无异常，Ⅲ期以上者的软组织因子图像可见髋关节处有明显浓聚。因此，核素动态显像因子分析不但可以早期诊断ＡＦＨＩＮ，而且对该病的分期判定也有重要的临床应用价值。     

Sparing of the flexor carpi ulnaris in ulnar neuropathy at the elbow

A common misconception attributes sparing of the flexor carpi ulnaris (FCU) in ulnar neuropathy at the elbow (UNE) to its innervating branch arising "at or above the elbow." We examined the relationship of FCU branches to the medial epicondyle (ME) and humeroulnar aponeurotic arcade (HUA) in 30 cadaver elbows. In only three did the first FCU branch arise at or proximal to the ME. In 36 UNE cases with fibrillations in the first dorsal interosseous, the FCU was normal in 10, mildly abnormal in 11, and severely abnormal in 15. FCU involvement correlated with the severity of the neuropathy and with whether compression was retroepicondylar or at the HUA. We conclude that sparing of the FCU in UNE is unrelated to the level of origin of its innervating branch, but rather is related to the internal neural topography and to the severity and level of compression.     

Arterial endothelial function in a porcine model of early stage atherosclerotic vascular disease

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States and is projected to become the leading cause of mortality in the world. Atherosclerosis is the most important single factor contributing to this disease burden. In this study, we characterize relationships between endothelial dysfunction and vascular disease in an animal model of diet-induced, early-stage atherosclerotic vascular disease. We tested the hypothesis that hypercholesterolaemia induces vascular disease and impairs endothelium-dependent relaxation (EDR) in conduit arteries of adult male Yucatan pigs. Pigs were fed a normal fat (NF) or high fat cholesterol (HFC) diet for 20-24 weeks. Results indicate that, while the HFC diet did not alter EDR in femoral or brachial arteries, EDR was significantly decreased in both carotid and coronary arteries. Sudanophilic fatty streaks were significantly present in the abdominal aorta and common carotid artery. Histopathology revealed increased intima-media thickness (IMT) and foam cell accumulation in Stary Stage I-III lesions in the abdominal aorta, common carotid artery and femoral arteries. In the coronary arteries, the accumulation of foam cells in Stary Stage I and II lesions resulted in a trend for increased IMT. There was no evidence of vascular disease in the brachial arteries. These results indicate that early stages of CVD (Stary Stage I-III) precede decreases in EDR induced by HFC diet, because femoral arteries exhibited foam cell accumulation and an increased IMT but no change in endothelial function.     

狗股动脉拉伸损伤后的顺应性变化

采用成年狗正常股动脉段６例，测定其拉伸后的压力一容积关系，并求出其顺应性。另取狗股狗股动脉段３０例拉伸固定后，观测其形态结构变化。发现狗股动脉段拉伸后的Ｐ－Ｖ曲线可用抛物线来拟合，狗股动脉段拉伸１５％后顺应性明显下降，其形态结构无明显改变，拉伸３０％后才出现明显的结构改变。狗股动脉拉伸后顺应性变化的出现较形态结构变化早。     

Construction of a risk model of steroid-induced necrosis of the femoral head and prediction of potential Chinese medicine treatments北大核心

背景:随着疾病治疗模式的改变,人们已经意识到中医药在激素性股骨头坏死治疗过程中的重要性,因此利用生物信息学从分子水平分析激素性股骨头坏死的发病机制,构建疾病风险模型,并预测具有潜在治疗作用的中药,为后期中医药治疗激素性股骨头坏死提供一定的理论依据。目的:基于生物信息学挖掘激素性股骨头坏死的竞争性内源RNA(ceRNA)调控网络,分析其在激素性股骨头坏死中的分子调控机制,预测相关疾病靶点并构建疾病风险模型,同时预测具有潜在治疗作用的中药。方法:检索GEO数据库,下载激素性股骨头坏死的矩阵文件GSE123568和基因注释文件GPL15207。借助R语言等软件分析得到差异表达的长链非编码RNA与mRNA,并通过公共数据库预测与差异表达长链非编码RNA关联的miRNA-mRNA,再将预测到的mRNA与差异表达mRNA取交集,整合得到ceRNA网络。随后采用STRING数据库和Cytoscape软件筛选关键基因,利用R语言分析关键基因的功能与相关通路,并挖掘关键ceRNA网络。最后根据关键基因构建激素性股骨头坏死的风险模型,并进行中药预测。结果与结论:(1)与健康对照相比,激素性股骨头坏死患者共有7个长链非编码RNA和1763个mRNAs存在差异表达;(2)筛选出STAT3、KAT2B、AGO4、JAK2、JAK1、PTGS2共6个关键基因;(3)关键基因所富集的功能包括对肽激素的反应、白细胞介素6介导的信号通路、细胞对白细胞介素6的反应等生物学过程,涉及JAK-STAT、脂肪细胞因子、催乳素等信号通路;(4)4种mi RNAs(mi R-135a-5p、mi R-137、mi R-17-5p、miR-20b-5p)和2种长链非编码RNA(SNHG11、C20orf197)可能在导致激素性股骨头坏死发生发展过程中发挥关键作用;(5)KAT2B最有可能是激素性股骨头坏死发生发展的风险因子;(6)郁金、淫羊藿、黄芪具备治疗激素性股骨头坏死疾病靶点的可能。通过对激素性股骨头坏死相关长链非编码RNA介导的ceRNA网络进行分析,识别出潜在的疾病靶点、信号通路及潜在治疗中药,为进一步阐明其发病机制,并为后续的实验研究提供参考依据。     

The Genée-Wiedemann syndrome,an acrofacial dysostosis—further observation

We report on a consanguineous Brazilian couple whose 2 children had tibial aplasia-ectrodactyly. Femoral bifurcation was present in one of the affected children. The relationship of tibial aplasia-ectrodactyly to the Gollop-Wolfgang complex is discussed. Clinical and genetic aspects of the conditions involving tibial aplasia and femoral bifurcation are discussed.     

MRI of bilateral bipartite hamulus: a case report

Normal skeletal variants are a common occurrence in clinical practice and may lead to misinterpretation. As part of a case control study investigating the carpal tunnel, our asymptomatic and voluntary participant underwent magnetic resonance (MR) imaging of both wrists from the metacarpal bases to the distal radiocarpal joint. The imaging techniques included spin echo (SE), turbo spin echo (TSE) and fast field echo (FFE) sequences using 4 mm-slice thickness. As an incidental finding bipartite hamulus was detected bilaterally. The anomaly was evident in both hamuli with similar MRI characteristics. The congenital origin was further supported by the absence of trauma or surgery to the wrists. In this case report the authors discuss the anatomical variant, bilateral bipartite hook of the hamate, and demonstrate the reliability of contiguous slices of MR axial slices in displaying an anatomical variant of the carpus. This normal variant of the hamate is not commonly encountered in MR imaging of the wrist and can be misinterpreted as fracture or post-traumatic sequelae. Images of the normal hamulus are presented for comparison.     

缺血性股骨头坏死患者血清透明质酸及层粘连蛋白的研究

为探讨细胞外间质主要成分透明质酸（ＨＡ）与层粘连蛋白（ＬＮ）在缺血性股骨头坏死（ＩＮＦＨ）中的生理病理过程及临床价值，采用放射免疫分析法对４５例不同病因的ＩＮＦＨ患者进行了血清ＨＡ与ＬＮ的定量分析，并与３０例正常人对照。结果显示，ＩＮＦＨ患者血清ＨＡ含量极显著地高于对照组（ｔ＝３－２９；Ｐ＜０－０１）。尤以激素性ＩＮＦＮ增高最为显著（ｔ＝３－６２；Ｐ＜０－０１）。ＩＮＦＨ患者ＬＮ含量亦明显高于对照组（ｔ＝２－８４；Ｐ＜０－０１）。同时，ＨＡ与ＬＮ含量增高与病程发展密切相关。故定量检测ＨＡ与ＬＮ可作为ＩＮＦＨ早期诊断及判断预后的良好指标     

中国人群DXS102座位多态性鉴定及其应用

目的探讨中国人群中ＤＸＳ１０２座位的多态分布。方法应用ＰＣＲ扩增片段长度多态性（Ａｍｐ－ＦＬＰ）研究了无亲缘关系的２３４条Ｘ染色体。结果ＤＸＳ１０２座位等位片段有８个，核心单元ＡＣ二核苷酸重复数为１３～２１，频率分布在０．０１３～０．１５６之间，杂合度观察值和无偏估测值分别为０．８７和０．８０，多态信息含量（ＰＩＣ）０．８０，女性基因型数为２２个，男性基因型数为８个，该座位多态分布符合Ｈａｒｄｙ－Ｗｅｉｎｂｅｒｇ平衡定律。ＤＸＳ１０２座位在中国人群和欧洲人群的分布有明显的种族差异，在中国人群中发现了两个新的等位片段。应用ＤＸＳ１０２座位的短串联重复序列多态性对一接受基因治疗的血友病Ｂ家系进行分析和携带者筛查。结论ＤＸＳ１０２座位连锁分析有望成为一种有效的血友病Ｂ基因诊断的方法。