骨水泥强化椎弓根螺钉固定治疗老年退行性腰椎疾病的疗效观察

目的评价骨水泥强化椎弓根螺钉固定治疗老年退行性腰椎疾病的近期临床疗效。方法回顾性分析2011年6月~2013年5月采用聚甲基丙烯酸甲酯(PMMA)骨水泥强化椎弓根螺钉固定结合后路椎体间植入聚醚醚酮(PEEK)材质椎间融合器治疗老年退行性腰椎疾病30例。所有患者术前骨密度检测均符合骨质疏松诊断(超声骨密度值测定-2.5)。结果 30例患者均顺利完成手术,术中无神经及硬膜损伤,骨水泥无严重渗漏,术后复查X线、CT显示骨水泥分布均匀。随访10~21个月,平均(16±2.11)个月,神经受压症状均得到改善。VAS评分术前(7.01±1.44)、术后6个月随访为(3.00±0.57)、末次随访为(2.23±1.19);JOA评分术前为(9.98±5.64)、术后6个月随访为(17.99±1.41)、末次随访为(18.42±1.47);ODI评分术前为(0.64±0.24)、术后6个月为(0.27±0.07)、末次随访为(0.22±0.09)。三项评分术后6个月、末次随访分别与术前对比差异有统计学意义;术后6个月和末次随访对比差异无统计学意义。末次随访时复查X线或CT显示椎弓根螺钉无松动,椎间融合器无下沉,椎间融合满意,融合率为86.7%。结论使用骨水泥强化椎弓根螺钉能够提高螺钉对伴有骨质疏松的椎体的握持力,防止椎弓根螺钉松动,保证较高的椎间融合率,是治疗老年退行性腰椎疾病一种安全而有效的手术方式。     

HA/PDLLA复合材料的体内成骨过程研究

目的研究HA／PDLLA复合材料植入体内后与细胞、组织的相互作用，探讨HA／PDLLA复合材料在体内的成骨过程，为其临床应用及设计具有生物功能的人工骨替换材料和骨组织工程支架材料提供依据。方法采用液相吸附法制备了HA／PDLLA复合材料，以纯PDLLA和空白组进行对照，进行体内植入实验，通过组织学观察和四环素标记考察其成骨过程。结果HA／PDLLA复合材料植入机体后，体内的无菌性炎症轻微，新骨形成速率高于PDLLA材料。HA微粒的存在，加强了复合材料的机械强度，使之可以避免过早的丧失力学强度。第24w时，材料被组织分隔包裹，新生骨组织长入材料，骨愈合情况良好。结论HA／PDLLA复合材料具有良好的生物相容性、生物降解性能、生物学活性和骨传导性能。     

Investigating the effects of bone cement, cyanoacrylate glue and marine mussel adhesive protein from Mytilus edulis on human osteoblasts and fibroblasts in vitro

Bone cement is a widely used standard fixation substance in Orthopaedic Surgery. Cyanoacrylate glue is available for wound closure to supplement suturing. The mussel adhesive protein extracted from Mytilus edulis (Cell-Tak©, BD Biosciences, Heidelberg, Germany) is an experimental fixation device used for in vitro purposes of cell adhesion.

The aim of this study is to introduce a cell culture model investigating the effects of commonly applied and experimental glues on human fibroblasts and osteoblasts in vitro. Cells cultured without additives served as a control group. Microscopic examination was performed to evaluate the morphologic changes. An apoptosis test (Apo-Tag©, Chemicon International, Temecula, CA, U.S.A.) was applied to determine the rate of natural cell death at the end of the study.

It could be demonstrated that morphological changes in bone cement are different in fibroblasts and osteoblasts. Osteoblasts seem to grow on bone cement and develop an orderly formation. Fibroblasts grow in a confluent monolayer around bone cement but do not adhere to the cement itself. This is a desirable effect since most Orthopaedic applications aim at osteointegration as opposed to fibrous tissue overgrowth. Apoptosis attributed to bone cement is comparable to the respective natural rate of apoptosis. Cyanoacrylate glue and the mussel adhesive protein lead to an almost complete apoptosis in the investigated cells. Their routine application should be avoided. The developed cell culture model seems appropriate for performing further investigations.     

Bioreactions at the tissue/hydroxyapatite interface

The events at the hydroxyapatite implant material/tissue interface in the rat middle ear were studied by light microscopy, autoradiography, morphometry, transmission electron microscopy (TEM), scanning electron microscopy (SEM), and X-ray microanalysis. Deposition of calcium, partially in the form of calcium phosphate, was found at the interface. Resorption of the implant material occurred as the result of mono- and multinuclear phagocyte activity. Resorption decreased 6 mnth after the operation, possibly due to the decreasing number of phagocytes at the interface and the increasing amount of bone in the macropores.     

Dual antibiotic loaded bone cement in patients at high infection risks in arthroplasty: Rationale of use for prophylaxis and scientific evidence

In view of the demographic changes and projected increase of arthroplasty procedures worldwide, the number of prosthetic joint infection cases will naturally grow. Therefore, in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance. In the absence of a "miracle weapon" priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks, the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen. Instead of a "one size fits all" philosophy, it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors. A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre. The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.     

溶胶-凝胶法制备纳米羟基磷灰石粉体的研究进展

目的 利用溶胶凝胶法制备纳米羟基磷灰石粉体的方法进行研究。方法综述了溶胶凝胶法的基本原理和分类，介绍了制备纳米羟基磷灰石粉体采用的溶胶-凝胶方法，提出了相关待解决的问题。结果溶胶-凝胶法的研究已取得一定的进展。结论利用该方法有望制备出形状可控、粒度均匀的纳米羟基磷灰石粉体。     

人工义眼台治疗眼窝凹陷畸形23例

目的;观察眼球摘除后羟基磷灰石义眼台植入物眼窝成形术的疗效。方法：采用巩肛 埋羟基磷灰石义眼台做为眼球摘除术后眼窝成形的填充物,观察２３例成形效果。结果：患者获得良好的义眼运动,术后并发症少,效果满意。结论：羟基磷灰石义眼台适合各种眼窝凹陷畸形患者的整形。     

Surgically Controlled, Transpedicular Methyl Methacrylate Vertebroplasty with Fluoroscopic Guidance

Summary  The authors report a series of 13 patients with osteoporotic vertebral fractures treated by transpedicular vertebroplasty. Because of a neurological complication due to posterior leakage of acrylic cement the classical percutaneous approach was converted to an open surgical procedure. The latter allows direct visual control of neural structures and immediate removal of spilled cement, thus eliminating the danger of compressive, chemical and thermal effects of methyl methacrylate on neural elements.  By use of this elegant technique primary stability of fractured vertebras is obtained leading to prompt pain relief in all patients. Surgically controlled vertebroplasty can be used in conjunction with internal fixation. By having studied the different ways of cement escape in their patients, the authors are convinced that surgically controlled vertebroplasty is safer than percutaneous vertebroplasty.