雷公藤单体T4对IL-1刺激引起的类风湿患者关节滑膜成纤维细胞增殖和产生IL-6的影响

目的　探讨雷公藤单体 T4对经 IL- 1刺激的体外培养的类风湿关节炎 (RA)患者的关节滑膜成纤维细胞增殖和产生 IL- 6的影响。方法　关节滑膜组织来自行关节置换术或滑膜切除术的类风湿患者。滑膜组织经体外消化使细胞分散后 ,传代培养。以培养 3代后的滑膜成纤维细胞为对象 ,先给予 IL- 1刺激 ,再加入雷公藤 T4单体。结果　 T4可抑制由 IL- 1刺激的滑膜成纤维增殖 ,但不影响 IL- 6的产生。结论　 T4的上述作用可能是其治疗RA的机制之一 ,本研究结果为 T4早日应用于临床治疗 RA提供了一定的理论依据     

带蒂皮瓣修复关节损伤的实验研究

目的：将家兔带蒂皮瓣移植于破坏掉关节软骨的股骨头上,探讨皮肤成纤维细胞的成软骨潜能。方法：用家兔２０只,每只任选一侧股骨头作为实验组,对侧作为对照组。将带蒂皮瓣移植于破坏掉了关节软骨的股骨头上后,将股骨头复位,作为实验组。对侧则以游离全厚皮片作对照。分别在术后８ｗｋ、１６ｗｋ时各探查１０只动物,通过肉眼观察,光镜观察移植物的转归。结果：实验组皮瓣成活并以骨头愈合,表皮逐渐变性消失,真皮纤维组织增生     

Ultrasound of femoral head cartilage: a new method of assessing bone age

This paper analyses the relationship between the thickness of the anterior femoral head cartilage (FHC), as measured by ultrasound, and some anthropometric parameters, such as height, weight, skeletal and chronological age. In addition, it provides standard norms for FHC thickness in a paediatric population. Both hips were examined in 213 consecutive subjects (99 boys and 114 girls), aged 1.9–14 years. Seventy-four subjects underwent hand and wrist X-rays for skeletal maturation: 32 of these were dropped from the study because a discrepancy as high as two standard deviations was found between their skeletal and their chronological age. The thickness of FHC correlated strongly with skeletal and chronological age, standing height and body weight. A side difference of 0.2 mm in FHC was considered to be abnormal. The study population was divided into 13 groups according to chronological age and values of FHC for boys and girls are provided for each group. It is suggested that the magnitude of hyaline FHC is a valuable feature in the evaluation of skeletal maturation in children.     

目前下肢被动运动装置存在的问题和改进原则

本文分析了目前下肢ＣＰＭ装置存在的问题,指出在ＣＰＭ每一运动周期,人体下肢与ＣＰＭ支架之间都将产生有害的相对位移和交替牵拉应力,影响关节功能顺利康复。提出下肢ＣＰＭ的正确使用方法和设计原则。     

Do laws of biomechanics work in reconstruction of the cartilaginous nasal septum?

Biomechanical techniques can be used for correcting C-shaped or S-shaped nasal septum cartilage deformities. These include mucoperichondrium elevation on the concave side, trimming cartilage to its necessary size, incisions to release cartilaginous bends and strip resections. Resection and reimplantation of cartilage are preferable when correcting a difficult post-traumatic septum. While biomechanical principles are applicable to nasal septum surgery, further clinical studies must be devised to provide proper correction of the nasal septum with minimal sacrifice of cartilage.     

Purification of alkaline phosphatase from extracellular vesicles of fracture callus cartilage

Summary Extracellular matrix vesicles from fracture callus cartilage were isolated by differential centrifugation and resolved by equilibrium centrifugation on a discontinuous sucrose gradient into two bands. The phosphohydrolytic activity towards p-nitrophenyl phosphate, tetrasodium pyrophosphate and adenosine triphosphate was distributed similarly after differential and equilibrium centrifugation suggesting the association of this activity with the matrix vesicles. The two bands isolated by equilibrium centrifugation of the partially purified vesicular preparation demonstrated high levels of alkaline phosphatase activity. Observed with an electron microscope, the 1.07–1.14 g/cm³ band from the gradient was enriched in electron luscent matrix vesicles while the 1.27 g/cm³ band contained electron dense matrix vesicles. Enzymatic analysis of the 1.27 g/cm³ band indicated a slight contamination due to the presence of mitochondria and lysosomes while the 1.07–1.14 g/cm³ band gave no enzymatic indication of subcellular contamination. A phosphohydrolytic enzyme active towards p-nitrophenyl phosphate, tetrasodium pyrophosphate and adenosine triphosphate was purified from the 1.07–1.14 g/cm³ fraction by DEAE-cellulose column chromatography. Electron micrographs of callus cartilage sections demonstrated densification of the plasma membrane and matrix vesicles following substrate incubation with-glycerophosphate or tetrasodium pyrophosphate. The histochemical and biochemical data indicate that a phosphatase, with multiple substrate specificity, is a component of fracture callus cartilage matrix vesicles.     

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities

The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months.     

Unusual fractures and dislocations of the axis vertebra

Seven percent of 400 patients with cervical spine fractures and/or dislocations had unusual lesions of the axis. The authors have analyzed axis injuries by review of radiographs and clinical data and have derived a classification of traumatic conditions. Uncommon traumatic axis abnormalities are discussed with reference to incidence, causes, clinical findings, mechanism of injury, and roentgen characteristics.Picker Scholar, James Picker Foundation     

跨声门癌50例观察

为确立一种原发喉室的跨声门癌，选择肿瘤主体以喉室为中心经全喉切除手术的标本５０例，火棉胶包埋，连续切片观察。结果发现①跨声门癌的肿瘤原发部位在喉室，５０例中有Ｔ２３例。②肿瘤以深层浸润为主占９０％（４５／５０），易侵及声门旁间隙（８２％，４１／５０）和甲状软骨（６４％，３２／５０），临床分期与病理分期不符达４８％（２４／５０）。结论：原发喉室的跨声门癌是声门上型癌的一种特殊类型。     

邻关节骨囊肿的临床特点

目的探讨邻关节骨囊肿的临床特点。通过1例股骨头颈部临关节骨囊肿诊治中发现新的病理改变,追问有髋部疼痛、跛行15年病史,关节面软骨破坏、磨损、消失,囊肿周围骨质硬化、变白,髋臼亦硬化、变白。方法采用手术治疗的股骨头颈部邻关节骨囊肿进行分析,手术方法行股骨头颈部肿瘤切除人工全髋关节置换术,术中发现头颈部圆形破坏5·0cm×3·4cm×3·2cm,关节间隙消失,半脱位,圆形骨质破坏内含胶冻样物并有灰白纤维组织囊壁,囊壁易剥离,厚约2mm,股骨头剖面正常骨质消失,转化为白色硬化矿化骨,髋臼骨质亦硬化、变白。结果随访8个月,病灶无复发,功能良好。结论邻关节骨囊肿是一种罕见的类肿瘤疾患,难于早期正确诊断;建议行MRI检查,并尽早结合手术探查及病理检查完成诊治。