DACT1对Ⅰ型卵巢癌恶性侵袭行为的影响

目的 探讨β-环连蛋白抑制基因1(dapper antagonist of catenin-1,DACT1)对Ⅰ型上皮性卵巢癌迁移侵袭能力的影响及可能机制.方法 免疫组织化学检测Ⅰ型人卵巢癌临床组织中DACT1的表达;采用人黏液性卵巢癌细胞株3AO构建外源性转染DACT1的稳转株,通过划痕实验、Transwell迁移及基质胶侵袭实验检测细胞运动能力;免疫荧光观察DACT1对细胞骨架重塑的影响.结果 Ⅰ型卵巢癌组织中DACT1表达低于正常卵巢组织(P＜0.01).外源性转染DACT1后3AO细胞株迁移侵袭能力降低(P＜0.01),且腹腔内成瘤能力有所下降,细胞骨架中特化膜结构减少.结论 DACT1对Ⅰ型卵巢癌浸润转移具有抑制效应,其在Ⅰ型卵巢癌组织中的低表达可能与其疾病发生相关.     

AO/ASIF锁骨钩钢板治疗TossyⅢ型肩锁关节脱位11例疗效分析

目的：比较AO／ASIF锁骨钩钢板与常规手术方法治疗TossyⅢ型肩锁关节脱位的疗效。方法：对11例TossyⅢ型肩锁关节脱位的患者采用AO／ASIF锁骨钩钢板治疗，对19例采用常规手术方法治疗。结果：用AO／ASIF锁骨钩钢板治疗的11例患者中，1例术后出现伤13感染，1例术后关节疼痛及活动受限。应用常规手术方法治疗的19例患者中，1例术后出现伤13感染，1例术后螺丝钉断裂．1例术后钢丝断裂．3例术后肩锁关节复发脱位，3例术后出现关节疼痛及活动受限。结论：AO／ASIF锁骨钩钢板设计合理，符合肩锁关节的解剖生理特征．其疗效优于常规手术治疗的方法．但其远期疗效尚需继续观察。     

Heredity mode of genetic polymorphism in aldehyde oxidase activity in Donryu strain rats

Donryu strain rats show genetic polymorphisms in the aldehyde oxidase gene, resulting in the phenotypic expression of ultrarapid metabolizers with homozygous nucleotide sequences (337G, 2604C), extensive metabolizers with heterozygous nucleotide sequences (377G/A, 2604C/T), and poor metabolizers with homozygous nucleotide sequences (377A, 2604T). In the mating experiments the ratio of the number of ultrarapid metabolizers, extensive metabolizers, and poor metabolizers rats in the F1 generation from the heterozygous F0 extensive metabolizers male and female rats was roughly 0.6 : 1.5 : 1, and the ratio converged to approximately 1 : 2 : 1 in the F2 generation from the heterozygous F1 extensive metabolizers male and female rats. On the contrary, all the F2 generation from homozygous F1 ultrarapid metabolizers male and female rats or from homozygous F1 poor metabolizers male and female rats had the ultrarapid metabolizers or the poor metabolizers genotypes and phenotypes. The genotypes completely agreed with the phenotypes in all individuals of F0, F1, and F2 generations. The results indicate that the genetic polymorphism of aldehyde oxidase in Donryu strain rats obeys Mendelian heredity. The reason for a low ratio of the ultrarapid metabolizers rats in the commercially available Donryu strain rats?—?not more than several per cent?—?compared with the ratio expected from the Mendelian rule is unknown.     

股骨粗隆间骨折的AO分型与治疗对策

目的：探讨各种股骨粗隆间骨折的最佳手术选择方法。方法：106例股骨粗隆间骨折，据AO分型，分别采用6种不同术式，进行讨论。结果：随访6个月—4年，固定组全部骨性愈合，股骨头置换组近期疗效满意。按黄公怡疗效评定法评定：本组优77例，良25例，差4例，疗效满意。结论：对31-A1、31-A2．1型选择DHS内固定，对31-A2．2型、31-A2．3型、31-A3．3型选择DHS—TSP—防旋钉组合内固定；对31-A3型选择DCS或PFN内固定；对DHS内固定失效二次翻修选择DCS内固定；对术前需内科干预才能耐受手术且时间不宜过长的31-A1型选择小切口3枚空心钉内固定；对31-A2、31-A3型选择双极人工股骨头置换术。     

多发性掌骨或跖骨骨折AO微型钢板内固定

目的 评估AO微型钢板治疗多发性掌骨或跖骨骨折的疗效。方法 采用AO微型钢板内固定治疗9例第2-5掌骨或跖骨骨折患者。结果 术后随访2-8个月,骨折均一期愈合,患掌指关节和跖趾关节伸屈功能恢复正常。结论 多发性掌骨或跖骨骨折局部创伤重,畸形明显,对手、足部的外形和功能影响大,治疗中注重软组织肿胀因素和指（趾）血循环,骨折应解剖对位。采用AO微型钢板内固定治疗,配合术后早期功能锻炼,疗效满意。     

Does an additional antirotation U-Blade (RC) lag screw improve treatment of AO/OTA 31 A1-3 fractures with gamma 3 nail?

IntroductionPoor bone quality and unstable fractures increase the cut-out rate in implants with gliding lag screws. The U-Blade (RC) lag screw for the Gamma3^® nail was introduced to provide monoaxial rotational stability of the femoral head and neck fragment. The purpose of this study was to evaluate whether the use of the U-Blade (RC) lag screw is associated with reduced cut-out in patients with OTA/AO 31A1-3 fractures.Material & methodsBetween 2009 and 2014, 751 patients with OTA/AO 31A1-3 fractures were treated with a Gamma3^® nail at our institution. Out of this sample 199 patients were treated with U-blade (RC) lag screws. A total of 135 patients (117 female, 18 male) with standard lag screw (treatment group A) were matched equally regarding age (±4 years) sex, fracture type and location to 135 patients with U-blade (RC) lag screw (treatment group B). Within a mean follow up of 9.2 months (range 6–18 months) we assessed the cut-out rate, the calTAD, lag screw migration, the Parker's mobility score and the Parker’s ratio at postoperatively, six and 12 months following surgery. Furthermore we recorded all complications, ASA-Score, hospital stay and duration of surgery retrospectively.ResultsThe most common fracture among group B with a cut-out of the lag screw were AO/OTA 2.3 and 3.2 fractures whereas in group A cut-out was most commonly seen in AO/OTA 2.1, 2.2 and 2.3 fractures, there was no significant reduction of the cut-out rate in group B 2.2% (n = 3) compared to group A 3.7% (n = 5). The duration of surgery was significantly shorter in group A (p < 0.05). There was no significant difference in lag screw placement, the Parker’s ratio and mobilization.ConclusionIn our study the U-Blade (RC) lag screw did not reduce the cut-out in treatment of OTA/AO 31A1-3 fractures at all. Considering the longer duration of surgery and the higher costs of the U-Blade (RC) lag screw, our results do not justify its use. However, further prospective randomized studies will be necessary.     

胫骨平台骨折52例临床分析

目的 比较胫骨平台骨折的几种治疗方法，选择治疗胫骨平台骨折的最佳方案。方法 本组总结胫骨平台骨折52例，按A0分型和塌陷程度分为B、C两种类型。B1、B2型骨折主要采用手法整复骨牵引或石膏外固定；B3、C1型骨折主要采用撬拨复位，植骨后采用松质骨螺钉固定；C2、C3型骨折主要采用坚强固定。结果 52例胫骨平台骨折获得随访47例，膝关节功能恢复按关节功能、活动范围、膝关节轴线、关节稳定性及骨折复位综合评定，膝关节功能优良41例(87.24％)，可及差6例(12.76％)。结论 胫骨平台骨折的治疗应以关节面损伤程度为中心，选择恰当的治疗方案，早期膝关节功能练习能够获得满意的治疗效果。     

AO技术治疗胫骨平台骨折疗效探讨

目的：探讨AO技术治疗胫骨平台骨折的疗效,为临床选择更好的治疗胫骨平台骨折的方法。方法：本组总结胫骨平台骨折46例,男16例,女30例。按AO分类法分类后严格按照AO内固定原则及AO技术和材料进行骨折治疗。结果：46例胫骨平台骨折随访39例。膝关节功能恢复按KDLMERT标准,膝关节功能优良者34例（87．2％）,可、差者5例（12．8％）。结论：我们认为,胫骨平台骨折的AO分类法能综合骨折的受伤机制、骨折类型、骨折治疗及预后来反映骨折的特点,并能指导治疗。移位性平台骨折应扩大手术范围,进行满意复位后采用AO坚强的固定技术重建关节的正常平整关系。术后术后应用静脉泵及早期配合膝关节被动（CPM）练习能够获得满意的治疗结果。     

钛质网笼内植物加前路带锁钢板对颈椎稳定性的生物力学评价

目的评价颈椎在植入颈椎钛质网笼内植物和植入钛质网笼内植物辅助AO前路带锁钢板内固定两者的生物力学稳定性.方法测量6例新鲜人颈椎骨骼韧带标本(C2～T1)在正常、C5椎体次全切除减压后植钛质网笼内植物、植钛质网笼内植物后辅助AO前路带锁钢板内固定三种工况下C4～C6节段的三维运动数据,并做统计学处理.结果6例颈椎标本C4～C6节段在正常、植钛质网笼内植物、植钛质网笼内植物加AO前路钢板三种工况下,前屈/后伸、左/右侧弯、左/右轴向旋转的运动范围(ROM)平均值(°)分别为14.12/12.94、13.39/13.11、9.77/10.72;9.70/14.42、8.94/8.61、7.65/8.09和4.39/1.36、4.08/4.19、3.46/3.63.结论颈椎减压、植入钛质网笼后在后伸运动时的稳定性明显不足;辅助AO前路带锁钢板内固定后在各个方向的稳定性都显著增强,可满足临床应用的要求.     

AO支持钢板治疗股骨髁部C型骨折

目的探讨应用AO股骨髁支持钢板治疗C型髁部骨折的效果。方法采用AO股骨髁支持钢板治疗C型股骨髁部骨折65例。结果所有患者获得10—28个月（平均15个月）随访。采用Kolmert评定标准,优：C1型21例,C2型15例;良：C1型5例,C2型6例,C3型10例;可：C2型3例,C3型2例;差：C2型1例,C3型2例,优良率87．7％。结论髁支持钢板可单矢状面多层次螺钉固定,充分利用股骨髁的有效固定空间,易达到坚强固定,为术后早期功能锻炼提供保证。