五种松质骨理化性质的比较

BACKGROUND: Existing evidence has shown that xenogeneic bone derived graft materials have the ability to repair bone defects, but little report is on the comparison of composition of xenogeneic bone and human bone. OBJECTIVE: To analyze the chemical composition, mineral phase, calcium and phosphorus contents, total protein contents, and appearance of the cancellous bones of the tibia from pig, bovine and human. METHODS:Cancellous bones of the tibia from pig, Banna miniature pig, bovine, young and old people were cut into bone particles of 0.5 cm×0.5 cm×0.5 cm. After degreasing or drying treatment, chemical composition, mineral phase, calcium and phosphorus contents, total protein contents of bone particles were detected using Fourier transform infrared spectroscopy, X-ray diffraction, plasma emission spectroscopy, scanning electron microscopy, and Kjeldahl method, respectively. Nano Measurer 1.2 and Photoshop cs6 were used to measure pore diameter and porosity rate based on the results of scanning electron microscope. RESULTS AND CONCLUSION: The main inorganic phase of five kinds of cancellous bones was hydroxyapatite and the main chemical composition was phosphate and carbonate. The calcium content of the bovine cancellous bonewas lower than that of the other cancellous bones (P < 0.05) and the phosphorus content of the cacellous bone of young man was higher than that of the pig and bovine cancellous bones (P < 0.01). The total protein content in the cancellous bones of normal pig and Banna miniature pig was higher than that in the other three kinds of cancellous bones (P < 0.05). The pore diameter of five kinds of cancellous bones was 400 to 600 μm and the porosity rate was 60% to 70%. Moreover, the porosity rate of the bovine cancellous bone was the highest. Therefore, we conclude that there are some certain differences in the organic and inorganic components of the pig or bovine cancellous bones as compared with humans. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

α-磷酸三钙骨移植材料在骨科领域应用的研究与进展

BACKGROUND: As one of the important bone substitute materials in bone tissue engineering, α-tricalcium phosphate (α-TCP) has been widely applied and researched. OBJECTIVE: To introduce the newest research progress about α-TCP as a kind of bone substitute material, and to prospect its development. METHODS: The first author searched the relative literatures addressing α-TCP as a bone substitute material published from January 1965 to August 2015 in PubMed, FMJS, CNKI, Wanfang and CBM databases. The keywords were “alpha tricalcium phosphate, composite material, bone graft, bone substitution material” in English and Chinese, respectively. According to the inclusion and exclusion criteria, finally 42 articles were reviewed. RESULTS AND CONCLUSION: α-TCP is one of calcium phosphate compounds which has been extensively applied and researched. It holds good bioactivity, biocompatibility, biodegradability, biodegradation and osteoconductivity except osteoinduction. Therefore, combining α-TCP with inorganic or organic factors to establish the composite material cannot only overcome the shortage of α-TCP in physicochemical characteristics, but also provide a mixed material with better resilience that is easy for cells to adhere, shorten bone reconstruction time, and even can carry antibacterial drugs. All these improvements will markedly shorten the bone repair time and provide a new idea for future development of bone graft materials.     

三维有限元分析内侧半月板全部切除后不同软骨缺损面积对膝关节应力的影响

目的  利用核磁共振成像（MRI）二维图像数据准确构建出膝关节三维有限元模型,采用有限元方法分析内侧半月板全部切除后股骨软骨缺损面积大小对膝关节应力变化的影响。方法  利用膝关节MRI图像建立包括股骨、胫骨、内外侧半月板、内外侧副韧带、前后交叉韧带、髌骨及髌韧带的仿真膝关节数字化模型,在内侧半月板全部切除后的仿真数字化模型上于股骨内侧髁部最容易损伤部位虚拟0.49、0.80、1.0、1.70、2.56及3.24 cm2大小的缺损模型,在股骨上施加1 150 N垂直压应力,类似于在步态周期中的伸直状态,主要分析膝关节软骨及半月板最大压应力与最大剪切应力。结果  内侧半月板全部切除后股骨内侧髁部软骨缺损对内外侧间室接触应力均有影响,但以内侧间室影响较为明显。结论  利用仿真膝关节数字化模型可以有效模拟正常膝关节生物力学变化及内侧半月板全部切除后缺损面积大小对膝关节应力变化的影响。

     

从血水理论辨治高血压病

高血压病不完全等同于眩晕、头痛,单纯从中医症状论治,有时难以准确贴合病机,甚或无症可辨。文章认为血脉属于高血压病的基础病位,血水同病是其重要临床特点,而水气亢逆、血热驰张,阳不化饮、血涩失和,精微胶滞、痰阻血浊是其主要病机特点。高血压病的治疗应在调节脏腑阴阳的基础上,参以血水论治,临证可施以泻水凉血法、散水和血法、化浊行瘀法。血水同治法对于血压的控制和症状的改善具有显著意义,值得临床推广应用。     

阴虚失眠文献计量学分析

目的:提取阴虚失眠相关文献的基本信息和医学专业内容,分析目前国内对阴虚失眠的研究概况。方法:检索中国学术期刊全文数据库,以阴虚失眠、阴虚不寐为主题,共得文献227篇,经专业判读后,剔除不符合纳入标准及内容重复的文献122篇,最终得可供分析的文献105篇。采用文献计量学、内容分析法对纳入文献进行研究。结果:1965年至2018年阴虚失眠相关文献的数目总体呈增长趋势。文献量排名前10的省份为广东、浙江、河南、吉林、福建、江苏、北京、湖北、山东、南京。期刊方面,《长春中医药大学学报》发文量最多。105篇文献中,以临床研究文献为主,共92篇,西医诊断标准以《中国精神病疾病分类方案与诊断标准》应用频率最高;中医诊断标准以《中药新药临床研究指导原则》和《中医病证诊断疗效标准》为主。结论:自1965年1月至2018年初,中医学对阴虚失眠的探讨日益深入和广泛。失眠从阴虚角度辨治具有重要临床意义,广大医学工作者应予重视。针对阴虚失眠的中医药治疗有效可靠、不良反应少。     

基于现代验案解析乌梅丸方证应用

临证验案报道,乌梅丸主治广泛,但若囿于原著字面之“蛔厥”,仅将该方视作驱虫剂,似乎有失公允。本文以现代验案为依据,从多个辨证角度解析乌梅丸方证内涵,并合理定义本方功用类型。     

锚钉加可吸收螺钉治疗后叉胫骨止点骨折的临床效果

目的 探究带线锚钉结合膝后正中小切口治疗后交叉韧带胫骨止点撕脱骨折的临床效果。方法 选取2019年1月-2021年12月收治的24例后交叉韧带胫骨止点撕脱骨折患者，均取腘窝后正中入路小切口，用带线锚钉结合可吸收螺钉进行骨块固定，术后指导患者进行功能锻炼。在随访中采用IKCD主观评分及Lysholm功能评分表、后抽屉试验及放射学愈合对治疗效果进行评价。结果24例患者均成功完成了手术且获得随访，随访时间平均(28.7±11.6)个月。末次随访的IKDC功能评分与Lysholm功能评分平均分别为(96.5±7.3)分与(97.3±4.6)分，较术前(42.2±2.6)分与(34.4±9.6)分显著改善(t=36.565,P<0.001;t=29.136,P<0.001)。术后3个月，所有患者骨折部位均愈合，后抽屉试验查体阴性。结论 应用带线锚钉加可吸收螺钉结合膝后正中小切口治疗后交叉韧带胫骨止点撕脱骨折是一种有效、安全的手术方法，膝关节功能得到良好地恢复。     

宋朝运气学说发展脉络考略

运气学说是中国传统思维下“天人相应”理念的外化,其开倡与盛行始于赵宋时期。本文在现有研究的基础上,再次梳理运气学说在宋朝的发展历程,将其划分为四个阶段:开国之初,受诏入朝的民间医者将运气学说援入宋廷,促使传承方式由秘传转向公开授受;至仁宗朝,校正医书局取王冰次注本为“八书”之一,确立了运气学说的医经正统地位,随后由儒医群体推动其基本知识普及化传播;徽宗时期,运气推广进入高潮阶段,正式进入医学教育与考核体系,同时参与国家民政治理;南宋之后,在名医学士的临证探索中,运气学说迎来实践化发展的新阶段。