• 【低水平激光治疗对链脲佐菌素诱导的糖尿病大鼠骨缺损愈合的影响: 组织学和形态计量学评估。】 复制标题 收藏 收藏
    DOI:10.1080/14764172.2017.1341048 复制DOI
    作者列表:Yildirimturk S,Sirin Y,Soluk Tekkesin M,Gurler G,Firat D
    BACKGROUND & AIMS: BACKGROUND:The aim of the present study was to evaluate the effects of low-level laser therapy (LLLT) on the healing of bone defects in rats with streptozotocin (STZ)-induced DM. METHODS:28 male Sprague-Dawley rats were used in this study. 14 animals received a single dose of STZ intraperitoneally (65 mg/kg) to induce Type I DM, whereas others were injected only with sterile saline solution. Four weeks later, standard bone defects were created in the tibiae of rats. Surgical wounds in one group from each of the diabetic and non-diabetic animals were irradiated with diode laser for every other day for 4 weeks and they were described as DM + LLLT and CONT + LLLT groups, respectively. Remaining two groups received no laser treatment. New bone formation, osteoblast and blood vessel counts were calculated in histologic sections. RESULTS:DM group had significantly smaller bone area and lower blood vessel count when compared to DM + LLLT, CONT and CONT + LLLT groups (p < 0.05 for each). CONT and CONT + LLLT groups had significantly larger bone area than DM + LLLT group (p < 0.05 for both). CONCLUSIONS:LLLT application promoted vascularization and new bone formation in animals with DM to a limited extent, since it was unable to support the healing process up to the level of non-diabetic animals.
    背景与目标:
  • 【骨的全基因组分析揭示了骨质疏松症和骨关节炎的差异甲基化区域。】 复制标题 收藏 收藏
    DOI:10.1002/art.37753 复制DOI
    作者列表:Delgado-Calle J,Fernández AF,Sainz J,Zarrabeitia MT,Sañudo C,García-Renedo R,Pérez-Núñez MI,García-Ibarbia C,Fraga MF,Riancho JA
    BACKGROUND & AIMS: OBJECTIVE:To determine genome-wide methylation profiles of bone from patients with hip osteoarthritis (OA) and those with osteoporotic (OP) hip fractures. METHODS:Trabecular bone pieces were obtained from the central part of the femoral head of 27 patients with hip fractures and 26 patients with hip OA. DNA was isolated, and methylation was explored with Illumina methylation arrays. RNA was extracted, pooled, and deep-sequenced to obtain the whole transcriptome. Differentially methylated regions were identified, and connections between genes with differentially methylated regions were explored by pathway and text-mining analyses. RESULTS:After quality control, methylation of 23,367 CpG sites (13,463 genes) was analyzed. There was a genome-wide inverse relationship between methylation and gene expression in both patient groups. Comparison of OP and OA bones revealed 241 CpG sites, located in 228 genes, with significant differences in methylation (false discovery rate<0.05). Of them, 217 were less methylated in OP than in OA. The absolute methylation differences were >5% in 128 CpG sites and >10% in 45 CpG sites. The differentially methylated genes were enriched for association with bone traits in the genome-wide association study catalog. Pathway analysis and text-mining analysis with Gene Relationships Across Implicated Loci software revealed enrichment in genes participating in glycoprotein metabolism or cell differentiation, and particularly in the homeobox superfamily of transcription factors. CONCLUSION:Genome-wide methylation profiling of bone samples revealed differentially methylated regions in OP and OA. These regions were enriched in genes associated with cell differentiation and skeletal embryogenesis, such as those in the homeobox superfamily, suggesting the existence of a developmental component in the predisposition to these disorders.
    背景与目标:
  • 【电刺激通过肝素生物激活的导电支架调节成骨细胞的增殖和骨蛋白的产生。】 复制标题 收藏 收藏
    DOI:10.1002/bem.21766 复制DOI
    作者列表:Meng S,Rouabhia M,Zhang Z
    BACKGROUND & AIMS: :Electrical fields are known to interact with human cells. This principle has been explored to regulate cellular activities for bone tissue regeneration. In this work, Saos-2 cells were cultured on conductive scaffolds made of biodegradable poly(L-lactide) and the heparin-containing, electrically conducting polypyrrole (PPy/HE) to study their reaction to electrical stimulation (ES) mediated through such scaffolds. Both the duration and intensity of ES enhanced cell proliferation, generating a unique electrical intensity and temporal "window" within which osteoblast proliferation was upmodulated in contrast to the downmodulation or ineffectiveness in other ES regions. The favourable ES intensity (200 mV/mm) was further investigated in terms of the gene activation and protein production of two important osteoblast markers characterised by extracellular matrix maturation and mineralisation, that is alkaline phosphatase (ALP) and osteocalcin (OC). Both genes were found activated and the relevant protein production increased significantly following ES. In contrast, ES in the down-modulation region (400 mV/mm) suppressed the production of both ALP and OC. This work demonstrated that important osteoblast markers can be modulated with specific ES parameters mediated through conductive polymer substrates, providing a unique strategy for bone tissue engineering.
    背景与目标: 已知电场与人类细胞相互作用。已探索此原理来调节骨组织再生的细胞活性。在这项工作中,将Saos-2细胞培养在由可生物降解的聚 (L-丙交酯) 和含肝素的导电聚吡咯 (PPy/HE) 制成的导电支架上,以研究它们对通过此类支架介导的电刺激 (ES) 的反应。ES的持续时间和强度都增强了细胞增殖,产生了独特的电强度和时间 “窗口”,与其他ES区域的下调或无效相反,在该窗口内对成骨细胞增殖进行了上调。进一步研究了有利的ES强度 (200  mV/mm),即两种重要的成骨细胞标志物的基因活化和蛋白质生产,其特征是细胞外基质成熟和矿化,即碱性磷酸酶 (ALP) 和骨钙素 (OC)。发现两个基因都被激活,并且在ES之后相关的蛋白质产量显着增加。相反,下调制区域 (400  mV/mm) 中的ES抑制了ALP和OC的产生。这项工作表明,重要的成骨细胞标志物可以通过导电聚合物底物介导的特定ES参数进行调节,为骨组织工程提供了独特的策略。
  • 【植入腹股沟下旁路移植物的球囊扩张支架的挤压变形。】 复制标题 收藏 收藏
    DOI:10.1177/1538574417714396 复制DOI
    作者列表:Ahmed N,El-Khoury R,Sabri MN,White JV,Jacobs CE,Schwartz LB
    BACKGROUND & AIMS: :A 59-year-old man with critical claudication underwent left femoro-anterior bypass grafting, which was uneventful. The graft was tunneled medially across the knee, then anterior to the tibia. His symptoms recurred 1 year later and he was found to have critical stenosis of the vein graft just proximal to the anterior tibial arterial anastomosis. This was treated with scaffolded balloon angioplasty and implantation of a coronary, zotarolimus-eluting balloon-expandable stent, which was also uneventful. However, his claudication again recurred 1 year later. Diagnostic angiography revealed crush, deformation and restenosis of the balloon-expandable stent requiring surgical revision of the bypass graft.
    背景与目标: : 一名59岁的严重跛行男子接受了左股骨前旁路移植术,手术顺利。移植物在膝盖内侧穿过隧道,然后在胫骨前。一年后,他的症状复发,发现他在胫骨前动脉吻合术附近有严重的静脉移植物狭窄。用支架球囊血管成形术和冠状动脉zotarolimus洗脱球囊扩张支架进行治疗,这也很顺利。然而,他的跛行在1年后再次复发。诊断性血管造影显示球囊扩张支架的挤压,变形和再狭窄,需要手术修复旁路移植物。
  • 【使用三次谐波产生显微镜对骨骼多尺度孔隙率和界面进行无标记成像。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03548-5 复制DOI
    作者列表:Genthial R,Beaurepaire E,Schanne-Klein MC,Peyrin F,Farlay D,Olivier C,Bala Y,Boivin G,Vial JC,Débarre D,Gourrier A
    BACKGROUND & AIMS: :Interfaces provide the structural basis of essential bone functions. In the hierarchical structure of bone tissue, heterogeneities such as porosity or boundaries are found at scales ranging from nanometers to millimeters, all of which contributing to macroscopic properties. To date, however, the complexity or limitations of currently used imaging methods restrict our understanding of this functional integration. Here we address this issue using label-free third-harmonic generation (THG) microscopy. We find that the porous lacuno-canalicular network (LCN), revealing the geometry of osteocytes in the bone matrix, can be directly visualized in 3D with submicron precision over millimetric fields of view compatible with histology. THG also reveals interfaces delineating volumes formed at successive remodeling stages. Finally, we show that the structure of the LCN can be analyzed in relation with that of the extracellular matrix and larger-scale structures by simultaneously recording THG and second-harmonic generation (SHG) signals relating to the collagen organization.
    背景与目标: : 接口提供了基本骨骼功能的结构基础。在骨组织的分层结构中,在从纳米到毫米的范围内发现了诸如孔隙率或边界之类的异质性,所有这些都有助于宏观特性。然而,迄今为止,当前使用的成像方法的复杂性或局限性限制了我们对这种功能集成的理解。在这里,我们使用无标签的三次谐波产生 (THG) 显微镜解决了这个问题。我们发现,多孔腔-小管网络 (LCN) 揭示了骨基质中骨细胞的几何形状,可以在与组织学兼容的毫米视野中以亚微米精度在3D中直接可视化。THG还揭示了描绘在连续重塑阶段形成的体积的界面。最后,我们表明,通过同时记录与胶原蛋白组织有关的THG和二次谐波产生 (SHG) 信号,可以分析LCN的结构与细胞外基质和较大规模的结构有关。
  • 【是否可以使用囊肿体积对髂嵴移植重建囊肿缺损后并发症的风险进行分层?】 复制标题 收藏 收藏
    DOI:10.1016/j.jcms.2017.05.010 复制DOI
    作者列表:Safi AF,Grandoch A,Dreiseidler T,Nickenig HJ,Zöller J,Kreppel M
    BACKGROUND & AIMS: INTRODUCTION:The role of the volume of radicular and dentigerous cysts on clinical symptoms is unclear and potentially may predict development of pre- and postoperative complications, especially after cystectomies with large bony defects. Therefore the aim of this study was to assess pre- and postoperative symptoms associated to the volume of jaw cysts. MATERIAL AND METHODS:Retrospective chart review of 111 patients with follicular or dentigerous cysts from 2008-2012. Anterior iliac crest grafts were used to fill defects after cystectomy. χ2-test was performed to analyze associations between two qualitative variables. Binary logistic regression analysis was used as multivariate analysis. P-values p < 0.05 were considered as significant. Volume measurement was performed in a semiautomatic segmentation method with the software "ITK-Snap". RESULTS:Postoperative hypaesthesia correlated significantly with histology (p = 0.025) and localization (p = 0.006). Volume was associated significantly with preoperative hypaesthesia (p = 0.052), postoperative hypaesthesia (p < 0.001), wound healing complications (p < 0.001) and length of wound healing complications (p = 0.001). Multivariate analysis identified volume as independent risk factor for postoperative hypaesthesia (p = 0.015). CONCLUSIONS:Volume analysis appears to be a method that allows risk stratification after surgery of jaw cysts. Therefore we recommend a precise treatment planning with the means of volume analysis to improve therapy outcome of patients with jaw cysts.
    背景与目标:
  • 【提出了一种用有限元方法模拟无骨水泥中骨向内生长过程的方法。】 复制标题 收藏 收藏
    DOI:10.1016/j.medengphy.2012.10.010 复制DOI
    作者列表:Tarala M,Janssen D,Verdonschot N
    BACKGROUND & AIMS: :In cementless total hip arthroplasty, long-term implant stability is achieved by bone ingrowth. The strength of the new bond gradually increases in time, due to bone maturation and progression of ingrowth. In finite element simulations, osseointegration generally is implemented as an instant change in the mechanical behavior of the implant-bone interface, although this is a simplified interpretation of the bone ingrowth process. The aim of the present study was to build on previous bone ingrowth simulations and propose a new methodology to simulate bone ingrowth as a time-dependent process. We developed an algorithm to calculate the strength of the local implant-bone bond based of the magnitude of interface micromotions and gaps in time. Our algorithm was subsequently tested in multiple hip reconstructions in which the bone quality and implant-bone contact area were varied. The results of the simulations showed that in the ideal situation (good bone quality and no interface gaps), 91% of implant area could achieve ingrowth, while in the worst case only 17% of implant area showed ingrowth. The initial contact area had a significant effect on ingrowth, overruling the effect of variations in bone quality. The progression of ingrowth had a stabilizing effect on adjacent regions, especially in the high contact area cases. Further development and validation of the presented algorithm requires more information on the nature of the relation between the ingrowth rate and the magnitude of micromotions and gap.
    背景与目标: : 在无骨水泥全髋关节置换术中,植入物的长期稳定性是通过骨向内生长来实现的。由于骨骼的成熟和向内生长的进展,新键的强度随时间逐渐增加。在有限元模拟中,骨整合通常是作为植入物-骨界面的机械行为的即时变化来实现的,尽管这是对骨向内生长过程的简化解释。本研究的目的是在以前的骨向内生长模拟的基础上,提出一种新的方法来模拟骨向内生长,这是一个与时间有关的过程。我们开发了一种算法,可以根据界面微动的大小和时间间隙来计算局部植入物-骨键的强度。随后,我们的算法在多次髋关节重建中进行了测试,其中骨质量和植入物-骨接触面积发生了变化。模拟结果表明,在理想情况下 (良好的骨质量和无界面间隙),植入物区域的91% 可以实现向内生长,而在最坏的情况下,只有17% 的植入物区域显示向内生长。初始接触面积对向内生长有显着影响,从而推翻了骨质量变化的影响。向内生长的进程对相邻区域具有稳定作用,尤其是在高接触面积的情况下。提出的算法的进一步开发和验证需要更多有关向内生长速率与微动和间隙大小之间关系的性质的信息。
  • 【T细胞缺失骨髓移植后慢性粒细胞性白血病患者嵌合和白血病复发的细胞遗传学分析。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Offit K,Burns JP,Cunningham I,Jhanwar SC,Black P,Kernan NA,O'Reilly RJ,Chaganti RS
    BACKGROUND & AIMS: :Serial cytogenetic studies were performed on 64 patients with chronic myelogenous leukemia (CML) after T cell-depleted allogeneic bone marrow transplantation (BMT). Forty patients with CML in chronic phase (CP) received cytoreduction followed by BMT with HLA-matched T cell-depleted allogeneic marrow. The remaining 24 patients were transplanted in second chronic, accelerated, or blastic phase, or received T cell-depleted grafts with a dose of T cells added back. The Y chromosome and autosomal heteromorphisms were used to distinguish between donor and host cells. Mixed hematopoietic chimerism (presence of donor and host cells) was identified in 90% of patients in first CP. The Philadelphia (Ph) chromosome reappeared in 16 of the 40 first CP CML patients. As expected, patients who had detectable Ph chromosome positive cells at any time during the posttransplant period had a high likelihood of subsequent clinical relapse. Transient disappearance of the Ph positive clone was rarely observed, and was followed by reappearance of the Ph chromosome or clinical relapse. A subset of engrafted patients with greater than 25% host cells within 3 months post-BMT had a significantly shorter survival time free of cytogenetic or clinical relapse compared with other patients. In patients who had received donor T cells added to the T cell-depleted graft, there was a higher proportion of complete chimerism. Clonal progression of Ph positive as well as negative cells was observed and may be the result of radiation induced breakage. Serial cytogenetic studies of patients post-BMT can provide useful information regarding the biologic and clinical behavior of CML.
    背景与目标: : 在T细胞耗尽的同种异体骨髓移植 (BMT) 后,对64例慢性粒细胞性白血病 (CML) 患者进行了系列细胞遗传学研究。40例慢性期 (CP) 的CML患者接受了细胞减灭,然后接受了HLA匹配的T细胞耗尽的同种异体骨髓的BMT。其余24例患者被移植到第二个慢性,加速或母细胞期,或接受T细胞耗尽的移植物,并加回一定剂量的T细胞。Y染色体和常染色体异形被用来区分供体细胞和宿主细胞。在第一个CP的90% 患者中鉴定出混合的造血嵌合体 (供体和宿主细胞的存在)。费城染色体重新出现在40例第一批CP CML患者中的16例中。如预期的那样,在移植后的任何时候都具有可检测到的Ph染色体阳性细胞的患者随后临床复发的可能性很高。很少观察到Ph阳性克隆的瞬时消失,随后出现Ph染色体或临床复发。与其他患者相比,BMT后3个月内移植的宿主细胞大于25% 的患者亚群的无细胞遗传学或临床复发的生存时间明显更短。在接受T细胞耗尽移植物中添加了供体T细胞的患者中,完全嵌合的比例更高。观察到Ph阳性细胞和阴性细胞的克隆进程,这可能是辐射引起的破坏的结果。BMT后患者的一系列细胞遗传学研究可以提供有关CML生物学和临床行为的有用信息。
  • 【微型机组周围牙槽骨密度变化: 一项前瞻性临床研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajodo.2012.07.013 复制DOI
    作者列表:Al Maaitah EF,Safi AA,Abdelhafez RS
    BACKGROUND & AIMS: INTRODUCTION:Our objective was to assess the effects of miniscrews on interproximal alveolar bone density and adjacent gingival tissue health. METHODS:Forty-four titanium miniscrews were inserted between maxillary second premolars and first molars on both sides of the dentition in 22 consecutive patients (15 female, 7 male; ages, 14-24 years). A control area (between the maxillary first and second premolars) was also assessed. Both miniscrew (study) and control areas were monitored clinically and radiographically at different time points: before insertion of the miniscrews and at 1 month, 3 months, and 6 months after insertion. Software associated with a digital intraoral radiography machine was used to assess changes in alveolar bone density. Clinical gingival parameters of the study and control areas were also recorded. A repeated-measures analysis of variance and the Bonferroni post-hoc pairwise comparison tests were used to assess the changes at the different time points. RESULTS:Thirty-nine miniscrews were successful for the study duration. Male subjects had significantly (P <0.001) higher alveolar bone density than did the females at baseline. Alveolar bone density around the miniscrews increased significantly (P <0.001) between 3 and 6 months after insertion upon loading. Alveolar bone density of the control area did not change significantly during the experiment (P >0.05). The width of keratinized gingiva increased significantly (P <0.001) in the study and control areas after insertion of miniscrews and remained with no significant change throughout the study. CONCLUSIONS:Miniscrews increased the alveolar bone density significantly after 3 months of insertion and were not associated with detrimental effects on the adjacent gingival tissues.
    背景与目标:
  • 【壳聚糖-磷酸甘油/血液植入物增加钻孔软骨缺损中的细胞募集,瞬时血管化和软骨下骨重塑。】 复制标题 收藏 收藏
    DOI:10.1016/j.joca.2006.08.007 复制DOI
    作者列表:Chevrier A,Hoemann CD,Sun J,Buschmann MD
    BACKGROUND & AIMS: OBJECTIVE:Marrow-stimulation techniques are used by surgeons to repair cartilage lesions although consistent regeneration of hyaline cartilage is rare. We have shown previously that autologous blood can be mixed with a polymer solution containing chitosan in a glycerol phosphate (GP) buffer (chitosan-GP), and that implantation of this polymer/blood composite onto marrow-stimulated chondral defects in rabbit and sheep leads to the synthesis of more chondral repair tissue with greater hyaline character compared to marrow-stimulation alone. In the current study, we examined the modulation of cell recruitment and repair tissue characteristics at early post-surgical time points (from day 1 to 56) in a rabbit model to elucidate potential mechanisms behind this improved repair outcome. DESIGN:Thirty-three skeletally mature New Zealand White rabbits underwent bilateral arthrotomies, with each trochlea receiving a cartilage defect (3.5 mm x 4.5mm) bearing four microdrill holes (0.9 mm diameter, approximately 4 mm deep) into the subchondral bone. One defect per rabbit was treated with a chitosan-GP/blood implant, while the other defect was left as a microdrilled control. Repair tissues were stained by histochemistry, for collagen types I, II, and X by immunohistochemistry and analyzed using quantitative stereological tools. RESULTS:Histological analyses demonstrated that control defects followed a typical healing sequence observed previously in marrow-stimulation animal models while chitosan-GP/blood implants led to three significant modifications in the healing sequence at early stages: (1) increased inflammatory and marrow-derived stromal cell recruitment to the microdrill holes, (2) increased vascularization of the provisional repair tissue in the microdrill holes, and (3) increased intramembranous bone formation and subchondral bone remodeling (BR). CONCLUSIONS:These results suggest that the greater levels of provisional tissue vascularization and BR activity are main factors supporting improved cartilage repair when chitosan-GP/blood implants are applied to marrow-stimulated cartilage lesions.
    背景与目标:
  • 【供体嵌合症是慢性粒细胞性白血病骨髓移植后无病生存的有力指标。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Gardiner N,Lawler M,O'Riordan J,De'Arce M,McCann SR
    BACKGROUND & AIMS: Although Chronic Myeloid Leukaemia (CML) can be treated successfully with allogeneic bone marrow transplantation (BMT), leukaemia relapse remains a significant clinical problem. Molecular monitoring of the post transplant marrow can be useful in predicting relapse particularly in CML patients where the Philadelphia chromosome or its molecular counterpart, the BCR-ABL fusion messenger RNA can be used as a leukaemia specific marker of minimal residual disease (MRD). We have investigated chimaerism (using polymerase chain reaction of short tandem repeat sequences (STR-PCR)) and MRD status (using reverse transcriptase PCR of the BCR-ABL fusion mRNA) in a serial fashion in 18 patients who were in clinical and haematological remission post allogeneic BMT for chronic phase CML. Eleven patients exhibited complete donor chimaerism with no evidence of minimal residual disease. Five patients had transient or low level stable MC. Late MC and MRD was observed in two patients who relapsed > 6 years after T cell depleted BMT for CML. Thus STR-PCR is an appropriate screening test in the post transplant setting for CML patients, but those patients exhibiting mixed haemopoietic chimaerism should also be monitored using a leukaemia specific sensitive molecular assay.

    背景与目标: 尽管同种异体骨髓移植 (BMT) 可以成功治疗慢性粒细胞白血病 (CML),但白血病复发仍然是一个重要的临床问题。移植后骨髓的分子监测可用于预测复发,特别是在费城染色体或其分子对应物的CML患者中,bcr-abl融合信使RNA可用作最小残留疾病 (MRD) 的白血病特异性标志物。我们已经连续研究了18例临床和血液学患者的嵌合体 (使用短串联重复序列的聚合酶链反应 (str-pcr)) 和MRD状态 (使用bcr-abl融合mRNA的逆转录酶PCR) 慢性期CML的同种异体BMT后缓解。11例患者表现出完全的供体嵌合体,没有最小残留疾病的证据。5例患者有短暂或低水平稳定的MC。在两名T细胞耗尽CML BMT后复发> 6年的患者中观察到晚期MC和MRD。因此,在CML患者的移植后环境中,STR-PCR是一种适当的筛查测试,但是那些表现出混合造血嵌合体的患者也应使用白血病特异性敏感分子测定法进行监测。
  • 【急性淋巴细胞白血病同基因骨髓移植后闭塞性细支气管炎机化肺炎。】 复制标题 收藏 收藏
    DOI:10.1038/sj.bmt.1700816 复制DOI
    作者列表:Kanda Y,Takahashi T,Imai Y,Miyagawa K,Ohishi N,Oka T,Chiba S,Hirai H,Yazaki Y
    BACKGROUND & AIMS: :We report a patient who developed bronchiolitis obliterans organizing pneumonia (BOOP) after syngeneic BMT for ALL. The patient complained of persistent low-grade fever and non-productive cough after engraftment. Chest CT scan showed patchy infiltration bilaterally in the lower lung fields. Antibiotics were ineffective. Cultures, serological studies and polymerase chain reaction detected no infectious pathogens. We finally made a diagnosis of BOOP by thoracoscopical lung biopsy. The lung lesion disappeared in a month with corticosteroid therapy. While BOOP following allogeneic BMT has been reported, this is the first report after syngeneic transplantation.
    背景与目标: : 我们报告了一名患者,该患者在所有同系BMT后发展为闭塞性细支气管炎机化肺炎 (BOOP)。患者抱怨植入后持续低发热和非生产性咳嗽。胸部ct扫描显示下肺区域双侧斑片浸润。抗生素无效。培养,血清学研究和聚合酶链反应未检测到传染性病原体。我们最终通过胸腔镜肺活检诊断为BOOP。使用皮质类固醇治疗一个月后,肺部病变消失。虽然已经报道了同种异体BMT后的BOOP,但这是同基因移植后的首次报道。
  • 【带有反向设计假体的关节盂骨移植。】 复制标题 收藏 收藏
    DOI:10.1016/j.jse.2006.02.002 复制DOI
    作者列表:Neyton L,Boileau P,Nové-Josserand L,Edwards TB,Walch G
    BACKGROUND & AIMS: :The purpose of this study was to evaluate the outcome of patients who underwent glenoid bone grafting and implantation of a reverse design prosthesis in 1 or 2 stages for the treatment of glenoid bone loss and rotator cuff insufficiency. Indications for the reverse prosthesis in this series included cuff tear arthropathy and revision arthroplasty. Nine patients were reviewed clinically and radiographically with a minimum 2-year follow-up (range, 24-41 months). Despite a low postoperative functional score (mean Constant score, 53 points [range, 22-79 points]), most patients were satisfied with their results primarily because of pain relief. (The mean pain score increased from 3 points preoperatively to 12.5 points postoperatively.) Radiographic evaluation did not demonstrate component loosening or evidence of graft failure. Six patients had radiographic evidence of an inferior scapular notch, which may be of concern in the future. Early results of this procedure are encouraging, but further clinical and radiologic assessment is necessary.
    背景与目标: : 这项研究的目的是评估在1或2个阶段接受关节盂骨移植和反向设计假体植入治疗关节盂骨丢失和肩袖功能不全的患者的结果。该系列中反向假体的适应症包括袖套撕裂关节病和翻修关节置换术。对9例患者进行了临床和影像学检查,并进行了至少2年的随访 (范围为24-41个月)。尽管术后功能评分较低 (平均恒定评分,53分 [范围,22-79分]),但大多数患者对其结果感到满意,主要是因为疼痛缓解。(平均疼痛评分从术前3分增加到术后12.5分。)影像学评估未显示组件松动或移植物失败的证据。六名患者的影像学证据表明存在下肩胛骨切口,这在将来可能会引起关注。该程序的早期结果令人鼓舞,但需要进一步的临床和放射学评估。
  • 【一项评估女性受试者年龄和无性对下颌骨骨矿物质密度的相对影响的研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.tripleo.2006.06.061 复制DOI
    作者列表:Devlin H,Horner K
    BACKGROUND & AIMS: OBJECTIVE:The aim of this study was to assess the relative influence of age and edentulousness upon mandibular bone mineral density (BMD) in a sample of dentate and edentulous female subjects. STUDY DESIGN:Seventy-two patients (43-79 years of age; mean age, 62.5 years), of whom 49 were edentulous and 23 dentate, underwent dual x-ray energy absorptiometry (DXA) to determine the BMD of the body of mandible. Mandibular BMD was measured using DXA. The investigators independently determined rectangular regions of interest (ROIs) on the mandibular images, and the computer calculated the BMD of these specified regions. For the dentate patients, the ROIs were placed to exclude the roots of teeth. RESULTS:A linear multiple regression model was fitted to the dependent variable, mandibular body BMD, with age and whether the patient was edentulous or dentate being explanatory factors in the statistical model. The variable describing the dentate/edentulous state was not significant in the statistical model (P = .91). The model showed that age was significantly related negatively to the BMD of the mandibular body (P = .01). CONCLUSION:Age was a predictor of mandibular BMD but edentulousness was not.
    背景与目标:
  • 【转移性骨病和疼痛患者静脉注射氯膦酸盐的随机对照试验。】 复制标题 收藏 收藏
    DOI:10.1016/s0885-3924(97)00075-4 复制DOI
    作者列表:Ernst DS,Brasher P,Hagen N,Paterson AH,MacDonald RN,Bruera E
    BACKGROUND & AIMS: :To evaluate the effectiveness of intravenous clodronate in ameliorating refractory bone pain in patients with metastatic bone disease, 60 patients with established osseous metastases and persistent bone pain were randomized to receive either clodronate (600 mg or 1500 mg in 500 mL of normal saline) or 500 mL of saline as placebo. After 2 weeks, the patients were crossed over to receive the alternate treatment. After another 2 weeks, each patient and investigator made a blinded choice. Daily visual analogue scales (VAS) and analgesic diaries were recorded throughout the study period. Forty-six patients were evaluable (77%). A treatment x period interaction was identified in the VAS and daily morphine equivalent dose (DMED) scores. First period analysis of the VAS scores for general pain, pain at rest, and pain upon movement demonstrated an average reduction of 13, 14, and 24 mm, respectively, from baseline, but were not significantly different from changes following placebo. The average change in DMED was -6.4 (SE = 2.9) following clodronate and was +24.6 (SE = 14.9) following placebo (p = 0.03). In the blinded choice of which agent resulted in improvement in pain, 26 (57%) patients chose clodronate, 12 (26%) chose placebo, and eight (17%) had no preference (p = 0.0021). For the investigators who also made a blinded selection, clodronate was chosen in 30 (65%) patients, placebo in ten (22%) patients, and no difference was apparent in six (13%) (p < 0.0001). Intravenous clodronate appeared to have analgesic effect in patients with refractory bone pain due to metastatic bone disease. The optimal dose and duration of effect require further evaluation, particularly in patients with stable disease and persistent bone pain.
    背景与目标: : 为了评估静脉注射氯膦酸盐缓解转移性骨病患者难治性骨痛的有效性,将60例已确定骨转移和持续性骨痛的患者随机分为氯膦酸盐 (600 mg或1500 mg,500 mL生理盐水) 或500 mL生理盐水作为安慰剂。2周后,患者交叉接受替代治疗。再过2周后,每位患者和研究者都做出了盲法选择。在整个研究期间记录每日视觉模拟量表 (VAS) 和镇痛日记。46例患者可评估 (77%)。在VAS和每日吗啡等效剂量 (DMED) 评分中确定了治疗x期相互作用。一般疼痛,静息疼痛和运动时疼痛的VAS评分的第一阶段分析显示,与基线相比分别平均降低了13、14和24毫米,但与安慰剂后的变化没有显着差异。氯膦酸盐后DMED的平均变化为-6.4 (SE = 2.9),安慰剂后为 + 24.6 (SE = 14.9) (p = 0.03)。在盲目选择哪种药物导致疼痛改善的过程中,26 (57%) 名患者选择氯膦酸盐,12 (26%) 选择安慰剂,8 (17%) 没有偏好 (p = 0.0021)。对于也进行盲法选择的研究者,在30 (65%) 例患者中选择氯膦酸盐,在10 (22%) 例患者中选择安慰剂,在6 (13%) 例患者中没有明显差异 (p <0.0001)。静脉注射氯膦酸盐似乎对转移性骨病引起的难治性骨痛患者具有镇痛作用。最佳剂量和效果持续时间需要进一步评估,尤其是在疾病稳定和持续性骨痛的患者中。

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