颞骨关节结节气室样改变流行情况及临床特征的影像学研究

目的通过口腔曲面断层片回顾性研究颞骨关节结节气室样改变临床特征及在人群中流行情况.方法收集2012年1月至2012年12月就诊于昆明医科大学附属口腔医院患者的3 966张全口曲面断层片,并记录患者性别、年龄以及颞骨关节结节气室样改变的临床特征,后对相关数据进行统计学分析.结果 3 966名患者中,共有128（3.5%）名患者颞骨关节结节发生气室样改变,其中男性60名,女性68名,年龄8-86岁,平均（25.5±6.4）岁,性别之间差异无统计学意义（P〉0.05）;单侧颞骨关节结节气室样改变有104名,占81.3%,双侧24名,占18.7%;在这128个病例中,多房型为主要的病变类型,占60.5%,而单房型占39.5%.结论颞骨关节结节气室样改变在人群中有较高的患病率.治疗颞骨关节结节气室样改变是没有必要的,当手术涉及病变区域时,充分认识该区域的病变,对减小手术风险及并发症是有重要意义的.

关节镜下双滑轮无结缝线桥固定术对肩袖撕裂损伤患者肩关节功能与肩袖再撕裂发生率的影响

目的探讨关节镜下双滑轮无结缝线桥固定术对肩袖撕裂损伤患者肩关节功能与肩袖再撕裂发生率的影响。方法选取2018年3月至2019年3月本院收治的肩袖撕裂损伤患者80例,根据治疗方法的不同分为观察组和对照组,每组40例。对照组采用传统缝线桥固定术,观察组采用关节镜下双滑轮无结缝线桥固定术,比较两组肩关节功能、肩关节前屈、外旋活动度及肩袖再撕裂发生情况。结果术后,两组Constant评分均高于术前,差异有统计学意义(P<0.05);术后,两组Constant评分比较差异无统计学意义;术后,两组肩关节前屈、外旋活动度均高于术前,差异有统计学意义(P<0.05);术后,两组肩关节前屈、外旋活动度比较差异无统计学意义;观察组肩袖再撕裂发生率低于对照组,差异有统计学意义(P<0.05)。结论肩袖撕裂损伤患者行关节镜下双滑轮无结缝线桥固定术有利于改善肩关节功能,降低术后肩袖再撕裂发生率。

再定位[牙合]垫治疗颞下颌关节盘可复性移位伴间断性锁结患者的临床观察

目的观察再定位[牙合]治疗颞下颌关节盘可复性移位伴间断锁结患者的临床疗效。方法选取2017年12月至2018年6月大连市口腔医院颞下颌关节门诊接诊的34例患者(男9例,女25例,平均年龄31岁),经MRI确诊为颞下颌关节盘可复性移位伴间断性锁结,采用再定位[牙合]治疗,治疗期限为6个月,治疗后1个月和3个月进行随访,比较戴用再定位[牙合]3个月、6个月,取下[牙合]后1个月和3个月复查时的关节弹响,疼痛程度、颞下颌关节功能障碍指数和紊乱指数。结果治疗结束时,34例患者中32例(94.12%)弹响完全消失,1个月复查时,弹响消失患者占88.24%,3个月复查时,弹响消失患者占76.46%;治疗开始后3个月患者疼痛主诉与治疗前相比有明显下降;颞下颌关节功能障碍指数、肌肉压痛指数和颞下颌关节功能紊乱指数均有显著下降。结论再定位垫治疗关节盘移位伴间断性锁结,在短期内可有效消除关节弹响,缓解疼痛症状,解除功能障碍,利于关节盘获得良好的盘突关节。

愈痹方联用甲氨喋呤治疗类风湿性关节炎54例

目的:探讨中西医结合治疗类风湿性关节炎(RA)的疗效。方法:对102例RA病例采用随机双盲对照法观察自拟愈痹方(羌活、独活、桔梗、防己、川乌、草乌、生黄芪等)联用甲氨喋呤和单用甲氨喋呤治疗RA的疗效。结果:治疗组总有效率达83.3%,对照组总有效率为62.5%,两组比较有显著性差异(P<0.01);且治疗组的副作用较对照组也有明显减少。结论:采用中西药综合治疗RS可明显提高疗效,降低副作用。

Tongue image feature correlation analysis in benign lung nodules and lung cancer

Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine;respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument;and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L;TB/TC-a;and TB/TC-b);textural parameters[TB/TC-contrast(CON);TB/TC-angular second moment(ASM);TB/TC-entropy(ENT);and TB/TC-MEAN];as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson’s or Spearman’s correlation analysis;and the overall correlation was analyzed using canonical correlation analysis(CCA).Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L;TB-b with TC-b;and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover;the correlation of TB-a with TC-a;TB-a with perAll;and the texture parameters of the TB(TB-CON;TB-ASM;TB-ENT;and TB-MEAN)with the texture parameters of the TC(TC-CON;TC-ASM;TC-ENT;and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group;with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05);and 0.940 and 0.822(P<0.05);re-spectively.Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L;a;and b values of the TB and TC;as well as the perAll value of the TC;and the texture parameters(TB/TC-CON;TB/TC-ASM;TB/TC-ENT;and TB/TC-MEAN)between the TB and TC.Additionally;there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer;thereby providing a scientific basis for the ear-ly detection;diagnosis;and treatment of lung cancer.

Structure and function of aggrecan

Aggrecan is the major proteoglycan in the articular cartilage. This molecule is important in the proper functioning of articular cartilage because it provides a hydrated gel structure (via its interaction with hyaluronan and link protein) that endows the cartilage with load-bearing properties. It is also crucial in chondroskeletal morphogenesis during development. Aggrecan is a multimodular molecule expressed by chondrocytes. Its core protein is composed of three globular domains (G1, G2, and G3) and a large extended region (CS) between G2 and G3 for glycosaminoglycan chain attachment. G1 comprises the amino terminus of the core protein. This domain has the same structural motif as link protein. Functionally, the G1 domain interacts with hyaluronan acid and link protein, forming stable ternary complexes in the extracellular matrix. G2 is homologous to the tandem repeats of G1 and of link protein and is involved in product processing. G3 makes up the carboxyl terminus of the core protein. It enhances glycosaminoglycan modification and product secretion. Aggrecan plays an important role in mediating chondrocyte-chondrocyte and chondrocyte-matrix interactions through its ability to bind hyaluronan.

乌龙止痛丹结合外治法治疗类风湿性关节炎痰瘀互结型疗效观察

本文就乌龙止痛丹结合外治法治疗类风湿性关节炎痰瘀互结型疗效观察进行了探讨,并做如下报告。

Rheumatoid arthritis and ankylosing spondylitis occurring together: a case report

Ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are two different rheumatoid immune diseases. It is not common that the two diseases occur simultaneously in the same patient in clinical practice. Here, we reported a case of meeting the diagnostic criteria for both AS and RA, who was treated with integrated traditional Chinese and Western medicine and received apparent improvement.

Seismic analysis of a long-span continuous steel truss-arch bridge across the Yangtze River

In this paper, an FEM （Finite Element Method） model is established for the main span of the bridge, with the main box arch and suspender members modeled by beam elements, truss members by truss elements, and the orthotropic steel deck by plate elements. The natural frequencies and mode shapes are acquired by the eigen-parameter analysis. By input of a typical earthquake excitation to the bridge system, the dynamic responses of the bridge, including the displacement and accelerations of the main joints of the structure, and the seismic forces and stresses of the key members, are calculated by the structural analysis program, based on which the main laws of the seismic responses of the bridge are summarized, and the safety of the structure is evaluated.

CEMENTLESS TOTAL HIP ARTHROPLASTY IN PATIENTS OLDER THAN 70 YEARS

Objective To present 3-15 years follow-up of patients older than 70 years who underwent cementless total hip arthroplasty. Methods One hundred and two consecutive primary total hip arthroplasties utilizing a circumferential proximal porous coated femoral component and smooth surfaced threaded acetabular were performed in 92 patients. The patients were followed up clinically and radiographically every two years from their third year after surgery. Ten patients (10 hips) died and 14 patients (15 hips) were lost to follow up in three years after surgery. Sixty-seven patients (77 hips) were included in this study. Results The pre-operative Harris hip scores and pain scores were 45 and 15 points. They increased to 89 and 42 points by the third year. These scores decreased to 81 and 42 points in the ninth year and 77 and 37 points in the fifteenth year, respectively. More than 75% of the hips demonstrated good or excellent clinical results in the fifth year and 60% of the hips were rated good to excellent in the seventh to eleventh year. In the fifteenth year, only 50% of the hips had good or excellent results. All femoral components showed stable fixation by bone in-growth. Eight acetabular components were revised, with 5 due to mechanical loosening and 3 for recurrent instability. Thigh pain was documented in 4 hips. ConclusionThe smooth-surfaced threaded acetabular component has a high rate of failure. Circumferential proximal porous coated femoral components provided excellent radiographic results and acceptable clinical outcome with definite bone ingrowth. Patients older than 70 may be suitable candidates for cementless total hip arthroplasty.

Combined therapeutic approach:Inflammatory bowel diseases and peripheral or axial arthritis

Inflammatory bowel diseases(IBDs), particularly Crohn's disease(CD) and ulcerative colitis(UC), are associated with a variety of extra-intestinal manifestations(EIMs).About 36% of IBD patients have at least one EIM, which most frequently affect the joints, skin, eyes and the biliary tract.The EIMs associated with IBD have a negative impact on patients with UC and CD, and the resolution of most of them parallels that of the active IBD in terms of timing and required therapy;however, the clinical course of EIMs such as axial arthritis, pyoderma gangrenosum, uveitis, and primary sclerosing cholangitis is independent of IBD activity.The peripheral and axial arthritis associated with IBD have traditionally been treated with simple analgesics, non-steroidal anti-inflammatory drugs, steroids, sulfasalazine, methotrexate, local steroid injections and physiotherapy, but the introduction of biological response modifi ers such as tumor necrosis factor-α blockers, has led to further improvements.

基于锥形束CT的骨性Ⅰ类伴安氏Ⅰ类及安氏Ⅱ类错[牙合]畸形患者颞下颌关节窝形态分析

目的应用锥形束CT分析骨性Ⅰ类伴安氏Ⅰ类及安氏Ⅱ类错[牙合]畸形患者颞下颌关节窝形态差异。方法收集2019年1月至2020年12月于首都医科大学附属北京友谊医院口腔科就诊的78例骨性Ⅰ类成年患者的双侧颞下颌关节锥形束CT影像资料进行回顾性分析,并根据磨牙关系及上前牙倾斜度分为安氏Ⅰ类组、安氏Ⅱ1类组及安氏Ⅱ类组。对3组颞下颌关节窝与髁突的角度和线性指标进行测量评估。结果(1)各组颞下颌关节窝和髁突测量指标总的比较,除关节结节高度(AEH)外,差异均具有统计学意义(均P<0.05)。其中,安氏Ⅱ类组和安氏Ⅱ1类组的关节结节后斜面斜度(AEI-BFL和AEI-TRL)均较安氏Ⅰ类组大(均P<0.05)。安氏Ⅱ类组的关节窝深度(GFD)大于安氏Ⅰ类组,关节窝长度(GFW)、关节窝长深比(GFW/GFD)、髁突角(CA)及髁突间角(IA)均小于安氏Ⅱ1类组和安氏Ⅰ类组(均P<0.05)。(2)除了安氏Ⅱ类组左右侧CA差异具有统计学意义(P<0.05)以外,各组左右侧颞下颌关节的其他测量指标差异均无统计学意义(均P>0.05)。(3)除了安氏Ⅱ1类组女性患者的GFW/GFD大于男性患者(P<0.05)以外,各组不同性别患者其他颞下颌关节窝测量指标比较,差异均无统计学意义(均P>0.05)。(4)各组相同性别患者的AEI-BFL、AEI-TRL及GFW/GFD比较,差异均具有统计学意义(均P<0.05)。此外,各组女性患者的GFW、CA及IA比较,差异也具有统计学意义(均P<0.05)。结论骨性Ⅰ类伴安氏Ⅰ类及安氏Ⅱ类错[牙合]畸形患者的颞下颌关节窝形态存在差异,但其两侧关节窝形态的对称性良好;且性别因素对骨性Ⅰ类伴同种牙性错[牙合]畸形患者颞下颌关节窝的形态发育影响较小,而不同错[牙合]畸形女性患者的颞下颌关节形态差异要较男性患者明显。

学界女杰——谢希德

1 1921年3月,谢希徒出生在闽南泉州。其父谢玉铭教授是中国物理学的先驱者之一,对她的影响最大。父亲每晚工作到深夜,谢希德也养成了晚上一定要看书的习惯。2知识的早期启蒙,使谢希德一踏进校门就显示了过人的聪颖。一年级时,她门门功课满分,排名第一。有位大学心理系教授为了研究,给她和同学们测量智商,谢希德果然"不同寻常",高于其他人。她被允许从一年级跳到了三年级,功课学起来仍很轻松。

3D optical measurement of relative displacement for the tuberosities in the shoulder prosthesis

In this paper,a binocular 3-D computer vision measurement system is used to measure the relative displacement for the greater and lesser tuberosities in the shoulder prosthesis.The basic principles of binocular optical measurement are introduced in detail,and the loading apparatus is designed for external rotation and anteflexion of the shoulder prosthesis.Both the motion of external rotation and anteflexion of the shoulder are measured,and the corresponding displacement values for the greater and lesser tuberosities are extracted.These results will play an important role in evaluating the stability of humeral tuberosity in the shoulder prosthesis.

Developmental dysplasia of the hip： A special pathology

Developmental dysplasia of the hip （DDH） is one of the most common congenital disorders in childhood. Its diverse pathological changes require different treatments and result in different outcomes. Although many studies have been conducted on DDH, some special pathology is still unrecognized. We here presented a rare case of a one-year and eleven-month old girl with DDH; a half-free intra-articular osteocartilaginous tissue was found in her right hip joint. X-ray, computer assisted tomography （CT） and magnetic resonance imaging （MRI） were performed to evaluate the pathological changes. MRI revealed some positive findings. The patient experienced open reduction and histopathological examination of the small tissue. Through gross anatomy it is a half-free intra-articular osteocartilaginous tissue, which can fully match a fossa observed at the femoral head. Histopathological examination found that the tissue was composed of collagenous fiber and cartilage-like tissue. Interestingly, we found the expression of type l collagen according to immunohistochemical analysis, which indicated that the cartilage-like tissue was formed due to laceration of the articular cartilage. This kind of disorder should be included as one of the pathologies of DDH. The most possible origin of this tissue is the femoral head which we speculate may have been fractured before.

Four Proven Cases by Acupuncture

In late November 2006, I was honored to participate in the Advanced Class on the Inheritance of Shanghai Senior TCM Doctors＇ Academic Experience, and studied under Professor CHEN Han-ping for 3 years. Now I introduced some of my clinical experience on acupuncture as follows.

Inferior glenohumeral joint dislocation with greater tuberosity avulsion

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.

Assessment of Clinical Effect of Therapy Combining Disease with Syndrome on Rheumatoid Arthritis

Objective： To observe the effectiveness and safety of a therapy combining disease with syndrome on rheumatoid arthritis. Methods： Eighty patients with rheumatoid arthritis belonging to syndrome of damp-heat obstruction were randomly divided into a treatment group and a control group according to stratified blocked randomization method.Forty cases in the control group orally took Loxoprofen Sodium Tablet and Leifumite Tablet and the other 40 cases in the treatment group orally took a Chinese medicine for 12 weeks as a course of treatment. ACR therapeutic effect was used as the standard for evaluating the total therapeutic effect. Results： After l 2 weeks of treatment, there was a statistical difference （P〈0.01） in the improvement of VAS score, morning stiffness time, number of swelling joints, index of swelling joints, number of joints with tenderness, index of joints with tenderness, average grip strength of both hands, DSA28 score, HAQ, patient＇s assessment, physician＇s assessment, ESR, CRP and RF in both groups. The improvement of morning stiffness time, number of swelling joints, index of swelling joints, grip strength, HAQ and patient＇s assessment in the treatment group was much better than that in the control groups with statistical difference （P〈0.05）. ACR20, ACR50 and ACR70 was 27.5% （11/40）, 37.5% （15/40） and 22.5% （9/40） respectively in the treatment group and 40% （16/40）, 27.5% （11/42） and 10.0% （4/40） respectively in the control group with statistical difference （P〈0.05） in the superiority of the treatment group over the control group. The incidence of adverse reaction in the control group was higher than that in the treatment group （P〈0.05）. Conclusion： Definite therapeutic effect and high safety can be achieved in using the therapy combining disease with syndrome to treat rheumatoid arthritis belonging to syndrome of damp-heat obstruction.

Tubercular arthritis of the elbow joint following olecranon fracture fixation and the role of TGF-beta in its pathogenesis

Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.