目的探讨颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)应用超声骨刀行前路骨化灶切除术的临床价值。方法颈椎OPLL患者62例,前路骨化灶切除术中均应用超声骨刀切除骨化灶。记录手术时间、术中出血量...目的探讨颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)应用超声骨刀行前路骨化灶切除术的临床价值。方法颈椎OPLL患者62例,前路骨化灶切除术中均应用超声骨刀切除骨化灶。记录手术时间、术中出血量、术后并发症发生率;比较术前,术后3d、3个月、1年及末次随访时日本骨科协会评分;末次随访时评价手术优良率。结果62例骨化灶均完全切除,脊髓减压满意,手术时间60~190(129.4±30.9)min,术中出血量80~600(204.2±126.0)mL;术后发生脑脊液漏3例,吞咽困难3例,喉返神经牵拉伤1例,对症处理后逐渐恢复,未发生切口感染、食管瘘、喉上神经损伤、术后血肿等并发症;随访12~40个月,失访4例,余58例植骨融合良好,均未出现螺钉松动、断裂;日本骨科协会评分在术后3d[(14.0±1.3)分]、术后3个月[(14.7±0.9)分]、术后1年[(15.8±1.0)分]、末次随访时[(16.2±0.8)分]均较术前[(10.2±1.9)分]明显增高(P<0.05);手术优良率为86.2%。结论颈椎OPLL患者行前路骨化灶切除术中使用超声骨刀可实现骨化灶的完全切除,脊髓减压满意,手术优良率高,且操作时间短、出血少、并发症少。展开更多
目的探讨超声骨刀在颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)颈前路骨化灶切除术中应用的有效性和安全性。方法43例颈椎OPLL患者均行超声骨刀辅助下颈前路骨化灶切除术,记录手术时间、术中出血...目的探讨超声骨刀在颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)颈前路骨化灶切除术中应用的有效性和安全性。方法43例颈椎OPLL患者均行超声骨刀辅助下颈前路骨化灶切除术,记录手术时间、术中出血量、术后住院时间及术后并发症发生情况。术后随访34~46个月,记录术前、术后3d、术后3个月、术后1年及末次随访时日本骨科协会(Japanese Orthopaedic Association,JOA)评分和颈椎功能障碍指数(neck disability index,NDI);末次随访时计算JOA评分改善率,评价手术疗效优良率;术后3、6、9、12个月及之后每年1次行颈椎正侧位X线片或颈椎CT检查评估植骨融合情况。结果43例患者手术均顺利完成,后纵韧带骨化灶完全切除,脊髓及神经根压迫完全解除;手术时间80~160(118.1±19.3)min,术中出血量45~185(98.1±35.6)mL,术后住院时间2~3(2.2±0.4)d。43例患者随访(42.0±6.6)个月,术后6个月时均植骨融合良好。术前、术后3d、术后3个月、术后1年及末次随访时JOA评分[(9.9±1.4)、(13.0±0.8)、(14.3±0.7)、(15.5±1.0)、(16.8±0.6)分]依次升高(P<0.05),NDI评分[(48.8±8.6)、(28.8±3.3)、(11.3±2.3)、(6.2±0.6)、(4.2±0.9)分]依次降低(P<0.05)。末次随访时手术疗效优良率为86.0%。43例患者术后发生脑脊液漏1例,声音沙哑3例,吞咽困难2例,给予对症治疗后逐渐恢复;未发生切口感染、食管瘘、气管损伤、喉上神经损伤、血肿等并发症。末次随访时患者均植骨融合良好,未发生内固定松动、断裂、移位、下沉等并发症。结论颈椎OPLL患者行超声骨刀辅助下颈前路骨化灶切除术,骨化灶切除完全,脊髓减压充分,手术时间短、术中出血量少、恢复快,疗效良好,安全性高。展开更多
The expression of mRNA for bone morphogenetic protein-1 (BMP-1) was investigated in fetal human cartilage and bone during the developing endochondral ossification by using in situ hybridization. BMP-1 mRNA was localiz...The expression of mRNA for bone morphogenetic protein-1 (BMP-1) was investigated in fetal human cartilage and bone during the developing endochondral ossification by using in situ hybridization. BMP-1 mRNA was localized in the hypertrophic chondrocytes, the cells of perichondrium, osteoblasts and marrow cells. The results suggest that BMP-1 may involve in cartilage and bone formation, and in regulation of calcification of growth plate.As a comparative study, the expression of TGF-β1 protein was investigated in cartilage and bone using immunohistochemical staining, correlated expression of TGF-β1 and BMP-1 was found. The results suggest that BMP-1 and TGF-β1 act synergistically to influence endochrondral ossification.展开更多
This paper presents 5 patients with repeated recurrence of osteosarcoma (RROS). The primary focus of 3 patients were in the distal portion of femur, and 2 patients were in the proximal Portion of tibia. Three patients...This paper presents 5 patients with repeated recurrence of osteosarcoma (RROS). The primary focus of 3 patients were in the distal portion of femur, and 2 patients were in the proximal Portion of tibia. Three patients, whose chest X ray film were negative, were treated by amputation and chemotherapy. Two patients had isolated metastatic focus l. 5 cm in diameter in lung, were treated by amputation after 1 week of chemotherapy and then treated by lobectomy after 2 weeks of chemotherapy. After operation, the chemotherapy was carried out for 3 courses of treatment. The roentgenogram of chest and affected limb were taken once every two months. There were metastatic focuses found in the lung of 1 patient and in the distal portion of femur of 2 patients. One patient was operated on for 4 times. UP to now, 3 patients have been living for 5 yeara and 2 patients for 6 years after operation.展开更多
Objective: To study the influence of polar patel lectomy and the site of reanchored the patellar tendon on femoral quadriceps extensing force. Methods: The experiment was designed by using 5 lower limbs of cadavers fo...Objective: To study the influence of polar patel lectomy and the site of reanchored the patellar tendon on femoral quadriceps extensing force. Methods: The experiment was designed by using 5 lower limbs of cadavers for extracorporal biodynamic test. The maximal fixing force of the double stainless steel wire ( 0.4 mm in diameter) reanchoring the patellar ligament to the patellar cortical edge was measured. Clinically 21 patients with polar fractures were treated by removing the small fragments and reanchoring the patellar ligament to the cortical edge of the patella using the wires. Results: Resection of the lower 1/4 part of the patella and the patellar ligament reanchored to cortical edge of the patella would not increase femoral quadriceps contracting force arm. But if the patellar tendon reanchored near the joint surface, much more extending force would be needed than the former (P<0.001). The maximal fixing force of the wires is 67.4 kg (60.9 72.5 kg). All the patients using this modified procedure gained satisfactory functional recovery. Conclusions: The modified partial patellecomy is a simple and effective procedure for choice.展开更多
文摘目的探讨颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)应用超声骨刀行前路骨化灶切除术的临床价值。方法颈椎OPLL患者62例,前路骨化灶切除术中均应用超声骨刀切除骨化灶。记录手术时间、术中出血量、术后并发症发生率;比较术前,术后3d、3个月、1年及末次随访时日本骨科协会评分;末次随访时评价手术优良率。结果62例骨化灶均完全切除,脊髓减压满意,手术时间60~190(129.4±30.9)min,术中出血量80~600(204.2±126.0)mL;术后发生脑脊液漏3例,吞咽困难3例,喉返神经牵拉伤1例,对症处理后逐渐恢复,未发生切口感染、食管瘘、喉上神经损伤、术后血肿等并发症;随访12~40个月,失访4例,余58例植骨融合良好,均未出现螺钉松动、断裂;日本骨科协会评分在术后3d[(14.0±1.3)分]、术后3个月[(14.7±0.9)分]、术后1年[(15.8±1.0)分]、末次随访时[(16.2±0.8)分]均较术前[(10.2±1.9)分]明显增高(P<0.05);手术优良率为86.2%。结论颈椎OPLL患者行前路骨化灶切除术中使用超声骨刀可实现骨化灶的完全切除,脊髓减压满意,手术优良率高,且操作时间短、出血少、并发症少。
文摘目的探讨超声骨刀在颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)颈前路骨化灶切除术中应用的有效性和安全性。方法43例颈椎OPLL患者均行超声骨刀辅助下颈前路骨化灶切除术,记录手术时间、术中出血量、术后住院时间及术后并发症发生情况。术后随访34~46个月,记录术前、术后3d、术后3个月、术后1年及末次随访时日本骨科协会(Japanese Orthopaedic Association,JOA)评分和颈椎功能障碍指数(neck disability index,NDI);末次随访时计算JOA评分改善率,评价手术疗效优良率;术后3、6、9、12个月及之后每年1次行颈椎正侧位X线片或颈椎CT检查评估植骨融合情况。结果43例患者手术均顺利完成,后纵韧带骨化灶完全切除,脊髓及神经根压迫完全解除;手术时间80~160(118.1±19.3)min,术中出血量45~185(98.1±35.6)mL,术后住院时间2~3(2.2±0.4)d。43例患者随访(42.0±6.6)个月,术后6个月时均植骨融合良好。术前、术后3d、术后3个月、术后1年及末次随访时JOA评分[(9.9±1.4)、(13.0±0.8)、(14.3±0.7)、(15.5±1.0)、(16.8±0.6)分]依次升高(P<0.05),NDI评分[(48.8±8.6)、(28.8±3.3)、(11.3±2.3)、(6.2±0.6)、(4.2±0.9)分]依次降低(P<0.05)。末次随访时手术疗效优良率为86.0%。43例患者术后发生脑脊液漏1例,声音沙哑3例,吞咽困难2例,给予对症治疗后逐渐恢复;未发生切口感染、食管瘘、气管损伤、喉上神经损伤、血肿等并发症。末次随访时患者均植骨融合良好,未发生内固定松动、断裂、移位、下沉等并发症。结论颈椎OPLL患者行超声骨刀辅助下颈前路骨化灶切除术,骨化灶切除完全,脊髓减压充分,手术时间短、术中出血量少、恢复快,疗效良好,安全性高。
文摘The expression of mRNA for bone morphogenetic protein-1 (BMP-1) was investigated in fetal human cartilage and bone during the developing endochondral ossification by using in situ hybridization. BMP-1 mRNA was localized in the hypertrophic chondrocytes, the cells of perichondrium, osteoblasts and marrow cells. The results suggest that BMP-1 may involve in cartilage and bone formation, and in regulation of calcification of growth plate.As a comparative study, the expression of TGF-β1 protein was investigated in cartilage and bone using immunohistochemical staining, correlated expression of TGF-β1 and BMP-1 was found. The results suggest that BMP-1 and TGF-β1 act synergistically to influence endochrondral ossification.
文摘This paper presents 5 patients with repeated recurrence of osteosarcoma (RROS). The primary focus of 3 patients were in the distal portion of femur, and 2 patients were in the proximal Portion of tibia. Three patients, whose chest X ray film were negative, were treated by amputation and chemotherapy. Two patients had isolated metastatic focus l. 5 cm in diameter in lung, were treated by amputation after 1 week of chemotherapy and then treated by lobectomy after 2 weeks of chemotherapy. After operation, the chemotherapy was carried out for 3 courses of treatment. The roentgenogram of chest and affected limb were taken once every two months. There were metastatic focuses found in the lung of 1 patient and in the distal portion of femur of 2 patients. One patient was operated on for 4 times. UP to now, 3 patients have been living for 5 yeara and 2 patients for 6 years after operation.
文摘Objective: To study the influence of polar patel lectomy and the site of reanchored the patellar tendon on femoral quadriceps extensing force. Methods: The experiment was designed by using 5 lower limbs of cadavers for extracorporal biodynamic test. The maximal fixing force of the double stainless steel wire ( 0.4 mm in diameter) reanchoring the patellar ligament to the patellar cortical edge was measured. Clinically 21 patients with polar fractures were treated by removing the small fragments and reanchoring the patellar ligament to the cortical edge of the patella using the wires. Results: Resection of the lower 1/4 part of the patella and the patellar ligament reanchored to cortical edge of the patella would not increase femoral quadriceps contracting force arm. But if the patellar tendon reanchored near the joint surface, much more extending force would be needed than the former (P<0.001). The maximal fixing force of the wires is 67.4 kg (60.9 72.5 kg). All the patients using this modified procedure gained satisfactory functional recovery. Conclusions: The modified partial patellecomy is a simple and effective procedure for choice.
