多囊蛋白在骨形成及骨疾病治疗中的作用和机制

背景:多囊蛋白最早是在常染色体显性多囊肾病中发现的,它参与了囊肿的形成,后来又发现其与骨形成及颅缝早闭、骨质丢失和骨肉瘤等骨相关疾病的发生发展有关。目的:对多囊蛋白在骨形成及骨相关疾病的发生发展过程中所发挥的作用进行综述。方法:以“bone”or“bone formation mechanism”or“craniosynostosis”or“bone loss”or“osteosarcoma”and“polycystin”为检索词,检索PubMed数据库1990年1月至2020年4月的相关文献;同时以“多囊蛋白”and“骨”,“多囊蛋白”and“骨形成机制”,“多囊蛋白”and“骨质丢失”,“多囊蛋白”and“骨肉瘤”,“多囊蛋白”and“颅缝早闭”为检索词,检索CNKI数据库1979年1月至2020年4月的相关文献,最终选择45篇密切相关文献进行综述。结果与结论:①研究发现多囊蛋白作为机械感受器存在于骨细胞的质膜中,被外界机械刺激激活,并在细胞内触发信号通路,参与骨形成及骨丧失机制的调节,参与骨发育过程,并在颅缝早闭、骨质丢失和骨肉瘤等骨疾病的发生发展过程中起到重要作用;②迄今对多囊蛋白在颌面骨及颅骨疾病中的研究不多,对于多囊蛋白在骨骼的生理病理过程中的作用及调节机制尚待深入研究。

胶原作为骨修复材料的研究进展

胶原作为生物材料具有其独特的功能,已越来越多地应用于临床,特别是在骨修复中的应用越来越引起人们的重视。概要地介绍了胶原促进骨形成的机制,并对胶原用作引导骨再生材料、骨组织工程的基质材料、骨生长因子的载体材料和羟基磷灰石颗粒的粘结材料等的应用原理和现状作了系统介绍,指出了胶原作为骨修复材料的广泛应用前景。

Experimental study on mechanism of vertebral osteophyte formation

The purpose of this experimental study was to explore the mechanism of the vertebral osteophyte formation. Methods: An experimental model of cervical spondylosis in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from cervical vertebrae. Because of individual difference, the natural development procedure of the vertebral osteophyte formation could be seen with a microscope by dynamic observation. Results: The cartilage end-plate was divided into a growth cartilage layer and an articular cartilage layer. Vertebrae and discs from the 3-month control group rabbits showed normal structure. The changes of cartilage plates from the 3-month experimental group and the 8-month control group animals showed proliferation in peripheral articular cartilage. The osteophytes from the 8-month experimental group animals could be seen. The osteophyte obviously arised from proliferation, calcification and ossification of the peripheral articular cartilage. Conclusions: The vertebral osteophyte arises from proliferation of peripheral articular cartilage which undergoes cartilaginous osteophyte, and then changes into bony osteophyte through an endochondral calcification and ossification.

Femoral component revision using extensively porous-coated cementless stem

To evaluate the clinical and radiographic results of extensively porous-coated femoral stem in revision of total hip arthroplasty （THA）. Methods： From January 1999 to December 2003, fifteen hips of fifteen cases received revision of THA with extensively porous-coated femoral stem. There were six males and nine females. The average age was 66 years （ranging 58-82 years ）. The reason for the revision was aseptic loosening in 10 cases, septic loosening in 2, femoral shaft fracture around loose implant in 2, and femoral revision for malposition of the femoral component in 1. All the patients were clinically evaluated using Harris hip score and radiographically evaluated both preoperatively and postoperatively at regular follow-up intervals. Results： No patients were lost for follow-up. The average length of follow-up was 2.3 years （ range, 1-5 years）. The average preoperative Harris hip score was 42 points, which was improved to 89 points at latest follow-up. The latest follow-up showed that bone in-growth occurred in fourteen stems and solid fibrous fixation in one. Complications consisted of femoral shaft fracture in two cases （1 undisplaced distal femur fracture and 1 cortical perforation at the tip of the prosthesis）, and postoperative dislocation in one. There was no mechanical failure of the stem in this study. Conclusions ： Satisfactory results of short-term clinical and radiographic follow-up have been achieved in using extensively porous-coated femoral stem for revision of THA. It should be noticed that the straight, 203 mm stem should be used with caution in short people.