Bone marrow, the vital organ which maintains lifelong hemopoiesis, currently receives considerable attention, as a source of multiple cell types which may play important roles in repair at distant sites. This emerging...Bone marrow, the vital organ which maintains lifelong hemopoiesis, currently receives considerable attention, as a source of multiple cell types which may play important roles in repair at distant sites. This emerging function, distinct from, but closely related to, bone marrow roles in innate immunity and inflammation, has been characterized through a number of strategies. However, the use of surgical models in this endeavour has hitherto been limited. Surgical strategies allow the experimenter to predetermine the site, timing, severity and invasiveness of injury; to add or remove aggravating factors(such as infection and defects in immunity) in controlled ways; and to manipulate the context of repair, including reconstitution with selected immune cell subpopulations. This endows surgical models overall with great potential for exploring bone marrow responses to injury, inflammation and infection, and its roles in repair and regeneration. We review three different murine surgical models, which variously combine trauma with infection, antigenic stimulation, or immune reconstitution, thereby illuminating different aspects of the bone marrow response to systemic injury in sepsis, trauma and allergy. They are:(1) cecal ligation and puncture, a versatile model of polymicrobial sepsis;(2) egg white implant, an intriguing model of eosinophilia induced by a combination of trauma and sensitization to insoluble allergen; and(3) ectopic lung tissue transplantation, which allows us to dissect afferent and efferent mechanisms leading to accumulation of hemopoietic cells in the lungs. These models highlight the gain in analytical power provided by the association of surgical and immunological strategies.展开更多
There is a considerable amount of interest in the futurerole of bone marrow-derived stem cells(BMDSCs) and tissue engineering techniques to manage conditions within the musculoskeletal system. Repair of soft tissue an...There is a considerable amount of interest in the futurerole of bone marrow-derived stem cells(BMDSCs) and tissue engineering techniques to manage conditions within the musculoskeletal system. Repair of soft tissue and bone defects, in the early stages of injury, may lead to a reduction in progression of symptoms. Furthermore, troublesome soft tissue injuries that are notoriously fraught with problems either in healing or function, could be augmented with such techniques. The aim of this review paper is to look at the advances in such strategies to tackle these problems and assess how BMDSCs, with the aid of growth factors and scaffolds, are being used in vitro, animal and even human models to treat problems within the field of trauma and orthopaedics. There is plenty of evidence that the results are encouraging and thus gaining momentum toward their use in human studies.展开更多
目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在...目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在此基础上联合黄芪桂枝五物汤加减联合针刺,连续治疗2周。比较两组的临床疗效、机械通气时间、ICU住院天数、日常生活活动能力Barthel指数(BI)评分、APACHEⅡ评分、肌力状态(MRC)评分。结果观察组的有效率90.91%(30/33),高于对照组的有效率69.70%(23/33)(P<0.05);观察组机械通气天数、住ICU时间明显短于对照组(P<0.05);治疗14d,观察组患者的BI等级优于对照组(P<0.05);治疗3d、治疗5d、治疗7d的观察组的APACHEⅡ评分明显低于对照组,肌力状态MRC评分明显高于对照组(P<0.05)。结论黄芪桂枝五物汤加减联合针刺治疗能明显缩短重症骨创伤ICU获得性衰弱患者的机械通气时间、ICU住院天数,提高日常活动能力,改善肢体肌力,更利于促进疾病康复。展开更多
目的 探讨并比较我国中西医骨科研究生教育的研究现状、热点和趋势,为后续研究提供科学依据与参考。方法 检索中国知网、万方数据知识服务平台、维普网、Web of Science核心合集数据库收录的中西医骨科研究生教育期刊论文。统计年度、...目的 探讨并比较我国中西医骨科研究生教育的研究现状、热点和趋势,为后续研究提供科学依据与参考。方法 检索中国知网、万方数据知识服务平台、维普网、Web of Science核心合集数据库收录的中西医骨科研究生教育期刊论文。统计年度、期刊及研究机构发文情况,采用VOSviewer 1.6.19软件绘制作者合作及关键词共现图谱,采用Cite Space 6.2.R4软件绘制机构合作、关键词聚类、突现及时间线图谱。结果 共纳入文献252篇。中医和西医均经历了由早期探索到波动增长的阶段;中医刊文量最高期刊为《中医教育》,西医为《中国继续医学教育》;中医和西医的代表作者分别为韦贵康和王新伟;中西医均以临床能力教学为主要研究内容,中医较为关注理论思辨研究,西医更集中于技术应用研究;未来教学改革可能基于教学方法创新、数字技术迭代等方面展开。结论 中西医骨科研究生教育仍有巨大发展空间和潜力,后续应着重开展促进研究主体交流、聚焦前沿技术应用、打造特色传承模式等研究。展开更多
背景:人工智能在医疗领域的发展日益迅速,在骨创伤领域的应用研究不断增多。文章旨在通过文献计量学分析,分析近年来人工智能在骨创伤领域中的研究热点,并预测未来的研究趋势。目的:总结人工智能技术在骨创伤领域的应用发展历程、研究...背景:人工智能在医疗领域的发展日益迅速,在骨创伤领域的应用研究不断增多。文章旨在通过文献计量学分析,分析近年来人工智能在骨创伤领域中的研究热点,并预测未来的研究趋势。目的:总结人工智能技术在骨创伤领域的应用发展历程、研究现状、热点和未来发展趋势,以期为今后的研究提供新的见解。方法:选择Web of Science核心集数据库中,时间跨度设为自建库至2023年8月,检索人工智能、机器学习、深度学习应用于骨创伤相关的文献420篇。通过人工筛选,导出与文章相关的文献共202篇,采用Citespace软件进行国家、机构、被引期刊和引文分析等的合作和关键词的共现等可视化分析。结果与结论:①分析筛选后纳入的202篇文献,总体发文量呈上升趋势,且在未来研究潜力巨大。研究中心性最高和发文量排名第一的国家均为美国。加州大学(美国)是发文量最多的研究机构。②人工智能在骨创伤研究中最常用的前5个关键词是深度学习、人工智能、骨密度、机器学习、诊断,中心性最高的关键词为骨密度,关键词数量最多的为深度学习。③共被引频次前10位的参考文献分别从多个方面介绍了人工智能技术应用于骨创伤领域诊断的可行性研究,其中8篇涉及骨关节损伤与深卷积神经网络,1篇涉及深度学习在CT检查中检测骨质疏松从而预防脆性骨折,1篇通过人工智能识别皮肤纹理变的特征应用于骨的特征性识别的相关性研究。④今后,人工智能的研究热点将主要集中在骨关节创伤和骨质疏松引发的骨折特异性研究上,未来研究趋势主要集中在提升人工智能算法的性能上,使用人工智能新技术对骨损伤进行精准划分和快速高效诊断,尤其是针对复杂和隐匿性骨折的诊断,通过建立有限元分析模型,实现对骨创伤的更加标准化评估。展开更多
目的比较控制性阶梯式减压术与快速标准大骨瓣减压术治疗重度颅脑损伤的疗效。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、万方医学网、CNKI、CBM和VIP数据库,查找自建库至2022年11月能查到的有关控制性阶...目的比较控制性阶梯式减压术与快速标准大骨瓣减压术治疗重度颅脑损伤的疗效。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、万方医学网、CNKI、CBM和VIP数据库,查找自建库至2022年11月能查到的有关控制性阶梯式减压术和快速标准大骨瓣减压术治疗重度颅脑损伤疗效对比的相关文献,采用RevMan 5.4软件对符合条件的文献进行meta分析。结果共纳入23篇文献,其中17篇是回顾性临床对照研究,6篇是随机对照试验,共计2141例患者,其中控制性阶梯式减压术患者1080例,快速标准大骨瓣减压术患者1061例。Meta分析结果显示,与快速标准大骨瓣减压术相比,控制性阶梯式减压术开始减压时间更早[MD=-25.39,95%CI(-30.96,-19.81),P<0.01]、手术时间[MD=-21.49,95%CI(-34.22,-8.76),P<0.01]、住院时间[MD=-3.02,95%CI(-3.70,-2.34),P<0.01]更短、术中出血量[MD=-23.82,95%CI(-32.42,-15.22),P<0.01]更少、减压术后第1天颅内压(ICP)[MD=-4.58,95%CI(-6.03,-3.13),P<0.01]更低,术中术后总并发症发生率[OR=0.18,95%CI(0.15,0.23),P<0.01]更低、术后2周GCS评分[MD=1.94,95%CI(1.31,2.56),P<0.01]及预后恢复良好率(GOS≥4)[OR=3.08,95%CI(2.15,4.43),P<0.01]优于快速标准大骨瓣减压。结论相比于快速标准大骨瓣减压术,控制性阶梯式减压术在开始减压时间、手术时间、术中出血量、术后住院时间、术中术后总并发症发生率以及后期恢复方面有着一定的优势,表明控制性阶梯式减压术可以在大多数情况下作为降低ICP的首选手术方式,可以在临床上进行推广及应用。展开更多
文摘Bone marrow, the vital organ which maintains lifelong hemopoiesis, currently receives considerable attention, as a source of multiple cell types which may play important roles in repair at distant sites. This emerging function, distinct from, but closely related to, bone marrow roles in innate immunity and inflammation, has been characterized through a number of strategies. However, the use of surgical models in this endeavour has hitherto been limited. Surgical strategies allow the experimenter to predetermine the site, timing, severity and invasiveness of injury; to add or remove aggravating factors(such as infection and defects in immunity) in controlled ways; and to manipulate the context of repair, including reconstitution with selected immune cell subpopulations. This endows surgical models overall with great potential for exploring bone marrow responses to injury, inflammation and infection, and its roles in repair and regeneration. We review three different murine surgical models, which variously combine trauma with infection, antigenic stimulation, or immune reconstitution, thereby illuminating different aspects of the bone marrow response to systemic injury in sepsis, trauma and allergy. They are:(1) cecal ligation and puncture, a versatile model of polymicrobial sepsis;(2) egg white implant, an intriguing model of eosinophilia induced by a combination of trauma and sensitization to insoluble allergen; and(3) ectopic lung tissue transplantation, which allows us to dissect afferent and efferent mechanisms leading to accumulation of hemopoietic cells in the lungs. These models highlight the gain in analytical power provided by the association of surgical and immunological strategies.
文摘There is a considerable amount of interest in the futurerole of bone marrow-derived stem cells(BMDSCs) and tissue engineering techniques to manage conditions within the musculoskeletal system. Repair of soft tissue and bone defects, in the early stages of injury, may lead to a reduction in progression of symptoms. Furthermore, troublesome soft tissue injuries that are notoriously fraught with problems either in healing or function, could be augmented with such techniques. The aim of this review paper is to look at the advances in such strategies to tackle these problems and assess how BMDSCs, with the aid of growth factors and scaffolds, are being used in vitro, animal and even human models to treat problems within the field of trauma and orthopaedics. There is plenty of evidence that the results are encouraging and thus gaining momentum toward their use in human studies.
文摘目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在此基础上联合黄芪桂枝五物汤加减联合针刺,连续治疗2周。比较两组的临床疗效、机械通气时间、ICU住院天数、日常生活活动能力Barthel指数(BI)评分、APACHEⅡ评分、肌力状态(MRC)评分。结果观察组的有效率90.91%(30/33),高于对照组的有效率69.70%(23/33)(P<0.05);观察组机械通气天数、住ICU时间明显短于对照组(P<0.05);治疗14d,观察组患者的BI等级优于对照组(P<0.05);治疗3d、治疗5d、治疗7d的观察组的APACHEⅡ评分明显低于对照组,肌力状态MRC评分明显高于对照组(P<0.05)。结论黄芪桂枝五物汤加减联合针刺治疗能明显缩短重症骨创伤ICU获得性衰弱患者的机械通气时间、ICU住院天数,提高日常活动能力,改善肢体肌力,更利于促进疾病康复。
文摘目的 探讨并比较我国中西医骨科研究生教育的研究现状、热点和趋势,为后续研究提供科学依据与参考。方法 检索中国知网、万方数据知识服务平台、维普网、Web of Science核心合集数据库收录的中西医骨科研究生教育期刊论文。统计年度、期刊及研究机构发文情况,采用VOSviewer 1.6.19软件绘制作者合作及关键词共现图谱,采用Cite Space 6.2.R4软件绘制机构合作、关键词聚类、突现及时间线图谱。结果 共纳入文献252篇。中医和西医均经历了由早期探索到波动增长的阶段;中医刊文量最高期刊为《中医教育》,西医为《中国继续医学教育》;中医和西医的代表作者分别为韦贵康和王新伟;中西医均以临床能力教学为主要研究内容,中医较为关注理论思辨研究,西医更集中于技术应用研究;未来教学改革可能基于教学方法创新、数字技术迭代等方面展开。结论 中西医骨科研究生教育仍有巨大发展空间和潜力,后续应着重开展促进研究主体交流、聚焦前沿技术应用、打造特色传承模式等研究。
文摘背景:人工智能在医疗领域的发展日益迅速,在骨创伤领域的应用研究不断增多。文章旨在通过文献计量学分析,分析近年来人工智能在骨创伤领域中的研究热点,并预测未来的研究趋势。目的:总结人工智能技术在骨创伤领域的应用发展历程、研究现状、热点和未来发展趋势,以期为今后的研究提供新的见解。方法:选择Web of Science核心集数据库中,时间跨度设为自建库至2023年8月,检索人工智能、机器学习、深度学习应用于骨创伤相关的文献420篇。通过人工筛选,导出与文章相关的文献共202篇,采用Citespace软件进行国家、机构、被引期刊和引文分析等的合作和关键词的共现等可视化分析。结果与结论:①分析筛选后纳入的202篇文献,总体发文量呈上升趋势,且在未来研究潜力巨大。研究中心性最高和发文量排名第一的国家均为美国。加州大学(美国)是发文量最多的研究机构。②人工智能在骨创伤研究中最常用的前5个关键词是深度学习、人工智能、骨密度、机器学习、诊断,中心性最高的关键词为骨密度,关键词数量最多的为深度学习。③共被引频次前10位的参考文献分别从多个方面介绍了人工智能技术应用于骨创伤领域诊断的可行性研究,其中8篇涉及骨关节损伤与深卷积神经网络,1篇涉及深度学习在CT检查中检测骨质疏松从而预防脆性骨折,1篇通过人工智能识别皮肤纹理变的特征应用于骨的特征性识别的相关性研究。④今后,人工智能的研究热点将主要集中在骨关节创伤和骨质疏松引发的骨折特异性研究上,未来研究趋势主要集中在提升人工智能算法的性能上,使用人工智能新技术对骨损伤进行精准划分和快速高效诊断,尤其是针对复杂和隐匿性骨折的诊断,通过建立有限元分析模型,实现对骨创伤的更加标准化评估。
