Reliability of the pronator quadratus fat pad sign to predict the severity of distal radius fractures

AIM To evaluate the reliability of pronator quadratus fat pad sign to detect distal radius fracture and to predict its severity.METHODS Retrospectively we identified 89 consecutive patients(41 female, mean age 49 ± 18 years) who had X-ray(CR) and computed tomography(CT) within 24 h following distal forearm trauma. Thickness of pronator quadratus fat pad complex(PQC) was measured using lateral views(CR) and sagittal reconstructions(CT). Pearson's test was used to determine the correlation of the PQC thickness in CR and CT. A positive pronator quadratus sign(PQS) was defined as a PQC > 8.0 mm(female) or > 9.0 mm(male). Frykman classification was utilized to assess the severity of fractures.RESULTS Forty-four/89 patients(49%) had a distal radius fracture(Frykman Ⅰ n = 3, Ⅱ n = 0, Ⅲ n = 10, Ⅳ n = 5, Ⅴ n = 2, Ⅵ n = 2, Ⅶ n = 9, Ⅷ n = 13). Mean thickness of the PQC thickness can reliably be measured on X-ray views and was 7.5 ± 2.8 mm in lateral views(CR), respectively 9.4 ± 3.0 mm in sagittal reconstructions(CT), resulting in a significant correlation coefficientof 0.795. A positive PQS at CR was present in 21/44 patients(48%) with distal radius fracture and in 2/45 patients(4%) without distal radius fracture, resulting in a specificity of 96% and a sensitivity of 48% for the detection of distal radius fractures. There was no correlation between thickness of the PQC and severity of distal radius fractures.CONCLUSION A positive PQS shows high specificity but low sensitivity for detection of distal radius fractures. The PQC thickness cannot predict the severity of distal radius fractures.

Recurrence of Lower Eyelid Fat Pads (Herniated Fat) after Blepharoplasty: An Analysis of Different Operative Techniques

Background: Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts [1]. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. Methods: The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. Results: The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. Conclusions: The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.

Role of infrapatellar fat pad in pathological process of knee osteoarthritis: Future applications in treatment

It has been found that obese people have a higher proportion in suffering from osteoarthritis (OA),not only in the weight-bearing joints like knee and hip joints,even in non-weight-bearing joints such as hand joints.One of the reasons is because the large amount of adipose tissue secretes some factors,which can promote the occurrence of arthritis.As an important structure of the knee joint,the infrapatellar fat pad (IPFP) is actually a piece of adipose tissue.The aim of this review is to offer a comprehensive view of the anatomy and physiological characteristics of IPFP and its relationship with the pathological process of OA,indicating the important function of IPFP in OA.At the same time,with the development of adipose derived stem cells in the treatment of OA,owing to its special advantages,the IPFP is becoming a kind of important,minimally invasive fat stem cell source,providing a new approach for the treatment of OA.We hope that this review will offer an overview of all published data regarding the IPFP and will indicate novel directions for future research.

New scoring system in assessment of Hoffa's fat pad synovitis: A comparative study with established scoring systems

AIM To investigate the reliability of the established and new scoring methods for Hoffa's fat pad synovitis using magnetic resonance imaging(MRI).METHODS A total of 139 knees of 115 patients who underwent MRI of the knee with and without gadolinium contrast were enrolled in this study. Proton density(PD)-weighted, PD-weighted fat-suppressed(PD-FS), and postcontrast T1-weighted fat-suppressed(T1CE) images were used for evaluation. Using contrast and noncontrast images, our grading method for synovitis was performed to measure synovial thickness and signal intensity changes of the fat pad [Synovial membrane(SM) score], which was compared with the established methods,including MRI Osteoarthritis Knee Score(MOAKS), parapatellar synovitis score,Whole-Organ Magnetic Resonance Imaging Score(WORMS), and suprapatellar effusion diameter. Intraclass correlation coefficients(ICC) for intra and interobserver reproducibility and Spearman correlation coefficients(r) were calculated for the parapatellar synovitis score and each scoring method.RESULTS All of the scores presented substantial to almost perfect intrareliability. Among three readers, effusion diameter had substantial to almost perfect interreliability(ICC = 0.68-0.81) and WORMS had substantial interreliability(ICC = 0.61-0.70).For two out of three readers, there was substantial interreliability for the thickness score in T1CE(ICC = 0.55-0.69), SM scores in T1CE(ICC = 0.56-0.78)and PD-FS(ICC = 0.51-0.79), and parapatellar synovitis score in T1CE(ICC =0.53-0.72). The parapatellar synovitis score was significantly correlated with the thickness score in T1CE(r = 0.70) and the SM score in T1CE(r = 0.81) and PD-FS(r = 0.65).CONCLUSION The newly proposed quantitative thickness score on T1CE and the semiquantitative SM score on T1CE and PD-FS can be useful for Hoffa's fat pad synovitis.

NEEDLING THREE POINTS AROUND THE KNEE-JOINT FOR TREATMENT OF 138 CASES OF INFRAPATELLAR FAT PAD STRAIN

Infrapatellar fat pad strain is a common disease and is referred to the chronic cumu-lative lesion of the knee joint, manifested mainly as arthralgia. The author treated 100 cases ofthis disease by noedling Neixiyan(EX-LE 4), Waixiyan and Zusanli (ST 36) and other 38 caseswith combined therapies of acupuncture(of the same three points) and infrared radiation, achiev- ing cure rates of 68% and 71. 1 %, and total effective rates of 93.0% and 92.1% respectively.Comparison between the two groups in cure rate shows no statistical difference (P】0. 05).

Hypothenar fat pad flap vs conventional open release in primary carpal tunnel syndrome:A randomized controlled trial

AIM To compared outcomes between the hypothenar fat pad flap(HTFPF) and conventional open carpal tunnel release(COR) in primary carpal tunnel syndrome(CTS). METHODS Forty-five patients(49 hands) were enrolled into the study from January 2014 to March 2016, 8 patients were excluded. Randomization was conducted in 37 patients(41 hands) by computer generated(Block of four randomization) into COR and HTFPF group. Nerve conduction study(NCS) included distal sensory latency(DSL), distal motor latency(DML), sensory amplitude (S-amp), motor amplitude(M-amp) and sensory nerve conduction velocity(SCV) were examined at 6 and 12 wk after CTR. Levine score, grip and pinch strength, pain [visual analog scale(VAS)], 2-point discrimination(2-PD), Semmes-Weinstein monofilament test(SWM), Phalen test and Tinel's sign were evaluated in order to compare treatment outcomes.RESULTS The COR group, 19 patients(20 hands) mean age 50.4 years. The HTFPF group, 20 patients(21 hands) mean age 53.3 years. Finally 33 patients(36 hands) were analysed, 5 patients were loss follow-up, 17 hands in COR and 19 hands in HTFPF group. NCS revealed significant difference of DSL in HTFPF group at 6 wk(P < 0.05) compared with the COR group. S-amp was significant improved postoperatively in both groups(P < 0.05) but not significant difference between two groups. No significant difference of DML, M-amp and SCV postoperatively in both groups and between two groups. Levine score, pain(VAS), grip and pinch strength, 2-PD, SWM, Phalen test and Tinel's sign were improved postoperatively in both groups, but there was no significant difference between two groups.CONCLUSION There is no advantage outcome in primary CTS for having additional HTFPF procedure in CTR. COR is still the standard treatment. Nevertheless, improvement of DSL and S-amp could be observed at 6 wk postoperatively.

Fat management in upper blepharoplasty:Addition or subtraction blepharoplasties,how and when

BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.

Clinical application and histological observation of pedicled buccal fat pad grafting

To introduce the applied anatomy of pedicled buccal fat pad (BFP) graft and a series of histological changes in the healing process of BFP as an uncovered pedicled graft Methods The healing processes of BFP are demonstrated via uncovered pedicled grafts on rabbits in histological examination Uncovered buccal fat pads were used to repair soft tissue defects in rabbit oral cavities Results The uncovered buccal fat pads showed complete epithelialization of their oral surfaces at 6 to 8 weeks after surgery and were slowly replaced by fibrous tissue Conclusions Advantages of the pedicled buccal fat pad graft include an anatomic region that is consistent and easy to excise The operation can be performed in one incision, affecting neither appearance nor function of the area Use of the buccal fat pad provides a good reconstruction of soft tissue defects in the mouth

Tropoelastin improves adhesion and migration of intra-articular injected infrapatellar fat pad MSCs and reduces osteoarthritis progression

Intra-articular injection of mesenchymal stem cells(MSCs)is a promising strategy for osteoarthritis(OA)treatment.However,more and more studies reveal that the injected MSCs have poor adhesion,migration,and survival in the joint cavity.A recent study shows that tropoelastin(TE)regulates adhesion,proliferation and phenotypic maintenance of MSCs as a soluble additive,indicating that TE could promote MSCs-homing in regenerative medicine.In this study,we used TE as injection medium,and compared it with classic media in MSCs intra-articular injection such as normal saline(NS),hyaluronic acid(HA),and platelet-rich plasma(PRP).We found that TE could effectively improve adhesion,migration,chondrogenic differentiation of infrapatellar fat pad MSCs(IPFP-MSCs)and enhance matrix synthesis of osteoarthritic chondrocytes(OACs)in indirect-coculture system.Moreover,TE could significantly enhance IPFP-MSCs adhesion via activation of integrin β1,ERK1/2 and vinculin(VCL)in vitro.In addition,intra-articular injection of TE-IPFP MSCs suspension resulted in a short-term increase in survival rate of IPFP-MSCs and better histology scores of rat joint tissues.Inhibition of integrin β1 or ERK1/2 attenuated the protective effect of TE-IPFP MSCs suspension in vivo.In conclusion,TE promotes performance of IPFP-MSCs and protects knee cartilage from damage in OA through enhancement of cell adhesion and activation of integrin β1/ERK/VCL pathway.Our findings may provide new insights in MSCs intra-articular injection for OA treatment.

Reconstruction of palate with buccal fat pad secondary to resection of desmoplastic ameloblastoma

Desmoplastic ameloblastoma(DA)is an unusual variant of ameloblastoma exhibiting important differences in the anatomical distribution,radiographic features and histologic appearance compared with the classic type of ameloblastoma.The purpose of this paper is to report a case of DA in the anterior left maxilla and to describe a simple method of reconstruction with the use of buccal fat pad(BFP).BFP is an excellent choice for reconstruction of small to medium sized defects.It should be manipulated gently and hemostasis should be achieved meticulously during this surgery.It should not be sutured under tension.

脱细胞真皮基质和带蒂颊脂垫瓣修复颊部软组织缺损的对比研究

目的比较脱细胞真皮基质(ADM)和带蒂颊脂垫瓣(PBFPF)修复颊部软组织缺损的效果。方法选取我院84例行颊黏膜缺损修复的患者,随机分为ADM组和PBFPF组,每组42例。ADM组患者采用ADM修复,PBFPF组患者使用PBFPF修复。比较2组患者修复时间、经口进食时间、住院时间。于术前、术后1周、术后1个月、术后6个月测量并比较患者的最大开口度,记录患者的修复有效率及并发症发生情况。观察患者术后口腔颌面部功能(吞咽功能、语言功能、咀嚼功能)改善情况。结果2组患者修复时间、经口进食时间、住院时间、并发症总发生率、术后吞咽功能、术后语言功能比较,差异均无统计学意义(P>0.05)。ADM组与PBFPF组患者最大开口度组间比较、组间与时点的交互效应差异无统计学意义(P>0.05),时点的比较差异有统计学意义(P<0.05)。PBFPF组中缺损面积为>13~20 cm2的患者修复有效率高于ADM组(P<0.05)。PBFPF组患者的咀嚼功能优于ADM组(P<0.05)。结论PBFPF及ADM用于口腔黏膜组织缺损的修复各有优势,对于黏膜缺损面积较大(>13~20 cm2)的患者,PBFPF的修复效果更好。

研究测量前脂肪垫与肱骨皮质角度诊断肘关节骨折的意义

目的研究测量肘关节标准侧位片中前脂肪垫与肱骨皮质间角度,探讨诊断肘关节骨折引起的前脂肪垫征阳性角度的临界值,从而帮助骨科医生确定治疗方案。方法从CT检查确诊的肘关节外伤引起的骨折与未骨折患者中,各选取X线片侧位中前脂肪垫征阳性患者50例,进行ROC曲线回顾性分析。结果前脂肪垫与肱骨皮质夹角为15.6°,灵敏度+特异度值最大。讨论前脂肪垫与肱骨皮质夹角≥15.6°为骨折临界值,为基层医院骨科医生治疗提供了清晰、客观的诊断依据。

能谱CT物质分离技术对膝关节骨性关节炎髌下脂肪垫物质的相关性研究

目的利用能谱CT水脂分离技术对膝关节骨性关节炎患者进行髌下脂肪垫水脂定量分析的相关性研究,探讨髌骨下脂肪垫在骨性关节炎中的病理变化。方法对临床已进行WOMA疼痛评分的176膝患者进行分组,研究组A组为疼痛评分>40分的骨性关节炎患者98膝,对照组B组为疼痛评分<40分且无临床症状的78膝患者均行膝关节Gemstone Spectral Image(GSI)扫描,所得原始数据进行单能量60KeV及层厚1.25mm重建,利用GSI viewer软件进行分析,分别记录髌骨下内侧、中间及外侧脂肪垫的水基值及脂基值并取其平均值。对组间数据进行独立样本t检验,组内数据采进行皮尔逊相关性R检验。结果A、B两组患者年龄无统计学差异,P>0.05,58.62±8.13 vs 56.56±7.99岁。组内脂基值及水基值数据均呈明显的负相关,P<0.05,A组r=-0.93,B组r=-0.90;组间脂基值及水基值P<0.05,有统计学差异。结论膝关节骨性关节炎的患者其髌骨下脂肪垫的水含量(炎性水肿)增高,相对脂肪含量降低。

髌下脂肪垫IDEAL-IQ和T2 mapping定量参数与膝骨关节炎程度的相关性研究

目的 探讨膝骨关节炎(knee osteoarthritis, KOA)患者髌下脂肪垫(infrapatellar fat pad, IPFP)脂肪分数(fat fraction,FF)及T2值与KOA程度之间的关系。材料与方法 前瞻性招募同日行膝关节X线和MRI检查的受检者(男34例,女65例),依据膝关节X线Kellgren-Lawrence分级(KLG)将受检者分成无KOA组(KLG 0~1级)、轻度KOA组(KLG 2级)和重度KOA组(KLG 3~4级)三组。应用3.0 T MR非对称回波的最小二乘估算法迭代水脂分离(iteraterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation, IDEAL-IQ)、T2 mapping技术测量IPFP的FF及T2值,采用Pearson或Spearman相关性分析FF值及T2值与KOA程度的相关性;采用受试者工作特征(receiver operating characteristic,ROC)曲线评估其对KOA的诊断性能。结果 随着KOA程度进展,IPFP的FF值相应越低,T2值越高。无KOA、重度KOA和轻度KOA三组间FF及T2值差异显著,三组的FF值分别为73.13%±3.98%,67.42%±2.25%,61.92%±3.24%,T2值分别为81.04 (79.61, 82.44)ms, 82.72 (81.44, 84.46)ms, 86.79 (85.32, 89.12)ms,两两组间比较均具有统计学意义(P<0.001)。IPFP FF值与KLG呈负相关(r=-0.779),T2值与KLG之间呈正相关(r=0.688)。应用FF值及T2值诊断有无KOA的曲线下面积(area under the curve, AUC)分别为0.937、0.837,敏感度分别为71.8%、70.0%,特异度分别为91.7%、82.1%。结论 IPFP的FF值及T2值与KOA严重程度相关,可以在一定程度上反映IPFP的病理生理改变,有望作为KOA新的评估手段。

改良颧脂肪垫和颈阔肌悬吊联合高位SMAS多矢量斜拉折叠的中下面部除皱术

目的:探讨行中下面部除皱手术时,对表浅肌肉腱膜系统(SMAS筋膜)进行多矢量斜拉折叠悬吊的临床效果。方法:选取2020年1月-2022年10月笔者医院收治的13例中下面部皱纹皮肤松弛就医者,均采用SMAS浅层剥离,递进折叠固定在颞深筋膜上,同时将下垂的颧脂肪垫折叠悬吊于颞深筋膜上,暴露的颈阔肌的后半部分向耳后乳突附近坚韧的软组织悬吊固定,使老化的中下面部维持长期的提升效果。结果:本组13例就医者均顺利完成手术,术后1例就医者一侧切口延迟愈合,其余12例均正常愈合。随访9~18个月,所有就医者口角囊袋、下颌线紧致清晰度、中面部提升和饱满度都得到了很好改善,面部轮廓外形自然协调,满意率达到92.3%(12/13)。结论:采用改良颧脂肪垫和颈阔肌悬吊联合高位SMAS多矢量斜拉折叠技术行中下面部年轻化治疗可取得良好的手术效果。

膝关节周围脂肪垫MRI表现与膝关节炎联系的研究进展

膝关节骨性关节炎(knee osteoarthritis,KOA)是一种常见的膝关节退行性疾病。早期诊断膝关节骨关节炎对于采取及时干预和治疗具有重要意义。近年来,越来越多的研究表明,膝关节周围脂肪垫在膝关节骨关节炎的早期诊断中发挥着重要的角色。磁共振成像(MRI)因其无创、精确的优点,已成为一种常规的膝关节检查手段。该技术拥有出色的软组织分辨力,对于膝关节骨性关节炎患者在早期的骨质及周围软组织结构的细微改变,其展示出特有的优势,并且具有更高的敏感性和特异性,可以直接观察和量化膝关节周围脂肪垫的变化,为膝关节骨关节炎早期诊断开拓思路。

髌腱-股骨外侧髁摩擦综合征MRI表现及分析

目的探讨髌腱-股骨外侧髁摩擦综合征(PT-LFCFS)的MRI表现与相关参数。方法研究对象60例,收集临床和MRI均诊断为PT-LFCFS的患者30例作为研究组,收集同期无膝关节MRI髌下脂肪垫损伤者30例作为对照组。对比观察研究组与对照组的MRI征象,测量Install-Salvati指数(ISR)、髌腱-股骨外侧髁滑车关节面(PL-T)最短距离、胫骨结节-股骨滑车沟(TT-TG)距离、股骨外侧髁角(LFCA)、股骨外侧髁长度(LTL)和股骨外侧髁高度(LTH),统计两组病例髌腱炎、髌骨外侧支持带损伤、髌股关节炎、胫股关节炎及股四头肌腱炎的发病率,并对两组结果进行比较。结果PT-LFCFS组在质子密度加权成像(PDWI)脂肪抑制序列见髌下脂肪垫外上部局限性水肿,对照组无髌下脂肪垫水肿表现。PT-LFCFS组PL-T、LFCA小于对照组[(0.26±0.08)cm,(0.76±0.11)cm,t=20.913,P<0.001;(82.99±4.94)°,(100.52±5.07)°,t=13.565,P<0.001],ISR、TT-TG、LTL、LTH大于对照组[(1.41±0.12),(1.01±0.08),t=-14.649,P<0.001;(1.14±0.37)cm,(0.69±0.21)cm,t=-5.899,P<0.001;(2.19±0.21)cm,(1.98±0.12)cm,t=-4.784,P<0.001;(0.80±0.13)cm,(0.68±0.11)cm,t=-4.003,P<0.001]。PT-LFCFS组在髌股关节炎、髌骨外侧支持带损伤的发病率高于对照组[25(83.3%),2(6.7%),x^(2)=32.593,P<0.001;27(90%),1(3.3%),x^(2)=41.853,P<0.001]。两组间髌腱炎、胫股关节炎及股四头肌腱炎的发病率差异无统计学意义(P>0.05)。结论PT-LFCFS的MRI特征性表现是髌下脂肪垫外上部局限性水肿,PL-T、LFCA减小,ISR、TT-TG、LTL、LTH增大。PT-LFCFS患者中,髌股关节炎、髌骨外侧支持带损伤的发病率较高。

限时饮食对高脂饮食诱导肥胖大鼠髌下脂肪垫的影响及作用机制

背景:超重或肥胖是膝骨关节炎最主要的危险因素。限时饮食在预防超重或肥胖方面显示出明显的效果。髌下脂肪垫是膝关节的重要组成部分,其是否受到限时饮食的影响,从而影响膝骨关节炎目前仍不清楚。目的:利用高脂饮食诱导的大鼠模型,探究限时饮食减重对髌下脂肪垫的影响,为肥胖相关性膝骨关节炎的早期预防和治疗提供证据。方法:将15只雄性SD大鼠随机分为3组,每组5只。正常对照组大鼠可24 h任意进食,饲喂普通饲料(12%脂肪);高脂饮食组大鼠可24 h任意进食,饲喂高脂饮食(45%脂肪);高脂饮食限时进食组大鼠只在9:00(光照后2 h)至17:00(黑暗前2 h)饲喂高脂饮食。饲养8周后,m Dixon-Quant序列用于评估髌下脂肪垫和右侧腹股沟区皮下脂肪组织的质子密度脂肪分数;ELISA用于定量血清中脂肪因子水平;天狼猩红染色评估髌下脂肪垫纤维化变化;免疫组织化学染色检测解偶联蛋白1在髌下脂肪垫和右侧腹股沟区皮下脂肪组织中的表达以及瘦素、脂联素和肿瘤坏死因子α在髌下脂肪垫中的表达。结果与结论:饲养8周后,(1)与高脂饮食组相比,正常对照组(P=0.036)和高脂饮食限时进食组(P=0.003)的大鼠体质量明显减轻;(2)高脂饮食组大鼠髌下脂肪垫的质子密度脂肪分数明显大于正常对照组(P <0.001)和高脂饮食限时进食组(P=0.004),而3组间皮下脂肪组织的质子密度脂肪分数差异无显著性意义;(3)高脂饮食组的大鼠血清瘦素水平明显高于正常对照组(P=0.030)和高脂饮食限时进食组(P=0.018);(4)与高脂饮食组相比,正常对照组(P <0.001)和高脂饮食限时进食组(P=0.003)以天狼猩红染色为特征的髌下脂肪垫纤维化程度明显降低;(5)高脂饮食组的髌下脂肪垫中瘦素相对表达明显高于正常对照组(P <0.001)和高脂饮食限时进食组(P <0.001);高脂饮食组的髌下脂肪垫中脂联素相对表达明显低于正常对照组(P=0.004)和高脂饮食限时进食组(P=0.048);然而,3组髌下脂肪垫和皮下脂肪组织中均无解偶联蛋白1阳性表达以及髌下脂肪垫中均无肿瘤坏死因子α阳性表达;(6)上述结果表明,限时饮食可以延缓高脂饮食诱导的大鼠髌下脂肪垫的纤维化,降低髌下脂肪垫的质子密度脂肪分数值,并影响血清和髌下脂肪垫中脂肪因子的水平,限时饮食可能是治疗和预防肥胖相关膝骨关节炎的一种简单有效的方法。

磁共振mDIXON-Quant技术在评估膝骨关节炎中髌下脂肪垫质子密度脂肪分数改变的价值研究

目的基于磁共振mDIXON-Quant技术分析膝骨关节炎(knee osteoarthritis,KOA)髌下脂肪垫质子密度脂肪分数(proton density fat fraction,PDFF)改变,及其与KOA严重程度的相关性。材料与方法前瞻性招募44例KOA患者,共计对70例膝关节进行磁共振常规序列及mDIXON-Quant序列扫描,测量KOA患者髌下脂肪垫PDFF。膝关节采用全器官磁共振评分(whole-organ magnetic resonance imaging score,WORMS)评估受试KOA严重程度。分析各膝髌下脂肪垫PDFF与WORMS 11个特征独立评分及总评分的相关性。结果髌下脂肪垫PDFF与膝关节WORMS总评分、关节软骨完整性、边缘骨赘、关节面下骨磨损、关节面下骨髓异常、关节面下骨囊肿、内外侧半月板完整性、关节内游离体、关节周围囊肿/滑囊炎、前后交叉韧带完整性、滑膜炎/积液(r=-0.94、-0.85、-0.83、-0.80、-0.72、-0.52、-0.54、-0.39、-0.27、-0.27、-0.24,P均<0.05)WORMS评分均呈负相关性;与内外侧副韧带完整性(r=0.27,P=0.826)WORMS评分无显著相关性。观察者间一致性非常好ICC=0.793(P<0.001),95%可信区间为(0.667~0.875)。结论磁共振mDIXON-Quant技术可以定量评估KOA患者髌下脂肪垫PDFF改变,髌下脂肪垫PDFF随着KOA严重程度进展而下降。髌下脂肪垫PDFF可以作为反映KOA严重程度的客观评价指标。

应用颊脂垫联合邻近软组织瓣修复老年大型口腔上颌窦瘘

目的:评价应用颊脂垫瓣联合邻近软组织瓣,同期修补由骨髓炎或肿瘤切除术中造成的老年大型口腔上颌窦瘘的临床效果。方法:收集南京大学医学院附属口腔医院口腔颌面外科2020年1月~2022年12月收治的术中并发大型(最大直径大于4 cm)口腔上颌窦瘘患者8例,患者年龄62~84岁。回顾性分析应用颊脂垫瓣联合颊侧推进瓣或腭黏膜瓣覆盖缺损,术后随访对疗效进行评估。结果:全部病例修复成功,未见软组织瓣坏死、穿孔、感染及上颌窦炎鼻窦炎,随访3个月颌面部基本对称,经张口训练后,张口度恢复正常。结论:颊脂垫瓣联合邻近软组织瓣是方便可靠的修复老年大型口腔上颌窦瘘方法,值得临床推广。