AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions(SNU) with immunohistochemistry.METHODS: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The ...AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions(SNU) with immunohistochemistry.METHODS: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin(HE), tartrate resistant acid phosphatase(TRAP), CD 68, osteocalcin(OC) and osteopontin(OP). Histological examination was performed in a blinded fashion.RESULTS: The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU(P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts(P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts(P = 0.008; r = 0.43). SNU older than 6 mo showed a signifi-cant decrease of the number of fibroblasts(P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in SNU.CONCLUSION: Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.展开更多
目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用...目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用西医复位治疗,观察组采用中医正骨手法联合筋伤膏治疗。比较两组临床疗效、临床指标变化、治疗前后视觉模拟评分量表(Visual Analog Scale,VAS)评分、腕关节功能改良加特兰德-韦利评分(Gartland-Werley,GW)及治疗前后腕关节活动度。结果观察组总有效率为100.00%高于对照组,差异有统计学意义(χ^(2)=5.982,P=0.014)。治疗后,观察组各项临床指标优于对照组,差异有统计学意义(P均<0.05)。治疗后,两组背伸度、掌屈度、旋后度明显升高,差异有统计学意义(P均<0.05),且观察组治疗后背伸度、掌屈度、旋后度更高,差异有统计学意义(P均<0.05)。治疗后,两组VAS、GW评分显著降低,差异有统计学意义(P均<0.05),且观察组治疗后VAS、GW评分更低,差异有统计学意义(P均<0.05)。结论桡骨远端伸直型骨折患者采用中医正骨手法联合筋伤膏治疗效果显著,可改善患者临床症状,促进骨折愈合,提高腕关节活动度。展开更多
文摘AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions(SNU) with immunohistochemistry.METHODS: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin(HE), tartrate resistant acid phosphatase(TRAP), CD 68, osteocalcin(OC) and osteopontin(OP). Histological examination was performed in a blinded fashion.RESULTS: The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU(P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts(P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts(P = 0.008; r = 0.43). SNU older than 6 mo showed a signifi-cant decrease of the number of fibroblasts(P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in SNU.CONCLUSION: Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.
文摘目的:观察病灶清除植骨融合联合外固定架治疗腕关节结核的临床疗效。方法:2015年10月至2019年5月,采用病灶清除植骨融合联合外固定术治疗25例晚期腕关节结核患者,男14例,女11例;年龄40~74 (60.72±8.45)岁;病程5~24 (11.52±7.61)个月;左腕结核11例,右腕结核14例,合并窦道形成者5例。术后继续规律抗结核,观察患者治疗前后视觉模拟疼痛评分(vasual analogue scale,VAS)、炎症指标、Gartland-Werley腕关节功能评分、上肢功能评分(disabilities of the arm,shoulder and hand,DASH)。结果:25例患者获得随访,时间12~36(19.7±6.3)个月,末次随访患者切口愈合可,均无结核、感染复发。术前1周与术后3个月VAS分别为(5.16±1.14)、(1.68±0.80)分,红细胞沉降率(enythrocyte sedimentation rate,ESR)分别为(44.20±20.56)、(14.44±1.14) mm·h^(-1),C反应蛋白(C-reactive protein,CRP)为(12.37±7.95)、(4.30±3.37) mg·L^(-1),各时间点比较差异均有统计学意义(P<0.01)。术前1周与术后1年Gartland-Werley腕关节功能评分分别为(21.32±3.44)、(14.96±1.37)分,两者比较差异有统计学意义(P<0.01);DASH由术前1周的(70.52±7.95)分,提高至术后1年的(28.84±2.30)分(P<0.01)。末次随访所有患者结核病无复发。结论:采用病灶清除植骨融合联合外固定术治疗腕关节结核近期临床疗效满意。
文摘目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用西医复位治疗,观察组采用中医正骨手法联合筋伤膏治疗。比较两组临床疗效、临床指标变化、治疗前后视觉模拟评分量表(Visual Analog Scale,VAS)评分、腕关节功能改良加特兰德-韦利评分(Gartland-Werley,GW)及治疗前后腕关节活动度。结果观察组总有效率为100.00%高于对照组,差异有统计学意义(χ^(2)=5.982,P=0.014)。治疗后,观察组各项临床指标优于对照组,差异有统计学意义(P均<0.05)。治疗后,两组背伸度、掌屈度、旋后度明显升高,差异有统计学意义(P均<0.05),且观察组治疗后背伸度、掌屈度、旋后度更高,差异有统计学意义(P均<0.05)。治疗后,两组VAS、GW评分显著降低,差异有统计学意义(P均<0.05),且观察组治疗后VAS、GW评分更低,差异有统计学意义(P均<0.05)。结论桡骨远端伸直型骨折患者采用中医正骨手法联合筋伤膏治疗效果显著,可改善患者临床症状,促进骨折愈合,提高腕关节活动度。
