Objective:To study the expression of microRNA (miR)-214-3p in osteoarthritis (OA) chondrocytes and its mechanism of regulating endothelial cell migration and angiogenesis.Methods:A total of 16 patients with OA who underwent total knee arthroplasty in the First Affiliated Hospital of Zhengzhou University from June 2020 to December 2020 and 12 patients without knee disease but lower limb amputation due to trauma were selected as OA group and healthy group respectively. Cartilage samples were obtained and chondrocytes were extracted. Western blotting and real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) were used to detect the expression level of miR-214-3p in chondrocytes. The cell migration rate, angiogenesis rate and the secretion of vascular endothelial growth factor (VEGF) were detected by wound healing experiment, tubule formation experiment and enzyme-linked immunosorbent assay (ELISA). The relationship between miR-214-3p and neurotrophic tyrosine kinase receptor type 2 (TrkB) was analyzed by bioinformatics analysis and double luciferase analysis. The data were analyzed by statistical software, and the statistical differences were determined by analysis of variance (ANOVA) and t-test. Results:The expression level of TrkB in OA group was significantly higher than that in healthy group (2.13±0.41 vs. 0.92±0.21, t=9.318, P< 0.01). The expression of miR-214-3p in OA group was significantly lower than that in healthy group (0.26±0.12 vs. 1.12±0.31, t=-10.177, P< 0.01). The expression level of miR-214-3p in OA group was negatively correlated with the expression level of TrkB ( r=-0.730, P<0.05), and the expression level of miR-214-3p in healthy group was negatively correlated with the expression level of TrkB ( r=-0.705, P<0.05). Targetscan database predicted the targeted binding sites of miR-214-3p and TrkB. Double luciferase experiment verified the targeted binding of TrkB to miR-214-3p. The VEGF level in TrkB overexpression group was higher [(221.3±5.2) ng/L vs. (137.2±4.8) ng/L, t=43.742, P<0.01], the endothelial cell migration rate was higher (1.71±0.22 vs. 0.98±0.11, t=10.516, P<0.05), and the angiogenesis rate was higher (1.41±0.12 vs. 0.99±0.10, t=9.822, P<0.05) than in empty body group. After down-regulating the expression of miR-214-3p in OA group, the expression level of VEGF increased by 0.95 times ( t=5.245, P<0.01), the migration rate of endothelial cells increased by 1.12 times ( t=3.283, P<0.01), and the angiogenesis rate increased by 0.52 times ( t=1.174, P<0.01). Conclusion:The activation of paracrine VEGF in TrkB signaling pathway is mediated by miR-214-3p, which regulates endothelial cell migration and angiogenesis during the development of OA.

Objective:To explore the effect of long non-coding RNA nuclear receptor subfamily 2 F group member 2 antisense RNA 1 (lncRNA NR2F2-AS1) on the proliferation, migration and invasion of rheumatoid arthritis synovial fibroblasts (RASF) and its molecular mechanism.Methods:Select 35 patients with rheumatoid arthritis synovium tissue from the Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) to detect the expression levels of NR2F2-AS1 and microRNA (miR)-588; RASF was divided into si-NR2F2-AS1 group, si-NC group, miR-588 group, miR-NC group, si-NR2F2-AS1+ anti-miR-588 group, si-NR2F2-AS1+ anti-miR-NC group; cell counting kit-8 (CCK-8) to detect cell viability; clone formation experiment to detect the number of cell clone formation; the scratch test was used to detect the healing rate of cell scratches; the number of cell invasion was detected by Transwell; the protein expression was detected by Western blotting; the dual luciferase reporter test was used to detect the targeting relationship between NR2F2-AS1 and miR-588. Statistical analysis was performed with SPSS 20.0 software.Results:The expression level of NR2F2-AS1 in the synovial tissue of RA patients was higher than that of normal synovial tissue (3.50±0.23 vs. 1.00±0.06, t=62.223, P<0.05), while the expression level of miR-588 was lower than that of normal synovial tissue (0.29± 0.04 vs. 1.00±0.09, t=42.649, P<0.05). The cell viability of the si-NR2F2-AS1 group was lower than that of the si-NC group (0.55±0.04 vs. 1.03±0.08, t=16.100, P<0.05), and the number of cell clone formation was lower than that of the si-NC group [(47.58±5.03) vs. (103.93±10.24), t=14.818, P<0.05], the number of invasive cells [(55.31±5.28) vs. (123.37±10.09), t=17.929, P<0.05] was lower than the si-NC group, the scar healing rate was lower than that of the si-NC group [(23.21±2.47)% to (64.19±5.55)%, t=20.238, P<0.05], and the expression level of E-cadherin was higher than that of the si-NC group, the expression level of N-cadherin was lower than that of the si-NC group ( P<0.05). Overexpression of miR-588 has the same effect. NR2F2-AS1 targets and regulates miR-588; down-regulation of miR-588 expression reversed the effect of inhibiting NR2F2-AS1 expression on the proliferation, migration and invasion of RASF. Conclusion:Inhibiting the expression of lncRNA NR2F2-AS1 can inhibit the proliferation, migration and invasion of rheumatoid arthritis synovial fibroblasts through targeted regulation of miR-588.

[目的]比较颈椎后路单开门椎板成形术中切除与保留C3椎板治疗多节段脊髓型颈椎病的临床效果.[方法] 2018年1月-2019年12月,对56例多节段脊髓型颈椎病患者行后路单开门椎板成形术,其中,31例术中切除C3椎板(切除组),25例术中保留C3椎板(保留组).比较两组患者围手术期、随访与影像资料.[结果]切除组手术时间显著少于保留组(P＜0.05),但两组间术中出血量、术后引流量和平均住院时间的差异无统计学意义(P＞0.05).随时间推移,两组患者JOA评分显著增加(P＜0.05),而VAS评分显著减少(P＜0.05).术前和术后3个月,两组间的JOA与VAS评分的差异无统计学意义(P＞0.05),但是,末次随访时,切除组的JOA和VAS评分均显著优于保留组(P＜0.05).影像方面,与术前相比,末次随访时两组患者C2-7 Cobb角无显著变化(P＞0.05),切除组C2-7矢状垂线(sagittal vertical axis,SVA)无显著变化(P＞0.05),而保留组C2～7 SVA显著增加(P＜0.05).末次随访时,切除组的C2～7 SVA显著小于保留组(P＜0.05).[结论]单开门椎板成形术中C3椎板切除能够增加颈椎的前向稳定性,减小传统术式对颈椎矢状面力线的影响.

[目的]比较踝关节融合术(ankle arthrodesis,AA)和胫距跟关节融合术(tibiotalocalcaneal arthrodesis,TTCA)治疗终末胫距关节病的临床疗效.[方法]2015年1月～2018年12月郑州大学第一附属医院骨科和北京大学人民医院创伤骨科手术治疗终末胫距关节病患者71例,其中,43例采用AA术,28例采用TTCA术.比较两组围手术期、随访与影像资料.[结果]两组患者均顺利完成手术,AA组患者手术时间和术中出血量显著小于TTCA组(P＜0.05).两组患者随访12～46个月,平均(24.31±8.22)个月.与术前相比,两组术后12个月的VAS评分显著减少(P＜0.05),而AOFAS评分显著增加(P＜0.05).相应时间点,两组间VAS和AOFAS评分的差异均无统计学意义(P＞0.05).术后12个月,患者满意率AA组93.02％(40/43);TTCA组为92.86％(26/28),差异无统计学意义(P＞0.05).至末次随访时,两组患者均达到融合关节的骨性愈合,内固定物无松动.[结论]踝关节融合术和胫距跟关节融合术治疗终末胫距关节病均能取得满意的临床疗效.

Objective:To compare the clinical effects of laparoscopic transabdominal and transthoracic Ivor-Lewis esophagectomy (Ivor-Lewis) versus transcervical, transchest and transabdominal McKeown esophagectomy (McKeown) on elderly patients with esophageal cancer.Methods:A total of 85 elderly patients with esophageal cancer who underwent laparoscopic assisted treatment in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2018 to January 2020 were selected. And the clinical data of the 85 elderly patients were retrospectively analyzed. The Ivor-Lewis group included 39 patients who underwent Ivor-Lewis operation, and the McKeown group included 46 patients who underwent McKeown operation. The operation status, perioperative immune function, stress response, and intestinal barrier function were compared between the two groups.Results:The operation time and hospitalization time in Ivor-Lewis group were (150.81±25.73)min and (12.67±2.08)d, respectively, shorter than the (165.62±30.48)min and (15.39±2.47)d in McKeown group (all P<0.05). Cluster of differentiation (CD) 3 +, CD4 + and CD4 +/CD8 + in Ivor-Lewis group were higher than those in McKeown group 1 h, 1 d and 3 d after surgery ( P<0.05). The levels of cortisol, C-reactive protein, and interleukin-6 in Ivor-Lewis group were lower than those in McKeown group (all P<0.05). The diamine oxidase and D-lactic acid in Ivor-Lewis group were lower than those in McKeown group (all P<0.05). Conclusions:The curative effect of laparoscopic assisted Ivor-Lewis is comparable to that of McKeown surgery on elderly patients with esophageal cancer. However, Ivor-Lewis can shorten operation time and hospitalization time, and improve immune function, with fewer influence on stress response and intestinal barrier function.

Objective:To investigate the clinical effect of subxiphoid and subcostal arch thoracoscopic surgery on patients with myasthenia gravis and its influence on stress inflammatory response.Methods:A total of 68 patients with myasthenia gravis treated in Luoyang Central Hospital Affiliated to Zhengzhou University from September 2017 to January 2020 were selected and divided into observation group (34 cases) and control group (34 cases), according to the surgical methods. Patients in the observation group underwent subxiphoid and subcostal arch thoracoscopic surgery; and patients in the control group underwent conventional thoracotomy. The changes of surgical indicators, postoperative complications, preoperative and 3-day postoperative stress inflammatory response, assessed by cortisol (Cor), C-reactive protein (CRP) and interleukin-6 (IL-6) of the two groups were observed. The clinical efficacy during 1 year follow-up of the two groups were observed and compared.Results:Compared with the control group, the amount of blood loss and postoperative drainage of the observation group were less, the postoperative hospital stay was shorter, while the operation time was longer ( P<0.05). The incidence of postoperative complications of the observation group (5.88%, 2/34) were less than those of the control group (26.47%, 9/34), P<0.05. Three days after treatment, the serum levels of Cor, CRP and IL-6 in the two groups were higher than those before surgery ( P<0.05), and these indexes of the observation group were lower those of the control group ( P<0.05). The effective rate of the observation group (94.12%, 26/34) was higher than that of the control group (76.47%, 32/34), P<0.05. Conclusions:The subxiphoid and subcostal arch thoracoscopic surgery has a good clinical effect on myasthenia gravis, with few postoperative complications, and less impact on the stress inflammatory response.

目的 探讨3D打印联合Ilizarov技术治疗胫骨畸形的临床效果.方法 选取2013年1月1日至2019年12月1日郑州大学第一附属医院骨科病区收治的接受3D打印联合Ilizarov技术治疗的17例胫骨畸形患者,包括胫骨骨折畸形愈合患者9例,骨髓炎导致胫骨短缩畸形患者8例.患者术前均拍摄双侧下肢全长正侧位X线和患侧胫腓骨64层CT.应用3 D打印技术个体化打印患肢胫腓骨模型,在模型上进行手术预演,确定截骨位置并准确安装环形外架.术中记录手术时间、手术出血量.术后指导患者调节环形外架,观察手术切口愈合情况,定期复查X线.测定下肢力线恢复情况和患者行走功能改善情况.分别于术前和术后3个月采用视觉模拟量表(VAS)评价患者疼痛情况.结果 术后所有患者均获得随访,随访时间为5～11个月,平均(8,3±2,1)个月.17例患者胫骨畸形均获得纠正,双下肢力线恢复良好,手术切口均一期愈合,术后无针道感染、固定针松动、血管神经损伤、骨不愈合或畸形愈合等并发症.术后随访6个月,患者行走功能较术前有明显改善.术后3个月,患肢VAS评分与术前比较,差异有统计学意义(P<0,05).结论 3D打印联合Ilizarov技术能顺利纠正胫骨畸形,恢复双下肢力线,术前协助设计个体化截骨方案.在3D打印模型上提前进行手术预演,精确安装外固定支架,能够提升手术效率,达到精准矫形的目的.

Background: Osteoarthritis (OA) is an aging-related chronic degenerative joint disease. A number of miRNAs have been found to be involved in the development of OA, but the role of miR-613 in OA remains unclear. Thus, this study aimed to investigate the role of miR-613 during the progression of OA. Methods: CHON-001 cells were transfected with miR-613 agonist for 48 h, and then exposed to 10 ng/mL IL-1 beta for 24 h. Cell viability, cell proliferation and cell apoptosis in CHON-001 cells were assessed by CCK-8, immunofluorescence, and flow cytometry assays, respectively. In addition, the dual luciferase reporter system assay was used to determine the interaction of miR-613 and fibronectin 1 in CHON-001 cells. Results: The level of miR-613 was significantly decreased in IL-1 beta-treated CHON-001 cells. Overexpression of miR-613 markedly inhibited IL-1 beta-induced apoptosis in CHON-001 cells. In addition, upregulation of miR-613 obviously alleviated IL-1 beta-induced inflammatory response and cartilage matrix degradation in CHON-001 cells. Meanwhile, fibronectin 1 was identified as a direct binding target of miR-613 in CHON-001 cells. Overexpression of miR-613 alleviated IL-1 beta-induced injury in CHON-001 cells via downregulating the expression of fibronectin 1. Furthermore, overexpression of miR-613 alleviated cartilage degradation, and reduced OARSI scores and subchondral bone thickness in a mouse model of OA. Conclusion: Our data indicated that overexpression of miR-613 could inhibit IL-1 beta-induced injury in CHON-001 cells via decreasing the level fibronectin 1 in vitro, and alleviate the symptoms of OA in vivo. Therefore, miR-613 might be a potential therapeutic option for the treatment of OA.

Objective:To investigate the effect of long-chain non coding RNA (lncrna) loc730101 in the proliferation, invasion and migration of U2OS cells, and its mechanism.Methods:From February, 2019 to October, 2019, U2OS cells cultured in vitro were divided into control group (normal culture), negative group (transfection nega- tive control), and interference group (transfection of interference sequences targeting LOC730101). The expression of LOC730101 in cells was detected by reverse transcription-polymerase chain reaction (RT-PCR). Cell proliferation ac tivity was tested by methylthiazolyldiphenyl-tetrazolium bromide (MTT) method. Cell clone formation rate was mearused by plate clone formation test. Cell cycle distribution was tested by flow cytometry. Cell invasion and migra- tion were examed by Transwell chamber. The expression levels of epithelial-mesenchymal transition-related proteins Vimentin, N-cadherin, E-cadherin, and Wnt/β-catenin signaling pathway related proteins in cells β-catenin, c-Myc, cyclin D1(CyclinD1) and matrix metalloproteinase-7(MMP-7) proteins were detected by Western blotting method. The date was statistical analysed and considered as statistically significant when P<0.05. Results:Compared with the control group, the expression level of LOC730101 (0.25±0.03 and 1.00±0.06) in interference group and control group, respectively. The same below), cell survival rate [(57.65±3.26)% and (100.00±7.39)%], clone formation rate [(13.03± 2.12)% and (25.35±3.58)%], number of invasive cells(51.36±3.48 and 92.85±6.62), number of migrating cells (77.15± 5.05 and 136.92±15.35), the percentage of cells in S phase [(20.54±2.15)% and (28.15±2.38)%] and G 2/M phase [(16.87±2.12)% and (23.36±3.12)%], as well as the expression level of Vimentin (0.52±0.04 and 1.17±0.13), N-cadherin (0.31±0.03 and 0.65±0.04), β-catenin (0.42±0.03 and 0.73±0.04), c-Myc (0.29±0.03 and 0.65±0.03), CyclinD1 (0.26± 0.02 and 0.58±0.04), MMP-7 protein (0.55±0.03 and 0.86±0.06) was decreased significantly ( P<0.05), while the per- centage of cells in G 0/G 1 phase [(62.62±5.15)% and (48.46±3.65)%] and the expression level of E-cadherin protein(0.82± 0.06 and 0.38±0.03) were increased significantly in the interference group ( P<0.05). But there was no significant differ- ence in each index in the negative group ( P>0.05). Conclusion:Reduce the regulation of LOC730101 can inhibit the proliferation, invasion and migration of U2OS cells, and its mechanism may be related to the inhibition of Wnt/β-catenin signaling pathway.

目的:提出胸腰椎椎旁占位性病变新的临床分型并评价其对手术治疗方案选择的参考价值.方法:收集2013年1月～2019年12月接受手术切除治疗的35例胸腰椎椎旁占位性病变患者的临床资料,其中男15例,女20例,年龄7～70岁(42.4±16.1岁).后正中入路6例,经椎旁肌间隙切除横突入路7例,腹膜后间隙入路17例,病变后方直接切除5例.依据占位病变的影像学特点,将胸腰椎椎旁占位性病变按部位分为3型:Ⅰ型,病变位于椎体旁,小部分沿神经根向椎间孔生长,未突入中央椎管;Ⅱ型,病变位于椎体旁椎间孔之外;Ⅲ型,病变位于椎弓后方的竖脊肌.每型按占位大小进一步分为a、b两个亚型,病变长轴≤50mm为a型,＞50mm为b型.3名观察者先后进行两次评估分型(间隔1周),并进行Kappa一致性检验.手术前后及末次随访时行疼痛VAS评分,并结合影像学复查进行疗效评定.结果:35例患者中Ⅰa型4例,Ⅰb型3例,Ⅱa型9例,Ⅱb型14例,Ⅲa型3例,Ⅲb型2例.3位观察者分型自身一致性的Kappa值为0.924～1,观察者之间一致性的Kappa值为0.849～0.924,均高度一致.6例经后正中入路切除患者为胸段Ⅰa(1例)、Ⅱa(5例)型,7例经椎旁肌间隙入路切除患者为腰段Ⅰa(3例)、Ⅱa(4例)型,17例经腹膜后间隙入路切除患者为腰段Ⅰ b(3例)、Ⅱb(14例)型,5例病变后方直接切除患者为胸、腰段Ⅲa(3例)、Ⅲb(2例)型.34例一期全切,1例未能全部切除.术后患者症状明显缓解,神经功能均未见明显缺失.33例患者获得3～90个月(42.5±33.3个月)随访,其中32例复查MRI未发现病变复发,1例脂肪肉瘤复发.VAS评分术前为7.7±1.6分,术后1个月2.4±1.3分,末次随访时1.2±1.1分.结论:基于胸腰椎椎旁占位性病变的部位和大小,进行合理临床分型,并制定相应的手术治疗策略能够获得良好的临床疗效.

目的 探讨以胫腓联合下为合页位置的内侧开放楔形高位胫骨截骨术(MOWHTO)的疗效.方法 以2016年9月至2018年10月于郑州大学第一附属医院骨科接受MOWHTO联合π形钛板内固定治疗的29例(43膝)膝关节内侧间室骨关节炎患者为研究对象.观察患者膝关节屈曲活动度、Lysholm膝关节功能评分量表(LKSS)评分、美国特种外科医院膝关节评分系统(HSS)评分、胫骨近端内侧角(MPTA).结果 所有患者均获得随访,随访时间为11～27个月,平均(19.74±4.86)个月.术后切口均一期愈合,1膝发生外侧合页骨折(LHF).术后1 a,患者膝关节屈曲活动度、MPTA均较前增大,LKSS评分和HSS评分均较前增高(均P<0.05).结论 以胫腓联合下为合页位置的MOWHTO手术治疗膝关节内侧间室骨关节炎创伤小,近期效果满意,可有效减少术后LHF的发生.

Objective:To investigate the molecular mechanism of long non-coding RNA (lncRNA) LBX2-AS1 targeting microRNA (miRNA, miR)-491-5p to influence the proliferation and apoptosis of osteosarcoma cells.Methods:Real-time quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) was used to detect the expression of LBX2-AS1 and miR-491-5p in osteosarcoma and adjacent tissues. Human osteosarcoma U2OS cells were selected as research objects, and si-NC, si-LBX2-AS1, si-LBX2-AS1 and anti-miR-NC, si-LBX2-AS1 and anti-miR-491-5p were transfected into U2OS cells, respectively. Methyl thiazol tetrazolium (MTT) measures were used to assay the cell viability. Flow cytometry was used to examine the cell cycle and apoptosis rate. The double luciferase report experiment verified the targeting relationship between LBX2-AS1 and miR-491-5p. Western blotting was used to detect the expression of Cyclin D1, p21 and cysteinyl aspartate-specific protease (Caspase)-3.Results:The expression levels of LBX2-AS1 in paratumoral tissues and osteosarcoma tissues were (1.01±0.10) and (3.56±0.35), and the expression levels of miR-491-5p were (1.02±0.10) and (0.16±0.02). As Compared with adjacent tumor tissues, the expression level of LBX2-AS1 in osteosarcoma tissues was significantly increased ( t=35.027, P<0.05), and that of miR-491-5p was significantly decreased ( t=42.165, P<0.05). The cell survival rates of si-NC group and si-LBX2-AS1 group were (100.02±10.00)%, (55.67±5.54)%, G 1 phase ratio were (38.51±2.55)%, (52.27±4.68)%, S phase ratio were (30.10±2.14)% and (15.36±1.26)%, respectively, and the apoptosis rates were (8.28±0.92)% and (24.11±2.37)%, respectively. As compared with the si-NC group, the cell survival rate in the si-LBX2-AS1 group was significantly reduced ( t=11.638, P<0.05), the proportion of cells in the G 1 phase was significantly increased ( t=7.745, P<0.05), and the proportion of cells in the S phase was significantly reduced ( t=17.806, P<0.05), apoptosis rate was significantly increased ( t=18.680, P<0.05), the expression of Cyclin D1 was significantly reduced ( t=20.871, P<0.05), and the expression of p21 and Caspase-3 was significantly increased ( t=22.687, P<0.05; t=20.871, P<0.05). Double luciferase reporting experiments confirmed that LBX2-AS1 could target miR-491-5p. Inhibition of miR-491-5p expression could attenuate the inhibitory effect of LBX2-AS1 expression on proliferation of U2OS cells, and could also attenuate the inhibitory effects of LBX2-AS1 expression on apoptosis of U2OS cells. Conclusion:LncRNA LBX2-AS1 promotes osteosarcoma cell proliferation and inhibits apoptosis by regulating miR-491-5p.

Objective:To investigate the effect of Ilizarov technique in the treatment of tibia shortening deformity.Methods:The data of 16 cases with tibia shortening deformity who were treated by Ilizarov technique in the Frist Affiliated Hospital of Zhengzhou University from March 2017 to December 2018 were retrospectively analyzed. Among them, there were 11 males and 5 females, with age of 20~61 years. The rang of shortening deformity was 4.0~14.0 cm. The time of treatment was 2~19 months. The patients were followed up for 11 to 26 months, and their clinical treatment effects were counted.Results:All 16 patients were followed up, with an average follow-up time of 14.6 months. All patients met the clinical standard of fracture healing, and the average time required for healing was 5.0 months. The average bone elongation time was 53.6 days; the average time for epiphyseal mineralization was 118.9 days. Of the 16 patients, 12 cases of excellent clinical results and 4 cases of were good, 11 cases of excellent limb function and 5 cases of good.Conclusions:Ilizarov technique for tibial shortening is beneficial to the length extension of the affected limb, and it can achieve better clinical healing.

[目的]介绍滑动撑开配合解剖钢板治疗腓骨短缩和旋转畸形的手术技术与初步临床疗效.[方法] 2015年9月～2017年3月对17例踝部骨折术后腓骨畸形患者行手术矫正;从第一次手术至畸形愈合矫正时间平均(5.59±1.94)个月;术前常规行影像检查,对腓骨短缩和旋转畸形进行个体化评估,术中截骨后采用滑动撑开技术配合解剖钢板恢复腓骨长度和旋转.[结果] 17例患者获得随访,平均随访(25.65±11.10)个月.所有患者均无感染,术后AOFAS评分、SF-36评分较术前显著提高,而VAS评分显著下降(P＜005).影像学显示术后骨折线愈合时间(11.88±1.32)周,且力线恢复良好.[结论]滑动撑开技术配合解剖钢板能很好地纠正腓骨长度和旋转畸形,恢复踝穴的匹配,改善踝关节功能,有助于延缓骨性关节炎的发生.

Objective:To evaluate the clinical efficacy of zero-profile anchored spacer (ROI-C) and conventional titanium plate with cage fixation for the treatment of single-segment cervical spondylotic myelopathy.Methods:A total of 70 patients with single-segment cervical spondylotic myelopathy underwent the anterior cervical discectomy and fusion surgery. The patients were divided into ROI-C group and plate-cage group according to the surgical procedures. During the follow-up period, general situations, the postoperative complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) score, preoperative and postoperative cervical curvature, postoperative intervertebral fusion and adjacent segment degeneration were observed.Results:In two groups, the JOA score was improved statistically (ROI-C group: 5.94±1.56, 12.66±0.79, 13.69±0.78, 14.41±0.61; plate-cage group: 6.21±1.36, 13.00±1.14, 13.68±0.87, 14.32±0.74; t=-27.675, -29.601, -31.441, -33.338, -33.148, -40.052, P<0.05), tut there was no statistically significant difference between two groups at the same time ( t=-0.781, -1.441, 0.016, 0.550, P>0.05). Also, the Cobb angle was improved statistically (ROI-C group: 8.14±0.50, 16.76±0.72, 15.86±0.59, 14.94±0.56; plate-cage group: 8.11±0.58, 16.62±0.69, 15.86±0.72, 14.92±0.69; t=-52.937, -48.922, -43.901, -66.986, -57.391, -53.618, P<0.05), but there was no statistically significant difference between two groups ( t=0.247, 0.808, -0.007, 0.091, P>0.05) at the same time. At the last follow-up, postoperative intervertebral fusion and no adjacent segment degeneration was observed in both groups. Conclusion:Both ROI-C and conventional titanium plate with cage fixation can achieve satisfied clinical efficacy in ACDF for the treatment of single-segment cervical spondylotic myelopathy. The operation time is shorter, blood loss is less and incidence of postoperative dysphagia is lower in ROI-C group.

目的 比较桡骨远端不稳定骨折应用手术与石膏外固定治疗的临床效果.方法 选取郑州大学第一附属医院近两年收治的90例桡骨远端不稳定骨折患者作为研究对象,按照平行对照法将其分为观察组(45例)与参考组(45例),观察组、参考组分别采用手术治疗、石膏外固定治疗,观察两组治疗效果、并发症发生情况.结果 两组术后1周视觉模拟评分(VAS)比较无统计学意(P＞0.05);观察组术后第12周腕关节优良率明显高于参考组(P＜0.05);术后8周、12周,观察组腕关节主动活动范围与参考组比较无统计学意义(P＞0.05);观察组关节功能Gartland-Werley评分及PRWE评分均明显优于参考组(P＜0.05);观察组术后并发症发生率明显低于参考组(P＜0.05).结论 手术治疗桡骨远端不稳定骨折效果确切,有助于腕关节功能恢复,并发症发生率低,具有比较优势.

Objective To observe the effect of atractylodesin on human osteoarthritis (OA) chondrocytes.Methods Human OA chondrocytes were pretreated with 10,50,100 mg/kg stractylodesin,followed by stimulation with interleukin (IL)-1β (10 μg/L) for 24 h.The expression levels of cyclooxygenase 2 (COX2) and nitric oxide (NO) were detected by enzyme linked immunosorbent assay (ELISA).The mRNA expression of matrix metalloproteinases (MMP)-1,MMP-13,COX2 and NO was measured by real-time quantitative polymerase chain reaction (Real-time PCR).Western blotting was used to ex amine the activity of nuclear factor-κB (NF-κB) pathway and the expression of human liver X receptor alpha (LXRα).Results Atractylodesin significantly decreased MMP-1 (618.99 ± 12.68,478.65 ± 11.25,243.17±7.88;t=5.120,P＜0.05),MMP-13 (62.78±5.16,48.35±4.28,30.66±4.17;t=4.178,P＜0.05),COX2 (71.41 ±4.33,58.62 ±3.65,37.48 ±2.52;t=4.782,P＜0.05),NO (245.87 ± 9.96,183.26 ± 8.47,120.56 ± 5.38;t =5.030,P ＜ 0.05) in human OA chondrocytes induced by IL-1β.Atractylodesin could attenuate chondrocyte inflammatory response by inhibiting IL-1β-mediated NF-κB activation.Atractylodesin can inhibit IL-1β-mediated chondrocyte inflammatory response by activating LXRα activity (P ＜ 0.05).Conclusion Atractylodesin has anti-inflammatory activity in human OA chondrocytes.

目的 研究掌侧钢板联合尺骨茎突螺钉治疗桡骨远端伴尺骨茎突骨折的效果.方法 收集2015年10月至2017年4月于郑州大学第一附属医院治疗的62例复杂桡骨远端骨折患者,均为闭合性的合并尺骨茎突骨折的桡骨远端骨折,按照治疗方法分为A、B组,A组(32例)采用掌侧钢板联合尺骨茎突螺钉治疗骨折,B组(30例)采用掌侧钢板治疗骨折,术后统计两组患者的掌倾角、尺偏角、Gartland-Werley腕功能评分,分析掌侧钢板联合尺骨茎突螺钉治疗复杂桡骨远端骨折的效果.结果 术后所有患者均获得随访,随访时间为9个月(7～14个月).术后X线检查骨折均愈合,无钢板螺钉断裂,无深部及切口感染,Gartland-Werley功能评分A组优24例,良6例,可2例,优良率93.75％;B组优21例,良6例,可3例,优良率90％.术后出现腕尺侧疼痛患者,A组2例,占本组6.25％;B组7例,占本组23.33％,组间比较,差异有统计学意义(P<0.05).两组间术后掌倾角、尺偏角、Gartland-Werley评分比较,差异无统计学意义(均P>0.05).结论 掌侧钢板联合尺骨茎突螺钉固定桡骨远端伴尺骨茎突骨折与单纯掌侧钢板治疗相比,前者术后出现腕尺侧疼痛比例低于后者,能够更高效恢复腕关节功能.

病人,男性,33岁,发现胸壁包块1年.1年前无意中发现右侧胸壁包块,如鸡蛋大小,无红肿、压痛,未行检查及治疗.近1个月发现包块较前增大,胸部CT检查示右胸壁包块.以右侧胸壁包块收入我科.体格检查:胸廓对称,右侧胸壁可见一大约8 cm×7 cm大小肿物,边界尚清,质地软,无红肿及压痛,可活动,双侧呼吸运动对称,触觉语颤正常,无胸膜摩擦音,双肺叩诊清音,听诊呼吸音清,未闻及干湿性啰音.

[目的]评价改良Sauvé-Kapandji手术联合尺侧腕屈肌固定术治疗陈旧性下尺桡关节脱位的临床疗效.[方法] 2014年10月～2018年10月采用改良Sauvé-kapandji手术联合尺侧腕屈肌固定术治疗24例陈旧性下尺桡关节脱位患者,评价指标包括:术前术后腕关节活动度、改良Mayo腕关节功能评分、是否存在尺骨残端不稳和冲击痛、术后X线片等.[结果]本组手术时间35～60 min,术中出血量很少,平均(3.81±0.98) ml,切口长度5～7 cm,平均(6.05±0.46) cm,住院时间5～9 d,均未出现血管、神经损伤等早期并发症.24例患者术后随访腕关节功能明显改善,未见尺骨残端不稳和冲击痛,复查X线片均提示桡尺远侧关节融合,未见尺骨残端骨再连.[结论]改良Sauvé-Kapandji手术是治疗陈旧性下尺桡关节脱位的一种良好选择,结合尺侧腕屈肌固定术可以进一步增加尺骨残端的稳定性.