Objective To observe the changes of cytokines in degenerated cervical intervertebral discs and the relationship between cartilage end-plate calcification and degeneration of cervical intervertebral discs in rabbits,and to investigate the effect of gene therapy on the contents of IL-1β,TNF-α in degenerated cervical intervertebral discs and on the thickness of the calcified layer of the cartilage end-plate of cervical spine.Methods 25 New Zealand rabbits(4-month-old) were enrolled in the study,whose weight was 2～3kg.The rabbits were randomly divided into five groups:normal group,model group 1(shallow layer),model group 2(whole layer),gene-treatment group 1(shallow layer),gene-treatment group 2(whole layer).The model of the cervical dynamic unbalance were established by surgical intervention except for the rabbits in normal group.After eight months,the contents of IL-1β,TNFαin cervical intervertebral discs of every group were detected by ELISA,and the thickness of the calcified layer of the cartilage end-plates in every group were measured.Results The contents of IL-1β,TNF-α in degenerated cervical intervertebral discs and the thickness of the calcified layer of the cartilage end-plate in gene-treatment groups were significantly decreased,as compared with those in model groups(P0.05).Conclusion The gene therapy can decrease the contents of IL-1β,TNF-α in degenerated cervical intervertebral discs and the thickness of the calcified layer of the cartilage end-plate in cervical spine of rabbits.

Objective:To explore the changes of cytokines in degenerated cervical intervertebral discs and the relationship between cartilage end-plate calcification of cervical spine and the degeneration of cervical intervertebral discs,and also to study the effect of combination treatment with Chinese and western medicine on cytokines and cartilage end-plate calcification.Methods:Twenty-five four-month-old New Zealand rabbits were made into dynamic imbalance model of cervical vertebra in order to induce cervical intervertebral disc degeneration.After 7 months,rabbits in treatment group were given anti-hyperosteogeny capsule and glucosamine hydrochloride capsule,twice a day for one month.Thereafter,all rabbits were sacrificed and the cervical intervertebral discs were collected.The contents of IL-1β and TNFα in cervical intervertebral discs in every group were determined by ELISA method,meanwhile,the degeneration of the cervical vertebrae and the thickness of the calcified layer of the cartilage end-plates were also measured.Results:The contents of IL-1β and TNFα in degenerated cervical intervertebral discs and the thickness of the calcified layer of the cartilage end-plate in anti-hyperosteogeny capsule combined with glucosamine hydrochloride capsule group declined significantly compared with model group(P0.05).Conclusion:Anti-hyperosteogeny capsule in combination with glucosamine hydrochloride capsule can decrease the contents of IL-1β and TNFα in degenerated cervical intervertebral discs and the thickness of the calcified layer of the cartilage end-plate in cervical spine.

我院自1995-2006年采用中药清热解毒法为主，配合病灶清除持续闭式冲洗引流法治疗小儿急性骨髓炎165例,疗效满意，现报告如下。

Objective It is to approach the influence of gene in treatment of rabbit with degenerated cervical intervertebral discs cartilage end plate calcification.Methods 25 four-month-old New Zealand rabbits were randomly divided into 5 groups: normal group,model group(shallow layer),model group(whole layer),gene group(shallow layer),gene group(shallow layer),gene group(whole layer).In all groups except for the normal group,the cervical dynamic unbalance models of rabbits were made to induce to inter vertebral disc degeneration.7 months after operation,the gene groups were infused recombinant plasmid DNA of TGF-β1 in intervertebral discs of C2—5,20 μL each disc.After the 8th months,the intervertebral discs of C4—5 was intercepted and used to evaluate the degree of degenerative intervertebral disc,and the thickness of cartilage end plate calcification layer were detected.Results Compared with control group,the thickness of cartilage end plate calcification layer in model group were inspissate significantly(P<0.01),and the calcification of cartilage end plate were suppressed in gene group(P<0.05).Conclusion The calcification of cartilage end plate is the initiating agent of the degeneration of intervertebral disc,there is a remarkably positive correlation.The gene therapy of intervertebral disc degeneration can inhibit the calcification of cartilage end plate.

肱骨外上髁炎是骨科门诊常见病,多发病.既往治疗方法虽多,但疗效不满意.我们从1994～2003年应用局部注氧疗法治疗肱骨外上髁炎968例,其中对217例病人进行了3～6年的随访,现报告如下.

Objective It is to make rabbit models of cervical vertebra disease in order to explore the changes of concentrations of IL-1β and TNF-α in cervical intervertebral disc,and to explore the effect of gene therapy on the concentrations of the cytokine in abnormal cervical intervertebral disc.Methods 25 four-month-old New Zealand rabbits(weight 2-3 kg) were randomly divided into 5 groups: normal group,shallow layer model group,whole layer model group,shallow layer gene group,whole layer gene group.In all groups except for normal group,the cervical dynamic unbalance models of rabbits were made to induce to intervertebral disc degeneration.7 months after operation,the gene groups were infused recombinant plasmid DNA of TGF-β1 in intervertebral discs of C2—5,20 μL each disc.After 8 months,the contents of IL-1β and TNF-α in cervical intervertebral discs in every group were determined with ELISA method.Results Compared with that in normal group,the contents of IL-1β and TNF-α in cervical intervertebral discs were significantly higher(P<0.01),but the contents in gene group were obviously lower than that in model group(P<0.05).Conclusion Gene therapy has a obvious inhibiting function on many kinds of cytokine and mediators of inflammation released from abnormal cervical intervertebral disc.

目的研究坐位作业人群颈椎曲度以及伸屈活动变化,比较其与工龄长短及坐位作业时间长短间的差异。方法随机抽取200例坐位作业职业人群,工作在5~30 a,男女不限,采用动态条件下X线测量颈椎曲度及屈伸活动度。结果颈曲值减少。颈椎曲度及颈椎活动度随工龄的增长而减少,随坐位作业时间增加而减少。结论颈椎曲度的变化是与单颈椎节段的不稳定有关,与调人群的工龄呈正相关。颈椎伸屈活动度的下降主要由于后伸幅度减少所致。

2002年7月-2006年7月我院用月骨切除后游离肌腱填塞的方法治疗晚期月骨缺血性坏死,共收治18例,其中14例经过5～50个月随访,腕关节活动好,无并发症,疗效满意,现报道如下.

目的总结小切口治疗臀肌挛缩症的疗效及体会。方法采用经大转子后上方弧形小切口的术式治疗臀肌挛缩症28例,术后早期功能锻炼。结果随访1~7 a,25例疗效满意,远期无活动范围丢失;3例远期随访活动范围有一定的丢失,无复发病例。结论该术式简单安全,松解病变组织彻底,创伤小,疗效肯定。

Objective:To observe the influence of Chinese and west medicine therapy on the content of SOD in blood serum and the score of ache and function. Methods:The patients with cervical spondylotic radi- culopathy were treated with Glucosamine Hydrochloride Capsules and Antihyperosteogeny Capsules. The content of SOD and the score of ache and function after six months were valueel. Results:the content of SOD in blood serum increased but the scores of ache and function decreased significantly. Conclusion:Glucosamine Hydrochloride Capsules in combination with Antihyperosteogeny Capsules therapy could relieve the patients’clinical symptoms, enhanced the vitality of SOD in blood serum and postpone the process of cervical intervertebral disc degeneration. It has significant effect on the patients with cervical syndrome.

目的了解、观察葡立胶囊与抗骨增生胶囊联用治疗颈椎病对血清SOD含量及疼痛功能评分的影响.方法对一组神经根型颈椎病患者,用葡立胶囊与抗骨增生胶囊联合应用治疗3个月,测定血清SOD含量及疼痛功能评分变化.结果颈椎病患者治疗组血清SOD含量与治疗前相比明显升高,疼痛功能评分治疗前相比明显降低.结论葡立胶囊与抗骨增生胶囊联合应用可明显缓解症状,提高血清SOD活力,延缓颈椎间盘退变,对治疗颈椎病有明显疗效.

BACKGROUND: Degenerated cervical intervertebral discs can release many kinds of cytokines and inflammatory mediums, which plays an important role in onset and development of cervical syndrome.OBJECTIVE: To observe the effect of anti-cytokine Chinese herb combined with western drug (anti-hyperosteogeny capsule combined with glucosamine hydrochloride capsule) and gene therapy, on the contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) of degenerated cervical intervertebral discs in rabbits.DESIGN: Randomized controlled observation.SETTING: Department of Orthopaedics and Central Laboratory of Hebei People's Hospital.MATERIALS: The experiment was carried out in the Central Laboratory of Hebei People's Hospital from March 2003 to January 2004. A total of 35 New Zealand rabbits of both genders were selected and divided into 7groups according to randomly digital table: normal control group, shallowlayer model group, whole-layer model group, shallow-layer medicine group,whole-layer medicine group, shallow-layer gene group and whole-layer gene group. There were 5 rabbits in each group.METHODS: Except normal control group, rabbits in other 6 groups were used to establish models of dynamic dysequilibrium of cervical vertebra through cutting muscles of cervical back to induce degeneration of cervical intervertebral discs. Superficial group of muscle in cervical region was resected in shallow-layer groups, and both superficial and deep group of muscle was resected in whole-layer groups. ① Seven months after operation, rabbits in medicine groups were respectively treated with 1.1 g/kg anti-hyperosteogeny capsule (consisting of gouji, gusuibu, jixueteng, laifuzi,niuxi, nvzhenzi, roucongrong, shudihuang and yinyanghuo, etc.; Jiangsu Kangyuan Pharmaceutical Company Limited) and 0.06 g/kg glucosamine (Shanxi Zhongyuanwei Pharmaceutical Company Limited), which was dissolved into 20 mL distilled water. The medicine was administrated twice a day for 1 month. ② After anesthetization of rabbits in gene groups, recombinant plasmid DNA combined with transforming growth factor-β1 (TGF-β1) was injected to C2-3, C3-4 and C4-5 intervertebral disc (20μL per intervetebral disk). Eight months after modeling, rabbits in each group were sacrificed and C3-4 and C4-5 intervertebral disc was used as samples. In addition, contents of IL-1β and TNF-α were measured with double-antibodies-sandwich-ELISA method.MAIN OUTCOME MEASURES: Contents of IL-1β and TNF-α in cervical intervertebral discs of rabbits at 8 months after modeling.RESULTS: All 35 rabbits were involved in the final analysis. Eight months after modeling, for contents of IL-1β and TNF-α, shallow-layer model group was higher than normal control group (P ＜ 0.05-0.01); shallow-layer medicine group and shallow-layer gene group were obviously low er than shallow-layer model group (P ＜ 0.05); whole-layer medicine group and whole-layer gene group were lower than whole-layer model group (P＜ 0.05-0.01).CONCLUSION: The degenerated intervertebral discs can release many kinds of cytokine and inflammatory mediators which can enhance the degeneration of cervical intervertebral discs. Antihyperosteogeny capsule combined with glucosamine hydrochloride capsule and gene therapy can obviously reduce the contents of IL-1β and TNF-o in degenerated cervical intervertebral discs.

Objective:To study the effect of Chinese and western medicine on the change of the contents of cytokine,proteoglycan and the thickness of the cartilage end-plate in rabbits' degenerated cervical intervertebral discs. Method:By removing superficial and whole layer dorsal neck muscles, to establish the model of degenerated cervical intervertebral discs in rabbits and applied to examine the contents of cytokine,proteoglycan and the thickness of cartilage end-plate under the therapy of Chinese and western medicine for a month.Result:Compared with control group of normal rabbits,the contents of interleukin-1α(IL-1α)?tumor necrosis factor α(TNFα) and the thickness of cartilage end-plate increased significantly while the contents of proteoglycan decreased markedly in the model group. After Chinese and western medicine treatment, the contents of IL-1α?TNFα decreased while the contents of proteoglycan was significantly inhibiting on the calification of cartilage end-plate.Conclusion:Anti-hyperosteogeny capsule in combination with glucosemine hydrochloride capsule can inhibit inflammatory reaction and the thickening of cartilage end-plate,relieve cytokine products and enhance the contents of proteoglycan.

目的:研究抗细胞因子的中西药联合应用、基因治疗对兔退变颈椎间盘内细胞因子含量变化的影响。方法:选用35只4个月龄新西兰兔,体质量2~3 kg,雌雄不分,并随机分为正常对照组、模型浅层组、模型全层组、药物治疗浅层组、药物治疗全层组、基因治疗浅层组、基因治疗全层组。建立家兔颈椎动力平衡失调模型,诱导颈椎间盘退变（正常对照组不作处理）。术后7个月,药物治疗组（浅层、全层）给予抗骨增生胶囊和葡立胶囊（剂量按体质量折算）灌胃,2次/d,连用1个月;基因治疗组则将带有转化生长因子β1（TGF-β1）基因的重组质粒DNA注入C2-C5椎间盘中（每个椎间盘用量为20μl）。8个月后用双抗夹心ELISA法检测各组动物颈椎间盘中IL-1β、TNF-α抗体含量。结果:模型组与正常对照组比较,颈椎间盘中IL-1β、TNF-α含量均明显升高（P＜0.01）;中西药治疗和基因治疗组与模型组比较IL-1β、TNF-α含量明显降低（P＜0.05）。结论:退变颈椎间盘组织释放多种细胞因子和炎性介质,它们可加速颈椎间盘退变。中西药联合应用及基因治疗能对其含量起明显的抑制作用。

OBJECTIVE To study the relationship between cartilage end-plate calcification (CEC) and cervical intervertebral discs regression (CIDR) in rabbits, and to study the inhibitory effect of combined therapy of Kanggu Zengsheng Capsule (KZC) ansforming growth factor-apsule (TGF-PLC) and igene therapy (GT) on CEC by measuring the thickness of CEC layer. METHODS Thirty-five New Zeland rabbits of 4 months old were selected to establish cervical dynamic imbalance rabbit model for inducing CIDR (No disposal was given to rabbits in the normal control group). Seven months after operation, combined therapy of KZC and PLC were given, in doses calculated by body weight, to the modeled rabbits in the drug treated group with CEC of either superficial layer or full layer, twice a dantly by gavage for 30 successive days. While to those in the gene therapy group, the recombinant plasmid DNA with transforming growth factor-beta1 (TGF-beta1) was injected once their intervertebral discs (ID) of C(2-3) C(3-4) and C(4-5), 20 microl for each injection. One month later, all rabbits were sacrificed with periotic venous gas embolic method and their ID of C(4-5) (including partial body of the upper and lower vertebrae) was resected. The degree of CIDR was evaluated morphologically, and the thickness of CEC in rabbits was measured and compared between groups. RESULTS Thickness of CEC in the model group, either of superficial layer or of full layer, was significantly more than that in the normal control group with significant difference. Both combined KZC and PLC therapy and gene therapy showed significant inhibitory effects on CEC in treating CIDR (P < 0.05). CONCLUSION CEC is the initial factor of CIDR with highly positive correlation. Both combined therapy of KZC and PLC and gene therapy can significantly inhibit CEC.

目前关于颈椎间盘退变机制的研究报道很多,但其确切原因还不清楚,现将这方面的研究进展情况综述如下.

目的探讨单开门颈椎椎板成形术的手术适应证、手术方法及近期随访结果.方法回顾性分析了应用单开门颈椎椎板成形术治疗脊髓型颈椎病、颈椎间盘突出症及无骨折脱位型颈脊髓损伤共24例.结果经近期随访,术后20例病人的JOA评分提高2～6分,脊髓功能平均改善率为42%,椎管矢状径平均增加4 mm.结论单开门颈椎椎板成形术对于治疗脊髓型颈椎病、颈椎间盘突出症及无骨折脱位型颈脊髓损伤等是一种安全、有效的手术方法.

在当今信息时代,知识不断更新,骨伤学科也随着社会节奏的加快,交通、生产现代化的发展而发展很快.科学发展的特点是学科之间相互交叉而又相互促进.由于生物力学等边缘学科的迅速发展,给骨伤的救治,正确、合理有效的治疗,提供了可靠的理论根据.因此,为了适应骨伤学科生物力学知识更新日益加快的特点,编写一本既有基本理论、基础知识、基本技能,又能反映当代最新进展,知识新颖而全面的教程——《骨伤科生物力学》,就显得十分必要.