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.

<正>急性化脓性骨髓炎多见于儿童和青少年(2～15岁),具有发病急、病情重的特点,如治疗不当,往往造成严重后果。2001-03—2008-09,我们早期诊断并采用中药、手术、持续闭式引流治疗并护理小儿急性化脓性骨髓炎86例,结果如下。1资料与方法1.1一般资料86例均为我院骨科住院患儿。男57例,女29例;年龄6～15岁,平均10.4岁;发病部位于胫骨32例,股骨27例,肱骨14例,尺桡骨4例,髂骨2例,其

急性化脓性骨髓炎多见于儿童和青少年(2 ～15岁),具有发病急、病情重的特点,如治疗不及时,可导致慢性骨髓炎,造成不可逆的骨骼损害及畸形,如局部死腔形成、患肢缩短及成角畸形等[1],严重影响患儿的生理及心理发育,给患儿家庭带来沉重的经济负担,对患儿家属也是负性事件.患儿家属多伴有不同程度的焦虑.因此,对患儿家属进行心理干预也是临床护理的重要内容.2001 -03-2010 -03,我们对54例急性化脓性骨髓炎患儿家属进行心理干预,并与单纯常规治疗及护理患儿44例对照,观察对患儿家属焦虑情绪的影响.

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。

滑膜软骨瘤病（synovial chondromatosis）是一种少见关节滑膜疾患,好发于膝、髋、肘等全身大关节,其中以膝关节发病率最高。我院收治一位病史长达30年且合并病理性骨折的患者,国内报道较少,现报告如下。患者,男,65岁,因右膝关节外伤后肿胀30年,活动受

寰枢椎旋转半脱位（atlanto axial rotatory subluxation,AARS）是一种多发于儿童、也发生于成年人的疾病。1998年至2003年共收治29例,报告如下。

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]To study the effect of arthroscopic reconstruction of anterior cruciate ligament with hamstring tendons and mini-plates.[Method]Thirteen cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with over six strands of hamstring tendons in way of one-bundle and two-tunnel reconstruction.The grafts were fixed with suspension technique by mini-plates.The patients were followed up for one year.The clinical results were evaluated according to Lysholm rating scale.[Result]Twelve patients(92.31%) had negative Lachman test,and one patient showed positive Lachman test.Pivot shift test was negative in 12 cases,and was positive in one case.The Lysholm score increases from 47.77±1.96 to 95.38±4.74(P<0.01).[Conclusion]Arthroscopic reconstruction of anterior cruciate ligament with hamstring tendons and mini-plates is reliable to restore the stability of the knee.

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.

患者,女,38岁,主因右膝下渐肿胀3年入院,不伴有关节交锁,打软腿,无外伤病史.查体:右膝髌下膨隆肿大,象眼消失,触诊约有5 cm×5 cm大小肿物,表面欠光滑,质柔韧,无压痛,活动差,右膝关节活动度良好.辅助检查:CR拍片可见右膝髌下散在多个圆形高密度影.MRI扫描见,右膝髌骨下方,关节囊前方有团状异常信号影,T1W1上以低信号为主,内见斑点状高信号影(图1),T2W1上呈高低混杂信号,内见多发结节状影(图2),GR序列上以高信号为主,内间低信号影.

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。

1临床资料 患者,男性,18岁,在校大学生,主因颈部被打伤疼痛10h入院.

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.

儿童寰枢椎旋转性半脱位是引起儿童斜颈的常见原因,2000年我院共收治此病患儿6例,现报告如下.

患者,男,19岁.主因颈部外伤致疼痛、活动受限15 d入院.患者于15 d前跳水时头部撞击池底,当即感到头颈部疼痛,活动受限.