Background: We sought to investigate whether growth hormone (GH) treatment increases the risk of scoliosis in children with short stature and analyse a dose-response relationship. Methods: A retrospective cross-sectional and cohort study design was used. The cross-sectional study included 1160 children with short stature (355 and 805 in the GH-exposed and non-exposed groups, respectively). The scoliosis prevalence was compared. A total of 313 short stature children without scoliosis at baseline were enrolled in the cohort study (158 and 155, respectively, in the GH and non-GH groups). The median follow-up time was approximately 4.5 years. The relationship between risk factors and GH dose and the occurrence of scoliosis was evaluated with the outcome of new-onset scoliosis. Results: The incidence of scoliosis in the GH exposure group was significantly higher than that in the non-exposure group (5.40% vs. 2.40%, p=0.008). The risk of scoliosis in the GH group was 2.726 times higher than that in the non-GH group (HR=2.726, 95%CI: 1.326-5.605, p=0.006). The total GH dose was positively correlated with scoliosis risk, and there was a dose-response relationship between the total GH dose and the risk (HR=1.002, 95%CI: 1.001-1.003, p<0.001). A dose-response relationship was confirmed, with the predicted probability of scoliosis increasing continuously with cumulative GH dose. Conclusions: GH therapy is an independent risk factor for scoliosis in children with short stature, with a significant dose-response relationship. The cumulative GH dose can be used as a preliminary reference indicator for risk stratification and personalized monitoring.

BACKGROUND:Optimal treatment for developmental dysplasia of the hip (DDH) in 18-24-month-old children is debated. This study compares closed reduction (CR) to open reduction with pelvic osteotomy (ORPO) to determine efficacy and complications. MATERIALS AND METHODS:Data from 97 patients (131 hips) undergoing CR or ORPO (June 2012 to September 2019) were analyzed. Pre- and postoperative measures including acetabular index (AI), International Hip Dysplasia Institute (IHDI) grade, center-edge angle (CEA), Severin grades, Mckay criteria and avascular necrosis (AVN) were assessed. Statistical analysis compared outcomes and complications. RESULTS:Of 131 hips, 101 underwent CR and 30 ORPO. Preoperative characteristics and radiographic outcomes did not significantly differ. Postoperative AI (CR: 25.2 ± 5.3°, ORPO: 24.3 ± 6.1°, P = 0.441) and CEA (CR: 25.6 ± 11.5°, ORPO: 29.2 ± 16.5°, P = 0.263) showed no significant differences. Satisfactory Severin grades were achieved in 58.4% (CR) and 56.6% (ORPO), P = 1.000. Mckay grade II and above were observed in 66.3% of CR group and 66.7% of ORPO group, P = 1.000. AVN above type Ⅱ incidence was 18.9% (CR) and 33.3% (ORPO), P = 0.131. After using multiple linear regression and logistic regression to control confounding factors, we came to the same outcome. No significant differences were observed in postoperative AI, CEA, Severin grade, Mckay grade or AVN. CR had significantly lower total hospitalization costs. Among the CR group, 19 hips (18.8%) underwent secondary surgery. And their postoperative outcomes were comparable to those in the ORPO group. CONCLUSION:Closed reduction with spica cast immobilization is a viable treatment option for DDH in 18-24-month-olds, with close monitoring. Prompt consideration of secondary surgery is advised for residual acetabular dysplasia.

A retrospective study compared the anterior cubital approach to the triceps-sparing approach for treating T-condylar humerus fractures in 19 children and adolescents from January 2008 to May 2023. Patients were divided into group A (seven patients, mean age 10.7 years, triceps-sparing) and group B (12 patients, mean age 11.32 years, anterior cubital). Outcomes included surgical duration, incision length, scarring [Vancouver Scar Scale (VSS)], neurovascular complications, and functional results [Mayo Elbow Performance Score (MEPS) and Flynn's criteria]. Group A had a mean incision length of 8.60 cm, surgery duration of 68.29 min, and VSS scores averaging 3.71, with five excellent and two good MEPS results, and five excellent, one good, and one fair Flynn's outcomes. Two patients had radial nerve palsy. Group B showed a shorter mean incision length of 4.63 cm, surgery duration of 51.42 min, and VSS scores averaging 1.33, with 10 excellent and two good results for both MEPS and Flynn's criteria. One patient developed cubitus varus, with one case each of radial and median nerve palsy. Significant differences were found in surgery duration, incision length, and scarring, but functional outcomes were comparable. Multivariable regression, adjusted for confounders, validated significant associations of the anterior cubital approach with reduced surgery duration, shorter incision length, and lower VSS scores, with no significant difference in functional outcomes. The anterior cubital approach is minimally invasive, safe, and effective, offering shorter surgeries, smaller incisions, less scarring, and better neurovascular exploration, with similar functional recovery.

IntroductionOsteosarcoma is the most common primary bone tumor. Patients require chemotherapy drugs with high-targeting ability and low off-target toxicity to improve their survival. Exosomes are biological vesicles that mediate long-distance communication between cells and naturally target their source sites. Exosomes derived from bone marrow mesenchymal stem cells (BMSCs) naturally target bone tumor sites, suggesting their potential as effective anti-tumor therapy vectors. In this study, we evaluated the potential of BMSC-derived exosomes in targeting osteosarcoma and serving as a carrier for doxorubicin (DOX).MethodsWe isolated exosomes from human BMSCs and synthesized hybrid exosomes (HEs) by fusing these exosomes with liposomes. These HEs were loaded with DOX to produce a novel drug, HE/DOX.ResultsWe confirmed the successful synthesis of HE/DOX using fluorescence spectroscopy and estimated its size to be 151.1 ± 10.2 nm. HEs expressed the known exosomal proteins ALIX, CD63, and TSG101. Under acidic conditions similar to those observed in the tumor microenvironment, the drug release from HE/DOX was enhanced. In osteosarcoma cell lines and in a mouse osteosarcoma model, HE/DOX exhibited stronger tumor-inhibitory effects than free DOX.ConclusionsOur study demonstrates that BMSC-derived exosomes could effectively target osteosarcoma. Furthermore, HEs can serve as effective carriers of DOX, enabling the treatment of osteosarcoma. These findings highlight a promising direction for tumor-targeted therapy.

Background Long-term extensive use of glucocorticoids will lead to hormonal necrosis of the femoral head, and osteoblasts play an important role in the prevention of osteonecrosis. However, there is no complete cure for necrosis of the femoral head. Mesenchymal stem cell- (MSCs-) derived exosomes are widely used for the repair of various tissue lesions. Therefore, the aim of this study was to investigate the mechanism of dexamethasone- (DEX-) induced osteoblast apoptosis and the therapeutic effect of human umbilical cord MSC- (hucMSC-) derived exosome mimetic vesicles (EMVs) on osteoblast-induced apoptosis by DEX. Methods The viability and apoptosis of primary MC3T3-E1 cells were determined by the Cell Counting Kit-8 (CCK-8), FITC-Annexin V/PI staining and immunoblot. The intracellular levels of reactive oxygen species (ROS) after DEX treatment were measured by 2′, 7′ -dichlorodihydrofluorescein diacetate (DCFH-DA) staining. In this study, hucMSC-EMVs and N-acetyl-l-cysteine (NAC) were used as therapeutic measures. The expression of B-cell lymphoma 2-associated X, Bcl 2, HO-1, and nuclear factor erythroid-derived 2-like 2 and MAPK- signaling pathway in osteogenic cell MC3T3-E1 cells treated with Dex was analyzed by the immunoblotting. Results DEX significantly induced osteoblasts MC3T3-E1 apoptosis and ROS accumulation. MAPK-signaling pathway was activated in MC3T3-E1 after DEX treatment. hucMSC-EMVs intervention significantly downregulated DEX-induced MAPK-signaling pathway activation and ROS accumulation. In addition, hucMSC-EMVs can reduce the apoptosis levels in osteoblast MC3T3-E1 cells induced by DEX. Conclusions Our study confirmed that hucMSC-EMVs regulates MAPK-signaling pathway and ROS levels to inhibit DEX-induced osteoblast apoptosis.

Purpose: Congenital pseudarthrosis of the tibia is a rare disease that is particularly difficult to treat; the most difficult complications include nonunion of the tibia, refracture, and failed surgery. This study aimed to evaluate the efficiency of transposing gastrocnemius flaps for the treatment of congenital pseudarthrosis of the tibia. Methods: Nine patients (aged 6.2 ± 3.6 years) diagnosed with congenital pseudarthrosis of the tibia in our hospital between March 2013 and March 2018 were enrolled. The tibial pseudarthrosis and thickened periosteum were completely removed, and intramedullary nails were used to fix the tibia. Bone harvest from the iliac, mixed with allogenic bone, was filled in the gap created by excision of the pseudarthrosis site and the surrounding periosteum; the gastrocnemius flap was then used to wrap the pseudoarthrosis site. The plaster cast was fixed postoperatively. The tibial union was evaluated via radiograph, and the plaster cast was removed after 12–24 weeks. Patients began walking approximately 12–14 weeks postoperatively. Results: Anatomical reduction was achieved in all the patients; the mean bone healing time was 10.1 ± 2.1 months. Bone nonunion was observed in one patient, and no neurovascular injury or wound infection occurred. Limb length discrepancy was in the range 3.2 ± 1.8 cm at 1 year and 4.7 ± 2.7 cm at 2 years after surgery. Two patients underwent replacement of the intramedullary nail, and eight patients exhibited good functional and radiographic outcomes. Conclusion: This preliminary study proved that using the gastrocnemius muscle flap to cover the pseudarthrosis site was an effective method to promote the tibial union and treat congenital pseudarthrosis of the tibia.

Background To summarize and analyze the epidemiological characteristics, treatment and corresponding curative effect of triradiate cartilage injury(TCI) in children after trauma, to provide a theoretical basis for early diagnosis and improvement of treatment. Methods The TCI was classified according to Bucholz classification, and the final curative effect was evaluated with Harris Hip Score and imaging examination during follow-up. Finally, a comprehensive analysis was made by reviewing the cases in the literature combined with the patients in our hospital. Results A total of 15 cases (18 hips) of triradiate cartilage injuries were collected in our hospital. There was 1 hip with type I injury, nine hips with type II injury, two hips with type IV injury, one hip with type V injury and five hips with type VI injury. Among the 12 cases with complete follow-up, the bone bridge was found in or around the triradiate cartilage in 8 cases, early fusion of triradiate cartilage occurred in 5 patients, 3 cases had hip dysplasia, 4 cases had a subluxation of the femoral head, and HHS was excellent in 8 cases and good in 4 cases. Conclusion The early diagnosis of TCI is still a difficult problem. Conservative treatment is often the first choice. The overall prognosis of acetabular fractures involving triradiate cartilage is poor. The formation of the bone bridge in triradiate cartilage usually indicates the possibility of premature closure, which may lead to severe complications of post-traumatic acetabular dysplasia and subluxation of the femoral head.

目的 探讨非典型WasselⅥ型重复拇指畸形的病理解剖结构与治疗策略.方法 2008年5月至2019年6月,重庆医科大学附属儿童医院骨科二病房共治疗非典型WasselⅥ重复拇指畸形46例,即桡侧拇指掌骨发育好,拇指畸形;尺侧拇指掌骨发育不良,拇指外观良好.其中男26例,女20例;平均手术年龄1.4岁(11个月～3.8岁).在手术治疗时对其病理学解剖结构进行统计和分析,包括掌骨发育、长短,拇指大小,形状,指甲宽度,指屈肌腱及指伸肌腱的发育、走向等.结果 46例病例中,尺侧拇指发育细小者6例,无1例指间关节发生偏斜,屈伸肌腱均缺如者5例;单纯屈肌腱缺如者3例;单纯伸肌腱缺如者7例.X线片显示,掌骨长度小于对侧1/3者38例,掌骨长度介于1/2～1/3者8例.近端细小呈锥形,直径约为桡侧拇指的2/3.46例桡侧拇指外观均向桡侧偏斜,34例指端较细小,14例3节指骨,5例屈曲畸形.46例中桡侧拇指均长于尺侧拇指约1～1.5 cm,指屈肌腱及指伸肌腱均存在.41例指端小于尺侧拇指、指甲窄于尺侧拇指;5例指甲宽度与对侧相当.拇短展肌止点均附着于桡侧拇指近节指骨基底桡侧.术后随访6个月～3年;1例随访4个月后失去随访.1例骨折延迟愈合;1例指间关节伸直障碍;1例掌指关节稳定性差.术后6个月采用Tada评分标准进行评价显示,优30例;良13例;差2例.结论 非典型VI型重复拇指畸形除尺侧拇指掌骨发育不良的特点外,多数情况下尺侧拇指外观较好.在解剖结构方面多数有完整的指屈肌腱及指伸肌腱,极少数指屈肌腱及指伸肌腱缺如,或仅有屈肌腱而没有伸肌腱.根据手术移位截骨平面需要将其分为两种类型,即屈肌腱缺如型和屈肌腱完整型两种.手术治疗宜将尺侧拇指移位于桡侧拇指,至于在掌骨远端移位还是近节指骨平面移位需根据有无屈肌腱存在而决定.

目的 探讨跨关节外固定架治疗儿童胫骨远端骨折的临床疗效.方法 选取重庆医科大学附属儿童医院2010年1月至2016年12月于门诊手法复位失败的胫骨远端闭合性骨折患者49例为研究对象,其中男34例,女15例,年龄8.5～16.2岁,平均12.3岁.右踝骨折39例,左踝骨折10例.手术在C型臂X光机监视下进行,行踝关节轴向牵引,根据骨折类型对患者足部进行内旋或外旋,达到解剖复位后行跨关节外固定架固定,远端螺钉固定于距骨颈与跟骨,近端固定于胫骨近端.如骨折断端嵌有软组织阻碍复位或牵引复位不成功,则行切开复位.术中行X线检查,确定骨折是否解剖复位,骨折间隙<2 mm为复位成功.术后无需石膏固定,术后1周开始下床负重,术后3周活动踝关节,并采用AOFAS评分系统评估整体疗效.结果 49例中,闭合复位成功30例,有限切开复位固定19例.随访12～90个月,平均38个月.末次X线片检查提示49例均骨性愈合,未发现关节面不平整现象,无踝关节内外翻和短缩畸形,术后5～8周拆除外固定架.AOFAS评分系统判定结果:优39例,良9例,一般1例.患者均能正常参加体育活动.结论 跨关节外固定架治疗儿童胫骨远端骨折整体疗效满意,能有效恢复踝关节关节面的平整,避免踝关节僵硬,是治疗儿童胫骨骨折的可选方法之一.

背景:骨软骨瘤生长在儿童尺骨骨骺时,会对尺骨的发育造成影响,需要早期手术干预.目的:分析采用尺骨截骨延长、Ilizarov技术治疗尺骨干续连症的优缺点.方法:回顾分析2013年12月至2017年6月收治的16例尺骨干续连症患者,男9例,女7例,年龄6～11岁,平均(8.5±0.5)岁.手术预先在尺骨近端安置Ilizarov环形架,中上段微创截骨,术后5～7 d开始延长,每天延长0.5～1 mm,分3～4次进行.通过X线测量评价、功能评价、外观满意度评价等,对患儿手术前后的情况进行对比分析.X线评价包括相对尺骨短缩长度(ulnar shortening,US)、桡骨关节面尺倾角(radial articular angle,RAA)、腕骨偏差率(carpal slip,CS).功能评价包括肘关节、腕关节及前臂的活动情况.美观评价基于患儿父母对外观的满意程度.结果:所有患者全部获得随访,随访时间1.5～2.3年,平均(1.7±0.4)年.术侧前臂外观及功能均得到改善,患者US、RAA明显较术前降低,CS中月骨尺偏率降低.功能评价结果显示患者的肘关节屈伸、腕关节屈伸和尺桡偏活动、前臂旋转活动较术前明显好转.患儿父母对外观均满意.结论:对于骨软骨瘤引起的伴有尺骨短缩畸形的尺骨干续连症,采用尺骨截骨、Ilizarov外固定架延长可以改善前臂外观畸形,恢复肘关节、前臂及腕关节功能,通过有效调节Ilizarov外支架,可使伴有脱位的肱桡关节得到复位.

There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. Here, we compared patients on whom no surgery was performed with those who underwent open surgery and investigated the feasibility of using absorbable screws as a new fixation material for treating ASIS avulsion fractures in children and adolescents. We retrospectively analysed the data of 59 patients diagnosed with ASIS avulsion fractures in our hospital between January 2009 and December 2016. Based on the clinical data, these patients were assigned into group A (non-surgical group) and group B (absorbable screws group). After the inclusion and exclusion criteria were applied, patients’ clinical records, including radiographs, were analysed. All patients were assessed for range of motion (ROM) and by X-ray as they returned to activity. Evaluation of hip function was done by calculating the American Academy of Orthopedic Surgeons (AAOS) lower limb and hip scores. According to AAOS scores, there were significant differences between the two groups at the first and third months postoperatively (p = 0.003), but by the sixth and twelfth months, there was no significant difference (p = 0.42). Significant differences were also observed between both groups regarding callus growth on radiographs, time to resume sporting activities, and occurrence of complications such as meralgia paresthetica. All complications resolved by 6 months follow-up. Our study agrees with previous reports, absorbable screws can be safely used for ASIS avulsion fractures with greater than 1.5 cm displacement in children and adolescents. In comparison with non-surgical therapy, our results indicate that absorbable screws are associated with shorter recovery time and lesser early complications. IV, retrospective study with control group.

Introduction: There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. Hypothesis: Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. Aim of the study: Here, we compared patients on whom no surgery was performed with those who underwent open surgery and investigated the feasibility of using absorbable screws as a new fixation material for treating ASIS avulsion fractures in children and adolescents. Patients and methods: We retrospectively analyzed the data of 59 patients diagnosed with ASIS avulsion fractures in our hospital between January 2009 and December 2016. Based on the clinical data, these patients were assigned into group A (non-surgical group) and group B (absorbable screws group). After the inclusion and exclusion criteria were applied, patients' clinical records, including radiographs, were analyzed. All patients were assessed for range of motion (ROM) and by X-ray as they returned to activity. Evaluation of hip function was done by calculating the American Academy of Orthopedic Surgeons (AAOS) lower limb and hip scores. Results: According to AAOS scores, there were significant differences between the two groups at the first and third months postoperatively (p = 0.003), but by the sixth and twelfth months, there was no significant difference (p = 0.42). Significant differences were also observed between both groups regarding callus growth on radiographs, time to resume sporting activities, and occurrence of complications such as meralgia paresthetica. All complications resolved by 6 months follow-up. Conclusion: Our study agrees with previous reports, absorbable screws can be safely used for ASIS avulsion fractures with greater than 1.5 cm displacement in children and adolescents. In comparison with non-surgical therapy, our results indicate that absorbable screws are associated with shorter recovery time and lesser early complications. (C) 2020 Elsevier Masson SAS. All rights reserved.

对于儿童陈旧性肱骨髁上骨折合并肘外翻畸形，目前主要的治疗方式是截骨矫形及骨不连处植骨，但是截骨方式多样，术后常遗留外观畸形或肘关节功能障碍等并发症。因此，笔者采用回顾性病例系列研究分析2015年2月— 2018年9月重庆医科大学附属儿童医院收治的6例陈旧性肱骨外髁骨折合并肘外翻畸形患儿临床资料，探讨梯形截骨的可行性及临床效果，为儿童肘外翻畸形的治疗提供一种新的方式。

Background: The application of external femoral fixation techniques often causes complications of knee flexion dysfunction. We report on technical modifications in the complications of external femoral fixation leading to knee flexion disorders. Methods: We flexed the knee joint 90 degrees during the operation, and then placed the external fixation nail. A retrospective review was performed for all patients undergoing repair by this technique. Results: A total of 52 children with femoral shaft fractures were included, the flexion of the knee joint measured at the time of discharge was 80 degrees (70-90 degrees) on average; when the external fixation is removed, the knee flexion can reach an average of 95 degrees (90-115 degrees), no children have stiff knees. Conclusion: This technique is simple and easy to implement, and it is worthy of popularization and application in clinical practice.

Objective To explore the relationship between the changes of coagulation parameters and Legg-Calve-Perthes disease (hereinafter referred to as Perthes disease) in children with Herring C Perthes disease .Methods Clinical data were retrospectively reviewed for 65 hospitalized patients with Herring C Perthes disease (research group) from January 2012 to June 2016 . They underwent unilateral surgery for the first time . The relevant parameters included progression time between initial onset of pain ,claudication and other related symptoms after a definite diagnosis of Herring C Perthes disease and the related coagulation parameters . The data were analyzed with regards to in-group correlation .At the same time ,30 children with elective surgery without obvious influence on thrombotic tendency such as olydactyly ,clubfoot and so on were included as control group in the same age range .The relevant coagulation parameters were recorded and compared .Results In research group ,there was no correlation between prothrombin time (PT ) ,international normalized ratio of prothrombin time (PT .INR) ,activated partial thromboplastin time (APTT ) ,fibrinogen (Fib) ,thrombin time (TT ) ,d-dimer (D-Dim ) or time of disease progression (|r | > 0 .7 ) . The coagulation parameters in research group were PT (11 .45 ± 0 .77) s ,PT .INR 0 .97 ± 0 .06 ,APTT (28 .25 ± 3 .36)s ,Fib(2 .24 ± 0 .48)g/L ,TT (18 .09 ± 1 .35)s and D-Dim (0 .34 ± 0 .72)mg/L .And control group were PT (11 .43 ± 0 .77)s ,PT .INR 1 .00 ± 0 .08 ,APTT (30 .20 ± 5 .06)s ,Fib(2 .14 ± 0 .50)g/L ,TT (18 .32 ± 1 .21)s and D-Dim(0 .21 ± 0 .16)mg/L .There were no inter-group statistical differences (all P > 0 .05) .Conclusions There is no correlation between disease progression and the coagulation parameters of Perthes disease .Moreover ,no significant inter-group difference exists in coagulation parameters . Therefore the result of this research fails to support the assumption that coagulation abnormality is one of the pathogenetic factors for Legg-Calve-Perthes disease .

Objective To establish a solid model of congenital spinal hemivertebra body using three -dimensional(3D)printing technology and explore its application value of this model during hemivertebral surgery.Methods Retrospective analyses were performed for 40 surgical children diagnosed with congenital spinal hemivertebra deformity from September 2012 to May 2016.According to whether or not 3D printing technology was employed,they were divided into 2 groups of experimental(n=18)and control(n=22)groups.The duration of nailing operation,accuracy of placement and the incidence of neurovascular injury were compared between two groups.Results In control group,102 pedicle screws were implanted with an average setting time of 10 to 15 min and an accuracy of placement of 85.3%(87/102);In experimental group,94 pedicle screws were implanted with an average setting time of 5 to 8 min and an accuracy of placement of 94.7%(89/94).The duration of nailing operation and accuracy of placement were statistically significant between two groups(P<0.01).There was no perioperative occurrence of such complications as nervous or vascular injury.Conclusion Compared with traditional surgery without 3D printing,using preoperative patient CT data and producing spinal half-vertebral body model through 3D printing may guide operations so as to shorten the time setting nail and improving accuracy.

目的 对比分析儿童及青少年髂前上棘撕脱骨折的治疗方法.方法 回顾性分析2009年1月1日至2014年12月31日在该院诊断为髂前上棘撕脱骨折的44例患儿的临床资料.根据治疗方式将其分为手术组24例和非手术组20例.手术组采用骨折切开复位可吸收螺钉内固定术的手术方法,非手术组采用屈髋屈膝卧床休息的保守治疗方法.结果 两组患儿均获得随访,随访时间1～7年,平均4.0年,手术组患儿均骨性愈合,髋关节活动度正常,恢复正常运动,无可吸收螺钉脱出、骨折不愈合、切口感染、大腿前外侧皮肤感觉减退表现.非手术组患儿均骨性愈合,1例出现延迟愈合,愈合时间为6.5个月,1例出现髋部及大腿外侧不适感,自行缓解.结论 髂前上棘撕脱骨折后手术切开复位可吸收螺钉固定较非手术治疗愈合快,功能恢复早,可以早期活动,防止关节僵硬,可吸收螺钉不需要取出,避免二次手术.

Objective To observe the neuronal regeneration after spinal cord injury in adult rats.Methods Thirty-six adult Wistar rats were randomly divided into normal control group (n =6) and spinal cord injury group (n =30).Allen' s weight-drop method (25 g/cm) was adopted to produce acute spinal cord injury at T10 segment.Rats were sacrificed at 3 days and 1,2,3,and 4 weeks postinjury.BrdU was administered intraperitoneally to the rats 72 hours before operation,once per 12 hours.Double immunofluorescence staining of NF-200 and BrdU was performed at spinal sites within 10 mm away from the injury to detect the positive cells in both groups.Results A few BrdU-positive cells were founded in the normal control group,with no BrdU/NF-200 positive cells.In spinal cord injury group,BrdU-positive cells were abundant at day 3 and peaked at week 1 along with few Brdu/NF-200 positive cells ; Brdu/NF-200 positive cells showed a peak increase at week 2 with majority accumulated at area 3-5 mm away from the injury,were rare at week 3 and none at week 4.Conclusion Neuronal regeneration is detected in the vicinity of the injury,which provides new ideas for induction of endogenous stem cells to treat spinal cord injury.

目的 探讨可吸收螺钉治疗儿童肱骨外髁骨折的中期疗效.方法 分析2007年1月至2008年6月重庆医科大学附属儿童医院骨科中心采用可吸收螺钉治疗儿童肱骨外髁骨折的患儿临床资料,选取随访资料完整的56例作为实验组;选取我院同期采用传统克氏针治疗儿童肱骨外髁骨折的随访资料完整的32例作为对照组.按照HSS评分系统对其疗效进行评定,采用SPSS 14.0统计软件,对肘关节功能、骨折愈合、骨骺发育、骨质异常增生进行X2检验.结果 手术病例骨折均愈合,术后根据HSS评分系统,实验组组优42例,良9例,一般5例,优良率达到91.1％;对照组优23例,良6例,一般3例,优良率达到90.6％.实验组瘢痕增生8例,肱骨外髁骨质增生9例;对照组瘢痕增生6例,肱骨外髁骨质增生4例.HSS肘关节功能评分系统(P =0.999),瘢痕增生分析(P =0.582),肱骨外髁骨质增生(P =0.887).结论 可吸收螺钉治疗儿童肱骨外髁骨折远期疗效与克式针相比,在肘关节功能、骨折愈合、骨骺发育、骨质异常增生对比并无统计学差别,可作为儿童肱骨外髁骨折的固定材料.