Essex-Lopresti损伤是指桡骨头骨折合并下尺桡脱位及骨间膜损伤,通常由前臂受轴向暴力导致.该损伤发病率低,诊疗难度高,若诊疗不及时,通常导致前臂轴向不稳定,从而引起患者肘关节及腕关节的功能障碍.近年来,随着对前臂稳定性的理解加深及内固定器械的发展,关于Essex-Lopresti损伤的诊断及治疗方案得到了越来越多的关注及研究.该文就Essex-Lopresti损伤的诊断及治疗进展作一综述.

目的 比较长解剖钢板和髓内钉两种固定方式治疗肱骨近端骨折累及肱骨干骨折的疗效.方法 将32例肱骨近端骨折累及肱骨干骨折患者根据治疗方法不同分为长解剖钢板组(14例)和髓内钉组(18例).根据各项手术指标和随访时的肩关节功能评分评价治疗效果.结果 患者均获得随访,时间9～20个月.切口长度、手术时间、术中出血量髓内钉组明显优于长解剖钢板组,差异均有统计学意义(P<0.05).住院时间、骨折愈合时间、术后6个月颈干角两组比较差异均无统计学意义(P>0.05).术后6个月,相对冈上肌力量长解剖钢板组优于髓内钉治疗组,差异有统计学意义(P<0.05);相对三角肌力量髓内钉组优于长解剖钢板组,但差异无统计学意义(P>0.05).术后6个月,Constant-Murley评分、VAS评分、患侧肩关节活动度两组比较差异均无统计学意义(P>0.05).结论 长解剖钢板和髓内钉治疗肱骨近端骨折累及肱骨干骨折均能获得良好的预后,髓内钉具有手术微创等优点,但在相对冈上肌力量影响方面长解剖钢板优于髓内钉.

BACKGROUND: Silver nanoparticle is a potential coating material with resistance ability to infection. Using the ion implantation method, we can make silver nanoparticles tightly connect with the base material, and meanwhile effectively control the content of silver nanoparticles. Titanium oxide coating has good biocompatibility, which is a good choice for the preparation of internal fixation materials. But the in vivo antibacterial activity of titanium oxide coating with silver ions is rarely reported, and the relationship between the content of silver nanoparticles and the antibacterial activity is still unknown. OBJECTIVE: To investigate the antibacterial of silver plasma immersion ion implantation implants in vivo. METHODS: Forty New Zealand white rabbits were randomized into four groups, and animal models of bone marrow infection of the distal femur were made in all the rabbits. Model rabbits were subjected to the implantation of titanium rob in control group, implantation of titanium oxide‐coated implants in experimental group, implantation of implants covered with titanium oxide coating with low concentration of silver ions in low concentration group, and implantation of implants covered with titanium oxide coating with high concentration of silver ions in high concentration group. We assessed the antibacterial activities of the implants by blood test, radiographic observation and bacteriological methods thereafter. RESULTS AND CONCLUSION: (1) After modeling, the body temperature in all the animals increased to different extents, and the body weight decreased, and gradually recovered at 14‐21 days after modeling. (2) At 7, 14, 21, 28 days after modeling, white blood cell count and C‐reactive protein level in the titanium rod group and titanium oxide group were significantly higher than those in the low and high concentration groups (P < 0.05). At 7 days after modeling, the percentage of neutrophils in the titanium oxide group was significantly higher than that in the low and high concentration groups (P < 0.05). At 14, 21, 28 days after modeling, the percentage of neutrophils in the titanium rod group and the titanium oxide group was significantly higher than that in the low and high concentration groups (P < 0.01). (3) At 14 and 28 days after modeling, the Norden scores in the low and high concentration groups were significantly lower than those in the titanium rod group and the titanium oxide group (P < 0.05). (4) The number of bacterial colonies in the titanium rod group and titanium oxide groups was significantly higher than that in the low and high concentration groups (P < 0.01), while the bacterial colony count in the low concentration group was significantly higher than that in the high concentration group (P < 0.01). Findings from the present study reveal that the titanium oxide‐coated implant with silver ions is an antibacterial implant, and its antibacterial property is closely related to the concentration of silver ions, that is, a higher concentration of silver ions indicates stronger antibacterial property. Therefore, the use of titanium oxide coating with silver ions may provide an effective solution for implant‐related infections. Funding: the Funded Project of Shanghai Municipal Health and Family Planning Commission, No. 201440268

蛋白质的翻译后修饰对调节蛋白质的功能活性和定位以及调控细胞周期进程和细胞分化都起着非常重要的作用,其中小泛素样修饰蛋白(SUMO)化修饰是一个可以由SUMO特异性蛋白酶(SENPs)家族逆转的高度动态的过程.SENPs能够从与SUMO连接的靶蛋白上催化去除SUMO,以及从它的前体蛋白上裂解SUMO;同时,此家族部分成员还参与SUMO的成熟活化过程;因此,去SUMO化修饰对于调节SUMO连接蛋白的功能及活性与SUMO化同样重要.本文就SENPs家族的结构及生物学特性作一综述.