Objective:To explore the relationship between the transforming growth factor-β (TGF-β) signaling pathway and steroid-induced osteonecrosis of the femoral head in young rabbits.Methods:Sixty 8-week-old rabbits weighing 1.5-2.0 kg were randomly divided into steroid injection group (48 cases) and control group (12 cases). Rabbits in the former group were injected with Prednisolone Acetate 7.5 mg/kg into bilateral gluteal muscles twice a week for 8 weeks, and those with successful modeling were included in the disease group; otherwise, they were included in the non-disease group.Rabbits in control group were similarly injected with the same volume of 9 g/L saline.Penicillin sodium 50 000 U/rabbit was injected once a week for preventing infection.After 8 weeks of injection, CT was performed in all the experimental animals.They were then sacrificed for collecting bilateral femoral heads.Expression levels of TGF-β1, TGF-β2, Smad2 and Smad3 in the femoral head were detected by enzyme linked immunosorbent assay (ELISA), and the mRNA level of Runx2 in the femoral head was detected by quantitative real-time PCR (qPCR), the expression differences of related factors in each group were compared.Results:In steroid injection group (48 cases), 6 rabbits were sacrificed, and 32 survived, involving 6/32 cases (18.75%) experimental animals with positive avascular necrosis (disease group), and 26 negative ones (non-disease group). ELISA data showed that expression levels of TGF-β1 in control group, non-disease group and disease group were (77.12±14.62) ng/L, (90.17±11.90) ng/L and (126.14±25.66) ng/L, respectively ( t=3.35, 4.24, all P<0.05). The expression levels of TGF-β2 in control group, non-disease group and disease group were (74.54±7.63) ng/L, (89.24±9.51) ng/L and (109.74±16.45) ng/L, respectively ( t=4.12, 5.65, all P<0.01). The expression levels of Smad2 in control group, non-disease group and disease group were (17.74±2.72) μg/L, (23.82±3.58) μg/L and (31.28±3.88) μg/L, respectively ( t= 4.54, 7.99, all P<0.01). The expression levels of Smad3 in control group, non-disease group and disease group were (1.76±0.52) μg/L, (2.39±0.45) μg/L and (3.53±0.47) μg/L, respectively ( t=5.60, 6.71, all P<0.01). qPCR data showed that the mRNA levels of Runx2 in control group, non-disease group and disease group were 1.02±0.17, 1.27±0.14, and 1.72±0.11, respectively ( t=7.60, 8.91, all P<0.01). Conclusions:TGF-β is up-regulated in the model of steroid-induced osteonecrosis of the femoral head in young rabbits, which stimulates the proliferation and differentiation of osteoblasts and osteoclasts, and triggers the process of bone remodeling.The TGF-β signaling pathway involved in the repair of necrotic bone.

目的 总结儿童髋关节一过性滑膜炎(TSH)的临床特点,进一步提高对该病的诊治水平.方法 回顾性分析2010年1月至2019年12月于遵义医科大学附属医院小儿矫形外科治疗的1054例入院诊断为髋关节性滑膜炎患儿的临床资料并分析其特点.结果 1054例中最终确诊967例,其中男性702例,女性265例,男女发病数量比较差异具有统计学意义(P<0.05);患儿年龄0.5～14岁,平均年龄(5.6±3.1)岁;170例有呼吸道感染病史,39例有外伤史,18例有剧烈活动病史,1例有腮腺炎病史;秋季多见,4月、9月为发病高峰;实验室检查多数患儿表现为淋巴细胞及单核细胞计数的增加,超声及MRI检查多提示髋关节积液、滑膜增厚及软组织肿胀;单髋发病917例,双髋发病50例.患儿主要表现为髋关节疼痛伴跛行(555例),部分可仅表现为跛行(150例)或伴大腿或膝关节的疼痛(108例),少数可仅表现为髋关节疼痛(73例)或伴下肢拒绝承重(67例),极少数仅表现为大腿或膝关节疼痛(14例),所有患者均出现不同程度的髋关节活动受限.结论 儿童TSH好发学龄前期,男性多见,单侧发病较多,主要表现为不同程度的髋关节疼痛、活动受限、患肢乏力及跛行,治疗上主要以卧床休息及患肢牵引制动为主.

尤文肉瘤(Ewing sarcoma,ES)是一种高度恶性肿瘤,病理上表现为小圆细胞,其主要来源于骨,骨外的尤文肉瘤较为罕见,椎管内尤文肉瘤/外周原始神经外胚层肿瘤(ewing sarcoma/peripheral primitive neuroec-todermal tumors,ES/p PNETs)更是一种罕见的尤文肉瘤骨外类型,该病早期均无明显临床症状,影像学检查常难以明确,晚期预后极差.现报道我院收治的2例患儿并复习相关文献,以加深对该病的认识.

Objective:To analyze the clinical characteristics of bone tumors in children, so as to improve the understanding and diagnosis of bone tumors in children.Methods:The clinical data of bone tumors in children hospitalized in the Affiliated Hospital of Zunyi Medical University from January 2009 to December 2018 were collected, with the age ≤ 14 years old.All children′s gender, age, tumor type, location, number of lesions and first symptoms were counted, and the clinical characteristics of bone tumors in children in this area were analyzed.Results:Totally 548 children with bone tumor were collected, with 344 males and 204 females, and the ratio of males to females was 1.69∶1.00, with 462 single cases and 86 multiple cases.Among the multiple cases (86 cases), 82 cases (95.35%) were benign bone tumors.The total number of cases increased with age.The age of different tumors has its own characteristics.Tibia was the most common tumor location (223 in total), followed by femur (177 in total) and humerus (82 in total). According to the classification of tumor nature, there were 478 cases (87.22%) of benign bone tumors, 43 cases (7.85%) of intermediate bone tumors and 27 cases (4.93%) of malignant bone tumors.The incidence of benign bone tumors was significantly higher than that of intermediate and malignant bone tumors, with statistically significant differences ( χ2=72.604, P<0.05). Among the benign bone tumors (478 cases), osteochondroma was the most common (265 cases), accounting for 55.44%; among the intermediate bone tumors (43 cases), aneurysmal bone cyst was the most common (20 cases), occupying 46.51%; among the malignant bone tumors(27 cases), osteosarcoma was the most common (16 cases), accounting for 59.26%.Among the initial symptoms, 268 cases were local masses, and 166 cases were pain, which were significantly higher than that of 79 without symptoms, with 28 lameness, 4 deformity and 3 dysfunction, and the differences were statistically significant( χ2=71.422, P<0.05). Conclusions:The majority of bone tumors patients in children were male, and the incidence increased with age.Benign and solitary are common, and the multiple cases were mainly benign.The most common locations are tibia and femur.The initial symptoms were mainly local mass and pain.Most importantly, the clinical characteristics of different tumors are slightly different.