The dynamic balance between osteoblasts（OB） and osteoclasts（OC） regulates the homeostasis of bone remodeling. The imbalance between them may mediate the occurrence and development of a series of bone diseases, such as osteoporosis（OP）, rheumatoid arthritis（RA）, and osteosclerosis. Tumor necrosis factor-α（TNF-α） is an inflammatory cytokine produced by activated macrophages/monocytes. TNF-α is a bone resorption enhancer and bone formation inhibitor. It regulates bone marrow mesenchymal stem cells（BMSCs）. The expression of BMSCs, OB, and OC-related signaling pathways, proteins, and genes attenuates osteogenic differentiation of BMSCs, inhibits OB mineralization, and promotes the activation, proliferation, and maturation of OC, leading to the dynamic imbalance between bone formation and resorption, which disturbs bone reconstruction and promotes the progression of OP. Therefore, the author summarizes the relevant mechanism of TNF-α in OP by referring to relevant national and international literature, in order to provide a certain theoretical basis for further clinical research.

Objective:To discuss the possible mechanism of atragalosides in treating cervical sondylotic melopathy(CSM) by observing its effects on the contents of IL-6 and TNF-α in intervertebral disc and morphological changes of spinal cord of CSM rats.Methods:Among 110 rats,18 rats were taken as blank control group,and the rest of the rats accepted the implanting of BMP complexing agent at posterior margin of cervical intervertebral disc to prepare the rat model,they were randomly allocated to five groups:the model group,high,moderate and low dosages groups of atragalosides,and mecobalamine group,and the rats accepted corresponding intragastric administration according to experimental design,morphological changes of spinal cord were observed by HE staining after the tissue was taken under strict aseptic conditions,and the contents of IL-6 and TNF-α in intervertebral disc were detected.Results:The contents of IL-6 and TNF-α in the model group,high,moderate and low dosages groups of atragalosides,and mecobalamine group were higher than these ofblank control group (P＜0.05);high,moderate and low dosages groups ofatragalosides,and mecobalamine group were lower than these of the model group in the contents ofIL-6 and TNF-α (P＜0.05);in the contents ofIL-6 and TNF-α in moderate dosages group of atragalosides were lower than these of high and low dosages groups of atragalosides notably,there was no difference compared with mecobalamine group after medication for one week,they were lower compared with mecobalamine group after medication for four weeks (P＜0.05),and tissue HE staining slices demonstrated that there were differences when blank control group and the model group were compared with high,moderate and low dosages groups of atragalosides,there was difference when moderate dosages group of atragalosides was compared with mecobalamine group.Conclusion:Atragalosides could notably decrease the contents of IL-6 and TNF-α in intervertebral disc,and there is dose-effect difference.It could prevent and treat CSM by lowering the contents of cell factors in intervertebral disc,relieving and improving degeneration ofintervertebral disc.

目的 探讨黄芪总苷对大鼠退变颈椎间盘内白细胞介素-1 β(IL-1β)、肿瘤坏死因子-α(TNF-α)含量的影响.方法 将110只SD大鼠随机分为空白对照组、模型组、黄芪总苷高剂量组、黄芪总苷中剂量组、黄芪总苷低剂量组和甲钴胺对照组,每组18只(2只造模失败剔除).造模成功后,按要求给予药物灌胃,分别于灌胃前后监测大鼠的运动功能,灌胃1,2,4周后分3次处死大鼠,取各组大鼠颈椎间盘,用放射免疫分析法分别检测标本中IL-1β,TNF-α的含量.结果 与空白对照组比较,造模成功后即给药前,其他5组斜板试验角度均明显减小(P＜0.05);在给药1,2,4周后,与模型组比较,黄芪总苷高、中、低剂量组,甲钴胺对照组斜板试验角度均明显增大,IL-1β,TNF-α含量均明显降低(P＜0.05),且以黄芪总苷中剂量组作用最为显著(P＜0.05).结论 退变椎间盘不但释放大量的细胞因子,还可加速椎间盘的退变,黄芪总苷能降低退变颈椎间盘中细胞因子的含量,具有减弱炎性反应和减缓椎间盘退变的作用,且存在量效关系.

脊髓型颈椎病是骨科的常见病、多发病,其致残率高,康复率低,但目前仍缺乏一体化的防治策略.三级预防是中医“治未病”思想的延伸和扩展,将其作为脊髓型颈椎病防治的理论策略,采取病因预防、“三早”预防及康复治疗,以期为临床提供理论指导.

In order to study the radiological features of osteogenesis imperfecta(OI),the X-ray and clinic information of 18 patients(16 adults and 2 foetus)with OI were reviewed.Most X-ray films of OI patients showed multiple fractures,periosteal reaction,metaphyseal sclerosis,morphologic changes of bones and articulations,spinal lateral curvature,basilar impression,osteopenia,etc.

据联合国艾滋病规划署和世界卫生组织估计,自从艾滋病病毒/艾滋病(HIV/AIDS)流行以来,到2007年底,有230万15岁以下儿童感染上HIV,2006年新增感染儿童70万人,死亡57万人[1].预计到2010年,因AIDS失去母亲或双亲的儿童将达到2500万,15岁以下的儿童将超过1 400万[2].感染了HIV的儿童,大部分是因母婴传播而感染,少部分是由于输血感染.

20世纪70年代以来,手术之前清晰显示胆道系统的影像及其病理改变,是胆道疾病治疗的前提[1],近年来胆道影像学发展迅速,现介绍如下. 1 X线平片及胆道造影 在很长一段时间,X线平片及胆道造影是胆道重要检查方法,随着影像学技术发展,临床现已较少使用.

本文主要总结了成骨不全的一些影像学表现.包括X线、CT、MRI和超声检查.其中超声检查主要用于产前诊断.成骨不全的影像学特征主要有颅底凹陷征,增生性骨痂,骨折,骨量减少,Wormian骨,骨膜反应,干骺端硬化,骨形态改变,四肢关节改变以及脊柱侧凸等.根据其影像学特征及临床特点,能够对成骨不全作出早期诊断.