[目的]评价麻醉下手法松解术(manipulation under anesthesia,MUA)结合等速肌力锻炼治疗冻结肩的临床疗效.[方法]回顾性分析2017年10月—2019年2月在本院采用MUA治疗的冻结肩60例患者的临床资料.依据医患沟通结果,30例的MUA治疗后行等速肌力锻炼(等速组),30例在MUA治疗后常规康复锻炼(常规组).比较两组治疗期、随访和ISOMED2000检查资料.[结果]所有患者均顺利完成治疗,无严重并发症发生.等速组治疗周期显著短于常规组[(84.6±8.3)d us(103.9±28.3)d,P＜0.05],但等速组治疗费用显著高于常规组[(2 760.7±134.2)元vs(2 355.2±401.9)元,P＜0.05].随时间推移,两组疼痛VAS评分均显著下降(P＜0.05);治疗后2、4周等速组VAS评分显著优于常规组(P＜0.05).治疗期间等速组止痛药物的使用强度显著低于常规组(P＜0.05).所有患者随访平均(34.5±5.9)个月,随时间推移,两组Constant-Murley评分,以及肩关节外展、前屈、后伸活动度(range of motion,ROM)均显著增加(P＜0.05).末次随访时等速组的Constant-Murley评分,以及外展、前屈、后伸 ROM 均显著优于常规组[(91.4±4.2)分vs(88.3±4.6)分;(165.8±9.6)°vs(149.7±14.8)°;(171.1±8.3)° vs(159.2± 12.6)°;(49.7±5.6)° vs(40.0±4.7)°,P＜0.05].ISOMED2000检测方面,与治疗前相比,末次随访时两组60°/s外展、60°/s前屈、60°/s后伸、120°/s外展、120°/s前屈、120°/s后伸、180°/s外展、180°/s前屈和180°/s后伸峰值扭矩(peak torque,PT)均显著增加(P＜0.05),治疗前两组间上述测量指标的差异无统计学意义,但末次随访时等速组均显著优于常规组(P＜0.05).[结论]MUA结合等速肌力锻炼治疗冻结肩可显著改善治疗效果,有效缓解肩关节疼痛、增加关节活动度和增强肩关节力量.

Osteosarcoma (OS) is characterized by aggressive features including invasiveness and high incidence of metastasis. OS patients with metastases are difficult to treat and suffer from a poor prognosis. DPY30 (protein dpy-30 homolog) is a key component of SET1/MLL family of H3K4 methyltransferases, which is implicated in the progression of multiple cancers. However, the potential functional engagement of DPY30 in OS remains to be unveiled. The objective of this study is to investigate the potential roles of DPY30 in the regulation of malignant phenotypes of OS cells. We examined DPY30 expression from a published dataset (GSE28424) as well as in OS tissues and adjacent normal tissues from OS patients. The association of DPY30 expression level and clinicopathologic parameters was assessed by Chi-square test. The role of DPY30 in regulating the malignant phenotype of OS cells and tumorigenesis was examined by in vitro functional assays and xenograft mouse model. We reported an upregulation of DPY30 in OS tumor tissues in both published dataset and clinical samples. A high level of DPY30 expression was associated with larger tumor size and more metastasis in OS patients, as well as poor overall survival. DPY30 knockdown in OS cells significantly impairs proliferation, migration and invasion, but induced cellular apoptosis. We further demonstrated that the agonist of PI3K/AKT pathway can rescue the inhibitory effects of DPY30 knockdown in OS cells. Together, our data indicate that DPY30 functions as an oncogene to promote the malignancy of OS cells possibly through PI3K/AKT pathway. The dependency of OS cells on DPY30 overexpression is a targetable vulnerability in OS cells.

OBJECTIVE:To investigate the diagnostic value of 6 conventional physical examination tests for the diagnosis of supraspinatus tendon tears, and how well they could tell the difference between partial-and full-thickness tears.METHODS:A total of 91 patients with different shoulder symptoms who received shoulder arthroscopic procedure were enrolled in the study from June 2017 to September 2020. The intraoperative findings were compared with the results of the preoperative physical examination of 6 clinical tests, including the Hug-up test, the Jobe test, the 0°abduction test, the drop arm test, the Neer test, and the Hawkins test, to determine the sensitivity, specificity, positive and negative predictive value, accuracy, positive and negative likelihood ratio of each test.RESULTS:By arthroscopy, a total of 44 full-thickness tears, 34 partial-thickness tears, and 13 intact supraspinatus tendons were found in all 91 cases. The Hug-up and the Jobe tests significantly correlated with the intraoperative findings. The sensitivity of the Hug-up test, the Jobe test, the 0° abduction test, the drop arm test, the Neer test, and the Hawkins test was 0.90, 0.79, 0.64, 0.42, 0.49, 0.24 respectively;the specificity was 0.61, 0.69, 0.54, 0.38, 0.31, 0.77;the positive predictive value was 0.93, 0.94, 0.89, 0.80, 0.81, 0.86;the negative predictive value was 0.50, 0.36, 0.20, 0.10, 0.09, 0.14;the accuracy was 0.86, 0.78, 0.63, 0.42, 0.46, 0.32;the positive likelihood ratio was 2.30, 2.58, 1.39, 0.69, 0.71, 1.06;and the negative likelihood ratio was 0.16, 0.30, 0.67, 1.50, 1.65, 0.98.CONCLUSION:The Jobe test and the Hug-up test are both effective at accurately diagnosing supraspinatus tendon tears, the Hug-up test detects supraspinatus tears with a high sensitivity, and similar specificity. The tests assessed in this study are not capable of distinguish between partial-and full thickness supraspinatus tendon tears.

目的 分析3D打印技术在运动医学骨科临床教学中的应用效果,旨在为相关人员的研究工作提供参考.方法 试验选择2019年6月—2020年6月滨州医学院烟台附属医院所接收的运动医学骨科实习本科生60名为研究对象,现按照所接受的临床带教方法不同,将其分为对照组30名以及观察组30名.对照组学生沿用传统带教方案,以此为基础,观察组学生应用3D打印模型方案学习,分析两组学生综合能力问卷评分以及考试成绩对比情况.结果 与对照组相比,观察组学生教学满意度、理解能力水平、自学能力水平以及学习兴趣得分明显更高,差异有统计学意义(P<0.05).和对照组相比,观察组学生的理论知识以及操作技能考试成绩得分明显更高,差异有统计学意义(P<0.05).结论 将3D打印技术全面运用于运动医学骨科实习带教工作之中,可以在极大程度上提升学生对于实习带教工作的满意度,同时可提升学生们的成绩,帮助实习生创建立体化思维,增强学习兴趣,值得进一步推广及应用.

目的 评估静脉应用氨甲环酸减少膝关节镜下前交叉韧带重建术后关节失血量的临床效果.方法 选择自2019年至2020年期间在滨州医学院烟台附院接受膝关节镜下前交叉韧带重建手术治疗的80例患者作为研究对象,其中男55例,女25例;年龄19～49岁,平均(31.4±10.7)岁.患者被随机分成氨甲环酸组和对照组,氨甲环酸组的患者于止血带充气前按体重15 mg/kg静滴应用氨甲环酸,术后按体重每小时10 mg/kg持续应用氨甲环酸3h,对照组不使用氨甲环酸.术后24 h评估膝关节引流血量,术后1d、7d、14 d评估膝关节膝关节髌骨周径、膝关节活动度及疼痛视觉模拟评分(visual analogue scale,VAS).结果 与对照组相比,术后24 h氨甲环酸组的膝关节引流血量明显减少(P＜0.05);术后7d,氨甲环酸组的VAS、膝关节活动度和髌骨周径更优势(P＜0.05);术后14 d,氨甲环酸组的VAS和髌骨周径更优势(P＜0.05),膝关节活动度无明显差异(P＞0.05).结论 关节镜下前交叉韧带重建术后静脉应用氨甲环酸可以有效减少失血量,减轻术后早期膝关节肿胀及疼痛.

PURPOSE:There is increasing evidence that non-coding RNAs (ncRNAs), including long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), produce a critical regulatory effect on osteosarcoma (OS). LINC01278, as a newly discovered lncRNA, is found to be highly expressed in OS, but its related mechanism remains unclear. This research, therefore, is designed to study the mechanism of LINC01278 in OS and to find potential targets for clinical use.METHODS:qRT-PCR was applied to determine the relative expression of LINC01278 and analyze its diagnostic value in OS. CCK-8, Transwell and flow cytometry were utilized for the determination of cell proliferation, migration/invasion, and apoptosis. RIP and RNA pull-down experiments were used to verify the targeted binding effect of miR-134-5p and LINC01278. The relationship between miR-134-5p and LINC01278 or KRAS was analyzed using dual luciferase reporter gene. The effects of LINC01278 on tumor growth in nude mice was analyzed by in vivo experiment.RESULTS:qRT-PCR showed that LINC01278 increased in OS tissues and serum, indicating poor prognosis. In addition, LINC01278 was also of high value for OS diagnosis. Functional experiments showed that LINC01278 inhibited KRAS-mediated OS cell proliferation and metastasis through miR-134-5p. Finally, the results of an in vivo animal model indicated that LINC01278 promoted OS growth.CONCLUSION:LINC01278 is expressed highly in OS, and patients with high LINC01278 expression have poor prognosis. Moreover, LINC01278 can suppress the proliferation and apoptosis of OS cells through mediating miR-134-5p/KRAS axis, which is expected to become a potential therapeutic target for OS.

The objective was to study the effects of ropivacaine combined with lumbar epidural anesthesia (LEA) on immune and cognitive functions of elderly patients undergoing joint replacement. A total of 153 elderly patients undergoing joint replacement in our hospital from January 2014 to February 2015 were prospectively analyzed. They were divided into a LEA group and a ropivacaine + LEA group (a Rop+LEA group) based on therapeutic methods. Efficacy, adverse reactions, recurrence, the incidence of postoperative cognitive dysfunction (POCD), immune function, and cognitive function were compared between the two groups. Compared with those in the LEA group, patients in the Rop+LEA group had the best efficacy and 3-year survival, the lowest incidence of adverse reactions, recurrence rate, and incidence of POCD, the highest IL-10 level, the lowest TNF-alpha and IL-6 levels, and the highest MMSE score, Barthel index, and SF-36 score. In addition, there was no significant difference in CD8+ level between the two groups, but CD4+ level and CD4+/CD8+ratio in the Rop+LEA group were lower than those in the LEA group. Ropivacaine combined with LEA can promote the recovery of cognitive and immune functions and reduce inflammatory responses in elderly patients undergoing joint replacement, so the combination is expected to be widely popularized in clinical practice.

Background: Osteosarcoma (OS) is a complex cancer and depends on multiple biological processes and pathways. Therefore, there is an urgent need to identify reliable prognostic biomarkers for predicting clinical outcomes and helping personalize treatment of OS. Results: An expression Quantitative Trait Methylations (eQTMs)-based risk score model was developed to infer the prognostic efficacy for OS based on gene expression and methylation level. Some OS-specific eQTMs were identified and divided to positive and negative eQTMs. We found that some OS-specific eQTMs were significantly associated with survival in OS according to the eQTM-based risk score. The global characteristics for these prognosis-associated eQTMS were depicted and analyzed. These prognosis-associated eQTMS are stable in multiple experiments and showed better performance in predicting survival than single gene expression, age and gender of OS. Functional analysis indicated that the genes in prognosis-associated eQTMS were associated with essential biology processes of cancer development. In addition, these genes were also drug targets for many kinds of drugs and may provide assistance for studying drug repurposing of OS. Conclusion: These results highlight the potential of eQTMs as novel diagnostic, prognostic and therapeutic targets for OS.

The content of high ash fine slime in raw coal of Shiguai area in Inner Mongolia is high, the load of flotation system of coal preparation plant is heavy and the flotation clean coal ash is difficult to meet the local standard lower than 15.00% thus resulting in a serious waste of slime resources. This paper took the primary slime of Guo Hui Coal Preparation Plant in Baotou, Inner Mongolia as the research object, small screening test of coal slime, batch flotation test, regressive release flotation test and flotation column test were undertaken. The results showed that when the required flotation clean coal ash was 15.00%, the theoretical clean coal yield was 24.66%, the tailing ash was 53.73%, the combustible recovery was 37.95% and the slurry floatability rank was determined to be extremely difficult to float; primary flotation clean coal ash of flotation machine or flotation column did not meet the requirement; flotation concentrate obtained by primary roughing and secondary concentration of flotation column can meet the requirement and the clean coal ash was 13.67% while the yield was 33.45%. The results can be used as reference for field production.

目的探讨分析在膝关节镜下对前交叉韧带损伤患者采用半腱肌与股薄肌肌腱重建方法治疗的临床效果评价。方法选取在本院接受治疗的34例前交叉韧带损伤患者随机分为治疗组与对照组，平均每组17例患者，对照组采用传统的切开术治疗，治疗组采用膝关节镜下半腱肌与股薄肌肌腱重建的方法进行治疗，比较两组患者的治疗效果。结果术后治疗组Lysholm评分明显高于对照组；术后治疗组并发症的发生率明显低于对照组的，具有统计学意义(P<0.05)。结论采用膝关节镜下半腱肌与股薄肌肌腱重建方法治疗的临床效果优于传统的切开术治疗，可以提高膝关节的稳定度，减少并发症的发生。

目的总结我院对退行性腰椎管狭窄症后路钉棒系统内固定手术治疗的现状，通过对这些病例的分析及研究，为临床上治疗退行性腰椎管狭窄症提供更多指导。方法本研究以Denis疼痛分级评估、ODI评价等为观察指标，结合术前、术后的影像学（X光片、CT、MRI）表现，对50例退变性腰椎管狭窄症行手术治疗的病例，根据患者随访结果，进行疗效分析与评价，并探讨影响其疗效的因素。结论年龄及性别对术后疗效无明显差异，术前疼痛比较严重，功能较差的患者，其术后功能症状改善明显，效果比较理想。

Objective:To investigate the operational approach to Extrapedicular percutaneous vertebroplasty in the thoracic and lumbar spine and make an anatomic study so as to offer safer and more reliable operational approaches to per-cutaneous vertebroplasty and avoid dangerous complications of thoracic transpedicular operations. Methods:A radiological anatomical study was conducted on the thoracolumbar data obtained from the 64-slice spiral CT examination of 100 pa-tients with three-dimensional reconstruction of CT in our hospital radiology department to measure the three approaches of data, which were statistically analyzed. Results:The three approach groups were compared, and the difference was statisti-cally significant (P<0.01). In addition, the narrowest distance from the outside of the traditional needle points and improved pedicle needle point to the spine was compared, and the difference was statistically significant(P<0.01). Conclusions:Com-pared with the traditional approach, the vertebroplasty surgical path through the outside thoracolumbar pedicle point is safe, reliable, simple and of practical advantages and theoretical biomechanics superiority, and serves as a good choice for poste-rior thoracic and lumbar vertebroplasty.

目的:研究分析椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折的临床效果。方法:选取我院于2010年5月-2011年9月收治的25例老年骨质疏松脊柱压缩骨折患者的临床资料,所有患者均采用椎体后凸成形术进行治疗,将其设置为治疗组。选取同期实施保守治疗的20例患者为对照组,观察对比两组患者的临床治疗效果。结果:治疗组患者平均手术时间为(49.36±12.31)min,术中出血量(52.30±11.32)ml,平均住院时间为(5.3±5.7)d;治疗组患者并发症发生率为12.0%,明显低于对照组患者(50.0%),两组患者对比P<0.01,具有显著差异性;对照组远期效果不如治疗组患者,对比有统计学意义(P<0.01)。结论:椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折可以有效缓解患者的疼痛,恢复椎体高度,且临床并发症较少,远期疗效理想,是一种安全有效的治疗方式。

目的研究分析关节外固定架对高能量Pilon骨折的治疗效果。方法选取我院于2007年1月至2011年6月收治的高能量Pilon骨折患者的临床资料,将有限切开复位内固定与关节外固定联合治疗的37例患者设置为治疗组,将采用切开复位内固定治疗的34例患者设置为对照组,两组患者均进行为期6个月的随访,对比分析两组患者的临床效果。结果治疗组患者有效21例,可以5例,差11例,对照组患者有效16例,可以7例,差11例,两组效果对比P>0.05为有差异性,有统计学意义,治疗组与对照组患者在伤口感染、皮肤坏死以及骨折不愈合方面差异性不大,无统计学意义P>0.05,两组患者关节僵硬对比P<0.05,有差异性,具有统计学意义。结论有限切开复位内固定与关节外固定联合治疗高能量Pilon骨折的临床效果优于单纯切开,关节外固定架可以提高治疗效果,减少并发症发生率,安全有效,值得推广。

<正>医院信息系统的应用是医院参与市场竞争、更好地服务于人民的重要手段,也是医院提高管理水平、加大科学管理力度、监督医疗活动的基本措施。多年医院信息系统的应用充分证明医院信息系统是企业信息系统中最为复杂、最为庞大的一类。随着医院的发展、新的管理思路不断涌现,对原

目的应用现代化的科技手段,实现数字化管理的全覆盖,为促进医院的发展提供可靠的数据保证,使数据来源于临床,服务于临床。方法利用网络系统,建立各个部门相对独立的管理模块,彼此通过网络连接,实现数据共享,资源共享。结果数据采集的及时准确,大大缩短了诊断时间,方便了广大患者就医,同时也完成了医院管理的基础数据库。结论数字化系统的建立,是医院管理必不可少的手段。全院一本账,增加了管理的透明度,减少了各项分配指标的不平衡以及由此引起的矛盾,实践证明早应用,早受益。

目的观察化脂降浊方治疗高脂血症并脂肪肝的效果。方法将高血脂并脂肪肝患者随机分为2组,治疗组(60例)患者采用自拟的化脂降浊方口服用药,对照组(60例)每日早、中、晚给予降脂平1片治疗,同样持续3个月。结果 2组治疗后血脂水平均较治疗前明显下降(P均<0.05),但治疗后2组血脂水平比较差异无统计学意义(P>0.05);脂肪肝治疗总有效率治疗组明显高于对照组(P<0.05)。结论以化脂降浊方治疗高脂血症并脂肪肝效果明显。

目的探讨应用肱骨近端锁定钢板治疗复杂肱骨近端粉碎骨折的疗效。方法2005年4月至2008年2月,应用肱骨近端锁定钢板治疗肱骨近端粉碎骨折28例,男18例,女10例;患者平均年龄53.6岁(22～78岁)。按Neer分型,NeerⅢ型17例,NeerⅣ型11例,全部采用肱骨近端锁定钢板内固定。结果28例随访12～26个月,平均18.6个月。按照Neer功能评定标准进行评分,优17例,良9例,可2例,优良率为92.8%。结论锁定钢板的螺钉锁扣于接骨板上,能够提高对肱骨近端粉碎骨折及伴有骨质疏松患者的固定效果。

目的观察中医药综合治疗白塞病的临床效果。方法将来院就医的35例白塞病患者随机分为2组,治疗组(19例)应用中医辨证方法分型,以中药配伍口服,中药洗剂外用消除溃疡;对照组(16例)给予左旋咪唑50mg,每日3次,醋酸泼尼松20mg,每日2次口服,并配合西药外用。2组均治疗1个月,随访3个月后比较2组疗效,1年后对比复发率。结果治疗组与对照组的总有效率分别为78.95%、75.00%,2组比较差异无统计学意义(P>0.05)。1年后随访复发率,治疗组与对照组的总复发率分别为26.67%、75.00%,2组比较差异具有统计学意义(P<0.05)。结论中医药综合治疗白塞病疗效较好,可减少远期复发率,具有理想的前景。

目的评价中药对痛风急性发作期的临床疗效和安全性。方法将患者85例随机分为两组,治疗组45例用以中药清热利湿为治疗原则,对照组40例用秋水仙碱,观察两组治疗后临床指标、安全评价、疗效评价。结果其治疗前后两组在症状体征差异无显著性,实验室结果显示中药清热利湿法对肝肾功能及血象均无明显影响;治疗前后两组疗效比较差异无显著性;两组中治疗组无不良反应,对照组均出现消化系统恶心、呕吐、腹泻等症状。两组间差异有显著性。结论清热利湿法有抗炎、镇痛、消肿作用,无不良反应,患者耐受性好,较安全。