Objective:To investigate the effect of fibulin-3 on the senescence of intervertebral disc nucleus pulposus cells (NPCs) through the regulation of tissue inhibitor of metalloproteinases 3 (TIMP-3) expression and to elucidate the molecular mechanisms involved. Methods:1). The nucleus pulposus tissues and imaging data of 37 patients who had undergone intervertebral disc surgery were collected. The degree of degeneration of the intervertebral discs were classified according to the Pfirrmann grading system. The senescence degree of NPCs was determined using senescence-associated β-galactosidase (SA-β-gal) staining. Fibulin-3 expression levels were determined using Western blot and ELISA. The relationship between fibulin-3 and disc degeneration and NPCs senescence was investigated. 2). Human intervertebral disc NPCs were cultured in vitro. The proliferation and senescence of NPC across continuous passage were observed via CCK-8 assay and SA-β-gal staining, respectively. Fibulin-3 expression levels and the expression of inflammatory cytokines and matrix metalloproteinases were assessed. Exogenous fibulin-3 was added to verify its effect on the proliferation and senescence of NPCs. 3). The effect of fibulin-3 on the apoptosis and proliferation of NPCs was verified through gene overexpression, which was used in combination with an apoptosis inhibitor for bidirectional verification. 4). Bioinformatics analysis was performed to explore the relationship between fibulin-3 and the TIMP family. Experiments overexpressing fibulin-3 and silencing the TIMP-3 gene were performed to verify their role in NPCs senescence. Results:1). The intervertebral disc degeneration samples from 37 patients were classified according to the Pfirrmann grading system. The higher the degeneration grade, the lower fibulin-3 expression. Spearman correlation analysis showed that the disc grade was negatively correlated with the NPC senescence grade (r=－0.87, P<0.001) and fibulin-3 expression (r=－0.79, P<0.001). 2). As the passage number of NPCs increased, fibulin-3 expression gradually decreased, cell proliferation ability weakened, and the expression of inflammatory cytokines and matrix metalloproteinases increased. After exogenous fibulin-3 was added, cell morphology and growth status were maintained, cell senescence was significantly inhibited, and the expression of inflammatory cytokines and matrix metalloproteinases was markedly reduced. 3). Gene overexpression experiments showed that fibulin-3 reduced NPC apoptosis and promoted cell proliferation, thereby inhibiting NPC senescence. 4). Bioinformatics analysis revealed a significant association between fibulin-3 and TIMP-3 of the TIMP family. Further experiments confirmed that overexpressing fibulin-3 enhanced TIMP-3 expression, while silencing the TIMP-3 gene significantly weakened the inhibitory effect of fibulin-3 on NPCs senescence. This indicates that, through regulating TIMP-3, fibulin-3 inhibits the activity of matrix metalloproteinases, affects the synthesis and degradation of the extracellular matrix, and ultimately inhibits NPCs senescence. Conclusion:This study demonstrates that fibulin-3 plays a crucial role in inhibiting the senescence of intervertebral disc NPCs by regulating TIMP-3. The specific mechanisms involved are as follows, fibulin-3 upregulates TIMP-3 expression, inhibits matrix metalloproteinase activity, and reduces extracellular matrix degradation, thereby promoting extracellular matrix synthesis. Additionally, fibulin-3 inhibits NPCs senescence by reducing apoptosis and promoting cell proliferation. Therefore, fibulin-3 and TIMP-3 have potential therapeutic significance in maintaining intervertebral disc health and delaying degeneration.

Objective:To explore the feasibility and accuracy of ultrasound volume navigation (UVN) combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation through a prospective randomized controlled study. Methods:Patients with thoracic and lumbar vertebral fractures scheduled for percutaneous pedicle screw fixation between January 2022 and January 2023 were enrolled. Among them, 60 patients met the selection criteria and were included in the study. There were 28 males and 32 females, with an average age of 49.5 years (range, 29-60 years). The cause of injury included 20 cases of traffic accidents, 21 cases of falls, 17 cases of slips, and 2 cases of heavy object impact. The interval from injury to hospital admission ranged from 1 to 5 days (mean, 1.57 days). The fracture located at T 12 in 15 cases, L 1 in 20 cases, L 2 in 19 cases, and L 3 in 6 cases. The study used each patient as their own control, randomly guiding pedicle screw implantation using UVN combined with X-ray fluoroscopy on one side of the vertebral body and the adjacent segment (trial group), while the other side was implanted under X-ray fluoroscopy (control group). A total of 4 screws and 2 rods were implanted in each patient. The implantation time and fluoroscopy frequency during implantation of each screw, angle deviation and distance deviation between actual and preoperative planned trajectory by imaging examination, and the occurrence of zygapophysial joint invasion were recorded. Results:In terms of screw implantation time, fluoroscopy frequency, angle deviation, distance deviation, and incidence of zygapophysial joint invasion, the trial group showed superior results compared to the control group, and the differences were significant ( P<0.05). Conclusion:UVN combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation can yreduce screw implantation time, adjust dynamically, reduce operational difficulty, and reduce radiation damage.

Objective To observe the influence of the bone cement injection volume on the efficacy of percutaneous vertebroplasty（PVP） in elderly patients with osteoporotic vertebral compression fracture（OVCF）,and to provide reference for clinicians to choose the volume of bone cement injection.Methods A total of 90 elderly patients with OVCF admitted to Luoyang Orthopedic-Traumatological Hospital of Henan Province from January 2019 to January 2021 were selected as the study subjects.All patients were treated with PVP.According to the ratio of volume of bone cement to the volume of vertebral body（Vbc/Vvb）,the patients were divided into low-dose group（0.1＜Vbc/Vvb≤0.2）,medium-dose group（0.2＜Vbc/Vvb≤0.3） and high-dose group（Vbc/Vvb＞0.3）,with 30 patients in each group.At the time points of before operation, the first day after operation, 3 and 12 months after operation, the patients′ back pain was assessed by visual analogue scale（VAS）,and their functional recovery was assessed by Oswestry dysfunction index（ODI）.All patients were reexamined with CT on the first to second day after operation to observe the leakage of bone cement.All patients were followed up for 12 months to observe the refracture of the injured vertebral body and adjacent vertebral body.Results There was no significant difference in the VAS score and ODI score among the three groups at the time points of before operation, the first day after operation, 3 and 12 months after operation（P＞0.05）.The VAS score and ODI score of the patients in the three groups on the first day, 3 and 12 months after the operation were significantly lower than those before operation（P＜0.05）.The leakage rate of bone cement in the low-dose group, middle-dose group and high-dose group was 13.33%（4/30）,16.67%（5/30） and 40.00%（12/30）,respectively.The leakage rate of bone cement in the low-dose group and medium-dose group was significantly lower than that in the high-dose group（χ~2=4.022,0.020;P＜0.05）.There was no statistically significant difference in the leakage rate of bone cement between the low-dose group and medium-dose group（χ~2=1.131,P＞0.05）.Within 3 months after operation, the refracture rate of patients in the low-dose group, medium-dose group and high-dose group was 3.33%（1/30）,0.00%（0/30） and 6.67%（2/30）,respectively.There was no statistically significant difference in the refracture rate among the three groups（χ~2=2.069,P＞0.05）.Within 6 months after operation, the refracture rate of patients in the low-dose group, medium-dose group and high-dose group was 6.67%（2/30）,0.00%（0/30） and 6.67%（2/30）,respectively.There was no statistically significant difference in the refracture rate among the three groups（χ~2=2.093,P＞0.05）.Conclusion The PVP with medium-dose bone cement injection（0.2＜Vbc/Vvb≤0.3） can effectively relieve the low back pain, promote the functional recovery of OVCF patients, and reduce the incidence of bone cement leakage.

目的 探讨骨炎膏对大鼠感染性创面愈合的影响及可能作用机制.方法 选取72只SPF级SD大鼠,随机取18只作为正常创面组,其余大鼠采用外科手术联合接种金黄色葡萄球菌液方法制备感染性创面模型.将造模成功大鼠随机分为感染创面组、骨炎膏组、京万红组,每组18只.于制备创面后第1天开始,正常创面组及感染创面组大鼠创面予生理盐水棉球擦拭后无菌纱布包扎固定,京万红组创面涂抹适量京万红软膏(约2 g)后予无菌纱布包扎固定,骨炎膏组创面给予涂抹骨炎膏无菌纱布包扎固定,每天换药1次,直至创面完全愈合.观察并记录各组大鼠造模后第3天、第7天、第14天创面愈合面积及大鼠创面完全愈合时间;分别于造模后第3天、第7天、第14天随机取各组大鼠创面组织,使用酶联免疫法(ELISA)检测创面组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量.结果 造模后第7天、第14天,骨炎膏组和京万红组大鼠创面愈合率均明显高于感染创面组(P 均<0.05),且骨炎膏组均明显高于京万红组(P 均<0.05).骨炎膏组和京万红组大鼠创面愈合时间均明显短于感染创面组(P均<0.05),且骨炎膏组明显短于京万红组(P<0.05).造模后第3天、第7天、第14天,感染创面组、骨炎膏组及京万红组大鼠创面组织中TNF-α、IL-6含量均明显高于正常创面组(P均<0.05);造模后第7天、第14天,骨炎膏组及京万红组大鼠创面组织中TNF-α、IL-6 含量均明显低于感染创面组(P均<0.05),且骨炎膏组均明显低于京万红组(P均<0.05).结论 骨炎膏可明显促进大鼠感染性创面愈合,缩短创面愈合时间,其机制可能与下调创面TNF-α、IL-6表达水平,减轻创面局部炎症有关.

Intervertebral disc degeneration (IDD) is a chronic disease affecting millions of patients; however, its specific etiology is unknown. G protein-coupled receptors (GPRs) are a superfamily of integral membrane receptors in cells, and the receptors respond to a diverse range of stimuli and participate in multiple cellular activities. Here, using RNA-sequencing (RNA-seq) methods and immunohistochemistry, we revealed that G protein-coupled receptor 35 (GPR35) may have a relationship with IDD. Then, we demonstrated that the deletion of GPR35 in nucleus pulposus cells (NPCs) with siRNA or in Gpr35-/- mice significantly alleviated IDD caused by senescence or mechanical stress, further validating the pathological role of GPR35 in IDD. In addition, GPR35 induced the influx of Ca2+ and upregulation of reactive oxygen species (ROS) under mechanical stress in NPCs, which we believe to be the mechanism of GPR35-induced IDD. Finally, GPR35 caused upregulation of ROS in NPCs under mechanical stress, while excessive ROS stimulated the NPCs to express more GPR35 with a significant dose or time response. The u-regulated GPR35 could sense mechanical stress to produce more ROS and perpetuate this harmful cycle. In summary, our study shows that GPR35 plays a critical role in mediating IDD via mediating the influx of calcium ions and upregulating ROS, which implies a strong potential advantage of GPR35 as a prevention and treatment target in IDD.

目的 筛选7-羟基黄烷酮抑制大鼠生长板软骨细胞凋亡的最适药物浓度并观察其对大鼠骨骺闭合和胫骨生长的影响.方法 解剖大鼠胫骨生长板软骨,体外分离生长板软骨细胞并进行鉴定.然后采用IL-1β诱发软骨细胞凋亡,分别加入含有10、20、40、60 μM的7-羟基黄烷酮培养液进行培养,采用MTT法初步观察各浓度抑制软骨细胞凋亡效果,筛选出最佳药物浓度.随后采用流式细胞仪对筛选出的最佳浓度进行验证.此外给予大鼠100 mg/kg 7-羟基黄烷酮灌胃,观察其对骨骺闭合及胫骨生长的影响.结果 软骨细胞免疫荧光鉴定结果显示,分离培养的细胞符合软骨细胞的生物学特征.MTT法实验结果显示,10、20、40、60μM7-羟基黄烷酮均可以不同程度地抑制生长板软骨细胞凋亡,其中抑制软骨细胞凋亡的最佳药物浓度为40 μM,通过流式细胞仪进一步验证显示40 μM 7-羟基黄烷酮抑制细胞凋亡作用明显,且效果优于阳性对照组.此外,100 mg/kg 7-羟基黄烷酮灌胃结果显示其能够延缓骨骺闭合并促进大鼠胫骨生长.结论 本次研究结果显示,7-羟基黄烷酮能够抑制大鼠生长板软骨细胞凋亡,最适药物浓度为40 μM.此外,体外实验证实给予大鼠灌胃7-羟基黄烷酮的确能够延缓骨骺愈合,促进胫骨生长.

目的:观察顽痹康丸治疗肾虚湿热型强直性脊柱炎的临床疗效.方法:选取2018年1月至2020年1月于我院风湿科住院的100例肾虚湿热型强直性脊柱炎合并骨质疏松患者,依据随机、对照的原则,将患者分为两组,每组50例.对照组患者给予柳氮磺吡啶肠溶片联合美洛昔康胶囊,治疗组在对照组的基础上口服顽痹康丸,疗程均为12周.比较两组患者治疗前后的血沉(ESR)、血清C反应蛋白(CRP)、股骨颈骨密度、血清骨钙素(BGP)、β异构C末端肽(β-CTX)水平的变化情况,并在治疗12周后依据ASAS20疗效评价标准评估临床疗效.记录两组患者不良反应发生情况.结果:治疗后,两组患者的ESR、CRP及β-CTX水平均低于治疗前,股骨颈骨密度值及BGP水平高于治疗前(P<0.05);且治疗组上述指标改善程度均优于对照组(P<0.05).治疗12周后治疗组有效率为77.08％,高于对照组的有效率(52.17％)(P<0.05).结论:顽痹康丸能够降低强直性脊柱炎患者的炎性指标ESR、CRP,改善股骨颈骨密度值,提高血清BGP水平,降低血清β-CTX水平,使之达到骨代谢的平衡,延缓疾病进展,减少骨量丢失,且不良反应较少.

近年来,精益管理已经被应用于我国医疗等行业中,在提高医院工作效率,降低医院运营成本等方面取得了良好成效.洛阳正骨医院作为百年老字号三级甲等医院,诊疗水平居国内领先地位,但是由于中医院规模和传统思维的局限性,科研课题管理理念相对保守,直接影响了医院在学术领域的影响力.因此,立足实际,结合科研发展新形势,引入科研课题精益管理新模式,更好服务于科研工作者,使整个科研课题管理系统高效运转,最终提高医院的科研学术地位及综合影响力是该院今后可持续发展的一个工作重点.

目的:探讨滋阴益骨方在类风湿关节炎合并骨质疏松症肝肾不足证治疗中的应用价值及作用机制.方法:将符合要求的90例类风湿关节炎合并骨质疏松症肝肾不足证患者随机分为2组,每组45例,分别采用常规药物治疗(常规药物组)和滋阴益骨方联合常规药物治疗(滋阴益骨方组).常规药物治疗采用口服甲氨蝶呤片、硫酸羟氯喹片、美洛昔康片和利塞膦酸钠片,其中甲氨蝶呤片,每周1次,每次10 mg;硫酸羟氯喹片,每日2次,每次0.2 g;美洛昔康片,每晚1次,每次15 mg;利塞膦酸钠片,每周1次,每次5 mg;均连续服用12周.滋阴益骨方水煎服,每日1剂,早晚2次服用,连续服用12周.治疗结束后比较2组患者的临床疗效,并分别于治疗前和治疗结束后记录并比较2组患者核因子κB受体活化因子配体(receptor activator of nuclear factor-κBligand,RANKL)和骨保护素(osteoprotegerin,OPG)血清含量.结果:①临床疗效.治疗结束后,常规药物组显效7例、有效22例、无效16例,滋阴益骨方组显效14例、有效26例、无效5例;滋阴益骨方组的临床疗效优于常规药物组(Z=-2.762,P=0.006).②OPG血清含量.治疗前2组患者OPG血清含量比较,差异无统计学意义[(271.83±35.62)pg·mL-1,(274.36±31.23)pg·mL-1,t=-0.174,P=0.864];治疗结束后,常规药物组OPG血清含量低于滋阴益骨方组[(343.28±29.67)pg·mL-1,(396.81±27.73)pg·mL-1,t=-12.201,P=0.000],2组患者OPG血清含量均高于治疗前(t=-12.817,P=0.000;t=-42.566,P=0.000).③RANKL血清含量.治疗前2组患者RANKL血清含量比较,差异无统计学意义[(177.34±22.63)pg·mL-1,(179.61±20.06)pg·mL-1,t=-0.286,P=0.776];治疗结束后,常规药物组RANKL血清含量高于滋阴益骨方组[(141.25±22.37)pg·mL-1,(111.42±23.57)pg·mL-1,t=19.304,P=0.000],2组患者RANKL血清含量均低于治疗前(t=12.125,P=0.000;t=28.387,P=0.000).结论:对于类风湿关节炎合并骨质疏松症肝肾不足证患者,在口服常规药物的基础上联合口服滋阴益骨方,疗效确切.其作用机制可能是通过提高OPG血清含量和降低RANKL血清含量,抑制破骨细胞活性,从而减少骨量丢失,延缓疾病进展.

目的:观察采用生物陶瓷骨混合自体髂骨骨粒微创治疗ARCOⅡ、Ⅲ期股骨头坏死的临床疗效及安全性,丰富股骨头坏死保头治疗体系.方法:将2016年6月至2017年12月股骨头坏死患者40例(42髋),分为生物陶瓷骨组(对照组)和生物陶瓷骨混合自体髂骨组(治疗组),对照组行微创粗通道减压病灶清除生物陶瓷骨植骨术,治疗组行微创粗通道减压病灶清除生物陶瓷骨混合自体髂骨骨粒植骨术.记录两组手术时间,术中出血量,治疗前、术后6个月、术后12个月及末次随访Harris评分,采用X线片评价术后股骨头形态及植骨情况.结果:两组随访21～42个月,平均随访时间(26.34±3.52)个月.对照组在手术时间、术中出血量方面优于治疗组,差异有统计学意义(P＜0.05),两组患者术后均无静脉血栓、感染等并发症.与术前相比,两组患者术后12个月Harris评分均明显提高,差异有统计学意义(P＜0.05),且术后12个月治疗组Harris评分、末次随访影像学评价结果均优于对照组,差异有统计学意义(P＜0.05).结论:采用生物陶瓷骨混合自体髂骨骨粒微创治疗ARCOⅡ、Ⅲ期股骨头坏死,中短期临床疗效优于对照组,虽然该手术方式手术时间长、出血量略多,但不影响康复时间,后期X线结果更优,可以作为治疗早中期股骨头坏死的推荐方法.

目的 分析平乐正骨骨炎膏在骨伤科疾病中的应用研究情况,总结其治疗骨伤科疾病的用药规律.方法 以“骨炎膏”和“洛阳正骨”为检索词,检索中国期刊全文数据库(CNKI)1979年1月至2019年3月收录的文献,采用Microsoft Excel2016软件建立平乐正骨骨炎膏文献研究数据库,并进行统计描述.结果 共检索获得平乐正骨骨炎膏在骨伤科疾病中的应用研究文献25篇,其中治疗髋关节滑膜炎12篇,治疗骨髓炎3篇,治疗膝关节滑膜炎4篇,治疗股骨头坏死1篇,治疗急性感染2篇,治疗骨折肿胀3篇;组方所用药物种类包括清热药、攻下药、利水渗湿药、补虚药、解表药、活血化瘀药、安神药,以清热药和攻下药最多(占58.8％);组方配伍以臣药为主(占64.7),五味以苦、甘、辛为主(分别占52.9％、41.2％、23.5％),药性以寒性为主(占64.7％).结论 平乐正骨骨炎膏主要用于治疗髋、膝关节滑膜炎,骨折肿胀及感染疾病,处方以清热药、攻下药为主,治以清热解毒、利水消肿、拔毒生肌、祛瘀消肿、活血化瘀为主.

总结分析股骨头坏死愈胶囊修复股骨头坏死的文献资料,探讨其药理作用机制.现有研究从动物实验、临床研究等层面对其作用机制进行了探讨和报道,为后续深入研究提供指引和方向,并为其临床推广应用提供了循证依据,但研究相对分散且不够深入.

腰痛是临床常见病,平乐正骨"筋滞骨错"理论针对腰痛的诊治提出了腰腹联合诊疗思维.其核心思想是腰腹平衡观,依中医理论论述,即腰痛是阴阳失衡、气血失衡、筋骨失衡所致;依西医理论论述,即腰痛是解剖结构失衡、血液循环系统及神经系统失衡所致;治疗的根本是腰腹联合恢复机体的平衡.本文从腰腹联合诊疗思维的解剖学基础、经络学基础及其与脏腑辨证的关系、临床应用4个方面,对平乐正骨"筋滞骨错"理论指导下的腰痛腰腹联合诊疗思维进行了阐述.

目的 通过对医院近5年发表的科研学术论文数量、质量等情况进行统计分析,旨在了解医院科研团队及人才培养的现状,为医院实施"研究型医院"及可持续发展战略,壮大科研队伍、提高医院学术地位提供参考.方法 数据来源于该院科研与知识产权部期刊论文管理系统.结果 ①从2013—2017年,该院每年发表的科研学术论文总数基本上保持稳定不变,但是SCI、中文核心和科技核心文章每年都呈增长趋势,其他论文比例(国家级期刊和省部级论文)呈明显下降趋势;②科研学术论文的发表量与职工本人的学历有着密不可分的关系;③医院建立的论文规范化管理办法增加了科研学术论文的产出.结论 2013—2017年,该院发表的中文科研学术论文质量明显提高,但是,SCI文章的发表仍较低下,仅占全部论文的7.59％,说明我院整体科研水平较低,在科研发展对策上还需不断进行调整和完善.

Objective To explore the effectiveness of ultrasound-guided percutaneous Herbert screw for the treatment of fresh nondisplaced carpal scaphoid fracture. Methods Between May 2013 and August 2015, 15 patients with fresh nondisplaced carpal scaphoid fractures (Krimmer type A2) were treated with ultrasound-guided Herbert screw fixation. There were 12 males and 3 females with an average age of 33.4 years (range, 18-51 years). The causes of injury included 9 cases of falls, 3 cases of training injuries, and 3 cases of machine injuries. The interval from injury to surgery was 2-15 days (mean, 5 days). No other complication was found. The operation time, intraoperative blood loss, intraoperative fluoroscopy times, and the fracture healing time were recorded. The wrist function was assessed by the modified Mayo wrist score standard. Results The operation time was 28-53 minutes (mean, 33.9 minutes); the intraoperative blood loss was 5-30 mL (mean, 10.5 mL); the intraoperative fluoroscopy was 2-6 times (mean, 2.6 times). All 15 patients were followed up 6-18 months (mean, 10.5 months). One patient developed pain and soreness in the skin of the nail entrance, and gradually relieved after fumigation. No complication such as infection occurred. All fractures healed clinically, and the healing time was 8-16 weeks (mean, 11.6 weeks). At last follow-up, the modified Mayo wrist score was 76-99 (mean, 92.5). Among them, 12 cases were excellent, 2 cases were good, and 1 case was fair, and the excellent and good rate was 93.3%. Conclusion Ultrasound-guided fixation with Herbert screw is a reliable treatment method for fresh nondisplaced carpal scaphoid fractures with small invasion, less bleeding, and small radiation damage.

目的 观察骨碎补总黄酮对大鼠诱导膜中血管内皮生长因子(VEGF)、骨形态发生蛋白-2(BMP-2)表达的影响.方法 60只3月龄SD大鼠,随机分为3组:模型组、填充组和填充+TFDR组,每组20只,建立大鼠长段骨缺损模型,模型组骨缺损处仅克氏针固定,填充组及填充+TFDR组骨缺损处用抗生素骨水泥填充,并用克氏针固定;填充+TFDR组ig给予TFDR(67.5 mg/kg),模型组及填充组ig等量生理盐水,每天给药1次,连续6周.给药结束后,处死大鼠,切取骨水泥周围包绕的白色膜状物,模型组切取对应阶段的瘢痕组织,Elisa定量及免疫组化法观察诱导膜中BMP-2、VEGF表达变化.结果 填充组BMP-2、VEGF表达水平显著高于模型组,填充+TFDR组BMP-2、VEGF表达水平均显著高于填充组和模型组,各组间差异均有统计学意义(P＜0.05);免疫组化检测结果显示相同趋势.结论 TFDR促进Masquelet技术诱导膜中BMP-2和VEGF表达.

目的 探讨CD117在骨肉瘤组织中的表达及其临床意义.方法 选取2009年1月至2016年12月洛阳正骨医院保存的骨肉瘤组织标本及肿瘤周围正常骨组织标本各45例,采用免疫组织化学法检测骨肉瘤组织及正常骨组织中CD117的表达,分析骨肉瘤组织中CD117的表达与患者临床病理特征的关系.结果 骨肉瘤组织和正常骨组织中CD117阳性表达率分别为53.3％ (24/45)、0.0％ (0/45),骨肉瘤组织中CD117阳性表达率显著高于正常骨组织(r=32.727,P＜0.05).骨肉瘤组织中CD117表达与患者的年龄、性别及肿瘤直径无相关性(P＞0.05),而与肿瘤组织学类型、肿瘤转移及TNM分期有相关性(P＜0.05).结论 骨肉瘤组织中CD117表达上调,且与肿瘤组织分化程度、肿瘤转移及TNM分期有相关性,CD117可以作为骨肉瘤恶性程度的判断指标.

手部掌骨伴皮肤软组织缺损,临床比较常见,修复有一定的困难,处理的恰当与否直接影响手部功能的恢复[1]. 因此,如何早期修复组织缺损、早期功能锻炼至关重要.自2010年1月至2015年2月,我们采用游离旋髂浅动脉骨皮瓣一期修复此类缺损5例,取得了较好的效果,现报道如下.

Objective To explore the clinical efficacy of the integrated Chinese and western medicine on osteoporosis.Methods 65 cases of osteoporosis treated in the hospital were randomized into a treatment group(33 cases)and a control group(32 cases).In the control group,32 cases were treated with the oral administration of caltrate D tablets.In the treatment group,33 cases were treated with the oral administration of caltrate D tablets and Chinese medicine.Results The cases in either group were treated for 6 months(2 sessions,3-month treatment made one session).Afterward,the effect was assessed according to the efficacy assessment standards.Of 33 cases in the treatment group,13 cases were cured,14 cases remarkably effective,4 cases effective and 2 cases failed.The total effective rate was 93.9%.Of 32 cases in the control group,8 cases were cured,10 cases remarkably effective,8 cases effective and 6 cases failed.The total effective rate was 81.3%.The comparison of the total effective rate presented statistically significant difference between the treatment group and the control group(P0.05),which explained that the clinical efficacy of integrated Chinese and western medicine in the treatment group was superior to that of the simple western medicine in the control group.Conclusion The integrated Chinese and western medicine achieves the good efficacy on osteoporosis and deserves to be promoted clinically.

医学科研是推动医学科学发展和进步的强劲动力。医院的科研管理是影响重点学科发展的重要因素,强有力的科研资源与管理方式,是学科发展壮大的有力杠杆。文章就医院在科研管理促进学科建设方面的措施,学科建设成效,下一步建设办法等方面做一探讨,以期进一步探究医院重点学科建设的新方法,新思路。