Comparison of the clinical effect of DHS and PFNA on senile osteoporotic fracture and their significance of changes in BALP expression level

Objective:To investigate the clinical effects of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) on senile osteoporosis patients and their effects on the expression level of bone-specific alkaline phosphatase (BALP).Methods:116 elderly patients with osteoporotic fracture were divided into DHS group (n=67) and PFNA group (n=49). BALP values were measured by ELISA before operation and 30 days after operation.Results:The operation time, the bleeding volume, and the weight-bearing time of PFNA group was shorter than DHS group (p<0.05); the dominant blood loss and occult blood loss in PFNA group were less than those in DHS group (p<0.05); the healing time and detumescence time, the complications of PFNA group was fewer than the DHS group (p<0.05). The ten-meter walking speed and the five sitting tests in PFNA group were shorter than that in DHS group (p<0.05); the excellent and good rate and Harris score in PFNA group were higher than those in DHS group (p<0.05). The expression of BALP in PFNA group was lower than that in DHS group (p<0.05).Conclusion:PFNA surgery has less trauma, fewer complications, more optimistic postoperative healing and recovery degree, and is more conducive to the reduction of BALP expression level.     

适温压榨牡丹籽油工艺优化及理化性质分析

为了提高压榨牡丹籽油产率及油品质量,并为进一步探索低温压榨牡丹籽油的可行性提供技术和理论基础,本实验应用Box-Behnken实验设计对适温压榨牡丹籽油提取工艺进行优化。结果表明,模型拟合程度高,实验误差小,最终得到适温压榨制备牡丹籽油最佳制备工艺为：压力4.6 MPa、进料速度1 600 g·min^-1、压榨温度73℃、含水率4.6%;所得最大出油率为23.11%,残油率为7.02%。经检测最佳制备条件提取的牡丹籽油不饱和脂肪酸的含量为90.36%,其中亚麻酸含量为40.71%、亚油酸含量为27.25%、油酸含量为22.40%、饱和脂肪酸中棕榈酸含量为7.23%、硬脂酸为1.60%。牡丹籽油酸价为2.61 mg·g^-1、过氧化值为1.56 mmol·kg^-1。所有检测结果均高于《中华人民共和国粮食行业标准LS/T 3242-2014》牡丹籽油中质量标准的要求。     

经皮RTS钉固定与常规椎弓根固定在胸腰段压缩骨折中的疗效比较

目的:分析和比较使用经皮RTS钉固定与常规椎弓根固定在胸腰段骨折中的临床疗效和安全性。方法:对2017年6月至2018年6月在我院住院,经诊断为胸腰段骨折,且经纳入及排除标准筛选后的共计74例患者进行回顾性分析。根据不同的手术方式和选择,将纳入的患者分为经皮RTS钉固定组(观察组;40例)和常规椎弓根螺钉固定组(对照组;34例)。在术后的3天,1月及1年比较两组患者的疼痛评分及功能评分;并通过其影像学指标(伤椎高度恢复,cobb角恢复等)比较两组的影像学疗效;比较两组患者的手术时间,出血量,切口长度等手术指标;比较两组患者的并发症等情况。结果:在术后3天时,观察组患者的VAS评分显著优于对照组(P0.05),而在术后1月及1年时,两组患者未见显著差异(P0.05)。两组患者的Cobb角及前缘高度百分比较术前均有显著改善(P0.05),且两组间均有显著差异(P0.05)。两组患者在手术时间,切口长度,透视次数,出血量,出院时间等均有显著差异(P0.05)。两组患者在并发症的比较中并无统计学差异(P0.05)。结论:与常规的开放椎弓根螺钉固定相比,对于胸腰椎压缩骨折,RTS螺钉能够有效的恢复影像学指标,特别是在前缘高度及Cobb角恢复,并且能够有效地减少创伤及出血,加快功能恢复,在临床中可以进一步推广。     

Plasticity of the TSG-6 HA-binding loop and mobility in the TSG-6-HA complex revealed by NMR and X-ray crystallography

Tumour necrosis factor-stimulated gene-6 (TSG-6) is a glycosaminoglycan-binding protein expressed during inflammatory and inflammation-like processes. Previously NMR structures were calculated for the Link module of TSG-6 (Link_TSG6) in its free state and when bound to an octasaccharide of hyaluronan (HA(8)). Heparin was found to compete for HA binding even though it interacts at a site that is distinct from the HA-binding surface. Here we present crystallography data on the free protein, and (15)N NMR relaxation data for the uncomplexed and HA(8)-bound forms of Link_TSG6. Although the Link module is comparatively rigid overall, the free protein shows a high degree of mobility in the beta4/beta5 loop and at the Cys47-Cys68 disulfide bond, both of which are regions involved in HA binding. When bound to HA(8), this dynamic behaviour is dampened, but not eliminated, suggesting a degree of dynamic matching between the protein and sugar that may decrease the entropic penalty of complex formation. A further highly dynamic residue is Lys54, which is distant from the HA-binding site, but was previously shown to be involved in heparin binding. When HA is bound, Lys54 becomes less mobile, providing evidence for an allosteric effect linking the HA and heparin-binding sites. A mechanism is suggested involving the beta2-strand and alpha2-helix. The crystal structure of free Link_TSG6 contains five molecules in the asymmetric unit that are highly similar to the NMR structure and support the dynamic behaviour seen near the HA-binding site: they show little or no electron density for the beta4/beta5 loop and display multiple conformations for the Cys47-Cys68 disulfide bond. The crystal structures were used in docking calculations with heparin. An extended interface between a Link_TSG6 dimer and heparin 11-mer was identified that is in excellent agreement with previous mutagenesis and calorimetric data, providing the basis for further investigation of this interaction.     

数字化骨科理念辅助椎弓根置钉在寰枢椎不稳中的临床应用

目的:探讨3D打印辅助置钉技术用于寰枢椎不稳椎弓根置钉的安全性及准确性。方法:收集2013年1月到2015年1月西安交通大学第一附属医院收治的寰枢椎不稳病例,术前采用3D打印技术构建个体化3D打印模型,在模型上模拟置钉,获取最佳置钉点、置钉角度等个体化置钉数据,并于术中辅助椎弓根螺钉置入。通过CT扫描评价置钉准确性,测量术前、术后患者寰齿间隙判断寰枢椎复位情况,测量颈延角评价脊髓压迫改善情况,并采用日本骨科学会(JOA)评分判断患者脊髓功能改善情况。术后定期随访观察固定效果、稳定性、神经损伤等手术并发症的发生情况。结果:13例患者均采用3D打印辅助置钉技术进行内固定治疗,手术顺利,术中及术后无血管、神经损伤等并发症,复位及内固定效果满意。共置入椎弓根螺钉31枚,其中29枚完全在椎弓根内,置钉准确率为93.5%。寰枢椎较术前明显复位,术后寰齿间隙、颈延角和JOA评分较术前明显改善,差异具有统计学意义(P0.05)。结论:3D打印技术辅助上颈椎椎弓根置钉的准确性及安全性均较高。     

皮质骨轨迹螺钉与椎弓根螺钉行经椎间孔入路椎间融合术的疗效比较

目的:探讨皮质骨轨迹螺钉(cortical bone trajectory,CBT)与椎弓根螺钉(pedicle screw,PS)行经椎间孔入路椎间融合术(transforaminal lumbar interbody fusion,TLIF)治疗腰椎退行性疾病的临床疗效。方法:选取2016年5月至2018年5月采用TLIF治疗的腰椎退行性疾病患者资料50例作为研究对象,其中行CBT螺钉固定组25例,行PS螺钉内固定组25例。分别记录患者一般资料、围手术期参数及并发症发生情况。腰痛VAS评分、腿痛VAS评分及ODI功能指数评分评估临床效果。Bridwell分级标准评价两组融合情况。结果:平均随访时间16.72±3.6个月。两组患者在性别、年龄、疾病诊断、手术节段方面组间差异无统计学意义(P0.05)。皮质骨轨迹螺钉组平均手术时间及术中出血量为171.88±25.75 min、225.20±51.57 m L,椎弓根螺钉组为221.24±33.53 min、297.60±66.40 m L,两组比较差异有统计学意义(P0.05)。两组患者术后1月及末次随访腰痛VAS评分、腿痛VAS评分及ODI功能指数评分均较术前有明显改善,两组间差异无统计学意义。末次随访两组患者均取得骨性融合。结论:对于腰椎退行性疾病患者,采用CBT螺钉和PS螺钉内固定方式行TLIF均能到达良好的临床疗效及融合率,采用皮质骨轨迹螺钉行TLIF患者手术时间短,术中出血量更少。     

Stress analysis of a centrally fractured rib fixated by an intramedullary screw

The stress on an intramedullary screw rib fixation device holding together a centrally fractured human rib under in vivo force loadings was studied using finite element analysis (FEA). Validation of the FEA modelling using pullout from porcine ribs proved FEA to be suitable for assessing the structural integrity of screw/bone systems such as rib fixated by a screw. In the human rib fixation investigation, it was found that intramedullary bioresorbable Bioretec screws can fixate centrally fractured human ribs under normal breathing conditions. However, under coughing conditions, simulation showed Bioretec fixating screws to bend substantially. High stresses in the screw are mainly the result of flexion induced by the force loading, and are restricted to thin regions on the outside of the screw shaft. Stiffer screws result in less locally intense stress concentrations in bone, indicating that bone failure in the bone/screw contact regions can be averted with improvements in screw stiffness.     

Human platelet 12-lipoxygenase, new findings about its activity, membrane binding and low-resolution structure

Human platelet 12-lipoxygenase (hp-12LOX, 662 residues + iron nonheme cofactor) and its major metabolite 12S-hydroxyeicosatetraenoic acid have been implicated in cardiovascular and renal diseases, many types of cancer and inflammatory responses. However, drug development is slow due to a lack of structural information. The major hurdle in obtaining a high-resolution X-ray structure is growing crystals, a process that requires the preparation of highly homogenous, reproducible and stable protein samples. To understand the properties of hp-12LOX, we have expressed and studied the behavior, function and low-resolution structure of the hp-12LOX His-tagged recombinant enzyme and its mutants in solution. We have found that it is a dimer easily converted into bigger aggregates, which are soluble/covalent-noncovalent/reversible. The heavier oligomers show a higher activity at pH 8, in contrast to dimers with lower activity showing two maxima at pH 7 and pH 8, indicating the existence of two different conformers. In the seven-point C → S mutant, aggregation is diminished, activity has one broad peak at pH 8 and there is no change in specificity. Truncation of the N_t-β-barrel domain (PLAT, residues 1-116) reduces activity to ∼ 20% of that shown by the whole enzyme, does not affect regio- or stereospecificity and lowers membrane binding by a factor of ∼ 2. “NoPLAT” mutants show strong aggregation into oligomers containing six or more catalytic domains regardless of the status of the seven cysteine residues tested. Time-of-flight mass spectrometry suggests two arachidonic acid molecules bound to one molecule of enzyme. Small angle X-ray scattering studies (16 Å resolution, χ∼ 1) suggest that two hp-12LOX monomers are joined by the catalytic domains, with the PLAT domains floating on the flexible linkers away from the main body of the dimer.     

有限接触动力加压钢板与微创拉力螺钉治疗投弹骨折疗效比较

目的:评价有限接触动力加压钢板与微创拉力螺钉固定治疗肱骨投弹骨折的临床疗效。方法:回顾性分析2013年12月至2016年2月收治的37例肱骨投弹骨折的临床资料。其中29例行切开复位钢板内固定治疗,8例行有限切开复位拉力螺钉固定。两组研究对象性别、年龄、入伍前受教育程度、受伤至手术时间等一般资料比较,无显著性统计学差异(p0.05),术后定期行临床检查及X线检查,根据MEPS肘关节功能评分标准评价肘关节功能。结果:切开复位LC-DCP内固定组手术时间及术中出血显著多于有限切开拉力螺钉固定组(p0.05);两组住院时间无统计学差异(t=1.615,P=0.127),两组患者均获得随访,随访时间9-36月,平均12月。术后6个月,两组骨折愈合率均为100%,无统计学差异,切开复位LC-DCP内固定组,骨折愈合时间9.93±3.05周,有限切开拉力螺钉固定组骨折愈合时间11.09±2.33周,比较无显著性差异(t=1.07,p=0.302)。术后桡神经挫伤(钢板内固定组2例,螺钉内固定组1例)和肘关节功能评价比较,两组无统计学差异(p0.05)。两组术后均未出现内固定失效、感染、骨不连等并发症。结论:采用切开复位LC-DCP内固定及有限切开拉力螺钉固定治疗投弹骨折均可取得较好临床疗效,使用钢板内固定时注意避免过多破坏骨折断端血运和保护桡神经;使用螺钉内固定时需要注意术后肩肘关节支具保护6-8周,避免早期主动功能锻炼,导致内固定失效。     

Isolation and characterization of microsatellite markers in the new world screw‐worm Cochliomyia hominivorax (Diptera: Calliphoridae)

The new world screw‐worm, Cochliomyia hominivorax, is one of the most important parasitic insect pests. This species causes myiasis and, consequently, significant losses to livestock industries in neotropical regions. As part of an investigation into the genetic variability and population structure of the new world screw‐worm, a set of 10 polymorphic microsatellite markers was isolated from an AC‐enriched genomic library. Amplification of the reported loci in 30 screw‐worms revealed an average of 6.9 alleles per locus with expected heterozygosities ranging from 0.3831 to 0.8022. Cross‐species amplifications suggested that these loci may be useful in other Calliphoridae species.