Percent osteonal bone versus osteon counts: the variable of choice for estimating age at death.

Ahlqvist and Damsten's (1969) modification of the Kerley (1965) method for histological age estimation uses percent osteonal bone, rather than actual osteon counts, in order to eliminate the difficulty of distinguishing between intact and fragmentary osteons. Since their method has been developed for the femur only, and several more recent methods have been proposed that utilize percent osteonal bone, a study was undertaken to ascertain the relative value of percent osteonal bone compared with osteon counts to estimate age at death for the radius, tibia, and fibula. First the question of how much of the cross-section of a bone should be sampled was addressed by comparing the results of regression against age for percent osteonal bone derived from sampling only four fields with those derived from the entire cross-section of the radius. A significant age association was found only when the entire cross-section was sampled. In order to evaluate the relative merit of using either percent osteonal bone, or osteon counts to estimate age, each variable was regressed against age. Significant correlation coefficients were found for all three bones when the independent variable was osteon counts. When percent osteonal bone was employed, a significant correlation was found only for the radius. Stepwise linear regression found osteon counts for the fibula alone to be the best age predictor. Finally, a repeated measures analysis of variance revealed that percent osteonal bone and osteon counts both differ among the three bones within an individual. Based upon these results, osteon counts, rather than percent osteonal bone, should be the variable of choice when developing histological age predicting methods.     

下肢长骨骨重的非对称性

本文测量82副中国成年下股长骨即股骨,胫骨和腓骨的重量,在两侧骨重相差>1％时,则股骨、胫骨和腓骨及其三骨总重均以非对称性为多,均具有非常显著性差异(P<0.001)。除腓骨重具有明显侧别差异外,其余无显著性侧别差异,对腓骨侧差解释为:①腓骨主要机能是肌的附着,而下肢对踢和足趾取物具有明显的侧别差异;②以两侧骨重相差>1％时为非对称性的标准,由于腓骨绝对重量较小,在两侧相差<0.5克时即多属非对称性。     

Bilateral asymmetry in bone measurements of the hand and lateral hand dominance

Two hundred thirty–five (235) normal male participants of the Baltimore Longitudinal Study were classified as right handed, left handed, and ambidextrous on the basis of their grip–strength performance. Their left and right hands were also radiographed and the measurements of the second metacarpal bones were evaluated on the basis of hand dominance. The results indicated that, as a rule, the right hand measurements are higher than those of the left hand, regardless of hand dominance. The bilateral differences in total width, length, total area and cortical area are significant among the right hand dominant and nonsignificant among the left hand dominant. Regardless off hand dominance the bilateral differences in medullary width are nonsignificant. These results suggest an inherent tendency of the right second metacarpal to have more bone than the left regardless of hand dominance. Differential stress due to hand dominance will increase the bilateral difference in the right handed and reduce it in the left handed.     

带腓肠腱膜的腓肠神经营养皮瓣修复KuwadeⅣ型跟腱缺损

目的:回顾性分析带腓肠肌腱膜的腓肠神经营养皮瓣修复KuwadeⅣ型跟腱缺损的临床病例,探讨其手术注意事项及治疗经验。方法:总结2008年5月-2013年8月收治的KuwadeⅣ型跟腱缺损19例,应用带腓肠肌腱膜的腓肠神经营养皮瓣进行一期修复。7例为新鲜损伤,12例为陈旧性缺损。19例跟腱缺损均伴有皮肤及软组织坏死,皮肤缺损范围为4.0 cm×6.0 cm-6.0cm×12.0 cm,跟腱缺损长度为5-9 cm,术中皮瓣切取范围为6.0 cm×5.5 cm-12.0 cm×8.0cm,腓肠腱膜切取范围5.5 cm×6.0cm-10.0 cm×6.0 cm;供区游离植皮修复。客观性评价指标包括关节跖屈、背伸动度及形态学,主观性评价采用AOFAS评分。结果:术后17例跟腱功能重建良好,2例感染控制不良,跟腱移植体部分坏死。皮瓣完全成活13例,创面Ⅰ期愈合。2例术后6天皮瓣远端表皮坏死,经换药后愈合。2例术后10天皮瓣远端部分坏死,经局部皮瓣移位修复愈合,2例感染控制不良者,皮瓣未愈合,移植跟腱部分坏死,经再次清创后,行阔筋膜条修复术,局部皮瓣移位修复。术后19例均获随访,随访时间6~24个月,平均18个月。术后皮瓣略臃肿,但不影响穿鞋,行走功能恢复良好,术后1年AOFAS评分平均80.31分。结论:带腓肠肌腱膜的腓肠神经营养皮瓣用于治疗KuwadeⅣ型跟腱缺损,可以同时修复皮肤及跟腱缺损,是一种较为理想的一期修复方法。     

前臂皮瓣修复外伤性颌面部缺损的护理体会

目的:探讨颌面部外伤后遗留大面积软组织缺损采用血管化游离前臂皮瓣修复的护理方法。方法:采用前臂皮瓣血管吻合修复17例外伤导致的颌面部软组织缺损,围术期采取严格的护理措施,术前的心理护理、术后的严密观察,最大限度防止皮瓣血管危象发生,保证治疗效果。结果:2例出现血管危象,进行抢救,其中1例失败,另1例抢救成功,其余15例顺利成活。结论:术前进行心理护理、术后严密观察、及时抢救是确保手术成功的关键。     

探讨生物活性接骨板研制的动物实验模型

目的探索生物活性接骨板修复骨折和骨缺损的动物实验模型,为研制不同强度的生物活性接骨板、观察骨折和骨缺损修复的机制提供实验对象。方法通过观察2.0cm兔股骨骨折和去骨膜缺损动物模型、2.0cm兔胫骨骨折和去骨膜缺损动物模型以及2.0cm兔桡骨骨折和去骨膜缺损动物模型,比较三种不同动物实验模型在兔节段性骨折和缺损实验修复中的大体标本及其术后4周的X线图片,了解三种动物实验模型在生物活性接骨板研制中的优缺点。结果2.0cm兔股骨骨折和去骨膜缺损组及2.0cm兔胫骨骨折和去骨膜缺损组术后均出现固定石膏脱落,生物活性接骨板断裂,骨折和缺损部位移位等现象;而2.0cm兔桡骨骨折和去骨膜缺损组术后4周X片发现生物活性接骨板的固定和复位良好,并且有骨痂形成。结论2.0cm兔桡骨骨折和去骨膜缺损动物模型,较好地模拟人体骨折和骨缺损的愈合过程,可能是研制生物活性接骨板的最佳动物实验模型之一。     

Stress intensity variations in bone microcracks during the repair process

Microscopic cracks form and grow in compact bone in vivo due to cyclic loading. Their growth can cause stress fractures and has been implicated in the processes of remodelling and adaptation. These cracks are repaired by the actions of BMUs which are mobile resorption cavities. In this work, we studied the interaction between cracks and BMUs by making finite element models representing different stages in the repair process. The tendency of the crack to grow was measured by its stress intensity factor, K. We found that K changes in a complex manner during the repair process, both decreasing and increasing depending on the size of the crack and the type of loading applied. For loading conditions similar to those that exist in vivo, the presence of the BMU can cause K to rise significantly, in some cases by more than 20%, implying a substantial increase in crack growth rate. This information is important for our general understanding of the complexities of the repair process, and especially for the development of theoretical models to simulate damage and repair in bone.     

血管内皮细胞生长因子促进成骨作用的研究进展

骨组织的生长和血供密切相关 ,血管内皮细胞生长因子 (VEGF)被公认为是诱导血管生成作用最强的一种细胞因子 ,其自身也和骨形成有着直接的关系。通过对VEGF及其受体分子结构、其在骨发育和骨损伤修复中所起作用、以及目前常见应用方式的相关研究作一系统性回顾 ;阐述了VEGF在软骨内成骨、膜内成骨过程中所起的促进作用 ,对成骨细胞和破骨细胞的积极影响 ,增强其表达的相关条件 ,以及各应用方式的利弊 ;从而展示了VEGF在骨缺损修复中的良好的前景。     

Lower limb bone structure of Middle Pleistocene hominins from the Caune de l’Arago (Tautavel,France): Evolutionary and functional comparison with the penecontemporaneous hominins of Sima de los Huesos (Atapuerca,Spain)

The Caune de l’Arago (Arago) and Sima de los Huesos (Sima) human bones from the European Middle Pleistocene are penecontemporaneous, although the Sima hominins are closely related to Neandertal, and Arago hominins present more archaic features. In previous and in press studies, the cross-sectional geometric properties (CSG) of lower limb bones of Arago and Sima have been studied separately without comparative analyses. Here, in order to bridge this gap, we use the same criteria for both samples to highlight evolutionary affinities and to compare their level and pattern of mobility. This study focuses on the femur, fibula and tibia from Arago and Sima with references to fossils from the sites of Trinil, Zhoukoudian and Lazaret, and ancient and recent Homo sapiens (including athletes and non-athletes). We analyze the cross-sectional areas, biomechanical bone “shape” indices (Ix/Iy, Imax/Imin) and pattern of cortical bone distribution. All lower limb bones from Arago have noticeably high to very high relative cortical areas and low to very low medullary areas. The overall femoral pattern in Arago, like Sima, is similar to that of Middle Pleistocene hominins (e.g., low femoral shape indices, Ix/Iy) and Neandertals (e.g., large cross-sectional size). However, the femoral midshaft in Sima presents prominent posteromedial cortical thickening, as a result of a spiral cortical reinforcement along the medial side of the diaphysis. This characteristic is specific to Neandertal and some Middle Pleistocene hominins. In contrast, the midshaft femoral pattern in Arago is close to that of some Homo erectus. We also note that the femoral cross-sectional size and relative cortical area in Arago differ drastically to the small size and low relative cortical area of Lazaret and Trinil hominins. The very high shape index at midshaft (i.e., high Imax/Imin) of the Arago tibia is observed in ancient H. sapiens and runners; the tibial posterior “pilaster” is found in Neandertals and ancient H. sapiens; and the flat or convex tibial faces are similar to Neandertals. Furthermore, the Arago fibulas show marked fibular posterolateral cortical reinforcement with low anteroposterior strengthening. These leg features (tibia, fibula) are also found in some Sima hominins (but not in all individuals). Consequently, this study confirms the presence of archaic features in Arago and the close evolutionary relationship between Sima and Neandertal. This proposition is mainly based on the femoral midshaft pattern influenced by the pelvofemoral complex, considered to be substantially genetically controlled. The leg functional analysis highlights a high level of mobility and travelling in uneven terrains or in mountainous areas in Arago, consistent with known environments and hunting practices. Previously, an analogous hypothesis was proposed put forward for Sima hominins.     

颏下岛状皮瓣修复口腔颌面部肿瘤术后缺损60 例分析

目的:对颏下岛状皮瓣修复口腔颌面部肿瘤术后缺损患者进行观察与探讨,为临床应用颏下岛状皮瓣修复治疗存在口腔颌面部肿瘤术后缺损情况的患者提供依据。方法:对2013年6月到2015年6月期间在医院接受颏下岛状皮瓣修复治疗的60例口腔颌面部肿瘤术后缺损患者进行临床回顾性研究,按照是否存在颈淋巴结转移分为两组进行研究比较。结果:研究组口腔颌面部肿瘤术后缺损患者的颏下岛状皮瓣存活率,术后复发率,术后6个月、1年、2年的生存率,术后并发症总发生率,总满意度与对照组口腔颌面部肿瘤术后缺损患者相比,组间差异不明显(P0.05),不具有统计学意义。结论:使用颏下岛状皮瓣修复治疗口腔颌面部肿瘤术后缺损患者的效果较好,大多数患者对于临床修复治疗效果比较满意。而且,对存在颈淋巴结转移的患者实施颈部淋巴结的清扫术及术后放疗对于临床疗效的影响不大,基本不影响皮瓣的存活,具有重要的临床应用价值。     

Construction of recombinant adenovirus vector containing hBMP2 and hVEGF165 genes and its expression in rabbit Bone marrow mesenchymal stem cells

To construct an adenovirus vector co-expressing human bone morphogenetic protein (hBMP2) and human vascular endothelial growth factor (hVEGF165) as well as green fluorescence protein (GFP) as a marker, with which the intracellular expression of the inserted genes could be identified in Bone marrow mesenchymal stem cells (BM-MSCs). BMP2 and VEGF165 genes were PCR amplified from a cDNA library and inserted to the polyclonal site of adenovirus shuttle plasmid pAd-MCMV-GFP. The virus solution (Ad-BMP2-VEGF165) was generated by co-transfecting HEK293 cells with the constructed recombinant shuttle plasmid pAd-MCMV-BMP2-VEGF165 and adenovirus helper plasmid pBHGloxΔ (delta) E1, 3Cre. The virus solution was further purified and virus titer was determined accordingly. The expression of the target genes was subsequently detected and quantified in rabbit BM-MSCs by using real time PCR, ELISA and Western blotting. The recombinant adenovirus vector containing BMP2 and VEGF165 (Ad-BMP2-VEGF165) was successfully constructed, which was confirmed by Sanger sequencing, colony PCR, as well as visually detection of GFP, and the titer of the adenovirus was 1 × 10¹⁰ PFU/mL, and the proteins level of BMP2 and VEGF165 secreted in the supernatant are significantly higher than the control. Recombinant adenovirus vector containing hBMP2 and hVEGF165 genes was successfully constructed. The transfection rate of BM-MSCs by the adenovirus was high (95% at 100 MOI) and the BMP2 and VEGF165 genes was highly expressed in the cells. The present study provides a method to efficiently express the target genes in BM-MSCs and an vector for further research of bone defect repair using dual genes of BMP2 and VEGF165.     

Reconstruction of radial bone defect using gelatin sponge and a BMP-2 combination graft

Many bioactive molecules like recombinant human bone morphogenetic protein 2 (rhBMP-2) have been developed for mineralized bone grafts, for which proper scaffolds are necessary to successfully apply the bioactive molecules. In this study, we tested the osteogenic efficacy of rhBMP-2 produced in-house in combination with gelatin sponge as the scaffold carrier in a rabbit radial defect model. The efficacy of the rhBMP-2 was determined by alkaline phosphatase activity assay of C2C12 cells. Two groups of ten rabbits each were treated with rhBMP-2/gelatin sponge, or gelatin sponge only. At 4 weeks, rhBMP-2/gelatin sponge grafts showed more bone regeneration than gelatin sponge grafts, as determined by X-ray radiography, micro-computed tomography, and histological analyses. At 8 weeks, rhBMP-2/gelatin sponge grafts exerted much stronger osteogenic effects. The study demonstrates the improved osteogenic efficacy of the rhBMP-2/gelatin sponge grafts in a rabbit radial bone defect model acting as a bone-inductive material. [BMB Reports 2013; 46(6): 328-333]     

犬完整骨及骨水泥重建骨缺损微波灭活后的生物力学研究

目的:研究微波消融(microwave ablation)对结构正常及缺损后骨水泥修复重建的犬骨生物力学性能的影响.方法:取成年犬股骨12对,随机分为完整组和重建组,再随机选取每对股骨的一侧作为对照组,另一侧为实验组,试验由此分为四组:完整对照组,完整微波组,重建对照组,重建微波组.然后将每根股骨制作成两个不同的骨标本,分别长3 cm和6 cm.两种微波组的标本均进行微波灭活,两种重建组的标本均制备成缺损模型并行骨水泥修复重建.然后分别对3、6 cm两种标本行压缩和三点弯曲试验.结果:完整对照组与完整微波组之间,重建对照组与重建微波组之间的最大压缩力、最大压缩位移、最大弯曲力及最大挠度等均无显著性差异.结论:微波消融对结构正常的犬骨的生物力学性能无明显影响,且不会加剧对重建犬骨的力学强度的破坏.     

自固化磷酸钙人工骨修复小儿局部骨缺损的临床应用

目的：研讨自固化磷酸钙人工骨（Calcium Phosphate Cement,CPC)填充修复小儿局部骨缺损的临床意义,方法：选用CPC修复小儿骨缺损18例,年龄最小8个月,最大12岁,平均8岁,骨缺损部位：肱骨9例,胫骨6例,胫骨3例,病因,单纯性骨囊肿8例,骨纤维异常增生症5例,动脉瘤样骨囊肿4例,嗜酸性肉芽肿1例,骨缺损大小,最大7cm,最小2cm,平均5cm,CPC填充方式：单纯粉末7例,粉末＋松质骨粒6例,粉末＋条形骨块5例。CPC初步固化时间,最短15分钟,最长30分钟,平均20分钟,随访时间：13－27个月,平均18．5个月。结果：全组18例应用CPC后未见明显局部和全身不良反应。手术前后血PH值钙磷代谢无异常改变。X线片显示：CPC与宿主骨接触紧密,无脱落,术后3个月出现降解,新生骨形成。结论：CPC安全无毒,使用方便,易塑形,生物相容性好,能在体内降解,可以替代自体骨材料在小儿局部骨缺损应用。     

改良Masquelet技术治疗胫骨感染性缺损的临床疗效分析

摘要 目的：探讨和分析使用改良Masquelet技术在胫骨感染性缺损中的临床疗效。方法：回顾性分析2018.01-2022.01范围内,使用改良Masquelet治疗胫骨感染性缺损的共计21患者。通过骨愈合(Samantha X 线评分),软组织愈合,感染控制,下肢功能,并发症等方面对临床疗效进行评价。结果：21例患者均获得完整随访,随访时间为12-36个月,平均为18.6个月。所有患者均达到骨愈合标准（3.2±8.3个月）。Samantha X 线评分：1例为4分,8例为5分,12例6分。PALEY功能评分为：优9人,良11人,可1人,差0人,优良率为95.2%。患者中均未出现严重并发症(P>0.05)。结论：在胫骨感染性缺损的治疗中,改良Masquelet技术是一种简单,安全,有效的治疗方法,在临床中可以进一步推广。     

人工骨表面覆盖口腔修复膜对颌骨囊性缺损人工骨植入术患者植入腔感染的预防作用

目的:探讨人工骨表面覆盖口腔修复膜对颌骨囊性缺损人工骨植入术患者植入腔感染的预防作用。方法:将我院2012年4月～2016年2月收治的78例颌骨囊性缺损患者按治疗时间分为对照组38例与观察组40例,均行开窗人工骨植入术,其中对照组采取常规抗感染,观察组采取人工骨表面覆盖口腔修复膜。比较两组的囊腔体积、面积缩减率、人工骨植入量、骨厚度及植入腔感染率。结果:两组的囊腔体积、面积缩减率及人工骨植入量比较差异无统计学意义(P0.05)。但观察组的骨厚度明显大于对照组(P0.05),植入腔感染率明显低于对照组(P0.05)。结论:在开窗人工骨植入术的基础上使用口腔修复膜不仅能引导骨组织再生,而且能够显著降低植入腔的感染率。     

Development of the lateral line canal system through a bone remodeling process in zebrafish

The lateral line system of teleost fish is composed of mechanosensory receptors (neuromasts), comprising superficial receptors and others embedded in canals running under the skin. Canal diameter and size of the canal neuromasts are correlated with increasing body size, thus providing a very simple system to investigate mechanisms underlying the coordination between organ growth and body size. Here, we examine the development of the trunk lateral line canal system in zebrafish. We demonstrated that trunk canals originate from scales through a bone remodeling process, which we suggest is essential for the normal growth of canals and canal neuromasts. Moreover, we found that lateral line cells are required for the formation of canals, suggesting the existence of mutual interactions between the sensory system and surrounding connective tissues.     

Transplantation of engineered bone tissue using a rotary three-dimensional culture system

Bone is a complex, highly structured, mechanically active, three-dimensional (3-D) tissue composed of cellular and matrix elements. We previously published a report on in situ collagen gelation using a rotary 3-D culture system (CG–RC system) for the construction of large tissue specimens. The objective of the current study was to evaluate the feasibility of bone tissue engineering using our CG–RC system. Osteoblasts from the calvaria of newborn Wistar rats were cultured in the CG–RC system for up to 3 wk. The engineered 3-D tissues were implanted into the backs of nude mice and calvarial round bone defects in Wistar rats. Cell metabolic activity, mineralization, and bone-related proteins were measured in vitro in the engineered 3-D tissues. Also, the in vivo histological features of the transplanted, engineered 3-D tissues were evaluated in the animal models. We found that metabolic activity increased in the engineered 3-D tissues during cultivation, and that sufficient mineralization occurred during the 3 wk in the CG–RC system in vitro. One mo posttransplantation, the transplants to nude mice remained mineralized and were well invaded by host vasculature. Of particular interest, 2 mo posttransplantation, the transplants into the calvarial bone defects of rats were replaced by new mature bone. Thus, this study shows that large 3-D osseous tissue could be produced in vitro and that the engineered 3-D tissue had in vivo osteoinductive potential when transplanted into ectopic locations and into bone defects. Therefore, this system should be a useful model for bone tissue engineering.     

微波高温灭活及自体髂骨异体骨粒复合骨水泥修复治疗长骨骨巨细胞瘤骨缺损

目的：探讨微波高温灭活及自体髂骨、异体骨粒复合骨水泥修复骨巨细胞瘤病灶刮除后骨缺损的临床应用效果。方法：应用原位分离插入式微波天线高温灭活技术,自体髂骨、异体骨粒复合骨水泥修复21例长骨骨巨细胞瘤术后骨缺损,从手术技术、肿瘤复发情况、肢体关节功能等方面全面综合评价此方法临床应用效果。结果：21例患者均获得骨性愈合,无骨折及内固定断裂发生,2例复发,复发率9.8%;肢体关节功能优18例（85.7%）、良3例（14.3%）、中差0例。结论：微波高温能彻底杀灭肿瘤组织降低复发率,自体髂骨保证与近关节软骨下骨愈合,异体骨粒复合骨水泥能良好充填残余瘤腔、且具有良好的生物力学性能,以防发生关节软骨面塌陷。