复杂胫骨平台骨折18例治疗方法探讨

目的探讨复杂胫骨平台骨折的治疗方法和临床疗效。方法自2006年1月至2008年6月,笔者对复杂胫骨平台骨折进行了手术治疗并获随访的病例共18例,所有病例术前均予X线、CT、MRI检查,并按Schatzker分型：IV型IO例,V型12例,VI型6例。结果平均随访8个半月,均获骨性愈合,无螺钉松动、断裂。根据Merchant标准综合评分：优12例,良4例,可2例。优良率83.3%。结论在良好复位,有效稳固的支撑固定下早期功能锻炼,不仅有利于骨折愈合,还对关节功能的最大恢复起着重要作用。     

bFGF/BMP/ 胶原膜加速颌骨骨折愈合的大体及X 线观察

目的:了解胶原膜作为生长因子缓释材料治疗颌骨骨折的应用前景。方法:将100μg的rhBMP-2用1ml的bFGF溶液完全溶解;用移液器移出40μl的该溶液,滴加到面积为0.5cm×1cm的胶原膜组织块中,冻干后制成生长因子缓释系统;在12只新西兰大白兔两侧制成人工下颌骨骨折模型,左侧置放bFGF/BMP/胶原膜;右侧均为空白对照;术后2、4、12周行临床大体观察及X线片观察。结果:实验组骨折愈合速度明显快于对照组。术后2周,X线结果显示bFGF/BMP/胶原膜组骨折断端边缘模糊。对照组骨折线明显。术后4周,X线结果显示bFGF/BMP/胶原膜骨折线基本不可见,骨折对位良好,断端边缘基本消失,骨折无错位。对照组骨折下缘可见纤维性骨痂形成,骨折线模糊。术后12周,各组X线结果无差异,骨折部位接近正常骨组织。结论:bFGF/BMP/胶原膜能加速骨折愈合,提高骨折愈合效果。     

In the limb AER Bmp2 and Bmp4 are required for dorsal-ventral patterning and interdigital cell death but not limb outgrowth

The apical ectodermal ridge (AER) in the vertebrate limb is required for limb outgrowth and patterning. To investigate the role BMP ligands expressed in the AER play in limb development we selectively inactivated both Bmp2 and Bmp4 in this tissue. The autopods of mice lacking both of these genes contained extra digits, digit bifurcations and interdigital webbing due to a decrease in programmed cell death and an increase in cell proliferation in the underlying mesoderm. Upon removal of Bmp2 and Bmp4 in the AER, no defects in proximal-distal patterning were observed. At the molecular level, removal of Bmp2 and Bmp4 in the AER caused an increase in Fgf expression, which correlated with an increase in both the width and length of the AER. Investigation of Engrailed-1 (En1) expression in the AER of limb buds in which Bmp2 and Bmp4 had been removed indicated that En1 expression was absent from this tissue. Our data suggests that AER expression of Bmp2 and Bmp4 is required for digit and dorsal-ventral patterning but surprisingly not for limb outgrowth.     

人工半肩关节置换治疗肱骨近端粉粹骨折的疗效及影响因素分析

目的:探讨人工半肩关节置换治疗肱骨近端粉粹骨折的疗效及其影响因素。方法:选择2010年1月-2013年12月间我院收治的肱骨近端粉粹骨折患者80例,随机分为研究组和对照组,每组40例,研究组应用人工半肩关节置换治疗,对照组应用切开复位内固定治疗。对比两组的术中情况、术后疼痛强度以及不良情况发生情况,术后应用Constant-Murlay评分评价两组肩关节功能。应用多因素Logistic回归分析分析疗效影响因素。结果:研究组手术时间、术中出血量均显著低于对照组(P<0.05);研究组Constant-Murlay中疼痛、ADL、ROM和总分评分显著优于对照组(P<0.05);手术前,两组患者VAS评分无统计学差异(P>0.05),手术后两组患者VAS评分显著降低,术后5 d、15 d、30 d和60 d,研究组VAS评分显著低于对照组(P<0.05);对照组患者肌力不足、异位骨化等不良反应发生率显著高于对照组(P<0.05)。以Constant-Murlay总分为因变量,以年龄、性别、是否合并内科疾病、受伤原因、骨折分型、受伤时间为自变量,经Logistic分析显示,年龄、合并内科疾病、骨折分型、受伤时间是肱骨近端粉碎性骨折疗效的影响因素(P<0.05)。结论:人工半肩关节置换治疗肱骨近端粉粹骨折安全有效,具有很高的临床价值,值得临床推广,同时在手术中应对影响疗效的因素予以注意,提高治疗效果。     

A random fatigue of mechanize titanium abutment studied with Markoff chain and stochastic finite element formulation

To measure fatigue in dental implants and in its components, it is necessary to use a probabilistic analysis since the randomness in the output depends on a number of parameters (such as fatigue properties of titanium and applied loads, unknown beforehand as they depend on mastication habits). The purpose is to apply a probabilistic approximation in order to predict fatigue life, taking into account the randomness of variables. More accuracy on the results has been obtained by taking into account different load blocks with different amplitudes, as happens with bite forces during the day and allowing us to know how effects have different type of bruxism on the piece analysed.     

关节镜下逆行交锁髓内钉治疗股骨远端骨折36例分析

目的:探讨关节镜下逆行交锁髓内钉治疗股骨远端骨折的疗效、特点及其必要性.方法:采用关节镜下逆行交锁髓内钉进行手术治疗36例股骨远端骨折.结果:36例中膝关节内病损17例,经随访6个月至2年,平均10月,膝关节活动度90°～140°,平均125°.骨折愈合时间3～9个月,平均6个月.结论:关节镜引导下逆行交锁髓内钉治疗股骨远端骨折,同时对膝关节内损伤或病变明确诊断并进行相应处理,避免漏诊,手术时间短,最大限度地保留了膝关节的解剖与功能的完整性,对膝关节损伤小,值得推广.     

Unusual features of intercellular junctions in the larvacean Oikopleura dioica

Summary In the pelagic larvacean Oikopleura dioica, the epithelium lining the alimentary tract consists of ciliated and unciliated cell types. The ciliated cells also exhibit an apical border of long microvilli. Between the microvilli, the cellular membrane often projects deeply down into the cytoplasm; the membranes of these invaginations and those of apicolateral interdigitations may be associated with one another by tight junctions. Some of these junctions may be autocellular. The tight junctions are seen by freeze-fracture to be very simple in construction, composed of a single row of intramembranous particles, which may be fused into a P-face ridge. There is a dense cytoplasmic fuzz associated with these tight junctions which may extend into adjoining zonula adhaerens-like regions. The invaginations of the apical membranes are, in addition, associated by gap junctions which may also be autocellular. More conventional homocellular and heterocellular tight and gap junctions occur along the lateral borders of ciliated cells and between ciliated and unciliated cells. These gap junctions possess a reduced intercellular cleft and typical P-face connexons arranged in macular plaques, with complementary E-face pits. Both cell types exhibit extensive stacks of basal and lateral interdigitations. The tight junctions found here are unusual in that they are associated with a dense cytoplasmic fuzz which is normally more characteristic of zonulae adhaerentes.     

Influence of the Cytoplasmic Domains of Aquaporin-4 on Water Conduction and Array Formation

Phosphorylation of Ser180 in cytoplasmic loop D has been shown to reduce the water permeability of aquaporin (AQP) 4, the predominant water channel in the brain. However, when the structure of the S180D mutant (AQP4M23S180D), which was generated to mimic phosphorylated Ser180, was determined to 2.8 Å resolution using electron diffraction patterns, it showed no significant differences from the structure of the wild-type channel. High-resolution density maps usually do not resolve protein regions that are only partially ordered, but these can sometimes be seen in lower-resolution density maps calculated from electron micrographs. We therefore used images of two-dimensional crystals and determined the structure of AQP4M23S180D at 10 Å resolution. The features of the 10-Å density map are consistent with those of the previously determined atomic model; in particular, there were no indications of any obstruction near the cytoplasmic pore entrance. In addition, water conductance measurements, both in vitro and in vivo, show the same water permeability for wild-type and mutant AQP4M23, suggesting that the S180D mutation neither reduces water conduction through a conformational change nor reduces water conduction by interacting with a protein that would obstruct the cytoplasmic channel entrance. Finally, the 10-Å map shows a cytoplasmic density in between four adjacent tetramers that most likely represents the association of four N termini. This finding supports the critical role of the N terminus of AQP4 in the stabilization of orthogonal arrays, as well as their interference through lipid modification of cysteine residues in the longer N-terminal isoform.     

Strategies of burrowing in soft muddy sediments by diverse polychaetes

Muddy sediments are elastic solids through which morphologically diverse animals extend burrows by fracture. Muddy sediments inhabited by burrowing infauna vary considerably in mechanical properties, however, and at high enough porosities, muds can be fluidized. In this study, we examined burrowing behaviors and mechanisms of burrow extension for three morphologically diverse polychaete species inhabiting soft muddy sediments. Worms burrowed in gelatin, a transparent analog for muddy sediments, and in natural sediments in a novel viewing box enabling visualization of behaviors and sediment responses. Individuals of Scalibregma inflatum and Sternaspis scutata can extend burrows by fracture, but both also extended burrows by plastic deformation and by combinations of fracture and plastic deformation. Mechanical responses of sediments corresponded to different burrowing behaviors in Scalibregma; direct peristalsis was used to extend burrows by fracture or a combination of plastic deformation and fracture, whereas a retrograde expansive peristaltic wave extended burrows by plastic deformation. Burrowing speeds differed between behaviors and sediment mechanical responses, with slower burrowing associated with plastic deformation. Sternaspis exhibited less variability in behavior and burrowing speed but did extend burrows by different mechanisms consistent with observations of Scalibregma. Individuals of Ophelina acuminata did not extend burrows by fracture; rather individuals plastically deformed sediments similarly to individuals of the related Armandia brevis. Our results extend the range of natural sediments in which burrowing by fracture has been observed, but the dependence of burrow extension mechanism on species, burrowing behavior, and burrowing speed highlights the need for better understanding of mechanical responses of sediments to burrowers.