目的探讨自体富血小板血浆（platelet-rich plasma，PRP）联合骨搬移技术在治疗胫骨缺损方面的有效性及安全性。方法采用前瞻性随机对照单盲的方法，选取2013年1月至2015年3月因创伤、感染因素造成的胫骨骨缺损的28例患者，采用随机数表加密闭信封方法将全部患者随机分为两组，其中PRP联合骨搬移组（简称PRP组）15例及单纯骨搬移组13例。PRP组15例，男12例，女3例；平均年龄40．9岁；平均骨缺损长度7．1cm；创伤性6例，感染性9例。骨搬移组13例，男10例，女3例；平均年龄37．7岁；平均骨缺损长度6．5cm；创伤性3例，感染性10例。采用Ilizarov方法研究与应用学会（Association of the Study and Application of the Method of Ilizarov，ASAMI）分类评价骨愈合及下肢功能情况，并记录两组外固定支架指数（患者佩戴外固定支架的时间除以骨搬移长度或骨延长长度）、并发症及术后疼痛情况[采用视觉模拟评分（visual analogue scale，VAS）进行评价]等。结果PRP组和骨搬移组的平均随访时间分别为21．8个月和23．2个月。PRP组15例骨缺损均愈合，愈合时间为平均183．2d；骨搬移组13例患者中，11例骨缺损愈合，愈合时间平均218．6d，2例骨缺损未愈合，经再次手术打通髓腔，植骨后愈合。术后疼痛VAS评分：术后第1天，PRP组（3．33±2．58）分，骨搬移组（4．46±2．73）分；第7天，PRP组（2．67±2．09）分，骨搬移组（3．00±2．20）分；术后两周，PRP组（1．46±1．77）分，骨搬移组（2．62±2．72）分；各时间点两组比较差异均无统计学意义。两组外固定支架指数，PRP组为（37．9±7．7）d／cm，骨搬移组为（46．9±13．7）d／cm，两组比较差异有统计学意义。按照ASAMI评价骨折愈合情况，PRP组9例评价为优，5例为良，优良率为93．3％（14／15）；骨搬移组7例评价为优，3例为良，优良率为76．9�
Many studies have reported the relationship between CXCL12 G801 A polymorphism and cancer risk, with conflicting results. In this study, we tried to clarify the possibility that this polymorphism may increase cancer risk by conducting an updated meta-analysis. Pub Med and EMbase were searched for case-control studies regarding the association of the gene polymorphism and cancer risk. Data were extracted and odds ratios（ORs） with 95% confidence intervals（95% CIs） were used to assess the strength of the association. Heterogeneity among articles and publication bias was also assessed. Significantly increased risk for cancer was found（A vs. G： OR=1.26, 95% CI=1.13-1.40, P〈0.01; AA＋AG vs. GG： OR=1.33, 95% CI=1.16-1.52, P〈0.01）. In subgroup analysis, statistically elevated cancer risk was found in both Asian and Caucasian populations（for Asian, AA＋AG vs. GG： OR=1.74, 95% CI=1.22-2.47, P〈0.01; for Caucasian, AA＋AG vs. GG： OR=1.24, 95% CI=1.09-1.42, P〈0.01）. Our result indicated that CXCL12 G801 A polymorphism is a risk factor for cancer. To validate the finding, further large-size case-control studies are warranted.
