目的探讨骨关节炎(OA)膝关节正常及退变区域原位软骨细胞自发性[Ca^(2+)]i(细胞内游离钙离子浓度)信号特征与差异。方法以西南医院关节外科提供的OA患者膝关节置换软骨组织作为研究对象,根据软骨区域分正常组与OA组。使用Fluo-8 AM钙离子探针以及荧光显微镜观测法对组织中原位软骨细胞在不同Ca^(2+)浓度环境下自发性[Ca^(2+)]i信号进行观测;使用图像处理软件与统计学单因素方差分析法对检测结果进行分析。结果正常与OA软骨细胞在0 mM与4 mM Ca^(2+)环境中均产生自发性[Ca^(2+)]i信号,且具向相邻细胞传递特性。正常组处于4 mM Ca^(2+)浓度中,表层及中层软骨细胞自发性[Ca^(2+)]i信号各项指标与深层软骨细胞比较存在统计学差异。(1)表层vs.深层,峰值量级:(1.73±0.13)vs.(2.90±0.25);响应率:(15.08%±8.29%)vs(69.65%±5.21%);峰值数目:(0.17±0.09)vs(0.95±0.08),P<0.05。(2)中层vs深层,峰值量级:(2.03±0.76)vs(2.90±0.25);响应率:(36.75%±6.73%)vs(69.65%±5.21%);峰值数目:(0.61±0.10)vs(0.95±0.08),P<0.05。但该差异在0 mM Ca^(2+)环境中不存在。OA组在0 mM或4 mM Ca^(2+)环境中各层软骨细胞[Ca^(2+)]i信号均不存在差异;但其中层与深层软骨细胞[Ca^(2+)]i信号易受胞外Ca^(2+)浓度影响。(1)中层,4 mM vs 0 mM:峰值量级:(2.3±0.11)vs.(1.86±0.11)、响应率:(53.88%±8.21%)vs.(26.50%±8.89%)、峰值数目:(0.84±0.94)vs.(0.28±0.07),P<0.05;(2)深层,4 mM vs 0 mM:峰值数目:(0.59±0.11)vs.(0.21±0.06),P<0.05。在4 mM Ca^(2+)环境中,OA组表层与中层细胞[Ca^(2+)]i信号明显强于正常组:(1)表层,OA vs正常:峰值量级:(2.62±0.51)vs(1.73±0.13),P<0.05;(2)中层,OA vs.正常:峰值量级:(2.3±0.11)vs.(2.03±0.76),P<0.05。但深层区域中没有此差异。结论正常软骨组织内各层细胞[Ca^(2+)]i信号特征具有差异,且依赖于胞外Ca^(2+)浓度调控;OA软骨细胞[Ca^(2+)]i信号相对于正常细胞存在差异,OA软骨组织内环境的异常
Objective:To evaluate the effect of encircled fixer of shape memory alloy on bone fracture. Methods:A total of twenty patients with eighteen males and two females was studied. There were three patients with fractares in the upper one third of thighbone, five with fractures in the middle part of thighbone, six with humeral fractures, three with collarbone fractures,one with ulna fracture and two with thighbone fractures as complication of artificial hipbone arthroplasty. After exposure and fixation of fracture ends, prepared encircled fixer was inserted into 0～4℃ normal reline(NS) to lower its temperature, then pulled out with a clamp. Encircled fixer was put on the tersile side of the fractured bone(center pointed to fracture line), restored and stabilized after raising temperature in 40℃ NS. Results: Encircled fixers of shape memory alloy were used to treat twenty patients with bone fracture.Clinical concrescence was obtained in 1.5 to 3 months after operation,and the joint gained its normal function without complication. Conclusion:Encircled fixer of shape memory alloy has features as exerting vertical pressure continoulsy, little stress shield effect and convenient manipulation, especially adapt to stem fracture after artificial arthroplasty.
【目的】探讨关节镜治疗髌内侧滑膜皱襞综合征的适应证选择、手术技巧和临床疗效。【方法】2012年1月至2013年6月收治30例髌内侧滑膜皱襞综合征患者，采用关节镜下滑膜皱襞完全切除术，分别在术前及术后末次随访时采用 Lysholm评分进行膝关节功能评估。【结果】本组30例均获得随访，随访时间7～21个月，平均12个月，膝关节功能较术前明显改善，Lysholm评分较术前明显提高（90．7 vs 63．2，P＜0．05）；优和良29例，中1例，优良率96．7％，【结论】关节镜下髌内侧滑膜皱襞切除术治疗髌内侧滑膜皱襞综合征具有损伤小、关节功能恢复快等特点，能有效改善膝关节功能。
