Quantitative evaluation of lumbar spine osteoporosis by apparent diffusion coefficient and signal intensity ratio of magnetic resonance diffusion-weighted magnetic resonance imaging / 中国骨伤

OBJECTIVE@#To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis.@*METHODS@#A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L@*RESULTS@#There were statistically significant differences in ADC and SIR values among three groups (@*CONCLUSION@#ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.

Use of titanium elastic intramedullary nails in the treatment of adult midshaft clavicular fractures: technical skills, precautions and complications / 中国骨伤

<p><b>OBJECTIVE</b>To discuss surgical skills,precautions and complications of using titanium elastic intramedullary nails in the treatment of adult midshaft clavicular fractures and evaluate the therapeutic efficacy.</p><p><b>METHODS</b>From June 2006 to January 2009, 28 patients with completely displaced midshaft clavicular fractures (15 simple fractures, 8 wedge fractures and 5 comminuted fractures) were enrolled in the study,included 19 males and 9 females with a mean age of 39.0 years (range 19-67 years). The injury was on the left side in 14 cases and on the right side in 14 cases. The mean course of disease was 2.9 days. The shoulders of the patients were swollen, deformed and disabled before operation. X-rays revealed complete displacement of the clavicle. The mean clavicular shortening after injury was 6.76% vs. that measured after bone healing. The Constant-Murley Shoulder Scoring System was used to assess shoulder function, and the DASH Score was used to assess the disability degree of the upper arm.</p><p><b>RESULTS</b>Closed operation with titanium elastic intramedullary nails was undertaken in 26 cases, and open reduction was performed in the remaining two cases. Satisfactory reduction was achieved in all patients, who were followed up for a mean of 10 months (range 6-15 months). The mean union time was 11.5 weeks. No severe complication occurred in any patient. The mean clavicular shortening after bone healing was 3.38%, which was significantly different as compared with the mean clavicular shortening after injury. Constant-Murley Shoulder Score was (97.0 +/- 4.2), and DASH score was (3.4 +/- 4.8). Anatomical reduction, functional recovery and appearance were satisfactory in all patients.</p><p><b>CONCLUSION</b>Treatment of adult midshaft clavicular fractures with titanium elastic intramedullary nails is advantageous and may prove to be an alternative option for nonsurgical treatment and plate osteosynthesis of midshaft clavicular fractures in adults.</p>

Detecting and Analyzing on Mutation of Fibroblost Growth Factor Recepter 3 Gene in A Congenital Achondroplasia Family / 实用儿科临床杂志

Objective To detect and analyze the mutation of fibroblast growth factor receptor 3(FGFR3) gene among a family with congenital achondroplasia(ACH).Methods Six blood samples of family member in this pedigree were cellected according to the informed consent process for genetic research,and 2 unralted healthy human blood sample were taken as controls.The mutation at nucleotide position 1 138 on FGFR3 gene was detected by using Polymerase chain reaction and single-strand conformation polymorphism(PCR-SSCP)and polyme-rase chain reaction and restriction endonuclease technology(PCR-RFLP) methods.Results Using PCR-SSCP method firstly,only the proband with ACH and his father in this family had the same abnormal band.The amplified products including 1 138 loci on FGFR3 gene further was analyzed by Sfe Ⅰ digestion,3 fragments including 164 bp,109 bp and 55 bp were detected in the proband and his father again,and the other members in the family and 2 controls just showed 164 bp band.It indicated that just 2 patients (proband and his father) showed heterozygous G→A transition mutation at nucleotide position 1 138 on the FGFR3 gene.The amplified products at 1 138 loci was also detected by MspⅠ digestion,just 1 band was observed in all members in this family and 2 controls.It showed that there was no G→C substitution at nucleotide position 1 138.Conclusions The G→A transition mutation at nucleotide position 1 138 in transmembrane domain of FGFR3 gene may be the main cause of achondroplasia in this family.In this pedigree,the proband showed's father a de novo mutation which was transferred to his child again.