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Objective To investigate the effect of quantitative ultrasound bone mineral density test on the screening of osteoporosis in patients with knee osteoarthritis and to explore the relationship between knee osteoar-thritis and osteoporosis. Methods 160 patients with knee osteoarthritis were divided into 4 groups:Ⅰ,Ⅱ,ⅢandⅣby Kellgren-Lawrence and measured height,weight,age,quantitative ultrasound bone mineral density and dual energy X-ray bone density.We compared the T values measured by quantitative ultrasound bone mineral density test and dual energy X-ray bone density,assessed the accuracy of quantitative ultrasound bone mineral density test for osteoporosis,and investigated the correlation between the value of quantitative ultrasound bone mineral density and knee osteoarthritis in different grades. Results Quantitative ultrasound bone mineral density was positively correlated with dual energy X-ray bone density(r = 0.751,P < 0.05). The AUC of diagnosis of osteoporosis by quantitative ultrasound bone mineral density test with T<-2.5 was 0.774,95% CI was 0.676 and 0.791,specificity was 96.7%,sensitivity was 85.7% and Youden index was 82.4%.With an increase in the grades of Kellgren-Law-rence,the knee osteoarthritis gradually worsened.The T values of quantitative ultrasound bone mineral density and dual energy X-ray bone density increased gradually in negative direction,and the difference was statistically signifi-cant(P<0.001).Conclusions Quantitative ultrasound bone mineral density test has good specificity and sensi-tivity and can be used to screen patients with knee osteoarthritis. The more severe the knee osteoarthritis is,the easier to develop osteoporosis.
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BACKGROUND: Ankle fracture combined with deltoid ligament rupture and distal tibiofibular syndesmosis injury occurs occasionally. Its treatment with distal tibiofibular syndesmosis screw fixation or deltoid ligament repair remains controversial. The former appears with poor reduction, broken nails, secondary surgery and other problems.OBJECTIVE: To observe the clinical effectiveness of suture anchor repair for ankle fracture combined with deltoid ligament injury.METHODS: Twelve patients with ankle fracture combined with deltoid ligament injury were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2013 and December 2015. All patients were treated with open reduction, internal fixation, and anchor repair, but without distal tibiofibular syndesmosis screw fixation. The curative efficacy and joint stability were observed.RESULTS AND CONCLUSION: (1) All patients were followed-up for more than 12 months. (2) The modified Baird-Jackson scoring system showed excellent in nine cases, good in two cases, average in one case, poor in none case, and the excellent and good rate was 92%. (3) At 1 year after internal fixation, the X-ray examination showed the malleolus gap and talus slope angle of the affect side were (3.47±0.12) mm and (0.45±0.18)°, and the malleolus gap and talus slope angle of the healthy side were (3.44±0.05) mm and (0.43±0.14)°, and there was no significant difference between two sides (P > 0.05). (4) These results indicate that the suture anchor can repair the anatomy and biomechanics of deltoid ligament with stable ankle joint, and secondary surgery is unnecessary.
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BACKGROUND: Osteoporosis is a serious threat to the health and quality of life in the elderly. It is important to establish an ideal experimental animal model to study the etiology and treatment of osteoporosis.OBJECTIVE: To establish a rat model of osteoporosis induced by different dosages of retinoic acid, thus selecting the optimal dosage.METHODS: Eighty female Sprague-Dawley rats were randomly divided into control, low-, middle- and high-dosage groups based on body mass (n=20 per group), The rats in the latter three groups were induced with 80, 100, and 120 mg/(kg?d) retinoic acid via gastric lavage for 14 days.RESULTS AND CONCLUSION: Compared with the control group, the bone mineral density, number of osteoblasts and osteoclasts, and bone microarchitecture in the low-dosage group showed no significant changes, while there were significant decrease in the serum level of calcium and bone mineral density of femur, significant increase in the number of osteoclasts at the femur and significant changes in the femoral microarchitecture in the middle- and high-dosage groups, especially in the middle-dose group. To conclude, 120 mg/(kg?d) retinoic acid via gastric lavage for 14 days can induce a stable osteoporosis model in rats.
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To improve the quality of teaching, teaching reform and exploration on integration of Ttradition Chinese Orthopedics curriculum has been carried out by orthopedics teaching and research section in our school. Putting Traditional Chinese Orthopedics as the framework of curriculum knowledge, the im-portant and difficult points of Human Anatomy and Clinical Medical Science were combined, which builds the overall teaching mode of normal-disease-cases and get some results. The evaluation of teaching effect shows thatthe integration of Traditional Chinese Orthopedicscourse will enable students to lay a solid the-oretical foundation and improve their ability.
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BACKGROUND:Fracture healing is the coupling interaction of osteoblasts and osteoclasts that promotes bone growth, in which osteoblast-mediated bone resorption and osteoclasts-mediated bone reconstruction make the bone reconstruction in a dynamic equilibrium to promote bone growth. However, the majorities of the current studies focus on osteogenic or osteoclastic mechanism alone, and ignore the interaction mechanism between these two cels under co-existing conditions. OBJECTIVE:To investigate the effects of Kidney Chinese Herbs on osteoblasts and osteoclasts coupling of osteoprotegerin-receptor activator of nuclear factor kappaB ligand-receptor activator of nuclear factor kappaB and its mechanism of action in fracture treatment. METHODS: Mouse osteoblasts and osteoclasts were isolated and cultured in vitro to establish the mouse “osteoblast-osteoclast co-culture system” as a research platform. Then, Kidney Chinese Herbs at doses of 1.25, 2.5, 6.25 g/(kg?d) were given intragastricaly for 7 consecutive days. Mice in the blank control group were fed with the same volume of normal saline. RESULTS AND CONCLUSION:The alkaline phosphatase activity in osteoblasts co-cultured with osteoclasts was significantly higher than that in osteoblasts cultured alone at 24 hours of culture (P < 0.05). Real-time PCR showed that in the co-culture system, the expression of alkaline phosphatase, Runt related transcription factor 2 and osteoprotegerin were increased in a dose-dependent manner (P < 0.05). Western blot assay showed 6.25 g/(kg?d) Kidney Chinese Herbs could dramaticaly promote the expression of osteoprotegerin and receptor activator of nuclear factor kappaB ligand, but restrained the expression of receptor activator of nuclear factor kappaB (P < 0.05). These findings indicate that Kidney Chinese Herbs can dynamicaly regulate the osteoprotegerin-receptor activator of nuclear factor kappaB ligand-receptor activator signaling pathway, and has a positive effect to promote bone reconstruction and rehabilitation.
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Objective To investigate an early diagnostic method and a rapid efficient treatment method to teat osteofascial compartment syndrome(OCS). Methods From January 2007 through December 2008,16 male patients with OCS were treated in our department.They were aged from 15 to 55 years (average,32 years).Twelve patients had OCS at the leg and 4 at the foot.All patients had no vascular or nerval injury.The modified Whiteside method was used to measure the pressue of the osteofascial compartment.All patients were treated with open decompression and vacuum sealing drainage (VSD).After swelling subsided,the wounds were directly sutured,decompresively sutured or treated with skin grafting. Merchant scoring was used to evaluate the postoperative efficacy in terms of limb-affected function,pain,gait,joint function,joint stability and range of motion. Results All patients were followed up for 12 to 14 months (average,13 months).All incisions closed up.Fourteen patients obtained excellent recovery of the function and sensation of the distal limb-affected;one patient had hypoesthesia and numbness at the the distal limb-affected; one patient had contracture,numbness and functional disturbance.By the Merchant scoring system,9 cases were excellent,5 good and 2 fair,giving a good to excellent rate of 87.5％. Conclusions The modified Whiteside method used to meausre the interstitial pressure is a reliable early diagnostic method for OCS.Decompression plus VSD may lead to rapid and efficient treatment of OCS and a reduced disability rate of the limb-affected.
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Under the guidance of the learning theory of constructivism,the mode of curriculum educational reform is designed and experimented on the"acupuncturology" on-line study website using the method of action research.The action experiment contains 3 kinds of different teaching modes: the teaching center mode,the study center mode and teacher donimated-students centered mode.A whole process intervention to question senses is carried on.The relative theoretical basis and problem-solving research methods are found out during the experiment.Phase summary is formed and the teaching project is constantly revised and become perfect.
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Objective To evaluate the therapeutic effect of proximal femoral nail(PFN)and dynamic hip screw(DHS)for intertrochanteric femoral fracture(IFF).Methods From September,2004 to May,2007,39 IFF patients treated by PFN and 36 by DHS were enrolled into the analysis.The operative complications,postoperative complications and the recovery of hip function of IFF patients were observed to evaluate the therapeutic effect of the two methods.Results The blood loss amount was higher,the incidence of postoperative complications was higher and the excellent rate of Harris score of hip function was lower in IFF patients treated by DHS than that in IFF patients by PFN(P