Thirty cases of femoral head osteonecrosis misdiagnosed as lumbar disc herniation / 中华老年医学杂志

Objective To analyze the causes for the femoral head osteonecrosis misdiagnosed as lumbar disc herniation.Methods Thirty cases of lumbar disc herniation receiving lumbar CT and MRI were collected,and the causes of misdiagnoses were analyzed.Results Twenty-nine cases with femoral head osteonecrosis were misdiagnosed as lumbar disc herniation.And the diagnosis of femoral head osteonecrosis was missed in a single case of lumbar disc herniation combined with femoral head necrosis.Conclusions The major factors of misdiagnoses and missed diagnosis are the neglect of physical examination,lack of detailed clinical history data collection,excessive reliance on imaging findings,and the absence of necessary differential diagnosis of similar symptoms.

Parathyroid hormone related peptides affect diabetic osteoporotic fracture / 中国组织工程研究

BACKGROUND:Parathyroid hormone related peptides are accompanied by the syndrome of humoral hypercalcemia of malignancy. As a potential therapeutic drug of promoting the healing of bone fracture, parathyroid hormone related peptides have significant clinical application value. OBJECTIVE:To explore the regulating effects of parathyroid hormone related peptides in diabetic osteoporotic fracture METHODS:A computer-based online research of CNKI and PubMed databases was performed to col ect articles published between 1990 and 2013, with the key words“parathyroid hormone related peptides, diabetes, osteoporotic fracture”in Chinese and English. There were 1 279 articles after the initial survey. A total of 43 articles were included according inclusion and exclusion criteria. RESULTS AND CONCLUSION:Animal and clinical experiments demonstrated that parathyroid hormone related peptides notably accelerate bone fracture healing, and improve the repair process of islet cellfunction defects that are related with diabetes. Meanwhile, as an analogue, parathyroid hormone has been identified as clinical medication in the treatment of fracture. But the appropriate dose, and method of application at the different stages of bone fracture healing and the problem of drug combination need further investigation.

Clinical efficacy of Qizhengxiaotong plaster plus Xianling Gubao for osteoarthritis of knee / 中国基层医药

ObjectiveTo compare and observe the clinical effect of Qizhengxiaotong plaster and Votalin emulsion in curing osteoarthritis of knee (KOA) for outpatient treatment.MethodsIn 70 cases,the KOA patients are randomly divided into treatment group and control group,respectively given Qizhengxiaotong plaster plus Xianling Gubao and Votalin emulsion for one month.To observe the clinical effects of patients respectively pre and post treatment.ResultsAfter a course of treatment,Qizhengxiaotong plaster plus Xianling Gubao could improve the clinical symptoms and signs significantly.Its improvement for pain was the same as Votalin.But Qizhengxiaotong plaster plus Xianling Gubao was significantly better than Votalin in eliminating the swollen,tenderness and dysfunction.And there was no obvious difference between Qizhengxiaotong plaster plus Xianling Gubao and Votalin emulsion in total effective rate,evaluated by WOMAC Osteoarthritis Index Guide and VRS-5.The typical symptoms were improved after the therapeutic method.No adverse reaction was found during the treatment.ConclusionQizhengxiaotong plaster plus Xianling Gubao had obvious effect on the osteoarthritis of knee and could improve the patients' pain and limitation of activity.Hence,it was worthy to be generalized in the conservative treatment of the osteoarthritis of knee for out-patients.