支撑应力对骨小梁分布的影响及股骨头坏死因素的研究

目的通过犬股骨颈骨折螺钉内固定模型的力学检测及组织学观察,从微观角度认识骨小梁重建对股骨头坏死的影响。方法选取18只成年田园犬制作成股骨颈骨折螺钉内固定模型,于造模后12周确认所有股骨颈骨折已愈合随机分为取钉组、取钉植骨组及不取钉组,于造模后20周分离所有犬的股骨并进行股骨颈力学测试及组织学观察。结果取钉组、取钉植骨组及不取钉组断裂点载荷、最大载荷差异有统计学意义(P0.05),不取钉组与取钉植骨组断裂点载荷大于取钉组;不取钉组最大载荷大于取钉植骨组与取钉组,取钉植骨组最大载荷大于取钉组。取钉组、取钉植骨组及不取钉组骨小梁宽度与新鲜骨面积差异有统计学意义(P<0.05);不取钉组骨小梁宽度、新鲜骨面积大于取钉植骨组,且取钉植骨组大于取钉组。结论支撑应力的改变将导致骨小梁重新分布,骨小梁再分布是影响股骨头坏死塌陷的重要因素。福建省卫生系统中青年骨干人才培养项目(2014-ZQNJC-34

术中自体血回输在骨盆骨折中的应用研究

目的通过分析自体血回输技术在骨盆骨折手术中的应用情况,为自体血回输技术在临床骨科应用的有效性及安全性提供一定参考。方法通过收集2015年2月至2018年2月期间骨盆骨折术中单纯使用自体血回输或异体血输血的患者,对符合纳入标准患者的基本信息、术中出血量、输血量、血常规、ATP酶活性、TNF-α及C3b,并使用SPSS 20.0软件进行统计学分析。结果自体血回输组与异体血输血组均为20例,其中自体血回输组术中出血量为1 127.50 ml,回输自体血量为464.00 ml;异体血输血组术中出血量为745.00 ml,异体血输血量为300.00 ml。术前自体血回输组的血红蛋白及红细胞比容（Hb:112.80 g/L,Hct:32.9%）与异体血输血组（Hb:112.00 g/L,Hct:33.4%）比较差异无统计学意义（Hb:P=0.908,Hct:P=0.510）;输血后2 h及术后第3天两组的血红蛋白及红细胞比容有所下降,但组间比较差异无统计学意义。通过对比自体血回输与异体血输血后发现两组患者在输血后ATP酶活性都有所降低,但是采用自体血回输方法能够抑制ATP酶活性的降低,组间比较发现自体血回输组ATP酶活性明显高于异体血输血组（P=0.002）。输血后两组TNF-α与C3b值都有所升高,输血前后组间比较差异均无统计学意义。结论术中自体血回输可以提高患者红细胞水平,且与异体血回输相比有更高的ATP酶活性,但并不会明显增加机体的炎症反应,是一种值得推广应用的血液管理方法。福建省自然科学基金资助项目(2016J01597);;\n福州市卫生计生科技计划项目(2016-S-wq2);;\n福州市科技计划项目(2017-S-130-5

Effect of Ginsenoside Rgl on Expression of Integrin and Regulation of Signal Transduction Pathway in Osteoblasts Co-cultured with Ti Particles

目的：通过研究人参皂甙Rg1对体外钛微粒诱导的成骨细胞整合素通路相关因子的影响,以期为临床运用人参皂甙Rg1防治人工关节无菌性松动提供实验依据。方法：用人参皂甙Rg1与钛微粒共培养成骨细胞,通过ELISA法检测细胞液中的FN,Col-Ⅰ及VN含量,Western Blot检测MG-63细胞FAK和FAK（pTyr397）蛋白的含量,qPCR法检测MG-63细胞内FAK,Integrinαv及Integrinβ1 mRNA的表达。结果：正常组细胞较大,视野内细胞数最多,实验组细胞数量次之,对照组最少且形态较小,钛微粒周围无细胞生长,并可见凋亡细胞。实验组细胞液中FN,Col-Ⅰ及VN的表达较对照组有明显增高,细胞mRNA与蛋白中FAK,FAK（pTyr397）,Integrinαv及Integrinβ明显高于对照组。结论：人参皂甙Rg1可能通过直接或间接作用于MG-63Integrin及其相关信号因子,使与钛微粒共培养的MG-63细胞被抑制的FAK磷酸化再次增强,从而VN和FN功能增强,加速细胞的分裂增殖。Objective：To study the effect of Ginsenoside Rgl on integrin pathway-related factors of osteoblasts induced by titanium particles in vitro, so as to provide experimental basis for the clinical application of Ginsenoside Rgl in the prevention and treatment of aseptic loosening of artificial joints. Methods：The osteoblasts were co-cultured with Ginsenoside Rgl and Ti particles. The con- tent of FN,Col-I and VN in cytoplasm was detected by ELISA method,the content of FAK and FAK（pTyr397） protein in MG- 63 cells was detected by western blot, the expression of FAK, integrinav and integrint31 mRNA in MCJ-63 cells was detected by qPCR method. Results：The cells in the normal group were larger, and the number of the cells within the view was the highest. The number of cells in the experimental group was the second, while the control group was the smallest and the morphology was smal- ler. There was no cell growth around Ti particles, and apoptotic cells were found near the Ti particles. The expression of FN,Col- I and VN in the cytoplasm in the experimental group was increased significantly than that in the control group. The expression of mRNA,FAK,FAK（pTyr397） ,Integrinav and Integrin]3 protein was significantly higher when compared with the control groups. Conclusion：Ginsenoside Rgl may enhance the phosphorylation of FAK again, which is inhibited by MC,-63 cells co-cultured with Ti particles,by direct or indirect acting on MG-63 Integrin and its related signaling factors,so that the function of VN and FN is enhanced to accelerate cell division and proliferation.国家自然科学基金（81302986）; 福建省卫生厅中医课题（wzgs201308