骨生化指标在骨肿瘤中的临床应用进展

骨肿瘤是起源于间充质细胞，发生于骨组织及其附属结构的一类良、恶性肿瘤的总称，骨肿瘤的发病率女性约为1.060/10万，男性约为1.112/10万，虽属少见的肿瘤类型，但对人体的危害大，特别是恶性肿瘤，目前疗效虽然提高，但仍不令人满意，发病趋势呈年轻，在骨科领域中占有重要地位[1]。正常的骨代谢是骨生成和骨吸收的动态平衡，这种平衡主要有骨组织中成骨细胞或破骨细胞维持，当这种平衡被打破时就会表现出各种骨疾病。骨生成和骨吸收异常伴随的生化指标及导致骨生成和骨吸收变化的相关因素均可作为骨肿瘤的生物标记。随着分子生物学技术的发展，有望通过检测骨肿瘤患者体内的生化指标变化达到早期诊断和治疗的目的。现在就骨组织生化指标在骨肿瘤患者诊治中的研究作一综述，以探讨他们的临床应用价值。

牵拉成骨术重建骨肉瘤切除后缺损一例报告

骨肉瘤为原发恶性骨肿瘤中发病率高的疾病，致死率及致残率很高，文献报道新辅助化疗后的5年生存率为50%～60%[1-3]，特别是对于儿童，由于其存在骨骼生长问题，而肿瘤往往侵犯骨骺和干骺端，保肢手术很难避免远期的肢体不等长的问题。牵拉成骨术早被广泛应用于肢体不等长、骨不愈合、创伤性骨缺损、畸形和骨髓炎的治疗，其在骨肿瘤切除手术的应用并不常见。日本学者Tsuchiya等[4]早尝试将骨牵拉延长术应用于骨肿瘤切除后的干骺端、骨骺或骨干的缺损，并取得了一定的效果。我科采用牵拉成骨术治疗骨肉瘤患儿1例并获长期随访，现结合相关文献，对该方法进行总结和探讨，为以后的推广应用提供借鉴。

异体脱钙骨基质骨粒复合骨水泥骨缺损修复材料结构特征及生物力学性能

AIM: To analyze constructive and biomechanical properties of different quality ratio material impregnated decalcified bone matrix (DBM) with bone cement (BC) . METHODS: The DBM particles and the materials impregnated 0 rmg/g, 300 mg/g and 400 mg/g maas ratio DBM particles with BC were made according to the methods of Urist et al. The compound material constructions were observed by scanning electron microscope and the biomechanical properties were measured by Instron mechanics testing-machine. RESULTS: The DBM particles with irregular gaps existing within interspace were connected with BC by the multipoint mode in the compound material. The ultimate compressive strength were 0 mg/g DBM in (59.3 ±2.2) MPa, 300 mg/g in (27.1 ±1.8) MPa, 400 mg/g in (19.3±1.6) MPa. The ultimate bending strength were 0 mg/g in (54.3±3.7) MPa, 300 mg/g in (18.5±1.1) MPa, 400 mg/g in (13.3±1.4) MPa. CONCLUSION: The materials of DBM impregnated with BC had perfect plastic property with much more irregular gaps existing within interspace. The materials could provide abundant biomechanical support.

Objective: To study the biomechanical properties of the new bone generated by mandibular distractionosteogenesis (DO).Methods: A total of 11 healthy adult goats wererandomly divided into 2 groups, the experimental group (n=9) and the control group (n = 2). For the goats in theexperimental group, the bilateral mandibles were graduallylengthened for 10 mm with distraction appliances. Threegoats were sacrificed respectively at 2, 4 and 8 weeks aftercompletion of distraction. Compressive, three-pointbending and shearing tests were conducted on the standardregenerated bone samples and the whole unilateralmandibular specimens. For the goats in the control group,no operation was made and the whole unilateral mandiblewas taken as the test specimen.Results: The compressive strength and bendingstiffness of the new bone reached the normal level at 4 and 8weeks after completion of distraction, respectively. But theshearing strength remained significantly weaker than that of the controls at 8 weeks after distraction.Conclusions: The distraction appliance can beremoved and the lengthened mandible should be exposed toadaptive functional exercise at 8 weeks after completion ofdistraction.