目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得...目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得到三期骨髓水肿标准化CT值增量与VNCa标准化CT值增量。对数值变量行统计学描述,并对三期骨髓水肿标准化CT值增量、VNCa标准化CT值增量进行各自组间比较及两两间比较,对有差异的组别行诊断效能比较,由接受者工作特征(ROC)曲线下面积(AUC)进行评估,并计算Cut-off值。结果三期骨髓水肿标准化CT值增量及VNCa标准化CT值增量组间均有统计学意义(H=10.788,p=0.005;F=115.787,p=0.000),其中,软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量有统计学意义(H=54.958,p=0.003),其余两两间无统计学意义(分别为H=-25.603,p=0.183;H=29.354,p=0.113)。而三期VNCa标准化CT值增量两两间均有统计学意义(P均为0.000)。ROC曲线鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量曲线下面积为0.652,Cut-off值为81.575 Hu,鉴别血肿炎症机化期与软骨痂期(纤维性骨痂期)VNCa标准化CT值增量曲线下面积为0.668,Cut-off值为55.700 Hu,鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期VNCa标准化CT值增量曲线下面积为0.905,Cut-off值为37.625 Hu。结论通过双能量CT Bone Marrow Edema可定量评估肋骨骨折演变时间节点,骨折时间演变的标准化CT值增量差异性可为法医鉴定骨折处于不同时间段提供理论依据。通过标准化CT值增量Cut-off值可一定程度上预测骨折所处时间阶段,为法医在鉴定肋骨骨折方面提供定量依据。展开更多
Prostate cancer is one of the most common cancers among males worldwide and a common cause of cancer related mortality in males. Bone metastasis from prostate cancer is common in advanced stage disease leading to majo...Prostate cancer is one of the most common cancers among males worldwide and a common cause of cancer related mortality in males. Bone metastasis from prostate cancer is common in advanced stage disease leading to major complications including severe bone pain and fractures. Here, we present a case of 79-year-old male newly diagnosed metastatic prostate cancer, with metastasis to the lungs, liver and lymph nodes, and a solitary osteolytic bone metastasis seen in bone scan. It is well known that osseous metastasis from prostate cancer is primarily sclerotic, although lytic bone metastasis is rare, but it can also be seen as in our case.展开更多
Maxillary bone loss impairs essential functions (chewing, swallowing, speech) and gives patients a very unaesthetic appearance due to the removal of facial support tissues, leading to serious psychological consequence...Maxillary bone loss impairs essential functions (chewing, swallowing, speech) and gives patients a very unaesthetic appearance due to the removal of facial support tissues, leading to serious psychological consequences. Treatment is multidisciplinary and requires a resective surgery if the cause is tumor-related, or an additive surgery if the cause is traumatic. This article aims to show the role of making a prosthesis to restore function (chewing, swallowing, speech) and aesthetics following maxillary bone loss. We will eighter present a clinical case involving a right maxillary tumor that was surgically resected followed by radiotherapy, and subsequently rehabilitated with a maxillofacial prosthesis in the consultation and dental treatment center of the university hospital center of Casablanca.展开更多
Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous ma...Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.展开更多
背景:新型生物材料不仅提供必要的机械支撑,还能促进细胞增殖和分化、诱导骨再生,从而改善治疗效果,为骨再生技术的发展提供了新的视角和方法。目的:通过文献计量学方法可视化分析生物材料在骨再生领域的研究状况及发展前景。方法:在Web...背景:新型生物材料不仅提供必要的机械支撑,还能促进细胞增殖和分化、诱导骨再生,从而改善治疗效果,为骨再生技术的发展提供了新的视角和方法。目的:通过文献计量学方法可视化分析生物材料在骨再生领域的研究状况及发展前景。方法:在Web of Science核心数据库中,精选了数据库建库至2024-09-24关于骨再生和生物材料领域最具影响力的文献500篇,运用VOSviewer和CiteSpace两款工具进行深入的计量学可视化分析,以揭示该领域的研究趋势和核心文献结果与结论:在所选的500篇文献中,中国和美国在发表论文数量和被引用率方面均占据领先地位,而常江是发文最多的作者,发表文章最多的期刊为Acta Biomaterialia。骨再生和材料学是一个跨学科的研究范畴,涵盖了材料科学、生物医学工程、细胞生物学、分子生物学等多个学科领域。骨修复材料的研究正从传统的生物惰性材料向生物活性材料转变,这些材料不仅提供机械支撑,还能促进细胞增殖和分化,诱导骨再生。合成骨修复材料因丰富的来源、可调节的物理化学特性以及较低的免疫排斥和疾病传播风险,正逐渐替代传统材料,成为临床骨移植手术的首选。研究者们正在不断改进这些材料的生物相容性、仿生特性、骨传导性和骨诱导性,使其更接近天然骨,前沿主要集中在生物活性陶瓷、3D打印、水凝胶、壳聚糖、羟基磷灰石等材料。新型材料在骨再生领域中的作用至关重要,随着材料科学技术的不断进步,这些新型材料在骨再生领域的应用前景非常广阔,有望为骨缺损治疗提供更为有效和个性化的治疗方案。展开更多
背景:骨代谢紊乱会引起骨相关疾病的发生,而叉头框转录因子O3可以通过调节氧化应激、自噬水平等来影响骨组织细胞增殖、分化与凋亡,调控骨代谢过程。目的:系统性分析叉头框转录因子O3调控骨代谢及其在骨科疾病中作用机制的相关研究文献...背景:骨代谢紊乱会引起骨相关疾病的发生,而叉头框转录因子O3可以通过调节氧化应激、自噬水平等来影响骨组织细胞增殖、分化与凋亡,调控骨代谢过程。目的:系统性分析叉头框转录因子O3调控骨代谢及其在骨科疾病中作用机制的相关研究文献,为后续以叉头框转录因子O3为靶点治疗骨疾病的研究提供参考。方法:以“(SU=FoxO3a OR SU=Foxo3 OR SU=Forkhead box O3 OR SU=叉头框转录因子O3)AND SU=骨”为检索句在中国知网进行检索,以“主题:(“FoxO3a”)OR主题:(“Foxo3”)OR主题:(“Forkhead box O3”)OR主题:(“叉头框转录因子O3”)AND主题:(“骨”)”为检索句在万方医学数据库进行检索;以“((FoxO3a)OR(Foxo3)OR(Forkhead box O3))AND((bone)OR(Skeleton))”为检索句在PubMed数据库进行检索,排除陈旧、重复、质量较差以及不相关的文献,最终纳入56篇文献进行综述分析。结果与结论:①叉头框转录因子O3与骨髓间充质干细胞:叉头框转录因子O3能够促进成骨谱系的形成,还可通过激活自噬促进早期成骨分化。同时,叉头框转录因子O3在骨髓间充质干细胞中体现抗氧化特性,保护细胞免受氧化应激诱导的衰老。②叉头框转录因子O3与成骨细胞:叉头框转录因子O3在成骨细胞中能通过干扰Wnt/β-连环蛋白通路抑制成骨,同时能激活抗氧化酶保护成熟成骨细胞。叉头框转录因子O3能促进成骨祖细胞的增殖,并通过激活自噬促进成骨分化。③叉头框转录因子O3与破骨细胞:叉头框转录因子O3表达可抵抗氧化应激和激活自噬抑制破骨细胞生成。④叉头框转录因子O3与骨细胞:叉头框转录因子O3可通过抗氧化作用保护骨细胞,还可通过抑制p16和p53信号通路和抑制衰老相关分泌表型来减少骨流失。⑤叉头框转录因子O3与软骨细胞:叉头框转录因子O3在骨关节炎中对软骨细胞起到保护作用,抑制软骨细胞分解或凋亡,促进软骨细胞外基质合成,可抑制软骨细胞肥大;然而,叉头框转录因子O3与Runt相关转录因子1在软骨细胞中高度共表达却会促进软骨祖细胞的早期软骨形成和终末肥大。⑥叉头框转录因子O3通过参与氧化应激抵抗与调控自噬等过程影响骨代谢,参与多类骨相关疾病的病理进程。展开更多
文摘目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得到三期骨髓水肿标准化CT值增量与VNCa标准化CT值增量。对数值变量行统计学描述,并对三期骨髓水肿标准化CT值增量、VNCa标准化CT值增量进行各自组间比较及两两间比较,对有差异的组别行诊断效能比较,由接受者工作特征(ROC)曲线下面积(AUC)进行评估,并计算Cut-off值。结果三期骨髓水肿标准化CT值增量及VNCa标准化CT值增量组间均有统计学意义(H=10.788,p=0.005;F=115.787,p=0.000),其中,软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量有统计学意义(H=54.958,p=0.003),其余两两间无统计学意义(分别为H=-25.603,p=0.183;H=29.354,p=0.113)。而三期VNCa标准化CT值增量两两间均有统计学意义(P均为0.000)。ROC曲线鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量曲线下面积为0.652,Cut-off值为81.575 Hu,鉴别血肿炎症机化期与软骨痂期(纤维性骨痂期)VNCa标准化CT值增量曲线下面积为0.668,Cut-off值为55.700 Hu,鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期VNCa标准化CT值增量曲线下面积为0.905,Cut-off值为37.625 Hu。结论通过双能量CT Bone Marrow Edema可定量评估肋骨骨折演变时间节点,骨折时间演变的标准化CT值增量差异性可为法医鉴定骨折处于不同时间段提供理论依据。通过标准化CT值增量Cut-off值可一定程度上预测骨折所处时间阶段,为法医在鉴定肋骨骨折方面提供定量依据。
文摘Prostate cancer is one of the most common cancers among males worldwide and a common cause of cancer related mortality in males. Bone metastasis from prostate cancer is common in advanced stage disease leading to major complications including severe bone pain and fractures. Here, we present a case of 79-year-old male newly diagnosed metastatic prostate cancer, with metastasis to the lungs, liver and lymph nodes, and a solitary osteolytic bone metastasis seen in bone scan. It is well known that osseous metastasis from prostate cancer is primarily sclerotic, although lytic bone metastasis is rare, but it can also be seen as in our case.
文摘Maxillary bone loss impairs essential functions (chewing, swallowing, speech) and gives patients a very unaesthetic appearance due to the removal of facial support tissues, leading to serious psychological consequences. Treatment is multidisciplinary and requires a resective surgery if the cause is tumor-related, or an additive surgery if the cause is traumatic. This article aims to show the role of making a prosthesis to restore function (chewing, swallowing, speech) and aesthetics following maxillary bone loss. We will eighter present a clinical case involving a right maxillary tumor that was surgically resected followed by radiotherapy, and subsequently rehabilitated with a maxillofacial prosthesis in the consultation and dental treatment center of the university hospital center of Casablanca.
文摘Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.
文摘背景:新型生物材料不仅提供必要的机械支撑,还能促进细胞增殖和分化、诱导骨再生,从而改善治疗效果,为骨再生技术的发展提供了新的视角和方法。目的:通过文献计量学方法可视化分析生物材料在骨再生领域的研究状况及发展前景。方法:在Web of Science核心数据库中,精选了数据库建库至2024-09-24关于骨再生和生物材料领域最具影响力的文献500篇,运用VOSviewer和CiteSpace两款工具进行深入的计量学可视化分析,以揭示该领域的研究趋势和核心文献结果与结论:在所选的500篇文献中,中国和美国在发表论文数量和被引用率方面均占据领先地位,而常江是发文最多的作者,发表文章最多的期刊为Acta Biomaterialia。骨再生和材料学是一个跨学科的研究范畴,涵盖了材料科学、生物医学工程、细胞生物学、分子生物学等多个学科领域。骨修复材料的研究正从传统的生物惰性材料向生物活性材料转变,这些材料不仅提供机械支撑,还能促进细胞增殖和分化,诱导骨再生。合成骨修复材料因丰富的来源、可调节的物理化学特性以及较低的免疫排斥和疾病传播风险,正逐渐替代传统材料,成为临床骨移植手术的首选。研究者们正在不断改进这些材料的生物相容性、仿生特性、骨传导性和骨诱导性,使其更接近天然骨,前沿主要集中在生物活性陶瓷、3D打印、水凝胶、壳聚糖、羟基磷灰石等材料。新型材料在骨再生领域中的作用至关重要,随着材料科学技术的不断进步,这些新型材料在骨再生领域的应用前景非常广阔,有望为骨缺损治疗提供更为有效和个性化的治疗方案。
文摘背景:骨代谢紊乱会引起骨相关疾病的发生,而叉头框转录因子O3可以通过调节氧化应激、自噬水平等来影响骨组织细胞增殖、分化与凋亡,调控骨代谢过程。目的:系统性分析叉头框转录因子O3调控骨代谢及其在骨科疾病中作用机制的相关研究文献,为后续以叉头框转录因子O3为靶点治疗骨疾病的研究提供参考。方法:以“(SU=FoxO3a OR SU=Foxo3 OR SU=Forkhead box O3 OR SU=叉头框转录因子O3)AND SU=骨”为检索句在中国知网进行检索,以“主题:(“FoxO3a”)OR主题:(“Foxo3”)OR主题:(“Forkhead box O3”)OR主题:(“叉头框转录因子O3”)AND主题:(“骨”)”为检索句在万方医学数据库进行检索;以“((FoxO3a)OR(Foxo3)OR(Forkhead box O3))AND((bone)OR(Skeleton))”为检索句在PubMed数据库进行检索,排除陈旧、重复、质量较差以及不相关的文献,最终纳入56篇文献进行综述分析。结果与结论:①叉头框转录因子O3与骨髓间充质干细胞:叉头框转录因子O3能够促进成骨谱系的形成,还可通过激活自噬促进早期成骨分化。同时,叉头框转录因子O3在骨髓间充质干细胞中体现抗氧化特性,保护细胞免受氧化应激诱导的衰老。②叉头框转录因子O3与成骨细胞:叉头框转录因子O3在成骨细胞中能通过干扰Wnt/β-连环蛋白通路抑制成骨,同时能激活抗氧化酶保护成熟成骨细胞。叉头框转录因子O3能促进成骨祖细胞的增殖,并通过激活自噬促进成骨分化。③叉头框转录因子O3与破骨细胞:叉头框转录因子O3表达可抵抗氧化应激和激活自噬抑制破骨细胞生成。④叉头框转录因子O3与骨细胞:叉头框转录因子O3可通过抗氧化作用保护骨细胞,还可通过抑制p16和p53信号通路和抑制衰老相关分泌表型来减少骨流失。⑤叉头框转录因子O3与软骨细胞:叉头框转录因子O3在骨关节炎中对软骨细胞起到保护作用,抑制软骨细胞分解或凋亡,促进软骨细胞外基质合成,可抑制软骨细胞肥大;然而,叉头框转录因子O3与Runt相关转录因子1在软骨细胞中高度共表达却会促进软骨祖细胞的早期软骨形成和终末肥大。⑥叉头框转录因子O3通过参与氧化应激抵抗与调控自噬等过程影响骨代谢,参与多类骨相关疾病的病理进程。
