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
目的观察知柏地黄丸对老年前列腺癌药物去势治疗后骨密度及骨代谢指标的影响。方法选取老年前列腺癌药物去势治疗患者82例,使用随机数字表法,将其分为两组,实验组42例、对照组40例。两组患者均给予药物去势治疗,对照组应用药物去势治疗...目的观察知柏地黄丸对老年前列腺癌药物去势治疗后骨密度及骨代谢指标的影响。方法选取老年前列腺癌药物去势治疗患者82例,使用随机数字表法,将其分为两组,实验组42例、对照组40例。两组患者均给予药物去势治疗,对照组应用药物去势治疗基础上补钙,不加服任何中医药治疗;实验组在对照组的基础上再加服知柏地黄丸,观察时限均为12个月,分别记录治疗前与治疗后3、6、12个月的总前列腺抗原(Prostate specific antigen,PSA)、游离前列腺特异抗原(Free prostate specific antigen,FPSA)、骨密度(Bone mineral density,BMD)T值(腰椎L2~4、股骨颈以及Wards三角),以及骨代谢指标,即骨钙素(Bone glaprotein,BGP)、Ⅰ型胶原交联C末端肽(C-terminal cross-linked telopeptides of typeⅠcollagen,CTX-Ⅰ)、骨源性碱性磷酸酶(Bone alkaline phosphatase,BALP)、25-羟维生素D[25-hydroxyvitamin D,25(OH)D]等指标。结果治疗后3个月,两组PSA、FPSA、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)、骨代谢指标差异无统计学意义;治疗6个月后,实验组BALP指标明显低于对照组、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)明显高于对照组(P<0.05),其余指标差异无统计学意义;治疗后12个月,实验组BALP、CTX明显低于对照组(P<0.05)、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)、25-D及BGP明显高于对照组(P<0.05),其余指标差异无统计学意义。实验组组内治疗前后比较结果为,实验组患者治疗前后VAS评分组内两两比较差异均有显著统计学意义;实验组患者治疗前后骨代谢指标,除了BALP治疗3个月与6个月、6个月与12个月两两比较差异无统计学意义,其余组内两两比较差异均有显著统计学意义(P<0.01,P<0.001)。结论知柏地黄丸可显著改善老年前列腺癌药物去势治疗后的骨质疏松,能够增加骨密度,抗氧化应激,有助于提高老年前列腺癌患者的生活质量。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
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.
文摘目的观察知柏地黄丸对老年前列腺癌药物去势治疗后骨密度及骨代谢指标的影响。方法选取老年前列腺癌药物去势治疗患者82例,使用随机数字表法,将其分为两组,实验组42例、对照组40例。两组患者均给予药物去势治疗,对照组应用药物去势治疗基础上补钙,不加服任何中医药治疗;实验组在对照组的基础上再加服知柏地黄丸,观察时限均为12个月,分别记录治疗前与治疗后3、6、12个月的总前列腺抗原(Prostate specific antigen,PSA)、游离前列腺特异抗原(Free prostate specific antigen,FPSA)、骨密度(Bone mineral density,BMD)T值(腰椎L2~4、股骨颈以及Wards三角),以及骨代谢指标,即骨钙素(Bone glaprotein,BGP)、Ⅰ型胶原交联C末端肽(C-terminal cross-linked telopeptides of typeⅠcollagen,CTX-Ⅰ)、骨源性碱性磷酸酶(Bone alkaline phosphatase,BALP)、25-羟维生素D[25-hydroxyvitamin D,25(OH)D]等指标。结果治疗后3个月,两组PSA、FPSA、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)、骨代谢指标差异无统计学意义;治疗6个月后,实验组BALP指标明显低于对照组、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)明显高于对照组(P<0.05),其余指标差异无统计学意义;治疗后12个月,实验组BALP、CTX明显低于对照组(P<0.05)、骨密度T值(腰椎L2~4、股骨颈以及Wards三角)、25-D及BGP明显高于对照组(P<0.05),其余指标差异无统计学意义。实验组组内治疗前后比较结果为,实验组患者治疗前后VAS评分组内两两比较差异均有显著统计学意义;实验组患者治疗前后骨代谢指标,除了BALP治疗3个月与6个月、6个月与12个月两两比较差异无统计学意义,其余组内两两比较差异均有显著统计学意义(P<0.01,P<0.001)。结论知柏地黄丸可显著改善老年前列腺癌药物去势治疗后的骨质疏松,能够增加骨密度,抗氧化应激,有助于提高老年前列腺癌患者的生活质量。
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.
