Objective:To investigate the clinical efficacy of the Shaoyang Zhugu Formula based on the“Shaoyang Governing Bones”theory in treating residual pain after vertebroplasty.Methods:A total of 60 outpatients and inpatien...Objective:To investigate the clinical efficacy of the Shaoyang Zhugu Formula based on the“Shaoyang Governing Bones”theory in treating residual pain after vertebroplasty.Methods:A total of 60 outpatients and inpatients from the Second Orthopedics Ward and Preventive Treatment Center of Chuxiong Prefecture Hospital of Traditional Chinese Medicine between January 2024 and December 2024 were selected and randomly divided into a control group(celecoxib capsules,30 cases)and an observation group(Shaoyang Zhugu Formula+celecoxib capsules,30 cases)using a lottery method.Postoperative pain levels,TCM symptom scores,Japanese Orthopaedic Association(JOA)scores for the lumbar spine,and adverse reactions were compared between the two groups.Results:The observation group showed better pain relief than the control group(P<0.05).The TCM symptom efficacy in the observation group was superior to that of the control group(P<0.05).After two treatment courses,both groups exhibited improved JOA scores,but the observation group demonstrated significantly better postoperative JOA scores(P<0.05).Additionally,the observation group had fewer adverse reactions(P<0.05).Conclusion:The Shaoyang Zhugu Formula,based on the“Shaoyang Governing Bones”theory,effectively alleviates residual pain after vertebroplasty,improves TCM symptoms and lumbar function,and demonstrates high safety.展开更多
Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,c...Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.展开更多
BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complet...BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.展开更多
BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.A...BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.展开更多
BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bo...BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bone healing.However,donor site morbidity,particularly anterior knee pain(AKP),limits its utilization despite its advantages.Various techniques have been proposed to reduce AKP,but they show variable outcomes and several limitations.AIM To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.METHODS We conducted a retrospective observational study of 24 patients aged 20-45 years,who had primary ACL reconstruction with BPTB grafts.During surgery,autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation.All patients were followed up for at least twelve months.Using the Kujala Anterior Knee Pain Score,clinical outcomes were evaluated,including the pain-specific subcomponent.RESULTS With scores ranging from 86 to 100,the average overall Kujala score was 95.67±4.01.No patient scored below 85.There was no complication such as patellar fracture,tibial tuberosity fracture,or infection.Grouped data showed 20.8%of patients scored 100,whereas 54.2%scored between 95 and 99,and 25%scored between 86 and 94.One patient(4.2%)had an 8/10 pain subcomponent,whereas 23 patients(95.8%)had a 10/10.CONCLUSION This procedure is easy to incorporate into routine surgical practice,cost-effective and reproducible without requiring extra incisions or raising the patient’s surgical expenses.Excellent short-term results back up this technique.展开更多
Bone regeneration for non-load-bearing defects remains a significant clinical challenge requiring advanced biomaterials and cellular strategies.Adiposederived mesenchymal stem cells(AD-MSCs)have garnered significant i...Bone regeneration for non-load-bearing defects remains a significant clinical challenge requiring advanced biomaterials and cellular strategies.Adiposederived mesenchymal stem cells(AD-MSCs)have garnered significant interest in bone tissue engineering(BTE)because of their abundant availability,minimally invasive harvesting procedures,and robust differentiation potential into osteogenic lineages.Unlike bone marrow-derived mesenchymal stem cells,AD-MSCs can be easily obtained in large quantities,making them appealing alternatives for therapeutic applications.This review explores hydrogels containing polymers,such as chitosan,collagen,gelatin,and hyaluronic acid,and their composites,tailored for BTE,and emphasizes the importance of these hydrogels as scaffolds for the delivery of AD-MSCs.Various hydrogel fabrication techniques and biocompatibility assessments are discussed,along with innovative modifications to enhance osteogenesis.This review also briefly outlines AD-MSC isolation methods and advanced embedding techniques for precise cell placement,such as direct encapsulation and three-dimensional bioprinting.We discuss the mechanisms of bone regeneration in the AD-MSC-laden hydrogels,including osteoinduction,vascularization,and extracellular matrix remodeling.We also review the preclinical and clinical applications of AD-MSC-hydrogel systems,emphasizing their success and limitations.In this review,we provide a comprehensive overview of AD-MSC-based hydrogel systems to guide the development of effective therapies for bone regeneration.展开更多
Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains uncle...Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains unclear;although endoplasmic reticulum stress(ERS) has been found to play a role in glucocorticoid-induced FHN broilers.In this study,we collected samples from broilers with femoral head separation(FHS) and femoral head separation accompanied with growth plate lacerations(FHSL) in a broiler farm.The aim was to investigate the potential association between the severity of FHN,bone remodeling and cartilage damage.Additionally,primary chondrocytes were treated with methylprednisolone(MP) to construct an in vitro FHN model,followed by inhibition or activation of ERS or hypoxia inducible factor-1α(HIF-1α) to further investigate the mechanism of apoptosis in cartilage.The results suggested that cartilage appeared to be the appropriate tissue to investigate the potential mechanisms of FHN,as the degree of cartilage damage was found to be closely related to the severity of the disease.Bone quality was only affected in FHSL broilers,although factors related to bone metabolism were significantly altered among FHN-affected broilers.In addition,cartilage in FHN-affected broilers exhibited high levels of apoptosis and upregulated expression of ERS-related and HIF-1α,which was consistent with both in vivo and in vitro findings after MP treatment.The results were further supported by treatment with HIF-1α or ERS inhibition or activation.In conclusion,bone remodeling and cartilage homeostasis were affected in FHN broilers,but only cartilage damage was significantly exacerbated with FHN development.Moreover,activation of ERS or HIF-1α resulted in apoptosis in cartilage,thus exhibiting a significant correlation with FHN severity.展开更多
Objective To investigate the effect of oral administration of arginine on linear growth of long bones in male pubertal rats and the underlying mechanisms, focusing on expression of genes related to the hypothalamus-pi...Objective To investigate the effect of oral administration of arginine on linear growth of long bones in male pubertal rats and the underlying mechanisms, focusing on expression of genes related to the hypothalamus-pituitary growth axis and the nitric oxide （NO）-cyclic guanosine monophosphate （cGMP） pathway. Methods Rats were randomly divided into control and intervention groups. In the intervention group, arginine was solved in water （0.045 g L-arginine was mixed with 1 mL water） and administered in rats （10 mL/kg） through gastric perfusion once per day, for totally 28 d. Rats in the control group received normal saline treatment. Bone histomorphometry analysis was used to measure growth plate width and mineral apposition rate of the tibia, as well as trabecular bone volume fraction, osteoblast surface and osteo- clast surface of the femur. Serum growth hormone （GH） concentration was determined by radioimmunoassay. Real-time PCR was used to measure the expression of neuronal nitric oxide synthase （nNOS）, soluble guanylyl cyclases （sGCal and sGCfll）, growth hormone-releasing hormone （Ghrh） and somatostatin （SS） in hypothalamus, as well as Gh in pituitary. Western blot was used to detect the protein levels ofnNOS, sGCα1 and sGCβ1 in hypothalamus. Results After treat- ment with arginine, the growth plate width of tibia and osteoblast surface of femur were increased （P 〈 0.05）, and serum GH concentration was elevated （P 〈 0.05）. Besides, mRNA and protein levels ofnNOS and sGCα1 （P 〈 0.05）, as well as the expression of Gh mRNA （P 〈 0.01）, were significantly up-regulated, while the expression of SS mRNA was down- regulated （P 〈 0.05）. Conclusion Oral administration ofarginine could improve linear growth of long bones by regulating mRNA expression of SS and Gh and inducing GH secretion, possibly via nNOS-NO-sGC-cGMP signal transduction pathway.展开更多
Ovine bones are the major by-products after slaughtered. The present study was conducted to extract and characterize acid soluble collagens （ASC） and pepsin soluble collagens （PSC） from ovine bones （Ujumuqin shee...Ovine bones are the major by-products after slaughtered. The present study was conducted to extract and characterize acid soluble collagens （ASC） and pepsin soluble collagens （PSC） from ovine bones （Ujumuqin sheep）. Ovine bones collagen were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis （SDS-PAGE） and liquid chromatography-tan- dem mass spectrometry （LC-MS/MS） as type I collagen. The results of Fourier transform infrared （FTIR） spectra analysis testified the existence of triple superhelical structure in both ASC and PSC, showing pepsin did not disrupt the triple helical structure of ovine bones collagen. Glycine, accounting for one-third of total amino acids, was the major amino acid for ovine bones collagen. Higher imino acid content was responsible for higher thermal denaturation temperature of ovine bones collagen compared to fish collagens. The isoelectric point of ASC was lower than PSC due to the higher content of acidic amino acids. Therefore, this study provides the potential reference for collagen extraction and application of ovine bones by-procduct.展开更多
Skeletal stem/progenitor cells(SSPCs)are tissue-specific stem/progenitor cells localized within skeletons and contribute to bone development,homeostasis,and regeneration.However,the heterogeneity of SSPC populations i...Skeletal stem/progenitor cells(SSPCs)are tissue-specific stem/progenitor cells localized within skeletons and contribute to bone development,homeostasis,and regeneration.However,the heterogeneity of SSPC populations in mouse long bones and their respective regenerative capacity remain to be further clarified.In this study,we perform integrated analysis using single-cell RNA sequencing(scRNA-seq)datasets of mouse hindlimb buds,postnatal long bones,and fractured long bones.Our analyses reveal the heterogeneity of osteochondrogenic lineage cells and recapitulate the developmental trajectories during mouse long bone growth.In addition,we identify a novel Cd168þSSPC population with highly replicating capacity and osteochondrogenic potential in embryonic and postnatal long bones.Moreover,the Cd168þSSPCs can contribute to newly formed skeletal tissues during fracture healing.Furthermore,the results of multicolor immunofluorescence show that Cd168þSSPCs reside in the superficial zone of articular cartilage as well as in growth plates of postnatal mouse long bones.In summary,we identify a novel Cd168þSSPC population with regenerative potential in mouse long bones,which adds to the knowledge of the tissuespecific stem cells in skeletons.展开更多
A case of florid reactive periostitis ossificans(RPO) arising in a long bone is presented. This is a rare bone proliferation with a pronounced periosteal reaction. Less than 100 cases have been described in the litera...A case of florid reactive periostitis ossificans(RPO) arising in a long bone is presented. This is a rare bone proliferation with a pronounced periosteal reaction. Less than 100 cases have been described in the literature with far fewer outside the bones of the hand, feet, fingers, and toes. Although the etiology is unknown, a relationship to preceding trauma is suggested. The imaging and histologic features show an overlap with other bone lesions including bizarre parosteal osteochondromatous proliferation, subungual exostosis, and malignant surface tumors of bone and cartilage which include, periosteal and parosteal osteosarcoma. It is important to recognize the clinical presentation and diagnostic features of RPO as a benign entity so that it is not mistaken for a more aggressive neoplasm. We present a case of a right distal humeral lesion that on histopathological review revealed florid RPO. This diagnosis was not suspected on imaging studies, but was made on open biopsy of the mass. The patient remains disease free, years postoperatively. In addition to presenting this unique case report, we review the pertinent literature, and offer a differential diagnosis and treatment strategy for its management.展开更多
Multimodal imaging-guided chemo-photothermal therapy is an excellent cancer treatment,which can not only efficiently against tumor,but also can offer precise treatment window and real-time monitoring of the treatment ...Multimodal imaging-guided chemo-photothermal therapy is an excellent cancer treatment,which can not only efficiently against tumor,but also can offer precise treatment window and real-time monitoring of the treatment efficiency.In our work,polydopamine(PDA)-coated gold nanobones(AuNBs@PDA nanocomplexes)were designed for this approach.The AuNBs@PDA nanocomplexes have strong absorbance in the near infrared(NIR)region and higher photothermal conversion efficiency(75.48%)than gold nanobones alone,which was facilitated for photoacoustic imaging and photothermal therapy.Besides,the loading efficiency of doxorubicin(DOX)by AuNBs@PDA nanocomplexes could be up to about 70%and DOX release from AuNBs@PDA/DOX nanocomplexes sensitively response to the lower pH environment and NIR laser irradiation,which makes them become the excellent nano-carrier for the delivery of chemotherapy drug.In vitro and in vivo studies showed significant cytotoxicity and antitumor efficacy by the AuNBs@PDA/DOX nanoplatform with negligible side effects.Meanwhile,the nanoplatform was also successfully employed for computed tomography(CT)imaging,attributing to the high atomic number and high X-ray attenuation coefficient of gold.Therefore,we believed that the proposed PDA-coated gold nanobones would be a novel multifunctional theranostic nanoagent to realize the PA/CT imaging-guided chemo-photothermal therapy of cancer.展开更多
Objective： To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods： This study had local ethical...Objective： To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods： This study had local ethical committee approval, and all patients gave written informed consent. Thirty seven consecutive patients with primary malignant tumor in jaw bones were recruited for the study. Bone scintigraphy was performed in all patients before surgery to measure the full extent of bony involvement, which was compared with histologic findings. Results： Whole body scan revealed one case with multiple bony metastases. Resection specimens of 36 bone neoplasms were pathologically analyzed to identify type and size of each tumor. The lengths of the tumor involvement in jaw bones defined by bone scintigraphy and pathology were 5.62 ± 1.58 cm, 4.48 ± 1.57 cm, respectively （P 〈 0.05）. The tumor negative margins from removed specimens according to bone scintigraphy were pathologically confirmed. With histologic findings as the standard of reference, the accuracy of bone scintigraphy was 100% （36 of 36 patients） in determining the full extent of tumor involvement in jaw bones. Conclusion： Bone scintigraphy tends to offer specific guidelines in determining the appropriate extent of bone resection while entirely clearing the tumor cells and preserving functions whenever possible and in establishing the bony metastases.展开更多
Environmental pollution is today a very important issue and the development of low cost materials and different sources need to be investigated. Our research group for several years she has been the development of ads...Environmental pollution is today a very important issue and the development of low cost materials and different sources need to be investigated. Our research group for several years she has been the development of adsorbent materials for industrial wastewater treatment and rivers. In this research compares the porosity developed by two different treatments using bovine bones to adsorb metal ions. Using bovine bones as raw material, two carbonized samples were obtained under different conditions. One of the carbonized samples was obtained in an oxidizing atmosphere at up to 600℃ for 2 hours. The other was obtained in an inert atmosphere at up to 800℃, during 2 hours. Different textural characteristics were obtained in each of the carbonized samples according to the conditions of synthesis. The carbonized sample obtained in the oxidizing atmosphere, CHUOX, produces a great pore distribution, with a significant mesopore volume, reflected in the hysteresis loop, while in carbonized bone obtained in an inert atmosphere, CHUN, a formation of micropores and mesopores smaller than that obtained in the other carbonized sample is observed. The surface area obtained is 130 m2 g-1 for CHUOX and 170 m2 g-1 for CHUN. Furthermore, the adsorption capacity of Ni2+ and Cu2+ ions from solution was measured for these two carbonized samples, and a higher retention of both ions in the carbonized sample obtained in the inert atmosphere was found, with values between 28.57 and 67.56 mg g-1. The immersion enthalpies of carbonized samples in ion solutions are determined with an exothermic effect for the solution-solid interaction.展开更多
In the prosthetic socket design, aimed at the high cost and radiation deficiency caused by CT scanning which is a routine technique to obtain the cross-sectional image of the residual limb, a new ultrasonic scanning m...In the prosthetic socket design, aimed at the high cost and radiation deficiency caused by CT scanning which is a routine technique to obtain the cross-sectional image of the residual limb, a new ultrasonic scanning method is developed to acquire the bones and skin contours of the residual limb. Using a pig fore-leg as the scanning object, an overlapping algorithm is designed to reconstruct the 2D cross-sectional image, the contours of the bone and skin are extracted using edge detection algorithm and the 3D model of the pig fore-leg is reconstructed by using reverse engineering technology. The results of checking the accuracy of the image by scanning a cylinder work pieces show that the extracted contours of the cylinder are quite close to the standard circumference. So it is feasible to get the contours of bones and skin by ultrasonic scanning. The ultrasonic scanning system featuring no radiation and low cost is a kind of new means of cross section scanning for medical images.展开更多
This study aimed to assess whether a daily supplementation with Lactobacillus rhamnosus GG (LGG) can alter the body composition as well as bone turnover and the mechanical properties of the bones in systemic immunodef...This study aimed to assess whether a daily supplementation with Lactobacillus rhamnosus GG (LGG) can alter the body composition as well as bone turnover and the mechanical properties of the bones in systemic immunodeficiency. For this, we use an in vivo model of severe combined immunodeficient (scid) mice supplemented daily with LGG over 8 weeks period. After 8 weeks of the treatment, the animals were assessed by DEXA and then the blood was collected from the hepatic portal vein for bone turnover biomarkers;post-mortem, the caecum was removed for isolation and enumeration of the gut bacteria, while femurs/tibiae were excised for the assessment of their mechanical properties. LGG treatment affected the composition of the gut microbiota at the order level, and it decreased (P = 0.002) total adipose tissue content. Moreover, LGG treatment decreased the stiffness (N/mm) of both femurs (P = 0.008) and tibiae (P = 0.011). To conclude, this study shows that dietary supplementation with LGG in immunodeficient animals can alter mechanical properties of the long bones and concomitantly it can modify host’s total adiposity level.展开更多
Adamantinoma is a primary low grade malignant bone tumor that is predominantly located in the mid-portion of the tibia. The tumor is of interest for two reasons： first, there still exists considerable dispute as to t...Adamantinoma is a primary low grade malignant bone tumor that is predominantly located in the mid-portion of the tibia. The tumor is of interest for two reasons： first, there still exists considerable dispute as to the origin of the lesion and recent reports reveal that the condition is more malignant than had previously been supposed. Although cases of adamanti- noma located to the axial skeleton have been reported, this is the first case of adamantinoma located to pelvic bone in Iran. Here we present the clinical, radiological ＆ histopathological features of a 19 year-old male with painful lesion located to the right pelvic bone which was morphologically and immunohistochemically diagnosed as adamantinoma. In general, metastasis is seen in 15%-20% of patients. The spread can occur to regional nodes, lung and infrequently to skeleton, liver and brain . Several weeks after surgery, our patient＇s condition gradually worsened. A CT-scan of abdomen revealed widespread liver metastasis and the patient died due to acute liver failure. This case demonstrates that the mortality rate from adamantinoma is not always low.展开更多
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
基金Therapeutic Effect of Shaoyang Zhugu Formula on Residual Pain After Vertebroplasty Based on the Theory of Shaoyang Governing Bones(Project No.:XYLH202369)。
文摘Objective:To investigate the clinical efficacy of the Shaoyang Zhugu Formula based on the“Shaoyang Governing Bones”theory in treating residual pain after vertebroplasty.Methods:A total of 60 outpatients and inpatients from the Second Orthopedics Ward and Preventive Treatment Center of Chuxiong Prefecture Hospital of Traditional Chinese Medicine between January 2024 and December 2024 were selected and randomly divided into a control group(celecoxib capsules,30 cases)and an observation group(Shaoyang Zhugu Formula+celecoxib capsules,30 cases)using a lottery method.Postoperative pain levels,TCM symptom scores,Japanese Orthopaedic Association(JOA)scores for the lumbar spine,and adverse reactions were compared between the two groups.Results:The observation group showed better pain relief than the control group(P<0.05).The TCM symptom efficacy in the observation group was superior to that of the control group(P<0.05).After two treatment courses,both groups exhibited improved JOA scores,but the observation group demonstrated significantly better postoperative JOA scores(P<0.05).Additionally,the observation group had fewer adverse reactions(P<0.05).Conclusion:The Shaoyang Zhugu Formula,based on the“Shaoyang Governing Bones”theory,effectively alleviates residual pain after vertebroplasty,improves TCM symptoms and lumbar function,and demonstrates high safety.
文摘Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.
基金Supported by Russian Science Foundation Grant,No.24-15-00185.
文摘BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.
文摘BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.
文摘BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bone healing.However,donor site morbidity,particularly anterior knee pain(AKP),limits its utilization despite its advantages.Various techniques have been proposed to reduce AKP,but they show variable outcomes and several limitations.AIM To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.METHODS We conducted a retrospective observational study of 24 patients aged 20-45 years,who had primary ACL reconstruction with BPTB grafts.During surgery,autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation.All patients were followed up for at least twelve months.Using the Kujala Anterior Knee Pain Score,clinical outcomes were evaluated,including the pain-specific subcomponent.RESULTS With scores ranging from 86 to 100,the average overall Kujala score was 95.67±4.01.No patient scored below 85.There was no complication such as patellar fracture,tibial tuberosity fracture,or infection.Grouped data showed 20.8%of patients scored 100,whereas 54.2%scored between 95 and 99,and 25%scored between 86 and 94.One patient(4.2%)had an 8/10 pain subcomponent,whereas 23 patients(95.8%)had a 10/10.CONCLUSION This procedure is easy to incorporate into routine surgical practice,cost-effective and reproducible without requiring extra incisions or raising the patient’s surgical expenses.Excellent short-term results back up this technique.
文摘Bone regeneration for non-load-bearing defects remains a significant clinical challenge requiring advanced biomaterials and cellular strategies.Adiposederived mesenchymal stem cells(AD-MSCs)have garnered significant interest in bone tissue engineering(BTE)because of their abundant availability,minimally invasive harvesting procedures,and robust differentiation potential into osteogenic lineages.Unlike bone marrow-derived mesenchymal stem cells,AD-MSCs can be easily obtained in large quantities,making them appealing alternatives for therapeutic applications.This review explores hydrogels containing polymers,such as chitosan,collagen,gelatin,and hyaluronic acid,and their composites,tailored for BTE,and emphasizes the importance of these hydrogels as scaffolds for the delivery of AD-MSCs.Various hydrogel fabrication techniques and biocompatibility assessments are discussed,along with innovative modifications to enhance osteogenesis.This review also briefly outlines AD-MSC isolation methods and advanced embedding techniques for precise cell placement,such as direct encapsulation and three-dimensional bioprinting.We discuss the mechanisms of bone regeneration in the AD-MSC-laden hydrogels,including osteoinduction,vascularization,and extracellular matrix remodeling.We also review the preclinical and clinical applications of AD-MSC-hydrogel systems,emphasizing their success and limitations.In this review,we provide a comprehensive overview of AD-MSC-based hydrogel systems to guide the development of effective therapies for bone regeneration.
基金supported by the National Natural Science Foundation of China (32072936 and 32273080)。
文摘Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains unclear;although endoplasmic reticulum stress(ERS) has been found to play a role in glucocorticoid-induced FHN broilers.In this study,we collected samples from broilers with femoral head separation(FHS) and femoral head separation accompanied with growth plate lacerations(FHSL) in a broiler farm.The aim was to investigate the potential association between the severity of FHN,bone remodeling and cartilage damage.Additionally,primary chondrocytes were treated with methylprednisolone(MP) to construct an in vitro FHN model,followed by inhibition or activation of ERS or hypoxia inducible factor-1α(HIF-1α) to further investigate the mechanism of apoptosis in cartilage.The results suggested that cartilage appeared to be the appropriate tissue to investigate the potential mechanisms of FHN,as the degree of cartilage damage was found to be closely related to the severity of the disease.Bone quality was only affected in FHSL broilers,although factors related to bone metabolism were significantly altered among FHN-affected broilers.In addition,cartilage in FHN-affected broilers exhibited high levels of apoptosis and upregulated expression of ERS-related and HIF-1α,which was consistent with both in vivo and in vitro findings after MP treatment.The results were further supported by treatment with HIF-1α or ERS inhibition or activation.In conclusion,bone remodeling and cartilage homeostasis were affected in FHN broilers,but only cartilage damage was significantly exacerbated with FHN development.Moreover,activation of ERS or HIF-1α resulted in apoptosis in cartilage,thus exhibiting a significant correlation with FHN severity.
文摘Objective To investigate the effect of oral administration of arginine on linear growth of long bones in male pubertal rats and the underlying mechanisms, focusing on expression of genes related to the hypothalamus-pituitary growth axis and the nitric oxide （NO）-cyclic guanosine monophosphate （cGMP） pathway. Methods Rats were randomly divided into control and intervention groups. In the intervention group, arginine was solved in water （0.045 g L-arginine was mixed with 1 mL water） and administered in rats （10 mL/kg） through gastric perfusion once per day, for totally 28 d. Rats in the control group received normal saline treatment. Bone histomorphometry analysis was used to measure growth plate width and mineral apposition rate of the tibia, as well as trabecular bone volume fraction, osteoblast surface and osteo- clast surface of the femur. Serum growth hormone （GH） concentration was determined by radioimmunoassay. Real-time PCR was used to measure the expression of neuronal nitric oxide synthase （nNOS）, soluble guanylyl cyclases （sGCal and sGCfll）, growth hormone-releasing hormone （Ghrh） and somatostatin （SS） in hypothalamus, as well as Gh in pituitary. Western blot was used to detect the protein levels ofnNOS, sGCα1 and sGCβ1 in hypothalamus. Results After treat- ment with arginine, the growth plate width of tibia and osteoblast surface of femur were increased （P 〈 0.05）, and serum GH concentration was elevated （P 〈 0.05）. Besides, mRNA and protein levels ofnNOS and sGCα1 （P 〈 0.05）, as well as the expression of Gh mRNA （P 〈 0.01）, were significantly up-regulated, while the expression of SS mRNA was down- regulated （P 〈 0.05）. Conclusion Oral administration ofarginine could improve linear growth of long bones by regulating mRNA expression of SS and Gh and inducing GH secretion, possibly via nNOS-NO-sGC-cGMP signal transduction pathway.
基金funded by the emarked fund for China Agriculture Research System (CARS-39)the National Agricultural Science and Technology Innovation Program
文摘Ovine bones are the major by-products after slaughtered. The present study was conducted to extract and characterize acid soluble collagens （ASC） and pepsin soluble collagens （PSC） from ovine bones （Ujumuqin sheep）. Ovine bones collagen were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis （SDS-PAGE） and liquid chromatography-tan- dem mass spectrometry （LC-MS/MS） as type I collagen. The results of Fourier transform infrared （FTIR） spectra analysis testified the existence of triple superhelical structure in both ASC and PSC, showing pepsin did not disrupt the triple helical structure of ovine bones collagen. Glycine, accounting for one-third of total amino acids, was the major amino acid for ovine bones collagen. Higher imino acid content was responsible for higher thermal denaturation temperature of ovine bones collagen compared to fish collagens. The isoelectric point of ASC was lower than PSC due to the higher content of acidic amino acids. Therefore, this study provides the potential reference for collagen extraction and application of ovine bones by-procduct.
基金supported by the National Key R&D Program of China(2022YFA1104100,2022YFA1103500)the National Natural Sciences Grants China(82172388,82372373,81871771)the Beijing Natural Sciences Foundation(7222123,L212065).
文摘Skeletal stem/progenitor cells(SSPCs)are tissue-specific stem/progenitor cells localized within skeletons and contribute to bone development,homeostasis,and regeneration.However,the heterogeneity of SSPC populations in mouse long bones and their respective regenerative capacity remain to be further clarified.In this study,we perform integrated analysis using single-cell RNA sequencing(scRNA-seq)datasets of mouse hindlimb buds,postnatal long bones,and fractured long bones.Our analyses reveal the heterogeneity of osteochondrogenic lineage cells and recapitulate the developmental trajectories during mouse long bone growth.In addition,we identify a novel Cd168þSSPC population with highly replicating capacity and osteochondrogenic potential in embryonic and postnatal long bones.Moreover,the Cd168þSSPCs can contribute to newly formed skeletal tissues during fracture healing.Furthermore,the results of multicolor immunofluorescence show that Cd168þSSPCs reside in the superficial zone of articular cartilage as well as in growth plates of postnatal mouse long bones.In summary,we identify a novel Cd168þSSPC population with regenerative potential in mouse long bones,which adds to the knowledge of the tissuespecific stem cells in skeletons.
基金Supported by The University of Alabama at Birmingham,Alabama and The Orthopaedic Center,Birmingham,AL,United States
文摘A case of florid reactive periostitis ossificans(RPO) arising in a long bone is presented. This is a rare bone proliferation with a pronounced periosteal reaction. Less than 100 cases have been described in the literature with far fewer outside the bones of the hand, feet, fingers, and toes. Although the etiology is unknown, a relationship to preceding trauma is suggested. The imaging and histologic features show an overlap with other bone lesions including bizarre parosteal osteochondromatous proliferation, subungual exostosis, and malignant surface tumors of bone and cartilage which include, periosteal and parosteal osteosarcoma. It is important to recognize the clinical presentation and diagnostic features of RPO as a benign entity so that it is not mistaken for a more aggressive neoplasm. We present a case of a right distal humeral lesion that on histopathological review revealed florid RPO. This diagnosis was not suspected on imaging studies, but was made on open biopsy of the mass. The patient remains disease free, years postoperatively. In addition to presenting this unique case report, we review the pertinent literature, and offer a differential diagnosis and treatment strategy for its management.
基金financially supported by the National Key R&D Program of China(No.2018YFB1105700)the National Natural Science Foundation of China(Nos.81902913,81930048 and 81627805)+9 种基金the Guangdong Basic and Applied Basic Research Foundation for Distinguished Young Scholars(No.2020B1515020027)the Fundamental Research Funds for the Central Universities(No.19ykpy108)the Natural Science Foundation of Jiangsu Province(No.BK20190821)the Postdoctoral Science Foundation of China(No.2019M651953)the Open Project Program of the State Key Laboratory of Radiation Medicine and Protection,Soochow University(No.GZK1201909)the Guangdong Science and Technology Department(No.2020B1212060018)the Science and Technology Project from Suzhou City Commission of Health and Family Planning(No.LCZX201712)the grants from Guangzhou Science and Technology Bureau(202002020070,201902020015)Opening Foundation of Hubei Province Key Laboratory of Molecular Imaginga Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions。
文摘Multimodal imaging-guided chemo-photothermal therapy is an excellent cancer treatment,which can not only efficiently against tumor,but also can offer precise treatment window and real-time monitoring of the treatment efficiency.In our work,polydopamine(PDA)-coated gold nanobones(AuNBs@PDA nanocomplexes)were designed for this approach.The AuNBs@PDA nanocomplexes have strong absorbance in the near infrared(NIR)region and higher photothermal conversion efficiency(75.48%)than gold nanobones alone,which was facilitated for photoacoustic imaging and photothermal therapy.Besides,the loading efficiency of doxorubicin(DOX)by AuNBs@PDA nanocomplexes could be up to about 70%and DOX release from AuNBs@PDA/DOX nanocomplexes sensitively response to the lower pH environment and NIR laser irradiation,which makes them become the excellent nano-carrier for the delivery of chemotherapy drug.In vitro and in vivo studies showed significant cytotoxicity and antitumor efficacy by the AuNBs@PDA/DOX nanoplatform with negligible side effects.Meanwhile,the nanoplatform was also successfully employed for computed tomography(CT)imaging,attributing to the high atomic number and high X-ray attenuation coefficient of gold.Therefore,we believed that the proposed PDA-coated gold nanobones would be a novel multifunctional theranostic nanoagent to realize the PA/CT imaging-guided chemo-photothermal therapy of cancer.
文摘Objective： To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods： This study had local ethical committee approval, and all patients gave written informed consent. Thirty seven consecutive patients with primary malignant tumor in jaw bones were recruited for the study. Bone scintigraphy was performed in all patients before surgery to measure the full extent of bony involvement, which was compared with histologic findings. Results： Whole body scan revealed one case with multiple bony metastases. Resection specimens of 36 bone neoplasms were pathologically analyzed to identify type and size of each tumor. The lengths of the tumor involvement in jaw bones defined by bone scintigraphy and pathology were 5.62 ± 1.58 cm, 4.48 ± 1.57 cm, respectively （P 〈 0.05）. The tumor negative margins from removed specimens according to bone scintigraphy were pathologically confirmed. With histologic findings as the standard of reference, the accuracy of bone scintigraphy was 100% （36 of 36 patients） in determining the full extent of tumor involvement in jaw bones. Conclusion： Bone scintigraphy tends to offer specific guidelines in determining the appropriate extent of bone resection while entirely clearing the tumor cells and preserving functions whenever possible and in establishing the bony metastases.
文摘Environmental pollution is today a very important issue and the development of low cost materials and different sources need to be investigated. Our research group for several years she has been the development of adsorbent materials for industrial wastewater treatment and rivers. In this research compares the porosity developed by two different treatments using bovine bones to adsorb metal ions. Using bovine bones as raw material, two carbonized samples were obtained under different conditions. One of the carbonized samples was obtained in an oxidizing atmosphere at up to 600℃ for 2 hours. The other was obtained in an inert atmosphere at up to 800℃, during 2 hours. Different textural characteristics were obtained in each of the carbonized samples according to the conditions of synthesis. The carbonized sample obtained in the oxidizing atmosphere, CHUOX, produces a great pore distribution, with a significant mesopore volume, reflected in the hysteresis loop, while in carbonized bone obtained in an inert atmosphere, CHUN, a formation of micropores and mesopores smaller than that obtained in the other carbonized sample is observed. The surface area obtained is 130 m2 g-1 for CHUOX and 170 m2 g-1 for CHUN. Furthermore, the adsorption capacity of Ni2+ and Cu2+ ions from solution was measured for these two carbonized samples, and a higher retention of both ions in the carbonized sample obtained in the inert atmosphere was found, with values between 28.57 and 67.56 mg g-1. The immersion enthalpies of carbonized samples in ion solutions are determined with an exothermic effect for the solution-solid interaction.
基金This project is supported by National Hi-tech Research and Development Program of China(863 Program, No.2002AA421130)Excellent Doctoral Dissertation Fund(No.200026).
文摘In the prosthetic socket design, aimed at the high cost and radiation deficiency caused by CT scanning which is a routine technique to obtain the cross-sectional image of the residual limb, a new ultrasonic scanning method is developed to acquire the bones and skin contours of the residual limb. Using a pig fore-leg as the scanning object, an overlapping algorithm is designed to reconstruct the 2D cross-sectional image, the contours of the bone and skin are extracted using edge detection algorithm and the 3D model of the pig fore-leg is reconstructed by using reverse engineering technology. The results of checking the accuracy of the image by scanning a cylinder work pieces show that the extracted contours of the cylinder are quite close to the standard circumference. So it is feasible to get the contours of bones and skin by ultrasonic scanning. The ultrasonic scanning system featuring no radiation and low cost is a kind of new means of cross section scanning for medical images.
文摘This study aimed to assess whether a daily supplementation with Lactobacillus rhamnosus GG (LGG) can alter the body composition as well as bone turnover and the mechanical properties of the bones in systemic immunodeficiency. For this, we use an in vivo model of severe combined immunodeficient (scid) mice supplemented daily with LGG over 8 weeks period. After 8 weeks of the treatment, the animals were assessed by DEXA and then the blood was collected from the hepatic portal vein for bone turnover biomarkers;post-mortem, the caecum was removed for isolation and enumeration of the gut bacteria, while femurs/tibiae were excised for the assessment of their mechanical properties. LGG treatment affected the composition of the gut microbiota at the order level, and it decreased (P = 0.002) total adipose tissue content. Moreover, LGG treatment decreased the stiffness (N/mm) of both femurs (P = 0.008) and tibiae (P = 0.011). To conclude, this study shows that dietary supplementation with LGG in immunodeficient animals can alter mechanical properties of the long bones and concomitantly it can modify host’s total adiposity level.
文摘Adamantinoma is a primary low grade malignant bone tumor that is predominantly located in the mid-portion of the tibia. The tumor is of interest for two reasons： first, there still exists considerable dispute as to the origin of the lesion and recent reports reveal that the condition is more malignant than had previously been supposed. Although cases of adamanti- noma located to the axial skeleton have been reported, this is the first case of adamantinoma located to pelvic bone in Iran. Here we present the clinical, radiological ＆ histopathological features of a 19 year-old male with painful lesion located to the right pelvic bone which was morphologically and immunohistochemically diagnosed as adamantinoma. In general, metastasis is seen in 15%-20% of patients. The spread can occur to regional nodes, lung and infrequently to skeleton, liver and brain . Several weeks after surgery, our patient＇s condition gradually worsened. A CT-scan of abdomen revealed widespread liver metastasis and the patient died due to acute liver failure. This case demonstrates that the mortality rate from adamantinoma is not always low.
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。
