小骨片

Objective To explore an approach to distinguish avulsion fracture of articular portion from anatomic separated epiphysis.

目的 探讨生理性小骨骺分离的影像学特征及其与骨端撕脱性小骨折片的鉴别方法。

objective to evaluate early signs of avascular necrosis of femoral head in adult by ct and to guide clinical treatment.methods the cases with suspicious diagnose of anfh were scaned in the both hip joints by x ray and ct to find the early signs of anfh with ct.results early signs of anfh using ct showed that, in 38 femoral heads 31 cases, there were radiate star shape of high density osteosclerosis of the trabeculae in 13 femoral head.twenty five femoral heads showed osteosclerosis and trabeculae structure disappearing and vague,incoordinately low ostedensity area and cyst change.there were fracture under the cartilage and light subsid in 5 cases.the cases in stage ⅰwere given decompression, while the pationtsresul in stageⅱand stageⅲ were given decompression and ostetransplant.conclusion ct results show that the sign of the high osteodensity and low osteodensity and cyst change can disply early anfh.

摘 要］目的：探讨成人股骨头缺血性坏死的早期ct征象并指导临床治疗。方法：对临床疑诊anfh的全部病例均行x线平片及ct检查，分析anfh的早期ct征象。结果：早期anfh的ct表现：31例38个股骨头，其中13个股骨头骨小梁呈放射状高密度的"星状征"，骨小梁境界清楚、锐利，属ⅰ期；25个股骨头表现为骨硬化，骨小梁结构消失、模糊不清，骨密度减低及囊性改变，属ⅱ期；并有5个股骨头在ⅱ期影像学改变基础上出现软骨下骨折及轻微塌陷，属ⅲ期。治疗结果：ⅰ期行钻孔髓内减压术，ⅱ、ⅲ期行钻孔减压植骨术。

Here we present a case of 21 year-old male who suffered from recurrent swelling in left side of mandible which had received surgery for ossifying fibroma in another hospital when he was 19 years old. Obvious facial asymmetry was noted but no sensory dysfunctions were detected. The lesion showed well-demarcated, multilocular radiolucency but radiopacity centrally. We applied segmental resection via extra-oral approach and reconstructed with anterior iliac crest bone graft. After removal of MMF in six week, the wound healed well and joint function was good without malocclusion. After follow-up of one year, no recurrences were noted.

本病例为－21岁之男性，在19岁时因为左下颚骨角区肿大在某医院接受外科手术处理，术后病理报告为骨化纤维瘤，因为复发的肿胀而来本院寻求治疗，临床检查并无疼痛及下唇区感觉异常的问题，放射线影像为周界清晰，多腔室放射透过性合并中央放射不透过性之不规则小块，手术方式为从口外颚下切线，做下颚骨片段式切除，并以肠骨脊海绵骨移植修补骨缺损加以颚间固定六周，术后伤口恢复及愈合良好，颚骨关系稳定无咬合异常的情况，无张口受限的问题。

METHODS: The rib trabeculae were resected and broken, trypsinizated and washed completely by PBS. Bone surface and non-adhesive floating cells in cleaning fluid were observed with inverted microscope. Rib trabeculae was washed by DMEM culture medium once, and cultured in culture bottle. The culture liquid was replaced by new one once a week. The osteoblast was moved from the sclerite a week later. The cells were fused monolayer and could be subcultured 4 to 6 weeks later.

切下人肋骨骨小梁剪碎，胰酶消化后以PBS彻底冲洗直至于倒置显微镜下观察骨片表面及清洗液中无粘着及漂浮的细胞，以DMEM完全培养液清洗骨小梁1次，移入培养瓶内培养，每周更换培养液1次，1周后可见成骨细胞自骨片移出，4~6周细胞融合成单层可作传代培养。

The focus in long bone appears patchy geographic type, the courser of its long axis was coherent with the stress bone trabecula; the focus in vertebral bodies show laterigrade band-like which was distributed in the middle of the vertebral bodies or near the termibal lamella and plumbed with stress bone trabecula of the vertebral bodies.

在长骨灶病呈长斑片地图样，其长轴大体与应力骨小梁走行相一致；在脊柱椎体病灶表现为分布于椎体中央或近终板区的呈横形小片条带状，与椎体应力骨小梁排列垂直。

The function of flexion and extension of metacarpophalangeal and inter～phalangeal joints were achieved satisfactorily.

因此骨片钉除微小螺纹钉加压作用外，后端增粗的钉杆和小垫片可起到双重加压作用。

Methods 21 cases with suspicioned avulsion fracture of articular portion of tubular bone were reviewed. The cortical continuity of separate small bone and contiguous bone portion was investigated. The swell of soft tissue around these small bones was observed simultaneously.

回顾性分析21例怀疑骨端骨折而行法医学鉴定的案例，通过观察骨端游离小骨周边是否存在连续的骨皮质、小骨片相对侧表面是否有连续的骨皮质和局部软组织肿胀情况，并结合损伤机理考察骨折形态。

Methods MSCs were cultured with inbred line small-ear cancellous bone of Ban Na pigs . A 1.5 centimeter segmental defect was created in the mid-upper part of the radial shaft of adult rabbit. The defects were implanted into composited xenogeneic bone in experimental group and xenogeneic bone alone in control group , the defects were not filled with anything in blank group . The repair capability of the defects was assessed by scan electron microscope before operation and physical , histology, X-ray , transmission electron microscope, SPECT and bone mineral density examinations 4 , 8 and 12 weeks after operation .

将MSCs与版纳近交系小耳猪松质骨在体外联合培养，兔桡骨中上段制成1.5cm的骨—骨膜缺损模型，实验组植入复合异种骨，对照组植入单纯异种骨，空白对照组不植入任何材料，分别于术前行标本的扫描电镜观察和术后4周，8周，12周各时间点行标本的大体观察，组织学观察，X线片观察，透射电镜观察，SPECT扫描及骨密度测试，比较其骨缺损区骨修复愈合情况。

SEM examination showed that the experimental group has regular spongiest structure,complete bone lacuna structure,partial broken os-teone and visible bone canaliculus, while the sham control group has disorderly structure, broken osrteone, little bone lacuna and total invisibility of bone canaliculus.

结果 X线片示A组右侧股骨头骨密度增高，透光区较小，B组骨密度减低，有大小不等透光区；ECT扫描示A组静态放射性分布中等浓聚，而B组静态图像放射性分布呈炸面包圈样改变，欠均匀；组织学检查显示A组骨空陷窝率、血管数、骨髓腔内脂肪细胞直径较B组明显改善(P＜0.01)；扫描电镜检查显示A组松质骨结构较规则，骨陷窝结构完整，部分骨板断裂，骨小管可见。B组结构紊乱不清，骨板断裂，骨陷窝少，骨小管消失。

objective to evaluate early signs of avascular necrosis of femoral head in adult by ct and to guide clinical treatment.methods the cases with suspicious diagnose of anfh were scaned in the both hip joints by x ray and ct to find the early signs of anfh with ct.results early signs of anfh using ct showed that, in 38 femoral heads 31 cases, there were radiate star shape of high density osteosclerosis of the trabeculae in 13 femoral head.twenty five femoral heads showed osteosclerosis and trabeculae structure disappearing and vague,incoordinately low ostedensity area and cyst change.there were fracture under the cartilage and light subsid in 5 cases.the cases in stage ⅰwere given decompression, while the pationtsresul in stageⅱand stageⅲ were given decompression and ostetransplant.conclusion ct results show that the sign of the high osteodensity and low osteodensity and cyst change can disply early anfh.

摘 要］目的：探讨成人股骨头缺血性坏死的早期ct征象并指导临床治疗。方法：对临床疑诊anfh的全部病例均行x线平片及ct检查，分析anfh的早期ct征象。结果：早期anfh的ct表现：31例38个股骨头，其中13个股骨头骨小梁呈放射状高密度的&星状征&，骨小梁境界清楚、锐利，属ⅰ期；25个股骨头表现为骨硬化，骨小梁结构消失、模糊不清，骨密度减低及囊性改变，属ⅱ期；并有5个股骨头在ⅱ期影像学改变基础上出现软骨下骨折及轻微塌陷，属ⅲ期。治疗结果：ⅰ期行钻孔髓内减压术，ⅱ、ⅲ期行钻孔减压植骨术。

I didn't watch TV last night, because it .

昨晚我没有看电视，因为电视机坏了。

Since this year, in a lot of villages of Beijing, TV of elevator liquid crystal was removed.

今年以来，在北京的很多小区里，电梯液晶电视被撤了下来。