从生物力学角度出发 ,采用力学研究方法 ,对组织的力学性质进行研究 ,可为康复治疗的机理探讨和治疗手段的改进提供理论依据。本文简要介绍在制动综合征、软组织损伤、颈椎牵引、关节挛缩等一些骨科康复领域中所涉及的力学问题 ,以期更好地指导临床治疗。

Purpose:To discuss the treatments for lung cancer which involved carina of the bronchus and its complications. Methods:The surgical skill, airway management, postoperative complications of the pneumonectomy of right lung and reconstruction of carina and bronchus for lung cancer in 12 patients were discussed. Results:The 1.2.3 year survival rates are 100%(12/12),67%(8/12)and17%(2/12) respectively.There was no cases operative mortality and no severe past-operative complications. Conclusions:There is some value in this method but the indication must be strictly controlled.

Objective To explore the effect of treadmill running at different intensities on three-dimensional structure of rat subchondral bones.Methods A total of 24 female Wistar rats were randomly assigned into a sedentary (SED) group,a low-intensity running (LIR) group,a medium-intensity running (MIR) group,or a high-intensity running (HIR) group,each of 6.Rats in LIR,MIR and HIR groups underwent treadmill running exercises with respective protocol,while rats in SED group serve as controls.Eight weeks later,all animals were sacrificed and their proximal end of tibia was examined using Micro-CT.Results Compared with SED group,in HIR group the subchondral plate became thicker with higher BMD and lower porosity,while trabecular bone became more and denser with higher BMD and a more plate-like architecture.LIR and MIR failed to result in considerable changes in the microstructure.Conclusion Treadmill running has an intensity-dependent effect on the three-dimensional structures of subchondral bones.High-intensity running can evoke significant structural changes in subchondral bones.

Objective To differentiate the myogenic and arthrogenic components of knee contracture resulting from being immobilized in extension for 4 weeks.Method Ten rabbits were used as experimental animals. The right hindlimbs were immobilized with the knee in extension for four weeks, while the left served as controls. The range of motion (ROM) of both knees was measured before and after myotomy.Result In immobilized and control hindlimbs, knee mean ROM were 79.5° and 138.5° respectively. The gain of ROM after myotomy in immobilized and control hindlimbs were (8.7± 0.45)° , (11.6± 0.58)° respectively. Only 14.75％ of the limitation of motion in ROM was accounted for by the myotomy component. Conclusions After immobilized for 4 weeks, the ROM of knee was limited.However,the myogenic part was small and not different from normals.Because this study reports on only one time point,further investigations are needed.

Objective To evaluate the effects of different intensities of treadmill running on changes in tibial bone composition in a rat model.Methods A total of 24 female Wistar rats were randomly assigned into 4 even groups (n =6) of free movement (FM),low-intensity running (LR),medium-intensity running (MR),and high-intensity running (HR).Rats in LR,MR,and HR groups underwent treadmill running with respective intensities (15 m/min and a 0° gradient,20 m/min and a 5° gradient,25 m/min and a 10° gradient) for 8 weeks (1 h/d and 5 d/week).FM group were taken as controls.The cortical and trabecular bone at the left tibial metaphysis was harvested after 8 weeks in each group for Raman spectroscopy to analyze mineral-matrix ratio,carbonate-phosphate ratio and crystallinity.Results In MR group,the mean mineral-matrix ratio was 4.883 ± 0.128 for cortical bone and 4.216 ±0.213 for trabecular bone,both significantly higher than those in FM group (4.113 ±0.132 and 3.773 ±0.122) (P ＜ 0.05).The mean mineral-matrix ratio was 3.222 ± 0.329 for trabecular bone in HR group,significantly lower than that in FM group (P ＜ 0.05).In MR group,the mean carbonate-phosphate ratio was 0.166 ± 0.013 for trabecular bone,significantly lower than that in FM group (0.177 ± 0.011) (P ＜ 0.05).In HR group,the mean carbonate-phosphate ratio was 0.195 ± 0.012 for cortical bone and 0.187 ± 0.010 for trabecular bone,both significantly higher than those in FM group (0.183 ± 0.014 and 0.177 ± 0.011) (P ＜ 0.05).In HR group,the mean crystallinity was 0.0521 ± 0.0012 for cortical bone and 0.0522 ± 0.0017 for trabecular bone,both significantly higher than those in the other 3 groups (P ＜ 0.05).Conclusions Running with medium intensity may increase bone mineralization and turnover,thus enhancing bone quality.However,running with high intensity may decrease bone mineralization and thus bone quality.

Objective:To differentitate the myogenic from arthrogenic component of knee contracture resulting from being immobilized in extension for 4 weeks. Method:Ten rabbits were used as experimental animals. The right hindlimbs were immobilized with knee in extension for 4 weeks, while the left severed as controls. The range of motion ( ROM ) of both knees were measured before and after myotomy. Result:In immobilized and control hindlimbs, the mean ROM of the knee were 79.5°and 138.5°, respectively. The gain of ROM after myotomy in immobilized and control hindlimbs were 8.7° ±0. 45°, 11.6° +0.58°, respectively. Only 14.75% of the limitation of motion in ROM were accounted for by the myotomy component. Conclusion:After immobilizing for 4 weeks, the ROM of knee was significantly limited. However, the myogenic part was small and not different from normals.

Objective To investigate the effect of treadmill running with different intensities on type Ⅱ collagen (Col2) of knee joint articular cartilages in rats.Methods A total of 48 adult Sprague-Dawley rats were randomly divided into a control (C) group,a low-intensity exercise (L) group,a moderate-intensity exercise (M)group and a high-intensity exercise (H) group,each of 12.Rats in three exercises groups were regularly trained on treadmill at low,moderate,and high intensities respectively.Eight weeks later,all the animals were sacrificed.The right tibial plateau samples were collected to observe collagen fibers under polarizing light microscopy,and the collagen Ⅱ content were examined using immunohistochemistry.The mRNA expression of biglycan (BGN),fibromodulin (FMOD) and Col2 was tested using the quantitative real-time reverse transcription-polymerase chain reaction.Results Compared with group C,collagen fibers in group L and M exhibited almost the same organization,whereas,alteration in organization and shape of collagen fibers was found in group H.Significantly lower content of type Ⅱ collagen was found in group H than that in group C.In comparison with group C,group L had significantly higher gene expression of Col2,whereas group H had significantly higher BGN mRNA expression.Conclusion Low-or moderate-intensity treadmill running appears to have beneficial effect on articular cartilages to maintain its integrity.Highintensity exercises induce lower content and disorder of type Ⅱ collagen in articular cartilages,but the self-healing of cartilage may still exist.

Objective To investigate the influence of gene therapy using survivin as a gene target on biological behavior of pancreatic carcinoma cell line. Methods Chemically synthesized siRNA and shRNA in pGCSi vector were used to silence survivin expression of pancreatic carcinoma cell line PaTu8988. The therapeutical effects of survivin as a gene target were evaluated through determination of the down-regulation of survivin gene expression, cellular shape, cell apoptosis, cell viability and apoptosis signal pathway changes. Results After transfection of different arrays of siRNA and shRNA vectors to silence the survivin expression, survivin mRNA and protein levels were significantly decreased (P < 0.05) ; PI staining revealed the presence of karyopyknosis, the cell apoptosis index was more than 20%; hypodiploid DNA content before G0/G1 detected by flow cytometry ; cell viability measured by MTT assay was significantly decreased (P <0.05) ; the activity of caspase-3 remarkably increased (P < 0. 05). Conclusions The pancreatic carcinoma cell line PaTu8988 be induced to promote spontaneous apoptosis procedure through silencing survivin expression by RNAi, which could accelerate carcinoma cell apoptosis and improve therapeutic effect on pancreatic carcinoma.

Objective To assess the efficacy of triple therapy including proton pump inhibitor (PPI), levofloxacin and amoxicillin for the first-line treatment of H. pylori infection, and the relation between H. pylori eradication and CYP2C19 genetic polymorphism. Methods Two hundred and five H. pylori-positive patients were divided into group E_(20) (esomeprazole 20 mg twice daily), group E_(40)(esomeprazote 40 mg twice daily),group R (rabeprazole 10 mg twice daily) and group L (lansoprazole 30 mg twice daily). Besides PPI, all patients were received levofloxacin 500 mg daily and amoxicillin 1000 mg twice daily for 1 week. The CYP2C19 genotypes were detected in 161 patients. The eradication of H. pylori were analyzed by intention-to-treat (ITT) and per protocol (PP) methods.ResultsThe H. pylori eradication was 86.70% in group E_(20), 88.5% in group E_(40),73.5% in group R and 78.1% in group L. Whereas the H. pylori eradication was 90% in patients with PM genotype,81.5% in patients with HetEM genotype and 82.1% in patients with HomEM genotype. The H.pylori eradication was 83.4% and 79.00% by per protocol (PP) and intention-to-treat (ITT) analyses,respectively. There was no significant difference in H. pylori eradication among four groups (P>0.05), and no relation was found between H. pylori eradication and genotypes (P>0.05). Conclusions PPI based triple therapy was effective in eradication of H. pylori, which is not influenced by CYP2C19 genotypes.

Objective To investigate the effect of cyclic tensile stress (CTS) on the metabolism inand apoptosis of rat chondrocytes.Methods Primary rat chondrocytes were cultured on a Bioflex plate for one day and then stretched cyclically for 24 hours at a frequency of 0.5 Hz using a Flexcell-5000T apparatus.The cells were divided into 5 groups according to their stretching ratio:0％ (the control group),2％,6％,10％ and 14％.After the stretching,Col Ⅱ,Aggrecan,MMP-13 and ADAMTS-5 mRNA were measured using qPCRs,and the NO and PGE2 levels were measured using ELISA kits.Moreover,TUNEL staining and Annexin V-FITC/PI were used to analyze the apoptosis of chondrocytes.Results Compared with the control group,the average levels of Col Ⅱ and Aggrecan mRNAdecreasedin 10％ and 14％ groups [(0.738±0.11) and (0.58±0.13),(0.75±0.11) and (0.55±0.09)].In those groups,the MMP-13 [(2.47±0.47) and (2.88±0.36)] and ADAMTS-5 mRNA level [(2.39±0.33) and (2.75±0.49)],the NO [(6.96±0.96) and (8.28±0.82)] and PGE2 level [(6.83±0.66) and (7.15±0.71)] had increased significantly.In the 6％ group the average levels of Col Ⅱ(1.76±0.30) and Aggrecan mRNA (1.93±0.14)of 6％ group were significantly higher than the control group,but the NO level of the former (3.07±0.20) was significantly lower than the control group (3.89 ± 0.33).The apoptosis rate of chondrocytesin 2％ and 6％ groups were (0.065±0.013) and (0.063 ± 0.147),without significant differences to that of the control group (0.045 ± 0.008).However,compared with the control group,apoptosis in the 10％ and 14％ groups [(0.135 ±0.026) and (0.184±0.020)] increased significantly.Conclusion The effect of cyclic tensile stress on chondrocyte metabolism and apoptosis was magnitude-dependent.Ten percent and 14％ CTS can increase the catabolism and apoptosis of chondrocytes.Ten percent and 14％ strain can increase the catabolism and apoptosis of chondrocytes.Cyclic 6％ strain can increase the anabolism of chondrocytes,but 2％ strain has no impact on metabolism or apoptosis.