骨肉瘤(OS)是最常见的原发性骨恶性肿瘤,其具备较高的局部侵袭、肺部转移率和病死率,常见于儿童、青少年,其次是老年人,目前针对骨肉瘤的主流治疗方式即手术切除并化疗,但该疾病治疗后转移进展和复发风险很高,其中的一个主要原因是化疗...骨肉瘤(OS)是最常见的原发性骨恶性肿瘤,其具备较高的局部侵袭、肺部转移率和病死率,常见于儿童、青少年,其次是老年人,目前针对骨肉瘤的主流治疗方式即手术切除并化疗,但该疾病治疗后转移进展和复发风险很高,其中的一个主要原因是化疗过程中骨肉瘤产生了对化疗药物的耐药性,肿瘤细胞产生耐药性是多水平、多因素、多基因机制引起的,其中外泌体-miRNAs机制是近些年在研究肿瘤耐药过程中所发现的一种机制,外泌体本质是一种双层脂质胞外囊泡,其可以参与细胞间的信息交流和物质传递,从而对骨肉瘤的耐药性造成影响。本文对当前较主流的外泌体在骨肉瘤耐药性产生中所起的作用机制进行了综述。Osteosarcoma (OS) is the most common primary bone malignant tumor, which has a high local invasion, lung metastasis rate and mortality rate. It is common in children and adolescents, followed by the elderly. The mainstream treatment for osteosarcoma is surgical resection and chemotherapy. However, the risk of metastatic progression and recurrence after treatment of this disease is very high. One of the main reasons is that osteosarcoma develops resistance to chemotherapeutic drugs during chemotherapy. The drug resistance of tumor cells is caused by multi-level, multi-factor, and multi-gene mechanisms. Among them, the mechanism of exosome-miRNAs is a mechanism discovered in the process of studying tumor drug resistance in recent years. The essence of exosomes is a bilayer lipid extracellular vesicle, which can participate in information exchange and material transmission between cells, thus affecting the drug resistance of osteosarcoma. This article reviews the mechanisms by which exosomes, currently one of the mainstream factors, contribute to the development of drug resistance in osteosarcoma.展开更多
发育性髋关节发育不良(development dysplasia of the hip, DDH),是儿童骨科常见的肌肉骨骼畸形之一,其发病的确切病因尚不明确,但是遗传因素和环境因素被认为在发病机制中起作用。其发病率存在地区差异和年龄差异,疾病的严重程度以及...发育性髋关节发育不良(development dysplasia of the hip, DDH),是儿童骨科常见的肌肉骨骼畸形之一,其发病的确切病因尚不明确,但是遗传因素和环境因素被认为在发病机制中起作用。其发病率存在地区差异和年龄差异,疾病的严重程度以及治疗方式的选择通过影像学分型来决定,如果没有合适的治疗,DDH儿童将影响正常行走功能以及过早产生骨关节炎,从而对生活质量产生重大影响。如今Pemberton截骨术治疗DDH被儿童骨科医生广泛采用,Pemberton截骨术不仅是一种实现髋臼形态矫正的技术,而且是可以联合其他术式以减少并发症的技术。本综述旨在总结Pemberton截骨术在DDH手术治疗中的应用及相关困难之处,以期为今后更加细节化的治疗提供参考。Developmental dysplasia of the hip (DDH) is one of the common musculoskeletal deformities in pediatric orthopedics. The exact cause of its onset is not yet clear, but genetic and environmental factors are believed to play a role in the pathogenesis. There are regional differences and age differences in its incidence rate. The severity of the disease and the choice of treatment methods are determined by the type of imaging classification. Without proper treatment, DDH children will affect their normal walking function and develop osteoarthritis prematurely, which will have a significant impact on the quality of life. Nowadays, Pemberton osteotomy is widely used by pediatric orthopedic surgeons to treat DDH. Pemberton osteotomy is not only a technique for correcting acetabular morphology, but also a technique that can be combined with other surgical procedures to reduce complications. This review aims to summarize the application and related difficulties of Pemberton osteotomy in the treatment of DDH surgery, in order to provide reference for more detailed treatment in the future.展开更多
青少年特发性脊柱侧凸(Adolescent Idiopathic Scoliosis, AIS)是一种常见的青少年脊柱畸形,其特征是脊柱侧凸角度超过10˚,且椎体发生不明原因的旋转,形成二维或三维畸形。AIS患者在接受定制支具治疗或手术干预时,都需要定期进行放射学...青少年特发性脊柱侧凸(Adolescent Idiopathic Scoliosis, AIS)是一种常见的青少年脊柱畸形,其特征是脊柱侧凸角度超过10˚,且椎体发生不明原因的旋转,形成二维或三维畸形。AIS患者在接受定制支具治疗或手术干预时,都需要定期进行放射学检查。而且,X线片的放射性可能导致人们担忧电离辐射增加癌症风险。超声作为一种普遍且必要的医学诊断和治疗工具,具有无辐射的优点。三维超声成像系统(Scolioscan)推动了无辐射脊柱成像技术的发展,为青少年脊柱侧凸的检查提供了一个优秀的替代方案。Adolescent Idiopathic Scoliosis (AIS) is a common adolescent spinal deformity characterized by a scoliotic angle of more than 10˚ and unexplained rotation of the vertebral bodies, resulting in a two- or three-dimensional deformity. Patients with AIS undergoing customized bracing or surgical interventions require periodic radiologic examination. Moreover, the radioactivity of radiographs may lead to concerns about increased cancer risk from ionizing radiation. Ultrasound, a common and necessary medical diagnostic and therapeutic tool, has the advantage of being radiation-free. The three-dimensional ultrasound imaging system (Scolioscan) has advanced the development of radiation-free spinal imaging and provides an excellent alternative to screening for adolescent scoliosis.展开更多
发育性髋关节发育不良(Developmental Dysplasia of the Hip,简称DDH)是是一种涉及髋关节结构异常和功能障碍的疾病,然而其具体发病机制及原因仍不清楚。其发病特征在于以髋关节发育不良为基础,导致关节囊松弛,股骨近端继发畸形,在髋臼...发育性髋关节发育不良(Developmental Dysplasia of the Hip,简称DDH)是是一种涉及髋关节结构异常和功能障碍的疾病,然而其具体发病机制及原因仍不清楚。其发病特征在于以髋关节发育不良为基础,导致关节囊松弛,股骨近端继发畸形,在髋臼对股骨头覆盖不良的情况下,逐渐出现股骨头脱位或半脱位于髋臼之外的下肢畸形。髋臼变浅以至于对股骨头覆盖降低是DDH引发髋关节不稳定进而引发青少年和青年期骨关节炎的重要原因。遗传和环境因素在DDH的发病机制中起重要作用。其发病机制和易感性相关基因尚未阐明。我们评估了PubMed数据库中索引的各种遗传学研究。我们分析了纳入研究的基本信息,并总结了DDH相关的突变位点,动物模型实验,与DDH相关的表观遗传学变化。展开更多
髋关节发育不良(Developmental Dysplasia of the Hip, DDH)是一种复杂的髋关节疾病,其涉及范围从新生儿的不稳定髋到髋臼或股骨的发育不良、髋关节半脱位直至完全脱位。这种疾病可能导致结构上的改变,从而引发早期的髋关节病变。尽管...髋关节发育不良(Developmental Dysplasia of the Hip, DDH)是一种复杂的髋关节疾病,其涉及范围从新生儿的不稳定髋到髋臼或股骨的发育不良、髋关节半脱位直至完全脱位。这种疾病可能导致结构上的改变,从而引发早期的髋关节病变。尽管已经确定了一些危险因素,但其确切的病因和病理生理机制仍未完全明了。新生儿筛查、体格检查以及超声检查在DDH的早期诊断和预防早期髋关节病变中起到了至关重要的作用。这篇综述着重总结了目前DDH的检测和治疗的实践策略。Developmental Dysplasia of the Hip (DDH) is a complex disease of the Hip, which involves from the unstable Hip to acetabular or femoral Dysplasia, subluxation and complete dislocation of the Hip. The disease can lead to structural changes that can lead to early hip disease. Although a number of risk factors have been identified, the exact etiology and pathophysiological mechanisms remain unclear. Neonatal screening, physical examination and ultrasonography play an important role in the early diagnosis and prevention of DDH. This review summarizes current practical strategies for the detection and treatment of DDH.展开更多
间充质干细胞(MSCs)起源于胚胎的中胚层,具有在体内外分化为骨骼、软骨等多种组织的能力。这些干细胞在修复和再生医学中具有显著的应用潜力,尤其是在心脏、肝脏和皮肤损伤的修复。在骨科领域,MSCs能够促进骨折愈合,但其机制仍不完全明...间充质干细胞(MSCs)起源于胚胎的中胚层,具有在体内外分化为骨骼、软骨等多种组织的能力。这些干细胞在修复和再生医学中具有显著的应用潜力,尤其是在心脏、肝脏和皮肤损伤的修复。在骨科领域,MSCs能够促进骨折愈合,但其机制仍不完全明确。近年的研究表明,MSCs通过调节炎症反应、免疫系统和血管新生,以及促进成骨分化,对骨折愈合的各个阶段产生影响。通过分泌生长因子、外泌体和其他生物活性物质,这些细胞激活多条信号通路,加速骨折的愈合过程,并显示出在骨组织修复中的重要性。Mesenchymal stem cells (MSCs) originate from the mesoderm of the embryo and have the ability to differentiate into various tissues such as bone and cartilage in vitro and in vivo. These stem cells have significant potential for applications in restorative and regenerative medicine, especially in the repair of heart, liver, and skin damage. In orthopedics, MSCs can promote fracture healing, but the mechanism is still not fully understood. Recent studies have shown that MSCs have an impact on all stages of fracture healing by modulating the inflammatory response, immune system and angiogenesis, and promoting osteogenic differentiation. By secreting growth factors, exosomes, and other bioactive substances, these cells activate multiple signaling pathways, accelerate the healing process of fractures, and show importance in bone tissue repair.展开更多
文摘骨肉瘤(OS)是最常见的原发性骨恶性肿瘤,其具备较高的局部侵袭、肺部转移率和病死率,常见于儿童、青少年,其次是老年人,目前针对骨肉瘤的主流治疗方式即手术切除并化疗,但该疾病治疗后转移进展和复发风险很高,其中的一个主要原因是化疗过程中骨肉瘤产生了对化疗药物的耐药性,肿瘤细胞产生耐药性是多水平、多因素、多基因机制引起的,其中外泌体-miRNAs机制是近些年在研究肿瘤耐药过程中所发现的一种机制,外泌体本质是一种双层脂质胞外囊泡,其可以参与细胞间的信息交流和物质传递,从而对骨肉瘤的耐药性造成影响。本文对当前较主流的外泌体在骨肉瘤耐药性产生中所起的作用机制进行了综述。Osteosarcoma (OS) is the most common primary bone malignant tumor, which has a high local invasion, lung metastasis rate and mortality rate. It is common in children and adolescents, followed by the elderly. The mainstream treatment for osteosarcoma is surgical resection and chemotherapy. However, the risk of metastatic progression and recurrence after treatment of this disease is very high. One of the main reasons is that osteosarcoma develops resistance to chemotherapeutic drugs during chemotherapy. The drug resistance of tumor cells is caused by multi-level, multi-factor, and multi-gene mechanisms. Among them, the mechanism of exosome-miRNAs is a mechanism discovered in the process of studying tumor drug resistance in recent years. The essence of exosomes is a bilayer lipid extracellular vesicle, which can participate in information exchange and material transmission between cells, thus affecting the drug resistance of osteosarcoma. This article reviews the mechanisms by which exosomes, currently one of the mainstream factors, contribute to the development of drug resistance in osteosarcoma.
文摘发育性髋关节发育不良(development dysplasia of the hip, DDH),是儿童骨科常见的肌肉骨骼畸形之一,其发病的确切病因尚不明确,但是遗传因素和环境因素被认为在发病机制中起作用。其发病率存在地区差异和年龄差异,疾病的严重程度以及治疗方式的选择通过影像学分型来决定,如果没有合适的治疗,DDH儿童将影响正常行走功能以及过早产生骨关节炎,从而对生活质量产生重大影响。如今Pemberton截骨术治疗DDH被儿童骨科医生广泛采用,Pemberton截骨术不仅是一种实现髋臼形态矫正的技术,而且是可以联合其他术式以减少并发症的技术。本综述旨在总结Pemberton截骨术在DDH手术治疗中的应用及相关困难之处,以期为今后更加细节化的治疗提供参考。Developmental dysplasia of the hip (DDH) is one of the common musculoskeletal deformities in pediatric orthopedics. The exact cause of its onset is not yet clear, but genetic and environmental factors are believed to play a role in the pathogenesis. There are regional differences and age differences in its incidence rate. The severity of the disease and the choice of treatment methods are determined by the type of imaging classification. Without proper treatment, DDH children will affect their normal walking function and develop osteoarthritis prematurely, which will have a significant impact on the quality of life. Nowadays, Pemberton osteotomy is widely used by pediatric orthopedic surgeons to treat DDH. Pemberton osteotomy is not only a technique for correcting acetabular morphology, but also a technique that can be combined with other surgical procedures to reduce complications. This review aims to summarize the application and related difficulties of Pemberton osteotomy in the treatment of DDH surgery, in order to provide reference for more detailed treatment in the future.
文摘青少年特发性脊柱侧凸(Adolescent Idiopathic Scoliosis, AIS)是一种常见的青少年脊柱畸形,其特征是脊柱侧凸角度超过10˚,且椎体发生不明原因的旋转,形成二维或三维畸形。AIS患者在接受定制支具治疗或手术干预时,都需要定期进行放射学检查。而且,X线片的放射性可能导致人们担忧电离辐射增加癌症风险。超声作为一种普遍且必要的医学诊断和治疗工具,具有无辐射的优点。三维超声成像系统(Scolioscan)推动了无辐射脊柱成像技术的发展,为青少年脊柱侧凸的检查提供了一个优秀的替代方案。Adolescent Idiopathic Scoliosis (AIS) is a common adolescent spinal deformity characterized by a scoliotic angle of more than 10˚ and unexplained rotation of the vertebral bodies, resulting in a two- or three-dimensional deformity. Patients with AIS undergoing customized bracing or surgical interventions require periodic radiologic examination. Moreover, the radioactivity of radiographs may lead to concerns about increased cancer risk from ionizing radiation. Ultrasound, a common and necessary medical diagnostic and therapeutic tool, has the advantage of being radiation-free. The three-dimensional ultrasound imaging system (Scolioscan) has advanced the development of radiation-free spinal imaging and provides an excellent alternative to screening for adolescent scoliosis.
文摘发育性髋关节发育不良(Developmental Dysplasia of the Hip,简称DDH)是是一种涉及髋关节结构异常和功能障碍的疾病,然而其具体发病机制及原因仍不清楚。其发病特征在于以髋关节发育不良为基础,导致关节囊松弛,股骨近端继发畸形,在髋臼对股骨头覆盖不良的情况下,逐渐出现股骨头脱位或半脱位于髋臼之外的下肢畸形。髋臼变浅以至于对股骨头覆盖降低是DDH引发髋关节不稳定进而引发青少年和青年期骨关节炎的重要原因。遗传和环境因素在DDH的发病机制中起重要作用。其发病机制和易感性相关基因尚未阐明。我们评估了PubMed数据库中索引的各种遗传学研究。我们分析了纳入研究的基本信息,并总结了DDH相关的突变位点,动物模型实验,与DDH相关的表观遗传学变化。
文摘髋关节发育不良(Developmental Dysplasia of the Hip, DDH)是一种复杂的髋关节疾病,其涉及范围从新生儿的不稳定髋到髋臼或股骨的发育不良、髋关节半脱位直至完全脱位。这种疾病可能导致结构上的改变,从而引发早期的髋关节病变。尽管已经确定了一些危险因素,但其确切的病因和病理生理机制仍未完全明了。新生儿筛查、体格检查以及超声检查在DDH的早期诊断和预防早期髋关节病变中起到了至关重要的作用。这篇综述着重总结了目前DDH的检测和治疗的实践策略。Developmental Dysplasia of the Hip (DDH) is a complex disease of the Hip, which involves from the unstable Hip to acetabular or femoral Dysplasia, subluxation and complete dislocation of the Hip. The disease can lead to structural changes that can lead to early hip disease. Although a number of risk factors have been identified, the exact etiology and pathophysiological mechanisms remain unclear. Neonatal screening, physical examination and ultrasonography play an important role in the early diagnosis and prevention of DDH. This review summarizes current practical strategies for the detection and treatment of DDH.
文摘间充质干细胞(MSCs)起源于胚胎的中胚层,具有在体内外分化为骨骼、软骨等多种组织的能力。这些干细胞在修复和再生医学中具有显著的应用潜力,尤其是在心脏、肝脏和皮肤损伤的修复。在骨科领域,MSCs能够促进骨折愈合,但其机制仍不完全明确。近年的研究表明,MSCs通过调节炎症反应、免疫系统和血管新生,以及促进成骨分化,对骨折愈合的各个阶段产生影响。通过分泌生长因子、外泌体和其他生物活性物质,这些细胞激活多条信号通路,加速骨折的愈合过程,并显示出在骨组织修复中的重要性。Mesenchymal stem cells (MSCs) originate from the mesoderm of the embryo and have the ability to differentiate into various tissues such as bone and cartilage in vitro and in vivo. These stem cells have significant potential for applications in restorative and regenerative medicine, especially in the repair of heart, liver, and skin damage. In orthopedics, MSCs can promote fracture healing, but the mechanism is still not fully understood. Recent studies have shown that MSCs have an impact on all stages of fracture healing by modulating the inflammatory response, immune system and angiogenesis, and promoting osteogenic differentiation. By secreting growth factors, exosomes, and other bioactive substances, these cells activate multiple signaling pathways, accelerate the healing process of fractures, and show importance in bone tissue repair.
