凝血酶肽复合人工骨修复兔桡骨大段骨缺损的实验研究

目的 探讨凝血酶肽(TP508)复合人工骨对兔桡骨大段骨缺损的修复效果。方法 随机选取新西兰大白兔42只,建立双侧桡骨1.5cm骨-骨膜缺损模型。随机 选取其中36只,将右侧作为实验侧,骨缺损处植入羟基磷灰石人工骨材料并注入TP508;左侧为对照组,仅植入上述人工骨材料;剩余6只作为空白对照组,骨缺损处不 植入任何物质。术后4周、8周、12周分批处死实验动物,对实验段桡骨进行X线及组织学分析。结果 术后4周、8周、12周实验组X线评分、组织学评分及骨缺损区 新生骨组织面积百分比均优于同期对照组(P均<0.05);术后12周空白对照组骨缺损区无骨连接形成,X线评分及组织学评分明显低于同期实验组及对照组(P均 <0.05)。结论 TP508在骨缺损修复过程中具有促进愈合作用,复合人工骨植骨对兔桡骨大段骨缺损的修复效果良好。     

骨基质明胶在异位成骨区的成骨研究

目的探讨不同处理后的骨基质明胶（BMG）在异位成骨区的成骨效果。方法将36只日本大耳白兔随机分为3组,每组12只。A组血管束植入用bFGF预处理过的BMG中;B组血管束植入未作任何预处理的BMG中;C组单独植入BMG。分别于术后4、8、12周给各组动物灌注墨汁后做HE及Masson染色进行组织学观察和定量分析。结果新生骨面积定量分析,各个时间点上A组新生骨面积均最大,与C组比较差异均有统计学意义（均P﹤0.05）。新生骨面积比与血管面积比相关分析结果显示,r4周=0.53,P﹤0.05;r8周=0.46,P﹤0.05;r12周=0.61,P﹤0.05。结论血管化程度越高,新生骨面积越大;新生骨面积比与血管化程度呈正相关。     

3D打印多孔钛材料修复兔股骨髁骨缺损的实验研究

目的 研究3D打印的多孔钛材料对骨缺损的修复能力和成骨性能.方法 选取20只6月龄新西兰白兔,在其股骨髁上制备直径6 mm,深10 mm的临界性骨缺损.实验组将多孔钛材料迅速注入骨缺损区.对侧生理盐水冲洗,不植任何材料,作为对照组.术后3d、4周、8周、12周通过X线及CT观察骨缺损处生长变化,术后12周处死所有新西兰白兔,通过大体观察、X线、CT、Micro-CT及组织学观察骨缺损处的修复情况.结果 实验组与对照组一般情况良好,术后12周取出标本清理周围软组织,实验组缺损部位被新生骨填充;对照组见缺损处骨质凹陷;影像学观察,实验组植入物区域与周围界限模糊不清;对照组未见明显新生骨阴影;Micro-CT观察,术后12周实验组植入物区域空隙内长入新生骨组织,植入物附近可见骨小梁长入;对照组缺损区未见明显的骨长入;硬组织切片观察,实验组植入材料与成骨细胞结合,可见成熟的哈佛氏系统散在分布于新生骨内;对照组骨缺损区被大量纤维组织填充.IPP5.1计算新生骨与缺损区面积比,差异有统计学意义.结论 多孔钛材料可以促进骨组织的生长愈合,新生骨组织可以长入并充满孔隙,是一种很有应用前景的组织工程修复材料.     

血管束植入骨内的形态学研究

选用32只(64后肢)体重在11～18.5kg成年健康杂种狗,随机分为三组,每组10～11只。实验组将血管束植入源于肋骨、胫骨段的骨块内,并埋置肌间,对侧骨为无血管束植入的对照组。术后60～180天作大体观测、X线检查和组织学观察。在半数动物作骨缺血坏死模型实验的骨块,采用热灼法、蒸煮游离骨和硅膜包骨法,在不同时间内进行观察,其中以硅膜包骨的骨缺血坏死模型最为满意。实验证明,在血管束植入骨内后,可以重建血供,血管长入,骨细胞再生,发现有很多密集的成骨细胞、骨软骨母细胞、胶原纤维、新骨小梁和黄骨髓等组织,而无血管束植入的对照骨块均成为死骨。     

自体髂骨血管化治疗胫骨骨折后骨不连26例

目的：用自体髂骨移植并血管化治疗胫骨骨折不愈合,并通过MRI、X线检查,观察移植骨血管化和骨折愈合情况,并探讨其在治疗骨折不愈合中的疗效及可行性。方法：将2006年1月至2008年11月于我院临床诊断26例胫骨骨折不愈合患者,随机分为A、B两组,A组采用常规胫前入路,于胫骨内侧皮下找到隐动脉分支,将所取血管束不切断置于骨折两断端中央,取合适长度自体髂骨块,中央纵行剖开,将所取骨块置于骨折端之间,包绕移植的血管束,用钛合金钢板将髂骨与隐动脉分支牢固于骨缺损处。B组常规取髂骨植骨钛合金钢板内固定,用对比剂首过灌注成像技术分别于术后4、8、12周作磁共振灌注成像检查及x线检查,了解移植骨块再血管化情况和骨折愈合情况。结果：试验组各项监测指标（基线、最大斜率指标、最大信号强度上升值）较对照组有差异,P〈0．05,有统计学意义。结论：将移植骨与移植血管束恰当的有效结合,即将移植骨不挤压移植血管束,移植血管供应移植骨所需营养,达到将移植骨血管化,较单纯移植骨更可靠、更有效解决骨折不愈合,缩短骨折愈合时间。     

BMP-9基因修饰的骨髓基质细胞促进山羊骨缺损愈合

目的观察BMP-9基因修饰的骨髓基质细胞(marrow stromal cells,MSCs)治疗山羊骨缺损的效果。方法 12只12～18月龄中国青山羊,股骨中段建立临界骨缺损模型,按照配对比较法随机分为2组,缺损区域明胶海绵填充,实验组加入预先准备好的BMP-9腺病毒感染的MSCs悬液,对照组加入GFP腺病毒感染的MSCs悬液,术后1 d、2、4、8、12、20周行X线片检查,20周时进行CT检查,处死动物,行大体标本、组织学染色和生物力学的检测。结果 X线片显示实验组较对照组骨痂形成更早更多,大体标本、组织学染色显示实验组的新生骨更加成熟,CT显示实验组新生骨塑形更好,生物力学检测显示实验组新生骨痂的力学强度更强。结论 BMP-9基因修饰的MSCs可以有效地促进山羊股骨骨缺损的愈合。     

淫羊藿苷/固邦人工骨修复骨缺损的实验研究

目的：探讨淫羊藿苷/固邦人工骨修复骨缺损的效果.方法：将淫羊藿苷与固邦人工骨复合,植入兔下颌骨的缺损区.分别在术后4、8、12周取材,进行大体现察、X线检测、扫描电镜、组织学观察、以及新骨的形成观察.结果：时间点大体观察、X线、扫描电镜、组织学观察及新骨的形成,实验组均优于对照组.结论：淫羊藿苷/固邦人工骨具有明显加速颜面部骨缺损修复的作用.     

带血供骨膜瓣包裹同种异体骨修复骨缺损的实验研究

目的探讨带血供骨膜瓣包裹去抗原异体骨修复骨缺损的效果。方法将兔的股骨经去抗原化后作为供体，制作带血供骨膜瓣色裹同种异体骨修复免大段骨缺损模型，实验设置对照组，即未用血管化骨膜瓣包裹移植物。分别在术后第4周、8周和16周分别行X线摄片，并对移植物及周围软组织、骨组织进行组织学观察（HE染色），对两组移植物骨形态发生蛋白（BMP）进行免疫组织化学染色。结果X线表现为实验组骨痂形成的速度快于对照组，骨痂形成的质和量优于对照组，组织学观察显示实验组骨质更新速度以及新生血管速度均快于对照组，BMP免疫组织化学染色显示在相同时期实验组的表达明显强于对照组。结论带血供骨膜瓣包裹异体骨修复骨缺损优于单纯异体骨移植，明显缩短骨缺损的修复时间。     

海藻酸钙/纳米羟基磷灰石/胶原复合材料修复兔桡骨缺损

目的 探讨海藻酸钙/纳米羟基磷灰石/胶原复合材料植入动物体内的成骨能力.方法 用18只3月龄健康新西兰大白兔制备兔桡骨中段15 mm骨缺损模型.将每只兔子的左右前肢按随机数字表法分为实验组和对照组.在实验组兔桡骨缺损部位植入海藻酸钙/纳米羟基磷灰石/胶原复合材料,对照组为空白对照,骨缺损部位不植入任何材料.分别于术后4、8、12周采用X线和组织学方法检测缺损部位的成骨情况.结果 18只模型兔均进入结果分析.X线结果显示,4周时实验组桡骨缺损区可见明显的骨生成影像,呈云雾状分布,随时间的延长骨量增多,至12周时,植入体已与缺损处断端骨性愈合,皮质骨连续性较好.对照组12周时显示骨断端骨质硬化,骨缺损区尚未修复.组织学结果表明,4周时实验材料内部可见骨形成细胞集中,随时间的延长骨量增多,并相互连接成片,到12周时,材料内骨小梁成熟,网孔间新生骨小梁相互连接成板状.结论 海藻酸钙/纳米羟基磷灰石/胶原复合材料具有良好的成骨能力.     

rhBMP-2复合人工骨对兔股骨头坏死模型修复的实验研究

目的 观察重组人骨形态发生蛋白-2（rhBMP-2）／β-磷酸三钙（β-TCP）复合人工骨是否对液氮冷冻兔股骨头坏死模型有修复作用。方法20只成年大白兔，建立双侧股骨头骨缺损模型，并用液氮从缺损内将股骨头冷冻坏死，右侧股骨头为实验组，植入复合人工骨，左侧为对照组，仅植入β-TCP。术后2、4、6、8周进行有关指标检测。结果X线检查：2周时两组股骨头骨密度均未明显增高；4周后实验侧股骨头相对骨密度显著高于对照侧。组织学检查观察：术后4周时实验组股骨头内纤维组织增生，有大量的软骨形成和成骨细胞增生明显，新骨形成多于对照组，8周时实验组股骨头内填充区骨组织修复大部分已完成，充填区广泛分布相对较成熟的骨小梁。计算机图像分析：术后4、6和8周实验组骨小梁体积（TBV％）明显多于对照组，差异有显著性（P〈0．05）。结论rhBMP-2／β-TCP对液氮冷冻兔股骨头坏死试验修复过程有明显的促进作用。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.