CPPf/PLLA支架负载人半月板纤维软骨细胞的体外实验研究

目的探讨聚磷酸钙纤维／左旋聚乳酸（CPPf／PLLA）支架负载人半月板纤维软骨细胞的有效性和可行性。方法将人半月板纤维软骨细胞接种CPPf／PLIA支架并在体外培养，应用倒置相差显微镜和扫描电镜观察纤维软骨细胞的粘附、生长和增殖情况，培养14d，行HE、TB（甲苯胺蓝）及Ⅰ型胶原免疫组化染色观察纤维软骨组织形成情况。结果纤维软骨细胞在支架上粘附、生长和增殖良好，体外培养14d能形成较成熟的纤维软骨组织。结论CPPf／PLLA支架具有良好的细胞相容性，可作为负载人纤维软骨细胞的载体。     

胶原凝胶包埋软骨细胞接种骨胶原基质支架体外构建组织工程软骨

目的探讨复合应用胶原凝胶和骨胶原基质（BCM）支架作为软骨细胞载体体外构建组织工程软骨的有效性和可行性.方法将胶原凝胶包埋的软骨细胞接种BCM支架并在体外培养,应用倒置相差显微镜和扫描电镜观察软骨细胞的粘附、生长和增殖情况,培养14d,行HE、TB（甲苯胺蓝）染色观察软骨组织形成情况.结果软骨细胞在支架上粘附、生长和增殖良好,体外培养14d能形成较成熟的软骨组织.结论胶原凝胶复合BCM支架可作为软骨细胞的载体体外构建组织工程软骨.     

脱细胞骨软骨支架的细胞相容性测定及与软骨细胞体外复合的实验研究

目的 测定经自创的去垢剂--酶法进行脱细胞和脱钙处理的脱细胞骨软骨支架的细胞相容性,及该支架与软骨细胞体外复合培养的生物学特性和粘附关系, 以探讨脱细胞骨软骨支架作为软骨组织工程支架的可行性。方法 采用自制脱细胞骨软骨支架与软骨细胞体外复合培养，用细胞增殖度法测定脱细胞骨软骨支架的细胞相容性，并行电镜观察其相互粘附关系。结果 脱细胞骨软骨支架的细胞相容性良好；体外复合实验中，软骨细胞可贴附于材料上生长增殖，并分泌细胞外基质。结论 细胞增殖实验显示脱细胞骨软骨支架的细胞相容性良好；体外复合实验显示脱细胞骨软骨支架可与软骨细胞良好复合，适于软骨细胞贴附生长。     

脱细胞骨软骨支架的细胞相容性测定及与软骨细胞体外的复合

目的测定脱细胞和脱钙处理的脱细胞骨软骨支架的细胞相容性及该支架与软骨细胞体外复合培养的生物学特性和黏附关系,以探讨脱细胞骨软骨支架作为软骨组织工程支架的可行性。方法采用自制脱细胞骨软骨支架与软骨细胞体外复合培养,用细胞增殖度法测定脱细胞骨软骨支架的细胞相容性,并行电镜观察其相互黏附关系。结果脱细胞骨软骨支架的细胞相容性良好;体外复合实验中,软骨细胞可贴附于材料上生长增殖,并分泌细胞外基质。结论细胞增殖实验显示脱细胞骨软骨支架的细胞相容性良好;体外复合实验显示脱细胞骨软骨支架可与软骨细胞良好复合,适于软骨细胞贴附生长。     

细胞-支架复合体构建及其异体移植修复关节软骨缺损的形态学观察

目的 探讨应用组织工程技术进行异体移植修复关节软骨缺损的有效性和可行性。方法 采用动态倒置显微镜与扫描显微镜观察及大体，组织学和免疫组织化学观察方法，以优化获取的单层传代培养幼兔关节软骨细胞及结构与性能优化的CPPf(Calcium polyphosphate fibers,CPPf)/PLLA(poly-L-lactic acid,PLLA)自制支架复合材料，进行细胞－支架复合体体外构建与培养及其异体移植修复关节软骨缺损的病理形态学实验研究。结果 将适宜密度培养细胞种植于支架材料中，细胞密集，分布均匀，经一定时间体外培养，基种植细胞与支架材料粘附，生长繁殖并分泌细胞外基质，支架材料保持培养前的外形与内部微结构。其细胞－支架复合体异体移植修复关节软骨缺损的病理形态学特征为：（1）修复后的关节面光滑，与周围组织整合良好；（2）软骨细胞呈柱状排列；（3）Ⅱ型胶原及硫化糖胺多糖在空间上分布均匀；（4）软骨下板得以重建;(5)修复组织与其下方骨质紧密结合；（6）支架材料逐渐降解吸收。结论 应用细胞－支架复合体异体移植进行关节骨缺损修复，具有种植细胞来源广泛，可根据缺损大小和形状设计支架外形，使缺损完全生物学再上修复的优点，这一组织工程技术为关节软骨缺损完全再生修复提供了一条新的有效途径。     

Ⅱ型胶原-透明质酸-软骨脱细胞基质制备组织工程软骨支架的实验研究

目的探索Ⅱ型胶原(CollagenⅡ,COLⅡ)-透明质酸(Hyaluronic acid,HA)-软骨脱细胞基质(Cartilageacellular extracellular matrix,CAEM)通过低温冷冻法制备组织工程软骨支架的可行性。方法将COLⅡ和HA及CAEM按15∶3∶45的比例混合,通过低温冷冻干燥的方法制备组织工程软骨支架,测定其孔隙率、吸水率、降解率,检测支架的理化性能,并行HE染色及甲苯胺蓝染色观察支架结构情况。用CCK8法评价其细胞毒性及粘附性情况。结果 COLⅡ-HA-CAEM复合支架孔隙率为87.3%±3.7%,吸水率为1522.0%±29.3%,21天降解率为29.2%±2.4%,CCK8法检测结果显示,COLⅡ-HA-CAEM复合支架对细胞具有良好的粘附性,其生物学性能良好。结论 COLⅡ-HA-CAEM复合支架能为软骨细胞的生长和增殖提供优良的微环境,在组织工程软骨重建中具有潜在的应用价值。     

骺板软骨细胞复合生物凝胶体外培养生成软骨组织的实验研究

目的 观察将骺板软骨细胞接种于自制的生物凝胶经体外培养生成软骨组织的生物学特点，初步评价这一凝胶基质作为软骨组织构建材料的生物学性能。方法 将第一代骺板软骨细胞接种于生物凝胶进行体外培养，行大体，倒置显微镜以及组织学，Ⅰ型和Ⅱ型胶原免疫组化光镜观察。结果 骺板软骨细胞－生物凝胶复合的，在体外培养过程中不能春初始外形，培养1周直径可收缩为初始的45％，但能保持种子细胞的稳定均发布。经体外培养2周后由外周向中心逐渐形成软骨组织，表面为由1－3层梭形细胞组成的膜样结构，内部细胞主要为圆形细胞，有细胞外基质相隔，形成软骨细胞陷窝。基质中富含软骨特异性基质成分Ⅱ型胶原和蛋白聚糖，而Ⅰ型胶原免疫组化逐渐转为弱阳性，位于表面膜结构。结论 这一生物凝胶具有良好的细胞相容性，适合软骨细胞在其中生成成熟的工程化软骨，但难以维持其初始外形。     

丝素蛋白无纺网支架体外构建组织工程化软骨

目的:探讨丝素蛋白无纺网作为耳廓软骨细胞外支架构建组织工程化软骨的可行性。方法:取成年新西兰兔耳廓软骨,酶消化法获取软骨细胞,体外培养扩增后取原代细胞接种到制备好的丝素蛋白无纺网支架上,体外复合培养。每天倒置显微镜下观察细胞黏附、生长、增殖情况,于复合培养第3、7、10天时取材进行扫描电镜观察;于复合培养第1、2、4、6周取材进行组织学评价,同时取材通过RT-PCR方法检测复合物上软骨细胞Ⅱ型胶原mRNA的表达情况。结果:48 h后软骨细胞已黏附于丝素蛋白纤维上,72 h后细胞开始分泌少量细胞外基质;电镜下观察显示软骨细胞及分泌的薄层细胞外基质主要分布于支架材料表面。组织学观察显示2周时支架浅层已有一定厚度软骨组织,可见少量类软骨陷窝,4周和6周时支架浅层软骨组织增厚,软骨陷窝增多,但支架内部软骨细胞数目少,细胞呈星形或梭形,细胞分泌的基质也很少。RT-PCR检测显示在各检测时间点均有Ⅱ型胶原mRNA的表达。结论:兔耳廓软骨细胞在丝素蛋白无纺网支架上已初步形成软骨样组织,但培养条件应进一步优化。     

利用PLGA细胞支架再生人关节软骨的实验研究

目的：研究人关节软骨细胞在PLCA三维支架上的贴附和生长情况，利用组织工程技术培养工程化关节软骨。方法：制作PLGA三维细胞支架。分离培养成人关节软骨细胞，体外扩增后种植到PLGA支架中。在体外和裸鼠体内分别培养软骨细胞一支架复合物，分期终止培养，进行组织学染色、扫描电镜、Ⅱ型胶原免疫组织化学及cDNA探针原位杂交检测。结果：体外培养发现，软骨细胞支架材料内贴附生长良好，长期培养仍保持软骨细胞特性，棵鼠体内培养8周后可形成软骨样组织。结论：PLGA三维支架适合软骨细胞贴附生长和分泌软骨外基质，可作为软骨组织工程的细胞载体。利用组织工程的方法可获得适于移植的工程化关节软骨。     

软骨细胞与复合水凝胶的生物相容性研究

目的构建光固化壳聚糖与自固化海藻酸钠复合水凝胶体系,研究其与软骨细胞的体外生物相容性,探索其作为软骨组织工程支架的可行性。方法以三维多孔光固化壳聚糖水凝胶作为细胞的空间载体,利用自固化海藻酸钠水凝胶将软骨细胞胶封入光固化壳聚糖水凝胶支架,构成复合水凝胶-细胞复合体。采用扫描电子显微镜观察光固化壳聚糖的结构形貌以及细胞在支架内部的分布与形态;CCK8法绘制细胞增殖曲线;DAPI细胞核染色荧光显微镜观察细胞核形态变化,判断细胞活性。结果纯光固化壳聚糖水凝胶材料呈孔隙较为均匀一致的多孔结构,平均孔径为300μm左右。复合水凝胶能够模拟天然软骨细胞外基质环境,使细胞保持圆形生长状态;促进成软骨细胞的增殖,具有良好的生物相容性。结论复合水凝胶能够为软骨细胞提供一个类似天然的生活环境,并能够促进其增殖、生长,有望作为软骨组织工程支架应用于软骨缺损修复的实验研究。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…