大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.     

大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.     

后路微创全髋关节置换术早期体会

报道后路小切口微创单侧全髋关节置换术15例。后路小切口微创全髋置换术具有创伤小、出血少、恢复快等优点，但要有严格的手术指征、熟练的操作技术和专用的器械。     

经椎间孔椎体间融合与后路椎体间融合治疗腰椎退行性疾病的疗效比较

<正>本文回顾性分析了我院2010年7月至2011年5月行后路椎体间融合术(PLIF)或经椎间孔椎体间融合术(TLIF)治疗腰椎退变性疾病(DLD)112例,并对2种术式的疗效进行比较研究,现报告如下。1资料与方法1.1一般资料     

同种异体骨移植与自体骨移植修复四肢粉碎性骨折:骨性愈合及骨活性比较

背景:骨移植是一种治疗四肢粉碎性骨折常用的方法,并且可以选择同种异体骨移植或者自体骨移植,两种骨移植方法各有优缺点。目的:对比同种异体骨移植与自体骨移植修复四肢粉碎性骨折在骨性愈合及骨活性方面的临床效果。方法:回顾性分析49例四肢粉碎性骨折患者的临床资料,按照骨移植方法分为观察组与对照组,观察组采用同种异体骨移植修复,对照组采用自体骨移植修复。观察两组骨折临床愈合时间、骨性愈合时间及骨特异性碱性磷酸酶活性,并进行比较。结果与结论:观察组骨折愈合时间及骨性愈合时间分别为(5.8±1.2)周、(5.8±1.5)个月,对照组骨折愈合时间及骨性愈合时间分别为(6.1±1.3)周、(6.1±0.8)个月,两组间骨折愈合时间及骨性愈合时间比较差异无显著性意义(P>0.05);观察组与对照组骨特异性碱性磷酸酶活性分别为(10.45±1.53),(13.58±1.69)μg/L,两组间比较差异有显著性意义(P<0.05)。表明同种异体骨移植与自体骨移植修复四肢粉碎性骨折均可获得良好的临床疗效,但自体骨移植在促进骨骼愈合能力方面有一定的优势。     

胃窗－85超声显像剂在胆总管下段梗阻性病变中的应用

超声对胆总管下段病变的检查, 往往因胃肠道气体的干扰而难以显示。1988年以来, 我们应用胃窗一85超声显像剂充盈胃与十二指肠, 形成一种“前声窗”后对胆总管下段病变进行超声检查, 获得良好效果。     

小儿秋季腹泻244例临床护理

近年来，随着各类突发公共卫生事件的明显增多，应急护理管理成为医院护理工作的新课题，应急状态下，护理管理是否及时、到位、有力，直接影响到医疗救治工作的开展和患者的安危。为使护生适应新形势要求，全面掌握常用急救知识、急救技术、提高应急能力，对各种可能发生的事件做到尽早预防和有效救护，自2006年，我院增设了“助理护士长”实习应急预案及处理程序的实习内容，取得满意效果。现报告如下。     

儿科全院疑难病例护理讨论方法探讨

<正>儿童的健康一直是全社会关注的重要内容,目前患儿的护理质量越来越受到家长的关注,同时对护理技术提出了更高的要求。对危重患儿的护理质量直接代表了专科儿童医院的护理水平。我科通过疑难病例护理的讨论,不断解决在临床护理中遇到的难点,总结出更多、更好的护理经验,大大提高了我院护理的整体水平。2009年我院采取了新的护理疑难病例讨论方法,取得了良好的实际效果,现报告如下。     

中药心舒宁注射液Beagle犬静脉滴注给药的急性毒性试验

目的采用累积剂量法推测出无毒、低毒和最高非致死剂量等,为多次重复给药毒性试验的剂量、可能的靶器官和毒性反应等指标的设计,以及临床剂量设计与观察提供参考依据。方法本试验设一个给药组(剂量递增依次为52.5、105、210和420mg/kg)和一个空白对照组,每组4只动物,雌雄各半。所有试验动物药前进行2次、给药结束和恢复期结束次日进行一次常规检测;每个剂量给药前进行一次体重和心电检测,同时,每个剂量给药后5min再进行一次心电检测;对濒死、死亡和试验结束存活的动物进行病理组织学检查。结果静脉滴注给予Beagle犬受试药52.5~105mg/kg剂量时,给药组4只动物未出现任何毒性反应。当剂量增至210mg/kg时,仅一只动物出现呕吐;而剂量增至420mg/kg时,给药组4只动物均出现恶心、呕吐、流涎等胃肠道毒性反应;同时还有2只动物白细胞略有升高。除此之外,未见其他毒性反应出现。结论毒性主要表现为恶心、呕吐、流涎及白细胞升高;低毒剂量为210mg/kg[相当于临床拟用日剂量(25mg/d)的312倍];最高非致死剂量大于420mg/kg(相当于临床拟用日剂量的623倍);毒性靶器官可能是胃肠道。提示在临床试验中应注意白细胞检测。