4种生物材料大鼠体内生物相容性的对比实验研究

目的：探讨羟基磷灰石（HA）、高密度多孔聚乙烯（Medpor）、聚己内酯（PLA）、硅橡胶在大鼠体内的生物相容性,为骨组织修复材料的选择和临床修复骨缺损提供参考依据.方法：Wistar大鼠28只随机分为对照组、实验1组和实验2组,实验1组分别将HA、Medpor植入大鼠背部左、右侧肌肉内,实验2组分别将PLA、硅橡胶植入大鼠背部左、右侧肌肉内,对照组不植入任何材料.分别于术后2、4、8、12周处死大鼠,进行大体标本、光镜和电镜下观察.结果：所有动物没有出现感染死亡.实验1组HA界面的炎性反应较重,Medpor界面无明显炎性反应,Medpor与周围组织紧密结合,组织可长入材料的微孔内.实验2组PLA界面无明显炎性反应,并可在体内缓慢降解,硅橡胶界面的炎性反应较重.结论：Medpor和PLA具有良好的生物相容性,无毒性及免疫原性,是较好的生物材料.     

壳聚糖短纤维增强聚己内酯复合材料重建犬缺损胸壁

目的:采用可降解性生物材料壳聚糖短纤维增强聚己内酯(PCL)制备人工胸壁,重建犬缺损胸壁,探讨其用于临床修复胸壁缺损的可行性.方法:建立面积达10 cm×10 cm的两种犬胸壁缺损,实验组Ⅰ单纯切除肋骨(n=2),实验组Ⅱ整块切除包括肋骨骨膜、肋骨、肋间肌和壁层胸膜(n=8),分别用壳聚糖短纤维增强PCL板重建两种缺损胸壁,X线、胸部CT及组织学观察复合材料植入后犬胸壁组织的再生情况.结果:所有动物均存活,无手术和围手术期死亡,无胸壁塌陷及反常呼吸.实验组Ⅰ犬新生骨质沿人工胸壁表面生长,在PCL板与胸膜之间再生完整肋骨;实验组Ⅱ人工胸壁材料能够与周围胸壁肋骨及肌肉组织达到很好的结合,界面良好,固定牢靠.结论:可降解性壳聚糖纤维增强PCL复合材料具有良好的生物相容性,能够对缺损胸壁提供有效的支撑作用,值得进一步研究以应用于临床.     

低弹性模量纯钛种植体的骨内植入试验研究

[目的]评价新研制的低弹性模量纯钛种植体的生物相容性。[方法]将弹性模量为53 GPa、78 GPa、110 GPa的种植体各6枚分别植入3只狗的两侧下颌骨内,3个月后取下标本,行X线检查、制作不脱钙牙种植体切片,观察种植体—骨界面形成情况。[结果]X线检查:种植体与骨质紧密接触,其间无阴影,种植体颈周骨组织未见吸收。不脱钙牙种植体切片的组织学观察:种植体与骨组织紧密接触,无间隙,均形成了骨整合界面。[结论]本实验中所研制的53 GPa、78 GPa低弹性模量纯钛种植体材料生物相容性好,为进一步的生物力学测试提供了实验基础,为开发新的种植体材料提供实验依据     

形状记忆聚合物聚醚多元醇-异氰酸酯的组织相容性

目的:探讨新型形状记忆聚合物(SMP)聚醚多元醇-异氰酸酯(PTMEG-MDI)的生物安全性及组织相容性,为其应用于生物医学领域提供理论依据。方法:将PTMEG-MDI植入实验组大鼠后肢皮下,对照组仅进行手术操作,不埋植PTMEG-MDI,分别于术后3d及1,2,4周抽血行血常规及肝肾功能检测,HE切片行组织学检查。结果:两组动物血常规及肝肾功能指标无显著性差异,病理组织切片示材料植入后周围组织反应符合一般炎症变化的转归规律。结论:新型形状记忆聚合物PTMEG-MDI具有良好的生物安全性及组织相容性,可应用于生物医学领域。     

XDBM生物相容性以及促进大鼠桡骨缺损修复

目的探讨异种脱钙骨基质（Xenogeneic Demineralized Bone Matrix,XDBM）的体内、外生物相容性以及促进骨缺损修复愈合,为临床应用提供实验依据。方法新生sD颅盖骨成骨细胞培养。取人及大鼠松质骨制备人（异种）及大鼠（同种）脱钙骨基质;观察成骨细胞在XDBM表面的黏附、增殖;行一侧大鼠骶棘肌肌袋内植入异种脱钙骨基质（实验组）,对侧植入同种脱钙骨基质（对照组）。分别于术后2,4,8周取材。另取8周龄大鼠造桡骨中段5mm节段性骨缺损模型。分为异种脱钙骨组（实验组）及同种脱钙骨组（对照组）。分别于2、4、8、12周处死动物并取材。大体、组织学观察及CD34免疫组化染色计数微血管密度。结果成骨细胞在XDBM贴壁生长、增殖、分泌骨基质;XDBM植入肌袋内各时间点均未见炎症、坏死及排斥。桡骨缺损区域微血管密度增加,新骨形成最终缺损区被新骨代替。结论XDBM具有良好的生物相容性、可降解性及良好骨传导及骨诱导作用。当植入大鼠桡骨缺损后具有促进骨再生的能力,有望成为理想的骨组织工程支架材料。     

自制镍钛记忆合金网状内支架气管内生物相容性实验研究

目的 :研究气管内镍钛金属网状内支架生物相容性。方法 :在实验兔气管内放置 30枚网状内支架 ,通过观察其 1周～ 6个月局部组织和全身反应 ,初步评价其生物相容性。结果 :自制镍钛记忆内支架具有局部组织反应较轻 ,局部管腔通肠 ,全身重要脏器无改变 ,植入后记忆合金无腐蚀生锈。结论 :自制镍钛记忆合金具有良好的力学性能和生物相容性 ,是一种理想的生物医用材料     

鸡羽根管作为组织工程支架材料的初步研究

目的 了解鸡羽根的结构特点,观察其在活体组织内的降解情况及其对周围组织的影响,为其作为组织工程备选支架材料提供依据.方法 健康鸡羽根,采用序贯的、不同程度(轻、中、重)理化处理程序,得到3种鸡羽根角蛋白(CCK-Ⅰ、CCK-Ⅱ、CCK-Ⅲ),光学显微镜/扫描电镜观察其形态结构.大鼠背部肌组织内植入鸡羽根角蛋白片(实验组)和未处理鸡羽根片(对照组),以及坐骨神经束间植入鸡羽根角蛋白丝(实验组)和未处理羽根丝(对照组),于不同时间点取材,观察其降解情况和组织相容性.结果 (1)光镜:鸡羽根管壁从内到外依次为4个致密层:嗜碱性均质状粗线,3～5层的嗜酸性角质层,60～100层含大量色素颗粒的环行角蛋白束和10～20层含少量色素颗粒的角蛋白束.扫描电镜:未处理的鸡羽根结构致密,管壁平整,无孔洞;处理后结构较疏松,可见大小、深浅不等的孔洞.(2)肌组织内植入:第8周材料呈细丝状或散在细颗粒状,部分被降解吸收,仍有少量炎性细胞,可见多核巨细胞;第12周材料降解为细小碎片.对照组各时间段材料结构完整.(3)神经束间植入:引起的组织反应与细胞类型同肌组织内植入组,神经组织无变性、坏死.结论 未处理的鸡羽根由多层致密的角蛋白束构成,含色素颗粒和少量基质.处理后表面出现许多孔洞,结构疏松,且体内可降解,其降解产物不引起机体组织的变性、坏死.鸡羽根有可能成为组织工程化器官或组织构建的备用支架材料.     

低弹性模量纯钛种植体的骨内植入试验研究

目的 评价新研制的低弹性模量纯钛种植体的生物相容性。方法 将弹性模量为53GPa，78GPa，110GPa的种植体各6枚分别植入3只狗的两侧下颌骨内，3个月后取下标本，行X线检查，制作不脱钙牙种植体切片，观察种植体－骨界面形成情况。结果 X线检查：种植体与骨质紧密接触，其间无阴影，种植体颈周骨组织未见吸收。不脱钙牙种植体切片的组织学观察：种植体与骨组织紧密接触，无间隙，均形成了骨整合界面。结论 本实验中所研制的53GPa，78GPa低弹性模量纯钛种植体材料生物相容性好，为进一步的生物力学测试提供了实验基础，为开发新的种植材料提供实验依据。     

纳米生物陶瓷人工听骨周围组织生物相容性的研究

目的:评价纳米生物陶瓷(纳米羟基磷灰石复合多孔陶瓷)与皮下周围组织的生物相容性,探讨其作为经皮下植入听骨材料的可行性.方法:采用大鼠皮下植入模型.大鼠30只,随机分成6组,每组5只.将氧化铝陶瓷和纳米羟基磷灰石复合多孔陶瓷人工听骨植入大鼠背部肩胛区的左、右侧皮下组织,左侧作为对照组,右侧作为实验组.分别于术后 1、2、4、8、16、32周时处死各组实验动物,运用大体和一般组织学方法及扫描电镜动态观察材料与周围组织的生物学反应.结果:纳米羟基磷灰石复合多孔陶瓷材料与氧化铝陶瓷材料植入初始引起周围组织以嗜中性粒细胞、巨噬细胞等急性炎症细胞为主,至1周炎症反应减轻,有疏松的纤维包膜形成.2周时以淋巴细胞浸润为主,部分纤维细胞.4周时炎症反应消退,以纤维母细胞、纤维细胞为主,有少许淋巴细胞浸润.8周后纤维包膜变薄,无炎细胞浸润.结论:纳米羟基磷灰石复合多孔陶瓷材料与皮下组织有良好的生物相容性.     

国产多孔钽材料兔竖脊肌植入组织学及生物学效应

目的:观察国产多孔钽材料的三维孔隙结构以及兔竖脊肌植入后组织形态学特点,对其组织相容性进行评价,为临床骨缺损修复重建提供实验依据?方法:扫描电镜观察国产多孔钽结构;成年新西兰大白兔24只,建立多孔钽兔竖脊肌植入动物模型?将2枚直径1.5 cm?厚0.2 cm圆型多孔钽植入脊柱一侧竖脊肌内(实验组),对侧植入同等数量及体积的多孔钛(对照组)?于术后2?4?8?12 周处死行硬组织切片观察肌肉周围纤维包膜及新生血管形成,并计算小血管生成数量;扫描电镜观察肌肉组织在两种材料内的生长状态?结果:扫描电镜观察多孔钽具有三维立体多孔结构,孔隙直径在400~600 μm;肌肉及纤维组织早期在多孔钽表面及孔隙内生长;晚期胶原纤维延展,相互连接并充满孔隙?硬组织切片显示:随时间的延长多孔钽-肌肉界面形成薄而致密的血管化包膜?孔隙内充满肌肉?纤维组织及小血管?结论:国产多孔钽材料具有良好的组织相容性,其三维结构可使肌肉组织在表面及孔隙内生长及延伸,有可能成为骨缺损修复材料?     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.