下颌骨牵引成骨过程中转化生长因子表达

目的通过建立兔下颌骨牵引成骨实验动物模型,研究下颌骨牵引成骨过程中TGF-β1表达及意义。方法选用新西兰白兔30只,随机选取6只动物作空白对照组,24只动物右侧下颌骨植入外置式颌骨牵引器。经7d延迟期后,按1mm/d速率延长下颌骨7d,固定期8周。在延迟期第7天,牵引期第2、4、7天,固定期第1、3、6、8周分别处死3只动物,采用免疫组化、RT-PCR方法,检测TGF-β1表达变化。结果TGF-β1表达贯穿下颌骨牵引成骨全过程,下颌骨牵引成骨过程中不同时相多种组织细胞参与表达TGF-β1。TGF-β1 mRNA及其蛋白表达在牵引早期达到高峰,此后逐渐减弱。结论TGF-β1在下颌骨牵引成骨血运重建及新骨生成过程中发挥重要作用。TGF-β1可能与传导机械牵引力刺激的细胞信号传导有关,从而启动血运重建和新骨生成机制。     

兔下颌牵引成骨区应用rhBMP-2对BMP-7表达的影响

目的:研究不同剂量外源性rh BMP-2对兔下颌骨牵引成骨区新骨BMP-7表达的影响。方法:选取成年日本大耳白兔45只,雌雄不限,适应性饲养1周,随机分为对照组、实验1组和实验2组,每组各15只。在兔下颌骨磨牙前行截骨术,分别将空白胶原载体、rhBMP-2胶原复合物1.5 mg和rh BMP-2胶原复合物3 mg植入其下颌骨切开处。观察稳定期的第1、3、7、14、28 d的兔的新骨生成,并用免疫组织化学染色法观察BMP-7的表达。结果:成骨细胞(OB)和骨髓基质细胞(SC)的细胞质免疫组织化学法BMP-7阳性表达呈棕色或棕褐色颗粒状着色,结果显示BMP-7的表达与rh BMP-2有剂量依赖性。在同一稳定期内实验组兔成骨细胞和骨髓基质细胞与对照组有显著性差异(P<0.05),且实验2组与实验1组也有显著性差异(P<0.05),在同一剂量下,稳定期1 d BMP-7表达达到高峰,主要集中在间充质细胞的细胞质中,随着稳定期的延长其表达逐渐下降,但稳定期3 d和7 d BMP-7仍为强阳性表达,稳定期14 d进一步减弱,到稳定期28 d表达的很少,达到正常水平。结论:BMP-7在兔牵引成骨过程的不同稳定期的成骨细胞和骨髓基质细胞有不同的表达,说明其对牵引成骨的新骨形成有一定的调节作用。     

BMP-2基因修饰自体BMSCs移植促进兔下颌骨牵张成骨新骨形成的实验研究

目的:检测骨形态发生蛋白-2(BMP-2)基因mRNA及其蛋白的表达,探讨BMP-2基因修饰自体骨髓间充质干细胞(BMSCs)移植对兔下颌骨牵张成骨新骨形成的促进作用。方法:取新西兰白兔36只随机分为3组,每组12只。建立牵张成骨动物模型,在固定期第2天,实验组于牵张间隙注射200μL的BMP-2基因修饰的自体BMSCs液;对照组注射等量自体BMSCs液;空白组注射等量生理盐水。分别于固定2,6周通过逆转录多聚酶链式反应(RT-PCR)、免疫组化等手段检测BMP-2基因mRNA及其蛋白的表达情况。结果:实验组牵张间隙新生骨组织均可见BMP-2基因mRNA和其蛋白强阳性表达。结论:BMP-2基因修饰的自体BMSCs移植能有效促进兔下颌骨牵张成骨新骨形成。     

骨形成蛋白-2在上颌骨快速牵引骨愈合中的作用

目的探索上颌骨经缝牵引中(当弹性牵引力大于800g)加入重组人骨形成蛋白-2(rhBMP-2)对新骨形成的影响。方法将36只健康杂种犬随机分为5个组,即对照组、400g组、600g组、800g组及800g+rhBMP-2组(联合组)。术后1～8周处死动物,行X线检测及免疫组织化学染色检测。结果各牵引组上颌骨成功前徙,以600g组效果明显[(25.3±5.2)mm]。800g组在2周内牵引速度快,4周后明显减慢[(12.1±2.3)mm],但在注射rhBMP-2后得以改善[(24.2±3.4)mm]。BMP-2、BMP-4、BMP-7阳性染色主要定位于成骨细胞细胞质中,BMP-7在注射rhBMP-2后光密度值明显增强。CT检测各牵引组腭骨水平板骨密度值明显减低,以800g组最为显著[(317.8±185.5)HU],而在注射rhBMP-2后骨密度值明显增强[(1 158.0±93.0)HU]。结论骨缝牵引前移上颌骨能在微创早期延长骨长度;rhBMP-2可以有效促进骨形成并在调节rhBMP-7活性方面起到一定作用。     

犬上颌窦底黏膜骨原细胞的培养和成骨性能的研究

【目的】 研究犬上颌窦底黏膜骨原细胞的成骨性能?【方法】 取Beagle犬上颌窦底黏膜,显微镜下观察其组织学形态?分离培养犬上颌窦底黏膜骨原细胞?流式细胞术检测一代细胞的表面抗原CD44?CD146和CD34?一代细胞经成骨诱导培养用于研究其体外成骨性能?诱导3 d?7 d和12 d时分别检测其碱性磷酸酶活性,对照组细胞用基础培养基培养?诱导16 d时,进行BMP-2免疫组化染色,对照组细胞经基础培养基培养?Western blot检测诱导0 d?7 d和16 d时BMP-2的表达?诱导28 d时,茜素红染色和Von Kossa染色观察钙结节形成情况?二代细胞成骨诱导培养7 d,与Bio-Oss复合后,植入裸鼠背部皮下,观察体内成骨情况,对照组植入Bio-Oss颗粒?【结果】 犬上颌窦底黏膜由上皮层?固有层?黏膜下层和骨膜层组成,黏膜下层富含毛细血管?流式细胞术检测显示CD44和CD146阳性,CD34阴性?在3 d?7 d和12 d时,培养细胞碱性磷酸酶活性逐渐升高,成骨诱导培养细胞高于基础培养细胞?16 d时,与基础培养基中细胞相比,经成骨诱导的细胞BMP-2表达增强?Western blot检测发现诱导0 d?7 d和16 d时BMP-2的表达明显,且逐渐升高?诱导培养28 d时,可矿化形成明显的钙结节?细胞与Bio-Oss复合物植入裸鼠皮下可观察到成骨现象,对照组没有成骨表现?【结论】与人上颌窦底黏膜相同,犬上颌窦底黏膜含有骨原细胞,具有成骨能力?     

骨基质蛋白在小鼠胫骨牵引成骨过程中的表达

目的探讨小鼠胫骨牵引成骨动物模型,并检测骨基质蛋白在牵引成骨过程中的表达和作用.方法8周龄雄性CD-1小鼠36只,接受左胫骨中上段骨干横行截骨,安置特制延长外固定架,胫骨牵引过程包括5 d静止期,12 d牵引期和70 d固塑期,牵引速率为0.1 mm/Bid,共0.2 mm/d.术后于不同时间点分组采集左胫骨标本,分别作组织学检查和骨基质蛋白mRNA检测.结果组织学检查显示静止期其修复过程基本与骨折愈合相似.牵引期,被牵引骨痂显示三个典型的生物学功能区:纤维间区,初始骨基质前沿和微脊柱形成区.固塑期早期,牵引骨痂骨性愈合,第10周骨髓腔再通,新生骨再塑基本上完成.mRNA分析显示在牵引成骨早期,软骨内成骨及膜内成骨同时发生.牵引中期以后软骨内成骨逐渐减少,而转为以膜内成骨为主的成骨过程.结论通过对骨基质蛋白及相关蛋白的分析,结果表明牵引成骨与骨折愈合过程不同.早期软骨内成骨和膜内成骨同时存在,但在机械牵张力作用下转为以膜内成骨为主的成骨过程.该研究亦证实小鼠胫骨牵引成骨过程与人体及其他动物模型基本相同,可作为一种非常有意义的研究骨再生和修复的在体动物模型.     

EXPERIMENTAL STUDY ON TRANSPLANTATION OF BMP-2 GENE TRANSFECTED AUTOGENOUS BONE MESENCHYMAL STEM CELLS FOR PROMOTING BONE REGENERATION IN RABBIT MANDIBULAR DISTRACTION OSTEOGENESIS

目的:检测骨形态发生蛋白-2(BMP-2)基因mRNA及其蛋白的表达,探讨BMP-2基因修饰自体骨髓间充质干细胞(BMSCs)移植对兔下颌骨牵张成骨新骨形成的促进作用.方法:取新西兰白兔36只随机分为3组,每组12只.建立牵张成骨动物模型,在固定期第2天,实验组于牵张间隙注射200 μL的BMP-2基因修饰的自体BMSCs液;对照组注射等量自体BMSCs液;空白组注射等量生理盐水.分别于固定2,6周通过逆转录多聚酶链式反应(RT-PCR)、免疫组化等手段检测BMP-2基因mRNA及其蛋白的表达情况.结果:实验组牵张间隙新生骨组织均可见BMP-2基因mRNA和其蛋白强阳性表达.结论:BMP-2基因修饰的自体BMSCs移植能有效促进兔下颌骨牵张成骨新骨形成.     

骨痛膏对家兔骨愈合过程中骨形态发生蛋白表达的影响

目的观察骨痛膏对实验性家兔骨愈合过程中骨形态发生蛋白(BMP-2mRNA)表达的影响。方法将30只日本大耳白兔随机分成骨痛膏外用药组和空白对照组,再将每组15只随机分成3个亚组,即第1周取标本组(A组)、第2周取标本组(B组)、第4周取标本组(C组),均以手术造成双桡骨中段宽约3 mm、深达髓腔的骨缺损模型,空白对照组以石膏固定,用药组外敷骨痛膏后以石膏固定,用药组每2 d换1次药,1周处死A组,2周处死B组,4周处死C组。原位杂交法检测BMP-2mRNA。结果骨痛膏可以明显促进家兔骨愈合过程中BMP-2mRNA的表达。结论骨痛膏具有明显促进骨愈合作用。     

自体骨用于脊柱后路植骨融合中BMP-2、VEGF的表达

目的:观察自体骨用于脊柱后路融合过程中BMP-2、VEGF的表达和分布,并探讨其在脊柱融合过程中的作用机制.方法:成年雄性新西兰大白兔36只,随机分为2组,每组12只,分别在兔腰椎5、6横突植入自体骨,异体骨制作腰椎后路融合模型.于2、4、7、14、27、35天,6个时间点处死,取其融合节段标本,进行X线拍片,HE染色及免疫组化染色观察,进行阳性细胞计数及计算机病理图文分析.结果:1.在脊柱后路融合模型中自体骨骨组软骨生成面积要大于异体骨组.2.脊柱融合的过程中,自体骨组BMP-2、VEGF表达高于异体骨组.结论:在脊柱后路植骨融合中,自体骨组植骨融合速度及质量优于自异体骨.自体骨组BMP-2、VEGF的表达明显高于异体骨,证实在脊柱融合移位成骨的过程中,BMP-2起到关键性作用,并促进VEGF的表达.     

bFGF和IGF-Ⅰ在生长期山羊颅骨缝牵张成骨中的时空表达及意义

目的观察生长期山羊颅骨冠状缝受牵张力作用后碱性成纤维细胞因子(bFGF)与胰岛素样生长因子-Ⅰ(IGF-Ⅰ)的时空表达。方法选用12只生长期山羊,用自制牵张器按0.4mm/d的速率扩张颅骨冠状逢。在牵张结束后第0、2和4周分别处死4只动物,取骨缝标本作组织学和免疫组化检测。另取2只未进行缝牵张的动物作为对照。结果bFGF与IGF-Ⅰ在牵张骨缝组织中均呈高水平表达。bFGF主要在成纤维样细胞与成骨细胞中表达,IGF-Ⅰ阳性信号主要定位于新生骨小梁边缘的成骨细胞和埋入新骨基质中的骨细胞,在骨缝扩张的0～2周这两种生长因子的表达最强。结论张应力可刺激颅骨缝细胞分泌bFGF与IGF-Ⅰ,这两种骨生长因子在骨缝牵张成骨过程中可能起着重要的调控作用。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.