细胞间隙连接蛋白43在骨质疏松领域研究进展

骨质疏松症是骨代谢紊乱、骨微结构被破坏、骨骼脆性增加,致使容易造成骨折的代谢性骨病综合征.越来越多的证据表明,连接蛋白介导的细胞间隙间通道促进了骨骼生物学的许多方面,包括骨骼发育、骨骼稳态的维持及骨骼细胞对多种细胞外信号的反应性.细胞间隙连接蛋白43(Cx43)是骨骼中存在含量最丰富的间隙连接蛋白,已被证明是骨骼动态平...     

间隙连接蛋白43在胶质瘤中的研究进展

间隙连接蛋白 (Connexin,Cx)是一个构成间隙连接(Gap junction,GJ)的蛋白家族 ,大约有 2 0个成员。相邻细胞间通过间隙连接所介导的间隙连接通讯 (Gap junctionintercellular communication,GJIC)进行细胞间信息和能量交换 ,对细胞的新陈代谢、内环境稳定、增殖和分化起着重要的调控作用 [1 ] 。几乎所有正常组织细胞都表达间隙连接蛋白。研究表明 ,多种恶性肿瘤的发生及其恶性程度与间隙连接蛋白表达下调或缺失密切相关 [2 ]。其中间隙连接蛋白 4 3与恶性脑胶质瘤关系的研究较为深入。现就 Cx4 3的生物学特征、在恶性脑胶质瘤中的表达…     

间隙连接蛋白Cx43在妇产科领域的研究进展

间隙连接(gap junction,GJ)是细胞间连接方式的一种,由间隙连接蛋白(connexin,Cx)所构成.相邻细胞间通过间隙连接所介导的细胞间隙连接通讯(gap junction intercellular conmunication,GJIC)进行着信息和能量物质的交换,参与细胞间物质交换的代谢偶联和电信号传递的电耦联,对细胞的新陈代谢、内环境稳定、增殖和分化等生理过程起着重要的调控作用.     

激素性股骨头坏死中骨代谢改变的研究进展

临床上激素的应用是引起非创伤性股骨头坏死(ONFH)的重要高危因素。长期外源性激素的使用干扰了骨髓基质细胞的增殖与分化以及成骨与破骨的平衡,从而影响正常的骨代谢,引起ONFH。激素抑制了骨重塑导致骨质疏松并增加股骨头塌陷的风险。临床上应用激素治疗时应注意预防激素性ONFH,恰当的药物治疗能起到预防ONFH发生的作用。对激素性ONFH中骨代谢改变的研究可为临床治疗提供依据。     

细胞凋亡在激素诱导性股骨头坏死中的研究进展

目前糖皮质激素作为治疗某些疾病如SARS、系统性红斑狼疮、类风湿性关节炎、白血病、器官移植后等的有效手段[1],已广泛使用于临床,因而激素的使用已成为目前非创伤性股骨头坏死的最常见原因。激素诱导性股骨头坏死又称激素诱导的股骨头缺血性坏死或股骨头无菌性坏死,是一种由于股骨头血供中断或受损,引起骨细胞及骨髓成分死亡及随后的修复,继而导致股骨头结构改变、股骨头塌陷、关节功能障碍的疾病,大部分患者最终不得不接受人工关节置换。如能早期诊断股骨头坏死,尤其在MRI发现之前,积极治疗后可防止股骨头塌陷,保护关节功能,控制和延缓病情发展,可显著减少致残率[2]。     

间隙连接蛋白connexin43基因在真核细胞中的表达

目的：构建携带间隙连接蛋白connexin43 cDNA的真核表达载体,建立connexin43蛋白高表达细胞株。方法：connexin43 cDNA在大肠杆菌中扩增后连入真核表达载体pEN4,转染中国仓鼠卵巢（CHO）细胞,用甲氨喋呤（MTX）筛选得到connexin43基因高表达细胞。结果：酶切电泳结果显示载体pED4-Cx43按设计构建。经MTX筛选得到不同抗性的CHO细胞,免疫组织化学方法显示有connexin43蛋白的表达,但表达量有限。细胞间染料传递实验证实不同MTX抗性的CHO细胞间传递小相对分子质量物质的能力有差异。结论：利用载体pED4可以使connexin43基因在真核细胞内表达。     

细胞间隙连接蛋白43在耐药性卵巢癌中的表达

目的探讨细胞间隙连接蛋白43(CX43)与上皮性卵巢癌化疗疗效(耐药或敏感)及临床病理的关系.方法从1999年1月至2003年6月间临床资料及随访资料完整的卵巢癌病例中,筛选出60例原发上皮性卵巢癌和6例正常卵巢作为研究对象.根据临床诊断将其分为3组:①化疗耐药组30例,②化疗敏感组30例,③正常卵巢组6例.全部病例术前均未接受过放疗,入院后均行全子宫和双附件切除 盆腔淋巴结清扫 阑尾切除 大网膜切除术,66例患者均有随访结果.用流式细胞仪定量分析66例标本组织中CX43蛋白的表达量.结果CX43蛋白的表达为化疗耐药组＜化疗敏感组＜正常卵巢组织,单向方差分析两两比较结果差异有显著意义.结论CX43蛋白表达量的下降与上皮性卵巢癌的化疗耐药显著相关.     

激素性股骨头缺血性坏死动物模型研究进展

激素性股骨头缺血性(SANFH)坏死其详细发病机理至今仍未完全明了,通过动物模型复制原发病,有利于阐明该病的发病机理,并在此基础上对该病治疗方法的选择与改进作进一步研究,但SANFH发病机制复杂,动物模型建立时间长、成本大、成功率低、动物死亡率高,因而与临床股骨头坏死病理机制相似的理想SANFH动物模型的诱导和SANFH的病理机制研究将是长期面临的一项课题。自1948年起皮质类固醇药物开始在临床广泛使用,1957年Pietuograndi和Mastromarino首先报道由于使用皮质类固醇药物引起股骨头缺血性坏死(SANFH)后,世界各国相继出现大量报…     

BMP治疗激素性股骨头坏死的研究进展

激素性股骨头坏死(SANFH)是世界性的难治病,其主要受限于局部坏死骨组织修复作用的不足,最终造成股骨头塌陷而导致肢体的功能障碍。而骨形态发生蛋白(BMP)是具有强烈的诱导骨组织形成作用的局部生长因子之一,能弥补激素性股骨头坏死病理过程中骨组织修复的不足。该文简要介绍当前对BMP的基础研究,重点回顾总结了BMP单独或联合治疗激素性股骨头坏死的方法及其疗效以及优缺点,并对其今后的研究方向进行了展望。     

间隙连接蛋白Cx43在卵巢肿瘤中的初步研究

目的 探讨间隙连接蛋白Cx43（Connexin43）在上皮性卵巢肿瘤中的表达及意义。方法 应用SP免疫组织化学法检测Cx43在10例正常卵巢组织及38例卵巢浆液性肿瘤（其中浆液性囊肿腺瘤8例，交界性浆液性囊腺瘤6例，不同分化程度的浆液性囊腺部24例）中的表达，并采用计算机图像分析系统对Cx43的表达进行定量分析。结果 在卵巢表面上皮细胞中及肿瘤细胞中，Cx43蛋白定位于细胞膜及胞质中，与正常卵巢上皮相比，浆液性囊腺瘤中的Cx43无明显改变（P＞0.05）；交界性浆液性囊腺瘤中Cx43有明显下降（P＜0.05）；浆液性囊腺癌中Cx43表达显著降低（P＜0.01），而且随囊腺癌分化程度的下降，Cx43表达也显著降低（P＜0.01）。结论 卵巢良性肿瘤发生与Cx43无关，Cx43表达下降可能是卵巢癌发生发展的重要环节。     

髓芯减压植骨+BMP治疗早期股骨头坏死

目的 探讨更有效的治疗早期股骨头坏死的方法.方法 对2002年1月～2004年4月在潍坊医学院附属医院应用髓芯减压植骨＋BMP治疗的15例（17个髋）股骨头坏死的患者进行回顾性的分析.男6例,女9例;年龄36～62岁,平均47岁,随访时间26～94个月,平均53个月.按改良的Ficat分期标准,ⅡA期15髋,ⅡB期1髋,Ⅲ期1髋.结果 采用改良Jacobs百分评价法作为疗效标准,优14个髋（12个病人,均为ⅡA期）,可2个髋,差1个髋.结论 髓芯减压植骨＋BMP能有效地治疗早期股骨头坏死.     

Gastrodin prevents steroid-induced osteonecrosis of the femoral head in rats by anti-apoptosis

Background Gastrodin,as one of the major components extracted from the Chinese herb Gastrodia elata BI.,has many biologic effects,one of which is anti-apoptosis.Apoptosis is considered to be one of the pathogenetic mechanisms in steroid-induced osteonecrosis of the femoral head （ONFH）.Therefore,we performed this study to investigate whether gastrodin has the potential to prevent steroid-induced ONFH.Methods All 18 male adult Wistar rats were divided equally into three groups：the steroid group,the gastrodin＋steroid group,and the control group.Osteonecrosis was induced by low-dose lipopolysaccharide and subsequent high-dose methylprednisolone.Histomorphometric method was used to determine the incidence of osteonecrosis.Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling （TUNEL） assay was performed to detect apoptotic index of osteocytes and osteoblasts.Real-time PCR and Western blotting were performed to detect mRNA and protein expression of Bax,Bcl-2,and Caspase-3.Fisher＇s exact probability test and one-way analysis of variance （ANOVA） with Turkey＇s post hoc test were used to examine significant differences between groups.Results The incidence of osteonecrosis in the gastrodin＋steroid group （16.7％） was significantly lower than that in the steroid group （83.3％）.According to TUNEL assay,the apoptotic indices in the steroid group,the gastrodin＋steroid group,and the control group were 91.1％,27.1％,and 5.4％,respectively,and the differences were significant between groups.Compared with the control group and the gastrodin＋steroid group,the mRNA and protein expression levels of Bax and Caspase-3 were significantly higher in the steroid group,but the Bcl-2 mRNA and protein expression levels were significantly lower.Conclusion Gastrodin could prevent steroid-induced ONFH by anti-apoptosis.     

自体松质骨加骨玻璃植入治疗缺血性股骨头坏死--犬股骨头骨缺损模型初步实验研究

目的:探讨使用人工合成骨移植替代材料--骨玻璃部分或完全代替自体骨移植,用于保存自身股骨头手术中充填股骨头骨缺损灶.方法:实验犬12只随机分为3组,每组4只,单侧髋制作成股骨头骨缺损模型,对侧髋作为对照.Ⅰ组植入自体松质骨;Ⅱ组植入自体松质骨加骨玻璃;Ⅲ组植入骨玻璃.对实验侧和对照侧犬股骨头行大体观察、X线检查、力学性质测定和组织学观察.结果:共10只犬术后存活4个月.大体观察:只有Ⅰ组1髋未发生塌陷,三组间平均塌陷高度无显著差异.X线检查:Ⅲ组塌陷高度显著高于Ⅰ、Ⅱ组.组织学观察:回植愈合的软骨帽软骨均出现软骨增厚纤维化,Ⅰ组和Ⅱ组的植入物区均出现骨小梁粗大、骨细胞量增加新生骨形成、骨髓腔小;Ⅲ组的植入物区呈现类粗大骨小梁样改变但骨细胞样结构量少,无新生骨形成.股骨头压应力强度测定:Ⅰ组对照侧与实验侧间无显著差异;Ⅱ组和Ⅲ组对照侧与实验侧间差异显著.结论:对股骨头缺血坏死实验犬植入自体骨和植入自体骨加骨玻璃后,组织学和影像学均显示愈合良好.采用"活门板"式手术充填股骨头骨缺损灶时骨玻璃可部分替代自体骨.     

统计学方法在股骨头坏死随访疗效分析中的应用

目的探讨不同的统计学方法在股骨头坏死随访资料疗效分析中的应用。方法利用Excel2003和SAS6.12软件包,运用CMHχ^2检验、Ridit分析、两组等级资料的秩和检验和多分类有序反应变量的Logistic回归,对现有文献Harris评分资料的近期疗效评价进行统计分析。结果四种不同的统计分析方法皆能分析出两组优良率的差别有统计学差异,且其P值的趋势大小是一致的。结论四种方法皆适合于随访资料的疗效分析,只不过不同作者有不同的选择而已。     

A modified technique of bone grafting pedicled with femoral quadratus for alcohol-induced osteonecrosis of the femoral head

Background Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head （ONFH） in pre-collapse ONFH without extensive lesion. However, for pre-collapse ONFH with extensive necrotic area, it is still challenging to preserve the femoral head. The current study aimed to introduce a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus and to evaluate its short-term outcomes.Methods From January 2008 to December 2008, 10 ONFH patients （12 hips） underwent operations by a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus （group A）.According to the ARCO classification system, there were two hips in stage Ⅱ B and 10 hips in stage Ⅱ C. Also in the same period, 12 ONFH patients （16 hips） underwent operations by the conventional procedure of quadratus femoris pedicled bone grafting （group B）. There were 6 hips in stage Ⅱ B and 10 hips in stage Ⅱ C. All patients were males and suffered from alcohol induced ONFH. For the new technique, the necrotic area was evaluated, and a titanium mesh piece of the same size （range from 2.5 cm×2.8 cm to 2.8 cm×3.4 cm） was obtained and shaped to match the contour of the head. The cancellous bone was first placed underneath the subchondral bone and was densely impacted （about 1 to 2 mm thick）.Then the titanium mesh piece was inserted. The length of the decompressive trough was measured. A titanium cylinder mesh cage with a diameter of 1.6 cm of the same length was obtained, with a ＂U＂ shaped window in the wall being created to make room for the muscle pedicle. The muscle pedicle bone was inserted into the titanium mesh cage to form a bone graft-titanium cage complex and, then the complex was inserted. The hundred percent score method was used for outcome evaluation. Clinical and radiographic outcomes were compared between group A and group B.Results The average operative time was 150 minutes （130 to 185 minutes） in group A, with an average of 130 minutes （120 to 180 minutes） in group B. The mean blood loss was 400 ml （300 to 500 ml） in group Aand 350 ml （250 to 500 ml）in group B. Group A patients were followed up for an average of 19.2 months （14 to 24 months）, with an average of 18.5 months （12 to 24 months） for Group B. Full weight bearing was allowed 5 to 7 months postoperatively. Pain and function were obviously improved. For group A, pain score improved from a mean of 9.8 points preoperatively to an average of 24.6 points postoperatively, and function score improved from a mean of 9.0 points preoperatively to an average of 17.4 points postoperatively. In group B, pain score improved from a mean of 9.5 points preoperatively to an average of 24.2 points postoperatively and function score improved from a mean of 9.2 points preoperatively to an average of 17.2 points postoperatively. The range of motion changed the least, with score improvement from a preoperative mean of 13.9 points to postoperative 16.8 points for group A and from a preoperative mean of 13.7 points to postoperative 16.5 points for group B. Radiographic score improved from preoperative 31 points to postoperative 38 points for group A, in comparison with an improvement from preoperative 31 points to postoperative 37 points for group B. At the latest follow up, 11 hips were rated as excellent and 1 hip was better for group A, with 14 hips being rated as excellent and 2 hips being better in group B. There was no statistically significant difference between groups A and B in clinical and radiographic outcomes.Conclusion For ONFH in stage ARCO llC, satisfactory clinical outcome can be achieved by the new technique in the short-term period while the long-term clinical outcome has yet to be determined.     

钻孔减压术治疗早期股骨头坏死的疗效分析

目的 :观察分析钻孔减压术治疗股骨头缺血性坏死的疗效。方法 :采用钻孔减压术治疗股骨头缺血性坏死 5 6例 67髋 ,从股骨大转子外、下 2cm向股骨头内不同方向钻 3个直径 3 5mm的孔道 ,根据髋关节功能、术前术后MRI、X光片结果进行综合评价 ,分析其疗效。结果 :术后平均随访 4 3年 (0 5～ 7 0年 ) ,IA、IB、IC的优良率分别为 10. 0 0 %、90. 0 %、63 .6% ,IIA、IIB、IIC的优良率分别为 83 3 %、5 4 5 %、5 0. 0 %。各期别之间的疗效差别有显著性 (P <0 . 0 5 )。结论 :钻孔减压术对股骨头坏死的疗效与股骨头坏死的期别有关 ,股骨头坏死分期越早效果越好。     

不稳定逼尿肌Cx43基因表达及其与逼尿肌细胞间缝隙连接通讯功能的关系研究

目的研究连接蛋白Cx43基因在体外培养不稳定逼尿肌细胞中的表达及不稳定逼尿肌细胞间缝隙连接通讯(gap junction intercelluar communication,GJIC)功能的变化,初步探讨二者与逼尿肌不稳定(destrusor instability,DI)的关系.方法健康雌性Wistar大鼠40只,分为DI组和正常组.RT-PCR及Western blot法检测各组逼尿肌细胞中Cx43 mRNA及蛋白表达变化,划痕标记荧光染料示踪技术(SLDT)检测各组逼尿肌细胞间GJIC功能变化.结果RT-PCR及Western blot检测结果显示DI组逼尿肌细胞中Cx43 mRNA及蛋白含量明显高于正常组(P＜0.01),SLDT结果表明DI组逼尿肌细胞间GJIC明显强于正常组(P＜0.01).结论体外培养不稳定逼尿肌细胞中Cx43基因表达增加,细胞间GJIC增强,二者可能与DI的发生有密切关系.     

缝隙连接蛋白43 (Cx43)与神经炎症的研究进展

 缝隙连接蛋白43(connexin43, Cx43)是中枢神经系统(central nervous system, CNS)中含量最丰富的连接蛋白,主要分布于星形胶质细胞,以缝隙连接(gap junction, GJ)和半通道(hemichannel, HC)的形式存在,分别介导细胞间和细胞与外环境间的信息交流。随着人口的老龄化,阿尔茨海默病(Alzheimer's disease, AD)、脑卒中及术后认知功能障碍等疾病的发生率越来越高,神经炎症是这些CNS疾病的一个共同特征,涉及到白细胞聚集、胶质细胞激活、炎性因子释放等,该过程需要高效的信息交流,研究表明Cx43在该过程中发挥着不可忽视的作用,主要表现为GJ抑制和HC活性增加并影响神经功能。本文重点综述Cx43与神经炎症的关系,为多种CNS疾病的治疗提供新的靶点。     

Effect of superior retinacular artery damage on osteonecrosis of the femoral head

Background Osteonecrosis of the femoral head （ONFH） is the result of dysfunctional blood supply, but associations between specific damaged arteries, imaging changes and clinical sign require more understanding. We investigated characteristics of ONFH that pertain to blood supply, imaging appearance, and clinical feature to judge the prognosis of ONFH.