牙齿根分歧部植入不同移植骨的实验研究

在犬齿根分歧部人工制作病损骨模型,再分别植入羟基磷灰石人工骨、胎儿－羟基磷灰石复合骨。以前者做对照组,术后４、８、１２周取材、,通过组织学对比观察,评价其骨修复能力,结果表明,在根分歧部植入２种移植骨均不干扰骨愈合的生理过程,并有骨促进作用。胎儿－羟基磷灰石复合材料修复骨缺损效果明显优于单纯人工骨植入。证明胎儿－羟基磷灰石复合骨是一种较理想的治疗根分歧部病变的骨移植应用材料。     

BMP诱导成骨过程中胶原生成及TGF-β1的促进作用

目的 探讨骨形态发生蛋白（Bne morphogenetic protein,BMP)诱导成骨过程中肌胶原氨基酸的变化规律及转化生长因子β1（Transforming growth factorβ1,TGF-β1)对骨胶原生成的影响，BMP的诱导成骨机制和TGF－β1对骨损伤修复的调节机制。方法 实验采用日本大耳白兔左尺骨中上段12mm骨缺损实验模型，随机分为实验组，对照组及空白组，缺损内分别植入BMP／TGF－β1／载体，BMP／载体及单纯载体。分别于术后第1，2，3，4，5周检测各组缺损区胶原羟脯氨酸（Hydroxyproline,HP)及羟赖氨酸（Hydroxylysin,HL)量的变化，并作胶原VG染色图像分析，组织学及电镜观察。结果 实验组较同期对照组及空白组胶原HP生成骨胶原在BMP诱导成骨过程中生成增加。TGF－β1通过促进成骨细胞生成使I型胶原分泌能力增强，并抑制Ⅱ型胶原产生使软骨期缩短，骨损伤修复提前。BMP，TGF－β1两者在骨损伤修复中相互加强，具有协同作用。     

TGF-β1在羟基磷灰石多孔层修饰镍钛合金修复骨缺损中的表达及意义

目的：研究TGF-β1在羟基磷灰石多孔层修饰镍钛合金修复骨缺损过程中的表达和意义,为羟基磷灰石多孔层修饰镍钛合金作为生物医学材料在临床上广泛应用提供理论依据。方法：选取健康成年兔24只,随机分为实验组和对照组,选取左侧股骨下1／3处为种植区,其中实验组植入羟基磷灰石多孔层修饰镍钛合金,对照组植入镍钛合金,通过大体观察、HE染色观察术后1,2,4,8wk骨组织局部组织反应、骨缺损的修复情况以及免疫组织化学染色测定TGF-β1的表达。结果：大体观察、常规HE染色显示实验组1,2,4,8wk骨痂生长、骨缺损修复情况明显优于对照组;免疫组织化学染色显示实验组于1,2,4,8wk TGF-β1表达明显高于对照组,且具有统计学差异（P〈0.05）。结论：羟基磷灰石多孔层修饰镍钛合金能够刺激TGF-β1的表达,促进骨缺损修复;羟基磷灰石多孔层修饰镍钛合金与骨组织具有很好的相容性。     

腭板缺失修复的动物模型实验研究

目的：研究羟基磷灰石－骨粘合剂复合人工骨作为植骨材料修复腭板骨缺损的可行性，为临床腭裂患者进行植骨术提供依据。方法：对4组共16只狗腭板人为制造裂隙，用羟基磷灰石－骨粘合剂修复腭板骨缺损。术后4，8，16，24周分别处死一组试验狗，取上颌腭板进行X线平片观察，同期扫描电镜观察骨愈合情况。术后24周，处死最后一组狗前行腭 板冠状位CT扫描。结果：手术创口Ⅰ期愈合，未发现明显的并发症和病理排斥现象，人工骨板形态规则，未见移位、塌陷、断裂。人工骨与受植床周围骨有较好的骨性愈合，骨量随观察时间延长而逐渐增加。结论：羟基磷灰石－骨粘合剂复合人工骨具有良好的组织相容性；具有良好的塑性、固位、成骨作用。     

转化生长因子-β1对骨形态发生蛋白诱导成骨的促进作用

目的：我们通过观察转化生长因子β1（transforming growth factorβ,TCF－β1）和骨形态发生蛋白(bone morpho-genetic protein,BMP)共同修复骨缺损,达到进一步阐明BMP诱导成骨机制的目的,方法：实验采用日本大耳白兔左尺骨中段12mm骨缺损实验模型,分为实验组,对照组和空白组,缺损内分别植入BMP／TGF－β1／载体,BMP／载体,载体,通过X线,组织学及电镜对比观察三组骨缺缶修复情况,结果：实验组骨缺损无论是骨痂出现还是骨接发生时间均较对照组明显提前,空白组骨缺损形成骨不连,实验组成骨细胞和软骨细胞无论出现的时间,数量和功能活跃程度均优于对照组,电镜观察见成骨细胞,软骨细胞内线粒体丰富,内质网增多,而对照组则相对较少,软骨细胞内线粒体丰富,内质网络增多,而对照组则相对较少,结论：TGF－β1具有促进BMP诱导成骨的作用,TGF－β1通过促进间充质细胞分裂增殖为BMP提供靶细胞,促进成骨细胞及软骨细胞的分裂增殖,促进骨细胞合成产生I型胶原,促进基质钙化,碱少骨吸收等作用来促进BMP的诱导成骨。     

碳酸化羟基磷灰石表面成骨活性的研究

目的：探讨碳酸化羟基磷灰石(carbonated hydroxuapatite，CHA)表面的成骨活性。方法：在CHA直接培养成骨细胞MC3T3-E1，观察细胞的黏附和增值数目，并检测碱性磷酸酶(ALP)活性和Ⅰ型胶原mRNA的表达，并以骨水泥(PMMA)作为对照。结果：MC3T3-E1细胞在CHA表面黏附和增值数目明显高于PMMA，并且ALP活性和Ⅰ型胶原mRNA表达水平均高于PMMA。结论：成骨细胞可直接在CHA表面黏附、增殖和并表达较高的成骨活性，可能是一种较为理想的骨缺损修复材料。     

超声波对骨痂中Ⅰ、Ⅱ型胶原代谢的影响

目的 探讨低强度超声波对骨折愈合中Ⅰ、Ⅱ型胶原代谢的影响。方法建立大鼠双侧胫骨近侧皮质骨缺损的动物模型，随机分为2组，实验组每日接受低强度超声波刺激，而对照组给予假刺激。于术后10、20、30d处死动物，取标本(骨痂)进行组织学及免疫组化染色观察。结果组织学检查显示：实验组的血肿机化、吸收，软骨性骨痂和软骨内化骨明显早于对照组，免疫组化检查显示：实验组在20d时Ⅱ型胶原的表达明显高于对照组；在30d时Ⅰ型胶原的表达也略高于对照组。结论低强度超声波通过增加骨痂内Ⅰ、Ⅱ型胶原的合成来促进骨折的愈合，其中以Ⅱ型胶原的作用尤其明显。     

纳米羟晶／胶原仿生骨修复家兔颅颌骨缺损的实验研究

目的：采用先进的仿生骨材料制备工艺,摹仿天然骨骼的形成过程,制备具有天然骨中纳米尺寸的羟基磷灰石／胶原复合人工骨材料,并用其修复家兔颅颌骨实验性穿通型骨缺损．方法：用四环素荧光示踪,放射性同位素^45CaCl2标记和放射自显影等手段观察和评价骨创的愈合情况。结果：该新型仿生骨材料具有良好的生物相容性,促进和加快骨创愈合的作用明显,为一种颇有前途的颅颌面骨缺损修复材料。     

胶原复合羟基磷灰石人工骨植入试验的扫描电镜观察研究

本研究用扫描电镜观察了胶原复合羟基磷灰石人工骨植块在小型猪下颌骨中种植后4周到48周的组织学变化。发现复合材料有良好的生物相容性、骨引导性，又具备了可塑性和可降解性。可做为骨缺损修复材料。     

氧化铝-羟基磷灰石修复兔骨腔隙性骨缺损的CT观察

目的通过CT摄片观察致密型氧化铝-羟基磷灰石人工骨材料修复兔骨腔隙性骨缺损的效果。方法采用放电等离子烧结(SPS,SparkPlasmaSintering)技术制备氧化铝-羟基磷灰石(Al2O3-HA)人工骨,植入兔股骨腔隙性骨缺损模型中,术后1天、12周通过CT摄片,观察人工骨与兔骨结合状况。结果术后12周宿主骨缺损完全愈合。结论SPS技术烧结的氧化铝-羟基磷灰石人工骨具有良好的生物相容性,是一种理想的承重骨人工骨替代材料。     

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.     

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.     

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.