生物降解材料己内酯/还氧乙烷共聚物的生物相容性及体内外降解

目的：探讨国产生物降解泌尿系支架材料己内酯/还氧乙烷共聚物（PCL-EO）的生物相容性及体内、体外降解特性。 方法：将PCL-EO试件埋植在Wistar大鼠脊柱两侧肌肉内或浸泡于流动的尿液中,分别于2、4、6、8、10、12、14及16周取出,通过组织病理学切片研究材料周围组织反应,利用扫描电镜检查和分子量、重量检测以了解PCL-EO在体内、体外的降解情况。 结果：PCL-EO材料在16周内可降解为随尿液流动的细小颗粒。材料的体内、体外降解趋势相同,体内降解速度略快于体外降解。埋植材料周围肌肉组织无脓肿形成和组织坏死发生,局部组织反应为非细菌性炎症反应。 结论:PCL-EO材料生物相容性良好,降解时间适宜,适用于制备泌尿系支架,可进一步临床研究开发。     

纳米羟基磷灰石复合物修复骨缺损实验研究的影像学评价

目的:通过磁共振成像(Magnetic resonance imaging,MRI)与X线方法检测纳米羟基磷灰石/聚酰胺(n-HA/PA66)复合材料应用于修复骨缺损实验研究,综合评价其成骨能力,为骨缺损修复后全面、准确的影像学评价提供理论依据.方法:30只新西兰大白兔行一侧胫骨髁钻孔,并植入n-HA/PA66复合材料.术后2、4、6、8、12周各时相点摄DR片、MRI及动态增强MRI检查,并取材进行组织学观察.结果:(1)MRI显示n-HA/PA66复合材料与骨组织易于区分,术后第4周开始从材料内部逐步强化,周围软组织水肿逐步吸收,术后12周修复区强化明显,周围水肿基本吸收.(2)X线显示术后第8周开始,缺损填修复区内的骨质增生开始,术后12周缺损区呈高密度骨质修复表现.(3)组织学显示术后4～12周,n-HA/PA66复合材料被界膜分隔成小岛,界膜内可见大量间充质细胞、成纤维细胞及小血管,后形成破骨及成骨细胞,修复区内骨小梁逐步形成.结论:MRI联合X线能够清楚显示n-HA/PA66复合材料修复过程,对早期骨移植的成功有很好预测作用,并兼顾术区周围关节及软组织的恢复显示,具有临床可操作性.     

生物降解输尿管支架材料丙交酯/乙交酯共聚物的生物相容性及体内外降解特性

目的：探讨国产生物降解输尿管支架材料丙交酯/乙交酯共聚物（PLGA 80∶20）的生物相容性及体内、体外降解特性。 方法：体内实验采用PLGA试件埋植在Wistar大鼠脊柱两侧肌肉内,体外实验采用PLGA试件浸泡于流动的尿液中,分别于观察时间内取出,通过组织病理学切片观察材料周围组织反应,利用扫描电镜检查和分子量、质量检测了解材料在体内、体外的降解情况。 结果：PLGA材料在6～7周内可降解为随尿液流动的细小颗粒;材料的体内、体外降解趋势相 同,体内降解速度略快于体外;埋植材料周围肌肉组织无脓肿形成和组织坏死发生,局部组织反应为非细菌性炎症反应。 结论：PLGA材料生物相容性良好,降解时间适宜,适用于制备输尿管支架。     

鹿茸多肽-胶原蛋白/壳聚糖复合材料对家兔下颌骨缺损愈合的促进作用及其机制

目的：制备鹿茸多肽-胶原蛋白/壳聚糖复合材料,探讨其对家兔下颌骨缺损愈合的促进作用及其可能机制。方法：将胶原溶液和壳聚糖溶液充分混匀,采用戊二醛交联法制备复合材料,扫描电子显微镜（SEM）下观察复合材料的微观结构。选择36只家兔建立兔下颌骨单侧缺损模型,分为实验组和对照组,每组又设4、8和12周亚组,每亚组各6只家兔。实验组家兔植入鹿茸多肽-胶原蛋白/壳聚糖复合材料,对照组家兔不植入任何材料。分别于术后4、8和12周采用CT观察家兔造模部位的组织学及周围神经重建情况,免疫组织化学法检测家兔骨组织中血管内皮生长因子（VEGF）表达量,SEM下观察骨缺损处的超微结构。结果：复合材料呈现规则的层状皱褶结构,支架内部孔径变大且以片状结构为主,是生物材料理想的结构。术后4周,实验组家兔有新骨生成,新生骨样组织致密材料大部分降解,VEGF呈高表达;术后8周,实验组家兔中的骨缺损部位骨小梁明显增多,VEGF表达呈下降趋势;术后12周,实验组家兔新骨形成且密度基本与正常组织一致,VEGF表达恢复正常。术后各时间点实验组家兔骨缺损愈合程度和成骨速度明显优于对照组。结论：鹿茸多肽-胶原蛋白/壳聚糖复合材料对家兔下颌骨缺损愈合具有明显的促进作用,其机制可能与促进VEGF表达有关。     

胶原膜包裹或应用环孢素A改善鸡羽根角蛋白材料的组织相容性

目的 观察经胶原膜包裹或应用免疫抑制剂后,鸡羽根角蛋白(CCK)材料在体埋植对周围组织的影响.方法 30只SD大鼠,随机均分为5组.将经特殊处理的CCK埋植入竖脊肌组织中.实验组:A组为CCK材料埋植加术后两周腹腔内注射免疫抑制剂环孢素A(CsA,日剂量5 mg/kg),B组为CCK材料浸泡CsA(2.5 mg/ml)后埋植,C组为胶原膜包裹CCK材料后埋植,D组仅埋植CCK材料.空白对照组仅作切口,不埋植材料.分别于术后2、4、8周取材,常规切片染色,光镜下观察埋植材料的降解情况及对周围组织的影响,免疫组织化学术检测周围组织内T淋巴细胞浸润情况.结果 术后各组大鼠一般状况良好,术后第2、4、8周,可见大量巨噬细胞,尤其是多核巨细胞分布于材料边缘,吞噬材料.炎性细胞数量较少.第2、4、8周A组CD3阳性表达细胞数较B组少,与D组有显著差异(P＜0.05),A组与空白对照组无显著差异(P＞0.05).结论 短期应用免疫抑制剂可显著改善CCK的在体组织相容性;CCK在体内可降解,巨噬细胞,尤其多核巨细胞参与了该过程.     

对BCP/PLLA复合骨修复材料的生物相容性研究

在分析BCP/PLLA复合材料成分、特性和使用条件的基础上,以一系列体内体外试验对该复合材料的生物相容性进行研究。选择家兔在其肌袋内长期埋植进行组织学观察,以豚鼠静脉注射材料浸提液实验来验证材料的短期毒性。实验结果表明：BCP/PLLA复合骨修复材料的生物相容性优良,可望成为一种优异的骨组织工程支架材料和骨修复替代材料。     

纳米羟基磷灰石/聚酰胺复合材料预防椎板切除后椎管狭窄、粘连的初步影像研究

目的：探讨影像学关于纳米羟基磷灰石／聚酰胺复合材料（n-HA／pA66）在预防椎板切除后并发症的表现，通过病理对照研究来提供临床指导。方法：建立22只家犬L5椎板切除实验模型，随机分成实验组和对照组。术后行CR和MRI扫描等影像方法与组织学的检测。结果：X线结果术后8周人工椎板与骨接触面开始模糊，至术后24周人工椎板与骨接触界面消失，密度增高，钙化；而对照组始终表现为腰5椎板棘突缺损，无致密影出现。组织学结果术后8周人工椎板内层的纤维组织-材料界面就出现较多成骨细胞团及骨小梁；对照组椎板缺损处是纤维瘢痕逐步形成，最终与硬膜粘连。MRI对脊髓受压及硬膜粘连情况显示较好，实验节段与对照节段相比，椎管面积及矢状径有明显差异（P〈0．05）。显示出重建椎板节段椎管完整性得到恢复，与组织学一致。结论：n-HA／PA66复合材料能够阻止硬膜外粘连，X线及MRI对其检测准确、全面。     

珍珠层/聚乳酸重组人工骨修复动物骨干缺损的实验研究

目的 探讨珍珠层/聚乳酸重组人工骨(NPCB)在体内的生物相容性、降解情况及成骨特点,评价其性能,为进一步的应用提供实验依据。方法 将NPCB随机植入成年新西兰白兔1.5 cm的桡骨缺损内,并设立不植入任何材料的空白对照,观察NPCB植入后动物的局部反应,检测动物术后1周、4周的血钙值,并与术前1天比较;于术后6、8、12、16周取材,作X线、骨矿含量、大体标本及组织形态学观察,分析不同时期组织反应、骨缺损修复及材料降解情况。结果 NPCB植入后无明显的局部不良反应,术后1周、4周血钙值与术前1天相比无明显差异。植入NPCB的骨缺损内骨矿含量在6~12周时升高幅度明显高于空白对照组,但12周后植入NPCB的骨缺损内骨矿含量出现下降。X线检查、大体标本及组织形态学观察显示NPCB的成骨方式主要是骨传导成骨,至术后16周时骨缺损基本修复,NPCB与宿主骨结合紧密,而空白对照骨缺损断端仅有少量骨修复,形成骨不连。NPCB植入后即开始其降解过程,12周以后材料周围出现较多吞噬有材料颗粒的巨噬细胞和多核巨细胞,16周时仍有部分材料未降解吸收。结论 NPCB具备良好的生物相容性和骨传导能力,可以在体内逐渐发生生物降解。     

牡蛎壳粉/α-半水硫酸钙复合人工骨修复兔股骨髁缺损的实验研究

目的 评价牡蛎壳粉/α-半水硫酸钙复合人工骨材料填充兔股骨髁缺损的成骨能力及降解性.方法 用牡蛎壳粉及α-半水硫酸钙按1:3比例混合,制备人工骨.采用新西兰大白兔制做股骨髁缺损的动物模型,将复合人工骨植于一侧股骨髁,另一侧为空白对照,分别于术后4、8、12周取材、脱钙、组织包埋、切片行HE染色,观察成骨及材料降解情况.结果 大体观察未见组织炎症反应,缺损区内填充的复合人工骨逐渐降解.4周时实验组有少量新骨形成,对照组无明显成骨,到8周时实验材料几乎降解完全,有部分骨小梁形成,对照组有少量新骨形成,生长部位主要在髓腔附近.在12周时实验组骨组织已经较为生熟,对照组有贴壁生长的骨小梁组织.经骨量评估发现在不同时间点,实验组骨量均高于对照组.结论 牡蛎壳粉/α-半水硫酸钙复合人工骨材料成骨能力及降解能力良好.     

阶梯缓释抗结核纳米人工骨复合体的生物安全性研究

目的研究阶梯缓释抗结核纳米人工骨复合体（β-TCP／INH-RFP-PCL／SM-SA）的生物安全性。方法对β-TCP／INH-RFP-PCL／SM-SA复合体进行体外噻唑蓝（M1Tr）细胞毒性实验,动物体内急性全身毒性实验、原发性皮肤刺激实验、皮内刺激实验和致敏实验,并设置对照组进行比较。结果β-TCP／INH-RFP-PCL／SM-SA复合体MTT细胞毒性实验显示人工骨材料组细胞存活率在95％以上,细胞毒性1级。人工骨复合材料浸取液不引起豚鼠过敏。原发性皮肤刺激实验和皮内刺激实验均提示复合材料对兔皮肤、皮内无刺激反应。小鼠尾静脉注射后未出现明显全身毒性反应。结论β-TCP／INH-RFP-PCL／SM-SA无明显细胞毒性,具有良好的细胞相容性,在应用过程中能够降低直接使用抗结核药物所带来的生物毒性。动物全身毒性反应、皮肤／内刺激反应和急性过敏反应提示该材料具有良好的生物安全性。     

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.