组织工程方法进行特定形态骨组织构建的研究

目的 用组织工程方法构建人下颌骨升支外形的骨组织。方法 体外培养、扩增、诱导兔骨髓基质干细胞（MSCs）,细胞长满后用基因重组人骨形成蛋白-2诱导 3天;收集细胞,按 5×107/ml的浓度混匀至 1.5％藻酸钠溶液中,然后接种于人下颌骨升支外形的多孔珊瑚中,以CaCl2固化后,植入裸鼠背部皮下组织中,于植入术后1、2个月取材,通过大体标本、X线检查、组织学检查观察新骨的形成情况。结果2月时形成的组织在裸鼠背部界限清晰,取材后观察珊瑚表面有坚硬组织形成,形状与支架材料的外形基本一致,X线检查证实珊瑚已有明显吸收,在其表面有明显X线组射影形成;组织学检查表明,在珊瑚表面及内部的孔洞内均有大量新骨形成,新骨形成过程为软骨内成骨。结论 用组织工程方法可以构建出特定形态骨组织,因此适于进行颌面部骨缺损的修复。     

骨髓来源成骨细胞接种于珊瑚中再造下颌骨髁状突的研究

目的：研究用组织工程方法再造人下颌骨髁状突形状骨组织的可行性。方法：W本外培养、扩增、诱导兔骨髓基质干细胞（MSCs)、将细胞接种于人工下颌骨髁状突形状的多孔珊瑚中,植入裸鼠背部皮下组织中,术后1、2月取材,通过大体标本观察、X线检查,扫描电镜观察、组织学检查,观察新骨的形成情况。结果：大体标本观察,2月时成功地再造出具有髁状突解剖形态的骨组织、X线检查表明新组织骨骨和未降解的珊瑚构成;扫描电镜和组织观察均证明在珊胡表面和孔洞内有大量新骨形成,结论：骨髓来源成骨细胞接种于珊瑚中再造成特定形成骨组织的有效方法。     

hBMP-7基因修饰犬骨髓基质干细胞复合珊瑚羟基磷灰石修复下颌骨缺损

目的:构建携带人骨形态发生蛋白7(hBMP-7)基因的重组腺病毒载体,体外转染犬骨髓基质干细胞(dMSCs)复合珊瑚羟基磷灰石(coral hydroxyapatite, CHA),观察其修复下颌骨缺损的效果。方法:利用AdEasy腺病毒表达系统,体外构建高效表达hBMP-7重组腺病毒载体,转染dMSCs 与珊瑚羟基磷灰石支架材料复合,再分别植入取材动物的自体下颌骨缺损区,分别于4周和8周取材观察成骨情况。结果:大体观察、X线检查及组织学观察均发现构建组织工程骨在祼鼠皮下及骨缺损处均有明显新骨组织形成。结论:构建携带人骨形态发生蛋白7(hBMP-7)基因的重组腺病毒载体,体外转染dMSCs后复合珊瑚羟基磷灰石有较多量骨组织形成,可有效修复下颌骨缺损。[关键词] 人骨形态发生蛋白7 骨髓基质干细胞 腺病毒 组织工程     

钛网加强的BMSC/珊瑚修复下颌骨缺损的实验研究

目的:观察钛网加强的骨髓基质细胞(BMSC) /珊瑚复合物对下颌骨缺损的修复能力。方法:体外培养兔BMSC,经扩增、诱导分化后复合角孔珊瑚,植入自体下颌骨缺损区,修复骨缺损,并采用钛网固位和加强,植入 6、12周后进行X线观察和组织学检查,观察骨形成情况。结果:骨髓基质细胞 (BMSC) /珊瑚复合物有很强的成骨作用。实验组X线观察有骨形成,组织学染色证实有新骨形成,骨磨片显示钛网和新骨获得良好的骨愈合。结论:钛网 /BMSC/珊瑚复合物可修复兔下颌骨缺损,有良好的临床应用前景。     

血管束法构建血管化组织工程骨支架材料的组织学观察

目的:比较末端结扎和不结扎两种血管束法在珊瑚中预构血管化的程度,探索一种先血管后成骨,最终解决骨组织工程血管化的方法。方法:选择新西兰兔的股动脉和股静脉解剖分离形成血管束,方法一是末端切断结扎形成动静脉环,环绕套入珊瑚支架的侧槽中;方法二是血管束保持血流通畅,动静脉分别套入珊瑚支架的两侧槽中。外用ePTFE膜包裹隔绝,植入大腿皮下。单纯珊瑚块埋植于皮下作为空白对照。术后2、4、6周行大体形态学和组织学检查,分析珊瑚孔隙中组织结构和血管新生情况并作定量分析。结果:珊瑚侧槽、表层和深层间隙内有大量血管和纤维结缔组织新生,4周基本充满全层,6周血管化明显。组织学和定量分析显示血管通畅组较末端结扎组和空白对照组血管生成更明显,空白组主要是纤维组织增生。结论:珊瑚植入血管束并被隔绝后可以形成血管化的活体组织,血管化的珊瑚有望作为骨组织工程的支架材料,为下一步构建组织工程骨提供早期营养。     

复合血管内皮细胞组织工程骨修复兔下颌骨缺损的研究

目的探讨血管内皮细胞构建的组织工程骨修复兔下颌骨缺损。方法实验分为三组,A组：兔成骨细胞（rabbit osteoblast,ROB）和血管内皮细胞（rabbit vascular endothelial cell,RVEC）复合外消旋聚乳酸（poly-DL-lacide,PDLLA）;B组：单纯成骨细胞复合PDLLA,C组：单纯PDLLA。分别修复兔下颌骨缺损,手术后4周、8周通过形态学、X线观察骨缺损修复及血管化情况。结果A组骨组织形成与血管化程度均高于B组,在材料中心区可见有血管形成,越靠近血管成骨越多。X线观察,A组：骨缺损区阴影面积明显减小,材料植入区可见骨组织影像;B组：缺损面积减小,骨组织影像增加,中心区影像低于周围区域。C组：缺损区未见骨组织影像,周围可见骨痂形成。结论复合血管内皮细胞和成骨细胞的细胞支架复合体无论在成骨还是血管化方面均好于单纯成骨细胞复合支架植入组。     

预构血管化神经的动物模型的建立

目的 :建立兔耳中央动静脉束植入预构面神经上颊支的动物模型。方法 :选用 2 8只新西兰大白兔 ,将兔右耳中央动静脉束植入右面神经上颊支旁 ,2周、3周、4周、5周后进行血管墨汁灌注检查。结果 :兔耳中央动静脉束植入预构面神经 2～ 4周后 ,无明显的新生血管化 ,预构 5周后 ,神经外膜、束膜、内膜新生血管化明显。结论 :兔右耳中央动静脉束植入预构面神经是研究预构带血管神经移植的比较理想的动物模型。     

复合珊瑚骨修复颌骨实验性骨缺损

珊瑚人工骨具有良好的生物相容性，生物降解性和骨传导性；单纯植入机体后有定的体积丧失。本文将珊瑚骨和自体骨髓复合，修复兔下颌骨实验性骨缺损，术后不同时间行Ｘ线检查，＾９９ｍＴｃ－ＭＤＰ骨显像和组织学检查。     

钛网加强的BMSC/松质骨基质修复下颌骨缺损的实验研究

目的：观察钛网加强的骨髓基质细胞(BMSC)／松质骨基质复合物修复下颌骨缺损的能力。方法：体外培养兔BMSC经扩增，诱导分化后复合同种异体松质骨基质，植入自体下颌骨缺损区，修复骨缺损，钛网固位和加强，植入6周、12周后经X线，组织学检查，观察骨形成情况。结果：骨髓基质细胞(BMSC)/松质骨基质复合物有很强的成骨作用，实验组X线观察有骨形成，组织学染色证实有新骨形成，骨磨片显示钛网和新骨获得良好的愈合。结论：钛网加强的BMSC／松质骨基质可诱导修复兔下颌骨缺损，为组织工程方法修复骨缺损提供了新的思路。     

培养成骨细胞接种于天然珊瑚中再造骨组织的研究

目的：对成骨细胞接种于天然珊瑚中的再造骨组织进行组织学观察。方法：体外分离、培养扩增兔成骨细胞,将细胞接种于多孔珊瑚中,然后植入兔背部皮下组织,术后４、８、１２ 周取材,通过组织学、扫描电镜观察新骨的形成情况。结果：表明培养的兔成骨细胞可以在珊瑚表面良好生长,成骨细胞／珊瑚复合物植入皮下 ４ 周,局部形成骨样组织,可见大量成骨细胞,胞浆丰富,某些部位可见红色的骨基质形成;８ 周时,形成大量新骨组织,但不成熟;１２ 周时板层骨形成,扫描电镜观察见大量成骨细胞位于基质中。结论：用这种方法进行骨再造和骨缺损修复有很多优点,具有广阔的应用前景。     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

拔牙位点保存用复合温敏凝胶的构建及体外表征

目的:制备多壁碳纳米管/羟基磷灰石/壳聚糖复合温敏凝胶,探讨其作为拔牙位点保存材料的理化性能。方法:采用原位沉积方法制备多壁碳纳米管/羟基磷灰石(MWNT/ HA简称HAC)复合无机材料,将其分散至壳聚糖温敏凝胶中,制备壳聚糖/多壁碳纳米管/羟基磷灰石(CS /MWNT/HA简称CS/HAC)复合温敏凝胶,以成胶时间、孔径、孔隙率、机械强度及降解性能为指标优化配方设计,并表征复合温敏凝胶的微观形貌及理化性能。结果:以10 g/L的HAC作为补强成分加入到壳聚糖溶液中,能够在不影响成胶并保证一定孔隙率(84%)的前提下,提高材料的机械性能(抗压强度0.441 MPa),所获复合温敏凝胶具有适宜的临床操作时间(12 min),并具有可控的降解速率。结论:负载HAC的复合温敏凝胶具有良好的成型性,并具有较好的机械性能,在拔牙位点保存领域具有良好的应用前景。     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.