兔Perthes病模型中骺软骨血管化的实验研究

目的：建立兔Perthes病模型,探讨Perthes病程中股骨头局部血管内皮细胞生长因子（vascular endothel growth faictor,VEGF）表达的变化及意义。方法：兔龄三个月左右的新西兰大白兔24只,模型组16只,实验对照组8只。采用手术1方法,切断圆韧带和股骨头支持带血供,建立兔Perthes病模型。两组分别于手术后1、2、4、8周分批处死动物,行X线检查,股骨头标本行组织学检查,VEGF免疫组化染色观察。结果：手术方法成功重复了Perthes病的基本病理变化,X线、组织学均表现出与Perthes病相似的特点。正常对照和实验对照组的股骨头骺软骨中,肥大区表现出较高的免疫反应性（VEGF—IR）,而增殖区VEGF—IR却表现较低水平。术后1周,实验组股骨头增殖区VEGF阳性细胞率开始高于正常。相反,实验组股骨头肥大区VEGF阳性细胞率明显减少。术后8周,实验组股骨头整个骺软骨区都表现VEGF—IR,增殖区VEGF阳性细胞率较正常股骨头明显增加。此时坏死股骨头软骨内骨化中心修复重建,肥大区VEGF阳性细胞率较正常接近。结论：VEGF有可能在坏死股骨头骺软骨促进血管发生,软骨内骨化中心的修复重建方面起关键的调节作用。     

音猬因子调控BMSCs表达和分泌VEGF及bFGF的实验研究

目的音猬因子(Sonic hedgehog,Shh)介导的信号参与调控血管生成的重要环节。研究不同浓度的重组Shh-N(recombinant Shh N-termitant,rShh-N)对BMSCs表达和分泌VEGF和bFGF的影响。方法取健康3日龄SD大鼠骨髓分离培养BMSCs,体外扩增至第3代,分别用含0、10、100、200 ng/mL rShh-N的L-DMEM培养BMSCs,作为A、B、C、D组。培养12、24、48、72 h后行ELISA法检测各组上清液中VEGF和bFGF的浓度,实时荧光定量PCR法检测各组VEGF和bFGF mRNA的表达水平。结果在基因表达水平上,D组各时间点的VEGF和bFGF mRNA表达量均明显高于A组(P<0.05),且在12、48 h表达量高于24、72 h(P<0.01);C组在各时间点均促进bFGF mRNA表达(P<0.05),在24～72 h促进VEGF mRNA表达(P<0.05),且在72 h时表达量均最高(P<0.01);B组在12 h抑制VEGF mRNA表达(P<0.05),48 h和72 h表现出促进作用(P<0.05),在12～48 h明显促进bFGF mRNA表达(P<0.05),且在48 h时的表达量最高(P<0.01)。在蛋白水平上,D组各时间点VEGF和bFGF分泌量均高于A组(P<0.01);C组在24～72 h VEGF和bFGF分泌量明显多于A组(P<0.05);B组在12 h和48 h抑制VEGF的分泌(P<0.05),24 h增加其分泌作用(P<0.05),而在24 h和48 h促进bFGF的分泌(P<0.05)。各组在48 h和72 h时的VEGF和bFGF分泌量明显多于12 h和24 h(P<0.05)。结论 rShh-N可促进BMSCs表达和分泌VEGF和bFGF,为进一步探讨rShh-N和MSCs联合应用于治疗缺血性相关疾病以及促进骨修复重建的可行性提供了实验依据。     

大剂量激素对兔股骨头与股骨近端影响的实验研究

[目的]研究大剂量甲强龙(糖皮质激素)对股骨头、股骨近端组织BMP-2表达的影响,探索ONFH行人工关节置换治疗翻修率较高的原因.[方法]健康新西兰成年大白兔45只,随机分为1个对照组(A组),2个实验组(B、C组),每组均15只,B组连续3d,C组连续6d肌注甲强龙80 mg/( kg·d),诱发股骨头坏死模型,分别于注射后2、4、8周切取双侧股骨头、小转子处约3 mm厚的股骨近端段,行SABC法免疫组化染色,观察BMP-2表达情况.[结果]对于股骨头、股骨近端骨,激素使用剂量或作用时间,均可致BMP-2的表达减少,且激素使用剂量与作用时间有交互佧用,(P＜0.05).[结论]大剂量甲强龙可以造成股骨头、股骨近端骨组织内BMP-2表达降低,激素的应用时间越长,应用总量越大,对其骨骼的影响越严重.     

bFGF/BMP/AACB复合物修复犬股骨头缺损坏死模型的实验研究

目的制备bFGF/BMP/AACB复合物,通过动物实验研究其对股骨头缺损坏死模型的修复作用及相关问题,探讨临床应用的可能性。方法制备异体脱抗原松质骨(AACB),并将其与碱性成纤维细胞生长因子(bFGF)及骨形态发生蛋白(BMP)复合制成bFGF/BMP/AACB复合物,植入通过液氮冷冻建立的犬股骨头缺损坏死模型,术后不同时间处死动物。通过大体解剖、X线片、组织学染色、图像分析、血管免疫组化染色、X线能谱分析、生物力学测定等手段观察缺损坏死模型的修复情况。结果术后各组动物均无毒性反应和炎症反应。A组(空白缺损组)术后12周缺损仍未愈合;B组(AACB组)虽然优于A组,但成骨作用不及C组(BMP/AACB组);而D组(bFGF/BMP/AACB组)成骨和成血管作用优于A、B、C组。早期(3、6周)甚至优于E组(自体骨组),后期(12周)的骨修复及骨改建效果与E组相当。结论bFGF/BMP/AACB复合物具有明显促进犬股骨头缺损坏死模型再血管化及新骨形成的作用,可望成为新型的股骨头缺血性坏死(ANFH)修复材料。     

hVEGF165及hBMP-7共表达重组腺相关病毒载体对兔激素性股骨头坏死的修复作用研究

目的探讨hVEGF165及hBMP-7双基因共表达重组腺相关病毒载体对兔激素性股骨头坏死的修复作用。方法应用细菌脂多糖联合甲基强地松龙制备兔激素性股骨头坏死模型。30只经MRI筛选造模成功动物随机分为模型组、髓芯减压组和病毒治疗组。病毒治疗组动物于髓芯减压术后将rAAV-hVEGF165-IRES-hBMP-7病毒载体注入减压区内。选取病毒注射后12周时间点分别行核素骨扫描,股骨头大体观察、HE染色、VEGF和BMP免疫组化染色检测。结果 MRI检测、大体观察以及HE染色发现早期股骨头坏死动物模型建立成功,且病毒治疗组较髓芯减压组及模型组相比股骨头坏死表现明显减轻,VEGF及BMP表达增强,髓腔组织代谢旺盛,组间差别有统计学意义（P〈0.05）。结论重组腺相关病毒载体rAAV-hVEGF165-IRES-hBMP-7通过增加髓腔组织的血运、增强股骨头区骨组织质量提高激素性股骨头坏死区骨修复能力。     

pcDNA3.1-BMP-2真核表达载体构建及转染兔骨髓基质细胞的实验研究

目的 构建人骨形态发生蛋白2(BMP-2)真核表达载体，鉴定并转染兔骨髓基质细胞，为转基因治疗骨缺失疾病提供实验基础。方法 双酶切克隆载体将BMP-2目的基因与真核表达载体pcDNA3．1连接，免疫组化及Western blotting检测转染BMP-2基因骨髓基质细胞的表达效果。结果 成功构建BMP-2真核表达载体，转染骨髓基质细胞后，有BMP-2表达。结论 骨髓基质细胞经基因转染后可以表达BMP-2。为进一步实验研究提供基础。     

甲基强的松龙联合内毒素诱导兔股骨头缺血性坏死的实验研究

目的 建立兔激素性股骨头缺血性坏死模型,为进一步研究早期股骨头缺血性坏死的治疗奠定基础. 方法 健康成年雄性新西兰白兔36只,体重3～4 kg,根据给药方式不同随机分成4组.A组(n=10)于耳缘静脉注射大肠杆菌内毒素(10μg/kg),24 h后重复给药1次;B组(n=10)大肠杆菌内毒素注射同A组,注射完毕后,立即臀肌注射甲基强的松龙(40 mg/kg)3次,每次间隔24 hC组(n=10)单纯臀肌注射甲基强的松龙(40 mg/kg)3次,每次间隔24 h;D组(n=6)与B组相同时间点注射等量生理盐水,作为对照.注射后观察动物一般情况;于注射前及末次注射后2、4及6周,行MRI检查,观察股骨头改变;6周时通过组织学检查、墨汁血管灌注和透射电镜观察各组股骨头病理和血管形态变化,并计算空骨陷窝率、微血管密度和骨小梁面积百分比,根据组织学和MRI检查结果计算各组骨坏死发生率. 结果 A、B组动物注射内毒素后出现精神萎靡,眼睑充血发红等症状,活 动及饮食减少.B、C组动物于末次注射后3周明显消瘦,体重减轻;A、D组动物于末次注射后4周体重增加.B、C组分别于末次注射后2 d和16 d各有1只动物死亡.注射前及末次注射后2周各组动物股骨头MRI信号未见异常.4、6周时B、C组股骨头MRI检查T1WI表现为不规则低信号,T2WI呈高信号或低信号;A、D组股骨头MRI信号未见异常.A、B、C及D组空骨陷窝率分别为11.8%±4.7%、34.4%±6.2%、20.0%±4.7%、9.3%±4.6%;骨小梁面积百分比分别为59.2%±6.8%、40.1%±6.0%、51.5%±5.6%、63.2%±8.3%;微血管密度分别为14.3%±2.7%、4.5%±2.1%、10.2%±3.1%、15.4%±4.1%;各指标B组与A、C及D组比较,差异均有统计学意义(P＜0.01).透射电镜观察,B组和C组骨细胞和内皮细胞胞浆内均出现脂滴,B组骨细胞皱缩,核膜失去连续性、染色质溶解或固缩,A组和B组血管内皮细胞肿胀,细胞之间的连接增宽、破坏.B组骨坏死发生率为88.9%,显著高于C组的22.2%(P＜0.05),A、D组无骨坏死发生. 结论 甲基强的松龙联合内毒素能诱导出典型的兔早期股骨头缺血性坏死模型,成功率高,重复性好.     

去势加地塞米松肌肉注射法兔骨质疏松模型建立的实验研究

目的 探究应用去势加肌肉注射地塞米松的方法建立兔骨质疏松模型的可行性.方法 将24只5月龄雌性新西兰兔随机分成假手术 肌注生理盐水组、去势 肌注生理盐水组和去势 肌注地塞米松组,每组8只动物.后两组动物行双侧卵巢切除术.术前和术后2、3月时采用双能x线吸收骨密度测量仪及术后3月应用micro-CT进行测量分析.结果 micro-CT三维重建分析表明,去势加肌注地塞米松肌肉注射组兔术后3月时股骨远端BMD、BMC和骨小梁立体测量的一些指标与假手术的差值有统计学意义,去势 肌注地塞米松组和去势组兔骨小梁稀疏、断裂、排列紊乱,但前者更为明显.结论 去势 肌注地塞米松法建立新西兰兔骨质疏松症模型切实可行,造模时间较单纯去势法更短,3个月即可.     

兔自体细胞-载体复合物修复关节软骨缺损的实验研究

目的 研究兔MSCs向软骨细胞方向诱导后复合自体双相骨基质明胶(bone matrix gelatin,BMG)对膝关节软骨缺损的修复作用.方法 健康成年新西兰大白兔24只,雌雄不限,体重2～3 kg,随机分为A、B、C组,每组8只.取A组骨髓行原代培养,胰酶消化按12比例传至第5代,倒置相差显微镜观察细胞形态.取1、3、5代细胞绘制生长曲线.于第3代MSCs生长密集时加入TGF-a1 10 ng/mL、IGF-1 10 ng/mL、维生素C 50 ng/mL诱导8 d后倒置相差显微镜下观察,爬片行免疫组织化学及Mallory染色.取A组髂骨按Urist方法 制备双相BMG,将第3代经诱导8 d得到的种子细胞以5 X 106/mL密度接种于自体BMG制备细胞.载体复合物,体外培养3 d后扫描电镜观察.制作膝关节软骨直径3 mm,深3 mm的缺损模型,A组植入自体细胞.载体复合物,B组植入自体BMG,C组不作处理,第8、12周取材行大体观察、HE染色、免疫组织化学染色观察,Wakitani法组织学评分.结果 倒置相差显微镜观察MSCs原代细胞呈短梭形;传代细胞呈长梭形.传代细胞1～3 d增殖缓慢,3 d后增殖旺盛,7～8 d进入平台期,第3代增殖最为旺盛.诱导后MSCs细胞呈椭圆形,Ⅱ型胶原、S-100免疫组织化学染色阳性,Mallory染色胞浆蓝染.细胞-载体复合物扫描电镜观察BMG结构符合细胞载体要求,细胞种植于BMG后生长良好.动物实验大体观察A组术后8、12周缺损处均由透明软骨样组织修复,8周较12周表面稍凹陷;B、C组术后8、12周均为纤维样组织修复,表面凹凸不平.组织学观察HE染色A组术后8、12周修复组织与周围软骨组织结合良好,以圆形、椭圆形透明软骨样细胞为主,12周较8周细胞数多且大B、C组均为纤维样组织修复,12周较8周纤维样组织增厚.Ⅱ型胶原免疫组织化学染色A组术后8周呈阳性、12周呈强阳性;B、C组均无表达.Wakitani评分术后8周A、B、C组分别为(3.50±1.51)、(10.00±1.41)、(12.00±0.93)分,术后12周分别为(1.13±0.99)、(8.38±1.30)、(10.13±1.64)分,A组优于B、C组,B组优于C组,差异均有统计学意义(P＜0.05).结论 自体MSCs向软骨细胞方向诱导后,复合自体BMG对关节软骨缺损有较好的修复作用.     

新型抗冻剂海藻糖对低温保存皮肤组织α-辅肌动蛋白表达的实验研究

目的 比较海藻糖与传统低温保护剂对皮肤组织a-辅肌动蛋白(a-actinin)低温保存后表达的影响,进一步揭示海藻糖的低温抗冻机制.方法 实验共进行6次,每次取自愿捐献烧伤患者整形术后所余大腿部刃厚皮片5块,根据冻存时添加保存液不同,将皮片随机分为5组,每组各1块.T/D组添加0.5 mol/L海藻糖/DMSO,完全浸没皮片;D/P组DMSO/丙二醇;D/K组DMSO/无血清角质细胞培养基;DMEM组DMEM;置于-196℃液氮中储存14 d后复温进行实验;对照组刃厚皮片不作任何处理.对各组皮片进行免疫组织化学染色观察,RT-PCR方法 检测皮片a-actinin基因水平,皮肤内琥珀酸脱氢酶(succinate dehydrogenase,SDH)定量测定法检测皮肤活力.结果 对照组、T/D组、D/P组、D/K(组及DMEM组吸光度(A)值分别为27.50±7.92、18.40±5.81、13.10±5.11、11.50±4.54及5.30±2.14.对照组与T/D组比较差异无统计学意义(P＞0.05),与其他组比较差异均有统计学意义(P＜0.05).RT-PCR检测对照组、T/D组、D/P组、D/K组及DMEM组a-actinin基因表达A值分别为0.816±0.134、0.723±0.245、0.564±0.265、0.245±0.071及0.148±0.048.对照组与T/D、D/P组比较,差异无统计学意义(P＞0.05);与D/K、DMEM组比较,差异均有统计学意义(P＜0.05).对照组、T/D组、D/P组、D/K组及DMEM组SDH活性值分别为18.2±3.7、12.3±3.6、10.2±2.4、7.3±2.1及5.7±1.5.对照组与T/D组比较差异无统计学意义(P＞0.05),与其他组比较,差异均有统计学意义(P＜0.05).结论 海藻糖对低温保存皮肤组织a-actinin的保护作用在其抗冻机制中发挥了重要作用.     

AN ANIMAL MODEL OF PEYRONIE''S-LIKE CONDITION ASSOCIATED WITH AN INCREASE OF TRANSFORMING GROWTH FACTOR BETA mRNA AND PROTEIN EXPRESSION

Purpose

Transforming growth factor beta (TGF-beta) is involved in numerous vital processes including tissue fibrosis. Our objective was to study the role of TGF-beta in the induction of a Peyronie's-like condition and to produce an animal model for the further study of Peyronie's disease.

Materials and Methods

Twenty-four adult male Sprague-Dawley rats were divided into two groups. Different concentrations of cytomodulin, a synthetic heptopeptide with TGF-beta-like activity, were injected into the tunica of each rat from the first group (n = 18). Rats in the second group (n = 6) received saline injections as a control. The tunical tissues were taken after 3 days, 2 weeks, and 6 weeks and were examined using Hart and Trichrome stains. In the same tissue samples, TGF-beta mRNA and protein expression were studied.

Results

Histological alterations were observed in 15 out of 18 cytomodulin-injected rats, especially in tissue examined after 6 weeks. The most prominent changes were chronic cellular infiltration, focal and diffuse elastosis, thickening, disorganization and clumping of the collagen bundles. Results from immunoblot revealed remarkable TGF-beta₁ protein expression in all the cytomodulin-injected rats only after 2 and 6 weeks. No remarkable TGF-beta₂ or TGF-beta₃ protein expression was observed. TGF-beta sub 1 mRNA expression in the cytomodulin-injected rats was noticed in rats injected with higher concentrations after 3 days, while it was expressed in all rats after 2 weeks. There was no expression in the control group after either 3 days or 2 weeks.

Conclusions

Cytomodulin can induce Peyronie's-like condition in the rat penis, which may explain the role of TGF-beta in the pathogenesis of Peyronie's disease.     

毒藜碱诱导形成山羊先天性腭裂模型的实验研究

目的探讨采用毒藜碱肌肉注射形成先天性腭裂山羊模型的方法以及先天性腭裂畸形对山羊面中部发育的影响。方法取40只8～12月龄杂交波尔雌性山羊,体重35～55 kg,以配种日期定为孕0 d,于孕30 d经B超确认怀孕后随机将实验动物分为4组。取30只实验动物按照注射剂量分为实验组1、实验组2、实验组3(n=10),分别于孕31～42 d肌肉注射毒藜碱10、15、20 mg/d;余10只作为对照组不作处理。每组于孕120 d及出生后1个月,各取5只胎羊或小羊行头颅三维CT重建,测量上颌最前磨牙前方的两侧凹陷处间距(PPMM),及以此线为基准测量上颌骨最前点至此线的垂直距离(APMM);完成三维CT重建后行硬腭大体观察,并制备干颅行上颌骨前后向及宽度发育情况观察。结果实验组3母羊注射药物后全部流产;实验组2母羊注射药物后2只流产,余8只维持妊娠。孕120 d取材时,实验组1取出5只胎羊,均无腭裂;实验组2取出5只胎羊,其中3只腭裂,上颌发育不足;对照组取出5只胎羊,均无腭裂。出生后1个月,实验组1有11只小羊娩出,均无腭裂;实验组2有7只小羊娩出,其中5只腭裂,上颌骨明显发育不足,饲养及进食困难;对照组有8只小羊娩出,均无腭裂。硬腭及干颅大体观察见实验组2上颌骨明显发育不足。实验组2的孕120 d胎羊及出生后1个月小羊PPMM及APMM与对照组比较,差异均有统计学意义(P<0.05)。实验组2的5只腭裂小羊存活1～2个月。结论采用孕31～42 d肌肉注射毒藜碱15 mg/d,可以制备先天性山羊腭裂模型,形成的腭裂山羊面型特征基本符合人类腭裂畸形面中部发育特征。     

胆汁动态研究动物模型的建立与应用研究

应用“导管胆肠皮下转流法”建立家兔胆色素结石胆汁的动态研究动物模型，并应用该模型检测胆汁中免疫复合物含量的变化。结果显示：在胆色素结石形成过程中，胆汁中免疫复合物含量呈从低到高的变化规律。     

ELECTROENCEPHALOGRAPHIC EFFECTS OF LAUDANOSINE IN AN ANIMAL MODEL OF EPILEPSY

We examined the effects of laudanosine, one of the principalmetabolites of atracurium. on the electroencephalogram (EEG)in an animal model of induced epilepsy. Fourteen rabbits wereanaesthetized with 4% halothane in oxygen, the trachea intubatedand the lungs ventilated mechanically with 30% oxygen and 1%halothane in nitrogen. Animals were assigned randomly to receiveeither an in fusion of laudanosine (laudanosine group, n = 7)at a rate calculated to produce plasma concentrations similarto those found following the clinical use of atracurium, oran equal volume of normal saline (control group, n = 7). Toinduce an epileptogenic focus, gel-foam sponges soaked in apH-adjusted 4% cefazolin solution were applied bilaterally tothe parietal cortical surface. This resulted in the productionof spike and burst EEG activity in all animals. However, scoringthe frequency of the spikes and bursts revealed no significantdifferences between the laudanosine and control groups. We concludethat, in this animal model of epilepsy, no increased incidenceof seizure activity was produced by mean plasma laudanosineconcentrations as great as 0.8 µg ml^–1. These resultssuggest that the routine use of atracurium is unlikely to provokeseizures, even in the presence of an epileptogenic focus.     

UNILATERAL CRYPTORCHIDISM: AN ANIMAL MODEL

Unilateral division of the distal gubernaculum testis was performed, using hypothermic anaesthesi, in Wistar rats within 48 hours of birth. This resulted in ipsilateral abdominal testicular retention and contralateral descent. This model is suitable for the experimental study of congenital unilateral cryptorchidism and is presented in detail.     

THE DEVELOPMENT AND ENHANCEMENT OF THE COLLATERAL CIRCULATION IN AN ANIMAL MODEL OF LOWER LIMB ISCHAEMIA

In an animal model of hind limb ischaemia we documented the levels of endogenous basic fibroblast growth factor (bFGF) in control and ischaemic hind limbs, and evaluated the response to the administration of exogenous recombinant bFGF and heparin, Variations in this model were tested for their ability to alter the development of the collateral circulation. Recovery after acute arterial occlusion was significantly delayed by immediate bilateral mirror-image arterial ligations, when compared with either unilateral arterial ligation or delayed contralateral ligations performed after 2 months. If the major veins were also occluded all limbs developed gangrene, tissue loss and a marked delay in the recovery of blood flow, while none of the animals with unilateral arterial ligations developed gangrene. This indicates that the recovery in blood flow during the acute phase in this model is dependent on collateral vessels from the contralateral iliac artery and that major venous occlusion impedes the development of collateral vessels. Lumbar sympathectomy did not alter the recovery of blood flow after arterial occlusion, suggesting that collateral blood flow is not significantly influenced by autonomic neural supply. Following arterial occlusion there was a ten-fold increase in the levels of endogenous bFGF in all ischaemic muscle groups. Intramuscular implantation of bFGF in heparin-sepharose pellets at the time of arterial ligation markedly enhanced the blood flow for 3 weeks compared with untreated ischaemic limbs. A further increment in blood flow occurred if an additional dose of bFGF was administered 4 weeks after ligation. Administration of heparin for 1 week during either the acute or chronic phases of collateral development significantly improved the blood flow in ischaemic limbs. This was neither as profound nor as prolonged as that observed for bFGF. Treatment with heparin for 4 weeks following arterial ligation provide an increased blood flow for the first 3 weeks. These results indicate that tissues respond to ischaemia by an increased release of bFGF and that the evolution of collateral vessels can be enhanced by the administration of both exogenous recombinant bFGF and heparin. We conclude that bFGF is an important biochemical mediator in the development of the collateral circulation.     

动物血管电凝止血的实验研究

采用三种不同的电凝方法(即非接触点式电凝、接触点式电凝和段式电凝)对6只家兔四肢及腹内大血管行电凝止血效果观察。结果:对直径<1.5mm的动静脉,三种方法均能有效止血。对直径为1.5～2.0mm的动脉,段式电凝由于电凝后焦头较长,其止血效果较其他两种方法好。     

两种胆道重建术犬模型的建立及近期疗效比较

目的　探讨肝管胆囊吻合术 (hepaticocholedochostomy,HC)和肝管空肠吻合术 (hepaticojejunostomy,HJ)两种胆道重建术的动物模型建立方法 ,并比较其近期疗效。方法　健康成年杂种犬 2 9只 ,随机分为对照组 (5只 )和不全梗阻模型组 (2 4只 )。不全梗阻 7周后随机分为 HC组 (n=12只 )和 HJ组 (n=12只 ) ,分别实施 HC和 HJ。观察其术中情况及术后 1个月疗效。　结果　不全梗阻后肝管直径明显扩张 ;HC组手术时间、术中出血量及术后 1个月体重下降均低于 HJ组 ,差异有统计学意义 (P<0 .0 5 ) ;HC和 HJ术后 1个月时 ,肝功能各项指标均恢复正常。　结论　在不全梗阻的基础上建立胆道重建动物模型是可行的 ;HC较 HJ术中损伤小 ,术后恢复好。