骨形态发生蛋白2在骨修复中的应用

目的:回顾分析近年来国内外有关骨形态发生蛋白2在骨修复中应用的研究近况。资料来源:应用计算机检索Medline1999-01/2005-06相关骨形态发生蛋白2的文献,检索词“bonemorphogeneticprotein-2,bonetissueengineering,genetherapy”并限定文献语言种类为English。同时计算机检索CNKI中文数据库1999-01/2005-06相关骨形态发生蛋白2的文献,检索词为“骨形态发生蛋白2,骨组织工程,基因治疗”,并限定文献语言种类为中文。资料选择:对资料进行初审,选出包含研究目的的文献,筛选与目的有关的文献。纳入标准:①骨修复与骨组织工程。②骨形态发生蛋白2。排除标准:①文献中重复研究和综述文章。②Meta分析类文章。资料提炼:共收集到中文文献67篇,英文文献55篇,另有英文摘要近百篇,符合标准的文章15篇。排除的文献多为重复研究或非骨组织工程研究。资料综合:骨形态发生蛋白2可诱导间充质细胞分化为成骨细胞和成软骨细胞而促进新骨形成,并具有强大的异位成骨作用。载体或基因释放的骨形态发生蛋白2可有效修复骨缺损。骨形态发生蛋白2的基因治疗研究为修复骨缺损提供了新途经。结论:应用骨形态发生蛋白2修复骨缺损是肯定可行的,但方法有待进一步研究。     

骨形态发生蛋白2在骨修复中的应用

目的：回顾分析近年来国内外有关骨形态发生蛋白2在骨修复中应用的研究近况。 资料来源：应用计算机检索Medline1999-01／2005-06相关骨形态发生蛋白2的文献，检索词“bone morphogenetic protein-2．bone tissue engineering，gene therapy”并限定文献语言种类为English。同时计算机检索CNKI中文数据库1999-01／2005-06相关骨形态发生蛋白2的文献，检索词为“骨形态发生蛋白2，骨组织工程，基因治疗”。并限定文献语言种类为中文。 资料选择：对资料进行初审，选出包含研究目的的文献，筛选与目的有关的文献。纳入标准：①骨修复与骨组织工程。②骨形态发生蛋白2。排除标准：①文献中重复研究和综述文章。②Meta分析类文章。资料提炼：共收集到中文文献67篇，英文文献55篇，另有英文摘要近百篇。符合标准的文章15篇。排除的文献多为重复研究或非骨组织工程研究。 资料综合：骨形态发生蛋白2可诱导间充质细胞分化为成骨细胞和成软骨细胞而促进新骨形成，并具有强大的异位成骨作用。载体或基因释放的骨形态发生蛋白2可有效修复骨缺损。骨形态发生蛋白2的基因治疗研究为修复骨缺损提供了新途经。 结论：应用骨形态发生蛋白2修复骨缺损是肯定可行的，但方法有待进一步研究。     

骨形态发生蛋白-2在糖尿病大鼠种植体周围的表达

目的：应用大鼠糖尿病模型,观察实验性2型糖尿病（T 2DM）大鼠种植体周围骨形态发生蛋白-2（BM P-2）的表达水平,探讨影响糖尿病种植体骨整合的分子生物学机制,试图为发现新的治疗糖尿病骨整合方法打下理论基础。方法：将48只大鼠均分为正常组和糖尿病组。糖尿病组按40 m g/kg腹腔内一次性注射枸橼酸钠链脲佐菌素溶液建立T 2DM模型。在胫骨近骺端种植纯钛种植体。种植后2,4,8周分批分次处死动物。采用不带种植体脱钙标本硬组织切片、脱钙标本切片常规苏木精-伊红染色（HE染色）和免疫组织化学法检测种植体周围骨组织中骨形态BM P-2的表达并做图像分析。结果：HE染色镜下观察糖尿病组骨形成滞后。正常组和糖尿病组的种植体周围骨组织BM P-2免疫组织化学灰度值两组间差异有显著性（P〈0.05）。结论：糖尿病者的骨质疏松化倾向可能与糖尿病种植修复较正常者失败率高有关,糖尿病者BM P-2的减少可能是影响种植体骨整合的原因之一。     

Predicting urinary tract infections in a urogynecology population

A retrospective chart review was performed on all new patients presenting to a urogynecology clinic. Urine dipsticks, symptoms, and cultures were evaluated to identify urinary tract infections. The most sensitive result was for the combination of nitrites or leukocytes (59%) without significant change in specificity (95%) for either result individually. The addition of the statistically significant symptoms did not improve the outcome. Based on these findings, it was determined that no combination of dipstick and/or symptoms adequately predicted an infection to the point that a recommendation to dispense with the need for a culture in this urogynecology population could be made.     

骨形态发生蛋白12对肌腱和韧带损伤的修复作用

目的：骨形态发生蛋白12属于转化生长因子β超家族成员，能诱导间充质干细胞定向分化为成腱细胞。重组人骨形态发生蛋白12不但能使腱纤维原细胞的增殖，还能使Ⅰ型和Ⅲ型原胶原高表达，有助于肌腱的修复和愈合。回顾骨形态发生蛋白12的发展及其研究成果，并对其综述。资料来源：应用计算机检索NCBI Entrez Pubmed和CNKI 1965-01／2004-12骨形态发生蛋白12的相关献，检索词：骨形态发生蛋白12（bonemorphogenetic protein-12）。损伤（repairing）。资料选择：对资料进行初审，纳入标准：①有关骨形态发生蛋白12生物学效应。②有关骨形态发生蛋白12与其家族成员比较研究。排除标准：重复研究。资料提炼：共收集42篇相关献，排除重复或类似的同一研究，28篇符合研究要求。资料综合：①骨形态发生蛋白12的生物学作用：能诱导间充质干细胞定向分化为成腱细胞。重组人骨形态发生蛋白12不但能使腱纤维原细胞的增殖，还能使Ⅰ型和Ⅲ型原胶原高表达，有助于肌腱的修复和愈合。②与其家族其他成员比较：骨形态发生蛋白12和骨形态发生蛋白-2的信号转导途径不同；虽然骨形态发生蛋白13具有近似骨形态发生蛋白12的作用，能促进成腱细胞的增殖和Ⅰ型原胶原的基因表达，但对Ⅲ型原胶原的基因表达作用不显。结论：成功克隆骨形态发生蛋白12基因，将其用于腱损伤的修复，具有重要临床应用价值，但目前对于骨形态发生蛋白12诱导骨髓间充质干细胞定向分化为腱细胞的机制尚未阐明，还有待进一步的研究。     

骨形态发生蛋白12对肌腱和韧带损伤的修复作用

目的:骨形态发生蛋白12属于转化生长因子β超家族成员,能诱导间充质干细胞定向分化为成腱细胞。重组人骨形态发生蛋白12不但能使腱纤维原细胞的增殖,还能使Ⅰ型和Ⅲ型原胶原高表达,有助于肌腱的修复和愈合。回顾骨形态发生蛋白12的发展及其研究成果,并对其综述。资料来源:应用计算机检索NCBIEntrezPubmed和CNKI1965-01/2004-12骨形态发生蛋白12的相关文献,检索词:骨形态发生蛋白12(bonemorphogeneticprotein-12),损伤(repairing)。资料选择:对资料进行初审,纳入标准:①有关骨形态发生蛋白12生物学效应。②有关骨形态发生蛋白12与其家族成员比较研究。排除标准:重复研究。资料提炼:共收集42篇相关文献,排除重复或类似的同一研究,28篇符合研究要求。资料综合:①骨形态发生蛋白12的生物学作用:能诱导间充质干细胞定向分化为成腱细胞。重组人骨形态发生蛋白12不但能使腱纤维原细胞的增殖,还能使Ⅰ型和Ⅲ型原胶原高表达,有助于肌腱的修复和愈合。②与其家族其他成员比较:骨形态发生蛋白12和骨形态发生蛋白-2的信号转导途径不同;虽然骨形态发生蛋白13具有近似骨形态发生蛋白12的作用,能促进成腱细胞的增殖和Ⅰ型原胶原的基因表达,但对Ⅲ型原胶原的基因表达作用不显著。结论:成功克隆骨形态发生蛋白12基因,将其用于腱损伤的修复,具有重要临床应用价值,但目前对于骨形态发生蛋白12诱导骨髓间充质干细胞定向分化为腱细胞的机制尚未阐明,还有待进一步的研究。     

钙磷涂层镁合金植入体周围组织中骨形成蛋白2的表达

背景:改变合金构成可以改善镁合金的耐腐蚀性和机械性能。目的:观察钙磷涂层对镁合金植入体周围软组织中骨形成蛋白2表达的影响。方法:将27只兔随机分成3组,分别在兔下颌骨内植入钙磷涂层镁合金螺钉、镁合金螺钉及钛合金,植入后1,2,3个月,采用反转录聚合酶链技术检测植入体周围软组织中骨形成蛋白2mRNA的表达情况。结果与结论:钙磷涂层镁合金螺钉组、镁合金螺钉组周围软组织中骨形成蛋白2mRNA的表达,随时间的增加逐渐增高,钙磷涂层镁合金螺钉组内各时间点间骨形成蛋白2mRNA的表达水平差异有显著性意义(P<0.05),且镁合金螺钉组植入后1,2个月周围软组织中骨形成蛋白2mRNA的表达水平高于钙磷涂层镁合金螺钉组(P<0.05)。显示钙磷涂层能够促进骨形成蛋白2mRNA的表达,并抑制其过度表达,有利于早期成骨过程,表现出良好的生物活性。     

新型含重组人骨形态发生蛋白2骨修复材料的制备及生物学评价

背景：含有重组人骨形态发生蛋白2的骨修复材料（骨优导）已经作为国内第1个Ⅲ类医疗器械注册并获得国家食品药品监督管理局（SFDA）的批准。目的：制备骨修复材料（骨优导），并对其进行生物学评价。设计：分组对比，多角度评估观察实验，于2008-01／07在杭州华东医药集团投资有限公司实验室进行。材料：骨修复材料（骨优导）由杭州华东医药集团投资有限公司提供，是在无菌的洁净车间内，采用基因工程方法，用大肠杆菌发酵技术大规模生产重组人骨形态发生蛋白2，然后与载体材料混合制备得到。方法：根据GB／T16886．12-2005中的规定制备骨修复材料（骨优导）浸提液，按照医疗器械生物学评价方法进行了一系列体内外试验，包括成骨试验、无菌检验、细胞毒性试验、植入试验、热原试验、致敏试验和遗传毒性试验，评价骨修复材料（骨优导）的生物学特性。主要观察指标：各项体内外试验的结果。结果：骨修复材料（骨优导）符合无菌要求，无细胞毒性、无致热原性、无遗传毒性、无致敏性、无组织刺激性，具有良好的组织相容性，且具有异位诱导成骨能力。结论：骨修复材料（骨优导）符合医疗器械骨科植入材料的生物学评价的各项要求。     

Sodium-glucose cotransporter-2 inhibitors and genital and urinary tract infections in type 2 diabetes

Coincident with the high and increasing worldwide prevalence of type 2 diabetes (T2D), a growing armamentarium of antidiabetes medications has been introduced to target different organ systems that play a role in the pathophysiology of T2D. Among these, the sodium-glucose cotransporter-2 (SGLT-2) inhibitors were introduced in the United States in 2013 as a new treatment option to address the hyperglycemia associated with T2D. SGLT-2 inhibitors decrease renal glucose reabsorption, resulting in glucosuria, alleviation of hyperglycemia, and modest weight loss and are associated with a low risk of hypoglycemia. The SGLT-2 inhibitors have been linked to an increased incidence of genital mycotic infections and, to a lesser extent, urinary tract infections, which may limit their utility in some patients. This review examines the prevalence, recurrence rates, treatment options, and responses to treatment of genital and urinary tract infections in patients with T2D receiving SGLT-2 inhibitors, with the aim of guiding clinicians in the most effective use of these agents for the treatment of hyperglycemia.     

Acute and recurrent urinary tract infections in children

Urinary tract infection is a common problem in children. Significant renal damage can result from the first episode of urinary tract infection. Early diagnosis, treatment, and evaluation can significantly reduce the potential for renal injury. All children with a potential urinary tract infection should have a reliable urine specimen sent for culture, and if infection is documented, a radiographic evaluation of their urinary system is required.     

泌尿系感染病原菌的分布及耐药性分析

目的探讨本地区引起泌尿系感染的病原菌及其耐药性,为临床治疗提供依据。方法用常规方法分离鉴定病原菌,用K-B法进行药物敏感试验。结果302株病原菌中革兰阴性杆菌252株,占83%,主要为大肠埃希菌和肺炎克雷伯菌。革兰阳性球菌38株,占13%。真菌12株,占4%。大肠埃希菌产ESBLs检出率为43.8%,肺炎克雷伯菌产ESBLs检出率为57.1%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为56.2%,MRSA的检出率为22.2%。结论了解引起泌尿系感染病原菌的分布及耐药性监测,合理使用抗菌药物以减少耐药菌株的产生和医院感染的爆发流行。     

Bone morphogenetic protein‐2 release profile modulates bone formation in phosphorylated hydrogel

The optimal release profile of locally delivered bone morphogenetic protein‐2 (BMP‐2) for safe and effective clinical application is unknown. In this work, the effect of differential BMP‐2 release on bone formation was investigated using a novel biomaterial oligo[(polyethylene glycol) fumarate] bis[2‐(methacryloyloxy) ethyl] phosphate hydrogel (OPF‐BP) containing poly(lactic‐co‐glycolic acid) microspheres. Three composite implants with the same biomaterial chemistry and structure but different BMP‐loading methods were created: BMP‐2 encapsulated in microspheres (OPF‐BP‐Msp), BMP‐2 encapsulated in microspheres and adsorbed on the phosphorylated hydrogel (OPF‐BP‐Cmb), and BMP‐2 adsorbed on the phosphorylated hydrogel (OPF‐BP‐Ads). These composites were compared with the clinically used BMP‐2 carrier, Infuse® absorbable collagen sponge (ACS). Differential release profiles of bioactive BMP‐2 were achieved by these composites. In a rat subcutaneous implantation model, OPF‐BP‐Ads and ACS generated a large BMP‐2 burst release (>75%), whereas a more sustained release was seen for OPF‐BP‐Msp and OPF‐BP‐Cmb (~25% and 50% burst, respectively). OPF‐BP‐Ads generated significantly more bone than did all other composites, and the bone formation was 12‐fold higher than that of the clinically used ACS. Overall, this study clearly shows that BMP‐2 burst release generates more subcutaneous bone than do sustained release in OPF‐BP‐microsphere composites. Furthermore, composites should not only function as a delivery vehicle but also provide a proper framework to achieve appropriate bone formation.     

Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy

Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy.     

Diagnosis and treatment of urinary tract infections in children

Acute urinary tract infections are relatively common in children, with 8 percent of girls and 2 percent of boys having at least one episode by seven years of age. The most common pathogen is Escherichia coli, accounting for approximately 85 percent of urinary tract infections in children. Renal parenchymal defects are present in 3 to 15 percent of children within one to two years of their first diagnosed urinary tract infection. Clinical signs and symptoms of a urinary tract infection depend on the age of the child, but all febrile children two to 24 months of age with no obvious cause of infection should be evaluated for urinary tract infection (with the exception of circumcised boys older than 12 months). Evaluation of older children may depend on the clinical presentation and symptoms that point toward a urinary source (e.g., leukocyte esterase or nitrite present on dipstick testing; pyuria of at least 10 white blood cells per high-power field and bacteriuria on microscopy). Increased rates of E. coli resistance have made amoxicillin a less acceptable choice for treatment, and studies have found higher cure rates with trimethoprim/sulfamethoxazole. Other treatment options include amoxicillin/clavulanate and cephalosporins. Prophylactic antibiotics do not reduce the risk of subsequent urinary tract infections, even in children with mild to moderate vesicoureteral reflux. Constipation should be avoided to help prevent urinary tract infections. Ultrasonography, cystography, and a renal cortical scan should be considered in children with urinary tract infections.