可切削生物活性玻璃陶瓷对机体免疫影响的研究

本研究对临床植入可切削生物活性玻璃陶瓷整复颌面畸形患者，进行了术前术后免疫球蛋白ｇＧ、ＩｇＡ、ＩｇＭ，补体成分Ｃ３、Ｃ４和循环免疫复合物的检测。结果显示：术前术后各项检测指标的差异无显著性，表明该材料植入体内不改变机体正常免疫状态，具有很好的血液相容性。     

食管癌术后肠外营养支持早期机体免疫功能的变化(附30例临床分析)

目的观察食管癌术后肠外营养支持早期机体免疫功能的变化。方法对３０例食管癌病人根治术后,随机分为ＰＮ组和非ＰＮ组进行对比观察,分别在手术前、术后１天及术后８天检测ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３、Ｔ细胞亚群、ＮＫ细胞活性和ＩＬ－２等的改变。结果食管癌病人术前均有不同程度的免疫功能低下,术后第１天,ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３较术前显著下降,术后１周ＰＮ组ＩｇＧ、ＩｇＡ、Ｃ３恢复较快,达到或超过术前水平,与非ＰＮ组比较差异有显著意义（Ｐ＜００１）。ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值术后第１天下降明显,而ＰＮ组术后１周迅速恢复并明显超过术前水平,与非ＰＮ组相比差异有显著意义（Ｐ＜００１）。ＮＫ细胞活性术后第１天也明显降低,ＩＬ－２显著减少。术后１周ＮＫ细胞活性ＩＬ－２ＰＮ组较非ＰＮ组恢复较快,差异有显著意义（Ｐ＜００１）。结论食管癌病人术后早期免疫功能低下,应用ＰＮ包括脂肪乳剂可以有效地改善机体的免疫功能,并相应降低术后并发症和病死率。     

体外循环心脏手术对机体免疫功能的影响

为了进一步探讨体外循环心脏手术对机体免疫功能的影响，以及环氧化酶抑制剂的免疫增强作用，我们将４０例心脏手术病人分为４组。分别检测术前、术后２天、７天的白细胞介素－２（ＩＬ－２）、ＩｇＭ，ＩＧＧ，ＩｇＡ，Ｃ３的变化。结果表明，体外循环心脏手术可引志ＩＬ－２、ＩｇＧ，Ｃ３下降，ＩＬ０２下降的程度与体外循环转流的时间有关。环氧化酶抑制剂可使术后ＩＬ－２的水平有部分恢复。结论为体外循环心脏手术后ＩＬ－２及     

应用显微外科带血管自体部分脾移植治疗外伤性脾破裂

１３例外伤性脾破裂患者脾切除后，即选正常一极脾叶动脉插管。４℃肝素平衡液灌洗。切除伤脾部分。保留带有脾叶血管部分正常脾。将叶动静脉显微镜下分别与胃网膜右动静脉端端吻合。术后第２周，８例患者分别行ＤＳＡ及ＥＣＴ检查，移植脾血管及实质显影正常。术后第４周血清ＩｇＭ、ＩｇＡ、ＩｇＧ及Ｃ＿３检测结果与术前自身对照无统计学意义（Ｐ＞０．０５）。证明移植脾存活并具有免疫功能。     

肝癌患者免疫功能的临床研究

通过对１４例肝癌患者围术期ＮＫ细胞、Ｔ细胞亚群，单个核细胞ＩＬ－２Ｒ表达与体液免疫指标ＩｇＧ、ＩｇＡ、ＩｇＭ进行动态测定，结果发现肝癌患者ＮＫ细胞、ＣＤ３细胞、ＣＤ４细胞降低，ＣＤ４／ＣＤ８细胞比值降低，ＣＤ８细胞增高，ＩＬ－２Ｒ表达降低，Ｉｇ升高，后１０天ＮＫ细胞、ＣＤ４细胞、ＣＤ４／ＣＤ８细胞比值、ＩＬ－２Ｒ表达回升。术后３０天升至正常水平；Ｉｇ术后２０天降低，术后３０天至术前水平。结果表明手     

IgM捕获酶联免疫吸附法诊断巨细胞病毒感染在肾移植中的应用

应用捕获酶联免疫吸附法检测人巨细胞病毒抗体，以诊断肾移植受者ＨＣＭＶ感染。共检测１０份供者血清、２０份受者术前血清及３７例受者术后血清。结果肾移植受者ＨＣＭＶ－ＩｇＭ的阳性率明显高于其它二组；肾移植受者１５份双血清ＩｇＧ有４倍以上增高，同时ＩｇＭ均为阳性。本法不受特异性ＩｇＧ的竞争和类风湿因子干扰，与同属其它病毒无交叉反应，具有特异性强、灵敏度高、重复性好、简便快速等优点，是检验ＨＣＭＶ－ＩｇＭ较     

体外循环对病人特异性免疫功能的影响

用ＯＫＴ单克隆抗体玫瑰花试验法和速率散射比浊法，对１３例ＣＰＢ手术前后风心病和先心病病人的Ｔ细胞亚群和Ｉｇ进行了动态观察。结果发现，ＣＰＢ术后早期风心病和先心病病人的Ｔｈ细胞，Ｔｈ／Ｔｓ比值及ＩｇＧ均明显低于术前水平，术后２周风心病和先心病病人的Ｔ细胞亚群均恢复至术前水平，风心病和先心病病人的ＩｇＧ分别于术后２周和１周恢复至术前水平。     

食管癌术后肠外营养支持早期机体免疫功能的变化（附30例？…

目的 观察食管癌术后肠外营养支持早期机体免疫功能的变化。方法 对３０例食管癌病人根治术后,随机分为ＰＮ组和非ＰＮ组进行对比观察,分别在手术前,术后１天及术后８天检测ＩｇＧ,ＩｇＡ,ＩｇＭ、Ｃ３、Ｔ细胞亚群,ＮＫ细胞活性和ＩＬ－２等的改变。     

皮肤疣的生物学疗法及免疫学研究

９０例多发性皮肤疣患者采用自体疣移植主动免疫法治疗，随机分为２组，疣移植加服左旋咪唑５１例，单纯疣移植３９例．结果显示：治愈率分别为９０．２％与８２．５％（Ｐ＞０．２５）．对２３例进行了免疫学研究，统计资料表明：术前与术后患者的ＩｇＧ、ＩｇＡ、ＩｇＭ及淋巴细胞转化率均无明显差异（Ｐ＞０．０５）．检测１０例患者ＣＤ_３、ＣＤ_４、ＣＤ_８细胞百分率均下降（Ｐ＜０．０５），ＣＤ_４／ＣＤ_８比值下降（Ｐ＜０．０５）．病理活检和电镜检查示：正在消退的疣组织中有大量单核细胞浸润．上述资料表明本疗法主要是增强细胞免疫功能．     

肺癌冷冻术后早期机体免疫功能的变化

对冷冻手术治疗的１０例肺癌患者使用单抗致敏红细胞花环法及单向免疫琼脂扩散法分别检测手术前及手术后不同时期的外周血Ｔ淋巴细胞亚群及血清免疫球蛋白（ＩｇＧ、ＩｇＡ、ＩｇＭ）的改变。结果表明：（１）冷冻术后的ＯＫＴ＋３、ＯＫＴ＋４、ＯＫＴ＋４／ＯＫＴ＋８比值均较术前显著增加（Ｐ＜０．０１），而ＯＫ＋８则显著减少（Ｐ＜０．０１）。（２）冷冻术后免疫球蛋白也显著增加（Ｐ＜０．０１）。提示：（１）冷冻术能恢复肺癌病人的免疫平衡。（２）冷冻术尚可激发人体的抗肿瘤免疫，即存在冷冻免疫效应。     

可切削生物活性玻璃陶瓷对机体免疫影响的研究

本研究对临床植入可切削生物活性玻璃陶瓷整复颌面畸形患者,进行了术前术后免疫球蛋白IgG、IgA、IgM,补体成分C_3、C_4和循环免疫复合物的检测。结果显示,术前术后各项检测指标的差异无显著性,表明该材料植入体内不改变机体正常免疫状态,具有很好的血液相容性。     

可切削生物活性玻璃陶瓷的致突变性研究

了解可切削生物活性玻璃陶瓷 (MBGC)的潜在致突变性。方法　采用微核试验。按照有关规定制备MBGC材料浸提液 ,将浸提液和阴性、阳性对照液分别注入各实验组小白鼠的静脉内 ,于第 2次注射后 6h取其骨髓涂片 ,双盲法观察骨髓嗜多染红细胞内的微核发生率。结果　MBGC浸提液的微核率分别为 (2 .4 1.7)‰和 (2 .2 1.3)‰ ,与阴性对照组生理盐水 (2 .6 0 .9)‰无显著性差异。结论　该材料未见潜在致突变性。     

可切削生物活性玻璃陶瓷在颌面整形外科中的应用

将可切削生物活性玻璃陶瓷（ＭＢＧＣ）应用于颌面畸形患者３６例，获得满意效果。就该材料的特性和临床应用体会进行了讨论。     

Enhancement of bone bonding to bioactive ceramics by demineralized bone powder.

In an attempt to enhance the bonding of bone to bioactive ceramics, allogeneic demineralized bone powder (DBP) was used in combination with bioactive ceramic implants in rabbit tibiae. Rectangular plates (10 x 15 x 2 mm) made of apatite-wollastonite-containing glass ceramics were implanted in the proximal metaphyses of the bilateral tibiae of 20 rabbits, with DBP packed into the medullary cavity. In the control group, only the plates of A-W GC were implanted in the bilateral tibiae of 20 rabbits. Four rabbits from each group were killed at two, four, eight, 12, and 25 weeks after implantation for the tensile test. Results of the tensile test and histologic examination of the undecalcified specimens by Giemsa surface stain and contact microradiography confirmed that DBP significantly accelerated the process of bone bonding to the implant and increased the strength of bone-implant bonding.     

可切削生物活性玻璃陶瓷在颌面整形外科中的应用

将可切削生物活性玻璃陶瓷(MBGC)应用于颌面畸形患者36例,获得满意效果。就该材料的特性和临床应用体会进行了讨论。     

Molecular basis for action of bioactive glasses as bone graft substitute.

Bone grafting procedures are undergoing a major shift from autologous and allogeneic bone grafts to synthetic bone graft substitutes. Bioactive glasses are a group of synthetic silica-based bioactive materials with bone bonding properties first discovered by Larry Hench. They have several unique properties compared with other synthetic bioresorbable bioactive ceramics, such as calcium phosphates, hydroxyapatite (HA) and tricalcium phosphate (TCP). Bioactive glasses have different rates of bioactivity and resorption rates depending on their chemical compositions. The critical feature for the rate of bioactivity is a SiO2 content < 60% in weight. In vivo, the material is highly osteoconductive and it seems to promote the growth of new bone on its surface. In a recent study, the activity of the material was found even to overshadow the effect of BMP-2 gene therapy. In vivo, there is a dynamic balance between intramedullary bone formation and bioactive glass resorption. Recent studies of molecular biology have shown that bioactive glass induces a high local turnover of bone formation and resorption. Many osteoporotic fracture patients are candidates for concurrent treatment with bisphosphonates and bioceramic bone graft substitutes. Since osteopromotive silica-based bioactive glasses induce accelerated local bone turnover, adjunct antiresorptive agents may affect the process. However, a recent study showed that an adjunct antiresorptive therapy (zoledronic acid) is even beneficial for bone incorporation of bioactive glass. Based on these observations, bioactive glasses are a promising group of unique biomaterials to act as bone graft substitutes.     

先天性颅面环束带畸形

目的提高对颅面环束带畸形的认识与治疗水平。方法对6例颅面环束带畸形病例,全部采用骨膜下充填羟基磷灰石或可切削生物活性玻璃陶瓷进行畸形修复,并复习了有关文献,对其病因、发病机理、临床表现、诊断、分类及治疗进行了分析。结果6例均获满意效果,随访3个月～5年,颅面环形沟消失,皮肤平整。结论骨膜下充填有活性的生物材料是矫正颅面环束带畸形的有效方法。     

Finite Element Modeling of Stress Distribution in Intervertebral Spacers of Different Surface Geometries

Intervertebral disc spacers using bioactive ceramics have been used to treat degenerative spinal disease. Tooth‐shaped spacers are commonly used to prevent migration, but there is a possibility of fracture when inserted or after insertion. Intervertebral disc spacers with either an isosceles triangle‐shaped tooth (T1) or a right triangle‐shaped tooth (T2) were used as a control group. The design factors for the experimental group were modified to prevent fractures induced by stress concentration, and the surfaces of the spacers were designed as either an isosceles triangle‐shaped valley (V1) or a right triangle‐shaped valley (V2). Linear analysis using finite element model (FEM) was performed, and Von Mises stress distribution was calculated by applying 1000 N of uniformly distributed load. Samples of the V2 design were made with bioactive glass‐ceramics (BGS‐7) and evaluated for compressive strength, fatigue degree, and impact strength. Von Mises stress was highest at the first tooth from the posterior side for the control group and at the center for the experimental group. Compared with the control group, the experimental group showed 18.4% and 82.5% reduction (V1 vs. T1 and V2 vs. T2, respectively) in the maximum stress at the bottom of the valleys. The FEM analysis revealed that the V2 design had the most even load distribution. The V2 samples with bioactive glass‐ceramics were evaluated for compressive strength, and all six samples were not fractured up to 24 000 N. However, the average impact strength was 19.42 kN, suggesting that momentary force caused damage at a lower load than compression with a steady speed. The BGS‐7 intervertebral disc spacer with V2 design was not fractured during the fatigue test at maximum pressure of 8000 N, R ≥10, 5 Hz, and 5 million cycles. These data confirm that the BGS‐7 spacer with the V2 design may be clinically applicable. Collectively, the modified surface geometry of the experimental group significantly lowered Von Mises stress values at the bottom of the valleys, and thus the possibility of fracture by compressive load was greatly reduced. Also, impact during insertion was confirmed to cause fracture more easily, as the impact strength was lower than the compressive strength in the experimental group.     

骨髓基质细胞与生物活性玻璃陶瓷和聚乳酸生物相容性的实验研究

目的 探讨骨髓基质细胞与生物活性玻璃陶瓷（ＢＧＣ）和聚乳酸（ＰＬＡ）的生物相容性,为骨组织工程中生物材料的选择提供依据。方法 将骨髓基质细胞与ＢＧＣ、ＰＬＡ复合体培养,进行形态学观察、细胞增殖、蛋白质含量及酶学测定。结果 骨髓基质细胞能在ＢＧＣ、ＰＬＡ上贴附、繁殖,其生长及功能不受影响,并且ＢＧＣ具有一定的促细胞增殖作用。结论 ＢＧＣ、ＰＬＡ具有良好的细胞相容性,有可能作为骨髓基质细胞的载体应用于     

Backscattered electron microscopy evidences tight apposition between bone and bioactive glass coating in vivo

Abstract The rationale for a degradable bioactive glass coating is to lead the bone to appose gradually to the metal. A bioactive glass already described in the literature (bg A) and a sodium-calcium-silicate non-bioactive glass sprayed as a control were studied. Young adult New Zealand White rabbits were selected as animal model. A hole was drilled from the femural intercondylar groove and Ti6Al4Vcoated cylinders were implanted. Retrieval took place at 1, 2, 4, 6, 8 and 10 months and samples were analyzed by backscattered electron microscopy (BSEM). For all the samples of bioactive glass, bone was in tight apposition with the coating. As time progressed, bone showed characters of physiological remodelling (newly formed bone substituting areas of bone resorption) close to the coating. At the interface between bone and bioactive glass coating, the apposition was so tight that it was not possible to discern a clear demarcation, even at higher BSEM magnification. A second key feature, in the behavior of the bioactive glass coatings invivo, was the gradual degradation and the eventual apposition of bone directly to Ti6Al4V.