海螵蛸/外消旋聚乳酸复合人工骨在动物体内的降解及相容性

BACKGROUND: Cuttlebone/racemic polylactic acid composite artificial bone has been prepared in the previous studies to improve the incomplete degradation of cuttlebone. OBJECTIVE: To observe the degradation and biocompatibility of cuttlebone/racemic polylactic acid composite artificial bone in animals. METHODS: Thirty healthy New Zealand white rabbits were randomly divided into four groups. Models of right radial defects were prepared in rabbits, and model rabbits were subjected to implantation of cuttlebone/racemic polylactic acid composite artificial bone into the defects and muscular sac between the radial lateralis muscle and rectus (experimental group), implantation of cuttlebone into the defects and muscular sac between the radial lateralis muscle and rectus (control group 1), implantation of racemic polylactic acid into the defects and muscular sac between the radial lateralis muscle and rectus (control group 2), or no treatment (blank control group), respectively. At 2, 4, 8 weeks after operation, X-ray and histological examinations were performed in the four groups. RESULTS AND CONCLUSION: (1) Compared with the other three groups, the bone mineral density of the experimental group was significantly higher at 4 and 8 weeks after material implantation into the defects (P < 0.05), and moreover, the bone mineral apposition rate of the experimental group was significantly higher at different time after operation (P < 0.05). At 8 weeks after operation, the bone tissues in the experimental group grew from the both ends to the center to form multiple bone island-like structures, with less residual materials, and the marrow cavity and implanting material were in a traffic manner; in the control group 1, there were many residual materials, and no intercommunication was found between the marrow cavity and implant material. (2) At 2 weeks after material implantation into the muscle capsule, there were more inflammatory cells, but the inflammation relieved at 4 weeks and disappeared basically at 8 weeks, and the material was degraded partially. These findings indicate that the cuttlebone/racemic polylactic acid composite artificial bone is a kind of good bone substitute material that has good biocompatibility and degradability.  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

自体髂骨植骨联合自体骨髓干细胞移植治疗骨折术后骨不连

BACKGROUND: Bone nonunion is a common complication in the orthopedic treatment, and its morbidity reached 5%-10%, which results in the long-term functional disturbance of the limbs, and even disability. Autogenous iliac crest graft has been commonly used to treat bone nonunion, but some limitations still exist. OBJECTIVE: To investigate the treatment outcomes of autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion after fracture surgery. METHODS: Clinical and follow-up data from 69 patients with bone nonunion were analyzed retrospectively. All patients were allotted to combination (n=37) and iliac (n=32) groups, followed by treated with autologous iliac crest graft combined with autologous bone marrow stem cell transplantation or  autologous crest graft, respectively. Afterwards, the hospitalization time, fracture healing time, bone mineral density and Fereadez-Esteve callus scores were detected and compared between groups. RESULTS AND CONCLUSION: The hospitalization time did not differ significantly between groups (P > 0.05). The fracture healing time in the combination group was significantly shortened compared with the iliac group (P < 0.05). The bone mineral density and Fereadez-Esteve callus scores in the combination group were significantly higher than those in the iliac group at 3 and 6 months after surgery (P < 0.05). The excellent and good rate of the affected limb function in the combination group was significantly higher than that in the iliac group (P < 0.05). These results suggest that autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion can accelerate fracture healing, promote porosis and improve the functional recovery of affected limbs. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

3D生物打印构建聚乳酸羟基乙酸/纳米羟基磷灰石支架骨形态发生蛋白2缓释复合体的实验研究

BACKGROUND: Tissue-engineered bone scaffold fabricated by 3D-bioprinting technique has good controllability in morphology and structure. However, construction of tissue-engineered bone/cell growth factor complex and time-dose effect of sustained-release factors are needed to be further researched.  OBJECTIVE: To fabricate a sustained-release composite of polylactic-co-glycolic acid (PLGA)/nano-hydroxyapatite (n-HA) scaffold carrying bone morphogenetic protein-2 (BMP-2) using 3D-bioprinting technique, and test the biological properties of the PLGA/n-HA scaffold carrying BMP-2 and the sustained-release properties, thereby to discuss its feasibility as the tissue-engineered bone scaffold composite.  METHODS: Temperature-sensitive chitosan hydrogel was prepared using chitosan and β-glycerophosphate to construct a sustained-release composite, chitosan nanoparticles carrying BMP-2 . 3D-bioprinting technique was utilized to fabricate the PLGA/n-HA scaffold carrying BMP-2. Biological features of the scaffold composite were tested, and time-dose effect of BMP-2 sustained-release was observed.  RESULTS AND CONCLUSION: The average pore size of the scaffold-cytokine composite was (431.31±18.40) μm, and the porosity was (73.64±1.82)%. The cumulative release rate of BMP-2 from the scaffold-cytokine composite that effectively controlled the burst release during 48 hours and 30 days were suitable for the physiological needs. In conclusion, the porosity, pore size, release property, degradation rate, and mechanical strength of the scaffold-cytokine composite all meet the biological requirements of tissue-engineered bone construction. 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

同种异体骨移植强化高危人群肱骨近端骨折内固定的疗效观察

BACKGROUND: Numerous studies have focused on the clinical efficacy of allogeneic bone graft and humeral head replacement for the treatment of proximal humeral fractures, but their comparative studies are rarely reported. OBJECTIVE: To investigate the effect of allogeneic bone grafting in the treatment of proximal humeral fractures in the high risk group. METHODS: Clinical data of 120 cases of proximal humeral fractures aged ≥ 60 years were retrospectively analyzed. Sixty of the 120 cases underwent allogeneic bone grafting combined with locking plate fixation as experimental group, and the other 60 cases were subjected to semi-shoulder joint replacement as control group. All patients were followed up for 8-24 months. Fracture healing, collodiaphyseal angle, humeral head height and shoulder joint function were observed and measured. RESULTS AND CONCLUSION: During the postoperative 8-24 months, all the fractures were healed by first intention, and there were no rejection reactions, large/small nodules, humeral head displacement, necrosis, and screw loosening. Loss of the humeral head height at the last follow-up and the active flexion angle of the shoulder at postoperative 12 weeks were significantly higher in the experimental group than the control group (P < 0.05). Scores on forearm, shoulder and hand dysfunction were significantly lower in the experimental group than the control group (P < 0.05). However, no significant difference was observed in the collodiaphyseal angle and SF-36 scores between the two groups. These finding indicate that allogeneic bone grafting can strength the internal fixation of proximal humeral fractures in the high-risk group, and improve patient’s upper limb function.   中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

N-乙酰半胱氨酸丝素微球复合磷酸钙骨水泥的制备及表征

BACKGROUND: Calcium phosphate bone cement has been applied to clinical surgery because of its good biocompatibility and osteoconduction. However poor mechanical properties and lack of osteoinductivity limit its wide application. OBJECTIVE: To develop calcium phosphate cement incorporated with N-acetylcysteine (NAC) loaded silk fibroin microspheres (SFM), which is a kind of new injectable bone graft material with slow-release function, and evaluate its physical and chemical properties and cell compatibility. METHODS: Empty SFMs were prepared with emulsion solvent evaporation to absorb NAC solution of different concentrations by NAC-SFM and the concentration of NAC at the maximum drug loading ratio was determined. Then, NAC-SFM was loaded into calcium phosphate bone cement to test the drug release properties in vitro. MC3T3-E1 osteoblasts were cultured on the surface of NAC-SFM calcium phosphate bone cement and cell attachment and growth were observed by scanning electron microscope. Additionally, MC3T3-E1 cells were cultured with three kinds of bone cement extracts (calcium phosphate cement, SFM-calcium phosphate cement, NAC-SFM-calcium phosphate cement, as well as cultured in the α-minimum essential medium containing a volume fraction of 10% fetal bovine serum and 1% penicillin-streptomycin double antibody as the control. MTS assay was used to evaluate cell proliferation. RESULTS AND CONCLUSION: Microspheres in the composite bone cement presented with smooth surface, same size, diffused distribution and no obvious destroy. Thus, the SFM could remain stable in the reaction process of the composite bone cement. The double slow release system which contained silk fibroin microspheres and calcium phosphate bone cement showed a significant decrease in the cumulative release percentage of NAC within the first 24 hours compared with the control group (P < 0.05). In the next 28 days, the release speed of NAC was significantly lower in the NAC-SFM-calcium phosphate cement group than the calcium phosphate cement group (P < 0.05). In addition, different extracts had no significant cytotoxicity to the growth of MC3TC-E1 cells. Thus, the NAC-SFM-calcium phosphate cement has good cytocompatibility, which provide a new insight into the development of bone repair biomaterials. 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

纳米羟基磷灰石/聚酰胺66复合生物活性人工椎体修复前路颈椎骨折的应用

BACKGROUND: Nano-hydroxyapatite crystals are highly similar to human bone hydroxyapatite crystals in the shape, size, component, structure and crystallinity, and have an analogous elasticity modulus compared with human cortical bone. The application of nano-hydroxyapatite is increasingly widespread in medical field because  of excellent osteoconduction, biocompatibility, bioactivity and high strength and toughness. OBJECTIVE: To evaluate the primary efficacy of nano-hydroxyapatite/polyamide 66 composite bioactive artificial vertebral body for anterior column reconstruction in cervical vertebral fractures. METHODS: A total of 78 patients with cervical vertebral fracture combined with quadriplegia admitted at the Department of Spine Surgery, the First Affiliated Hospital of Sichuan Medical University in China underwent anterior cervical corpectomy decompression, bone grafting and nano-hydroxyapatite/polyamide 66 composite bioactive artificial vertebral body fixation. RESULTS AND CONCLUSION: The surgery was sucessful in all patients. Totally 67 patients were followed up. During the follow-up of 4-39 months, X-ray and MRI examinations showed no obvious displacement of the implants, and less loss of cervical physiological sequence and vertebral body height. The spinal function recovered to varying degrees after internal fixation. These results suggest that the application of nano-hydroxyapatite/ polyamide 66 composite bioactive artificial vertebral body in anterior cervical vertebral fractures can increase the area of bone graft fusion, decrease local intensity of pressure and prevent the loosening and sinking of the implants. The initial supporting and stability can effectively maintain cervical physiological sequence and intervertebral height. The bone graft fusion is higher after the internal fixation. It is easy for the X-ray observation, and meanwhile, there is no influence on the MRI scanning for observation of signals of the spinal cord.  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程       

Application and characteristics of bone graft materials in the treatment of spinal tuberculosis北大核心

BACKGROUND: Thorough removal of local necrotic lesions and one-stage use of bone repair materials can significantly promote local bony fusion, avoid recurrence of tuberculosis in the middle and long terms and reconstruct spinal stability in the surgical treatment of spinal tuberculosis. OBJECTIVE: To review the application of bone graft materials in the treatment of spinal tuberculosis. METHODS: The first author searched the articles related to bone graft materials of spinal tuberculosis in Bailian, CNKI, and Natures databases published from 2001 to 2020. The priority was the articles published recently or in authoritative journals. The search keywords were “bone graft materials, bone tissue engineering; spinal tuberculosis; titanium mesh; autogenous bone” in Chinese and English. RESULTS AND CONCLUSION: At present, bone graft materials have been widely used in clinic, but each has its own disadvantages. For example, the amount of autologous bone is limited, and the transplantation of autologous bone will cause bleeding and potential complications of donor site; allogeneic bone will lead to delayed healing and infection; titanium mesh has the problems of postoperative subsidence and kyphosis correction angle loss; the organic polymer materials such as polylactic acid and polymethyl methacrylate are lack of bone induction performance. Although Ca/P-based ceramic materials can be used as carrier materials of antituberculosis drugs, their biomechanical properties cannot fully meet the clinical needs. In view of the shortcomings of the above materials, it is necessary to find a composite bone tissue engineering material, which can meet the requirements of good biocompatibility, mechanical properties, degradation properties, osteogenic activity, and drug release performance. © 2022, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响：三维有限元分析

BACKGROUND: Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but bone cement injection can cause the change of stress in the fractured vertebrae and adjacent vertebrae after surgery, leading to new fractures. OBJECTIVE:To analyze the stress changes of the fractured vertebrae and adjacent vertebrae after vertebroplasty with different elastic modulus bone cement by a three-dimensional finite element method. METHODS:One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. An osteoporotic vertebral compression fracture model in L_2-4 segments was established after assignment. Bone cement (4 mL) with different elastic moduli (8 000, 4 000, 2 000 and 1 000 MPa) injected into the L₃ segment distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on the L₂ surface with an additional bending moment of 50 N•m. The lower surface free degree of L₄ was restrained. The L_2-4 forward flexion, posterior extension, right flexion and axial rotation on the right side were stimulated. The stress changes of the fractured vertebrae and the upper and lower adjacent vertebrae before and after bone cement injection with different elastic moduli were compared.  RESULTS AND CONCLUSION: The stress of the fractured vertebrae and adjacent vertebrae were significantly increased compared with that before operation. With the increase of elastic modulus, the stress of the fractured vertebrae increased, but there were no changes in the stress of adjacent vertebrae. These findings indicate that the elastic modulus of bone cement may be a method to reduce new fractures of the fractured and adjacent vertebrae after bone cement injection. 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

Hydroxyapatite/beta-tricalcium phosphate scaffolds combined with adipose-derived stem cells for the treatment of spinal defects in rabbits北大核心

BACKGROUND: Repair of bone defects is not only a clinical problem, but also a hot topic in the field of orthopedics. Although autologous bone grafting is considered as the “gold standard” for bone repair, its use is limited due to the limited source of autogenous bone, bone infections and pains that are easy to occur in the donor region. Allograft bones are always associated with immune rejection, slow healing, and infection. Therefore, it is imminent to develop new materials for bone repair. OBJECTIVE: To explore the effect of rabbit adipose-derived stem cells (rADSCs) as seed cells and hydroxyapatite/p-tricalcium phosphate (HA/β-TCP) composite as a carrier on the repair of rabbit vertebral defects. METHODS: Thirty-eight 3-month-old New Zealand white rabbits were selected, ond two of them were used to culture rADSCs in vitro. Passage 3 rADSCc were inoculated on HA/β-TCP scaffolds and then cultured in vitro for 2 weeks. A 5 mmx5 mmx3 mm bone defect was prepared at the anterior edge of L4/5 vertebral body in the remaining 36 rabbits. These model rabbits were then randomized into cell-scaffold composite group, scaffold group and control group with no intervention, with 12 rabbits in each group. rADSCs/HA/β-TCP composite and HA/β-TCP scaffold were implanted into the cell-scaffold and HA/β-TCP groups, respectively. Anteroposterior and lateral DR of the spine and Lane-Sandhu X-ray wera performed at 4, 8, 12 postoperative weeks. All rabbits wera sacrificed at 12 postoperative weeks and specimens were collected for grass and histopathological observations. RESULTS AND CONCLUSION: Under the grass observation, bone defects in the cell-scaffold group were essentially replaced by new bone tissues, which was significantly better than that in the scaffold group and control group. At 12 postoperative weeks, the material implanted was basically absorbed in the cell-scaffold group, partially absorbed in the scaffold group and poorly absorbed in the control group in which there was a clear boundary with the surrounding tissues and patchy calcifed shadows were visible. X-ray results showed that the repair effect in the cell-scaffold group was better than that in the scaffold group and control group (P < 0.05). Histopathological findings showed the marked absorption of the iplant in the cell-scaffold group, partial residual in the scaffold group with some fibrous calluses and osteoid tissues, and a large amount of fiber tissues and a small amount of calluses in the control group. Overall, the rADSCs/HA/β-TCA has a good ability to repair bone defects. © 2018, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

牙槽骨骨密度与甲状腺激素的影响

BACKGROUND: Overproduction of thyroid hormones is shown to increase the activities of osteoblasts and osteoclasts, stimulating bone resorption and transformation. Inadequate compensation of increased bone resorption by bone transformation results in an increased loss of bone mass. OBJECTIVE:To investigate the effects of hyperthyroidism on the density of the alveolar bone. METHODS:Twenty-four New Zealand rabbits were equally randomized into hyperthyroidism group and control group. Rabbits in the hyperthyroidism group or control group were daily injected intraperitoneally with 50 μg/kg levothyrocine diluted in physiological saline solution or equal volume of physiological saline. At 8 weeks after treatment, serum levels of thyroid hormones (FT3 and FT4), alkaline phosphatase, magnesium and calcium, phosphorus were determined; meanwhile, the bone densities of the lumbar vertebra, mandible, bilateral distal femur were determined by dual energy X-ray absorptiometry and the correlation analysis was performed. RESULTS AND CONCLUSION: At 8 weeks after treatment, serum levels of FT3, FT4, alkaline phosphatase calcium, phosphorus, and magnesium in the hyperthyroidism group were significantly increased (P < 0.01), while the bone densities of the lumbar vertebra, mandible, bilateral distal femur were significantly decreased (P < 0.05), compared with the control group. Bone density of the mandible was positively correlated with the bone density the lumbar vertebra and bilateral distal femur. These findings suggest that the changes in FT3 and FT4 are sufficient for the diagnosis of hyperthyroidism. Hyperthyroidism results in the decreased density of the alveolar bone, indicating the occurrence of osteoporosis. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

自体骨、同种异体骨及骨形态发生蛋白重组骨治疗腰椎骨折

背景：骨形态发生蛋白重组骨是一种新型植骨材料,已逐步应用于临床,但在腰椎骨折植骨融合中效果仍少见报道。 目的：比较自体骨、同种异体骨及骨形态发生蛋白重组骨治疗腰椎骨折的疗效差异。 方法：选择2005年3月至2009年3月南阳医学高等专科学校附属第一医院收治的腰椎骨折患者78例,根据植骨材料不同随机分为3组,分别植入自体骨、同种异体骨、骨形态发生蛋白重组骨。 结果与结论：78例腰椎骨折患者均获24个月的随访。植骨后24个月JOA评分改善率骨形态发生蛋白植入组90%>自体骨植入组85%>同种异体骨植入组70%(P < 0.05);植骨后12,24个月,同种异体骨植入组Cobb角较其他2组和植骨后6个月增大(P < 0.05),较植骨前减小(P < 0.05);自体骨植入组与骨形态发生蛋白植入组相比,差异无统计学意义(P > 0.05);同种异体骨植入组植骨后各时间点骨融合率均低于其他2组(P < 0.05)。提示骨形态发生蛋白重组骨与自体骨应用于脊椎腰椎骨折近期疗效相似,均优于同种异体骨移植,骨形态发生蛋白重组骨在腰椎骨折脊柱融合快,效果更好,临床应用更有优势。     

骨组织工程支架材料--陶瓷化骨

陶瓷化骨作为骨移植材料 ,得到广泛的研究 ,并已应用于临床。由于其具有天然的骨小梁结构 ,可降解 ,无免疫原性 ,是骨组织工程比较理想的支架材料 ,因此越来越受到重视。本文主要综述陶瓷化骨的理化性质、生物学特性及在骨组织工程中的应用     

纳米脱钙骨基质促进骨愈合

背景：纳米脱钙骨基质具有较大的表面积/体积比,纳米颗粒团聚后在表面自然形成不规则的纳米沟槽,可促进成骨细胞在其表面黏附生长及基质分泌。 目的：评价纳米脱钙骨基质作为骨移植替代物的植骨融合能力。 方法：以改良Urist法制备人同种异体脱钙骨基质,使用液氮冷冻球磨机及MICROS超细粉碎机制备纳米脱钙骨基质。咬除家兔L2-4双侧小关节及双侧椎板和横突表面皮质骨,随机分为3组,分别在腰椎椎板及横突间植入纳米脱钙骨基质、脱钙骨基质及自体骨,术后4,8,12周通过影像学、组织学观察植骨融合效果。 结果与结论：①X射线与CT表现：术后12周,纳米脱钙骨基质组椎板、附件形态已接近正常节段,新生骨与椎板间隙完全消失,新生骨与植骨床骨质密度均匀一致;脱钙骨基质组植骨区域椎板表面有少量新生骨块影,在新生骨与椎板表面尚有一定间隙;自体骨组椎板与植骨融合界面愈合良好,植骨区有新生骨块影,融合骨块质地均匀。②组织学表现：术后12周,纳米脱钙骨基质被新生骨替代,与椎板间形成骨性连接,新生骨内可见大量骨细胞,与自体骨组效果相似;脱钙骨基质组植骨区达到骨性愈合,新生骨内可见板层样骨,也有类骨物质。表明纳米脱钙骨基质具有良好的成骨诱导能力,是自体骨移植的良好替代物。     

Replacement of bone marrow by bone in rat femurs: the bone bioreactor

During development and repair of bone, two distinct yet complementary mechanisms, intramembranous and endochondral, mediate new bone formation via osteoblasts. Because mechanical bone marrow ablation leads to the rapid and transient formation of new bone in the marrow cavity, we postulated that parathyroid hormone (PTH), which is a bone anabolic hormone, enhances the formation of new bone that forms after marrow ablation. We subjected the left femur of rats to mechanical marrow ablation, or sham operation, and injected the animals daily with PTH or vehicle for 1, 2, or 3 weeks in a first experiment, then with PTH, parathyroid hormone-related peptide (PTHrP), or vehicle for 3 weeks in a second experiment. We subjected both femurs from each rat to soft X-ray, peripheral quantitative computed tomography, computed tomography on a microscale, and histological analysis, and determined the concentration of serum osteocalcin. In addition, in the second experiment, we determined the serum concentration of calcium, tartrate-resistant acid phosphatase (TRAP), and receptor activator of NF-kappaB ligand (RANKL) at 3 weeks, and subjected femurs to biomechanical testing. Following treatment with PTH or PTHrP for 3 weeks, bone filled the marrow cavity of the shafts whose marrow had been ablated. PTH increased trabecular density in the right femur, but failed to induce bone formation in the medullary region of the right unoperated femoral shafts. The newly formed bone endowed left femoral shafts with improved biomechanical properties when compared to those of right femurs and left femurs from control, sham-operated, and vehicle-treated rats. PTHrP, like PTH, increased serum osteocalcin, but neither increased serum calcium, TRAP, or RANKL at 3 weeks. Our results reveal that the newly formed bone that follows marrow ablation is responsive to PTH, expand the role of PTH in bone, and might open new avenues of investigations to the field of regenerative medicine and tissue engineering. Local bone marrow removal in conjunction with pharmacologic intervention with an anabolic agent might provide a technique for rapid preferential site-directed bone growth in areas of high bone loss.     

Bioactive glass and autogenous bone as bone graft substitutes in benign bone tumors

In a prospective randomized study, 25 patients with benign bone tumors were surgically treated with either bioactive glass S53P4 (BG) or autogenous bone (AB) as bone graft material. X-rays were taken preoperatively and postoperatively at 2 weeks and at 3, 8, 12, 18, 24, and 36 months. In addition, for most of the patients, CT scans were performed at the same time-points. No infections or material-related adverse reactions occurred in any patient. The filled cavity was replaced faster by new bone in the AB group than in the BG group (p = 0.0001). However, at 36 months, no statistical difference in cavity volume between the two groups was observed on X-rays (p = 0.7881) or on CT scans (p = 0.9117). In the BG group at 3 years, the filled cavity appeared, however, dense on X-rays, and glass granules on CT scans were observed. During the follow-up period, the cortical thickness seemed to increase more in the BG group than in the AB group (p < 0.0001).     

自体骨髓移植复合人工骨治疗骨缺损

背景：到目前为止,国内人工骨联合自体骨髓移植治疗新鲜骨折、骨缺损方面的基础与临床研究尚未见报道。 目的：分析自体骨髓移植复合人工骨修复四肢粉碎性骨折骨缺损的作用途径。 方法：42例四肢骨缺损患者按治疗方法分为3组,均采用内固定方法修复骨折骨缺损。复合组采用自体骨髓移植复合人工骨,人工骨移植组仅作单纯的人工骨移植,自体骨髓移植组仅将单纯的自体骨髓注射入骨缺损处。所有患者均行骨特异性碱性磷酸酶活性检测和影像学随访,观察骨痂形成及骨折愈合情况。 结果与结论：在内固定后第3,4,6周,复合组伤肢骨痂形成率、骨特异性碱性磷酸酶活性均显著高于人工骨移植组及自体骨髓移植组(P < 0.01)。提示自体骨髓移植复合人工骨较单纯的人工骨移植或自体骨髓移植更能促进早期骨痂反应,加速骨折后骨缺损愈合,缩短骨愈合时间及住院时间。     

骨水泥成形术治疗骨转移瘤的临床观察

目的 观察应用微创技术治疗骨转移瘤引起疼痛的效果.方法 17例骨转移患者,59处骨转移病灶(55处在椎体,3处在四肢骨,1处在骨盆),其中男性5例,女性12例,年龄30～78岁,平均年龄58.9岁,影像学检查均证实有骨转移瘤(X线片、CT及MRI).临床伴有明显持续性骨痛,症状持续时间为2～18个月,平均5.7个月.17例患者59处骨转移灶均给予骨水泥成形术治疗.观察治疗前后患者的疼痛强度的变化情况、镇痛药使用评分并行SF-12健康状况调查.结果 17例59处病灶手术顺利完成.患者的疼痛评分由治疗前的5.0～9.5(平均7.9±1.2)减少为治疗后的3.1～6.8(平均5.1±1.0)(P＜0.01).患者的止痛药使用评分由治疗前的3～4(平均3.6±0.6),减少为治疗后的1～3(平均2.4±1.1)(P＜0.01).SF-12健康调查评分治疗前为-17～-33,平均-30.00±4.03,治疗后为-18～-33,平均-26.00±3.94(P＜0.05).术后随访6～17个月,平均12.3个月,患者疼痛均较术前减轻,17例患者中1例在治疗期间出现1个椎体新发的压缩性骨折.结论 应用骨水泥成形术治疗骨转移瘤可有效地缓解疼痛,改善患者后期生活质量.     

Pseudotumors of bone and bone lesions mimicking tumours

We review entities that have historically been thought to be pseudotumors or mimics of bone tumours. We discuss tumifactive amyloid deposits, the brown tumours of hyperparathyroidism, the various types of cysts that can be seen in bone, Nora lesion, subungual exostosis, haemophilic pseudotumors, non-ossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, Paget disease, tophaceous gout and pseudogout.     

生物衍生骨在骨组织工程研究中的应用

支架材料的选取是骨组织工程研究的关键 ,生物衍生骨具有较好的生物相容性和材料界面 ,三维立体孔隙 -网架合理 ,可塑性强 ,可降解 ,并具备一定的力学强度 ,兼备良好的骨传导及一定的骨诱导能力。可作为种子细胞的支架材料应用于骨组织工程研究。     

Harvest of human bone marrow directly from bone

Harvest of human bone marrow directly from freshly resected bone provides purer preparations of marrow than can be obtained by the conventional technique of multiple aspirations from the iliac crests. In particular, directly harvested marrow is much less heavily contaminated with peripheral blood lymphocytes, a known source of mature T cells. Because of the possible relevance of these contaminating T cells for cadaveric bone marrow transplants, the best source of human marrow harvested directly from bone has been studied. Human bone marrow was harvested from 46 surgical specimens and 9 cadaveric tissue donors. Vertebral bodies provided the best source of bone marrow with average yields of 3.1 ± 1.6 × 10⁹ cells per vertebra. When entire ilia were removed and processed for marrow, an average of 1.6 ± 1.0 × 10⁹ cells was obtained. Surgically resected ribs yielded lower amounts of marrow with a mean cell number of 3.2 ± 2.6 × 10⁸ per rib. Isolation of bone marrowb mononuclear cells from these preparations by density gradient centrifugation resulted in a loss of 45% of the starting cells. Human bone marrow was found to contain 5–6% T cells before gradient separation and these cells were immunologically competent as measured in vitro by responses to mitogens and alloantigens. This technique may be useful in obtaining human bone marrow for both immunologic studies and allogeneic transplantation.