高能震波对骨痂中骨形成蛋白表达的影响

目的 观察高能震波（ＨＥＳＷ）对骨痂中骨形成蛋白（ＢＭＰ）表达的影响，探讨其促进骨折愈合的机理。方法 手术造成家兔双侧胫骨中段标准骨折模型，对一侧胫骨骨折部施以ＨＥＳＷ，另一侧为对照组，术后每周进行Ｘ线及组织学检查，并取骨痂组织切片用ＢＭＰ抗体进行免疫组化染色（ＳＡＢＣ法（）。结果 实验组骨痂中ＢＭＰ表达强度在第２－４周时明在于对照组（Ｐ〈０．０１），且Ｘ线摄片及组织学观察均显示实验组骨折愈合时间     

无名异接骨冲剂对骨痂局部骨形态发生蛋白含量的影响

为探讨无名异接骨冲剂加速骨折愈合的作用机理，选用５５只新西兰大白兔，随机选择５只作为正常组；另５０只在无菌条件下造成双桡骨标准骨折模型。将５０只骨折兔随机平均分为实验组和对照组，实验组用无名异接骨冲剂每天４ｇ／ｋｇ溶于２０ｍｌ蒸馏水中分早晚两次灌胃；对照组用２０ｍｌ蒸馏水灌胃。于骨折后第１，２，３，４及５周用断颈法每次每组处死５只兔，取骨痂进行抗骨形态发生蛋白（ＢＭＰ）单克隆抗体免疫组化染色，并用ＣＭＩＡＳ型图像分析仪对ＢＭＰ含量进行定量分析。结果发现：实验组骨折局部ＢＭＰ含量明显高于正常组（Ｐ＜０．０１）；第１，２周实验组明显高于对照组（Ｐ＜０．０１）；实验组ＢＭＰ高峰出现在第２周，而对照组出现在第３周。认为，无名异接骨冲剂能促进成骨细胞合成ＢＭＰ，使ＢＭＰ峰值提前，从而加速骨折愈合。     

中老年糖尿病Ⅱ型患者骨密度与骨代谢变化的研究

为观察中老年糖尿病（ＤＭ）患者的骨代谢变化，我们应用单光子骨密度仪对９８例中老年ＤＭ患者和正常对照组６３人进行骨密度测量比较，同时对ＤＭ患者进行空腹血糖、空腹胰岛素、血钙、血磷、血ＡＫＰ及尿钙、尿磷测定。结果提示：（１）ＢＭＤ降低３５例，占３５．７％，男性ＢＭＤ降低发生率为３２．８％，（Ｐ＜０．０５），女性ＢＭＤ降低率为４０．０％，（Ｐ＜０．０１）；（２）ＤＭ患者ＢＭＤ正常组与降低组的各项血尿生化指标（血Ｃａ、Ｐ、ＡＫＰ、ＦＢＧ、ＦＩＮＳ，尿Ｃａ、Ｐ）无显著差异（Ｐ＞０．０５）；（３）ＤＭ患者各病程组间ＢＭＤ无显著差异（Ｐ＞０．０５），病程与ＢＭＤ亦无明显相关；（４）除血Ｃａ外（ＢＭＤ与血Ｃａ有明显相关，ｒ＝０．２５，Ｐ＜０．０５），ＢＭＤ与它们之间亦无明显相关，说明一般血尿生化指标对中老年ＤＭ患者的骨代谢变化不敏感、无特异性、不可靠。而ＢＭＤ检查则可早期发现骨量减少，预测骨质疏松的发生和骨折的危险性，不失为早期诊断的主要依据     

高海拔对实验性骨折愈合骨矿含量的影响

本文旨在探讨高海拔对骨折愈合矿含量的影响，分别在拉萨（海拔３６５８ｍ）和重庆，采用当地家兔制成胫骨横形骨折模型，三角针内固定，于术后２，４，６，８，１０，１２周分别截取标本，行Ｘ线摄片，单光子吸收检测骨密度（ＢＭＤ）和骨矿含量（ＢＭＣ）以及ＣＴ扫描，测定骨痂区ＢＭＤ，ＢＭＣ和ＣＴ值，结果ＢＭＤ，ＢＭＣ，Ｃ值两组镁有显著差异（Ｐ〈０．０５或Ｐ〈０．０１），结论：高海拔环境下骨折区骨矿析出和沉积速度较     

补肾中药对骨质疏松大鼠性激素影响的实验研究

目的　探讨补肾中药骨康对去势所造成骨质疏松大鼠性激素及骨密度的影响及性激素水平在骨质疏松发病中的作用。方法　通过切除大鼠睾丸和卵巢造成骨质疏松模型,观察中药骨康不同剂量对骨质疏松大鼠血睾酮（Ｔ）、血清雌二醇（Ｅ２）、ＢＭＤ 和ＢＭＣ的影响,并与特乐定、尼尔雌醇作阳性对照。结果　中药骨康高、中剂量防治的去势大鼠Ｔ 含量高于模型组（Ｐ＜ ０．０５ 和０．０１）,高、中、低剂量组的Ｅ２、全身及左、右股骨ＢＭＤ、ＢＭＣ高于模型组（Ｐ＜ ０．０５）。结论　骨康能提高去势大鼠血性激素含量、骨的骨矿含量及骨密度,其提高骨矿含量及骨密度的作用可能与其提高性激素水平有关。     

利美达松等糖皮质激素对慢性卡压周围神经损伤后功能恢复的研究

目的　探讨利美达松等糖皮质激素伍用局麻药对周围神经慢性卡压损伤后功能恢复的影响。方法１０８只ＳＤ成年雄性大鼠随机等分为６组,对照组根据是否卡压坐骨神经分为２组（Ａ、Ｂ）,治疗组根据去卡压后给予的糖皮质激素和／或局麻药分为４组（Ｃ、Ｄ、Ｅ、Ｆ）。术前、去卡压时、去卡压后１、３、５周Ｂ、Ｃ、Ｄ、Ｅ、Ｆ组大鼠行趾展功能指数（ＴＳＩ）、电生理检测（ＭＮＣＶ、Ｌａｎ）、轴突图像分析及神经单丝观察。结果　去卡压后３周,损伤组ＴＳＩ、ＭＮＣＶ、Ｌａｎ均有恢复,给予糖皮质激素组更明显（Ｐ＜０．０５）;去卡压后５周,各激素组功能恢复越来越显著,结合轴图图像分析及神经单丝观察,证实利美达松组各项指标恢复与其它组相比有显著性差异（Ｐ＜０．０５）。结论　利美达松对慢性神经卡压损伤后神经结构和功能恢复有明显的促进作用,且作用优于其它各组。     

104例骨质疏松性病理骨折的临床分析

本文回顾性分析了１０４例骨质疏松性病理骨折的资料。女性２５例，６０岁以上占８０％。男性７９例，７０岁以上占７７％。女性骨折类型中髋和椎体骨折占９２％，而男性则占８５％。在１４例骨Ｘ线片所证实的脊椎骨折中，ＢＭＤ达－３．０ＳＤ者１例，－１．１～－２．４ＳＤ者７例，－１．０～＋１．０ＳＤ者６例。因此ＢＭＤ－１．０ＳＤ或更严重者，有必要对骨质疏松作治疗。对骨质疏松的诊断来说，既要用双能Ｘ线骨密度仪测定ＢＭＤ，又要拍脊柱Ｘ线平片。测定尿中脱氧吡啶啉和羟脯氨酸，以及血骨钙素来决定骨转换率时，１４例老年男性骨质疏松性骨折资料显示，骨转换率正常者６例，增加者５例，降低者３例。本组骨质疏松的独立病因如下：９３％为原发性退化性，７％为继发性，包括原发性甲旁亢、肾小管酸中毒和多发性骨髓瘤。促进骨质疏松发生发展的因素有：钙和ＶｉｔＤ缺乏（４８％），肾小管酸中毒（１７％），以及心、肺、神经、消化系的慢性老年病     

高能震波促进骨折愈合机理的探讨

目的 探讨高能震波（ＨＥＳＷ）对兔骨折愈合的影响及其机理。方法 手术造成家兔双侧胫骨标准骨折模型,对１侧胫骨骨折部施以ＨＥＳＷ;另１侧为对照。术后每周进行Ｘ线及组织学检查,并取骨折骨痂切片用骨形态发生蛋白（ＢＭＰ）抗体进行免疫组织化学染色（ＳＡＢＣ法）。结果 Ｘ线摄片及组织学观察显示,实验侧骨痂出现时间及骨折愈合时间均明显早于对照组;骨痂区毛细血管计数、ＢＭＰ表达强度在第２～４周时实验侧均明显大于     

诱导性人工骨膜的研制及实验研究

目的　本研究研制了一种诱导性人工骨膜。方法　用猪真皮提取纯化胶原,盐析法制备胶原膜,并用此吸附ＢＭＰ,制备成胶原－ＢＭＰ人工骨膜。用大鼠桡骨３ｍｍ长骨缺损作为骨折模型。设空白、单纯胶原膜、胶原－ＢＭＰ膜包绕骨折段以及新鲜同种异体植骨共４组。术后０．５、１、２和３个月分批处死各组大鼠数只,处死前２天每只大鼠腹腔内注射钙黄绿素８０ｍｇ／ｋｇ。处死后分别行Ｘ线和软Ｘ线摄片,血清ＢＧＰ测定以及荧光显微镜观察。结果　胶原－ＢＭＰ人工骨膜组的上述多项检测指标均表明其成骨效能明显优于其他各组。结论　作者认为该组成骨效果优良的原因是由于胶原膜吸附了ＢＭＰ,同时具有骨诱导和骨引导的两种成骨作用,而仅胶原膜包绕骨折段的单纯骨引导效果并不理想。     

大鼠被动型Heymann肾炎的实验研究

目的探索被动型Ｈｅｙｍａｎｎ肾炎（ｐａｓｉｖｅＨｅｙｍａｎｎｎｅｐｈｒｉｔｉｓ，ＰＨＮ）的发病机理与新的治疗途径。方法采用兔抗大鼠肾近曲小管上皮细胞刷状缘微绒毛（ｂｒｕｓｈｂｏｒｄｅｒｍｅｍｂｒａｎｅ，ＢＢＭ）抗血清经Ｗｉｓｔａｒ大鼠尾静脉注射，复制ＰＨＮ模型。考马斯亮兰法检测实验大鼠尿蛋白排泄，免疫组织化学法（ＳＰ法）及计算机图象分析系统检测基质金属蛋白酶９（ｍａｔｒｉｘｍｅｔａｌｏｐｒｏｔｅｉｎａｓｅ９，ＭＭＰ９）及Ⅳ型胶原的表达及其与蛋白尿的关系。观察牛磺酸对该模型的干预作用。结果（１）成功复制了ＰＨＮ模型。（２）ＭＭＰ９在注射抗血清后７天表达明显增高，以３周时为著，ＭＭＰ９的升高与蛋白尿的产生呈线性相关关系（ｒ＝０．９８，Ｐ＜０．０５）；Ⅳ型胶原在２周以后沿基底膜连续性分布中断呈溶解现象。（３）给予牛磺酸的实验大鼠蛋白尿减轻，ＭＭＰ９的表达明显降低，Ⅳ型胶原溶解现象及病理改变也得到了不同程度的改善。结论ＭＭＰ９参与了ＰＨＮ肾小球基底膜的损伤过程；牛磺酸对该模型具有一定的保护作用。     

异体软骨痂移植的初步结果

目的 通过观察异体软骨痂移植后的生物学过程判断其作为植骨材料的可行性。方法 将1只SD大鼠的双侧股骨干造成闭合骨折,1周时切开获取软骨痂,－196℃冻存2周后移植于5只SD大鼠的左侧胫骨干部分缺损区（此骨缺损模型的成骨活动只表现为膜内化骨的方式）,右侧植入异体松质骨作为对照组。将取材标本制成不脱钙切片,经亮绿和藏红T染色。结果 术后1周取材1例,缺损区实验侧和对照侧均未见有软骨组织和骨组织形成。术后2周处死其余4只大鼠,实验侧（3／4）可见有软骨组织和骨组织形成。骨组织内已有髓腔形成,骨组织周围是软骨组织,与宿主骨之间有纤维组织相隔。结论 异体软骨痂移植后未被吸收,可经软骨内化骨的方式产生骨组织,为软骨痂作为植骨材料的进一步研究和开发提供了初步依据。     

Early period of fracture healing in ovariectomized rats

Objective. To evaluate the effect of osteoporosis on fracture healing through observing the hlstomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta 1 (TGF-β1 ), basic fibroblast growth factor (bFGF)and bone morphogenetic protein.2 (BMP-2) in ovariectomized rats. Methods. Sixty female Sprague-Dawley rats ( aged 12 weeks and weighing 235 g on average ) were randomly divided into an ovariectomized (OVX) group (n =30) anda sham-operated (SO) group ( n = 30). Ovariectomy was performed in the OVX rats and same incision was made in the SO rats. Three months later, fracture of femoral shaft was made on all the rats. Then they were killed at different time points. Callus formation was observed with histological and imethods. Results: A reduction in callus and bone mineral density in the healing femur and a decrease of osteoblasts expressing TGF-β1 near the bone trabecula were observed in the OVX rats 3-4 weeks after fracture.Histomorphological analysis revealed a higher content of soft callus in the OVX rats than that in the SO rats.Immunohistochemistry results showed that no remarkable difference in expression and distribution of BMP-2 and bFGF between the OVX and SO groups was found. Conclusions: Osteoporosis influences the quantity and quality of callus during the early period of fracture healing. The effect of osteoporosis on fracture healing has no relationship with the expression of BMP-2 or bFGF. The decreased expression of TGF-I31 in osteoblasts may cause a decrease in quality of facture healing after osteoporosis.     

Osteoporosis influences the middle and late periods of fracture healing in a rat osteoporotic model

Osteoporosisischaracterizedbydecreasedbonemass, increasedbonefragilityinducedbydemolitionofbonemicrostructureandincreasedsusceptibilitytofracture. Currentstudiesmainlyfocusonthepreventionoffracture. However, theinfluenceofosteoporosisonthefracturehealingremainspoorlyunderstoodandcontroversial.Inourpreviousstudy, wehaveevaluatedtheeffectofosteoporosisontheearlyperiodoffracturehealing, andfoundthatosteoporosisinfluencesthequantityandqualityofcallusduringtheearlyperiodofracturehealing.1 Incurrent…     

The role of cell type in bone healing mediated by ex vivo gene therapy

Background The ideal cellular vehicle for use in cell-mediated gene therapy to enhance bone healing has not yet been identified. The purpose of this study was to compare the capacity of two types of cells transduced with retro-bone morphogenetic protein 4 (BMP4)—muscle-derived cells (MDCs) and unfractioned bone marrow stromal cells (BMSCs).Method Primary rat MDCs and unfractioned rat BMSCs were transduced with a retrovirus to express BMP4. A 7-mm, critical-sized femur defect was created in adult rats, and 5×10⁶ transduced cells were implanted into the femoral defect. Bone healing was monitored radiographically and histologically at 4, 8, and 12 weeks post-implantation.Results All specimens in the MDC-BMP4 group and BMSC-BMP4 group showed a bridging callus at 8 and 12 weeks. At 12 weeks post-implantation the calluses of the MDC-BMP4 femora displayed significantly higher bone photodensity than the BMSC-BMP4 femora (P<0.05). Histomorphometry revealed no difference between the two treatment groups. However, non-union between newly formed and original bone was observed in none of the MDC femora but in six femora from the BMSC-BMP4 group.Conclusion Both MDCs and unfractioned BMSCs can improve healing of a critical-sized bone defect following transduction of the cells with retroBMP4. However, MDCs appear to yield superior results when compared with BMSCs in terms of improved healing of segmental defects.     

骨形态发生蛋白在异体骨段移植愈合中的表达及临床意义

目的：研究骨形态发生蛋白（BMP）在异体骨段移植愈中的表达及临床意义。方法：采用新西兰大白兔股骨中段切除1．5cm骨干和骨膜实验动物模型。方法：36只兔随机分实验组和对照组。实验组植入深低温保存的异体骨,对照组植入自体新鲜骨,均用髓内针固定,分别于术后第1、2、3个月用免疫组织化学染色法观察BMP在异体骨愈合过程的表达情况,结果：深低温保存的同种异体骨移植愈合BMP表达与体骨相似,移植骨段BMP表达阴性,新生骨及其周围类基质表达阳性。新生编织骨BMP表达活跃,成熟板层骨BMP表达减弱（P＜0．01）。结论：异体骨移植愈合中骨吸收和骨诱导是同时,骨诱导在异体骨愈合早期发挥了重要作用。     

复方仙贞汤对去卵巢大鼠模型骨密度和骨形态的影响

目的 研究复方仙贞汤对去卵巢大鼠的骨密度和骨形态的影响。方法 3月龄的雌性SD大鼠，普通饲料喂养1周后，随机分为假手术组（Sham）、模型组（OVX）、尼尔雌醇阳性药物对照组、复方仙贞汤小剂量组、复方仙贞汤中剂量组、复方仙贞汤大剂量组。除假手术组，其余都经背部切开后切除双侧卵巢，制造去卵巢模型（OVX），假手术组则背部切开后切除部分脂肪组织再分层缝合。造模完成后，假手术组及模型组用生理盐水灌胃，阳性药物组用尼尔雌醇混悬液灌胃，复方仙贞汤小、中、大剂量组分别给以6．5g／kg、13g／kg、26g／kg大鼠体重（按生药计算）的复方仙贞汤药液，每日固定上午九点灌胃1次。全部动物共持续喂养3个月后处死，测定股骨的骨密度和胫骨骨体积、胫骨类骨表面，类骨质宽、骨吸收表面。结果 复方仙贞汤组和尼尔雌醇组均较模型组的骨密度显著性增高（P〈0．01），而且复方仙贞汤中剂量组与尼尔雌醇阳性对照组接近。与模型组比较，中药组和尼尔雌醇组的骨体积显著上升（P〈0．01），而类骨表面、类骨质宽和骨吸收表面却显著下降（分别P〈0．01）。结论 复方仙贞汤能提高去卵巢大鼠的骨密度和骨体积，减少类骨质宽、类骨质表面、骨吸收表面，提示复方仙贞汤能起到和尼尔雌醇相似的作用，即降低绝经后骨质疏松的高转换率，从而减慢骨质的丢失。     

The effects of EHDP on regenerating trabecular bone usingin vivo microscopic,light and electron microscopic,and electron microprobe techniques

Metallic chambers were implanted into the proximal tibiae of rabbits to permit microscopic examination of living bonein situ. The bone repair process secondary to the injury produced during installation of the chamber, was visualized. Six to 8 weeks after implantation, osteoid and/or bone could be seen. The effects of various doses of disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) on the repair and regeneration processes following chamber implantation were studied. Data from various techniques indicated that: (1) following low dose EHDP (0.25 mg/kg/day) chambers contained bone tissue morphologically and ultrastructurally indistinguishable from controls; and (2) with higher doses of EHDP (2.5 or 10 mg/kg/day) chamber contained spicules of normal osteoid, osteoblasts and osteocytes, but were devoid of osteoclasts. The effects of the various regimes of EHDP also were assessed on regenerated, trabecular bone contained within the tibia chambers three months after implantation of the chambers. Data from various methods of analysis supported the following conclusions: (1) the low dose of EHDP (0.25 mg/kg/day) had no toxic effects on the trabecular bone within the chambers but there appeared to be an increase in bone formation as compared to saline control; (2) higher doses of EHDP (2.5 or 10 mg/kg/day) were not toxic to bone cells but thick osteoid seams formed on the trabecular bone within the chambers. No osteoclasts were found associated with the bone apparently due to the coverage of bone surfaces by osteoid seams; and (3) osteoid which accumulated after EHDP treatment of 2.5 mg/kg/day for 2 months remained uncalcified for as long as 2 months following withdrawal of EHDP administration. The results showed the value of tibial chamber for examining microscopically living bonein situ and demonstrated the inhibitory effect of EHDP on mineralization of newly formed osteoid and a lack of effect on bone cells.     

The relationship between serum vitamin D concentrations andin vivo tetracycline labeling of osteoid in crush fracture osteoporosis

Summary Twenty of 22 consecutive British patients with crush fracture osteoporosis had transiliac bone biopsies following doublein vivo tetracycline labeling synchronized with the collection of serum for the measurement of vitamin D metabolites. A significant but direct (rather than inverse) relationship was found between 25-hydroxyvitamin D (calcidiol) levels and the fraction of cancellous surfaces covered with osteoid not taking either tetracycline label (r=0.53,P<0.02). There was no correlation with 1,25-dihydroxyvitamin D levels. No patient had frankly thickneded osteoid seams although 3 had reduced but measurable calcidiol levels. These results make it unlikely that the majority of patients with osteoporosis who have osteoid of normal thickness but reduced uptake of tetracycline have a mineralization defect secondary to vitamin D deficiency. The pathophysiological significance of unlabeled osteoid in osteoporosis requires further investigation.     

Bone morphogenetic protein-7 accelerates fracture healing in osteoporotic rats

Background:

Osteoporosis is characterized by low bone mass, bone fragility and increased susceptibility to fracture. Fracture healing in osteoporosis is delayed and rates of implant failure are high with few biological treatment options available. This study aimed to determine whether a single dose of bone morphogenetic protein-7 (BMP-7) in a collagen/carboxy-methyl cellulose (CMC) composite enhanced fracture healing in an osteoporotic rat model.

Materials and Methods:

An open femoral midshaft osteotomy was performed in female rats 3 months post-ovarectomy. Rats were randomized to receive either BMP-7 composite (n = 30) or composite alone (n = 30) at the fracture site during surgery. Thereafter calluses were collected on days 12, 20 and 31. Callus cross-sectional area, bone mineral density, biomechanical stiffness and maximum torque, radiographic bony union and histological callus maturity were evaluated at each time point.

Results:

There were statistically significant increases in bone mineral density and callus cross-section area at all time points in the BMP-7 group as compared to controls and biomechanical readings showed stronger bones at day 31 in the BMP-7 group. Histological and radiographic evaluation indicated significant acceleration of bony union in the BMP-7 group as compared to controls.

Conclusion:

This study demonstrated that BMP-7 accelerates fracture healing in an oestrogen-deficient environment in a rat femoral fracture healing model to scientific relevance level I. The use of BMP-7 composite could offer orthopedic surgeons an advantage over oestrogen therapy, enhancing osteoporotic fracture healing with a single, locally applied dose at the time of surgery, potentially overcoming delays in healing caused by the osteoporotic state.     

前交叉韧带切断对卵巢切除大鼠股骨骨折愈合的影响

目的观察前交叉韧带切断(OA动物模型)对双侧卵巢切除大鼠(OVX绝经后骨质疏松模型)股骨骨折愈合的影响。方法12周龄SD大鼠共70只，分成基础对照组(Basal)、假手术组(Sham)、双侧卵巢切除术组(OVX)、卵巢切除 前交叉韧带切断术组(OVX OA)、假手术 骨折组(Sham F)、卵巢切除术 骨折组(OVX F)、卵巢切除 前交叉韧带切断 骨折组(OA OVX F)，每组10只大鼠。所有受试大鼠在处死前第10d天和第4d天分别皮下注射盐酸四环素和钙黄绿素行双荧光标记。基础对照组在实验开始时杀死，其余6组在术后6W杀死，取大鼠右侧股骨标本。然后，分别进行CR摄片、组织形态学染色，以及应用Norland-XR36双能X线骨密度仪(DXA)测量右股骨远段骨密度和中段骨密度，并将股骨远段及骨折段骨痂进行硬组织包埋、切片，作骨组织形态计量学测量。结果①OVX OA组与OVX组比较，股骨远段。BMD和BWTV显著增加；②OVX F组与Sham F组比较，骨痂(股骨中段)BMD和BV／TV显著降低：③OVX OA F组与OVX F组比较，骨痂(股骨中段)BMD利BV／TV无统计学差异。结论①骨质疏松不仅延缓骨折愈合过程，而且降低骨折愈合质量；②在此动物模型中，骨性关节炎延缓股骨骨质疏松的发生，但是，对骨质疏松性骨折的愈合没有确切的促进作用。