肝癌动物模型的建立

自20世纪初获得小鼠自发性肝癌动物模型以来，人们对肝癌动物模型的研究不断深入，逐渐建立了诱发性肝癌模型、移植性肝癌模型及转基因动物肝癌模型。下面就各类肝癌动物模型的建立方法和特点作一简述。     

动脉瘤动物模型的建立

颅内动脉瘤是引起蛛网膜下腔出血的主要原因。建立颅内动脉瘤模型,探索其发病机制和治疗方法具有重要意义。文章回顾了动脉瘤动物模型的建立方法和动物选择。     

心房颤动动物模型建立的研究进展

心房颤动是临床上最为常见的心律失常。近年来,在揭示其发生机制、动物模型的建立及治疗措施等方面有许多新进展。现对心房颤动动物模型建立的方法进行综述。     

隐孢子虫动物模型的建立

本文通过饮水给予免疫抑制药和用人源隐孢子虫卵囊感染ＮＩＨ小鼠，建立了隐孢子虫感染小鼠模型。实验结果显示：免疫功能抑制组比正常组易感，两者感染度有显著性差异（Ｐ＜０．０５）。通过动物实验进一步证明免疫功能正常宿主感染隐孢子虫为自限性感染，免疫功能低下或缺陷者感染隐孢子虫可引起严重腹泻甚至死亡。     

采用副结核杆菌建立肉芽肿性肠炎动物模型的研究

目的:利用副结核杆菌接种地鼠,以图建立一个模拟克隆病的小动物模型。方法:将40只地鼠随机分为两组,实验组:20只腹腔接种副结核杆菌;对照组:20只分别接种生理盐水和死菌(各10只)。8个月后处死动物,作病理学观察,并对动物肠组织进行 Polymerase chain reaction(PCR)扩增副结核杆菌 DNA。结果:实验组 80% (16/ 20)的地鼠出现肉芽肿性肠炎。实验组所有 20只地鼠的肠组织均扩增出 400 bp的 DNA 片段。结论:建立了一个新的肉芽肿性肠炎的小动物模型。     

慢性胰腺炎动物模型的建立

本研究首次报道通过胰管内注入三硝基苯磺酸（trini-trobenenze sulfonic acid,TNBS）,成功诱导大鼠慢性胰腺炎模型。     

应用开胸法建立室壁瘤动物模型

用杂种犬10只,麻醉后左侧开胸,结扎左前降支（LAD）及其第二对角支,5周后行心脏二维超声检查以明确室壁瘤形成效果。结果为10只犬均完成冠状动脉结扎手术,1只房室收缩分离术中死亡,1只心室纤颤术中死亡。存活的8只均成功建立了左室急性心肌梗死后室壁瘤的动物模型。心脏二维超声检查示左室前壁、心尖部室壁瘤形成。认为应用开胸法结扎冠状动脉可以成功建立急性心肌梗死后室壁瘤的动物模型。     

实验性糖尿病结核动物模型的建立

目的：建立糖尿病合并结核的动物模型。方法：腹腔一次性注射2％链脲佐菌素（60mg/kg体重）建立Wistar大鼠糖尿病模型，再经大鼠尾静脉注射结核分支杆菌H37Rv0.01mg/0.4ml建立糖尿病结核模型，分别测定血糖值，肺脏病变指数和肺泡巨噬细胞吞噬细胞吞噬的结核分支杆菌数，观察肺、肝、脾及胰腺组织的病理学改变。结果：实验组不仅血糖≥16.65mmol/L，胰岛受损，且肺、脾组织有明显结核病变。结论：实验表明我们建立的糖尿病结核病变。结论：实验表明我们建立的糖尿病结核动物模型是成功的。     

大鼠持久性肝硬化动物模型的建立

目的探讨建立持久性肝硬化动物模型的方法。方法将200只3月龄雄性Wistar大鼠,随机分成空白对照组(A组),药物对照组(B组)和药物联合肝中叶切除组(C组),用四氯化碳联合肝中叶切除术建立肝硬化模型,分7批,每隔三个月处死一批动物,分别记录各组每只动物的脾脏重量、门静脉宽度、睾丸重量、肝纤维化或肝硬化程度。结果三组动物脾脏重量依次增加,门静脉宽度依序增宽。而睾丸重量变化无明显规律。至21月时,C组S3 S4仍为92%~100%,而B组则为50%~75%(P<0.01)。结论四氯化碳/乙醇联合肝中叶切除术建立的大鼠肝硬化模型持久稳定。     

Expression of tenascin-C in aseptic loosening of total hip replacement

OBJECTIVE—To assess if the bonding interlayer between the implant and bone in aseptic loosening of total hip replacement (THR) is qualitatively deteriorated by excessive accumulation of anti-adhesive glycoprotein, tenascin-C.
METHODS—Alkaline phosphatase-anti-alkaline phosphatase (APAAP) method was used for immunohistochemical staining of tenascin-C in interface tissue and control synovial tissue.
RESULTS—Tenascin-C was found to be a major component of the extracellular matrix at a hitherto unrecognised site, namely the synovial membrane-like interface tissue between implant and bone in aseptic loosening of THR. The overall tenascin-C staining (median score 4.0) was greatly increased in aseptic loosening compared with synovial membrane (median score 2.0; p<0.001) and fibrous capsule (median score 2.0; p<0.001) from primary THR operations. Topological analysis disclosed that tenascin-C was also found at the critical implant-interface and interface-bone surfaces.
CONCLUSION—Local tenascin-C expression is increased as a result of a chronic foreign body type reaction associated with excessive cytokine production and tissue injury mediated by microtrauma and neutral endoproteinases. This qualitative and topological deterioration of the bonding interlayer by an increase of anti-adhesive tenascin-C expression may inadvertantly contribute to loosening.

Keywords: tenascin; aseptic loosening; total hip replacement     

Production of platelet-derived growth factor in aseptic loosening of total hip replacement

Aseptic loosening is the predominant cause of total hip implant failure. It has been assumed that a layer or membrane, containing macrophages, fibroblasts and vascular endothelial cells, of synovial-like tissue develops at the implant-to-bone interface almost invariably and, with time, somehow leads to loosening of the components from the surrounding bone. These cells produce a variety of cytokines and proteolytic enzymes which stimulate bone resorption. Platelet derived growth factor (PDGF) may be one of the cytokines which stimulate bone resorption and contribute to aseptic loosening in total hip replacement (THR). Synovial-like membrane from the implant or cement-to-bone interface (n=10) and pseudocapsule (n=10) were obtained from ten patients operated on for aseptic loosening of THR. As a control, nine samples of connective tissues were obtained from patients who had mandibular or maxillary fractures fixed with bone implant. The avidin-biotin-peroxidase complex (ABC) method with polyclonal rabbit anti-human IgG against the A-chain and B-chain of PDGF was used for staining. ABC-alkaline phosphatase-anti-alkaline-phosphatase double staining with monoclonal mouse anti-human fibroblast IgG₁ and CD68 antibodies was used to ascertain the cellular origin of PDGF. Results of the PDGF staining were quantitated by a semi-automatic VIDAS image analysis system. The PDGF-A and PDGF-B chain containing cells were found in all periprosthetic tissues, in particular in macrophages with phagocytosed particulate debris, but to some extent also in fibroblasts and in endothelial cells. The numbers of PDGF-A and PDGF-B chain positive cells per mm² in synovial-like interface membrane (1881±486 and 1877±214) and pseudocapsule (1786±236 and 1676±152) were higher (P<0.01) around loose THR than in control tissue (821±112 and 467±150), respectively. The results of the present study suggest that PDGF is preferably expressed by macrophages, which to an increased extent produce it in the synovial-like interface membrane and pseudocapsular synovial-like membrane. Because of its role in bone resorption, it may well play a role in periprosthetic bone loss and aseptic loosening and deserves more detailed study as a mediator and potential target in the modulation or prevention of loosening of THR. Received: 11 March 1997 / Accepted: 9 January 1998     

Comparison of two home care protocols for total joint replacement

OBJECTIVES: To examine the effect of a more-efficient home care protocol to manage total joint replacement (TJR) patients after surgery. DESIGN: A randomized trial of two home care protocols for TJR management. SETTING: A hospital-affiliated home healthcare agency in a large midwestern city. PARTICIPANTS: Medicare-eligible individuals undergoing elective total hip or knee replacement surgery (N = 136). INTERVENTION: A home care protocol that included preoperative home visits by a nurse and a physical therapist and fewer postoperative visits (range of 9-12 visits) to the home than an existing protocol (range of 11-47 visits). MEASUREMENTS: Functional status, lower extremity functioning, health-related quality of life, satisfaction with care, and use and cost of healthcare services for 6 months postsurgery. RESULTS: There were no differences in functional status, health-related quality of life, or lower extremity functioning by group at 6 months. A marginally significant gain in satisfaction with access to care (P =.059) was found in the intervention group at 6 months. Home healthcare costs were 55% lower for the streamlined group (P <.001). Other costs did not differ significantly by group. CONCLUSION: TJR patients who received the more-efficient home care protocol experienced comparable outcomes to those who received the existing protocol. An abbreviated set of home care visits resulted in more-efficient delivery of care without compromising patient outcomes.     

全膝关节表面置换治疗老年严重膝骨关节炎的临床体会

目的作者报道了用全膝关节表面置换治疗老年性严重膝骨关节炎的临床体会。方法我院自１９９６年３月～１９９８年４月对１０例６０岁以上的严重膝骨关节炎的患者进行了全膝关节表面置换,均采用进口非限制性膝关节假体。结果经过６～３０个月随访,采用ＨＳＳ膝关节评分系统,术后所有患者在关节疼痛、功能及活动度均有明显改善,没有１例发生感染及深静脉栓塞。结论全膝关节表面置换对老年性严重膝骨关节炎治疗效果满意。     

Distribution of tenascin-X in different synovial samples and synovial membrane-like interface tissue from aseptic loosening of total hip replacement

 The distribution of tenascin-X (Tn-X) was investigated in synovial samples from rheumatoid arthritis (RA), osteoarthritis (OA) and knee injuries, and in synovial membrane-like interface tissue (SMLIT) from aseptic loosening of total hip replacement (THR). An affinity purified rabbit antiserum against Tn-X was applied in avidin-biotin-peroxidase complex method. Double immunofluorescence labeling was used to assess the spatial relationship of Tn-X and Tn-C. All samples showed Tn-X immunoreactivity. Strong staining appeared in the lining and lining-like layers of RA and SMLIT samples, respectively. An intensive immunoreactivity was also found in pannus tissue in RA, and around multinucleate giant cells and polyethylene wear debris in SMLIT. Staining intensity/extent varied significantly in different samples in the following rank order: SMLIT, RA, OA, knee synovium membrane. Double labeling revealed two patterns of Tn-X/Tn-C distribution, reciprocal and co-localization. Our results suggest that Tn-X is an essential component of normal synovial membrane, and that inflammatory mediators may increase local Tn-X production. Tn-X distribution is not always reciprocal to that of Tn-C. Received: 16 July 1999 / Accepted: 20 January 2000     

Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series

Summary. The standard treatment for end‐stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid‐term outcome in patients treated with total ankle replacement using an unconstrained three‐component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7–57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7–7.6). The outcome was measured with clinical and radiological evaluations. There were no intra‐ or peri‐operative complications. The AOFAS‐hindfoot‐score increased from 38 (range 8–57) preoperatively to 81 (range 69–95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4–9) preoperatively to 0.8 (range 0–3) postoperatively. All categories of SF‐36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.     

Clinical outcomes and patient satisfaction following total joint replacement in haemophilia – 23‐year experience in knees,hips and elbows

Summary. Joint replacement surgery is an available option for end‐stage haemophilic arthropathy. However, reports with long‐term follow‐up are limited. Moreover, patient satisfaction in this setting has never been measured. We share our institution’s experience with joint arthroplasty in haemophilic arthropathy and report on clinical outcomes and patient satisfaction. Between 1985 and 2007, 65 consecutive joints in 45 patients (mean age: 48.6; range: 22–83) underwent joint replacement surgery. Of these, 40 total knee replacements in 31 patients, 18 total hip replacements in 16 patients and 6 total elbow replacements in 3 patients were included. Average follow‐up was 10.7 years (2.4–24.3). Charts were reviewed retrospectively and patients were asked to return for clinical assessment and completion of questionnaires. According to the Knee Society clinical score, postoperative results were good to excellent in 83% of knees. According to the Harris Hip Score, results were good to excellent in 31% of hips. According to the Mayo Elbow Performance Score, results were good to excellent in 83% of elbows. Complication rates are higher than in the non‐haemophilic population, while prosthesis survival rates are lower. Patient satisfaction with pain relief is higher than satisfaction with functional improvement. For 88% of joints, patients are willing to have the same operation again. This study confirms previous knowledge on the role of total joint arthroplasty in haemophilic arthropathy. Despite high complication rates and modest functional outcomes, the operations are valuable for achieving pain relief. In general, patients find that risks are outweighed by the benefits.