部分脱抗原同种异体牙本质在颌骨囊肿术后的临床应用

目的：经脱抗原处理的同种异体牙本质(HPDD)用于颌骨囊肿术后遗留的死腔，替代自体骨移植。方法：将口腔外科门诊拔除牙齿磨除牙釉质、牙骨质，经脱抗原处理对32例颌骨囊肿术后腔内植入HPDD。结果：其中30例患者伤口一期愈合，X片示领骨密度正常，未见免疫排斥反应。结论：HPDD免疫原性弱，成骨作用好，植入颌骨囊肿术后遗留的死腔，可替代自体骨移植。     

脱抗原同种异体牙本质粘骨膜下植入治疗萎缩性鼻炎

目的 经脱抗原处理的牙本质(HPDD)植入治疗萎缩性鼻炎替代自体骨移植。方法 将口腔门诊拔除的牙齿磨除牙质、牙骨质,经脱抗原处理,对31例萎缩性鼻炎采用粘骨膜下植入。结果 术后3年随访,痊愈22例(70.97％),有效7例(22.58％),无效2例(6.45％),总有效率93.55％,有15例术前病理检查:发现上皮大部鳞状化生,纤毛、腺体萎缩;术后三年再次病理检查:粘膜有假复层柱状上皮,纤毛不完全生长,腺体数量增加。结论HPDD免疫原性弱,成骨作用好,无排斥反应,用于萎缩性鼻炎粘骨膜下植入,可替代自体骨和其它植入材料。     

脱抗原同种异体牙本质粘骨膜下植人治疗萎缩性鼻炎

目的 经脱抗原处理的牙本质(HPDD)植入治疗萎缩性鼻炎替代自体骨移植。方法 将口腔门诊拔除的牙齿磨除牙质、牙骨质，经脱抗原处理，对31例萎缩性鼻炎采用粘骨膜下植入。结果 术后3年随访，痊愈22例(70．97％)，有效7例(22．58％)，无效2例(6．45％)，总有效率93．55％，有15例术前病理检查：发现上皮大部鳞状化生，纤毛、腺体萎缩；术后三年再次病理检查：粘膜有假复层柱状上皮，纤毛不完全生长，腺体数量增加。结论 HPDD免疫原性弱，成骨作用好，无排斥反应，用于萎缩性鼻炎粘骨膜下植入，可替代自体骨和其它植入材料。     

LeFort Ⅲ型截骨后部分脱抗原同种异体牙本质移植治疗上颌后缩畸形

目的：经脱抗原处理的同种异体牙本质(HPDD)用于正颌外科，替代自体骨移植。方法：将口腔外科门诊拔除的牙齿磨除牙釉质、牙骨质，经脱抗原处理，对11例上颌后缩畸形采用LeFort Ⅲ型截骨，上颌骨前移，骨间隙植入HPDD。结果：11例病人伤口一期愈合，上颌骨前移，咬合恢复。结论：HPDD免疫原性弱，成骨作用好，用于正颌外科支撑作用强，可替代自体骨移植。     

部分脱抗原牙本质下颌骨移植的实验研究

目的：脱抗原异体牙本质（PDD）植入颌骨缺损部,观察成骨情况。方法：将口腔科门诊拔除的牙齿,磨除牙釉质,保留牙本质,经脱抗原处理。将口只新西兰大耳白兔两则下 骨部分截骨,造成骨损,左侧植入PDD,右侧不植骨作同体对照。术后2－5月切除下颌骨,分别作x线和组织学检查,结果：组织学检查,2－5月分别出现纤维母细胞、骨细胞、骨样基质、骨小梁和成熟的骨组织。x线显示术后5月PDD被新骨替代。伤口愈替代,伤口愈合好,没有出现免疫排斥反应。结论：PDD免疫原性弱,成骨作用好,用于下 骨缺损移植,,可替代自体骨移植。     

同种异体脱钙骨基质研究现状

同种异体骨为替代自体骨移植的首选材料。经脱脂、脱水、脱钙、冻干等处理制备的脱钙骨基质,具有较低的免疫源性,又保留骨形态发生蛋白等一些骨生长因子而具有骨诱导活性,已广泛运用于骨科临床。本文对同种异体脱钙骨基质的成骨能力,及其构成复合材料、组织工程材料的研究方面进行综述。     

同种异体骨移植治疗骨缺损的临床应用

目的：应用同种异体骨移植治疗骨缺损，并评价疗效。方法：新鲜同种异体骨在-80℃保存3w，经过超声清洗脱脂等一系列破坏细胞并降解抗原性的处理，再经辐射灭菌、复温后，将同种异体骨植入缺损区。植入长度大于缺损医长度，外固定架加压固定，术后抗感染。结果：术后3个月植骨与骨交界处有骨小梁通过，6个月骨折线模糊，1～1.5年植骨骨化。结论：同种异体骨移植治疗骨缺损，植入1～1．5年后，异体骨骨化，疗效显著，是治疗骨缺损的良好方法。     

同种异体酒精骨库的建立及临床应用

骨库存骨目前国内外普遍采用冻干骨、深低温冷冻骨、重组合异种骨、辐射灭菌骨、脱钙骨等。这几种方法存骨具有抗原性低 ,骨愈合快 ,保留了肌诱导能力 ,但这些存骨方法要求特殊的设备和技术 ,操作复杂 ,价格昂贵 ,在我国只有条件好的大医院方能开展 ,基层卫生组织及中小医院无此条件。我们从 1 994年开始建立同种异体酒精骨库 ,经 5ａ共 2 6例临床应用 ,取得满意效果。1　供体的选择及酒精骨库的建立　先用无传染病、无恶性肿瘤、无内分泌疾病、无代谢性疾病、无与毒物与放射性长期接触史的 4～ 8ｈ以内的新鲜尸骨、外伤性截肢骨、手术切除…     

颈椎前路椎间盘摘除植骨融合术中应用新型脱细胞同种异体骨的临床效

目的 分析在实施颈椎前路椎间盘摘除植骨融合术过程中使用新型脱细胞同种异体骨的治疗效果.方法 收集需实施颈椎前路椎间盘摘除植骨融合术的40例患者,将其分为对照组和观察组.分别实施自体骨移植以及新型脱细胞同种异体骨移植.结果 两组患者均可取得较好效果,但相比对照组,观察组在治疗效果以及治疗安全性上均更高,所有差异均有统计学意义(P＜0.05).结论 在实施颈椎前路椎间盘摘除植骨融合术治疗时,相比常规自体骨移植新型脱细胞同种异体骨可取得更加安全可靠的临床疗效,有很高应用价值.     

脱钙牙本质诱导骨生成的实验研究与临床应用

骨缺损的修复,近年来用异体脱钙骨移植法已有报道,用异体脱钙牙本质移植修复牙槽骨缺损,国内尚未报道。为证实其临床应用价值与探讨其生物学机制,我们用脱钙牙本质颗粒(简称HDDP)移植进行了动物实验研究,并对牙周病植入进行了临床观察,取得显著效果,现总结如下。 材料与方法 一、移植物的制备:将年轻健康人的无功能牙或阻生齿拔除后,去除牙髓和釉质,粉碎成小块用70％酒精脱脂,用0.5N盐酸脱钙,每24小时更换一次液体,脱钙后将其切成直径约0.7毫米的小颗粒,用70％酒精洗去残酸后,置入70％酒精瓶内放于4℃冰箱备用,植入前用生理盐水浸泡半小时以去除酒精。     

化学-机械祛腐法与传统车针祛腐法在乳牙活髓保存治疗中的效果分析

目的探讨化学-机械祛腐法与传统车针祛腐法对深龋近髓乳磨牙治疗结果的差异。方法选取2007年6月—2009年6月就诊患儿的638颗深龋近髓乳磨牙,分为化学-机械祛腐法和传统车针祛腐法两组,去除腐质后,护髓剂Ca(OH)2间接盖髓,含氟玻璃离子水门汀一次性填充,术后1个月～1年内门诊随诊。结果化学-机械祛腐法去龋活髓保存成功率95.3%;传统车针祛腐法去龋活髓保存成功率89.1%,二者有显著性差异(χ2=8.28,P<0.01)。结论化学-机械祛腐法在深龋近髓乳磨牙的治疗中可以更大程度地保存活髓,从而减少对后继恒牙发育的影响。     

三种不同剂型氢氧化钙间接盖髓临床疗效评价

目的　观察氢氧化钙、碘仿氢氧化钙、光固化氢氧化钙三种盖髓剂间接盖髓时临床疗效的差异。方法　选择 14 0个深龋患牙随机选用三种不同剂型氢氧化钙 (分为A ,B ,C三组 )盖髓 ,术后 3个月 ,6个月 ,1年后分别观察并记录。结果　A组成功率 63 .8%,B组成功率 75 .6%,C组成功率 85 .4%。A ,B ,C组三组之间均有显著性差异 (P <0 0 1)。结论　光固化氢氧化钙可作为间接盖髓的首选材料     

In vitro antibacterial activity and durability of a nano-curcumin-containing pulp capping agent combined with antimicrobial photodynamic therapy

BackgroundConsidering the antibacterial properties of nano-curcumin (nCur) reinforced with antimicrobial photodynamic therapy (aPDT), this study aimed to assess the antibacterial activity and durability of Activa BioActive Base/Liner (ABBL) containing nCur (nCur-ABBL) as a pulp capping agent against Streptococcus mutans, the most common cause of secondary caries.Materials and methodsIn this in vitro experimental study, ABBL discs containing 0.5 %, 1%, 2%, and 5% (w/w) concentrations of nCur were fabricated. After aPDT using light emitting diode (LED) at 435 ± 20 nm wavelength for 5 min, the discs were undergone aging in artificial saliva for 90 days. The antibacterial activity of the discs against S. mutans was evaluated by the disc agar diffusion test, and the number of bacterial colonies present in the biofilm formed on the disc surfaces was counted after 0, 15, 30, and 60 days of aging.ResultsThe maximum growth inhibition zone was noted around the 5% nCur-ABBL discs. Increasing the concentration of nCur from 0.5 % to 5% combined with aPDT significantly decreased the number of S. mutans colonies in the biofilm over time (P < 0.05). nCur-ABBL discs containing 2% and 5% nCur had no difference in antibacterial activity at any time point up to 60 days (P > 0.05).ConclusionAccording to our data, 5% nCur-ABBL revealed the largest growth inhibition zone in S. mutans culture. Moreover, 5% nCur can serve as an excellent ABBL additive in aPDT producer against S. mutans biofilms up to 60 days of aging period.     

~(99)Tc~m标记双膦酸盐骨显像剂的研究进展

双膦酸盐是一类具有很强亲骨性的药物,99Tcm标记的双膦酸盐如~(99)Tc~m-亚甲基二膦酸盐(~(99)Tc~m-MDP)等被广泛应用于骨显像.近些年来,为了克服~(99)Tc~m-MDP的缺点,许多新型的双膦酸配体被设计与合成,以期望获得性能更加优异的骨显像剂.该文对近10年来发展的99Tcm标记双膦酸盐类骨显像剂的结构与性能进行了综述.     

烧伤生肤剂与湿润烧伤膏对镇痛及抗炎因子影响分析

目的：探讨烧伤生肤剂与美宝湿润烧伤软膏对烧伤患者的镇痛和消炎作用。方法采用随机数字表法将我院烧伤整形外科2012年8月～2014年4月收治的96例中度烧伤患者分为研究组和对照组各48例,研究组患者采用常规治疗结合烧伤生肤剂进行治疗,对照组采用美宝湿润烧伤软膏进行治疗。比较两组患者用药前、用药后第3、7天的疼痛、细胞炎性因子变化及疗效情况。结果研究组和对照组的视觉模拟评分（VAS）及C反应蛋白（CRP）、降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）、白细胞介素-6（IL-6）在治疗前比较差异均不显著（P＞0.05）;治疗后第3天的CRP、PCT、TNF-α、IL-10、IL-6值均低于对照组但差异均不显著（P＜0.05）;研究组第3天的VAS及第7天的VAS、CRP、PCT、TNF-α、IL-10、IL-6水平均显著低于对照组（ P＜0.05）。结论烧伤生肤剂对于缓解烧伤患者的疼痛、烧伤后炎症反应较美宝湿润烧伤软膏具有较好的临床效果。     

人甲状旁腺素1-34及其聚乙二醇修饰物对鸡血钙含量的影响

目的：通过观察人甲状旁腺素(hPTH1-34)及其聚乙二醇修饰物对鸡血钙含量的影响判断它们的体内活性。方法：12日龄的小鸡分别翼静脉注射赋形剂，hPTH1-34，Cys(mPEG5000-MAL)-hPTH1-34和hPTH1-34-Cys(mPEG5000-MAL)-NH2。60min和120min后翼静脉采血，分离血清并测定钙含量。结果：给药后60min，hPTHI1-34，Cys(mPEG5000-MAL)hPTH1-34和hPTH1-34-Cys(mPEG5000-MAL)-NH2组静脉血清钙含量均明显升高；120min后，Cys(mPEG5000-MAL)-hPTH1-34组血清钙含量仍维持升高水平，而hPTH1-34和hPTH1-34-Cys(mPEG5000-MAL)-NH2组血清钙含量则明显回落。结论：合成人甲状旁腺素(hPTH1-34)及其聚乙二醇修饰物可以明显升高小鸡的血清钙水平；N端聚乙二醇修饰的hPTH1-34维持血钙升高的时间较长。     

New radiosynthesis of 2-deoxy-2-[(18)F]fluoroacetamido-D-glucopyranose and its evaluation as a bacterial infections imaging agent

Introduction

The diagnosis of infection and the ability to distinguish bacterial infection from nonbacterial inflammation by positron emission tomography (PET) have gained interest in recent years, but still few specific radiopharmaceuticals are available for use. In this study, we developed a new radiosynthesis method of 2-deoxy-2-[¹⁸F]fluoroacetamido-d-glucopyranose ([¹⁸F]FAG) by applying microwave irradiation and demonstrated that [¹⁸F]FAG could be a potential radiopharmaceutical to distinguish bacterial infection from nonbacterial inflammation.

Methods

1,3,4,6-Tetra-O-acetyl-2-deoxy-2-bromoacetamido-d-glucopyranose was used as precursor, and labeling was performed under microwave irradiation conditions followed by alkaline hydrolysis and high-performance liquid chromatography (HPLC) purification. In vitro uptake of [¹⁸F]FAG by Escherichia coli was performed. Tissue biodistribution of [¹⁸F]FAG was performed in mice. Moreover, PET imaging acquisition of E. coli infection and nonbacterial inflammation models was performed in rats. Tissue radiotracer-accumulated sites were analyzed by hematoxylin and eosin staining and anti–E.coli immunostaining.

Results

The radiosynthesis of [¹⁸F]FAG was achieved with microwave irradiation, and the radiochemical yield was 9.7%±2.8% end of bombardment (EOB); the radiochemical purity was more than 98%, and the total synthesis time was 62 min. Compared with control group, in vitro uptake of [¹⁸F]FAG by E. coli was significantly decrease in inhibition group (P<.05). Biodistribution studies in mice showed rapid clearance of [¹⁸F]FAG from the animal body. [¹⁸F]FAG clearly visualized the infection areas but not nonbacterial inflammation areas in PET studies. Quantitative analysis revealed that the uptake of [¹⁸F]FAG into infection areas was significantly higher than that of [¹⁸F]FAG into inflammation areas (P<.05). Histological analysis demonstrated the presence of bacterial cells at the sites of accumulation of [¹⁸F]FAG.

Conclusions

Using 1,3,4,6-tetra-O-acetyl-2-deoxy-2-bromoacetamido-d-glucopyranose as a precursor, the new radiosynthesis method of [¹⁸F]FAG was achieved in fewer steps and with a shorter synthesis time than previously reported. Furthermore, [¹⁸F]FAG was able to distinguish bacterial infection from nonbacterial inflammation.     

颅脑损伤术后早期深低温保存自体颅骨修补颅骨缺损对患者神经功能及并发症的影响

目的分析颅脑损伤开颅去骨瓣减压术后接受深低温保存自体颅骨修补时机对患者神经功能恢复及并发症的影响。方法前瞻性对照研究2015年3月—2017年3月青岛大学附属医院因颅脑损伤接受开颅手术去骨瓣减压并-196℃深低温保存自体颅骨骨瓣患者216例,男性137例,女性79例;年龄18~60岁,平均44.4岁。依据开颅手术后颅骨修补时间间隔分为早期组(67例)和晚期组(149例)。早期组男性45例,女性22例;年龄18~59岁,平均43.3岁。晚期组男性92例,女性57例;年龄19~60岁,平均45.0岁。早期组为去骨瓣术后12周内接受深低温保存自体颅骨修补术;晚期组为去骨瓣术12周后接受深低温保存自体颅骨修补术。比较两组患者颅骨修补术后12个月颅骨修补感染、骨瓣吸收等相关并发症及神经功能恢复的差异。结果早期组和晚期组患者共发生感染8例,感染率为3.7%。手术区域及颅内感染发生分别为早期组2例、晚期组6例,两组比较差异无统计学意义(P=0.525)。晚期组术后皮下积液发生例数多于早期组,但差异无统计意义(17例vs.3例,P=0.008);早期组骨瓣不愈合/吸收发生例数少于晚期组(7例vs.41例,P=0.003)。术后12个月早期组Barthel指数(BI)高于晚期组(79.85±7.43)分vs.(70.18±8.16)分,t=2.623,P=0.004。术后12个月早期组GOS评分高于晚期组(3.98±0.94)分vs.(3.22±0.87)分,t=1.834,P=0.041。结论早期深低温保存自体颅骨修补术可以改善颅脑损伤开颅去骨瓣术后患者神经功能恢复,降低颅骨修补并发症的发生率。     

Visualization of deep veins and detection of deep vein thrombosis (DVT) with balanced turbo field echo (b‐TFE) and contrast‐enhanced T1 fast field echo (CE‐FFE) using a blood pool agent (BPA)

Purpose:

To assess image quality, vessel visualization, preliminary diagnostic properties, and interobserver variability of a novel balanced turbo field echo (b‐TFE) sequence and contrast‐enhanced T1 fast field echo (CE‐FFE) sequence with blood pool agent (BPA).

Materials and Methods:

A total of 15 healthy volunteers and six patients with ultrasound‐verified proximal deep vein thrombosis (DVT) were examined from the inferior vena cava (IVC) to the proximal calf veins.

Results:

The great majority of deep veins were completely visualized on both sequences. In healthy volunteers the IVC was completely visualized in five b‐TFE and 11 CE‐FFE scans, and partially in seven b‐TFE and four CE‐FFE scans (P = 0.008). Poorest image quality was in the pelvis. Contrast‐to‐noise ratio (CNR) was higher on b‐TFE compared to CE‐FFE, with significant difference in calf images (P = 0.036). Sensitivity was 100% for proximal DVT with both methods. Specificity was 70% (CE‐FFE) and 80% (b‐TFE) for proximal femoral DVT; 100% in distal femoral. Interobserver reliability was kappa 1.0 (b‐TFE), 0.9 (CE‐FFE) for proximal, and overall poor for distal DVT.

Conclusion:

Contrast‐enhancement did not add valuable information in visualizing deep veins of the lower limbs compared to b‐TFE, though the IVC was slightly better visualized. Diagnostic properties and interobserver reliability of both sequences were good for proximal DVT and poor for distal DVT. J. Magn. Reson. Imaging 2010; 31: 416–424. © 2010 Wiley‐Liss, Inc.