血小板裂解液对人脐带间充质干细胞体外成骨分化的影响

背景：血小板裂解液是浓缩后血小板的裂解产物,含有多种活性成分。有研究表明这些活性成分可促进间充质干细胞的增殖和分化,但血小板裂解液作为一个整体,对间充质干细胞成骨分化的作用尚不明确。目的：分析血小板裂解液对人脐带间充质干细胞成骨诱导分化的干预效应。方法：采用胶原酶消化法分离人脐带间充质干细胞,体外培养扩增,流式细胞仪进行细胞表型鉴定。实验分为以下4组：普通矿化液组,血小板裂解液组,矿化液-血小板裂解液联合诱导组,对照组。加入相应诱导培养基诱导培养2周。结果与结论：分离得到的人脐带间充质干细胞的细胞表型CD34（-）﹑CD45（-）、HLA-DR（-）,CD44（＋）﹑CD105（＋）﹑CD146（＋）。茜素红染色在3个诱导组中皆为阳性,染色效果未见明显差异,而对照组阴性。碱性磷酸酶活性测定显示3个诱导组的碱性磷酸酶活性都明显高于对照组（P〈0.05）,矿化液-血小板裂解液联合诱导组碱性磷酸酶活性明显高于普通矿化液组和血小板裂解液组（P〈0.05）。结果显示在体外条件下,单纯的5%血小板裂解液可以诱导人脐带间充质干细胞向成骨细胞定向分化,且联合应用矿化液时能更有效地诱导人脐带间充质干细胞分化为成骨细胞。     

脉搏波传导速度评估高血压患者动脉僵硬度的临床价值及危险因素

高血压是引发心脑血管疾病的重要病理基础和独立危险因子。准确评估动脉弹性功能,早期干预亚临床期病变,预防心脑血管突发性事件的发生,是当前研究和关注的焦点[1]。本文采用压力波描记法测定高血压患者脉搏波传导速度（PwV）,旨在探讨PwV评估高血压患者动脉僵硬度的临床价值及危险因素。     

携带人骨形态发生蛋白2可诱导慢病毒载体转染人脐带间充质干细胞的成骨

目的：观察携带骨形态发生蛋白2的tet-on慢病毒载体对人脐带间充质干细胞转染表达及稳定转染后成骨的影响。方法：取第3代人脐带间充质干细胞分组培养：实验组稳定转染携带骨形态发生蛋白2的tet-on慢病毒载体,并加入10mg/L强力霉素;未加强力霉素组：同实验组但不加强力霉素;空病毒组转染携带绿色荧光蛋白的慢病毒载体;空白对照组未进行任何处理。结果与结论：①骨形态发生蛋白2表达：实验组、未加强力霉素组均有表达,且实验组表达量高于未加强力霉素组（P〈0.05）;空病毒组、空白对照组未见表达。②碱性磷酸酶染色：实验组可见细胞胞浆中出现大量红色或红棕色颗粒,未加强力霉素组可见少量红色颗粒,实验组碱性磷酸酶活性高于未加强力霉素组（P〈0.05）;空病毒组、空白对照组未见明显红色颗粒。③茜素红染色：实验组、未加强力霉素组均可见钙结节形成,实验组较未加强力霉素组矿化结节数量多,面积更大;空病毒组、空白对照组未见明显矿化结节形成。表明携带骨形态发生蛋白2的慢病毒载体可稳定转染人脐带间充质干细胞,显著增强其成骨能力。     

影响脐血间充质干细胞分离培养的关键环节

背景：脐血中存在间充质干细胞,目前国内外尚未见到对脐血间充质干细胞体外分离、培养及扩增较统一且有效的方法。目的：探讨影响人脐血间充质干细胞成功分离培养的相关因素。方法：分别从不同胎龄（≥40 周,37 周和≤32 周）,脐血中单个核细胞数量（≥2.5×109L-1,〈2.5×109 L-1）, 不同细胞接种浓度（1×107,1×109,1×1011 L-1）,不同体积分数胎牛血清（5%,10%,15%,20%）以及培养瓶是否被胎牛血清包被等方面对人脐血间充质干细胞分离培养成功率进行比较。结果与结论：脐血间充质干细胞的分离培养成功率为 58.3%,且随胎龄的增高而培养成功率降低（P〈0.01）;脐血中单个核细胞浓度≥2.5×109 L-1组培养成功率高于〈2.5×109 L-1组（P〈0.01）;相同容量脐血中单个核细胞数量与胎龄呈负相关（r=-0.95,P〈0.01）;1×1011 L-1 组原代及传代培养的间充质干细胞生长及扩增情况高于 1×107,1×109 L-1;体积分数 5%FBS 组间充质干细胞贴壁速度较其他 3 组略慢,但细胞纯度较高,且细胞传代速度与其他 3 组无明显差别;胎牛血清包被组脐血间充质干细胞原代和传代后的纯度及扩增能力均高于未包被组。提示脐血间充质干细胞分离培养成功率受多种因素的影响：通过选择较低胎龄的胎儿,采集足够量的脐血,以较高的细胞密度接种,培养基中添加较低浓度的胎牛血清,并将培养瓶预先用胎牛血清进行包被,能在体外建立稳定的脐血间充质干细胞培养体系。     

自体与γ射线照射和非照射异体骨-髌腱-骨重建前十字韧带的比较研究

目的 比较自体与γ射线照射和非照射异体骨-髌腱-骨(bone patellar tendon bone,B-PT-B)重建膝关节前十字韧带(anterior cruciate ligament,ACL)的临床疗效.方法 107例ACL断裂患者随机分为三组:36例采用自体B-PT-B(自体组),36例采用深低温冷冻保存异体B-PT-B(异体组),35例采用γ射线照射深低温冷冻保存异体B-PT-B(γ射线组).由同一术者采用标准关节镜技术完成ACL重建.结果 自体组(36例)平均随访39.5个月、异体组(34例)36.3个月、γ射线组(33例)37.6个月.(1)自体组术中髌骨骨折1例、术后膝前痛2例,异体组出现迟发感染1例.自体组手术时间较异体组、γ射线组长,术后发热天数较异体组、γ射线组短.(2)自体组、异体组轴移试验、Lachman试验或前抽屉试验及KT-2000检测结果 的差异无统计学意义,与γ射线组比较差异均有统计学意义.γ射线组ACL重建失败率(36%)高于自体组(8%)、异体组(9%).三组Daniel单腿水平跳跃试验、IKDC评分及Lysholm-Tegner运动水平评分的差异无统计学意义.结论 深低温冷冻异体与自体B-PT-B重建ACL短期疗效接近.经γ射线照射后异体B-PT-B重建ACL的膝关节前后及旋转稳定性均降低.     

膝关节单室置换的近期疗效

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.     

青岛市民与住青韩国人脂肪肝人群流行病学特点及高危因素

目的:研究青岛市民与住青韩国人脂肪肝(fatty liver,FL)人群流行病学特点及高危因素.方法:运用流行病学调查方法调查青岛市民FL患者1031例(青岛组),住青韩国人FL患者1543例(韩国组),填写相关内容,包括个人一般资料、腹部彩超检查及生化指标,应用SPSS11.0软件进行t检验、χ2检验及回归分析.结果:青岛市FL患病率35.49%,住青韩国人FL患病率16.68%.两组比较差别具有显著性(χ2=507.91,P＜0.01);青岛组FL患者体质量指数(BMI)大于韩国组,两组比较差别具有显著性(t=13.10,P＜0.01);青岛组FL患者空腹血糖(GLU)、胆固醇(TC)高于韩国组,二者具有统计学意义(t=2.31,t=3.51,P＜0.05);男性FL患者超重、肥胖及高空腹血糖青岛组高于韩国组,有统计学意义(χ2=35.68,)χ2=61.49,χ2=3.88,P＜0.05);女性FL患者超重、肥胖及高甘油三酯(TG)青岛组高于韩国组,有统计学意义(χ2=29.70、χ2=12.35、χ2=9.88,P＜0.05);多因素Logistic回归分析,两组FL患者均与肥胖、高甘油三酯(TG)密切正相关,与年龄、超重、高胆固醇(TC)和空腹高GLU呈正相关.结论:青岛市民FL患病率远高于住青韩国人,两组FL与肥胖、高TG密切正相关,与年龄、超重、高TC和空腹高GLU呈正相关.     

尿酸与脂肪肝的关系探讨

[目的]研究高尿酸血症与脂肪肝的危险因素及二者的相关性. [方法]运用流行病学调查方法调查987例脂肪肝患者的一般资料、尿酸等生化指标. [结果]① 987例脂肪肝患者高尿酸血症392例,男女尿酸水平比较差异有统计学意义(t'=16.00,P<0.01),男性组41～50岁达峰值(31.19%);女性组51～60岁达峰值(21.68%);X2检验差别具有统计学意义(X2=90.14,X2=129131,P<0.01).②多因素Logistic回归分析,饮酒、超重、高甘油三酯患者高尿酸血症相对危险度明显增高;饮酒、肥胖、高甘油三酯、高尿酸患者脂肪肝相对危险度明显增高.[结论]高尿酸血症及脂肪肝患者中青年多见,高尿酸血症与饮酒、超重、高甘油三酯呈正相关,脂肪肝与高尿酸血症、肥胖、高甘油三酯密切正相关.     

膝关节单室置换的近期疗效

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.     

膝关节单室置换的近期疗效

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.