钛表面梯度生物活性涂层材料在颅骨修补中的生物性能

BACKGROUND: Titanium mesh has good clinical effect in repairing skull defects, but due to the lack of bone induction ability, the titanium mesh has a poor integration with the bone tissue. OBJECTIVE: To observe the biological properties of the gradient bioactive coating materials on the titanium surface in the skull repair. METHODS: Osteoblasts were co-cultured with the titanium mesh with or without gradient bioactive coatings for 14 days, and then cell proliferation was detected using MTT method. Seventy-one patients with skull defects were enrolled, including 43 males and 28 females, aged 15-60 years, and were subjected to skull repair using the titanium mesh with (observation group, n=3) or without (control group, n=38) gradient bioactive coatings. During the postoperative follow-up of 12 months, the repairing effects and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION: (1) In vitro cell culture: the cell proliferative ability was increased significantly in the observation group as compared with the control group at 8, 10, 12 and 14 days after cell culture. (2) In vivo repair: the hospital stay and wound healing time in the observation group were significantly lower than those in the control group (P < 0.05), and at the final follow-up, the postoperative recovery effect was significantly higher in the observation group than the control group (P < 0.05). The titanium meshes were fixed firmly in the two groups, with no floating, infection and exposure. These results show that the titanium mesh with gradient bioactive coating has good biocompatibility and osteoinduction capacity.      

颞叶内侧癫痫的手术治疗

目的 分析总结颞叶内侧癫痫的临床特点,探讨前颞叶内侧切除术的手术方法,并对手术效果进行评价.方法 回顾性分析2003年4月至2007年6月诊断为颞叶内侧癫痫行前颞叶内侧切除术21例患者的临床资料.手术方式:标准前颡叶内侧切除术,部分加做皮层热灼术.结果 21例患者中,术后早期3例出现一过性失语,2例出现短暂的肢体力弱,1例复视,均在术后1～2周恢复正常.1例术后出现永久性轻偏瘫.术后病理检查发现,18例颞叶内侧硬化,其中1例伴灰质异位;1例伴右颞叶隐匿性脑动静脉畸形(AVM);3例无异常发现.随访4个月至4年,所有患者术后服用抗癫痫药物较术前减少或停药.Engel I级11例(52.4%),EngelⅡ级6例(28.6%),EngelⅢ级2例(9.5%),EngelⅣ级2例(9.5%),手术总有效率为90.5%,优良率为81.0%.结论 颞叶内侧癫痫行前颞叶内侧切除术效果良好.