胶原-生物衍生骨材料与兔成骨细胞的相容性及其体外附着特点

目的:观察胶原-生物衍生骨复合材料与兔成骨细胞的相容性及体外附着规律,为进一步的体内实验提供参考数据。方法:实验于2003-10/2005-02在华西医科大学组织工程实验室进行。①材料制备:新鲜捐献骨(人),经脱脂、脱蛋白等工艺制成单纯生物衍生骨材料,以Ⅰ型胶原通过真空吸附法修饰单纯生物衍生骨材料表面,构建出胶原生物衍生骨材料。②实验方法:将体外培养的兔骨膜成骨细胞分别复合于单纯生物衍生骨材料和胶原生物衍生骨材料,共同培养7d。③观察指标:分别于培养第1,3,5和7天取材,扫描电镜观察成骨细胞形态及附着情况;用紫外/荧光/可见光高效分析仪测定成骨细胞产生的碱性磷酸酶活性;MTT检测成骨细胞增殖情况;用流式细胞仪检测兔成骨细胞的细胞周期、DNA含量及倍体水平。结果:①扫描电镜结果:胶原生物衍生骨材料组成骨细胞黏附和增殖优于生物衍生骨材料组。②碱性磷酸酶活性:生物衍生骨材料组低于胶原生物衍生骨材料组(0.019±0.003,0.038±0.004,P<0.05)。③细胞增殖情况:在培养第1,3,5,7天胶原生物衍生骨材料组成骨细胞A值均高于生物衍生骨材料组(P<0.05)。④流式细胞检测生物衍生骨材料、胶原生物衍生骨材料对兔成骨细胞的细胞周期影响不大,各组细胞皆为正常的二倍体细胞,未见异倍体细胞形成,胶原修饰后无细胞毒性。结论:以单纯生物衍生骨作为载体,其表面经胶原修饰后的复合材料与成骨细胞有良好的细胞相容性,无细胞毒性。     

Further characterization of platelet-type von Willebrand's disease in Japan

We studied four patients who showed aggregation of platelets in platelet-rich plasma at lower concentrations of ristocetin than those required for normal platelet-rich plasma and who demonstrated an increased capacity of the platelets to bind normal von Willebrand factor. The four patients were from two Japanese families. Platelets from one family aggregated spontaneously in vitro, and platelets from both families aggregated upon the addition of normal plasma and cryoprecipitate, in the absence of ristocetin or other agonists. Analysis of the multimeric composition of von Willebrand factor by sodium dodecyl sulfate-agarose gel electrophoresis revealed a decrease in large multimers or a decrease in both large and intermediate multimers in plasma, but normal multimers in platelets. 1-Deamino-[8-D- arginine]-vasopressin caused by an immediate appearance of larger multimers in plasma, followed by the rapid disappearance of these multimers from circulating plasma. Analysis of platelet membrane glycoproteins from the patients showed that there were two distinct bands in the glycoprotein I region; one migrated in a slower region and the other in a faster region than normal glycoprotein Ib. We suggest that the platelet receptor abnormality in these patients is related to this abnormality of glycoprotein Ib.     

Real-time analysis of shear-dependent thrombus formation and its blockade by inhibitors of von Willebrand factor binding to platelets

Two likely mechanisms for the initiation of arterial platelet thrombus formation under conditions of elevated fluid shear stresses are: (1) excessive adhesion and aggregation of platelets from rapidly flowing blood onto the exposed sub-endothelium of injured, atherosclerotic arteries; or (2) direct, fluid shear stress-induced aggregation of platelets in constricted arteries with intact endothelial cells. Mechanism (1) was simulated using a parallel plate flow chamber, fibrillar collagen type I-coated slides, and mepacrine-labeled (fluorescent) platelets in whole blood anticoagulated with citrate, hirudin, unfractionated porcine heparin, or low molecular weight heparin flowing for 1 to 2 minutes at wall shear rates of 100 to 3,000 seconds-1 (4 to 120 dynes/cm2). The precise sequence of interactions among von Willebrand factor (vWF), glycoprotein (GP)Ib, and GPIIb-IIIa during platelet adhesion and subsequent aggregation were resolved by direct real-time observation using a computerized epifluorescence video microscopy system. Adhesion at high shear rates was the result of the adsorption of large vWF multimers onto collagen and the binding of platelet GPIb to the insolubilized vWF. Aggregation occurred subsequently and required the binding of ligands, including vWF via its RGD binding domain, to GPIIb-IIIa. Mechanism (2) was modeled by producing shear stresses of 90 to 180 dynes/cm2 in a rotational cone and plate viscometer, which aggregates platelets from platelet-rich- plasma (PRP) anti-coagulated with citrate, hirudin, or either type of heparin in reactions that require large vWF multimers, Ca2+, adenosine diphosphate, and both GPIb and GPIIb-IIIa. Both vWF-mediated shear- aggregation in PRP and platelet-collagen adhesion in flowing whole blood (anticoagulated with citrate and hirudin) are inhibited by two potentially useful anti-arterial thrombotic agents: polymeric aurin tricarboxylic acid (ATA; 28.5 to 114 micrograms/mL), which binds to vWF and inhibits its attachment of GPIb, and a recombinant vWF fragment (rvWF445-733; 30 to 200 micrograms/mL) that binds to platelet GPIb (in the absence of any modulator) and blocks attachment of vWF multimers. Unfractionated heparin, but not low molecular weight heparin, apparently binds to rvWF445-733 and counteracts the inhibitory effects of the vWF fragment in vitro on shear-aggregation and platelet-collagen adhesion.     

Assessment of anxiety and depression after lower limb amputation in Jordanian patients

OBJECTIVE: This study aimed to assess the prevalence of anxiety and depression among Jordanian lower limb amputees with different clinical characteristics and sociodemographic data (gender, marital status, social support, income, type and level of amputation, and occupation). METHODS: Participants were 56 patients with unilateral lower limb amputation with mean duration (8.4 +/- 5.75 years). They were recruited from inpatient and outpatient clinics of Jordan University hospital, Royal Farah Rehabilitation Center, and Al-basheer hospital in Amman, Jordan. Participants responded to a questionnaire that included a battery of questions requesting brief information about sociodemographic variables and characteristics of amputation. The level of depression and anxiety in each participating patient was assessed by the Hospital Anxiety and Depression Scale (HADS). RESULTS: The prevalence of anxiety and depressive symptoms were 37% and 20%, respectively. Factors associated with high prevalence of psychological symptoms included female gender, lack of social support, unemployment, traumatic amputation, shorter time since amputation, and amputation below the knee. These findings were confirmed by a significant reduction of anxiety and depression scores in patients who received social support, patients with amputation due to disease, and patients with amputation above the knee. Presence of pain and use of prosthesis had no effect on the prevalence. CONCLUSIONS: The findings of the present study highlight the high incidence of psychiatric disability and depression in amputees; it also showed the importance of sociodemographic factors in psychological adjustment to amputation. It is suggested that psychiatric evaluation and adequate rehabilitation should form a part of their overall management.     

青春发育突增期肥胖型和偏瘦型学生体质形态学特征成因回归分析

目的:了解广西大学生营养和健康状况的影响因素及其分布规律,探索青春发育突增期肥胖型和偏瘦型学生体质形态学特征的成因、发生规律。方法:⑴调查对象:为保证样本(调查对象)的同质性、科学性和代表性,于2005-11/2006-05通过完全随机抽取8所大学8529名学生体质测试指标,在此基础上对指标进行筛选抽取,纳入标准:①调查对象父母的籍贯必须是广西壮族自治区。②身体健康,测试时无急性疾病。③经医院检查均无心脏、肺脏疾病史,血压正常,无传染病。④获全面知情同意。⑤监测样本含量不低于100人。⑥体质量指数≤18.5kg/m2或体质量指数≥28kg/m2。排除标准:身体发育异常、残缺或畸形。符合纳入标准143人。⑵调查方法:①文献资料法:依据研究目的和内容,查阅国内、国外有关资料30余篇,并对其进行有效的检索、分析。②调查法:调查问卷的设计严格按照社会学研究规律,对所设问题通过筛选并进行信度和效度检验,采用较为科学的调查方案在广西8所大学随机抽样。最后将回收的调查问卷中存在的特殊问题又进行专题访谈。⑶对具有研究价值的143名学生的体质测试数据通过逐级加权处理,得出的各指标具有全国代表性。原始数据由MicrosoftExcel储存,并建立数据库。由第一作者采用SPSS11.5forwindows软件包进行统计学处理。结果:①对体质量指数≤18.5kg/m2或体质量指数≥28kg/m2体质形态学特征体质量比的预测公式为:yz=-21.12 1.6599x1-0.2623x2,y=-21.12 1.6599x1-0.2623x2 δ。其中学生体质量比受父亲的体质量比影响最大,其次是影响参数δ。②对体质量指数≤18.5kg/m2或体质量指数≥28kg/m2男女学生体质形态的体格营养指数体质量与y与父亲的体质量具有高度相关r1y=0.84,与母亲的体质量比呈中度相关r2y=0.50。③预测线性回归方程的平方和Q=103.26,占总平方和8.11%,回归平方和U=1170.15,已占总平方和的91.89%,检验回归方程显著性F=126.69>F0.01(2,9)=8.02,P<0.01。④对体质量指数≤18.5kg/m2或体质量指数≥28kg/m2男女学生体质形态的体格营养指数体质量比影响最大的是父亲的体质量比,其次是参数δ(即:学生的家庭病史、本人病史、营养情况、饮食习惯、家庭经济等)。结论:①非正常男女学生体质形态营养指数体质量比影响最大的是父亲的体质量比,其次是影响参数δ。②得出子女与父母的体质量比的预测线性回归方程,经实测检验具有较高的信度和效度,基本符合测量学要求。     

中空栓剂在医院制剂中的发展前景

目的 :展示一种新剂型中空栓剂作为医院制剂发展的前景及可行性。方法 :参考国内外文献 ,概括中空栓剂的特性 ,并介绍其处方设计和制备方法。结果 :中空栓剂具有生物利用度高 ,副作用小 ,制剂稳定性好 ,临床应用广泛等优点 ,而且便于个体化给药 ,尤适于小儿、呕吐及慢性病患者应用。其处方设计和制剂制备简单。结论 :中空栓剂在医院制剂室中发展 ,具有良好的可行性和广阔的开发前景。     

红花油乳液生产中的质量控制条件探索

建立红花油乳液的生产质量控制条件。方法：检测乳滴大小、离心效果及卫生学指标变化。结果：在640倍显微镜下观察,红花油乳滴直径小于5μm;使用高速离心机,以4000r／min离心10min后无明显分层,若有少许分层但振摇后立即恢复均相;卫生学符合国家标准。     

自体骨髓干细胞移植治疗神经系统损伤和变性疾病42例报告

目的:观察42例神经系统损伤和变性疾病患者经自体骨髓干细胞移植后,其神经系统症状与体征的改善。方法:①选取2005-06/2006-09解放军第四六三医院神经外科收治的神经系统损伤和变性疾病患者42例,对本试验均签署知情同意书。其中各种原因所致脊髓损伤30例,脑血管意外引起的偏瘫4例,老年痴呆2例,小脑疾患引起的共济失调2例,运动神经元变性疾病4例。患者入院后常规检查身体各项指标以评估是否适合行干细胞移植术。②术前患者均于皮下注射粒细胞集落刺激因子进行骨髓干细胞动员,5～12μg/(kg.d),连续4～5d。动员结束后患者在局麻状态下,于髂后上棘采集自体骨髓血约200mL,去除红细胞,密度梯度离心,分离出单个核细胞,再将收获的单个核细胞制成1.5mL细胞悬液(约1×108个细胞)备用。③通过手术或立体定向的方法将干细胞直接移植在神经损伤或变性部位,然后再根据病情经腰穿或静脉途径进行细胞移植,每次给予干细胞量按(2～3)×102个/kg计算,1次/周,共4周。④自体骨髓干细胞移植治疗过程中,为促进干细胞的生长和分化,根据患者病情及个人身体状况给予物理疗法、作业疗法等相应的康复功能锻炼,同时配以针灸、高压氧及药物营养神经和改善微循环治疗。结果:42例神经系统损伤和变性疾病患者均进入结果分析。自体骨髓干细胞移植治疗后1～3个月,17例脊髓损伤患者肢体症状明显改善,尤其是脑损伤后遗症引起的脊髓损伤其肢体症状改善更为显著;2例脑出血和1例脑血栓引起偏瘫的患者其肢体症状改善效果均较好;遗传性共济失调的2例患者疗效均不明显;1例老年痴呆患者其老年痴呆症状得到明显改善,并能在搀扶下行走,与旁人进行正常的交流;运动神经元变性病中1例患者肌萎缩性侧索硬化症改善效果较好,肌张力正常,颤抖减轻及至消失,多发性硬化中2例患者症状减轻。结论:干细胞移植配合功能锻炼等辅助手段对神经系统损伤和变性疾病的治疗效果肯定,有一定的临床应用价值。