Human osteoblasts' proliferative responses to strain and 17beta-estradiol are mediated by the estrogen receptor and the receptor for insulin-like growth factor I.

The mechanism by which mechanical strain and estrogen stimulate bone cell proliferation was investigated using monolayer cultures of human osteoblastic TE85 cells and female human primary (first-passage) osteoblasts (fHOBs). Both cell types showed small but statistically significant dose-dependent increases in [3H]thymidine incorporation in response to 17beta-estradiol and to a single 10-minute period of uniaxial cyclic strain (1 Hz). In both cell types, the peak response to 17beta-estradiol occurred at 10(-8) - 10(-7) M and the peak response to strain occurred at 3500 microstrain ((mu)epsilon). Both strain-related and 17beta-estradiol-related increases in [3H]thymidine incorporation were abolished by the estrogen receptor (ER) modulator ICI 182,780 (10-8 M). Tamoxifen (10(-9) - 10(-8) M) increased [3H]thymidine incorporation in both cell types but had no effect on their response to strain. In TE85 cells, tamoxifen reduced the increase in [3H]thymidine incorporation associated with 17beta-estradiol to that of tamoxifen alone but had no such effect in fHOBs. In TE85 cells, strain increased medium concentrations of insulin-like growth factor (IGF) II but not IGF-I, whereas 17beta-estradiol increased medium concentrations of IGF-I but not IGF-II. Neutralizing monoclonal antibody (MNAb) to IGF-I (3 microg/ml) blocked the effects of 17beta-estradiol and exogenous truncated IGF-I (tIGF-I; 50 ng/ml) but not those of strain or tIGF-II (50 ng/ml). Neutralizing antibody to IGF-II (3 microg/ml) blocked the effects of strain and tIGF-II but not those of 17beta-estradiol or tIGF-I. MAb aIR-3 (100 ng/ml) to the IGF-I receptor blocked the effects on [3H]thymidine incorporation of strain, tIGF-II, 17beta-estradiol, and tIGF-I. HOBs and TE85 cells, act similarly to rat primary osteoblasts and ROS 17/2.8 cells in their dose-related proliferative responses to strain and 17beta-estradiol, both of which can be blocked by the ER modulator ICI 182,780. In TE85 cells (as in rat primaries and ROS 17/2.8 cells), the response to 17beta-estradiol is mediated by IGF-I, and the response to strain is mediated by IGF-II. Human cells differ from rat cells in that tamoxifen does not block their response to strain and reduces the response to 17beta-estradiol in TE85s but not primaries. In both human cell types (unlike rat cells) the effects of strain and IGF-II as well as estradiol and IGF-I can be blocked at the IGF-I receptor.     

Preparation and degradation characteristic study of bone repair composite of DL—polylactic acid／hydroxyapatite／decalcifying bone matrix

Objective:To explore the preparative method and study the degradation characteristics of bone repair composite of DL-polyactic acid(PDLLA) /hydroxyapatite(HA)/decalcifying bone matrix(DBM) in vitro.Methods:An emulsion blend method was developed to prepare the composite of PDLLA/HA/DBM in weight ratio of PDLLA:HA:DBM=1.2-2:1.5:1.The dynamic changes of weight,biomechanical property and pH value of PDLLA/HA/DBM and PDLLA in phosphate buffered saline(PBS,pH7.4)were studied respectively through degradation tests in vitro.Results:Without being heated,PDLLA,HA and DBM could be synthesized with the emulsion blend method as bone composite of PDLLA/HA/DBM,wich had both osteoconductive and osteoinductive effects.The diameter of the aperture was 100-400μm and the gap rate was 71.3%.During degradation,the pH value of PDLLA solution decreased lightly within 2 weeks,but decreased obviously at the end of 4 weeks and the value was 4.0 .While the pH value of PDLLA/HA/DBM kept quite steady and was 6.4 at the end of 12 weeks.The weight of PDLLA changed little within 4 weeks,then changed obviously and was 50% of its initial weight at the end of 12 weeks.While the weight of PDLLA/HA/DBM changed little within 5 weeks ,then changed obviously and was 60% of the initial weight at the end of 12 weeks.The initial biomechanical strength of PDLLA was 1.33 MPa, decreased little within 3 weeks, then changed obviously and kept at 0.11 MPa at the end of 12 weeks.The initial biomechanical strength of PDLLA/HA/DBM was 1.7 MPa, decreased little within 4 weeks, then changed obviously and kept at 0.21 MPa at the end of 12 weeks.Conclusions:The emulsion blend method is a new method to prepare bone repair materials.As a new bone repair material,PDLLA/HA/DBM is more suitable for regeneration and cell implantation,and the environment during its degradation is advantageous to the growth of bone cells.     

内窥镜下直接经蝶入路切除垂体腺瘤

目的 探讨内窥镜控制下直接经蝶入路切除垂体腺瘤的方法。方法 22例垂体腺瘤患者,在内窥镜控制下,经单鼻孔进入,术中不切除鼻中隔,直接自蝶窦开口打开蝶突前壁,进一步经鞍底切除垂体腺瘤。结果 22例患者中,15例肿瘤全部切除,7例肿瘤次全切除。术后随访1－12个月,17例患者内分泌功能恢复正常。4例术后发生暂时性尿崩症。结论 内窥镜控制下直接经蝶切除垂体腺瘤入路与目前常规经蝶显微手术比较,入路途径较短,且安全简捷、损伤小,手术显露良好,术后反应小,值得进一步推广。     

儿童颈椎间盘钙化的诊断和治疗

目的 探讨儿童颈椎间盘钙化诊断和治疗的有效方法。方法 回顾性分析13例儿童的颈椎间盘钙化,其中上感后颈痛5例,外伤后偶然发现2例,突发颈部疼痛3例,突发斜颈3例。所有患者均经颈椎正、侧位X片证实。伴有疼痛症状应用非甾体抗炎镇痛药类药物,对于颈部症状较重则予预围外固定或短暂牵引后颈围外固定3－4周。结果 13例患儿共发现14个椎间隙的颈椎间盘钙化。经对症处理后临床症状均消失,所有的钙化均于5个月内完全消失。结论 儿童颈椎间盘钙化是一良性自限性疾病,正确认识其病理生理过程,可避免不必要的手术创伤。     

P-Selectin Glycoprotein Ligand-1 (rPSGL-Ig)-Mediated Blockade of CD62 Selectin Molecules Protects Rat Steatotic Liver Grafts from Ischemia/Reperfusion Injury

We examined the effects of early blockade of CD62 selectin-mediated adhesive interactions in steatotic rat liver models of ex vivo cold ischemia followed by reperfusion or transplantation by administration of P-selectin glycoprotein ligand-1 (rPSGL-Ig). In the model of cold ischemia/reperfusion, livers pretreated ex vivo with rPSGL-Ig at harvesting from obese Zucker rats showed significantly decreased portal resistance, increased bile production, and diminished hepatic endothelial neutrophil infiltration, as compared with untreated controls. Pretreatment of fatty livers with rPSGL-Ig prior to transplantation extended the survival of lean Zucker rat recipients from 40% to 90%. This effect correlated with significantly improved liver function, depressed neutrophil activity, and decreased histologic features of hepatocyte injury. Intragraft expression of CD62 P-selectin was similar in both recipient groups. rPSGL-Ig treatment decreased intragraft infiltration by CD3/CD25 cells, diminished expression of pro-inflammatory TNFalpha, IL-6, iNOS, IL-2 and IFN-gamma, without significantly affecting mRNA levels coding for anti-inflammatory IL-4. Thus, rPSGL-Ig blockade of CD62-mediated adhesive interactions protects against severe ischemia/reperfusion injury suffered otherwise by steatotic rat livers. These findings document the potential utility of rPSGL-Ig in increasing the transplant donor pool through modulation of marginal steatotic livers.     

Human umbilical cord blood serum in culture medium on oocyte maturation In vitro

In vitro maturation (IVM) of immature oocytes for infertile patients is an attractive treatment. It can avoid side effects of ovarian stimulation with gonadotropins. However, at the present the successful results of IVM treatment are lower than conventional in vitro fertilization (IVF) treatment. The key issue may be the IVM medium for immature oocyte maturation. In the present study, we compared 20% (v/v) human follicular fluid (hFF) and 20% (v/v) human umbilical cord serum (hUS) as a supplement to IVM medium. A total of 47 patients with polycystic ovary syndrome (PCOS) underwent 47 IVM treatment cycles. Immature oocytes (349) collected from 32 patients were cultured in IVM medium supplemented with hFF, and immature oocytes (160) collected from 15 patients were culture in IVM medium supplemented with hUS. The results indicate that the final maturation rate of oocytes cultured in IVM medium supplemented with hUS (93.8%) is significantly higher than those cultured in IVM medium supplemented with hFF (77.1%). The percentage of high-quality embryos produced from IVM medium supplemented with hUS (50.0%) is significantly higher than IVM medium supplemented with hFF (23.8%). In addition, the results also indicate that the final maturation rate of oocytes is higher in IVM medium supplemented with hUS and the time course of oocyte maturation is hastened. Following transfer 6 out of 15 patients (40.0%) become pregnant when IVM medium was supplemented with hUS, and 7 out of 31 patients (22.6%) were pregnant when IVM medium was supplemented with hFF. These results suggest that IVM medium containing hUS appears to be a more effective means to stimulate in vitro oocyte maturation and is capable of achieving a promising clinical outcome.     

经尿道等离子前列腺剜除术和电切术治疗前列腺增生症的比较

目的比较经尿道等离子前列腺剜除术和电切术的疗效。方法2003年10月~2006年7月,在127例前列腺增生症患者中,计算机随机数字法分组。1例神经源性膀胱患者,3例剜除术失败的患者退出试验。62例行经尿道等离子前列腺剜除术,61例行经尿道等离子前列腺电切术。比较手术腺体切除量、手术时间、术中出血量。结果剜除组术中出血少[(78.5±46.2)ml vs(115.0±43.5)ml,t=4.511,P=0.000],切除腺体多[(60.5±29.3)g vs(45.9±30.5)g,t=2.709,P=0.008]。两组手术时间相近[(93.4±35.5)min vs(81.3±46.3)min,t=1.629,P=0.106]。术后3个月前列腺症状评分、生活质量指数、最大尿流率、残余尿量以及并发症发生率(2/61 vs 5/62)差异无显著性。结论治疗前列腺增生症,经尿道等离子前列腺剜除术和电切术比较,剜除术腺体切除更彻底、出血少。     

第2代(温控)射频消融子宫内膜切除术

目的探讨第2代（温度控制）射频消融子宫内膜切除术的疗效、安全性和可行性。方法2004年9月-2006年2月由上海市4家医院联合开展一项多中心、前瞻性研究,完成功能性子宫出血温控射频消融子宫内膜切除术81例。在超声监护下,射频治疗以温度控制模式输出功率50 W、温度设定85℃,按照两侧宫角、宫底、宫体、下段部位顺序射频消融子宫内膜。每个治疗点治疗时间为4 min。结果81例术后随访4-17个月。术后6个月随访70例,其中闭经48.6%（34/70）,点滴状月经41.4%（29/70）,少量月经10%（7/70）,总有效率为100%（70/70）。术后12个月随访67例,其中闭经56.7%（38/67）,点滴状月经29.9%（20/67例）,少量月经9.0%（6/67）,正常月经量3.0%（2/67）,月经量过多1.5%（1/67）,总有效率98.5%（66/67）。结论温控射频消融子宫内膜切除术不仅使患者的异常子宫出血在保留子宫的情况下得到有效的治疗,同时具有操作方便、治疗时间短、并发症少、术后恢复快等特点。     

硬膜外穿刺针外套管在腹腔镜小儿斜疝高位结扎术中的应用

目的探讨硬膜外穿刺针外套管在腹腔镜小儿斜疝疝囊高位结扎中的应用价值。方法2003年4月-2006年5月,我院对230例小儿斜疝手术应用硬膜外穿刺针外套管代替雪橇钩针实施腹腔镜疝内环口荷包高位结扎术。结果230例手术均获得成功,手术时间：单侧161例8-10 min,嵌顿疝39例15-20 min,双侧30例16-20 min;术后未见有阴囊水肿及睾血疼痛及缺血坏死。术后随访2-6个月111例,6-12个月52例,12-24个月37例,24-36个月30例,无复发。结论硬膜外刺针外套管可替代小儿疝囊结扎专用的雪橇钩针,简便,经济,适合在所有基层医院推广。     

抗肿瘤药物对杯状细胞黏液分泌的实验研究

目的 观察抗肿瘤药物对回肠杯状细胞黏液分泌抑制的作用.方法 SD大鼠24只,随机分为生理盐水对照组、丝裂霉素给药组、比柔吡星给药组.制备在体游离回肠袢模型,分别于给药后8、16、24、32、40、48 h抽取大鼠回肠袢内肠液,测定肠液内蛋白含量,48 h后处死大鼠,取肠袢石蜡包埋行HE、阿利辛兰-过碘酸雪夫反应(AB-PAS)、黏液蛋白(MUC2)免疫组化染色,观察黏液分泌量及回肠杯状细胞的变化.结果 丝裂霉素组排放入肠袢中的黏液蛋白总量(32.09±7.12)mg与对照组(55.71±20.35)mg相比,差异有统计学意义(P＜0.05);各时间点均少于对照组,以32～40h(3.11±0.31)、40～48 h(2.65±0.58)排放入肠袢中的蛋白量与对照组比较差异有统计学意义(P＜0.05).比柔吡星组排放入肠袢中的黏液蛋白总量(44.32±18.47)少于对照组,但无统计学意义;比柔吡星组各时间点与对照组比较差异均无统计学意义.丝裂霉素组杯状细胞数(33.97±7.61)与对照组(25.13±11.29)比较,差异有统计学意义(P＜0.01),比柔吡星组杯状细胞数(28.69±9.24)与对照组比较,差异无统计学意义.黏蛋白MUC2免疫组化染色:丝裂霉素组杯状细胞数(46.60±8.94)与对照组(34.7±10.98)比较差异有统计学意义(P＜0.01),比柔吡星组杯状细胞数(35.87±5.84)与对照组比较差异无统计学意义.结论 丝裂霉素可以抑制杯状细胞分泌黏液,随时间延长杯状细胞分泌黏液量逐渐减少.