采用异体腘绳肌腱Rigidfix交叉钉与Intrafix膨胀挤压螺钉重建前交叉韧带初步报道

前交叉韧带(anterior cruciate ligament,ACL)损伤是常见的膝关节韧带损伤,如不及时修复将造成膝关节其他韧带松弛、关节软骨退变、半月板损伤等并发症,严重影响膝关节功能。关节镜下ACL重建术作为修复ACL、延缓膝关节退变的重要方法[1],已被广泛应用于临床,其移植物和移植材料     

危重症患儿疼痛管理的研究进展

患儿在重症监护室治疗期间会经历频繁的疼痛刺激, 疼痛会给患儿带来严重不良影响。但现阶段危重患儿疼痛管理开展较少, 疼痛管理临床实践情况不佳。本文对危重症患儿疼痛管理临床实践现状、危重症患儿疼痛管理方法和应对策略进行综述, 并提出建议和展望, 以期为重症患儿疼痛管理研究提供参考。     

强力霉素对兔骨关节炎软骨组织形态的影响

目的研究口服强力霉素对兔骨关节炎软骨组织形态的影响及其机制。方法30只日本大耳白兔随机平分为对照组(假手术组)、模型组和治疗组。对照组只行右膝关节切开术,模型组和治疗组行右前交叉韧带切断术,以建立兔膝关节炎模型。术后4周起,治疗组每日给予口服强力霉素1次(4 mg/kg),共5周,观察指标包括软骨大体形态,软骨Mankin评分,关节液中NO含量。结果强力霉素治疗组软骨面退变明显轻于模型组,Mankin评分和NO含量亦显著降低。结论口服强力霉素对兔骨关节炎软骨退变有明显的治疗作用,其机制与抑制NO产生有关。     

大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.     

退变颈间盘组织中一氧化氮和超氧化物歧化酶含量的变化及其意义

目的：研究一氧化氮(N0)和超氧化物歧化酶(SOD)在退变颈问盘组织中含量的变化并对其意义进行探讨。方法：用分光光度法测定32例颈间盘突出症(PCID)患者的颈间盘组织及10例正常颈间盘组织中的NO和SOD的含量并进行比较。结果：退变颈间盘组织中NO含量高于正常颈间盘组织，SOD含量低于正常颈间盘组织。结论：颈间盘退变时，颈问盘组织中NO升高SOD降低，氧自由基损伤在颈间盘退变中发挥重要作用。     

间充质干细胞在构建组织工程软骨中的实验研究

目的探索利用几丁质支架和间充质干细胞(MSC)构建组织工程软骨。方法抽取兔股骨骨髓,密度梯度离心分离骨髓MSC,用转化生长因子β(1TGF-β1)诱导第3代的骨髓MSC向软骨方向分化,2周后用免疫组化检测Ⅱ型胶原表达情况。将分化后的软骨样细胞传代,接种在几丁质支架上,用含TGF-β1的培养基继续培养2周,再用免疫组化检测Ⅱ型胶原表达情况,并在电镜下观察软骨细胞的生长情况。结果骨髓MSC经TGF-β1诱导后,具有软骨细胞特点,接种在几丁质支架上继续培养2周,这些细胞在支架上生长良好,并仍能很好表达Ⅱ型胶原。结论MSC经TGF-β1诱导,分化成的软骨样细胞在几丁质支架上表型稳定,生长良好。     

中药抑瘤胶囊对荷瘤小鼠免疫系统的作用

目的观察中药抑瘤胶囊对荷瘤小鼠免疫系统的影响。方法检测胸腺细胞自然增殖能力，脾细胞诱导的白细胞介素-2（IL-2）、干扰素（IFN）的产生及活性，自然杀伤细胞（NK）杀伤活性等四项指标，观察中药抑瘤胶囊对荷瘤小鼠免疫系统的作用。结果中药抑瘤胶囊可促进小鼠胸腺细胞自然增殖能力，受试药三个剂量组与对照组比较，P〈0．05；对小鼠脾细胞诱导产生的IFN活性随剂量增高而增强，各剂量组与对照组比较，P〈0．05；该药对小鼠NK细胞杀伤活性的作用也与剂量呈正相关，但对小鼠脾细胞诱导产生的IL-2活性随剂量增高而呈下降趋势，与对照组比较，只有低剂量组IL-2活性增强作用明显，P〈0．05。结论中药抑瘤胶囊对荷瘤小鼠免疫系统功能有明显增强作用。     

椎间孔镜经不同入路治疗腰椎间盘突出症的临床进展

与传统开放性手术相比,应用经皮椎间孔镜技术(percutaneous transforaminal endoscopic discectomy,PT-ED)治疗腰椎间盘突出症具有手术创伤小、对脊柱稳定性影响小、恢复较快等特点。但是由于突出物位置的不同、病变节段高低或髂嵴阻挡等原因,PTED经椎间孔入路的适应证相对狭窄,尚不能取代开放性手术。新入路的开发及器械的改良已成为PTED目前研究的热点及未来发展方向。近年来,经椎板间隙入路和经髂骨入路的出现使得PTED的适应证得到了极大扩展。然而,操作不规范、对适应证或手术入路选择失当仍然是导致PTED手术失败的主要原因,因此本文就PTED的适应证、3种不同入路的手术方法、临床疗效和并发症进行综述。     

甲状旁腺素抑制人骨关节炎软骨细胞终末期分化的实验研究

目的:探讨甲状旁腺素(PTH)对人骨关节炎软骨细胞终末期分化的抑制作用。方法:分离和培养人骨关节炎软骨细胞,将其进行分组(PTH处理组和对照组),分别经PTH和盐水处理细胞,倒置显微镜观察细胞形态的变化,碱性磷酸酶(ALP)染色法检测ALP的分泌,RT-PCT法和WesternBlot法检测细胞内促终末期分化因子基因mR-NA和蛋白的表达。结果:人骨关节炎软骨细胞具有终末期成熟分化的特征,与对照组相比,PTH明显降低ALP染色的强度,显著降低细胞内促终末期分化基因mRNA和蛋白的表达。结论:PTH具有抑制人骨关节炎软骨细胞终末期分化的作用。     

有机镓对去势大鼠骨代谢及骨量变化的影响

目的 观察有机镓对去势大鼠骨代谢及骨量变化的影响.方法 将30只大鼠随机分为假手术组、卵巢切除组和有机镓组.除正常对照组外,其他 2 组行卵巢切除.12周后假手术组、卵巢切除组给予PBS治疗,有机镓组给予有机镓干预.8周后取大鼠第五腰椎、股骨分别进行Micro-CT测定骨小梁组织结构;组织形态学测骨小梁占总骨量的百分数(BV/TV);生物力学测定股骨颈机械强度检查;生化指标检测比较血清TRAP、ALP、钙、磷.结果 Micro-CT测试表明有机镓组平均骨小梁厚度(Tb.Th)、皮质厚度Ct.Th)均明显高于卵巢切除组(P＜0.05),BV/TV明显高于卵巢切除组(P＜0.05),破骨细胞数显著减少,有机镓组股骨颈平均最大骨折负荷比卵巢切除组高27.4%,血清TRAP、钙、磷减少(P＜0.05).结论 有机镓减少骨吸收的同时增加骨形成,对于去势大鼠骨量减少有明显的改善作用.