尿激酶角膜接触镜辅助羊膜移植治疗严重角膜烧伤的临床研究

目的:探讨尿激酶和角膜接触镜对急性期严重角膜烧伤羊膜重建的临床治疗可行性和疗效.方法:对63例(65眼)严重角膜烧伤的患者,随机对其中33眼作为治疗组,采用尿激酶(0.5 ml,3 000 U)球结膜下注射,每日1次,连续7-10 d,择机羊膜移植术并配戴软型角膜接触镜,共10-15 d,其余32眼作为对照组,羊膜眼表...     

早期人胚羊膜共聚焦激光扫描光学切片及F-肌动蛋白的研究

目的　建立羊膜组织共聚焦激光扫描显微镜光学切片的方法 ,探讨早期人胚羊膜细胞结构、分层及细胞骨架的空间结构。　方法　采用共聚焦激光扫描光学切片和荧光探针双重标记技术对妊娠 7～ 9周早期人胚羊膜进行形态观察、细胞F 肌动蛋白表达定量分析、细胞分层及厚度计算。　结果　羊膜由两层不同类型的细胞组成 ,内层细胞为多边形扁平细胞 ,外层细胞为长梭形细胞 ;内层细胞胞质中的F 肌动蛋白表达量较低 ,外层细胞胞质中的F 肌动蛋白表达量明显高于内层细胞 ,两者差异有统计学意义 ;7～ 9周人胚羊膜厚度为 30± 2 μm。其中 ,上皮层厚度为 10 μm± 2 μm ,间充质层厚度为 14μm± 2 μm。　结论　 1 早期人胚羊膜由两层细胞即内层的上皮细胞层和外层的间充质细胞层组成 ,胞质中F 肌动蛋白的表达量间充质细胞高于上皮细胞 ;2 通过共聚焦激光扫描连续光学切片可以计算出羊膜各层的厚度 ;3 共聚焦激光扫描显微镜光学切片技术结合FITC 鬼笔环肽和碘化丙啶双重标记技术是观察和分析羊膜组织细胞立体结构的良好方法。     

Combination of hydroxyapatite,platelet rich fibrin and amnion membrane as a novel therapeutic option in regenerative periapical endodontic surgery: Case series

IntroductionPeriapical surgery is the last resort in the arsenal of an endodontist to effectively deal with periapical lesions that result from necrosis of the pulp. Bone grafts, growth factors and membranes form an array of regenerative materials that influence the healing outcome of periapical surgery.Presentation of caseThe main purpose of the two cases reported here was to assess the potential benefits of a combination of bone graft, platelet-rich fibrin (PRF) and amnion membrane in terms of reduced post-operative discomfort, radiographic evidence of accelerated periapical bone healing and present a novel therapeutic option in the management of large periapical lesions. Two cases of radicular cysts were treated through a combined regenerative approachof Bio-Gen mix^®, PRF and amnion membrane. The patients were assessed for discomfort immediate post-operatively and after a week. The patients were recalled every month for the next 6 months for radiographic assessment of the periapical healing.DiscussionLiterature is replete with articles that have substantiated the role of demineralized bone matrix comprising a mixture of cancellous and cortical bone graft particles in enhancing regeneration. To the best of our knowledge, there has been no evidence related to the application of a human placental membrane in periapical surgery. Hence, the rationale of using a combined approach of Bio-Gen mix^®, PRF and amnion membrane was to combine the individual advantages of these materials to enhance clinical and radiographic healing outcomes. Our present case reports provide an insight into this novel therapeutic option.ConclusionThe results of this case seriessubstantiatesthe credibility of using a combination ofamnion membrane with a bone graft and PRF to enhance radiographic healing outcome with decreased post-operative discomfort and present a viable regenerative treatment modality in periapical surgery.     

新鲜羊膜移植治疗角膜溃疡

目的 观察新鲜羊膜移植治疗角膜溃疡的临床效果。方法 对26例26眼角膜溃疡病人采用新鲜羊膜移植手术,其中细菌性角膜溃疡16眼．真菌性角膜溃疡6眼,病毒性角膜溃疡3眼,化学烧伤性角膜溃疡1眼。结果 26眼中24眼治愈。术后随访12个月,均未见新鲜羊膜移植片急性排斥反应,22眼视力不同程度提高,1眼复发,1眼早期羊膜溶解。结论 新鲜羊膜移植是治疗角膜溃疡的有效方法。     

The effects of cryopreserved human amniotic membrane on fracture healing: Animal study

ObjectiveThe aim of this study was to investigate the effects of human amniotic membrane (HAM) on fracture healing in an animal model.MethodsStandard tibial diaphysial fractures were created in twenty-eight Wistar-Albino rats and treated with intramedullary Kirschner wire (K-wire) and HAM (HAM (+) group) or K-wire only (HAM (–) group). Fracture healing was evaluated by histological analysis, radiologic X-ray views and callus diameter measurements at 3rd and 6th weeks postoperatively.ResultsFracture healing was histologically better in the HAM (+) group and the difference was statistically significant at both 3rd and 6th weeks postoperatively (p < 0.05). The highest histologic scores and entire woven bone formation (Huo Stage 8–9) were obtained at 6th weeks postoperatively in the HAM (+) group. Histological examination also revealed predominant fibrous tissue and partial cartilage formation (Huo Stage 2) at the postoperative 3rd week in the HAM (-) group. Equal amounts of woven bone and cartilage formation (Huo Stage 6–7) were observed at 3rd weeks postoperatively in the HAM (+) group and at 6th weeks postoperatively in the HAM (-) group. The callus diameters were greater in the HAM (+) group and the difference was statistically significant (p < 0.05) at 3rd and 6th weeks postoperatively. Although there was only a statistically significant difference (p < 0.05) at the postoperative 3rd week, radiological scores tended to be higher in the HAM (+) group at both the 3rd and 6th weeks postoperatively.ConclusionHAM is a cheap and easily accessible alternative biological material. HAM may be used to support surgical treatment of fractures, particularly where bone healing is expected to last longer.     

HLA匹配角膜缘干细胞联合羊膜移植修复翼状胬肉

背景：HLA匹配的角膜缘干细胞联合羊膜移植治疗翼状胬肉是眼科医生治疗的新理念,该方法治疗后并发症少、康复快、复发率低,尤其是能减少移植排斥反应等已被广泛接受。 目的：探讨HLA匹配的角膜缘干细胞联合羊膜移植治疗翼状胬肉疗效。 方法：选取2013年3月1日至2014年4月30日行HLA匹配的角膜缘干细胞联合羊膜移植治疗的翼状胬肉患者47例(47眼)作为试验组;回顾性分析2010年3月1日至2012年12月1日采用单纯翼状胬肉切除方法治疗的翼状胬肉患者40例(47眼)作为对照组,对两组患者治愈和复发情况进行比较。 结果与结论：试验组47例,全部顺利完成治疗,无并发症,其中1例切口感染,特殊对症治疗后均已好转出院,全部患者均无移植排斥反应。试验组治愈45眼,复发2眼,复发率为4.3%。对照组47眼中治愈32眼,复发15眼,复发率31.9%。结果表明HLA匹配的角膜缘干细胞联合羊膜移植治疗翼状胬肉并发症少、复发率低,是治疗翼状胬肉一种行之有效的方法。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

人羊膜匀浆上清液对大鼠角朊细胞生长的影响

目的观察不同浓度人羊膜匀浆上清液(hAHS)对体外培养的SD大鼠角朊细胞生长的影响。 方法取SD大鼠背部皮肤,采用中性蛋白酶与胰蛋白酶复合消化的方法,分离第一代角朊细胞。将新鲜人羊膜制备成hAHS,采用考马斯亮蓝法、酶联免疫吸附试验分别测定hAHS中总蛋白含量和表皮生长因子(EGF)、碱性成纤维生长因子(bFGF)、血管内皮生长因子(VEGF)的浓度。用不同浓度hAHS对第一代角朊细胞进行体外培养：将细胞以2.5×10⁴个/mL密度接种于96孔板中(每孔100 μL),随机数字表法将其分为体积分数0(对照组)及10%、15%、20%、25% hAHS组,用含10%胎牛血清低糖培养基培养24 h后,根据hAHS在低糖DMEM培养基中的不同体积分数进行换液,分别于培养即刻和培养24、48、96 h,用噻唑兰法检测各孔的吸光度值并绘制角朊细胞的生长曲线和计算各组细胞增殖率。采用SPSS13.0统计软件进行分析,各不同体积分数hAHS组的数据与对照组比较采用Dunnett－t检验。 结果hAHS中总蛋白含量为(675.435±9.215)×10^－3 g/L,EGF、bFGF和VEGF的浓度分别为(470.625±2.546)×10^－6、(4.121±0.026)×10^－6和(0.172±0.002)×10^－6 g/L。与对照组比较,10% hAHS组培养48、96 h角朊细胞增殖率明显高于对照组,差异均有显著性统计学意义(t＝4.644、9.694,P值均小于0.01),15% hAHS组培养48、96 h角朊细胞增殖率均明显高于对照组,差异均有显著性统计学意义(t＝4.766、6.648,P值均小于0.01);20% hAHS组培养24 h角朊细胞增殖率高于对照组,差异有统计学意义(t＝2.272,P<0.05),培养48、96 h增殖率均明显高于对照组,差异有显著性统计学意义(t＝5.027、8.861,P值均小于0.01);25% hAHS组培养48 h增殖率低于对照组,差异有统计学意义(t＝2.188,P<0.05),培养96 h增殖率明显低于对照组,差异有显著性统计学意义(t＝5.147,P<0.01)。 结论体积分数10%、15%、20% hAHS对体外培养的角朊细胞增殖有明显促进作用,且促增殖的效果随hAHS体积分数的增加而增强,但hAHS的体积分数在25%时角朊细胞的增殖受到抑制,平稳期相对缩短。     

Healing of experimental gingival recession defects treated with amnion allograft: Histologic and histometric analysis in dogs

ObjectivesThis study was conducted to compare the healing response of localized gingival recession defects treated with a coronally advanced flap (CAF) and either an amnion allograft membrane (AM) or a connective tissue graft (CTG).MethodsGingival recession defects were surgically created in six healthy mongrel dogs at the labial root surface of the maxillary canines, bilaterally. Using a split mouth design, the defects were treated with CAF and either AM (CAF/AM) or CTG (CAF/CTG). Three animals for each group were scarified at 1 and 3 months. Segments containing the defects were prepared for histological and histometric analysis.ResultsBoth techniques showed similar clinical findings with adequate root coverage. Histologically, healing was characterized by the formation of new cementum and new connective tissue attachment in the CAF/AM group; in the CAF/CTG group, healing was characterized by junctional epithelium, coronally, and connective tissue fibers parallel to the root surface, apically. Histometrically, the CAF/AM group revealed a substantially shorter epithelial length and a longer, new cementum compared with those of the CAF/CTG group after a healing period of 3 months.ConclusionsWithin the limits of this study, we concluded that the AM allograft could promote periodontal healing in gingival recession defects.     

自制全结膜囊羊膜固定器在重症眼表烧伤中应用

目的观察自制全结膜囊羊膜固定器在重症眼表烧伤行羊膜遮盖手术中应用效果。方法在11例（13眼）眼部重症烫伤患者治疗中采用自制全结膜囊羊膜固定器将羊膜固定于眼表及眼睑皮肤面。根据病情需要更换羊膜,随访3月至3年。结果患者平均手术时间为（8．0±3．0）分钟;眼表组织上皮化时间（13．2±11．3）天。重复手术次数3．5次,患者手术依从性良好,观察病例无角膜穿孔,无睑球粘连。结膜囊狭窄5例,角膜斑翳5例,角膜血管化2例。结论采用自制全结膜囊羊膜固定器手术,缩短手术时间,无创伤,重症烧伤患者可多次重复手术,特别适合重症眼表烧伤早期治疗,减少晚期严重并发症的发生。