氯氮平对51例精神病患者骨髓象的影响

精神病女性患者５１例，服用氯氮平１００－３５０ｍｇ／ｄ，共４２ｄ。２２例骨髓象由用药前的增生活跃变为增生明显活跃，骨髓粒细胞系统所占比例明显增多；２９例无变化。未见骨髓抑制者。     

Graves病骨生化标志的变化初探

目的 探讨Graves患者骨生化标志的改变。方法 对38例Graves患者进行血AKP、Ca、P、ICTP、DPD、BGP、U-HOP/Cr及BMD测定。结果 Graves组的BMD显著低于正常对照组(P<0.01),Ca、ICTP、DPD、BCP、U-HOP/Cr显著高于对照组,Graves组的BMD与ICTP和DPD,BGP有很好的相关性(r=0.36,r=0527、r=0.401)。结论 Graves组骨吸收增加,骨形成减少。     

带血管骨膜瓣移植修复烧伤坏死管状骨的实验研究

目的探讨带血管骨膜瓣移植修复烧伤坏死管状骨的可行性，试图为临床修复烧伤坏死骨提供一种有效的方法。方法8月龄成年新西兰家兔20只，设一侧肢体的桡骨为实验组，另一侧为对照组，采用同体对照法。实验组保留带血管的骨膜瓣，从桡骨中下段离断1．2cm桡骨，置沸水中煮沸30min冷却后原位回植，再行骨膜瓣移植包绕、固定。对照组按上述方法处理后不移植骨膜瓣。分别于术后2、4、6、8～10、12周摄X线平片，同时分别处死4～5只兔并取两侧桡骨行组织学切片检查。结果实验组：术后2～4周在骨坏死区见到明显的骨膜增生影像；术后6～8周见骨折断端连接征象，新生骨小梁形成并逐渐改建；术后8—10周可见网织骨普遍融合重建，形成板层，新的哈佛系统形成；术后12周新生骨结构更加成熟，骨折愈合。对照组：术后2周仍为死骨，骨坏死区无骨膜增生现象；术后4、6周未见骨折愈合征象；8周可见骨缺损；12周坏死骨完全溶解、吸收，骨缺损区清晰可见，骨缺损区被少许纤维组织充填。结论带血供的骨膜瓣能不断形成新生骨并爬行替代原坏死骨，使坏死骨获得再生，能很好地修复烧伤坏死的管状骨。     

Calcium pyrophosphate dihydrate deposition disease: morphological and microanalytical features

The light microscopic and polarization appearances of calcium pyrophosphate dihydrate crystal deposits in tissues are reviewed. In routine sections haematoxylinophilic crystalline deposits with a feathery or brush-like pattern are typical of calcium pyrophosphate dihydrate. Short rhomboidal crystals showing positive birefringence are seen on polarization; X-ray microanalytical and infrared spectroscopic data support the specificity of these appearances. The appearances of the crystal deposits in decalcified specimens are also described. We include six cases of calcium pyrophosphate dihydrate deposition within periarticular bone; to the best of our knowledge this has not previously been described.     

贺斯预防骨水泥所致低血压的临床探讨

目的:观察6%贺斯预防骨水泥所致低血压的效果。方法:30例人工股骨头置换病人随机分为两组:Ⅰ组为6%贺斯组(n=15);Ⅱ组为平衡盐组(n=15)。在填充骨水泥前分别输入6%贺斯及平衡盐500ml,分别测定入室(基础)、填充骨水泥前1min收缩压、填充骨水泥后5min最低收缩压,并观察心率变化。结果:Ⅰ组用骨水泥后最低收缩压明显高于Ⅱ组(P<0.01)。I组低血压发生率仅为13.3%,而Ⅱ组为60%。结论:在填充骨水泥前输注胶体能有效预防骨水泥所致的低血压。     

水泥型羟基磷灰石人工骨的制备及性能分析

Objective: To prepare hydroxyapatite cement (or calcium phosphate cement,CPC) and analyze its capability. Methods: Tetracalcium phospluge (TTCP ) was prepared by the method of high heat. TTCP reacted with in simulated body situation and produced CPC. Its capability was analyzed by scanning electron microscopy ( SEM), X-ray diffraction( XRD). Its density, absorbing water coefficient, macroporosity and compressive strength were measured also. Results: The main element of CPC is hydroxyapatile (HA), its microstructure comprised of petal crys-tals. The diameter of micropore was 4-10μm, density was 1. 922 g/cm^3, macroporosity was 29. 777%, absorbing coefficient was 15. 503%, compressive strength was 42.70 Mpa. Conclusion: This CPC has three-dimensional spatial structure, its strength meets the need of cancellous bone grafting.     

干细胞动员对骨创伤大鼠免疫功能的保护作用

目的：观察自体干细胞动员对骨创伤大鼠的免疫功能的保护作用，为战创伤后的免疫抑制及继发性感染、系统性炎症反应等治疗提供依据。方法：挤压折断法复制大鼠双后肢股骨骨折模型，于致伤后0、24、48h连续给模型动物肌肉注射GM—CSF20μg／kg，致伤后72h细胞增殖法检测T、B淋巴细胞活性，ELISA法检测血清IL-1、IL-2、IFN-7、TNF—α浓度，自动系列化分析法检测C3、CA、IgM、IgG浓度，称重法观察脾重与体重的比例变化。结果：股骨骨折模型大鼠致伤后72h，GM—CSF动员骨髓干细胞组大鼠的T、B淋巴细胞活性和血清IFN-γ、IL-2浓度高于对照组（P〈0．01），IL-1、TNF—α浓度低于对照组（P〈0．01），血清C3、CA、IgM、IgG浓度及脾／体重比值高于对照组（P〈0．01）。结论：GM—CSF动员自体干细胞动员对大鼠骨创伤诱导的免疫功能抑制具有保护作用。     

Smoking delays chondrogenesis in a mouse model of closed tibial fracture healing.

Smoking delays the healing process and increases morbidity associated with many common musculoskeletal disorders, including long bone fracture. In the current study, a murine model of tibial fracture healing was used to test the hypothesis that smoking delays chondrogenesis after fracture. Mice were divided into two groups, a nonsmoking control group and a group exposed to cigarette smoke for 1 month prior to surgical tibial fracture. Mice were euthanized at 7, 14, and 28 days after surgery. The outcomes measured were immunohistochemical staining for type II collagen protein expression as a marker of cartilage matrix and proliferating cell nuclear antigen (PCNA) staining to measure proliferation at the site of injury. Toluidine blue staining and histomorphometry were used to quantify areas of cartilaginous and noncartilaginous fracture callus. Radiographs were analyzed for evidence of remodeling after injury. At day 7 after injury, mice exposed to cigarette smoke had a smaller fracture callus with less cartilage matrix compared to controls. Proliferation was present at high levels in both groups at this time point, but proliferating cells had a more immature morphology in the smoking group. At day 14, chondrogenesis was more active in smokers compared to controls, while a higher percentage of bone was present in the control animals. At day 28, X-ray analysis revealed a larger fracture callus remaining in the smoking animals. Together, these findings show that the chondrogenic phase of tibial fracture healing is delayed by smoking. This study represents, to our knowledge, the first analysis of molecular and cellular mechanisms of healing in a smoking mouse fracture model.     

Global gene profiling reveals a downregulation of BMP gene expression in experimental atrophic nonunions compared to standard healing fractures.

Nonunion is a challenging problem that may occur following certain bone fractures. However, there has been little investigation of the molecular basis of nonunions. Bone morphogenetic proteins (BMPs) play a significant role in osteogenesis. However, little is known about the expression patterns of BMPs in abnormal bone healing that results in nonunion formation. These facts prompted us to investigate and compare the gene expression patterns of BMPs and their antagonists in standard healing fractures and nonunions using rat experimental models. Standard closed healing fractures and experimental atrophic nonunions produced by periosteal cauterization at the fracture site were created in rat femurs. At postfracture days 3, 7, 10, 14, 21, and 28, total RNA was extracted from the callus of standard healing fracture and fibrous tissue of nonunion (n=4 per each time point and each group). Gene expression of BMPs, BMP antagonists, and other regulatory molecules were studied by methods including Genechip microarray and real-time quantitative RT-PCR. Gene expression of BMP-2, 3, 3B, 4, 6, 7, GDF-5, 7, and BMP antagonists noggin, drm, screlostin, and BAMBI were significantly lower in nonunions compared to standard healing fractures at several time points. Downregulation in expression of osteogenic BMPs may account for the nonunions of fracture. The balance between BMPs and their endogenous antagonists is critical for optimal fracture healing.     

前列腺癌细胞株Du145裸鼠胫骨部骨肿瘤转移模型的建立

目的:建立一种裸鼠前列腺癌骨转移模型,观察肿瘤局部生长和远处转移情况,并进一步探讨其应用价值。方法:9只6周龄雄性BALB/C裸鼠麻醉后,将前肢及左后肢固定,以1 m l TB针筒-29G针头从胫骨头关节窝,刺入骨髓腔缓缓注入人前列腺癌Du145细胞悬液30μl(约5×106个细胞)至骨髓腔,以建立前列腺癌骨转移模型。观察裸鼠生命体征变化。于濒死状态下处死,取右后肢及其附近淋巴结、肺脏和肝脏等标本,用40 m l/L甲醛固定、石蜡包埋、苏木精-伊红染色后显微镜下观察。结果:9只裸鼠中有6只模型建立成功。接种后平均48 d裸鼠出现跛行现象,右后肢胫骨部可触及米粒大小的包块,质硬,进一步发展至小鼠行走障碍。55 d后出现恶病质,解剖后发现右后肢胫骨部骨质疏松,局部有“腐肉”样组织突出髓腔,填塞肌肉间隙,病理证实为肿瘤组织。肝脏泛黄、被膜皱缩,镜下呈急性重型肝炎的病理改变。结论:胫骨内注射细胞悬液制作裸鼠前列腺癌骨转移模型较好地模拟了人前列腺癌在骨骼微环境中的生长及转归情况,是研究前列腺肿瘤骨转移的适宜模型。