Comparison of osmotic swelling influences on meniscal fibrocartilage and articular cartilage tissue mechanics in compression and shear

Although the contribution of the circumferential collagen bundles to the anisotropic tensile stiffness of meniscal tissue has been well described, the implications of interactions between tissue components for other mechanical properties have not been as widely examined. This study compared the effects of the proteoglycan‐associated osmotic swelling stress on meniscal fibrocartilage and articular cartilage (AC) mechanics by manipulating the osmotic environment and tissue compressive offset. Cylindrical samples were obtained from the menisci and AC of bovine stifles, equilibrated in phosphate‐buffered saline solutions ranging from 0.1× to 10×, and tested in oscillatory torsional shear and unconfined compression. Biochemical analysis indicated that treatments and testing did not substantially alter tissue composition. Mechanical testing revealed tissue‐specific responses to both increasing compressive offset and decreasing bath salinity. Most notably, reduced salinity dramatically increased the shear modulus of both axially and circumferentially oriented meniscal tissue explants to a much greater extent than for cartilage samples. Combined with previous studies, these findings suggest that meniscal proteoglycans have a distinct structural role, stabilizing, and stiffening the matrix surrounding the primary circumferential collagen bundles. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:95–102, 2012     

不同预处理对肝硬化兔缺血再灌注肝组织HSP70及ET-1表达的影响

目的:探讨两种预处理方式,即经典缺血预处理(IPC)与肢体缺血预处理(LIPC),对肝硬化兔肝缺血再灌注(I/R)损伤的保护作用及可能的作用机制。方法:皮下注射CCl4-橄榄油溶液制备兔肝硬化模型,随后将模型兔随机分为假手术组,肝I/R组(I/R组),IPC+肝I/R组(IPC组),LIPC+肝I/R组(LIPC组),每组7只。肝I/R模型制作方法:阻断入肝血流30 min,再灌注2 h;IPC诱导方法:在行肝I/R处理前阻断入肝血流10 min,开放10 min;LIPC诱导方法:在行肝I/R处理前24 h,采用止血带捆扎兔单侧后肢5 min,再开放5 min,重复3次。各组于再灌注2 h后切取肝组织,行组织形态学观察,用ELISA法测定内皮素1(ET-1)含量及Western blot法检测热休克蛋白(HSP70)的表达。结果:与假手术组比较,其余各组在肝硬化病变的基础上均出现不同程度的变性、水肿和炎性细胞浸润,但IPC组与LIPC组明显轻于I/R组,而LIPC组及IPC组间病变程度无明显差异;与假手术组比较,其余各组肝组织ET-1含量和HSP70的表达均明显增加(均P<0.05),但IPC组与LIPC组肝组织ET-1含量低于I/R组,HSP70的表达高于I/R组(均P<0.05),而上述2项指标在LIPC及IPC组间均无统计学差异(均P>0.05)。结论:LIPC和IPC均能对肝硬化肝I/R损伤有保护作用,且保护强度相似,其机制可能均与抑制ET-1的释放及增加HSP70的表达有关;LIPC具有无创性,可能具有更大的临床应用前景。     

伤科消肿止痛膏制备工艺以及有效成分含量测定

目的：优选伤科消肿止痛膏的制备工艺,测定指标成分的含量。方法：设计正交实验优选伤科消肿止痛膏醇提工艺。运用单因素考察法优选制备工艺。采用HPLC色谱法检测大黄素和虎杖苷的含量。结果：优选的醇提工艺为7倍量的70%乙醇提取3次,每次2 h。优选的制备工艺为明胶和阿拉伯胶的比例为1:4,使用3倍量伤科消肿止痛膏提取液,所得膏体黏度适中。测得大黄素的含量为4.14 μg·g-1,虎杖苷的含量为12.71 μg·g-1。结论：实验优选的工艺稳定可行,可用于伤科消肿止痛膏制备。选取的指标成分大黄素和虎杖苷含量测定结果稳定,可用于质量控制。     

TST联合外剥内扎术预防环状混合痔术后肛缘水肿的临床观察(附100例报告)

目的探讨选择性痔上黏膜切扎肛垫保留术(Tissue-Selecting Therapy Stapler,TST)联合外剥内扎术预防环状混合痔术后肛缘水肿的方法及疗效。方法对100例环状混合痔的患者行选择性痔上黏膜切扎肛垫保留术(TST)联合外剥内扎术,术后住院期间肛缘水肿情况进行评价。结果术后住院期间水肿得分情况:0分90例,1分8例,2分2例。住院天数7.5±4.5d。结论 TST联合外剥内扎术可以很好的保护肛垫组织,一定程度上阻断脱垂较严重的痔核的血供,可以良好的预防术后肛缘水肿的发生。     

倒凹形旋转截骨术治疗先天性尺桡骨近端联结

先天性尺桡骨近端骨性联结(congenital radioulnar synostosia)是一种少见的先天性畸形，主要是尺骨和桡骨近端发生骨性联结，使前臂固定在不同角度的旋前位。尺桡骨近端截骨术是目前公认的较好的治疗方法之一，自1987年以来，在传统截骨方法的基础上加以改良，采用倒凹形旋转截骨术治疗先天性尺桡骨近端骨性联结9例，效果良好，现报告如下。     

大鼠同种异体肢体移植中T淋巴细胞亚群的变化及其意义

目的 建立大鼠同种异体肢体移植模型，研究肢体移植中T细胞亚群的变化及其与急性排斥反应的关系。方法 将31只SD雄性大鼠随机分成两组，其中对照组14只为Wista→SD肢体移植术后不用药组，实验组17只为FK506(4mg／kg体重) RS-61443(30mg／kg体重)联合免疫抑制治疗组，观察各组移植术后排斥反应；用免疫荧光染色流式细胞仪检测各组手术前后T细胞亚群。结果 术后第3天，CD4／CDs比值显著增高，移植肢体开始出现肿胀、皮肤红斑等表现；CD4／CD8比值增高与排斥反应程度呈正相关，而用药组术后，CD4／CD8较术前无明显变化，未出现排斥反应。结论 T细胞亚群中CD4／CD8比值的变化与肢体移植急性排斥反应的发生、强烈程度有密切关系，可作为监测异体肢体移植急性排斥反应的免疫学指标。     

大鼠骨骼肌缺血再灌注时血红素氧合酶-1的表达

目的：观察大鼠缺血再灌注时骨骼肌中血红素氧合酶－1（HO－1）表达的变化，方法：夹闭大鼠股动脉造成下肢缺血模型，分别采集假手术（S）组，单纯缺血（I）4小时组及缺血4小时再灌注（R）2、4、8、16和24小时组的比目鱼肌，检测其组织学和丙二醛（MDA）含量变化，通过Northern印迹、Western印迹及免疫组织化学分析，观察HO－1表达的变化。结果：S组和I组未见HO－1mRNA表达；R2组可见其表达信号，且随着再灌注时间延长表达信号逐渐增强，到R8组时达到高峰，之后渐减弱，R24组时已消失。蛋白表达的变化与mRNA变化基本一致，免疫组织化学显示，R组HO－1阳性信号主要出现在骨骼肌细胞浆内，S组和I组均未见阳性信号。与S组相比，R各组MDA含量显著增高（P＜0．05），但R8组较R4组显著减低（P＜0．05）。结论：肢缺血再灌注可诱发骨骼肌HO－1的表达，其表达可能具有保护作用。     

Nerve Growth Factor Promotes Angiogenesis and Skeletal Muscle Fiber Remodeling in a Murine Model of Hindlimb Ischemia

Background:

Therapeutic angiogenesis has been shown to promote blood vessel growth and improve tissue perfusion. Nerve growth factor (NGF) has been reported to play an important role in both physiological and pathological angiogenesis. This study aimed to investigate the effects of NGF on angiogenesis and skeletal muscle fiber remodeling in a murine model of hindlimb ischemia and study the relationship between NGF and vascular endothelial growth factor (VEGF) in angiogenesis.

Methods:

Twenty-four mice were randomly allocated to normal control group (n = 6), blank control group (n = 6), VEGF gene transfection group (n = 6), and NGF gene transfection group (n = 6). The model of left hindlimb ischemia model was established by ligating the femoral artery. VEGF₁₆₅ plasmid (125 μg) and NGF plasmid (125 μg) was injected into the ischemic gastrocnemius of mice from VEGF group and NGF group, respectively. Left hindlimb function and ischemic damage were assessed with terminal points at 21^th day postischemia induction. The gastrocnemius of four groups was tested by hematoxylin-eosin staining, proliferating cell nuclear antigen and CD34 immunohistochemistry staining, and myosin ATPase staining. NGF and VEGF protein expression was detected by enzyme-linked immunosorbent assay.

Results:

On the 21^th day after surgery, the functional assessment score and skeletal muscle atrophy degree of VEGF group and NGF group were significantly lower than those of normal control group and blank control group. The endothelial cell proliferation index and the capillary density of VEGF group and NGF group were significantly increased compared with normal control group and blank control group (P < 0.05). The NGF and VEGF protein expression of NGF group showed a significant rise when compared with blank control group (P < 0.05). Similarly, the VEGF protein expression of VEGF group was significantly higher than that of blank control group (P < 0.05), but there was no significant difference of the NGF protein expression between VEGF group and blank control group (P > 0.05). The type I skeletal muscle fiber proportion in gastrocnemius of NGF group and VEGF group was significantly higher than that of blank control group (P < 0.05).

Conclusions:

NGF transfection can promote NGF and VEGF protein expression which not only can induce angiogenesis but also induce type I muscle fiber expression in ischemic limbs.     

关节假体置换术在髋关节周围骨折中的应用及对骨折愈合与患肢疼痛的影响

目的 探讨关节假体置换术在髋关节周围骨折中的应用及对骨折愈合与患肢疼痛的影响。方法 选择2015年6月~2016年10月北京市丰台中西医结合医院收治的96例髋关节周围骨折患者为研究对象,按抽签法随机分为实验组和对照组,每组48例。实验组采用关节假体置换术进行治疗,对照组采用动力髋螺钉内固定术进行治疗,所有患者均给予术后常规护理,观察比较两组患者治疗后血清中骨代谢分子及骨细胞因子含量,治疗前后血清疼痛介质含量,治疗前后关节功能评分（Harris评分及LKSS评分）及术后并发症。结果 两组患者接受手术治疗1个月后,实验组患者血清中PINP、PICP的含量明显高于对照组［（26.43±3.54）vs（12.56±1.43）、（19.45±2.32）vs（10.12±1.55）］,TRAP5b、GatK的含量明显低于对照组［（17.62±2.11）vs（29.21±3.67）、（9.53±1.11）vs（22.32±2.82）］,差异均有统计学意义（P＜0.05）;实验组患者血清中骨细胞因子（BMP、TGF β、FGF、IGF-I、IGF-II）的含量显著高于对照组［（9.32±1.12）vs（4.39±0.71）、（36.64±4.75）vs（16.56±2.23）、（1152±1.52）vs（5.13±0.65）、（8.66±0.98）vs（4.14±0.62）、（1432±1.79）vs（7.89±0.92）］,差异均有统计学意义（P＜0.05）;治疗3、6个月后两组患者Harris评分、LKSS评分均明显提高,且实验组较对照组显著提高［（68.53±11.61）vs（56.02±12.51）、（80.01±3.82）vs（74.32±4.41）;（87.14±12.72）vs（7853±10.43）、（94.27±4.79）vs（84.11±3.22）］,差异均有统计学意义（P＜0.05）;实验组患者术后并发症发生率（10.42%）明显低于对照组（27.08%）,差异有统计学意义（P＜0.05）。结论 采用关节假体置换术治疗髋关节周围骨折,能够明显改善患者髋关节及膝关节功能,促进骨折愈合,明显减轻患者疼痛,减少术后并发症,值得临床推广应用。     

鼻病治验三则

连建伟老师擅治内科疾病，但通过辨证论治，司外揣内，对治疗鼻病也有很好的效验，兹摘录三则以飨同道。