Auricular skin-cartilage sandwich graft technique for full-thickness eyelid reconstruction

Full-thickness deficiency of eyelid tissues can result in coloboma or retraction or both. Here we report our initial experience on the use of auricular skin-cartilage sandwich graft technique for full-thickness eyelid deformities. Five patients (4–32 years) underwent the procedure. Patients with full-thickness eyelid deformity were included. Three patients were operated for large-sized coloboma and two for eyelid retraction. One patient had congenital, and four patients had acquired etiology. The following parameters were specifically assessed: correction of deformity, ocular surface problems, graft status, and epithelization of skin-cartilage graft. All the patients had a good correction of eyelid position, except one patient who had severe eyelid retraction (8 mm) at presentation. None of our patients had corneal erosion/defect, persistent ocular surface redness, or graft loss. The auricular skin-cartilage sandwich graft technique produces optimal results with no graft loss. Advancement of orbicularis muscle in between the auricular skin and cartilage grafts (sandwich technique) is an imperative step that leads to the survival of both grafts.     

灵仙通络方对C518大鼠膝关节退变软骨细胞增殖、Ⅱ型胶原及基质金属蛋白酶-13表达的影响

目的：探讨灵仙通络方对C518大鼠膝关节退变软骨细胞增殖、Ⅱ型胶原（COL-Ⅱ）及基质金属蛋白酶-13（MMP-13）的影响。方法选取C518大鼠膝关节软骨细胞株,随机分为中药组（灵仙通络方）、西药组（氨糖美辛）和对照组（氯化钠溶液）,进行培养、诱导退变等处理,于给药后第1、2、3 d,分别检测中药组、西药组和对照组不同浓度下对软骨细胞增殖、COL-Ⅱ及MMP-13表达的影响。结果同一时间点的中药组、西药组不同浓度之间噻唑蓝（MTT）值差异有统计学意义（P＜0.01）。对照组不同浓度氯化钠溶液的MTT值差异不具有统计学意义（P＞0.05）。在COL-Ⅱ免疫组化染色中,中药组与西药组和对照组相比差异有统计学意义（P＜0.01）,且中药组优于西药组（染色指数χ2=16.26,df=2,P＜0.01）。在 MMP-13免疫组化染色中,对照组较中药组、西药组差异有统计学意义（P＜0.01）,且中药组优于西药组（染色指数χ2=54.31,df=2,P＜0.01）。结论 C518大鼠膝关节退变软骨细胞经灵仙通络方干预后能够促进其增殖,调节COL-Ⅱ、MMP-13的表达,延缓膝关节骨性关节炎疾病的发展进程。     

骨关节炎髌下脂肪垫与软骨缺损的相关性研究

目的 探讨膝骨关节炎( OA )患者髌骨下脂肪垫( IPFP)大小与软骨缺损之间的关系. 方法 收集174例膝OA患者,对患者一般情况行问卷调查,在核磁共振3D脂肪抑制T1加权回波序列上利用Osirix软件测量IPFP容积,在核磁共振T2加权质子密度加权快速自旋回波序列上对软骨缺损进行评级(0~4级),分析IPFP容积与软骨缺损之间的关系. 结果 放射性OA与非放射性OA患者IPFP体积差异无统计学意义;不同严重程度OA患者的IPFP体积差异有统计学意义(P<0. 05);OA患者IPFP体积与性别呈负相关性,与身高、体重呈正相关性,差异有统计学意义(P <0. 05);IPFP体积与膝关节内外侧股骨、外侧胫骨以及髌骨软骨缺损呈负相关性,差异有统计学意义( P<0. 05 ). 结论IPFP体积与软骨缺损及OA的病情严重程度相关, IPFP在OA发生发展中可能起保护作用.     

富血小板血浆联合骨髓间充质干细胞不同 配比浓度对兔软骨缺损的影响

目的: 研究富血小板血浆(PRP)与骨髓间充质干细胞(BMSCs)不同的配比浓度对兔软骨缺损的治疗效果。方法: 随机将60只新西兰兔随机分为模型对照组、PRP组(3%)、BMSCs组(1×10⁶/mL)、不同配比浓度的PRP+BMSCs联合组(1:5,2:5,3:5)。建立兔软骨损伤模型,术后第2周靶侧肌肉注射不同配比浓度的PRP与BMSCs,每周1次,连续给药4周。采用Masson's三色染色法,观察关节软骨缺损情况;采用Pineada法进行关节软骨组织学半定量计分,并通过观察患兔术膝切口,了解术后愈合情况。结果: 与模型对照组比较,不同配比浓度的PRP与BMSCs联合组中的关节软骨半定量分值均减少(P<0.05)。不同配比浓度的PRP与BMSCs联合组中,关节软骨半定量分值随PRP浓度的增加而减少,关节软骨半定量分值与PRP值呈现线性关系,其中PRP与BMSCs配比浓度为3:5的效果最为明显,差异有显著性意义(P<0.05)。结论: PRP,BMSCs在一定程度上可促进骨组织恢复;关节软骨缺损恢复程度与PRP浓度表现出一定的量效关系。     

大鼠膝关节软骨不同染色方法的差异

背景：国内外学者对关节软骨对软骨进行了大量研究,需要用不同的染色方法对研究结果进行分析,但将多种染色方法同时应用于软骨研究及探讨染色机制的较少。 目的：探讨不同染色方法对大鼠膝关节软骨染色的优缺点。 方法：取正常大鼠膝关节软骨,行苏木精-伊红、番红O、阿尔辛蓝、甲苯胺蓝、番红-阿尔辛蓝、番红-固绿染色,观察软骨结构。 结果与结论：苏木精-伊红、番红O、甲苯胺蓝染色均可观察到潮线,分别为蓝色、红色和蓝色,番红O和甲苯胺蓝染色强度朝潮线方向增强,番红O染色对潮线的观察优于其他染色方法。苏木精-伊红染色关节软骨4层结构清晰,软骨细胞呈柱状排列,基质呈均匀呈嗜碱性染色。番红O染色显示4层结构层次清楚,基质深层染色最红。阿尔辛蓝染色显示,pH 1.0时软骨细胞周边部分被阿尔辛蓝强烈染色,pH 2.5时阿尔辛蓝染色较深。甲苯胺蓝染色显示组织结构层欠清,胞核染色清晰,胞浆几乎不着色,基质呈淡蓝紫色。番红-阿尔辛蓝染色显示软骨表面及基质呈不均一的红色,深层颜色较深,软骨细胞周围蓝染;番红-固绿染色显示软骨基质呈均匀的红色,软骨下骨呈绿色,软骨组织与骨组织分对比鲜明。提示上述各种方法均可观察到软骨的四层结构,但以番红O染色显示软骨各层和潮线结构最佳;苏木精-伊红染色观察软骨细胞形态变化较其他方法清楚。     

Quantitative MRI of articular cartilage and its clinical applications

Cartilage is one of the most essential tissues for healthy joint function and is compromised in degenerative and traumatic joint diseases. There have been tremendous advances during the past decade using quantitative MRI techniques as a noninvasive tool for evaluating cartilage, with a focus on assessing cartilage degeneration during osteoarthritis (OA). In this review, after a brief overview of cartilage composition and degeneration, we discuss techniques that grade and quantify morphologic changes as well as the techniques that quantify changes in the extracellular matrix. The basic principles, in vivo applications, advantages, and challenges for each technique are discussed. Recent studies using the OA Initiative (OAI) data are also summarized. Quantitative MRI provides noninvasive measures of cartilage degeneration at the earliest stages of joint degeneration, which is essential for efforts toward prevention and early intervention in OA. J. Magn. Reson. Imaging 2013;38:991–1008. © 2013 Wiley Periodicals, Inc.     

Current concepts in stem cell therapy for articular cartilage repair

Introduction: Hyaline articular cartilage is the connective tissue responsible for frictionless joint movement. Its degeneration ultimately results in complete loss of joint function in the late stages of osteoarthritis. Intrinsic repair is compromised, and cartilage tissue regeneration is difficult. However, new options are available to repair cartilage tissue by applying ESCs, MSCs and CPCs.

Areas covered: In this review, the authors shed light on the different concepts currently under investigation for cartilage repair.

Expert opinion: So far, there is no way to derive a chondrogenic lineage from stem cells that forms functional hyaline cartilage tissue in vivo. One alternative might be to enhance the chondrogenic potential of repair cells, which are already present in diseased cartilage tissue. CPCs found in diseased cartilage tissue in situ are biologically driven toward the osteochondrogenic lineage and can be directed toward chondrogenesis at least in vitro.     

类风湿性关节炎的MRI研究进展

传统X线平片、CT及超声在早期诊断类风湿性关节炎（RA）方面存在一定局限性。MRI已成为目前早期诊断RA、判断病情及监测疗效的主要方法之一。本文就近年来MRI诊断RA方面的应用现状进行综述。     

Matrix depletion of young and old human articular cartilage by cultured autologous synovium fragments: a chondrocyte-independent effect

Summary Human articular cartilage of different ages was cultured for 8 days and proteoglycan (PG) release into the medium was measured. Retinol and synovial co-culture increased the PG release of cartilage of all ages. The effect of retinol was dose-dependent. Synovium increased also the PG release of dead cartilage, whereas retinol did not. The increased PG release by synovial co-culture is therefore mainly the result of synovial enzymes acting directly on the matrix rather than of a factor inducing chondrocyte-mediated breakdown.