臭氧与胶原酶联合应用治疗腰椎间盘突出症

目的：研究臭氧髓核氧化术结合胶原酶溶解术治疗腰椎间盘突出症的临床疗效。方法：对45例腰椎间盘突出症患者进行臭氧结合胶原酶盘内、外注射治疗。术后随访6-12个月,按照Macnab评定标准进行疗效评定。结果：45例患者,优32例,良8例,可2例,差3例;优良率为88.9%,有效率为93.3%。结论：臭氧髓核氧化术结合胶原酶溶解术治疗腰椎间盘突出症集合了两者的优点,疗效好,是腰椎间盘突出症首选的微创治疗方法。     

Use of intralesional collagenase in the treatment of peyronie’s disease: A review

AIM: To review the relevant literature in an effort to examine the body of evidence available to date. METHODS: Ovid MEDLINE search database was queried using MeSH terms “penile induration”, “peyronie’s disease”, “Collagenases” and “Collagenase” using various permutations. No temporal parameters were employed. RESULTS: In all, 5 relevant clinical trials were isolated from 34 results. These trials were analyzed using the Oxford Centre for Evidence-Based Medicine criteria. They were further examined based on study design and methods; the primary and secondary outcomes were reviewed for treatment efficacy and collagenase-related side effects. CONCLUSION: Intralesional collagenase appears to be safe and effective in the non-surgical treatment of Peyronie’s disease. However, the data remains limited and further inquiries into the safety of collagenase, treatment standardization and standardized outcomes reporting remain necessary. Furthermore, studies comparing intralesional collagenase to alternative medical and surgical therapy will be important in guiding the future treatment decision process.     

胶原酶对人根面牙本质胶原蛋白降解作用的实验研究

目的：探讨胶原酶对脱矿后的人牙根面牙本质胶原蛋白的降解作用。方法：根面牙本质标本用pH5.0的乳酸37℃孵育脱矿。分别于第1、7、14、21和28天取孵育液，10000r/min，4℃离心，上清液作Ca^2 测定和羟脯胺酸分析。脱矿后的标本加入pH7.4的胶原酶溶液，37℃孵育7d。孵育液10000r/min、4℃离心，上清液作羟脯胺酸分析。结果：随着时间的延长，Ca^2 释放量逐渐增加，增加量有显著性差异（P＜0．05）；胶原蛋白的释放量随时间的延长而增加，但增加量无显著性差异。如胶原酶降解后，当Ca^2 少于80.01μmol/cm^2时，胶原蛋白释放量增加明显（P＜0．001）；以后虽然Ca^2 浓度增加，胶原蛋白的增加量无显著性差异。结论：胶原酶对根面牙本质胶原蛋白的降解作用与Ca^2 密切相关。保留龈损区的矿物质对于预防胶原纤维的降解、促进早期根面龋的再矿化是非常重要的。     

The prognostic value of the expression of collagenase IV, cathepsin D and metallothionein in squamous cell carcinomas of the skin determined by immunohistochemistry

Abstract  We analyzed 53 specimens from primary squamous cell carcinomas of the skin for the expression of collagenase IV, cathepsin D and metallothionein by means of immunohistochemistry along with histological data. We compared tumors that metastasized (30) with tumors that did not (23) during a follow-up period of at least 5 years. The expression of the two proteolytic enzymes cathepsin D and collagenase IV was also assessed at the invading front of the tumors. Statistical analyses revealed significant differences for the overall expression of cathepsin D (P < 0.05), expression of cathepsin at the invading front (P < 0.05) and the tumor thickness (P < 0.01). The results showed that cathepsin D may be a prognostic factor for squamous cell carcinomas of the skin. We then combined the results of parameters with statistically significant differences by multiplication. The prognostic value of such a combined risk-factor score showed higher confidence than any of the single parameters alone: a sensitivity of 63.3%, a specificity of 87.0% and an efficiency of 73.6%. This kind of combined risk-factor score might be used to more accurately detect patients at high risk of metastasis. Received: 16 June 2000 / Revised: 1 September 2000 / Accepted: 10 December 2000     

CT导引注射胶原酶治疗腰椎间盘突出症的临床研究

目的：探讨ＣＴ引导下椎间盘突出的髓核内和突出物表面注射胶原酶治疗椎间盘突出 的效果。方法：对９０例椎间盘突出的患者在ＣＴ导引下分别于椎间盘突出的髓核内和突出物的表达注射胶原酶,所有患者随访３个月￣２年,其中３０例行ＣＴ复查。结果：穿刺成功率１００％,术后随访３个月￣２年,优良率为９５．６％,２９例ＣＴ随访突出物 部分缩小或消失（９６．７％）,本组无并发症。结论”腰椎间盘突出的髓核内和突出物的表面共     

经皮切割联合盘内注射治疗腰椎间盘突出症

目的 :探讨经皮切割抽吸 (PLD)联合盘内注射胶原酶 (CNL)治疗腰椎间盘突出症的临床价值。方法 :本组共2 95例腰椎间盘突出症患者 ,其中联合治疗组 (PLD加CNL组 ) 14 5例和单纯经皮椎间盘切割组 (PLD组 ) 15 0例。PLD按常规操作完成 ,在PLD基础上 ,椎间盘内注射胶原酶 60 0U。术后观察、分析两组疗效及并发症。结果 :术后随访 6～ 2 4个月 ,全部病例 1次穿刺成功率为 93 .75 % ,治疗有效率 (按Macnab标准 ) :PLD CNL组 94% ,PLD组为 82 .5 % ,前者明显高于后者 (P <0 .0 0 1) ;PLD加CNL组中有疼痛反应者占 8%。结论 :PLD加CNL联合治疗腰椎间盘突出症具有更好的疗效、更广的适应证、较少的疼痛反应 ,值得推广。     

注射胶原酶治疗腰椎间盘突出症的临床应用

１９９４年１２月至１９９６年８月，我院主要采用盘外注射（２３０例）部分患者采用盘内注射（２０例）胶原酶治疗腰椎间盘突出症，随访２００例，优良率达９１％。介绍了注射胶原酶的操作方法及注意事项，认为：胶原酶化学溶解术疗效好、创伤小、操作简单、安全、并发症少。髓核突出大小１０ｍｍ，髓核突出伴钙化，伴侧隐窝狭窄，手术治疗复发的椎间盘突出症等，不是盘外注射胶原酶治疗的绝对禁忌证。     

胶原酶消化分离关节软骨种子细胞的优化获取

目的 探讨Ⅱ型胶原酶法消化分离关节软骨种子细胞的优化获取，以期保证获取关节软骨种子细胞的最佳生物活性。方法 采用不同浓度及不同消化时间的关节软骨细胞收获量、细胞存活率及细胞体外培养的生物活性为观察指标，探讨消化酶浓度及消化时间对于种子细胞获取量及细胞活性的影响。结果 种子细胞获取率与消化浓度无显著的线性相关关系；细胞活性在超过2．5h消化时间后显著减弱，部分细胞出现易老化现象；在0．15％消化酶浓度消化2．5h内所获取的种子细胞可达到满意的种子细胞获取率及良好的种子细胞生物活性。结论 适当浓度的胶原酶，在相应的时间内消化分离关节软骨种子细胞，或获取数量多及活性高的关节软骨组织工程种子细胞。     

胶原酶注射椎间盘溶解术治疗腰椎间盘突出症临床研究（附115例报告）

本文探讨胶原酶注射椎间盘突出溶解术治疗腰椎间盘突出症的临床意义于局麻下Ｘ线引导胶原酶硬膜外注射１１５例，治疗效果优良率８３．５％，表明该法是治疗腰椎间盘突出症一种有效的办法。     

The synovial production of collagenase and chondrocyte activating factors in response to cobalt

Addition of CoCl2 solutions to the culture media of confluent monolayers of lapine or human synoviocytes stimulated their production of the neutral proteinases collagenase, gelatinase, and caseinase. With lapine cells, maximum stimulation occurred at 10(-7) M CoCl2, while human cells required 10(-4)-10(-5) M CoCl2 to achieve a maximum stimulation. Production of prostaglandin E2 by lapine cells was enhanced some 30-40% by concentrations of CoCl2 that maximally stimulated synthesis of the neutral proteinases, whereas all concentrations of CoCl2 slightly depressed the production of prostaglandin E2 by human cells. Lapine synovial cells that had been stimulated by CoCl2 also produced a substance, or substances, that provoked the synthesis of collagenase, gelatinase, caseinase, and prostaglandin E2 by monolayers of articular chondrocytes. Chondrocytes themselves, however, resisted activation by CoCl2. These findings may be relevant to the aseptic loosening of joint prostheses.