持续成骨力值对犬骨盆弓状线部骨折愈合的影响

[目的]探讨持续顺应生理力线的压应力对犬骨盆弓状线部骨折愈合的影响.[方法]选用10只成年杂种家犬,双侧髋臼臼顶上方1.5 cm处横形截骨,分别采用ATMFS（骨盆髋臼三维记忆内固定系统）前柱固定器和5孔重建钢板内固定,于术后2、4、6、8、12周处死动物取材,行HE染色、Masson三色法染色组织学检查,图像分析新骨形成积分光密度值,研究不同应力作用模式下的骨盆骨折愈合情况.[结果]ATMFS侧软骨组织形成,骨皮质、骨小梁及胶原纤维成熟时间明显早于钢板侧,术后6、8、12周,两侧骨折端新骨生成面积之间存在显著性差异（P＜0.05）.[结论]ATMFS固定后于骨折端产生的持续顺应生理力线的压应力能够刺激骨折端成骨细胞的形成及骨胶原的合成与分泌,促进骨折早期愈合.     

A Tissue-Engineered Artificial Bile Duct Grown to Resemble The Native Bile Duct

The aim of this study was to fabricate an artificial bile duct for the development of a new treatment for biliary diseases. Eighteen hybrid pigs were implanted with a bile duct organoid unit (BDOU) made of a bioabsorbable polymer. Twelve of the transplanted BDOUs had been seeded with autologous bone marrow cells (BMCs) in advance. Six animals, the controls, were grafted with the scaffold alone with no BMCs seeded. The common bile duct was cut, the hepatic cut end of the native common bile duct was anastomosed to the BDOU and the other end was anastomosed to the duodenum. The controls underwent a similar operation. The neo-bile duct was removed at pre-determined time points and investigated histologically. All 18 recipient pigs survived until their sacrifice at 6 weeks, 10 weeks or 6 months. Histological examination revealed incomplete epithelialization of the neo-bile duct at 6 weeks and 10 weeks after transplantation. At 6 months, the organoid exhibited a morphology almost identical to that of the native common bile duct. No differences were found between the controls and BMC-seeded pigs. These results show that the artificial bile duct thus fabricated can serve as a substitute for the native bile duct.     

Effects of gastric bypass procedures on bone mineral density,calcium, parathyroid hormone,and vitamin d

Weight loss after gastric bypass procedures has been well studied, but the long-term metabolic sequelae are not known. Data on bone mineral density (BMD), calcium, parathyroid hormone, and vitamin D were collected preoperatively and at yearly intervals after gastric bypass procedures. A total of 230 patients underwent preoperative BMD scans. Fifteen patients were osteopenic preoperatively, and three patients subsequently developed osteopenia postoperatively within the first year. No patient had or developed osteoporosis. At 1 year, total forearm BMD decreased by 0.55% (n = 91; P = .03) and radius BMD had increased overall by 1.85% (n = 23; P = .008); both total hip and lumbar spine BMD decreased by 9.27% (n = 22; P < .001) and 4.53% (n = 31; P < .001), respectively. By the second postoperative year, BMD in the total forearm had decreased an additional 3.62% (n = 14; P<.001), whereas radius BMD remained unchanged. Although total hip and lumbar spine BMD significantly decreased at 1 year, by year 2 both total hip and lumbar spine BMD only slightly decreased and were not significantly different from before the operation. Serum calcium decreased from 9.8 mg/dL to 9.2 during the first year (not significant [NS]) and then to 8.8 (NS) by the second year. Parathyroid hormone increased from 59.7 pg/mL (nl 10-65 pg/mL) preoperatively to 63.1 during year 1 (NS) and continued to increase to 64.7 by year 2 (NS). No difference was noted among levels of 25-hydroxy vitamin D preoperatively (25.2 ng/mL; nl 10-65 ng/mL), at 1 year (34.4), and at 2 years (35.4). Our data indicate that bone loss is highest in the first year after gastric bypass with stabilization, and that, in some cases, there is an increase in bone density after the first year. Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18, 2005 (oral presentation).     

兔骨髓基质细胞诱导分化为胰岛素分泌细胞的方法

目的 探讨将骨髓基质细胞（MSCs）诱导成为胰岛素分泌细胞（IPCs）的方法。方法 体外培养新西兰兔骨髓及胰腺基质细胞和SD大鼠胰腺基质细胞，利用含有胰腺基质细胞培养基的混合培养基诱导培养MSCs。结果 以兔及SD大鼠胰腺基质细胞培养基均可诱导兔MSCs生成IPCs。结论 兔及SD大鼠的胰腺基质细胞培养基均可将兔MSCs诱导分化为IPCs。     

Electrophysiological study on differentiation of rat bone marrow stromal stem cells into neuron-like cells in vitro by edaravone

To explore the electrophysiological proper-ties of differentiation of rat bone marrow-derived stromal stem cells (rBMSCs) to neuron-like cells in vitro by edaravone, a new type of free radical scavenger. Methods: Stromal stem cells were separated from rat bone marrow with Ficoll-Paque reagent and expanded in different culture medium in vitro, rBMSCs were induced by edaravone containing serum-free L-DMEM. Morphologic observation and Western blot analysis including the ex-pression of Nav1.6, Kv1.2, Kv1.3, Cav1.2 were performed, and whole patch-clamp technique was used. Results: Cyton contraction and long processes were shown in differentiated stromal stem cells. Nav1.6, Kv1.2, Kv1.3 and Cav1.2 were expressed in both differentiated and undifferentiated cells. However, the expression of channel proteins in differentiated cells was up-regulated. Consistently, their resting potential and outward currents were also enhanced in the differentiated cells, which was especially significant in the outward rectifier potassium current. Conclusion: In vitro, neuron-like cells derived from rBMSCs, induced by edaravone, possess electrophysiologi-cal properties of neurons.     

自体骨髓基质干细胞复合珊瑚修复犬下颌骨节段缺损的初步研究

目的应用自体骨髓基质干细胞(bonemarrowstromalcells,BMSCs)复合珊瑚构建组织工程化骨,修复犬下颌骨节段性缺损。方法体外扩增培养、成骨诱导犬BMSCs。将第二代细胞复合珊瑚后修复犬自体右侧3cm的下颌骨节段缺损(n=6);以单纯珊瑚植入缺损处为对照(n=6),术后12、32周分别通过影像学,大体形态观察,组织学和生物力学的方法检测骨缺损的修复效果。结果成骨诱导的BMSCs在珊瑚支架上生长良好。X线片显示12周时实验组骨痂较多,对照组材料明显吸收;32周时CT、X线片和大体观察显示术后实验组骨愈合良好,对照组为骨不连;骨密度检测示实验组显著高于对照组(P<0.05);组织学示实验组有较多成熟骨呈骨性愈合,对照组为纤维性愈合;生物力学测试实验组与正常下颌骨力学强度差异无统计学意义(P>0.05)。结论自体成骨诱导BMSCs复合珊瑚形成的组织工程化骨可修复犬下颌骨节段缺损。     

以冻干骨为平台重建组织工程化关节软骨的研究

目的:探索在兔冻干异体骨关节平台上利用组织工程的方法再造人工关节软骨的可行性。方法:实验分成四组,运用组织工程方法将不同构成的同种异体兔软骨细胞-支架材料复合物种植于兔冻干异体骨关节平台上,植入实验兔体内,3月后取材观察体内成软骨情况。结果:仅种植兔软骨细胞的冻干骨关节支架上未见新生软骨形成。粘合有种植兔软骨细胞的PLGA膜片的冻干骨支架关节腔内见新生类软骨样物出现。自体软骨层孔洞缺损模型使用软骨细胞-PLGA膜片复合物可修复软骨缺损。结论:软骨细胞-PLGA膜片复合物实验动物关节内可形成软骨样物;但在冻干骨关节平台上尚不能形成有功能意义的关节软骨层。     

面神经管病变的多层螺旋CT评价

目的:分析面神经管病变CT表现,评价多层螺旋CT的临床价值。方法:回顾性分析面神经管病变患者35例CT资料,男24例,女11例,年龄4～51岁,平均27岁,所有患者均行多层螺旋CT扫描,常规行多平面重建和面神经管曲面重建。结果:面神经管骨折15例,其中鼓室段骨折8例,乳突段骨折5例,迷路段骨折2例;胆脂瘤型中耳炎侵犯面神经管15例;面神经瘤1例,乳突段面神经管前移2例,颞骨骨纤维异常增殖症累及面神经管2例。结论:多层螺旋CT及后处理成像能清晰显示面神经管病变,对临床诊断和治疗有重要价值。     

保留骨骺灭活再植术治疗儿童股骨远端骨肉瘤

[目的]探讨保留骨骺灭活再植术的临床应用注意事项及并发症的防治。[方法]回顾6年间所治疗的11例患者,男5例,女6例。平均年龄7.6岁。均位于股骨下端。MRI分型:Ⅰ型7例,Ⅱ型4例。1例合并病理骨折。治疗方法均采用术前化疗2疗程 保留骨骺灭活再植手术 术后化疗。[结果]手术时间为3~4 h。术中出血量为300~500 ml。无血管、神经损伤。术后切口一期愈合,无切口感染及切口延迟愈合。11例获得随访10~72个月,患膝屈曲>110°3例,90°~110°3例,60°~89°4例,<60°1例。下肢等长4例,患肢较健侧短<2 cm 5例,2~3cm 2例。复发1例,转移2例,死亡3例,螺钉松动1例,灭活骨骨折1例。[结论]保留骨骺灭活再植术有利于术后功能恢复和肢体长度的保持;严格无瘤及无菌操作、彻底引流、适当延长外固定的时间、功能锻炼时注意保护肢体等是预防并发症发生的主要措施。