臭氧与胶原酶联合治疗腰椎间盘突出症的临床应用价值

目的观察DSA引导下臭氧与胶原酶联合治疗腰椎间盘突出症的临床应用价值。方法56例腰椎间盘突出症患者在DSA监视引导下，经患侧后方穿刺成功后，病变椎间盘注射60μg/mL O3 20～30mL，盘外及神经根周围注入浓度为30μg/mL O3 10-20mL，后经骶管裂孔穿刺置管于硬膜前间隙病变椎间盘处注射600～1200U胶原酶。结果术后随访1个月、3个月，3个月获得最佳疗效，其优、良、中、差率分别为62．3％、32．1％、3．9％、1．7％，优良率94．4％。结论DSA引导下臭氧与胶原酶联合治疗腰椎间盘突出症，在作用机制上优势互补，是一种安全、有效的方法。     

Expression of Interstitial Collagenase (Matrix Metalloproteinase-1) in Gastric Cancers

The expression of matrix metalloproteinase-1 (MMP-1) gene and the presence of MMP-1 protein in gastric cancer were examined by in situ hybridization and immunohistochemistry. Expression of the interstitial Collagenase (MMP-1) gene was detected within the stroma of the neoplastic glands, and infiltration of eosinopilic was observed to be associated with regions of MMP-1 gene expression. The degree of eosinophils infiltration correlated with the level of MMP-1 mRNA expression. Immunostaining showed localization of MMP-1 protein in the stromal cells, and additionally in the neoplastic glands. These findings indicate that the stromal cells may play an important role in the expression of MMP-1, and suggest a pathophysiological role for MMP-1 in the invasion and metastasis of gastric cancer.     

Technical aspects of islet preparation and transplantation

The introduction of insulin therapy for the management of diabetes mellitus is arguably the greatest milestone in the history of modern medicine. -cell replacement therapy is the only treatment that reestablishes and maintains long-term physiological normoglycemia. Until recently, successful clinical outcomes of pancreas transplantation for patients with long-standing diabetes were much superior to that of islet transplantation. Significant advances in islet isolation and purification technology, the development of more specific and less diabetogenic immunosuppressants and the prophylactic administration of antiviral agents have rekindled a worldwide interest in islet transplantation. This chapter will review the rationale of islet transplantation and the development of islet isolation and purification. The challenges facing clinical islet transplantation in the twenty-first century will also be introduced.     

椎间盘突出症不同治疗方法回顾性分析

目的分析臭氧髓核消溶术（A组）、后路开窗髓核摘除术（B组）以及胶原酶化学髓核消溶术（C组）治疗椎间盘突出症的方法和后期效果。方法采用统一的病例选择和疗效标准,对185例患者（其中A组60例,B组63例,C组62例）进行分析,比较3组治疗后评分和优良率。结果A组治疗后评分和优良率明显高于B组和C组,有非常显著性差异（P〈0.01）,B组高于C组有显著性差异（P〈0.05）。结论椎间盘突出症不同治疗方法中,臭氧髓核消溶术和胶原酶化学髓核消溶术明显优于开窗髓核摘除术,具有基本无创的优点。而开窗髓核摘除术相对而言创伤较大,对脊柱的稳定性有一定的影响。臭氧髓核消溶术是椎间盘突出症治疗方法中最理想的方法。     

大鼠胰岛分离及纯化方案的改进

目的优化大鼠胰岛分离纯化条件,为糖尿病胰岛受损的发病机制研究及胰岛再生的应用提供必要材料。方法胆总管原位灌注胶原酶V消化胰腺并分离胰岛后,比较经典不连续密度梯度Ficoll离心法和Histopaque1077密度离心法纯化胰岛的效果,其间观察胰腺灌注液体积及消化时间不同对大鼠胰岛分离纯化的影响,并对纯化后的胰岛进行数量、纯度和功能的体外检测。结果 Histopaque 1077密度离心法比经典不连续密度梯度Ficoll离心法可得到更多优质的胰岛(P<0.01)。两种方法获得的胰岛在高糖刺激下释放胰岛素的能力差异无统计学意义(P>0.05)。胰腺灌注液之体积及消化时间对胰岛提取有十分重要的影响。结论 Histopaque 1077密度离心法简单易行且效率较高,有望成为纯化大鼠胰岛的首选方法,便于临床和基础研究工作的开展。     

胶原酶溶解术治疗腰椎间盘突出症的适应症分析

目的：评价胶原酶溶解术后1、2、3年的疗效，分析疗效与适应症之间的关系。材料与方法：按统一的诊断标准、治疗方法，对1996年1月-1999年1月行胶原酶溶术、资料完整的腰椎间盘突出症患者1254例进行随访观察，按统一的疗效标准评价胶原酶溶解术的1、2、3年的疗效。结果：“单纯性椎间盘突出症”，1年优良率93．1％，2年优良率90．3％，3年优良率90．9％。结论：“单纯性椎间盘突出症”是胶原酶溶解术的最佳适应症，合并有其他影响因素的椎间盘突出症应慎重选择胶原酶溶解术。     

探讨硫酸软骨素酶在兔耳增生性瘢痕模型中的作用

目的应用兔耳模型探讨硫酸软骨素裂解酶在增生性瘢痕中的作用。方法将健康的日本大耳白兔12只，随机分成胶原酶治疗组（A组）、硫酸软骨素裂解酶与胶原酶混合治疗组（B组）、硫酸软骨素裂解酶治疗组（C组）、对照组（D组）。采用复合染色法观察组织形态学变化，并进行图像定量分析。羟脯氨酸含量测定。结果各治疗组酸性黏多糖染色变浅，数量减少，胶原纤维被破坏，排列稀疏。A、B、C、D组的羟脯氨酸含量，随着时间的变化其含量不一致（P〈0．05），A、C组与B组比较在第28天差异有显著意义（P〈0．05），B组与A组比较在第35天差异有显著意义（P〈0．05），在用药两周后B组羟脯氨酸含量始终低于其他各组。结论硫酸软骨素裂解酶水解了硫酸软骨素，在去除了胶原纤维周围的酸性黏多糖后，促进了胶原的降解，提示可能为瘢痕的治疗提供新的途径。     

Ⅳ型胶原酶门脉灌注治疗兔肝硬化有效性与安全性的观察

目的应用四氯化碳(CCl4)诱导兔肝硬化模型,观察Ⅳ型胶原酶门脉灌注对肝硬化程度及全身重要器官组织病理学的影响。方法新西兰大白兔皮下注射50%CCl4橄榄油造模后,将已形成肝硬化并门静脉插管成功的30只兔随机分为2组,组1经门静脉给药通路注入0.1%Ⅳ型胶原酶1.5 mL,组2注入等量0.9%氯化钠,5次/周,共4周。4周后,将各组动物处死,留取各器官组织,观察其病理学变化。结果造模成功后可观察到典型肝硬化病理表现,门脉灌注0.1%Ⅳ型胶原酶肝硬化动物肝脏纤维化程度明显降低,门静脉、心脏、肺、肾脏、脑组织等部位组织病理学无异常表现。结论采用门脉灌注0.1%Ⅳ型胶原酶可显著降低肝纤维化程度,在此剂量下,具有一定的全身安全性。     

Neutral metalloprotease from tendons

Tendon repair following trauma, rupture, or surgery involves both synthesis and degradation of collagen in order to reweave new collagen bundles in with the old. Using an in situ assay on polyacrylamide gels containing gelatin, we have identified protease activity from tendon tissue and from tendon cells in culture. A population of synovial cells from the epitenon surrounding the tendon as well as the tendon fibroblasts themselves were examined. The cells and the conditioned medium from both cell populations exhibited a major band of gelatin-degrading activity at 70 kdaltons and a minor band of activity at 60 kdaltons. When preparations were reacted with p-aminophenylmercuric acetate (APMA) before electrophoresis, a third band appeared at 63 kdaltons. The main band at 70 kdaltons comigrated with a [35S]methionine-radiolabeled protein band. Inhibitor and pH studies identified the enzymes as neutral metalloproteases requiring disulfide bonds for activity. No proteolytic activity was detected on casein-containing gels, ruling out the presence of stromelysin. Since electrophoresis in the presence of SDS would separate the metalloprotease from the smaller molecular weight inhibitor (TIMP), these in situ assays provide a sensitive screening system for gelatin-degrading enzymes present in tendon without prior removal of TIMP.