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。     

一种高活力分离肿瘤浸润淋巴细胞方法的建立

肿瘤浸润淋巴细胞（ＴＩＬ）的增殖力、活力、杀伤力是ＴＩＬ临床治疗的基本问题。由于Ｒｏｓｅｎｂｅｒｇ方法存在着许多不足之处，本实验室对其一些重要步骤进行了改进：①用单一冷胶原酶消化肿瘤组织块；②省去影响ＴＩＬ活力的离心操作；③ＴＩＬ培养４８ｈ内除去掺杂在ＴＩＬ中的肿瘤细胞等。由于除去了影响ＴＩＬ活力的抑制因素，ＴＩＬ的增殖率、生存率、活力、杀伤力明显增加。有８０％肿瘤组织的ＴＩＬ经扩增可超过１×１０     

胶原酶对裸鼠移植肥厚性瘢痕的治疗作用

目的观察胶原酶对肥厚性瘢痕(HTS)胶原降解的影响,探讨它对 HTS 的治疗作用。方法建立 HTS 裸鼠移植模型,局部注射胶原酶于瘢痕组织。治疗后取材行光、电镜观察和分析。结果 HTS 组织胶原纤维被降解,真皮层变薄,瘢痕缩小,质地变软,与对照组差异十分明显。结论胶原酶的局部注射可能是治疗 HTS 的较好方法。     

经椎间孔硬膜外注入胶原酶治疗腰椎间盘突出症(附382例报告)

方法：自１９９４年以来采用胶原酶经腰椎间孔硬脊膜外注射治疗腰椎间盘突出症３８２例。本方法,采用胶原酶１２００Ｕ注入突出节段的硬脊膜外腔、让药物渗透到病变的椎间盘内,达到了溶解的目的。经随访优良率达９１％。结论：作者认为本手术方法简单易行、病人痛苦少、无后遗症收到较好的经济效益和社会效益,有推广的必要     

Involvement of 5-hydroxytryptamine and bradykinin in the hyperalgesia induced in rats by collagenase from clostridium histolyticum

The involvement of bradykinin, 5-hydroxytryptamine, substance P and prostanoids in the hyperalgesia elicited by collagenase in rat paw was investigated. Collagenase (100μg) induced a slight hyperalgesia in kininogen deficient rats in comparison with the behavioural response obtained in normal rats. Lisinopril (10^–5M), and angiotensin-converting enzyme inhibitor, increased the duration of the hyperalgesia elicited in normal rats. Ondansetron (0.5 to 5μmol/kg), a 5-HT₃ antagonist, suppressed the hyperalgesia as did methysergide (1.1 to 11μmol/kg), a mixed 5-HT₁ and 5-HT₂ receptor antagonist. However, the hyperalgesia was not modified by RP67580 (1.8 to 18μmol/kg), a NK₁ receptor antagonist, and was only slightly delayed by indomethacin (2mg/kg), a cyclo-oxygenase inhibitor. The oedema-promoting effect of 5-HT (6nmol) was inhibited by methysergide but not by ondansetron. The swelling induced by collagenase in rat paw was reduced by methysergide but not by ondansetron. We conclude that the behavioural reponse induced by collagenase depends on an interactions between bradykinin and 5-HT. Prostanoids play a minor role in the beginning of the reaction whereas substance P is not significantly involved in this hyperalgesia. Received: 23 September 1996 / Accepted: 20 January 1997     

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.     

CT引导下靶位注射胶原酶治疗腰椎间盘突出症中、远期疗效观察

目的探讨CT引导下靶位注射胶原酶治疗腰椎间盘突出症的中、远期疗效。方法在CT引导下经皮靶位注射胶原酶准确到达突出物治疗腰椎间盘突出症50例。结果随访36～60个月,总有效率分别为82．97％（大于36个月）、82．23％（大于60个月）。结论把握好适应证,CT引导下经皮穿刺靶位注射胶原治疗腰椎间盘突出症准确、安全、简便、有效,是此类患者首选的治疗方法之一。     

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.