大鼠基质金属蛋白酶-1表达质粒对实验性肝纤维化的影响

目的 观察重组基质金属蛋白酶－１真核细胞表达质粒对大鼠肝纤维化的影响。方法 运用ＤＮＡ重组技术,构建融合Ｆｌａｇ标记多肽的大鼠基质金属蛋白酶－１真核细胞表达质粒,经糖化多聚赖氨酸偶联后,利用静脉注射将其导入大鼠肝纤维化模型体内;通过ＲＴ－ＰＣＲ,Ⅰ、Ⅲ型胶原的免疫组化以及Ｍａｓｓｏｎ胶原染色观察重组基质金属蛋白酶－１表达质粒对大鼠肝纤维化的影响。结果 重组基质金属蛋白酶－１表达质粒可在大鼠肝脏中表     

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     

王氏抗肝纤方治疗肝纤维化的实验研究

目的：观察王氏抗肝纤方对肝纤维化的治疗作用及其作用机制。方法：采用二甲基亚硝胺诱导肝纤维化模型,从组织学改变观察王氏抗肝纤方的疗效,以γ干扰素及膈下逐阏汤作为对照组。结果：王氏抗肝纤方对肝纤维化大鼠能显著降低血清ＡＬＴ、ＡＳＴ及肝组织Ｈｙｐ含蛳,减少肝组织中ＣｏｌＩ、ＣｏｌⅣ的沉积和α－ＳＭＡ的表达,提高肝组织间质胶原酶活性。其作用同γ干扰素而明显优于膈下逐瘀汤。结论：王氏抗肝纤方具有较好的抗肝纤     

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     

Clinical outcomes following collagenase injections compared to fasciectomy in the treatment of Dupuytren’s contracture

IntroductionThe aim of this study is to compare the efficacy of collagenase injections with that of fasciectomy in the treatment of Dupuytren’s contracture.MethodsThis is a case–control retrospective study. We reviewed the electronic medical records from January 2009 through January 2013, identifying 142 consecutive patients who underwent either fasciectomy or collagenase injection. Exclusion criteria for both groups were age <18 years, pregnant women, and arthroplasty or arthrodesis of the treated joint. Follow-up data beyond 1-year duration was available for 117 of the patients: 44 patients who had undergone fasciectomy, and 73 patients who had received collagenase injection. The primary outcome measure in this study was resolution of joint contracture to 0–5° deficit of full extension. Data was analyzed using two-sample t tests for continuous data and chi-square test for categorical data. A significant P value was set at <0.05.ResultsAt the latest follow-up, significantly more joints treated with fasciectomy met the primary outcome measure. Metacarpophalangeal (MP) joints responded better than the proximal interphalangeal (PIP) joints for both treatments. At the latest follow-up (14.2 months for collagenase, 16.3 months for fasciectomy), 46 % of MP joints treated with collagenase and 68 % of MP joints treated with fasciectomy maintained resolution of joint contracture. Sub-analysis of the affected joints based on the severity of initial contracture demonstrated that MP and PIP joints with contractures <45° responded better than more severely contracted joints (>45°).ConclusionsFasciectomy yields a greater mean magnitude of correction for digital contractures at the latest follow-up when compared to collagenase. Both treatments were more effective for treatment of MP joint contracture compared to PIP joint contracture.

Level of Evidence

Level III, therapeutic.     

胶原酶溶解术治疗腰椎间盘突出症

采用国产胶原酶行腰椎间盘内注射治疗腰椎间盘突出症９０例。有效率为９３％，优良率为８４％。作者体会该方法创伤小，无出血，对椎管内无干扰。只要严格选择适应症，掌握正确的操作方法，无疑是一种有效的治疗方法。     

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。