珊瑚骨粉、口腔修复膜应用于即刻种植的临床研究

目的:选择合适的适应征进行微创拔牙后行即刻种植术,观察人工珊瑚颗粒、海奥生物膜行GBR技术,应用于前牙区即刻种植成骨效果.方法:25例前牙冠根折伴骨吸收患者进行即刻种植手术.微创拔除残根,牙槽窝嵴周少量骨缺损或伴唇侧骨壁洞穿,常规预备后植入种植体,种植体与牙槽窝骨壁间隙内、骨缺损处植入人工珊瑚颗粒(天博骨粉),盖海奥口腔修复膜,种植体均为潜入式愈合,二期手术后常规修复.观察二期手术及修复后6月或1年植骨区外形及牙龈状况.结果:二期手术时牙槽嵴成骨明显,包绕种植体颈周,二期手术修复后6月或1年牙槽外形均较植骨前丰满,牙龈质地、色泽良好.结论:珊瑚骨粉颗粒联合海奥生物膜应用于即刻种植修复少量骨缺损,成骨效果可靠.     

Successful Treatment of a Patient with a Severely Calcified Aorta by an Ascending Aorta to Iliac Artery Graft – A Case Report

Coral reef aorta is a rare, unique entity with extensive calcification of the entire aorta, mainly the supra- and juxtarenal part. The main symptoms are lower limb claudication, hypertension, deterioration of renal function and angina abdominalis.We report a case of successful treatment of a patient with a coral reef aorta by an ascending aorta to iliac artery bypass graft. Five years later the descending aorta was found to be completely occluded with visceral and distal perfusion via the bypass only.     

兔动静脉短路环法诱导组织工程骨支架材料血管生成的初步研究

目的 通过比较动静脉短路环(AV环)和动静脉束(AV束)植入珊瑚后诱导血管新生的程度,探讨构建带血管蒂的组织工程骨支架材料动物模犁的可行性.方法 新西兰兔36只,解剖分离出左侧股静脉和股动脉及腘动脉分支.AV环组(A组)将胭动脉和股静脉末端切断,近心端行血管端端吻合,形成动静脉短路环,环绕套入天然珊瑚块的侧槽中.AV束绀(B组)股动静脉血管束保持血流通畅,不切断,动静脉分开套人珊瑚块的两边侧槽中.植人体外加ePTFE膜包裹隔绝,固定于大腿皮下.2、4、6周行标本的墨汁灌注和血管铸型,墨汁灌注后珊瑚脱钙、HF染色、组织学观察,分析珊瑚孔隙中组织结构和血管新生情况,计数每份标小的平均血管密度,血管密度做计量统计学分析;血管铸型标本行大体解剖和腐蚀后血管分栉等观察,了解血管与珊瑚的火系,以及新生血管程度和米源.结果 珊瑚植入体内后表面和深部有大量纤维血管样组织生长.墨汁灌注显示血管广泛分布在珊瑚表层和间隙内,结构成熟,4周已贯穿珊瑚块的全层.2、4、6周血管密度逐渐加大,A组(2周276.6±4.67;4周517.20±10.66,6周707.00±11.87)较B组(2周153.60±7.16,4周269.40±6.80,6周279.20±6.53)血管生成密度更大,筹异有统计学意义(P<0.01).血管铸型显示A组血管环周边和珊瑚表层充满小血管,B组血管明显稀疏.腐蚀铸型显示A组血管环动静脉段芽生和伴行有丰富的小血管,在入口处形成网状结构,并相互吻合;B组主干动脉血管无发芽新生血管,仅有周边伴行的部分小血管长入.结论 AV环方法和AV束方法均可以促进驯瑚的血管化,前者诱导血管新生的能力更强.     

bBMP-胶原-珊瑚复合人工骨修复桡骨干骨缺损的实验研究

目的评价牛骨形态发生蛋白(bBMP)-胶原-珊瑚复合人工骨对长骨干骨缺损的修复效果.方法建立46只兔双侧桡骨干骨缺损模型,分为4组1.人工骨组(18侧)、2.自体骨组(16侧)、3.单纯珊瑚组(12侧)、4.对照组(为以上各组的左侧,未治疗).于4周及16周末分别行X线、病理学、ALP活性、四环素荧光标记及生物力学检查.结果4周,人工骨组组织中的ALP活性高于对照组.16周,1、2、3、4组的愈合率,分别为75%(9/12)、100%(10/10)、28.6%(2/7)、31.0%(9/29).与3组及4组相比,1组及2组的荧光带较宽,桡骨的抗弯强度较高.结论复合人工骨有较强的修复长骨干骨缺损的能力,有望成为自体骨的替代品.     

绿色荧光蛋白标记的犬脂肪干细胞体外复合珊瑚材料的生长特性

目的研究犬脂肪干细胞(AdiposeDividedStromalCells,ADSCs)作为种子细复合珊瑚材料体外培养的生长特性。方法分离犬ADSCs,成骨诱导并转染绿色荧光蛋白(GFP)后,复合珊瑚材料培养。检测细胞总数,激光共聚焦观察细胞形态。结果ADSCs-珊瑚复合物体外增殖良好。激光共聚焦显示培养2周后细胞呈老化形态。结论GFP转染不影响细胞传代、增殖。细胞-材料复合物体外培养7天后回植较为适宜。     

珊瑚羟基磷灰石人工骨在颈前路植骨融合术中的应用

目的研究珊瑚人工骨在颈前路手术中的愈合情况。方法应用珊瑚羟基磷灰石人工骨替代自体髂骨进行颈椎前路减压人工骨植骨融合钢板内固定手术180例(男126例、女54例),根据影像学资料,统计椎间隙高度、椎间角、颈前屈术前与随访时的变化。结果通过总结6年的随访结果,珊瑚人工骨得到了良好的愈合,使患者术后椎间隙高度、椎间角、颈前屈的纠正得到了的保持。结论珊瑚人工骨具有良好的愈合效果,可以达到和自体髂骨同样的临床作用。     

培养成骨细胞接种于天然珊瑚中再造骨组织的研究

目的：对成骨细胞接种于天然珊瑚中的再造骨组织进行组织学观察。方法：体外分离、培养扩增兔成骨细胞,将细胞接种于多孔珊瑚中,然后植入兔背部皮下组织,术后４、８、１２ 周取材,通过组织学、扫描电镜观察新骨的形成情况。结果：表明培养的兔成骨细胞可以在珊瑚表面良好生长,成骨细胞／珊瑚复合物植入皮下 ４ 周,局部形成骨样组织,可见大量成骨细胞,胞浆丰富,某些部位可见红色的骨基质形成;８ 周时,形成大量新骨组织,但不成熟;１２ 周时板层骨形成,扫描电镜观察见大量成骨细胞位于基质中。结论：用这种方法进行骨再造和骨缺损修复有很多优点,具有广阔的应用前景。     

应用^99mTc—MDP骨显像评价复合珊瑚骨移植成骨状况的研究

目的 评价＾９９ｍＴｃ－ＭＤＰ骨显象检测复合珊瑚骨移植成骨情况。方法 通过动物实验和临床病例观察,采用＾９９ｍＴｃ－ＭＤＰ、组织学检查和Ｘ线检查动态观察复合珊瑚骨移植后的成骨情况。结果 动物实验,核素骨显像能在３周对植入骨的成骨作出预测,较Ｘ线早３周;临床上,该方法能在术后１个月预测植入骨成骨情况,较Ｘ线早２个月。结论核素骨显像能较早地预测植入骨的成骨情况。     

Case Series: Inhaled Coral Vapor—Toxicity in a Tank

Introduction

Palytoxin (PTX) is considered a severe marine toxin. Although rare, reports of human exposure from consumption of PTX have described significant morbidity and mortality. PTX is the suspected agent in Haff disease, in which rhabdomyolysis occurs within 24 h of eating contaminated fish such as buffalo fish. PTX is primarily present in soft corals or in dinoflagellates, and it can contaminate crustaceans and other fish as it bioaccumulates up the food chain. Only 23 cases have been reported in the USA, including two recent cases in New York City. Reports of inhalational exposure to PTX are uncommon.

Case Reports

We describe a case series of six patients, including four adults and two children, with inhalational exposure to PTX aerosolized from Palythoa corals. Their symptoms included some degree of respiratory involvement, myalgias, paresthesias, low-grade fevers, and gastrointestinal symptoms. Fortunately, there were no serious outcomes and all patients survived without sequelae.

Discussion

Although rare, exposure to palytoxin is not restricted to people visiting marine environments because of Palythoa coral in some home aquariums. Routes of exposure go beyond consumption of fish that feed on the coral and include dermal as well as inhalational exposure. Palytoxin exposure should be considered in the differential diagnosis of patients who own or work with fish tanks and present with symptoms that include respiratory complaints, myalgias, neuromuscular dysfunction, hemolysis, and cardiac toxicity. There is no known antidotal therapy and treatment should focus on meticulous supportive care.