骨组织工程研究中整合素的意义

组织工程是骨科临床应用研究最活跃的领域之一。目前，组织工程支架研究的前沿是细胞外基质如何通过细胞膜表面的整合素影响细胞的生物学行为。本文通过回顾不同组织来源细胞整合素研究的普遍问题及成骨细胞整合素研究的最新进展，为骨组织工程支架的研究提供线索。     

柳叶刀

常规临床实践中西罗莫司洗脱支架和紫杉醇洗脱支架的早期和晚期冠状动脉支架血栓形成之比较：一项较大规模、由两个机构完成的队列研究的资料;心肌肌钙蛋白T升高的非ST段抬高型急性冠状动脉综合征患者采用早期与选择性有创治疗的长期预后比较（ICTUS试验）：一项随访研究;比伐卢定对行经皮冠状动脉介入的急性冠状动脉综合征患者的作用：ACUITY试验的一项亚组分析。     

置入支架排除体内“定时炸弹”

日前，驻山东省胸科医院的北京阜外医院专家组为一主动脉夹层动脉瘤患者实施了支架置入介入治疗术，成功为其排除了这颗体内“定时炸弹”。     

记忆合金支架放置放治疗食管癌狭窄25例报告

食管癌引起的食管狭窄或梗阻是消化科常见病之一 ,对于失去手术机会或因其他原因不能手术治疗者 ,放置合金支架使之通畅 ,不失为一种较好的保守治疗方法。自 2 0 0 0年 8月至今 ,我院消化科采用该方法治疗此类病人 2 5例 ,现报告如下。1　临床资料1.1　一般资料 :2 5例病人中女 1例 ,男 2 4例 ,年龄 4 8～ 72岁。狭窄长度为 2～ 11cm,平均 6.5 cm,管腔狭窄度按 STOOL分级 : 级 (进半流饮食 ) 4例 ; 级 (进流质饮食 ) 18例 ,其中 2例带有食管 -气管、食管 -纵隔瘘 ; 级 (滴水不进 ) 3例。1.2　材料与方法 :2 5例病人均采用常州智力医疗器械…     

冠心病PTCA及支架植入术前后QT离散度的变化

目的　为了探索冠心病患者PTCA及支架植入术前后QT离散度的改变。方法　我们对 10 0例经选择性冠状动脉造影显示单支、双支、三支冠脉狭窄≥ 70 %的患者 ,对其中 6 0例行PTCA及支架置入术及未行手术而药物治疗的 4 0例患者及正常对照组 5 0例 (冠脉造影正常 )均行心电图QT离散度测量。结果　冠心病患者PTCA及支架置入术后QT离散度较术前及药物治疗组减小 (P <0 0 5 )。结论　QT离散度对判断冠心病心肌缺血及心律失常有重要的临床价值     

罗格列酮对2型糖尿病患者冠脉支架内再狭窄的预防作用

目的 探讨罗格列酮对2型糖尿病患者行冠脉成形及支架植入术后支架内再狭窄的预防作用。方法 选择行冠脉成形及支架植入术的2型糖尿病患者60例。在原有降糖药物治疗的基础上，研究组(n=31)加服罗格列酮；对照组(n=29)用药方案不变。术后随访6mo，观察患者死亡、急性心肌梗死及再次血管重建术等心血管事件的发生情况，在随访结束时行活动平板检查，结果 阳性的再次行选择性冠脉造影术。结果2组患者随访期间均无死亡、急性心肌梗死等心血管事件发生。6mo内研究组9例再次心绞痛发作，5例活动平板试验阳性，其中5例(16．1％)冠脉支架内再狭窄；而对照组18例再次心绞痛发作，其中15例活动平板阳性，15例(48．4％)冠脉造影术证实支架内再狭窄，2组再狭窄对比有显著差异(P=0．013)。结论 对于2型糖尿病合并冠心病行冠脉成形及支架植入术患者，罗格列酮能有效降低支架内再狭窄。     

外固定支架在治疗桡骨远端粉碎性骨折中的应用

近年来，随着桡骨远端骨折的治疗观念不断更新，传统闭合复位石膏固定和切开复位内固定术在治疗桡骨远端粉碎性骨折中的局限性越来越突出，而外固定支架则显示出其独特的优势。本文笔者就有关外固定支架治疗桡骨远端粉碎性骨折的基本原理、临床疗效、发展及其并发症作一综述。     

大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.