镁基金属作为生物骨科材料应用的研究进展

镁及镁合金具有密度小,比强度和比刚度高,弹性模量接近人骨,有良好的生物相容性和生物可降解性。且镁是可被人体吸收的常量元素等优点,在骨科生物医用材料领域具有广阔的应用前景。综述了镁及镁合金作为骨科内固定材料及骨组织工程多孔支架材料方面的研究现状,并对如何改善镁基金属的耐腐蚀性的方法进行了简单论述。     

腹股沟疝无张力修补术体会

目的研究生物植入性网片无张力修补术治疗腹股沟疝的临床效果。方法对惠济区人民医院收治的136例腹股沟疝选用生物植入性网片行无张力修补术。结果 136例患者经生物植入性网片无张力修补术后恢复快,无疼痛及异物感。随访至今,未见复发。结论生物植入性网片无张力疝修补术治疗腹股沟疝,效果满意,恢复快,患者痛苦小,为较理想的治疗方法。     

Laparoscopic Surgical Complete Sling Resection for Tension-Free Vaginal Tape–Related Complications Refractory to First-Line Conservative Management: A Single-Centre Experience

Background

Tension-free vaginal tape (TVT) has been largely used for the management of stress urinary incontinence. In certain cases, however, this procedure results in bothersome complications that lead to a complete resection.

Objective

We assessed the technical feasibility and functional outcome after complete laparoscopic resection of TVT.

Design, setting, and participants

Thirty-eight women with TVT-related complications refractory to first-line management underwent a complete laparoscopic tape resection between 2001 and 2009.

Surgical procedure

Complete laparoscopic resection was achieved with either an intra- or extraperitoneal laparoscopic approach. Laparoscopy was performed with four ports: a 10-mm umbilical telescope port, two 5-mm ports placed medially to the anterior superior iliac spines, and a 10-mm port placed at the midpoint between the pubis and umbilicus. The two half-tapes were dissected towards the urethra and removed.

Measurements

All data referring to patient demographics, surgery, tape-related complication, and perioperative outcomes were recorded.

Results and limitations

The mean age of the patients was 66.2 yr (range: 45–79 yr). TVT-related complications included bladder erosion, vaginal extrusion, and bladder outlet obstruction or groin pain. The resection took place at a mean time of 25 mo (range: 6–80 mo) after TVT placement. Resection was complete in all patients, within a mean operative time of 110 min (range: 50–240 min). All women reported a total decrease of symptom-related complications within a mean follow-up period of 37.9 mo (range: 2–80 mo). However, recurrent incontinence occurred in 65.7% (n = 25) of the patients. The main limitation of the study was the lack of a validated questionnaire to assess the evolution of functional disorders.

Conclusions

Complete laparoscopic resection of TVT is safe and technically feasible. In the limited number of women who have persisting disabling symptoms after conservative management, urologists must be aware that a complete resection can help resolve the symptoms.     

Bone regeneration in sinus lifts: comparing tissue-engineered bone and iliac bone

Lifting of the sinus floor is a standard procedure for bony augmentation that enables dental implantation. Although cultivated skin and mucosal grafts are often used in plastic and maxillofacial surgery, tissue-engineered bone has not achieved the same success. We present the clinical results of dental implants placed after the insertion of periosteum-derived, tissue-engineered bone grafts in sinus lifts. Periosteal cells were isolated from biopsy specimens of periosteum, resuspended and cultured. The cell suspension was soaked in polymer fleeces. The cell–polymer constructs were transplanted by sinus lift 8 weeks after harvesting. The patients (n = 35) had either one or both sides operated on. Seventeen had a one-stage sinus lift with simultaneous implantation (54 implants). In 18 patients the implants were inserted 3 months after augmentation (64 implants). Selected cases were biopsied. A control group (41 patients: one stage = 48 implants, two stage = 135 implants) had augmentation with autologous bone only. They were followed up clinically and radiologically for at least 24 months. Both implants and augmentation were significantly more successful in the control group. Failure of augmentation of the tissue-engineered bone was more common after large areas had been augmented. Eleven implants were lost in the study group and only one in the control group. Lifting the sinus floor with autologous bone is more reliable than with tissue-engineered transplants. Although lamellar bone can be found in periosteum-derived, tissue-engineered transplants, the range of indications must be limited.     

Influence of low-level laser therapy on biomaterial osseointegration: a mini-review

The aim of this paper is to provide an overview of the available literature on low-level laser therapy (LLLT) and its influence on bone repair and the osseointegration of biomaterials. Extensive studies of alveolar bone repair, a common problem in periodontal therapy, have been conduced worldwide. The utility of LLLT in biomaterial osseointegration is still unanswered, due to lack of literature and poorly understood mechanisms. It is still difficult for one to compare studies about the action of LLLT on the osseointegration of biomaterials because the experimental models and duration of treatments are very distinct. However, it could be concluded that LLLT may offer advantages in terms of periodontal and bone functional recovery and biomaterial osseointegration.     

壳聚糖/肝素层层自组装涂层与CD133^＋内皮祖细胞生物相容性的实验研究

目的研究壳聚糖/肝素层层自组装涂层对CD133＋内皮祖细胞的黏附、增殖相关基因表达的影响,并从分子生物学角度探讨其作为促内皮修复功能药物洗脱支架涂层材料的可行性。方法（1）分离人脐血单个核细胞,免疫磁珠分选CD133＋内皮祖细胞;（2）制备壳聚糖/肝素层层自组装涂层,1%明胶涂层以及玻璃对照皿,接种并培养分选所得内皮祖细胞;（3）免疫荧光鉴定内皮祖细胞;（4）抽提总RNA,RT-PCR法比较不同培养介质中细胞的eNOS、VE-cadherin、KDR、PECAM-1、Sirtuin-1、Thrombomodulin等基因的表达差异。结果（1）重力梯度离心及磁珠分选法所得CD133＋内皮祖细胞纯度较高（92.88%±0.51%（n=4）,在VEGF诱导下能较好的分化为内皮细胞;（2）eNOS、VE-cadherin、KDR、PECAM-1和Sirtuin-1在壳聚糖/肝素层层自组装涂层组表达丰度较玻璃对照组显著增高（P〈0.05）,与明胶组差异不明显,Thrombomodulin在壳聚糖涂层表达丰度较明胶组、玻璃组表达均增高（P〈0.05）结论壳聚糖涂层能促进内皮祖细胞的黏附、增殖,生物相容性好,为理想的生物材料。     

酶组织化学方法在HA/TCP体内外生物相容性评价中的初步应用

通过研究材料与细胞 /组织相互作用后胞内酶活性的变化与材料生物相容性之间的关系 ,探讨酶组织化学法应用于材料生物相容性评价的可行性。结果发现 ,与 HA/ TCP和钛合金复合培养的成骨细胞形态学上无明显差异。但 HA/ TCP与兔成骨细胞复合培养初期可导致细胞 NADH、SDH、L DH和 CCO酶活性的一过性下降 ,而钛合金对复合培养细胞的酶活性没有明显影响 ,提示 HA/ TCP材料溶出物对细胞有轻微的损伤。两种材料体内植入后引起的组织学变化过程相似 ,主要表现为损伤引起的急性炎症过程。酶组织化学检测发现 ,术后 10 d内植入体周围组织四种酶活性均明显下降 ,15 - 30 d内逐渐恢复正常。但 HA/ TCP组酶活性的恢复略滞后于钛合金组 ,也表明材料溶出物对细胞有一定损伤。体内外实验均发现酶学指标能更灵敏地反映材料对细胞的作用 ,酶组织化学法可望应用于材料生物相容性评价。     

羟基磷灰石/壳聚糖生物复合材料的制备研究进展

羟基磷灰石/壳聚糖复合材料因其生物相容性和合适的力学性能逐渐成为骨替代材料研究的热点。本文综述了羟基磷灰石/壳聚糖复合材料的研究现状,探讨了其特点、制备和性能。并在此基础上提出了此类材料今后的发展方向：三相复合材料和电、磁学性能的研究。     

生物活性陶瓷-聚合物生物材料的复合技术

介绍了目前生物活性陶瓷和聚合物生物材料的常用复合技术，以及所得复合材料的力学和生物学性能及其临床应用情况。     

生物医学工程学的重要领域及研究进展

按生物医学工程的最终目标，在生物医学材料、生物医学工程器械、远程诊闻系统和生物医学康复工程等四个方面进行了综述，引论文１４篇。