Properties and clinical application of collagen sponge

摘要 背景: 胶原蛋白海绵具有良好的功能和特性,及其易于加工、灭菌和保存等独特的优势,被视为最有用途的生物材料,具有广泛的科研和临床应用价值。 目的：介绍胶原蛋白海绵的性质,对近年来胶原蛋白海绵在临床应用上的研究成果进行综述。 方法：由第一作者应用计算机检索2000-01/ 2010-08 Pubmed数据库和Elsevier数据库,在标题和摘要中以 “collagen, collagen sponge, clinical application”为检索词进行检索。检索1993-01/2010-08 CNKI数据库,在标题和摘要中以“胶原,胶原蛋白海绵,临床应用”为检索词进行检索。纳入38篇文献进行综合分析。 结果与结论：胶原蛋白海绵作为一种新型生物材料,越来越广泛地被应用于止血、创面愈合、抗感染、软骨修复、神经修复等相关方面的组织工程与临床研究。但目前所使用的胶原几乎都是来源于动物,无法彻底消除免疫原性。 国外已有人利用生物反应器和转基因技术合成了重组人胶原,其在临床应用上的有效性和安全性等问题仍有待进一步的探索和研究。 关键词：胶原蛋白海绵;性质;止血;创面愈合;抗感染;骨和软骨修复;神经修复;临床应用     

中药治疗功能性子宫出血案例分析

目的观察中药治疗功能性子宫出血的疗效。方法共观察本病45例,急性出血期用自拟固冲1号方止血,出血减少缓解期给予辩证施治,血止后中药人工周期调理以善后。1个月经周期为1个疗程,连续3个疗程。结果痊愈18例（占40.6%）,显效14例（占31.2）,有效10例（占21.8%）,无效3例（占6.2%）,总有效率93.8%。     

胶原蛋白制备基质网架对成纤维细胞增殖的影响

目的观察胶原蛋白制备基质网架的孔径、空孔率对成纤维细胞增殖的影响. 方法胶原蛋白制备基质网架结构,在扫描电子显微镜下观察胶原网架的结构和网孔大小,将传代培养的成纤维细胞接种于胶原网架上,连续观察成纤维细胞和基质网架的动态变化. 结果在扫描电镜下观察,胶原蛋白呈纤维状,错综连结形成许多网孔,网孔直径介于180～260μm之间,成纤维细胞可以自由通过网孔,为成纤维细胞提供生长空间和附着点. 结论人工制备的胶原网架有明显的调节成纤维细胞增殖作用.     

Therapy with gentamicin-PMMA beads,gentamicin-collagen sponge,and cefazolin for experimental osteomyelitis due to<Emphasis Type="Italic"> Staphylococcus aureus</Emphasis> in rats

Introduction In spite of new surgical techniques and recently developed antibiotics, there is no satisfactory solution for the treatment of chronic posttraumatic osteomyelitis. The introduction of local antibiotic treatment with gentamicin-PMMA beads according to Klemm has provided new stimuli for the treatment of chronic osteomyelitis. With the development of collagen as an absorbable carrier substance, the disadvantages of the rigid carrier system became evident. Due to the varying surgical techniques and different forms of adjuvant therapy, it is difficult to assess therapeutic methods and compare different studies. Therefore, it seemed appropriate to study the effect of local treatment with different antibiotic carriers in the setting of an animal study.Materials and methods The proven rat model for Staphylococcus aureus-induced osteomyelitis was used to compare the results of monotherapy with cefazolin, gentamicin-PMMA beads, or gentamicin-containing collagen sponge with the combination of local and systemic antibiotic treatment.Results Single-agent therapy with parenterally administered cefazolin reduced the CFU from 3.7×10⁶ to 2.9×10⁴ g^-1 of tibial bone. The effect on osteomyelitis was more pronounced with the local application of antibiotics. The best results were achieved with the gentamicin-containing collagen sponge which reduced the bacterial colony count to 1.4×10² CFU/g compared with 9.8×10² CFU/g achieved with gentamicin-PMMA beads. The effect was most marked using a 4-week combination therapy with local application of the gentamicin-containing collagen sponge and systemic administration of cefazolin. In 9 of 11 animals, no bacteria could be detected in the bone.Conclusion Each of the treatment modalities resulted in a significant therapeutic effect. Due to its ability to quickly release large amounts of gentamicin, the flexible gentamicin-containing collagen sponge proved to be superior to the rigid PMMA system. Although the gentamicin-containing collagen sponge provided high antibiotic concentration at the site of implantation, an additive effect was attained when combined with systemic antibiotic treatment.     

儿童髓质海绵肾的合并症分析及与预后关系探讨

目的 髓质海绵肾（Medullary sponge kidney,MSK）多在成年发病,儿童期发病者罕见且病情多较严重,导致肾功能不全者较多,这可能与同时存在影响肾脏的一些合并症有关.本文分析儿童期发病的MSK的合并症发生情况并探讨合并症与预后的关系.方法 收集20例MSK患儿的临床资料,分析其合并症发生率并探讨合并症与预后的关系.结果 20例儿童MSK患儿,其中男13例,女7例,年龄10个月～13岁,平均年龄（7.95±11.49）岁.所有病例均有特征性多发性双肾结石表现,15例（占75%） 例并发尿路感染.此外,15例合并症中有14例为远端肾小管酸中毒（dRTA）,4例为胱氨酸尿症,1例为Carolis病,1例为肝豆状核变性.慢性肾功能不全的发生与结石关系不大,而与合并症有无以及泌尿道感染发生有关,差异有统计学意义（P〈0.05）.结论 儿童期发病的MSK合并症发生率高,对于儿童MSK,应积极治疗合并症,及时控制尿路感染,以减少慢性肾衰的发生.     

子宫动脉栓塞治疗子宫肌瘤的临床疗效分析

目的 分析平阳霉素混合乳剂加明胶海绵在子宫动脉栓塞治疗症状性子宫肌瘤的疗效.方法 对50例符合筛选条件的症状性子宫肌瘤患者在数字减影技术指导下,采用平阳霉素及明胶海绵颗粒栓塞双侧子宫动脉,观察手术后症状缓解情况、子宫肌瘤缩小程度.结果 50例行栓塞治疗患者,除5例患者子宫肌瘤为多发,5个月后症状有明显缓解,其余45例临...     

Bioactive Compounds in the Ethanol Extract of Marine Sponge Stylissa carteri Demonstrates Potential Anti-Cancer Activity in Breast Cancer Cells

Objective: Despite advanced treatment options available, drug resistance develops in breast cancer (BC) patientsrequiring novel effective drugs. Stylissa carteri, a marine sponge predominantly living in Indonesia territories, hasnot been extensively studied as anti-cancer. Therefore, this study targeted to assess the anti-tumor activity of theethanol extract of S. carteri in BC cells. Methods: S. carteri was collected from Pramuka Island, at Kepulauan SeribuNational Park, Jakarta, Indonesia and extracted using ethanol. Different BC cells including MDA MB 231, MDAMB 468, SKBR3, HCC-1954 and MCF-7 cells were treated with this extract for cytotoxic analysis using MTT assay.Spheroid growth assay and apoptosis assay were conducted in HCC-1954 cells. In addition, cell migration analysis andsynergistic activity with doxorubicin or paclitaxel were conducted in MDA MB 231 cells. This extract was subjectedalso for GC-MS analysis. Results: The results show that ethanol extract of S. carteri demonstrated a cytotoxic activityin BC cells. The IC50 of this extract was lower 15 μg/ml in MDA MB 231, MDA MB 468, SKBR3, and HCC-1954cells. Moreover, this extract inhibited spheroids growth and induced apoptosis in HCC-1954 cells. It inhibited cellmigration and demonstrated a synergistic activity with doxorubicin or paclitaxel on triggering cell death in MDA MB231 cells. Furthermore, GC-MS analysis indicated that this extract contained 1,2-Benzenediol, Dibutyl phthalate and9,12-Octadecadienoic acid, ethyl ester. Conclusion: Our preliminary data indicate a potential anti-tumor activity ofethanol extract of S. carteri in breast cancer cells.     

Warfarin affects acute inflammatory response induced by subcutaneous polyvinyl sponge implantation in rats

Purpose: Warfarin (WF) is an anticoagulant which also affects physiological processes other than hemostasis. Our previous investigations showed the effect of WF which gained access to the organism via skin on resting peripheral blood granulocytes. Based on these data, the aim of the present study was to examine whether WF could modulate the inflammatory processes as well. To this aim the effect of WF on the inflammatory response induced by subcutaneous sponge implantation in rats was examined.

Materials and methods: Warfarin-soaked polyvinyl sponges (WF-sponges) were implanted subcutaneously and cell infiltration into sponges, the levels of nitric oxide (NO) and inflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) production by sponge cells were measured as parameters of inflammation. T cell infiltration and cytokine interferon-γ (IFN-γ), interleukin-17 (IL-17) and interleukin-10 (IL-10) were measured at day 7 post implantation.

Results: Warfarin exerted both stimulatory and suppressive effects depending on the parameter examined. Flow cytometry of cells recovered from sponges showed higher numbers of granulocytes (HIS48⁺ cells) at days 1 and 3 post implantation and CD11b⁺ cells at day 1 compared to control sponges. Cells from WF-sponges had an increased NO production (Griess reaction) at days 1 and 7. In contrast, lower levels of TNF (measured by ELISA) production by cells recovered from WF-soaked sponges were found in the early (day one) phase of reaction with unchanged levels at other time points. While IL-6 production by cells recovered from WF-soaked sponges was decreased at day 1, it was increased at day 7. Higher T cell numbers were noted in WF sponges at day 7 post implantation, and recovered cells produced more IFN-γ and IL-17, while IL-10 production remained unchanged.

Conclusions: Warfarin affects some of the parameters of inflammatory reaction induced by subcutaneous polyvinyl sponge implantation. Differential (both stimulatory as well as inhibitory) effects of WF on inflammatory response to sponge implants might affect the course and/or duration of this reaction.