微粒骨膜-三维支架修复大面积关节软骨缺损

目的 探讨微粒骨膜-三维支架修复大面积关节软骨缺损的有效性和可行性.方法 于兔股骨滑车关节面制作直径4.5 mm深达软骨下骨板的全层软骨缺损模型,缺损处随机行自体微粒骨膜-纤维蛋白混凝物、单纯纤维蛋白"浇铸"移植.分别于术后3 h、4 d及1、2、4、8、12、24周取材,行大体观察、苏木素.伊红(HE)、Masson及藏红花(safranin-0)染色组织学检查,并进行组织学评分半定量分析.结果 微粒骨膜.三维支架制备简便.微粒骨膜被均匀种植于纤维蛋白三维支架中,可随意"浇铸"充填骨软骨缺损,移植物不易脱落,手术1次完成.术后微粒骨膜在缺损空间内全方位迅速增殖、分化、分泌基质完成缺损骨软骨修复.新生软骨具有与周围正常软骨基本一致的厚度、细胞形态及排列、基质胶原及蛋白多糖染色,且与周边软骨及软骨下骨结合良好.术后4、8、12及24周,两组组织学评分差异有统计学意义(P<0.05).结论 该方法能简单高效地构建工程化组织复合体,随意浇铸充填软骨缺损,完成较大面积关节软骨缺损的生物性修复.     

对耳轮过度前突畸形的整复

对耳轮过度前突为对耳轮的角度过锐，致使耳轮的位置相应后移，表现为与招风耳完全相反的畸形。畸形虽不十分明显，但影响美观。自１９９２年４月开始应用患侧耳廓软骨和耳后皮瓣对５例患者８只外耳进行治疗得到满意效果。认为文中所述方法是矫正对耳轮过度前突畸形的良好方法。     

Amelioration of established murine collagen-induced arthritis with anti-IL-1 treatment.

Inflammatory cytokines have been implicated in the pathogenesis of rheumatoid arthritis. To validate a key role for IL-1 in arthritic processes we have studied the protective effect of neutralizing antimurine IL-1 antibodies in the murine collagen-induced arthritis (CIA) model. Combination of anti-IL-1 alpha and anti-IL-1 beta given before onset of arthritis was shown to prevent disease completely. Remarkably, a single treatment was also highly effective in the established phase of arthritis, reducing both inflammation as well as cartilage destruction. Suppression was most pronounced with the combination, but anti-IL-1 beta alone also induced significant relief. Finally, we studied the protective effect of IL-1 neutralization on cartilage metabolism in a unilateral expression model of collagen arthritis. To this end zymosan was injected in one knee joint before onset of disease, resulting in accelerated expression in that particular joint and the draining paw. Anti-IL-1 treatment started after accelerated expression of arthritis was able to fully normalize chondrocyte synthetic function, which was highly suppressed in the control group. It is concluded that IL-1 is an important determinant in both inflammation and cartilage destruction in collagen arthritis, and this may have implications for therapy in human arthritis.     

Do laws of biomechanics work in reconstruction of the cartilaginous nasal septum?

Biomechanical techniques can be used for correcting C-shaped or S-shaped nasal septum cartilage deformities. These include mucoperichondrium elevation on the concave side, trimming cartilage to its necessary size, incisions to release cartilaginous bends and strip resections. Resection and reimplantation of cartilage are preferable when correcting a difficult post-traumatic septum. While biomechanical principles are applicable to nasal septum surgery, further clinical studies must be devised to provide proper correction of the nasal septum with minimal sacrifice of cartilage.     

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities

The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months.     

杜仲苷对炎性环境下软骨细胞的增殖和Ⅱ型胶原蛋白分泌的影响

目的：观察杜仲苷对IL-1β刺激大鼠体外软骨细胞的增殖及Ⅱ型胶原蛋白分泌的影响。方法：利用IL-1β刺激建立体外大鼠软骨细胞炎性模型,实验分为空白组、IL-1β组、10μM杜仲苷组、100μM杜仲苷组、500μM杜仲苷组、1000μM杜仲苷组;空白组加入10%FBS培养液,IL-1β组加入10ng/mL IL-1β＋10%FBS培养液,4个不同浓度杜仲苷组分别加入10μM、100μM、500μM、1000μM杜仲苷＋10ng/mL IL-1β＋10%FBS培养液,分别培养48小时,采用CCK8检测软骨细胞增殖活力及Ⅱ型胶原蛋白的分泌。结果：IL-1β组的OD值低于空白组（P〈0.05）;4个不同浓度杜仲苷组的OD值均高于IL-1β组（P〈0.05）,且存在一定的量效关系;4个不同浓度杜仲苷组的Ⅱ型胶原蛋白表达均高于IL-1β组（P〈0.05）,且存在有一定的量效关系。结论：杜仲苷可以提高体外大鼠软骨细胞炎性环境下的增殖活力,促进Ⅱ型胶原蛋白的分泌,表明杜仲苷对体外大鼠软骨细胞有一定的抗炎保护作用。     

痹祺胶囊对兔骨关节炎软骨代谢的作用研究

目的：观察痹祺胶囊对骨关节炎软骨代谢的作用。方法：以Hulth法复制兔膝骨关节炎模型,对软骨组织行Mankin标准评分,设置空白组、假手术组,观测各组兔血清及尿液的羟脯氨酸含量,并设痹祺胶囊低、中、高浓度组及西药组以了解其疗效。结果：各治疗组间Mankin标准评分水平无差异,痹祺胶囊各剂量组血清、尿羟脯氨酸含量与模型组比较差异均有显著意义（P〈0.05）。结论：痹祺胶囊可通过促进骨修复或抑制软骨破坏而减低兔骨关节炎模型体内羟脯氨酸含量,对骨关节炎软骨代谢有明确的改善作用。     

Current concepts in stem cell therapy for articular cartilage repair

Introduction: Hyaline articular cartilage is the connective tissue responsible for frictionless joint movement. Its degeneration ultimately results in complete loss of joint function in the late stages of osteoarthritis. Intrinsic repair is compromised, and cartilage tissue regeneration is difficult. However, new options are available to repair cartilage tissue by applying ESCs, MSCs and CPCs.

Areas covered: In this review, the authors shed light on the different concepts currently under investigation for cartilage repair.

Expert opinion: So far, there is no way to derive a chondrogenic lineage from stem cells that forms functional hyaline cartilage tissue in vivo. One alternative might be to enhance the chondrogenic potential of repair cells, which are already present in diseased cartilage tissue. CPCs found in diseased cartilage tissue in situ are biologically driven toward the osteochondrogenic lineage and can be directed toward chondrogenesis at least in vitro.     

Differentiating normal hyaline cartilage from post-surgical repair tissue using fast gradient echo imaging in delayed gadolinium-enhanced MRI (dGEMRIC) at 3 Tesla

The purpose was to evaluate the relative glycosaminoglycan (GAG) content of repair tissue in patients after microfracturing (MFX) and matrix-associated autologous chondrocyte transplantation (MACT) of the knee joint with a dGEMRIC technique based on a newly developed short 3D-GRE sequence with two flip angle excitation pulses. Twenty patients treated with MFX or MACT (ten in each group) were enrolled. For comparability, patients from each group were matched by age (MFX: 37.1 ± 16.3 years; MACT: 37.4 ± 8.2 years) and postoperative interval (MFX: 33.0 ± 17.3 months; MACT: 32.0 ± 17.2 months). The Δ relaxation rate (ΔR1) for repair tissue and normal hyaline cartilage and the relative ΔR1 were calculated, and mean values were compared between both groups using an analysis of variance. The mean ΔR1 for MFX was 1.07 ± 0.34 versus 0.32 ± 0.20 at the intact control site, and for MACT, 1.90 ± 0.49 compared to 0.87 ± 0.44, which resulted in a relative ΔR1 of 3.39 for MFX and 2.18 for MACT. The difference between the cartilage repair groups was statistically significant. The new dGEMRIC technique based on dual flip angle excitation pulses showed higher GAG content in patients after MACT compared to MFX at the same postoperative interval and allowed reducing the data acquisition time to 4 min.     

破骨细胞在骨关节炎中的增殖变化及意义

目的 探讨破骨细胞(OC)在骨关节炎(OA)各个时期中的增殖变化及临床意义.方法 20只健康成年SD雄性大鼠用改良Hulht手术方法造模,左膝为对照组,右膝为OA模型组.分别于术后1、2、4、8周时采集全膝关节(n=5),并置于4℃多聚甲醛(PFA)液固定,石蜡包埋切片,抗酒石酸酸性磷酸酶(TRAP)、甲苯胺蓝(TB)及番红-O快绿染色,观察软骨形态学改变并半定量TRAP染色阳性的OC数量,通过Mankin's评价OA软骨破坏的进展,采用SPSS17.0统计软件进行统计分析.结果 两组间OC均呈快速增高,然后下降的一过性增殖变化.对照组(左膝)在1周时OC数量为(65.20±4.12)个/mm2,2、4周时逐渐减少,分别为(47.20±4.31)个/mm2、(26.20±3.87)个/mm2,8周时几乎看不到,细胞数为(7.00±2.28)个/mm2;OA模型组(右膝)在1周时OC数量为(70.40±5.46)个/mm2,2周时增加至(86.20±5.42)个/mm2,4周时减少至(38.00±3.16)个/mm2,8周时几乎看不到,细胞数为(6.21±2.93)个/mm2.模型组OC数量在2、4周时明显高于对照组,差异有统计学意义(P<0. 05).结论 大鼠膝关节OA实验的早中期OC大量增殖,OC可能参与了骨关节炎的形成.