椎内裂隙征和椎基静脉孔相通与 PK P术后骨水泥渗漏的相关性分析

目的：探讨椎内裂隙征和椎基静脉孔存在通道对经皮椎体后凸成形术（PK P ）患者发生骨水泥渗漏的影响,为临床研究提供可参考依据。方法回顾性分析300例该院骨科行PK P治疗的骨质疏松性椎体压缩骨折患者,根据是否发生骨水泥渗漏分为渗漏组与非渗漏组,分析A、B、C、D4型骨水泥渗漏情况及椎内裂隙征和椎基静脉孔存在通道对骨水泥渗漏的影响。结果300例患者中有椎内裂隙征者70例,占23．3％,其中,24例观察到椎内裂隙征与椎基静脉孔相通,占34．3％（24／70）。80例骨水泥渗漏患者中B型骨水泥渗漏最多,共42例（52．5％）,依次为 D 型骨水泥渗漏20例（25．0％）,A 型骨水泥渗漏12例（15．0％）,C型骨水泥渗漏6例（7．5％）。椎内裂隙征组与无椎内裂隙征组比较,B型骨水泥渗漏例数间比较差异有统计学意义（P＜0．05）。两组患者穿刺点、骨水泥注射剂量、注射时期、脊柱后突Cobb′s角,椎体前后缘高度的压缩率及椎内裂隙征与椎基静脉孔相通比较差异有统计学意义（P＜0．05）。多因素显示单侧穿刺、脊柱后突Cobb′s角较大、椎体前缘及后缘高度的压缩率较大、骨水泥注射剂量多、粥状期进行注射及椎内裂隙征与椎基静脉孔相通是影响 PK P术后骨水泥渗漏的独立危险因素（ P＜0．05）。结论椎内裂隙征和椎基静脉孔存在通道可以明显增加PK P患者发生骨水泥渗漏的风险,其中B型骨水泥渗漏最常见,在临床中需要对存在椎内裂隙征的患者引起重视,尽可能避免其通过椎基静脉孔发生骨水泥渗漏。     

骨髓间充质干细胞对创伤性骨折愈合的促进作用

BACKGROUND:In recent years, the development of stem cell culture and isolation technologies provides new therapeutic choices for fracture healing. OBJECTIVE:To investigate the effect of exogenous bone marrow mesenchymal stem cells on bone fracture healing in traumatic fracture rats and on the migration ability of endogenous bone marrow mesenchymal stem cells. METHODS:Femoral fracture models were made in 48 Wistar rats and then randomized into experimental group and control group (n=24/group). Bone marrow mesenchymal stem cells from another healthy rats were isolated using adherent method and then injected into the rats via the tail vein in the experimental group. Rats in the control group were given the same volume of normal saline. At 2, 3, 4, 8, 12 weeks after injection, we extracted bone marrow mesenchymal stem cells from the femur of rats in the two groups. RT-qPCR was used to detect expression levels of type I collagen and CD44. Transwell method was used to detect cell migration ability. Immunohistochemitry method was employed to detect expression of nerve growth factors in the callus. RESULTS AND CONCLUSION:mRNA levels of type I collagen and CD44 in rat bone marrow mesenchymal stem cells were significantly higher in the experimental group than the control group at 2, 3 and 4 weeks after injection (P < 0.05). Compared with the control group, the higher migration ability of bone marrow mesenchymal stem cells was found in the experimental group at 2 and 3 weeks after injection (P < 0.05) as well as the higher expression of nerve growth factor in the callus in the experimental group at 3, 4, 8, 12 weeks after injection. All these findings suggest that exogenous bone marrow mesenchymal stem cells can improve the migration ability of endogenous bone marrow mesenchymal stem cells and the expression of nerve growth factor in the callus in rats with femoral fracture, thereby promoting fracture healing in rats.     

腹水前期处理满足双向凝胶电泳技术的探索

目的用双向凝胶电泳方法分析不同腹水中的蛋白质谱。方法用防止腹水蛋白质降解、去细胞成分、浓缩、去脂、脱盐及去干扰大的白蛋白等腹水的前期处理以满足双向凝胶电泳的条件。结果经2次离心可基本去除腹水细胞成分;用分子量5000的膜包超滤浓缩腹水,可消减腹水蛋白质的浓度差异;去白蛋白前,0.3mg上样量双向电泳图中可检出(421±20)个蛋白质点,去白蛋白后可检出(483±24)个蛋白质点。经上述腹水前期处理后得到较为清晰的双向凝胶电泳图谱。结论腹水前期处理能满足双向凝胶电泳技术的要求,已建立的腹水蛋白双向凝胶电泳技术将为进一步的腹水蛋白质成分研究奠定基础。     

精子库引发的伦理问题研究

论述了精子库建立的目的,精子库在辅助生殖技术的作用,并对精子库所带来的社会各方面的伦理问题和引发的哲学思考做了阐述,最后提出相关建议.     

膝关节炎软骨基质金属蛋白酶2、基质金属蛋白酶9表达与MRI表现的相关性

BACKGROUND: Matrix metalloproteinases (MMPs) have been shown to break the balance between the production and degradation of extracellular matrix by degrading collagen, gelatin, elastin and other macromolecules, which is the leading cause of bone and cartilage damage in rheumatic arthritis. OBJECTIVE: To determine the expression levels of MMP-2 and MM-9 in the rabbit knee osteoarthritis cartilage, and to analyze whether they are related to the early MRI performance. METHODS: Fifty healthy Japanese white rabbits free from osteoarthritis were enrolled and randomly divided into control group (n=10) and model group (n=40). The anterior and posterior cruciate ligament amputation was adopted to establish the model of osteoarthritis. Subsequently, MRI examination and the expression levels of MMP-2 and MMP-9 were detected at 1, 3, 5 and 7 weeks (n=10 at each time point), respectively. RESULTS AND CONCLUSION: MRI examination showed that more damaged cartilage appeared with time in the rabbit model of osteoarthritis, and significantly different from MRI classification (P < 0.05). The expression levels of MMP-2 and MMP-9 mRNA in the model group were always significantly higher than those in the control group (P < 0.05); MMP-2 level reached the highest at 3 weeks after modeling (P < 0.01), and then presented a slight decline; MMP-9 level peaked at 5 weeks after modeling (P < 0.01) and slightly decreased at 7 weeks. MRI classification of cartage injury and expressions of MMP-2 (R2=0.119, P=0.119) and MMP-9 (R2= 0.466, P=0.466) were shown to have the correlation. These results illustrate that the serum levels of MMP-2 and MMP-9 are related to the early destruction of articular cartilage in patients with osteoarthritis, and can be used as predictors for early osteoarthritis. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

骨水泥型股骨柄人工股骨头置换治疗老年骨质疏松股骨颈骨折的可行性：随机对照临床试验方案

BACKGROUND: Osteogenesis is a common problem after surgery for femoral neck fracture in elderly patients. Internal fixation for the treatment of femoral neck fracture should be performed to optimize bone remodeling and strengthen fractured bone trabeculae, with the aim of achieving strong fixation from the perspective of biomechanics. Percutaneous internal fixation with cannulated compression screws has become a preferred treatment method of osteoporotic femoral neck fracture in elderly patients, but the insufficient holding power of the screws used in the femoral neck does not lead to strong fixation. An alternative, joint prosthesis, is recommended for the repair of femoral neck fracture in elderly patients. However, its long-term therapeutic effects in the treatment of osteoporotic fracture of proximal femoral neck remain poorly understood in patients with avascular necrosis of the femoral head.     

富集低丰度蛋白的人类精子全蛋白二维电泳整合图的建立

目的:运用二维电泳(2-DE)技术分离人类正常精子低丰度蛋白并建立全精子蛋白的2-DE整合图。方法:30例精子标本混匀后一次性进行蛋白提取,分别使用0.8、0.6、0.5、0.3 mg的蛋白上样量进行2-DE。运用MALD I-TOF法对确定2个恒定蛋白点的等位点(PI)和相对分子质量(Mr)作为图像的内参照点,对不同上样量的2-DE图进行比较分析,最后合成1张富集低丰度蛋白的整合图。结果:在0.5 mg图中分离出(1 080±23)个蛋白点,并合成具889个匹配点的整合图A。在上样量为0.8、0.6及0.3 mg的2-DE图中,分别新检测到381、50、32个在0.5 mg图中未检测到的蛋白点。最后合成具1 352个蛋白点的整合图B。结论:通过改变上样量的方法促进低丰度蛋白分离并合成具1 352个蛋白点富集低丰度蛋白的2-DE整合图。     

冷冻保存对人类卵母细胞线粒体 DNA 缺失和能量代谢的影响

Objective： To explore the effect of cryopreservation on the mitochondrial DNA （mtDNA） deletions and energy metabolism of human oocyte, so as to investigate the effect of cryopreservation on oocytes preservation. Methods： The dumped oocytes with 0PN, 2PN and 3PN during routine IVF were collected for this cryopreservation study. Those oocytes were randomly divided into two groups, one for vitrification cryopreservation （Group A） and the other as control （Group B, without cryopreservation）. The nested polymerase chain reaction （PCR） was used to detect the mtDNA deletions of oocyte mtDNA before and after cryopreservation. Real-time quantitative PCR was adopted to determine the copy number of oocyte mtDNA. ATP contents were detected using luciferin-luciferase assays. Results： There were not significant differences in the mutation frequency of oocyte mtDNA deletions and the copy number of mtDNA between two groups （P>0.05）. However, The ATP content in the group A was significantly lower than that in the group B. Conclusions： The effect of cryopreservation on the oocyte mtDNA deletions and the copy number of mtDNA was limited, suggesting that cryopreservation can be properly used to preserve oocyte. [ABSTRACT FROM AUTHOR]     

中空多孔金属假体复合诱导因子对骨髓间充质干细胞生长及成骨分化的影响

BACKGROUND: Bone morphogenetic protein in combination with hollow porous titanium alloy can improve the affinity with surrounding bone tissues.     

单冷试验用于前庭功能筛查的可行性分析

目的探讨单冷试验用于前庭功能筛选的价值及在临床评估前庭功能的可行性。方法回顾性分析以眩晕为主诉的149例眩晕症患者的温度试验结果,分析患者温度试验结果与单冷试验结果的相关性及单冷试验的灵敏度和特异度。结果 149例眩晕患者男90例、女59例,年龄22～70(中位数46)岁。根据文献研究报道,以温度试验半规管轻瘫(CP)值为20%作为正常参考值,得出温度试验与单冷试验结果呈线性关系(r=0.872,P <0.001)。以CP值≥20%为温度试验的异常标准,温度试验作为金标准,受试者工作特征(ROC)曲线分析,单冷试验正常者的ROC曲线下面积为0.894(95%CI 0.833～0.939,P <0.001),通过约登指数确定临界点为20%,单冷试验结果大于20%为异常,灵敏度为84.62%,特异度为84.54%。结论单冷试验在前庭功能筛查的可靠性高,是一种灵敏的筛查工具,在临床中结合眼震电图将单冷试验作为筛查工具,将缩短患者检查时间及减少不适感。