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.     

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.     

后路微创全髋关节置换术早期体会

报道后路小切口微创单侧全髋关节置换术15例。后路小切口微创全髋置换术具有创伤小、出血少、恢复快等优点，但要有严格的手术指征、熟练的操作技术和专用的器械。     

骶尾部肿瘤的发病特点及外科治疗体会

骶尾部肿瘤因其侵袭位置深在、局部血供丰富,常发生不易控制的大出血和骶神经的损伤,因此该部位肿瘤一直是脊柱外科及普通外科的难题之一,现将我院2003年1月至2006年11月收治的9例报告如下。临床资料1.一般资料:本组9例,其中男5例,女4例,年龄16~59岁。病程2个月~10年,骶13例,骶2以下6例(其中1例尾骨受侵)。骶1病例分别为脂肪瘤、滑膜肉瘤、骨巨细胞瘤,骶2病例为尤文肉瘤,其他5例为转移癌2例和脊索瘤3例。临床表现:骶尾部及臀部持续性隐痛,双下肢受累3例,单下肢受累6例,二便困难5例,直肠受压5例。所有病例行X线、CT和MRI检查,骶尾椎受累7…     

创伤性脑损伤住院患儿主要照顾者负担及其影响因素

目的 调查创伤性脑损伤(traumatic brain injury, TBI)住院患儿的主要照顾者负担现状并分析影响因素,为开展相关干预提供参考。方法 2020年4月至2021年5月,采用便利抽样选取深圳市某三级甲等儿童医院神经外科TBI住院患儿的主要照顾者128例为研究对象,采用一般情况调查表、Zarit照顾者负担量表(Zarit caregiver burden interview, ZBI)、简易应对方式问卷(simplified coping style questionnaire, SCSQ)对其进行调查,分析负担的影响因素。结果 TBI住院患儿的主要照顾者ZBI得分为31.5(24.00,40.75)分。SCSQ中积极和消极应对维度均分分别为(23.30±5.55)和(10.04±4.64)分。TBI住院患儿的主要照顾者Ln ZBI评分在患儿TBI分类、住院天数、有无后遗症、有无入住ICU、照顾者学历及月均收入上的差异均有统计学意义(均P<0.05)。入住ICU、消极应对、有后遗症、月均收入为TBI住院患儿的主要照顾者负担的影响因素(均P<0.05)。结论 住...     

四种前路手术治疗单节段颈椎病疗效比较

目的比较四种颈椎前路融合术治疗单节段颈椎病的临床疗效。方法将2002年1月-2006年1月168例脊髓型颈椎病（CSM）患者分为A、B、C、D四组。A组42例采用前路减压并植骨融合治疗;B组54例采用颈椎前路减压界面固定术（CIFC）;C组40例采用植骨融合并颈椎前路钢板内固定;D组32例采用CIFC并前路钢板内固定。术后定期随访及拍摄X线片,观察疗效、椎间高度、颈椎前弯曲度和融合情况。结果经过随访,A组融合率为83．3％,B组融合率为96．3％,C组融合率为95．0％,D组融合率为96．9％。终访时,A组平均椎间高度和颈椎前弯曲度较术后2周之间差异有显著性意义（F=3．06,P〈0．05）,B、C和D组之间差异无显著性意义（F=2．42,P〉0．05）。A组与B、C组和D组远期疗效之间差异均有显著性意义（F=3．15,P〈0．05）,B、C和D组远期疗效之间差异无显著性意义（F=2．32,P〉0．05）。结论脊髓型颈椎病的治疗关键不仅在于充分减压及有效植骨融合,而且不同融合技术对疗效有明显影响。     

小儿腓骨小细胞性骨肉瘤一例

小细胞性骨肉瘤(small cell osteosarcoma,SCOC)是一种非常罕见的骨肉瘤,约占骨肉瘤的1.3％～4％.发病年龄与普通骨肉瘤相似,多发生在10～20岁[1,2].该病于1979年由Sim等[3]首次发现.这种小细胞骨肉瘤组织学形态类似于尤文氏肉瘤,预后比传统的骨肉瘤更差.其与尤文氏肉瘤的区别在于二...     

扶正益津汤对放疗所致免疫功能抑制小鼠细胞毒功能的影响

目的观察扶正益津汤对放疗所致免疫功能抑制小鼠细胞毒功能的影响。方法以小鼠腹腔巨噬细胞介导的肿瘤细胞溶解作用(MTC)和抗体依赖细胞介导的细胞毒作用(ADCC)为指标,观察中药扶正益津汤对小鼠巨噬细胞细胞毒活性的影响。结果扶正益津汤对受X射线照射所致免疫功能抑制小鼠细胞毒活性有显著增强作用。结论扶正益津汤可用于放疗辅助用药。     

丙泊酚静脉全麻下人工流产围手术期的护理干预

目的:探讨门诊日间手术人工流产术在丙泊酚静脉全麻时,护理技术的管理水平.更好地预防并发症,提高手术质量.方法:收集2006年1月～2007年12月我院应用丙泊酚静脉全麻做人工流产的患者1820例,行一般护理,围手术期护理,术后观察的相关护理和心理护理.结果:在丙泊酚静脉全麻下,成功率达98%,病人的平均手术时间(53.7±9.2)min,A组视觉模拟评分(1.69±0.63)分;病人术后头痛头晕、恶心呕吐、皮肤搔痒发生率(18.0%、9.0%、4.0%);第一次排气时间、第一次排尿时间[(20.29±8.16)h、(5.06±1.86)h].结论:患者满意度大幅度提高,很好的预防了相关并发症的发生.     

全髋关节置换术后迟发性感染的诊断和手术治疗

全髋关节置换术（THA）目前已趋于成熟,给许多患者解除了痛苦,术后迟发性感染的发生率约为1％。然而术后迟发性感染目前尚缺乏严格诊断标准,早期诊断率很低,而且术后迟发性感染一旦发生后果将相当严重,将给患者造成极大精神痛苦和经济损失,也给医生带来很大的压力,治疗起来非常困难。