骨膜间质干细胞移植时机的实验和临床研究

目的 研究骨膜间质干细胞异体移植时机。方法 根据骨缺损内纤维组织生长时间的不同，将从大鼠骨膜分离培养的细胞分别分批植入，在植入的第2、3、4和8周时动态观察其成骨量，即骨小梁体积比；另将幼儿骨膜间质干细胞悬液，移植于26例长管状骨干骨折2周后的缺损内，观察骨折临床愈合的时间。结果 大鼠骨缺损后2周以内移植干细胞其骨小梁体积比大，愈合快，2周以后与对照组比无显著差异；临床应用9个月内病人骨折缺损愈合15例(57．7％)，骨不愈合者11例(42．3％)。结论 大鼠骨缺损2周以内移植干细胞其疗效好，大鼠实验和临床上骨缺损2周以后移植骨膜间质干细胞不能明显促进骨缺损愈合。     

Effects of palatine bone denudation repair with periosteal graft on maxillary growth: An experimental study in rats

BackgroundThe long-term goal of cleft palate repair is to provide normal maxillary growth and speech capacity. However, most surgical repairs of cleft palate result in areas of bone denudation on lateral aspects of the hard palate. It is widely acknowledged that palatal bone denudation and subsequent scar contracture resulting from cleft palate surgery can inhibit maxillary growth.MethodThis study is designed to investigate the effect of the periosteum on growth patterns of the maxilla. A total of 32 three-week-old Sprague-Dawley rats were randomly divided into a control group and three experimental groups: a mucosa excision group, a mucosa-periosteum excision group and a periosteal graft group. Nine weeks postoperatively the skulls were prepared for study and palatal widths and lengths were determined. The experimental groups were investigated for various histological changes.ResultsThere was no statistically significant difference for the maxillary measurements (palatal width and length) between the mucosa excision group and the periosteal graft group when compared with the control group. However, the mucosa-periosteum excision group compared to the control indicated a statistically significant decrease in the same measurements. There was also a statistically significant difference for the maxillary measurements between the periosteal graft group and the mucosa-periosteum excision group.It was demonstrated histologically that the density of the Sharpey's fibres and periodontal scar tissue showed a slight increase in the mucosa excision group and the periosteal graft group compared with the control group. In the mucosa-periosteum excision group, the density increased significantly as expected.ConclusionsAll of these findings testify that retaining the periosteum or replacement with a periosteum graft after surgery can prevent the inhibition of maxillary growth.     

舌侧缘淋巴引流与下颌骨舌侧骨膜淋巴管的关系及其临床意义

本文应用十二例新鲜成人尸体的舌－口底－下颌骨－颈部标本，采用淋巴含间接注射法，对舌侧缘淋巴引流及其与下颌骨舌侧骨膜淋巴管的关系进行了观察。初步发现：舌侧缘淋巴引流与下颌骨舌侧骨膜淋巴管没有关系，下颌骨舌则骨膜淋巴管不是舌侧缘向颌下和颈部淋巴结引流的通道因而，舌癌不会通过下颌骨舌侧骨膜淋巴管途径而转移至局部淋巴结。在临床上，对没有直接侵犯至下颌骨舌侧粘骨膜的舌癌病例，保留下颌骨或保持其连续性是可行的。     

兔骨膜成骨细胞与肾血管内皮细胞间接共培养的体外实验研究

目的　探讨兔骨膜成骨细胞 (RPOB)和肾血管内皮细胞 (RRVEC)不同比例下间接共培养对成骨细胞增殖及功能的影响 ,优选细胞间接共培养的适宜比例。方法　取 RPOB和 RRVEC,采用细胞嵌盒培养系统 ,对照组、试验 1、2、3组分别以 RPOB和 RRVEC按 1∶ 0、2∶ 1、1∶ 1和 1∶ 2间接共培养 4天。通过细胞计数、碱性磷酸酶 (AL P)活性测定及 3H-脯氨酸掺入试验观察 RPOB和 RRVCE增殖分化能力及功能状态。结果　试验 1组 RPOB较对照组、试验2、3组增殖活跃 (P<0 .0 5 ) ,且 3H-脯氨酸掺入较高 (P<0 .0 5 ) ;试验 1组 AL P活性较对照组和试验 3组高 (P<0 .0 5 ) ,但与试验 2组无显著差异 (P>0 .0 5 )。结论　 RPOB和 RRVEC以 2∶ 1进行间接共培养时 RPOB增殖能力强、功能活跃 ,适宜进一步组织工程研究     

人骨膜细胞体外成骨分化的基因表达和功能检测

目的 探讨并鉴定骨膜细胞经骨形成蛋白7(BMP7)诱导分化为成骨细胞的基因表达和细胞功能.方法 成人胫骨骨膜常规体外细胞培养法,分实验组和对照组,分别加入BMP7加成骨辅助剂和单纯成骨辅助剂进行体外培养.CCK-8法检测细胞增殖活性,第5、10、15和20天分别采用Real Time-PCR检测骨钙素基因表达,ELISA法检测上清液碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素(osteocalcin,OCN)及骨桥蛋白(osteopontin,OPN)的水平,甲苯胺蓝染色检测糖胺聚糖(GAG),Real Time-PCR检测Ⅱ型胶原基因,比色法检测细胞ALP活性,ALP染色法检测ALP,Yon Kossa染色法检测钙结节.结果 两组骨钙素基因表达及上清液ALP、骨钙素、骨桥蛋白的含量均增高,实验组与对照组差异有统计学意义(P＜0.05).两组细胞的ALP和钙结节染色阳性率增高,实验组与对照组差异有统计学意义(P＜0.05).甲苯胺蓝染色阳性率及Ⅱ型胶原基因表达表现为先高后低,实验组与对照组差异有统计学意义(P＜0.05).结论 骨膜细胞在BMP7诱导下体外大量增殖和分化成骨,表达出明显的成骨特异基因,并具有合成分泌成骨特异蛋白的功能;成骨化过程中,除直接分化成骨外,还存在部分细胞先经软骨形成再钙化成骨的现象;经骨膜细胞-BMP7途径在体外获取大量成骨细胞可用于组织工程的体外构骨及临床应用.     

兔VX-2骨肿瘤早期骨膜反应的影像学研究及病理对照

目的研究兔VX-2骨肿瘤模型早期骨膜改变的影像学表现及其病理基础。材料与方法将VX-2肿瘤细胞悬液注入20只新西兰大白兔的右侧胫骨骨髓腔内制成骨肿瘤模型,种植后每隔5天对所有兔进行X线及MRI检查直至骨膜新生骨形成,每次影像检查之后处死4只实验兔取其胫骨制成病理标本,进行影像学与病理学观察及对照。结果肿瘤种植后第5～15天,MRI显示20只实验侧胫骨骨膜水肿;第20天,MRI发现8只实验侧胫骨骨膜增厚;第25～30天,MRI显示4只骨膜新生骨及其外缘增厚的骨膜。结论兔VX-2骨肿瘤中骨膜水肿及骨膜增厚是发生在骨膜新生骨形成之前的早期骨膜反应,MRI可显示这两种骨膜异常。     

骨膜细胞联合BMP成骨作用的实验研究

目的 观察骨膜细胞联合BMP协同成骨作用及其效果，探索骨缺损后骨再生的新方法。方法 采用自体骨膜细胞体外培养、扩增、传代，观察兔骨膜细胞活细胞形态学和功能变化；兔24只随机分四组，切除双侧连同骨膜桡骨1cm，分别置入骨膜细胞＋BMP、骨膜细胞、BMP、空白对照，术后定期进行X线拍片、组织学检查。结果 兔骨膜培养活细胞形态分三期：细胞分裂期、细胞发展期、细胞功能期，细胞传代进化后，其结构与原代细胞无明显差异；骨膜细胞体外培养，大量增殖，其细胞悬液自体移植至骨缺损区能形成骨组织；修复骨缺损能力骨膜细胞＋BMP〉BMP〉骨膜细胞，骨膜细胞移植后表现为在骨缺损端形成骨样组织。类似膜内化骨形成新骨，BMP类似软骨内化骨形成新骨，骨膜细胞＋BMP表现膜内化骨和软骨内化骨两种机制，以前者明显。结论 骨膜细胞或BMP两者均有修复骨缺损的能力，骨膜细胞联合BMP有协同成骨作用，为修复骨缺损的一种理想方法。     

Periosteal chondroma of the clavicle

 We report a case of periosteal chondroma of the clavicle. To our knowledge, this benign cartilaginous tumor has never been previously reported in this location. Clinical, radiographic and pathological investigations were necessary to establish the diagnosis. Marginal excision proved an effective treatment.     

Periosteal osteosarcoma--a European review of outcome

Periosteal osteosarcoma is a rare primary malignant bone tumour. Treatment is by surgical excision, but controversy remains about the value of chemotherapy. The members of the European Musculo Skeletal Oncology Society (EMSOS) collaborated to produce a dataset of 119 patients. The predominant site for the tumour was the femur, followed by the tibia. All but 2 patients underwent surgery, with 9 requiring amputation and the others having limb salvage. A total of 81 patients had chemotherapy, of whom 50 had neoadjuvant chemotherapy. There was no standard chemotherapy regime, but all patients receiving chemotherapy were given doxorubicin combined with at least one other agent. The overall survival was 89% at 5 years and 83% at 10 years. Eight patients developed local recurrence, of whom 5 died. Survival was related to appearance of local recurrence (P < 0.0001) but no other single factor. The use of chemotherapy was not shown to be a prognostic factor, but was used in two-thirds of the patients in this study.     

Primary Ewing's sarcoma of the sphenoid bone with unusual imaging features: a case report

Ewing's sarcomas (ES) account for approximately 10% of primary malignant bone tumors. Primary Ewing's sarcoma of the skull is a very rare entity. We report a case of Ewing's sarcoma of the sphenoid bone in a 5-year-old boy. CT scan showed heterogeneously enhancing mass with associated spiculated new bone formation along the posterolateral wall of the orbit. Magnetic resonance (MR) imaging showed markedly heterogeneously signal intensity mass lesion containing areas of hemorrhage and fluid–fluid levels. Spiculated new bone formation and fluid–fluid levels had not been reported previously in skull Ewing's sarcomas and may be helpful features for preoperative diagnosis.