复合干细胞生物陶瓷在裸鼠异位成骨中的评价

目的 研究h-BMP-2基因转染骨髓间充质干细胞(BMSCs)在复合煅烧骨、β-TCP或直接植入裸鼠股部后的成骨能力。方法 通过影像学、组织学和形态计量学等方法,观察未经诱导、OS液诱导和h-BMP-2基因转染BMSCs在复合煅烧骨,或多孔β-TCP后植入裸鼠皮下,或直接制成细胞悬液注入,在4、8、12周诱导成骨和材料降解情况。结果 在裸鼠皮下,单纯生物陶瓷不能诱导成骨,而复合了未诱导、OS液诱导和h-BMP-2基因转染BMSCs的生物陶瓷均能成骨,成骨量为h-BMP-2基因转染组>OS液诱导组>未经诱导组(P<0.05),B-TCP可随骨长入而降解;注入裸鼠肌肉的OS液诱导的和h-BMP-2转染的BMSCs均能诱导成骨,而未经诱导MSCs则不能成骨。结论 复合人BMP基因转染BMSCs的β-TCP是一种理想的骨修复材料。     

Catastrophic failure of modular Zirconia—Ceramic femoral head components after total hip arthroplasty

Catastrophic failure of two zirconia—ceramic modular femoral heads occurred, despite the theoretical improved toughness of zirconia—ceramic relative to alumina—ceramic. This experience led the authors to return to cobalt—chromium as the metal of choice for articulation against polyethylene in total hip arthroplasty.     

多孔陶瓷板固定床生物反应器设计及模拟

设计了一种结构新型的多孔陶瓷固定床生物反应器，与传统的固定床相比，该反应器具有氧传递性能好，能够均匀接种等优点，通过模拟，考察了反应器内的流体流动和气液传递性质，计算证明反应器的供氧能力能够满足链霉菌发酵过程对氧的需求。     

MANAGEMENT OF CHONDROSARCOMA INCLUDING MODULAR CERAMIC AND ALUMINA PROSTHETIC REPLACEMENT

Forty-one cases of chondrosarcoma from varying sites throughout the body, and treated exclusively by one of the authors (R. L. H.) from 1972 to 1990 were reviewed. The symptoms, signs, location of tumours, treatment and progress are presented. Particular attention was paid to modular bone replacement techniques. Excision and reconstruction of the bone or joint were carried out in 17 femora, five tibia and six humeri. Comparison between this method of management and other techniques is discussed. Titanium and alumina prostheses for the hip, femur, tibia, shoulder and humerus have been designed by the senior author. These are both inert and modular, and have been found to be superior to other methods of treatment in both function and cosmesis. They do not possess the same potential donor infection risks and other disadvantages of allograft replacement. Immediate postoperative weight bearing and mobilization are possible with these systems. The Huckstep prostheses allow for bony in growth into their porous coated alumina sleeves, spacers and stems. In addition, the titanium alloy locking component for the femoral stems has an elasticity half that of other metal alloys and this was found to minimize stress shielding.     

口腔修复陶瓷材料的磨损性能北大核心

背景:陶瓷材料因具有优良的机械性能、与口腔组织良好的生物相容性及高度美观性广泛应用于口腔修复领域,良好的磨损性能对修复体临床应用有重要意义。目的:综述口腔修复陶瓷材料磨损性能机制及临床研究,以期为临床选择适宜的陶瓷材料提供思路。方法:应用计算机在PubMed和Web of Science数据库检索在2016年1月至2021年4月期间涉及口腔修复陶瓷材料磨损性能的相关研究。英文检索词为“dental ceramic material,wear property”,最终共纳入36篇文献进行分析。结果与结论:①全瓷材料自身耐磨性均高于树脂陶瓷复合材料,全瓷材料中氧化锆陶瓷磨损性能最佳,美学性能较弱。②玻璃陶瓷中氧化锆加强型硅酸锂玻璃陶瓷磨损性能较好,但应用时间较短,长期疗效还有待更多的研究证实。③树脂陶瓷复合材料中树脂纳米陶瓷材料磨损性能优于聚合物渗透陶瓷。④在后牙区全冠修复可选择氧化锆陶瓷,前牙区全冠修复可以根据患者的美学需求选择高透性氧化锆陶瓷或玻璃陶瓷。⑤贴面、嵌体和高嵌体修复可选择长石瓷、玻璃陶瓷和树脂陶瓷复合材料,但树脂陶瓷复合材料耐磨性差,需避免用于高应力承载区。⑥对牙本质暴露、氟斑牙和牙齿酸蚀症患者可考虑树脂纳米陶瓷材料,但这类患者适宜的陶瓷材料相关研究较少。⑦表面粗糙度对陶瓷材料的磨损性能有显著影响,临床口腔修复应用中采用良好的抛光表面可提高陶瓷材料磨损性能,而且对修复体进行定期复查也至关重要。     

A scanning electron microscopy study of the interface between ceramics and bone

By use of scanning electron microscopy (SEM), together with energy dispersive chemical analysis, a study has been made of the comparison of an in vitro method of assessing interface reactions between bone and ceramic implants with the naturally occurring changes seen in the rat ear model. Interface reactions between bone and two ceramic materials were examined following 4 wk in culture and 4 wk implantation. In both cases a gradual chemical change occurred at the calcium silicate surface during the fibrous growth onto the ceramic material. Gradual mineralization of the connective fibres was found at the interface of the calcium silicate material, whereas, in the case of alumina ceramic a connective fibrous bond had formed with no associated chemical change at the ceramic surface.     

In Vivo Corrosion of Sleeved Ceramic Femoral Heads: A Retrieval Study

BackgroundThe purpose of this study was to evaluate a series of retrieved sleeved ceramic femoral heads used in total hip arthroplasty (THA) and determine qualitative and quantitative damage and corrosion patterns.MethodsAn IRB-approved implant retrieval database was utilized to identify all sleeved ceramic femoral heads collected from 1995 to 2004. There were 16 implants with an average duration of in situ of 70 months (range, 13-241 months). The femoral stem was known in 14 cases and was titanium alloy in each of those cases. None were revised for metal-related complications. Ten implants (63%) were from primary THAs, and 6 (38%) were from revision THAs. Damage and corrosion were qualitatively graded using a modified Goldberg method. A quantitative assessment was performed with a coordinate measurement machine (CMM).ResultsAmong the 16 retrieved implants, 1 (6%) demonstrated severe Grade 4 corrosion, 5 (31%) had moderate Grade 3 corrosion, 5 (31%) had mild Grade 2 corrosion, and 5 (31%) had no visible corrosion at the inner sleeve that interfaces with the stem trunnion. The only case of grade 4 corrosion occurred in the only head-sleeve in the study that was not factory assembled and was mated with a titanium molybdenum zirconium ferrous (TMZF) alloy stem. The mean maximum linear corrosion depth at the taper interface, as measured by the CMM, was 7.7 microns (range, 0.9-32.9 microns).ConclusionThis study is the first to quantify corrosion at the titanium interface of sleeved ceramic femoral heads. Potentially clinically significant damage and corrosion patterns were observed in a few failed retrievals; however, the majority of cases demonstrated minimal or no damage.     

Survivorship of Ceramic-on-Ceramic Total Hip Arthroplasty With Metal-Backed Acetabular Liners at 10 Years

BackgroundCeramic-on-ceramic bearings are becoming increasingly popular in primary total hip arthroplasty (THA). To enhance ceramic-on-ceramic liner exchange in case of revision surgery, metal-backed liner systems have been proposed. Little is known about the clinical performance of these implants. The purpose of this study is to evaluate a metal-backed liner implant system for primary THA.MethodsA total of 422 patients (with 468 consecutive THAs) were followed over a mean period of 10 years. All arthroplasties were performed with a cementless stem, a press-fit cup, and a metal-backed liner system. Surgical and clinical data, complications, and revisions were analyzed. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before surgery and at 1 and 10 years after surgery were compared.ResultsThe overall 10-year implant survival rate was 93.8%. The survival rate was 97.0% for heads and liners, 97.5% for stem, and 99.3% for acetabular cup. The most common reason for revision was ceramic breakage (2.4%) of the third-generation (BIOLOX forte) acetabular liner. Mean WOMAC score improved significantly from 50.1 before surgery to 13.2 at 1 year after surgery. There was no difference in WOMAC scores between surgical approach and type of bearing at 1 and 10 years after surgery.ConclusionTHA using cementless stem, press-fit cup, and metal-backed liner system provides satisfactory long-term outcomes, with revision rate comparable to that with other systems available in the market. The metal-backed liner system has low risk of mal-seating. Third-generation ceramic liners should be avoided as they seem to be more prone to breakage.     

双相生物钙磷陶瓷生物相容性及异位骨诱导的实验研究

目的检测运用羟基磷灰石及β-磷酸三钙制备的双相钙磷陶瓷的生物相容性及其异位骨诱导效率。方法采用化学共沉淀法及过氧化氢发泡法,将羟基磷灰石及β-磷酸三钙以6∶4的比例在1 100 ℃条件下烧结3 h获得双相钙磷陶瓷,利用X线衍射评估材料组成成分。分离SD大鼠骨髓间充质干细胞,接种于双相钙磷陶瓷,通过扫描电镜、鬼笔环肽及DAPI染色观察细胞的黏附,CCK8法评估细胞增殖,碱性磷酸酶测定法评估骨髓间充质干细胞的碱性磷酸酶表达活性。将不含骨髓间充质干细胞的双相钙磷陶瓷置入比格犬竖脊肌内,于4、8、12周对样本行大体检测、组织染色,测算新骨生成率,从而评估双相钙磷陶瓷的异位骨诱导效率。结果成功制备双相钙磷陶瓷,X线衍射分析可见羟基磷灰石及β-磷酸三钙特异性的衍射峰。扫描电镜可见双相钙磷陶瓷表面广泛分布大孔及连通孔,孔壁粗糙不平,孔内可见均匀分布的微孔。鬼笔环肽及DAPI染色显示,骨髓充质干细胞在材料表面伸展黏附,共培养后逐渐从不规则形转变为均一的长梭形。CCK8法提示共培养后第1天,细胞活力降低,而第3、4、5、7天,细胞增殖活力逐渐增加。碱性磷酸酶活性检测提示,与对照组相比,共培养后第1、7天,双相钙磷陶瓷组的骨髓间充质干细胞可分泌更多的碱性磷酸酶。双相钙磷陶瓷顺利置入比格犬竖脊肌内,术后8周材料孔隙内可见骨样组织沉积,术后12周大孔成骨比例为0.77±0.11,孔内成骨面积比例为0.71±0.14。结论双相钙磷陶瓷具有良好的生物相容性及异位骨诱导效率。