Real-time-guided bone regeneration around standardized critical size calvarial defects using bone marrow-derived mesenchymal stem cells and collagen membrane with and without using tricalcium phosphate: an in vivo microcomputed tomographic and histologic e

The aim of the present real time in vivo micro-computed tomography （pCT） and histologic experiment was to assess the efficacy of guided bone regeneration （GBR） around standardized calvarial critical size defects （CSD） using bone marrow-derived mesenchymal stem cells （BMSCs）, and collagen membrane （CM） with and without tricalcium phosphate （TCP） graft material. In the calvaria of nine female Sprague-Dawley rats, full-thickness CSD （diameter 4.6 mm） were created under general anesthesia. Treatment-wise, rats were divided into three groups. In group 1, CSD was covered with a resorbable CM; in group 2, BMSCs were filled in CSD and covered with CM; and in group 3, TCP soaked in BMSCs was placed in CSD and covered with CM. All defects were closed using resorbable sutures. Bone volume and bone mineral density of newly formed bone （NFB） and remaining TCP particles and rate of new bone formation was determined at baseline, 2, 4, 6, and 10 weeks using in vivo pCT. At the lOth week, the rats were killed and calvarial segments were assessed histologically. The results showed that the hardness of NFB was similar to that of the native bone in groups I and 2 as compared to the NFB in group 3. Likewise, values for the modulus of elasticity were also significantly higher in group 3 compared to groups 1 and 2. This suggests that TCP when used in combination with BMSCs and without CM was unable to form bone of significant strength that could possibly provide mechanical ＂lock＂ between the natural bone and NFB. The use of BMSCs as adjuncts to conventional GBR initiated new bone formation as early as 2 weeks of treatment compared to when GBR is attempted without adiunct BMSC therapy.

Healing Mechanism and Osteogenic Capacity of Bovine Bone Mineral—Human Amniotic Mesenchymal Stem Celland Autogenous Bone Graft in Critical Size Mandibular Defect

Experiments on maxillofacial bone tissue engineering showed the promising result;however, its healing mechanisms and effectiveness had not been fully understood. The aim of this study is to compare the bone healing mechanism and osteogenic capacity between bovine bone mineral loaded with hAMSC and autogenous bone graft in the reconstruction of critical size mandibular bone defect. Critical size defects were made at the mandible of 45 New Zealand white rabbits reconstructed with BBM-hAMSC, BBM alone, and ABG, respectively. At the end of first, second, and twelfth weeks, five rabbits from each experimental week were sacrificed for histology and immunohistochemistry staining. Expressions of vascular endothelial growth factor (VEGF), bone mor-phogenic proteins-2 (BMP2), Runx2 and the amount of angiogenesis were analyzed in the first and second week groups, while expressions of Runx2, osteocalcin, collagen type-I fibres, trabecular area and bone incorporation were analyzed in the twelfth week groups. The result showed that expressions of VEGF, BMP2 and Runx2 as well as the amount of angiogenesis were higher in ABG compared with BBM-hAMSC group in the first and second weeks of healing. The result of twelfth week of healing showed that expressions of Runx2 and osteocalcin as well as the thickness of collagen type-I fibres were significantly higher in BBM-hAMSC compared to ABG group, while there was no statistically difference in trabecular area and bone incorporation between BBM-hAMSC and ABG group. This study concluded that early healing activities were higher in auto-genous bone graft than in BBM-hAMSC, while osteogenic activities in the late stage of healing were higher in BBM-hAMSC compared to autogenous bone graft. It was also concluded that the osteo-genic capacity of BBM-hAMSC was comparable to autogenous bone graft in the reconstruction of critical size defect in the mandible.

Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats’ critical-sized mandibular defects

BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.

Effects of heme oxygenase-1-modified bone marrow mesenchymal stem cells on microcirculation and energy metabolism following liver transplantation

AIM To investigate the effects of heme oxygenase-1(HO-1)-modified bone marrow mesenchymal stem cells(BMMSCs)on the microcirculation and energy metabolism of hepatic sinusoids following reduced-size liver transplantation(RLT)in a rat model.METHODS BMMSCs were isolated and cultured in vitro using an adherent method,and then transduced with HO-1-bearing recombinant adenovirus to construct HO-1/BMMSCs.A rat acute rejection model following 50%RLT was established using a two-cuff technique.Recipients were divided into three groups based on the treatment received:normal saline(NS),BMMSCs and HO-1/BMMSCs.Liver function was examined at six time points.The levels of endothelin-1(ET-1),endothelial nitric-oxide synthase(e NOS),inducible nitric-oxide synthase(i NOS),nitric oxide(NO),and hyaluronic acid(HA)were detected using an enzyme-linked immunosorbent assay.The portal vein pressure(PVP)was detected by Power Lab ML880.The expressions of ET-1,i NOS,e NOS,and von Willebrand factor(v WF)protein in the transplanted liver were detected using immunohistochemistry and Western blotting.ATPase in the transplanted liver was detected by chemical colorimetry,and the ultrastructural changes were observed under a transmission electron microscope.RESULTS HO-1/BMMSCs could alleviate the pathological changes and rejection activity index of the transplanted liver,and improve the liver function of rats following 50%RLT,with statistically significant differences compared with those of the NS group and BMMSCs group(P<0.05).In term of the microcirculation of hepatic sinusoids:The PVP on POD7 decreased significantly in the HO-1/BMMSCs and BMMSCs groups compared with that of the NS group(P<0.01);HO-1/BMMSCs could inhibit the expressions of ET-1 and i NOS,increase the expressions of e NOS and inhibit amounts of NO production,and maintain the equilibrium of ET-1/NO(P<0.05);and HO-1/BMMSCs increased the expression of v WF in hepatic sinusoidal endothelial cells(SECs),and promoted the degradation of HA,compared with those of the NS group and BMMSCs group(P<0.05).In term of the energy metabolism of the transplanted liver,HO-1/BMMSCs repaired the damaged mitochondria,and improved the activity of mitochondrial aspartate aminotransferase(ASTm)and ATPase,compared with the other two groups(P<0.05).CONCLUSION HO-1/BMMSCs can improve the microcirculation of hepatic sinusoids significantly,and recover the energy metabolism of damaged hepatocytes in rats following RLT,thus protecting the transplanted liver.

Porous titanium granules in critical size defects of rabbit tibia with or without membranes

Recently, porous titanium granules （PTGs） have been indicated for the preservation of the dimensions of post-extraction sockets, as a filler in sinus lift procedures and for the treatment of peri-implant and periodontal defects, based on the osteoconductivity and dimensional stability of the titanium granules. However, there is a lack of information regarding the use of this material in larger defects and in conjunction with membranes. The objective of this study is to test the behavior of PTGs used to fill critical size defects in rabbit tibiae, with and without membranes. Critical defects were created in both tibiae of rabbits, divided randomly into three groups： Group A （defect filled with PTG）, Group B （defect filled with PTG＋collagen membrane） and a control group （empty defect）. After six weeks, histomorphometric analysis was performed. The results showed more defect closures at the cortical area （87.37%±2.2%） and more bone formation at the marrow area （57.6%± 1.3%） in Group B, in comparison with the other groups （P〈0.05）; the use of membranes improved the material stability expressed as more percentages of the original material when membranes were used （P〈0.05）. Finally, inflammatory reactions were observed when the granules were not protected by membranes. In spite of the limitations of this animal study, it may be concluded that PTG particles are osteoconductive and allow bone growth. The PTG particles must be covered by a membrane, especially when grafting larger defects, in order to control particle migration, promote clot stabilization and separate the PTG graft from undesired soft tissue cells.

Production Performance of Different Generations of Muchuan Blackbone Chicken

In order to formulate feasible conservation measures and develop and utilize Muchuan black-bone chicken rationally,two generations of Muchuan black-bone chicken were bred,and their production performance and slaughter traits( at the age of 300 d) were compared. The results showed that the reproductive performance,slaughter performance and body size of the Muchuan black-bone chicken of Generation 1( G_1)were all improved compared with those of the Generation 0( G_0)( P <0. 05). At the age of 300 d,the live weight,carcass weight,and leg muscle weight of the G_1 were significantly higher than those of the G_0( P <0. 05); and the chest width of the cocks of the G_1 was significantly higher than that of the G_0( P <0. 05). It suggests that after rigorous selection and utilization of modern poultry breeding techniques,the reproductive performance,slaughter performance and survival rate of Muchuan black-bone chicken can be improved significantly.

股骨骨缺损动物模型制备现状及特点

背景:骨缺损的修复及后期临床转归仍是临床研究中的热点和难点,是困扰临床医师的常见问题。构建合适、可重复性及无限接近临床的动物实验模型及科学的评估对进一步的临床治疗相关疾病至关重要。目的:回顾性分析文献中股骨骨缺损常用实验动物模型制备方法及不同模型特点,评估优势与不足,为相关研究者选择合适的股骨骨缺损动物模型提供一定的参考。方法:检索PubMed、Web of Science、Medline数据库及CNKI数据库,设定英文检索词为:bone defect,bone,bones,defect,defects,defective,animal model,animal,model,laboratory,laboratory animal,animal laboratory;中文检索词为:骨缺损,动物模型,实验。检索时限为2000-01-01/2022-08-01。结果与结论:①对入选的27篇随机对照动物实验进行了分析和评估,实验动物包含大鼠、小鼠、新西兰兔及羊,骨缺损类型主要包含圆柱形骨缺损和节段性截骨骨缺损,部位以股骨中段及远端居多。多用于评估骨修复材料、药物、载药活性物质及物理治疗等方法对骨缺损修复的影响及缺损愈合机制研究,尤其是负重骨缺损修复机制的研究。②不同缺损类型及不同实验动物股骨骨缺损值的范围不同,研究者可结合实验目的,选择合适的动物及骨缺损类型,并设置合理的骨缺损值。③目前的研究表明,股骨骨缺损模型以圆柱形及节段截骨骨缺损为主,主要是在股骨远端及中段,手术方法及术后处理较为成熟,可操作性强,能够提供成熟的实验动物模型。④就圆柱形骨缺损而言,大鼠及新西兰兔更适合,而节段性截骨则无特殊要求,各种动物均能满足实验要求。

膜诱导技术结合Ca(OH)_(2)-PMMA治疗节段性骨缺损的研究进展

节段性骨缺损是一种负担较大、治疗具有挑战性的疾病,其病因包括创伤、感染、肿瘤等。目前骨缺损的重建方法主要有血管化骨移植、骨搬运以及膜诱导技术(Masquelet技术)等。而血管化自体骨移植虽然被认为是重建大尺寸骨缺损的金标准,但其具有专业性要求高、治疗周期长、过程复杂等局限性,而膜诱导技术因简单、高效及可靠等特性被广泛应用于骨缺损的治疗。膜诱导技术通过两次手术获取具有生物效应的诱导膜,促进缺损部位新骨的生长和愈合,是目前国内外公认的治疗节段性骨缺损的有效方法。本文将概述骨缺损的现状,介绍临界尺寸骨缺损的概念,探讨及思考在膜诱导技术中结合聚甲基丙烯酸甲酯氢氧化钙混合物[Ca(OH)_(2)-PMMA]新型材料应用于节段性骨缺损治疗的临床意义。

Vascular restoration through local delivery of angiogenic factors stimulates bone regeneration in critical size defects

Critical size bone defects represent a significant challenge worldwide,often leading to persistent pain and physical disability that profoundly impact patients’quality of life and mental well-being.To address the intricate and complex repair processes involved in these defects,we performed single-cell RNA sequencing and revealed notable shifts in cellular populations within regenerative tissue.Specifically,we observed a decrease in progenitor lineage cells and endothelial cells,coupled with an increase in fibrotic lineage cells and pro-inflammatory cells within regenerative tissue.Furthermore,our analysis of differentially expressed genes and associated signaling pathway at the single-cell level highlighted impaired angiogenesis as a central pathway in critical size bone defects,notably influenced by reduction of Spp1 and Cxcl12 expression.This deficiency was particularly pronounced in progenitor lineage cells and myeloid lineage cells,underscoring its significance in the regeneration process.In response to these findings,we developed an innovative approach to enhance bone regeneration in critical size bone defects.Our fabrication process involves the integration of electrospun PCL fibers with electrosprayed PLGA microspheres carrying Spp1 and Cxcl12.This design allows for the gradual release of Spp1 and Cxcl12 in vitro and in vivo.To evaluate the efficacy of our approach,we locally applied PCL scaffolds loaded with Spp1 and Cxcl12 in a murine model of critical size bone defects.Our results demonstrated restored angiogenesis,accelerated bone regeneration,alleviated pain responses and improved mobility in treated mice.

胶原基骨、天然煅烧骨在大鼠颅骨缺损修复术中的诱导成骨效果对比观察

目的对比观察胶原基骨和天然煅烧骨在大鼠颅骨缺损修复术中的诱导成骨效果。方法18只SD大鼠随机分为3组,每组6只,均建立SD大鼠颅骨双侧临界尺寸骨缺损模型,均行缺损修复术,术中颅骨一侧缺损部位填充胶原基骨(胶原基骨组),另一侧缺损部位填充天然煅烧骨(煅烧骨组)。术后第4、8、12周,取大鼠颅骨双侧缺损部位新生的骨组织,通过Micro-CT方法及病理检查结果评价成骨效果[成骨速度(新生骨骨体积分数、新生骨骨面积分数)、成骨质量(骨小梁数量、厚度、间隙;新生骨组织中纤维结缔组织、新生毛细血管数量)],并比较。结果Micro-CT结果显示,术后第4、8、12周,胶原基骨组的新生骨骨体积分数、骨小梁数量、骨小梁厚度均高于天然煅烧骨组,骨小梁间隙低于煅烧骨组。HE染色结果显示,术后第4、8、12周,与煅烧骨组比较,胶原基骨组的新生骨骨面积分数高。胶原基骨组胶原基骨吸收速度快,新生骨含较多的结缔组织、新生血管,骨质较软;煅烧骨组天然煅烧骨吸收速度慢,新生骨中结缔组织、血管较少,骨质偏硬。结论在大鼠颅骨临界尺寸骨缺损修复术中,胶原基骨诱导成骨的速度较快,成骨量高,吸收快,新生骨组织中结缔组织、新生血管多,新生骨质类似“松质骨”;天然煅烧骨诱导成骨速度较慢,新生骨组织中结缔组织、新生血管少,新生骨质类似“皮质骨”。

人工智能三维规划系统在全髋关节置换中的准确性及其影响因素

背景:人工智能三维规划系统能够自动建立三维模型并生成规划方案,但其预测假体型号的准确性尚未得到充分验证。目的:探讨人工智能三维规划系统在全髋关节置换前预测假体型号的准确性及对临床预后的影响,并进一步分析影响规划准确性的危险因素。方法:前瞻性收集2021年1月至2022年6月在徐州医科大学附属医院骨科接受单侧初次全髋关节置换患者的临床资料,随机分为人工智能组(n=80)和传统模板组(n=79)。对比两组术中使用假体与术前规划假体的匹配情况,记录术后随访Harris功能评分、双下肢不等长、脱位和假体松动等并发症的发生情况,采用单因素及多因素Logistic回归分析来探究人口统计学指标、术前诊断、Dorr分型对股骨柄规划准确性的影响。结果与结论:①人工智能组髋臼侧、股骨侧假体完全符合率分别为50%(40/80)、55%(44/80),传统模板组为34%(27/79)、37%(29/79),组间差异有显著性意义(P<0.05);②人工智能组在髋臼、股骨侧假体相差1个尺寸内的准确率分别91%(73/80)、86%(69/80),传统模板组为82%(65/79)、72%(58/79),差异仅在股骨侧有显著性意义(P<0.05);③两组术后随访期间均无脱位及假体松动的发生,人工智能组、传统模板组术后双下肢长度差值分别为(3.56±2.32)mm、(3.52±2.41)mm;末次随访时人工智能组与传统模板组Harris评分分别为(92.74±3.08)分、(91.81±3.52)分,上述指标两组比较差异均无显著性意义(P>0.05);④单因素分析结果显示,术前诊断为先天性髋关节发育不良、股骨头坏死以及Dorr B型、C型股骨对人工智能三维规划系统预测股骨假体准确率有显著影响(P<0.05);⑤多因素logistic回归分析显示,术前诊断为先天性髋关节发育不良(OR=18.233,95%CI:2.662-124.888)是影响人工智能三维规划系统预测股骨柄型号的独立危险因素;⑥提示人工智能三维规划系统预测假体型号较传统二维模板具有更高的准确率,且对术后并发症的发生风险和关节功能并不会造成明显的差异。由于解剖畸形和髋臼解剖位置重建,人工智能三维规划系统在先天性髋关节发育不良患者中准确率较低。

金属声屏障用陶粒吸声板制备及性能实验研究

陶粒吸声板耐候性好、对环境影响小,是一种极具潜力的吸声材料,应用于金属声屏障需要深入研究其吸声、隔声性能。基于多孔材料的声学机理,通过振动加压成型技术,制备了陶粒吸声板,研究不同因素对其吸声、隔声性能的影响。测试结果表明:不同工况陶粒吸声板吸声系数、隔声量曲线趋势基本一致,中低频区段吸声系数逐渐增加,1000 Hz左右达到峰值,1000~5000 Hz吸声系数曲线存在波动及第二峰值;隔声量曲线基本呈先降低后增加趋势,区间存在波动,5000 Hz达到峰值;陶粒吸声板采用的陶粒粒径越小,吸声系数、隔声量越高;骨胶比由3.5提升至5.0,吸声系数、隔声量降低;降低水胶比,高频区段吸声系数增加明显,中高频隔声量降低明显;板厚增加,中高频段吸声系数曲线有向低频平移趋势,隔声量整体变化不大;陶粒吸声板放入金属外壳形成单元板后,吸声系数、隔声量较单一陶粒板整体提升显著。经过设计配比陶粒吸声板可以达到Ⅱ级吸声要求,同时兼具一定的隔声效果,放置入金属外壳组成声屏障单元板后,满足TB/T 3122—2019《铁路声屏障声学构件》标准要求,将陶粒吸声板用于金属声屏障吸声材料是可行的。

超细微兔骨理化性质的研究

以兔骨为研究对象,研究了兔骨的一般营养物质及矿质元素,氨基酸的含量及组成,超细微兔骨的球磨工艺,表面结构,化学结构和游离氨基酸的组成及含量。结果表明:兔骨中含有丰富的蛋白质、钙和磷元素,人体所需的必需氨基酸占5%左右,非必需氨基酸占13%左右。超细微兔骨的最佳球磨工艺为4 h、500 r/min、10 g装料量,粒径为10.203μm。超细微兔骨由于在球磨过程中受到机械作用和热作用,游离氨基酸的含量比经过不同目筛的兔骨要少。电镜结果显示,超细微兔骨颗粒外形呈规则的多边形。FT-IR图谱显示,超微细兔骨的化学结构与其他粒径相比没有明显差别。

羟基磷灰石人工骨研究进展与展望

羟基磷灰石具有良好的生物相容性、骨传导性与骨诱导性,因此被广泛应用于人工骨的制造,但因其强 度和韧性较低,使其使用范围受到限制,如何提高其性能便成了研究的热点,本文综述了HAP人工骨的进展情况,并指 出了其可能的发展方向。

兔髌骨-髌腱结合部新骨形成与大小预测其愈合程度

目的探讨髌骨-髌腱结合部愈合中新骨形成量和力学指标之间的关系。方法15只雌性成年兔,在一侧后肢的髌骨远端1/3处横行截骨,切除远端1/3髌骨。将髌腱与髌骨断端连接。分别于术后第8和16周取材进行生物力学、组织学和新骨形成情况(X线摄片测量和骨密度测定)检测,进行对比研究。结果髌骨-髌腱结合部新骨面积、新骨长度及骨矿密度在第8和16周之间仍未达到显著性水平,但在第16周时的拉断载荷、极限拉应力和拉断能量均明显大于第8周;新骨面积与拉断载荷及极限拉应力呈显著性相关。结论新骨面积与拉断载荷及极限拉应力间显著相关,通过临床无创X线影像学对新骨面积的定量,可有效评估髌骨部分切除后髌骨-髌腱结合部愈合状况,为术后主动康复提供参考。

细胞色素P450c 17α基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系

目的探讨细胞色素P450c 17α(CYP17)基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系.方法应用聚合酶链反应-限制性片段长度多态性检测上海市397例46～80岁无亲缘关系的汉族男性(其中324例健康男性,73例骨质疏松患者)CYP17基因Msp AI多态性,并用双能X线吸收仪检查研究对象腰椎1～4和股骨近端股骨颈、大转子区及Ward's三角部位骨密度(BMD)、骨矿含量(BMC)和骨截面大小(CSA).结果397例男性CYP17 Msp AI基因型频率分布依次为TC(51.1%)、CC(33.8%)和TT(15.1%),等位基因T和C频率分布分别为40.7%和59.3%,等位基因频率分布符合Hardy-Weinberg定律.未发现该多态性在73例骨质疏松患者和324例健康男性之间频率分布的差异.通过协方差分析,在397例受试者、73例骨质疏松患者或324例健康男性中,均未显示CYP17基因Msp AI多态性与腰椎1～4和股骨近端各部位BMD、BMC和CSA的相关性.结论CYP17基因MspAI多态性不是影响上海市汉族男性骨量和骨大小变异的遗传因素.

中国男女性骨大小和体积骨密度的探讨

目的 确定中国北方人群在腰椎和股骨部位峰值骨大小和体密度的性别差异 ,并分析影响其大小的因子。方法 年龄 15至 4 0岁 2 5 6例健康男性和 30 9例健康女性 ,他们的腰椎和股骨颈的骨大小和体积骨密度用双能X线骨密度仪测量。椎体和股骨颈近似为圆柱体 ,骨体积V =π× (宽度 2 ) 2 ×高度 ,vBMD =BMC 体积。结果 椎体峰值BMC ,体积和vBMD女性在 30～ 4 0岁达到峰值 ,而男性 15～ 17岁达到峰值。椎体和股骨颈的BMC男性比女性高 18 1%～ 2 6 7% ,而骨体积相应高 2 8 5 %～ 32 0 % ,这样vBMD男性比女性低 4 0 %～ 8 3% (P <0 0 1)。初潮较晚 (≥ 15岁 )绝经前妇女比来潮较早者 (≤ 12岁 ) ,BMC低 10 % (P <0 0 5 )。男性抽烟者与非抽烟者骨大小和vBMD没有统计学差异。饮酒也没有观察到明显的效应。结论 中国男性比女性有较低的vBMD 。

中国绝经前女性群体中钙敏受体基因内多态性位点A986S与骨密度和骨大小的关联研究(英文)

目的在中国绝经前女性群体中研究钙敏受体基因内多态性位点986Ala/Ser(A986S)与骨密度和骨大小的关联.方法样本为来自上海市区的285例20.0～41.9岁绝经前汉族女性.用双能X射线骨密度仪测量腰椎和髋部骨密度和骨大小.用限制性片段长度多态性方法(PCR-RFLP)分析钙敏受体基因外显子7内的多态性位点986Ala/Ser(A986S)的多态性.有酶切位点基因片段表示为A,无酶切位点表示为S,基因型为AA、AS、SS.结果在中国女性群体中,AS基因型个体很少而缺少SS基因型个体.AA和AS基因型个体间骨密度和骨大小不存在显著性差异.结论钙受体在钙的代谢中有显著的作用,该基因与骨表型间的关系需要进一步利用有意义的遗传标记来进行研究.

关于鼻内窥镜下鼻腔泪囊造孔术骨孔大小的探讨

目的:探讨鼻内窥镜下鼻腔泪囊造孔术中骨孔的大小对手术效果的影响,以寻求最合适的骨孔大小。方法:采用随机、单盲、平行研究方法。选取2010-01/10在株洲三三一爱尔眼科医院欲行鼻内窥镜下鼻腔泪囊造孔术治疗的慢性泪囊炎患者200例200眼随机分成两组:A组100眼:骨孔大小6mm×6mm(±2mm),B组100眼:骨孔大小10mm×10mm(±2mm)以上。手术时按分组做相应大小骨孔,术后观察各种不良反应及手术效果。结果:A组9例因骨壁太厚,3例因骨孔位置不在最佳位置需扩大骨孔,失访4例,最后进入观察病例84例,其中无效2例,有效82例。B组失访3例,最后进入观察病例97例,其中无效3例,有效94例,两组统计学上成功率无明显差别,A组患者术后反应更小效果更好。结论:鼻内窥镜下鼻腔泪囊造孔手术治疗慢性泪囊炎时6mm×6mm(±2mm)的骨孔大小是合适的,具有微创、术中出血少、术后不良反映少、且不影响手术效果的特点。

构建组织工程骨修复兔颅骨极限缺损的实验研究

目的观察以胶原缓释重组人骨形成蛋白2(recom b inan t hum an bone m orphogenetic prote in 2,rhBM P-2)复合骨髓间充质干细胞(m arrow m esenchym a l stem ce lls,M SC s)及珊瑚构建的组织工程骨修复兔颅骨极限缺损的能力。方法新西兰大白兔40只,制备颅骨极限缺损,按植入的修复物不同随机分为5组,每组8只。Ⅰ组:自体髂骨,为阳性对照组;Ⅱ组:珊瑚,为阴性对照组;Ⅲ组:rhBM P-2+珊瑚;Ⅳ组:胶原+rhBM P-2+珊瑚;Ⅴ组:M SC s+胶原+rhBM P-2+珊瑚。将其分别植入兔颅骨极限缺损处,术后8、16周行大体观察、X线片、HE染色及M asson三色染色法观察比较骨缺损修复的情况。结果术后Ⅴ组材料与Ⅰ组修复颅骨极限缺损的效果相近,缺损区大体标本可见骨样组织充填,硬度与周边骨质相近,并与周边骨质形成明显骨融合;X线阻射程度高,16周时达80.45%±2.52%;组织学观察为板层状结构的新骨组织,空白孔隙区较少。Ⅳ组修复效果次之,Ⅲ组材料成骨能力较弱,Ⅱ组大部为半透明的纤维薄膜,缺损区界限清晰。结论胶原是rhBM P-2适宜的缓释载体,胶原及M SC s对促进复合支架材料修复骨缺损有重要意义。以M SC s+胶原+rhBM P-2+珊瑚构建的组织工程骨可成为一种良好的骨缺损修复材料。