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find Author "吕超亮" 4 results
  • 颅底凹陷症外科治疗的手术入路研究进展

    【摘要】 颅底凹陷症(basilar invagination,BI)是颅颈交界区(craniovertebral junction,CVJ) 常见的先天性畸形。其外科治疗已有近一个世纪的历史,为达到有效的减压及坚强的内固定,多种手术入路陆续得到开展。如何正确选择手术入路对其治疗的安全性及疗效具有重要的意义。本文根据国内外近期文献综述了应用于颅底凹陷症患者不用手术入路的研究进展,总结颅底凹陷症外科治疗的不同手术入路特点及适应证,以期对临床工作起到一定的指导作用。

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 生物材料预防椎板切除术后硬膜外瘢痕粘连的研究进展

    椎板切除术后硬膜外瘢痕粘连是脊柱外科常见并发症,研究认为硬膜外瘢痕粘连与腰椎手术失败综合征密切相关。根据不同文献报道,5%~60% 的腰椎手术失败综合征是硬膜外瘢痕粘连引起的。硬膜外瘢痕粘连会大大增加再次手术的风险,治疗效果也不理想。所以,找寻一种更加安全合理的预防方法一直是脊柱外科研究的重点。自体组织、天然高分子等作为物理屏障阻隔硬模外瘢痕的方法已使用了几十年,取得了一定疗效。近年来随着对硬膜外瘢痕粘连机制的认识以及材料学的发展,新的方法层出不穷。自体组织、天然高分子及人工合成高分子等生物材料在动物实验甚至临床上取得了一定进展。该文对近年国内外有关生物材料在预防硬膜外瘢痕粘连的研究进展进行了综述。

    Release date:2017-01-18 08:50 Export PDF Favorites Scan
  • Effects of daphnetin combined with insulin-like growth factor 1 on chondrogenic differentiation of adipose-derived mesenchymal stem cells in rats

    ObjectiveTo investigate the effect of daphnetin (DAP) combined with insulin-like growth factor 1 (IGF-1) gene transfection on chondrogenic differentiation of adipose-derived mesenchymal stem cells (ADSCs) in rats.MethodsRat ADSCs were isolated and amplified by enzymatic digestion. The third generation ADSCs were treated with IGF-1 gene transfection as experimental group and normal ADSCs as control group. The cells of the two groups were treated with different concentrations of DAP (0, 30, 60, 90 μg/mL), respectively. Cell proliferation was detected by cell counting kit 8 (CCK-8) after cultured for 72 hours. After 14 days, real-time fluorescence quantitative PCR and Western blot were used to detect the mRNA and protein expressions of chondrocyte markers (collagen type Ⅱ and Aggrecan) in each group; and toluidine blue staining and collagen type Ⅱ immunohistochemical staining were performed.ResultsCCK-8 assay showed that with the increase of DAP concentration, the cell absorbance (A) value of the control group and the experimental group increased gradually (P<0.05). At the same DAP concentration, the cell A value of the experimental group was significantly higher than that of the control group (P<0.05). Real-time fluorescence quantitative PCR and Western blot showed that with the increase of DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the control group did not change significantly, and there was no significant difference among the different concentration groups (P>0.05). But the mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the experimental group increased gradually, and the 60 and 90 μg/mL DAP concentration groups were significantly higher than 0 μg/mL DAP concentration group (P<0.05). At the same DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan were significantly higher in the experimental group than in the control group (P<0.05). Toluidine blue staining showed that with the increase of DAP concentration, there was no significant difference in cell staining between the control group and the experimental group. At the same DAP concentration, the cells in the experimental group were slightly darker than those in the control group. Immunohistochemical staining of collagen type Ⅱ showed that with the increase of DAP concentration, there was no significant difference in the cytoplasmic brown-yellow coloring of the cells in the control group. The cytoplasmic brown-yellow coloring of the cells in the experimental group gradually deepened, with 60 and 90 μg/mL DAP concentration groups significantly deeper than 0 μg/mL DAP concentration group. At the same DAP concentration, the color of the cells in the experimental group was significantly deeper than that in the control group.ConclusionDAP can promote the proliferation of ADSCs in rats. The differentiation of ADSCs into chondrocytes induced by DAP alone was slightly, but DAP combined with IGF-1 gene transfection has obvious synergistic effect to promote chondrogenic differentiation of ADSCs.

    Release date:2019-06-04 02:16 Export PDF Favorites Scan
  • NOVEL ARTIFICIAL LAMINA FOR PREVENTION OF EPIDURAL ADHESIONS AFTER POSTERIOR CERVICAL LAMINECTOMY

    Objective To evaluate the application of artificial lamina of multi-amino-acid copolymer (MAACP)/nano-hydroxyapatite (n-HA) in prevention of epidural adhesion and compression of scar tissue after posterior cervical laminectomy. Methods Fifteen 2-year-old male goats [weighing, (30 ± 2) kg] were randomly divided into experimental group (n=9) and control group (n=6). In the experimental group, C4 laminectomy was performed, followed by MAACP/n-HA artificial lamina implantations; in the control group, only C4 laminectomy was performed. At 4, 12, and 24 weeks after operation, 2, 2, and 5 goats in the experimental group and 2, 2, and 2 goats in the control group were selected for observation of wound infection, artificial laminar fragmentation and displacement, and its shape; Rydell’s degree of adhesion criteria was used to evaluate the adhesion degree between 2 groups. X-ray and CT images were observed; at 24 weeks after operation, CT scan was used to measure the spinal canal area and the sagittal diameter of C3, C4, and C5 vertebrea, 2 normal goats served as normal group; and MRI was used to assess adhesion and compression of scar tissue on the dura and the nerve root. Then goats were sacrificed and histological observation was carried out. Results After operation, the wound healed well; no toxicity or elimination reaction was observed. According to Rydell’s degree of adhesion criteria, adhesion in the experimental group was significantly slighter than that in the control group (Z= — 2.52, P=0.00). X-ray and CT scan showed that no dislocation of artificial lamina occurred, new cervical bone formed in the defect, and bony spinal canal was rebuilt in the experimental group. Defects of C4 vertebral plate and spinous process were observed in the control group. At 24 weeks, the spinal canal area and sagittal diameter of C4 in the experimental group and normal group were significantly larger than those in the control group (P lt; 0.05), but no significant difference was found between experimental group and normal group (P gt; 0.05). MRI showed cerebrospinal fluid signal was unobstructed and no soft tissue projected into the spinal canal in the experimental group; scar tissue projected into the spinal canal and the dura were compressed by scar tissue in the control group. HE staining and Masson trichrome staining showed that artificial lamina had no obvious degradation with high integrity, some new bone formed at interface between the artificial material and bone in the experimental group; fibrous tissue grew into defect in the control group. Conclusion The MAACP/n-HA artificial lamina could maintaine good biomechanical properties for a long time in vivo and could effectively prevent the epidural scar from growing in the lamina defect area.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
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