Objective To demonstrate the importance of bioreactor to tissue engineering and to disscuss the direction of bioreactor- researching. Methods Alarge quantity of literature was reviewed, analyzed and summarized. Results Bioreactor has greatly promoted the progress of tissue engineering in heoretics and practice,and has become one of the most important parts of tissue engineering. Conclusion Bioreactor is indispensable for tissue engineering,and it should be developed along integration,automation and intelligentificaton.Its application should run through the whole process of tissue engineering.
Objective To investigate the therapeutic effectof the modified anterior approach in treatment of the patients with cervicothoracic junction spinal lesions. Methods From September 2000 to January 2005, 23 patients (15 males, 8 females) with spinal lesions in the cervicothoracic junction underwent a standard cervical approach, which was combined with apartial median steotomy and transverse steotomy through the synostosis between the manubrium and body of the sternum to expose the lesion adequately. Among thepatients, 3 had fracture, 7 had dislocation, 6 had tuberculosis, and 7 had tumor. The pathologic change regions was as follows: 2 in the C6-T1 segment, 2in the C6-T2 segment, 3 in the C7-T1 segment, 3 in the T3 segment, 8 in the T1 segment, and 5 in the T2egment. The classification of Frankel were as follows: 2 at grade A, 4 at grade B, 7 at grade C, 4 at grade D, and 6 at grade E. All the patients underwent a radical excision of the affected spinal bone, were given a proper tricortical iliac crest and anterior instrumentation to reconstruct the anterior spinal column, followed by immobilization in a brace for 3-6 months. Results The mean followup period was 30 months (range, 1042 months). Bony fusion was obtained in all the patients.One patient died of pulmonary cancer metastasis 10 months after operation. The nerve function of the spinal cord recovered at different degrees (1 at grade A, None at grade B, 2 at grade C, 10 at grade D, 10 at grade E). Conclusion Ourmodified anterior approach can provide a direct and safe access to the lesions in the region.
Objective To observe the efficiency and biological characteristics in regenerating in vitro tissue-engineered cartilage from epiphyseal chondrocyte-scaffold complex. MethodsThe first passage epiphyseal chondrocytes were collected and mixed with the biological gel-matrix, the chondrocyte-gel fluid wasdropped into the scaffold to form a complex. The complexes were in vitro cultivated. The changes of complexes in morphology and synthesis of collagens type ⅡandtypeⅠ and aggrecan were observed under the gross and the inverted and light microscopes. The sulfate GAG content in complexes was measured by the the modified dimethylmethylene blue method. Results During cultivation, thecomplexes could keep its original shape with the stable homogeneous three-dimensional distribution of chondrocytes,gradually became milk white and translucence with their rigidity increasing. In the 1st week, the chondrocytic lacunae formed in the complexes. After 2 weeks, the complex was gradually reorganized into the mature engineered cartilage with rich collagen typeⅡand aggrecan and typical cartilage histological structure, but with negative immunological staining of collagen typeⅠ. In the 4th week, the engineered cartilage resembled the nature epiphyseal plate in the characteristic of histological structure, and had over 34% of the sulfate GAG content of the natural epiphyseal plate. Conclusion Theepiphyseal chondrocyte-scaffold complex can be reorganized into typical cartilage with the epiphyseallike histological structure, and be fit for repairing the epiphyseal defect. The tissue engineered cartilage cultivated for 1-2 weeks may be a good choice for repairing epiphyseal defect.
OBJECTIVE: To observe the effect of engineered epiphyseal cartilage regenerated in vitro with 3-D scaffold by chondrocytes from epiphyseal plate in repairing the tibial epiphyseal defect, and to explore the methods to promote the confluence between engineered cartilage and epiphyseal plate. METHODS: Chondrocytes were isolated enzymatically from the epiphyseal plates of immature rabbits, and then planted into the tissue culture flasks and cultivated. The first passage chondrocytes were collected and mixed fully with the self-made liquid biological gel at approximately 2.5 x 10(7) cells/ml to form cell-gel fluid. The cell-gel fluid was dropped into the porous calcium polyphosphate fiber/poly-L-lactic acid(CPPf/PLLA)scaffold, and a cell-gel-scaffold complex formed after being solidified. The defect models of 40% upper tibial epiphyseal plate were made in 72 immature rabbits; they were divided into 4 groups: group A(the cell-gel-scaffold complex was transplanted into the defect and the gap filled with chondrocyte-gel fluid), group B (with noncell CPPf/PLLA scaffold), group C(with fat) and group D(with nothing). The changes of roentgenograph, gross and histology were investigated after 2, 4, 6, 8, 12 and 16 weeks of operation. RESULTS: In group A, the typical histological structure of epiphyseal plate derived from the engineered cartilage with a fine integration between host and donor tissues after 2 weeks. The repaired epiphyseal plate had normal histological structure without deformation of tibia after 4 weeks. The early histological change of epiphyseal closure appeared in the repaired area with varus and shortening deformation of the tibia after 8 weeks. The epiphyseal plate was closed in the repaired area with more evident deformation of tibia; the growth function of repaired epiphyseal plate was 43.6% of the normal one. In groups B, C and D, deformation of tibia occurred after 2 weeks; the defect area of epiphyseal plate was completely closed after 4 weeks. The deformation was very severe without growth of the injured epiphyseal plate after 16 weeks, and no significant difference was observed between the three groups. CONCLUSION: Engineered epiphyseal cartilage can repair the epiphyseal defect in the histological structure with partial recovery of the epiphyseal growth capability. Injecting the suspension of fluid chondrocyte-gel into the defects induces a fine integration of host and donor tissues.
目的总结结肠冗长症合并结直肠癌的临床病理特征,并文献复习结肠冗长症与结直肠癌的关系。 方法回顾性分析兰州大学第一医院普外一科2011年1月至2012年12月期间收治的17例结肠冗长症合并结直肠癌患者的临床资料。 结果184例结直肠癌患者中合并结肠冗长症17例(9.24%),合并家族性息肉病恶变2例(1.09%),合并遗传性非息肉病性结直肠癌1例(0.54%),合并炎症性肠病1例(0.54%)。合并结肠冗长症的比例较高(P<0.05)。其中术前经结肠气钡灌肠检查诊断为结肠冗长症5例,术中诊断为结肠冗长症12例。所有患者均行手术治疗,切除结肠13~80 cm,平均33.8 cm。术后发生肺部感染、切口液化1例,腹水1例,肠瘘1例,骶前感染1例。术后17例患者均获随访,随访时间6~12个月,中位数为10个月。随访期间,1例患者于术后1年出现卵巢转移。 结论结肠冗长症合并顽固性便秘可能是结直肠癌发病的高危因素。