目的 观察盐酸氨基葡萄糖对兔关节腔积血造成的软骨损伤的保护作用。 方法 成年新西兰大白兔50只，随机分为A、B、C、D、E共5组，每组10只。A、B、C、D组采用自体静脉血4 mL右侧关节腔内注射建立关节腔积血模型。建模后，A、B、C组分别给予25、82.5、500 mg/kg的盐酸氨基葡萄糖灌胃，1次/d；D组为阳性对照组，以6 mL/kg蒸馏水灌胃，1次/d；E组为阴性对照组，以6 mL/kg蒸馏水灌胃，1次/d。灌胃8周后取材。肉眼大体观察，光镜下进行Mankin评分及沙红O染色观察，评估软骨损伤程度；采用免疫组织化学法测定Ⅱ型胶原蛋白（COL Ⅱ）表达情况。 结果 软骨大体观察和沙红O染色组织学观察显示，A、B、C组与D组、E组之间差异均有统计学意义（P＜0.05）。免疫组织化学提示，A、B、C组COL Ⅱ表达明显高于D组（P＜0.05）。 结论 盐酸氨基葡萄糖对兔关节腔积血导致的软骨损伤有一定的保护治疗作用，在防治关节腔积血导致的软骨损伤的发生发展方面，具有一定的作用。
目的 观察比较盐酸氨基葡萄糖单独使用及与硫酸软骨素联合使用治疗腰椎小关节骨关节炎（LFOA） 的临床疗效。 方法 2009年1月－2011年1月，将80例LFOA患者随机分成两组，A组口服盐酸氨基葡萄糖，B组口服盐酸氨基葡萄糖和硫酸软骨素两种药物，6周为1个疗程，间断治疗4个疗程。分别比较用药前与用药后3、6周及5、8、11个月时的日本骨科协会（JOA）评分、晨僵和压痛程度变化。 结果 治疗后，两组的JOA评分在各观察时点均增加，与治疗前比较差异有统计学意义（P＜0.05）。组间行JOA评分治疗改善率的比较，在各观察时点差异均有统计学意义（P＜0.05），B组JOA评分改善率优于A组。治疗3周后，两组晨僵和压痛评分均降低，与本组治疗前比较差异有统计学意义（P＜0.05）；组间比较，差异亦有统计学意义（P＜0.05），B组晨僵和压痛程度均低于A组。第6周，第5、8、11个月，两组组间比较晨僵和压痛程度差异均无统计学意义（P＞0.05），但各疗程结束后两组晨僵和压痛程度均呈持续降低趋势。 结论 单独应用盐酸氨基葡萄糖及盐酸氨基葡萄糖与硫酸软骨素的联合应用治疗LFOA疗效确切，联合用药优于单独应用盐酸氨基葡萄糖。
The effect of proximal subtotal or total gastrectomy by choosing abdominal median incision plus left 7-9 ribs resection in 32 cases of upper gastric cancer had been studied. There was 1 case of residual tumor cells at the esophageal margin, 1 case of hydrothorax and hydrops of costal bed, no costal chondritis, pneumothorax and fistula formation. We consider that it is better to choose abdominal median incision plus left ribs resection in patients with upper gastric cancer in which subphrenic esophageal invasion is under 2cm of length and the function of heart or lung is severely damaged.
Dissections of the recurrent laryngeal nerves (RLN) were made on 50 cadavers (100 RLN). The right nerves were found to be anterior to the inferior thyroid artery in a half of cases and the left nerves were found more posterior to the artery (38 of 50). 64% of nerves branched off into 2 to 5 branches before entering the larynx. 89%of nerves tan medially to the suspensory ligment and 91% of nerves located inferior and somewhat superfical to the cornu before entering the laryx. Based on this finding, we instituted the policy of lingitunal dissection of the Berry’s ligament close the capsule of thyroid gland, 70 patients underwent operation (83 nerves), the nerves were exposed in 39 cases and unexposed in 44, there was no injury to the nerve in this serries. The authors believe that to familiarize the anatomy and the skillful technic is crucial to prevent injury to the RLN, and it is unnecessary to expose the RLN rountinely.
Objective To isolate，culture and expand bone marrow mesenchymal stem cells （MSCs） in vitro，induce MSCs to differentiate directionally towards chondrocytes，and provide experimental basis for clinical application of MSCs and construction of tissue engineering tracheal cartilage. Methods Cultured MSCs were isolated from bone marrow of Sprague-Dawley rats，purified using adherence separation，and identified by flow cytometry analysis. Transforming growth factor β1 （TGF-β1）and insulin-like growth factor 1 （IGF-1） were used as main induction factors to induce MSCs to differentiate directionally towards chondrocytes. The expression of collagen typeⅡwas evaluated by immunocytochemical staining 21 days after induction. Light microscope and electron microscope were used to observe tiny and ultrastructural changes of the cells before and after induction. Results The expression of collagen typeⅡwas positive by immunocytochemical staining 21 days after induction. MSCs were fusiform before induction under light microscope and electron microscope. After induction，the cells became larger，polygon，star-shaped or triangular. Transmission electron microscope showed that the cells had abundant organelles，larger nuclei and more nucleoli after induction. Conclusion Abundant organelles，larger nuclei and more nucleoli are the ultrastructure changes of chondrocytes differentiated from MSCs，indicating that the cells are active in differentiation and metabolism.
Objective To investigate and compare the effectiveness of perichondrial cutaneous graft (PCCG) of dorsal auricle for repairing defect after excision of melanocytic nevus in different parts of the face. Methods Between February 2008 and October 2012, 29 cases of facial melanocytic nevus were admitted. There were 11 males and 18 females, aged 3-25 years (median, 11 years). The locations were the upper eyelid in 5 cases, the nose in 15 cases, and the buccal region in 9 cases. The size of the nevi ranged from 1.2 cm × 1.0 cm to 4.0 cm × 2.2 cm. Defects after excision of nevi were repaired by PCCG of the dorsal auricle, which size ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.5 cm. The postoperative effectiveness was scored by patients according to color match, scar formation, and flatness of the reception site. The satisfaction evaluations were compared by the score among different parts. Results All the PCCG survived. All the patients were followed up 7-15 months (mean, 10 months). All the reception site had good color match and acceptable scar formation. The nasal part had good flatness, and the upper eyelid had poor flatness. Score comparison showed no significant difference in color match between 3 parts (P gt; 0.05). Nasal part had significantly less scar formation than buccal region and upper eyelid (P lt; 0.05), but no significant difference between buccal region and upper eyelid (P gt; 0.05). Nasal part and buccal region both had significantly better flatness than upper eyelid (P lt; 0.05), but no significant difference between nasal part and buccal region (P gt; 0.05). The overall evaluation score of nasal part and buccal region was significantly higher than that of the upper eyelid group (P lt; 0.05), and the score of the nasal part was significantly higher than that of the buccal region (P lt; 0.05). Conclusion PCCG of dorsal auricle has a good color match in repair of facial defect, especially in repair of nasal defect with good flatness and no obvious scar formation.
Objective To construct recombinant lentiviral vectors of porcine bone morphogenetic protein 2 (BMP-2) gene and to detect BMP-2 gene activity and bone marrow mesenchymal stem cells (BMSCs) osteogenetic differentiation so as to lay a foundation of the further study of osteochondral tissue engineering. Methods BMSCs were isolated from bone marrow of 2-month-old Bama miniature porcines (weighing, 15 kg), and the 2nd generation of BMSCs were harvested for experiments. The porcine BMP-2 gene lentiviral vector was constructed by recombinant DNA technology and was used to transfect BMSCs at multiplicity of infection (MOI) of 10, 25, 50, 100, and 200, then the optimal value of MOI was determined by fluorescent microscope and inverted phase contrast microscope. BMSCs transfected by BMP-2 recombinant lentiviral vectors served as experimental group (BMP-2 vector group); BMSCs transfected by empty vector (empty vector group), and non-transfected BMSCs (non-transfection group) were used as control groups. RT-PCR, immunohistochemistry staining, and Western blot were performed to detect the expressions of BMP-2 mRNA and protein. Then the BMSCs osteogenesis was detected by alkaline phosphatase (ALP) staining, ALP activities, and Alizarin red staining. Results The recombinant lentiviral vectors of porcine BMP-2 gene was successfully constructed and identified by RT-PCR and gene sequencing, and BMSCs were successfully transfected by BMP-2 recombinant lentiviral vectors. Green fluorescent protein could be seen in the transfected BMSCs, especially at MOI of 100 with best expression. The immunohistochemistry staining and Western blot showed that BMSCs transfected by BMP-2 recombinant lentiviral vectors could express BMP-2 protein continuously and stably at a high level. After cultivation of 2 weeks, the expression of ALP and the form of calcium nodules were observed. Conclusion The porcine BMP- 2 gene lentiviral vector is successfully constructed and transfected into the BMSCs, which can express BMP-2 gene and protein continuously and stably at a high level and induce BMSCs differentiation into osteoblasts.