鹿脱蛋白松质骨的生物相容性

背景：经过脱蛋白去抗原处理的异种松质骨作为骨移植材料,具有天然的多孔结构、可塑性及一定的机械强度。目的：观察鹿脱蛋白松质骨的生物相容性。方法：①热源实验与急性毒性实验：将鹿新鲜骨、脱蛋白松质骨及深低温冻干脱蛋白松质骨浸提液分别注入家兔耳缘静脉与小鼠腹腔。②溶血实验：将兔血混悬液分别加入鹿新鲜骨、脱蛋白松质骨、深低温冻干脱蛋白松质骨、碳酸钠（阳性对照）、生理盐水（阴性对照）中。③凝血实验：将鹿新鲜骨、脱蛋白松质骨及深低温冻干脱蛋白松质骨分别加入兔正常混合血浆中。④肌袋实验：在小鼠大腿肌袋处分别植入新鲜鹿骨、鹿脱蛋白松质骨及深低温冻干脱蛋白松质骨。结果与结论：鹿脱蛋白松质骨及深低温冻干鹿脱蛋白松质骨无热源反应,未引起毒性、溶血及凝血反应,植入小鼠肌肉内后未发生排斥反应。新鲜鹿骨6种实验有轻度异常,但无动物死亡。表明鹿脱蛋白松质骨及深低温冻干鹿脱蛋白松质骨具有良好的生物相容性。     

Grafting of deproteinized bone particles inhibits bone resorption after maxillary sinus floor elevation

OBJECTIVES: To evaluate the value of deproteinized bone particles on bone resorption in the augmented space after maxillary sinus floor elevation in rabbits. MATERIAL AND METHODS: A total of 20 rabbits underwent bilateral grafting, using blood clots (control group) and deproteinized bone particles (experimental group), and followed with histologic and histomorphometric analysis. RESULTS: Two weeks after grafting, the augmented space was almost completely obliterated by both newly formed bone and fibrous connective tissue in the control group. Some osteoclasts were found on the surface of newly formed bone, especially near the elevated sinus membrane. In the experimental group, newly formed bone was found along the elevated sinus membrane, the cortical wall of the augmented space, and the surface of deproteinized bone particles near the cortical wall. Some osteoclasts were found along the deproteinized bone particles and a few adhered to the surface of the newly formed bone. Eight to 10 weeks after implantation in the control group, most of the newly formed bone had been resorbed. In the experimental group, newly formed bone was found in most parts of the convex augmented space. Histomorphometrical analysis showed that the augmented height was significantly higher in the experimental group than in the control group at all evaluation times. Bone area was significantly higher in the experimental group than in the control group at 6, 8, and 10 weeks after implantation. The area of grafted deproteinized bone particles did not change significantly from 2 to 10 weeks. CONCLUSION: Slowly resorbed deproteinized bone particles contribute to stable augmentation of the maxillary sinus floor by inhibiting bone resorption.     

小牛血去蛋白提取物注射液治疗背景期DR的疗效观察

目的 探讨小牛血去蛋白提取物注射液治疗背景期糖尿病视网膜病变(DR)的临床疗效.方法 选取78例(156眼)DR患者采用随机数字表法分为试验组和对照组,每组39例(78眼),2组患者均采取常规降血糖、改善微循环治疗措施;试验组患者加用小牛血去蛋白提取物进行注射治疗.对比2组患者用药2个疗程后的临床疗效差异,观察血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血清转化生长因子β1(TGF-β1)、尿蛋白排泄率(UAER)水平的变化.结果 治疗前2组视力差异无统计学意义(P＞0.05),治疗后试验组视力优于对照组(P＜0.05).治疗后试验组患者血清中血清TGF-β1水平显著的低于对照组(P＜0.05).治疗后试验组的显效率高于对照组,但差异无统计学意义(P＞0.05),试验组患者治疗的总有效率显著高于对照组,差异有统计学意义(P＜0.05).结论 小牛血去蛋白提取物注射液治疗背景期DR患者能提高治疗效果,具有一定的临床实用价值.     

A randomized-controlled clinical trial evaluating clinical and radiological outcomes after 3 and 5 years of dental implants placed in bone regenerated by means of GBR techniques with or without the addition of BMP-2

Objective: The aim of this randomized-controlled clinical trial was to evaluate the long-term outcome of implants placed in bone augmented with a xenogenic bone substitute material and a collagen membrane with or without the addition of recombinant human bone morphogenetic protein-2 (rhBMP-2).
Material and methods: Eleven patients received a total of 34 implants placed into sites exhibiting lateral bone defects. In a split mouth design, the defects were randomly treated with the graft material and the collagen membrane either with (test) or without (control) rhBMP-2. The patients were examined 3 and 5 years after insertion of the prosthetic restoration. Student's paired t -test was performed to detect differences between the two groups.
Results: The survival rate at 3 and 5 years was 100% for both groups. The peri-implant soft tissues were stable and healthy without any difference between the two groups. The prosthetic reevaluation demonstrated four loose prosthetic screws during the first 3 years and seven ceramic chippings after 3 and 5 years. The mean distance between the first bone to implant contact to implant abutment junction at 3 years was 1.37 mm (test), 1.22 mm (control), and 1.38 mm (test), and 1.23 mm (control) at 5 years. The difference of <0.2 mm between test and control implants was not statistically significant. The mean change of the marginal bone level between baseline and 5 years ranged from −0.07 mm (mesial, test), −0.11 mm (distal, test), −0.03 mm (mesial, control), to +0.13 mm (distal, control). No statistically significant differences were observed between test and control sites.
Conclusion: Implants placed in bone augmented with and without rhBMP-2 revealed excellent clinical and radiological outcomes after 3 and 5 years.     

Critical features of periodontal flaps with regard to blood clot stability: A review

BackgroundWound healing is a multifactorial procedure involving different cell types and biological mediators. The principles of wound healing are also applicable to periodontal tissues. The formation and stability of blood clots play a vital role in successful healing of wounds in periodontal tissues. The aim of the present review was to highlight the vital factors of periodontal flaps associated with blood clot stability.HighlightThe data on periodontal regeneration and wound healing have evolved greatly in light of several factors, including space for blood clots and blood clot stabilization. In periodontal osseous defects, the stability of blood clots seems critical to wound healing. If mechanical forces can be managed by wound stabilization, the gingival flap-tooth root interface may show connective tissue repair. However, compromised adhesion is susceptible to mechanical forces and can cause wound breakage and epithelialization.ConclusionThe presence of a thick blood clot may hinder the plasmatic circulation between the recipient bed and graft during the initial stage of healing, which is critical in cases of mucogingival surgery. Root conditioning can also determine the healing consequence by enhancing blood clot adhesion.     

蛙血清去蛋白提取物抗缺氧作用的初步研究

目的 研究蛙血清去蛋白提取物对小鼠的抗缺氧作用.方法 通过建立小鼠常压缺氧模型、急性脑缺血性缺氧模型及亚硝酸钠中毒缺氧模型,以生理盐水为空白对照,盐酸普萘洛尔为阳性对照,观察蛙血清去蛋白提取物3个剂量组(10,30,90 mg/kg)对小鼠的抗缺氧作用.结果 蛙血清去蛋白提取物能显著延长模型小鼠在常压缺氧、急性脑缺血性缺氧及亚硝酸钠中毒缺氧时的存活时间.结论 蛙血清去蛋白提取物具有抗缺氧作用.     

小牛血去蛋白提取物治疗缺血性脑梗死疗效分析

目的：探讨小牛血去蛋白提取物在缺血性脑梗死患者中的应用价值。方法：将66例缺血性脑梗死患者随机分为对照组和小牛血去蛋白提取物治疗组,治疗组33例予以小牛血去蛋白提取物30mL静脉滴注,1次/日,连续3周。对照组33例除未给予小牛血去蛋白提取物外其它治疗相同。对两组患者治疗前后血液流变学及神经功能缺损程度评分的变化情况进行比较分析。结果：小牛血去蛋白提取物治疗组显效率为72.7%,明显高于对照组（45.5%,P〈0.05）。治疗后小牛血去蛋白提取物治疗组全血黏度（低切）、红细胞压积和血小板聚集率均明显低于对照组（P〈0.05）,且均明显低于治疗前（P〈0.05）;而血浆黏度两组变化相近。治疗后小牛血去蛋白提取物治疗组的神经功能缺损程度评分明显低于对照组（P〈0.05）。结论：小牛血去蛋白提取物对缺血性脑梗死患者有确切疗效,未发现不良反应,可在临床推广。     

过氧化氢-乙醚法制备脱蛋白骨的理化性质研究

目的探讨过氧化氢-乙醚法制备脱蛋白骨（deproteinized bone，DPB）的理化性质。方法采用过氧化氢-乙醚法将大白兔干骺端松质骨脱脂、脱蛋白制作成生物衍生骨材料——DPB。倒置相差显微镜、体视学显微镜、扫描电子显微镜观察DPB材料外表面、孔隙内表面结构、孔径大小和孔间交通情况。pH计检测仪检测DPB材料的培养液pH值。光学显微镜观察微生物生长情况。微量凯氏定氮法检测DPB材料中蛋白质含量。结果倒置相差显微镜、体视学显微镜、扫描电子显微镜观察结果显示，DPB材料具有原骨组织的三维多孔一网架结构系统。计算机图像分析系统结果显示，孔隙率为（83．26±5．35）％；孔径最大径为（315．11±17．51）μm，最小径为（109．37±11．33）μm。浸泡DPB材料组培养液pH为7．383±0．015，空白对照组培养液pH为7．380±0．020。光学显微镜下观察结果显示，DPB材料的培养液未发现细菌或霉菌生长。DPB蛋白质含量为（20．4±1.2）％。结论由松质骨来源制作的DPB是一种较理想的组织工程骨生物支架材料。     

碱性成纤维细胞生长因子复合部分脱蛋白骨增强兔股骨头骨缺损修复作用的研究

目的　探讨碱性成纤维细胞生长因子 (basic fibroblast growth factor,b FGF)复合部分脱蛋白骨(partially deproteinised bone,PDPB)对股骨头骨缺损的修复作用。　方法　成年健康新西兰白兔 2 4只 4 8髋 ,随机分为3组 (n=16 ) ,切开关节囊 ,在头颈交界处开窗 ,制备骨缺损模型。 A组植入 b FGF/ PDPB,B组植入 PDPB,C组为空白对照 ,于术后 2、4和 8周分别处死动物 ,制备血管墨汁灌注标本 ,样本行 X线、组织学观察和图像分析。　结果　组织学观察 A组于术后 8周股骨头骨缺损完全修复 ,B组 8周时修复区移植材料未被完全爬行替代 ,C组仍有缺损残存。墨汁灌注显示 ,术后 2周时 A组修复区新生血管丰富 ,8周时与 B组无明显差异 ,C组各时相点血管稀少。术后 8周 X线片评价 ,A组 3侧优 ,2侧良 ,1侧可 ,优良率 80 % ;B组 1侧优 ,2侧良 ,2侧可 ,1侧差 ,优良率 5 0 % ;C组 1侧可 ,5侧差。术后 8周修复组织骨小梁体积分数 A组优于 B组 ,具有统计学意义 (P<0 .0 5 ) ,A和 B组都优于 C组 (P<0 .0 5 )。　结论　b FGF与 PDPB复合有效促进了兔股骨头骨缺损的修复。