丹参提取物促进骨髓间充质干细胞增殖及成骨分化的研究

目的研究丹参提取物对骨髓间充质干细胞增殖及成骨分化的作用。方法采用全骨髓细胞接种法和贴壁纯化培养骨髓间充质干细胞,将浓度为0.2、0.4、0.8、1.6 mg/m L和3.2 mg/m L的丹参提取物加入到骨髓间充质干细胞中,观察不同浓度的丹参提取物对骨髓间充质干细胞的增殖作用;采用0.4、0.8 mg/m L和3.2 mg/m L的丹参提取物诱导骨髓间充质干细胞向成骨细胞分化,连续诱导21 d,利用ALP试剂盒测定成骨细胞内ALP活性和茜素红染色观察成骨细胞钙化结节情况;采用Western bloting法测定成骨细胞相关蛋白BMP-2和Runx的含量。结果不同浓度的丹参提取物均能够促进骨髓间充质干细胞的增殖,丹参提取物浓度0.8 mg/m L时对骨髓间充质干细胞的增殖作用最强;ALP测定结果发现0.4、0.8 mg/m L和3.2mg/m L的丹参提取物均能够提高ALP活性,丹参提取物浓度0.8 mg/m L时ALP活性最高;茜素红染色结果发现0.4、0.8 mg/m L和3.2 mg/m L丹参提取物均能够促进成骨细胞的钙化,丹参提取物浓度为0.8 mg/m L时钙化结节数量最多;Western bloting结果表明,0.8 mg/m L的丹参提取物能够促进成骨细胞分化相关蛋白BMP-2和Runx-2表达。结论丹参提取物能够促进大鼠骨髓间充质干细胞的增殖和成骨细胞分化作用。     

二甲双胍对去卵巢大鼠骨质疏松症的影响及机制研究

目的 以雌二醇为对照,观察二甲双胍(metformin, MF)对去卵巢大鼠骨密度及骨矿含量的影响,并从细胞、分子水平探究MF可能的骨保护机制。方法 将60只雌性SD大鼠随机均分4组：假手术（SHAM）组、去卵巢（OVX）组、去卵巢+二甲双胍（OVX+MF）组和去卵巢+雌二醇(OVX+E2 )组。分组灌胃给药60 d后测量大鼠右侧胫骨骨密度和骨矿含量;分离培养各组大鼠骨髓间充质干细胞（BMSCs）并诱导其向成骨细胞分化,用MTT法测定细胞活性及增殖能力;测定各组碱性磷酸酶（ALP）活性、矿化结节数目、钙含量以及I型胶原（collagen type I）、骨钙素（OC）、骨保护素 (OPG)、NFκB受体的配体 (RANKL)、白细胞介素-6（IL-6）基因表达水平。结果 与OVX组相比,OVX+MF组和OVX+E2组成骨细胞的增殖能力与ALP活性明显增强,骨密度、骨矿含量以及钙沉积量显著增加(P均<0.05),且两组collagen type I、OC、OPG mRNA的表达水平显著升高,而RANKL、IL-6mRNA表达明显受到抑制;但OVX+MF组去卵巢大鼠成骨细胞的增殖能力、ALP活性、钙沉积量、collagen type I、OC、OPG mRNA表达水平低于OVX+E2组,RANKL、IL-6mRNA表达高于OVX+E2组（P均<0.05）;与SHAM组比较,OVX+MF组的collagen type I、OC、OPG mRNA的表达水平更高（P<0.05）。结论 二甲双胍可能通过OPG/RANKL/RANK信号通路促进BMSCs向成骨细胞分化,有效逆转去卵巢大鼠骨质疏松的状态,这种潜在的骨保护作用可能会改善糖尿病引起的骨质疏松。     

负载BMP-2掺锶磷酸钙复合材料对成骨细胞增殖及功能的影响

目的探索负载BMP-2掺锶磷酸钙复合材料对成骨细胞增殖及功能的影响。方法获取SD大鼠成骨细胞,随机分为空白对照组(Con组)、磷酸钙组(CPC组)和复合材料组(BSCPC组);培养基中分别添加安慰剂、磷酸钙和负载BMP-2掺锶磷酸钙共培养一段时间,通过CCK-8法检测成骨细胞的增殖情况,碱性磷酸酶(alkalinephosphatase,ALP)及茜素红染色观察细胞的功能状态,蛋白电泳观察骨保护素(osteoprotegerin,OPG)、核因子κB受体活化因子(receptor activator of nuclear factor-KB,RANK)及核因子κB受体活化因子配体(ligand of receptor activator of nuclear factor-κB,RANKL)蛋白的表达情况。结果共培养1、3、5和7 d,和Con组比较,CPC组和BSCPC组的成骨细胞数目明显增加(P0.05),且以BSCPC组成骨细胞数目最多(P0.05);共培养14 d及21 d,和Con组比较,CPC组和BSCPC组的成骨细胞的矿化能力及ALP活性明显增加(P0.05),且以BSCPC组细胞钙化能力最强及ALP活性最高(P0.05);共培养7 d,和Con组比较,CPC组和BSCPC组的成骨细胞的OPG表达明显增加,而RANK及RANKL蛋白表达明显降低(P0.05),且以BSCPC组的成骨细胞蛋白OPG、RANK及RANKL蛋白表达量改善最为显著(P0.05)。结论负载BMP-2掺锶磷酸钙复合材料促进成骨细胞增殖分化和改善细胞活性和功能。     

地塞米松干预人骨髓间充质干细胞分化的表观遗传学修饰

目的观察高浓度地塞米松(dexamethasone, Dex)作用于人骨髓间充质干细胞(human bone marrow mesenchymal stem cells, hBMSCs)的表观遗传修饰及对其分化作用的影响。方法①人骨髓间充质干细胞培养于ɑ-MEM完全培养基中,体外扩增,传至第4代,拍摄显微电镜图片评估细胞生长状态;②通过Real-time PCR检测经不同地塞米松浓度(1、10μmol/L)作用细胞3 d后Runx2、ALP、OPG、RANKL、Dnmt1(DNA methyltransferase 1)的mRNA表达;③Western-blot检测经1μmol/L浓度地塞米松作用的细胞7 d后Dnmt1、H3K4me3 (trimethylation of lysine 4 on histone H3)、H3K27me3(trimethylation of lysine27 on histone H3)蛋白表达;免疫荧光检测细胞核内H3K4me3、H3K27me3抗原-抗体复合物的表达;加予DNA甲基化抑制剂5-氮杂-2’-脱氧胞苷(5-Aza-2'-deoxycytidine, 5-aza-dC)干预,观察Runx2、OPG、RANKL、Col1a1、Dnmt1的mRNA表达,分析表观遗传相关基因在其中的作用。结果①Real-time PCR示高浓度(1、10μmol/L)地塞米松对骨髓间充质干细胞干预早期有促进其成骨分化的作用,Runx2、ALP、OPG、DNMT1基因表达增加;②Real-time PCR和Western-blot示中晚期1μmol/L地塞米松抑制间充质干细胞向成骨细胞分化;同时Dnmt1、H3K27me3蛋白表达增加,H3K4me3表达下降;免疫荧光检测示细胞核内H3K4me3、H3K27me3抗原-抗体复合物表达情况与Western-blot结果类似;③DNA甲基化抑制剂5-aza-dC可影响地塞米松对骨髓间充质干细胞的分化效应。结论地塞米松对骨髓间充质干细胞分化的效应具有双向性,与干预时间有关,表观遗传相关因子修饰也参与其作用的发生发展,这有助于从表观遗传学角度寻找治疗激素性骨质疏松的新方法。     

右归饮对激素性股骨头坏死患者股骨近端骨髓骨活性影响的实验研究

目的：观察右归饮含药血清对激素性股骨头坏死患者股骨近端骨髓体外分化为成骨细胞的影响。方法：将右归饮含药血清加入人骨髓间充质细胞诱导分化成骨细胞的培养体系,采用观察细胞学形态、MTT法、细胞内ALP含量及矿化结节形成,并与普通血清组进行比较。结果：与普通血清组相比,形态学观察及MTT法表明,右归饮舍药血清对激素性股骨头坏死患者股骨近端骨髓体外分化成骨细胞的增殖起促进作用（P〈0．01）;矿化结节染色及细胞内ALP含量测定表明右归饮对成骨细胞的活性有促进作用（P〈0．01）。结论：右归饮对激素性股骨头坏死患者股骨近端骨髓间充质干细胞诱导分化的成骨细胞的增殖和活性起促进作用。     

慢病毒介导BMP-2过表达质粒转染骨髓间充质干细胞联合丝素蛋白支架向成骨细胞转化的实验研究

目的：探究慢病毒介导BMP-2过表达质粒转染骨髓间充质干细胞联合丝素蛋白支架向成骨细胞转化的作用效果。方法：构建慢病毒BMP-2过表达载体,培养骨髓间充质干细胞,构建细胞核支架的联合培养体系,体外实验利用茜素红染色和碱性磷酸酶染色检测骨髓间充质干细胞的成骨转化。选择10只新西兰大白兔,体重3.2～4.5 kg,平均3.9 kg;年龄（2.89±0.45）岁;使用口腔钻在兔子胫骨钻孔（长度5 mm、宽度2 mm、深度3 mm的锥形胫骨缺损）构建兔子胫骨骨缺损模型,HE染色观察动物模型内骨缺损的修复。实验组造模后植入丝素蛋白支架+转染BMP-2过表达载体骨髓间充质干细胞复合物,阴性对照组造模后植入丝素蛋白支架+未转染骨髓间充质干细胞复合物。结果：实验组（丝素蛋白支架+转染BMP-2过表达载体骨髓间充质干细胞复合物）中支架表面黏附的细胞与对照组（丝素蛋白支架+未转染骨髓间充质干细胞）相比,细胞数明显增多。实验组细胞外基质分泌与对照组相比,支架间细胞外基质含量明显增多。对照组支架表面元素EDX分析显示钙离子含量为0.22%,实验组支架表面元素EDX分析显示钙离子含量为0.86%,可见实验组诱导钙离子形成的能力要比对照组强。钙结节茜素红染色结果显示,对照组肉眼观无明显变化,镜下观察可见少量钙结节点。实验组肉眼观可见明显红色区域染色,镜下观察可见大量钙结节点。碱性磷酸酶染色结果显示,对照组肉眼观无明显变化,镜下观察未见明显变化。实验组肉眼观可见紫色区域染色,镜下观察可见ALP染色呈强阳性。丝素蛋白支架与骨髓间充质干细胞联合培养体系可以对软骨缺损有较好的修复作用,转染BMP-2骨髓间充质干细胞后修复作用明显优于未转染组。HE染色结果显示,对照组炎性细胞减少,支架略有消失。实验组炎性细胞明显减少,支架消失,血管生成。结论：慢病毒介导BMP-2过表达质粒可以促进BMSC向骨细胞的分化作用,并且分泌更多的含Ca²⁺成分的细胞外基质,从而发挥其促进骨缺损修复的作用。     

黄瓜籽总皂苷对MC3T3-E1细胞分化及SPARC、OPG/RANKL表达的影响

目的观察黄瓜籽总皂苷提取物(cucumber seed saponins,CSS)对小鼠成骨细胞MC3T3-E1增殖、分化和矿化的影响,以及与骨质疏松相关的SPARC、OPG/RANKL/RANK信号通路的作用。方法通过MTT实验、碱性磷酸酶(alkaline phosphatase,ALP)活性检测、茜素红染色,考察不同浓度CSS对MC3T3-E1细胞增殖、分化及矿化的影响;采用RT-PCR方法检测SPARC、OPG/RANKL mRNA表达水平; Western blot检测SPARC、OPG/RANKL的蛋白表达量。结果与阳性对照组相比,CSS能明显促进MC3T3-E1细胞增殖(P0.05),CSS高、中剂量组能明显提高MC3T3-E1细胞ALP活性及钙化结节数量(P0.05);与空白组相比,CSS不同剂量组均明显上调SPARC、OPG/RANKL mRNA及蛋白表达水平(P0.05)。结论黄瓜籽总皂苷能够促进成骨细胞MC3T3-E1的增殖、分化及矿化能力,并通过上调SPARC、OPG/RANKL的表达水平提高MC3T3-E1细胞的成骨能力。     

BMP-2重组质粒转染人骨髓基质干细胞及表达蛋白的诱导活性观察

目的 构建骨形态发生蛋白-2(BMP-2)真核表达质粒，使其在人骨髓基质干细胞(hBMSCs)中表达，并观察表达产物的诱导成骨活性。方法在脂质体介导下将BMP-2基因导入hBMSCs，流式细胞仪、ALP检测和VEGF探针原位杂交分析其对细胞增殖、ALP活性和VEGF表达的影响。并利用转染后的培养液上清诱导小鼠成纤维细胞(L929)，检测其骨钙素、Ⅱ型胶原表达。结果 转染后细胞稳定表达BMIP-2基因，S期细胞比例增多，ALP活性和VEGF的表达明显增加。且诱导L929细胞骨钙素、Ⅱ型胶原阳性表达。结论 BMP-2重组质粒转染hBMSCs后表达目的蛋白，促进自身增殖、分化和上调VEGF的表达，并诱导成纤维细胞向成骨细胞转化，为BMP-2基因治疗奠定了实验基础。     

包裹骨形态发生蛋白-2基因转染干细胞的微囊化方法和蛋白释放效应

目的观察转基因骨髓间充质干细胞的微囊化包裹方法和骨形态发生蛋白-2(BMP- 2)释放效应。方法利用高压微电场制备由海藻酸纳和多聚赖胺酸组成的微囊(细胞浓度为3×10~6个/ml,海藻酸钠浓度为1.5%)包被转β-gal(报告基因)或BMP-2基因的骨髓间充质干细胞,根据X-gal染色观察细胞在微囊内的存活情况,ELISA方法检测其所释放的BMP-2蛋白量,共培养方法检测其生物学活性。结果7、14、21、28 d时微囊内转基因细胞X-gal染色均为阳性。包裹后30 d,培养液上清中仍可检测到BMP-2蛋白。转BMP-2基因微囊化细胞与未包裹骨髓间充质干细胞共培养10 d后,ALP活性定量检测结果表明,Adv-hBMP-2转染细胞组ALP活性为(52.537±1.774)U/ml,明显高于未转染细胞组的(42.336±0.857)U/ml,差异有统计学意义(P<0.05)。结论微囊化转基因干细胞生长良好,能持续分泌BMP-2蛋白并促进干细胞向成骨细胞方向分化。     

THSD4基因在小鼠间充质干细胞及MC3T3-E1细胞成骨分化中的作用

目的 探讨THSD4基因对小鼠间充质干细胞和MC3T3-E1细胞成骨分化的影响。方法 提取绝经后骨质疏松症患者的骨髓间充质干细胞进行基因测序分析,与骨关节炎患者的骨髓间充质干细胞进行比较,分析基因表达差异。通过提取不同分化阶段的小鼠骨髓间充质干细胞（M-BMSC）及MC3T3-E1细胞的mRNA来检测THSD4 基因以及成骨分化的标志性基因（ALP、Runx2、Osx）的表达水平。通过构建慢病毒表达载体来实现对M-BMSC及MC3T3-E1细胞中THSD4的敲减及过表达,并观察其对M-BMSC及MC3T3-E1细胞成骨分化能力的影响。结果 THSD4基因在绝经后骨质疏松症患者骨髓间充质干细胞中明显下调,且通过KEGG以及GO富集分析发现THSD4基因可能与PI3K-AKT信号通路及Wnt信号通路相关。随着成骨诱导分化时间的延长,THSD4 mRNA和成骨分化标志性基因（ALP、Runx2、Osx）mRNA在MC3T3-E1以及M-BMSC中表达量均逐渐增加。过表达THSD4可以增强MC3T3-E1细胞和M-BMSC的成骨分化能力,而敲减THSD4则减弱了MC3T3-E1细胞和M-BMSC的成骨分化能力。结论 THSD4基因在绝经后骨质疏松症患者骨髓间充质干细胞中明显下调,且THSD4基因可以增强MC3T3-E1细胞以及M-BMSC的成骨分化能力。     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

下颌全牙弓后移量及最后界的测量

目的：研究下颌牙弓的有效后移量及找寻下颌牙弓移动的后界。方法：选取涉及拔除下颌第三磨牙或下颌第三磨牙缺失的病例18例（男6例,女12例）。采用种植支抗牵引下牙弓向远中,治疗完成时所有病例均明确到达下颌牙弓后界,即下颌第二磨牙远中到达下颌升支前缘软组织交界处。应用治疗前后的曲断片测量下颌第二磨牙远中到升支前缘的距离。结果：下颌第二磨牙后移量为（3.49±1.21）mm;治疗后磨牙后间隙的长度为（4.43±0.97）mm。结论：下颌牙弓可确定性地实现整体后移;最大后移量由磨牙后间隙的长度决定;其最后界止于下颌第二磨牙远中与下颌升支前缘软组织交界处。     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

Preservation of the pylorus in resection of the head of the pancreas

Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.