预扩张岛状皮瓣移植修复面部软组织缺损

目的:提供一种面部及眼睑软组织缺损的修复方法。方法:1995年4月至2003年4月采用颞浅动脉额支预扩张岛状皮瓣修复面部及眼睑软组织缺损16例,切取皮瓣大小最大4.5cm×6.5cm,最小4.5cm×2cm。结果:预扩张皮瓣全部成活,颜色、质地与周围组织无明显异常;3～6个月后行皮瓣修整术,效果理想;供瓣区瘢痕位于头皮内,发际无明显改变。结论:颞浅动脉额支预扩张岛状皮瓣修复面部及眼睑软组织缺损,皮瓣色泽与周围一致,外形满意,且切口隐蔽,是修复面部软组织缺损的一种较好方法。     

体外培养不同代次人成纤维细胞超微结构观察

背景：成纤维细胞是构建组织工程化皮肤的种子细胞，通过电镜对各代细胞的超微结构进行了观察，以期为组织工程皮肤选择合适的种子细胞奠定基础。目的：观察正常人成纤维细胞体外培养过程中超微结构的改变，设计：自身对照观察。单位：潍坊医学院整形外科研究所、潍坊医学院附属医院普外科。材料：实验于2000-09／2002-09在潍坊医学院整形外科研究所完成。6-8岁正常男性儿童20例包皮环切术切除的健康包皮组织，均征得监护人同意自愿提供。方法：将正常人二倍体成纤维细胞进行连续传代培养，以不同代次的细胞为实验对象，通过倒置相差显微镜和透射电镜对各代细胞进行形态学及超微结构的观察。主要观察指标：①倒置相差显微镜观察的细胞的形态学改变、②透射电镜观察的成纤维细胞超微结构。结果：①倒置相差显微镜观察的细胞的形态学改变：细胞可传65～70代，成活280～300d。45代以内的细胞生长较迅速，45代后的细胞生长逐渐缓慢，65代细胞几乎无增殖趋势。②透射电镜观察的成纤维细胞超微结构：40代以内细胞的超微结构无明显变化，41～65代细胞出现核膜内折，细胞核／浆比例减小，细胞表面突起和微绒毛减少。结论：体外培养的各代成纤维细胞超微结构改变程度不同，41代后变化明显。提示构建组织工程化皮肤宜选用40代以内的成纤维细胞为种子细胞。     

变性术后直肠阴道瘘一例

变性术是针对易性癖患者进行性别重塑的整形外科手术治疗方法之一,按1/10万～1/5万的比例计,我国的易性癖患者有数万人[1].2000年7月至2007年9月我院所行8例变性术中1例术后并发直肠阴道瘘,现报道如下.     

表皮细胞体外培养过程中生物学特性改变的观察

目的 通过观察表皮细胞体外增殖与老化规律，为选择合适的纽织工程化皮肤种子细胞提供依据。方法 取正常年轻人表皮细胞进行传代培养，以不同代龄细胞为实验对象，采用形态学观察、群体倍增时间(PDT)、免疫细胞化学及β-半乳糖苷酶染色等一系列方法，检测表皮细胞老化规律。结果 体外单层培养9代，P2的PDT最短，前5代增殖能力较强，P5以后PDT明显延长，P8细胞不再增殖；随着细胞的连续传代培养，SA-β-Gal表达呈现从弱(在年轻细胞中占9％)到强(在老化细胞中占65％)的趋势。结论 建立了体外培养正常人表皮细臆的衰老模型，第1-5代表皮细胞(拱者年龄16～18岁)可作为构建组织工程化皮肤的种子细胞。     

扩张皮肤微循环变化特征及稳定血供形成时间

背景：皮肤扩张是常用的皮肤软组织增量方法，目前对扩张皮肤的微血管变化特征尚缺乏深入研究。目的：研究扩张皮肤微循环变化特征，确定其稳定血供形成时间。设计：完全随机自身对照的实验研究。地点和材料：实验在山东省潍坊医学院完成，对象为健康成年大白兔20只，平均体质量3kg，潍坊医学院实验动物中心提供。干预：随机选择一侧兔耳，在兔耳背部皮下埋置扩张器，另一侧相同部位作对照。切口愈合后，以一定时间间隔注水扩张。用微循环显微成像、碱性磷酸酶组织化学染色等形态学研究手段对扩张皮肤微血管进行观测。主要观察指标：扩张皮肤微血管直径、密度、血流速度、流量。结果：扩张组各观测指标均明显高于对照组(P(0．01)。非扩张组的血管密度为(10．8&;#177;0．2)&;#215;10^-3μm^2／μm^2，扩张4周的是(61．1&;#177;2．9)&;#215;10^-3μm^2／μm^2，逐渐增加，第5周出现下降；微血管直径扩张第1周为(11．1625&;#177;1．0125)μm，3周后为(13．9047&;#177;1.4102)μm；血流量第1-3周逐渐增加，此后呈下降趋势；血流速度则在较高水平维持。结论：皮肤扩张后微循环功能增强，早期以血管增生扩张为主，以后逐渐稳定并向正常组织微循环状态转化，其稳定血供的形成至少需要1个月的时间。     

维拉帕米与曲安奈德注射治疗瘢痕疙瘩的疗效比较

目的 比较维拉帕米与曲安奈德注射治疗瘢痕疙瘩的疗效及安全性。方法 自2016年9月至2017年7月,对纳入研究的36例瘢痕疙瘩患者随机分为A组和B组,每组18例。A组于病灶内注射维拉帕米0.2～0.5 ml,每隔10周注射1次,共5次;B组于病灶内注射曲安奈德0.2～0.5 ml,每隔10周注射1次,共5次。两组治疗5次后,分别测量注射前后瘢痕疙瘩的厚度、长度和宽度,并应用温哥华瘢痕评分量表(VSS)对两组治疗前后进行评分,随访记录不良反应的发生率及患者的满意度。结果 两组患者治疗后共32例获随访1～13个月,均无瘢痕疙瘩增生及恶变发生。其中A组获随访17例,治疗后瘢痕疙瘩的平均厚度(3.1±1.5)mm,长度(38.2±29.1)mm,宽度(25.8±8.1)mm;B组获随访15例,治疗后瘢痕疙瘩的平均厚度(3.5±1.8)mm,长度(41.5±27.3)mm,宽度(28.6±10.1)mm;A组有效率88.2%(15例),B组有效率66.7%(11例)。A组与B组的测量结果均较治疗前有显著改善(P0.05),但A组治疗后的各项指标测量值均较治疗前有较大变化,说明A组较B组的疗效更加显著。结论 采用维拉帕米注射治疗瘢痕疙瘩,不良反应较轻,疗效较好,值得在临床推广应用。     

骨形态发生蛋白2/7异源二聚体的研究进展

骨形态发生蛋白2/7（BMP2/7）异源二聚体,较其同源二聚体具有更强的诱导成骨潜能,是目前组织工程骨研究的重要分支之一。本文介绍了异源二聚体BMP2/7诱导成骨的相关实验,比较其与同源二聚体生物活性的差异,并对相关机制进行综述。     

应用预扩张静脉皮瓣修复四肢软组织缺损

笔者自１９９４～１９９７年应用静脉皮瓣供区预扩张的方法，修复较大面积四肢软组织缺损病人１０例共１１块皮瓣，取得了满意效果。临床资料本组１０例１１块皮瓣，其中男７例，女３例；年龄７～３８岁。皮瓣最大面积９ｃｍ×１３ｃｍ，最小面积６ｃｍ×８ｃｍ，平均６８...     

软骨细胞与骨髓基质细胞共培养体外构建软骨组织的实验研究

Objective To investigate the feasibility of chondrogenesis in vitro with bone marrow stromal cells (BMSCs) induced by the co-cultured chondrocytes. Methods The BMSCs and chondrocytes were separated from pig and cultured. The supernatant of chondrocytes was used as the inducing solution for BMSCs from the 2nd generation. 7 days later, samples were taken and underwent immunohistochemistry and RT-PCR for detection of the expression of specific type Ⅱ cartilage collagen,type Ⅱ collagen and aggrecan mRNA. The cultured BMSCs and chondrocytes were mixed at a ratio of 8:2(BMSC: cartilage cell) and were inoculated into a polyglycolic acid/polylactic acid (PGA/PLA) scaffold at the final concentration of 5.0 × 107/ml. The cartilage cells and BMSCs were also inoculated seperately at the same concentration as the positive and negative control. Pure cartilage cells at 20% of the abovementioned concentration (1.0 × 107/ml) were used as the low concentration cartilage cell control group. Samples were collected 8 weeks later. General observations, wet weight, glycosaminoglycans (GAGs) determination and histological and immunohistochemistry examinations were performed. Results The expression of type Ⅱ collagen, type Ⅱ collagen and aggrecan mRNA were positive in induced BMSCs.In the co-cultured group and the positive control group, pure mature cartilage was formed after 8 weeks of culture in vitro, and the size and shape of the scaffold were maintained. The newly formed cartilage in the two groups were almost the same in appearance and histological properties. The immunohistochemistry results indicated that the cartilage cells of the two groups all expressed ample cartilage-specific type Ⅱ collagen. The average wet weight and GAG content in the co-cultured group reached more than 70% of those in positive control group. Only an extremely small amount of immature cartilage tissues was formed in local regions in pure BMSC group, and the scaffold was obviously shrunk and deformed. Although the wet weight of newly generated cartilage tissue in the low concentration cartilage cell group reached 30% of that in positive control group, the scaffold was obviously shrunken and deformed. Only regional and discontinuous cartilage tissues were formed, and the amount of newly formed cartilage was obviously less than that in the co-culture group and the positive control group. Conclusions Chondrocytes can provide a micro-environment for the formation of cartilage, and also effectively induce BMSC to differentiate into chondrocytes and form tissue-engineered cartilage in vitro.