关节软骨损伤与修复

外伤或炎症所造成得关节软骨损伤临床十分常见,且可能导致严重的后果,如关节疼痛、畸形和功能障碍。而临床治疗中却缺乏可靠的修复方法与准则指导临床工作。本文阐述了关节软骨生物组织及功能特性,并重点讲述了临床中常用的关节软骨修复方法及近年研究较多的修复方法,例如干细胞移植的应用等。     

自体肋软骨膜游离移植治疗颞颌关节强直的形态学研究

游离移植的自体肋软骨膜良好的再生软骨性能为生物性重建下领髁状突软骨开辟了新的治疗途径。通过组织学、电镜和放射自显影方法,对自体肋软骨膜游离移植于下颌髁状突切骨面后再生软骨生长发育过程进行了观察,发现:术后10天移植的软骨膜增厚,间充质样细胞增生;术后30天,软骨细胞逐渐发育成熟;60天后,新生的软骨关节面光滑,细胞形态和排列趋于规则,与正常关节软骨形态相似。结果表明:自体肋软骨膜游离移植于髁状突骨面可以形成新的软骨关节面,其组织学形态与正常关节软骨相同;关节运动和负重能促进新生软骨形成并进行生物性改建,逐渐形成正常的关节形态。     

外源性血管内皮生长因子结合微骨折术治疗全层关节软骨缺损的实验研究

目的:探讨外源性血管内皮生长因子(VEGF)结合微骨折术治疗全层关节软骨缺损的实验疗效.方法:24只健康新西兰大白兔,随机分为四组,制作膝关节股骨滑车软骨缺损模型,A组:微骨折+胶原海棉吸附VEGF100μg充填,B组:胶原海绵吸附 VEGF100μg充填,C组:微骨折+胶原海棉充填,D组:胶原海棉充填.术后16周取标本,进行HE染色,甲苯胺蓝染色,Ⅱ型胶原免疫组化染色,以及对16周标本扫描电镜观察软骨生长情况.结果:按Wakitani法评分标准对修复软骨进行评分,所得数据以D组为对照组进行组间两两比较(Dunnett t-tests),A、B、C三组与之比较差异均有统计学意义(P<0.01).A、B、C三组间两两比较(LSD法),结果显示A组与B组、C组间差异有统计学意义(P<0.01),而B组与C组间差异无统计学意义(P>0.05).结论:1.外源性VEGF和微骨折术均可以促进机体对软骨缺损的修复作用;2.外源性VEGF结合微骨折术能有效修复兔膝关节软骨的全层缺损,为临床治疗提供理论依据.     

体外再生移植用软骨

目前,由于患关节炎而导致软骨关节组织损伤的人很多。人体内的软骨组织一旦损伤很难治愈。如果对那些损伤和坏死的软骨进行人工再生,将会使很多患者恢复健康。科研人员经过常年的研究现已掌握软骨再生的条件。 患关节炎等关节疾病的人增多 随着社会高龄人口的增多,目前在日本患关节疾病、软骨损伤、坏死或变形的人日益增多。 软骨位于人体关节骨与骨之间接触的部位,当关节动作时它起着防止骨之间摩擦的作用。然而,关节炎、受伤或随着年龄的增长,软骨会出现损伤和疼痛,病情加重时甚至会影响行动。普通骨在不断地新陈代谢,即使骨折…     

组织工程学重建修复软骨损伤的研究进展

软骨分为关节软骨(透明软骨)和纤维软骨(半月板)。软骨除吸收震荡,润滑关节外,还有着承受载荷及分散负荷等重要功能,是保持良好关节功能不可缺少的一部分。软骨的自我修复能力有限,损伤后将直接影响关节的功能。关节人工假体置换适合于老年人,对年     

面向组织工程的骨缺损修复方法

骨缺损修复是当今国际组织工程领域的一个难题．本文通过颅骨缺损修复的典型案例，提出了一种三维骨模型重建与修复方法．首先对实体模型的建构进行研究，重点是模型的设计及缺损部分的建模，将逆向工程与CAD技术相结合和进行布尔运算，实现所需的骨缺损修复模型，最后利用快速成型技术获取实物模型．     

未来的人造关节

未来的人造关节王萍译星辰校１．为什么要使用人造关节人是属于内骨格系的动物，其身体结构关节是由连结长骨而成。当人体活动时，关节随着肌肉的收缩而动作。人体的关节软骨很弱，如用它做磨损试验，很快就会被磨耗尽。在生物体内，依靠关节特有的润滑机构保护，软骨组织...     

为人类器官制造活的代用品

三只耳朵的老鼠 ,怪不怪 ?而且多出的一只耳朵长在背部 ;更怪的是 ,那不是老鼠耳朵 ,而是一只活生生的人耳。这是美国麻省理工学院和马萨诸塞州大学工程师的精心杰作。三耳老鼠代表了２００１年以后新世纪医学的发展 ,正蓬勃发展的组织工程学 ,几乎可让任何生物物质都从培养皿中制造出来。利用组织工程学技术制造的皮肤、骨骼和软骨已进入诊所 ,但实验室培养的器官还有很长的路要走。少数目光远大的科学家正设法把活组织与精巧电子零件结合 ,做成大脑或眼睛装置。而在实验室制造出有功能的手或心脏 ,可能还要等数十年 ,但这幅景象变得愈来愈…     

人体中的软骨

软骨是人和脊椎动物特有的胚胎性骨骼，由软骨组织及其周围的软骨膜构成。其中软骨组织是由软骨细胞、基质和纤维构成，根据软骨组织所含纤维的不同，软骨可分为透明软骨、纤维软骨和弹性软骨三种。     

快速成型技术及其在骨组织工程中的应用（英文）

骨缺损的修复是临床工作中亟待解决的难题,寻求完善的骨移植替代物一直是各国学者的研究焦点所在。近年来快速成型技术在骨组织工程领域内的应用逐渐扩大,个体化定制的优势为骨缺损修复提供了新思路。本文对快速成型技术在骨组织工程中的研究进展进行综述,概述了不同快速成型技术的原理和特点,总结其在骨组织工程中的应用现状和发展趋势。     

Digital design of scaffold for mandibular defect repair based on tissue engineering

Mandibular defect occurs more frequently in recent years, and clinical repair operations via bone transplantation are difficult to be further improved due to some intrinsic flaws. Tissue engineering, which is a hot research field of biomedical engineering, provides a new direction for mandibular defect repair. As the basis and key part of tissue engineering, scaffolds have been widely and deeply studied in regards to the basic theory, as well as the principle of biomaterial, structure, design, and fabrication method. However, little research is targeted at tissue regeneration for clinic repair operations. Since mandibular bone has a special structure, rather than uniform and regular structure in existing studies, a methodology based on tissue engineering is proposed for mandibular defect repair in this paper. Key steps regarding scaffold digital design, such as external shape design and internal microstructure design directly based on triangular meshes are discussed in detail. By analyzing the theoretical model and the measured data from the test parts fabricated by rapid prototyping, the feasibility and effectiveness of the proposed methodology are properly verified. More works about mechanical and biological improvements need to be done to promote its clinical application in future.     

Osteogenic differentiation of mesenchymal stem cells promoted by overexpression of connective tissue growth factor

Objective: Large segmental bone defect repair remains a clinical and scientific challenge with increasing interest focusing on combining gene transfection with tissue engineering techniques. The aim of this study is to investigate the effect of connective tissue growth factor (CTGF) on the proliferation and osteogenic differentiation of the bone marrow mesenchymal stem cells (MSCs). Methods: A CTGF-expressing plasmid (pCTGF) was constructed and transfected into MSCs. Then expressions of bone morphogenesis-related genes, proliferation rate, alkaline phosphatase activity, and mineralization were examined to evaluate the osteogenic potential of the CTGF gene-modified MSCs. Results: Overexpression of CTGF was confirmed in pCTGF-MSCs. pCTGF transfection significantly enhanced the proliferation rates of pCTGF-MSCs (P<0.05). CTGF induced a 7.5-fold increase in cell migration over control (P<0.05). pCTGF transfection enhanced the expression of bone matrix proteins, such as bone sialo-protein, osteocalcin, and collagen type I in MSCs. The levels of alkaline phosphatase (ALP) activities of pCTGF-MSCs at the 1st and 2nd weeks were 4.0- and 3.0-fold higher than those of MSCs cultured in OS-medium, significantly higher than those of mock-MSCs and normal control MSCs (P<0.05). Overexpression of CTGF in MSCs enhanced the capability to form mineralized nodules. Conclusion: Overexpression of CTGF could improve the osteogenic differentiation ability of MSCs, and the CTGF gene-modified MSCs are potential as novel cell resources of bone tissue engineering.     

Rapid prototyping technology and its application in bone tissue engineering

Bone defects arising from a variety of reasons cannot be treated effectively without bone tissue reconstruction. Autografts and allografts have been used in clinical application for some time, but they have disadvantages. With the inherent drawback in the precision and reproducibility of conventional scaffold fabrication techniques, the results of bone surgery may not be ideal. This is despite the introduction of bone tissue engineering which provides a powerful approach for bone repair. Rapid prototyping technologies have emerged as an alternative and have been widely used in bone tissue engineering, enhancing bone tissue regeneration in terms of mechanical strength, pore geometry, and bioactive factors, and overcoming some of the disadvantages of conventional technologies. This review focuses on the basic principles and characteristics of various fabrication technologies, such as stereolithography, selective laser sintering, and fused deposition modeling, and reviews the application of rapid prototyping techniques to scaffolds for bone tissue engineering. In the near future, the use of scaffolds for bone tissue engineering prepared by rapid prototyping technology might be an effective therapeutic strategy for bone defects.     

机械工程材料课程中高分子材料的教学改革与实践

目前各高校机械工程材料课程均以金属材料为主线。近五十年来高分子材料异军突起,成为新型的工程材料,因此有必要在机械工程材料授课中增加高分子材料的比重并进行相应的改革。大连理工大学从授课内容、授课目标、授课过程、教学方式及参考教材等方面对机械工程材料课程中高分子材料部分进行了改革,实践表明教学改革取得了良好的效果。     

三维纳米纤维组织工程支架的研究进展

组织工程支架的关键作用是引导细胞粘附、扩散、分裂,促进组织修复的一个过程.三维纳米纤维支架能够提供三维空间结构,调节细胞行为,具有传递生物分子的潜能.因此在组织工程领域具有广泛地应用前景.因此如何构建三维纳米纤维支架成为人们关注的焦点.本文综述现阶段三维纳米纤维支架的制备方法,包括静电纺丝法、热致相分离法、自组装法、生物技术法等,并指出制备方法的优缺点.具有复杂外形及其相连通的孔的支架是今后支架研究的方向.只有达到临床所需要求,组织工程支架才有望应用于组织和器官损伤的病人.     

Relating Science to Engineering: Employing a Materials Approach

The development of manufactured goods is highly dependent on their basic materials properties. In all aspects of the sciences, materials science and engineering have both a direct and indirect influence on the final properties and performance of manufactured products. It is only during the later years of high school study that aspects of science describing materials behaviour become relevant to later studies in engineering. Students must attain a basic understanding of scientific principles to be able to master the rigours of tertiary engineering studies. A new system of teaching and learning science, with examples drawn from basic principles of materials behaviour, is shown to be commensurate with these requirements. It is our responsibility as educators to develop graduates who are effective in the workplace and understand the relevance of materials to engineering.     

脱细胞组织基质的研究进展

脱细胞组织基质是近年来在组织修复领域的热门话题.它是通过对异体组织进行脱细胞处理,去除移植相关抗原,从而获得的一种具有一定生物活性的生物衍生材料.目前在外科各分科均已开展了脱细胞组织基质的相关研究,主要有用于血管、瓣膜、泌尿道、皮肤、筋膜等的修复.作者重点介绍了脱细胞组织基质的基本结构、相关基础研究、临床应用方式及转归.脱细胞组织基质在直接修复组织缺损及作为组织工程的支架材料具有广阔的应用前景.但植入后早期炎症及血运来源等问题仍需进一步深入的研究.     

骨组织工程的研究进展

本介绍了组织工程的概念、基本方法和研究的主要内容；综述了骨组织工程领域的研究现状和发展方向；讨论了骨细胞与其生活环境支架材料和生长因子的相互作用。     

新型防水材料的应用及其与常用防水材料的对比

通过近年来对新型防水材料的工程设计和应用实践,对渗透结晶型防水材料的特点和适用性进行了分析和研究,提出了"以刚性为主、柔性为辅"的新防水结构体系。同时通过对比指出了常用防水材料的缺陷。     

二种光固化材料修复楔状缺损的临床分析

目的：评价Dyract复合体修复楔状缺损的临床疗效。方法：将80例楔状缺损的患者分成两组,一组采用Dyract复合体修复,另一组采用光固化复合树脂修复,追踪观察1～2年,观察二组的临床效果。结果：Dyract复合体组成功率94.44%,光固化复合树脂组成功率83.72%。结论：Dyract复合体是一种理想的修复楔形缺损材料,临床疗效肯定。