最轻的心脏植入泵

HeartWare医疗器械公司生产的心脏植入泵系统可有效延长心力衰竭病人寿命。该植入泵5盎司重,只有植入泵的二分之一重。重量小的压力泵能够在植入过程中降低手术创伤,需要的动力能量也更小。     

Caveolin-1在围植入期小鼠子宫内膜组织中的动态变化

目的检测caveolin-1在胚胎植入过程中小鼠子宫内膜组织中的表达,探讨其在胚胎植入过程中的作用。方法选择成年雌性昆明小白鼠42只,随机均分为7组(处于动情期的未孕组、妊娠3.5天组、妊娠4.5天组、妊娠5.5天组、妊娠6.5天组、妊娠7.5天组、妊娠9天组),采用免疫组织化学和RT-PCR方法检测子宫内膜组织中caveolin-1蛋白及mRNA水平在围植入期的变化。结果 (1)caveolin-1在胚胎植入前期(0d、3.5d)小鼠子宫内膜组织中的表达高于胚胎植入期(4.5d、5.5d、6.5d),差异有显著性(P<0.05)。(2)caveolin-1在胚胎植入后期(7.5d、9d)小鼠子宫内膜组织中的表达高于胚胎植入期(4.5d、5.5d、6.5d),差异有显著性(P<0.05)。(3)caveolin-1在胚胎植入后期小鼠子宫内膜组织中的表达略高于胚胎植入前期,但差异无显著性(P>0.05)。结论 Caveolin-1在胚胎植入前期和后期均高表达,植入期低表达。这种变化提示caveolin-1是影响胚胎植入的重要因素之一。     

凶险型前置胎盘对孕产妇的危害性研究

目的:探讨凶险型前置胎盘对孕产妇的危害性。方法:选择我院2009年3月至2012年3月收治的凶险性前置胎盘40例,对其临床资料进行回顾性分析。结果:植入型前置胎盘(植入组)占凶险型前置胎盘的55%(22例),非植入型前置胎盘(非植入组)占45%(18例)。植入组产前出血18例,占81.8%,非植入组产前出血8例,占44.4%,差异有统计学意义。植入组完全性前置胎盘17例,占77.3%;部分性4例,占18.2%;边缘性1例,占4.5%。非植入组分别为5例,占27.8%;1例,占5.6%;12例,占66.7%。两组之间比较差异具有统计学意义(P<0.05)。两组术前Hb值无明显差异(P>0.05),术后非植入组Hb水平高于植入组,手术时间、术中出血量、产后出血均显著少于植入组,差异均有统计学意义(P<0.05)。非植入组术中输血、切除子宫、应用宫腔纱条的百分率均显著低于植入组(P<0.05)。两组术中刮宫、徒手剥胎盘的百分率比较均无明显差异(P>0.05)。结论:对于凶险型前置胎盘孕产妇,产前应做好预防保健,术中加强观察,术中术后放置腹腔引流管,最大限度的降低对孕产妇的危害,确保母婴安全。     

功能基因组学和蛋白质组学在胚胎植入机制研究中的应用

胚胎植入是人类和哺乳动物生殖过程中的重要步骤,其分子机制至今尚未完全明了.近年来,功能基因组学和蛋白质组学等高通量检测新技术已广泛应用于胚胎植入机制的研究领域.通过从整体上观察胚胎植入过程中基因和蛋白质表达的变化,全面地筛选出大量胚胎植入相关因子,从而为在分子水平上阐明胚胎植入过程中的调控网络打下了基础.     

基于聚醚醚酮的骨科植入材料生物相容性研究

本研究基于聚醚醚酮的骨科植入材料生物相容性的研究,进一步分析聚醚醚酮(polyether-ether-ketone,PEEK)骨科植入材料生物的相容性能,以有效提高其生物功能性,进而获得更加可靠的骨-植入体界面。本研究通过以新西兰大白兔为研究对象,采用改性/未改性的PEEK材料制备了腰椎模型并植入,最后进行了生物力学与Micro CT分析。实验研究表明,以改性及未改性的PEEK材料制备的腰椎假体在植入动物体内后后,动物体内未发生显著相关的急慢性毒性反应。对比植入的两种PEEK假体我们发现,改性的PEEK腰椎假体在植入动物后第4周,其临近椎骨的植入部位在骨体积分数等参数上发生了明显的改善(p0.05);植入后第8周检查,以骨体积分数(BV/TV)、(骨密度(BMD)、骨小梁厚度(Tb.Th)、骨小梁分离度(Tb.Sp)以及骨表面体积分数(BS/BV)等为代表的多项重要的骨组织形态计量学参数均发生了显著的改善(p0.05)。同时,研究通过采用拔出试验来验证植入材料的生物力学性能,实验发现改性PEEK材料能够有效促进植入假体与椎骨的紧密结合。因此,实验中针对PEEK材料采用rh BMP-2与胶原蛋白对表面进行改性可以高效地、快速地达到效果,并且能够明显提高骨科植入的PEEK材料的生物功能性与生物相容性。     

玉米醇溶蛋白动物体内植入后的免疫学分析方法初探

目的：为了考察玉米醇溶蛋白作为生物医用材料的应用前景,需要检测玉米醇溶蛋白植入后的免疫反应。本实验中我们将玉米醇溶蛋白管植入SD（Sprague Dawley）大鼠皮下,流式细胞仪检测植入后大鼠外周血中CD4^＋和CD8^＋T淋巴细胞含量的变化;对不同部位植入材料的组织学切片方法进行改进,用于后续机体免疫反应分析。方法：雄性SD大鼠八只,随机分成两组：空白对照组、材料植入组。分别于植入后一、二和四周对实验大鼠进行眼眶取血,并用流式细胞仪检测外周血中CD4^＋和CD8^＋T淋巴细胞的含量。皮下或肌袋植入材料四周后,将玉米醇溶蛋白管或三维多孔支架连同周围组织一起取出,用改进的石蜡切片方法制备组织切片,HE染色后观察。结果：玉米醇溶蛋白管植入后一周,蛋白管植入组CD4^＋（T—test,P〈0．01）和CD8^＋（T-test,P〈0．05）T淋巴细胞的含量下降。植入后两周和四周,蛋白管植入组CD4^＋和CD8^＋T淋巴细胞的含量（T—test,P〉0．05）均无明显变化。植入后一、二和四周,与空白对照组相比,蛋白管植入组CD4^＋／CD8^＋的比值（T—Test,P〉0．05）均无显著差异。改进后的切片方法可以制备出完整的、并且耐HE（hematoxylin—eosin）和免疫组化染色处理的组织学切片。结论：利用流式细胞仪检测出了大鼠皮下植入玉米蛋白管后外周血中CD4^＋、CD8^＋T淋巴细胞的含量变化。并且,克服了切片制备过程中材料的脆性问题和贴片不牢固问题,可以进行HE和免疫组化染色处理,为进一步深入地分析玉米醇溶蛋白植入机体后的免疫反应打下了基础。     

哺乳动物滋养层细胞在胚胎植入中的作用

胚胎植入是哺乳动物生殖的关键环节,是一个非常复杂的过程.在胚胎植入过程中,多种着床相关因子、激素在母体-胚胎之间进行多重作用,引发复杂的生理作用,从而完成胚胎着床.在母体-胚胎界面上,胎源性滋养层细胞与母体子宫内膜细胞在信号联系（妊娠识别）和组织紧密连接（胚胎植入）过程中起着决定性作用,尤其是胚源性滋养层细胞,在胚胎植入过程中起主导作用.本文通过对滋养层细胞在胚胎植入中的作用的阐述,为进一步阐明胚胎植入的分子机制提供思路.     

植入金属材料断口扫描电镜观察

本文采用扫描电镜对3例不同类型的植入金属材料断口进行观察和分析。结果显示,植入金属材料在体内断裂的原因与材料的组织缺陷和加工不良所致的应力集中有关,并对植入金属材料的选材和加工工艺提出改进意见。     

胚胎植入中白细胞介素-1的信号转导及其生理作用

本文论述了白细胞介素－１（ＩＬ－１）的信号转导通路及其在胚胎植入中的调节作用。指出：植入过程中,ＩＬ－１起着十分重要的作用,但并非唯一的重要因子,成功的胚胎植入需要多种细胞因子的协同作用。     

小鼠体内外受精植入前胚胎全基因组甲基化模式比较

为考察体外受精、操作及培养环境对体外受精的小鼠植入前胚胎全基因组DNA甲基化模式的影响,本研究以体内受精的植入前胚胎作为对照,采用间接免疫荧光法检测小鼠体内外受精植入前胚胎基因组DNA甲基化模式.实验结果表明,体外受精各期植入前胚胎呈现出与之相应时期的体内受精植入前胚胎不同的DNA甲基化模式和水平,原核期甲基化水平较高,2-4-、8-细胞期明显降低,而桑葚胚和囊胚期又略有升高.各期体外受精植入前胚胎的基因组DNA甲基化水平都比同时期体内受精胚胎的甲基化水平低.本实验结果部分显示了体外受精、操作及培养环境可能对正常的DNA甲基化模式产生影响,造成体外受精植入前胚胎甲基化模式异常.     

Nanotopographical control of human osteoprogenitor differentiation

Current load-bearing orthopaedic implants are produced in 'bio-inert' materials such as titanium alloys. When inserted into the reamed bone during hip or knee replacement surgery the implants interact with mesenchymal populations including the bone marrow. Bio-inert materials are shielded from the body by differentiation of the cells along the fibroblastic lineage producing scar tissue and inferior healing. This is exacerbated by implant micromotion, which can lead to capsule formation. Thus, next-generation implant materials will have to elicit influence over osteoprogenitor differentiation and mesenchymal populations in order to recruit osteoblastic cells and produce direct bone apposition onto the implant. A powerful method of delivering cues to cells is via topography. Micro-scale topography has been shown to affect cell adhesion, migration, cytoskeleton, proliferation and differentiation of a large range of cell types (thus far all cell types tested have been shown to be responsive to topographical cues). More recent research with nanotopography has also shown a broad range of cell response, with fibroblastic cells sensing down to 10 nm in height. Initial studies with human mesenchymal populations and osteoprogenitor populations have again shown strong cell responses to nanofeatures with increased levels of osteocalcin and osteopontin production from the cells on certain topographies. This is indicative of increased osteoblastic activity on the nanotextured materials. Looking at preliminary data, it is tempting to speculate that progenitor cells are, in fact, more responsive to topography than more mature cell types and that they are actively seeking cues from their environment. This review will investigate the range of nanotopographies available to researchers and our present understanding of mechanisms of progenitor cell response. Finally, it will make some speculations of the future of nanomaterials and progenitor cells in tissue engineering.     

Growth of Leptospira pomona and Its Effect on Various Tissue Culture Systems

Miller, Robert E. (University of Nebraska College of Medicine, Omaha), Norman G. Miller, and Roberta J. White. Growth of Leptospira pomona and its effect on various tissue culture systems. J. Bacteriol. 92:502-509. 1966.-Leptospira pomona strain 3341 was grown in association with primary fetal bovine kidney (PBK) and human embryonic skin-muscle fibroblastic (HE) cells in Eagle's minimal essential medium (MEM) with 5% sheep serum. Growth curves of leptospires in PBK and HE cell cultures showed no substantial increase in growth above that obtained in Eagle's MEM in the absence of tissue culture cells. This suggested that no stimulatory growth factors for leptospires were produced by the tissue cells. Fibroblastic cells of the PBK monolayer showed separation, deterioration, and, finally, complete disintegration. Epithelial-like cells remained unaffected. HE cells showed the same cytopathic effect as PBK fibroblastic cells, indicating that this effect was not limited to PBK fibroblastic cells. Warthin-Starry stains of PBK and HE cell monolayers showed masses of leptospires adhering to fibroblastic cells, whereas only a few were seen on epithelial-like cells. Large numbers of leptospires on the surface of fibroblastic cells are very likely associated with the cytopathic effect. Dislodgment of leptospires from fibroblastic cells did not increase the total number of spirochetes in the culture. This indicated that leptospiral growth did not occur on the surface of these cells.     

Role of myofibroblasts during normal tissue repair and excessive scarring: interest of their assessment in nephropathies

Following injury, tissue repair process takes place involving inflammation, granulation tissue formation and scar constitution. Granulation tissue develops from the connective tissue surrounding the damaged area and contains vessels, inflammatory cells, fibroblasts and myofibroblasts. Myofibroblasts play an important role in many tissue injuries and fibrocontractive diseases. The process of normal wound repair after tissue injury follows a closely regulated sequence including the activation and the proliferation of fibroblastic cells. In pathological situations, the normal resolution stages are abrogated and the proliferation of myofibroblasts continues, inducing excessive accumulation of extracellular matrix. The differentiation of fibroblastic cells into myofibroblasts is an early event in the development of tissue fibrosis. Myofibroblastic cells express smooth muscle cytoskeletal markers (alpha-smooth muscle actin in particular) and participate actively in the production of extracellular matrix. The evaluation of myofibroblast differentiation in renal biopsies would be useful for histopathologists to appreciate the intensity of tissue injury and particularly to predict the long term outcome of some nephropathies. Immunohistochemical studies for alpha-smooth muscle actin should be made systematically in renal tissue biopsies. Myofibroblastic differentiation appears to play a significant role in the progression of renal failure and seems to be a useful marker of progressive disease.     

Differences in lectin binding patterns of normal human endometrium between proliferative and secretory phases

Summary The biological fate of a bovine collagen implant (Zyderm Collagen Implant ZCI), injected subcutaneously into rats, was studied by the immunoperoxidase technique using specific antibodies against the bovine implant and against types I, III, IV, V collagens, fibronectin and elastin. The implant remained in the animals until the end of the experiment (90 days), with no visible modification, as demonstrated by immunoperoxidase labelling and scanning electron microscopy. A slight inflammatory reaction was visible around the implant 24 h after injection and within the implant 3 days after injection. Fibroblast invasion began 7 days after injection. The chronology of the deposition in the implant of the host (rat) extracellular matrix components was as follows: by 24 h after injection, fibronectin was observed throughout the implant; types I and V collagens appeared on the 7th day, and, in contrast to surrounding connective tissue, type V collage labelling was obtained without acid pretreatment of the section. Types III and IV collagens were detected inside the implant only 30 days after injection. At the end of the experiment (90 days), there was abundant types I and V collagens after fibroblast migration, and abundant type IV collagen demonstrating an important vascularization. No elastic fibres could be detected inside the implant but they appeared as a dense network around the implant in host connective tissue.     

Trabecular bone strains around a dental implant and associated micromotions—A micro-CT-based three-dimensional finite element study

The first objective of this computational study was to assess the strain magnitude and distribution within the three-dimensional (3D) trabecular bone structure around an osseointegrated dental implant loaded axially. The second objective was to investigate the relative micromotions between the implant and the surrounding bone. The work hypothesis adopted was that these virtual measurements would be a useful indicator of bone adaptation (resorption, homeostasis, formation).In order to reach these objectives, a μCT-based finite element model of an oral implant implanted into a Berkshire pig mandible was developed along with a robust software methodology. The finite element mesh of the 3D trabecular bone architecture was generated from the segmentation of μCT scans. The implant was meshed independently from its CAD file obtained from the manufacturer. The meshes of the implant and the bone sample were registered together in an integrated software environment. A series of non-linear contact finite element (FE) analyses considering an axial load applied to the top of the implant in combination with three sets of mechanical properties for the trabecular bone tissue was devised. Complex strain distribution patterns are reported and discussed. It was found that considering the Young’s modulus of the trabecular bone tissue to be 5, 10 and 15 GPa resulted in maximum peri-implant bone microstrains of about 3000, 2100 and 1400. These results indicate that, for the three sets of mechanical properties considered, the magnitude of maximum strain lies within an homeostatic range known to be sufficient to maintain/form bone. The corresponding micro-motions of the implant with respect to the bone microstructure were shown to be sufficiently low to prevent fibrous tissue formation and to favour long-term osseointegration.     

Enhanced Adenovirus Transduction of hMSCs Using 3D Hydrogel Cell Carriers

Hydrogels are increasingly being investigated as a means to implant cells for tissue engineering. One way to further enhance the repair response would be to combine the hydrogel cell carrier with gene transfer. Gene therapy, using adenoviral vectors, is an effective way to provide transient delivery of bioactive factors. However, current protocols require further optimization, especially if they are to be transferred into the clinic. This study opted to compare the efficiency of protocols for standard two-dimensional (2D) versus three-dimensional (3D), adenoviral-mediated, transduction of human mesenchymal stem cells. Two different multiplicities of infection were tested. After encapsulation in fibrin, alginate or agarose, cells were cultured for 28 days. Transduction in 3D showed a much higher efficiency, compared to standard 2D transduction protocols. In 3D, the amount of transgene produced was significantly higher, for every condition investigated. Furthermore, transduction in 3D does not require a cell culture step and can be conducted within the operating theatre. In conclusion, it was demonstrated that 3D transduction, using adenoviral vectors, is superior to standard transduction protocols in 2D. It therefore, might help increasing its administration in tissue engineering and clinical applications.     

TGF-β-Operated Growth Inhibition and Translineage Commitment into Smooth Muscle Cells of Periodontal Ligament-Derived Endothelial Progenitor Cells through Smad- and p38 MAPK-Dependent Signals

The periodontal ligament (PDL) is a fibrous connective tissue that attaches the tooth to the alveolar bone. We previously demonstrated the ability of PDL fibroblast-like cells to construct an endothelial cell (EC) marker-positive blood vessel-like structure, indicating the potential of fibroblastic lineage cells in PDL tissue as precursors of endothelial progenitor cells (EPCs) to facilitate the construction of a vascular system around damaged PDL tissue. A vascular regeneration around PDL tissue needs proliferation of vascular progenitor cells and the subsequent differentiation of the cells. Transforming growth factor-β (TGF-β) is known as an inducer of endothelial-mesenchymal transition (EndMT), however, it remains to be clarified what kinds of TGF-β signals affect growth and mesenchymal differentiation of PDL-derived EPC-like fibroblastic cells. Here, we demonstrated that TGF-β1 not only suppressed the proliferation of the PDL-derived EPC-like fibroblastic cells, but also induced smooth muscle cell (SMC) markers expression in the cells. On the other hand, TGF-β1 stimulation suppressed EC marker expression. Intriguingly, overexpression of Smad7, an inhibitor for TGF-β-induced Smad-dependent signaling, suppressed the TGF-β1-induced growth inhibition and SMC markers expression, but did not the TGF-β1-induced downregulation of EC marker expression. In contrast, p38 mitogen-activated protein kinase (MAPK) inhibitor SB 203580 suppressed the TGF-β1-induced downregulation of EC marker expression. In addition, the TGF-β1-induced SMC markers expression of the PDL-derived cells was reversed upon stimulation with fibroblast growth factor (FGF), suggesting that the TGF-β1 might not induce terminal SMC differentiation of the EPC-like fibroblastic cells. Thus, TGF-β1 not only negatively controls the growth of PDL-derived EPC-like fibroblastic cells via a Smad-dependent manner but also positively controls the SMC-differentiation of the cells possibly at the early stage of the translineage commitment via Smad- and p38 MAPK-dependent manners.     

Irradiation after immediate tissue expander/implant breast reconstruction: outcomes, complications, aesthetic results, and satisfaction among 156 patients

Chest wall irradiation is becoming increasingly common for mastectomy patients who have opted for immediate breast reconstruction with tissue expanders and implants. The optimal approach for such patients has not yet been defined. This study assesses the outcomes of a reconstruction protocol for patients who require irradiation after tissue expander/implant reconstruction. The charts of all patients who underwent immediate tissue expander/implant reconstruction at Memorial Sloan-Kettering Cancer Center between January of 1995 and June of 2001 and who had not previously undergone irradiation were retrospectively reviewed. A subgroup of patients who required chest wall irradiation after mastectomy and reconstruction was identified. Those patients were treated according to the following treatment algorithm: (1) reconstruction with tissue expander placement at the time of mastectomy , (2) tissue expansion during postoperative chemotherapy, (3) exchange of the tissue expander for a permanent implant approximately 4 weeks after the completion of chemotherapy, and (4) chest wall irradiation beginning 4 weeks after the exchange. All irradiated patients with at least 1 year of follow-up monitoring after the completion of radiotherapy were evaluated with respect to aesthetic outcomes, capsular contracture, and patient satisfaction. A control group of nonirradiated patients was randomly selected from the cohort of patients treated during the study period. During the 5-year study period, a total of 687 patients underwent immediate reconstruction with tissue expanders. Eighty-one patients underwent postoperative irradiation after placement of the final implant. A total of 68 patients who received postoperative chest wall irradiation underwent at least 1 year of follow-up monitoring after the completion of radiotherapy, with a mean follow-up period of 34 months. Seventy-five nonirradiated patients were evaluated as a control group. Overall, 68 percent of the irradiated patients developed capsular contracture, compared with 40 percent in the nonirradiated group (p = 0.025). Eighty percent of the irradiated patients demonstrated acceptable (good to excellent) aesthetic results, compared with 88 percent in the nonirradiated group (p = not significant). Sixty-seven percent of the irradiated patients were satisfied with their reconstructions, compared with 88 percent of the nonirradiated patients (p = 0.004). Seventy-two percent of the irradiated patients stated that they would choose the same form of reconstruction again, compared with 85 percent of the nonirradiated patients. The results of this study suggest that tissue expander/implant reconstruction is an acceptable surgical option even when followed by postoperative radiotherapy and should be considered in the reconstruction algorithm for all patients, particularly those who may not be candidates for autogenous reconstruction.     

On the mechanical stability of porous coated press fit titanium implants: a finite element study of a pushout test

Pushout tests can be used to estimate the shear strength of the bone implant interface. Numerous such experimental studies have been published in the literature. Despite this researchers are still some way off with respect to the development of accurate numerical models to simulate implant stability. In the present work a specific experimental pushout study from the literature was simulated using two different bones implant interface models. The implant was a porous coated Ti-6Al-4V retrieved 4 weeks postoperatively from a dog model. The purpose was to find out which of the interface models could replicate the experimental results using physically meaningful input parameters. The results showed that a model based on partial bone ingrowth (ingrowth stability) is superior to an interface model based on friction and prestressing due to press fit (initial stability). Even though the present study is limited to a single experimental setup, the authors suggest that the presented methodology can be used to investigate implant stability from other experimental pushout models. This would eventually enhance the much needed understanding of the mechanical response of the bone implant interface and help to quantify how implant stability evolves with time.     

Determination of stromal signatures in breast carcinoma

Many soft tissue tumors recapitulate features of normal connective tissue. We hypothesize that different types of fibroblastic tumors are representative of different populations of fibroblastic cells or different activation states of these cells. We examined two tumors with fibroblastic features, solitary fibrous tumor (SFT) and desmoid-type fibromatosis (DTF), by DNA microarray analysis and found that they have very different expression profiles, including significant differences in their patterns of expression of extracellular matrix genes and growth factors. Using immunohistochemistry and in situ hybridization on a tissue microarray, we found that genes specific for these two tumors have mutually specific expression in the stroma of nonneoplastic tissues. We defined a set of 786 gene spots whose pattern of expression distinguishes SFT from DTF. In an analysis of DNA microarray gene expression data from 295 previously published breast carcinomas, we found that expression of this gene set defined two groups of breast carcinomas with significant differences in overall survival. One of the groups had a favorable outcome and was defined by the expression of DTF genes. The other group of tumors had a poor prognosis and showed variable expression of genes enriched for SFT type. Our findings suggest that the host stromal response varies significantly among carcinomas and that gene expression patterns characteristic of soft tissue tumors can be used to discover new markers for normal connective tissue cells.