目的探讨对于肥胖患者进行人工膝关节置换术可能面临的问题及评估其术后近期疗效。方法以我科自2011年11月至2014年9月同一手术组医生进行人工膝关节置换术的23例(28膝)终末期膝关节病变合并肥胖患者为研究对象,并与同期随机抽取的23例...目的探讨对于肥胖患者进行人工膝关节置换术可能面临的问题及评估其术后近期疗效。方法以我科自2011年11月至2014年9月同一手术组医生进行人工膝关节置换术的23例(28膝)终末期膝关节病变合并肥胖患者为研究对象,并与同期随机抽取的23例(24膝)非肥胖患者对比分析。研究组和对照组疗效评估采用美国膝关节协会评分(knee society score,KSS)系统。结果患者术后均获随访,随访时间2~18个月,平均15.2个月。术前两组间KSS临床评分差异无统计学意义(P>0.05),功能评分差异有统计学意义(P<0.05)。末次随访时,两组间KSS临床评分和功能评分差异无统计学意义(P>0.05),与术前比较差异均有统计学意义(P<0.05)。术后研究组患者中1例切口因脂肪液化而延迟愈合,1例患者未按要求服用抗凝药物发生下肢深静脉血栓,经治疗均获得治愈。结论对于终末期膝关节病变合并肥胖的患者进行人工全膝关节置换,合理治疗术前合并症,熟练术中操作技术以及进行系统的术后管理,可达到满意的近期临床疗效。展开更多
A novel unsaturated polyphosphoester(UPPE) was devised in our previous research,which is a kind of promising scaffold for improving bone regeneration.However,the polymerization process of UPPE scaffolds was unfavorabl...A novel unsaturated polyphosphoester(UPPE) was devised in our previous research,which is a kind of promising scaffold for improving bone regeneration.However,the polymerization process of UPPE scaffolds was unfavorable,which may adversely affect the bioactivity of osteoinductive molecules added if necessary,such as recombinant human bone morphogenetic protein-2(rhBMP2).The purpose of this study was to build a kind of optimal scaffold named UPPE-PLGA-rhBMP2(UPB) and to investigate the bioactivity of rhBMP2 in this scaffold.Furthermore,the cytotoxicity and biocompatibility of UPB scaffold was assessed in vitro.A W1/O/W2 method was used to fabricate PLGA-rhBMP2 microspheres,and then the microspheres were added to UPPE for synthesizing UPB scaffold.The morphological characters of PLGA-rhBMP2 microspheres and UPB scaffolds were observed under the scanning electron microscopy and laser scanning confocal microscopy.The cumulative release of UPB scaffolds was detected by using ELISA.The cytotoxicity and biocompatibility of UPB scaffolds were evaluated through examining the adsorption and apoptosis of bone marrow stromal cells(bMSCs) seeded on the surface of UPB scaffolds.The bioactivity of rhBMP2 in UPB scaffolds was assessed through measuring the alkaline phosphates(ALP) activity in bMSCs seeded.The results showed that UPB scaffolds sequentially exhibited burst and sustained release of rhBMP2.The cytotoxicity was greatly reduced when the scaffolds were immersed in buffer solution for 2 h.bMSCs attached and grew on the surface of soaked UPB scaffolds,exerting well biocompatibility.The ALP activity of bMSCs seeded was significantly enhanced,indicating that the bioactivity of rhBMP2 remained and still took effect after the unfavorable polymerization process of scaffolds.It was concluded that UPB scaffolds have low cytotoxicity,good biocompatibility and preserve bioactivity of rhBMP2.UPB scaffolds are promising in improving bone regeneration.展开更多
文摘目的探讨对于肥胖患者进行人工膝关节置换术可能面临的问题及评估其术后近期疗效。方法以我科自2011年11月至2014年9月同一手术组医生进行人工膝关节置换术的23例(28膝)终末期膝关节病变合并肥胖患者为研究对象,并与同期随机抽取的23例(24膝)非肥胖患者对比分析。研究组和对照组疗效评估采用美国膝关节协会评分(knee society score,KSS)系统。结果患者术后均获随访,随访时间2~18个月,平均15.2个月。术前两组间KSS临床评分差异无统计学意义(P>0.05),功能评分差异有统计学意义(P<0.05)。末次随访时,两组间KSS临床评分和功能评分差异无统计学意义(P>0.05),与术前比较差异均有统计学意义(P<0.05)。术后研究组患者中1例切口因脂肪液化而延迟愈合,1例患者未按要求服用抗凝药物发生下肢深静脉血栓,经治疗均获得治愈。结论对于终末期膝关节病变合并肥胖的患者进行人工全膝关节置换,合理治疗术前合并症,熟练术中操作技术以及进行系统的术后管理,可达到满意的近期临床疗效。
基金supported by a grant from the Scientific and Technological Project of Wuhan,China (No. 200960223069)
文摘A novel unsaturated polyphosphoester(UPPE) was devised in our previous research,which is a kind of promising scaffold for improving bone regeneration.However,the polymerization process of UPPE scaffolds was unfavorable,which may adversely affect the bioactivity of osteoinductive molecules added if necessary,such as recombinant human bone morphogenetic protein-2(rhBMP2).The purpose of this study was to build a kind of optimal scaffold named UPPE-PLGA-rhBMP2(UPB) and to investigate the bioactivity of rhBMP2 in this scaffold.Furthermore,the cytotoxicity and biocompatibility of UPB scaffold was assessed in vitro.A W1/O/W2 method was used to fabricate PLGA-rhBMP2 microspheres,and then the microspheres were added to UPPE for synthesizing UPB scaffold.The morphological characters of PLGA-rhBMP2 microspheres and UPB scaffolds were observed under the scanning electron microscopy and laser scanning confocal microscopy.The cumulative release of UPB scaffolds was detected by using ELISA.The cytotoxicity and biocompatibility of UPB scaffolds were evaluated through examining the adsorption and apoptosis of bone marrow stromal cells(bMSCs) seeded on the surface of UPB scaffolds.The bioactivity of rhBMP2 in UPB scaffolds was assessed through measuring the alkaline phosphates(ALP) activity in bMSCs seeded.The results showed that UPB scaffolds sequentially exhibited burst and sustained release of rhBMP2.The cytotoxicity was greatly reduced when the scaffolds were immersed in buffer solution for 2 h.bMSCs attached and grew on the surface of soaked UPB scaffolds,exerting well biocompatibility.The ALP activity of bMSCs seeded was significantly enhanced,indicating that the bioactivity of rhBMP2 remained and still took effect after the unfavorable polymerization process of scaffolds.It was concluded that UPB scaffolds have low cytotoxicity,good biocompatibility and preserve bioactivity of rhBMP2.UPB scaffolds are promising in improving bone regeneration.
