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1、TheMechanismofActionofInducedMembranesinBoneRepair.誘導(dǎo)膜在骨修復(fù)中的作用機(jī)制AbstractBACKGROUND:Inducementofforeign-bodygranulationtissueisarelativelynoveltherapeuticmodalityinbonerepair.Atwo-stagebonereconstructionmethod,knownastheMasquelettechnique,combinesinducementofagranulationtissuemem
2、braneandsubsequentboneautograftingasabiphasictechniqueallowingreconstructionoflargebonedefects.Inlightoftheiralreadywell-characterizedosteogenesis-improvingcapabilitiesinanimals,weperformedthistranslationalstudytoinvestigatethesemembranesinpatients.摘要背景：誘導(dǎo)異物肉芽組織在骨修復(fù)中是一種較新的治療方法。兩
3、階段骨重建方法，即熟知的Masquelet技術(shù)，是結(jié)合誘導(dǎo)肉芽組織膜和隨后的骨自體移植的雙向技術(shù)以允許大段骨缺損重建。根據(jù)它們在動物實(shí)驗(yàn)中良好的提高成骨能力特點(diǎn)，我們將這些膜植入患者中進(jìn)行研究。METHODS:Fourteenpatientswithcomplicatedfracturesandbonedefectswererandomlyselectedforthisstudy.Biopsysamplesofforeign-body-inducedmembraneswerecollectedatdifferenttimepointsduringsch
4、eduledsurgicalprocedures.Themembraneswereco-culturedwithmesenchymalstromalcells,anddifferentiationintotheosteoblasticlineagewasassessedbymeasuringalkalinephosphataseactivity,aminoterminalpropeptideoftype-Iprocollagen(PINP)production,andCa2+concentration.Histologicalcharacteristi
5、cswereevaluatedwithimageanalysis.Quantitativereversetranscriptionpolymerasechainreactionwasusedtomeasurevascularendothelialgrowthfactor(VEGF),interleukin-6(IL-6),andtype-Icollagen(Col-1)expression.方法：本研究將14例復(fù)雜骨折并骨缺損的患者隨機(jī)分組。按預(yù)定的手術(shù)方法在不同時間點(diǎn)活檢收集異物誘導(dǎo)的膜。這些膜和間充質(zhì)干細(xì)胞共同培養(yǎng)，通過測定堿性磷酸酶活性、I型膠原
6、(PINP)產(chǎn)物氨基端前肽、以及鈣離子濃度評估其分化成成骨細(xì)胞譜系。用圖像分析對組織學(xué)特點(diǎn)進(jìn)行評價。應(yīng)用定量逆轉(zhuǎn)錄聚合酶鏈反應(yīng)法對血管內(nèi)皮生子因子(VEGF)、白細(xì)胞介素-6(IL-6),以及I型膠原蛋白(Col-1俵達(dá)進(jìn)行測量＜RESULTS:Theinducedmembraneswerecharacterizedhistologicallybymaturatingvascularizedfibroustissue.Thevascularizationwasgreatestinone-month-oldsamplesanddecreasedto<60
7、%inthree-month-oldsamples.One-month-oldmembranesampleshadthehighestexpressionofVEGFrIL-6,andCol-1,whereastwo-month-oldmembranesexpressed<40%ofthelevelsoftheone-month-oldmembranes.Specificalkalinephosphataseactivity,PINPproduction,andCa2+concentrationwereincreasedinco-cultureswhe
8、namembranesamplewaspresent.Inculturesofone-mont
