目的 探讨骨髓间充质干细胞(BMSCs)和嗅黏膜神经干细胞(OM-NSCs)共移植对大鼠脊髓损伤后运动功能的影响.方法 分别提取培养并鉴定大鼠BMSCs和OM-NSCs.将60只雄性SPF级SD大鼠随机分为假手术组(仅做椎板切除,不损伤脊髓),对照组(在脊髓损伤区域注射5μL生理盐水),BMSCs移植组(在脊髓损伤区域注射5μL 5×104个细胞BMSCs单细胞悬液),OM-NSCs移植组(在脊髓损伤区域注射5μL 5×104个细胞OM-NSCs单细胞悬液,BMSCs和OM-NSCs共移植组(在脊髓损伤区域注射5μL 1:15×104个细胞BMSCs和OM-NSCs细胞混悬液).细胞移植后第1、3、7、14、21、28天分别对大鼠进行BBB评分,28天后处死大鼠,分离脊髓组织,进行免疫荧光染色观察细胞迁移情况.结果 造模后,大鼠双后肢瘫痪,BBB评分0分.细胞移植后14天起,与对照组相比,干细胞移植组运动功能有显著改善,BBB评分比较差异具有统计学意义(P<0.05).与BMSCs移植组和OM-NSCs移植组相比,移植后21、28天,共移植组BBB评分显著增加(P<0.05).免疫荧光观察结果表明,脊髓损伤28天后,损伤区脊髓内可见空泡形成,两种干细胞聚集在空泡周围,BMSCs在损伤区分布较为集中,而OM-NSCs相对散在分布,细胞较为伸展.结论 干细胞移植可以一定程度上恢复脊髓损伤大鼠的运动功能,BMSCs和OM-NSCs两种干细胞共移植效果优于单细胞移植.

OBJECTIVE:To assess the clinical efficacy of Tri-Lock bio-short prosthesis in artificial total hip arthroplasty(THA) in young patients with Dorr type C femoral medullary cavity.METHODS:From January 2010 to January 2014, 35 young patients(37 hips) with in the chimney-like femoral medullary cavity received Tri-Lock BPS prosthesis of THA, including 18 males(20 hips) and 17 females with an average age of (32.2±3.0) years old ranging from 21.2 to 38.5 years old. There were 16 cases of rheumatoid hip arthritis (17 hips), 8 cases of rheumatoid arthritis (9 hips), and 11 cases of aseptic necrosis of femoral head (11 hips). All cases were complicated with different degrees of osteoporosis. According to Singh index, 26 cases were classified as Grade III and 9 cases as Grade II. Biological prostheses were used for the acetabulum, with ceramic lining and full ceramic femoral head. The proximal femoral medullary cavity was Dorr type C on anteroposterior X-ray. After replacement, X-ray examination was performed to locate the prosthesis stem. Engh and Harris criteria were used to evaluate the stability of bone-prosthesis interface and hip function, respectively. Changes of hip movement pre-operation and at last follow-up were compared.RESULTS:All patients were followed up for 18 to 45 months(means 33.8 months). Harris hip scores in 35 cases (37 hips) increased significantly from preoperative 61.8±3.0 (51.2 to 73.5) to 93.3±6.5 (92.5 to 98.8) points at last follow-up (t=54.745, P<0.01). The hip mobility increased from (46.5±8.0)°(0° to 55°) before surgery to(101.2±10.5)°(85° to 130°) at the last follow-up, the difference was statistically significant(t=133.091, P<0.01). Immediately after surgery, the prostheses were tightly packed with the medullary cavity. At the final follow-up, 17 hips had significant femur cortical bone thickening;12 hips had varying degrees of stress occlusal bone resorption at proximal femoral, including 9 degree I(low femur density, round and blunt) and 3 degree II(involving small rotor) hips. Meanwhile, 15 hips had significant femur cortical bone thickening without thigh pain.CONCLUSIONS:The cone-shaped short Tri-lock biological short-stem can fill Dorr C chimney-like medullary cavity and effectively retain good proximal femoral bone mass. Titanium microporous coating on the surface can effectively increase the friction of the prosthesis. The short-stem end in the medullary cavity can effectively avoid the occurrence of coxa varus.