目的 设计并构建一种新型的神经引导导管。方法 将兔雪旺细胞种到用成粘蛋白多孔医用组织引导的再生胶原膜支架培养2周后，用倒置显微镜、扫描电镜观察雪旺细胞吸附、生长迁移情况；以雪旺细胞胶原膜管的形式植入体内，观察它诱导神经再生的能力。结果 成年兔雪旺细胞在医用组织引导再生胶原膜上生长良好，并均匀分布于支架表面，且基质分泌旺盛。体内模型发现神经已通过移植物长入远端，胶原膜已吸收。结论 雪旺细胞可以在多聚医用组织引导再生胶原膜上得到扩增，种有雪旺细胞的医用组织引导再生胶原膜导管可以形成一个诱导神经轴突再生的微环境，形成的三维立体结构具有人工神经的基本特性，为组织工程方法修复长段神经缺损提供了研究基础。

利用桥接物修复1.0cm以上神经缺损，效果不理想。本实验采用自体静脉桥接家兔4.0cm长胫神经缺损，术后2个月未发生神经再生现象。而利用自体静脉内种植雪旺氏细胞匀浆，桥接家兔4.0cm长胫神经缺损，术后电生理、组织学、透射电镜等项检测指标都能观察到神经再生现象。雪旺氏细胞匀浆在静脉桥接物的这一作用，增加了非神经移植物修复神经缺损的长度。

observed it s activity in stimulating neurite outgrowth in vitro. Methods cDNA encoding mature human HBNF was amplified from total RNA isolated from an 182week aborted human fetal brain by RT-PCR method. After amplification, the HBNF cDNA gene was cloned into p PIC9K, a shuttle expression vector for yea stsystem. The positive clone of expression vector bearing HBNF cDNA gene was obtained by screening. Verified recombinant vector was then used to transform Pichiastrain GS115 by electroporation. His+ transformants were selected on minimal dextrose medium (MD) plates which were histidine free1 His+ yeast recombinants with multi-copy insert s were screened in vivo by their resistance to G4181 PCR analysis was used to confirm the integration of the HBNF cDNA gene into the Pichia genome1 Secreted expre ssion of hrHBNF protein in culture medium was obtained when the positive clone containing the HBNF cDNA gene was induced by methanol. The hrHBNF product purified by gel chromatography was added to cultured rat pheochromocytoma (PC12) cells to observe it s ability to stimulate neurite outgrowth. Results In the recombinant expression vector, the insert was sequenced to show exactly the sequence encoding human HBNF according to Genbank data. The HBNF cDNA gene was cloned downstream to the α-factor, and it s open reading frame was in frame with the α-factor signal sequence in p PIC9K1 SDS2PAGE showed that the molecular weight of the induced expression product was about 18kDa, consistent with that of human HBNF reported in the literature. The protein product did promote neurite outgrowth in cultured rat pheochromocytoma (PC12) cells. Conclusion Recombinant human heparin-binding neurite-promoting factor can be expressed with a yeast system, and it s product possesses the biological activity to promote neurite outgrowth.

目的：比较游离腓骨或吻合血管腓骨移植治疗切除四肢侵袭性骨肿瘤或恶性骨肿瘤后引起的长段骨缺损的临床疗效。方法：对18例吻合血管移植及4例游离腓骨移植术的病例术后，采用ECT、彩色多普勒血管超声检查、X线照片检查及随访，时间为术后2～12年，移植骨最长达26cm。结果：侵袭性骨肿瘤和恶性骨肿瘤18例，肿瘤切除后用吻合血管腓骨移植重建缺损，15例桡骨远端骨巨细胞瘤患者作游离腓骨移植重建缺损，结果前者愈合良好，移植骨片与受骨接合牢固，游离腓骨移植则愈合较差。结论：吻合血管腓骨移植可一期重建因骨肿瘤或骨恶性肿瘤广泛切除后造成的6cm以上的骨缺损，其优越性远远超过游离腓骨移植。

应用带血管腓骨治疗上肢侵袭性良性骨肿瘤和恶性骨肿瘤10例，不带血管腓骨治疗桡骨远端骨巨细胞瘤13例，总共23例。随访时间2～12年，随访中使用ECT（单光子照射扫描照相），彩色多普勒血管超声检查，以及X线片检查。结果显示带血管腓骨10例移植骨片生长良好，移植骨片与受骨愈合牢固；不带血管腓骨移植骨片长度超过6cm时愈合困难。本组带血管腓骨移植骨片最长26cm，最短9cm，这种手术最大的进步是病变组织可彻底切除，切除后可一期重建缺损组织。另一个优点是移植后的骨片周径可有增粗。