Lub hli ib nrab yog cov pob txha mos fibrous nyob rau sab hauv thiab sab nraud ntawm tibial platform.Qhov sib txawv ntawm kev sib deev thiab kev tsis sib xws ntawm biomechanics tuaj yeem ua tau raws li ntau yam kev xav tau ntawm lub hauv caug sib koom ua ke, xws li kev thauj khoom, tuav lub hauv caug sib koom ua ke, kev tawm dag zog ruaj khov, thiab nqus cov kev poob siab.Yog tias ib nrab lub hli phaj raug mob tsis tuaj yeem kho tau raws sijhawm, feem ntau nws yuav ua rau osteoarthritis, thiab qhov laj thawj tseem ceeb ntawm tus neeg mob kev sab laj yog qhov mob hnyav thiab ua haujlwm tsis zoo.Lub hli ib nrab tuaj yeem muab faib ua peb thaj chaw hauv qab no, uas yog thaj chaw dawb, thaj chaw liab thiab thaj chaw liab thiab dawb ciam teb.Tsis muaj cov hlab ntsha faib rau hauv thaj chaw dawb, thiab tsis muaj cov ntshav hauv zos.Thaum kev puas tsuaj yog ib qho nyuaj ua kom tiav cov ntaub so ntswg kho.Yog li ntawd, nws yog ib qho nyuaj rau kho tom qab ib nrab hli board raug mob, thiab feem ntau cov neeg mob muaj cov tsis zoo prognosis.Nyob rau hauv xyoo tas los no, nrog rau kev txhim kho txuas ntxiv ntawm kev kho mob thev naus laus zis, cov txheej txheem biochemical uas txhawb nqa kev kho ntawm ib nrab lub hlis dispenation tau dav siv hauv tsev kho mob thiab pom tias muaj txiaj ntsig zoo.Plateau plasma plasma (PRP) tuaj yeem txhim kho lub peev xwm ntawm semi-moon phaj fibrocytocytes thiab thaj chaw dawb ntawm cov pob txha mos los txhawb cov ntaub so ntswg kho thiab ua tiav cov txiaj ntsig tseem ceeb.
Cov yam ntxwv ntawm ib nrab hli board puas
1) Lub cev thiab kev ua haujlwm ntawm lub hauv caug ib nrab hli board
Raws li cov pob txha mos fiber ntau, ib nrab lub hli board yog nruab nrab ntawm tibial platform thiab femoral cricket nyob rau hauv lub hauv caug sib koom.Cov yam ntxwv ntawm lub hli ib nrab yog raws li nram no: C - puab sab hauv thiab O -zoo li tus sab nraud;lub sab sauv yog sunken, lub hauv qab nto yog tiaj;Txuas.Tsis tas li ntawd, lub rooj tsavxwm ib nrab lub hli tuaj yeem txuas rau ntawm ntug ntawm tibial platform nrog kev pab los ntawm sab nrauv coronary ligament thiab txuas mus rau ib puag ncig lub hauv caug capsule, thaum lub router tendon tuaj yeem dhau los ntawm sab nrauv thiab sib koom ua ke ntawm ib nrab hli phaj. .Vim hais tias ib nrab lub hli phaj cov ntshav muab tsuas yog muab los ntawm cov ntaub so ntswg ib puag ncig, ib zaug cov ntaub so ntswg ib puag ncig puas lawm, lub hli hli ib nrab phaj yog qhov ua rau necrosis, uas yuav cuam tshuam rau lub hauv caug ua haujlwm.
2) Kev raug mob mechanism ntawm lub hauv caug ib nrab hli board
Cov neeg laus lub hauv caug sib koom ua ke ib nrab lub hli tuaj yeem ua rau muaj kev puas tsuaj vim muaj ntau yam sab nraud xws li hnub nyoog, kev ua haujlwm thiab kev siv zog ua haujlwm.Cov neeg mob nrog cov tub ntxhais hluas feem ntau raug torn, thaum cov neeg laus laus feem ntau cuam tshuam nrog kev hloov pauv degenerative.Lub degeneration ntawm ib nrab hli phaj tuaj yeem ua rau txo qis hauv nws lub zog, uas ua rau muaj kev pheej hmoo ntawm kev puas tsuaj.Yog li ntawd, inadvertent ce yuav ua rau ib nrab hli board puas.Thaum lub hauv caug sib koom tes ua si, ib nrab lub hli phaj raug mob yog cuam tshuam nrog kev txav ntawm nws cov txheeb ze rau lub hauv caug pob qij txha.Thaum lub hauv caug pob qij txha ncaj, ib nrab hli board txav mus rau pem hauv ntej;thaum lub hauv caug pob qij txha flexes, ib nrab hli phaj txav rov qab;thiab thaum lub hauv caug pob qij txha yog flexed, sab nraud, lossis sab hauv kev sib hloov, Tom qab txav mus.Yog tias lub hauv caug sib koom ua ke dheev tig thiab tig, daim phiaj ib nrab hli ntawm ob sab yuav muaj kev sib cav sib ceg, uas yog, "ib nrab hli pawg thawj coj tsis sib haum xeeb".
3) Kev kuaj mob thiab kev faib tawm ntawm ib nrab hli board raug mob
Feem ntau ntawm cov neeg mob uas raug mob ib nrab hli phaj muaj keeb kwm ntawm lub hauv caug raug mob.Lub tsev kho mob feem ntau yws cov tsos mob ntawm lub hauv caug mob, o, thiab elasticity.Ua ntej ntawm tag nrho cov, lub periphery ntawm lub semi moon phaj muaj ib tug loj tus naj npawb ntawm cov hlab ntsha peripherals uas muaj cov pob txha dawb paj fibers thiab medullary paj fibers, yog li ntawd lub ib nrab hli phaj puas tau yooj yim ua rau mob;Qhov thib ob, lub hauv caug kev ua si yuav raug rub thiab txhawb nqa los ntawm meniscus, uas yuav ua rau mob ntxiv.Mob yuav tshwm sim nyob rau hauv ib tug tej yam kev mob ntawm lub hauv caug pob qij txha, thiab rhiab heev yog ruaj thiab txwv rau ib tug tej yam sib txawv qhov sib txawv.Lub hli dispenation tuaj yeem ua rau pob qij txha los ntshav, los ntshav, thiab o ntawm cov pob qij txha.Thaum lub hauv caug yog flexed, txwv o tuaj yeem pom thaum koj kov cov pob qij txha puas.Lub hauv caug kev ua si kuj tuaj yeem nrog cov mos txwv rau qee yam.Nyob rau lub sijhawm no, zawv zawg ntawm ib nrab hli phaj tuaj yeem ua rau raug mob extrusion.Rau cov neeg uas muaj keeb kwm ntev ntawm keeb kwm kev kho mob, cov kev ua ub no saum toj no thiab qhov tshwj xeeb ntawm elasticity tuaj yeem tshwm sim.
PRPtus yam ntxwv lom thiab lub luag haujlwm
1) Cov yam ntxwv lom neeg
PRP yog ib qho concentrated autologous tag nrho platelet.Piv nrog rau cov platelets li qub, nws cov concentration yog 4-5 npaug ntau dua.High concentration platelets nrog coordinase thiab calcium ions Lub flocculent gels tsim yog hu ua richer platelet gels, uas muaj peev xwm koom nyob rau hauv lub tsim ntawm lub cell ceg architecture.PRP muaj ntau hom protein thiab cytokines, xws li platelet derivative growth factor (PDGF), vascular endothelial growth factor (VEGF), thiab fibrin.Cov alpha hais tawm tom qab cov kev loj hlob saum toj no tuaj yeem ua lub luag haujlwm kho, yog li txhawb cov pob txha kho thiab rov tsim kho vascular reconstruction.PRP muaj cov protein uas txhawb cov pob txha mos ntawm tes ntawm tes, yog li ua kom cov ntaub so ntswg kho.PRP raug cais los ntawm cov ntshav autologous, thiab nws txoj kev nyab xeeb tau lees paub los ntawm kev tshawb xav thiab kev sim tsiaj.PRP tsis tsuas yog muaj kev nyab xeeb xwb, tab sis kuj muaj cov yam ntxwv ntawm kev ua kom muaj roj ntsha, uas muaj kev kho mob tseem ceeb ntawm pob txha mos thiab cov ntaub so ntswg puas.
2) Proliferation mechanism ntawm pob txha mos
VEGF thiab Fiber cell loj hlob zoo tshaj plaws (FGF) muaj feem xyuam rau kev tsim kho ntawm vascular reconstruction.Raws li kev ua ntawm VEGF, kev loj hlob ntawm vascular endothelial hlwb tuaj yeem pab tsim cov hlab ntsha tshiab thiab txhim kho kev thauj mus los ntawm cov ntshav ntawm thaj chaw cuam tshuam, yog li txhawb cov ntaub so ntswg kho.FGF tseem tuaj yeem tswj cov hlwb kom nrawm nrawm ntawm vascular endothelial hlwb los ntawm kev tswj cov hlwb.Hepatocyte kev loj hlob zoo (HGF) tuaj yeem ua rau muaj qhov cuam tshuam nuclear-XB (NF-XB), leukocyte (IL) -1 los tiv thaiv cov lus teb inflammatory ntawm chondrocytes.Sab hauv fiber ntau cov ntsiab lus molecular ntawm PRP muaj cov ntsiab lus siab.Nws tuaj yeem tsim 3D daim phiaj fiber ntau hauv kev ua haujlwm ntawm coordinase thiab calcium ion.Yog li, PRP tuaj yeem hu ua platelet gel.PRP tuaj yeem tsis tsuas yog txhawb kev kho cov pob txha pob txha, tab sis kuj tseem muab cov hlua txuas rau pob txha pob txha anterior cell cell thiab txhawb nws qhov sib txawv, uas yuav pab tsim cov pob txha pob txha pob txha.Nws tuaj yeem pom tau tias PRP tsis tsuas yog pab txhim kho cov pob txha mos thiab cov hlab ntsha hauv cheeb tsam thiab cov synthesis ntawm pob txha mos fiber ntau brackets, tab sis kuj txhawb nqa qhov adhesion thiab tsiv teb tsaws ntawm cov pob txha mos ntawm cov pob txha mos, thiab tom qab ntawd kho qhov kev puas tsuaj ntawm cov pob txha mos.
3) PRP kev tshawb fawb kev tshawb fawb ntawm ib nrab hli board kho
Qee cov kws tshawb fawb tau xaiv cov luav los ua kev sim, thiab tom qab lub hli ib nrab ntawm lub rooj tsavxwm tau ua rau hauv ob lub hauv caug, cov luav tau raug tua ntawm 4 lub lis piam thiab 8 lub lis piam, thiab lawv cov kev ua tau zoo tau soj ntsuam.Txoj kev tshawb no pom tias ntawm 4 lub lis piam, pawg tswj hwm ib nrab lub hli phaj yog tsim los ntawm cov ntaub so ntswg sib txuas, uas tuaj yeem ua rau pom tias mob hnyav heev;thiab PRP kev kho mob pab pawg ib nrab lub hli phaj qauv pom zoo, thiab cov ntaub so ntswg sib txuas tau pom tseeb kho.Lub koom haum muaj pes tsawg leeg.Thaum 8 lub lis piam, pawg tswj tau muaj cov ntaub so ntswg, thiab cov pob txha mos ntawm ib nrab hli phaj tsis tsim.Cov pab pawg kho mob PRP yog nplua nuj nyob rau hauv fiber ntau nyob rau hauv ib nrab hli phaj, uas tau nce ntau.Nyob rau tib lub sijhawm, ib nrab lub hli phaj cov ntaub so ntswg manifests nyob rau hauv nruab nrab fibrosis, thiab txawm ib nrab kho yog tam sim no.Lwm txoj kev tshawb fawb tau pom tias fibrin nyob rau hauv pre-processing PRP tuaj yeem tsim ib lub mesh stent uas muaj polystumin-hydroxylcetic acid pawg.Yog tias PRP yog centrifuged, thiab ib nrab lub hli pob txha mos chondrocyte tau ua ke los cog 7D rau hauv cov nas liab qab ntawm pawg sim, kev tshuaj xyuas fluorescent microscope: Cov pob txha mos tom qab cov noob qoob loo tuaj yeem sib npaug thiab sib kis thoob plaws hauv lub voj voog.Tom qab PRP raug kho, tus naj npawb ntawm cov pob txha pob txha tau nce ntau.Cov txiaj ntsig ntawm scanning electron microscopy qhia tau hais tias ntawm cov txheej txheem PRP brackets, cov pob txha pob txha tuaj yeem txuas nrog cov fiber ntau protein network tom qab 24H thiab 7D.Ntawm 16 kis ntawm kev ua haujlwm ntawm PRP bracket pawg nas, 6 kis tau zoo tag nrho, 9 kis tsis tiav, thiab 1 kis tsis kho, thaum pawg tswj hwm nas tsis kho.Nws tuaj yeem pom tau tias tom qab PRP tau ua tiav, tib neeg cov pob txha pob txha pob txha muaj lub peev xwm tshwj xeeb ntawm cov cell adhesion, uas tuaj yeem txhim kho lub peev xwm ntawm lub hli ib nrab.Kev tshawb fawb hauv vitro thiab hauv vitro, piv nrog cov pab pawg PRP gel yooj yim, PRP-osteoma matrix cell gel kho pab pawg muaj ntau dua qhov sib txawv.pob txha.Muaj cov kev tshawb fawb txog kev ua ke PRP ua ke ntawm Jackie Daping qauv ntawm cov pob txha mos luav, thiab ua kom cov pob txha mos tsis zoo hauv cheeb tsam passive txav.Cov txiaj ntsig ntawm immunohistochemistry thiab kev kuaj xyuas qhov tsis raug tau lees paub tias nws cov qhab nia kho cov ntaub so ntswg yog siab.Qhov tshwm sim qhia tau hais tias PRP ua lub luag haujlwm tseem ceeb hauv kev kho pob txha mos, thiab kev sib xyaw ua ke ntawm daim ntawv thov kev sib xyaw ua ke ntawm kev sib xyaw ua ke ntawm cov pob txha pob txha mesenchymal qia hlwb thiab cov khoom siv bracket zoo dua.
(Cov ntsiab lus ntawm tsab xov xwm no tau luam tawm dua, thiab peb tsis muab ib qho kev qhia lossis kev lees paub rau qhov raug, kev ntseeg tau lossis ua tiav ntawm cov ntsiab lus muaj nyob rau hauv tsab xov xwm no, thiab tsis muaj lub luag haujlwm rau cov kev xav ntawm tsab xov xwm no, thov nkag siab.)
Post lub sij hawm: May-11-2023