摘要目的 建立全层无血运区半月板缺损模型,观察人胰岛素样生长因子Ⅰ (human insulin-like growth factor Ⅰ,hIGF-Ⅰ)基因修饰骨髓间充质干细胞(bone-marrow mesenchymal stem cells,BMSCs)复合可注射藻酸钙凝胶修复半月板缺损的效果. 方法 制造成年山羊半月板前角无血运区全层缺损模型.实验分为四组,即基因增强组织工程(gene-enhanced tissue engineering,GETE)组(GETE组):用hIGF-Ⅰ基因转染的BMSCs复合可注射藻酸钙凝胶修复半月板缺损；BMSCs组:用BMSCs复合藻酸钙凝胶修复缺损；空载体组:用藻酸钙凝胶空载体修复缺损；对照组:缺损旷置,不做任何修复.术后4,8,16周时相点行大体观察；光镜、电镜观察修复组织变化；测定修复组织中蛋白聚糖含量. 结果 GETE组修复半月板缺损在4～ 16周效果逐渐改善,缺损完全被修复组织填充,色白质韧,结合紧密,与正常半月板组织相似,大体观察优于其他各组；光镜下可见细胞随凝胶纤维排列分布,载体纤维间隙大多为细胞分泌基质所充填,细胞排列密集,基质分布均匀；扫描电镜观察到纤维排列规整紧密,纤维间缝隙为致密的细胞外基质填充；修复组织中蛋白聚糖含量较高,但与正常半月板仍有差异. 结论 转染hIGF-Ⅰ基因的BMSCs复合可注射藻酸钙凝胶可改善全层半月板缺损的修复效果.

abstractsObjective To establish a model of full-thickness avascular meniscal defect to assess outcome of bone-marrow mesenchymal stem cells (BMSCs) modified with human insulin-like growth factor Ⅰ (hIGF-Ⅰ) gene and compounded with injectable calcium alginate gel in repair of meniscal defect.Methods Models of full-thickness defect were created in the anterior comer of meniscus in goats,an area lacking of blood supply.The trial categorized the models to four groups:gene-ehanced tissue engineering (GETE) group (hIGF-Ⅰ transfected BMSCs were mixed with calcium alginate gel),BMSCs group (BMSCs were mixed with calcium alginate gel),empty group (calcium alginate gel was used alone) and control group (the defect was excluded from repair).Macroscopy was done at 4,8,and 16 weeks after operation.Variation of repair tissue was observed by light and scanning electric microscopy and aggrecan in repair tissue was determined as well.Results Meniscal defect was on the mend at 4-16 weeks after operation in GETE group,with the defect area being thoroughly filled with the white,elastic and tight repair tissue similar to normal meniscal tissue.Macroscopic examination showed a better result in GETE group than that in other groups.Light microscopy showed that repair tissue which was mainly fibrochondrocytes was arranged in line with calcium alginate fibers and that space between the fibers was mostly crammed with the matrix secreted by those cells.At the same time,those cells were tightly arranged and the matrix secreted by those cells was equally distributed according to light microscopy.Electroscopy demonstrated neat and tight arrangement of fibers and tight extracellular matrix in fiber space in GETE group.Aggrecan concentration in GETE group was relatively higher than in other groups,but still had difference from the normal meniscus.Conclusion hIGF-Ⅰ gene-transfected BMSCs combined with injectable calcium alginate gel can improve the effect in repair of full-thickness meniscal defect.