以乳房再造为代表的大体积软组织缺损的修复是整形外科的最大挑战，经典的手术治疗难以摆脱"拆东墙补西墙"的质疑。定形状,定体积软组织预构的"终极完美方案" 能否实现？尽管组织工程技术对此提供了新思路，但迄今体积仍无法超越1ml。2003年Hofer提出了组织工程室技术的设想，提出：无需外源性种子细胞的植入，工程室内仍可能实现组织的自组装，这为定形状,定体积的工程化软组织预构提供了可能。本课题组应用该技术成功构建了带血管蒂的定形状,大体积的工程化脂肪瓣，并初步揭示了工程室内脂肪新生的动态变化规律，但脂肪再生过程中成脂化与血管化的动态调控机制目前尚不清楚。本研究拟采用细胞生物学技术、免疫荧光技术、骨髓移植、脂肪移植、组织学技术等，重点研究新生脂肪组织中各种细胞的来源及趋化诱导,增殖及分化的调控机制，深入探讨工程室内脂肪再生的诱导机制，为定形状,定体积的工程化软组织预构的实现提供理论及实验依据。

Repair of large volume soft tissue defect, especially breast reconstruction is the biggest challenge for plastic surgeon. Donor site morbidity is inevitable with surgery. Adipose tissue engineering offers a new solution for soft tissue defects．However，the size of engineered adipose tissue was restricted to less than 1 ml. Tissue engineering chamber technique successfully solve some disadvantages of traditional method, make the prefabrication of large volume neogenesis adipose tissue possible. Our group successfully reconstructed the pedicled large volume engineered adipose flap with needed shape using tissue engineering chamber technique . The adipose regeneration and neoadipogenesis pattern within the chamber was also observed. But the mechanisms is not clear. The following researches will focus on the sources, chemotaxis, proliferation and differentiation of immigrated cells using cytobiology, immunohistochemical/immunofluorescence, bone marrow transplantation, fat graft and histomorphology methods, explore the dynamic change of matrix elements, growth factors, chemotactic factors in self-assembly fibrin matrix, clarify interaction effect between adipogenesis and vascularization in neogenesis tissue and post-transplantation. This research is believed to be helpful for better understanding the reconstruction of engineered adipose tisuue with needed volume and shape.

尽管组织工程技术对大体积软组织缺损的修复提供了新思路，但迄今体积仍无法超越1ml，难以实现定形状、定体积软组织预构的"终极完美方案"。2003年Hofer提出了组织工程室技术的设想，提出：无需外源性种子细胞的植入，工程室内仍可能实现组织的自组装，这为定形状,定体积的工程化软组织预构提供了可能。本课题组应用该技术成功构建了带血管蒂的定形状,大体积的工程化脂肪瓣，并初步揭示了工程室内脂肪新生的动态变化规律，但脂肪再生过程中成脂化与血管化的动态调控机制目前尚不清楚。本课题组构建兔背部脂肪组织工程室自组装模型，检测其组织学变化及小室内细胞因子的表达，并检测脂肪组织再生的细胞来源。发现小室内渗出的胶冻样物质内含有大量炎症细胞且形成自组装细胞外基质，为随后成脂分化的细胞提供细胞支架，炎症细胞因子的表达增高，说明在早期通过趋化巨噬细胞和骨髓来源的祖细胞到小室内并成脂。深入探讨工程室内脂肪再生的诱导机制，为定形状,定体积的工程化软组织预构的实现提供理论及实验依据。