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Objective To investigate a therapeutic method which could provide sustained-release delivery and local longlasting anti-TB treatment after debridement of thoracic and lumbar spine tuberculosis.Methods Data of 18 patients (including 2 revised cases),who were diagnosed of thoracic and lumbar tuberculosis and required surgery treatment from October 2008 to January 2011 were retrospectively analyzed.There were 12 males and 6 females,with an average age of 48.7± 13.3 years (range,22 to 67 years).Affected spinal segments in these patients spanned from T8 to S1.fourteen patients were treated with posterior surgical procedure alone while the other 4 were treated with one-stage combined anterior-posterior surgery.Combined with autogenous bone,OSTEOSET RBK drug carrier-type artificial bone mixed with isoniazid and streptomycin was used after debridement.Chlinical parameters including clinical symptoms,laboratory results,and imaging data were evaluated during follow-up.Results Incisions of all patients achieved primary healing.The duration of patient follow-up ranged from 29 to 56 months (average,39.5months).No liver and kidney function abnormalities,ototoxicity,or local nerve irritations were found perioperatively.Improvements in clinical symptoms were observed in all patients.One patient with L2a tuberculosis recurred 18 months after the initial surgery.At 6-month follow-up,intervertebral body fusion was achieved without complications of internal fixation or significant angle loss of kyphosis correction.Conclusion OSTEOSET RBK dmg carrier-type artificial bone mixed with isoniazid,streptomycin for treatment of thoracic and lumbar spine tuberculosis is a safe and effective way to control local infection and recurrence.Combined with autologous bone could contribute to bone fusion.
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Objective To evaluate the effect of dorsal dual-plate fixation for unstable distal radius fractures.Methods Twenty-two cases of unstable distal radius fractures undergone dorsal fixation with a 2.4 mm plate from June 2010 to June 2012 were enrolled.There were 16 males and 6 females with mean age of 54.5 years (range,22-75 years).According to the AO fracture classification,there were 12 cases of type B2,6 type C1 and 4 type C2.Five cases had autologous or allogeneic bone grafting.Results Mean period of follow-up was 14 months (range,5-30 months).According to Gartland-Werley score,the result was excellent in 13 cases,good in 5 cases and fair in 4 cases,with the excellent and good rate of 82％.Volar inclination [(11.07 ± 1.77) °],ulnar declination [(22.30 ± 3.13) °],and radial height [(11.40 ±1.51) °] showed statistical differences from that [(-1.50 ± 7.59) °,(11.90 ± 3.87) °,and (5.20 ±1.55) ° respectively] before operation (P ＜ 0.05).Conclusions Dorsal dual-plate fixation can be a reliable and effective technique for AO-B2 shear fractures with intact volar-cortex and dorsal criticallycomminuted fractures of the distal radius.Active bone grafting should be performed for bone defection to promote bone healing.
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Objective To compare the efficiency of explants adherent after enzymatic pre-digestion and traditional typeⅡ?collagenase digestion methods for culturing human nucleus pulposus cells from degenerated intervertebral discs.Methods Human nucleus pulposus tissues collected from patients'degenerated intervertebral discs were divided into Groups A and B.In Group A,the nucleus pulposus tissues were cultured using explants adherent method directly after 0.025 ％ typeⅡ?collagenase digestion for 30 minutes.In Group B,the tissues were firstly digested with 0.025 ％ typeⅡ?collagenase for five hours,and then underwent filtration,centrifugation and inoculation successively Success rate and primary cell fusion time of the two culture methods were compared.Cell morphology and expressions of sex determining region Y-box 9(Sox-9),collagenⅡ?and aggrecan were observed by HE staining,toluidine blue staining and immunofluorescence cell staining.Results There was no significant difference in the successful culture rate between the two groups(P＞0.05).However,the average fusion time of primary passage in Group A was significantly shorter than that in Group B(P＜0.01).In Group A,the nucleus pulposus cells could be stained as azure by toluidine blue and immunofluorescence cell staining showed positive expressions of Sox-9,collagenⅡ?and aggrecan.Conclusions Compared with traditional typeⅡ?collagenase digestion,explants adherent method after typeⅡ?collagenase pre-digestion for the culture of human nucleus pulposus cells from degenerative intervertebral discs has a high success rate and obtains a large number of cells in a short time.Meanwhile,the cells have strong expressions of Sox-9,collagenⅡ?and aggrecan.
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Objective To evaluate clinical effect of accurate pedicle subtraction osteotomy (PSO) using osteotomes in the treatment of thoracolumbar kyphosis (TLK).Methods From June 2007 to October 2010,18 patients with TLK underwent accurate PSO using osteotomes under X-ray fluoroscopy,including 13 males and 5 females,with an average age of 48.6 years.The primary causes of TLK included old fracture (11cases),chronic tuberculosis (4 cases) and hemivertebra (3 cases).Deformity apex occurred at T12 (5 cases),L1 (9 cases),and L2 (4 cases).Radiological assessment for sagittal balance was performed by measuring Cobb angle.The Frankel grade,visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pre-and post-operative neurological status,back pain and function.Results The mean operative time,mean blood loss and mean postoperative drainage volume were 247.0±29.3 minutes,708.5±34.5 ml and 337.3±74.6 ml,respectively.All patients were followed up for 1 to 4.5 years (average,2.8 years).Solid fusion was achieved in all patients.Cobb angle was corrected from preoperative 42.3°±5.7° to 2.2°±1.9° three months postoperatively and 2.7°±2.1 ° at final follow-up.VAS and ODI scores decreased from preoperative 8.5±1.0 and 72.8％±8.3％ to 2.1±0.7 and 21.6％±9.2％ three months postoperatively,and 1.9±0.6 and 19.3％±8.6％ at final follow-up,respectively.With regard to Frankel grade,a 1-grade and 2-grade improvement was observed in 7 cases and 2 cases 3 months postoperatively,respectively.At final follow-up,a 1-grade and 2-grade improvement was observed in 5 cases and 4 cases,respectively.Two patients had transient neurological symptoms postoperatively,which recovered after drug treatment for 2 weeks.No other complications occurred.Conclusion It is safe and effective to correct TLK through accurate PSO using osteotomes,which has some advantages,such as less blood loss,higher fusion rate and fewer complications.
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Objective To transduct with human telomerase reverse transcriptase(hTERT) to Schwann cells via electransfection technique to prolong the life span and enhance the proliferative capacity of Schwann cells.Methods The hTERT RNA was derived from esophagus cancer tissue and pcDNA3.1-hTERT vector was built.With electransfection technique, we tmnsfected vector into ADSCs.The PCR,TRAP-PCR, and PI-annexin V were tested to prove the expression of hTERT in ADSCs.Results After transduction the hTERT RNA in Schwann ceils, TRAP-PCR test, PI-annexin V dying and S100 dying was positive.Conclusion Telomerase catalytic subunit(hTERT) is transduct into Schwann cells, and it can to enhance the prolifertative capacity.