ABSTRACT
Objective:To identify the incidence and risk factors related to lumbodorsal fasciitis in acute osteoporotic vertebral compression fractures (OVCF).Methods:The clinical data of 1182 acute OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 219 males and 963 females, aged 72.19±9.39 years (range, 45-98 years). The demographics, comorbidity profile, spine trauma, back pain duration, and vertebral fracture number of the OVCF with or without lumbodorsal fasciitis were summarized and compared. The independent risk factors of lumbodorsal fasciitis were identified by binary logistic regression analysis.Results:There were 532 cases of OVCF complicated with lumbodorsal fasciitis among 1,182 patients, and the incidence was 45.01%. The OVCF with fasciitis had higher ratio of males (23.5%, 125/532) than the OVCF without (14.5%, 94/650) fasciitis (χ 2=15.82, P<0.001). The OVCF with fasciitis were aged 74.57±9.21 years and significantly older than the OVCF (aged 70.24±9.60 years) without fasciitis ( t=7.85, P<0.001). The highest proportion of patients with OVCF combined with fasciitis was ≥80 years old (36.1%, 192/532), while most (34.6%, 225/650) of the OVCF without fasciitis were aged 60-70 years (χ 2=56.27, P<0.001). The OVCF with fasciitis had higher ratio of no evident spine trauma (37.0%, 197/532) and multiple vertebral fractures involving ≥3 vertebra (10.5%, 56/532) than the OVCF without fasciitis [26.3% (171/650), 3.2% (21/650); χ 2=17.67, P<0.001; χ 2=40.63, P<0.001]. The ratio of pre-hospital back pain >4 weeks was higher in the OVCF with (20.7%, 110/532) than without (7.4%, 48/650) fasciitis (χ 2=62.46, P<0.001). The OVCF with fasciitis had higher comorbidity of hypertension (52.8%, 281/532), coronary heart disease (14.7%, 78/532), and cerebral infarction (24.8%, 132/532) than the OVCF without fasciitis [42.8% (278/650), 9.9% (64/650), 17.9% (116/650); χ 2=11.85, P<0.001; χ 2=6.42, P=0.011; χ 2=8.56, P=0.003]. The OVCF with fasciitis had higher ratio of two comorbidities (23.7%, 126/532) than the OVCF without fasciitis (16.1%, 105/650) (χ 2=21.15, P<0.001). Binary logistic regression analysis showed significantly higher risk of lumbodorsal fasciitis in males than in females ( OR=1.69, P=0.001), in age group 60-<70、70-<80 and ≥80 years than in <60 years ( OR=2.28, P=0.002; OR=2.64, P<0.001; OR=4.90, P<0.001), in back pain for 2-<4 weeks and >4 weeks than in ≤1 week ( OR=1.70, P=0.005; OR=3.81, P<0.001), and in multiple fractures involving 2 and ≥3 vertebra than in single vertebrae ( OR=1.75, P=0.003; OR=3.36, P<0.001). Conclusion:Up to 45% of acute OVCF have concurrent lumbodorsal fasciitis. Male, aged ≥60 years, pre-hospital back pain ≥2 weeks, and fractures in ≥2 vertebra are independent risk factors of lumbodorsal fasciitis in OVCF.
ABSTRACT
Objective:To identify the anatomical distribution of and factors related to single-segment osteoporotic vertebral compression fractures (OVCF).Methods:The radiology and clinical data of 944 patients with single-segment OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 175 males and 769 females, aged 72.1±9.6 years (range, 45-97 years). The anatomical distribution of OVCF was quantified. The demographics, comorbidity profile, spine trauma, back pain duration, vertebral compression degree, and bone mineral density of the OVCF patients in different anatomical segments were summarized and compared.Results:Of the 944 single-segment OVCF, 864 were located in the lower thoracic and lumbar spine that peaked at L 1 (Modal-1 group), and 80 were located in the middle and upper thoracic spine (Modal-2 group) that peaked at T 7, demonstrating an asymmetric bimodal distribution. The difference in the female/male ratio between the two groups was insignificant (χ 2=0.06, P=0.803). Patients in Modal-2 were aged 75.0±9.8 years and on average older than the patients (aged 71.8±9.6 years) in Modal-1 ( t=2.78, P=0.005). The female patients in Modal-2 (aged 75.0±9.6 years) were significantly older than that (aged 71.2±9.3 years) in Modal-1 ( t=3.17, P=0.002). The ratio of back pain duration for <1 week in Modal-2 (43.8%) was lower than that in Modal-1 (60.2%), and the ratio of back pain for 1-weeks (28.8%) was significantly higher than that (15.5%) in Modal-1 (χ 2=11.50, P=0.009). The most frequently reported spine traumas in Modal-2 (50.0%) were heavy lifting injury, lumbar sprain, and strenuous cough, which were significantly different from and less apparent than the fall on ground or crush injury to the spine (64.1%) in Modal-1 (χ 2=60.71, P<0.001). The anterior to posterior height ratio of the fractured vertebrae in Modal-2 was 0.78±0.13, 0.83±0.14, 0.84±0.13, and 0.78±0.18 in the OVCF patients complaining of back pain for <1 week, 1-weeks, 2-weeks, and >4 weeks respectively, showing no significant difference between groups ( F=1.01, P=0.009). In Modal-1, the anterior to posterior height ratio of the fractured vertebrae was lower in the OVCF patients complaining of back pain for 2-weeks (0.80±0.15) and >4 weeks (0.77±0.19) than in those with back pain for <1 week (0.85±0.11) and 1-weeks (0.86±0.14), with sinificant differences ( P<0.05). 32.4% (306/944) of the OVCF patients had one of the following geriatric comorbidities: hypertension, diabetes mellitus, coronary heart disease, cerebral infarction, and chronic obstructive pulmonary disease. The OVCF patients in Model-2 had higher comorbidity of coronary heart disease (21.3%) and cerebral infarction (36.3%) than those in Model-1 (11.6% and 20.3%). Bone mineral density information was available from 371 patients (308 females). In the age groups of <70, 70-, and >80 years, no significant difference was detected in the T-score values of the lumbar spine or hip joint between the OVCF patients in Model-1 and Model-2 ( F=0.13, P=0.880; F=0.62, P=0.538). Conclusion:Single-segment OVCF feature an asymmetric bimodal distribution that is demarcated by the T 10 vertebrae. The distribution pattern is not determined by gender or baseline bone mineral density but highlights the risk of mechanical stress and vertebral fragility within a specific segment. OVCF in the middle and upper thoracic spine is less frequent but common in older patients with higher comorbidity of coronary heart disease and cerebral infarction, which tend to be caused by less apparent spine trauma and maintain vertebral compression but complain of long back pain duration.
ABSTRACT
Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.
ABSTRACT
Objective:To compare the outcomes of arthroscopic rotator cuff repair in patients with or without stiffness.Methods:Retrospective analysis was performed on the data of 20 patients (stiffness group) who underwent arthroscopic rotator cuff repair combined with capsular release from January 2017 to November 2019. There are 9 males and 11 females, age 62.2±8.7 years old (range 45 to 80 years old), preoperative duration 5.2±4.3 months (range 1 to 12 months). 54 patients who underwent arthroscopic rotator cuff repair without stiffness were used as the control group. There were 16 males and 38 females, aged 60.9±9.1 years old (range 46 to 81 years old), preoperative duration 8.2±13.0 months (range 1 to 60 months). Pain, function and range of motion (ROM) were recorded at 1 month, 3 months, 6 months post-operatively and last follow-up, and compared with that of pre-operatively. Satisfaction and complication were recorded at the last follow-up. The main outcome measurements included the visual analogue scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles shoulder rating scale (UCLA), Constant-Murley score, and range of motion.Results:The mean follow-up period was 19.7±4.6 months (12-30 months) in the stiffness group, and 18.6±4.4 months (12-29 months) in non-stiffness group. VAS, ASES score, UCLA score, Constant-Murley score and ROM were significantly improved post-operatively. One month post-operatively, the VAS score was 4.2±1.5 in stiffness group, and 3.4±1.1 in the non-stiff group, and the difference was statistically significant between two groups ( t=2.381, P=0.020). There was no significant difference at 3 months post-operatively. The ASES score, UCLA score and Constant-Murley score were 52.3±10.2, 17.8±4.2 and 51.7±9.7 in stiffness group at 3 months post-operatively, and 57.4±7.4, 21.6±3.8, 63.2±13.5 in non-stiffness group, respectively. The difference was statistically significant ( t=2.363, P=0.021; t=3.713, P<0.001; t=3.484, P<0.001). There was no significant difference at 6 months post-operatively. The postoperative satisfaction of stiffness group and the non-stiffness group were 95.0% and 96.3%, respectively. The difference was not statistically significant ( χ2=0.2511, P=0.802). Conclusion:The results of stiffness group are statistically the same as those in non-stiffness group at last follow-up, although the recovery period is longer in patients who combined with stiffness at the first 6 months.
ABSTRACT
Objective:To observe the effect of Lafosse I subscapularis lesion repair on the reconstruction of anterosuperior rotator cufftear.Methods:A retrospective analysis was performed on patients who underwent surgical treatment of the supraspinatus torn combined with Lafosse I subscapularis lesion from January 2016 to October 2017. It was divided into two groups according to the subscapularis lesion was repaired or not. There were 16 cases in non-repaired group, 7 males and 9 females, aged from 48 to 75 years (average, 59.3 years). In this group, supraspinatus repair and subscapularis debridement with no repair were done. There were 13 cases in repaired group, 5 males and 8 females, aged from 45 to 72 years (average, 57.2 years). In this group, both supraspinatus and subscapularis were repaired. MRI was performed at last follow-up. The pain analogue scale (VAS), American Shoulder & Elbow Surgeons (ASES) score, Constant-Murley score and range of motion (ROM) were recorded at the last follow-up. Patients' satisfaction was recorded.Results:Twenty-nine patients had been followed up. Patients in non-repaired group were followed up 15.9±3.9 months (range 10-22 months), and patients in repaired group were followed up 16.9±3.4 months (range 10-21 months). At the last follow-up, VAS, ASES score, and Constant-Murley score of non-repaired group were 1.1±1.1, 88.4±4.0 and 85.9±3.2 respectively. VAS, ASES score, and Constant-Murley score of repaired group were 0.9±1.1, 89.6±2.9 and 87.5±2.6 respectively. VAS ( t=0.342, P=0.735), ASES score ( t=-0.941, P=0.355) and Constant-Murley score ( t=-1.392, P=0.175) showed no significant difference between non-repaired group and repaired group. At the last follow-up, forward flexion of affected shoulder in non-repaired group was 150.3°±17.3°, external rotation was 41.6°±16.0°, and internal rotation was L 2 level; Forward flexion in repaired group was 148.1°±16.3°, external rotation was 43.9°±9.2°, and internal rotation was L 1 level, which were improved significantly compared with those pre-operation. Forward flexion, external rotation, and internal rotation showed no statistically significant difference between non-repaired group and repaired group. 3 patients were found to have rotator cuff re-tear by MR examination. The re-tear rate was 10.34% (3/29). There were 2 cases in non-repaired group and 1 case in repaired group. At the last follow-up, the ASES score of re-tear patients was 85.3±3.1, which was better than preoperative 41.0±5.2 ( t=12.74, P<0.001). Forward flexion 131.67°±5.8° was better than preoperative 81.7°±11.5° ( t=6.708, P<0.001). One re-tear patient (in non-repaired group) received reoperation and got pain relief. The satisfaction of non-repaired group and repaired group were 93.7% and 92.3%, respectively. Conclusion:For type I subscapularis lesion combined with supraspinatus injury, wheter type I subscapularis lesion was repaired or notdidn't affect the repair effect of the anterosuperior rotator cuff tear in short-term follow-up.
ABSTRACT
Objective:To evaluate the prognostic effects of gradient boosting machine (GBM) model on the short-term effects of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation.Methods:Clinical data and outcomes of 475 patients who underwent PELD surgery for single-segment lumbar disc herniation from October 2016 to March 2018 were retrospectively collected. The lumbar JOA score was used as a reference for the evaluation of curative effects. The improvement rate ≥50% was considered as good curative effects, while <50% was considered as poor curative effects. GBM model and multivariate Logistic regression model were utilized to screen out the influencing factors of the short-term clinical effects of PELD. Prognostic models were established, receiver operating characteristic (ROC) curves were drawn and compared. Sensitivity, specificity and Youden index were compared to evaluate the predictive performance of GBM model.Results:A total of 395 patients were followed up effectively for 24 months. There were 347 patients (87.8%) with good curative effects. However, forty-eight patients (12.2%) had poor curative effects. There were statistically differences in the lumbar JOA score improvement rates between the groups in regards to age, location and type of herniated disc, degeneration level of intervertebral disc and facet joint in surgical segment, sagittal diameter of the protrusion and whether or not there was calcification, onset time to the surgery time period and degeneration level of intervertebral disc in adjacent segment ( P<0.05). The results of multivariate analysis showed that patients with age ≥60 [ OR=9.15, 95% CI(4.04, 20.73), P<0.001] and with larger sagittal diameter of the protrusion [ OR=1.37, 95% CI(1.18, 1.58), P<0.001] were more likely to have a poor prognosis. Patients with unilateral disc herniation had a better prognosis than the extreme lateral type [ OR=0.17, 95% CI(0.06, 0.55), P=0.003]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in surgical segment were worse than those with grade Ⅱ [ OR=0.17, 95% CI(0.04, 0.70), P=0.014]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in adjacent segment were worse than those with grade Ⅱ [ OR=0.29, 95% CI(0.10, 0.81), P=0.018]. The AUC predicted by GBM model was 0.92 [95% CI(0.77, 0.96)] with 93.46% sensitivity, 83.33% specificity and 0.77 Youden index. The above parameters were higher than those by the Logistic regression model. The predictive effects of the two models were both statistically significant ( P<0.001). The AUC values of the two models were also statistically significant ( Z=0.11, P<0.001). Conclusion:GBM model is better than multivariate logistic regression analysis model in predicting the short-term clinical effects of PELD in treating lumbar disc herniation.
ABSTRACT
[Summary] Lumbar disc herniation is rare in juveniles , which makes it more difficult to diagnose and treat .The prevalence , causes and risk factors , pathological changes , clinical characteristics , main treatment methods , and curative effects of lumbar disc herniation in juveniles were summarized in this review , for benefiting clinical diagnosis and treatment .
ABSTRACT
Objective To evaluate the midterm efficacy of prosthetic disc nucleus ( PDN) replacement for the treatment of lumbar disc herniation. Methods Twenty cases of lumbar disc herniation( including one case of recurrent lumbar disc herniation) were treated with PDN. The twenty cases were followed-up 5.4 ～6.2 years( mean 5.7 years). Functional,and radiographic follow-up examinations,MRI and follow-up records of all patients were reviewed carefully. Results Clinical evaluation at the end of follow-up,there were 10 cases in excellent,6 cases in good,2 cases in fair and 2 cases in poor,and good rate was 80%. One patient accepted the revision operation to remove the PDN because of device migration. One patient accepted the fusion because of adjacent segment disease. The others experienced pain relief, and resumed their normal life and work. The average Oswestry score and VAS get better significantly. Conclusion The PDN was effective in treating patients with lumbar disc herniation. However, the medium term complications of device subsidence should be taken seriously.
ABSTRACT
In the span of the interactions between cells and biomaterials, cell adhesion is the first biological behavior which has important effects on the following biological behaviors including cell migration, proliferation, and differentiation. So how to improve cell adhesion of biomaterials has become an important subject of tissue engi- neering. One of the popular methods is the surface modification of biomaterials. This article reviews the development of the research on the surface modification of biomaterials for improving cell adhesion.
ABSTRACT
BACKGROUND: The diversity of purification procedures resulting in various purities of olfactory ensheathing cells (OECs) used for grafting is considered to be relevant in the effectiveness of OECs transplant. It is important to develop a well-defined method which produces OECs of great purity and is easy to unify for the future standardization of research involving OECs.OBJECTIVE: To establish a method being easy to unify for purifying OECs to acquire highly and uniformly enriched population of OECs for standardized studies on cell transplantation.DESIGN: Randomized and controlled experiment.SETTING: Department of Orthopaedics, Affiliated Zhongda Hospital of Southeast University School of Clinical Medicine;Central Laboratory of Southeast University School of Clinical Medicine; Experimental Animal Center of Southeast University School of Clinical Medicine.MATERIALS: This experiment was carried out in the Central Laboratory of Southeast University School of Clinical Medicine from February to August 2006. Twenty-eight adult female SD rats weighing 200-250 g were selected in this study. The main reagents were detailed as follows: DMEM/F-12 (GIBCO); 2.5 g/L trypsin (GIBCO); poly-L-lysine (SIGMA); bovine pituitary extract (BPE, SIGMA); fetal bovine serum (FBS, Sijiqing Biological Agent Co., Ltd., Hangzhou);rabbit anti-low-affinity nerve growth factor receptor (anti-P75, SIGMA); biotinylated goat anti-rabbit IgG (Boster Bioengineering Co., Ltd., Wuhan); methyl thiazolyl tetrazolium (MTT) kit (SIGMA).METHODS: Primary cultures of OECs were separated from adult SD rats olfactory bulbs. At day 8 in vitro, the primary cultures were divided randomly into 4 groups, namely differential adhesion method group, immunoadsorption method group,the modified method group,and control group.①The cell suspension in the modified method group was seeded into uncoated flasks and incubated at 37 ℃ in 0.05 volume fraction of CO2 for 1 hours. The supematants were seeded into flasks that had been prepared as follows. The bottoms of these flasks were moistened with anti-P7s (1 mg/L) and were made to dry at 37 ℃, and then they were washed one time with DMEM/F-12. The supernatants were incubated on the anti-p75-treated flasks for 45 minutes at 37 ℃, 0.05 volume fraction of CO2. For removing unbound cells, the flasks were washed five times with DMEM/F-12. The bound cells were detached from the flasks with a cell scraper, centrifuged,and resuspended in D/F-10S with 105 U/L penicillin/streptomycin and 20 mg/L BPE. The cell suspension in differential anchoring method group or immunoadsorption method group was purified as previously described by Nash or Ramo'n-Cueto respectively. Three groups of cell suspensions resulted from the above three methods were seeded respectively onto poly-L-lysine-coated 24-well cell culture chambers and incubated for 14 days at 37 ℃ in 0.05 volume fraction of CO2. Without purification, the cell suspension in control group was also resuspended in D/F-10S with 105 U/L penicillin/streptomycin and 20 mg/L BPE and seeded onto poly-L-lysine-coated 24-well cell culture chambers and incubated under the same culture condition as the other groups.②Purity comparisons for the four groups were made at 2, 5, 8, 10, 12 and 14 days after the end of their respective manipulation to evaluate the effectiveness of the modified method. At per time point in each of the four groups, fifteen visual fields of cultures were selected randomly to count the At the day of 14, viabilities of OECs in the four groups were assessed by MTT assays.MAIN OUTCOME MEASURES: OECs purities at per time point and viabilities of OECs at the day of 14 in each of the four groups after the end of their respective manipulation.RESULTS:① The purities of OECs in the modified method group at each time point were greater (P＜0.05-0.01) than counterparts in the other three groups. OECs purities decreased with culture prolongation in all groups, but the changes of purities over the whole period of observation in the modified method group were the least. The last purities of OECs yielded from the modified method were still extremely great (92.1±1.2)%, whereas the parallels in the others were no more than (85.2±2.2)%.② There was no significant difference in viabilities of OECs between the modified method group and any of the others at the day of 14 (P=0.895).CONCLUSION: The modified method for purifying OECs from the adult rat olfactory bulb is highly effective without extra impairment on the viability of OECs and will be beneficial to the future standardization of research involving OECs.
ABSTRACT
[Objective]To study the mechanism of posterior longitudinal ligament in cervical spine through measuring the collagen and Proteoglycan and Calcium changes.[Method]Fifteen specimens of cervical longitudinal ligament from cervical spondylotic myelopathy(CSM)and ten control specimens from corpses without cervical spondylosis were obtained.The content of the collagen was measured by Weossner method.Collagen type Ⅰ and Ⅱ were measured by Enzyme-Linked Immunosorbentassay(ELISA)method.Phloroglucinol spectrophotometer to determine the change of amount of Proteoglycan.The Calcium by Methyl-Thymes-Blue(MTB)Colorimetric Method.The specimens were treated hy Hematoxylin and Eosin(HE)stain method and by Masson stain method,the pathological changes of two groups were observed through microscopy.[Result]In CSM,as compared to the control groups,there showed a decrease in the contents of the total Collagen,Collagen type Ⅰ and Proteoglycan,and increase in the content of collagen type Ⅱ.The rate of type Ⅰ/Ⅱ in CSM was lower than that in control groups.An increase in the content of the Calcium.All of which have statistic significance(P
ABSTRACT
[Objective]To evaluate short term clinic results of prosthetic disc nucleus(PDN)replacement for the treatment of lumbar disc herniation.[Method]Twenty cases of lumbar disc herniation(including one case of recurrent lumbar disc herniation)were treated with PDN from June 2003 to November 2003,including 13 males and 7 females with average age of 40.5 years.All cases were implanted with a single PDN,in which 7 cases with PR725,8 cases with PW725,and 5 cases with PDN-SOLO-7 respectively.[Result]After surgery,one patient accepted the revision operation to remove the PDN because of device migration,the others experienced pain relief.The nineteen cases were followed-up for 23～29 months(mean 26.4 months).Compared with preoperative height of intervertebral disc,it gained increase of 17.2%(P
ABSTRACT
[Objective]To evaluate whether transplanted marrow mesenchymal stem cells interfered in TGF-?1 can differentiate to nucleus pulposus cells and increase the amount of proteoglycan and collagenase Ⅱ content in intervertebral discs.[Method]We used an in vivo model to investigate the feasibility of marrow mesenchymal stem cells that cultured in vitro and interfered in TGF-?1 delivery,retention,and survival in the degeneratived disc space.In 2,4,6,8 weeks we used immunohistochemical staining to determine the change of collagenase Ⅱ content;spectrophotometry to determine the change of amount of proteoglycan with Phlorglucinol;the experiment date were analyzed by SPSS 11.5 soft ware.[Result]We found MSCs could maintain viability and proliferate within the rabbit inter vertebral disc.The amount of proteoglycan and collagen Type Ⅱ content of the intervertebral in matrix synthesis in the experiment group was increased in 8 weeks.We found no changes in the modle group.[Conclusion]Our data suggest that transplanted marrow mesenchymal stem cells in vivo can survive and increase proteoglycan and collagen Type Ⅱ amount interfered in TGF-?1 in some periods,which support its potential use as a treatment of intervertebral disc degeneration.
ABSTRACT
The original articles in recent years about solitary plasmacytomas of bone(SPB) were reviewed in terms of etiopathogenisis,diagnosis,therapy plan and prognosis.SPB is a rare tumor characterized by the uncontrolled proliferation of plasmocytes.After it is diagnosed by local biopsy and further immunocytochemistry test,the wide excision or thorough curettage in corporation with radiotherapy is the choice of treatment.The primary tumor size,the content and lasting time of M proteins or local recurrence evidence after properly treated are all closely correlated with SPB prognosis.SPB is a rare tumor with a tendency to grow into multiple myeloma.The correct diagnosis and treatmert in time and long-term fellow up are vital factors for prognosis.
ABSTRACT
[Objective]To evaluate the effect of bone mesenchymal stem cells(BMSCs) on healing of tendon-bone junction in a bone tunnel and to provide experimental evidence of labeling and tracing the stem cell.[Method]BMSCs from rats were harvested by adherent separation screening method and labeled by SPIO and DiI.Thirty-nine 8-week-old rats were randomly divided into two groups,21 rats injected with double-labeled BMSCs and Pluronic F-127 as experimental group and 18 rats injected with Pluronic F-127 alone as control group.In each group,biomechanical analysis was carried out to assess the effect of healing at 2,4 and 8 weeks.The transplanted BMSCs were traced by fluorescence microscope at 2,4,8 weeks and 7.0T MR instantly,3 and 7days after operation.[Result]BMSCs were labeled effectively by SPIO and DiI.DiI-labeled positive cells were observed between tendon and bone with fluorescence microscope at 2,4 and 8 weeks.No significant signal changes of tendon-bone interface could be observed by 7.0 T MR.Biomechanically,maximum pullout load had no statistical difference between experimental group and control group at 2 weeks.At 4 and 8 weeks,the experimental group had significantly higher maximum pullout load compared with control group(P
ABSTRACT
[Objective]To establish an in vitro two-dimensional culture model of degenerated nucleus pulposus and detect samples' cell cycle by flow cytometry to study why nucleus pulposus cells don't grow well after passage. [Method]Nucleus pulposus tissues taken from protruded discs of 24 patients were treated by Trypsin and collagenase after surgical procedures,and then the cells were cultured in DMEM/F12 medium.Cell morphology was observed by an invert microscope and cell cycle of the primary and P2 cells were detected by flow cytometry after proliferation in monolayer culture.[Result]1.Primary culture cells of nucleus pulposus grew well in the medium,and 90% cells adhere to layer after about 7d.2.The rate of apoptosis of NP: primary(38.10?11.7)%,P2(44.74?17.6)%.The rate of S period : primary(7.88?2.1%),P2(2.76?0.7)%.[Conclusion]When going down to posterity the cells' apoptosis rate grows while S period cells decrease.
ABSTRACT
[Objective]To study the biocompatibility and security of the recombinant human bone morphogenetic protein-2(rhBMP-2) loaded amorphous calcium phosphate(ACP) delayed release nano-sized material and investigate the feasibility of the clinical use as a kind of bone substitute in bone engineering.[Method]The in vitro hemolyzation,cytotoxicity,microkernel test in marrow smear,acute systemic toxicity,pyrogenicity,subcuticular stimulation reaction and short-term intramuscular implantation,as well as endosseous implantation were performed on the rhBMP-2/ACP delayed release nano-sized material.[Result]The material-extracted liquid induced no hemolyzation,no toxic effects of genetic,no pyrogenic reaction in rabbits,no cytotoxicity cultured in rabbit bone marrow-derived mesenchymal stem cells(BMSCs) in vitro and no acute toxicity in mice.The intramuscular implantation and endosseous implantation in rabbits induced no inflammatory reaction,tissue necrosis and the material was degraded gradually,fused organically with tissues.[Conclusion]The biocompatibility and security of the rhBMP-2/ACP delayed release nano-sized material could meet the requirements given in biological standards for implanted biomaterials ISO10993 and GB/T16886,suggesting that it could be a good bone substitution for the clinical trial.
ABSTRACT
[Objective]To investigate the effects of lysophosphatidic acid(LPA) on the morphology,proliferation and brain-derived neurotropic factor(BDNF) expression of olfactory ensheathing cells(OECs) in vitro.[Method]Primary cultures of OECs separated from adult rat olfactory bulbs were purified and cultured.Five experimental cultures were grown for a period of time in media with LPA at different concentrations,namely 1,5,10,20 and 50 ?mol/L,and the control culture was grown in the medium without LPA.Immunofluorescent staining was used to identify OECs and to observe their morphological changes.The proliferation of OECs was measured by MTT assay.Western blotting was used to detect the protein expression of BDNF.[Result]Exposure to LPA in medium induced the switch in the dominant morphology of OECs from process-bearing to flat morphology.This shift in morphology was reversed when LPA was removed from media.LPA at concentrations from 1 ?mol/L to 50 ?mol/L enhanced OECs proliferation,especially at the concentration of 10 ?m/L.Proliferation of OECs in all experimental cultures reached their respective significant peaks after 60 h of LPA treatment.There were significant upregulations in BDNF expression of OECs treated with LPA(1~50 ?m/L) compared with those in the control culture.[Conclusion]A reversible change from process-bearing to flat in morphology of OECs can be induced by LPA.LPA stimulates OECs proliferation in a time-and concentration-dependent manner.LPA upregulates BDNF expression of OECs.
ABSTRACT
[Objeetive] To develop the recombinant human bone morphogenetic protein-2(rhBMP-2)loaded amorphous calcium phosphate(ACP)delayed release nano-sized material,investigate its cytotoxicity of cell,and provide a reference for the experiment of composite material in vivo.[Method]The rhBMP-2/ACP delayed release nano-sized material were prepared by chemical wet method and cultured on rabbit bone marrow-derived mesenchymal stem cells(BMSCs)in vitro.Then the adhesion,proliferation,growth and functional expression of BMSCs were measured.[Result]Cytotoxicity test demonstrated that rhBMP-2/ACP delayed release nano-sized material had not affect the percentage of cell's proliferation with material-extracted liquid cultured with BMSCs and the cytotoxicity was graded zero.The adhesion,proliferation,configuration of the cells on the surface of this material were identical to the control group.[Conclusion]It was suggested that rhBMP-2/ACP delayed release nano-sized material might have good cellular biocompatibility,no cytotoxicity and not effected the normal functional expression of BMSCs in vitro.
ABSTRACT
Objective To explore clinical results of posterior spinal approach microendoscopic disectomy(MED) for the treatment of lumbar disc herniation in adolescents.Methods A total of 25 consecutive patients treated by MED from February 2000 to August 2004 in this hospital were analyzed retrospectively.Clinical results were assessed with the modified Macnab criterion.Pre-and post-operative symptoms and functional states were evaluated by the Chinese version Oswestry Disability Index(ODI).Results A conversion to open procedure was required in 1 patient.The operating time was 35～65 minutes(mean,44.8?9.0 minutes);the estimated blood loss during operation was 30～80 ml(mean,51.3?14.6 ml);the postoperative hospital stay was 6～10 days(mean,7.5?1.0 days).All incisions healed by first intention.There were no dural tears,nerve root injuries,intervertebral space infections,or great vessel injuries.Twentg-two patients were followed for 7～57 months(mean,33.4?17.8 months).There were significant differences between preoperative ODI(46.2%?8.5%) and postoperative ODI(1.8%?3.0%).The improvement rate of ODI was 44.4%?9.2%(t=21.61,P=0.00).Clinical results assessment by the modified Macnab criterion revealed "excellent" in 19 patients and "good" in 3 patients,the rate of excellent or good results being 100%. Conclusions Microendoscopic disectomy can be performed safely and effectively for lumbar disc herniation in adolescents,resulting in little trauma,fast recovery,and excellent clinical results.