ABSTRACT
BACKGROUND: Anterior cervical discectomy and fusion has been considered the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine.However,fusion may result in progressive degeneration of the adjacent segments.Artificial disc replacement seems to be promising,segmental motion and stability are preserved while the spinal canal has been enlarged,and the intervertebral disc biological mechanics has been preserved,but not leads to progressive degeneration of the adjacent segments.OBJECTIVE: To observe the functional outcome and kinematics after the Prodisc artificial neck intervertebral disc replacement.METHODS: A total of 55 cases (69 intervertebral discs),29 males and 26 females,aged 48 (31-76) years were selected,including14 with bi-segmental injury.There were 32 cases of cervical spondylotic myelopathy,9 of cervical spondylotic radiculopathy,and 14 of mixed type cervical spondylosis.Prodisc artificial neck intervertebral disc replacement was performed using anterior or oblique incision.Prospective data JOA score and kinematic measures were collected before surgery and at 3,6,12,and 24 months after surgery.Range of motion was determined by independent radiologic assessment of flexion-extension radiographs.RESULTS AND CONCLUSION: The 55 patients were followed-up,including 41 undergoing single segmental disc replacement and 14 undergoing bi-segmental disc replacement.They were followed up for 22(56-48)months postoperatively.JOA scores displayed improved cervical function by 56%.Range of motion of sagittal and coronal planes were similar to those prior to operation compared with preoperatively(P = 0.45,0.74),and the range of motion and stability were maintained as adjacent segments.Results showed that the artificial disc replacement maintained range of motion of original intervertebral disc,accelerated patient recovery,and slightly affected adjacent intervertebral disc.
ABSTRACT
BACKGROUND: Animal tests verified that alcohol could cause lipid accumulation in femoral head, leading to osteonecrosis. Molecular biology tests verified that alcohol could induce differentiation of marrow stromal cells (MSCs) into adipocytes. If a drug can resist the differentiation of MSCs into adipocytes induced by alcohol, it can prevent and treat alcoholinduced osteonecrosis.OBJECTIVE: To observe the effects of inhibition of puerarin on differentiation of MSCs into adipocytes induced by alcohol from the aspect of cell biology.DESIGN: Randomized controlled experiment.SETTING: Department of Orthopaedics, First Affiliated Hospital,Zhengzhou University and Department of Biochemistry and Molecular Biology, Basic Medical College, Zhengzhou University.MATERIALS: The experiment was conducted at the Department of Biochemistry and Molecular Biology, Basic Medical College, Zhengzhou University from April 2000 to December 2002. A total of 50 clean healthy Kunming mice aged 6-8 weeks, of either sex, were selected. Bone marrow cells of the bilateral femur were obtained, with the inoculated density of 1.5×106/cm2, implanted into 6 wells and 24 wells cultured plate, randomized into groups, a well as a specimen and 24 specimens in each group.METHODS: MSCs were separated, cultured and assigned into 3 groups at random: model group (cells were treated with 0.09 mol/L alcohol), experimental group (0.09 mol/L alcohol and 0.01 mg/mL final concentration of puerarin) and controlled group (no alcohol and puerarin). Sudan Ⅲ staining was performed and adipose cells was counted under light microscope.Content of triacylglycerol, activity of alkaline phosphatase and content of osteocalcin in cell culture fluid were measured.MAIN OUTCOME MEASURES: ①Result of differentiation of MSCs into adipocytes in micé of the three groups, ②content of triacylglycerol in MSCs of mice of the three groups, ③activity of alkaline phosphatase in MSCs of mice of the three groups, ④content of osteocalcin in cell culture fluid in the three groups.RESULTS: ①After being disposed and cultured for 21 days, number of adipocytes in the experimental group and control group decreased markedly compared with the model group. The number of adipocytes in the model group was 8.9 times of that in the experimental group, and 15.6 times of that in the control group [(319.17±19.92), (35.92±23.77)(20.42±12.15)per cm2,P＜0.001]. ②After being disposed and cultured for 21 days, coutent of triacylglycerol in the experinental group and control group was remarkably lower than that in the model group [(4.15±1.92) and (3.42±1.60),(11.55±4.42) μgin a well, P ＜ 0.001]. ③After being disposed and cultured for 12 days, activity of alkaline phosphatase in the experimental group and control group was distinctly higher than that in the model group [(9.51±2.96),(11.18±3.11), (4.84±2.23) μkat/g,P ＜ 0.001]. ④After being disposed and cultured for 14 days, content of osteocalcin in the experimental group and control group was 2.2 times and 2.7 times of that in the model group, respectively, and the difference was very significant com pared with themodel group [(11.11±4.57),(13.43±5.29), (4.95±2.31) μg/g,P ＜ 0.001].CONCLUSION: Puerarin can inhibit the differentiation of MSCs into adipocytes induced by alcohol, and maintain the osteogenic differentiation,which may prevent the development of osteonecrosis.
ABSTRACT
Objective To observe and analyze therapeutic effects of internal fixation reconstruction with titanium plate for intra articular calcaneus fractures. Methods 48 patients (56 feet) with calcaneal fracture were treated with reconstruction titanium plate, under the monitoring of C shape X ray. The therapeutic effects were evaluated according to the Maryland foot score system. Results 48 patients were followed up for an average of 18 months. 36 feet achieved excellent results, 14 good, and 6 fair. The good and excellent rate was 89.3%. The length, height, width and Bhler angle of the calcaneus were well improved. Conclusion Open reduction and internal fixation with reconstruction titanium plate is a reliable measure to treat intra articular calcaneus fractures, as long as the surgeon has a good command of the anatomic structure of calcaneus, indication and right timing for the operation.