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Objective:To evaluate the clinical efficacy of modified all-arthroscopic reconstruction of medial patella femoral ligament (MPFL) for the treatment of recurrent patellar dislocation.Methods:A retrospective case series study was conducted to analyze the clinical data of 38 patients (46 knees) with recurrent patellar dislocation, who were treated at First Affiliated Hospital of Shenzhen University from January 2017 to January 2020. The patients included 12 males (12 knees) and 26 females (34 knees), aged 14-40 years [(24.6±5.4)years]. All patients underwent the modified all-arthroscopic MPFL reconstruction procedure. The femoral tunnel locations were assessed by 3D-CT immediately after surgery. The MRI was performed at 6 and 12 months after operation to assess the healing morphology of the reconstructed MPFL. The Lysholm score and Kujala score were used to assess the knee function before operation, at 6 months after operation, at 12 months after operation and at the last follow-up. The time to return to sports as well as complications were observed.Results:All patients were followed up for 26-48 months [(32.4±8.6)months]. Postoperative 3D-CT examination showed that the femoral tunnels were located in the groove area of the medial epicondyle of the femur and the adductor tubercle. At 6 and 12 months after operation, MRI T2 images showed that the reconstructed MPFL had a low signal and well tensioned ligament tissue, indicating that the MPFL was healed well. The Lysholm scores at 6 and 12 months postoperatively and at the last follow-up were (81.1±12.0)points, (91.2±3.8)points, and (92.2±9.8)points, respectively, being significantly higher than the preoperative (52.4±10.6)points (all P<0.01). The Kujala scores at 6 and 12 months postoperatively and at the last follow-up were (85.4±3.9)points, (91.4±3.6)points, and (93.1±8.5)points, respectively, being significantly higher than the preoperative (55.2±6.8)points (all P<0.01). Compared with 6 months postoperatively, the Lysholm score and Kujala score were significantly improved at 12 months postoperatively and at the last follow-up (all P<0.05). All patients returned to sports, with the time to return to sports for 3-12 months [(8.7±2.3)months] after operation. One patient had poor wound healing but was healed after dressing changes. No wound infection, nerve injury, joint stiffness, patella re-dislocation or other complications occurred. Conclusion:For recurrent patellar dislocation, the modified all-arthroscopic MPFL reconstruction has advantages of accurate bone tunnel positioning, good ligament healing, good function recovery, early return to sports, and less postoperative complications.
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Objective:To observe the changes in acromiaohumeral distance(AHD) in patients undergoing the modified arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect.Methods:A retrospective study was performed of the 52 patients who had undergone the modified arthroscopic double-button Latarjet procedure from October 2014 to October 2016 at Department of Sports Medicine, The First Affiliated Hospital to Shenzhen University for recurrent anterior shoulder dislocation complicated with glenoid bone defect. They were 33 males and 19 females, having 30 left and 22 right shoulders affected. Their ages ranged from 19 to 45 years(mean, 29.6 years). Their glenoid bone defects ranged from 17% to 30%(mean, 23.4%). CT scans were performed on the surgery side to observe the healing and reshaping of the bone grafts and to measure the AHDs of healthy shoulder, immediately, 6, 18 and 36 months after operation. Their American Shoulder and Elbow Surgeons(ASES), Rowe and Walch-Duplay scores were recorded before operation and at the final follow-up for comparison.Results:The follow-up time for this series ranged from 37 to 44 months (mean, 40.6 months). The AHDs at immediate postoperation(9.6 mm ± 0.7 mm), 6 months postoperation(8.6 mm ± 0.9 mm), 18 months postoperation (8.0 cm ± 0.8 cm) and 36 months postoperation(7.9 cm ± 0.8 cm) were significantly wider than the healthy side value (7.8 mm ± 0.8 mm)( P<0.05). The ASES, Rowe and Walch-Duplay scores at the final follow-up (93.9±3.2, 94.5±2.7 and 95.7±3.6) were significantly improved than the preoperative values (67.3±9.1, 40.1±4.2 and 63.5±9.0) ( P<0.05). The final follow-ups observed no symptoms or signs of chronic shoulder pain, rotator cuff injury or acromion impingement. Conclusion:As the AHD becomes wider rather than narrower after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect, no subsequent rotator cuff injury may happen due to the uplift of the humeral head after the modified arthroscopic double-button Latarjet procedure.
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Objective To evaluate mid-term clinical outcomes of autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) (Hepple types Ⅳ and Ⅴ).Methods From October 2011 to September 2013,AOT procedure was performed in 13 patients with OLT (Hepple types Ⅳ and Ⅴ).They were 9 men 4 women,with a mean age of 31.7 years (range,from 19 to 46 years).There were 5 cases of type Ⅳ and 8 ones of type Ⅴ.The diameters of defective areas ranged from 0.5 to 2.0 cm (average,1.1 cm).Osteochondral plugs were harvested from the non-weight bearing area at the ipsilateral femoral lateral condyle.The arthroscopic single-plug or double-plug AOT procedure was conducted with a supplementary arthrotomy if necessary.Visual analogue scale (VAS),American Orthopedic Foot and Ankle Society (AOFAS) score,Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score,and the International Knee Documentation Committee Knee Evaluation Form (IKDC) score were measured pre-and post-operatively for assessment of clinical outcomes.Results After successful surgery,all the patients were followed up for 28 to 52 months (average,38.2 months).The VAS (0.7 ±0.8),AOFAS (95.2 ±2.9) and MOCART (6.6 ± 0.9) scores at the final follow-up were significantly improved compared with preoperation (7.9 ± 1.3,63.5 ± 7.4,3.2 ± 1.1,respectively) (P ＜ 0.05).There was no significant difference between pre-and post-operation in the IKDC score for the ipsilateral knee joint (98.5 ± 0.7 versus 98.3 ± 0.9) (P ＞ 0.05).Post-operative MRI showed complete hypertrophic cartilage layer filling in 3 cases,complete filling of the defect at the level of surrounding cartilage in 8 cases,and incomplete atrophic cartilage layer filling in 2 cases.Normal signal intensity of the repair tissue compared with the adjacent native cartilage was seen in 4 cases,and nearly normal activity in 9 cases.All the patients recovered normal walking and daily life.Conclusions In the treatment of Hepple types Ⅳ and Ⅴ OLT,AOT proves to be reliable and can lead to fine mid-term clinical outcomes.
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Objective To identify the effect of long hazardous drinking on cardiovascular function and cardiovascu?lar abnormalities among alcohol dependent patients. Methods A follow-up survey was conducted, 72 potential patients who were diagnosed as having alcohol dependence were recruited into case group and 75 staff who underwent routine health examination were subjected into control group. Furthermore, 52 patients were subdivided into long hazardous drinking group (GroupⅠ) according to the classification of alcohol consumption published by WHO. The rest patients in the case group were considered as not long hazardous drinkers (GroupⅡ). The blood lipid data, echocardiography and ca?rotid artery brachial artery ultrasonography measurement data were compared between the three groups. The high risk fac?tors for cardiovascular abnormalities among alcohol dependence patients were analyzed. And one year after discharge, telephone follow-up method was used to obtain the incidence of cardiovascular accident among patients. Results The dis?tribution of blood lipid data among GroupⅠ, Ⅱ and control group were not significantly different (P>0.05). The LVEF score in GroupⅠwas significantly lower than that in control group (P<0.01). The LAAEF score in GroupⅠwas signifi? cantly higher than that in control group and that in the GroupⅡ(P<0.05). While the FDM and IMT score in the GroupⅠwas significantly lower than that in control group (P<0.01). In the case group, the duration of drinking alcohol was neg?atively associated with LAPEF (r=-0.246, P=0.014) and LAAEF (r=0.239, P=0.016). The average daily alcohol consump?tion was positively associated with LVEF (r=0.256, P=0.010), while negatively correlated with FMD (r=-0.256,P=0.010). Multivariate logistic regression analysis showed that long hazardous drinking was an independent risk factor for cardiovas?cular abnormalities (OR=1.334, 95%CI: 1.060~1.678). Conclusion Long hazardous drinking can reduce left ventricular diastolic and vascular endothelial function. It is an independent risk factor for cardiovascular abnormalities in alcohol de?pendent patient.
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BACKGROUND:Studies have reported that the bone bridge and bone plug for meniscal alograft transplantation show better outcomes than simple soft tissue suture, but there are rare studies concerning the comparison of their fixation effects. OBJECTIVE:To compare the clinical effects of bone bridge and bone plug in meniscal alograft transplantation. METHODS:Eighteen patients undergoing arthroscopy-assisted meniscal alograft transplantation were enroled, including nine cases of bone plug fixation and nine cases of bone bridge fixation. Symptoms, physical examination, visual analog scale, Lysholm and Tegner scores were used to evaluate the clinic outcome. Every 6 months post operation, the signal and morphological changes of alograft meniscus was observed with MRI for each patient. RESULTS AND CONCLUSION:Al of the 18 patients were folowed up for 12-36 months after transplantation. No complications, absence of knee pain and effusion, and disappearance of the discomfort within the meniscectomy compartments after prolonged activity during folow-up period were found in al patients. The patients were competent of daily life and sports activity. The visual analog scale, Lysholm and Tegner scores were significantly increased after transplantation. MRI showed that the vicariousness and livability of the alograft menisci appeared within 1 year post operation. The safety and feasibility of the arthroscopy-assisted meniscal alograft transplantation were approved. Knee pain, knee effusion and joint stability and function were improved after arthroscopic-assisted alograft meniscus transplantation, and there was no difference between the clinical curative effects of the two kinds of fixed methods.
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BACKGROUND:Human hypoxia-inducible factor-1 alpha can regulate the expression of osteogenic and angiogenic genes, and promote osteogenic activity. OBJECTIVE:To observe the expression of osteogenic genes in rat bone marrow mesenchymal stem cells carrying human hypoxia-inducible factor-1 alpha slow virus infection. METHODS:Hypoxia-inducible factor-1 alpha was obtained from Hela cells using RT-PCR. Lentivirus expression vector plasmid carrying hypoxia-inducible factor-1 alpha (Lenti-HIF-1α-eGFP) was constructed. 293Ta cells with LentiPac HIV mixed packaging plasmid was packaged, and then lentivirus was obtained. Rat bone marrow mesenchymal stem cells were isolated and cultured using direct whole bone marrow adherent method. Bone marrow mesenchymal stem cells were identified using flow cytometry. Bone marrow mesenchymal stem cells were infected with slow virus for 1, 4, 7 and 14 days. Bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase expression levels were detected in bone marrow mesenchymal stem cells using real-time fluorescent quantitative PCR. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells were effectively infected with Lenti-HIF-1α-eGFP. Real-time fluorescent quantitative PCR results revealed that bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase began to obviously overexpress from 4 days after infection with Lenti-HIF-1α-eGFP until 14 days. Results suggested that hypoxia-inducible factor-1 alpha could elevate the osteogenic activity of bone marrow mesenchymal stem cells.
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BACKGROUND:Low-temperature rapid prototyping technology is a new kind of rapid prototyping technology, and it is rapidly used in the preparation of bone tissue engineering scaffolds because it can make scaffold forming control able and can keep the biological activity of the materials, also can easily realize the scaffold with porous of three-dimensional structure and other advantages. OBJECTIVE:To investigate the preparation process of polyethylene glycol-modified polylactic acid-glycolic acid/nano-hydroxyapatite (PLGA-PEG/n-HA) using the low-temperature rapid prototyping, and to test its performance. METHODS:PLGA-PEG/n-HA and PLGA/n-HA were prepared by low-temperature rapid prototyping equipment. Under an electron microscopy, we observed ultra-structure of the scaffolds. Immersion (ethanol) method was used to test the porosity, and electronic testing machine was used to determine the material mechanical properties. Then these two kinds of scaffolds with rat osteoblasts were cultured in vitro, the cel adhesion rate was detected by precipitation method after 12 hours, and cel counting kit-8 method was used to determine the cel proliferation at culture days 1, 3, 5, 7, 9, 12. RESULTS AND CONCLUSION:Both of the two scaffolds had ideal aperture range and high porosity. But the aperture range of PLGA-PEG/n-HA scaffolds had large fluctuations, and the average aperture was smal er than that of PLGA/n-HA. Some pores were closed up. The cel adhesion rate and the cel growth curve of PLGA-PEG/n-HA was better than that of PLGA/n-HA (P<0.05), but the mechanical properties were less than PLGA/n-HA (P<0.05). The results showed the PLGA-PEG/n-HA scaffolds had good cel compatibility.
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BACKGROUND:The umbilical cord blood is rich of mesenchymal stem cells, which can be used as a new source of seed cells in tissue engineering. OBJECTIVE:To compare two methods for culturing, expanding and purifying the mesenchymal stem cells in vitro isolated from the human umbilical cord blood. METHODS:The ful-term birth cord blood of 40 cases was col ected under sterile conditions with heparin anticoagulation. Ficol density gradient centrifugation was used to isolate the mononuclear cells from the umbilical cord blood. The cases were randomly divided into two groups according to the different culture media. Twenty cases of umbilical cord blood were cultured in MesenGro human mesenchymal stem cells culture medium (group A), and the remaining 20 cases of umbilical cord blood were cultured in Dulbecco’s modified Eagle’s medium (group B). The occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and the number of primary cells in the two groups were compared. Cells which grew well were selected to detect the surface markers by flow cytometry. RESULTS AND CONCLUSION: The mean occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and number of primary cells in group A were better than those in group B (P < 0.01). The strong expression of the surface markers of mesenchymal stem cells (CD73 and CD105) was found by flow cytometry, of which the positive rate was 99.1%. No expression of the surface markers of hematopoietic stem cells (CD45 and CD34) was seen, of which the negative rate was 99.3%. The number, morphology, growth rate and culture time of umbilical cord blood mesenchymal stem cells cultured in MesenGro human mesenchymal stem cells culture medium were better than those cultured in Dulbecco’s modified Eagle’s medium. Cells cultured in MesenGro human mesenchymal stem cell culture medium can better express surface markers of mesenchymal stem cells.
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BACKGROUND:Nano-hydroxyapatite helps to improve the mechanical properties of bone implants. OBJECTIVE:To study the clinical effect of nano-hydroxyapatite artificial bone on col apsed fracture of the tibial plateau. METHODS:Fourteen cases of col apsed fracture of the tibial plateau combined with bone defects from March 2010 to September 2012 were analyzed retrospectively. The bone defect range was from 1.5 cm×1.0 cm to 3.1 cm×4.5 cm. Al patients were treated with nano-hydroxyapatite artificial bone at an implant amount of 5-14 g. Clinical and X-ray observations were applied at 1 week, 1 month and 3 months postoperatively. Hospital for Special Surgery scores were employed for recovery of knee function. RESULTS AND CONCLUSION:The patients were fol owed up for 12-27 months. Except for one case of a smal amount of wound exudates, no general side effects occurred in 13 cases. X-ray photo showed an integrity interface between nano-hydroxyapatite artificial bone and host bone at 3 months after treatment. Primary healing was obtained in al cases without any complications. Hospital for Special Surgery score was increased to (88.7±4.3) points at 1 year later. These findings indicate that the nano-hydroxyapatite artificial bone has a good biocompatibility and biomechanics, and it may be an ideal artificial bone for repairing col apsed fractures of the tibial plateau.
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Objective To discuss the technique and result of arthroscopic suprascapular nerve release.Methods From February 2008 to February 2011, nine cases of suprascapular nerve compression were treated.Four of them were transverse scapular ligament compression,and 5 cases with cyst compression around spinoglenoid notch,one case was double nerve compression.The patients were manifested nerve compressive symptoms, and MRI, EMG can be a useful tool to identify the locations of compressions. All the patients were treament with arthroscopic nerve release, by transverse scapular ligament releasing or cyst removing. Results The average follow up time was 10 months,the symptoms disappeared,the atrophy or weakness of supraspinatus and infraspinatus muscles were significantly improved after operation. Conclusion The Arthroscopic suprascapular nerve release is an effective,miniinvasive,and fast recovery technique.
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Objective To compare clinical outcomes of double-bundle and single-bundle in individualized arthroscopic anatomical reconstruction of anterior cruciate ligament (ACL) . Methods The clinical data of 117 patients were reviewed who had received double-bundle or single-bundle arthroscopic ACL reconstruction from March 2007 through September 2009 in our hospital and had undergone complete follow-up. Of them, 35 cases had single-bundle ACL reconstruction and 82 double-bundle reconstruction. In the single-bundle group(group A), there were 31 men and 4 women, aged 28. 6 ±5. 1 years. In the double-bundle group(group B), there were 73 men and 9 women, aged 27. 6 ±5. 4 years. The 2 groups were comparable in the preoperative demographic data ( P > 0. 05). To evaluate the outcomes, Lachman and Pivot Shift exams , KT-2000, Lysholm and IKDC (International Knee Documentation Committee) scores, were adopted. Results The 117 patients received a mean follow-up of 15 months (from 11 to 25 months). The Lachman test showed 88. 6% (31/35) were normal in group A and 95. 1% (78/82) were normal in group B.The pivot-shift test showed 88. 6%(31/35) were normal in group A and 96. 3% (79/82) were normal in group B. Group A had a mean Lysholm score of 93. 4 ± 8. 2 and group B a mean Lysholm score of 93. 7 ±7. 0. There were no significant differences between the 2 groups in the above indexes ( P > 0. 05). By IKDC score, 71. 4% (25/135) were normal in group A and 93. 9% (77/82) were normal in group B. The KT-2000 test showed a mean of 1. 4 ± 0. 6 mm in group A and a mean of 1. 1 ± 0. 5 mm in group B. These 2 values were significantly different between the 2 groups ( P < 0. 05). Conclusions The individualized arthroscopic double-bundle anatomical reconstruction of ACL can maximally restore the anteroposterior and rotational stability. Arrangement of the ACL insertion site on the femoral and tibial side, three-portal technique and ruler application are keys for individualized anatomical double-bundle ACL reconstruction.
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BACKGROUND:Ginsenoside can promote wisdom,prevent aging,protect cortical motor neurons,resist cell apoptosis,but the mechanisms are unclear.OBJECTIVE:To observe the effect of Ginsenoside Rb1 and Rg1 on nerve growth factor expression in Schwann cells.DESIGN,TIME AND SETTING:The in vitro cytological study was performed at the Second People's Hospital of Shenzhen City from March to June 2004.MATERIALS:Fresh adult ex vivo nerve was obtained from limbs that were dissociated by trauma and could not be reimplanted at the Second People's Hospital of Shenzhen City.Ginsenoside Rb1 and Rg1 was supplied by the Norman Bethune University of Medical Sciences.METHODS:Epineurium was removed and cut into 1.0-2.0 mm blocks.Schwann cells were isolated by enzyme digestion.Following removing fibroblasts by double 30-minute differential attachment,Schwann cells with above 95% purity rate were harvested,and then incubated on a 96-well culture plate coated with polylysine (105 cells/well).Schwann cells in the Ginsenoside Rb1 group were subjected to 20 uL of Ginsenoside Rb1 at 10,20,40,60,80 ug.Schwann cells in the Ginsenoside Rg1 group underwent 20 uL of Ginsenoside Rg1 at 10,20,40,60,80 ug.Schwann cells in the control group were treated with 20 uL of phosphate buffered saline.MAIN OUTCOME MEASURES:Nerve growth factor expression rate was determined in Schwann cells by using flow cytometry.RESULTS:Nerve growth factor expression rate in Schwann cells was significantly increased in the Ginsenoside Rb1 and Ginsenoside Rg1 groups compared with the control group at 48 hours following incubation (P ＜ 0.05),in a dose-dependent fashion.Nerve growth factor expression rate peaked when Ginsenoside Rb1 and Ginsenoside Rg1 were 60 mg/L.No significant difference in nerve growth factor expression rate was detected between the Ginsenoside Rb1 and Ginsenoside Rg1 groups (P ＞0.05).CONCLUSION:Ginsenoside Rb1 and Rg1 has potential of promoting the recovery of damaged peripheral nerve by increasing Schwann cell producing and secreting nerve growth factor.
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BACKGROUND: Schwann cell-derived neurotrophic factor is a bioactive protein isolated and purified from the kytoplasm of Schwann cell. It can obviously maintain the survival of spinal cord anterior horn motor neuron and promote the regeneration of peripheral nerve.OBJECTIVE: To observe the protective effect of Schwann cell-derived neurotrophic factor on the high injury of peripheral nerve-induced apoptosis of sensory neurons in spinal dorsal root ganglia.DESIGN: Randomized and controlled animal experiment.SETTING: Shenzhen Second People's Hospital.MATERIALS: Totally 30 3-week-old SD infant rats, of clean grade and either gender, were used in this experiment. They were randomly divided into neurotrophic factor group and control group with 15 rats in each one.Left sides of the animals in both two groups were set as normal sides and right sides as injured sides.METHODS: This experiment was carried out at the Experimental Animal Center, Medical College of Sun Yat-sen University from May 2003 to July 2003. ① L4.5 nerve root high-mutilation animal models were developed on the rats in two groups. Proximal nerve stump was connected with silicone tube. According to grouping, 60 mg/L Schwann cell-derived neurotrophic factors and 20 μL normal saline were injected into the silicone tubes respectively. Two ends of silicone tube were enveloped with vaseline.② Sample collecting was conducted at postoperative 4 weeks, survival rate and morphological change of sensory neurons in dorsal root ganglia of injured nerve was observed.MAIN OUTCOME MEASURES: ① Gross observation of sciatic nerve regeneration at injured side of the rats in two groups ② Survival of sensory neurons in dorsal root ganglia ③ Morphological change of sensory neurons in dorsal root ganglia.RESULTS: All the 30 rats entered the stage of result analysis. ① Gross observation of sciatic nerve regeneration: In the neurotrophic factor group,nerve new born axon grew along silicone tube, with 1cm in length; there were few and thin newborn axons in control group with 0.8 cm in length.② Survival of neuron in dorsal root ganglia of the rats in two groups: There was little fibrous tissue proliferation in the dorsal root ganglion in neurotrophic factor group. The loss of neurons was not obvious and the survival rate was 91.8%. Obvious fibrous tissue proliferation appeared in the dorsal root ganglia in control group, and a great many neurons were lost with the survival rate of 58.6%. Survival rate of neurons was 33.2% higher in neurotrophic factor group than in control group (P ＜ 0.01 ). ③ Morphological change of neurons in dorsal root ganglia: The diameter and area of neurons in dorsal root ganglia were significantly lower in control group than in neu rotrophic factor group and normal side [(21.8±1.4) μm,(373.1±50.9) μm2 vs (24.8±1.1) μm, (482.8±42.2) μm2 and (24.5±1.3) μm, (471.5±51.4) μm2,P ＜ 0.01], while there were no significant difference in diameter and area of neurons between neurotrophic factor group and normal side(P ＞ 0.05).CONCLUSION: Schwann cell-derived neurotrophic factors have obvious neurotrophic bioactivity for sensory neurons in the injured dorsal root ganglia.
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BACKGROUND: Schwann cell derived neurotrophic factor, which is isolated and purified from the kytoplasm of Schwann cell with the relative molecular mass of 58000, is a kind of neurotrophic substance possessing obvious neurotrophic activity. It can be against neurovirulent substance of nitrogen monoxidum.OBJECTIVE:To create root avulsion animal models and observe the protective effects of Schwann cell derived neurotrophic factor (SDNF) on motoneurons of spinal anterior horn from spinal root avulsion induced cell death.DESIGN: Repeated observation and measure.SETTING: Third Department of Orthopaedics, Second People's Hospital of Shenzhen; Department of Micro-surgery , First Hospital Affiliated to Sun Yat-sen University.MATERIALS: This experiment was conducted at the Experimental Animal Center of Medical College of Sun Yat-sen University from March to May 2003. Twenty Sprague-Dawley rats with the age of 3-4 months, of clean degree, were selected and divided randomly into experimental group of Schwann cell derived neurotrophic factor and control group of normal saline with 10 rats in each group. The right side was injured, and the left side was intact served as normal control side.METHODS : ①A rat model of C6,7 spinal root avulsion induced motoneuron degeneration was established. ② A small piece of gelfoam presoaked in 40 μL SDNF solutions (1 g/L) was placed in contact with the injured spinal cord in the animals of the experimental group. Normal saline was added as the same way as above in the animals of the control group. ③ A silica pipe was put on the surface of gleform, one end of the silica was sutured to the glefoam , and the other end wasfixed subcutaneously with vaselinum. Local intramuscular injection of penicillinum was performed on the wound following closing the incision. All rats received an injection (20 μL) of either SDNF or normal saline solution at the lesion site through the silica pipe sutured to the glefoam once a week after the surgery. All the animals were killed by the end of the third weeks. ④The spinal region of C6,7 level was dissected out for observing survival rate and morphological change of motoneurons of spinal anterior horn as well as the expression of nitricoxide synthase(NOS).MAIN OUTCOME MEASURES: ① Survival and morphological change of spinal motor neurons. ②Change of nitricoxide synthase expression of spinal motor neurons.RESULTS: Totally 20 rats were enrolled in the experiment, and all of them entered the stage of result analysis. ① Survival and morphological changeof spinal motor neurons: 68.6% motoneurons of injured side of the control group died at 3 weeks after surgery. The survival rate was 31.4%,which was significantly lower than that of the intact side (P ＜ 0.01), and the survived neurons was shrinked significantly; the death rate of spinal motor neurons of injured side of experimental group was decreased by 35%as compared with control group (P＞ 0.05). The survival rate was 66.4%,and the survived neuron body was increased, similar to the intact side (P ＞ 0.05). ② Change of nitricoxide synthase expression of spinal motor neurons: In normal spinal cord, NOS positive neurons were shown in dorsal horn, surrounding the central canal and in the intermediolateral column.NOS was not seen in the anterior horn motonurons. At the end of the third week after C6,7 spinal root avulsion, increased NOS expression was not found at the injured side in the Schwann cell derived neurotrophic factor group and the intact side in the control side, while the significantly increased NOS expression of spinal motoneurons was found at the injured side of the control group.CONCLUSION: Degeneration of spinal motoneuron and increased expression of NOS can be induced by spinal root avulsion. SDNF has a significant effect in protecting spinal motoneurons from spinal root avulsion induced cell death and inhibiting the expression of NOS. These results suggest that the effects .of SDNF on motoneuron survival may be achieved by modifying the expression of certain cellular molecule such as NOS.
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BACKGROUND: The free border of meniscus is avascular portion, for which, it is not susceptible for the meniscus to be cured naturally after injury. Therefore, it is necessary to induce fibrous tissue healing probably under certain situation.OBJECTIVE: To adopt tissue engineered cartilage and fibrin adhesive to treat meniscus injury in avascular portion and compare the results.DESIGN: Randomized group division and blank control experiment was designed.SETTING: Animal Laboratory of a Shenzhen Second People's Hospital.green-purplish-blue adult rabbits were selected, randomized into 3 groups,12 rabbits in each, named blank control, fibrin adhesive group(FA group)and tissue engineered cartilage group(TE-C group).METHODS: The experiment was performed in Animal Laboratory of Shenzhen Second People's Hospital from September 2003 to March 2004.Ten baby rabbits borne in 3 to 5 days were sacrificed to collect fibrochondrocytes for culture so as to prepare tissue engineered cartilage containing 12 × 108 L-1chondrocytes. Thirty-six adult rabbits were prepared into the injured model in avascular portion of meniscus (0. 7 × 0. 3) cm with full-thickness laceration. In blank control, no any filler was applied for management; in FA group, fibrin adhesive was infused in laceration; and in TE-C group, tissue engineered cartilage was infused in laceration. Four animals of each of 3 groups were sacrificed in the 2nd, 6th and 12th weeks after operation. Eight menisci were collected in each group each time for gross morphological observation and histological examination.MAIN OUTCOME MEASURES: Gross morphological observation and histological examination in injured meniscus model of rabbit.logical observation in injured meniscus model of rabbit: In blank control, the splits in meniscus were not been healed and tissue filler was not apparent. In FA and TE-C groups, the splits had been filled up with tissue fillers comblank control, 2 to 12 weeks after operation, there was chondrocyte proliferation presented on the border of splits. In FA group, 12 weeks after operation, on the defect border, there were many fibroblastic cells that closely adhered to adjacent tissue, resulting in scar tissue healing. In TE-C group,12 weeks after operation, cartilage cavities and capsule were apparent in the defect and chondrocftes were in cell condensation.CONCLUSION: Tissue engineered cartilage is survived in the acceptors, resulting in fibrocartilaginous healing and specific biological label of chondrocytes. But the remarkable difference presents in collagen arrangement among the repaired tissue, adjacent normal meniscus tissue and normal cartilage.
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Objective To report the clinic experience of tr eatment of severe pelvic fracture in order to improve the early diagnosis and operation of the injury.Methods We retrospectively studied the clin ic data of106patients admitted to our hospita l for severe pelvic fracture from Apr il 1994to May 2002.Results The main causes for pelvic fracture were traffic accident injury(69cases,65.1%)and falling accident injury(31cases,29.3%).87cases were in the survival group,and 19cases in the death group,with t he mortality of about 17.9%.In the death group,10di ed from hemorrhagic shock,4of severe cerebral injury,3from MOF,and 2from ARDS.32cases with pelvic f ractures were treated by opening red uction and internal fixation,91.7%of which achieved good results.Conclusion In the treatment of severe pelvic fra ctures,prehospital emergency care is very important.Complicated severe injuries should be treated pr omptly and pelvic fractures be fixed with internal fixation as soon as possibl e.
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Objective To discuss the strategies for diagnosis and treatment of severe pelvic fracture. Methods 38 patients with severe fracture of pelvis circle and different complications were studied in this paper from May, 1997 to June, 2005. 28 cases underwent emergency treatment for shock, 31 cases had internal fixation, and 14 cases received operative procedures for their complications. Results All the 38 cases survived. The integrity of the pelvic circle was restored in patients with unstable pelvic fracture. Most of the patients were back to their former work. Conclusions In treatment of severe pelvic fractures, the hemorrhagic shock and other complications endangering life should be promptly treated, and restoration of the integrity of the pelvic circle is the most important step.
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Objective To investigate the culture conditions of bone marrow stromal cells(MSCs) to form the tissue engineering cartilage. Methods The MSCs were obtained by the method of primary and passage culture in vitro.Chondrocytes derived from MSCs were obtained with high initial cell density subculture.The cells were cultured and transferred to the 3rd generation,and mixed with fibrin sealing(FS,5?10~6cells/ml).The conformation and growing feature of the tissue engineering cartilage were observed.Results The cultivated MSCs had shown evident reproductive activity and high rate of adherence.The histological results showed that cartilage matrix was stained positively for toluidine blue.Conclusion Chondrocytes can be derived from MSCs and form into the tissue engineering cartilage with FS.
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Objective To study the comorbidity of somatic dis e ases and its significance among patients of psychiatric department of geriatrics . Methods The data about psychiatric diagnoses, co-existing so matic diseases and curative efficacy of mental diseases were investigated among 198 patients. Results 91.4% of patients co-existed somatic diseases, and the m ean of sort of somatic diseases among each patient was 1.65. Somatic diseases ma inly included pulmonary infection, cerebral vascular disease (CVD), hyper tension, heart disease, diabetes mellitus (DM) and chronic obstructed pulmonary disease (COPD), etc. By logistic regression, it was found that Alzheimer's disea se (AD), the numbers of somatic diseases and co-existing CVD w ere disadvantageous factors of the curative efficacy of mental diseases. Conc lusions The comorbidity of somatic diseases is common among patients of psychiatric department of geriatrics and it affects treatments and curative eff icacy of mental diseases. Furthermore, the comorbidity influences the clinical m odel of psychiatric department of geriatrics.