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Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA) and evaluate whether the age,body mass index and grade of KOA are associated with the treatment outcomes.Methods Using the prospective,randomized,controlled study,100 KOA patients hospitalized between December 2013 and November 2014 were enrolled.Twentyeight patients were men and 72 were women.Mean age was 58 years (range,35-85 years).Degenerative arthritis occurred in 68 patients and traumatic arthritis in 32 patients.Kellgren-Lawrence (K-L) score was grade Ⅱ in 35 patients,grade Ⅱ in 46 and grade Ⅲ in 19.The patients were assigned to receive hyaluronic acid (HA) (HA group,n =50) and PRP (PRP group,n =50) by an intraarticular route once weekly for 3 weeks,according to the random number table.Between-group differences were insignificant in age,gender,body mass index (BMI) and K-L grade.Western Ontario and McMaster Universities Arthritis Index (WOMAC),visual analog scale (VAS) and cartilage lesions score (CaLs) were used for clinical and MRI evaluations.At follow-up evaluation,the effective rate was defined at least 36％ improvement from the baseline WOMAC score.Results All patients were followed up for 6 months.The effective rate in PRP group was 84％ versus 68％ in HA group after the last treatment (P ＞0.05),and was 60％ versus 36％ in HA group at the final follow-up (P ＜ 0.05).WOMAC score in both groups had significant improvement after operation,while VAS improved only in PRP group (P ＜ 0.01).In PRP group patients with K-L grade I had better VAS and WOMAC scores than those with grade Ⅱ (P ＜0.05),and patients with grade Ⅱ had better WOAMC score than those with grade Ⅲ (P ＜ 0.05).MRI findings showed seven patients in PRP group had similar CaLs before and after operation (P ＞ 0.05),and the area of abnormal signal in subchondral bone and the depth of cartilage lesion gradually decreased in one of them.Follow-up study showed the outcomes had negative correlation with age and K-L grade (P ＜0.05),but no certain correlation with BMI in PRP group (P ＞ 0.05).Clinical effects in both groups were decreased over time.Conclusions Intraarticular injection of PRP benefits to pain relief,decreased inflammation and tissue repair,and has much better outcome in patients with younger age and lower K-L grade.However,BMI is not associated with the outcome.
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Objective To investigate the formation and special cell biological behavior of osteoclasts.Methods The live-cell imaging technology was adopted to consecutively and dynamically observe the whole process of multinuclear osteoclast formation induced by RANKL and M-CSF from rat peripheral blood monocyte.Meanwhile,the inverted phase contrast microscopy,TRAP staining,and scanning electron microscopy were also applied to identify the osteoclast.Results After 2-week cultivation,a great number of apocytes were found by the inverted phase contrast microscopy,and most apocytes and monocytes had positive reaction after TRAP staining.Moreover,many bone resorption lacunae in which osteoclasts were perhrming bone resorption function could be found in the bone slice under the scanning electron microscope.Live-cell imaging observation showed that the multinuclear osteoclasts were generated through self-fusion of monocytes,fusion of monocytes and apocytes,as well as fusion between apocytes.All fusion processes occurred under the condition of cell adherence.Time-lapse Microcinematography observation showed diverse shapes of osteoclasts and the cell division of multinuclear osteoclasts.Conclusion Rat peripheral blood monocyte can develop into osteoclast under induction of RANKL and M-CSF.Osteoclast can form gigantic apocyte via various types of cell fusion to increase its nucleus number and cell volume,vary its shape,and increase the area of plasma membrane.On the other hand,osteoclast can decrease its cell volume and nucleus number via cell division to adapt the needs of local morphology,biomechanics and bone resorption dynamics.It suggests that this non-mitosis cell division is a special cell biological behavior of osteoclast,which may be the basis of exerting its function and improving bone resorption efficiency.
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Objective To identify significantly differentially expression of rat by genes chip,try to find out the initiating factors and molecular mechanisms that oxidative stress originate or strengthen the steriod-induced necrosis of femoral head(SINFH).Methods Twenty Wistar rats were dived into experimental group and control group randomly.The rats were injected intraperitoneally whith endotoxin,and then injected intramuscularly with high-dose methylprednisolone or saline in experimental group and control group respectively.The mRNA was extracted from the femoral head of rats inevery group,and the cDNA probes were obtained by inverse transcript,and then carried out microarray detection.The quantitative RT-PCR was used to confirm the results of the microarray.Results Histopathological findings revealed that the experimental group rats had femoral head necrosis,trabecular bone disorders,thinning,bone cell necrosis,and the rate of empty lacunae increased,and in control group no femoral head osteonecrosis was found.Total of 27 differentially expressed genes were found,and of which 4 genes(COX6A2,COX4I2,SOD3,and DUSP1)were significantly different.The expression of these 4 genes were down-regulated.The functions of these four genes involved in inhibition of reactive oxygen species(ROS)generation,accelerated removal of ROS and protection tissue from oxidative damage and so on.Conclusion The expression of oxidative stress-related genes in SINFH of rats exist change.COX6A2,COX4I2,SOD3,and DUSP1 are key genes in process of oxidative stress originate or strengthen the SINFH.
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There is a summary for the study of MSCs in the area of osteonecrosis of the femoral head.It discusses the bionomics, isolation and culture, and osteogenesis of MSCs to expose its internal character, which has the potentiality to treat the osteonecrosis; Through the discussion of clinical application of MSCs in treating osteonecrosis of the femoral head, it provides the feasibility to treat the osteonecrosis with MSCs. At last, it analyzes and prospects the problems, which would be faced in the near future.