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Objective:To analyze the improvement of patients with basilar invagination and atlantoaxial dislocation that treated by anterior or posterior surgery.Methods:50 patients with basilar invagination and atlantoaxial dislocation that underwent simple anterior or posterior surgery from 2009 to 2021 were included. There were 34 females and 16 males with a mean age of 45.04 years (range, 18-65 years). All patients underwent thin- slice CT scan of the neck. Preoperative and postoperative measurements of atlantoaxial joint distance, atlantoaxial joint angle, atlantoaxial joint displacement, Claus' Height, atlas-dens interval, space available for the cord, cervicomedullary angle, C 0-C 2 angle, and C 2-C 7 angle were measured. Then, the data were analyzed by independent sample t test. Results:25 patients (7 males, 18 females) were included in the anterior surgery group, and 25 patients (9 males, 16 females) were included in the posterior surgery group. The mean age of the two groups was 45.24±9.86 years and 44.72±14.06 years, respectively, showing no statistical difference. The mean last follow-up time of the anterior and posterior surgery group was 6.48±3.14 months and 7.04±2.87 months, respectively. The odontoid distance, atlas-dens interval, space available for the cord and cervicomedullary angle in 2 groups were significantly improved after surgery ( P<0.05), while there were no significant differences in the above parameters between 2 groups ( P>0.05). In the anterior surgery group, the distance and angle of atlantoaxial joint were increased, and the atlantoaxial joint displacement decreased significantly. While in the posterior surgery group, only the atlantoaxial joint space increased ( P<0.05). The C 0-C 2 angle was significantly increased and the C 2-C 7 angle was significantly decreased in the anterior surgery group ( P<0.05), but there was no significant difference in these parameters in the posterior surgery group ( P>0.05). In addition, there was no significant difference in parameters between the two groups at the last follow-up compared with those immediately after surgery. Conclusion:Both anterior and posterior surgery can improve the compression of the spinal cord in patients with basilar invagination and atlantoaxial dislocation. Anterior surgery may be more adequate for the extension and reduction of the atlantoaxial joint space, however, excessive enlargement of the lordosis angle in upper cervical may lead to the reduction of the lordosis in lower cervical.
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The stability of the occipitocervical region mainly depends on the integrity of the bony structure,surrounding ligaments and joint capsules.The instability of this region often leadsto the clinical symptoms of compression injury of nerve and vascular,which requires early surgical intervention to rebuild its stability.Posterior occipitocervical fixations are main surgical treatment for the occipitocervical diseases.However,the posterior fixations are not suitable for some patients with congenital or iatrogenic causes.Recently,the anterior occipitocervical fixation with the screws anchored at clivus or into the occipital condyles have been used for the following operations.1.Anterior bone graft fusion.One case which was performed by oral approach was reported well fusion,but the stability was poor and there was a possibility of displacement.2.Anterior shaped titanium cage and plate fixation.The literatures reported that this anterior operation was completed in 35 cases by oral,oral combined with mandibulotomy,and anterior retropharyngeal approaches.This fixation has a good biomechanical stability and is widely used in clinical applications,including occipitocervical tumors and deformities.And the complications including intraoperative vascular,spinal and dural injuries,postoperative drinking cough,non-fusion,deep infection,and death.3.Anterior occipital-atlantoaxial joint screw fixation.Seven cases were performed by anterior occipital-atlantoaxial joint screw fixation through anterior percutaneous approach.This fixation is less trauma,but required precise placement of screw and not conducive bone fusion,and it is suitable for traumatic instability of the upper cervical spine,atlantoaxial dislocation and basilar invagination.Each procedure of anterior occipitocervical fixation is not suitable for all patients,and it should be adopted according to the patient's condition,surgical hardware conditions and the surgeon's habits.
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Pedicle screw fixation is widely applied to spinal surgery owing to its advantages of maitaining the stability of spine,promoting the bone graft fusing and so on. Remarkably implantation accu-racy is not only closely related to ultimate fixation,but also can affect the incidence and the severity of complications. Consequently,to improve screw implantation accuracy is one of the goals that spinal sur-geons always pursue. In recent years,newly-developed techniques have been preliminarily used in clinic. An overview on the progresses of these techniques in China and overseas is presented here.
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Objective To observe the effect of advanced oxidation protein products (AOPPs) on articular and synovial in a rabbit model of osteoarthritis (OA).Methods 48 male New Zealand rabbits were randomly divided into 3 groups:AOPPs group,PBS group and sham-operated group.OA model were created in AOPPs group and PBS group by anterior cruciate ligament transection and medial meniscus resection (ACLT+MMx).then intra-articular injection of 1 ml AOPPs or PBS were performed once every other day in AOPPs group and PBS group,respectively.In sham-operated group,the anterior cruciate ligament was just exposed without transection,and then the incision was sutured.All rabbits were saerificed after 4 and 8 weeks of intervention,respectively.Results The India ink seore of 4 and 8 weeks were 4.19±0.60,5.75±0.60 in AOPPs group,and 1.06±0.18,1.38±0.60 in sham-operated group,2.50±0.46、3.06±0.62 in PBS group,respectively.In addition,the differences were statistically significant among the three groups.The Mankin score of 4 and 8 weeks were 8.19±0.70,11.94±0.90 in AOPPs group,and 0.75±0.53,1.06± 0.73 in sham-operated group,4.25± 1.46、4.50±0.89 in PBS group,respectively.The differences were statistically significant among the three groups.Meanwhile,the protein expression level of matrix metalloproteinases (MMP)-3 on synovial at 4 and 8 weeks in AOPPs group were 1.006±0.080,1.098±0.088;0.065±0.006,0.053±0.011 in sham-operated group;and 0.552±0.024,0.839±0.084 in PBS group,respectively.The proteiu expression level of MMP-13 on synovial at 4 and 8 weeks in AOPPs group were 0.966±0.080,1.621 ±0.041;0.101±0.022,0.367±0.033 in sham-operated group;and 0.564±0.030,1.322±0.085 in PBS group,respectively.The differences were statistically significant among the three groups at two times.Conclusion AOPPs participate in the occurrence and development of artieular cartilage by upregulating the protein expression of MMP-3 and MMP-13 on synovial.
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Objective To analyze the related factors of surgical site infections after spine surgery so as to provide basis for clinical prevention. Methods We retrospectively reviewed the clinical data on 2,083 patients who had undergone spine surgery during the period of June 2010 to May 2013, and then conducted a statistica analysis. Results A total of 38 patients developed surgical site infections. The incidence of surgical site infections after spine surgery was 1.8%. 11 risk factors including gender, history of smoking, and history of prolonged uses of medications were related to surgical site infections The logistic regression analysis indicated that surgical site infections were more closely related to gender, length of hospital stay, and spine surgical invasiveness index. Conclusions Multiple factors can be attributed to surgical site infections after spine surgery. Gender , length of hospital stay, and spine surgical invasiveness index are the independent risk factors.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy and safety of percutaneous vertebroplasty by unipedicular and bipedicular approach for treatment of Kummell's disease.</p><p><b>METHODS</b>The clinical data of patients with Kummell's disease undergoing percutaneous vertebroplasty via unilateral or bilateral approach between January, 2006 and January, 2011 were reviewed. The clinical efficacy, operation time, bone cement injection volume, incidence of cement leakage, degree of vertebral height restoration, and degree of kyphosis correction were compared between the patients receiving surgery via the two approaches.</p><p><b>RESULTS</b>The operation time was shorter in the unipedicular group than in the bipedicular group (P<0.05), but bone cement injection volume, incidence of cement leakage, degree of anterior vertebral height restoration, degree of middle vertebral height restoration, degree of kyphosis correction, and VAS scores were all comparable between the two groups (P>0.05). In both groups, the VAS scores at 24 h, 3 months and at the last follow-up after the surgery were lowered compared to the preoperative scores (P<0.05).</p><p><b>CONCLUSION</b>Both unipedicular and bipedicular percutaneous vertebroplasty can achieve satisfactory analgesia in the treatment of Kummell's disease with similar clinical efficacy. The unipedicular approach is sufficient for treatment of Kummell's disease.</p>
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Humans , Bone Cements , Spinal Fractures , General Surgery , Spine , Treatment Outcome , Vertebroplasty , MethodsABSTRACT
<p><b>OBJECTIVE</b>To conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels.</p><p><b>METHOD</b>Ten patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD.</p><p><b>RESULTS</b>KD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from +++ to ++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments.</p><p><b>CONCLUSION</b>This preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Diet, Ketogenic , Methods , Feasibility Studies , Spinal Cord Injuries , Diet Therapy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To establish a model bearing human lung cancer xenograft with bone metastasis in mice with normal immune function.</p><p><b>METHODS</b>Forty female C57BL/6J mice were randomly allocated into 4 equal groups, including a control group and 3 immunosuppression groups treated with low, moderate, and high doses of dexamethasone (50, 100, and 150 mg, respectively). Four days after immune suppression, the mice were subjected to percutaneous injection of1.0×10(9) L(-1) A549 cells into the tibial plateau, and the bone defects were assessed radiographically 28 days after modeling. HE staining and immunohistochemical staining were used to examine the tumor tissues and bone tissue damages.</p><p><b>RESULTS</b>In each of the 4 groups one mouse died during tumor cell injection. Only 1 mouse showed tumor formation in low-dose immunosuppression group, as compared to 7 and 4 in moderate- and high-dose immunosuppression groups. X-ray and microCT scan showed significant tibial bone destruction in moderate- and high-dose groups. The moderate- and high-dose groups showed similar ALP activities but both were significantly higher than those in the other two groups (P<0.05).</p><p><b>CONCLUSION</b>Immunosuppression with a moderate dose of dexamethasone results in longer survival time of the human lung cancer xenograft-bearing model mice as well as a higher tumor formation rate.</p>
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Animals , Female , Humans , Mice , Bone Neoplasms , Cell Line, Tumor , Dexamethasone , Pharmacology , Disease Models, Animal , Immunosuppression Therapy , Lung Neoplasms , Pathology , Mice, Inbred C57BL , Neoplasm TransplantationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the influence and safety of denosumab on bone mineral density (BMD) of lumbar spine in women with low bone mass.</p><p><b>METHODS</b>The clinical literatures concerning denosumab for the treatment of osteopenia or osteoporosis in women were searched from Medline, Embase, Cochrane Central Register of Controlled Trials, Wanfang database, China National Knowledge Infrastructure database, Chinese Biomedical Database. Randomized controlled trials (RCT) were selected by the inclusive and exclusive criteria. The jadad scale was used in the quality assessment of included studies. Meta-analysis of valid data picked from included studies was performed by RevMan 5.0.24 software.</p><p><b>RESULTS</b>5 RCT were included in this meta-analysis. The results of meta-analysis using the fixed effects model showed that, the increase level of lumbar BMD after 12 month was 5.45% (95% CI, 5.05%~5.84%) higher in denosumab group than in placebo control group (P<0.00001). The serious adverse event, serious infection event and pack pain occurred during the followed-up were analysed using fixed effects model. The results showed no significant difference between two groups.</p><p><b>CONCLUSION</b>Compared with placebo control group, denosumab can significant increase the BMD of lumbar spine, and the safety of two groups is similar.</p>
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Female , Humans , Antibodies, Monoclonal, Humanized , Pharmacology , Bone Density , Bone Density Conservation Agents , Pharmacology , Denosumab , Lumbar Vertebrae , Randomized Controlled Trials as TopicABSTRACT
Objective To investigate the causes and prevention strategies of postoperative spinal cord injury after anterior approach surgery for cervical spondylotic myelopathy. Methods The clinical data of 749 patients with cervical spondylotic myelopathy treated with anterior approach surgery from 2001 to 2009 were retrospectively studied.There were five patients with spinal cord dysfunction instantly or early after operation,including three males and two females at average age of 52 years (range,48-62 years).Two patients were combined with ossification of the posterior longitudinal ligament.The Japanese Orthopaedic Association (JOA) score was average 12.4(9-16)preoperatively.The surgeries included anterior cervical diskectomy(or corpectomy)and interbody fusion(iliac bone graft or cage or titanium mesh)and locking plates fixation.The blood loss was 50-200 ml.The symptoms included instant spinal cord injury in two patients,loss of the motor and feeling of both legs at 6 h after surgery in one,paralysis of one side limbs at 24 h after surgery in one and numbness of limbs at 5 days after surgery in one.Four patients were treated by large dose of methylprednisolone.Five patients underwent anterior exploration surgery,of which one patient received posterior cervical one-door expansive laminoplasty. Results The patients were followed up for average 16 months(12-24 months).The JOA score of four patients was recovered at three months and WaS better than preoperation after surgery.The function of spinal cord of one patient showed no improvement at one year after surgery.The causes for spinal cord injury included inappropriate surgical manipulation in decompression and haemostasis in two patients,insufficient decompression in one,epidural hematoma in one and absorbable hemostatic gauze in one. Conclusions The major causes of postoperative spinal cord injury in anterior approach surgery for cervical spondylofic myelopathy are the delayed postoperative injury.The spinal cord can recover to normal and has satisfactory prognosis if discovered promptly.We must avoid the spinal cord injury by surgical Manipulation that may result in permanent neurological deficits.
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@# Evidence-based practice advocated that clinical decisions should based on the most relevant and valid evidence. The medical postgraduates in our university were investigated with questionnaires about their influencing factors of the evidence-based practice. The countermeasures were found to improve the competence of evidence-based practice.
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BACKGROUND: Whole body vibration which is used to prevent and treat osteoporosis recently is uncomfortable due to its strong vibration strength. The designed compound vibration with low vibration strength could effectively prevent bone quality decrease of ovariectomized rats. OBJECTIVE: To verify the effect of compound vibration with low vibration strength on the bone quality of ovariectomized rats. METHODS: A total of 32 4-month-old female SD rats were used in this study. All SD rats were randomly dlvided into 4 groups: normal control group, ovadectomized control group, vibration Ⅰ group (45 Hz-55 Hz, 0.05 g-0.1 g), and vibration Ⅱ group (45 Hz-55 Hz, 0.12 g-0.21 g), with8 rats for each group. The intervention to each vibration group was onea day, 20 minutes/tlmes and 5 days per week. The resting interval was shorted than 2 days, and the whole vibration intervention lasted 13 weeks. Bone mineral density (BMD) before and after vibration, ex vivo bone microstructure parameters and biomechanics parameters ware measured in this study. RESULTS AND CONCLUSION: Lumbar BMD of ovariectomized control group was decreased (P < 0.05), but the BMD in the normal control group and the two vibration groups was increased significantly. Femoral BMD of all groups was increased, but there was no significant difference among the four groups. Bone microstructure parameters of the three ovariectomized groups ware decreased; however, parameters including number, thickness and distance of bone trabecula and bone volume fraction in the vibration Ⅱ group were significantly improved compared to ovadactomized control group. Moreover, bone strength of lumbar vertebra in the two vibration groups was significantly increased (P=0.025, 0.006), but there was no significant difference compared to normal control group. Compound vibration with low strength could effectively prevent BMD decrease of ovadectomized rats, lighten the dagrea of bone microstructure damage, keep bone strength, improve bone quality of ovadectomized rats, and potentially prevent osteoporosis.
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[Objective]To study the degradation of nano-nacre powder and the biocompatibility of the composite artificial bone made from this nano-scale powder in vivo.[Method]The nano-nacre powder made through mechanical grinding and the artificial bones made from this powder and PDLLA(poly-D,L-lactide acid) were implanted into the femoral holes and the femoral muscle sacs of rats respectively.Normal micron-nacre powder and the artificial bones made from this powder and PDLLA were implanted as control group,and blank group was set up without implanting anything.X-ray photography was performed immediately and at 2,4 and 8 weeks after operation.The animals were injected with tetracycline for fluorescent mark before being killed.Then,the gross specimens,histological and SEM(scanning electron microscope) observations were performed.[Result]All the observations showed that nano-nacre powder degraded faster than micron-nacre powder,meanwhile,the bone defect recovery was the fastest in this group.Both of the composite artificial bones made from those two kinds of nacre powder had the good connection with the adjacent tissue.[Conclusion]The degradation of nano-nacre powder is faster than that of micron-nacre powder in vivo,and it can promote the growing of new bone.Nano-nacre composite artificial bone also has good biocompatibility.It is a kind of better bioactive degradable material.
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[Objective]To analyze the reasons and counter treatment of complication after prosthetic disc nucleus implantation.[Method]From Feb 2002 to Aug 2004,80 patients of lumbar disc herniation were implanted with one single PDN device at our centre.65 patients of them came to the clinical,functional,and radiographic follow-up examinations,magnetic resonance images and follow-up records of all patients were reviewed carefully.They were divided into three groups.Group A:30 cases had at least 24 months follow-up data.Group B:23 cases had at least 36 months follow-up data.Group C:12 cases had at least 48 months follow-up data.[Result]After implantation,device migrations were noticed in 3 patients.24 cases experienced low back pain.In 24~48 month follow-up,the MR images of 39 patients had shown the abnormal signal pattern of the endplate where PDN-solo was implanted,even 32 of them had been found subsidence.In Group A,the height of intervertebral disc at the 24 month follow-up was decreased 4%.In Group B,at 36 month follow-up,it was decreased 12%.In Group C,at 48 month follow-up,it was decreased 18%.[Conclusion]After follow-up,the clinical effect of PDN is preferred.However,the complications of device dislocation,device subsidence remain problems that must be highlighted.This study suggested that the complications of PDN are serious.Therefore,the proper selecting patients for PDN replacement are crucial for good results.The indications for PDN must be restricted.
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[Objective]To study the biocompatibility of nacre on cultured human osteoblasts in vitro.[Method]The iliac bone of human were added with collagenase-trypsin,a lot of osteoblasts were released out.Then the osteoblasts were purified and cultured.Subsequently,the 3rd generation cultured human osteoblasts were inoculated with the extract of three materials:nacre,hydroxyapatite,and rubber.The appearance of osteoblast was observed under the phase contrast microscope.Microstructure of the osteoblast was observed under transmission electron microscope.Additionally,to determine whether these three materials affect cell proliferation,the numbers of BrdU-labeled cells were examined at three groups.MTT assay was tested to observe the viability of human osteoblasts.[Result]Under the phase contrast microscope,the appearance of the osteoblasts in two groups were spindle or triangle like,and black nodes were seen in confluent cell layer 19 days after cultured.The observation of electron microscopy showed that the nucleus of the osteoblasts in two groups were big and round,and there were a large number of mitochondrion and rough endoplasmic reticulum in two groups.Stereological analyses of the numbers of BrdU-labeled cells revealed that females produced more cells than males in the dentate gyrus but not in the subventricular zone.[Conclusion]The nacre have no harmful effect to character of biology of human osteoblasts in vitro.
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In this paper,the mechanism,instrument design and clinical applications of interference electrotherapy in promoting bone healing are described.A new kind of electrotherapeutical instrument for bone injury is developed.With the variety of waveform and characterisics of easy operation,high intelligence and reliability,the instrument is improved obviously with the use of Single Chip Microcomputer.At the same time ,60cases with fracture were treated by interfere current stimulation in clinical research.It is achieved in accelerating bone healing,detumescence,comeback of tonicity.
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Objective To investigate the early clinical efficacy of percutaneous kyphoplasty using the Sky Bone Expander system in the treatment of osteoporotic compression fractures. Methods Twelve cases of osteoporotic vertebral body compression fracture (17 vertebrae) underwent percutaneous kyphoplasty using the Sky Bone Expander system. During the operation the unipedicle technique was applied and the expansion height was 14 mm for bone cement injection. Surgical complications and the restoration of vertebral height and kyphosis angle were observed. The pain of thoracic and lumbar region on the back was evaluated with the visual analogue scale (VAS). Results The operative time for each vertebra was 52.4?28.7 min (range, 23～90 min), with a volume of 5.4?1.0 ml (range, 3.5～7 ml) of cement injected. A follow-up was made for 3～6 months (mean, 4.5 months). The VAS scores were 7.6?1.8 points preoperatively, 2.8?1.1 points at day 1, 2.6?1.2 points at day 3, and 2.2?1.0 points at last follow-up. Preoperatively, the anterior vertebral height was 13.8?5.3 mm (compression by 49.1%?19.1%) and the midline vertebral height was 9.9?4.6 mm (compression by 39.8%?18.4%), while postoperative anterior and midline vertebral height were 16.6?4.8 mm (compression by 59.1%?17.2%) and 15.2?4.0 mm (compression by 60.6%?16.9%), respectively. The kyphotic angle was decreased from 22.3??8.5? preoperatively to 12.5??6.4? postoperatively. Intervertebral disc leakage of bone cement was observed in 1 case with no symptoms. There were no other surgical complications. Conclusions Kyphoplasty using the Sky Bone Expander system is an effective and safe treatment for osteoprotic vertebral compression fractures. The long-term outcomes are subject to further observations.
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Objective To discuss the selection of surgical procedures for the treatment of spinal tu-berculosis according to the status of segmental stability of the spine. Methods One hundred adult patients with spinal tuberculosis were treated surgically between January 1998 and December 2003. There were 57 males and 43 females with an average age of 39.4 years and an average history of 16 months. The lesion ranged from T2 to S 2, and involved single vertebral body in 3 cases, double vertebral bodies in 66 cases, and more than two vertebral bodies in 31 cases. Of 100 cases, 32 were with neurological dysfunctions, and 65 were accompanied by kyphotic deformity with an average Cobb angels of 36.4? (20? to 48?). Preoperative chemotherapy of four drugs lasted more than two weeks. Three surgical procedures were performed according to the status of segmental stability of the spine: 12 cases without spine instability underwent single debride-ment, 8 cases of spine instability with debridement and interbody fusion, and 80 cases of significant insta-bility with debridement, fusion and internal fixation. Results All patients' incision healed without chronic infection and sinus formation. 95 patients were followed up with an average of 2.9 years ranged 1 to 77 years except 5 patients lost at follow up. 68 cases with anterior fusion achieved solid fusion in average 3.5 months. 65 cases with kyphotic deformity had an average correction of 20.2? postoperatively, and 2? to 4? loss during follow-up. 32 cases with neurological deficits had an improvement of neurological function postoperatively. One patient of L 4,5 tuberculosis treated with anterior debridement, fusion and instrumentation recurred at 7 months due to an inadequate postoperative chemotherapy of 6 months, and healed with a continuous chemotherapy for 18 months, However, satisfactory clinical results were obtained in other patients without any recurrence. A left external iliac vein was torn and repaired successfully in 1 case. Conclusion The maintenance of segmental stability has significant effect in the surgical treatment of spinal tuberculosis. Sta-tus of segmental stability of each patient should be evaluated preoperatively. Satisfactory clinical results can be achieved by proper selection of the surgical procedure according to the status of segmental stability.
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Objective To establish osteoblasts osteoclasts co culture system in vitro for the study of the biological characteristics of osteoblasts and osteoclasts and also to analyze the interactions between osteoblasts and osteoclasts. Methods The osteoblasts and osteoclasts were isolated from cancellous bone in illium. Osteoblasts osteoclasts co culture system was built to prevent these two kinds of cells from contact with each other although with the facility of their medium exchange. The osteogenety of osteoblasts was evaluated by MTT and ALP activity; the resorption activity of osteoclasts was investigated by TRAP activity and the area of absorption lacuna. Results Osteoblasts are full fusiform, ALP stain positive cells, while osteoclasts are multinuclear and TRAP stain positive, with the ability of forming bone lacuna; while in the co culture system, the proliferation of osteoblasts in co culture (0.60?0.08)OD is quicker(P=0.000)than that in mono culture (0.36?0.03)OD, and the ALP activity increased significantly (P=0.000)from (18.33?0.34)u/mg to (23.37?2.48) u/mg; while the average area of bone resorption formed by osteoclasts [(6.55?0.34)?10-2] ?m2 was also increased obviously(P=0.000)from [(5.15?0.17)?10-2] ?m2. Conclusion In co culture system, osteoclasts were able to enhance ossification effects of osteoblasts by accelerating their proliferation and differentiation; at the same time, osteoblasts upregulated the ability of bone resorption of osteoclasts. This implied that osteoblasts and osteoclasts can promote each others function. This study provide reliable model for bone metabolism research.