ABSTRACT
Objective:To evaluate the physicochemical properties, degradation and drug release behaviour, cytocompatibility and bacteriostatic properties in vitro of porous magnesium alloy scaffolds containing vancomycin/poly(lactic-co-glycolic acid) (PLGA). Methods:Porous magnesium scaffolds (Mg-2Zn-0.3Ca) were prepared using the template replication technique. The MgF 2 surface layer was obtained by high temperature fluorination. The vancomycin/PLGA porous magnesium alloy drug-loaded scaffolds were obtained by homogeneous lifting after submersion in a dichloromethane solution of PLGA containing vancomycin hydrochloride. According to the products at each stage of the preparation (scaffolds of magnesium alloy, magnesium fluoride alloy, PLGA coated magnesium fluoride alloy, and vancomycin/PLGA magnesium fluoride alloy), they were divided into an Mg group, an MgF 2 group, a PLGA group, and a vancomycin/PLGA group. Immediately after preparation, the material science characterization, degradation rate, drug release rate, antibacterial properties, hemocompatibility, and cell proliferation and differentiation ability of the scaffolds were measured and evaluated. Results:Vancomycin-loaded magnesium alloy scaffolds were successfully prepared with an average porosity of 66.39%. Their degradation rate [(0.540±0.102) mm/year] was significantly lower than that of the Mg ones [(10.048±0.297) mm/year] ( P<0.05). Their pH of degradation in Hank equilibrium salt solution was close to the physiological pH. Their release of vancomycin was fast in the first 48 h and gradually slowed down after 48 h. Their cumulative drug concentration reached a maximum of 43 mg/L at d 11; their vancomycin was still released slowly after d 11. The antimicrobial rate in the vancomycin/PLGA group (97.89%±0.28%) was significantly higher than that in the Mg group (74.92%±2.20%), the MgF 2 group (78.46%±2.59%) and the PLGA group (61.08%±4.21%) ( P<0.05). Their hemolysis rate (0.55%) was much lower than the requirement of ISO 10993-4 (5%). The extract liquid from them promoted the proliferation of rat bone marrow mesenchymal stem cells (BMSCs), showing a gradually increased proliferation rate from d1 (104.80%±5.13%) to d3 (112.36%±2.07%) and d7 (127.79%±4.61%). The calcium nodules in BMSCs were significantly increased at d 14, with an OD value of absorbance of 1.189±0.020, significantly higher than that in the Mg group (0.803±0.020), the MgF 2 group (0.878±0.028) and the PLGA group (0.887±0.026) ( P<0.05). Conclusion:Vancomycin/PLGA-loaded porous magnesium alloy scaffolds exhibit good material properties, antibacterial properties, biocompatibility and osteogenic properties in vitro.
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 evaluate biomechanical properties of the personalized titanium alloy short femoral prosthesis by finite element analysis. Methods Based on the validated femoral finite element model, the base of the femoral neck was simulated, and by inserting different short femoral prostheses, four total hip replacement (THR) models, namely, the SMF stem model (Model A), BE1 stem model (Model B), MINI stem model (Model C) and personalized stem model (Model D) were established, respectively. The same loads and constraints were applied to four groups of models, and the von Mises stress distribution and deformation were calculated and analyzed, so as to compare mechanical stability of each model. Results The deformation of all THR models was smaller than that of the femur model under physiological state. The deformation of Model B was close to that of Model C, and the deformation of Model A was close to that of Model D. The peak stress of Model C was higher than that of the other 3 models, reaching 9555 MPa. The overall stress trend was Model C > Model B > Model D> Model A > Model under physiological state. Conclusions The peak stress, stress distribution of personalized short femoral stem were similar to that of SMF stem, with reasonable stress distribution, small stress shielding of the proximal femur, minimum overall deformation and shear stress of the prosthesis, and its effectiveness and stability could meet the requirements of human biomechanics, which could provide references for joint surgeons and prosthesis researchers.
ABSTRACT
Objective:To study the early effect of arthroscopy in the treatment of obsolete traumatic subscapularis tears.Methods:A retrospective case series study was used to analyze the clinical data of 28 patients with obsolete traumatic subscapularis tears admitted to Second People 's Hospital of Changzhou City from July 2017 to July 2020，including 16 males and 12 females，aged 47-72 years［（60.5±6.3）years］. According to Lafosse classification，the injury size was upper one third tear in 9 patients，upper half tear in 18 and complete tear in 1. According to Patte classification of the degree of retraction，4 patients were with no retraction，7 with retraction to the level of the lesser tuberosity，14 with retraction to the level of the humeral head，and 3 with retraction to the level of the glenoid. According to Goutallier classification，the level of fatty infiltration was at grade 0-1 in 17 patients，at grade 2 in 10 and at grade 3-4 in 1. All patients were repaired by arthroscopic surgery. The wound healing was observed at 2 weeks postoperatively. The visual analogue score（VAS），University of California at Los Angeles（UCLA）shoulder rating score，shoulder active forward elevation（AFE），active external rotation（AER），active internal rotation（AIR）were assessed before operation and at 3 months and 6 months postoperatively. Six months after operation，reexamination of the front and side view of the shoulder and MRI of the shoulder were performed to assess the recovery of the subscapular tendon. Results:All patients were followed up for 6-12 months［（8.7±1.3）months］. All wounds healed 2 weeks after operation，with no infection occurred. The VAS was（3.5±0.7）points and（2.6±0.5）points at 3 months and 6 months postoperatively，lower than（6.3±1.2）points before operation（ P<0.01）. The UCLA score was（20.4±2.5）points and（25.6±6.2）points at 3 months and 6 months postoperatively，higher than（9.5±1.7）points before operation（ P<0.01）. The preoperative range of motion of the affected shoulder in AFE，AER and AIR was（80.2±12.6）°，（52.5±7.6）°，（3.7±1.2）°，respectively. Three months after operation，the range of motion was（113.2±7.5）°，（60.1±6.3）°，（6.8±1.6）°，respectively. Six months after operation，the range of motion was（122.3±15.2）°，（65.6±10.5）°，（7.8±2.3）°，respectively. The range of motion of the affected shoulder at 3 months and 6 months postoperativley was better than that before operation（ P<0.01）. Six months after operation，MRI showed good recovery in 27 patients，while a small re-tear in 1 patient（Goutallier classification grade 3）. Conclusion:For patients with obsolete traumatic subscapularis tears，arthroscopic repair can significantly relieve the pain，and recover range of motion and function of the joint.
ABSTRACT
Objective:To evaluate composite bridge internal fixation in the treatment of limb metaphyseal fractures in children.Methods:From October 2015 to December 2018, 16 children was treated by composite bridge internal fixation for limb metaphyseal fractures at Department of Orthopaedics, The Second People's Hospital of Changzhou. They were 11 boys and 5 girls, aged from 8 to 14 years (average, 11.0 years). Their fractures were located at proximal humerus in 4 cases, at distal femur in 3 cases, at proximal tibia in 3 cases and at distal tibia in 6 cases. According to the Salter-Harris classification, 6 cases were type Ⅱ, 5 cases type Ⅲ and 5 cases type Ⅳ. The time from injury to surgery ranged from 3 to 8 days, averaging 5.3 days. The fracture healing time, postoperative complications (infection and implant failure) and postoperative functional recovery were recorded.Results:This cohort obtained follow-up from 12 to 18 months (average, 13 months). All the children obtained bony union after 2 to 5 months (average, 2.4 months). At the last follow-up, the 4 proximal humeral fractures were evaluated by the Neer scores, giving 4 excellent cases; the 6 distal femoral and proximal tibial fractures were evaluated by the knee function scores of The Hospital for Special Surgery (HSS), giving 5 excellent and one good cases; the 6 distal tibial fractures were evaluated by the Baird scores, giving 5 excellent and one good cases. Follow-ups found no complications like postoperative infection, loosening or breakage of implants, or bone nonunion.Conclusion:Composite bridge internal fixation is a good alternative treatment for children metaphyseal fractures, because it has advantages of minimal invasion, operative simplicity, reliable fixation and limited postoperative complications.
ABSTRACT
Objective To compare the efficacy of direct anterior approach ( DAA ) and posterolateral approach (PA) in hip arthroplasty for elderly patients with femoral neck fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 67 elderly patients with femoral neck fractures admitted to Second People's Hospital of Changzhou City, Affiliated Hospital of Nanjing Medical University from July 2015 to December 2017. There were 25 males and 42 females, aged 60-90 years [(76. 1 ± 7. 6)years]. There were 31 patients with right femoral neck fracture and 36 with left femoral neck fracture, all of whom underwent operations within 72 hours after injury. There were 18 patients with type III and 49 with type IV according to Garden typing. All patients were treated with total hip arthroplasty. Direct anterior approach ( DAA) was performed in 36 patients ( DAA group) and posterior approach ( PA) was performed in 31 patients ( PA group) . The operation time, intraoperative blood loss, postoperative drainage, recessive blood loss, total blood loss, the time when the patients got out of bed, and hospitalization time were compared between the two groups. Visual analogue scale ( VAS) and Harris score were used to evaluate hip joint function one month after operation. The complications of the two groups were recorded. Results All patients were followed up for 3-6 weeks, with an average of one month. The operation time of DAA group was longer than that of PA group [(75. 0 ± 10. 5)minutes vs. (54.0±11.4)minutes] (P<0.01). The DAA group had less intraoperative blood loss [(174.3 ± 60.1)ml vs. (254.8±79.9)ml] (P<0.05), total blood loss [(745.7 ±238.8)ml vs. (977.9 ± 301. 9)ml] (P<0. 05), recessive blood loss [(315. 4 ± 196. 7)ml vs. (457. 7 ± 286. 2)ml] (P<0. 05) than the PA group. There was no significant difference in the postoperative drainage between DAA groupandPAgroup[(246.1 ±110.1)ml vs. (265.3±164.2)ml] (P >0.05). DAA group had shorter durations in terms of the time when patients got out of bed [(23. 7 ± 18. 1)hours vs. (35. 1 ± 22. 5)hours] (P<0. 01) and hospitalization time [(9. 2 ± 1. 5)days vs. (12. 3 ± 2. 0)days] than the PA group (P <0. 05). The VAS scores of the DAA group and PA group at 1 month after surgery [(3. 0 ± 1. 9)points vs. (3. 3 ± 1. 9) points] and the Harris score [(87. 9 ± 6. 5) points vs. (87. 0 ± 6. 1)points ] were not significantly different (P>0. 05). Intraoperative and postoperative complications included femoral periprosthetic fracture in three patients, lateral femoral nerve injury in two patients and severe anemia requiring blood transfusion in two patients in DAA group. In the PA group, there was one patient with deep venous thrombosis of the lower extremity at one month after operation, two patients with posterior dislocation of the hip, four patients with periprosthetic fracture and four patients with severe anemia requiring blood transfusion (P>0. 05). Conclusion For femoral neck fracture in the elderly, compared with PA hip arthroplasty, DAA hip arthroplasty has less bleeding, earlier time to get out of bed and shorter hospital stay, with satisfactory short-term results.
ABSTRACT
Several studies have evaluated the association between vitamin D receptor, matrix metalloproteinase 3 (MMP-3) polymorphisms and the risk of intervertebral disc degeneration susceptibility. The findings were inconsistent. This meta-analysis aimed to systematically assess the association between vitamin D receptor, MMP-3 polymorphisms and the risk of intervertebral disc degeneration susceptibility. A search of various databases was done covering all papers published until December 31th, 2014. Eight, 4, 3 studies were finally included that addressed the risk of intervertebral disc degeneration susceptibility and vitamin D receptor FokI (rs2228570), ApaI (rs7975232), and MMP-3 (rs731236) polymorphisms, respectively. FokI (f vs. F: summary odds ratio [OR], 1.13; 95% confidence interval [CI], 0.76–1.69; ff vs. FF: OR, 1.02; 95% CI, 0.59–1.77; ff vs. Ff/FF: OR, 1.05; 95% CI, 0.70–1.58), ApaI (a vs. A: OR, 0.73; 95% CI, 0.45–1.19; aa vs. AA: OR, 0.53; 95% CI, 0.22–1.25 p=0.14; aa vs. AA/Aa: OR, 0.69; 95% CI, 0.53–0.89) in the vitamin D receptor gene and MMP3 polymorphisms (5A vs. 6A: OR, 1.92; 95% CI, 0.77–4.80; 5A5A vs. 6A6A: OR, 2.17; 95% CI, 0.75–6.24; 5A5A vs. 5A6A/6A6A: OR, 1.58; 95% CI, 0.72–3.44) were not obviously associated with risk of intervertebral disc degeneration susceptibility. FokI, ApaI polymorphisms in the vitamin D receptor gene and MMP-3 polymorphism are not obvious risk factors for intervertebral disc degeneration susceptibility.
Subject(s)
Intervertebral Disc Degeneration , Intervertebral Disc , Matrix Metalloproteinase 3 , Odds Ratio , Receptors, Calcitriol , Risk Factors , Vitamin D , VitaminsABSTRACT
Objective To evaluate preliminary effect of In-Space percataneous interspinous spacer in the treatment of lumbar instability.Methods Data of 18 patients who had undergone interspinous spacer implant for lumbar instability from May 2009 to June 2011 were retrospectively analyzed.There were 10 males and 8 female,aged from 39 to 58 years.All patients suffered from varying degrees of lower back pain induced by lumbar hyperextension,as well as radiating and segmental pain of unilateral lower limb.The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate clinical outcomes.The pre-and postoperative interspinous distance,trailing edge height of intervertebral space,foraminal width,foraminal height,segmental lordotic angle and lumbar range of motion were tested and compared.Results All patients were followed up for 18 to 36 months.The VAS score improved from preoperative 7.9±2.1 to 3.1±1.3 at 6 months postoperatively and 1.5±0.8 at final follow-up.The ODI improved from preoperative 82.1％±13.1％ to 54.7％±14.8％ at 6 months postoperatively and 10.1％±2.5％ at final follow-up.The postoperative interspinous distance,trailing edge height of intervertebral space,foraminal height,foraminal width,segmental lordotic angle and lumbar range of motion were 9.29±1.43 mm,11.28±0.85 mm,21.27±1.01 mm,10.83±0.73 mm,7.62°±0.74° and 6.34°±0.81°,respectively.Wound healed smoothly in all patients,and there were no complications such as spinous process fracture,spinal cord injury,cerebrospinal fluid leakage,device displacement and device dislocation.Conclusion It is easy and safe to use In-Space percataneousinterspinous spacer in the treatment of lumbar instability,and the preliminary effect is satisfactory.
ABSTRACT
Objective To study the predictive value of serum hyaluronic acid (HA) levels for morphological progression of osteoarthritis (OA).Methods Seventy New Zealand white rabbits were randomly and equally divided into the OA group and the normal control group.OA was induced by injecting 0.5 ml of 2％ papain into the left knee joints and the same volume of sterile saline solution was injected Into right knee joints in control group.The serum HA levels were detected at 1,2,4,6,8,10 and 12 weeks after injection.Then magnetic resonance imaging (MRI) and pathohistological changes were observed.T test was used for the analysis of measurment.Resuts Compared with the control group,degeneration changes were found in the OA group,such as thinner articular cartilage,fibrillation and destroyed cartilage matrix,and inflammation,proliferation and degeneration of the synovial tissue.All these changes were much worse with prolonged observation time.The serum HA levels were increased [12 week:(657±132) ng/ml,vs (166±8) ng/ml],which correlate with structural damage.Conclusion Serum HA levels had a predictive value for further development of OA.
ABSTRACT
ObjectiveTo discuss the clinical efficacy of hyperextension reduction with percutaneous kyphoplasty in treatment for osteoporotic vertebral compression fracture.MethodsTwenty-three patients with 23 vertebral compression fractures underwent hyperextension reduction with percutaneous kyphoplasty from September 2010 to October 2011.The vasual analogue scale(VAS) score and complications were recorded during followed up.Results All cases were successfully experienced the procedure using unilateral or bilateral percutaneous pedicle underwent hyperextension reduction.The operation time was (75 ± 45) minutes,the mean volume of cement injected into each vertebral body was(4.9 ± 1.9) ml.All patients had successful intervention without spinal cord injury,pulmonary embolism.Followed up(7.5 ± 6.5 ) months,the symptoms of the patients were improved,preoperative VAS score was (7.5 ± 0.7 ) scores,reduced to (3.4 ±0.4) scores at day 1 postoperatively,(2.7 ±0.5) scores at day 7 postoperatively and (2.3 ±0.5) scores at month 1 postoperatively,there was significant difference between preoperative and postoperative (P＜ 0.05).ConclusionsApplication of hyperextension reduction with percutaneous kyphoplasty can relieve pain and restore the vertebral body height,it may be an effective treatment method for patients with osteoporotic vertebral compression fracture.
ABSTRACT
ObjectiveTo probe into the dependability of trochlear line (TL) as the reference axis for femoral component rotation in total knee arthroplasty.MethodsEighty-nine healthy adults had computed tomography (CT) scan for knees to position the surgical transepicondylar axis (STEA),posterior condylar line (PCL) and TL on the transverse sections.In the meantime,the angles including angle between TL and STEA (TSA),angle between TL and PCL (TPA) and angle between PCL and STEA (PCA) were measured and compare the dependability of TSA and PCA.ResultsThe TSA,TPA and PCA were (6.77 ± 3.12) °,(4.22 ± 2.64) ° and (2.95 ± 1.77) °,respectively.Three types of angles showed no statistical differences between males and females or between right knees and left knees (P ＞0.05).Rank sum test displayed significant differences in the overall distributions of three kinds of angles ( HC =66.837,P ＜0.01 ).The coefficient of variation of TSA was insignificant,but the standard variation was significant (3.12°).ConclusionTL can be considered only as the subsidiary femoral rotation osteotomy axis in total knee arthroplasty.
ABSTRACT
Objective To investigate the difference of short-term clinical efficacy between decompressive laminectomy into In-Space and simple decompressive laminectomy for treatment of lumbar spinal stenosis with vertebral instability.Methods Thirty-three patients with lumbar spinal stenosis with vertebral instability admired from May 2009 to July 2010,were divided into two groups by random number table.Group A of 16 cases was treated with laminectomy decompression and placement In-Space,group B of 17 cases was treated with laminectomy decompression.Lumbar anteroposterior,lateral and flexion-extension X-ray films,preoperatively,and the follow-up were used to measure anterior and posterior disc height,foraminal height,segmental lordotic angle at surgical level.Using Oswestry disability index (ODI) and the visual analogue scale (VAS) to evaluate the clinical efficacy.Results All patients were followed up for (13.20 ± 2.91 ) months (range 6 to 21 months).The anterior disc height after operation of group A was slightly decreased compared with the preoperative(P＞ 0.05 ),the posterior disc height at 1 day after operation and foraminal height after operation of group A were significantly increased compared with the preoperative (P＜ 0.05).The anterior and posterior disc height,foraminal height of group B at 1 day,1 month,3 months after operation were no significantly different compared with the preoperative (P ＞ 0.05 ),at 6 months after operation and the end of follow-up were significantly decreased compared with the preoperative or 1 day after operation (P ＜ 0.05 ).Activity of lumbar vertebra by preoperative 9.86° ± 1.90° decreased to the end of followup 5.60° ± 2.02°in group A,while activity of lumbar vertebra by preoperative 9.89° ± 2.00°increased to the end of follow-up 10.76° ± 3.14° in group B.At the end of follow-up,lumbar back pain VAS,ODI score [ (2.02 ± 1.98 ),( 20.18 ± 18.80) scores ] of group A were significantly lower than those of group B [ (4.15 ±2.36),(30.39 ± 16.62 ) scores ],the differences were statistically significant (P ＜ 0.05 ).No patient suffered In-Space loosening,fracture and emerge.Conclusion The operation of In-Space can maintain spinal mobility and stability as well as avoiding lumbar vertebral instability,and its short-term efficacy is satisfactory.
ABSTRACT
Objective To compare the clinic effect of the locking compression plate (LCP) fixation and the anatomical plate in treatment of high-energy distal tibial fractures. Methods The study involved 42 patients with high-energy distal tibial fractures treated between May 2003 and May 2009. The anatomical plate group included 24 patients ( 16 males and 8 females, at average age of 39 years), of whom there were 13 patients with type A fractures, five with type B and six with type C according to the AO/ASIF classification. The LCP group included 18 patients ( 15 males and 3 females, at average age of 40 years), of whom there were 11 patients with type A fractures, three with type B and four with type C according to the AO/ASIF classification. All the patients were followed up for 8-17 months. Their functional and radiographic outcomes were collected. The operation time, intra-operative blood loss, X-ray exposure, bone healing time, post-operative complications and therapeutic effects were compared between both groups. Mazur's criteria was used to evaluate the function of the ankle. Results The LCP group was followed up for average 11.6 months and the anatomical plate group for average 14.2 months, which showed fracture healing in all the patients. The bone graft in the anatomical plate group was used more frequently than the LCP group, while the X-ray exposure in the LCP group was much more than that in the anatomical plate group. The operation time, incision size, blood loss, postoperative complications and radiographic bone healing time in the LCP group were significantly less than those in the anatomical plate group. Conclusions Both the LCP and anatomical plate are effective methods for the high energy distal tibial fractures. LCP has advantages of less trauma, quick fracture healing and less complications, is consistent with the biomechanics of internal fixation and hence is an ideal method for the treatment of the high-energy tibial fractures.
ABSTRACT
ObjectiveTo elucidate the association between RANKL rs7984870 C ＞G polymorphism and the susceptibility to rheumatoid arthritis in a Chinese Han population.MethodsGenotypes were determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) method in 214 rheumatoid arthritis cases and 478 controls.ResultsThe RANKL rs7984870 C＞G genotype frequencies were 27.3% ( CC),51.2% ( CG),21.5% (GG) in the rheumatoid arthritis group and 25.3% (CC),49.1% (CG),25.7% (GG) in the control group respectively; Logistic regression analyses revealed that the risk associated with RANKL rs7984870 C＞G variant genotype was 0.78 (95% CI =0.49-1.24) for RANKL rs7984870 GG compared with its wild-type homozygote.ConclusionRANKL rs7984870 polymorphism may not serve as a risk factor of rheumatoid arthritis susceptibility.Further functional studies are warranted to verify our findings.
ABSTRACT
Objective To study the clinical effect of expert tibial nail (ETN) in the treatment of distal tibial fractures. Methods From October 2007 to June 2008,ETN was performed in 13 patients with distal tibial fractures. There were eight males and five females, at age range of 25-47 years (33.8 on average). According to AO/ASIF classification, there were three patients with 43-A1 fractures, four with 43-B1 fractures, four with 43-B2 fractures and two with 43-C1 fractures. All the patients were with close fractures except for three patients with Gustilo-Anderson type Ⅰ fractures. Their clinical data were analyzed for assessing the clinical effect of ETN. Results All patients were followed up for a mean time of 8.4 months (range 3-13 months), which showed that all the fractures obtained stable fixation and sound healing, with no complications like breakage of ETN, wound infection, fracture nonunion or limb shortening. According to Johner-Wruhs standard, the functional results were excellent in 10 patients and good in three. Conclusion ETN has advantages of minimal invasion, shorter operation time, stronger fixation,better soft tissue protection and better functional recovery for distal tibial fractures in comparison with traditional open reduction and buttress plate fixation.
ABSTRACT
BACKGROUND: Centrifugal force is a contributing factor inducing osteoblastic differentiation from bone marrow stroma cells.OBJECTIVE: To explore whether centrifugal force promote osteoblastic differentiation from rabbit marrow stroma cell seeded on polylactic-co-glycolic acid (PLGA) scaffolds. METHODS: Rabbit bone marrow stroma cells were isolated and cultured by whole bone marrow method, purified by attachment method, and digested by trypsin-EDTA at 80% confluency. The cell concentration was adjusted to 1×10~9/L. PLGA was cut into pieces, 5 mm×5 mm, soaked in serum-conditioned culture medium for 24 hours. The third passage of bone stroma cell suspension at a density of 300 μL was respectively seeded into the PLGA material. The scaffold/cell compound was placed in centrifuge tube, with cell at the upper layer and cultured in osteoblastic induced medium containing antiscorbic acid, β-sodium glycerophosphate, and dexamethasone respectively under centrifugal force every 12 hours (1 000 r/min for 30 minutes, relative centrifugal force 132 g) and static condition. Alkaline phosphatase activity, osteocalcin content and calcium content as well as observation by light microscopy were used to evaluate osteoblastic differentiation. RESULTS AND CONCLUSION: After 16 days of in vitro culture, the scaffolds of centrifugal force group were coated by multiplayer cells and mineralized matrix, but only a thin layer of cells were observed on the scaffold of control group. The centrifugal force system resulted in a significant decrease in alkaline phosphatase activity at day 2 (P < 0.05) but significant increase at day 4 compared with the static culture condition (P < 0.05). During the whole culture time, osteocalcin secretion remained low in control group. At days 12 and 16, a significant enhancement in osteocalcin secretion was observed for centrifugal force culture compared with static culture conditions (P < 0.05). Moreover, after 16 days of culture a significant increase in calcium deposition was observed in the scaffolds subjected to centrifugal force compared with static culture condition (P < 0.05). Centrifugal force can enhance osteoblastic differentiation and mineralized matrix production of bone marrow stroma cell seeded in PLGA.
ABSTRACT
@#Objective To introduce a sort of method about thumb reconstruction to complex thumb defect. Methods From January 2003 to December 2006, 13 patients who incur sever thumb defect above5 grade adopt the upper limb lateral bone-skin flap combined with the second toe transplant primary thumb reconstruction, pestop follow-up visit 12 months to 3 years, according to hand surgery society of Chinese Medical Associaition thumb and finger reconstruction functional assessment probation standard to evaluatethe function of reconstituted thumb. Results All of the transplanted upper limb lateral bone-skin flaps and the second toes take, and function well. Conclusion The upper limb lateral bone-skin flap combined with the second toe transplant primary repair complex thumb defect had been tested one good method for thumb reconstruction to above 5 grade thumb defect.
ABSTRACT
[Objective]To explore the clinic results of the locking compression plate fixation for the acetabular fractures.[Method]Twenty-three patients were treated in the author's department, 16 of them were male and 7 were female patients.The ages ranged from 21 to 61 years, and mean age was 43.3 years.Ninteen patients had been injured in an automobile accident,3 were fell from height and 1 was crushed by a heavy object. The patients were classified according to Letournel classification.There were 7 anterior column fractures,3 posterior wall fractures,5 anterior wall fractures,2 transverse fractures,1 anterior column and posterior column fracture,1 T shape fracture, 3 posterior wall and posterior column fractures,1 transverse and posterior wall fracture.[Result]All the incisions healed during the primary procedure and all the patients were available at follow-up ranging from 3 to 24 months(average 20.1 months).The average intraoperation time was 123 minutes(50～235 minutes),and the intraoperative blood loss was 100 to 1500 ml.The patinents underwent blood transfusion from 0 ml to 1 200 ml.According to Matt's criteria, the rate of excellent and good was 73.9%(17/23).[Conclusion]The locking compression plate fixation is one of the effective methods for treatment of acetabular fractures, with the advantages of being simple and minimally traumatic.