ABSTRACT
OBJECTIVE@#To investigate clinical effect of open reduction and internal fixation in treating proximal humeral fracture by using long head of biceps tendon cutted-off and re-fixation.@*METHODS@#From January 2014 to January 2017, 50 patients with proximal humeral fractures were treated by open reduction and internal fixation. According to whether long head of biceps tendon cutted-off and re-fixation, patients were divided into control group and treatment group, 25 patients in each group. There were 13 males and 12 females with an average of (73.8±4.5) years old in control group, treated with conventional open reduction and internal fixation. There were 15 males and 10 females, with an average of (74.1±5.4) years old in treatment group, treated by using long head of biceps tendon cutted-off and re-fixation on the basis of control group. Fracture healing time and complications after operation were compared between two groups, VAS score was used to evaluate relieve degree of pain, and Neer functional score at 1, 3, 6, 12 months after operation was applied to access clinical efficacy.@*RESULTS@#All patients were followed up for 12 to 24 months with an average of (14.5±3.6) months. There was no statistical difference in following-up between tow groups. Postoperative VAS score at 1 week between treatment group and control group were 2.92±1.10 and 5.88±0.90 respectively, and had significant difference(0.05). According to postoperative Neer score at 12 months, 9 patients got excellent results, 14 moderate and 2 poor in treatment group; while 4 patients got excellent results, 18 moderate and 3 poor in control group; but there was no difference between two groups. Fracture were healed without postoperative complications between two groups.@*CONCLUSIONS@#Open reduction internal fixation with in treating proximal humeral fracture by using long head of biceps tendon cutted-off and re-fixation could reduce pain, speed up early recovery of joint function, is worthy of further promotion.
Subject(s)
Aged , Female , Humans , Male , Bone Plates , Case-Control Studies , Fracture Fixation, Internal , Fracture Healing , Humeral Fractures , General Surgery , Shoulder Fractures , Tendons , Treatment OutcomeABSTRACT
Bone marrow mesenchymal stem cells (BMSCs) are a group of pluripotential non-hematopoietic somatic stem cells niched in bone marrow.With the characteristics of stable genetic traits,pluripotential in differentiation,easy to isolate from source tissue,and fast to proliferate when cultured in vitro,BMSCs are currently attracting extensive research interests,and considered to be one of the most promising candidates in corneal tissue engineering.At present,many research groups,domestic and abroad,have reported that BMSCs can not only differentiate into corneal limbal stem cells,corneal epithelial cells,and corneal endothelial cells,but also play an important role in ocular surface repair.However,the successful application of BMSCs in cornea usually depends on the correct selection of supporting materials or scaffold,such as xenogeneic corneal stroma and amniotic membrane.Other unsolved problems in BMSCs-related corneal tissue engineering include the molecular biologic mechanism underlying the directional differentiation from BMSCs to corneal cells,the standards to identify BMSCs from differentiated corneal cells,the optimal scaffold materials and the potential tumorigenicity with grafting of transformed or undifferentiated BMSCs.This paper reviewed the progresses and issues of corneal tissue engineering with BMSCs.
ABSTRACT
Background Corneal blindness caused by ocular surface disease is one of the main reasons for the global blinding corneal diseases.With the development and progress of tissue engineering technology,tissueengineered cornea offers a new approach to the treatment of ocular surface disease.Objective This study was to obscrve the growth and differentiation of human umbilical cord mesenchymal stem cclls (UC-MSCs) on thc corneal stroma of receipts and investigate the feasibility of human UC-MSCs differentiated into corneal epithelium-like cells and the reparation of injury cornea.Methods Human UC-MSCs were isolated from human umbilical cord using collagenase Ⅳ digestion and passaged in DMEM/F12 containing fetal bovine serum in vitro.The immunophenotype of cultured human UC-MSCs was evaluated by flow cytometry.The differentiated osteoblasts from the human UC-MSCs by directional induce was identified.Twenty-four New Zealand albino rabbits were randomly divided into 2 groups.The human UC-MSCs were cultured on porcine corneal matrix without corneal epithelium for 4 days and then transplanted onto the 12 left eyes of 12 New Zealand albino rabbits,and porcine corneal matrix without corneal epithelium was transplanted onto the left eyes of other 12 New Zealand albino rabbits as control group.The rabbits received keratoplasty were examined using in vivo confocal microscope through focusing(CMTF).The eyeballs were taken off after 2,4 and 8 weeks,the growth and differentiation,expression of cytokeratin 3 (CK3),CK12 and ATP-binding cassette superfamily G memben 2 (ABCG2)of human UC-MSCs were observed by histopathology and immunofluorescence staining.This use of the experimental animals complied with ARVO Statement.Results Digestive human UCMSCs formed round in shape and was large in size.The attached cells displayed long-fusiform shape like fibroblasts.The cultured human UC-MSCs phenotype was CD105+/CD29+/CD44+/CD34-/CD45-and could be induced toward osteoblast differentiation under the appropriate experimental conditions.Human UC-MSCs grew well on the porcine corneal matrix.The corneal grafts survived wcll without rejection till the experiment end in experimental eyes,but the rejection of corneal graft occurred in control eyes.Confocal microscope could observe corneal epithelium-like cells.The corneal epithelium cells showed the positive response for CK3 and CK12 and absent response for ABCG2.Conclusions Human UC-MSCs with porcine corneal matrix can survive,proliferate and differentiate into corneal epithelium-like cells after transplanting onto the corneal stroma of rabbits.This result suggests that human UC-MSCs is able to repair and reconstruct the injured corneal surfaces.