Clinical analysis of prosthesis replacement for proximal humerus tumors / 中南大学学报(医学版)

OBJECTIVE@#To explore surgical strategies, functions and prognosis of artificial prosthesis replacement and soft tissue reconstruction for patients with invasive benign or primary malignant proximal humerus tumor.
@*METHODS@#A total of 17 patients with invasive benign or primary malignant proximal humerus tumor underwent prosthetic replacement after segment bone tumor resection and soft tissues reconstruction from April 2007 to April 2014 were enrolled. Based on histological types, tumor stages and surgical procedures, the effects of artificial prosthesis replacement and soft tissue reconstruction on prognosis and shoulder joint function were evaluated.
@*RESULTS@#All patients were followed up for 8 to 96 months (average time: 58.9 months). Among 11 patients with primary malignant tumor, 5 died of tumor recurrence or metastasis, and 6 showed tumor-free survival for 24 to 91 months (average time: 54.83 months). The 6 patients with aggressive benign tumors survived for 39 to 96 months, with an average of 72.33 months. The shoulder joint function of 17 patients recovered to 64.88% of normal. There were significant differences in the shoulder joint function between the patients who underwent half shoulder replacement and those who underwent total shoulder replacement (56.25% vs 72.56%, P<0.05). There were significant differences in the shoulder joint function between the patients who underwent Type I A excision (retention of abductor muscles and rotator cuff) and those who underwent Type I B excision (68.75% vs 61.44%, P<0.05).
@*CONCLUSION@#The survival of patients with invasive benign or primary malignant proximal humerus, who underwent artificial prosthesis replacement and soft tissue reconstruction, is closely related to tumor types. The shoulder joint function is associated with the methods of prosthesis replacement and soft tissue resection.

An preliminarily experimental study of bone mineral density mediated by new tuberculosis-controlled release composite / 中国医师杂志

Objective To investigate bone mineral density ( BMD ) after filling in the bone scaffolds with anti-tuberculosis controlled-release microspheres, and provide experimental basis for decrease of the side effects of anti-tuberculosis therapy after spinal surgery.Methods The bone densitometer was used to observe the changes of bone mineral density before and after the infusion with the artificial allograft bone (Group A), the controlled release complex of the RFP controlled-release microspheres-artificial allograft bone (Group B), and RFP-artificial allograft bone complex (Group C), respectively.Results BMDs of three groups before perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.186 ±0.016)g/cm2;Group C:(0.189 ±0.018)g/cm2;P >0.05].BMDs of three groups after perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.179 ±0.023)g/cm2;Group C:(0.185 ±0.021)g/cm2;P >0.05].Conclusions RFP microspheres using ultrasonic vibration method and the porous bone were prepared to controlled-release anti-tuberculosis complex .BMD of three groups after perfusion were not influenced obviously .

One-stage management of open distal tibial Pilon fractures / 中南大学学报(医学版)

Objective To explore the operative method of open distal tibial pilon fractures, and to evaluate the outcome of ankle joint function postoperatively. Methods From March 2003 to March 2007, 24 patients with open Pilon fractures were treated with one-stage open reduction and internal fixation (18 males and 6 females) . The average age was 37. 6 years (14 ～ 53 years) . All 24 patients had open fracture, 12 of whom combined fibular fracture. According to AO comprehensive classification system, the fractures was classified as C1 in 4, C2 in 9, and C3 in 11. According to Gustilo-Anderson classification method, the fracture was classified as Type Ⅰ in 3, Type Ⅱ in 5, Type Ⅲ A in 4, Type Ⅲ B in 10, and Type Ⅲ C in 2. All tibial pilon fractures were treated by radical debridement, one - stage open reduction and internal fixation. Soft tissue defection was covered by a vascularized flap and continually washed by pipes under the flap. Results All patients were followed-up at an average of 2. 3 years(1～3.8 years) after the surgery. All the fractures healed at an average of 22. 3 weeks (16 ～54 wk) postoperatively. According to the scoring system of Con-roy, 17 were excellent (62. 5%), 4 good (25%), and 3 poor (12.5%), The excellence rate was 87.5% . According to the ankle score of Teeny and Wiss, there were 11 excellent (37. 5%), 7 good (37.5%), 3 fair (16.7%), and 3 poor (8.3%) and the excellence rate was 75% . Conclusion One-stage management for open Pilon fracture has the advantages of fewer complications, lower infectious rate, and better ankle joint function.

Platelet-rich plasma induces osteogenetic activity of canine bone marrow mesenchymal stem cells in vitro / 中国组织工程研究

BACKGROUND: Platelet-rich plasma (PRP) contains abundant growth factors that were needed for osteanagenesis. Moreover,the proportion of each growth factor formed by an organism, with good synergism.OBJECTIVE: To explore the influence of PRP on osteogenetic activity of canine bone marrow mesenchymal stem cells (BMSCs) after induction in vitro.DESIGN, TIME AND SETTING: The in vitro cytological experiment was performed at the Central Laboratory of Xiangya Hospital of Central South University from June 2007 to February 2008.MATERIALS: Healthy 12-month male Beagle dogs were supplied by the Experimental Animal Center, Xiangya Medical College,Central South University.METHODS: The 3~(rd) generation BMSCs were collected and divided into 4 groups. BMSCs in the control group were incubated in standard medium. BMSCs in the osteogenetic induction medium group were incubated in high-glucose DMEM containing fetal calf serum, dexamethasone, beta-sodium glycerophosphate and vitamin C. BMSCs in the PRP group were incubated in low-glucose DMEM containing 6.25% PRP. BMSCs in the combination group were incubated in high-glucose DMEM containing 6.25% PRP, dexamethasone, beta-sodium glycerophosphate, and vitamin C.MAIN OUTCOME MEASURES: Alkaline phosphatase activities were measured. Expression of collagen type I was examined by immunocytochemical staining. Calcium tuberoses were labeled using modified Von Kossa staining. Expression of osteocalcin mRNA was examined by RT-PCR.RESULTS: Levels of alkaline phosphates of all groups became increased along with time. The alkaline phosphates level of combination group was strongest (P < 0.05). Following 7 and 14 days of induction, type I collagen expressed positively in the osteogenetic induction medium and combination groups, but negatively in the PRP and control groups. Following 14 days,formation of calcium nodules were found in the osteogenetic induction medium and combination groups. Following 7 and 14 days,expression of osteocalcin mRNA were similar between the control and PRP groups (P > 0.05), which was significantly lower than the osteogenetic induction medium and combination groups (P < 0.05). Expression of osteocalcin mRNA was significantly lower in the osteogenetic induction medium group compared with the combination group (P < 0.05).CONCLUSION: PRP gel can effectively promote osteoblastic effect of BMSCs after induction in vitro following induction in osteogenetic medium.

Influence of various volume fractions of platelet-rich plasma on dog bone marrow mesenchymal stem cell proliferation / 中国组织工程研究

BACKGROUND: Proliferation and differentiation of mesenchymal stem cells (MSCs) is associated with platelet concentration in platelet-rich plasma (PRP). Low enrich multiple cannot reach proper effects, but high level had inhibitory effects on osteoanagenesis.OBJECTIVE: To observe the effect of different volume fraction of PRP on dog BMSC proliferation.DESIGN: A cytological in vitro study.MATERIALS: Healthy 12-month male Beagle dogs were supplied by the Experimental Animal Center, Xiangya Medical College,Central South University.METHODS: Dog BMSCs of 5 passage were adjusted to 3×10~8/L, and incubated in a 96-well plate at 200 μL per well. Following 24 hours of routine culture, primary medium and non-adherent cells were discarded. Prepared PRP gel was mixed with serum-free low-glucose DMEM containing penicillin and streptomycin, and then diluted into 5%, 6.25%, 7.5%, 8.75%, 10% volume fraction. 200 μL above-described liquid was added into the 96-well plate, which was subsequently placed in a incubator.We set up a blank control.MAIN OUTCOME MEASURES: MTT was used to investigate effect of different volume fraction of PRP on dog BMSC proliferation.RESULTS: Compared with the blank control group, various volume fraction of PLP could promote dog BMSC proliferation in early stage. With prolonged time, proliferation speed began to increase at day 6 in the 8.75% and 10% PRP groups, entering platform stage. BMSC number was increased rapidly in the 5% and 6.25% PRP groups, especially in the 6.25% PRP group.CONCLUSION: PRP gel could promote BMSC proliferation markedly and proliferation strength of BMSCs was correlated to the density of PRP. BMSC proliferation would be accelerated by the low density of PRP.