Conditional Deletion of Foxg1 Alleviates Demyelination and Facilitates Remyelination via the Wnt Signaling Pathway in Cuprizone-Induced Demyelinated Mice / 神经科学通报·英文版

The massive loss of oligodendrocytes caused by various pathological factors is a basic feature of many demyelinating diseases of the central nervous system (CNS). Based on a variety of studies, it is now well established that impairment of oligodendrocyte precursor cells (OPCs) to differentiate and remyelinate axons is a vital event in the failed treatment of demyelinating diseases. Recent evidence suggests that Foxg1 is essential for the proliferation of certain precursors and inhibits premature neurogenesis during brain development. To date, very little attention has been paid to the role of Foxg1 in the proliferation and differentiation of OPCs in demyelinating diseases of the CNS. Here, for the first time, we examined the effects of Foxg1 on demyelination and remyelination in the brain using a cuprizone (CPZ)-induced mouse model. In this work, 7-week-old Foxg1 conditional knockout and wild-type (WT) mice were fed a diet containing 0.2% CPZ w/w for 5 weeks, after which CPZ was withdrawn to enable remyelination. Our results demonstrated that, compared with WT mice, Foxg1-knockout mice exhibited not only alleviated demyelination but also accelerated remyelination of the demyelinated corpus callosum. Furthermore, we found that Foxg1 knockout decreased the proliferation of OPCs and accelerated their differentiation into mature oligodendrocytes both in vivo and in vitro. Wnt signaling plays a critical role in development and in a variety of diseases. GSK-3β, a key regulatory kinase in the Wnt pathway, regulates the ability of β-catenin to enter nuclei, where it activates the expression of Wnt target genes. We then used SB216763, a selective inhibitor of GSK-3β activity, to further demonstrate the regulatory mechanism by which Foxg1 affects OPCs in vitro. The results showed that SB216763 clearly inhibited the expression of GSK-3β, which abolished the effect of the proliferation and differentiation of OPCs caused by the knockdown of Foxg1. These results suggest that Foxg1 is involved in the proliferation and differentiation of OPCs through the Wnt signaling pathway. The present experimental results are some of the first to suggest that Foxg1 is a new therapeutic target for the treatment of demyelinating diseases of the CNS.

Correlation between 1H-MRS metabolites in hippocampal and T lymphocyte subsets and cytokines in peripheral blood of patients with temporal lobe epilepsy / 中华行为医学与脑科学杂志

Objective:To analyze the correlation between 1H-MRS in hippocampus and peripheral blood cytokines and T lymphocyte subsets in patients with temporal lobe epilepsy, and to explore the relationship between immune dysfunction and the degree of neuronal injury. Methods:Fifty patients with temporal lobe epilepsy were selected from Affiliated Hospital of Xuzhou Medical University from October 2020 to July 2021.Clinical data of all patients were collected and they were divided into two groups according to MRI results of epileptic sequence: abnormal hippocampal MRI group ( n=20) and normal hippocampal MRI group ( n=30). Bilateral 1H-MRS scanning of hippocampal and detection of T lymphocyte subsets and cytokines in peripheral blood during interictal period were performed in both groups. The levels of hippocampal metabolites NAA, NAA/(Cr+ Cho), T lymphocyte subsets and cytokines in peripheral blood of the two groups were compared.At the same time, the levels of NAA and NAA/ (Cr+ Cho) in the hippocampus on the abnormal side and the normal side in the abnormal hippocampal MRI group were compared within the group. Finally, the correlation between the levels of metabolites NAA, NAA/ (Cr+ Cho) in the hippocampus on the abnormal side obtained by 1H-MRS scanning and T lymphocyte subsets and cytokines in the abnormal group of MRI was analyzed. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test or Mann-Whitney U test was used for comparison between the two groups. Paired sample t-test was used for intra group comparison of different sides. Spearman correlation analysis was used to analyze the correlation between each index. Results:The NAA and NAA/(Cr+ Cho) values of the abnormal MRI group(normal side NAA: (1.22±0.37), NAA/(Cr+ Cho): (0.56±0.15). abnormal side NAA: (1.02±0.34), NAA/(Cr+ Cho): (0.48±0.13)) were significantly lower than those of the normal MRI group (NAA: (1.51±0.36), NAA/(Cr+ Cho): (0.73±0.19))(NAA: t=2.705, 4.800, both P<0 05; NAA/(Cr+ Cho): t=3.394, 4.914, both P<0 05). The values of NAA and NAA/(Cr+ Cho) in the abnormal side in the MRI abnormal group were significantly lower than those in the normal side( t=6.467, P<0 05). The levels of IL-1β(11.19(3.56, 20.98)pg/ml), IL-5 (3.12(1.86, 6.41)pg/ml), TNF-α(2.55(1.19, 8.28)pg/ml), CD4+ T lymphocytes((43.13±6.82)%) and Th/Ts((1.96±0.66)) in the hippocampal MRI abnormal group were significantly higher than those in normal MRI group (IL-1β: 3.27(1.63, 6.17)pg/ml, IL-5: 1.15(0.96, 2.96)pg/ml, TNF-α: 1.34(1.02, 2.36)pg/ml, CD4+ T: (38.01±7.21)%, Th/Ts: (1.48±0.53))( Z=-3.041, -2.516, -2.496, all P<0.05; t=2.511, 2.810, both P<0 05). The level of CD8+ T ((23.48±5.33)%) in peripheral blood of abnormal MRI group was significantly lower than that of normal group CD8+ T((27.18±6.08)%)( t=2.210, P<0.05). In the abnormal MRI group, the levels of NAA and NAA/ (Cr+ Cho) in the abnormal hippocampus were negatively correlated with the levels of IL-1β, IL-5 and TNF- α ( r=-0.612--0.463, all P<0.05), and positively correlated with CD8+ T lymphocytes ( r=0.537, 0.478, P<0.05). Conclusion:There is neuronal damage and dysfunction in the abnormal hippocampal region of patients with temporal lobe epilepsy with abnormal hippocampal formation, and the degree of neuronal damage is highly correlated with CD8+ T lymphocytes, IL-5, IL-1β and TNF-α in peripheral blood. The imbalance of interictal lymphocyte subsets and chronic inflammatory response may play an important role in the pathogenesis of epilepsy and neuronal injury .

Aplication of 3D-printed prosthesis on construction of long segmental bone defect after tumor resection / 中华骨科杂志

Objective To explore the feasibility and clinical efficacy of long-segmental bone defects after en bloc tumor resection of lower limb segment with composite of titanium alloy 3D printed prosthesis and vascularized fibular autograft and bioceramics.Methods 5 patients with lower extremity tumor (1 high grade chondrosarcoma,1 Ewing sarcoma,1 single metastatic tumor and 2 osteosarcoma) were treated by en bloc resection and precise reconstruction with segmental 3D-printed,custom-made prosthesis from August 2015 to November 2016,which composed of 1 male and 4 females,ranged from 16 to 56 years old,the average was 32± 19.3 years old.Three-dimensional computed tomography reconstructed images of patients' tumors were built before surgery.Custom-made prostheses were manufactured based on the patients' reconstructed images with micro-pores on the surface.After en bloc tumor resection with the help of osteotomy guide plate,the defects were reconstructed with 3D-printed,custom-made prostheses.Vascularized fibular autografts were put inside the prostheses,and the interval space among them was filled with bioceramics.Results All the 5 cases were performed surgical planning before the surgery with prosthesis and guide plate were designed at the same time.After verification of the finite element analysis SLM (2 cases) and the EBM (3 cases) were used to process prosthesis,and were designed into porous sharp with 210.98±66.16 mm in length and 26 901.76±12 903.96 mm3 in volume.Then the prosthesis would be cleaned and sterilized.All 5 operation were proceeded according to the plan of preoperative.The intra-operative guide plate were installed on the bone surface stably.The bone cutting was guided according to the plan of preoperative.By intra-operative frozen pathological examination,there were no malignant tissues in near and far marrow cavity.Unfolded fibular flap with 168.75±49.07 mm in length and porous tricalcium phosphate particle composite implants with 10±4.08 g were used in 4 cases and bone cement was used in 1 cases of metastatic tumor.The average operation time was 261±85 min and average blood loss was 540±182 ml.After a mean follow-up time of 6.4 months (1-15 months),all 5 cases survived with no local recurrence and pulmonary metastasis tumor.2 cases with vascular pedicle fibular transplant confirmed the survival of fibula via bone scan 3 months after operation.All cases were no infection,fractures,prosthesis loosening,except broken screw in 1 case.The Musculoskeletal Tumor Society (MSTS) 93 score was 17-26.Conclusion Long segment tubular titanium alloy 3D printed prosthesis with vascularized fibular autograft and bioceramics could reconstruct the segmental defects caused by tumor resection.

Effects of reconstruction with unicondylar osteoarticular allografts with or without prosthesis for bone tumors around knee joint / 中华外科杂志

Objective@#To investigate the survival rate, function outcomes, and complications after using unicondylar osteoarticular allografts with or without prosthesis to reconstruct the knee joint for tumors located in distal femoral or proximal tibial uni-condyle.@*Methods@#Twenty-two patients who underwent unicondylar osteoarticular allografts with or without prosthesis composite reconstructions from January 2007 to December 2015 in Department of Orthopaedic Surgery of Xi Jing Hospital, the Fourth Military Medical University were retrospectively reviewed. There were 14 males and 8 females and the mean age was 35 years(8-65 years). There were 12 malignent tumors and 10 aggressive benign tumors. The tumors were located in distal femur in 14 cases and proximal tibia in 8 cases. After tumor excision, the distal femur was reconstructed with unicondylar osteoallograft-prosthesis composite, and proximal tibial plate was reconstructed with unicondylar osteoarticular allograft with the help of computer-assisted navigation system. Function and radiograph were documented according to the Musculoskeletal Tumor Society (MSTS) functional scoring system and the International Society of Limb Salvage (ISOLS) radiographic scoring system. The median follow-up time was 60 months (5-116 months).@*Results@#At the latest follow-up, 2 patients had amputation owing to local recurrence in 12 malignant tumors. Three patients had pulmonary metastasis and 1 patient died another 2 alive with disease. Kaplan-Meier analysis indicated that the disease-free survival rate was 73%. There was no recurrence and metastasis in 10 patients with giant cell tumor. The average MSTS score was 26 points and the radiographic score was 78%-94%(average 90%). The complications included superficial infection in 1 patient and screw broken in 1 patient. There was no broken or collapse allograft in all composite reconstruction patients but 6 cases in allograft reconstruction.@*Conclusions@#Unicondylar osteoarticular allografts or prosthesis composite was feasible reconstruction for tumors in distal femoral uni-condyle. It could provide good functional outcomes and also prevent joint degeneration. Similarly, allograft reconstruction was also a reliable technique for proximal tibial defect.

Effects of olfactory bulb lesion on neural stem cells proliferation and expression of NMDA-receptor subunit 2B in the subventricular zone of rats / 中华行为医学与脑科学杂志

Objective To investigate the effects of olfactory bulb(OB) lesion on neural stem cells proliferation and expression of NMDA receptor subunit 2B in subventricular zone(SVZ) of rats.Methods Sixty adult female SD rats were randomly divided into normal group,saline group and OB lesion group.OB lesion was induced by N-methyl-D-aspartic acid (NMDA) injection.Each group was respectively divided into four time points including 3 d,7 d,14 d and 28 d.Immunohistochemistry staining was used to detect the number of Nestin,Ki67 and NR2B-positive cells in the SVZ.Results (1) Nestin positive cells in the SVZ were shown at the different time of three groups.Seven days after OB lesion,IOD value of nestin-positive cells began to increase((29601± 1788)/0.01 mm2,P＜0.05),reached the maximum at 14 d((49800±3701)/0.01 mm2,P＜0.05) and still sustained a high level at 28 day((27600±3209)/0.01 mm2,P＜0.05).(2)Ki67 positive cells in the SVZ were shown at the different time of three groups.The number of Ki67-positive cells was increased significantly at 7 d,14 d and 28 d after OB lesion compared to normal group and saline group (P＜0.05).(3)NR2B immune expression in the SVZ was shown at the different time of three groups.The NR2B-positive cells increased at 3 d after OB lesion(58.80±2.95,P＜0.05),reached the maximum at 14 d(68.40±4.04,P＜0.05).At 28 d of OB lesion,the number of positive cells was reduced,but still sustained a high level(62.20±3.56,P＜0.05).(4)The positive cells of NR2B and Ki67 were highly positive correlation at different time after OB lesion(r=0.968,P＜0.05).Conclusions OB lesion can stimulate neural stem cell proliferation and increases the expression of NR2B.The increased mode of NR2B is in accordance with the schedule of the neural stem cells increase induced by OB lesion.Therefore,it indicates that the NMDA receptor subunit 2B may be involved in neural stem cell proliferation.

A comparative analysis of the changes of transcriptome after fusion of esophageal cancer cells with human umbilical mesenchymal stem cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the transcriptome of esophageal cancer cells (EC9706), human mesenchymal stem cells (MSCs), and after fusion of esophageal cancer cells with MSCs, and to further study their different expression profiles and the changes of their signaling pathways.</p><p><b>METHODS</b>We examined the gene expression profiles of these cells with transcriptome microarray using LIMMA package and several web-based applications, such as DAVID, ToppGene and MSigDB. The resulting sets of differentially expressed genes (DEGs) were comprehensively analyzed to identify the pathways and their changes after the cell fusion.</p><p><b>RESULTS</b>A total of 4 548 significantly DEGs among the three cell lines were found by LIMMA. Three functional annotation web tools predicted that DNA damage repair, cell cycle arrest and apoptosis pathways were enriched. Total DEGs were mapped to the canonic pathways with KEGGanim which depicted that the core genes of DNA damage repair, cell cycle arrest and pro-apoptosis were up-regulated in fusion cells, and they mightbe combined to respond the fusion-induced damage stress. The up-regulation of suppressive factor DUSP6 might feedback inhibit the MAPK signaling pathway in the fusion cells, too.</p><p><b>CONCLUSIONS</b>Transcriptome analysis suggests that hMSCs and EC9706 cell fusion may inhibit growth of EC cells by induction of pro-apoptotic signaling and DUSP6 negative feedback inhibition mechanism. In addition, the changes of immune regulation-related and differentiation-related genes indicate that the fusion cells inherited certain immune-suppressive function from the stem cells.</p>

Surgical technique and clinical efficacy of giant cell tumor of axis / 中华骨科杂志

Objective To evaluate the prognostic effects of treatment of giant cell tumor of axis by tumor resection associated with biological reconstruction and internal fixation.Methods From 2009 to 2013,5 patients that had giant cell tumor of axis underwent combined anterior and posterior surgery program.The posterior use pedicle screw system to stabilize the cervical spine,then the anterior use stemocleidomastoid inner edge of the mandibular angle approach to reveal the axis.When the cortex of vertebrae was relatively complete,.When the cortical bone was destroyed,vertebra was resected and the ilium was taken to reconstruct the defect.Adjuvant radiotherapy and diphosphate treatment was used postoperatively.Regular follow-up for X-ray,3D CT and MRI examination were done to observe the tumor recurrence,healing of biological reconstruction and function of cervical vertebra.Results The follow-up time was 12-60 months.No recurrence of the tumor was observed in all patients.The 3 patients accepted beta-TCP implanting after curettage was observed with fuzzy internal structure 3 months after surgery,and the grafted bone fusion can be found 12 months after surgery.The 2 ilium grafted patients can be found with bone fusion with the adjacent vertebrae 6 months after surgery.The bend and stretch function of cervical vertebrae of the 5 patients returned to normal after 3months.The biological healing of bone graft,cervical stability and activity were satisfied.The local pain and neurological symptoms were relieved.Conclusion Anterior and posterior surgery program in combination with biological reconstruction and adjuvant radiotherapy provide an excellent option for treatment of giant cell tumor of axis.The dens could be retained to keep the function of occipital cervical when the odontoid bone cortex is not destructed.

Construction and identification of a lentiviral vector mediating RNA interference of tyrosine kinase B gene / 中华行为医学与脑科学杂志

Objective To construct a tyrosine kinase B(TrkB) targeted RNA interference (RNAi) lentiviral vector.Methods Four oligonucleotides targeting rat TrkB gene were synthesized and cloned into lentiviral vector pXZRNAi 1.0 to construct recombinant lentiviral vectors pXZRNAi-shTrkB-1,2,3,4.Neural stem cells prepared from rat hippocampus were infected with these high-titer viruses.Real-time PCR was employed to detect the TrkB mRNA expression and western blot was used to assess the gene silencing efficacy of these recombinants.Results Enzyme digestion and DNA sequencing results demonstrated that these shRNAs were correctly inserted into lentiviral vectors and the four recombinants were constructed successfully with the titer of 8.6 × 105cfu/ml.The infection efficiency of the letivirus on neural stem cells reached 80％.Compared with the uninfection group,the expression levels of TrkB mRNA in neural stem cells decreased significantly after transfected with pXZRNAi-shTrkB-3 and 4((66.7 ± 5.5) ％ and(76.8 ± 4.9) ％ respectively,P ＜ 0.05) ; and the protein expression levels were also significantly decreased ((68.5 ± 4.3)％ and (78.2 ± 5.1)％ respectively,P ＜ 0.05).Conclusion The lentiviral vectors for TrkB have been successfully constructed with high yield of lentivirus,which provides versatile method for assessing gene function in neural stem cells.

Effect of mild hypothermia on the expression of Cyclin D1 in astrocytes under hypoxia/ reoxygenation / 中华行为医学与脑科学杂志

ObjectiveTo explore the changes of astrocytes in vitro on the expression of Cyclin D1 under normal and hypoxia/reoxygenation conditions.MethodsThe primary astrocytes were isolated from the cortex of SD fetal rats(less than 24 hours) and identified by immunosytochemical method with anti-GFAP antibody after 3 passages.Astrocytes of passage 3 were divided into normal group ( control group),hypoxia/reoxygenation group ( H/R 37℃ ),and mild hypothermiaintervention group( H/R 32℃ )separately.Astrocytes from the later tow groups were reoxygenated with 4,12,and 20 hours separately after exposed to hypoxia conditions for 8 hours.Trypan blue staining was employed to detect the survival rates and immunofluorescence,western-blot were used to analyse the expressin of Cyclin D1 of of astrocytes of different groups and time points.Results 1.The GFAP positive astrocytes from passage 3 exceeded 95 ％.2.With regard to morphology and survival rates,there is no difference between astrocytes of normal and hypothermia groups after 8 hours exposure to hypoxia conditions.Reoxygenation could obviously rise astrocytes mortality with time went by ( H/R 37 ℃ group:12.87 ± 2.76 ( R4 ),31.55 ± 3.00 ( R12 ),46.40 ±8.50(R20) ;H/R 32℃ group:6.77 ± 1.53( R4),15.97 ±4.00(R12),28.33 ±5.69(R20) ;all P＜0.05).3.Immunofluorescence and western-blot revealed that reoxygenation increased Cyclin D1expression markedly,which was proportional to the duration of reoxygenation.Mild hypothermia could reduce Cyclin D1 expression of astrocytes severely under reoxygenation condition.ConclusionCyclin D1 expression can be regarded as a sensitive index of damage to astrocytes caused by hypoxia/reoxygenation conditions.

Protective effect of necrostain-1 on oxygen-glucose deprivation induced caspase-independent cell death in primary cortical neurons / 中华行为医学与脑科学杂志

Objective To explore whether hypoxia-inducible factor-1α( HIF-1α )is involved in oxygenglucose deprivation (OGD)induced caspase-independent cell death in primary cortical neurons and whether their expression is infected by necrostatin-1 ( Nec-1 ).Methods ( 1 ) Primary cerebrocortical neurons were cultured for 14 days.Pretred z-VAD.Fmk (z-VAD)and Nec-1 with 0.1,1,5,10,25 and 50 μ mol/L before the neurons were exposed to OGD for 2 hours and reoxygenated for 12 hours,then cell viability was determined by measure LDH level.(2)Pretred z-VAD before the neurons were exposed to OGD for 2 hours,then reoxygenated for 0,2,6,12,24and 48 hours.Then western blot analysis protein level of HIF-1 α ;rt-PCR check its RNA level.(3)Pretred z-VAD and Nec-1 with 25μ mol/L before the neurons were exposed to OGD for 2 hours and reoxygenated for 12 hours.Then western blot analysis protein level of HIF-1 α; rt-PCR check its RNA level.Result ( 1 ) When cells were pretread Nec-1 with 5 μ mol/L(6.97 ± 0.06),the level of LDH was lower than cells untreated( 14.23 ± 0.08 ) (P＜ 0.05);At 25 μmol/L( 2.21 ± 0.05),the level of LDH was essentially the same as that of the control( 1.03 ±0.03 ) (P＞0.05).(2)The protein level of HIF-1 αwas different from normal (0.24 ±0.01 ) when exposed to OGD for 2 hours and reoxygenated for 2 hours (0.57 ± 0.09) and was highest after cells were exposed to OGD for 2 hours and reoxygenated for 12 hours(0.91 ± 0.08 ) (P＜ 0.05 ).The RNA level of HIF-1 α when cells were exposed to OGD was not deferent from normal (P ＞ 0.05 ).( 3 ) When cells were pretread with Nec-1 (0.32 ± 0.04 ),the protein level of HIF-1α were lower than untreated(0.83 ±0.03) (P＜0.05),but the RNA level of HIF-1α had no deference(P ＞ 0.05).Conclusion HIF-1α was involved in cell' s caspase-independent cell death;Nec-1 can protect neurons through inhibiting the expression of HIF-1α.

The resection of internal hemi-pelvic tumor using computer navigation and the reconstruction assisted by finite element analysis / 中华骨科杂志

Objective To analyze the security and effectiveness of the accurate resection and reconstruction of pelvic tumor with computer navigation and to evaluate the feasibility of pelvic ring structure and mechanics reconstruction using finite element analysis.Methors From December 2008 to June 2010,tumor resections assisted by computer navigation technology and pelvic reconstructions with assembly prosthesis designed by finite element analysis were performed in 12 patients with internal hemi-pelvic malignant tumors.There were 8 male and 4 female patients,with the average age of 39.7 years(range,25-53).The malignant tumors involved chondrosarcoma(4 cases),osteosarcoma(2),Ewing sarcoma(2),malignant fibrohistiocytoma(1),and metastatic tumor(3,in which including renal cell carcinoma 1 case,thyroid carcinoma 1,and breast carcinoma 1).According to Enneking staging classification,there were 1 case in Ⅰ A,2 cases in ⅠB,2 cases in Ⅱ A.and 4 cases in Ⅱ B.The local recurrence of tumor and functional results were followed up postoperatively.Results There were no nerves,vessels and pelvic organs injuries intra-operatively.The postoperative X-rays showed that the excised regions were proper to the preoperative schedule and en bloc resections were performed in all patients.All assembly prostheses were in satisfactory position.and the screw fixation was accordance with the finite element biomechanical analysis.All the cases were followed up for average 18.2 months (range,8-26).There were 1 case with local recurrence and pulmonary metastasis,1 case with deep infection,and 1 case with deep vein thrombosis.No prosthesis dislocation,loosening,breaking,and limb length discrepancy occurred in all patients.The average MSTS93 functional score was 70%in all patients at 6 months,and 68 % in 6 patients at 20 months follow.up.Conclusion The resection and reconstruction of pelvic tumor assisted by computer navigation is a safe and effective procedure.The finite element analysis can provide accurate biomechanical guidance to the reconstruction of pelvic ring.

The combination of a vascularized fibula with a massive allograft for reconstruction after intercalary resection of long bone tumor in extremities / 中华骨科杂志

Objective To investigate the effects of combined use of an allograft and vascularized fibular flap for the reconstruction of bone defects after intercalary resection of long bone malignancy.Methods From April 2006 to October 2009,19 patients that had intercalary resection of long bone malignancy (5 in humerus,7 in femur,7 in tibia)underwent reconstruction with an allograft and vascularized fibula construct,including 11 males and 8 females with an average age of 18.5 years.The average length of the defect was 13.2±4.3 cm.Free vascularized fibula flaps were used in 16 patients and ipsilateral pedicle vaseularized fibula grafts in 3.Time to union was recorded through evaluation of plain radiographs.Bone scan was used to evaluate the viability of the vascularized fibula.Patients were examined oncologically and radiographically and were assessed functionally with MSTS-93.Results The mean follow-up time was 27.5 months.The average length of the fibula flap was 17.9±5.2 cm.Viability of the fibular grafts was verified in all cases.The average time for bone union at allograft-host junction was 11.3±2.8 months in femur,14.1±3.3 in tibia,6.8±1.4 in humerus,respectively.The MSTS-93 average score at final follow-up was 95.2% in upper extremity and 91.8% in lower extremity.The oncology result in patients with follow-up more than 2 years was continuous disease free in 11 patients.no evidence of disease after recurrence following resection in 1,alive with tumor in 1,and died of lung metastasis in 1.Conclasion Vascularized fibular flap in combination with massive allograft provide an option for reconstruction of large bony defects after long bone malignancy extirpation.The viability of the fibula is a cornerstone in success of reconstruction that prevents allograft nonunion and result in decreased time to bone healing,leading to earlier patient's recovery of function.

Angiogenic effect of basic fibroblast growth factor on anterior cruciate ligament reconstruction with freeze-dried tendon implants at early stage: A histological observation / 中国组织工程研究

BACKGROUND: Based on previous studies, the combination of basic fibroblast growth factor (bFGF) with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament (ACL) graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex (MHC) through the treatment of allogenous tendon by freeze. The freeze. dried tendon showed advantages including prolonged storage time. availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE: To observe histologically the effect of exogenous application or bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING: Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital. Fourth Military Medical University of Chinese PLA between June 2006 and June 2007.MATERIALS: Fourteen dogs were used in the experiment. METHODS: Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF(100 u g/L)was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL. While only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES: Twelve of them were randomly divided into 6 groups according to the 6 time points,i,e.,1,2,3,4,5,6 weeks after surgery(2 dogs in each group).The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS: Neovascularization occurred at the 2nd to 3rd weeks and reached the peak at the 4th to 5th weeks postoperatively at the experimental sides. By contrast. The neovascularization occurred at the 4th to 5th weeks postoperatively at the control sides. Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION: The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.

Treatment of meniscal cyst by arthroscopic surgery:a report of 20 cases / 中国矫形外科杂志

[Objective]To introduce the treatment and result of meniscal cyst by arthroscopic surgery.[Method]During the period between 1997 and 2005,20 patients suffered from meniscal cysts have been treated by arthroscopic surgery in Xijing Hospital.Meniscal cysts were excised in all cases with shaver under arthroscopic visualization,whereas outside-in suture repair of meniscus was undergone in 8 cases to close the lacuna and repair the meniscal peripheral free which were resulted from remoral of cyst.The patients were followed up from 3 to 42 months with an average of(18.7?12.2)months.The patients were assessed pre-and post-operatively by the Lysholm score and Glasgow Assessment.[Result]Sixteen of total 20 patients were followed up.Meniscal cyst recurred in a patient one year after operation.Lysholm score of the 16 patients showed a significant improvement from(71.2?8.7)pre-operation to(97.1?2.9)post-operation(t=32.948,P

Arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament from the tibial eminence with stainless steel wire guided by meniscal stitching needle / 中国微创外科杂志

Objective To investigate the technique and efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament(ACL) from the tibial eminence with stainless steel wire guided by meniscal stitching needle.Methods Fifteen cases of avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle from December 1999 to August 2005.The Lysholm scoring scale system was used to evaluate knee functions before and after surgery.Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments.Results The operation was completed within 30 min.No complications of intraarticular infection,iatrogenic injury,fibroarthritis,or non-union of fracture were found.The 15 cases were followed for 6～54 months(mean,20.9?15.0 months).X-ray films revealed good bone union in all the 15 cases.The Lysholm scores were improved from 19.1?15.2(range,10～56) preoperatively to 97.5?3.7(range,91～100) postoperatively,with significant statistical difference by the student-t test(t=18.483,P=0.000).Wire breakage was found in 2 cases at 8 and 14 months after operation,respectively.But the bone union in the 2 cases was not affected.Conclusions Arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle in the treatment of avulsion fracture of the anterior cruciate ligament from the tibial eminence has advantages of simplicity,broad indications(from type Ⅱ to Ⅳ injuries),minimal invasion,and rapid postoperative recovery.

Management of Oxygen and Clinical Safe Use in Our Hospital / 医疗卫生装备

Standardized management and safe-supply system can be enhanced by oxygen chamber management rules,oxygen safe -supply management,daily maintenance of oxygen supply,solutions on common malfunctions and the management of oxygen humidifier. The importance of the management of oxygen is discussed and the regulations should be strictly abided to reduce accident. The oxygen used on clinic can be standardized to ensure the safe-supply.

Robotic and computer assisted orthopaedic surgery / 中华创伤骨科杂志

This paper introduces the applications of Computer Assisted Orthopaedic Surgery (CAOS), including pre-operative planner, surgical simulator, intra-operative navigation systems and medical robotics. Basic principals of surgical navigation are also discussed. In view of the high precision requirement for navigation assisted procedures, there exists a definite need for development of medical robotics to carry out these procedures. We have a brief review on the different robot systems and present the surgical navigation arm developed in the Chinese University of Hong Kong. The laboratory test results of navigation guided distal targeting of intramedullary nail with or without surgical navigation arm showed the better repeatability and precision when the robot arm was used. So far the surgical navigation arm has been successfully applied in clinical practice, including distal targeting of intramedullary nailing; percutaneous sacro-iliac screw and percutaneous trans-iliac screw in pelvic fractures and hip screw fixation for fracture of femoral neck. To conclude, medical robotics is an essential component of the future CAOS.

Arthroscopic surgery for patellar subluxation:surgical outcome of 17 cases / 第三军医大学学报

Objective To introduce arthroscopic technique in managing patellar subluxation and its clinical results. Methods Between Jan. 2004 and Jun. 2007, 17 patients suffered from patellar subluxation underwent arthroscopic surgery in Xijing Hospital. The key points of our technique are lateral retinaculum release and medial retinaculum shrinking suture. Tibial tuberosity was translated medially and elevated in 2 patients by osteotomy. The average age of all patients was (21.5?4.9) years (range 10 to 28). The patients suffering from patellar subluxation averaged (23.1?13.0) months (range 7 to 50) before operation. They were followed up for average (18.0?6.2) months (range 6 to 24). The Lysholm score before and after operation was compared in all patients. Results Fifteen of total 17 patients were followed up, and no recurrence was found. Lysholm score of 17 patients was significantly higher after operation than that before operation (t=5.63, P

Histological observation of the angiogenic effect of bFGF combined to freeze- dried tendon in ACL reconstruction at early stage / 中华创伤骨科杂志

Objective To observe histologically the effect of exogenous application of bFGF (basic fibroblast growth factor) combined to freeze- dried tendon on angiogenic enhancement in early ACL (anterior cruciate ligament) reconstruction. Methods 14 dogs were used in the experiment. 100 ng/mL bFGF was combined to freeze- dried tendon and then transplanted into one side knee to substitute the original ACL, while only freeze- dried tendon was used in the transplantation at the other side as control. The ACLs were harvested each week from 1 to 6 weeks from the 14 dogs respectively. The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. Results Neovascularization occurred at 2nd to 3rd week and reached the peak at 4th to 5th week postoperatively at the experimental sides. By contrast, the neovascularization occurred at 4th to 5th week postoperatively at the control sides. Conclusion The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze- dried tendon are superior to those in the control group.

CHANGES IN PROTEIN EXPRESSION OF NMDA RECEPTORSUBUNIT NR1 IN RAT HIPPOCAMPUS FOLLOWING TRANSIENTFOREBRAIN ISCHEMIA / 解剖学报

Objective To observe the changes in protein expression of NMDA receptor subunit NR1 in rat hippocampal subfields following transient forebrain ischemia. Methods immunohistochemistry and computer-assisted image analysis techniques were used. Results Early stage after reperfusion,NR1 protein expression levels were lower than that of sham control in all hippocampal subfields(P