Slow-release recombinant human bone morphogenetic protein-2 suppresses chromium wear particle-induced osteolysis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of a slow-release recombinant human bone morphogenetic protein-2 (rhBMP-2) formulation on the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) in a murine air pouch model of bone implantation.</p><p><b>METHODS</b>A cranial bone allograft was implanted in the air pouch induced on the back of the recipients. The rat models were then randomized into 5 groups, including a blank control group, chromium particle group, and 3 rhBMP-2 groups receiving 50, 100 or 200 µg/L slow-release rhBMP-2 in addition to chromium particles. Three weeks later, the expressions of RANKL and OPG in the air pouch was detected using Western blotting and RT-PCR, and the positively stained area for osteoclasts in the bone graft was determined with TRAP staining for drug effect assessment.</p><p><b>RESULTS</b>RANKL and OPG expressions were found in the air pouches in all the 5 groups. RANKL and OPG protein and mRNA expressions, RANKL/OPG ratio and osteoclast staining area in the bone graft were the highest in chromium particle group (P<0.05), but were significantly decreased by treatment with the slow-release rhBMP-2 formulation (P<0.05); the measurements showed no significant differences between the blank control group and 200 µg/L rhBMP-2 group (P>0.05).</p><p><b>CONCLUSION</b>Chromium particles can cause osteolysis by increasing the RANKL/OPG ratio in rats, and intervention with slow-release rhBMP-2 can significantly promote bone formation and suppress bone resorption by decreasing RANKL/OPG ratio.</p>

Expression of hypoxia-inducible factor-1α and vascular endothelial growth factor in the synovium of patients with osteoarthritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect the expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with osteoarthritis and investigate their roles in the synovial lesions of osteoarthritis.</p><p><b>METHODS</b>The expressions of HIF-1α and VEGF in the synovium were detected by immunohistochemical staining in 30 osteoarthritis cases, 20 acute traumatic arthritis cases and 10 normal synovial biopsy samples. The correlation between HIF-1α and VEGF, and their relationships with osteoarthritis were analyzed.</p><p><b>RESULTS</b>The rates of positive expression of HIF-1α and VEGF in osteoarthritis cases were significantly higher than those in acute traumatic arthritis (86.7% vs 60% and 80% vs 48%, P<0.05). Normal human synovium showed no positive expressions of HIF-1α and VEGF. HIF-1α expression was positively correlated to VEGF expression in acute traumatic synovitis and osteoarthritis cases, with correlation coefficients of 0.666 and 0.678, respectively.</p><p><b>CONCLUSION</b>The expressions of HIF-1α and VEGF in the synovial tissue are significantly higher in osteoarthritis cases than in cases of acute traumatic arthritis. They have close relationship in the synovial lesions of osteoarthritis and both contribute to the development of osteoarthritis.</p>

Interface shear stress between the artificial bones and injectable calcium phosphate glue: an experimental study in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of the composite bone material, fibrin glue (FG) combined with beta-tricalcium phosphate (beta-TCP)/monocalcium phosphate, in repairing bone defects and assess the feasibility of using this cement for artificial joint fixation.</p><p><b>METHODS</b>Bone defects were induced in 16 normal adult New Zealand white rabbits at the bilateral femoral lateral condyles where an 8-mm-deep hole (4 mm in diameter) was drilled on each side. The composite FG/calcium phosphate cement (CPC) (solution: power volume ratio of 0.3:1) was injected on one side of the bone defects (experimental group) and pressurized for 10 minutes, and CPC was injected on the other side (control). The rabbits were sacrificed at 2, 4, 8 or 12 weeks after the operation for gross observation and biomechanical tests.</p><p><b>RESULT</b>The composite material FG/CPC was more effective than CPC for bone defect repair, and biomechanical tests revealed significant differences between them (P<0.05). The shear stress of the artificial bone cement in the FG/CPC group was stronger than that in CPC group.</p><p><b>CONCLUSION</b>The FG/CPC composite possesses good biocompatibility and osteoconductivity and may serve as an ideal material for repairing bone defects.</p>

Short-term clinical follow-up of metal-on-metal hip resurfacing arthroplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the short-term outcome of patients receiving metal-on-mental hip resurfacing arthroplasty and analyze the factors affecting the result.</p><p><b>METHODS</b>In 13 patients receiving metal-on-metal hip resurfacing arthroplasties with scheduled follow-up, the treatment outcomes were assessed according to the Harris Hip Score.</p><p><b>RESULTS AND CONCLUSION</b>The short-term outcomes of hip resurfacing arthroplasties were encouraging, and intraoperative complications, infections, peripheral nerve palsy, hip dislocations or clinically overt lower limb deep vein thrombosis occurred in none of these cases. All the patients reported complete or major pain relief. Clinical assessment according to the Harris Hip Score revealed an improvement from an average score of 36.69 preoperatively to 89.63 after the surgery. Crutch use lasted for a maximum of 4 weeks postoperatively in these patients, after which the patients were all capable of walking without crutches with full weight-bearing.</p>

Biomechanical reconstruction of the hip in metal-on-metal total hip resurfacing / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the effect of biomechanical reconstruction of the hip in metal-on-metal total hip resurfacing.</p><p><b>METHODS</b>Thirty patients undergoing hip resurfacing arthroplasties were enrolled in this study. The clinical outcomes of the patients were assessed according to the Harris Hip Score before and after the surgery, X-ray examinations and biomechanical reconstruction evaluations.</p><p><b>RESULTS</b>After the operation, the length of the patients' legs was shortened by a mean of 2.4 mm. and the femoral offset was decreased by a mean of 5.45 mm. No dislocation were be found in these patients. The preoperative Harris Hip Score was 36.69-/+7.16, significantly lower than that postoperative score (89.63-/+3.36, P<0.01).</p><p><b>CONCLUSION</b>Precise biomechanical reconstruction of the hip can be achieved in hip resurfacing arthroplasty, and the stability and functional restoration is guaranteed by large diameter prosthesis design.</p>

Clinical observation of bushen er'xian decoction in treating premature ovarian failure / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect and immune regulatory mechanism of Bushen Er'xian Decoction (BED) on patients with premature ovarian failure (POF).</p><p><b>METHODS</b>Sixty patients with POF were randomly assigned to two groups in the ratio of 2:1, the 40 in the treatment group were treated with BED and the 20 in the control group were treated with artificial menstrual cycle therapy. The clinical efficacy was observed and the changes of serum reproductive hormone and T lymphocytes before and after treatment were observed.</p><p><b>RESULTS</b>The total effective rate in the treatment group was 72.5% (29/40 cases), which was higher than that in the control group, 45.0% (9/20 cases, P < 0.05). Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) decreased and estradiol (E2) increased in both groups after treatment (P <0.05), but the level of FSH was lower in the treatment group than in the control group (22.57 +/- 12.49 IU/L vs 31.10 +/- 14.50 IU/L, P <0.05). CD4 and CD4/CD8 increased, CD8 decreased in the treatment group after treatment, showing significant difference as compared with those before treatment and with those in the control group after treatment (P <0.01).</p><p><b>CONCLUSION</b>BED is favourable for improving POF, being a good remedy with better clinical efficacy.</p>

Clinical observation on treatment of infertile patients with severe endometriosis by Kangyi Zhongyu Decoction combined with gonadotropin releasing hormone-a / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Kangyi Zhongyu Decoction (KZD) combined with gonadotropin releasing hormone-a (GnRH-a) on infertile patients with severe endometriosis.</p><p><b>METHODS</b>Seventy-five infertile patients with the diagnosis of endometriosis confirmed by laparoscope who were scheduled to receive in vitro fertilization and embryo transfer (IVF-ET) were randomly assigned to three groups, they were treated respectively with KZD (A), GnRH-a (B) alone and combined of both (C), and IVF-ET were applied in the patients after 3 months of treatment. The clinical efficacy and adverse reactions in the three groups were observed and the changes of serum cancer antigen 125 (CA125) and endometrial antibody (EMAb) levels before and after treatment were tested.</p><p><b>RESULTS</b>Score of dyspareunia in Group A and C was obvioushy lower than that in Group B after treatment (P <0.01). Pregnancy rate in Group C was higher than that in Group A and B (P <0.05), with the adverse reactions less than in Group B (P <0.01). The positive rate of plasma EMAb was reduced obviously after treatment in Group C with the level lower than that in the other two groups (P<0.05).</p><p><b>CONCLUSION</b>The combined use of KZD and GnRH-a is a new method in treating infertile patients with severe endometriosis with ideal effectiveness and fewer adverse reactions, and it could advance the successful rate of reproductive assistant technique.</p>

The effect of disc degeneration on the structural property distributions in the cervical vertebral endplates / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of disc degeneration on the structural property distributions in the cervical vertebral endplates.</p><p><b>METHODS</b>A 2 mm-diameter hemispherical indenter was used to perform indentation tests at 0.03 mm/s to the depth of 2 mm at 20 normalized locations in 50 bony endplates of intact human cervical vertebrae (C2 approximately C7). The resulting load-displacement curves were used to extract the failure load and stiffness of each test site. Grade of disc degeneration was determined using Nachemson's grading scale. One-way ANOVA, factorial analyses, SNK tests and correlate analyses were used to analyze the result data.</p><p><b>RESULTS</b>Both the failure load and stiffness decreased with disc degeneration in the cervical endplates (P <0.001, both), and correlated significantly with the disc degeneration (rs=-0.429 and rs=-0.244, respectively). Only the distribution of superior cervical endplate changed with disc degeneration, but that of inferior cervical endplate changed little.</p><p><b>CONCLUSIONS</b>The structural property distributions in the cervical vertebral endplates change significantly in the degenerated discs. It suggests that disc degeneration is an important factor to evaluate the intervertebral implant subsidence in anterior cervical fusion.</p>