Clinical Analysis of Joint Health Status of Patients with Hemophilia Treated on-Demand / 中国实验血液学杂志

OBJECTIVE@#To investigate the joint health status of patients with hemophilia treated on-demand and to analyze the incidence trend of hemophilic arthritis, so as to probide the scientific clinical data for furture study.@*METHODS@#The clinical data of patients with hemophilia admitlted in Tianjin municipal first central hospital form March 2016 to October 2017 were collected, the basic information of patients was recorded; the joint health status was evaluated by using the hemophillia Joint Health Score (HJHS) 2.1; the life guality of patients was analyzed by using the MOS item short form-36 health survey, SF-36; the correlation of joint function with life guatity was analyzed by pearson correlation test.@*RESULTS@#196 ont of 210 patients with hemophila were treated on demand. The average age of patients was 27.81(2-73) years old, Among 196 patients, 189 was hemophilia A (96.43%) and 9 was hemophilia B (3.57). The patients without joint involvement, patients with 1 joint and 32 jionts involvement accounted for 3.57%, 11.72% and 84.71% respectively. The incidonce of involvement in elbow, knae and ankle joints was 71.93%, 80.61% and 82.91% respectively. The joint invlvement rate in patients with mild, intermediate and severe hemphilia accounted for 61.66%, 72.40% and 80.73% respectively. The mean HJHS in intermediate and severe henophilia patients was 23.59±17.02 scores and 26.69±17.68 scores respectively, there was no statistical difference (P>0.05). The joint fanction in hemophilia patients negatively correlated with life gnality of patients (r = 0.076).@*CONCLUSION@#The incidence of arthritis in hemophilia patients is high, and at least 1 joint has been involved in patients aged over 10 years old, moreover the multiple joint involvement exrsts in most patients. The impairment of joint function affects the routine behavious and activities.

Repair materials for bone defects: present status, needs and future developments / 中国组织工程研究

BACKGROUND:Great development has been made in the research of various repair materials and tissue-engineered bone, and different materials exhibit a strong ability to repair bone defects. OBJECTIVE:To review the research status and progress of repair materials for bone defects. METHODS:PubMed, PMC, CBM, CNKI and WanFang databases were used online to retrieve the relative articles regarding repair materials for bone defects published from June 2007 to June 2017. The key words were "biomaterials, bone repair materials, bone substitute, bone tissue engineering, bone defect, bone repair" in English and Chinese, respectively. Finally, 66 eligible articles were included, while the unrelated and repeated ones were excluded. RESULTS AND CONCLUSION:The main repair materials for bone defects include autologous bone, allogeneic bone, xenogeneic bone, demineralized bone matrix, bioceramics, metal materials, polymer materials,tissue-engineered bone and relative derived composites. Different materials have shown certain advantages and disadvantages. Clinicians should make an optimal choice in view of the characteristics of materials. Although there is a great progress in thestudies of repair materials for bone defects, further investigations are warranted on how to produce highly biomimetic materials, optimize cell adhesion and migration, precisely control the expression and release of related genes and growth factors, validate clinical safety, and provide medical evidence in clinical practice.

Comparisons of Emu Necrotic Femoral Head Micro Structure Repaired in Two Different Methods / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare emu necrotic femoral head micro structure repaired in two different methods.</p><p><b>METHODS</b>Fifteen adult emus were divided into 3 groups (all n=5), and the right femoral head was selected to research. The first group was the control group; in the second group, femoral head necrosis was made by cryogen with liquid nitrogen; and in the third group, femoral head necrosis was made by local pure ethanol injection. Right femurs were taken for micro CT examination,then femoral head micro structures were compared among these three groups.</p><p><b>RESULTS</b>No infection or unexpected death was found in all groups. Compared with normal group, necrotic femoral heads in cryogen group showed that bone mineral density significantly reduced after repaire (P=0.015), trabecular space significantly reduced (P=0.001), bone volume fraction significantly enlarged (P=0.036), bone surface/volume fraction (P=0.032) and trabecular numbers (P=0.002) significantly enlarged; trabecular thickness showed no significant difference (P=0.060). Compared with control group, necrotic femoral heads in ethanol group showed that bone mineral density significantly enlarged after repaire (P=0.001), trabecular thickness (P=0.003) and bone surface/volume fraction (P=0.022) significantly enlarged, trabecular space (P=0.001) and bone volume fraction (P=0.001) significantly reduced; the trabecular numbers showed no significant difference (P=0.143). Compared with ethanol group, necrotic femoral heads in cryogen group showed significant lower bone mineral density after repair (P=0.001), significantly lower bone volume fraction (P=0.001), significantly lower trabecular thickness (P=0.001), significantly higher bone surface/volume fraction (P=0.022) and higher trabecular numbers (P=0.003); the trabecular space showed no significant difference (P=0.398).</p><p><b>CONCLUSION</b>Different repair methods make reconstructed femoral head weight bearing area have different bone structure and bone mineral density, along with different bone trabecular quality.</p>

Study of animal model of osteonecrosis induced by local ethanol injection in emu / 中国医学科学院学报

<p><b>OBJECTIVE</b>To establish a new animal model of osteonecrosis of the femoral head by local ethanol injection in emu.</p><p><b>METHODS</b>Eight milliliter ethanol was injected slowly to the operated femoral head with customized probe in twenty adult male emus. Postoperatively, hip magnetic resonance imaging was performed at 1, 4, 8, 12 weeks. After emus were sacrificed, the femurs were collected for micro-computed tomography and histological analysis.</p><p><b>RESULTS</b>No emu demonstrated signs of infection or died unexpectedly. Magnetic resonance imaging examination showed broad edema at proximal femur at 1(th) week, and the edema decreased with time, till local edema at femoral head at the 12(th) week. Histological images showed human-like osteonecrotic changes with active bone repair. There were significant differences in trabecular structure and bone mineral density between the operated and intact femoral heads. No collapse was found 6 months after the operation.</p><p><b>CONCLUSIONS</b>This emu model of femoral head osteonecrosis by local ethanol injection can progress to early stage osteonecrosis. The different repair methods may have certain correlation with the results of osteonecrosis of the femoral heads.</p>

A method based on endogenous fluorescence determination for screening NAMPT inhibitors / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To establish a method for screening nicotinamide phosphoribosyl transferase (NAMPT) inhibitors based on endogenous fluorescence determination.</p><p><b>METHODS</b>The double mutants of NAMPT, G355C/D393C, was cross-linked by using 1, 4-Bismaleimidobutane (BMB) to block the entrance of enzymatic active site of NAMPT. The binding of compounds to NAMPT was evaluated according to the change of spontaneous fluorescence of NAMPT and BMB-NAMPT with 280 nm excitation and 333 nm emmision. The in vitro enzamatic activity of NAMPT was determined by nuclear magnetic resonance. The cell viability was determined by MTT assay.</p><p><b>RESULTS</b>FK866 significantly decreased the spontaneous fluorescence of NAMPT but not of BMB-NAMPT. Rosmaric, cynarine and 1, 3-dicaffeoylquinic acid also decreased the spontaneous fluorescence of both NAMPT and BMB-NAMPT. However, the inhibition on two proteins was equivalent. FK866 significantly inhibit the catalysis of NAMPT. Rosmarinic acid, cynarine and 1, 3-dicaffeoylquinic acid failed to inhibit the catalysis of NAMPT. FK866 inhibited the viability of A549 cells, but rosmarinic acid, cynarine and 1, 3-dicaffeoylquinic acid did not.</p><p><b>CONCLUSION</b>Endogenous fluorescence spectrometry based on NAMPT and BMB-NAMPT protein can be used for screening compounds that bind with NAMPT, and distinguishing the binding site - either within the enzymatic active site or not. Rosmarinic acid, cynarine and 1, 3-dicoffeoylquinic acid can bind to NAMPT out its enzymatic active site.</p>

Combined effects of NEL-like type 1 gene and zoledronate in preventing collapse of the femoral head / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine if combined therapy consisting of NEL-like type 1 gene (NELL-1) and zoledronate can prevent the collapse of the femoral head and stimulate the new bone formation in an animal model of osteonecrosis.</p><p><b>METHODS</b>Ischemic osteonecrosis was surgically induced in 24 SD rats, whicih were equally randomly divided into three groups: combination group, treated with both NELL-1 and zoledronate; sham operation group; and placebo group, treated with normal saline solution. The animals were killed 5 weeks after surgery. Radiography, MicroCT, histology, and immunohistochemistry were performed to analyze the results.</p><p><b>RESULTS</b>Morphologically, the femoral head was at good shape in the combination group, while mildly flattened femoral head was seen in the placebo group. No heterotopic ossifications were observed in each group. MicroCT assessment showed significantly higher total and bone mineral volume in the combination group than in the placebo group (P<0.01), whereas no such significant difference was found when compared with the sham operation group(P>0.05). Histological assessment showed more active osteoblast activity and reduced osteoclast activity in the combination group compared with placebo group.</p><p><b>CONCLUSION</b>A combination of NELL-1 and zoledronate can decrease the femoral head deformity while stimulating bone formation in a traumatic rat osteonecrois model, showing a potential to reverse the osteonecrosis.</p>

Effect and mechanism of zoledronate on prevention of collapse in osteonecrosis of the femoral head / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effect and mechanism of zoledronate on prevention of collapse in an animal model of osteonecrosis.</p><p><b>METHODS</b>Ischemic osteonecrosis was surgically induced in 16 SD rats (which were further divided into zoledronate group and placebo group); another 8 rats were used as sham surgery group (n=8). The animals were killed 5 weeks after surgery. Radiographic, Micro-CT, histological, and immunohistochemical assessments were performed.</p><p><b>RESULTS</b>Radiographic assessment showed better preservation of the femoral head shape in the zoledronate group than in the placebo group but not significantly different from the sham surgery group. Micro-CT assessment showed higher total volume, bone volume, and total mineralized content in the zoledronate group(all P0.05). Compared with the placebo group, the zoledronate group had reduced osteoclast and osteoblast activity, as confirmed by histological examinations.</p><p><b>CONCLUSION</b>Zoledronate can decrease the femoral head deformity by reducing the osteoclast activity while suppressing new bone and vessels formation in a rat model of traumatic osteonecrosis, and therefore may delay the collapse of femoral head.</p>

Reliability of magnetic resonance imaging in diagnosing posterior ligament complex injury in thoracolumbar fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the reliability of magnetic resonance imaging (MRI) in detecting posterior ligament complex injury in thoracolumbar fractures.</p><p><b>METHODS</b>Ninety-five patients with thoracolumbar fracture were evaluated by palpation of the inter-spinal gap, plain radiography, and MRI before operation. In addition to conventional MRI sequences, a fat-suppressed T2-weighted sagittal sequence was performed. Surgery was performed by a posterior approach. During the operation, posterior ligament complex was examined.</p><p><b>RESULTS</b>A wide inter-spinal gap was palpated in 41 patients and was found in 55 patients on plain radiography. According to MRI, injury to the supraspinal ligament was suspected in 85 patients, the inter-spinal ligament in 83 patients, and the ligamentum flavum in 26 patients. There were 82 supraspinal ligament injuries, 80 inter-spinal ligament injuries, and 20 ligamentum flavum injuries in operative findings. The relations between plain radiography and operative findings, between MRI interpretation and operative findings were statistically significant.</p><p><b>CONCLUSION</b>A fat-suppressed T2-weighted sagittal sequence of MRI is a highly sensitive, specific, and accurate method to detect posterior ligament complex injury and which is recommended for the accurate evaluation of posterior ligament complex injury in thoracolumbar fractures.</p>

Transforming growth factor-beta1-loaded fibrin sealant promote bone marrow Mesenchymal stem cells to contract injectable tissue engineering cartilage in vivo / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the feasibility that transforming growth factor-beta1 (TGF-beta1) -loaded fibrin sealant (FS) promotes bone marrow mesenchymal stem cells (BMSCs) to create tissue engineering cartilage in vivo.</p><p><b>METHODS</b>The BMSCs were isolated from healthy human and amplified in vitro, and then induced by defined medium containing TGF-beta1 and dexamethasone. After 7 days the induced BMSCs were collected and mixed with TGF-beta1-loaded FS or FS as BMSCs+ FS-TGF-beta1 group and BMSCs+ FS experimental group. Then the mixture was injected by a needle into the dorsum of nude mice. In control group, only FS or BMSCs were injected. The tissue engineering specimens were harvested from nude mice 12 weeks later. Gross observation, average wet weight measurement, glycosaminoglycan (GAG) quantification, histology and immunohistochemistry were used to evaluate the results.</p><p><b>RESULTS</b>The BMSCs have possessed the shape and functional characters of chondrocyte when transferred to a defined medium. After injection of the mixture, the cartilage-like tissue were formed in two experimental groups. Compared with BMSC+ FS group, the specimens of BMSCs +FS-TGF-beta1 group were larger and firmer. Alcian staining showed better metachromatic matrix formation. The GAG contents were significantly higher. Immunohistochemical staining of collagen type II was stronger. However, no cartilage-like tissue was formed in two control groups.</p><p><b>CONCLUSION</b>TGF-beta1-loaded FS can promote BMSCs to contract injectable tissue engineering cartilage in vivo.</p>

Short-term follow up of bipolar arthroplasties for aged cases with intertrochanteric fractures / 中华创伤杂志

Objective To evaluate the short term effect of bipolar arthroplasties in aged cases with intertrochanteric fractures.Methods There were 23 males and 15 females(at age of 70-93 years, average 76 years)with unstable intertrochanteric fractures treated with the third generation cementing techniques and bipolar arthroplasties that were followed up for average 2.4 years.The clinical effect was evaluate with Harris scale,X-ray films and complications.Results Of all,34 cases(89.5%)could walk freely.The average Harris scale was 84.2 points.The average period until walk with full-weight load was 5.6 weeks.The greater trochanters was united in 35 cases(92%)during average 4.2 months.No peri-prothetic ossteolysis and loosening or subsidence occurred.Conclusions Cemented bipolar arthro- plasty has good advantages of reduced laying up period and few complications.The short-term outcome is satisfactory hut the long-term outcome needs deeper observation.