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This meta-analysis compared the therapeutic effect of cable pin system (CPS) with K-wire tension band (KTB) in the treatment of patella fractures among Chinese Han population.The databases of PubMed,Cochrane library,China National Knowledge Infrastructure (CNKI),Chinese WanFang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population.Literatures were screened according to the inclusion and exclusion criteria.The quality of the studies was assessed,and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.3 software.A total of 932 patients from 15 studies were included in this meta-analysis (426 fractures treated with CPS and 506 fractures treated with KTB).There were significant differences in duration of hospital stay [mean difference (MD)=-1.07;95％ confidence interval (CI):-1.71 to-0.43],fracture healing time (MD=-l.23;95％ CI:-1.68 to-0.77),flexion degree of knee joint at 6th month after operation (MD=14.82;95％ CI:10.93 to 18.71),incidence of postoperative complication [risk ratio (RR)=0.16;95％ CI:0.09 to 0.27] and excellent-good rate of B(o)stman score (RR=1.09;95％ CI:1.03 to 1.16) between the CPS group and KTB group,while no significant difference was found in operative time between the two groups (MD=-4.52;95％ CI:-11.70 to 2.67).For the treatment of patella tractures among Chinese Han population,limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay,fracture healing time,flexion degree of knee at 6th month after operation,incidence of postoperative complication and excellent-good rate of B(o)stman joint score.Due to the limitation of high quality evidence and sample size,more large-scale randomized controlled trials are needed to validate the findings in the future.
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By co-culturing humm mesenchymal stem cells (hMSCs) and human umbilical rein endothelial cells (HUVECs) under hypoxia and creating a microenvironment similar to that of transplanted hMSCs for the treatment of avascular ni ANFH,the effect of hMSCs on survival,apoptosis,migration and angiogenesis of human umbilical vein endothelial cells (HUVECs) under the hypoxic condition were investigated in vitro.hMSCs and HUVECs were cultured and identified in vitro.Three kinds of conditioned media,CdM-CdMNOR,CdM-CdMHYP and HUVEC-CdMHYP were prepared.HUVECs were cultured with these conditioned media under hypoxia.The survival rate,apoptosis rate,migration and angiogenesis of HUVECs were respectively detected by CCK-8,flow cytometry,Transwell and tube formation assay.The content of SDF-1α,VEGF and IL-6 in CdM was determined by ELISA.Our results showed that hMSCs and HUVECs were cultured and identified successfully.Compared with MSC-CdMNOR and HUVEC-CdMHYP groups,the survival rate,migration and angiogenesis of HUVECs in MSC-CdMHYP group were significantly increased while the apoptosis rate was declined (P＜0.05).Moreover,the expression of SDF-1a VEGF and IL-6 in MSC-CdMHYP group was up-regulated.Under hypoxia,the apoptosis of HUVECs was inhibited while survival,migration and angiogenesis were improved by co-culture of hMSCs and HUVECs.The underlying mechanism may be that hMSCs could secrete a number of cytokines and improve niche,which might be helpful in the treatment of femoral head necrosis.
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The present study examined the role of Wnt/β-catenin signaling pathway in the degeneration of nucleus pulposus cells and the protective effect of DKK1 on nucleus pulposus cells.The model of nucleus pulposus cell degeneration was induced by intra-disc injection of TNF-α,and the expression of β-catenin protein was detected by Western blotting.The cultured rabbit nucleus pulposus cells were divided into 4 groups.In group A,the cells were cultured with normal medium and served as control group.In group B,the cells were cultured with TNF-α and acted as degeneration group.In group C,the cells were cultured with TNF-α and transfected with Adv-eGFP and was used as fluorescence control group.In group D,the cells were cultured with TNF-α and transfected with Adv-hDKK1-eGFP,serving as intervention group.The expression of type Ⅱ collagen,proteoglycan,β-catenin,and MMP-13 in each group was detected by immunocytochemistry and RT-PCR.The result showed that TNF-α increased the expression of β-catenin and MMP-13,and significantly inhibited the synthesis of type Ⅱ collagen and proteoglycan,which resulted in the degeneration of nucleus pulposus cells.This effect could be obviously reversed by DKK1.We are led to concluded that TNF-α could activate the Wnt/β-catenin signaling pathway,and increase the expression of MMP-13,thereby resulting in disc degeneration.Specifically blocking Wnt/β-catenin signaling pathway by DKK-1 could protect the normal metabolism of intervertebral disc tissue.The Wnt pathway plays an important role in the progression of the intervertebral disc degeneration.
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The mobilization efficiency of granulocyte colony-stimulating factor (G-CSF) and stem cell factor (SCF) to bone marrow mononuclear cells (MNCs) in mice was observed,and the changes of CXCL12/CXCR4 signal were detected in order to find out the mobilization mechanism of stem cells.Kunming mice were randomly divided into two groups.The mice in treatment group were subjected to subcutaneous injection of G-CSF at a dose of 100 μg/kg and SCF at a dose of 25 μg/kg every day for 5 days,and those in control group were given isodose physiological saline.The MNCs were separated,counted and cultured,and the colony-forming unit-fibroblast (CFU-F) was evaluated.CD34+CXCR4+ MNCs were sorted by flow cytometry.The expression of CXCL12 protein in bone marrow extracellular fluid was detected by ELISA,and that of CXCL12 mRNA in bone marrow was measured by RT-PCR.The results showed that the counts of MNCs in peripheral blood and bone marrow were increased after administration of G-CSF/SCF (P＜0.01).The factors had a dramatic effect on the expansion capability of CFU-F (P＜0.05).Flow cytometric of bone marrow MNCs surface markers revealed that CD34+CXCR4+ cells accounted for 44.6%±8.7% of the total CD34+ MNCs.Moreover,G-CSF/SCF treatment induced a decrease in bone marrowCXCL12 mRNA that closely mirrored the fall in CXCL12 protein.In this study,it is evidenced that G-CSF/SCF can effectively induce MNCs mobilization by disrupting the balance of CXCL12/CXCR4 signaling pathway in the bone marrow and down-regulating the interaction of CXCL12/CXCR4.
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In order to investigate the apoptotic pathway of rabbit annulus fibrosus(AF)cells induced by mechanical overload,an experimental air-pressure model was established in this study to pressurize the rabbit AF cells in vitro.Cells were randomly divided into five groups in which the cells were exposed to a continuous pressure of 1.1 MPa for different lengths of time(0,5,12,24 and 36 h).The cell proliferation and apoptosis were detected by cell counting kit-8(CCK-8)assay and flow cytometry; thealterations in mitochondrial membrane potential were measured by fluorescence microscopy and fluorescence spectrophotometer; the activities of caspase-8 and 9 were determined by spectrophotometry.The results showed that after the cells were subjected to the pressure for 24 or 36 h,the cell proliferation was inhibited; the ratio of cell apoptosis was increased; the mitochondrial membrane potential was decreased;the activity of caspase-9 was enhanced; no activity changes were observed in caspase-8.The results suggested that treatment with a pressure of 1.1 MPa for more than 24 h can lead to the proliferation inhibition and the apoptosis of rabbit AF cells in vitro,and the mitochondrial-dependent pathway is implicated in the pressure-induced AF cell apoptosis.
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S and NO production induced by rhIL-1β in a concentration-dependent manner. It is suggested that PDTC can inhibit NO production and iNOS mRNA expression induced by IL-1β, which may provide an alternative method for the treatment of osteoarthritis.
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In order to investigate the effect ofArg-Gly-Asp (RGD) peptide-modified silk biomaterial on the adhesion and proliferation of bone marrow-derived mesenchymal stem cells (MSCs),MSCs of third generation were seeded onto the surface of RGD-decorated silk (silk-RGD group),silk alone (silk group) or tissue culture plate (TCP group).After incubation for 4 or 12 h,MSCs were examined quantitatively by using precipitation method for cell attachment.The cell proliferation,which was de-fined as cell density,was compared among the three groups after culture for 1,2,3,and 4 days.Cell skeleton,which was labeled fluorescently,was observed under laser confocal microscope after 24 h of culture.The results showed that cell adhesion rate in silk-RGD group was higher than in silk group (P<0.05),but similar to that in TCP group after incubation for 4 or 12 h (P>0.05).There were no sig-nificant differences in the cell proliferation among the three groups at different time points (P>0.05 for all).Laser confocal microscopy revealed that in silk-RGD group,MSCs,strongly fluorescently stained,spread fully,with stress fibers clearly seen,while in silk group,actin filaments were sparsely aligned and less stress fibers were found.It was concluded that RGD peptide could improve the ad-hesion of MSCs to the silk scaffold,but had no impact on the proliferation of the cells.
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In order to provide anatomical basis for transoral approach (TOA) in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults' fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2±3.5mm and 39.3±3.7mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1±5.2mm and 50.2±4.6mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0±2.9mm and 24.0±3.5mm respectively, and the distance of bilateral axis screw inserting points was 18.0±1.2mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces: mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.
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To investigate the efficacy of a combination therapy on gluteal muscle contracture, 286 definitely diagnosed patients were subjected to surgical treatment, and then functional exercises and physical therapy. The patients with severe symptoms were asked to have a set of specially-designed functional exercises. All the patients were followed up for 3 to 24 months by hospital visit, correspondenee or telephone interview. The effective rate was 100%, and the curative rate was up to 94.6%. Few patients developed complications and relapse was rare. It is concluded that the combination therapy, including surgical removal of diseased tissues, functional exercises and physical therapy, is an effective approach for the treatment of severe juvenile gluteal muscle contracture.
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To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog, the model of the ischemic necrosis of femoral head was made with the liquid nitrogon in 15 hybrid adult dogs. The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel. The dogs were divided into 3 groups, each group was sacrificed 3, 6, 12 weeks after the operation respectively. No collapse of femoral head was observed after the operation. The position of the cages was good on radiograph. Microscopically, the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage. After 12 weeks of creeping substitution, the cancellous bone filled up the hollow cavity and holes of the cages. It is concluded that the titanium alloy cage can provide structural support for the subchondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.