The impact of specialized nursing care at fracture sites coordinated with disease progression monitoring in thoracolumbar spine fractures.

PURPOSE: This study aims to investigate the impact of specialized nursing care at fracture sites coordinated with disease progression monitoring in thoracolumbar spine fractures. MATERIALS AND METHODS: Patients diagnosed with definitive thoracolumbar spine fractures and underwent surgical treatment at our hospital between February 2022 and August 2023 were selected. Patients were divided into a treatment group (specialized nursing care at fracture sites coordinated with disease progression monitoring) and a control group (conventional care) based on different nursing methods. RESULTS: A comparative assessment was conducted to evaluate the role and significance of specialized nursing care at fracture sites coordinated with disease progression monitoring in thoracolumbar spine fracture rehabilitation. The results showed that compared to conventional care, specialized nursing care at fracture sites coordinated with disease progression monitoring could better promote the recovery of patients' neurological functions, alleviate pain, and effectively improve symptoms and functional recovery, thus enhancing patients' quality of life and satisfaction. CONCLUSION: The study confirms the effectiveness of specialized nursing care at fracture sites coordinated with disease progression monitoring in clinical practice post thoracolumbar spine fractures.

MiR-383 sensitizes osteosarcoma cells to bortezomib treatment via down-regulating PSMB5.

BACKGROUND: Proteasome inhibition is a promising strategy for cancer therapy. Bortezomib, which primarily targets the chymotrypsin-like activity of PSMB5, has demonstrated efficacy in various tumors. However, there is variable sensitivity to bortezomib, which could be attributed, in part, to variations in the expression of proteasome subunits. METHODS AND RESULTS: In this study, we investigated whether miR-383 affects the expression of proteasome subunits in osteosarcoma (OS) cells, and if so, whether OS cells display differential sensitivity to bortezomib concerning miR-383 expression. We detected a decreased miR-383 expression in OS cells and tissues. Then we found a negative correlation between the cytotoxicity of bortezomib and the expression level of the proteasome 20S core particle subunit ß5 (PSMB5). Intriguingly, we identified PSMB5 as a direct target of miR-383. Increased expression of miR-383 resulted in decreased PSMB5 expression and increased sensitivity to bortezomib in OS cells. CONCLUSIONS: In summary, our findings present the initial comprehensive analysis of the function of miR-383 in OS. The outcomes indicate that miR-383 may augment the anticancer effect of bortezomib through PSMB5 repression, offering a novel therapeutic approach in OS and a fresh pathway for proteasome regulation.

Effect of high-intensity training on bone mineral density in basketball players / Efeito do treinamento de alta intensidade na densidade mineral óssea em jogadores de basquete / Efecto del entrenamiento de alta intensidad sobre la densidad mineral ósea en jugadores de baloncesto

ABSTRACT Introduction Increasing the bone mineral density of athletes can provide better basic physical conditions for basketball players, prevent fractures caused by osteopenia and reduce the occurrence of serious sports injuries. Objective Explore the effect of high-intensity training on bone mineral density in basketball players. Methods In this experiment, 30 subjects were divided into male and female groups, and high-intensity exercise training was performed for 60 minutes, three times a week, for eight weeks. The relevant indices were measured before and after training, and their data were classified and analyzed. Results High-intensity training can significantly improve the bone mineral density of basketball players, and the increase of bone mineral density of female basketball players is slightly lower than that of male players. In addition, the increase in bone mineral density can comprehensively improve athletes' muscular strength and physical fitness. Conclusion High-intensity training can improve basketball players' bone mineral density and sports skills, requiring promoting studies for its popularization in colleges and universities. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Aumentar o nível de densidade mineral óssea dos atletas pode proporcionar melhores condições físicas básicas para jogadores de basquetebol, prevenir fraturas causadas pela osteopenia e reduzir a ocorrência de lesões esportivas graves. Objetivo Explorar o efeito do treinamento de alta intensidade na densidade mineral óssea de jogadores de basquetebol. Métodos Neste experimento, 30 indivíduos foram divididos em grupo masculino e feminino, o treinamento de exercícios de alta intensidade foi realizado por 60 minutos, três vezes por semana durante um total de 8 semanas. Os índices relevantes foram medidos antes e após o treinamento, seus dados foram classificados e analisados. Resultados O treinamento de alta intensidade pode melhorar significativamente a densidade mineral óssea dos jogadores de basquetebol, e o aumento da densidade mineral óssea das jogadoras de basquetebol feminino é ligeiramente menor do que o dos jogadores masculinos. Além disso, o aumento da densidade mineral óssea pode melhorar de forma abrangente a força muscular e a aptidão física dos atletas. Conclusão O treinamento de alta intensidade pode promover a melhoria da densidade mineral óssea e habilidades esportivas dos jogadores de basquetebol, necessitando de estudos promotores para sua popularização em Faculdades e Universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Aumentar el nivel de densidad mineral ósea de los deportistas puede proporcionar mejores condiciones físicas básicas a los jugadores de baloncesto, prevenir las fracturas causadas por la osteopenia y reducir la aparición de lesiones deportivas graves. Objetivo Explorar el efecto del entrenamiento de alta intensidad sobre la densidad mineral ósea en jugadores de baloncesto. Métodos En este experimento, 30 sujetos se dividieron en el grupo de hombres y mujeres, se realizó un entrenamiento de ejercicios de alta intensidad durante 60 minutos, tres veces por semana durante un total de 8 semanas. Se midieron los índices relevantes antes y después del entrenamiento, se clasificaron sus datos y se analizaron. Resultados El entrenamiento de alta intensidad puede mejorar significativamente la densidad mineral ósea de los jugadores de baloncesto, y el aumento de la densidad mineral ósea de las jugadoras de baloncesto es ligeramente inferior al de los jugadores. Además, el aumento de la densidad mineral ósea puede mejorar ampliamente la fuerza muscular y la forma física de los deportistas. Conclusión El entrenamiento de alta intensidad puede promover la mejora de la densidad mineral ósea y de las habilidades deportivas en los jugadores de baloncesto, siendo necesario promover estudios para su popularización en Colegios y Universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of delayed hip replacement on postoperative hip function and quality of life in elderly patients with femoral neck fracture.

BACKGROUND: For various reasons, some elderly patients with femoral neck fracture undergo delayed surgical treatment. There is little information about the effect of delayed treatment on postoperative hip function and quality of life. The aim of this study was to investigate the effect of delayed hip arthroplasty on hip function, quality of life, and satisfaction in patients with femoral neck fractures. METHODS: Forty-seven patients with femoral neck fracture and hip replacement delayed over 21 days served as the delayed group (D group). Patients with femoral neck fracture, matched 1:1 for age and sex, and hip replacement within 7 days served as the control group (C group). The Harris hip score (HHS) and health-related quality of life (HRQoL) were assessed before surgery and 3 months, 6 months and 1 year postoperatively. The satisfaction questionnaires were completed by the patients themselves at the last follow-up. RESULTS: The HHS in the C group was lower than that in the D group (32.64 ± 9.11 vs. 46.32 ± 9.88, P < 0.05) before surgery but recovered faster after surgery. The HHS in the D group was lower than that in the C group 1 year postoperatively (85.2 ± 3.80 vs. 89.8 ± 3.33, P < 0.05). The patients' quality of life changed similarly to their HHS. The HHS 1 year after surgery was related to the preoperative HHS in group D (rs = 0.521, P < 0.01). Patients in the D group showed significantly higher satisfaction scores than those in the C group (P < 0.05). CONCLUSIONS: Hip function in patients with femoral neck fracture surgery delayed over 21 days recovered more slowly than that in those who underwent surgery within 7 days. However, they were more satisfied with the surgery. Moderate hip movement to ameliorate the lower limb muscle atrophy was recommended for patients facing a temporary inability to undergo surgery.

[Effectiveness of total hip arthroplasty for hip infection sequelae].

Objective: To evaluate hip function and reinfection of the patients with hip infection sequelae after total hip arthroplasty (THA) treatment. Methods: A clinical data of 31 patients (31 hips) with hip infection sequelae, who were treated with THA between June 2010 and May 2017, was retrospectively analyzed. There were 18 males and 13 females, with an average age of 46.1 years (range, 20-71 years). There were pyogenic infection in 17 cases, tuberculous infection in 9 cases, and unknown source of infection in 5 cases. The average time from infection to cure was 13.9 months (range, 6-25 months). The average time from cure to operation was 23.4 years (range, 6-58 years) for patients with confirmed source of infection. According to Kim classification, 12 cases were rated as typeⅠ, 9 as typeⅡ, and 10 as type Ⅲ. There were 21 cases of osteoarthritis after dysplasia, 7 cases of pathologic dislocation, and 3 cases of hip ankylosis. After operation, the infection was assessed by physical signs and laboratory tests; X-ray film of the hip was taken to assess the skeletal structure of the hip and infectious lesion; the length of the lower limb was measured, and the function of the hip joint was evaluated by Harris score. Results: All patients were followed up 10-63 months (mean, 34 months). The result of bacterial culture was negative. The incisions healed by first intention. The sciatic nerve stimulation occurred in 1 case and posterior dislocation of the joint occurred in 1 case after operation. There was no recurrence of infection and no aseptic loosening of the prosthesis. According to Harris score, the function of the hip was rated as excellent in 8 cases, good in 19 cases, and fair in 4 cases at last follow-up; and the excellent and good rate of hip joint function was 87%. X-ray films showed no patchy bone density reduction, spot hardening, or light areas. The length of affected limb was not fully equal with the unaffected limb in 5 cases, and the difference between two sides ranged from 0.4 to 1.3 cm (mean, 0.6 cm). At last follow-up, all patients had no obvious claudication or sensation of unequal length. Conclusion: THA can obtain satisfactory hip function and has low risk of infection recurrence for the patients with hip infection sequelae, who were assessed as the hip infection in a dormant state.

In vivo Study on the Corrosion Behavior of Magnesium Alloy Surface Treated with Micro-arc Oxidation and Hydrothermal Deposition.

OBJECTIVE: To study the corrosion behavior of magnesium alloy surface treated with micro-arc oxidation and hydrothermal deposition in living animals. METHODS: A magnesium oxide (MgO) layer was prepared on Mg alloy using micro-arc oxidation technology, and then a composite coating composed of magnesium hydroxide, hydroxyapatite, and MgO was coated on the MgO layer using the hydrothermal deposition method for 2 h and 24 h. Male 3-month-old white New Zealand rabbits (n = 48) weighting 2200-2300 g, were divided into four groups randomly. The prepared Mg alloy samples with composite coatings were implanted into the femoral medullary cavity of rabbits. For the Mg group, bare Mg samples without any treatment were implanted; for the MgO group, bare Mg samples undergoing MAO treatment were implanted; for the HT2h group, samples of the MgO group undergoing hydrothermal treatment (HT) for 2 h were implanted; and for the HT24h group, samples of group MgO undergoing HT for 24 h were implanted. Then the in vivo corrosion behaviors of implants were evaluated by X-ray observation, micro-CT analysis and serum Mg2+ examination. RESULTS: The X-ray showed that samples implanted in animals were decreased as time went by. The micro-CT showed that on the fourth week, the residual volume percentages (RVP) of samples of the Mg, MgO, HT2h, and HT24h groups were 72.81% ± 2.10%, 71.68% ± 1.49%, 81.14% ± 1.54%, and 82.04% ± 0.89%, respectively; on the eighth week, the RVP of four groups were 29.45% ± 1.06%, 41.82% ± 1.13%, 53.92% ± 0.37%, and 62.53% ± 2.06%, respectively; while on the 12th week, RVP were 8.45% ± 0.49%, 9.97% ± 0.75%, 37.09% ± 0.89%, 46.71% ± 1.87%. The RVP of the HT2h group and the HT24h group were higher than for the Mg group and the MgO group for all three time points (P < 0.05); the RVP for HT24h was higher than for HT2h at 8 and 12 weeks, and the differences were significant, indicating that the degradation of Mg alloy slowed down after composite coating. In addition, the composite-coated Mg alloy by 24-h hydrothermal treatment exhibited a slower degradation than that treated by 2 h. Serum Mg2+ concentration results showed that on the second week, the Mg2+ concentrations of the Mg, MgO, HT2h, and HT24h groups were 2.24 ± 0.10 mmol/L, 2.12 ± 0.07 mmol/L, 2.06 ± 0.11 mmol/L, and 2.15 ± 0.12 mmol/L, respectively. On the fourth week, these concentrations were 1.99 ± 0.33 mmol/L, 2.18 ± 0.06 mmol/L, 2.17 ± 0.09 mmol/L, and 2.13 ± 0.14 mmol/L, respectively. On the eighth week, the concentrations were 2.22 ± 0.09 mmol/L, 2.20 ± 0.17 mmol/L, 2.06 ± 0.11 mmol/L, and 2.14 ± 0.07 mmol/L, respectively. On the 12th week, the concentrations were 2.18 ± 0.04 mmol/L, 2.20 ± 0.08 mmol/L, 2.09 ± 0.02 mmol/L, and 2.16 ± 0.11 mmol/L. CONCLUSION: The combination of micro-arc oxidation and hydrothermal deposition can greatly improve the anti-corrosion behavior of Mg alloy, and Mg alloy coated with this composite coating is a promising biomaterial with a satisfactory degradation rate.

Long-Term Selenium-Deficient Diet Induces Liver Damage by Altering Hepatocyte Ultrastructure and MMP1/3 and TIMP1/3 Expression in Growing Rats.

The effects of selenium (Se)-deficient diet on the liver were evaluated by using growing rats which were fed with normal and Se-deficient diets, respectively, for 109 days. The results showed that rats fed with Se-deficient diet led to a decrease in Se concentration in the liver, particularly among male rats from the low-Se group. This causes alterations to the ultrastructure of hepatocytes with condensed chromatin and swelling mitochondria observed after low Se intake. Meanwhile, pathological changes and increased fibrosis in hepatic periportal were detected by hematoxylin and eosin and Masson's trichrome staining in low-Se group. Furthermore, through immunohistochemistry (IHC) staining, higher expressions of metalloproteinases (MMP1/3) and their tissue inhibitors of metalloproteinases (TIMP1/3) were observed in the hepatic periportal of rats from the low-Se group. However, higher expressions of MMP1/3 and lower expressions of TIMP1/3 were detected in hepatic central vein and hepatic sinusoid. In addition, upregulated expressions of MMP1/3 and downregulated expressions of TIMP1/3 at the messenger RNA (mRNA) and protein levels also appeared to be relevant to low Se intake. In conclusion, Se-deficient diet could cause low Se concentration in the liver, alterations of hepatocyte ultrastructure, differential expressions of MMP1/3 and TIMP1/3 as well as fibrosis in the liver hepatic periportal.

Epitaxial growth of BaHfO3 buffer layer and its structure degeneration analysed by Raman spectrum.

BaHfO3 (BHO) has been proposed as a new cap layer material for YBa2Cu3O7-δ (YBCO) coated conductors. Highly c-axis oriented BHO cap layer has been deposited on ion-beam assisted deposition-MgO buffered Hastelloy tapes by direct-current-magnetron sputtering method. The epi-growth of BHO films combined with its properties is investigated in details. The degenerated cubic crystal structure of BHO film is confirmed by Raman spectrum analysis. XRD θ-2θ scan, φ-scan and ω-scan reveal an excellent c-axis alignment with good in-plane and out-of-plane textures for BHO cap layers. SEM and AFM investigations show BHO cap layer a dense and crack-free morphology. Subsequently pure c-axis orientation YBCO film was epitaxial grown on such BHO cap layer successfully, shown BaHfO3 a potential cap layer material for coated conductors.

Comparative study of serum proteomes in Legg-Calve-Perthes disease.

BACKGROUND: Legg-Calve-Perthes Disease (LCPD) is an idiopathic osteonecrosis of the developing femoral head complicated by pain and disability of the hip joint. To date, the pathological mechanisms of LCPD are not well-known. This study screened the changes in serum protein expression in patients with LCPD. METHODS: Age- and sex-matched serum samples from 10 control subjects and 10 patients with LCPD were compared using the isobaric tags for relative and absolute quantification (iTRAQ) technique. Gene ontology analyses, KEGG pathway and functional network analyses were performed. Proteins of interest with large differences in expression, S100-A8, alpha-1-acid glycoprotein 1, haptoglobin and apolipoprotein E, were compared by western blotting. RESULTS: The disease/control ratios showed 26 proteins were significantly differentially expressed (all p < 0.05). Including higher abundances of complement factor H (1.44), complement C4-B (1.45), isocitrate dehydrogenase [NAD] subunit alpha (2.7) alpha-1-acid glycoprotein 1 (1.87), heptoglobin (1.53) and Ig lambda-2 chain C regions (1.46), and lower levels of apolipoprotein E (0.50), apolipoprotein F (0.60), apolipoprotein C-III (0.69), S100-A8 (0.73), S100-A9 (0.75) and prothrombin (0.77) in LCPD than in controls. The alpha-1-acid glycoprotein 1 and haptoglobin increases, and apolipoprotein E and S100-A8 decreases were confirmed by western blot. KEGG pathway analysis revealed these proteins were related to the complement and coagulation cascades, Staphylococcus aureus infection, PPAR signaling, fat digestion and absorption, and vitamin digestion and absorption. Functional network analysis suggested that the proteins were involved in lipid regulation. CONCLUSIONS: The complement and coagulation cascades, and abnormal lipid metabolism may be involved in the pathogenesis of LCPD.

Sciatic nerve course in adult patients with unilateral developmental dysplasia of the hip: implications for hip surgery.

BACKGROUND: Sciatic nerve injury is a disastrous adverse complication of surgery and can cause debilitating pain, functional impairment and poor quality of life. Patients with developmental dysplasia of the hip (DDH) have a high incidence of sciatic nerve injury after total hip arthroplasty (THA). A better understanding of the course of the sciatic nerve in patients with DDH may help minimise the risk of sciatic nerve injury after THA. METHODS: A total of 35 adult patients with unilateral DDH were enrolled in this retrospective study. We reviewed the patients' computed tomography (CT) scans, which included the area from the iliac crest to below the lesser trochanter. The distance between the sciatic nerve and regional anatomic landmarks in four different sections on CT scans was measured to identify the course of the sciatic nerve. RESULTS: The distance from the sciatic nerve to the spine's midline was shorter on the affected side than on the healthy side (p < 0.05); the same difference was also detected in the distance to the ilium/ischium outside the true pelvis (p < 0.05). The distance to the greater trochanter was longer on the affected side (p < 0.05). However, the two sides showed no significant difference in the distance from the sciatic nerve to the lesser trochanter (p > 0.05). CONCLUSIONS: For patients with unilateral DDH, the sciatic nerve was located near the ischium and ilium but relatively far from the femur of the affected hip joint, compared to its location on the healthy side. These findings reveal that sciatic nerve becomes shorter in the affected low-limb and is relatively unlikely to be directly injuried using the posterolateral approach in patients with unilateral DDH.

[Effects of artificial disc replacement with angles on stress of adjacent intervertebral disc].

OBJECTIVE: To evaluate stress changes of intervertebral space and adjacent intervertebral space after artificial disc replacement with angles. METHODS: Artificial disc replacement with angles were designed according to existing data. Axial pressure, flexion/extension, lateral bending and torsion loading were applied on finite element models of normal cervical discs on C4,5 segments, C4,5 segments with 0 degrees artificial cervical discs and C4,5 segments with 10 degrees artificial cervical discs, then stress changes of C4,5 space was observed. The same loadings were applied on finite element models of normal cervical discs on C4-C6 segments, C4,5 segments with 0 degrees, C4,5 segments with 10 degrees, then stress changes of replaced segments space and adjacent segment space were observed. RESULTS: For C4,5 segments, 80 MPa/0 degrees artificial discs and 80 MPa/10 degrees artificial discs had the similar equivalent shear stress (Se), and were both larger than that of normal discs, when lateral bending were performed, 80 MPa/0 degrees artificial discs were closed to normal discs when axial pressure and flexion/extension were carried out, while 80 MPa/10 degrees artificial discs had a larger Se than that of normal ones,when torsion loading were applied, Szx/Szy stress of 80 MPa/0 degrees and 80 MPa/10 degrees artificial discs were closed to normal ones. For C4-C6 segments, the axial pressure, flexion/extension and lateral bending of C5,6 were all lower than normal discs after C4,5 discs were replaced by 80 MPa/10 degrees artificial discs, while Szx/Szy of torsion loading were closed to normal ones. CONCLUSION: Artificial discs with 10 degrees have less influences on stress of adjacent intervertebral space and closer to mechanical property after being implanted into intervertebral space.

Effect of preoperative limb-length discrepancy on abductor strength after total hip arthroplasty in patients with developmental dysplasia of the hip.

BACKGROUND: Limb-length discrepancy (LLD) arising from hip subluxation or dislocation and accompanied by insufficiency of hip abductor in patients with developmental dysplasia of the hip (DDH) can be corrected partially or completely with total hip arthroplasty (THA). However, information about post-THA changes in abductor strength related to preoperative LLD in patients with DDH is lacking. We aimed to explore the post-THA recovery course of abductor muscle strength and its related factors in patients with DDH. METHODS: A cohort of 45 patients with unilateral DDH was divided into two groups according to their Crowe classification: patients with class I or II DDH formed Group M, and patients in class III and IV DDH formed Group S. The following parameters were measured on standardized antero-posterior hip radiographs taken in the supine position pre- and post-THA: abductor muscle length, abductor lever arm, LLD, and femoral offset (FO). Abductor strength was evaluated quantitatively with the Isomed 2000 isokinetic test system (1 week before the operation and 1, 3, 6, and 12 months after the operation). The contralateral normal hip joint served as a within-patient control. The affected side:healthy side ratios of the parameters above were calculated. RESULTS: Abductor strength ratio evaluated at the five follow-up time points was larger in Group M than that in Group S (p < 0.001). The average abductor strength ratio reached 78.5, 85.4, and 89.2% at the 3, 6, and 12 months postoperative exams, respectively, in Group M, and reached 50.3, 63.2, and 72.9% in Group S. The abductor muscle length ratio, the abductor muscle level arm ratio, and the FO ratio were significantly increased postoperatively, relative to preoperative assessment, in the two groups. LLD was reduced significantly postoperatively, relative to preoperative values, in both groups. Both preoperative LLD (r = -0.791, p < 0.001) and the change in abductor muscle length ratio (r = -0.659, p < 0.001) correlated with abductor strength recovery. CONCLUSION: Patients showed the greatest improvement in abductor strength within the first 6 months after THA, especially during the first 3 months. Abductor strength was consistently greater in patients with mild dysplasia than in patients with severe dysplasia. The extent of preoperative LLD and the increase in abductor length were related with post-THA abductor strength recovery in patients with DDH.

[Expressions of bone morphogenetic protein 2 and runt-related transcription factor 2 and microarchitecture of trabecular bone periacetabula in adult patients with developmental dysplasia of hip].

OBJECTIVE: To explore the expressions of bone morphogenetic protein 2 (BMP-2) and runt-related transcription facotr 2 (Runx2) and microarchitecture of trabecular bone periacetabula in adult patients with developmental dysplasia of the hip (DDH). METHODS: Between March and September 2008, the trabecular bone periacetabulum was collected from 8 patients with DDH who were scheduled for total hip arthroplasty (aged 37-55 years, 3 males and 5 females, trial group) and from 8 patients with avascular necrosis of the femoral head (Ficat stage II) who were scheduled for hip resurfacing arthroplasty (aged 36-55 years, 3 males and 5 females, control group). The expressions of BMP-2 and Runx2 in the trabecular bone were determined by real-time quantitative PCR, and the microarchitecture was observed by micro-CT and the following parameters were determined: bone volume/total volume (BV/TV), connectivity density (Conn.Dens), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), and structure model index (SMI). RESULTS: The expressions of BMP-2 and Runx2 were significantly lower in trial group than in control group (P < 0.05). The micro-CT showed sparse trabecular bone in trial group and dense trabecular bone in control group. BV/TV and Tb.N in trial group were significantly lower than those in control group, and SMI and Tb.Sp in trial group were significantly higher than those in control group (P < 0.05); there was no significant difference in Conn.Dens and Tb.Th between 2 groups (P > 0.05). CONCLUSION: The trabecular bone is in a low metabolism condition and its microarchitecture is tendency to be osteoporosis trabecualr bone in adult patients with DDH. It may be related with the acetabular component loosening after total hip arthroplasty.

[Effects of novel angled cervical disc replacement on facet joint stress].

OBJECTIVE: To analyze the biomechanical changes of the adjacent cervical facet joints when the angled cervical prosthesis is replaced. METHODS: A total of 400 northwestern people were involved, with an age of 40 years or older. The cervical vertebra lateral X-ray films were taken, and the cervical angles were measured by professional computer aided design software, then the cervical intervertebral disc prosthesis with 10 degree angle was designed. The finite element models of C4, 5 and C4-6 segments with intact cervical discs were developed; the C4, 5 disc was replaced by the cervical prosthesis with 0 degrees and 10 degrees angle respectively; and then all models were subjected to axial loading, flexion/extension, lateral bending, and torsion loading conditions; the stress effects on adjacent facet joints after replacement were observed by comparing with that of the intact model. RESULTS: The cervical angles were (9.97 +/- 3.64) degrees in C3, 4, (9.95 +/- 4.34) degrees in C4, 5, (8.59 +/- 3.75) degrees in C5, 6, and (8.49 +/- 3.39) degrees in C6, 7, showing no significant difference between C3, 4 and C4, 5, C5, 6 and C6, 7 (P > 0.05) and showing significant differences between the other cervical angles (P < 0.05). When C4, 5 model was axially loaded, no significant difference in equivalent shearing stress were observed in intact, 0 degrees, and 10 degrees groups; at flexion/extension loading, the stress was biggest in intact group, and was smallest in 10 degrees group; at lateral bending, the stress got the high rank in intact group, and was minimum in 10 degrees group; at torsion loading, the stress state of 10 degrees group approached to the intact one condition. When C4-6 model was loaded, the facet joint stress of the replaced segment (C4, 5) decreased significantly at axial loading, flexion/extension, and lateral bending; while no obvious decrease was observed at torsion loading; the stress of the adjacent inferior disc (C5, 6) decreased significantly at axial loading and lateral bending condition, while less decrease was observed at torsion loading, no significant change at flexion/extension condition, it approached to that of the intact one. CONCLUSION: The finite element analysis reveals that the biomechanical properties of 10 degrees designed prosthesis is approximate to that of the intact cervical disc, thus the 10 degrees designed prosthesis can meet the requirements of biomechanical function reconstruction of the cervical spine.

Inflammatory response to orthopedic biomaterials after total hip replacement.

BACKGROUND: The aim of the present study was to investigate early inflammatory response in the first 3 days after the implantation of hip prostheses, and to compare the early inflammation responses associated with the use of different combinations of bearing materials. METHODS: 34 patients were enrolled, all of whom underwent unilateral total hip replacement and had identical hip prostheses, except for the bearing materials. These consisted of polyethylene on alumina (n = 8), polyethylene on CoCr (n = 11), or alumina on alumina (n = 15). Blood samples were collected preoperatively in the morning of the day of surgery, and at 6 h, 1 day, 2 days, and 3 days postoperatively. CK, CRP, and IL-6 in peripheral blood were measured. Pain score was obtained at 2 days after surgery. RESULTS: There were no significant differences in the pre- and postoperative background variables among the groups. Pain scores of different groups were not significantly different either (P > 0.05). There were also no significant differences in the levels of CK, CRP, and IL-6 when patients with the three combinations of bearing materials were compared. CONCLUSIONS: We concluded that varying the bearing materials used in the hip prosthesis did not influence the early inflammatory response after prosthesis implantation.

The influence of UV irradiation on the biological properties of MAO-formed ZrO2.

Zirconium and its alloys are thought to be ideal materials for dental and orthopedic implants. However, the surface of native zirconium is bio-inert. It has been reported that micro-arc oxidation (MAO) is a convenient and effective method to improving the biocompatibility and bioactivity of the zirconium surface, and ultraviolet (UV) irradiation can improve the bioactivity of the MAO-formed ZrO(2) without altering its surface morphology, grain size and phase component. The aim of the present study was to evaluate the influence of UV irradiation on the biocompatibility and bioactivity of MAO-formed ZrO(2). Two types of samples were established. Those formed by MAO were labeled as MAO ZrO(2) samples, while those that underwent UV irradiation after MAO treatment were labeled as MAO-UV ZrO(2) samples. In the in vitro study, osteoblasts were seeded on the surfaces of the MAO and MAO-UV samples and were then studied by inverted phase contrast microscopy, scanning electron microscope (SEM) and MTT (3-(4.5-dimethyl-2-thiazolyl)-2.5-diphenayl-2H-tetrazolium bromide) testing. While in the in vivo study, the samples were implanted into calvarias of New Zealand white rabbits and were then evaluated by histology and shear strength analysis. The results indicated that the MAO-UV surfaces showed better biocompatibility, faster new bone formation and firmer bonds with bone than the MAO surfaces. Therefore, UV irradiation may be an optimal second-stage treatment that can improve the properties of MAO-formed ZrO(2).

Panax notoginsenoside produces neuroprotective effects in rat model of acute spinal cord ischemia-reperfusion injury.

ETHNOPHARMACOLOGICAL RELEVANCE: Acute spinal cord ischemia-reperfusion injury (SCII) is associated with pathological changes, including inflammation, edema, and neuronal apoptosis. Panax notoginsenoside (PNS), an important traditional Chinese medicine, has shown a variety of beneficial effects, including homeostasis maintenance, anti-myocardial ischemia activities, and neuroprotective functions. However, whether it can produce neuroprotective effects in SCII and the underlying mechanisms remain largely elusive. AIM OF THE STUDY: In the present study, we investigated the effects of PNS on neurological and histopathological changes after SCII as well as the underlying mechanisms. MATERIALS AND METHODS: Sixty-four adult rats were randomly assigned into one of the four groups: the sham group, the ischemic group, the PNS group, and the Methylprednisolone group. A rat model of SCII was adopted from a commonly used protocol that was initially proposed by Zivin. Neurological function was evaluated with the Basso, Beattie and Bresnahan (BBB) locomotor rating scale. Histopathological changes were examined with hematoxylin and eosin staining as well as Nissl staining. Immunohistochemistry and Western blot were conducted to compare the changes in tumor necrosis factor-α, interleukin-1ß, interleukin-10, aquaporin-4 (AQP-4), member 6 of the TNF receptor superfamily (Fas), and Fas ligand (FasL) in the spinal cord. Finally, neuronal apoptosis was measured by electron microscopy. RESULTS: The BBB scores of the PNS-treated injured animals were significantly increased. The gross histopathological examination showed restored neuronal morphology and increased number of neurons after the PNS treatment. The PNS treatment decreased SCII-induced up-regulation of cytokine levels. In addition, PNS suppressed the increased expression of AQP-4 after SCII, suggesting an anti-edema effect. Finally, PNS treatment inhibited injury-induced apoptosis and reduced the expression levels of apoptosis-related proteins, Fas and FasL, confirming its anti-apoptosis effects against SCII. CONCLUSION: The current findings suggest that PNS produces robust neuroprotective effects in spinal cord ischemia-reperfusion injury, and this role may be mediated by its anti-inflammation, anti-edema, and anti-apoptosis actions.

[Construction and screening of neurite outgrowth inhibitory 66 eukaryotic expression vectors].

OBJECTIVE: To construct and screen neurite outgrowth inhibitory 66-small interfering RNA (nogo66-siRNA) eukaryotic expression vectors of effective interference, so as to lay a foundation for further reconstruction of related viral vector. METHODS: The nogo66-siRNA fragments were designed and cloned into pGenesil-1.1, 4 plasmids of pGenesil-nogo66-siRNA-1, pGenesil-nogo66-siRNA-2, pGenesil-nogo66-siRNA-hk, and pGenesil-nogo66-siRNA-kb were obtained, sequenced and identified, then were transfected into C6 cell line. The transfection efficiency was measured by fluorescence microscope. RT-PCR and Western blot were used to detect the expression of nogo gene and select the plasmid of effective interference. RESULTS: DNA sequencing results showed interference sequences were correct. The bands of 800 bp and 4.3 kb were detected when pGenesil-nogo66-siRNAs were digested by Kpn I/Xho I. The expression of green fluorescent protein could be detected under fluorescence microscope, and the transfection efficiency was about 73%. RT-PCR and Western blot results showed that compared to non-transfected cells, the transfection of pGenesil-nogo66-siRNA-1 made the expression of nogo gene decline 22% and the expression of nogo protein decline 73%; the transfection of pGenesil-nogo66-siRNA-2 made the expression of nogo gene decline 28% and the expression of nogo protein decline 78%; the differences were significant (P < 0.05); and the transfection of pGenesil-nogo66-siRNA-hk and pGenesil-nogo66-siRNA-kb did not make the expressions of nogo gene and nogo protein decrease significantly (P > 0.05). CONCLUSION: Nogo66-siRNA eukaryotic expression vector is successfully constructed, it lays an experimental foundation for repair of spinal cord injury.

[Free vascularized fibular associated with iliac graft to treat old femoral neck fracture].

OBJECTIVE: To evaluate the clinical outcome of free vascularized fibular associated with iliac graft in treatment of old femoral neck fracture. METHODS: From January 1994 to January 1997, 76 cases of old femoral neck fracture were treated with free vascularized fibular associated with iliac graft, including 54 males and 22 females, aging from 24 to 48 years with an average of 31.5 years. All of these fractures resulted from injury. There were 20 cases of Garden II, 41 of Garden III and 15 of Garden IV. Based on the location of fracture, there was 26 cases of subcapital, 42 cases of transcervical and 8 cases of basal. Sixty-five cases were treated with internal fixation, 7 cases with skin traction and 4 just with staying in bed. Their Harris score were from 52 to 72 with an average of 65.6. The time from injury to operation was 2-24 months. The size of free vascularized fibular was 6-8 cm and iliac graft was 3.0 cm x 2.0 cm x 1.5 cm. RESULTS: In 76 cases, 68 were followed up and all fractures healed within 4 to 6 months with an average of 5.2 months. The increased density in femoral head was observed 1 year after operation. After 10 years of operation normal hip function was achieved in 63 cases followed up 10.1-12.4 years with the average as 10.5 years); the Harris score was 87.5 (84 to 94). The structure of femoral head was normal and the grafted fibular and iliac bone healed with the femoral, no elapse or cyst occurred. Five cases had been complied with total hip replacement for femoral head necrosis or other. CONCLUSION: Free vascularized fibular associated with iliac graft is a good method to treat old femoral neck fracture.

[Comparison between solis fixation fusion and titanium plate fixation by cervical anterior approach].

OBJECTIVE: To investigate the effect difference between the Solis fixation fusion and the titanium plate fixation by the cervical anterior approach after decompression and bone graft implantation. METHODS: Of the 104 patients with cervical disease from September 2001 to March 2004, 36 were treated with the Solis implantation after decompression by the cervical anterior approach, and 68 were treated with the titanium plate fixation after decompression and bone graft implantation. The recovery of the neurological function in all the patients were assessed with the JOA Scoring at 6 weeks, 3, 6, 12, 24 and 36 months. The fragment fusion and its stability as well as the changes in the intervertebral height were assessed with X-ray examination. RESULTS: According to the JOA Scoring, the excellent and good outcomes accounted for 94.4% in the Solis group and 94.1% in the titanium plate group. In all the patients, the fragment fusion was achieved in 3 months. The change in the Cobb angle of the fused fragment was less than 5 degrees at the flexion-extension posture, 3.6 +/- 0.8 degrees in the Solis group, 2.4 +/- 0.7 degrees in the titanium plate group. There was significant differences between the two groups (P < 0.05). The intervertebral height of the operation fragment in the Solis group increased 1.6 +/- 0.7 mm, which was higher than that in the titanium plate group (P < 0.05). CONCLUSION: Clinical effects of the two internal fixation operations are good; however, the Solis fixation has more advantages because of its simpler performance, less trauma, and fewer complications.