ABSTRACT
Background:This retrospective study focuses on the application of computer simulation in reconstructing severe bone defects in adult players with fibrous dysplasia. Conducted from August 2017 to December 2020, the study analyzed medical records of nine patients treated in our department. The approach involved importing image data into a computer to reconstruct models of affected limbs, enabling precise lesion locationidentification for curettage, bone grafting calculations, and internal fixation matching. The study included nine adult patients, suffering from either monostotic or polyostotic forms of severe fibrous dysplasia, with lesions located in the humerus, femur, and tibia. The results showed that this method can shorten surgery time, minimize intraoperative trauma, and enhance the effectiveness of bone reconstruction. The average follow-up period was 32.27 months, with the MSTS score averaging 21.2 points and Shin's imaging scoring system for bone grafting scoring an average of 13.5 and 14.3 at the 1-and 2-year post-operation marks, respectively. Despite two patients experiencing complications, this technique demonstrates promise in managing severe bone defects in adults, particularly in sports-related contexts (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Fibrous Dysplasia of Bone/surgery , Computer Simulation , Athletic Injuries/surgery , Severity of Illness IndexABSTRACT
Objective@#To explore the effect of substrate mechanical microenvironment and cell-cell interaction on differentiation of bone marrow mesenchymal stem cells (BMSCs), intrahepatic cellular function and phenotype.@*Methods@#Bone marrow mesenchymal stem cells (BMSCs)-hepatocytes (HCs) and BMSCs-hepatic stellate cells (HSCs) were co-cultured on polyvinyl alcohol (PVA) hydrogel substrates at different stiffness (4.50 ± 0.47 kPa, 19.00 ± 3.51 kPa and 37.00 ± 2.09 kPa) by non-contact co-culture method. Furthermore, the effect of substrate mechanical microenvironment on BMSCs, HCs and HSCs and the activation and proliferation of HCs under different co-cultured condition was studied. A Student's t-test was used to compare the two groups.@*Results@#The expression ofα-smooth muscle actin (α-SMA) and collagenα1- I (Col1A1) in BMSCs and HSCs cultured on its own increased with increase of substrate stiffness. After 72 h, the expression of albumin (ALB) of HCs on three stiff substrates was significantly higher than that of 24 and 48 h. Moreover, the expression of ALB of HCs increased with the increase of substrate stiffness. During the co-culture of BMSCs and HSCs, BMSCs of all three stiffness substrates promoted the expression ofα-SMA, Col1A1 in HSCs, but reduced the expression of PPARγin HSCs cells, thererby promoted the activation of HSCs, with apparent stiffness at 37 kPa. HSCs promoted the expression of ABL in BMSCs at three stiff substrates, but inhibited the expression of alpha-SMA and Col1A1 in BMSCs at 37 kPa, suggesting that co-culture had inhibited the differentiation of BMSCs myofibroblasts, and promoted the differentiation of hepatocyte-like cells, especially at high stiff substrates. In the co-culture of BMSCs and hepatic parenchymal cells, BMSCs had promoted the proliferation of hepatic parenchymal cells at 4.5 kPa. Further, hepatic parenchymal cells had inhibited the expression ofα-SMA in BMSCs, and promoted the expression of Alb, with inhibition of BMSCs differentiation towards myofibroblasts.@*Conclusion@#The differentiation of BMSCs affects the substrate mechanical microenvironment, co-culture of HCs and HSCs. Simultaneously, affecting the function of hepatocytes in relation to the mechanical state of the substrates.
