Comparative study of CTX-II, Zn2+, and Ca2+ from the urine for knee osteoarthritis patients and healthy individuals.

The aim of the study was to explore the relationship between the concentration of C-telopeptide fragments of type II collagen (CTX-II), Zn, and Ca in urine and knee osteoarthritis (KOA).Eighty-two patients with KOA and 20 healthy volunteers were enrolled. Anteroposterior and lateral position x-rays of knee joints were collected. The images were classified according to Kellgren-Lawrence radiographic grading criterion. The patients were divided into group grade I, group grade II, group grade III, and grade IV. The concentration of CTX-II in the urine was detected by enzyme-linked immunosorbent assay. The concentration of Zn and Ca in urine was detected by inductively coupled plasma atomic emission spectrometry.Compared with the healthy individuals, the concentration of CTX-II was significantly higher in KOA patients. The concentration of CTX-II in KOA patients from high to low was as follows: group IV, group III, group II, and group I. There was no significant difference between group I and healthy individuals. The concentration of Zn and Ca in urine of KOA patients was higher than that in healthy individuals. There was no difference in each KOA group.The concentration of CTX-II is instrumental to diagnose the progress of KOA. The concentration of Zn and Ca in urine is helpful for early diagnosis of KOA.

[Transplantation of collagen-chitosan nerve conduits filled with glial cell line-derived neurotrophic factor gene-modified schwann cells for the repair of sciatic nerve defect].

OBJECTIVE: To explore the effects of the transplantation of collagen-chitosan nerve scaffold containing glial cell line-derived neurotrophic factor(GDNF)gene modified schwann cells on the recovery of long-distance sciatic nerve defect. METHODS: The rat models of 8 mm long-distance sciatic nerve defect were established and divided into three groups, with 6 rats in each group. In GDNF-Sch group, the defect was repaired by GDNF modified Schwann cells combined with collagen-chitosan nerve scaffold. In Sch group, the defect was repaired by Schwann cells combined with collagen-chitosan nerve scaffold. In the control group, the defect was repaired by autologous nerve graft. Sciatic function index(SFI)was detected 3, 6, and 12 weeks after surgery. After 12 weeks, the tibialis anterior muscle wet weight, electrophysiology, and regenerated nerve morphology were detected. RESULTS: The SFI in the operated side significantly differed among these three groups after 6 and 12 weeks(P<0.05). Along with prolonged treatment, the GDNF-Sch group had similar SFI recovery with the control group but significantly better SFI recovery than Sch group. After 12 weeks, the sensory nerve conduction velocity in the GDNF-Sch and Sch group was not significantly different(P>0.05)but was significantly lower than that in the control group(P<0.05). Both the GDNF-Sch group and Sch group had significantly lower sensory nerve amplitude comparing with the control group(P<0.05), whereas that in the GDNF-Sch group was significantly higher than that in the Sch group(P<0.05). GDNF-Sch group and the control group had significantly higher motor nerve conduction velocity and amplitude than Sch group(P<0.05), while no such statistically significant difference was seen between the two groups(P >0.05). After 12 weeks, the wet weight of the bridging side of the tibial muscle in the control group, Sch group, and GDNF-Sch group was(0.360±0.020), (0.250±0.018), and(0.310±0.025)g, which were significantly lower than the control side [(0.440±0.031), (0.420±0.024), and(0.430±0.027)g, respectively(P<0.05)]. Muscle wet weight in bridge side of GDNF-Sch group and the control group were significantly higher than in Sch group(P<0.05), but it was not significantly different between the GDNF-Sch group and the control group(P>0.05). CONCLUSION: Transplantation of collagen-chitosan nerve scaffold containing GDNF gene modified Schwann cells can remarkably facilitate sciatic nerve defect recovery, with a milimar effectiveness as autologous nerve grafting.

Comparing the chondrogenic potential in vivo of autogeneic mesenchymal stem cells derived from different tissues.

OBJECTIVE: to compare the chondrogenic ability of mesenchymal stem cells (MSCs) derived from different tissues in rabbits' full-thickness articular cartilage defects. METHODS: sixty New Zealand white rabbits of ordinary grade with a body weight of 2.5 approximately 3.5kg were selected for this study. Six were sacrificed for preparation of deminerized bone matrix (DBM) as scaffold. Fifty-four were used for cartilage defects model. Full-thickness cartilage defect of knee joint was created on trochlear groove at two sides of the femur with a diameter of 4 mm and thickness of 3 mm. All 54 rabbits were randomly divided into 6 groups and treated by autogeneic MSCs isolated from bone marrow, periosteum, synovium, adipose tissue and muscle, respectively. The 6th group was a control group with nothing plugged into the defects. Every three rabbits were killed at three time points, which were 4, 8, and 12 weeks after the operation in each group. The reparative tissue samples were evaluated grossly, histologically, immunohistochemically, and graded according to gross and histological scales 12 weeks postoperatively. We input the scores into SPSS 11.5 software and the analysis of variance (one-way-ANOVA) and student-newman-keuls (SNK-q) test were used to process statistical analysis and find out if the differences between each group had statistical significance. RESULTS: fifty-four rabbits are included in the final analysis. The defects are all repaired by hyaline-like tissue except the control group. The bone-marrow-MSCs produced much more cartilage matrix than that of other groups. Gross and histological grading scale indicates that the defects repaired by MSCs isolated from bone marrow are superior to that repaired by MSCs isolated from periosteum, synovium, adipose tissue, and muscle (p < 0.05). In adipose-MSCs and muscle-MSCs group, some defects are even repaired by fibrous tissue. CONCLUSION: bone-marrow-MSCs have greater in vivo chondrogenic potential than periosteum-, synovium-, adipose- and muscle-MSCs.

Nervus cutaneus femoris posterior pedicle flap for repairing large soft tissue defects at the heel or inferior segment of the shank.

OBJECTIVE: To investigate the clinical effect of the nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects at the heel or inferior segment of the shank. METHODS: Totally 14 cases were followed up for 8-22 months (mean 15.5 months) to observe the clinical effects of nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects of the heel or inferior segment of the shank. Among them, there were 3 patients afflicted with infection and cutaneous defects in the middle and inferior segment of the shank after internal fixation of open fracture, 4 patients with soft tissue defects of the ankle and uncovered tendo calcaneus, and 7 patients with soft tissue defects of the heel and exposed calcaneus. RESULTS: The flaps survived well in 13 cases and partial necrosis occurred in 1 case that was thereafter cured with changing dressing. Various extents of pain and stiffness of the knee joints were present in all cases and disappeared through 1-8 weeks' (mean 3.2 weeks) functional exercises. The last follow-up showed that all the flaps kept good texture and satisfactory appearance. CONCLUSIONS: The nervus cutaneus femoris posterior pedicle flap, having the advantages of simple surgical procedures, anastomosing the nerves and restoring the sensation of recipient site, can be used for recovering large soft tissue defects of the shank and ankle.

[Strategy of the treatment for dislocation of cervical vertebra].

OBJECTIVE: To study the strategy of the treatment for dislocation of cervical vertebra. METHODS: The clinical data of 39 cases with dislocation of cervical vertebra were analyzed. Among them,29 were male and 10 were female. The average age was 40 years old (range from 6 to 74 years old). Segment of dislocation: 15 cases in C(1,2), 1 case in C(3,4), 9 cases in C(4,5), 9 cases in C(5,6), 5 cases in C(6,7). Spinal injury according to Frankel grade, 9 cases were A grade,8 were B, 5 were C, 8 were D, 8 were E, 1 case had radicular symptom. Thirty-two cases were early and rapidly treated with traction (progressive weight). Seventeen cases were treated with operation. RESULTS: Traction-reduction was successful in 90% of patients. According to Frankel grade, 32 cases averagely improved 0.63 grades. Six cases of severe spinal injury accompany with interlocking of zygopophysis died. CONCLUSION: Inspecting weight of traction is important in rapid traction-reduction for dislocation of cervical vertebra. The choice of surgical treatment depends on the degree of reduction, the result of MRI,the grade of spinal trauma and the status of patients.