[Objective]To investigate the effect of coagulation of intervertebral disc nucleus pulposus(IDNP) by alum.[Method]In vitro,20 canine intervertebral discs(I D) were divided into 4 groups,and immersed into 2.5%,5%,10% alum solution and normal saline respectively.Another 16 I D also randomized into 4 groups and were injected into I D with corresponding solution.In vivo,6 canine ID were grouped into 4:A.blank control;B.one injection of alum;C.two points injection of alum;D.injection of N.S.Experimental dogs were sacrificed and disc samples were taken at 3 days,2 wks,and 1 month post-injection.Gross observation,histological exam by microscopy and scan electron microscopy(SEM) and histochemical test were performed.[Result]NS did not coagulate the IDNP in vivo and in vitro,while in vivo,coagulation was seen around the injection points,two points with two coagulation blocks,and grew with time culminating on one month after injection,but there was no coagulation appeared after alum injection.In vitro,histological study showed aboundant collagenous fibers gathered in coagulation lock representing manifold function of mesenchyme.[Conclusion]The alum can make the IDNP to be coagulated in vivo,the mechanism of coagulation is the collagenous fiber proliferation and fibrosis due to manifold function of mesenchyme.

[Objective]To explore the effects on surrounding tissue and bone regeneration by citrated calcium sulphate(CCaS) and Ostesset~.[Method]Bilateral or lateral femoral condyles were drilled into defects in 18 rabbits,and divided into 3 groups: A,12 rabbits,left defect filled with CCaS cylinder,right defect with osteoset~;B,3 rabbits,left defect with CCaS,right defect blank;C,3 rabbits,left defect with osteoset~GFDA3,right defect blank.The rabbits were sacrificed at 3 wks,6 wks and 13 wks,and defect samples were taken for histological exam,roengenographic observation and bone tissue calculation by image-plus CCD system.[Result]The defects that were not grafted were filled with bone marrow and there was minimal new bone,only at the margen of the defects CCaS and osteoset~GFDA3 implanted in the defects were gradually absorbed,and substituted by new bone trabecula,which became more mature and thicker.The area fraction and trabecula thickness of new bone in defects treated with CCaS were not significantly different from defects treated with osteoset~ after 3,6,13 wks.However,the degradation velocity of CCaS was slower than that of osteoset~.No inflammatory and foreign body response was observed.[Conclusion]Just like osteoset~,CCaS is more benefitial to new bone formation compared with osteoset~,because CCaS has relatively slower degradation velocity.

[Objective]To study the possibility of differentiation of rabbit marrow mesenchymal stem cells(MSCs)into endothelial cells in vitro.[Method]BMSCs of rabbits were obtained by using gradient centrifuge method.The adhesive cells were preserved to passage culture to get pure MSCs.MSCs in the second generation were used.After induction with vascular endothelial growth factor(VEGF),microscopic exarm,cytoimmunofluorescent staining confirmd the trial group cells becomes to endothelial cells.W-P corpuscles which was the symbol of endothelial cells were observed by transmission electron microscope.[Result]The differentiated cells demonstrated the characters of endothelial cells under phase contrast microscopy.The cytoimmunofluore-scent staining showed that the trial group cells were induced to endothelial cells.W-P corpuscles could be seen under transmission electron microscope.[Conclusion]The adult rabbit BMSCs can present features of endothelial cells in certain induction medium,they are ideal donor cells of tissue engineering vascularization.

[Objective]To evaluate the inhibiting affection of Ad-BMP-7 to osteoporosis of ovariectomized rats.[Method]Mice model of osteoporosis was made by surgical ovariectomy,and divided into 4 groups:A.group of vertebral body intramedullary injection of normal saline;B.injection of Adovirus(Ad)-GFp;C.injection of Ad;D.injection of Ad+BMP(bone morphogenetic protein),the bone losing of whole body were monitored by measuring dry bone weight after 1 month,the osteoporosic condition of bone trabecular were observed by histology,and bone histomorphometry of vertebral bodies were carried to quatitatively measure the dynamic and static indexes of osteoporosic bone.[Result]The dry bone weight of AdBMP-7 rats werehigher than that of other groups.Under the microscope,the bone trabecula form of the Ad BMP-7 groups were more integrity,however,the bone trabecular of the other groups showed sharpen and ruptured.In the bone histomorphomitry,the numbers of the osteoblasts,the thickness of osteoid of group D were obviously higher than other groups.[Conclusion]Ad BMP-7 injected into the vertebral bodies of ovariectomized rats may secrete BMP-7,and inhibits the osteoporosis of ovariectomized rats in the early stage.The protective effect of this gene was not restricted to bones receiving intramedullary injection of the vector,but occurred in all bones that were evaluated.This proof of concept encourages further development of gene therapy approaches to the treatment of osteoporosis.

[Objective]To observe the bone repairing efficacy of large segmental femur defects in rabbits with calcium phosphate cement(CPC)combined with bone morphogenetic protein(BMP)and massive bone allograft,which may benefit the clinical application of large segmental bone allograft transplantation.[Method]Fifty-four New Zealand white rabbits were divided into three groups and a 2 cm femur defect was created on one side of each rabbit,followed by implantation with:CPC combined with BMP and massive bone allograft(Group A),bone allograft only(Group B)and autograft transplantation(Group C).Intramedullary nails with a 3 mm diameter fixed all the grafts transplanted.The bone defect repair efficacy was evaluated by radiology and histology exam at 4,8 and 12 weeks after operation.[Result]The bone reparation capacities of allograft with CPC/BMP complex was better than that of the allograft alone after 4 ~8 weeks of transplantation,which were similar to the result of autograft transplantation.Complete bone union was achieved for all the groups after 12 weeks of operation,with better bone remodeling for group A and group C transplantation.The healing process of CPC/BMP combined with allograft transplantation was featured with large amount of bone callus forming surrounding the graft-host bone union area and the surface of allograft,which composd the extra cortical bone bridge and ingrowth(EBBI).Bone invasion,resorption as well as new bone genesis were seen in the surface of bone allograft at early stage,companied by expansion of Haversians canal,with more lanner cells,osteoblasts,osteoclasts and blood cells inside the allograft.CPC was slowly biodegraded with the bone graft resorption and new bone regeneration.[Conclusion]CPC combined with BMP can improve the bone reparation and substitution process in massive bone allograft transplantation for the treatment of large segmental bone defects.

[Objective]To assess the success of hallux valgus surgery of oblique and impaction osteotomy of first metatarsal neck.[Method]The outcome of 36 patients(45 feet)treated by this technique for symptomatic hallux valgus deformity was reviewed.The follow-up was two years.Lateral and AP radiographs were taken in a standing position pre-and postoperativly and hallux valgus angle(HV angle)and intermetatarsal angle(IM 1~2 angle)were measured accordingly.The efficacy of the surgery was evaluated by JOA scoring for foot disorders.[Result]The fracture healing was excellent.There was no case of delay union and nonunion.Two cases(three feet)were found to have superficial infection.The mean HV angle and IM 1~2 angle was revised by 15.6? and 4.2? respectively.JOA score was elevated for 29.6 points.[Conclusion]Hallux valgus can be corrected in three-dimension by the technique of first metatarsal neck osteotomy and inverted impaction fixation.

[Objective]To study the effect of semi-constrained total elbow arthroplasty in rheumatoid elbow arthritis.[Method]Eighteen semi-constrained total elbow replacements were performed on 22 rheumatoid patients with 28 elbows(Morrey Stage:6 of Ⅲ Stage,17 of Ⅳ Stage,5 of Ⅴ Stage).The elbows were reviewed retrospectively after a followup of mean 26 months(range12~44 months).Mayo Elbow Performance was used to evalue the function of preoperative and postoperative elbow.The curative effect and complications were observed.The statistically significant differences were analyzed.[Result]Elbow arthroplasty was successful in 22 rheumatoid patients with 28 elbows.After 6 weeks function exercise the Mayo Elbow Performance was improved from(31.6?29.2)to(82.1?24.3)with a statistically significant difference(P

[Objective]To analyze the reasons of complications in high tibial valgus osteotomy in the varus osteoarthritic knee and its management.[Method]We studied the results of valgus-producing high tibial osteotomies in patients who had medial unicompartmental osteoarthritis and varus malalignment.We performed the operation for 126 patients from January 2000 to October 2004.Twenty-one patients had complications,including four men and seventeen women,with average age of 61 years(ranged:48～64 years).The femorotibial angle was measured on the standing anteroposterior film of knee preoperatively in order to get high accuracy in preoperative planning.A lateral closing-wedge osteotomy was performed,the osteotomy site was stabilized by Giebel blade plate or stepped staple.[Result]The mean duration of follow-up was 7.5 months(ranged,6 to 12 months).There were twenty-three complications(21 patients,16.7%):tibial fracture in four cases,deep-vein thrombosis in five cases,peroneal nerve palsy in three cases,recurrence of varus deformity in six cases,internal fixation failure in four cases(recurrence of varus deformity developed in two patients),a superficial wound infection developed in one patient.[Conclusion]To reduce the incidence of complications in high tibial valgus osteotomy,we should make familiarication with anantomy and take more accuracy in preoperative planning,improve surgical skill as well as appropriate perioperative management.

[Objective]To evaluate the initial effect of the computer-assisted total knee replacement system.[Method]The 24 computer-navigated knees in our department were involved,and were matched at ratio of 1∶3 by previous cases at sex,age and disease.All cases anteroposterior and lateral projection X-ray films were checked postoperatively.We compared ? and ? angles at anteroposterior films,? and ? angles ant lateral films of all involved cases[Result]Although there was no significant differences existing between two groups,we still observed the obvious reduce risk of malplacement both for femoral and tibial prosthesis,and improvement of mechanical alignment.[Conclusion]By using computer-navigated total knee replacement system during operating,the precise and repeatability could be ensured.

[Objective]To evaluate the methods of operation and clinic effective of thoracolumbar spinal tuberculosis with paraplegia.[Method]Thirty cases of thoracolumbac spinal tuberculosis with paraplegia had been treated with primary anterior debridement,decompression of spinal cord,interbody graft bone,and interbody fixation,anti-tuberculosis drug was taken at 18 monthes ofter the operation.[Result]Thirty cases were followed-up for an overage of 19 months and were healed,in which 2 cases recurrence,29 cases spinal fusion of graft bone,12? of kyphosis correction had been gained,the neuropathic fuction had gained improvement excellently(90%).[Conclusion]It had gained good outcome that operation of the primary anterior debridement decompression of spinal cand interbody graft bone and interbody fixation to treat thoracolumbac spinal tuberculosis with pacaplegia.