ObjectiveTo observe the microstructure and ultrastructure of platelet-rich plasma gel. MethodsPRP gel samples were obtained by two-step centrifugation. The platelets were counted before and after centrifugation. TGF-β1, PDGF-AB were measured in the PRP gel and the whole blood using the enzyme-linked immunosorbent assay. PRP gel samples were observed with macroscopic observation, HE staining, transmission (TEM) and scanning electron microscopy (SEM). ResultsThe platelet concentration of PRP was 458% of whole blood. TGF-β1, PDGF-AB were found in high concentrations in PRP gel samples. Both SEM and TEM showed that PRP gel mainly contained fibrillar material with striated band similar to fibrin filaments, and platelet. ConclusionPRP gel may be an ideal injectable scaffold material for constructing tissue engineering nucleus pulposus.

Objective To explore the changes of rabbit adipose stem cells(ASCs)and bone mesenchymal stem cells(BMSCs)cultured in vitro and the anabolism under basic fibroblast growth factor(bFGF).Methods BMSCs and ASCs were cultured with DMEM,DMEM/F12(2∶1)or α-MEM respectively.The 3rd generation ASCs and BMSCs were divided into 2 groups respectively:group A:ASCs cultured in chondrogenic medium(CM),group B:ASCs cultured in CM supplemented with bFGF 5 ng/ml,group C:BMSCs cultured in CM,group D:BMSCs cultured in CM supplemented with bFGF 5 ng/ml.Morphological changes were observed under inverted microscope.The 35SO42-incorporation and total hydroxyproline were measured.Results BMSCs and ASCs showed much higher growth rate when cultured in α-MEM medium comparison with that in DMEM or in DMEM/F12(2:1).Both stem cells attachment cultured in monolayer greatly increased and cell clones were abundant,while the cells attachment became rather difficult and cell clones were less after cutured in CM.All stem cells possessed a round-like morphology,and the cells in group B and D were more than that in the other 2 groups.The 35SO42-incorporation and total hydroxyproline synthesis of group B or D increased compared with that of group A or C,but there was no diference between group D and B.Conclusion The rabbit ASCs and BMSCs cultured in CM suppling with bFGF grow well and their metabolism increased.

Objective To investigate the clinical characteristics of postoperative spondylodiscitis after lumbar intervertebral disc herniation.Methods 9 cases with spondylodiscitis were reviewed,about their clinical symptoms,laboratory tests,bacteria culture,CT and MRI finging,etc.Results and Conclusion The clinical symptoms occurred 8~24 d after operation.Laboratory test and MRI were helpful for the early diagnosis.The outcome of both surgical and non-surgical treatment was satisfactory.

Objective To observe the characteristics and treatment of malignant peripheral nerve sheath tumor originated from neurofibromatosis and the outcome of the patients. Methods A case was reported and the related literatures were reviewed. Results and Conclusion Malignant peripheral nerve sheath tumor is a rare soft tissue malignancy, which is with highly invasion. There are some difficulties with the diagnosis and treatment, and the outcome is poor. Early diagnosis is very important for treatment.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

ObjectiveTo observe the effect of adipose-derived stem cells (ADSCs) compound injective thermo-sensitive chitosan scaffold transplantation on content of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) in early degenerate lumbar intervertebral disc of rabbits. Methods24 white New Zealand rabbits (no limit of male or female) were randomly and equally divided into 4 groups: A. Degeneration model group: nucleus aspiration. B. ADSCs compound chitosan transplantation group. C. Cell-free chitosan transplantation group. D. Blank control group: only explore the target intervertebral disc. When aspirate pulposus with 21G needle, inject ADSCs-scaffold complex and chitosan scaffold respectively. The samples of L2-3, L3-4, L4-5, L5-6 intervertebral disc were obtained from 2 rabit in each group 2, 4, 8 weeks after operation. The contents of TNF-α, IL-1β were measured with ELISA. ResultsAll animals survived after the operation. Compare with the blank control group, the contents of TNF-α, IL-1β in degeneration model group increased significantly (P＜0.05). It decreased significantly (P＜0.05) in ADSCs compound chitosan transplantation group and cell-free chitosan transplantation group compared to model group. IL-1β decreased significantly (P＜0.05) 8 week after operation in ADSCs compound chitosan transplantation group compared to cell-free chitosan transplantation group. ConclusionADSCs compound injective thermo-sensitive chitosan scaffold transplantation in early degenerate lumbar intervertebral disc could decrease the content of TNF-α, IL-1β, and may regulate the inflammatory response.

Objective To investigate the osteogenic potential for size-critical bone defect of fibrin sealant combined with recombined human bone morphogenetic protein-2 (rhBMP-2) grafting and varied autologous bone marrow mesenchymal stem cells (BMSCs) implanting in vivo. Methods BMSCs were cultured and induced with osteogenic supplement (OS) medium. BMSCs with and without OS induction were collected and percutaneously autologous injected respectively into the 15 mm bone defect of experimental rabbit model. The grafts were BMSCs, osteo-induced BMSCs, BMSCs and osteo-induced BMSCs, BMP combined with fibrin sealant, 0.9% NaCl solution. Osteogenesis at the defect area was assessed with regular radiography, histology and biomechanics. Results The FS/BMP group and the BMSCs+osteo-induced BMSCs group achieved complete bone healing with medullary cavity united, with the most new bone formation and the maximal load among those groups. Conclusion The osteogenic potential of both osteo-induced BMSCs combined with BMSCs and FS/BMP are similar, which are superior to that of BMSCs or osteo-induced BMSCs along.

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.

Objective To explore the mechanism of percutaneous laser disc decompression (PLDD) for treating prolapse of intervertebral disc. Methods 15 rabbits were divided into 3 groups randomly: sham group, model group with PLDD treatment, model group without PLDD treatment. The nerve conduction velocity (NCV) of L6 nerve root and the activity of phospholipase A2 (PLA2) in the intervertebral disc of L5-6 were determined 2 weeks after the initial surgery. Results NCV in the group with PLDD was significantly faster than that in the group without PLDD (P<0.001); NCV in the group without PLDD was significantly lower than that in the sham group (P<0.001). The activity of PLA2 in the group with PLDD was significantly lower than that in the group without PLDD (P<0.001); The activity of PLA2 in the group without PLDD was significantly higher than that in the sham group (P<0.001). Conclusion The activity of PLA2 in the herniated discs is higher than that in normal discs, which result in NCV falls remarkably. The PLDD can reduces chemical factors such as PLA2.

OBJECTIVE: To explore the reasons of poor sensation recovery after anterolateral thigh flap (ALTF) transplantation and to improve the design and sensation reconstruction of ALTF. METHODS: Lower limbs from 21 adult cadavers were chosen, and the lateral femoral cutaneous nerves (LFCN) were dissected. Their courses, shape, distribution and anatomic variation were observed, the distance from original sites of LFCN's posterior and anterior branches to the anterior superior iliac spine (ASIS) were measured, and the external diameter of their main trunks,after piercing out from the inferior margin of inguinal ligament or sending out their posterior branches and their anterior branches, were measured. RESULTS: The plane which the posterior branches sent out from the LFCN located at 4.8 (0~16.9) cm below the ASIS. The plane which the anterior branches sent out from the LFCN located at 14.2 (6.7~24.1) cm below the ASIS. There were 6 branches of the LFCN, namely ordinary three branches (9/21), high-level posterior branch (5/21), posterior branch absent (3/21), anterior branch absent (1/21), tiny branch, (2/21) and LFCN absent (1/21). The section of the LFCN was oblate, the external diameter of the LFCN,s main trunk after piercing out from the inferior margin of inguinal ligament or sending out its posterior branch and its anterior branch was 2.68 (1.18-4.52) mm, 2.18 (0.80-4.10) mm and 1.63 (0.44-2.60) mm, respectively. CONCLUSION Poor sensation recovery after ALTF transplantation is due to anatomic variation of the posterior branch of the LFCN. The sensory recovery of ALTF may be improved if the 2/3 low to median part of the anterolateral thigh and the main trunk of the LFCN or its plane before sending out the anterior branch is chosen for anastomosis.
Cadaver ; Female ; Humans ; Ilium ; anatomy & histology ; Inguinal Canal ; anatomy & histology ; Male ; Skin ; innervation ; Surgical Flaps ; innervation ; Thigh ; innervation