Objective To investigate clinical diagnosis and clinical outcome of conservative treatment for transient osteoporosis of the hip. Methods Between October 2006 and July 2009, 10 patients with transient osteoporosis of the hip were treated in out-patient clinic. The clinical and radiologic characteristics were studied retrospectively. There were 4 males and 6 females with an average age of 35 years (range, 22-43). All female patients were not in the period of pregnancy. The diagnosis was made based upon detailed X-ray and MRI evaluations. X-ray revealed osseous demineralization of the femoral head at 8 patients and showed normal at 2 patients. All patients showed the characteristic MRI pattern of transient osteoporosis of the hip. The involved hip had a diffuse and homogeneous area of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in the head, neck and the intertrochanteric region in 7 patients. Non-operative management, consisting of symptomatic therapy and reduction of weight bearing was performed in all patients. Symptomatic therapy included nonsteroidal anti-inflammatory drug and bisphosphonate administration. Verbal pain rating scale and Harris hip score were used to assess the results of the treatment. Results All 10 patients have been followed up at 3, 6 and 12 months interval after they received treatments. The last follow-up duration of all 10 patients was 2.5 years (range, 1.0-3.5). All patients had pain relief in varying degrees at 1 day after the therapy. The pain scale level had diminished in all patients, while the Harris hip score had increased from 74.5 pre-therapy to 96 post-therapy. X-ray and MRI showed complete recovery after 6 months. No complications were found among them. Conclusion Transient osteoporosis of the hip was considered to be a distinct, self-limiting, and transient disease, which had specific clinical and radiologic characters. Non-operative management should be the first choice to treat this disease.

To observe the local microcirculation changes in primary bone lengthening for gunshot bone defect treated by external fixators, the experimental study was carried out by using canine model of gunshot bone defect of extremities. 16 mongrel dogs were randomly divided into 2 groups, external fixators were used to distract early callus in one group and plaster was used for immobilization in the other group. The local microcirculation in the two groups was measured. The results showed: (1) Different from the normal fractures, the local blood flow of gunshot fractures was reduced in the first 3 days and then increased, at the 6th week it was close to the normal level. (2) There was no significant difference in the restoration of blood flow between the groups of external fixation and plaster immobilization. It is suggested that primary bone lengthening for gunshot bone defect by external fixators has no adverse effect on the restoration of the local blood flow.

To further understand the function and biological activity of TGF ? 1, and to provide the basis for the production of biologically active TGF ? 1 protein, TGF ? 1 cDNA was cloned into procaryotic expression vectors--pBV220 and pQE30, and the monomeric form of the recombinant TGF ? 1expressed in E.coli DH5? and M15. Sephacryl S 100 HR and Ni + NTA agarose column were used to purify the TGF ? 1 protein. With digestion of the enzymes and sequencing, TGF ? 1 mature peptide gene was inserted into procaryotic expression vectors--pBV220 and pQE30. After purified, the expressed products of two plasmids in E.coli showed a single protein on SDS--PAGE, and their expression levels were about 15% and 20% of the total bacterial protein. The construction of recombinant plasmids and preparation of the monomeric protein of TGF ? 1 lay a solid foundation for further studying the function of TGF ? 1 and producing biologically active TGF ? 1 protein.

Objective To investigate the pathological changes of bone in situ lengthening for the gunshot bone defect, and to discuss the practical feasibility and biological basis of bone lengthening in the conditions of periosteum damage. Methods The 38 canines were randomly distributed into two groups and sustained the same gunshot bone defect in the mid femoral diaphysis. In one group, the femur were stabilized with Bastiani external fixator and 2 weeks later the fractured limb with fixation were lengthened 2-4 times per day at a speed of 0.5-1 mm/d until the normal length was reached. The control group only had external fixation without lengthening. 3, 6 and 12 weeks after injury, the canines were given 99mTc MDP and got radionuclide examination under SPECT (ADAC company, USA.). Pathological and X ray observation were carried out at 1, 2 ,3 ,6 and 12 weeks respectively after injury for comparison between two groups. Results The X ray measurement showed that the length of callus distraction in the bone lengthening group increased by (2.82?0.94)cm and the relative lengthening of bone is 19.3% (15.8%-21.4% ), compared with normal femur on the same X ray film. The count of radionuclide increased gradually at the region of bone defect in the lengthening group. While in the fracture ends, no significant difference was found in the development pattern through each radionuclide observation phase between two groups. The main mode of osteogenesis was endochondral ossification and the bone defect area was enriched by chondrocyte in the bone lengthening group. Conclusion There are no obvious negative influence on bone turnover and local blood flow in the bone lengthening for gunshot bone defect. The remained periosteum and bone fragment under gunshot injury may have important role in the progression of osteogenesis. The neogenetic capillary provided not only blood supply for healing of bone but also source of osteocyte for bone lengthening in the case of the periosteum and blood circulation damaged with gunshot wound.

Objective To discuss the therapy modalities and their efficacy for Cobb's syndrome Methods Data from 14 cases of Cobb's syndrome were retrospectively reviewed of which diagnosis, management and follow-up were discussend. Results Follow-up period of the 14 cases was 4 months to 3 years, of them, no complete cure occurred, 12 cases improved, 2 cases deteriorated. Conclusions Early diagnosis and early treatment using in terventional and surgical method are the key point for this kind of in curable diseases.

BACKGROUND: Some researches demonstrate that jog stress at fracture part can promote formation of callus, but molecular biological mechanism of jog stress on fracture healing is still unclear.OBJECTIVE:To study the effect of jog stress at fracture site on basic fibroblast growth factor(bFGF)at broken parts.DESIGN:Randomized controlled animal study.SETTING:Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA;Departments of Orthopaedics and Pharmacy,the First Affiliated Hospital of General Hospital of Chinese PLA.MATERIALS:The experiment was carried out in the Animal Laboratory,the First Affiliated Hospital of General Hospital of Chinese PLA and the 8th Laboratory,Academy of Military Medical Sciences of Chinese PLA from March 2003 to April 2004.A total of 72 healthy purebred New Zealand rabbits,of general grade,5-6 months old,weighing 2.5-3.0 kg,were provided by Animal Center of Academy of Military Medical Sciences of Chinese PLA.All rabbits were randomly divided into jog group and fixation group with 36 rabbits in each group.And then,every 6 rabbits in both groups were respectively observed at 6 time points,including 7,14,21,28,42 and 56 days.METHODS:All animals were anesthetized with ketamine and sumian xinji.Fixation needle was rotated into 3,3.5,5.5 and 6 cm below platform of tibia,respectively,and then external fixators were installed.Chuck which was located at 1.5 cm from internal cortical bone and 4.5 cm below platform of tibia crossly cut off tibia.Fracture space was 2.0 mm and 2.5 mm in the fixation group and jog group,respectively.Animals in the fixation group were fixed with unilateral external fixator to dissect replace fracture part.In addition,animals in the jog group cut off their bone,fixed,and moved 0.5 mm to axis along central staff of external fixator.Animals were able to freely walk and external fixator was slightly shaken based on body mass of animal.Furthermore,all animals were sacrificed at 7,14,21,28,42 and 56 days after operation.According to the center of fracture part,samples in 1 cm length were cut,divided and fixed for 12 hours.Quantitative analysis of bFGF and colorized intensity were detected with immunohistochemical stain and JVC imaging analytic system at 7,14,21,28,42 and 56 days after operation.MAIN OUTCOME MEASURES:①Detecting colored intensity of bFGF;②quantitative analysis of bFGF.RESULTS:A total of 72 rabbits were involved in the final analysis bFGF could express in interstitial cells,vascular endothelial cell,osteoblast,chondroblast and osteocyte plasma.At 14,21 and 28 days after operation,positive indexes of bFGF protein in the jog group were 1.98±0.14,2.04±0.12 and 2.13±0.17,respectively,which were obviously higher than those in fixation group(1.59±0.14,1.68±0.15,1.63±0.27,P＜0.05).CONCLUSION:Jog stress can increase numbers of bFGF at fracture part and promote fracture healing.

Objective To investigate the CT angiography techniques of the pulmonary artery and aorta at a time.Methods Twenty-three patients who underwent the 64-slice spiral CT examinations of pulmonary and aortic angiography at a time were analyzed retrospec-tively (Group A).Also,13 cases whose pulmonary angiography showed normal (Group B)and 13 cases whose aortic angiography showed normal (Group C)enrolled in this study as control groups.The contrast media dose and the radiation dose were analyzed among three groups.The abnormal blood vessels were observed,and the CT values of the normal pulmonary artery and aorta and the number of the pulmonary 4,5 grade were compared among all groups.Results The contrast media dose in Group A was more than that in Group B or Group C,but less than the sum of that in Group B and Group C.The radiation dose in Group A was equivalent to that in Group C,which was obviously less than the sum of that in Group B and Group C.Six of 23 cases were accurately diagnosed as pul-monary embolism,1 case as pulmonary malformation,4 cases as aortic dissection whose true and false lumens clearly showed with contrast,5 cases as aortitis,and 10 cases as aortic atherosclerosis.For the cases whose angiography showed normal,there was no statistically significance of the number of the 4,5 grade of pulmonary artery and the CT values of pulmonary artery and the aorta compared with those of the control group (P >0.05 ).Conclusion The 64-slice spiral CT can be used to complete pulmonary and aortic angiography at a time,and the contrast media dose and the radiation dose can be reduced obviously.

Objective By using 18F-deoxyglucose (18F-FDG) positron emission computed tomography (PET-CT) to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen (HBO) therapy,and to investigate the mechanisms of H BO treating patients with traumatic brain injury.Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group.The patients of both groups received routine clinical interventions (including neuroprotection,dehydration,reducing intracranial pressure,anti-infection and other symptomatic treatments).Patients of the HBO group received the basic treatment combined with HBO therapy one tine per day for 7 days per week.In early stage and 4 weeks after treatment,all patients were examined with PET-CT scanning and Glasgow coma scale (GCS),disability rating scale (DRS) at the same time.Results There was standard uptake value (SUV) of significant difference between affected and unaffected brain areas in two groups before treatment(P＜0.01),but no significant difference between two groups (P＞0.05).After 4-week of treatment,SUV of affected and unaffected brain areas of two groups improved,the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group (P＜0.0l).The GCS and DRS scores of HBO group were also significantly better than that of control group (P＜0.05).Conclusion The 18F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area,promote the brain functional recovery and awakening,and improve the prognosis in patients with severe traumatic brain injury.

Objective To observe the effects of hyperbaric oxygen (HBO) on cerebral small vessel disease (CSVD) and on learning,memory and the expression of brain-derived neurotrophic factor (BDNF) and acetylcholine (Ach) in the cerebral cortex and hippocampus.Methods Sixty healthy,male Wistar rats were studied.Allograft thrombosis particles 48 to 74 μm in diameter were injected into the rats' external carotid arteries to create a CSVD model.The rats were then divided randomly into a hyperbaric oxygen group,a nimotop group and a control group.The hyperbaric oxygen group rats were given hyperbaric oxygen therapy 12 hours after the modeling.The nimotop group rats were given nimodipine by intragastric perfusion 12h after the modeling.The rats in the control group had no special intervention.At 7,14 and 28 days after the modeling,any changes in learning and memory were assessed with a Morris water maze test.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of BDNF in the cerebral cortex and of Ach in the hippocampus at 28 days.Results At both 14 and 28 days the average escape latency of the rats in the hyperbaric oxygen group was significantly shorter than those of the nimotop and control groups.The average platform crossing time had increased significantly more than in the nimotop and control groups.At both 14 and 28 days the escape latency and platform crossing times of the nimotop group were significantly better than in the control group.Ach content and BDNF content were significantly higher in the HBO group than in the nimotop and control groups.Conclusions Hyperbaric oxygen treatment can promote BDNF release in CSVD,which is helpful to protect and repair neural mitochondria,to maintain the cortex and hippocampal neurotransmitters on a stable level,and to improve learning and memory.Its effect is better than that of nimotop.

Objective To explore the effects of semiconductor laser on proliferation of the multidrug-resistant model of human osteosarcoma cell line(ROS-732).Methods Four test groups and one control group were set up.The test groups were divided into A,B,C and D groups according to the irradiation time(output power was 200 mW).The time of laser irradiation of A,B,C and D groups were 5,10,20 and 40 min,repectively.The control group(E) wasn′t treated with laser irradiation.MTT method was used to observe the proliferation of R-OS-732,and the morphological changes of the cells were observed by inverted microscope.Results The survival rates of cells in all test groups under condition of semiconductor laser irradiation with 200 mW output power and 532 nm weavlength,compared with control group(P