5 mm. Oblique coronal MR of secrum could show the full length of sacral never. There were some primiral espression of MR of sacral neurological dam-age -- the variation of sacral never canal, the fatty disappearance of peri-never, the route alteration of never. 14 patients were followed up from 6 to 12 months with an average of 7.1 months. According to the BMRC score system the excellent result was obtained in 9 cases, good in 1 case, no change in 1 case. Con-clusion Clinic history and neurological examination associated with X-ray, CT and MRI was the important of the diagnosis of sacral neurological damage, the new surgical approach may be a ideal approach to treat sacral neurological damage in the sacral nerve canal region.

Objective To determine the efficacy and safety of reamed versus nonreamed intramedullary nailing for femoral fractures in adults on the rates of nonunion, the rates of implant failure, the rates of pulmonary implications, infections, the time of union, et al. Methods According to Cochrane Systematic Review, Medline, Embase, Cochrane Library and CBM disc were searched for RCTs without limitation of language, and gray literatures had been also searched, furthermore, the bibliographies of retrieved papers and content experts were consulted for additional references. Methodology quality of literatures used simple evaluate method the Cochrane Collaboration recommended, which was graded to A, B, C. Data was extracted by two reviewers for inclusion using the designed extraction form. Revman 4.2.3 the Cochrane Collaboration provided were used for data management and analysis, and obtained evidences for the efficacy and safety of reamed versus nonreamed intramedullary nailing for femoral fractures in adults. Results Five RCTs were included by total retrieve and riddling. For methodology quality of literatures, one was A scale, two was B, and two was C. The combined results showed that reamed intramedullary nailing for femoral fractures in adults reduce the rates of nonunion RR=0.38, 95% CI(0.17, 0.88), P=0.02 , implant failure RR=0.45,95% CI (0.21,1.00), P=0.05 and the time to union WMD=-10.90,95% CI (-18.16,-3.64), P=0.003 . Conclusion To compare with nonreamed intramedullary nailing for femoral fractures in adults, reamed intramedullary nailing can reduce the rates of nonunion. However, the relation between reaming or not and implant failure, the time to union, pulmonary complications, infection etc needs further study.

BACKGROUND:Studies have shown that bisphosphonates can act on osteosarcoma cels, but the comparative analysis of bisphosphonates and cisplatin, a traditional first-line chemotherapy drug, is rarely reported. OBJECTIVE:To investigate the differences between bisphosphonates and cisplatin to inhibitin vitroproliferation of osteosarcoma cels and induce cel apoptosis. METHODS: Subcultured MG-63 cel lines were intervened with different concentrations of bisphosphonates and cisplatin, respectively, and cels with no treatment served as negative controls (blank group). Cel inhibition rate was detected using MTT method, and cel morphology was observed using fluorescent staining. RESULTS AND CONCLUSION:After intervention with different concentrations of bisphosphonates and cisplatin for different time, the growth inhibition rate of MG-63 cels was significantly higher as compared with the blank group (P < 0.05). But there was no difference in the growth inhibition rate between the bisphosphonates and cisplatin groups at 24, 48 and 72 hours (P > 0.05). These findings indicate that bisphosphonates has obvious inhibitory effect on the growth of osteosarcoma celsin vitro, and its inhibitory effect is similar to that of cisplatin.

BACKGROUND:There are controversies about preserving the remnant in the anterior cruciate ligament reconstruction procedure because of its uncertain therapeutic effects.
OBJECTIVE:Tocompare the efficacy and safety of preserving-remnant with removing-remnant for arthroscopic anterior cruciate ligament reconstruction using a meta-analysis.
METHODS:A computer-based online search was conducted in PubMed,Embase,the Cochrane Library, CDSR, CBM, and CNKI databases by using the English key wordsof “anterior cruciate ligamentAND remnant (OR stump)ANDrandomized controled trial (RCT)ORquasi-RCT” and the Chinese key words of“anterior cruciate ligament reconstruction, preserving-remnant, removing-remnant” to screen the relevant articles publishedfrom 1995 to July 2015. Meta-analysis was performed using Review Manager 5.3 software.
RESULTS AND CONCLUSION:A total of 13 randomized controled trials were included. The meta-analysis resultsshowed that there were no statisticaly significant differences in KT1000/2000 scores (OR=-0.28, 95%CI:-0.76-0.20,P=0.25), the good rate of synoveal coverage (OR=-0.30, 95%CI:-0.30-0.90,P=0.32), and the incidence of cyclops leions (OR=0.87,95%CI: 0.63-2.90,P=0.44). Postoperative Lysholm scores (OR=2.45, 95%CI: 0.52-4.39,P=0.01), proprioceptive function (OR=-1.72, 95%CI:-3.32 to 0.13,P=0.03), tunnel enlargement (OR=-0.66, 95%CI:-1.08 to-0.23,P=0.002) in preserving-remnant were superior to removing-remnant for arthroscopic anterior cruciate ligament reconstruction. These results suggest that both preserving-remnantandremoving-remnant for arthroscopic anterior cruciate ligament reconstructioncanobtain satisfactory antero-posterior stability of the knee. Preserving-remnant exhibits superiority in post-operative scores of the knee, proprioceptive function, tunnel enlargement.Furtherhigh-quality randomized controled trials are warranted because of some low-quality studies and the existing biases.

Objective To observe the effects of bisphosphonate on the inhibit proliferation and the apoptosis effect in osteo‐sarcoma MG‐63 cells in vitro ,explore the phosphonic acid salt of bone sarcoma cells ,induce apoptosis and its possible mechanism . Methods Sixty three osteosarcoma MG‐63 cells were cultured in vitro .After treated with bisphosphonate 400 μg/mL ,without bi‐sphosphonate but normal saline ,they were incubated 72 h after the application of the two group cell immunofluorescence test ;then observe the expression of apoptosis factors Caspase 3 and Fas ;Flow cytometry detection line was used to detect the osteosarcoma cell line MG‐63 cells apoptosis rate of each group .Results 72 h after treatment with bisphosphonate ,the expression of apoptosis factor of Caspase‐3 and Fas in osteosarcoma MG‐63 cells were strongly expressed ,and it was observed by immunofluorescent assay , while in blank control group ,we could barely see the expression of apoptosis factors Caspase‐3 and Fas ;Flow cytometry test results showed that two phosphonic acid salt 400 μg/mL intervention group cell apoptosis rate was 54 .00% ,far more than normal saline blank control group ,of which the apoptosis rate was 3 .10% ,the difference was statistically significant (P<0 .05) ,there is an obvi‐ous phenomenon of induced apoptosis .Conclusion Bisphosphonate has a strong apoptotic effects of bisphosphonate in osteosarcoma MG‐63 cells in vitro .Bisphosphonate can inhibit osteolysis of osteosarcoma MG‐63 cells via regulating the expression of Caspase‐3 , Fas in osteosarcoma MG‐63 cells .Bisphosphonate may serve as a potential therapeutic agent for treatment of osteosarcoma .

BACKGROUND:Reconstruction with remnant preservation can enhance tendon-bone healing. However, the study limits on the histological level, and there is a lack of research based on the modular biological level.
OBJECTIVE:To investigate whether anterior cruciate ligament reconstruction with remnant preservation can enhance tendon-bone healing.
METHODS:Seventy-two New Zealand rabbits were randomly al ocated to three groups (n=24 per group), fol owed by cruciate ligament reconstruction without remnant (group A), with remnant preservation (femoral tensioning and augmented suture) (group B) and with remnant preservation (graft passing remnant anterior cruciate ligament sheath) (group C), respectively.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that the tendon-bone healing in the groups B and C surpassed that in the group A, and group B was better than group C. Real-time PCR revealed that the expression level of osteoprotegrin mRNA and the osteoprotegrin/receptor activator of nuclear factor-κB ligand (RANKL) ratio were greater in the groups B and C than in the group A, and highest in the group C, while the expression levels of RANKL mRNA in the groups B and C were lower than that in the group A. In conclusion, these two kinds of anterior cruciate ligament reconstruction methods with remnant preservation can enhance tendon-bone healing, which have obtained most obvious achievements in the anterior cruciate ligament reconstruction in the graft passing anterior cruciate ligament remnant sheath that may be related to the up-regulation of osteoprotegrin mRNA and down-regulation of RANKL mRNA.

BACKGROUND: Most of studies focus on the biomechanical characteristics of thoracic spine neoplasm, but there is little report on the fracture risk in the patients with vertebral hemangioma through finite element analysis.OBJECTIVE: To establish a finite element model of vertebral hemangioma, and to analyze its biomechanical characteristics, and assess the risk of vertebral fracture.METHODS: Three-dimensional finite element models of T12-L2 vertebrae from normal individuals, the patients with vertebral hemangioma (hemangioma accounting for 20%, 40%, 60%, 80% of the vertebral cancellous bone) and bone cement filling were established, respectively, and then the mechanical characteristics were analyzed. The stress distribution and characters of each model were determined under a vertical static pressure of 600 N.RESULTS AND CONCLUSION: (1) Three-dimensional finite element models of T12-L2 vertebrae were established successfully. Under static pressure, the stress distribution of L1 cortical bone showed no significant difference among models, and the maximum stress all occurred at the base of pedicle, zygapophysial joint and isthmus. (2) The stress distribution did not differ significantly between vertebral hemangioma accounting for 20%-40% of vertebral cancellous bone with complete cortical bone and normal ones, but which differed significantly in hemangioma accounting for 60%-80%. (3) To conclude, the established thoracolumbar three-dimensional model is available. Additionally,biomechanical tests manifest that the completeness of cortical bone and destruction ratio of cancellous bone destruction are key factors for the fracture risk of vertebral hemangioma.

Objective To investigate the significance of intensity modulated radiation therapy(IMRT)for spinal metastases during different target areas setting and evaluate the efficacy of pain relief before and after radiotherapy. Methods Forty-four cases of spinal metastases were treated with intensity modulated radiation therapy, including 18 males and 26 females; aging from 40 to 68 years with a mean of 56 years.Frankel grade before treatment: stage A in 2 patients, B in 2, C in 3, D in 3, E in 34. The target area was determined according to preoperative imaging, CT localization before radiotherapy and different anatomical characteristics of spinal cord segments. And then the intensity modulated radiation therapy was performed by means of 5-field irradiation. Prescription dose: 30-56 Gy, the average 40.5 Gy, the median dose of 40 Gy, 2-3 Gy/times, 5 times/week. Before and after radiotherapy for pain relief in patients, neurological function of spinal cord were compared and comprehensively evaluated. Results Among 44 patients undergone pain intensity modulated radiation therapy, 21 patients achieved complete remission, 17 achieved partial remission and 6 achieved minor effect, with a relief rate of 86.4% (38/44). Pain rating before treatment was not correlative with the state of pain relief. Evaluation of the effect of radiotherapy showed complete remission in 4 cases and partial remission in 33, no change in 7, with an efficiency rate of 84.1%(37/44). There was no relationship between pain relief with implant nails and implant bone cement. Ten patients with different degrees of neurological impairment before treatment were improved in Frankel grade after treatment. Conclusion IMRT can improve pain in patients with metastatic spinal tumors, and nerve dysfunction and other symptoms, which was not easy to result in radioactivity spinal cord and nerve injury.

Objective To explore a safe dose range of spinal IMRT by comparing the cell damage in Beagles at different dose levels.Methods Thirty Beagles were randomly divided into 5 groups.The Beagle clinical model of tumor was established in the ninth and tenth thoracic spine.The Beagles were subjected to IMRT with the total doses of 0,40,50,60,70 Gy,respectively.The samples of spine were taken out from the same locum of the ninth and tenth thoracic spine at 3 month after radiation.All the samples were observed by the hematoxylin-eosin staining,and the VEGF expression in spine was evaluated by immunohistochemistry.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spine.Results The osteocytes in the spine showed reversible injury in 40 Gy group,and cell apoptosis in 50,60,70 Gy groups.Compared with 40 Gy group,the rates of lacuna were increased in 50,60,70 Gy groups(F =2.57,P ＜0.05),as well as the cell apoptotic rates(F =3.52,P ＜ 0.05) and the expression of VEGF (F =3.64,P ＜ 0.05),but there were no significant differences among 50,60,70 Gy groups (P ＞ 0.05).Conclusions The late radiotherapy response of the spine was obviously observed at 3 month after radiation,especially at 50 Gy.

Objective To observe the efficacy of high-energy red light combined with human-like collagen dressing in treatment of facial corticosteroid addictive dermatitis.Methods Eighty-three patients with facial corticosteroid addictive dermatitis were divided into treatment group (42 cases) and control group (41 cases) by random digits table method.All patients in 2 groups were treated with ebastine 10 mg,once a day,and vitamin E cream,twice a day.At the same time,the patients in control group were given human-like collagen dressing,once a day in the first week,then 3 times/week.On the basis of control treatment,the patients in treatment group were irradiated with high-energy red light 10 min in face,2-3 times/week.The treatment of both groups lasted for 12 weeks.The symptoms,skin lesions and untoward reaction were observed after treatment of 4,8 and 12 weeks.Results After treatment of 4 weeks,there was no statistical difference in the effective rate between 2 groups (P ＞ 0.05).After treatment of 8 and 12 weeks,the effective rates in treatment group were significantly higher than those in control group [83.3％(35/42) vs.58.5％ (24/41),90.5％ (38/42) vs.65.9％ (27/41)],there were statistical differences (P ＜ 0.05).No untoward reaction was found in 2 groups.Conclusion High-energy red light combined with human-like collagen dressing is effective and safe in treatment of facial corticosteroid addictive dermatitis.