Objective]To establish a new volume-depending staging system for ONFH through an analysis software developed by ourselves, referring to Ficat staging system. [Method]With the help of the necrosis score calculated by our software, a new 0~6 volume-depending staging system for ONFH was established referring to Ficat staging system. The correlation analysis was conducted between the Ficat stages and necrosis scores of 22 ONFH cases. [Result]According to Ficat staging system, there were 4 stage Ⅰ, 2 stage Ⅱa, 3 stage Ⅱb, 9 stage Ⅲ, 4 stage Ⅳ. According to the volume-depending staging system, there were 4 cases of stage 1, 3 stage 2, 2 stage 3, 3 stage 4, 5 stage 5, 5 stage 6. A strong linear correlation was observed between the necrosis scores of volume-depending staging system and Ficat staging system(r=0.976,P<0.01). [Conclusion]The new volume-depending staging system might be accurate and feasible. It could indicate the whole condition of ONFH more objective than Ficat staging system, which would be helpful for early diagnosis of ONFH.

Objective] To assess the clinical efficiency of psychological care on the lumbar disc herniation in the early stage. [Methods] Patients of lumbar disc herniation were randomly divided into experimental and control groups. Psychological care was used in experiment group and routine nursing was used in control group. Then through comparing the score of JOA with VAS to evaluate effect. [Result] After treatment, the scores of anxiety and depression were decreased more than control group(P<0.05), the score of JOA in experiment group was statistically significant higher than control group(P<0.05); the score of VAS was decreased, compared with control group(P<0.05). [Conclusion] The clinical efficiency of Psychological care on the patient of lumbar disc herniation in the early stage is effective and it is worthy of promotion and application for the future.

Objective To study the therapeutic mechanism of medication p erfusion by femoral artery for the femoral head necrosis induced by glucocortico id experimentally. Methods Forty eight of New Zealand rabbits were used for esta blishing the model of femoral head necrosis. The rabbits were injected 50 ? g/ kg LPS in 24h twice intravenously, and methy prednisolone intramuscularly thre e times. The animals were divided into three groups: arterial group which was pe rfused urokinase 30 thousands units and 2 ml red sage root by left femoral arter y; venous group which was perfused urokinase 30 thousands units and 2 ml red sa ge root by era marginal vein; control group which was perfused normal saline. Mi crovessels ink perfusion and pathological examination were adopted to observed t he changes of the femoral head.The ratio of empty lacuna, fatty embolism, thromb us, VEGF positive osteoblast, chondrocyte and blood vessel in the subchondral pl ate were measured by means of HE, sudanⅢ , PTAH and immunohistochemistry in dif ferent periods (1,2,3,4weeks) after the medication perfusion.Results The treatme nt of urokinase and methyl- prednisolone could reduce the ratio of empty lacuna , fatty embolism, thrombus and increase the ratio of VEGF positive osteoblast, c hondrocyte and blood vessel, but the effects of femoral medication perfusion wer e more efficiency and quickly than vein injection. Conclusion The mechanisms con sist in re passing the blocked vessel by dissolving fatty embolism and thrombu s, accelerating the vascular developing and ossification by promoting the exudat ion of VEGF. [

Objective To study the distribution of TCM constitution of patients with postmenopausal osteoporosis to analyze the correlation between constitution and osteoporosis.Methods The pre-designed questionnaire and the method of case-control were used to classify and analyze the constitution of postmenopausal osteoporosis patients and normal population for comparison to understand the correlation between constitution and osteoporosis.Results The ratio of constitution type in two groups had statistical difference(P

Objective Get a primary culture method of osteoblast which is simple to operate and has many pure cells. Method Get osteoblast with improved I collagenase, and test the form of osteoblast, the alkaline phosphatase dyeing and formation of mineralization node. Result The improved rats primary culture method of osteoblast can get most cells in normal shape, alkaline phosphatase secretion and mineralization. Conclusion The improved rats primary culture method of osteoblast is convenient to operate, and can get most cells.

Objective To explore the biomechanics mechanism of ATP6i gene-interference treating steroid-induced necrosis of the femoral heads(SINFH)in rats.Methods Forty SD rats were randomly assigned to four groups:blank control group,experimental control group,ATP6i SiRNA(+)group and ATP6i SiRNA(-)group,10 rats in each group.We established rat models of SINFH by injecting Escherichia Coli Endotoxin and prednisolone for 12 weeks,then cut along the inner side of the patella for about 1 cm and turn the patellar outside of the both knees of the experimental control group,the ATP6i SiRNA(+)group and the ATP6i SiRNA(-)group,and drill from the intercondylar until the femoral neck.Rats were treated by transfecting ATP6i small interference RNA(ATP6i SiRNA)into the osteoclasts of the femoral heads to interference the expression of ATP6i SiRNA(+),or by the ATP6i SiRNA(-)and same amount of saline.One month later,test the load,stress,modulus of elasticity,and axial stiffness of the right femoral heads of all four groups,and at the same time take the left femoral heads of all four groups for pathological study.Results The load,stress,modulus of elasticity,and axial stiffness of the ATP6i SiRNA(+)group were(307.01±27.34)N,(60.44±5.38)MPa,(125.29±11.16)MPa,(162.42±14.45)N/mm,respectively,which were much greater than the ATP6i SiRNA(-)group and the experimental control group(P＜0.05).In the pathological studies,we found that the trabecula of the femoral heads of the ATP6i SiRNA(+)group was much thicker than the ATP6i SiRNA(-)group and the experimental control group,but the degeneration,necrosis and breakage of the osteoepiphysis in each group had no statistically significant differences.Conclusion ATP6i gene-interference can inhibit the acid-secreting function of osteoclasts and improve the biomechanical property of the femoral heads of rats in treating the SINFH.

[Objective]To retrieval a best cell factor which can induce bone marrow stromal cells (bMSCs) into chondrocyte in vitro and to explore an effective plan to repair rabbit's chondrocyte defect.[Method]Isolated bMSCs were cultured in vitro. rh Fibroblast Growth Factor 1(rhFGF-1)、rh Transforming Growth Factor-?1(rhTGF-?1)、rh Insulinlike Growth Factor-Ⅰ(rhTGF-Ⅰ) were utilizated. The proliferation of cells was detected by MTT assay, and the macroscopic histology , HE staining and immunohistochemical examinations were performed to seek the best cell factor. In vivo , to investigate the repair of the articular cartilage, bMSCs combined with fibrin glue and rhTGF-?1、rhIGF-I was compared with control group.[Result]The cells induced by rhTGF-?1 and rhIGF-I were similar to chondrocytes in morphology, and immunohistochemical examinations showed the cells possessed phenotype of chondrocytes. RhTGF-?1 and rhIGF-I could differentiate bone marrow stromal cells into cartilage cells in vivo, and repair the articular cartilage defect. The control group could not repair the articular cartilage defect efficiently.[Conclusion]rhTGF-?1 and rhIGF-I are best group which stimulate bMSCs to differenate into cartilage cells. BMSCs combined with fibrin glue and rhTGF-?1、rhIGF-I can repair the articular cartilage defect.

Objective To identify significantly differentially expression of rat by genes chip,try to find out the initiating factors and molecular mechanisms that oxidative stress originate or strengthen the steriod-induced necrosis of femoral head(SINFH).Methods Twenty Wistar rats were dived into experimental group and control group randomly.The rats were injected intraperitoneally whith endotoxin,and then injected intramuscularly with high-dose methylprednisolone or saline in experimental group and control group respectively.The mRNA was extracted from the femoral head of rats inevery group,and the cDNA probes were obtained by inverse transcript,and then carried out microarray detection.The quantitative RT-PCR was used to confirm the results of the microarray.Results Histopathological findings revealed that the experimental group rats had femoral head necrosis,trabecular bone disorders,thinning,bone cell necrosis,and the rate of empty lacunae increased,and in control group no femoral head osteonecrosis was found.Total of 27 differentially expressed genes were found,and of which 4 genes(COX6A2,COX4I2,SOD3,and DUSP1)were significantly different.The expression of these 4 genes were down-regulated.The functions of these four genes involved in inhibition of reactive oxygen species(ROS)generation,accelerated removal of ROS and protection tissue from oxidative damage and so on.Conclusion The expression of oxidative stress-related genes in SINFH of rats exist change.COX6A2,COX4I2,SOD3,and DUSP1 are key genes in process of oxidative stress originate or strengthen the SINFH.

Objective To investigate the formation and special cell biological behavior of osteoclasts.Methods The live-cell imaging technology was adopted to consecutively and dynamically observe the whole process of multinuclear osteoclast formation induced by RANKL and M-CSF from rat peripheral blood monocyte.Meanwhile,the inverted phase contrast microscopy,TRAP staining,and scanning electron microscopy were also applied to identify the osteoclast.Results After 2-week cultivation,a great number of apocytes were found by the inverted phase contrast microscopy,and most apocytes and monocytes had positive reaction after TRAP staining.Moreover,many bone resorption lacunae in which osteoclasts were perhrming bone resorption function could be found in the bone slice under the scanning electron microscope.Live-cell imaging observation showed that the multinuclear osteoclasts were generated through self-fusion of monocytes,fusion of monocytes and apocytes,as well as fusion between apocytes.All fusion processes occurred under the condition of cell adherence.Time-lapse Microcinematography observation showed diverse shapes of osteoclasts and the cell division of multinuclear osteoclasts.Conclusion Rat peripheral blood monocyte can develop into osteoclast under induction of RANKL and M-CSF.Osteoclast can form gigantic apocyte via various types of cell fusion to increase its nucleus number and cell volume,vary its shape,and increase the area of plasma membrane.On the other hand,osteoclast can decrease its cell volume and nucleus number via cell division to adapt the needs of local morphology,biomechanics and bone resorption dynamics.It suggests that this non-mitosis cell division is a special cell biological behavior of osteoclast,which may be the basis of exerting its function and improving bone resorption efficiency.

Objective To introduce a new classification system for femoral intertrochanteric fractures and propose classification to assist surgical management.Methods A total of 176 cases of femoral intertrochanteric fractures treated from September 2007 to October 2011 were enrolled in the study.X-ray and three-dimensional spiral CT reconstruction were performed to define fracture shape,location,number of major fragments and displaced direction.As combined with the intraoperative findings and cadaveric anatomical study,the femoral intertrochateric fractures was simulated using a three-dimensional entity of normal proximal femur produced by Mimics 11.1 program.A new classification system for femoral intertrochateric fractures was proposed.Results The new system categorized intertrochateric fractures of the femur into five types (Type Ⅰ,Type Ⅱ,Type Ⅲ,Type Ⅳ and Type Ⅴ) based on the integrity or destruction of the medial column,lateral column and posterior column set and divided on the basis of bone connection of femoral head-neck fracture fragments with the bone in intertrochanteric region.Conclusions The new classification system with introduction of three-column concept is brief and practical and has a clear definition of fracture stability.Besides,the new classification-based treatment is recommended.