Objective To investigate the differences in some measured paremeters on spino-pelvic sagittal X-ray films in middle-aged and elderly patients between lumbar spondylolysis and isthmic spondylolisthesis,and to explore the predictors that the spondylolysis at lumbar 5 may develope into spondylolisthesis in order to provide imaging details for the clinical treatment of teenage patients with lumbar spondylolysis.Methods Imaging data of 60 patients with spondylolysis at lumbar 5 and other 60 with isthmic spondylolisthesis in middle or elder age in our hospital were analyzed retrospectively,and a control group with 60 normal volunteers were recruited in this study.Some parameters including the angles of pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),lumbar-sacral angle (LSA)and lumbar lordosis (LL),and the sagittal vertical axis (SVA)were measured in sagittal radiographs of the spine and pelvis. Differences in sagittal parameters among 3 groups were analyzed by one-way variance analysis and SNK-q test.Results The PI,PT, SS and LL were higher,and LSA was lower in patients with isthmic spondylolisthesis than those in the control group and lumbar spondylolysis one (P<0.05).However,there was no significant difference in SVA (P>0.05).No significant differences in all spino-pelvic sagittal parameters were found between lumbar spondylolysis group and the control (P>0.05).Conclusion Such spino-pelvic sagit-tal parameters as PI,PT,SS,LL and LSA on X-ray film can be regarded as predictors that lumbar 5 spondylolysis may develop into spondylolisthesis and may provide imaging reference for the clinical treatment of teen-age patients with lumbar spondylolysis.

BACKGROUND: There are some limitations in induced differentiation of bone-marrow-derived mesenchymal stem cells (hBMSCs) and transplantation of nucleus pulposus cells (NPCs). Inhibition of autologous NPCs degeneration is expected to become an effective way for treatment of disc degeneration in the future. OBJECTIVE: To establish a layered coculture model of hBMSCs and NPCs in vitro, and to observe the effect of hBMSCs on the differentiation of NPCs. METHODS: The fourth passage of hBMSCs was divided into 2 groups. NPCs in the new-style layer culture group were incubated in Transwell cabin without arm, 0.4-μm membrane well; the proportion to BMSCs was 1: 1. NPCs in the traditional culture group were incubated in Transwell cabin with arm. NPC culture group was set. Each group was incubated for 7 days. Collagen Ⅱ was detected by immunohistochemical method. Aggrecan expression was detected by [~(35)S ]-sulfate uptake. RESULTS AND CONCLUSION: Compared with NPC culture group, collagen Ⅱ and aggrecan expression of NPCs were upregulated most evidently in new-style culture and traditional culture groups (P < 0.05, P < 0.01). The increased range of new-style culture group was greater than the traditional culture group (P < 0.05). These results suggested that coculture of BMSCs and NPCs can significantly increase NPC proliferation and specific substance expression. The surrounding of new-style culture surpassed the traditional culture.

Objective To investigate the clinical effect of bipolar artificial femoral head replacement in the treatment of elderly patients with unstable intertrochanteric fractures. Methods 82 elderly patients with unstable intertrochanteric fractures were randomly divided into two groups with 41 cases in each group. The control group was treated with dynamic hip screw internal fixation, and the observation group was treated with bipolar artificial femoral head replacement. The operation time, bleeding volume and ambulation time were compared, and all the patients were followed up for one year. Harris scores of the two groups at 1 month, 3 months, 6 months, and 12 months after operation were compared, and the incidence of complications were recorded and compared. Results The operation time, bleeding volume and ambu-lation time of the observation group were less than the control group with a statistically significant difference (P<0. 05);Harris scores of the 2 groups at 1 month and 3 months after operation were of significant difference, while there was no significant difference at 6 months, and 12 months after operation (P>0. 05). The incidence of complication of the observation group was lower than that of the control group, the difference was statistically significant (P<0. 05). Conclusion Bipolar femoral head replacement has the advantages of simple operation, less trauma and complications. It is conducive to the early ambulation of patients and the recovery of hip function, and it is suitable for elder-ly patients with unstable femoral intertrochanteric fracture.

BACKGROUND:There is notan effective method for inducing bone marrow-derived mesenchymal stem cells (BMSCs) differentiatied in to intervertebral disc cells.OBJECTIVE:To establish a model of human BMSCs (hBMSCs) differentiated in to nucleus pulposus-like cells in vitro.DESIGN,TIME AND SETTING:A single sample contrast.The experiment was performed at the Orthopaedics Institute and Central Laboratory,the Affiliated Hospital of Qingdao University Medical College,from August 2008 to March 2009.MATERIALS:Two New Zealand white rabbits with 8-week-old were used to culture nucleus pulposus cells.Human nucleus pulposus was obtained from a aged 16 years patient with T_(12)L_1,L_(1.2) congenital scoliosis.The informed consent was obtained from his patients,hBMSCs were purchased from Salye Biological Science and Technology Co.,Ltd.(Guangzhou,China).METHODS:hBMSCs and nucleus pulposus cells of rabbit were co-cultured in new-style culture model (in 6-well plates and inserts with track-etched membrane having 0.4 μm pores without arms) for 7 days,conventionally laminar culture,solitary hBMSCs and nucleus pulpesus cells culture were set up as controls at same time.MAIN OUTCOME MEASURES:The expressions of collagen Ⅱ and aggrecan mRNA were detected by RT-PCR and Western blot.RESULTS:hBMSCs in the conventionally laminar and single hBMSCs groups were negative to collagen Ⅱ and aggrecan.The collagen Ⅱ and aggrecan expression of hBMSCs were upregulated evidently in new-style culture group,which was similar to nucleus pulposus cells that from degenerate intervertebral disc of human,but these expression did not appear in conventionally laminar culture and solitary hBMSCs culture (P ＜ 0.01).The difference among new-style culture group and other groups had no significance (P ＞ 0.05).CONCLUSION:A new-style model of hBMSCs differentiation to nucleus pulposus-like cells is constructed in vitro,which can highly express collagen Ⅱ and aggrecan and provide a foundation for intervertebral disc degeneration cellular treatment.