Objective In order to investigate the effectiveness of unique cyclic biomechanical stretch on proliferation, alkaline phosphatase (ALP) activity and osteopontin (OPN) mRNA of colonal murine osteoblast-like cell line MC3T3-E1 in three-demensional culture. Methods Gelatin sponges with a size of 2.00 cm?2.00 cm?0.25 cm were used as the three-demensional culture vector of MC3T3-E1, 100 ?l cell suspension was applied to the surface of sponge, the cell number was 1.25?105. The gelatin sponges could be stretched to 5% with 60 cycles/min and 15 min/h on computerized bio-stretch controller. At 2, 4, 6, 8 and 10 d after stretch stimulation, three samples were collected at each time point from the stretch and con-trol group respectively. Cell counting, activity assay of ALP both of cells and medium as well as OPN mRNA measurement were carried out. Results The cell number of the stretch group was more than that of control group from 2 d (P

Objective To compare the treatment of displaced intra-articular calcaneal fractures by homeopathic closed leverage anatomical plate with compression bolt through small posterior lateral approach vs.traditional open reduction and internal fixation.Methods A retrospective case control study was made on 98 cases of displaced intra-articular calcaneal fractures admitted from September 2012 to May 2015.According to the random number table,the subjects were assigned to homeopathic closed leverage anatomical plating with compression bolt through small posterior lateral approach (experiment group,58 cases,66 sides) and open reduction and internal fixation through L-shape approach (control group,40 cases,45 sides).Experiment group consisted of 50 male and eight females cases aging from 27-56 years (mean,41.9 years),and the Sanders classification was 40 cases of type Ⅱ,24 type Ⅲ and two type Ⅳ.Control group consisted of 36 male and four female cases aging from 25-58 years (mean,43.7 years),and the Sanders classification was 25 cases of type Ⅱ,18 type Ⅱ and two type Ⅳ.Operation time,bone reduction,postoperative Bohler's angle,width of the calcaneum,and incision healing were recorded.Functional outcomes were evaluated with Maryland hindfoot scoring system at last follow-up.Results Operation time was (52.6 ± 11.2) min in experiment group,significantly shorter than that in control group [(86.4 ± 14.1) min] (P ＜ 0.01).All cases were followed up from 18-50 months (mean,30.8 months).Reduction of the calcaneal posterior facet in 53 sides (80％) was graded as nearly anatomical in experiment group,and 38 sides (84％) in control group (P ＞ 0.05).Postoperative Bohler's angle was (28.0 ± 6.2) ° in experiment group,and (26.8 ± 7.0) ° in control group (P ＞ 0.05).Width of the calcaneum was (31.3 ±3.6)mm in experiment group and (34.9 ± 4.0)mm in control group (P ＜ 0.01).All cases presented satisfactory shape of the calcaneus without lateral-side impact syndrome.No case had wound infection and incision-edge necrosis in experimental group,while two cases of superficial wound infection and three cases of incision-edge necrosis were found in control group (P ＜ 0.01).At last follow-up,Maryland hindfoot score was (87.1 ± 7.6)points in experiment group and (84.9 ± 9.1)points in control group (P ＞ 0.05).Conclusion Homeopathic percutaneous leverage and anatomical plate with compression bolt through small posterior lateral approach is an effective method for treatment of displaced intra-articular calcaneal fractures,for it has advantages of minimal invasion,less operation time,good reduction and function,and less wound complications.

Objective To explore the clinical pathological characteristics and prognostic factors of patients with neuroendocrine tumor of the appendix.Methods Data of 42 cases of the appendiceal neuroendocrine tumor from June 2006 to June 2016 at Tianjin Police Hospital were analyzed.Tumors were classified according to 2010 WHO classification.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by the Log-rank test.Results There were 27 males and 15 females,with median age of 60 years.Tumors located in the head of the appendix in 37 cases,in the body in 2 cases and at the base in 3 cases.The median of tumor sizes were 1.2 cm.G1 in 17 cases,G2 in 21 cases,G3 in 4 cases.The follow-up rate was 100％.The overall 1-year survival rate was 92％.Conclusions The clinical symptoms of appendiceal neuroendocrine tumors are most often nonspecific.The diagnosis depends on pathological examination and immunohistochemistry,and prognosis varies with pathological grades.

Objective To discuss the clinical effect of hallux valgus deformity treated with minimally invasive the first metatarsal distal osteotomy. Methods The data of 375 cases (626 feet) treated with minimally invasive the first metatarsal distal osteotomy was retrospectively analyzed. Hallux valgus angle was21°-65°(mean37.61°±9.25°), intermetatarsal (IM) anglewas7° -21° (mean 13.03°± 3.73°). The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was (46.5 ± 9.4) pints. Results The patients were followed up 12-30 months [mean (18.5 ± 6.8) months]postoperation, hallux valgus angle was 7.18°±4.55°,intennetatarsal angle was 5.07°± 1.70°,with a mean angle decreasing 30.54° and 12.33°.The AOFAS score was (84.8±7.6) points (P <0.01). Conclusion According to the hallux valgus angle,intermetatarsal angle and the length of the first metatarsal,decide the place and method of osteotomy, the hallux valgus can be corrected in three-dimensional and get an excellent effect.

Background and purpose:B7-H3 is a newly identiifed member of the B7-family of co-stimulatory molecule, and however, its exact role in human osteosarcoma is still unclear. The purpose of this study was to examine the expression of B7-H3 in osteosarcoma tissues and to investigate its correlations with clinicopathological factors and overall survival in patients with osteosarcoma.Methods:The expression of B7-H3 and the intensity of tumor-inifltrating T lymphocytes (TILs) in pathologic specimens of osteosarcoma, osteochondroma and bone ifbrous dysplasia tissues were evaluated by immunohistochemical assay.Results:The expression rate of B7-H3 was 91.8% (56/61) in osteosarcoma lesions, while B7-H3 was barely expressed in adjacent normal tissues and bone ifbrous dysplasia tissues. The intensity of B7-H3 expression in osteochondroma was 56.8%, which was signiifcantly decreased compared with osteosarcoma tissues. Tumor B7-H3 expression was associated with Ennecking stage and pulmonary metastasis, while inversely correlated with the number of tumor-inifltrating CD8+ T cells (P<0.05). Moreover, patients with high tumor B7-H3 levels had a signiifcantly shorter survival time and recurrence time than patients with low tumor B7-H3 levels (P<0.05).Conclusion:B7-H3 is overexpressed in human osteosarcoma tissues, and B7-H3 expression is highly correlated with tumor development and overall patients’ prognosis. Moreover, overexpression of B7-H3 in tissues can relfect CD8+T cell inifltration and may help tumor cells avoid immune surveillance.

Objective To investigate the effect and prevention of complications of selective posterior enlarged decompression and lateral mass screw fixation for multisegmental cervical spondylotic myelopathy with kyphosis.Methods From January 2008 to January 2011,43 patients with multisegmental cervical spondylotic myelopathy combined with kyphosis,aged from 42 to 74 years (average,59.6 years),underwent selective posterior enlarged decompression and lateral mass screw fixation.The JOA (Japanese Orthopaedic Association) scoring system and Neck Disability Index (NDI) were applied to evaluate the neurological function and axial neck/shoulder pain before and after surgery,respectively.The Ishihara method was employed to measure the cervical curvature index (CI).The expanding and shifting of the spinal cord was calculated in MRI.Results The decompression range was 3 to 5 segments (average,3.91±0.86 segments).All patients were followed up for 20 to 60 months (average,38 months).There were significant differences between preand post-operative JOA score (8.16±1.11 vs.14.31±1.33),CI (7.36％±9.69％ vs.15.30％±3.18％),anteroposterior diameter of the dural sac at the level of maximum stenosis in MRI [(2.92±1.49) mm vs.(6.10±0.89)mm],and NDI score (19.36±8.61 vs.4.90±2.46).The mean spinal cord posterior shift was (4.59±1.20) mm (range,2.97 to 6.68 mm).The complete bone graft fusion was achieved in all patients 3 to 6 months after surgery.No C5 nerve root palsy or instrument failure occurred.Conclusion The selective posterior enlarged decompression and lateral mass screw fixation is effective in treating multisegmental cervical spondylotic myelopathy with kyphosis,which can improve neurological function,recover and maintain the normal cervical curvature,and decrease the incidences of axial symptoms and C5 nerve root palsy

Objective To investigate the effect of transforming growth factor β1 (TGF-β1) on the early reconstruction of Wistar rats rotator cuff tears through the tendon-bone healing biomechanical testing . Methods A total of 45 healthy Wistar rats were randomly divided into three groups: the high-dose, the low-dose, and the control group, with 15 animals in each group. The rats underwent full thickness leisure and reconstructive surgery by suture-bridge and TGF-β1 injection at the tendon bone interface. The parameters of tendon-bone interface biomechanics, including tensile strength, cross-section area, stiffness, percentage of loading, were measured at 1-, 2-, 3-weeks post surgery. Results No significant differences werey observed at the fracture point within the tendon suture among the three groups The maximum tensile strength , maximum load percentage, stiffness and tendon bone repair interface in the high-dose group were higher than those in the low-dose group and those in the control group(P < 0.05, respectively). The maximum axial loading, tensile strength and stiffness of the tendon-bone interface in the low-dose group were significantly higher than those in the control group (P < 0.05). The high-dose group renovated the tendon-bone interface healing and increase stiffness with the extension of the rehabilitation. Conclusion TGF-β1 can enhance the maximum tensile strength of the tendon-bone and promote the healing of rotator cuff injury.

With the increasing enrollment of high school and commonalty of higher education,it is very important to transform educational thought and concept,explore the approach and method for clinical teaching administration,improve teaching condition,enhance construction of teaching staff and emphasize the development for learning ability,practice ability and pioneering ability of clinical medical undergraduates.

Traumatic fracture accounts for about 50% of the total of traffic accidents. The incidence of fracture in postmenopausal women is significantly higher than that in men. About 5%-10% of patients with bone fracture will suffer from complications such as delayed union or nonunion, which seriously affects the recovery of patients after operation and increases the economic burden of families and society, however, the specific regulatory mechanism has not been fully defined. Immune cells play an important regulatory role in fracture healing, and innate immune response is the first to initiate and participate in fracture healing. Macrophages are innate immune cells which widely exist in various tissues of the body. They play a complex and precise regulatory role in fracture healing by participating in inflammatory response, osteogenic and osteoclast differentiation, mineralization and angiogenesis. Nevertheless, macrophages can be polarized into different subsets and perform different or even opposite functions under different immune microenvironments. At present, it is believed that there are three main polarization states of macrophages: non-activated M0 macrophages, classically activated M1 macrophages and selectively activated M2 macrophage. It has been shown that each subset was positively involved in the regulation process of fracture healing at different stages. Herein, in this paper, the role of different subsets of macrophages in different stages of fracture healing and the related experimental studies are reviewed, helpfully to clarify the immunological mechanism of fracture in-depth and provide new strategies for the research on the immunological intervention of fractures targeting macrophages.

ObjectiveTo compare the stability of vertical fractures of posterior pelvic ring fixed with tension band plate (TBP),two sacroiliac(SI) screws and minimally invasive adjustable plate (MIAP) for posterior pelvic ring.MethodsEight adult male pelvic specimens without osteoporosis were selected.The sacroiliac complex was retained and other soft tissue was removed.The right sacral vertical fractures were made.The fractures were reduced anatomically and fixed in turn with TBP,two SI screws and MIAP.The pelvic specimens were fastened to the biomechanical testing machine in sitting position.Vertical load,ranging from 0 to 620 N,was applied on specimens at a speed of 20 N/s and the displacement was recorded.Then the specimens were exposed to torsional load at a speed of 0.1 degree/s.The rotation degree and corresponding torque were recorded.Analysis of variance was employed to analyze the data.ResultsUnder vertical load,the displacement of the pelvis fixed with MIAP was similar to that fixed with two SI screws.The displacement of the pelvic fractures fixed with either MIAP or two SI screws was smaller than that fixed with TBP.Under torsional load,the torque measured on the pelvis fixed with MIAP was similar to that fixed with two SI screws.The torque measured on the pelvic fractures fixed with either MIAP or two SI screws was greater than that fixed with TBP.ConclusionThe posterior pelvic ring disruptions fixed with MIAP is as stable as that fixed with two SI screws,both with better stability than that fixed with TBP,under both vertical load and torsional.