Objective To evaluate the assistant medial approach used in the surgical management of intraarticular fractures of calcaneus.Methods From January 2005 to December 2009,33 patients with intraarticular fracture of calcaneus were treated by open reduction and internal fixation through the expanded lateral L-shape approach and the assisted medial approach.They were 27 men and 6 women,aged from 18 to 62 years (average,36 years).There were 15 left sides and 18 right sides.According to Sanders' classification system,there were 27 patients with type Ⅲ displaced calcaneal fracture and 6 with type IV.Four cases were complicated with fracture of lumbar vertebra,one with pilon fracture and one with fracture of acetahulun.Fracture healing was observed and the Bǒhler and Gissane angles were measured.The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale system was used to evaluate the functional recovery.Results All patients were followed up postoperatively to assess their functional outcome.The follow-up duration was 6 to 24 months (mean,12 months).All incisions healed primarily and all fractures obtained bony union in an average of 8 weeks (from 6 to 24 months).All the Bǒhler and Gissane angles were corrected and AOFAS scores were improved.There were significant differences between preoperation and pestoperation in all indexes( P ＜ 0.05).Conclusion As the medial approach can be used to assist the expanded lateral L-shape approach in treatment of the intraarticular fractures of the calcaneus,the reduction and insertion of internal implants can be improved to achieve satisfactory functional outcome.

Objective To investigate the impact of stable expression of perlecan shRNA lentiviral particles on proliferation of NIH3T3 cells. Methods Mouse fibroblasts were cultured.Lentiviral particles-green fluorescent protein (LV-GFP) was used to transfect the cultured NIH3T3 cells with multiplicity of infection (MOI) of 10,30 and 50.The GFP expression was observed with fluorescence microscopy after transfection for one week to estimate the proper MOI and the time of GFP expression needed.The transfection efficiency of LV-GFP with the proper MOI by fluorescence-activated cell sorting was detected.The stably transfected cell lines were developed by puromycin screening for more than 2 weeks.The third generation HFF in good condition was randomly divided into 3 groups:GFP group,shRNA group and control group.RT-PCR,Western blot and MTT assays were used to detect the expressions of perlecan mRNA and protein and cell proliferation in the 3 groups. Results Perlecan mRNA and protein showed high expressions in the control and GFP groups but low expressions in the shRNA group,with significant differences respectively between the shRNA group and the other 2 groups ( P ＜ 0.05).There was no significant difference between the 3 groups in the optical density at the first 2 days ( P ＞ 0.05).On 3 to 6 days the cells in the control and GFP groups grew normally while the cells in the shRNA group proliferated in a weak manner.the transfected cells in the shRNA group showed a significantly reduced proliferation rate compared with the other 2 groups ( P ＜ 0.05 ). Conclusion The growth of NIH3T3 cells can be inhibited significantly by transfection with perlecan shRNA lentiviral particles.

[Objective]To investigate the role and mechanism of interleukin-1? on fibroblast synthesis of matrix metalloproteinase-3,and explore the impact of interleukin-1? on the formation of epidural scar.[Method]The NIH3T3 cells were divided into three groups:IL-1? group,IL-1? + SB202190 group and control group. After serum-free culture for 20 hours,IL-1? group was treated by IL-1? (10ng/ml) and IL-1? + SB202190 group was treated by the SB202190 (10?mol/L) for 1 hour before treatment with IL-1?(10ng/ml) and the control group was treated with 2% serum. Then those 3 groups were cultured for 24 hours under standard conditions (37℃ in a humidified atmosphere flushed with 5% CO2 in air). The expression of MMP-3 gene was examined by RT-PCR and Western blotting.[Result]The expression of MMP-3 significantly increased in the IL-1? group than that in the control group(P0.05). [Conclusion]IL-1? could stimulate the expression of MMP-3 in NIH3T3 cells which might inhibit the formation of epidural scar. Besides,the author found that the p38 pathway played an major role in this process.

Objective To study the effect on prevention of dura mater spinalis adhesion after laminectomy through an experiment by using keratin substance (KS) artificial fasciae.MethodSixty rats were randomly divided into three groups, each had 20. In all rats, total laminectomy were performed at T12 levels led to the defects of 2 mm?8 mm. The group A were sutured directly, which was regarded as control group; covered with artificial fasciae in group B; with self-faciae in group C. The animals were killed at the 2nd, 4th, 8th, 12th week after operation respectively, and macroscopy assessment was done with the help of the Rydell Criterion. The spine segment of T12 was removed en bloc including the paraspinal tissue, and all specimens were stained with hematoxylin and eosin. Improved Nussbaum Criterion was used for the following optical microscopy assessment. Transmission electron microscopy was performed on posterior epidural scar obtained from group-B at the 2nd, 4th, 8th, 12th week after operation respectively. The nonparametric Kruskal-Wallis test was used to determine the differences between the three groups, and a P value of 0.05).So compared to the control group, KS artificial fasciae and self-fasciae significantly reduced the formation of epidural fibrosis after laminectomy.ConclusionKS artificial fasciae have the best biological compatibility with the tissues with no adverse effects. The posterior hematoma and fibroblast (FB) are the main source of the epidural fibrosis.As placement of KS artificial fasciae over the laminectomy defect in rats could provide a physical barrier against invasion of fibrous tissue into the vertebral canal,and peridural fibrosis after laminectomy would be effectively prevented. KS artificial fasciae is safe and effective in limiting the direct contact by the postlaminectomy epidural fibrosis in rats.

Objective To evaluate the clinical outcome of operative management of displaced intraarticular fractures of the calcaneus using locking plates. Methods From October 2004 to October 2006, 34patients with close displaced intraarticular fractures of the calcaneus were fixed with Calcaneal locking Plates through the extensive lateral approach. The right foot was involved in 20 patients. The mean age was 34 yesrs with a range of 19 to 42 years. Accordiing to Sanders' classification system, there were 16 patients in style Ⅱ and 18 in style Ⅲ The mean interval between injury and operation was 13 days Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a locking calcaneal fracture plate. The result were evaluated with AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot scale. Results Twenty-eight patients were followed up. The follow-up duration ranged from six to forty months, with the mean of twenty months. angle and were measured at, The average B(o)hler angle was 29° and 30° and the average Gissane was 122° and 125° seven days and three months after operation. Bone union was achieved in all cases. All incisons had healed smoothly. No patient sustained lateral impingement syndrome or soft tissue complications The mean AOFAS scores that was measured three months and six months after operation was 74. Conclusion The application of the calcaneal locking plates through extended lateral approach is proved to be an effective treatment for displaced intra-articular calcaneal fracture, offering the combination of good reduction and early rehabilitation.

Objective To study the role of activated microglia transplantation in recovery of hindlimb locomotor function in rats with spinal cord injury(SCI). Methods A total of 40 female adult Wistar rats were selected and divided into four groups randomly(10 rats in each group).The former two groups were locomotor function observation groups,in which rat model with spinal cord was established by striking with improved self-made Allen's strike equipment to fabricate moderate spinal cord injury and divided into transplantation group and control group.The latter two were histological observation groups,the spinal cord injury model was fabricated by the same above-mentioned method and divided into transplantation and control groups.Before fabricating the spinal cord injury model,the microglia of the newborn rats were cultured,separated,purified and identified and the purity of the microglia determined.The injury position was exposed again seven days after transplantation and the cell suspension of microglia was injected around the injury position with microsyringe,which was free in the control group.The hindlimb locomotor function of rats was detected and scored at 1 day,1,2,3 and 4 weeks in the locomotor function observation groups after transplantation respectively.At the same time,two rats were extracted randomly from the control group and the transplantation group in histological observation groups to cut specimen and slice for Naoumenko-Feign paraffin section and dying.Then,the microglia were observed and counted by microscope and analyzed statistically. Results At 1,2,3 and 4 weeks after operation,the BBB score of the control group and the transplantation group was increased gradually with the time.But compared with the control group,transplantation group had higher scores of hindlimb locomotor function at 2,3 and 4 weeks after operation,with statistical difference(P＜0.05).Naoumenko-Feigin paraffin section and dying and microglia counting showed that positive microglia number in the transplantation group was increased more obviously than the control group,with statistical difference(P＜0.05).Conclusion Activated microglia transplantation can promote the recovery of the hindlimb locomotor function in SCI rats.

BACKGROUND:Cervical Open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation are both procedures that treat cervical spondylotic myelopathy by expanding the space available for the spinal cord. Effectiveness and safety of two operative methods remain unclear. OBJECTIVE:To investigate the biocompatibility of implant and host between open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation to treat multi-segment cervical spondylotic myelopathy. METHODS: Data of 117 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments) were retrospectively analyzed. Sixty-five cases underwent open-door laminoplasty with unilateral mass screw fixation (laminoplasty group). Fifty-two cases underwent laminectomy with bilateral mass screw fixation (laminectomy group). Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system and by recovery rate. Cervical curvature index and cervical range of motion were assessed by X-ray films in both groups. RESULTS AND CONCLUSION:The average folow-up time was 28 months (range 12-59 months) in both groups. No C5 nerve root palsy occurred in the two groups. Japanese Orthopaedic Association scores were greater during final folow-up than pre-fixation in both groups (P < 0.01). No significant difference in Japanese Orthopaedic Association score, recovery rate, and final folow-up cervical curvature index was detected in both groups (P > 0.05). Cervical range of motion was lower during final folow-up than pre-fixation in both groups (P < 0.01). Results confirmed that open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation have similar effectiveness in the improvement of neurological function, relieving pain and reducing complications, but wil greatly reduce the cervical range of motion.