BACKGROUND: Combined use of multiple interventions for different targets play superimposed or synergistic effects,which has become the current idea for spinal cord injury treatment.OBJECTIVE: To investigate the synergistic effects of low doses of 17-β estradiol combined with bone marrow mesenchymal stem cells (BMSCs) transplantation on the recovery of motor function and inflammatory reactions after spinal cord injury in rats.METHODS: The 10 of 70 male Sprague-Dawley rats served as sham group in which the spinal cord was only exposed but with no treatment, and the rest 60 rats were used to make animal models of spinal cord injury using modified Allen's method and then randomized into four groups (n=15 per group): model, estrogen, stem cell and combined treatment groups. Rats in the stem cell and combined treatment groups were given BMSCs transplantation at injured side; rats in the estrogen and combined treatment groups were given intramuscular injection of 17-β estradiol at 1 and 24 hours after modeling. At 1, 3, 5 and 7 days after modeling, rat functional recovery was evaluated by the Basso, Beatlie, Bresnahan score. The expressions of interleukin-1β and tumor necrosis factor-α in the injured spinal cord were detected by ELISA at 6, 12, 24, and 72 hours after modeling. Apoptosis in nerve cells was observed using TUNEL staining. RESULTS AND CONCLUSION: The Basso, Beatlie, Bresnahan scores were declined significantly after modeling,increased at 5 and 7 days after stem cell transplantation, estrogen treatment or their combined treatment (P < 0.05),especially in the combined treatment group (P < 0.05). The levels of interleukin-1β and tumor necrosis factor-α were elevated gradually after spinal cord injury (P < 0.05), but the levels decreased significantly at 12 and 24 hours in stem cell,estrogen and combined treatment groups (P < 0.05), and this decrease trend was more significant in the combined treatment group compared with the stem cell and estrogen groups (P < 0.05). At 72 hours after modeling, the rate of TUNEL positive cells was highest in the model group (P < 0.05) and lowest in the combined treatment group (P < 0.05).To conclude, the combined use of low doses of 17-β estradiol and BMSCs transplantation can facilitate the recovery of motor function after spinal cord injury by effectively inhibiting apoptosis in nerve cells.

Objective To compare the effect of hollow screw and double suture anchors for the treatment of the intercondylar eminence fractures of tibia.Methods The data of 68 patients with intercondylar eminence fractures of tibia from January 2006 to January 2012 were retrospectively reviewed.33 patients of them received treatment of hollow screw,35 patients received double suture anchors.All patients had X-ray films before operation.After follow-up of 3,6,12 and 36 months,they all were examined by X-ray eminence in an appropriate position.Union time was from 6 to 12 weeks and evaluated by Lysholm system.Results After a follow-up for 24 to 43 months and the average period was 36 months.A total of 68 patients turned up.The outcome of treatment was evaluated on the basis of X-ray and clinical findings in hollow screw group and double suture anchors group.Union and average time was 8 weeks.During the follow-up time,clinical evaluation included the range of motion and knee joint stability was examined and no knee joint instability and abnormal activity were found.During the 3 months and 6 months,there were significant differences between hollow screw group and double suture anchors group (P ＞ 0.05).But during the follow-up from 12 to 24 months,there were significant differences between hollow screw group and double suture anchors group (P＞0.05) according to Lysholm system,clinical evaluation including range of motion and knee pain was examined and knee pain and abnormal activity were found in this two groups.Conclusion Clinical characteristics of patients and individual requirement should be considered comprehensively before an individual treatment choice is made for the treatment of the intercondylar eminence fractures of tibia.