Bone Morphogenetic Proteins(BMPs)belong to the Transforming Growth Factor beta(TGF-?)family and play pivotal roles in osteogenesis,induction,maintenance and repair of bone.Differentiation of osteoprogenitor mesenchymal cells and up-regulation of osteoblastic features depend on the expressing level of BMPs.Because of their osteogenic potential,BMPs have tremendous potentia l as therapeutic agents in healing fractures of bone,preventing osteoporosis,healing of spinal fusion,treating periodontal defects and enhancing bone formation around alloplastic materials implanted in bone.Some mature products have been invented and available in market.This article reviews available therapeutic preparations of BMPs,involving carriers implanted for slow release,closed local injection and gene therapy,and suggests future applications likely to develop from current investigations.

BACKGROUND: The pain caused by osteoporosis and osteoporotic fracture is usually treated with non-steroidal anti-inflammatory drugs (NSAIDs) in clinic, which has been reported that dysfunction of liver and kidney will follow the use, but what has happened in the tissue of liver and kidney is not reported. OBJECTIVE: To study the effect of NSAIDs on the tissue of liver and kidney in osteoporotic fracture rats. DESIGN, TIME AND SETTING: Randomized controlled animal experiment. The experiment was completed in the Animal Experiment Center in Shanghai University of Traditional Chinese Medicine from August 2007 to February 2008.MATERIALS: A total of 24 female SD rats, 8-month-old, weighing 300-320 g, were randomly divided into 3 groups, saline group,diclofenac sodium (fracture before medicine) group and diclofenac sodium (fracture after medicine) group, with 8 rats in each group.METHODS: The rats were housed for 3 months after ovariectomized to establish osteoporosis models. Rats in the saline group and diclofenac sodium (fracture before medicine) group were administrated saline and diclofenac sodium after transverse osteotomy at the middle shaft of bilateral femur respectively; in the diclofenac sodium (fracture after medicine) group were femur.MAIN OUTCOME MEASURES: The histological observation of liver and kidney was performed at weeks 2, 3, 4 and 6 after fracture.RESULTS: In the diclofenac sodium (fracture before medicine) group, diclofenec sodium caused the inflammatory response at glomeruli, which exhibited expansion of tubular lumen, edema of epithelial cells, disappeared cell nuclei, degeneration and necrosis of renal tubule, cell debris and drugs crystals accumulated in the tubular lumen, congestion and inflammatory cell infiltration of renal interstitium. Administrating diclofenac sodium may cause the inflammatory response at portal area, indistinct structure of hepatic Iobule, hepatic cells edema, steatosis and necrosis. Administrating diclofenac sodium before osteoporotic fracture also resulted in tissue lesions in kidney and liver, the damage would continue about 3 weeks.CONCLUSION: The diclofenac sodium cause histological lesions of kidney and liver in osteoporotic rats, especially in kidney. The histological lesions of kidney and liver are inreversible after administrating diclofenac sodium for a long time.

BACKGROUND:The pain caused by osteoporosis and osteoporotic fracture is usually treated with non-steroidal anti-inflammatory drugs (NSAIDs) in clinic,which has been reported that dysfunction of liver and kidney will follow the use,but what has happened in the tissue of liver and kidney is not reported.OBJECTIVE:To study the effect of NSAIDs on the tissue of liver and kidney in osteoporotic fracture rats.DESIGN,TIME AND SETTING:Randomized controlled animal experiment.The experiment was completed in the Animal Experiment Center in Shanghai University of Traditional Chinese Medicine from August 2007 to February 2008.MATERIALS:A total of 24 female SD rats,8-month-old,weighing 300-320 g,were randomly divided into 3 groups,saline group,diclofenac sodium (fracture before medicine) group and diclofenac sodium (fracture after medicine) group,with 8 rats in each group.METHODS:The rats were housed for 3 months after ovariectomized to establish osteoporosis models.Rats in the saline group and diclofenac sodium (fracture before medicine) group were administrated saline and diclofenac sodium after transverse osteotomy at the middle shaft of bilateral femur respectively;in the diclofenac sodium (fracture after medicine) group were administrated 5 mg/(kg?d) diclofenac sodium for 3 weeks,then received transverse osteotomy at the middle shaft of bilateral femur.MAIN OUTCOME MEASURES:The histological observation of liver and kidney was performed at weeks 2,3,4 and 6 after fracture.RESULTS:In the diclofenac sodium (fracture before medicine) group,diclofenac sodium caused the inflammatory response at glomeruli,which exhibited expansion of tubular lumen,edema of epithelial cells,disappeared cell nuclei,degeneration and necrosis of renal tubule,cell debris and drugs crystals accumulated in the tubular lumen,congestion and inflammatory cell infiltration of renal interstitium.Administrating diclofenac sodium may cause the inflammatory response at portal area,indistinct structure of hepatic lobule,hepatic cells edema,steatosis and necrosis.Administrating diclofenac sodium before osteoporotic fracture also resulted in tissue lesions in kidney and liver,the damage would continue about 3 weeks.CONCLUSION:The diclofenac sodium cause histological lesions of kidney and liver in osteoporotic rats,especially in kidney.The histological lesions of kidney and liver are inreversible after administrating diclofenac sodium for a long time.

Objective The purpose of this study was to evaluate the relationship between the initial X-ray display and prognosis of intracapsular fractures of the proximal humerus, and to probe a new criterion which can accurately predict the prognosis of the fracture. Methods Between April 1999 and February 2004, 459 cases of intracapsular fractures of the proximal humerus were treated conservatively, among which 211 cases had completed at least 9 months of follow-up and their complete data were available(mean age, 54.2 years; minimum, 17 years; maximum, 81 years; 82 males, 129 females), all the patients were followed up for 1.7 years on the average (ranging from 9 months to 3 years). According to the original X-ray, the fractures were classified by Neer classification. There were 68 cases of one part fractures, 39 cases of two parts fractures, 59 cases of three parts fractures and 45 cases of four parts fractures. The original X-ray and that of at least 9 months postoperatively of every case were assessed by seven structured standards and studied the relationship between the standards and prognosis. The seven standards are listed as follow: Neer classification; the length of the medial side of proximal humerus; displacement between humeral head and shaft; displacement of greater tuberculosis relative to shaft; displacement of medial cortex in fracture site; glenohumeral dislocation and humeral head split. Results 79% of the cases with a length of the medial side of proximal metaphyseal less than 8 mm, and 84% case with medial cortex displacement over 2 mm and 68% of Neer four-part fractures have a poor prognosis. The prognostic significance of predictors were listed as follow: the medial cortex displacement more than 2 mm (accuracy, 0.85), the length of the medial proximal metaphyseal less than 8 mm (accuracy, 0.83), Neer four-part fractures (accuracy, 0.76), Neer three-part fractures (accuracy, 0.72), glenohumeral dislocation (accuracy, 0.64), head-split components (accuracy, 0.64), displa-cement of the head more than 10 mm (accuracy, 0.54). Conclusion The new criterion provides a precise pr-ognosis prediction for intracapsular fractures of the proximal humerus thus it may be helpful in selecting a proper procedure.

Objective To explore the ultrasound images features of breast infiltrating ductal carcinoma. Methods Retrospective analysis of operation pathology ,55 patients diagnosed preoperatively infiltrating ductal carcinoma of color Doppler ultrasound diagnostic information. Results Before operation, 55 patients with breast tumors had color Doppler shows in 49 cases,no color doppler showed 6 cases,color Doppler shows with pathologic diagnosis is 89.1%. An infiltrating ductal carcinoma ultrasound image characteristics:the larger mass was irregular form,no coated, posterior acoustic attenuation,burr levy ,and crabs foot shape more inside,bump such change for not uniformity hypoechoic,with tiny clusters of calcified or irregular flare,shadow,blood flow distribution after silent for AlderⅡmore performance level Ⅲ,axillary lymph node enlargement,a different level hilus structure was clear,the peak systolic velocity in 12-80cm/s (average 35.1 cm/s ) , resistance index in 0.62-0.92 (average for 0.79 + 0.10). Conclusion Color doppler ultrasonography had important value in early diagnosis of infiltrating ductal carcinoma.

Objective To observe the treatment effect of minimally invasive surgery on bone defects. Methods Bone defect model was established in bilateral shaft of radius in 30 rabbits. Forefoots of each rabbit were then randomized into open grafting group(group A) and minimally invasive grafting group(group B). Minimally invasive bone grafting was performed in group B with self-made instruments. DEXA and electron microscopy were investigated in radial bone defect after six rabbits were sacrificed randomly at different time after bone grafting. Results DEXA showed bone density increased gradually in both groups, the bone density in minimally invasive group was higher than that in open group with significant difference(P