Objective To evaluate a new type of bone graft material made by combining bFGF,BMP with AACB in the clinic repair of ANFH(avascular necrosis of the femoral head)in animal experiments.Methods The combined material of bFGF/BMP/AACB was made and then this composite was transplanted to the models of canine femoral head defects and necrosis established by liquid nitrogen freezing,The specimens were harvested respectively at the end of three,six and 12 weeks after operation.A series of examinations were carried out to evaluate the repair results,including gross observation,radiography,histology,image pattern analy sis,blood vessel immuhistochemical staining,EDAX(energy dispersion analysis X-ray),and mechanical measurement.Results All the animals had no toxic or inflammatory reactions.Little new bone formed in group A(control group)by the end of 12 weeks.Group B(AACB group)was better than group A,and group C(BMP/AACB group)better than group B in osteogenesis.All the results showed that group D(bFGF/BMP/AACB group)was much superior to groups A,B and C in angiogenesis and osteogenesis at all intervals,and even better than group E(bone autograft group)by the end of three weeks and six weeks.By the end of 12 weeks,bone repairing and remodeling effects in group D were as good as in group E.Conclusions Since the bFGF/BMP/AACB compsite has great potential for enhacing revascularization and osteogenesis in repairing the defect and necrosis model of canine femoral head,it can be used as a substitute bone graft material for clinical patients with ANFH.

BACKGROUND:Clinical y, bone marrow mesenchymal stem cel s combined with artificial bones for early osteonecrosis of the femoral head have a wonderful outcome.
OBJECTIVE:To review the biological properties of bone marrow mesenchymal stem cel s and to summarize the application progress of bone marrow mesenchymal stem cel s combined with different artificial bones in the treatment of early osteonecrosis of the femoral head.
METHODS:PubMed (2003-2013), FMJS (2003-2013), Wanfang (2005-2013), CNKI (2005-2013) and CBM (2005-2013) databases were retrieved by computer using the keywords of“bone marrow mesenchymal stem cel s;artificial bone;osteonecrosis of the femoral head”in Chinese and English.
RESULTS AND CONCLUSION:It wil lower the pressure of the femoral head, accelerate repair of the blood capil ary, improve the blood supply, osteoblast proliferation and differentiation, and thus delay or even prevent artificial joint replacement after osteonecrosis of the femoral head by applying bone marrow mesenchymal stem cel s combined with different artificial bones, such as corl ine hydroxyapatite, calcium hydroxylaptite, biological ceramics and calcium sulfate bones. But now, there are stil a lot of problems which need to be solved, including pathological mechanism underlying bone marrow mesenchymal stem cel s for treatment of osteonecrosis of the femoral head, obvious difference between the quantity and quality of seed cel s because of individual difference, different sites and culture techniques. So, artificial bone materials are under review, and large-sample randomized control trials are required. Its long-term outcomes also lack for fol ow-up observation, as wel as there is no a unified quantitative standard for the appropriate selection of indication, curative effect evaluation and the awareness of the operation.

Objective To explore the causes and management of delayed un ion and non-union of long bone fracture of the leg. Methods 13 cases of delayed union and non-union of long bone fracture of the leg were treated with interlo cking intramedullary nails. 2 cases were given close implanting, and 11 cases we re managed with open reduction, of whom 9 were also grafted with autogenous bone . All patients were given early static interlocking, and 4 cases were given late dynamic interlocking. Results X-rays and follow-up showed that all patients h ealed up after an average of 14.5 months.Conclusions Interlocking intramedullary nails are a satisfactory method to treat delayed union and non-union of long b one fracture of the leg. The key points of the operation are reaming, selecting suitable nails and dynamic interlocking when necessary.

BACKGROUND: An ideal model of osteonecrosis of the femoral head is beneficial to the study on the cause of disease, pathogenesy and treatment. So far there has not been a coherent method to prepare this model. OBJECTIVE: To establish a rabbit model of osteonecrosis of femoral head induced by microwave heating, and to decide optimum microwave temperature and heating time.DESIGN: Randomized controlled animal trial.SETTING: Animal Experimental Center of Kunming Medical College.MATERIALS: The experiment was performed at the Animal Experimental Center of Kunming Medical College between September 2004 and November 2005. Forty-eight healthy adult New Zealand rabbits, either male or female, were provided by the Animal Experimental Center of Kunming Medical College. The animal procedure was accorded with the ethical standards. GW-92C multi-functional microwave therapy apparatus was the product of Grand World Medical Apparatus (Tianjin) Co., Ltd. METHODS: The microwave antenna was inserted into the rabbit femoral head. Ninety-six femoral heads in forty-eight rabbits were randomly divided into four groups (n =24) according to the microwave temperature and heating time: microwave heating at 50 ℃ for 10 minutes group; 55 ℃ for 10 minutes group; 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. The models of osteonecrosis of femoral head were induced by microwave heating using multi-functional microwave therapy apparatus according to the temperature and heating time of grouping. MAIN OUTCOME MEASURES: In each group, two rabbits (four femoral heads) were killed immediately, one, two, four, eight and twelve weeks after operation, respectively. A series of examinations were carried out, including gross observation, X-ray to observe bone trabecular arrangement, cystis degeneration, head collapse or hip joint destruction, MRI to observe the necrotic area, and HE staining to observe the osteonecrosis and bone repair. RESULTS: Marrow tissues partially coagulated in the microwave heating at 50 ℃ for 10 minutes group at the end of the 1st week, and the osteonecrosis returned to normality at the end of the 8th week. In 55 ℃ for 10 minutes group, marrow tissues were completely coagulated at the end of the 1st week, and decreased signal on T1 weighted images and increased signal on T2 images were identified at the end of the 2nd week. In the 4th week, bone repair was found simultaneously when osteonecrosis occurred. At the end of the 12th week, the osteonecrosis continued and the repair stopped, and the femoral head collapse occurred. All femoral heads collapsed at the end of the 8th week in 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. CONCLUSION: Microwave heating at 55 ℃ for 10 minutes is the optimal choice to develop a rabbit model of osteonecrosis of the femoral head.

BACKGROUND:The treatment of avascular necrosis of femoral head remains a clinical challenge. However, recent study shows that basic fibroblast growth factor (Bfgf) is an effective angiogenic growth factor. We suppose that Bfgf has the potential in treating avascular necrosis of femoral head through revascularizing effect and steogenesis.OBJECTIVE: To develop a rabbit model that simulates the clinical situation with trapdoor bone rafting and evaluate the revascularizing effect in the repair of femoral head defect with Bfgf/partially deproteinised bone (PDPB).DESIGN: A completely randomized controlled trial.SETTING: Animal Experimental Center of Kunming Medical College.MATERIALS: The experiment was conducted in the Animal Experimental Center of Kunming Medical College between July 2002 and July 2003.Totally 27 adult male healthy New Zealand rabbits, weighing 2.2 to 2.8 kg,were recruited and randomly divided into Bfgf/composite PDPB group,single PDPB group, and blank control group with 9 rabbits in each group.INTERVENTIONS: ① Preparation of Bfgf/PDPB: containing Bfgf 10 ng/mm3. ② Establishment and repair of femoral head defect model:Totally 27 rabbits were chosen. Bone defect model was stablished by opening a trapdoor between femoral head and femoral neck. Bfgf/PDPB was implanted in composite group; single PDPB was implanted in PDPB group; no implants were given in blank control group. The rabbits were killed after injection through blood vessels with prepared Chinese ink 2, 4and 8 weeks after operation, and then the femoral head of each rabbit was taken out as specimen.MAIN OUTCOME MEASURES: ① Histological examination and blood vessel counting. ② Image analysis of microvessel area.RESULTS: Twenty-seven rabbits all entered the result analysis. ① Histological examination and vessel count of femoral head specimens in rabbits:8 weeks after operation, composite bone group: implants were replaced with bone tissues and medullary cavity of bone formed. A lot of medullary vessels were present. DPB group: implants were enwrapped by bonelike tissues and most of them were absorbed. Blank control group: the area of femoral head defect was filled with fibrous tissues. New bonelike tissues and scattered chondrocyte island appeared in the adjacent connective tissues of defect area, with a small number of blood vessels. Microvessel count at week 2 in composite group was significantly higher than that in PDPB group and blank control group [(31.833±7.914) vs (22.917±2.079)and (11.250±4.220) (number of blood vessel/field), P ＜ 0.01, P ＜ 0.05].The number of microvessels at weeks 4 and 8 in composite bone group and DPB group was significantly greater than that in blank control group. ②Image analysis of microvessel area: The transparent samples of 20 μm thick were observed under the optical microscope: 2, 4 and 8 weeks after operation, there were many vessels woven into nets. Many vessels woven into nets were also found in PDPB group; there were scattered vessels in blank control group.CONCLUSION: Bfgf has the revascularizing effect on the repair of femoral head defect, and has the potential and advantages in treating avascular necrosis of femoral head.

BACKGROUND:The existed femoral head necrosis(FHN)model can not reflex the clinical necrosis of femoral head correctly.Microwave heating provides a new approach for model preparation.but the concrete standard remains uncertain.OBJECTIVE:To study the optimal temperature and time jn preparing a FHN model induced by microwave heating.METHODS:Totally 48 rabbits were randomly divided into 4 groups on the basis of the microwave temperature(50,55,60℃)and heating time(10,20 minutes).The microwave antenne was inserted into the rabbit femoral head.The rabbits were sacrificed immediately and at 1,2,4,8 and 1 2 weeks after operation.A series of examinations were performed including gross observation,X-ray.histology and MRI to observe the femoral head necrosis and repair status.RESULTS AND CONCLUSION:Marrow partially solidified in the group(50℃,10 minutes)at 1 week,and the osteonecrosis returned to normaI at 8 weeks after operation.1n the group(55℃,10 minutes),marrow was completely coagulated at 1 week and low signal on T1 weighted images and increased signal on T2 images were identified at 2 weeks.Osteonecrosis and repair occurred at the same time at 4 weeks.At 12 weeks,the osteonecrosis continued and the repair stopped,and the femorel heads started to collapse.All femoral heads collapsed at 8 weeks in group(50℃,20 minutes)and group(60℃,10 minutes).Accordingly.microwave heating is a good method in developing FHN model.55℃ and 10 minutes are the optimal temperature and time for the development of FHN model of rabbits induced by microwave heating.

BACKGROUND:Single scaffold materials have some shortcomings to some extent or in different ranges. Therefore, new composite materials are developed in recent year, which are compounded by two or more materials with complementary characteristics in a certain manner or ratio.
OBJECTIVE:To investigate the histocompatibility and osteogenic induction of geneX artificial bone combined with bone marrow mesenchymal stem cel s and transforming growth factor beta 2 (TGF-β2).
METHODS:Injectable geneX was co-cultured with bone marrow mesenchymal stem cel s for 5 days, and under the electron microscope, the histocompatibility of the artificial bone was observed. Passage 3 rabbit bone marrow mesenchymal stem cel s were divided into three groups:simple cel group cultured with osteogenic medium, cel scaffold group cultured with geneX+osteogenic medium, combined group cultured with geneX+TGF-β2+osteogenic medium. After 7, 14, 21 days, cel morphology, alkaline phosphatase activity detection, MTT detection, methyl thymol blue detection and alizarin red staining were performed.
RESULTS AND CONCLUSION:After osteogenic induction, bone marrow mesenchymal stem cel s were fibroblast-like cel s and adhered to the surface of geneX bone with strong secretion of extracel ular matrix. Cel proliferation and osteogenic activity in the combined group were stronger than those in the simple cel and cel scaffold groups (P<0.05). The alkaline phosphatase activity was also higher in the combined group than the other two groups. These findings indicate that the geneX/bone marrow mesenchymal stem cel s/TGF-β2 composite has good histocompatibility and pro-osteogenic differentiation ability.

Objective To study the immunological pathogenesis of gluteal muscle contracture. Methods In 43 children with gluteal muscle contracture and 22 normal control cases, peripheral blood T-lymphocytes, B-lymphocyte and its subset were analyzed with flow cytometry. Results The percent of CD4+, B-lymphocyte and CD4+/CD8+ in children with gluteal muscle contracture were all significantly higher than those in the control(P0.05). Conclusion There is disorder of immunological regulation in children with gluteal muscle contracture. Immunologic factors may play an important role in the pathogenesis of gluteal muscle contracture.

Objective To observe the efficacy of a kind of complex composed of biphasic ceramic biologic bone (BCBB), bone morphogenetic protein (BMP) and basic fibroblast growth factor (bFGF) on the repair of necrotic areas of the femoral head. Methods The femoral head necrosis model of 64 femoral heads in 32 rabbits induced with microwave heating were randomly divided into four groups, which implanted with nothing (group A), BCBB/BMP (group B), BCBB/BMP/bFGF (group C) and with cancellous bone autograft (group D). The specimens were harvested separately at the end of 2, 4, 8 and 12 weeks after operation. 4 femoral heads were taken off at each interval in every group. A series of examinations were carried out including of naked eyes and gross anatomic observation, X-ray, histology, and blood vessel immunohistochemical staining. Results In group A, 1 femoral head collapsed by the end of 12 weeks, and there was only a little osteoid tissue formed. At the same time, a lot of new bone formed in group B and group C, and the boundary between the bone grafting area and the post bone still existed, but the boundary was unclear in group D, with the density consistent to the post bone. Under X-ray, the defect could be found and one femoral head collapsed in group A by the end of 12 weeks. The density of bone grafting area was high and the boundary to the post bone was unclear in group B and in group C. The density of bone grafting area was the same as the post bone and the boundary between them was unclear in group D. There was only a little osteoid tissue formed in group A by the end of 4 weeks. At the same time, there was a little new bone formed in group B, and BCBB was partly degraded. There was a lot of new bone formed in group C and group D, and BCBB was partly degraded in group C, but cancellous bone autograft was almost absorbed in group D. The new bone area by the end of 4, 8 and 12 weeks from more to less were: group C and group D (P>0.05), group B, and group A (P<0.05). At the end of 2, 4 and 8 weeks, the blood vessel area of group C was more than that of group A, group B, and group D (P<0.05). Conclusion The BCBB/BMP/bFGF complex can induced osteoinduction and revascularization, to repair rabbit femoral head necrosis as effective as cancellous bone autograft.