[Objective]To summarize and evaluate the curative effect of anterior decompression approach by using cervical retractor systems to treat cervical spondylosis.[Method]From April 2002 to October 2004,68 cases were performed anterior undermined far-reaching decompression and fusion with autograft and titanium plate internal fixation by using removing disc merely at the single-level or separately at the multilevels employing CCR self-retractor and Caspar cervical retractor systems via interspinal approach.The cases were followed up,and serial roantgcnographic evaluations being applied.Then the height of involved intcrspinal space was measured preoperatively and after 12 months postoperatively,and the spinal function was evaluated in accordance with the standard of Japanese Orthopeadic Association(JOA),and then all results were compared statistically.[Result]51 of all cases were followed up,of which 50 were better,1 was improved,no one worsened.After 12 months postoperatively,roentgenographic appearance showed that the allograft healing and interbody fusion of all patients were achieved,and the reserving height of involved interspinal space and JOA evaluation postoperatively were significantly superior to both preoperatively.No complications such as cervical spinal cord injury,internal fixation unfastening,and hematoma turned up.[Conclusion]Anterior decompression approach by using cervical retractor systems to treat cervical spondylosis could better reserve the height of involved interspinal space,and improve the spinal function significantly.

Objective To explore the clinical application of lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft taken from the groin area for reconstruction of the distal one third of anterior tibia,.around the ankle. Methods A distally based lesser saphenous.sural nerve adipofag.cial flap accompanied with a full-thickness skin graft which was taken from the groin area was studied and used to treat 12 patients with soft tissue defects in the distal one third of anterior tibia,3 cases with soft tissue defects and tibia osteomyelitis,2 cases with soft tissue defects and tibia osteomyelitis.The size of the soft tissue defects ranged from 3 cm×5 cm to 9 cm×13 cm,and the biggest donor flap was 13 cm×18 cm.The donor sites at the posterior aspect of the leg and at the groin area were closed primarily. Results All 17 patients were followed up for 6-12 months(average 9 months).All 17 flaps had good perfusion and survived completely,which successfully treated all 17 patients with soft tissue defects or with both soft tissue defects and osteomyelitis.The donor and recipient sites of adipofascial flaps and the groin area healed primarily,and satisfactory appearance and function were achieved.Conclusion Distally based lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft which was taken from the groin area can reconstruct the distal one third of anterior tibia,around the ankle,and even treat osetomyelitis successfully,in the same time,which can preserve the function and appearance of the involved limb to the utmost.

Objective To explore the application and clinical effect of bipolar hemiarthroplasty with bipolar prosthesis on unstable intertrochanteric fracture in the elderly patients.Methods The study involved 53 patients aged over 75 years with intertrochanteric fracture treated with bipolar hemiarthroplasty in our hospital from April 2003 to January 2010.According to Evans-Jensen classification,there were 24 patients with type Ⅲ fractures,eight with type Ⅳ and 11 with type Ⅴ.Osteoporosis degree was at Singh degree Ⅰ in 13 patients,degreeⅡ in 18,degree Ⅲ in 12 and degree Ⅳ in 10.Most patients underwent operation within three days after injury.Results The operation duration was(75 ±10)min,with intraoperative blood loss of(350 ± 68)ml.Three patients were lost to follow-up after discharge and one patient was died of respiratory failure caused by chronic bronchitis five months after operation.Forty-nine patients were followed up for 12-93 months(mean 38 months),which showed no joint dislocation,or loosening,subsidence or rupture of the prosthesis.According to the Harris score of hip joint,the result at final follow-up was excellent in 29 patients,good in 13 and fair in seven,with excellence rate of 86％.Conclusions Bipolar hemiarthroplasty is an effective treatment for osteoporotic and unstable intertrochanteric fractures in the elderly patients.However,as the complemented therapeutic method of proximal femoral nail antirotation(PFNA),bipolar hemiarthroplasty has severe secondary trauma and its indications must be strictly mastered.

Objective To study and evaluate the ability of allogeneic bone marrow stromal cells(BMSCs) to survive and regenerate bone in muscles without using immunosuppressive agents. Methods A complete mismatch between donor BMSCs and recipient rabbit was confirmed by one way mixed lymphocyte reaction assaysprior to implantation. And then bone marrow aspirates were obtained from donor rabbits.BMSCs were isolated from the bone marrow, cultured in conditional medium to be ubdyced to become osteogenic, and then to examine these characteristics. After that the donor BMSCs were transplanted into the recipient rabbits. Immunological tests such as lymphocyte transformation rate and cell mediated cytotoxity, histological observation, seeding cells survival and bone formation were performed following transplantation. Results Allogeneic BMSCs transplantation did not actually elicit an adverse immune response, and bone regenerated at the transplantation area, and then the transplanted BMSCs marked with BRDU preoperatively were founded to be living 8 weeks later after transplantation using immunohistochemistric technique. Conclusion Allogeneic BMSCs would not elicit an adverse immune response in vivo without the immunosuppressive therapy, which could survive and form new bone tissue with the help of BMP-2 in the muscles.

AIM:To investigate the effect of adenovirus-medicated decorin gene transfer into rat mesangial cells(RMCs)on the expression of decorin,TGF-?1 and the extracellular matrix(ECM)components.METHODS:Rat mesangial cells were transfected with recombinant adenovirus vector of decorin,the levels of mRNA for decorin,TGF-?1,collagen type IV and fibronectin were estimated by semi-quantitative RT-PCR.RESULTS:The transfection of AD-DCN significantly increased decorin mRNA expression compared with negative control(P

BACKGROUND:Stem cell transplantation and tissue engineering in repairing bone defects is a hotspots of recent study.OBJECTIVE:To observe the therapeutic effect of engineering repair on bone defect by auto-transplantation of bone marrow stromal cells(BMSCs)DESIGN: Left-right comparative studySETTING:Experimental center of the First Affiliated Hospital of Harbin Medical UniversityMATERIALS:Twelve New Zealand rabbits with birth age of 10 days to 2months were selected ,male or female with body mass of 2 to 2.5 kg.METHODS :The experiment was conducted in the Experimental Center of First Clinical Medical College, Harbin Medical University from June 2002to June 2003. Self-BMSCs were separated for subculture. 1.5 cm bone was intercepted at middle of radius in 12 rabbits so as to simulate complete bone defect. Then, the left radius defect was filled with collagen sponge carrying BMSCs ( experimental side),which was replaced by simple collagen sponge in the right side(control side). Twelve weeks later, rabbits were put to death and the outcomes of both sides were compared.X-ray assessment was accorded to the standardized stage of bone defect repair (bone repair was graded into 0 to 5 grades,grade 5 implies that bone defect has been completely replaced by new bone,grade 0 implies that no new bone repair).MAIN OUTCOME MEASURES:The general observations of rabbit radius defects,X-ray scanning, histological and electro-microscopic observations.At week 12, callus became strong and protruded to bone defects in experimental side,well connecting with broken ends. While broken ends in control group were only connected by fibrous tissue and no continuous callus was found continuously crossing through the bone defect of experimental side, marrow cavity was smooth, but molding was incomplete. While in control side, no continuous callus could be observed passing through the broteoblasts and new stroms could be observed in bone defect of experimental side, but only a few of osteocytes appeared in the broken ends of control vations: The osteoblast observed in the experimental side seems normal and was rich in enlarged endoplasmic reticula energetic in ,protein synthesis and abundant in organelle.CONCLUSION :As osteogenetic cells, BMSCs possess better osteogenesis property. They can be used as seed cellsin bone defect repair by using bone-engineering techniques.

BACKGROUND: Limb allograft is a sort of composite tissues allotrans plantation(CTA), some researches showed that the apoptosis of target cell is one of the main mechanism of the dysfunction of allograft.OBJECTIVE: To investigate the characteristic of cell apoptosis in acute rejection of limb allograft in rats based on limb allograft model.DESIGN: A randomized controlled trial using the experimental animals as the objects.SETTING: Experimental animal center Laboratory of a hospital of a medical university MATERIALS: The experiment was done in the Experimental Animal Central Laboratory of the First Affiliated Hospital of Harbin Medical University from November 2003 to May 2004. Totally 56 healthy and male SD rats and 28 Wister rats were involved with body mass of 200 to 250 g. The rats were provided by the Experimental Animal Center of the First Affiliated Hospital of Harbin Medical University. They were randomly divided into two groups:transplantation group with 28 Wistar rats and 28 SD rats and control group with 28 SD rats.INTERVENTIONS: The transplantation group of SD rats underwent limb allotransplantation from allogenetic Wistar. The control group of SD rats underwent limb replantation. The expression of acute rejected in limb allografts was observed. The limb grafts were harvested atday 1, 3, 5 or 7 after transplantation. Histopathological rejection grade of each tissue rejection was performed with hematoxylin-eosin staining. Apoptotic cells were detected by TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling) and apoptotic index(AI) was calculated.MAIN OUTCOME MEASURES: Primary results: ① istopathological grade of acute rejection in limb allografts ② The relationship between apoptosis and acute rejection in limb allograft in rats; Secondary results:General condition of rats in each group.RESULTS: The limb grafts showed edema and erythema and the skin became red at day(3.43 ±0.79) after transplantation. The average survival time was(7.42 ± 1.72) days. The acute rejection in skin was the strongest. On the day 3, 5 and 7 after operation, the histopathological rejection grades of skins in the transplantation group were(1.14±0.38) ,(2.28 ±0.48) and(2.86 ±0.38) grades respectively. They were significantly different from that of muscle and nerve( P ＜ 0.05 ) . The apoptotic cells in allografts were mainly infiltrating lymphocytes in subcutaneous tissues and then the muscle cells. All was positively correlated with acute rejection grade in limb allograft .CONCLUSION: Apoptosis was involved in acute rejection of limb allograft in rat. The apoptotic index can be used as a quantitative index to estimate the injury of grafts.

Pig copper zinc superoxide dismutase (CuZnSOD) is an important antioxidant enzyme. Some studies focused on the function of CuZnSOD gene, but the transcriptional regulation of the CuZnSOD gene is not yet fully elucidated. Therefore, the aims of the study were to determine the core promoter region and to explore its mechanism of transcriptional regulation. The 853 bp DNA sequence of 5'-flanking promoter was amplified by performing PCR. A series of CuZnSOD promoter fragments with gradually truncated 5'-end were produced by nested PCR and inserted into pGL3-Basic vector. The activities of the promoters were measured by the dual-luciferase assay system after transient transfection into the NIH/3T3 cells. The results demonstrated that there were 2 potential transcription start sites in the regions from initiation codon to -87 bp and -266 bp, respectively. The region from -383 bp to +67 bp in CuZnSOD gene promoter showed higher activity than other regions, and further deletion analysis demonstrated that the region from -75 bp to -32 bp contained an essential promoter sequence for pig CuZnSOD gene transcription. In addition, several potential transcription factor binding sites were predicted with bioinformatics method. These results suggest that these transcription factor binding sites may be involved in the transcriptional regulation of CuZnSOD gene.
Animals ; Cloning, Molecular ; Gene Expression Regulation ; Genetic Vectors ; Mice ; NIH 3T3 Cells ; Promoter Regions, Genetic ; Superoxide Dismutase ; genetics ; Swine ; Transfection

Objective The aim of this study was to investigate the relationship between phosphotyrosine interac-tion domain containing 1 ( PID1 ) gene and variation in intramuscular fat ( IMF ) content and the possibility to generate transgenic animals by testicular injection .Methods Expression vector pIRES2-acGFP-PID1 carrying pig PID1 gene was incubated with transfection reagents and injected into the testes of male New Zealand rabbits .We examined the F1 genera-tion by fluorescence detection , PCR, Western blotting and measuring the IMF content .The F1 generation gave birth to the F2 generation.Then we examined the F2 generation through detecting the positive rate and the IMF content .Results The exogenous PID1 gene and fluorescent protein gene were expressed at different levels both in the F 1 generation and the F2 generation, and the positive rates were 35.88%and 34.33%, respectively.The IMF content was significantly elevated (P<0.05) in the transgenic positive individuals compared with the negative ones and the control group , and the PID1 protein expression was similarly higher .Conclusions The results of this study demonstrate that PID 1 gene affects intramuscular fat content significantly .Moreover, the results of our analysis provide further evidence that transgenic animals can be gener -ated by testicular injection , and the exogenous gene can be inherited steadily .

Objective To evaluate correlation of radial head fracture with forearm interosseous membrane (IOM) injury.Methods Twenty-six patients with radial head fractures were studied prospectively between September 2007 and June 2010.There were 15 men and 11 women,with an average age of 37.6years (range,21-53).According to the Mason classification,there were 7 cases of type Ⅰ,9 cases of type Ⅱ,10 cases of type ⅢL All patients were subjected to forearm X-ray,CT scans and the MR within a week.Clinical and radiographic data of all the patients were collected.Spearman rank correlation statistical analysis was used to analyze the correlation between the radial head fracture and the IOM injury.Results The radial head fractures and IOM injury were directly related.The IOM injury was noted in all type of radial head fracture.The more severity radial head fracture had,the more IOM injury happened.In Mason Ⅰ-Ⅲ fractures,IOM injury was found in 2,4 and 7 cases respectively.The different degree of radial head fracture caused different effects on IOM injury.The severity of radial head fracture was correlated with damage degree of IOM.In Mason type Ⅰ and type Ⅱ fractures,the IOM injury were just partial disruption with distal part of the IOM and did not reach the biomechanically essential central band.In type Ⅲ fractures,central band disruption was found in 3 cases.Conclusion Mason Ⅰ-Ⅲ radial head fractures are associated with forearm IOM injury.There was a positive correlation between radial head fractures and IOM injury.If IOM lesions are suspected,magnetic resonance imaging should be performed,especially Mason Ⅲ fractures.