BACKGROUND:BACKGROUND:Present studies have shown that bone cement have less osteoinduction and slow degradation in the body,so the effect of alone application is not satisfactory. Therefore,people have modified them,hoping to research a new materials that can overcome all shortcomings above-mentioned. OBJECTIVE:To investigate the ability of decalcified bone matrix (DBM) and acrylic bone cement (ABC) compound in filling and repairing bone defect,and to determine the best component proportion of the composition. DESIGN,TIME AND SETTING:Randomized controlled animal experiments were performed at the Experimental Animal Center,Chongqing Medical University from May to September 2008. MATERIALS:ABC and DBM were prepared into compound material at various proportions (2:8,3:7,4:6,5:5,6:4). METHODS:The animal models of bilateral femur bone defects and fillers were established in the New Zealand White rabbits. The complex material was implanted on the bone defect; the ABC was used as blank control group. MAIN OUTCOME MEASURES:The complex and alone materials were examined by biomechanics and scan electron microscopes. Gross observation,histopathological and X-ray test were used at 4,8,12 weeks after operation respectively to observe the repaired and filled status of bone defect. RESULTS:DBM composite quality of the scope of 3:7 -6:4,the composite materials that existed in more cracks more than 100 ?m,when the DBM was less than 3:7,the material inside the aperture and the majority of material was similar to ABC,mass ratio greater than 6:4 when the DBM and the ABC could not effectively together solidification. When the mass ratio was increased,which matrix particles of demineralized bone and ABC,the compressive ultimate strength of composite materials was less than pure ABC (P

BACKGROUND:Diacerein is a new kind of interleukin-1 block agent.Researches regarding intervention effect of interleukin correlation factor on increase of bone absorption in postmenopausal osteoporosis are few.OBJECTIVE:To investigate the intervention effect of diacerein on bone mass loss in ovariectomized(OVX) rats.DESIGN,TIME AND SETTING:The complete randomized controlled experiment was performed in the Laboratory of Experimental Animal Center of Chongqing Medical University from August to November 2008.MATERIALS:Forty female,3-month-old,Sprague Dawley rats were randomly divided into sham operation,OVX,diacerein 10mg,100 mg/(kg?d) groups,with 10 animals in each group.Anbiding capsule(contains 48.1 mg diacerein in each 50 mg capsule) was produced by Kunming Jida Pharmaceutical Co.,Ltd,with batch number of 20070532.METHODS:All rats received ovariectomy exception the sham operation group.Rats of sham operation group were only received a little fatty tissue removal around the ovary,and sutured the skin.Diacerein was intragastric administrated at the second day after the ovariectomy in the diacerein 10mg,100 mg/(kg?d) groups,equivalent volume of normal saline was administrated in the sham operation,OVX groups.Then all rats were killed under anesthesia to collect the blood and skeleton samples after 10 weeks continue medication.MAIN OUTCOME MEASURES:Bone mineral density of the right femur and the third lumbar vertebra were determined by Dual-Energy X-ray bone densitometry.The levels of interleukin-1?,interleukin-6 in bone tissue and the level of serum osteocalcin were determined by radio-immunity assay.RESULTS:All rats were involved in the final analysis.The levels of bone mineral density in two diacerein groups were higher than that in the OVX group(P 0.05).CONCLUSION:The bone loss is obviously 10 weeks later after ovariectomy.Diacerein has intervention effect on bone loss induced by increase of bone absorption in OVX rats,which have no significant effects on bone formation mediated by osteoblast.

Objective To evaluate the curative effect and problems of X-ray fluoroscopy guided percutaneous vertebroplasty (PVP) in treating osteoporotic spinal compression fractures. Methods Twenty-four patients (15 females and 8 males) with 44 vertebral compression fractures underwent PVP. They were average 69 years of age (48-83 years). The fracture segment was within T 5-L 3 (20 thoracical vertebrae, 24 lumbar vertebrae). Under the guidance of C-arm fluoroscopy, bone marrow biopsy needle was inserted percutaneously via transpedicular way into the fractured vertebrae. Polymethylmethacrylate (PMMA) was then injected into the fractured vertebrae. Vasual analogue scale (VAS), mobility and analgesic usage were evaluated 2 days before and after PVP and in the follow-up period. Results PVP was successful in 21 cases (40 vertebrae ), but failed in 2 cases (4 vertebrae) due to weak position endurance. The volume of PMMA injected was 1.0-8.0 ml per vertebrae. The average follow-up period was 3.1 months (1-7 months). VAS was sharply decreased from pre-PVP 7.5?1.2 to 2.8?1.0 at day 2 after PVP (P

Objective To investigate the efficacy of the clinical pathway in geriatric orthope-dics clinical teaching. Methods From March 2010 to December 2011, 80 clinical undergraduates, who practiced in the Department of Orthopedics in the Second Affiliated Hospital of Chongqing Medi-cal University, were equally randomized divided into two groups. One group was taught by the con-ventional methods and the other group was taught by the clinical pathway teaching. After the teaching, the theoretical exam and operational skill test were performed among students in both groups. SPSS 17.0 software was employed and the scores before and after the teaching and scores between two groups was analyzed by paired t-test(inspection level α=0.05). Results There was no significant difference in average scores between two groups before teaching(theoretical exam: P=0.81, operating skill test:P=0.65) while significant increases were observed in scores of theoretical exam and operational skill test after teaching (theoretical exam and operating skill test: P<0.05) and clinical pathway teaching group had higher scores than conventional teaching group (theoretical exam and operating skill test:P=0.02 and P=0.01). Conclusions Better effects can be achieved by clinical pathway approach re-garding geriatric orthopedics teaching.

Objective To evaluate the feasibility, safety, and clinical outcome in patients with cervical spondylotic radiculopathy underwent cervical nerve root decompression using the anterior percutaneous endoscopic surgery.Methods Eleven subjects consisting of 6 men and 5 women treated from July 2012 to December 2013 were enrolled in the study.Mean age was 42.1 years (range, 27 to 63 years).All were diagnosed to be unilateral single-segment injury involving C3/4 in 1 case, C4/5 in 2 cases, C5/6 in 6 cases and C6/7 in 2 cases.Because of unsatisfactory results 6 week following the non-operative treatment, the patients were operated on using the anterior percutaneous endoscopic osteophyte removal and nerve root decompression.Operation time, postoperative complications, visual analogue scale (VAS) and modified Macnab scale were recorded.Results Operation time was (102.5 ± 21.3) min (range, 80-140 min).Nine patients were followed up for 12 months and no complications were noted.VAS improved significantly at postoperative 3 days and 1, 3, 6, as well as 12 months compared to the preoperative value (P ＜ 0.01).Modified Macnab scale presented great improvement at postoperative 3 and 12 months compared to the preoperative value (P ＜ 0.01).Conclusion The technique is reliable and effective in treatment of cervical spondylotic radiculopathy.

Objective To evaluate the safety,feasibility,and clinical outcome of anterior percutaneous endoscopic cervical discectomy (PECD).Methods The study involved 28 patients undergone PECD.Visual analogue scale (VAS) and MacNab scale were recorded before operation and at 3 days,1,3,6,12 and 18 months after operation.In addition,MRI examination was conducted at postoperative l month,3 months and 12 months.After data collection,single-factor T test with SAS software was performed.Results Follow-up (range,18-24 months,mean 19 months) was achieved in 25 patients.When compared to the preoperative score,VAS and MacNab scale presented improvement at postoperative 3 days (P ＞ 0.05) and great improvement at postoperative 1,3,6,12,18 and 24 months (P ＜ 0.01).VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3,6,12 and 18 months (P ＜0.05),but the differences were not statistically insignificant at postoperative 3,6,12,and 18 months (P ＞ 0.05).Moreover,VAS and MacNab scale showed significant improvement at postoperative 24 months as compared to those before operation (P ＜0.01) and those at postoperative day 3 (P ＜ 0.01).Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.

Background Conjunctivochalasis is an age-related inflammatory ocular surface disease manifesting redundant,loose conjunctiva folds.Studies showed that conjunctivochalasis often accompanies with inflammatory response,indicating that a variety of inflammatory cytokines are involved in pathogenesis of conjunctivochalasis.Objective This study attempted to investigate the expressions of pentraxin-3 (PTX-3) and tumor necrosis factor-α stimulated gene-6 (TSG-6) proteins in fibroblasts of conjunctivochalasis.Methods The protocol was approved by Ethic Committee of Putuo Hospital affiliated Shanghai University of Traditional Chinese Medicine.Thirteen eyes of 13 patients with conjunctivochalasis,16 eyes of 16 patients with age-related cataract and 16 eyes of 15 patients with pterygium were included in Putuo Hospital Affiliated to Shanghai University of Traditional Medicine from January,2011 to June,2012.The samples of conjunctival tissue were collected in the patients during surgery under the informed consent,and fibroblasts were cultured and passaged by explant culture method.Content of PTX-3 and TSG-6 proteins in cell supernatant was detected by ELISA.Results Translucent poor,dark black area was around the cell overflow.Cultured cells of third generation showed long shuttle type,uniform size,radiated out in all directions,and oval nuclei was sited in the cytoplasm,surrounded by varying the length of cross-linking of cell processes.The concentrations of PTX-3 protein in cell supernatant were (2 182.33 ± 738.68) pg/ml in the conjunctivochalasis group,which were higher than (738.32±335.00) pg/ml in the age-related cataract group and (981.37±416.04)pg/ml in the pterygium group,showing a significant difference among the three groups (F =6.474,P=0.032).The contents of TSG-6 proteins in cell supernatant were (59.10±6.52) pg/ml,(53.99± 11.16) pg/ml and (35.01±5.33)pg/ml in the conjunctivochalasis group,pterygium group and age-related cataract group,with a significant difference among the three groups (F =7.421,P =0.024),and contents of TSG-6 proteins in the agerelated cataract group was lowest,however,no significant difference was found in the TSG-6 contents between the conjunctivochalasis group and the pterygium group (P＞0.05).Conclusions Inflammatory reaction participates in the pathogenesis and development of conjunctivochalasis,up-regulation of PTX-3 and TSG-6 expression in fibroblasts might partakes in the pathogenesis of conjunctivochalasis.

Objective To explore the feasibility and short-term clinical efficacy of single segment thora-columbar tuberculosis treated with one-stage posterior approach lamina-sparing decompression.Methods A total of 11 patients with single segment thoracolumbar tuberculosis who underwent one-stage posterior ap-proach preservation of vertebral plate lesion removal,bone graft fusion,and internal fixation treatment in this hospital from September 2021 to June 2022 were selected.C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR)were monitored to evaluate tuberculosis bacteremia and activity control,visual analogue scale(VAS)score and Oswestry disability index(ODI)were followed up to evaluate the improvement of clin-ical function,and the American Spinal Injury Association(ASIA)injury scale was used to evaluate neurologi-cal function,and the correction of kyphosis was followed up.Results All 11 patients were fully followed up.The average surgical duration is(270.91±45.98)minutes,and the average surgical bleeding is(522.72± 194.11)mL.During the follow-up period,none of the 11 patients experienced tuberculosis recurrence,and all 11 patients achieved bone graft fusion.The fusion time was 6-9 months after surgery with an average of(7.36±1.12)months.Two patients with preoperative nerve damage recovered after surgery.During the fol-low-up period,11 patients did not experience any complications related to surgery.The average CRP,ESR,ODI score,and VAS score of postoperative patients decreased compared to preoperative levels,and further de-creased at 12 months after surgery;The patient's kyphosis caused by thoracolumbar tuberculosis was correc-ted,and no obvious angle loss was found at the last follow-up(P＞0.05).Conclusion One-stage posterior ap-proach lamina-sparing decompression is a safe and effective method for treating single segment thoracolumbar tuberculosis.

【Objective】 To investigate the feasibility of full-endoscopic posterolateral odontoidectomy through morphological analysis and cadaver specimen surgery. 【Methods】 We collected the DICOM data of 20 normal cervical CT patients （10 males and 10 females） from the PACS Image Library of our hospital. The Mimics software was used for cervical CT reconstruction and anatomical measurements were made to measure the maximum sagittal diameter， coronal diameter and height of the odontoid process. The C1 lateral mass could provide the maximum working height and width of endoscopic operation with a diameter of 7 mm， as well as the angle between the anchor point of C1 lateral mass and the notch on both sides of the odontoid process. The feasibility of endoscopic surgery was analyzed based on the measured data. The fresh frozen corpse was used for the operation in prone position under the guidance of C-arm. Kirschner wire was anchored at the midpoint of the lower surface of the C1 lateral mass. Part of the C1 lateral mass was removed by the grinding drill and endoscopic tools， and then the odontoid process and adjacent ligaments were removed. 【Results】 The maximum sagittal diameter， coronal diameter and height of the odontoid process were （11.73±0.74）mm， （10.97±0.71）mm and （14.51±0.91）mm， respectively. The working height and width of the C1 lateral mass were （13.53±0.57）mm and （10.00±1.27）mm， respectively. The angle between the anchor point and the double-edge notch of the odontoid process was （28.3±3.1）°， with no statistical difference between the male and female patients （P>0.05）. All the measurements met the requirements of 7 mm endoscopic implantation and surgical operation， and the space for swing could be provided for complete or partial removal of the odontoid process to meet the requirements of ventral spinal decompression. In cadaver surgery， a fully endoscopic posterolateral approach enabled complete removal of the odontoid process by grinding part of the C1 lateral mass. Postoperative cervical CT confirmed that the odontoid process had been completely resected， and there were no signs of dural sac or vertebral artery injury. 【Conclusion】 The odontoid process can be completely resected through a posterolateral endoscopic approach via the lateral mass approach of C1， providing a new surgical method for clinical odontoidectomy to decompress the spinal cord in craniovertebral junction.