Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.

Objective To compare the effect of preservation or complete excision of infrapatellar fat pad (IPFP) on clinical outcomes after total knee arthroplasty (TKA) at one year follow-up.Methods We randomized 100 patients (100 knees) undergoing TKA into two groups from June 2014 to August 2015,16 male and 78 female,with the average of 62.37 years old (range from 48 to 75).In excision group,50 patients underwent TKA with complete IPFP excision and in preservation group,50 patients received TKA without IPFP excision.We compared the outcome at postoperative 1 year between the two groups.Wound complication rate and patellar tendon injury rate were also evaluated.Results Complete follow-up data were available on 94 patients (46in preservation group and 48 in excision group).There were no intraoperative patellar tendon injury and postoperative wound complication cases.The patellar tendon length of excision group and preservation group at 1 week was (40.35±6.05) mm and (40.56±6.17) mm,and at 1 year were (36.18±7.09) mm and (38.75±6.23) mm,there were no statistical differences between the two groups.The patellar tendon shortening at postoperative 1 year in excision group was (-4.18±3.52) mm,more than preservation group which was (-1.81±2.08) mm,and there was statistically significant difference between the two groups.One year postoperatively,the anterior knee pain score in preservation group 2.42±2.19 was lower than excision group excision group 0.93± 1.40,and anterior knee pain rate was 2.2％ and 18.8％ in each group,the difference were all statistically significant.The Knee Society (KS) scores,knee flexion,flexion contracture,patient satisfaction score,and patient satisfaction rate had no statistical differences between the two groups.Conclusion Complete resection of IPFP results in a significant patellar tendon shortening and a higher probability of occurrence of knee pain after 1 year of TKA.Retention of IPFP did not increase the risk of patellar tendon injury and should therefore be kept as much as possible for complete IPFP.

Objective To determine the effects of gender on distal femoral aspect ratio (DFAR),femoral component fit,and clinical outcomes at 2 years after total knee arthroplasty (TKA).Methods From December 2012 to December 2014,the clinical and radiographic characteristics of 107 consecutive patients (109 knees) were studied prospectively.All patients were divided into two groups according to gender:33 cases (33 knees) were male and 74 cases (76 knees) were female.These subjectives underwent unilateral primary TKAs for end-stage osteoarthritis by using Vanguard high-flex open-box posterior-stabilized fixed-bearing prosthesis.The anterior-posterior size increment of the Vanguard femoral components was 2 mm.The clinical outcomes (Knee Society Score,Western Ontario and McMasters University osteoarthritis index,time-up-to-go test,chair rise test,stair-climbing test,range of flexion,extensor lag,flexion contracture,anterior knee pain score and patient satisfaction) between two groups were compared at 2 years postoperatively.The femoral component fit and two kinds of DFARs were also compared intraoperatively.Results The total overhang value in zone 2 was-5.51±4.46 mm in male and-3.24±3.93 mm in female,respectively.That in zone 3 was-5.99±4.73 mm in male and-3.45±3.98 mm in female.The total underhang value in male was significantly higher than that in female (P＜0.05).The rate of significant underhang in zone 3 was significantly higher in male than that in female (60.6％,23.7％,P＜O.05).Two kinds of DFARs in male were significantly higher than those in female (1.56±0.12 vs.1.51±0.12,1.28±0.08 vs.1.24±0.11,P＜0.05).Compared with intra-operative range of flexion (ROF) in the condition of 90° hip flexion after prosthesis implantation,the loss of ROF against gravity and the loss of passive ROF at 2 years postoperatively were statistically significant higher than those in female (-8.73°±7.71° vs.-4.82°±6.67°,-11.45°±8.78° vs.-7.34°±8.71°,P＜0.05).In the male group,the natural ROF after capsule closed (132.85°±6.01°) was significantly larger than that of the female group (128.78°±6.34°),but there was no significant difference in passive flexion.The change of non-weight-bearing passive ROF (1.67°± 14.76°),the Knee Society stairclimbing score (45.15±7.12) and the proportion of being able to squat and rise (97.0％) in male group were greater than those in female group,postoperatively.Conclusion Although DFAR is different within gender;it has little effects on early outcomes after unisex posterior-stabilized TKA.The loss of ROF in male is more prominent than that in female.Increased size offerings of femoral components improve fit in female distal femur.However,distal femur of male still exist obvious underhang.

OBJECTIVETo evaluate the effect of co-culture system of bone marrow mesenchymal stem cells (BMSC) and vascular endothelial cells (EC) on osteogenesis.

METHODSBMSC were isolated by whole bone marrow centrifugal adherent method. Then BMSC were induced into EC with induced medium. Co-culture system in different proportions of BMSC and EC (10:0, 10:1, 8:2, 7:3, 5:5, 3:7, 2:8, 1:10, 0:10) were further evaluated. The cell growth level of BMSC was examined. The CD44 expression of BMSC and von willebrand factor (vWF) expression of vascular EC were examined by immunofluorescence. Furthermore, calcium nodules exhibited by alizarin red staining, alkaline phosphatase activity, and the expression of osteogenic genes by reverse transcription-quantitative PCR (RT-qPCR) were observed to validate the osteogenesis of co-culture system.

RESULTSThe growth curve of P3 passage of BMSC demonstrated the doubling time of BMSC was 39.9 h. The positive specific markers of BMSC and EC showed efficient induction. Although the calcium nodules ratio of the co-culture [group 7:3 (19.0 ± 3.0) and group 5:5 (20.8 ± 2.9)] was not significantly different (P > 0.05), but higher than that of other co-culture groups with a significant difference (P < 0.01). Alkaline phosphatase activity was increased with prolonged induction of osteogenic medium. While alkaline phosphatase activity of group 10:0 (16.84 ± 0.82), group 10:1 (15.86 ± 3.10), group 8:2 (16.37 ± 1.33), group 7:3 (17.99 ± 1.98), and group 5:5 (17.49 ± 0.87) did not show significant difference after osteogenic induction for 7 days (P > 0.05), but significantly higher than that of other co-culture groups (P < 0.05). The co-culture ratio of 7:3 (33.74 ± 0.99) was slightly higher than that of 5:5 (31.09 ± 0.87), but significantly higher than that of other groups (P < 0.01). Moreover, the osteocalcin (OCN) and runt-related transcription factor 2 (RUNX2) expression of group 7:3 was significantly higher than that of other groups.

CONCLUSIONSThe EC that derived from BMSC can promote the BMSC differentiate into osteoblasts. The co-culture system of BMSC and EC with the ratio of 7:3 increases the alkaline phosphatase activity and facilitates the expression of osteogenic genes.

Alkaline Phosphatase ; metabolism ; Bone Marrow Cells ; cytology ; physiology ; Cell Culture Techniques ; Cell Differentiation ; Cell Proliferation ; Coculture Techniques ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Endothelial Cells ; cytology ; physiology ; Humans ; Hyaluronan Receptors ; metabolism ; Mesenchymal Stromal Cells ; cytology ; physiology ; Osteoblasts ; cytology ; Osteocalcin ; metabolism ; Osteogenesis ; physiology ; Time Factors ; von Willebrand Factor ; metabolism