Objective To explore the feasibility of implantation of a composite of tendon, grains of cancellous bone and bone morphogenic protein (BMP) wrapped in antologous periosteum to substitute lunate bone lunatum in the treatment of Kienbock disease. Methods 42 Japanese big ear rabbits were randomly divided into two groups. In group A periostum wrapping a composite of tendon, grains of cancellous bone and bone morphogenic protein (BMP) was implanted. In group B only tendon wrapped by periostum was used. Both of them were respectively implanted into rabbits' suprapatellar bursa, the physiological environment of which seemed to be similar to that of the carpal joint after extirpating the lunate bone in human being. The composites were removed in 1,2,4,8,12,16 and 24 weeks after the operation. X ray imaging, gross, histological and EM changes at varies intervals were observed. And CT value of the composite was statistically analyzed (Stata 4 0). Results Periosteum wrapped BMP/grains of cancellous bone could induce bone and cartilage formation. In group A, newly formed bone could be found at 2 weeks. Rounded bony body with cortex and bone marrow was found to be formed by the implanted composite at 8 weeks. No degenerative changes were observed up to 24 weeks. In group B, the composite didn't form bony body in 24 weeks. In different periods, statistically significant difference in CT value between group A and B was found ( P

This paper analyzed the exogenous and endogenous resource elements in a view of their supportive effect on the construction and development of clinical disciplines,proposed the relationship between two resources elements and development of clinical disciplines,,and provided references to the construction of clinical disciplines by elaborating the specific content and focus of these elements.

Objective To compare the mechanical properties of animal knee lateral collateral ligament tensile between the normal and atherosclerotic animal model of osteoarthritis,and to identify if there are effects of osteoarthritis on the animal knee lateral collateral ligament tensile mechanical properties.Methods The experimental rats were provided by the Changchun High Medical Center for animal experiments.The 6-month-old male rats were the copying model of osteoarthritis.The tensile experiments at electron Shimadzu universal testing machine was carried out on ten of normal and pathological specimens.The speed of the tensile experiments was 5mm/min.Experimental data were processed by polynomial least square method.Results The tensile maximum load of normal control group was(26.12?4.00)N,maximum stress was(40.93?6.71)MPa,maximum displacement was(3.08?0.77)mm,and maximum strain was(9.51?2.36)%.The tensile maximum load of model group was(12.05?2.07)N,maximum stress was(21.28?4.17)MPa,maximum displacement was(2.32?0.56)mm,and maximum strain was(7.04?1.79)%.Conclusion The tensile performance of normal control group was significantly greater than that of the model group(P

Objective To study the correlation between single nucleotide polymorphism (SNP) of downstream mononucleotide in signal transduction of Toll-like receptors and predisposing genes of rheumatoid arthritis (RA).Methods One hundred and sixty-two RA patients were selected from northern part of Han people in China,and 188 healthy subjects were enrolled as normal controls.Rs7744 of Myd88,rs5030445 of TRAF6,rs11265618 and rs4845626 of IL-6R were analyzed.The data of genotypic frequency and allele genotypic frequency were statistical analyzed by x2 test between the two groups.Results The difference of allele frequency of TRAF6 rs5030445 between the two groups were remarkable (x2=5.716,P＜0.05),and so did the IL-6R rs11265618 (x2=5.704,P＜0.05).But the difference of genotypic frequency was not statistically significant for locus of Myd88 rs7744,TRAF6 rs5030445 and IL-6R rs11265618 (P＞0.05).And the differenceof allele frequency and genotypic frequency between the two groups had no statistical significance in locus of Myd88 rs7744 and IL-6R rs4845626 (P＞0.05).Conclusion There is significant correlation between single nucleotide polymorphism and predisposing genes of RA.The G allele of TRAF6 rs5030445 gene locus is a possible predisposing gene for RA.The T allele of IL-6R rs11265618 is a possible predisposing gene of RA.

Objective To investigate the correlation of spinal canal stricture and intramedullary increased signal intensity (ISI) in patients with ossification of the posterior longitudinal ligament (OPLL). Methods 92 patients with OPLL were divided into 3 groups, those with the sagittal diameter remained ≥66.7% were as group A, 33.3%~66.7% as group B, and <33.3% as group C. The incidence of intramedullary ISI was recorded, and their neurological condition was assessed with the Japanese Orthopedics Association Assessment (JOA). Results ISI were found in 6 cases in the group A (20.7%), 17 cases in the group B (47.2%) and 19 cases in the group C (70.4%) (P<0.05). The score of JOA was (7.1±2.1) in the group A, (6.0±1.8) in the group B and (5.6±2.0) in the group C (P<0.05). Conclusion The incidence of intramedullary ISI increased with the severity of spinal canal stricture, and with more severe nerve damage in OPLL patients.

BACKGROUND:Transplantation of alogeneic intervertebral disc can be facilitated by the cryopreservation of the intervertebral disc. But the traditional cryopreservation methods always lead to the appearing of ice crystals inside and outside the cels which can cause celular injury. The vitrification method that can avoid the formation of ice crystals have been widely applied in the cryopreservation field. However, only a few reports have assessed the vitrified cryopreservation of the intervertebral disc, and the toxicity of cryoprotectants to the nucleus pulposus cels have not been fuly explored.
OBJECTIVE:To determine the order of toxicity of five commonly used cryoprotectants that are used alone or in combination to rabbit nucleus pulposus cels, and to select the optimal cryoprotectant for the vitrification of the intervertebral disc.
METHODS: We chose five most commonly used cryoprotectants including dimethyl sulphoxide, formamide, ethylene glycol, propylene glycol and glycerol. Then, 5 single commonly used cryoprotectants, 10 mixed agents containing any 2 commonly used cryoprotectants, and 10 mixed agents containing any 3 commonly used cryoprotectants were formulated. Cel viability of nucleus pulposus cels was determined using cel counting kit-8 and fluorescein diacetate/propidium iodide method. Al data obtained were analyzed statisticaly to choose the appropriate combining scheme with less toxicity.
RESULTS AND CONCLUSION: The order of the toxicity of these five commonly used cryoprotectants from low to high was ethylene glycol, glycerol, formamide, dimethyl sulphoxide, and propylene glycol. The toxicity of the combined agents containing two or three commonly used cryoprotectants was lower than that of any commonly used cryoprotectants that were used to formulate them. The toxicity of the mixed agents that contained ethylene glycol or glycerol was lower than that of any other mixed agents. So we can choose the mixed cryoprotectants that contain ethylene glycol and (or) glycerol for the vitrification of the intervertebral disc.

Objective:To compare the short-term efficacy between proximal femoral bionic nails (PFBN) and 3G Gamma nails in the fixation intertrochanteric femoral fractures in the elderly.Methods:A retrospective study was conducted to analyze the data of 78 elderly patients with intertrochanteric femoral fracture who had been admitted to Department of Trauma Surgery, The Hospital Affiliated to Qingdao University from October 2021 to December 2022. There were 35 males and 43 females with an age of (76.0±7.9) years. By Evans classification: 6 cases of type Ⅰ, 21 cases of type Ⅱ, 24 cases of type Ⅲ, 23 cases of type Ⅳ, and 4 cases of type Ⅴ. The patients were divided into 2 groups according to their internal fixation methods: a PFBN group of 35 patients fixed by PFBN and a Gamma group of 43 cases fixed with 3D Gamma nails. The time from injury to operation, hospital stay, operation time, intraoperative blood loss, weight-bearing time, fracture healing time, and Harris hip score, visual analogue scale (VAS) and incidence of complications at 6 months after operation were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for (14.0±4.0) months. There were no significant differences between the PFBN and Gamma groups in operation time [(58.9±8.2) min versus (58.1±6.8) min], intraoperative blood loss [(138.0±24.9) mL versus(126.8±25.7) mL], hospital stay [(10.9±2.9) d versus (10.3±4.0) d],fracture healing time [(5.0±1.3) months versus (5.1±1.3) months], or good and excellent rate by the Harris hip score [82.9% (29/35) versus 76.7% (33/43)], VAS score [0(0, 1) points versus 1(0, 1) points], or incidence of complications at 6 months after operation [2.9% (1/35) versus 4.7% (2/43)] (all P>0.05). However, the complete weight-bearing time for the PFBN group was (5.3±1.2) weeks, significantly earlier than that for the Gamma group [(6.9±1.4) weeks] ( P<0.05). Conclusion:In the fixation of intertrochanteric femoral fractures in the elderly patients, both PFBN and 3D Gamma nails can achieve satisfactory short-term efficacy, but PFBN is more beneficial to the functional recovery of the hip joint because it leads to earlier complete weight-bearing time than 3D Gamma nails.

Objective To observe the effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery??Methods From September 2014 to February 2016, 112 patients with multi?segment cervical spondylotic myelopathy underwent surgical treatment in Handan Central Hospital of Hebei Province??According to the lamina fixation methods,they were divided into groups A,B and C??There were 35 cases in group A,using suture suspension method to fix lamina; 34 cases in group B,using anchor suspension to fix lamina;and 43 cases in group C,using mini?titanium plate to fix lamina The operation time,intraoperative blood loss,laminae open angle,spinal drift distance,postoperative neurological recovery,cervical curvature index ( CCI ) and occurrence of axonal symptoms were compared in each group??Results All patients underwent surgery successfully??There were no significant differences in operation time,intraoperative blood loss,laminae open angle and spinal drift distance between the 3 groups (all P＞0??05)??The JOA score of group A was (7??9± 2??2) preoperatively,(9??3± 2??8) at 3 months after surgery,and (13??9±3??4) at the final follow?up??In Group B was (7??7±2??0) preoperatively,(9??1±2??7) at 3 months after surgery,and (13??6±3??7) at the final follow?up??In Group C was (7??8±2??1),( 9??0±2??6) and (13??8 ± 3??5 ), respectively, there were significant differences before and after operation ( Fintra?grouP＝7??271, Pintra?grouP ＜ 0??001; Finter?grouP ＝ 11??372, Pinter?grouP ＜ 0??001; Finteraction ＝ 9??831, Pinteraction＜0??001)??The CCI of group A was ( 22??7± 5??6)% preoperatively,(20??5± 4??4)% at 3 months after surgery,and (16??6± 3??0)% at the final follow?up??The CCI of group B was ( 21??4 ± 5??2)%,( 19??7 ±4??1)% and (17??8±2??9)% respectively??The CCI of group C was ( 21??1 ± 5??0)%,( 20??8 ± 4??6)% and (19??8 ± 4??0)% respectively??There were significant differences between group A and group B in the last follow?up and the three months before and after operation??( all P＜0??05),there was no significant difference between groups C at different time points ( P＞0??05)??According to the visual analogue scoring system,the distribution of axial symptoms in group C was significantly better than that in group A and group B ( Z＝6??678;P＝0??035)??Conclusion Posterior single?door mini?titanium plate fixation can not only improve nerve function,but also prevent cervical curvature loss and reduce the occurrence of axonal symptoms??

BACKGROUND:The key to preventing the recurrence of intrauterine adhesions is to reconstruct the endometrium with normal function.The latest breakthrough in the treatment of recurrent intrauterine adhesions in and outside China is the use of degradable materials to prepare hydrogels to prevent the recurrence of adhesions. OBJECTIVE:To review the research advance in hydrogel-promoted endometrial repair in intrauterine adhesions. METHODS:PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),and WanFang databases were searched systematically,with the keywords"intrauterine adhesions,endometrial injury,endometrium regeneration,hydrogel"in Chinese and English.Relevant articles published in each database from January 1990 to March 2023 were collected. RESULTS AND CONCLUSION:In recent years,research on hydrogel-promoted endometrial repair in uterine adhesions in and outside China has made some progress and plays an important role in the prevention and treatment of intrauterine adhesions and the promotion of endometrial repair:(1)As an important carrier in tissue engineering,hydrogel itself has excellent biocompatibility,biodegradability and three-dimensional network structure,which can be better applied in the treatment of intrauterine adhesions.(2)The hydrogel-based carrier system can promote the proliferation and differentiation of endometrial epithelial cells by transporting drugs/biologics/stem cells,and restore normal uterine morphology to prevent adhesion recurrence.(3)Hyaluronic acid hydrogels can not only meet good biocompatibility,but also promote the proliferation and differentiation of endometrial epithelial cells,and will be hydrolyzed by corresponding enzymes in utero,without affecting the normal metabolism of the body.They are currently commonly used uterine anti-adhesion agents in the clinic and are also the most commonly used hydrogel carriers in tissue engineering research.(4)Poloxamer hydrogel with excellent temperature-sensitive properties can rapidly gelate into the body,quickly form a physical barrier,and can play a slow-release effect on carrying substances and provide a platform for cell growth/adhesion.(5)There are broad prospects for the preparation of therapeutic hydrogels using materials with different characteristics,such as temperature-sensitive hydrogels,pH-responsive hydrogels and photosensitive hydrogels,but there are still many problems to be solved,such as the safety of the hydrogel system,whether the degradation products cause immune reactions,and whether they have an impact on the normal body's menstrual period.A large number of animal experiments and clinical trials are needed to verify its safety and efficacy,and continuously improve the treatment strategy.

Objective:To compare the therapeutic efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old.Methods:A retrospective study was conducted to analyze the data of 39 patients aged 65 to 75 years old who had been treated for femoral neck fractures at Department of Trauma Surgery, Hospital Affiliated to Qingdao University from January 2015 to September 2022. The patients were divided into 2 groups according to their internal fixation methods. In the FNS group of 18 cases subjected to FNS fixation, there were 8 male and 10 females with an age of (71.1±2.8) years. In the CCS group of 21 cases subjected to CCS fixation, there were 7 males and 14 females with an age of (70.1±2.9) years. The 2 groups were compared in terms of intraoperative fluoroscopy frequency, surgical time, intraoperative bleeding, hospitalization costs, fracture healing time, internal fixation failure, and Harris hip score, changes in neck shaft angle, and femoral neck shortening at 1 year after surgery.Results:The differences were not statistically significant in the preoperative general data or follow-up time between the 2 groups, indicating comparability ( P>0.05). In the FNS group, the intraoperative fluoroscopy frequency [(15.1±2.3) times] was significantly lower than that in the CCS group [(19.5±3.5) times], the surgical time [(49.2±5.2) minutes] was significantly shorter than that in CCS group [(62.4±11.2) minutes], and the intraoperative bleeding [(74.2±15.6) mL] and hospitalization costs [(39,928.7±1,438.3) yuan] were significantly higher than those in the CCS group [(53.1±17.3) mL and (23,527.9±2,126.3) yuan] (all P<0.05). The difference in fracture healing time was not statistically significant between the 2 groups ( P>0.05). In the FNS group, the decreased neck shaft angle (2.65°±1.66°) and femoral neck shortening (3.9±1.3 mm) were significantly smaller than those in the CCS group [4.18°±2.13° and (6.3±2.5) mm] at 1 year after surgery, and the Harris hip score [(82.2±7.2) points] was significantly higher than that in the CCS group [(76.4±5.9) points] (all P<0.05). Internal fixation failure occurred in 1 case in the FNS group and in 4 cases in the CCS group, respectively, showing no statistically significant difference ( P>0.05). Conclusions:Compared with CCS fixation, FNS fixation may lead to better therapeutic efficacy in patients with femoral neck fracture aged 65 to 75 years old. However, the risk of internal fixation failure should also be taken into consideration.