Objective To investigate the efficacy of the bioactive artificial vertebrae of a nano- hydroapatite crystals and polyamide 66 composite(n-HA/PA66)to restore the height and architecture of thoracolumbar burst fracture.Methods From December 2003 to February 2006,38 patients(29 males and 9 females)with a mean age of 35.6 years(17-63 years)were treated surgically through anterior ap- proach for decompression and implanted with the bioactive artificial vertebrae of n-HA/PA66 composite to reconstruct the structure of the thoracolumbar burst fractured vertebra.Results All the patients were successfuly followed-up for an average of 8 months,ranging from 6 to 21 months.The bioaetive artificial vertebrac of n-HA/PA66 composite were fused with the receptor bone 3-4 months after operation.The neu- rological function of the patients was restored partially or completely.The thoracolumbar spine was stable during physical examination and the height of thoraeolumbar burst fractured vertebrae that had been restored did not changa during the follow-up.Conclusions Our results show the bioaetive artificial vertebrae of n-HA/PA66 can restore the height and structure of thoracolumbar burst fractured vertebrae and reconstruct the structure of the tboraeolumbar vertebrae effectively,indicating that the bioaetive artificial vertebrae of n- HA/PA66 can be used extensively in clinical spinal surgery.

Objective To explore a better method for treatment atrophic rhinitis.Methods 56 patients with atrophic rhinitis(96 lateral)were treated by nasal submucou pediculated bone-suberiosteal muscle flap extracted from anterior wall of sinus maxillaries.Results All patients were followed 2 to 10 years,total effective rate was 100 %, with 49 cases(87.5 %)showing prominent effect.Conclusion The grafted flap cannot be assimilated,felled off and necrosis,because the flap has rich blood supply.This methods has obvious short-term effective and stable long-term effective.No complications were found.

OBJECTIVEBone-marrow derived mesenchymal stem cells (BMSC) have the potential to differentiate into endothelial cells. The aim of the study was to investigate the induction process of BMSC by B16 melanoma cells in vitro and to analyze the role of VEGF-a in the process.

METHODSA co-culture system containing BMSC and B16 melanoma cells based on transwell indirect model was established, and the induction process of BMSC by B16 melanoma cells was studied in vitro.

RESULTSBMSC were isolated from the bone marrow of C57 mice. BMSC expressed CD105, CD90, CD73, CD44 and CD166, and acquired expressin of endothelial phenotype markers including VEGFR-1, VEGFR-2 and Factor VIII after co-culture with B16 melanoma cells for 48 hours. The expression level of VEGFR-2 would be double and Factor VIII threefold more by extending the co-culture time to 72 hours. In the co-culture system, B16 melanoma cells also up-regulated the expression of VEGF-a.

CONCLUSIONSVEGF-a plays a significant role in the differentiation of BMSC into cells of endothelial phenotype, therefore, is important to tumor angiogenesis.

Animals ; Bone Marrow Cells ; cytology ; metabolism ; Cell Differentiation ; Cell Line, Tumor ; Coculture Techniques ; Endothelial Cells ; cytology ; metabolism ; Factor VIII ; metabolism ; Male ; Melanoma, Experimental ; metabolism ; pathology ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Mice, Inbred C57BL ; Pilot Projects ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

BACKGROUNDThe mechanisms underlying postoperative pain remain unclear. Neurotransmitters of excitatory and inhibitory amino acids play an important role in the transmission and modulation of pain in the spinal dorsal horn. This study aimed to investigate the changes of release of excitatory and inhibitory amino acids in the spinal cord during postoperative pain and to provide a novel theoretical basis for postoperative pain management.

METHODSLoop microdialysis catheters were implanted subarachnoidally via the atlanto-occipital membrane in 16 healthy Sprague-Dawley rats. All rats without neural deficits were divided into two groups, Group A and Group B, following 5 days of recovery. The tubes for microdialysis were connected and 25 microl microdialysate sample for baseline value was collected after one-hour washout in each rat. A plantar incision in the right hind paws of rats in Group A were performed under 1.2% isoflurane. All rats in Group B were only anesthetized by 1.2% isoflurane for the same duration. The microdialysate samples were collected at 3 hours, 1 day, 2 days and 3 days after the incision (or isoflurane anesthesia in Group B) in both groups. The cumulative pain scores were also assessed at the above time-points. The amino acids in the microdialysate samples were tested using high performance liquid chromatography.

RESULTSWithin Group A, the release of aspartate and glutamate at 3 hours after the incision was significantly higher than the baseline values and the release of glycine at 1 day after the incision significantly increased compared with the baseline values (P < 0.01). Within Group B, the release of neurotransmitters at each time point had no significant difference compared with the baseline values (P > 0.05). The release of aspartate and glutamate at 3 hours after the incision in Group A was significantly higher than that in Group B (P < 0.01). The release of glycine at 1 day after the incision in Group A significantly increased compared with Group B (P < 0.01). The cumulative pain scores at 3 hours, 1 day and 2 days after the incision in Group A were significantly higher than those in Group B (P < 0.01).

CONCLUSIONSThe release of the excitatory amino acids occurs in the early phase of postoperative pain and might not be involved in the maintenance of pain in a rat model of incision pain. The release of inhibitory glycine lagged behind the excitatory amino acids. The implication of inhibitory glycine release remained to be established further.

Animals ; Aspartic Acid ; secretion ; Excitatory Amino Acids ; cerebrospinal fluid ; secretion ; Glutamic Acid ; secretion ; Glycine ; secretion ; Male ; Microdialysis ; Neurotransmitter Agents ; secretion ; Pain, Postoperative ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; secretion

OBJECTIVETo investigate the possibility to enhance the proliferation of adipose-derived stem cells (ASCs) in a delayed fat flap in rabbits.

METHODSA delayed fat flap was formed in one side of inguinal region of a rabbit. 21 days after operation, the fat tissues at the delayed flaps and at the unoperated side were harvested and digested with 0.25% collagenase and sieved. The cell suspensions were centrifuged. The cells were obtained from tissue precipitate after centrifugation. The expression rates of the surface marker (CD29, CD44, CD14 and CD45) were measured by FCM and compared between the experimental and control groups.

RESULTSExpression rates of CD29 and CD44 were higher in the delayed fat flap (74.06% and 90.74%) than in the contralateral fat tissue (62.88% and 77.54%, P < 0.05), while those of CD14 and CD45 were lower in the delayed fat flap (57.66% and 4.84%) than in the contralateral fat tissue (72.10% and 75.82%, P < 0.05 and P < 0.01).

CONCLUSIONSTissue hypoxic ischemia such as fat tissue in a delayed fat flap can promote proliferation of ASCs. It indicates that tissue in the delayed flap may be transplanted with better survival rate. The ischemia pretreatment of fat tissue may become a new method for fat transplantation.

Adipose Tissue ; cytology ; transplantation ; Animals ; Cell Proliferation ; Cells, Cultured ; Graft Survival ; Postoperative Period ; Rabbits ; Stem Cells ; cytology ; Surgical Flaps

OBJECTIVETo observe the effects of the fat flap tissues after delay operation on free fat-graft survival rate and duration.

METHODSThe delay operation of fat flaps was performed in the inguinal region of a rabbit. Expression of VEGF was assayed using Elisa method after 12 hours of flap delay. The fat flaps were harvested and cut into pieces after 21 days. A subdermal pocket was created in each side of the dorsal midline of a rabbit, the fat pieces were grafted randomly into a pocket and the normal fat pieces into the other pocket as control. After 1, 3, 6, 9 and 12 months of implantation, the grafted fats were harvested, gross observation, weight measurement and histology were carried out. Number of the vessels stained with anti-CD34 antibody was counted out.

RESULTSVEGF concentrations in flaps were significantly higher (P < 0.05). The density of vessels in experimental groups increased significantly compared with that in control groups at 1 and 3 months, respectively (P < 0.01), and no significant differences in the survival rate of fat tissues between experimental and control groups were observed at 1 and 3 months (P > 0.05). The fat cells from the flaps survived after 12 months of fat plantation, while those in control groups disappeared after 6 months.

CONCLUSIONSThe survival rate and duration of grafted fat could be increased implanting the fat tissues from delayed fat flap, which may provide researchers with a new method for fat graft.

Adipocytes ; transplantation ; Adipose Tissue ; transplantation ; Animals ; Graft Survival ; Male ; Rabbits ; Surgical Flaps

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective To explore the subjective well-being (SWB) status among community elderly in Xi' an city,and find out the major influence factors.Methods A total of 400 community elderly in Xi' an city were investigated with MUNSH,GDS, GSES and General Status Questionnaire.Results The valid questionnaires were 390,and the response rate was 97.5％.SWB of community elderly in Xi' an was relatively higher as 276 of the elderly scored more than 36,which was 70.8％ of the total participants.Only 18 cases scored less than 12,which was 4.6％ of the total.By the analysis of variance ( ANOVA ),the following variables were significantly associated with SWB:personality,depressive emotion and self-efficacy( P ＜0.05),and the value of F(t) were 1.436,13.888 and 2.245; No significant difference was noted among age,.sex,education level and income (P＞ 0.05 ),and the value of F (t) were 0.746,0.972,0.757 and 0.615.Conclusions SWB of community elderly in Xi' an is relatively higher.Personality,depressive emotion and seff-efficacy are the major factors which affected SWB of the elderly in community.

OBJECTIVESTo investigate the mechanical properties of bilateral atlantoaxial trans-articular screws and atlas laminar hooks instrumentation with finite element method.

METHODSThere was a volunteer with age of 28 years old, body height 172 cm, body weight of 60 kg and without cervical deformity by X rays. The ligamentous, nonlinear, three-dimensional finite element models of normal upper cervical spine (C0-3) was developed and validated. The destabilized model with bilateral atlantoaxial trans-articular screws and atlas laminar hooks was evaluated for quasistatic loading.

RESULTSThe finite element model of upper cervical spine consists of 229,047 nodes and 152,475 elements, and correlated well with experimental data for all load cases and could be used for experiment. The finite model with bilateral atlantoaxial trans-articular screws and atlas-laminar hooks predicted that the maximum Von Mises Stress was in the region in which screws penetrated the atlantoaxial articular facet. The novel instrumentation resulted in sufficient stability.

CONCLUSIONThe bilateral atlantoaxial trans-articular screws and atlas laminar hooks instrumentation is useful and effective for atlantoaxial arthrodesis.

Atlanto-Axial Joint ; surgery ; Biomechanical Phenomena ; Bone Screws ; Cervical Vertebrae ; diagnostic imaging ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Internal Fixators ; Joint Instability ; surgery ; Male ; Radiography ; Spinal Fusion ; instrumentation ; methods