Objective To study the expression of interleukin 6 (IL 6) and tumor necrosis factor ? (TNF ?) , location of both cytokines and their relationship with the variation of bone mineral density (BMD). Methods Cancellous bone chips were obtained from the vertebral bone of senile osteoporosis and control subjects during operation. Slides were made and stained with IL 6 and TNF ? monoclonal antibody, respectively. Results Osteoblasts and stromal cells were strongly positive to IL 6 and TNF ? in osteoporosis groups. The number of positive cells in high power field are 107 9?42 6 and 99 0?31 8 in osteoporosis groups, and 31 4?20 5 and 28 5?17 1 in controls, respectively, showing significant difference between two groups ( P

Objective To observe histologically the effect of exogenous application of bFGF (basic fibroblast growth factor) combined to freeze- dried tendon on angiogenic enhancement in early ACL (anterior cruciate ligament) reconstruction. Methods 14 dogs were used in the experiment. 100 ng/mL bFGF was combined to freeze- dried tendon and then transplanted into one side knee to substitute the original ACL, while only freeze- dried tendon was used in the transplantation at the other side as control. The ACLs were harvested each week from 1 to 6 weeks from the 14 dogs respectively. The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. Results Neovascularization occurred at 2nd to 3rd week and reached the peak at 4th to 5th week postoperatively at the experimental sides. By contrast, the neovascularization occurred at 4th to 5th week postoperatively at the control sides. Conclusion The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze- dried tendon are superior to those in the control group.

Standardized management and safe-supply system can be enhanced by oxygen chamber management rules,oxygen safe -supply management,daily maintenance of oxygen supply,solutions on common malfunctions and the management of oxygen humidifier. The importance of the management of oxygen is discussed and the regulations should be strictly abided to reduce accident. The oxygen used on clinic can be standardized to ensure the safe-supply.

Objective To investigate the technique and efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament(ACL) from the tibial eminence with stainless steel wire guided by meniscal stitching needle.Methods Fifteen cases of avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle from December 1999 to August 2005.The Lysholm scoring scale system was used to evaluate knee functions before and after surgery.Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments.Results The operation was completed within 30 min.No complications of intraarticular infection,iatrogenic injury,fibroarthritis,or non-union of fracture were found.The 15 cases were followed for 6～54 months(mean,20.9?15.0 months).X-ray films revealed good bone union in all the 15 cases.The Lysholm scores were improved from 19.1?15.2(range,10～56) preoperatively to 97.5?3.7(range,91～100) postoperatively,with significant statistical difference by the student-t test(t=18.483,P=0.000).Wire breakage was found in 2 cases at 8 and 14 months after operation,respectively.But the bone union in the 2 cases was not affected.Conclusions Arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle in the treatment of avulsion fracture of the anterior cruciate ligament from the tibial eminence has advantages of simplicity,broad indications(from type Ⅱ to Ⅳ injuries),minimal invasion,and rapid postoperative recovery.

Objective To summarize complications of knee arthroscopic surgery and the prevention and treatment for the complications. Methods A review of 679 knee arthroscopic operations in 658 patients from March 1997 to March 2002 was carried out. Results The incidence of all complications was 6.8% (46 of 679). Incidences of hemarthrosis, superficial infection, fibroarthrosis, tourniquet paresis, instrument breakage and accidental damage were 2.7% (8 of 679), 0.4%(3 of 679), 1.5%(10 of 679), 0.6%(4 of 679), 1.2% (8 of 679) and 0.4% (3 of 679), respectively. No popliteal vessel injury, intra-articular infection, neurological injury, deep venous thrombosis or compartment syndrome occurred in this group. Conclusions The incidence of complications of knee arthroscopy is relatively low. Most of them are mild and curable, if prompt treatment is given.

Objective To test the strength of different suture fixation of tendon or ligament end and evaluate appropriate stitches number in cruciate ligament reconstruction. Methods Twenty-four specimens of patellar tendon with free ends, which was, divided into 3 groups according 2 or 3 stitches and 6 subgroups using different suture materials, either with No1 Ethilon or 0.4 mm diameter stainless steel wire, fixed with Krackow locking stitch, the tensile test were undertaken respectively, so as to find out the least stitches and efficient suture pattern. Results Two Krackow locking stitches had more strength than that of 0.4 mm diameter stainless steel wire itself, the fixation strength of 2 stitches which used No1 Ethilon was more than 80 N, superior to the failure strength of material itself, it still maintained the same strength if the first stitch was across the tendon tissue transversely. On the basis of testing results, this modified stitches pattern was used in 17 cases, all could be well withstand an accelerated postoperative ROM rehabilitation program in clinical practice. Conclusion There is no significant difference between 2 and 3 Krackow locking stitches in suture strength statistically, the fixation strength is superior to the suture material, it can lessen the suture exposure when the first stitch is across the tendon tissue while maintains a comparable strength to other suture. If attempt to make a higher strength of suture, one should focus on selecting a stronger materials or adding the suture materials in number, therefore, a rapid early ROM rehabilitation is possible and reliable in practice.

[Objective]To introduce the treatment and result of meniscal cyst by arthroscopic surgery.[Method]During the period between 1997 and 2005,20 patients suffered from meniscal cysts have been treated by arthroscopic surgery in Xijing Hospital.Meniscal cysts were excised in all cases with shaver under arthroscopic visualization,whereas outside-in suture repair of meniscus was undergone in 8 cases to close the lacuna and repair the meniscal peripheral free which were resulted from remoral of cyst.The patients were followed up from 3 to 42 months with an average of(18.7?12.2)months.The patients were assessed pre-and post-operatively by the Lysholm score and Glasgow Assessment.[Result]Sixteen of total 20 patients were followed up.Meniscal cyst recurred in a patient one year after operation.Lysholm score of the 16 patients showed a significant improvement from(71.2?8.7)pre-operation to(97.1?2.9)post-operation(t=32.948,P

[Objective]To explore the effect of external fixator combined with vaccum sealing drainage(VSD) for the treatment of infection after internal fixation in tibial and fibular fracture.[Method]Thirty-six patients with infection after internal fixation in tibial and fibular fracture were treated by external fixator combined with VSD from June 2004 to June 2008.[Result]During the following-up period from 8-30 months in thirty-two patients,the infection in all cases were controlled effectively,no case of recurrence was found in all patients,and satisfactory healing were found in 32 cases.The average time of fracture union were 4.5 months;the removal time of external fixation were 5 months on average.[Conclusion]The combined operative procedure is simple,reliable and less traumatic and allow to early functional exercises.Therefore,it is a satisfactory measure for the infection after internal fixation in tibial and fibular fracture.

BACKGROUND: Based on previous studies, the combination of basic fibroblast growth factor (bFGF) with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament (ACL) graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex (MHC) through the treatment of allogenous tendon by freeze. The freeze. dried tendon showed advantages including prolonged storage time. availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE: To observe histologically the effect of exogenous application or bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING: Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital. Fourth Military Medical University of Chinese PLA between June 2006 and June 2007.MATERIALS: Fourteen dogs were used in the experiment. METHODS: Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF(100 u g/L)was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL. While only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES: Twelve of them were randomly divided into 6 groups according to the 6 time points,i,e.,1,2,3,4,5,6 weeks after surgery(2 dogs in each group).The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS: Neovascularization occurred at the 2nd to 3rd weeks and reached the peak at the 4th to 5th weeks postoperatively at the experimental sides. By contrast. The neovascularization occurred at the 4th to 5th weeks postoperatively at the control sides. Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION: The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.

Objective To introduce arthroscopic technique in managing patellar subluxation and its clinical results. Methods Between Jan. 2004 and Jun. 2007, 17 patients suffered from patellar subluxation underwent arthroscopic surgery in Xijing Hospital. The key points of our technique are lateral retinaculum release and medial retinaculum shrinking suture. Tibial tuberosity was translated medially and elevated in 2 patients by osteotomy. The average age of all patients was (21.5?4.9) years (range 10 to 28). The patients suffering from patellar subluxation averaged (23.1?13.0) months (range 7 to 50) before operation. They were followed up for average (18.0?6.2) months (range 6 to 24). The Lysholm score before and after operation was compared in all patients. Results Fifteen of total 17 patients were followed up, and no recurrence was found. Lysholm score of 17 patients was significantly higher after operation than that before operation (t=5.63, P