Objective To study the OPG/RANKL gene expression of bone marrow stromal cell under stimulation of PTHrP.Method Primary bone marrow cells were cultured under the stimulation of 45 ng/ml PTHrP. Number of osteoclasts was counted after 6-day's culture.90 ng/ml PTHrP was used to stimulate adherent bone marrow stromal cells for 3 or 6 days.OPG and RANKL gene expression level were determined by real-time PCR. Result Large number of osteoclasts were formed in primary bone marrow cell culture after 6-day stimulation of PTHrP.RANKL gene expression level was up-regulated by PTHrP,while OPG gene expression level were down-regulated.Conclusion PTHrP stimulates osteoclast formation via up-regulating RANKL level and down-regulating OPG level.

Objective To investigate the effects of Basiliximab on alloreactive T lymphocytes precursors, hematopoietic progenitor cells by ex vivo assay and prophylaxis of graft-versus-host disease (GVHD) in mismatched bone marrow transplantation.Methods Two groups were set up: (1) Basiliximab group including 72 leukemia patients subject to haploidentical bone marrow transplantation (BMT) with Basiliximab for prophylaxis of GVHD without ex vivo T-cell depletion. (2) Control group having 15 patients receiving the same regimen before Nov. 2000, without Basiliximab for GVHD prophylaxis. Limiting-dilution method was used to determine the effect of Basiliximab on reactivity of cytotoxic T lymphocyte precursors (CTLP). In the semi-solid hematopoietic culture system, the effect of Basiliximab on the colony proliferation of CFU-GM, BFU-E and CFU-Meg was measured. Results In Basiliximab group, 72 patients established trilineage with full donor hematopoietic reconstitution. Engraftment rate showed no statistical difference between the two groups. The incidence of grade Ⅱ-Ⅳ GVHD was 12.5 % (9 cases) in Basiliximab group and 33.3 % (5 cases) in control group respectively (P

[Objective]To evaluate the effect of selective kyphoplasty in treatment of osteoporotic thoracolumbar multi-vertebral compressive fractures based on preoperative magnetic resonance imaging(MRI).[Method]Twenty-one cases(fifty-seven vertebral bodies) of osteoporotic thoracolumbar multi-vertebral compressive fractures were treated from June 2003 to December 2006.The signal changes in different sequences were confirmed by preoperative MRI.Based on the MRI signal changes,57 vertebral bodies were treated by selective kyphoplasty.Normal balloon pressure and cement volume were performed for the painful vertebral bodies and lower pressure and cement volume were preferred for the vertebral bodies with old fracture.[Result]All patients tolerated the operation well with immediate relief of their back pain in 24 hours.The mean height of the anterior,media and posterior vertebral bodies were(1.7?0.9)cm,(1.7?0.7)cm,(2.5?0.9)cm preoperatively and(2.2?0.4)cm,(2.4?0.6)cm,(2.6?0.3)cm postoperatively.The mean kyphosis was improved from(33.7?10.9) degrees to(25.9?9.3) degrees(P

Objective To explore the effects of Basiliximab (Simulect) on reducing the incidence of severe acute GVHD in haploidentical bone marrow transplantation (BMT). Methods Nine patients with leukemia received haplotype Allo-BMT from HLA two or three loci mismatched related donor. Most patients were classified as high risk category. The donors of patients were administrated with G-CSF 250 ?g/day for 7 doses prior to marrow harvest. In addition to combination of CsA, MTX, ATG and Mycophenolate mofetil for GVHD prophylaxis, Simulect was administered to prevent severe GVHD. A total 40 mg Simulect was given in two doses of 20 mg each by 30 min intravenous infusion on 2 h before transplantation and day 4 after transplantation.Results All patients were engrafted. 100 % donors hematopoietic cells after transplantation was determined by cytogenetic evidence analysis. None developed the Ⅱ-Ⅳ acute GVHD. Eight patients could be evaluated for chronic GVHD. All experienced chronic GVHD confined to the skin. The median follow-up duration was 14 months (range 12～20 months). One patient died from CMV infection on 3 months and one patient died from disease relapse on 14 months. The remaining 7 patients were survived in disease free situation.Conclusion The use of Simulect in haploidentical bone marrow transplantation is effective on preventing acute severe GVHD and improving disease-free survival.

Objective To study the diagnosis and the treatment of the arachnoid cysts in the sacral canal. Methods After decompression laminectomy of the sacral canal, the arachnoid cysts were dealt with in three ways: 13 cases with excision of the most of the cyst wall and suture of redundant wall around the intracystic nerves, 8 cases with the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle, 2 cases with excision of most of the cyst wall and leaving cystic wound unsutured. The clinical results were studied with 30.2 months follow up. The radiological changes including X-ray, CT, CTM and MRI were evaluated as well as their clinical behaviors, pathologies and post operative complications. Results Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between the results of the first two surgical methods. The post operative complications included the wound erosion and intracranial infection. Conclusion The cyst seems to arise as a result of congenital defect of the thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to be a reasonable surgical method. No drain tube should be used and a supine position should not be allowed so as to reduce the complications

Objective To evaluate clinical effect of accurate pedicle subtraction osteotomy (PSO) using osteotomes in the treatment of thoracolumbar kyphosis (TLK).Methods From June 2007 to October 2010,18 patients with TLK underwent accurate PSO using osteotomes under X-ray fluoroscopy,including 13 males and 5 females,with an average age of 48.6 years.The primary causes of TLK included old fracture (11cases),chronic tuberculosis (4 cases) and hemivertebra (3 cases).Deformity apex occurred at T12 (5 cases),L1 (9 cases),and L2 (4 cases).Radiological assessment for sagittal balance was performed by measuring Cobb angle.The Frankel grade,visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pre-and post-operative neurological status,back pain and function.Results The mean operative time,mean blood loss and mean postoperative drainage volume were 247.0±29.3 minutes,708.5±34.5 ml and 337.3±74.6 ml,respectively.All patients were followed up for 1 to 4.5 years (average,2.8 years).Solid fusion was achieved in all patients.Cobb angle was corrected from preoperative 42.3°±5.7° to 2.2°±1.9° three months postoperatively and 2.7°±2.1 ° at final follow-up.VAS and ODI scores decreased from preoperative 8.5±1.0 and 72.8％±8.3％ to 2.1±0.7 and 21.6％±9.2％ three months postoperatively,and 1.9±0.6 and 19.3％±8.6％ at final follow-up,respectively.With regard to Frankel grade,a 1-grade and 2-grade improvement was observed in 7 cases and 2 cases 3 months postoperatively,respectively.At final follow-up,a 1-grade and 2-grade improvement was observed in 5 cases and 4 cases,respectively.Two patients had transient neurological symptoms postoperatively,which recovered after drug treatment for 2 weeks.No other complications occurred.Conclusion It is safe and effective to correct TLK through accurate PSO using osteotomes,which has some advantages,such as less blood loss,higher fusion rate and fewer complications.

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.

Objective To evaluate the effect of dorsal dual-plate fixation for unstable distal radius fractures.Methods Twenty-two cases of unstable distal radius fractures undergone dorsal fixation with a 2.4 mm plate from June 2010 to June 2012 were enrolled.There were 16 males and 6 females with mean age of 54.5 years (range,22-75 years).According to the AO fracture classification,there were 12 cases of type B2,6 type C1 and 4 type C2.Five cases had autologous or allogeneic bone grafting.Results Mean period of follow-up was 14 months (range,5-30 months).According to Gartland-Werley score,the result was excellent in 13 cases,good in 5 cases and fair in 4 cases,with the excellent and good rate of 82％.Volar inclination [(11.07 ± 1.77) °],ulnar declination [(22.30 ± 3.13) °],and radial height [(11.40 ±1.51) °] showed statistical differences from that [(-1.50 ± 7.59) °,(11.90 ± 3.87) °,and (5.20 ±1.55) ° respectively] before operation (P ＜ 0.05).Conclusions Dorsal dual-plate fixation can be a reliable and effective technique for AO-B2 shear fractures with intact volar-cortex and dorsal criticallycomminuted fractures of the distal radius.Active bone grafting should be performed for bone defection to promote bone healing.

Objective To transduct with human telomerase reverse transcriptase(hTERT) to Schwann cells via electransfection technique to prolong the life span and enhance the proliferative capacity of Schwann cells.Methods The hTERT RNA was derived from esophagus cancer tissue and pcDNA3.1-hTERT vector was built.With electransfection technique, we tmnsfected vector into ADSCs.The PCR,TRAP-PCR, and PI-annexin V were tested to prove the expression of hTERT in ADSCs.Results After transduction the hTERT RNA in Schwann ceils, TRAP-PCR test, PI-annexin V dying and S100 dying was positive.Conclusion Telomerase catalytic subunit(hTERT) is transduct into Schwann cells, and it can to enhance the prolifertative capacity.

Objective To investigate a therapeutic method which could provide sustained-release delivery and local longlasting anti-TB treatment after debridement of thoracic and lumbar spine tuberculosis.Methods Data of 18 patients (including 2 revised cases),who were diagnosed of thoracic and lumbar tuberculosis and required surgery treatment from October 2008 to January 2011 were retrospectively analyzed.There were 12 males and 6 females,with an average age of 48.7± 13.3 years (range,22 to 67 years).Affected spinal segments in these patients spanned from T8 to S1.fourteen patients were treated with posterior surgical procedure alone while the other 4 were treated with one-stage combined anterior-posterior surgery.Combined with autogenous bone,OSTEOSET RBK drug carrier-type artificial bone mixed with isoniazid and streptomycin was used after debridement.Chlinical parameters including clinical symptoms,laboratory results,and imaging data were evaluated during follow-up.Results Incisions of all patients achieved primary healing.The duration of patient follow-up ranged from 29 to 56 months (average,39.5months).No liver and kidney function abnormalities,ototoxicity,or local nerve irritations were found perioperatively.Improvements in clinical symptoms were observed in all patients.One patient with L2a tuberculosis recurred 18 months after the initial surgery.At 6-month follow-up,intervertebral body fusion was achieved without complications of internal fixation or significant angle loss of kyphosis correction.Conclusion OSTEOSET RBK dmg carrier-type artificial bone mixed with isoniazid,streptomycin for treatment of thoracic and lumbar spine tuberculosis is a safe and effective way to control local infection and recurrence.Combined with autologous bone could contribute to bone fusion.