BACKGROUND:With the development of biochemistry and cel biology, fracture has being study deeper, blood supply has been known to be an important factor influencing the fracture healing. Endothelial progenitor cel s with good ability of angiogenesis wil have a good clinical prospect in fracture healing.
OBJECTIVE:To review the recent research of endothelial progenitor cel s in fracture healing.
METHODS:A computer-based online search of CNKI, Wanfang, PubMed databases was performed to col ect articles published between 1980 and 2014 with the key words“endothelial progenitor cel , fracture, neovascularization, angiogenesis”in Chinese and English. A total of 48 articles addressing endothelial progenitor cel for angiogenesis in fracture healing were included in result analysis.
RESULTS AND CONCLUSION:Increasing evidence has shown that endothelial progenitor cel s have great ability of neovascularzition and angiogenesis. Endothelial progenitor cel s used in tissue engineering scaffolds can promote the survival rate of scaffolds in vivo, which is appropriate to a great part of delayed union and nonunion patients. However, the large-scale treatment with endothelial progenitor cel s stil has many problems, such as isolation, culture and amplification of endothelial progenitor cel s in vitro, the number of transplanted cel s and selection of scaffolds for transplanted cel s, which need further research.

Applying cellular transplant methods in the treatment of peripheral nerve injury has become a new hot spot in tissue engineering and drawn much attention. Bone marrow stromal cells (BMSCs) grow fast and can be easily purified in vitro. Besides, they have the capability of differentiating into Schwann cells under specific conditions. For all the reasons above, BMSCs are considered good succedaneum of Schwann cells and new seed cells for tissue engineered peripheral nerve. In this review, the physiological functions and bionomics of Schwann cells and BMSCs are introduced, as well as various methods inducing BMSCs into nerve tissue cells and the foreground of the research.

Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42％-57％.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.

Objective To investigate the efficacy of platelet-rich plasma and hyaluronic acid intra-articular injection in patients with knee osteoarthritis. Method The following databases, including PubMed, Embase, the Cochrane Library and WANFANG, were used for collecting the randomized controlled trials, prospective control trials and experimental research about the therapy efficacies of platelet-rich plasma and hyaluronic acid on knee osteoarthritis. The meta-analysis was performed using RevMan 5.3 for Windows. Results Eleven publications, including six RCTs, one PCT and four ER, met the inclusion criteria. There were significant differences in WOMAC scores and IKDC scores between the PRP group and the HA group. but no significant differences were observed in Lequesne index between the PRP group and the HA groups at six month post treatment. Conclusion PRP intra-articular injection was better and more durable than HA in the treatment of knee osteoarthritis.

Objective To explore the angiogenesis&neovascularization effects of naringin treatment in ovariectomized rats’fracture healing. Methods Upper 1/3 transverse tibial fracture model 4 weeks later after ovariectomized were estimated and randomly divided into the naringin group and control group. Microfil perfusion technique was used to analysis the angiogene?sis situation at two weeks after bone fracture. HE staining was used to evaluate the level of angiogenesis&neovascularization of tis?sue from histological point of view. The relative expression of VEGF in the callus was identified by real?time polymerase chain re?action. Immunohistochemical technique was used to observe the vessel endothelial growth factor?2 in the callus of the two groups. Maximum fracture load was tested by three?point bend test. Results The vascular volume and vascular density were more in nar?ingin group than control group. The HE staining of the 2 week group slices shows that the VA, VN2 of the unit of high magnifica?tion vision of the naringin group was significantly larger compared to the control group. Real?time PCR revealed that the compara?tive expression of VEGF is more in naringin group than in control group; the positive number of VEGFR?2 is more in naringin group than in control group. Naringin can promote the maximum load of the callus. Conclusion Naringin can promote ovariecto?mized rats’angiogenesis&neovascularization in the early process of fracture healing. It may be act on the signaling pathway of VEGF/VEGFR?2.

Objective To assess the relationship between reconstruction of coronal trunk shift and changes of unfused segments after selective posterior thoracolumbar/lumbar curves fusion for idiopathic scoliosis.Methods Radiographic data of patients with thoracolumbar/lumbar idiopathic scoliosis who underwent selective posterior correction at our hospital from October 2005 to October 2011 with a minimum of 2 year follow-up period was retrospectively analyzed.Posteroanterior and lateral radiographs of the whole spine before surgery,after surgery and at the last follow-up were performed.Changes of coronal trunk shift during follow-up period were observed and multiple linear regression analysis was performed to determine its relationship with changes of upper thoracic curve,main thoracic curve,lumbar curve,distal unfused segments and coronal sacral inclination.Results Thirty-seven patients with 4 males and 33 females were included in this study.The average age was 14.6±2.0 years (range,12-20 years).The mean follow-up period was 3.6 years (range,2-8.9 years).The mean preoperative Cobb angles of lumbar and thoracic curve were 44.2° and 25.2°,respectively.At the last follow-up,they were corrected to 10.3° and 13.6°,indicating 75.7％ and 44.9％ correction rate,respectively.The pre-and post-operative mean trunk shifts were 2.2 cm and 2.0 cm with no significant differences.At the last follow-up,it compensated to 0.9 cm,which showed significant differences compared with that of postoperation.Linear regression analysis suggested that trunk shift changes during follow-up period were only correlated with changes of distal unfused segments.The regression equation could be described as Changes of trunk shift (cm) =1.248 7+0.137 8×Changes of distal unfused segments (°).Conclusion The reconstruction of coronal trunk balance is mainly compensated by distal unfused segments after selective posterior correction for thoracolumbar/lumbar idiopathic scoliosis.Although preserved most of its levels,unfused thoracic segments do not play an important role in the reconstruction of trunk shift.

Osteoporosis is a systemic metabolic osteopathy characterized by low bone mineral density, leading to an increased risk of bone fractures. The study on the treatment of osteoporosis is mostly a research hotspot, and traditional Chinese medicine in treatment of this disease has its distinctive ascendancy. A large quantity of research indicates that the effect of Longspur epimeium (LE) for treatment of osteoporosis is definite. In this article, the authors summarized the drug components, the results of experimental research and clinical trial of LE for treatment of osteoporosis in recent years.

Objective To investigate the effects of different cyclic tensile strain on the proliferation of human anulus fibrosus cells from degenerated discs.Methods Anulus fibrosus(AF) cells were isolated from a degenerated human IVD,expanded in monolayer,and cyclically strained for 3 hours,applying 0,5％,10％,15％ and 20％ strains at a frequency of 0.25 Hz with the use of the DioDynamic test instrument.The flow cytometry method was used to examine the Af cells proliferation at 24 hours following application of the cyclic tensile strains.Results The proliferative index (PI) increased with the magnitude value of cyclic tensile strain except 20％ group.The most significant increase of proliferation index were found in 15％ group.Conclusion There might be some corelationships between magnitude of cyclic tensile strain and the proliferation of the degenerative AF cells.

BACKGROUND:Joint immobilization is one of the methods used to treat joint pain and joint injury in the department of orthopedics. Compared with other treatment methods, immobilization can reduce the pain of the damaged synovial joints and avoid the contact stress and friction between the joints. However, immobilization can cause some serious complications such as joint contracture, osteoporosis and cartilage degeneration.
OBJECTIVE:To observe the effects of joint immobilization on the repair of cartilage injury of knee joint in rats.
METHODS:Osteochondral ful-thickness defects (2.5 mm in diameter;2 mm in depth) were created in the left femoral condyle fossa with a corneal trephine. 36 animals were randomly assigned into immobilization group and control group (n=18 per group). In the control group, animal models were established, without any treatment. In the immobilization group, after model establishment, rats were immobilized by a designed and modified simplified miniature Ilizarov fixator.
RESULTS AND CONCLUSION:(1) Repair rate of cartilage defect:No significant difference in repair rate was detected between immobilization group and control group. (2) Histological staining:Regeneration tissue was mainly fiber cel s in both groups. At 8 weeks after surgery, Wakitani score and Mankin score were higher in the immobilization group than in the control group (P<0.05). (3) Cartilage metabolic marker detection:Compared with the control group, at 8 weeks, C-telopeptide of type II col agen levels in the urine were significantly higher in the immobilization group than in the control group (P<0.05). (4) Results indicated that persistent immobilization could result in cartilage degeneration, and it was detrimental for cartilage repair.

ObjectiveTo investigate the proliferation of rat's osteoblasts promoted by mechanical strain via the protein kinases C ξ(PKCξ) protein path-way.MethodsOsteoblasts were retrieved from SD rats' skulls in the sterilized environment.BioDynamic testing instrument was used to exert 2％ and 0％ mechanical strain on rats' osteoblasts for 180 min on the each group(2％ mechanical strain was experimental group and 0％ mechanical strain was control group); and the same method was applied on the rats' osteoblasts which pretreated with the classical PKC ξ inhibitor with 2％ mechanical strain (inhibitor group).The cell cycles of rats' osteoblasts were measured by flow cytometry; and Western blotting and immunofluorescence were used to detect expression of protein PKC ξ and phosphorylationed PKC ξ in the rats' osteoblasts.ResultsThe mechanical strain obviously increased the ratio of S period in the cell cycles.Compared to the control group and inhibitor group,a significant increase of the expression of protein PKC ξ and phosphorylationed PKC ξ in the osteoblasts was detected in the mechanical strain experimental group.ConclusionPKCξ can respond to the stimulus of the mechanical strain,which promotes the proliferation of osteoblasts through PKCξ pathway.And it plays an important role in the process of signal conduction.