BACKGROUND: In clinic, many orthopaedic diseases are related to abnormal increase of intraosseous pressure, such as, avascular necrosis of femoral head and osteoarthritis and so on. Percutaneous bone puncture and other methods can decrease intraosseous pressure and release clinical symptoms immediately. Analysis on the changes in intraosseous pressure and medullary blood rheology following drilling decompression can further recognize the occurrence and development of intraosseous pressure OBJECTIVE: To observe the changes in intraosseous pressure and medullary blood rheology following drilling decompression in rabbits.DESIGN: A randomized and controlled trial.SETTING: Department of Orthopaedics, Affiliated Hospital of Youjing Medical College for Nationalities.MATERIALS: This experiment was carried out at Orthopaedic Department, Affiliated Hospital of Youjing Medical College for Nationalities between March and December 2005. Totally 30 New Zealand purebred white rabbits, of either gender, weighing (2.16±0.35) kg, were provided by Experimental Animals Center of Guangxi Medical University.METHODS: ① Animals grouping and modeling: 30 rabbits were randomly divided into 2 groups: model group and experiment group with 15 in each group. Intraosseous pressure models of the proximal right tibia were created on the rabbits in the two groups and drilling decompression was performed in the proximal tibia of rabbits in the experiment group. ②Measurement of intraosseous pressure of proximal tibia: After rabbits were anesthetized, needle for measuring blood pressure was pricked into the medullary canal at 0.5 cm internal plane up at the tubercle of right tibia.Intraosseous pressure of two groups was measured before and 2 days after decompression with BL-410 biologic functional system. ③ Measurement of medullary blood rheology: Before and 2 days after drilling decompression,medullary blood was extracted and blood rheology was measured with Blood Perfusion Monitor R80 (Vertebral plate type, Version 5.0) in the experiment group.MAIN OUTCOME MEASURES: Value of intraosseous pressure and medullary blood rheology before and after drilling decompression in the proximal right tibia.RESULTS: All the 30 rabbits entered the stage of result analysis. ①Measurement of intraosseous pressure: intraosseous pressure was significantly lower after drilling decompression in the proximal right tibia in the experiment group than in the model group (P ＜ 0.01). It approached normal value of intraosseous pressure of control side [(2.50±0.39) kPa]. Intraosseous pressure in the experiment group was significantly lower after than before drilling decompression (P ＜ 0.01). ② Measurement of medullary blood rheology: Medullary blood viscosity, plasm viscisity, whole blood reduced low-shear viscosity, red cell rigidity index, whole blood high-shear relative viscosity, whole blood low-shear relative viscosity, erythrocyte deformation index and erythrocyte aggregation index at the proximal end of tibia following drilling decompression were significantly lower than those before drilling decompression (P ＜ 0.05 or 0.01). Medullary erythrocyte sediment rate and erythrocyte hematocrit did not change significantly (P ＞ 0.05).CONCLUSION: Drilling decompression in proximal right tibia can obviously decrease intraosseous pressure, dilute medullary blood and decrease blood viscosity.

BACKGROUND:Research about the repair of articular cartilage with heterograft chondrocytes is frequently reported, but the method may cause immune rejection. Since the embryonic cells possess lower antigenicity and stronger proliferation capability, it is hoped that they can be used as a novel carrier substitute in tissue engineering research.DESIGN: A randomized grouping observation and comparative experiment.SETTING: Histological Embryonic Laboratory in Guangxi Medical University.MATERIALS: A big white adult New Zealand rabbit pregnant for 4 weeks was adopted; and another 24 big white adult New Zealand rabbits were selected, with no limitationin whether they were female or male and with a body mass of 2 to 2.5 kg.METHODS: This experiment was carried out at the Histological Embryonic Laboratory in Guangxi Medical University between December 2000and June 2002. The models of defects in articular cartilage were made artificially in femur medial malleolus of the mature rabbits. In the experimental group, defects were repaired by the implantation of Fibrin Sealant and embryonic chondrocytes mixture, but for the control group, only Fibrin Sealant was implanted or nothing was done about the defect. The restoration of articular cartilage defect was then observed 4,8 and 12 weeks after the operation, and was scored according to modified Pineda's method. The standard consists of 5 items, I.e., cellular morphology, matrix staining, surfacing smoothness, cartilage thickness and host union. 0 refers to normal and the higher the score is, the more serious the pathological changes are.MAIN OUTCOME MEASURES: ①The general observation of rabbit knee joint; ② Histological observation of rabbit knee joints; ③ Histological semi-quantitative score of articular cartilage; ④ Appraisal of the curative effect of articular cartilage defects.RESULTS: Totally 24 rabbits were enrolled in this experiment and all entered the stage of result analysis. ① The general observation of rabbit knee joint: In embryonic chondrocytes plus fibrin sealant group, the color in defect area was basically the same as that of the normal cartilage, showing a strong quality and better elasticity with the boundaries from the surrounding cartilage approximately vanishing. In Fibrin sealant group and the control group, the defect did not heal completely, but the defect area became small and filled with white fibrous tissues. ② Histological observation of rabbit knee joints: In embryonic chondrocytes plus fibrin sealant group,tissues were predominated by hyaline cartilage, with bone tissues appearing in deeper position, and the surface was slightly raised or smooth, and the matrix showed normal staining, and were completely united with the surrounding cartilage and the division line was not clear. There was no lymphocyte infiltration in the tissues. In Fibrin sealant group and the control group, tissues were predominantly fibrous tissues, and part of them showed obvious residual hollow scar, connecting or partly connecting with the surrounding tissues. ③ Histological semi-quantitative score of articular cartilage: According to modified Pineda's method, the scores of embryonic chondrocytes plus fibrin sealant group after 12 weeks were obviously lower than those of the fibrin sealant group and the control group [(0.50±0.76) vs (7.88±1.13), (8.13±1.36), P ＜ 0.05]; moreover, the difference between pure fibrin sealant group and the control group was of statistical significance 4weeks after the operation (P ＜ 0.05), but there was no obvious difference 8and 12 weeks after the operation. ④Appraisal of the curative effect of articular cartilage defects: 12 weeks after the operation, in the embryonic chondrocytes plus fibrin sealant group, the defect of 8 cases healed completely. In fibrin sealant group 1 case healed but not completely, and 7cases did not get repaired for their defect. In the control group, 8 cases failed to get their defect repaired.CONCLUSION: The repaired tissues in embryonic chondrocytes trans plantation group were basically the same as normal cartilage, obviously superior to the fibrin sealant group and the control group, suggesting that such method is feasible in the repair of articular cartilage defects.

Objective To study the theraputic effect of rebuilt posterior ligamentous complex in the treatment of thoracolumbar fracture.Method From 2003 to 2007,60 patients who had simple thoracolumbar fractures were treated with rebuild of posterior ligamentous complex(group A).At the same time,50 patients with the same condition were treated with ablation of posterior ligamentous complex(group B).Modify Japanese orthopedic association low back pain score(M-JOA)score and Functional Rating scales for Low Back Pain(FRS)score for lumbar function were compared between two groups perioperatively.Results Preoperative M-JOA score for lumbar function of group A was from 19 to 30 score,on average of23.83.M-JOA score of group B was from 17 to 30 score on average of 21.68.There was no significant different between group A and group B(P＞0.05).Postoperative M-JOA score for lumbar function of group A was from 8 to 12 score,on average of 9.05.M-JOA score of group B was from 9 to 14 score.on average of 11.95.There was significant difference between group A and group B(P＜0.01).Preoperative FRS score was 28.85 in group A and 26.56 in group B averagely(P＞0.05)while postoperative FRS score was 68.22(46-84)in group A and 46.87(39-65)in group B(P＜0.05).Conclusion Management with rebuild of posterior ligamentous complex for thoracolumbar fractures contributes to the improvement of the postoperative lumbar function and clinical symptoms.

Objective To study the method and therapeutic efficacy of the combined iliac screw with pedicle screw system internal fixation and one-stage anterior interbody autograft with iliac crest bone after focal cleaning in lumbosacral tuberculosis. Methods We summarized our 12 cases with lumbosacral tuberculosis treated using iliac screw combined with pedicle screw system internal fixation and one-stage anterior focus elimination plus iliac crest bone grafting during 3 years. Results All the incisions were healed by first intention. All patients can off-bed activity wearing lower back protector two weeks after operation and above eight months after operation,the follow up X-ray film showed all bone-grafts obtained solid fusion. Conclusion It was a safe and reliable method to treat lumbosacral tu-berculosis by using ilisc screw combined with pedicle screw system internal fixation and one-stage anterior focus elimi-nation plus iliac crest bone grafting.

Objective To investigate the frequencies of genotype and allele distribution of IL-12A gene single nucleo?tide polymorphisms (SNP) rs568408 and IL-12B gene SNP rs3212227 in Zhuang populations in Guangxi, and to compare the distribution of IL-12A and IL-12B polymorphisms among different races. Methods The IL-12A SNP rs568408 and IL-12B SNP rs3212227 were detected by SNaPshot SNP genotyping technique in 165 Zhuang people in Guangxi, frequen?cies of genotype and allele of IL-12A gene rs568408 and IL-12B rs3212227 polymorphisms were analyzed in Zhuang popu?lations compared with the other four populations(HapMap-HCB, HapMap-JPT, HapMap-YRI, HapMap-TSI)from Hap?Map database. Results There were polimorphisms of IL-12A and IL-12B gene in Zhuang populations in Guangxi. The fre?quencies of allele and genotype distribution of IL-12A gene rs568408 polymorphisms were not significantly differenct com?pared with HapMap-HCB, HapMap-JPT and HapMap-TSI(P>0.05), but were significantly different compared with Hap?Map-YRI(P<0.01);The frequencies of allele and genotype distribution of IL-12B rs3212227 polymorphisms were not sig?nificantly differenct compared with HapMap-HCB and HapMap-JPT(P>0.05), but were significantly different compared with HapMap-YRI and HapMap-TSI(P<0.01). Conclusion There are significant differences in the frequencies of allele and genotype distribution of IL-12A gene rs568408 and IL-12B gene rs3212227 between Zhuang populations and other eth?nic populations, and this variation might contribute to a variety of clinical manifestation and morbidity of some IL-12 related diseases.

BACKGROUND: Tuberculosis clearance, bone graft, internal fixation with or without plate for patients with spinal tuberculosis always lead to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) changes, which are associated with bone graft union time to certain degree.OBJECTIVE: To analyze the correlation between CRP, ESR and bone graft union time in patients with spinal tuberculosis.METHODS: A total of 60 patients with spinal tuberculosis underwent tuberculose focus clearance, autologous iliac bone grafting, and internal fixation without or with plate, including 38 undergoing fixation and 22 not undergoing fixation. They were divided into mild elevation, moderate elevation, high elevation, and extremely high elevation groups according to CRP and ESR. Correlation between CRP, ESR and bone graft union time was analyzed.RESULTS AND CONCLUSION: (1) CRP: there were 18 cases of mild elevation, 21 of moderate elevation, 13 of high elevation and 8 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.420, P=0.001, indicating positive correlation between CPR and bone union time. (2) ESR: there were 16 cases of mild elevation, 20 of moderate elevation, 13 of high elevation and 11 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.414, P=0.001, indicating positive correlation between ESR and bone union time. (3) Bone union was rapider in fixation group compared with non-fixation group, indicating that immediate, strong fixation can benefit bone union.

BACKGROUND: Clinical practice showed that there are certain correlations between postoperative C-reactive protein levels and bone graft fusion time following focal debridement,autologous iliac bone graft,with or without plate internal fixation,for the treatment of spinal tuberculosis.OBJECTIVE: To analyze the correlation between postoperative C-reactive protein levels and bone graft fusion time of spinal tuberculosis patients.METHODS: A total of 60 cases with spinal tuberculosis were selected from January 2007 to December 2009.All patients were underwent focal debridement,autologous iliac bone graft,with or without plate internal fixation,and confirmed by pathology.The C-reactive protein levels were determined at 1,7 and 14 days after operation,and then,according to average changes of C-reactive protein levels,the cases were assigned into 4 groups: 10-25 mg/L served as the mildly increase group,26-50 mg/L as the moderately increase group,51-100 mg/L as the highly increase group,and greater than 101 mg/L as the extremely increase group.Postoperative C-reactive protein levels were examined at 12,16,and 24 weeks after operation,the bone graft fusion was observed by X-ray or CT examination,in addition,bone block fusion time was recorded.All groups of patients with spinal tuberculosis postoperative C-reactive protein diversity and bone graft fusion time were analyzed by variability and correlation analysis.RESULTS AND CONCLUSION: There were 18 cases in the mildly increase group,21 cases in the moderately increase group,13 cases in the highly increase group,and 8 cases in the extremely increase group.The bone fusion time showed that: there were8 cases equal to or less than 12 weeks,34 cases equal to or less than 16 weeks,and 18 cases equal to or less than 24 weeks.There were significant differences among 4 groups in bone graft fusion times(X2=13.990,P=0.003).Spearman correlation analysis showed that,there was a positive correlation between postoperative C-reactive protein levels and bone fusion time(r=0.420,P=0.001).

BACKGROUND: Based on the multi-directional differentiation potential,the combined application of proper biological materials and growth factor can repair tissue defect.OBJECTIVE: To observe the growth characteristics of rabbit bone marrow-derived mesenchymal stem cells and their osteogenic potential under the induced condition.DESIGN: A single sample experiment.SETTING: The Department of Histology and Embryology of Youjiang Medical College for Nationalities; the Affiliated Hospital of Youjiang Medical College for Nationalities.MATERIALS: This experiment was conducted at the Department of Histology and Embryology of Youjiang Medical College for Nationalities in June 2004. Male new Zealand rabbits, with a body mass of 2.0 to 2.5 kg,were provided.METHODS: Rabbit bone marrow tissue was extracted. After gradient centrifugation, adherent cells were kept for cell passage. Culture medium was used for inducing culture of osteoblast when the passage was stable (50 mL/L of Dulbecco modified culture medium of bovine serum containing 10 mmol/L of β-sodium glycerophosphate, 10 nmol/L of dexamethasone, 50 mg/L of vitamine C). The culture medium was changed every other day. Osteogenic characteristics of the bone marrow-derived mensenchymal stem cells were observed under an inverted microscope after alkaline phosphatase immunohistological staining, osteonectin and osteopontin immunocytochemical staining.MAIN OUTCOME MEASURES: ① Morphological observation of bone marrow-derived mesenchymal stem cells; ② Osteogenic characteristics of bone marrow-derived mesenchymal stem cells.RESULTS: ① Morphological observation of bone marrow-derived mensenchymal stem cells: Primary rabbit bone marrow-derived mesenchymal stem cells could cover the Petri dish fully in 7 or8 days and could passage stably. Generative cells began to passage in 5 or 6 days. ② Osteogenic characteristics of bone marrow-derived mensenchymal stem cells:Alkaline phosphatase immunohistochemical staining showed a lot of brown particles in the kytoplasm, but no colored cells were found in the control group. Osteonectin and osteopontin immunohistochemical detection found that the nucleus was light blue and a lot of brown particles appeared in the kytoplasm, presenting obvious strong positive, but no brown particles appeared in the control group.CONCLUSION: After combined induced culture with dexamethasone, vitamine C and β-sodiumglycerophosphate, rabbit bone marrow mensenchymal stem cells showed the morphological and biological characteristics of osteoblasts with osteoblastic activity, and were able to supply autologous seed cells for constructing in vitro tissue engineered bone in a short period of time.