Objective To evaluate the clinical efficacy of total knee arthroplasty(TKA)in patients of osteo-arthris with valgus knee deformity after lateral meniscectomy(LMT). Methods Twenty six cases of osteo-arthris with valgus knee deformity after lateral meniscectomy were treated with total knee arthroplasty. Operation evaluations including the range of motion(ROM),the tibial and femur angle(T-F angle),Knee Society Score System(KSS)and the function score were performed as follow-up. Results The median follow-up periods was 22 months and ranged from 5 months to 3 years. The average ROM improved from 96° preoperatively to 116° at postoperatively. The average KSS improved from 22. 5 points preoperatively to 84. 4 points postoperatively. The average function score improved from 25. 5 points preoperatively to 84. 4 points postoperatively,and the average T-F angle was corrected from 22°( 13° - 31°) of valgus preoperatively to 7. 6°( 0° - 9°) of valgus postoperatively. Conclusion The TKA can provide excellent in patients undergoing osteo-arthris with valgus knee deformity after lateral meniscectomy.

BACKGROUND:The pathogenesis of intervertebral disc protrusion remains unclear.A stable and feasible intervertebral disc degeneration model is required to validate the pathology and imaging performance and to reveal intemal factors.OBJECTIVE:To investigate the feasibility of building rabbit model of intervertebral disc degeneration using aspiration method,as well as the convenience and stability of model establishment through the performance of pathology and imaging.MATERlALS:A total of 4210-month-old healthy New Zealand rabbits,irrespective of genders,were randomly divided into control group and experiment group with 21 rabbits in each group.Sumianxin was offered by Veterinary Institute,Quartermaster University of Chinese PLA in Changchun City.METHODS:The disc height index(DHI)of all rabbit swas set as 100%.A21-gauge hypodermic needle was used to aspirate nucleus pulposus 8-12 mg from L4-5 disc of rabbits in the experiment group,while control group received no management. At 4,12.20 weeks,7 rabbits were selected from each group for index determination.MAIN OUTCOME MEASURES:DHI percent,X-ray plain film,MRI and Alcian blue staining were used to observe the changes in the intervertebral disc degeneration.RESULTS:The DHI percentage of experiment group at 4,12 and 20 weeks respectively was(81.0±3.2)%,(75.0±2.5)%and (71.0±1.8)%,with significant difference compared to control group(P＜0.05).T2-weighted image showed that the signal of the discs was significantly decreased,and Alcian blue staining showed that the content of aggrecan was also significantly decreased.CONCLUSI0N:The aspiration is a reliable and convenient way to construct rabbit models of intervertebral disc degeneration.and these models exhibit the similar pathology and imaging performance with human intervertebral disc degeneration.

The cancer stem cells (CSCs) from human osteosarcoma by serum-free three-dimensional culture combined with anticancer drugs were isolated and identified. The primary cells derived from human osteosarcoma were digested by trypsin to prepare a single-cell suspension, and mixed homogeneously into 1.2% alginate gel. Single-cell alginate gel was cultured with serum-free DMEM/F12 medium. Epirubicin (0.8 mug/mL) was added to the medium to enrich CSCs. After cultured conventionally for 7 to 10 days, most of cells suspended in alginate gel were killed by epirubicin. But few cells survived and some single-cell cloning spheres formed. Immunofluorescent staining for Oct3/4 and Nanog was implemented to find cells with properties of self-renewal and multi-potential differentiation. Cells from cloning spheres were transplanted into BALB/c mice to detect the tumorigenicity in vivo. The results showed that some cells positive for Oct3/4 (TRITC) and Nanog (TRITC) were found in single-cell cloning spheres, and most of positive cells were concentrated in the core of sphere. Cells from spheres could form osteosarcoma in the body of mice. It was concluded that cells from single-cell cloning spheres had the properties of the expression of parts of stem cell genes (Oct3/4 and Nanog), resisting anti-cancer drugs, and tumorigenicity in vivo. To sum up, it is believed that cells obtained from osteosarcoma by serum-free three-dimensional culture combined with anticancer drugs are cancer stem cells.

The cancer stem cells(CSCs)from human osteosarcoma by serum-free three-dimensional culture combined with anticancer drugs were isolated and identified.The primary cells derived from human osteosarcoma were digested by trypsin to prepare a single-cell suspension,and mixed homogeneously into 1.2% alginate gel.Single-cell alginate gel was cultured with serum-free DMEM/F12 medium.Epirubicin(0.8 μg/mL)was added to the medium to enrich CSCs.After cultured conventionally for 7 to 10 days,most of cells suspended in alginate gel were killed by epirubicin.But few cells survived and some single-cell cloning spheres formed.Immunofluorescent staining for Oct3/4 and Nanog was implemented to find cells with properties of self-renewal and multi-potential differentiation.Cells from cloning spheres were transplanted into BALB/c mice to detect the tumorigenicity in vivo.The results showed that some cells positive for Oct3/4(TRITC)and Nanog(TRITC)were found in single-cell cloning spheres,and most of positive cells were concentrated in the core of sphere.Cells from spheres could form osteosarcoma in the body of mice.It was concluded that cells from single-cell cloning spheres had the properties of the expression of parts of stem cell genes(Oct3/4 and Nanog),resisting anti-cancer drugs,and tumorigenicity in vivo.To sum up,it is believed that cells obtained from osteosarcoma by serum-free three-dimensional culture combined with anticancer drugs are cancer stem cells.

Objective To investigate the effect of locking plate combined with cortical screw internal fixation on ankle function and quality of life in patients with ankle fracture with tibiofibular separation.Methods A total of 120 patients with ankle fracture and distal tibiofibular separation treated in our hospital from May 2020 to December 2021 were selected and divided into control group and observation group according to random number table method,with 60 patients/group.The control group was treated with cortical screw fixation alone,and the observation group was treated with locking plate combined with cortical screw internal fixation.Before surgery and 6 months after surgery,the recovery function of the two groups was compared.X-ray,operation duration,healing time,intraoperative blood loss,postoperative complications were compared,and the living ability of the two groups of patients was evaluated.Results Before treatment,there was no difference in joint function between the two groups(P＞0.05).After treatment,the longest walking of the control group(15.89±0.85),foot alignment(15.06±0.71),pain response(29.03±4.48)and ground walking(15.65±0.59).The longest walking distance(16.19±0.87),foot alignment(15.29±0.76),pain response(31.24±4.55)and ground walking(15.96±0.68)in the observation group,which were higher than those in control group(P＜0.05).Compared with the control group,the intraoperative blood loss and healing time in the observation group were lower(P＜0.05).BI index of the two groups before treatment had no difference(P＞0.05);After treatment,BI index of observation group was higher than that of control group(P＜0.05).There was no difference in the total complication rate between the two groups(P＞0.05).Conclusion Locking plate combined with cortical screw internal fixation has a good therapeutic effect on improving ankle function,reducing intraoperative blood loss,promoting healing and improving behavioral ability in the treatment of ankle fracture combined with hypotibiofibular syndesmosis injury.

Objective To investigate the clinical efficacy of endoscopic assisted minimally invasive trans foraminal lumbar interbody fusion(MIS-TLIF)and traditional open TLIF in the treatment of senile degenerative spondylolisthesis.Methods From January 2020 to March 2021,100 elderly patients with degenerative spondylolisthesis were selected and divided into MIS-TLIF group and TLIF group according to the surgical method,with 50 cases in each group.The preoperative and postoperative VAS,Japanese Orthopedic Association score(JO A)and Oswestry disability index(ODI),and the rate of interbody fusion and the incidence of complications were compared and analyzed between the two groups.Results In MIS-TLIF group,the operative time,intraoperative blood loss,incision length,postoperative drainage volume and hospital stay were(167.5±54.2)minutes,(173.8±47.1)ml,(3.5±0.7)cm,(69.6±16.3)ml,and(8.3±2.7)days,respectively.In the TLIF group,it was(136.3±38.9)minutes,(281.0±50.3)ml,(10.0±2.1)cm,(148.4±28.2)ml,and(11.2±3.1)days,respectively.The difference between the two groups was statistically significant(P＜0.05).The VAS,JO A and ODI scores of MIS-TLIF group were(2.17±0.62)points,(21.72±3.14)points and(13.22 ±2.43)points,respectively.The results in TLIF group were(3.24±1.06)points,(17.06±2.85)points and(16.83±2.87)points,respectively,and there was statistical significance between the two groups(P＜0.05).There was no significant difference in the rate of interbody fusion between the two groups at 12 months after operation(P＞0.05).The incidence of postoperative complications in MIS-TLIF group(8.00％)was significantly lower than that in TLIF group(24.00％,P＜0.05).Conclusion MIS-TLIF assisted by endoscope has the advantages of less trauma,faster recovery and less postoperative complications,and the short-term curative effect is more satisfactory than TLIF.