This article summarized literatures in the recent ten years on the mechanisms of Ci-xue therapy from such aspects as hemorheology, vascular biology, blood constituents and blood coagulating system.

Objective To analyze the ultra microstructure and histological properties of implanted composites of decalcified bone matrix (DBM) impregnated calcium phosphate cement (CPC) with recombinant human bone morphogenetic protein-2 (rhBMP-2) in bone defect, and evaluate the osteoplastic efficiency of this composites. Methods The rabbit DBM was prepared beforehand. The composites of DBM impregnated CPC with rhBMP-2 was made at 0.2 proportion of DBM. The rabbit's bone defect of femur condyle was filled with implantation of the composites (group A, n=12) or CPC (group B, n=12) or bone cement (group C, n=12). Animals were sacrificed at 6, 12, or 24 weeks after operation, and the implants were examined by histological technique and scanning electron microscopy (SEM). Results In group A, at the 6th week after operation, the interface region between implants and bone tissue became fuzziness, and was crossed by the generated fibers of bone tissue, and filled with woven bone growing inside into the composites; at the 12th week after operation, blood vessels, osteoblasts and new bone were generated inside of composites; at the 24th week after operation, the bone defects were recovered and became solid union, most of the implants were replaced by new bones. In group B, at the 6th week after operation, the interface of CPC and bone tissue was sharp, and was not crossed by new bones; at the 24th week after operation, the bone defects were still filled with materials of CPC and no new bone was found inside CPC. In group C, at the 24th week after operation, the interface of bone cement and bone remained non-union. Higher osteoblastic activity,more neogenetic blood vessels and higher growth rate of woven bone were observed in group A compared with those in group B. Conclusions For bone defect, the implantation of composites with DBM proportion of 0.2 can stimulate the growth of osteoblast, blood vessel and woven bone. It is biodegradable and can be replaced by autogenous bone.

[Objective]To analyze the clinical effect of microwave hyperthermia in limb salvage surgery for malignant bone tumor of extremities. [Methods]From July 1999 to July of 2005, 309 patients with malignant or bone tumors of extremities were treated by heat necrosis of tumor-bearing bone in situ for limb salvage.The most common diagnosis was osteosarcoma. The first step of the traditional limb salvage was en bloc resection of the tumor-bearing bone. For the novel method, the tumor bearing bone was just separated from surrounding normal tissues, and was devitalized by hyperthermia in situ.After re-strengthening the dead bone, its mechanical property became strong enough to support the body weight.[Results]The beyond 3 years survival rate was 60.2% for high-grade malignancy. In great majority of the patients, cosmetic and useful limbs were preserved. The complication rate was lower than that in the literature reports.[Conclusion]The long term experience has proved that the new method has made its way in the field of orthopedic oncology. The applying of hyperthermia for treatment of bone tumors is an effective, simple, and inexpensive method. The oncological and functional results are encouraging. Hyperthermia should deserve more attention than it has in the clinical practice.

[Objective] To analyze the treatment of malignant of highly aggressive bone tumors of pelvis by microwave-induced hyperthermia.[Methods]A novel surgical model was devised:after careful dissection of the tumor-bearing bone from surrounding normal tissues,the microwave antennae array was inserted into the tumor mass for emitting electromagnetic microwave which produced tumor cellular death via thermo-coagulation.No special reconstruction procedure was necessary,excepting the strengthening measures.[Results]From May 1994 to December 2005,152 patients with pelvic malignant or highly aggressive tumors received radical thermotherapy.Among 67 patients with stage IB tumors,48 patients achieved local and systematic control.Among 61 patients with stage IIB tumors,19 patients died from lesion,and the remaining 42 patents did not developed either metastasis or local recurrence after 3 to 11 years.Of 24 patients with pelvic metastatic lesions,11 patients collapsed during six months to three years,and 13 patients still lived without evidence of disease within one to seven years.In the majority of the patients,functional and cosmetic acceptable limbs were reserved.[Conclusion]The results revealed that the novel and greatly simplified method is justified from both oncological and functional standpoints.Hyperthermia should deserve more attention than it has in this field.

Objective To determine the causative association between a newly isolated coronavirus and the current epidemic of severe acute respiratory syndrome (SARS) Methods Coronavirus was isolated from the samples of patients with SARS by cell culture Immunofluorescence assay and neutralization test were used to detect the antibodies in serum of SARS patients against newly isolated coronavirus, in order to analyze and determine the association between coronavirus and SARS pathogen Results The antibodies against the novel coronavirus could be detected in 99 of 113 sera from clinically diagnosed SARS patients The results of 10 pairs of double serum detection showed that, antibody titers in the late phase were significantly higher than those in the acute phase, and a highest increase by 128 folds was being found. The neutralization test showed that the antibodies from SARS patients' sera could neutralize the novel coronavirus Conclusion The newly isolated coronavirus was closely associated with and possibly the key pathogen of SARS

The authors observed fifty petrosal veins in twenty five adult specimens with surgical microscope under ten times magnification.Special attentionwas paid to the microsurgical anatomical features of the petrosal vein andthe relations between these features and some aspects of the posterior rhi-zotomy of the trigeminal nerve. There is only one petrosal vein in each half of the specimen in themajority of the cases observed. All petrosal veins can be subdivided into three types: 1 ) single-trunk type; 2 ) two-trunk type; 3 ) three-trunktype. The micro-anatomical features of the vein are as follows: 1 ) in adeep position; 2 ) with a thinnest wall; 3 ) with a thicker and shortertrunk; 4 ) in a free and suspended manner during traversing the subarachnoidspace. During operation, the petrosal vein covered with a thin layer ofarachnoid can be seen. The method of how to sever the vein is different because the formationof it is different. Most of petrosal veins are located at a position superiorlateral to the teminal root, so they can be used as a guidance of looking for the nerve root.

BACKGROUND: Mesenchymal stem cells (MSCs) are capable of differentiating into a variety of lineages, including bone, cartilage, or fat, depending on the inducing stimuli, specific growth and differentiation factors.Recombinant human bone morphogenetic protein 2 (rhBMP-2) produced by gene engineering has an obvious osteoinductive activity and can induce undifferentiated mesenchymal cells into cartilage and bone irreversibly, resulting in new bone formation. Basic fibroblast growth factor (bFGF) modulates chondrogenic and osteogenic differentiation of MSCs.OBJECTIVE: To investigate the effect of bFGF and rhBMP-2 on the differentiation and proliferation of cultured rabbit mesenchymal stem cell in order to find out an optimal way of osteogenesis instead of conventional osteogenic supplements (OS).DESIGN: A randomized and controlled trial.SETTING: General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA.MATERIALS: The subjects were rabbit mesenchymal stem cells cultured by the author.METHODS: This experiment was conducted at the Center of Orthopaedic Surgery, General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA from June 2004 to December 2004. ①Rabbit MSCs cultured in vitro were treated with different growth factor (100 μg/L rhBMP-2, 100 μg/L bFGF, 10 μg/L rhBMP-2and 100 μg/L bFGF and OS; ②The proliferation and differentiation of MSCs were observed through activity of MTT, expression of alkaline phosphatase(ALP), and von Kossa staining.MAIN OUTCOME MEASURES: the rate of proliferation and the activity of ALP.RESULTS: ①rhBMP-2 could promote the proliferation and differentiation of MSCs, especially the cell differentiation; ②bFGF could stimulate the proliferation , the cellular proliferation rate increased 100% as compared with control group, and has no effect on differentiation of MSCs , but it could enhance effect on the cell proliferation of rhBMP-2.CONCLUSION: bFGF and rhBMP-2 are effective induction factors for MSCs. Both of them can stimulate the proliferation and differentiation of MSCs in vitro. bFGF and rhBMP-2 exerted a synergetic action in speeding up the pace of osteoinduction and osteogenesis and can be used to differentiate seed cells for tissue engineering bone.

Objective To discuss methods and clinical efficacy of patients treated with arthrolysis for posttraumatic elbow stiffness with heterotopic ossification.Methods The study involved 16 patients with posttraumatic elbow stiffness combined with heterotopic ossification treated by arthrolysis between June 2007 and June 2011.There were 11 males and 5 females,at average age of 29.6 years (range,18-53 years).Time from injury to surgery averaged 10.7 months (range,8-14 months).Other than medial approach for only one patient,the rest adopted medial to lateral approaches to have a complete clearance of periarticular heterotopic ossification tissue and hyperplastic tissue as well as partial resection of articular capsules and ligaments.Besides,seven patients were fixed using hinged external fixators.After surgery,three weeks of oral celecoxib was given for the patients.Rehabilitation was started immediately after operation.Range of motion (ROM) of the elbow and Mayo elbow pcrformance score (MEPS) were used to determine clinical results.Results All patients were followed up for 8-17 months (mean 13.4 months).ROM of the elbow (extension lag,flexion,pronation and supination)showed an improvement from (45.2-3.5)° to (27.2 ±8.4)°,(68.1-11.8)° to (106.8 ± 16.4)°,(55.8 ± 8.2) ° to (80.5 ± 3.3) °,and (53.7 ± 6.3) ° to (83.1 ± 5.3) ° respectively (P ＜ 0.01).MEPS increased from (46.8 ±7.0) points to (83.2 ±9.4) points after operation (P ＜0.01).According to MEPS criterion,the results were excellent in seven patients,good in five and fair in four.Conclusion With respect to posttraumatic elbow stiffness with heterotopic ossification,satisfactory therapeutic results can be achieved by thorough preoperative evaluation,strict control of surgical indications,appropriate selection of intraoperative techniques and early systematic rehabilitation.

Objective To compare and evaluate the defect-repaired capabilities of human bone morphogenetic protein-2(hBMP-2) gene modified tissue engineered bone in the segmental bone defect model of rabbit's radius.Methods Rabbit's bone mesenchymal stem cells (BMSCs)were transferred with hBMP-2 gene through Adeno-XTM adenoviral expression systems,then seeded onto the compound scaffold of calcium phosphate cemept(CPC)and fibrin glue(FG)to construct a new kind of gene modified tissue engineered bone after proliferation in vitro for three weeks(Group A).Meanwhile,the compound scaffold of calcium phosphate cement(CPC)and fibrin glue(FG),which were seeded by rabbit's bone knesenchyrmal stem cells(BMSCs) after proliferation in vitro for three weeks(group B)and the compound scaffold without cells(Group C)acted as control groups.Then,three kinds of reconstructive modalities were implanted into segmental bone defect of donator rabbit's radius.Besides these three groups,bone defect model of rabbit's radius without treatment(Group D)represented blank group.The defect-repaired capabilities were assessed by gross observation,radiograph,Single Photo Emission Computed Topography (SPECT)and histological analysis in the 4th week,8th week and 12th week after operation.The rates of bone healing in the different groups were compared each other.Results All defects that had been treated with implants(Group A,B,C)exhibited new bone formation and could attain osseous tissue healing 12 weeks after operation,but defects in blank group(Group D)were repaired only by fibrous tissue.The defects in the Group A regenerated more new bone,bridged earlier and stronger than those in the Group B and Group C.The quantity and rate of new bone formation in the Group B and Group C had no significant difference and the rates of bone healing in different groups showed the same results.Conclusion hBMP-2 gene modified tissue engineerod bone have better potential to form new bone and the rate of bone healing in repairing bone defects is higher,so this way is an optimal kind of material for artificial bone graft.

Objective To introduce a new design of interlocking system which is easy in use, makes the distal fracture fragments well aligned and rigidly fixated, reduces exposure to radiation for the surgeon and patient, and allows for a decrease in operating time. Methods The new interlocking system was designed to be a self-locking nail with bevels (b-SLN). According to the bevel principle, the axial force of the nail should be turned into a transverse force so as to control the transverse nail's movement. 10 dry-bone simples were made into the fracture model of the middle-femur to test the prototype nail. The retention of the nail in the intramedullary cavity was evaluated by the radiogram. The mechanical properties of a simulated model of single leg loading were tested on the instron-1342 type MTS. Results The prototype nail performed well as designed. The process was stable and reliable. The retention in the intramedullary cavity was fine. The shearing force between the transverse nail and main nail was enough to cut anything around them. The mechanical properties of b-SLN were similar to those of the Grosse-Kempf nail, better than auto fork compress locked intramedullary nail, and much better than MHUA nail and Ender's nail. Conclusions The structure of b-SLN is simple and reliable. There is no focus-point under stress. Its biomechanic properties are satisfactory. It is easy to use with no need of fluoroscopes in the operating theatre.