BACKGROUND: The improvement in production technology of new materials including artificial ligament reduces material rupture caused by fatigue and histocompatibility-related synovitis and other complications, leading to a wide application of artificial ligament. OBJECTIVE: To evaluate the histocompatibility and clinical curative effects of reconstruction of the anterior cruciate ligament (ACL) of the knee with ligament advanced reinforcement system (LARS) artificial ligament using arthroscopy. DESIGN: A completely randomized clinical design. SETTING: Department of Orthopedics, Second Affiliated Hospital of Soochow University. PARTICIPANTS: Thirty-two cases of ACL injury received LARS artificial ligament in the Department of Orthopedics, Second Affiliated Hospital of Soochow University From June 2005 to June 2006 and were recruited for this study. The 32 patients averaged 21 years old and were injured in sports. Prior to surgery, MRI showed injury to ACL and semilunar valve in all patients. Written informed consent for therapeutic contents was obtained from each patient. METHODS: Thirty-two patients with injury to ACL of the knee underwent arthroscopic ACL reconstruction. LARS was used to reconstruct the ACL. The LARS was produced by Laboratoire d'Application et de Recherche Scientifique, France (Certification No. CE0459, 1SO9002-EN46002). Artificial ligament was made of polyethylene terephthalate, which had the material type L021201 (left knee) and L021202 (right knee). Artificial ligament was designed to imitate the anatomic structure and biomechanical principle of artificial ligament with specification No. AC120 2BL(left knee) and No. AC120 2BR(right knee). The lot number for artificial ligament in China [import 03460468 (in 2004)]. All reconstructions were performed by a group of physicians who have worked for more than 10 years in the Department of Orthopedics, Second Affiliated Hospital of Soochow University and directed by a physician titled with doctor's tutor and chief physician. All included physicians were qualified to perform the surgery. The protocol of treatment was approved by the hospital's Ethics Committee. MAIN OUTCOME MEASURES: Biocompatibility of LARS artificial ligament was observed. Patients were followed up for 24 months on average to score knee function by Lysholm test and subjective satisfaction by Tegner test. RESULTS: All of 32 cases were followed up. The follow-up periods were 18 months (3 cases), 20 months (7 cases), 24 months (8 cases), 28 months (12 cases) and 30 months (2 cases). No complications, such as acute or chronic synovitis, LARS artificial ligament rupture, or limited range of motion were found. The knee joint function was ideal with the range of motion [0° to (128±11.56)°]. The postoperative scores with 85.6 ± 2.24 were significandy higher than the preoperative scores with 45.3±1.31 according to the Lysholm knee joint function evaluation system (P < 0.05). The instability of every knee disappeared with anterior drawer sign negative. Tegner's scores were also increased. CONCLUSION: The biocompatibility of LARS is optimal. LARS artificial ligament reconstruction showed excellent knee joint function and subjective satisfaction degree.

BACKGROUND: Of the many growth factors that can enhance bone formation, the bone morphogenic proteins (BMPs) are probably the most effective and most widely studied for applications requiring new bone growth. To analyze the effects, the gold standard is patient randomized control trials, however, only BMP-2 and BMP-7 have reached this level of investigation. OBJECTIVE: In this meta analysis the recent findings concerning the application of recombinant human bone morphogenic protein-2 (rhBMP-2) in tissue engineering and gene therapy, the options of its transfer means, as well as the ideal time of delivery is discussed. RETRIEVAL STRATEGY: The relevant articles published between January 1997 and December 2006 were searched for in Pubmed database by researcher of this article with the key words "recombinant human bone morphogenic proteins (rhBMPs), tissue engineering, gene therapy" in English. A total of 81 articles were selected and reviewed by the standards of: ① Having close relations with the application of rhBMP-2 in tissue engineering and gene therapy; ②The most recently published articles and articles in authority journals were chosen in the same field. Exclusion criteria: repetitive studies. LITERATURE EVALUATION: The main sources of literature are the application of rhBMP-2 in tissue engineering and gene therapy. Among the 52 selected articles, 12 are reviews or meeting reports, others are clinical or elementary experimental studies. DATA SYNTHESIS: BMPs are members of the TGF- β superfamily, which are released by osteoprogenitor cells and typically improve bone growth. The use of scaffolds, cells, and growth factors for bone regeneration is called bone tissue engineering. The application of rhBMP-2 in tissue engineering holds great promise for the augmentation and manipulation of bone and soft tissue repair. One potential alternative to direct rhBMP-2 delivery is to develop a biologic cellular delivery vehicle via gene therapy to enhance bone formation. The application of rhBMP-2 in gene therapy holds great promise for the augmentation and manipulation of bone and soft tissue repair. The research indicated that the dosing, time, and transfer mode of rhBMP-2 to the desired targets remain a facing challenge. Further studies should focus on the ideal dosing, time and method of delivery, which should be easily and reliably displayed, cost effective, and clearly controlled. CONCLUSION: The future of bone and soft tissue repair will likely be based on biologic augmentation of healing and tissue regeneration. The use of rhBMP-2 holds great promise for the augmentation and manipulation in tissue engineering and gene therapy.

Objective To evaluate the impact osteolytic cytokines of expression induced by micrometer-diameter wear particles(Ti-6Al-4V and UHMWPE).Methods Filtration air was subcutaneously injected into rats'back 6 times(3 mL q?d).After a week,wear particles suspension(group A: Ti-6Al-4V,group B: UHMWPE) or physiological saline(group C) was injected into air pouch tissues.After 14 days,pouch tissues were obtained from killed rats,and were weighted,wax embedded and stained with hematoxylin and eosin, observed under microscope.AKP of serium with Automated Biochemical Analyzer,IL-6 and TNF-? expression with immunohistochemical method,and mRNA expression of extracellular matrix metalloproteinase inducer(EMMPRIN) with real-time Polymerase Chain Reaction method were detected.Results Air pouch tissues were similar to limiting membrane of periprothesis tissue in the cases of aseptic loosening.As to pouch tissue weight,there was a significant increase in group B than in group C(P

Using the weight-average molecular weight 50 000 polylactic acid (PLA) as a carrier, and a certain proportion of erythromycin (EM) and prednisone acetate (PNA) to mixed prepare the compound erythromycin sustained release preparation (sustained-release tablets). Using ultraviolet spectrophotometry and high performance liquid chromatography (HPLC) to detect separately the release amount of EM and PNA in vitro medium. The sustained-release tablets release for about 21 days, the average content of EM is 99.7 mg/table, RSD = 0.82%; and the average content of PNA is 10.03 mg/table, RSD = 0.93%. Within 21 days, the cumulative releases of EM and PNA are 86.1% and 78.3%, respectively. The drug release is steady and slow after 5 days, the burst release phenomenon in early stage is more significant. The results showed that the sustained-release tablet preparation method is feasible, the release performance is good and the clinical efficacy is significant.

Objective The infants born to hepatitis B virus (HBV) carrier mothers are the high risk children who are susceptible to HBV infection. About ten years of studies show that hepatitis B virus vaccine plus hepatitis B immunoglobulin (HBIG) inoculation can interrupt mother to infant transmission, which has been generally accepted. About 70%～90% children can be protected by this way. Intrauterine HBV infection is responsible for most of the immunoprophylaxis failure, so we study on a combined antepartum with postpartum to interrupt transmission of HBV from HBsAg positive and HBeAg positive mothers to their infants. Methods HBV carrier mothers, whose HBsAg and HBeAg were both positive, and later their infants were randomly divided into two groups. The gravidas in group 1 received 400 IU HBIG every four week (from pregnancy for 28 week to delivery); the gravidas in group 2 didn't receive any HBIG (the control group). After delivery, all the infants in both groups were given 2 dose of 200 IU HBIG at birth and at 15 days, then accepted 3 dose of HBV vaccine at 1, 2 and 7 months. These infants were periodically followed up until 1 year of age and their sera were obtained to test HBV markers. 104 mothers and their 105 infants were followed for 12 months. Results There were 51 infants in group 1 and 54 infants in group 2. In group 1, the rate of intrauterine HBV infection was 5.9%, and at 12 month old, the rate of chronic HBV infection was 5.9% and the rate of infants with the protective level against HBV infection was 94.1%. In group 2, the rate of intrauterine HBV infection was 18.5%, and at 12 month old, the rate of chronic HBV infection was 16.7% and the rate of infants with the protective level against HBV infection was 83.3%. ? 2 test was used to compare the different rates of intrauterine HBV infection between the two groups (? 2=3.86, P

1.The sagittal and transverse diameters of 1,456 transverse foramina in 728cervical vertebrae were measured.The data are as follows:transverse diameter(mm) sagittal diameter (mm)Left Right Left RightMale(702 cases) 6.0?1.0 5.9?1.1 5.4?1.2 5.3?1.1Female(754 cases) 5.9?1.0 5.8?1.1 5.3?1.1 5.1?1.12.Among the 710 transverse foramina of 357 cervical vertebrae observed,mostof them are of the elliptical type.3.19.3% of double transverse foramen were found in 710 transverse foraminawhich were mostly encountered at the 6 th cervical vertebra.4.The mean value of the external diameter of the cervical part of the vertebralartery is 4?0.7mm.in 40 sides of specimens.5.63.1% of the vertebral artery in the 710 transverse foramina were foundmedial to its accompanying vein.6.According to the relationship between the sagittal(X_1)and transversediameter(X_2)of the transverse foramen and the diameter(Y)of the vertebralartery,a formula,(?)=1.859+0.172 X_1+0.24 X_2,of multiple regression was formulatedThus,the estimated diameter of the vertebral artery from the sagittal diameter X_1and transverse diameter X_2 of the transverse foramen could be obtained and it maybe helpful for clinical practice.7.In case of arthrosis,the vertebral artery could be compressed by the unco-vertebral joint which are found mostly at the level of the 4～5th cervicalvertebrae.

Objective To investigate the impact of injecting hepatitis B immune globulin(HBIG)at third trimester of pregnancy on the nucleotide sequences of precore and basal core promoter(BCP)regions of hepatitis B virus(HBV)DNA.Methods One hundred and twenty pregnant women(67 in HBIG group and 53 in no-HBIG group)were enrolled in this study.Serum HBV DNA level was determined using quantitative real-time polymerase chain reaction(RT-PCR).Relevant serum markers (HBeAg,HBsAg)of HBV were detected by enzyme-linked immunosorbent assay(ELISA).Nucleotide fragments of HBV precore and BCP regions were amplified by nested PCR and then sequenced by automated DNA sequencer.Data were analyzed using t test and chi-square test.Results Sera of 33 women in HBIG group were collected before interruption with HBIG and at delivery.Precore and BCP regions of HBV DNA were amplified and sequenced successfully from double sera of 23 among 33 women. The rates of total nucleotide substitute in precore and BCP regions, that in precore region, and that in BCP region before and after interruption were 1.5% and 1.4%, 0.7% and 0.6%, 1.7% and 1.7%, respectively (Fisher's exact test, X2 =0.627, 0.689, 1.000, respectively,all P＞0.05). The rates of total mutations of hot points including 1896G→A,1899G→A,1762A→T,1764G→A before and after interruption were 27.2% and 13.0%, respectively (x2=5.717, P=0. 017). But the prevalences of these hot points mutations before and after interruption were 30.4%and 17.4%, 17.40/00 and 4.3%, 26.1% and 13.0%, 34.80/00 and 17.4%, respectively, which were all not significantly different (P＞0.05). The rates of nucleotide substitute in precore and BCP regions,that in precore region, and that in BCP region of 53 women in HBIG group and 47 women in no-HBIG group at delivery were 0.9% and 0.8%, 0.3% and 0.3%, 1.1% and 0.9%, respectively (Fisher's exact test, )x2=0.434, 0.839, 0.340, respectively, all P＞0. 05). The rates of total mutations of hot points of women in HBIG group and those in no-HBIG group at delivery were 5.7% and 10.1%,respectively, which was not significantly different (P＞0.05). These hot points mutations including 1896G→A,1899G→A,1762A→T, 1764G→A of women in HBIG group and those in no-HBIG group at delivery were 9.4% and 14.9%, 0 and 2. 1%, 7.5%0 and 10.6%, 5.7% and 12.8%, respectively,which were all not significantly different ( P＞0.05). Conclusions Antepartum interruption of HBV intrauterine infection with HBIG may not raise the nucleotide mutations in precore and BCP regions of HBV DNA. On the other hand, antepartum interruption may decrease mutations of hot points in the precore and BCP regions of HBV DNA.

Objective To explore the effect of diphosphonate on expression of matrix metalloproteinase-9(MMP-9) and cathepsin K(CK) in subchondral bone of unstable rabbit knee joints.Methods Fifty male New Zealand white rabbits were divided randomly into three groups according to random digits table:the control group (n=10),the model group (n=20).the diphosphonate group (n=20).Hulth model of unstable rabbit knee joint was achieved in the right knee joint.Ten rabbits from the diphosphonate group and 5 rabbits from the control group were sacrificed by aeroembolism at the second and tenth week postoperatively,respectively.Then the medial femoral condyles of the right knee were harvested.Specimens were processed for immunohistochemical analysis of MMP-9 and CK.Results Cells with expression of MMP-9 and CK could be found in the three groups at the second and tenth week after operation.Compared with the control group,there was a significant increase in the number of cells with expression of MMP-9 and CK in model group at the second and tenth week after operation.Diphosphonate could inhibit expression of MMP-9 and CK in cells.Compared with the model group,the number of cells with expression of MMP-9 and CK in diphosphonate group was fewer; there was a statistical significance between them.Conclusion Diphosphonate can inhibit the expression of MMP-9 and CK in subchondral bone of unstable rabbit knee joints,which can resist the bone resorption and protect articular cartilage.

Objective To investigate whether oral administration of probiotics can reduce complications induced by interventional therapy in patients with primary hepatic carcinoma and liver cirrosis.Methods Two hundred and sixty four patients with primary hepatic carcinoma and liver cirrhosis who underwent transarterial chemoembolization(TACE) were randomly divided into two groups.and patients in experimental group were given probiotics but not in control group.Shoa-term clinical manifestations.liver functions,blood routine and pain scores were compared between two groups.Results On the day 3 after therapy,the incidence of abdominal distension and constipation in experimental group were less than that in control group(x2=18.22 and 55.22,P=0.000);On the day 7 after therapy,the incidence of abdominal distension,constipation and infection in experimental group were less than that in control group(x2=5.35,13.5 and 19.14,P=0.021,0.000 and 0.000).There were no significant difference in other clinical manifestations,liver function,blood routine and pain scores between the two groups. Conclusion Oral administration of probiotics can reduce the incidence of some short-term complication induced by interventional therapy in patients with hepatic carcinoma and liver cirrhosis.

OBJECTIVE:To optimize the methanol extraction technology of tripterine in the fruit of Celastrus monospermus. METHODS:HPLC was adopted to determine the content of tripterine. Using extraction time,extraction times,solid-liquid ratio as investigation factors,extraction rate of tripterine as investigation index,orthogonal test was designed,and verification test was con-ducted. RESULTS:The optimal methanol extraction technology was as follow as 45% methanol extracting 2 h each time with sol-id-liquid ratio of 1:8 for 3 times. In the verification test,the average extraction rate of tripterine was 0.917 mg/g(RSD=2.85%, n=3). CONCLUSIONS:The optimized methanol extraction technology is stable and feasible with high extraction rate,and is suit-able for the extraction of tripterine in the fruit of C. monospermus.