[Objective]To evaluate the therapeutic effects of the operation of latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement for treatment of thoracolumbar more vertebral compression fractures with osteoporosis.[Method]Twenty-two patients with osteoporosis and more vertebal compression fractures received latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement.Functions of spinal cord nerve were damaged in different degrees.Preoperative auxiliary examination of X-ray,CT and MRI was used.The spinal stabilization,spinal cord function and the state of chronic lumbodynia were observed by postoperative photographs.[Result]All the patients were followed up,and the implants showed bone union.Sensation and motor function were improved in various degrees.The pain of chest and back or other complaints were obviously relieved.No recurrence occurred.Vertebral bodies by vertebroplasty had no leakage and the short-term effects were satisfactory.[Conclusion]The operation of latero-anterior internal fixation by plate screw combining vertebroplasty is profitable to simultaneously improve nerve compression of thoracolumbar kyphosis,spine instability,and other chronic pain caused by osteoporotic vertebral compression fractures.

BACKGROUND:It wil provide a new insight into the future application of bone marrow mesenchymal stem cels in the treatment of spinal cord injury and tissue engineering by studying the effect of activation of Wnt signaling pathway in the neuronal differentiation of bone marrow mesenchymal stem cels.
OBJECTIVE: To detect the expression of related genes by gene chip technology during the neuronal differentiation of bone marrow mesenchymal stem cels.
METHODS:Human bone marrow mesenchymal stem cels were isolated and purified, and passage 5 cels were obtained. GatewayTM technology was used to build lentiviral vectors that was used to transfect Wnt-1 into human bone marrow mesenchymal stem cels. Control, non-transduction and transduction groups were set in this study. Human bone marrow mesenchymal stem cels were then induced to differentiate into neurons. Cel morphology was observed under inverted phase contrast microscope. Gene chip was used to detect the regulation changes and the differential expression of related genes in the Wnt signaling pathway.
RESULTS AND CONCLUSION: Under the scanning electron microscope, the transfected cels were found to have the similar morphology of neuron-like cels. Analysis by the gene chip hybridization technique showed that 3 287 genes were up-regulated and 4 215 genes were down-regulated in the signal pathway. In the Wnt signaling pathway, genes related to the nervous system development and differentiation were up- or down-regulated. It is verified that the Wnt signal pathway is activated via Wnt-1 transduction, and the downstream genes appear to have genetic transcription so as to promote the neuronal differentiation of human bone marrow mesenchymal stem cels.

Present research of bone marrow mesenchymal stem cells (BMSCs) mainly contains the studies of the characteristics of biology, the induced differentiation, the mechanism of regulation and so on. The research of the characteristics of biology and the osteogenic and adopocitic induction are comparatively mature, showing many biological characteristics such as adherence, plasticity, heterology, self-renewal, rapid clone formation and transplantation. Adherence combined with density gradient centrifugation method is widely used in the isolation and purification of BMSCs. As to neural induction, there are many uncertainties, such as morphous of typical neurons, specific labeling, excitability, synaptic connection with other neurons, synaptic potential, and whether the induction of fully functional neurons from BMSCs is possible. In addition, the research of the regulation mechanism is mostly uncertain, and there are still many safety problems.

BACKGROUND:Treatment prescription for intervertebral space infection is controversial. Conventionally,lying in bed,physical therapy,symptomatic therapy,and a large dosage of antibiotics were used frequently;however,the application of antibiotics was still controversial. OBJECTIVE:To explore the implantation of calcium sulfate powder combined with antibiotics for the treatment of suppurative spondyfitis of the thoracic vertebra. DESIGN,TIME AND SETTING:A retrospective case analysis was performed at Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College from October 2000 to August 2008. PARTICIPANTS:A total of 24 patients with suppurative spondyfitis of the thoracic vertebra,including 9 males and 15 females and aging 42-71 years,were provided by Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College. Suppurative spondyfitis of thoracic vertebra occurred on T6/7(n=9) ,T7/8(n=6) ,T8/9(n=3) ,T10/11(n=4) ,and T6/8(n=2) . Among all patients,8 cases had severe pain,myospasm of dorsal muscles,passive position,difficulty of turning over,and lateral or bilateral melosalgia;11 had anorexia and athrepsy;2 had paresis of both lower extremities and difficulty of automatic micturition;3 had diabetes mellitus. METHODS:After the 24 patients with suppurative spondyfitis of the thoracic vertebra received the cleaning operation on focus infection through latero-anterior thoracic cavity,the defect area of bone was inserted with titanium case filled with the calcium sulfate cement combined with antibiotics,and then the internal fixation and a plenty of antibiotics were applied after the operation. MAIN OUTCOME MEASURES:Recovery rate was evaluated using JOA assay,and blood sedimentation and bone healing were observed. RESULTS:All the 24 patients received the follow-up with the mean duration of 5.8 years. One case did not recovered,but other 23 patients recovered obviously. The recovery rate was 30%-100%. Blood sedimentation decreased from(86.74?10.56) mm/h before operation to(26.40?5.42) mm/h at 5 months after operation. Bone fusion occurred on all 24 patients,and the time lasted for 3-8 months. Relative death,complications,and infection-induced relapse were not found during the following up. CONCLUSION:To insert the titanium case filled with the calcium sulfate cement combined with antibiotics into the defect area of bone created by the cleaning operation on focus infection and combine with the application of the internal fixation by one stick and two screw and the brace for back and lumbar is an effective therapy for treatment of suppurative spondyfitis of the thoracic vertebra.

BACKGROUND:There are stil about 10%-30%of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are col ectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons. OBJECTIVE:To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor. METHODS:From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, al patients were fol owed-up to evaluate the effect of the treatment. RESULTS AND CONCLUSION:The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. Al incisions healed by first intention. Al patients were fol owed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the fol ow-up after 1 month and (25.35±2.61) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). According to reforming Macnab standard, the results were excel ent in 53 cases and good in 9 cases at the last fol ow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimal y invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.

OBJECTIVEIn our study, the function of the third-order branches of the mesentenc artery was measured by microvascular ring technique, which can be used to detect microvascular function in some disease related to microvascular dysfunction.

METHODSIsolated, fixed, standardized and then activated the third-order branches of rat mesenteric artery. Microvascular tone was measured by systolic and diastolic drags respectively, with the help of DMT tension apparatus and PowerLab data acquisition system.

RESULTSThe third-order branches of rat mesenteric artery showed excellent response to vasoactive drugs. The contraction effect of norepinephrine (NE) reached 19 in mN. When acetylcholine (Ach) or sodium nitroprusside (SNP) of 10(9)-10(5)mol/L was added, vascular tones showed gradient drop: 80% of maximal relaxation when adding ACh, while 95% of maximal relaxation when adding SNP.

CONCLUSIONThe third-order branches of the mesenteric artery function was successfully detected by using microvascular ring technique.

Acetylcholine ; pharmacology ; Animals ; In Vitro Techniques ; Male ; Mesenteric Arteries ; drug effects ; physiology ; Nitroprusside ; pharmacology ; Norepinephrine ; pharmacology ; Rats ; Vasoconstrictor Agents ; pharmacology ; Vasodilation ; physiology ; Vasodilator Agents ; pharmacology

Objective To explore the effects of gossypol acetate on the morphological features and the gene expression in the femoral head of Sprague-Dawley rat in vivo after treated with dexamethasone .Methods Dexamethasone(Dex) was injected into the abdominal cavity of SD rats at an dose of 10 mg/kg ,twice a week ,and feed gossypol acetate 5 mg · kg -1 · d-1 .The controls re-ceived saline 2 mL injection .The treatment lasted for 12 and 20 weeks .The slices of the femoral head were made for HE and immu-nohistochemical study .The total mRNA was extracted for RT-PCR assessment .Results The cancellous bone trabecular became sparse ,trabecular bone area ratio decreased ,bone marrow fat tissue increased .These changes were fitted for pathological character of bone necrosis .The gossypol acetate could not affect the pathological changes .The proportion of the positive stained osteoblasts increased ,adipocytes decreased .PPARγ,C/EBPα,11β-HSD1 expression enhanced ,Runx2 down regulated in the treatment groups and GAA group .Conclusion Dex can induce evident pathological changes conform to the characters of femoral head necrosis .They may have closed correlation between 11β-HSD1 and the gene expression .But GAA could not affected the pathological changes and abnormality of the gene expression .

Objective Through the research and analysis of guangdong medical college affiliated hospital orthopaedic hospitalized patients with a diagnosis of osteoporosis in Zhanjiang,this paper provide theoretical basis for the prevention of osteoporosis frac-ture.Methods The elderly aged over 40 years old,living in this area for a long time.Data was collected from August 2012 to Feb-ruary 2014,hospitalized patients in guangdong medical college affiliated hospital were diagnosed with osteoporosis.Contents include general situation survey,medical examination,venous blood tests and bone mineral density testing.Results Fracture group average age is older than the non fracture group;the fracture group lumbar spine bone mineral density(LSBMD)and femoral neck bone min-eral density(FNBMD)T value and Z value and serum calcium group is greater than the fracture and the differences were statistically significant(P <0.05).Fracture group in gender divided into two groups for comparison,in which women older than men,and the difference was statistically significant(P <0.05),male LSBMD T and Z values and FNBMD T value is greater than the female and the difference was statistically significant(P <0.05).According to the 10 year age group,Each age group compared with the frac-ture number and non fracture number,in the age group of 70-80 fracture number were the most;All age groups in LSBMD,FNB-MD,serum calcium(Ca)and VitD compared,non fracture group is most higher than that of fracture group.The influence factors of the fractures for non conditional Logistic regression analysis,age,LSBMD,FNBMD T value increased were risk factors for fracture, VitD,FNBMD,LSBMD T value increased were protective factors of fracture.Conclusion Need as soon as possible to prevent osteo-porosis,especially before the age of 40,try to improve the peak bone density,to prevent the occurrence of osteoporosis in the future.

? AlM: To evaluate the clinical application of simply performing phacoemulsification or combining intravitreal Ranibizumab injection in the treatment of cataract combined with diabetic retinopathy.
?METHODS:Forty-six patients (46 eyes) were recruited in this study. All of the patients were non-proliferative diabetic retinopathy without significant macular edema. They were randomly divided into two groups, the control group simply performed phacoemulsification, while the study group performed intravitreal Ranibizumab injection and phacoemulsification. Observation of indicators included the condition of best corrected visual acuity (BCVA), intraocular pressure, macular retinal thickness and complication at preoperative and postoperative 1, 6mo.
? RESULTS: BCVA and macular retinal thickness of patients in two groups had no differences in the preoperative and postoperative 1mo. At postoperative 6mo, the BCVA of the study group was better than that in the control group, while its macular retinal thickness was thinner than that in the control group (P<0. 05). The ratio of macular edema ( central macular thickness was >60μm than that in control group) was 13. 0% eyes in the study group which was significantly lower than the control group (47. 8%;P = 0. 033). The complications was no significant differences in two groups and neither occurred severe complications.
?CONCLUSlON: lntravitreal Ranibizumab injection can reduce the development of macular edema and improve the BCVA after phacoemulsification.

[ABSTRACT]AIM:Toexploretheeffectoftheelasticmodulusandsizesofliquidcrystal(LC)phasesonosteo-genic differentiation based on OPC/PU composite substrate by mimicking the microenvironment in rat bone mesenchymal stem cells (rBMSCs).METHODS: A series of composite substrates with different elastic modulus were constructed via modulation of LC content in the composites .The surface phase structure was observed by polarized microscopy , and the mechanical property was measured by a universal material testing machine .Furthermore, the laser confocal microscope was employed to observe the spreading , polarization and the cytoskeleton arrangement of the rBMSCs .The proliferation of rBM-SCs was evaluated by CCK-8 assay.The specific mRNA expression of osteogenic differentiation such as collagen Ⅰ, and osteopontin on the composite membranes was detected by real-time PCR.RESULTS:The size and number of LC phase in-creased and the elastic modulus of the composite substrates decreased with the increase of the LC content .The rBMSCs ex-hibited better characteristics of initial adhesion , spreading and proliferation on the OPC 10-PU and OPC30-PU in the early and medium culturing .The rBMSCs displayed higher expression of collagen Ⅰ and osteopontin on the OPC10-PU in the early and medium osteogenic induction , while the high expression of these osteogenic genes occured on the OPC 30-PU and OPC50-PU in later osteogenic induction .The emphasis of genetic expression was switched from collagen Ⅰin the early and medium osteogenic induction to osteopontin in the later stage .CONCLUSION:When the content of LC remained low in the composite substrates , rBMSCs mainly responded to the mechanical stimuli induced by substrate stiffness and exhibited distinguished cellular behaviors;with the increase in the LC content , rBMSCs had strong interactions with LC by sensing the viscoelasticity of LC , probably resulted from the contribution of both substrate stiffness and the viscoelasticity of LC phase .