BACKGROUND: Many studies have suggested that artificial joint replacement has a greater advantage in the treatment of cases of elderly osteoporosis, comminuted fractures and unable to internal fixation or failure of internal fixation. OBJECTIVE:To analyze the curative effect of cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture. METHODS: Totaly 18 patients with unstable intertrochanteric fracture, aged>75 years, were enroled and underwent cemented artificial femoral head arthroplasty. At 3 months after replacement, the curative effect was evaluated according to the Harris hip joint function score method. The early complications after replacement and long-term complications of prosthesis were observed by folow-up. RESULTS AND CONCLUSION:Al these 18 patients were folowed up for 13 to 34 months, and had no infections, pressure sores, femoral shaft fractures and other complications. X-ray films showed that the frauture healed wel, without prosthesis infection, dislocation, loosening, sinking and breaking. After 3 months of replacement, al patients returned to pre-injury level of walking function. The curative effect was excelent for eight cases, good for seven cases, fair for two cases, poor for one case. These results demonstrate that cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture has good biocompatibility and stability, and can restore the limb function of patients. 

0.05 ). The assessments of the 4 examiners were uniform(?=0.57~0.65).Conclusion:Radiograph can provide essential evidence for the clinical diagnosis of the vertical root fracture in mandibular first molar.

In this study we used two types of cell cultures, i.e., anchorage-dependent basket and full suspension batch cultures of sTNFRII-gAD-expressing CHO cells in the CelliGen 310 bioreactor (7.5 L) to compare their yields in order to optimize the culturing conditions for efficient expression of sTNFRII-gAD fusion protein consisting of soluble tumor necrosis factor receptor II and globular domain of adiponectin. The anchorage-dependent basket culture was performed in 4L 10% serum-containing medium with the final inoculating concentration of 3 x 10(5) to 4 x 10(5) cells/mL of sTNFRII-gAD-expressing CHO cells for 3 days, and then switched to 4 L serum-free LK021 medium to continue the culture for 4 days. The full suspension batch culture was carried out in the 4 L serum-free LK021 medium with the final inoculating concentration of 3 x 10(5) to 4 x 10(5) cells/mL of sTNFRII-gAD-expressing CHO cells for 7 days. The culturing conditions were monitored in real-time to maintain pH and dissolved oxygen stability through the whole process. The supernatants were collected by centrifuge, and the protein was concentrated through Pellicon flow ultrafiltration system and then purified by DEAE anion exchange. The results showed that the yields of sTNFRII-gAD fusion protein were 8.0 mg/L with 95% purity and 7.5 mg/L with 98% purity in the anchorage-dependent basket and the full suspension batch cultures, respectively. The study provided the framework for the pilot production of sTNFRII-gAD fusion protein.
Adiponectin ; biosynthesis ; genetics ; Animals ; Bioreactors ; CHO Cells ; Cell Culture Techniques ; methods ; Cricetinae ; Cricetulus ; Receptors, Tumor Necrosis Factor, Type II ; biosynthesis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics

BACKGROUND:Rheumatoid arthritis is an autoimmune disease, and traditional treatment methods are difficult to effectively solve the patient's lack of immune tolerance mechanisms. With the development of stem cel s in regenerative medicine, stem cel therapy has become a hot spot in the treatment of autoimmune diseases.
Currently, studies on cel transplantation for the treatment of rheumatoid arthritis are rarely reported.
OBJECTIVE:To study the influence of umbilical cord mesenchymal stem cel therapy on the changes of Th1/Th2 and Treg in rheumatoid arthritis patients, thereby seeking new therapies for rheumatoid arthritis.
METHODS:We selected 180 cases of rheumatoid arthritis, including 27 patients as control group undergoing non-steroidal anti-inflammatory drugs and anti-rheumatic drugs and 153 patients as cel treatment group undergoing intravenous infusion of 40 mL umbilical cord mesenchymal stem cel s at a density of 4×107. Dosing regimen was same in the two groups. The 76 of 153 patients accepted second cel therapy at 3-4 months after the first cel therapy. After fol ow-up of 3 and 6 months, clinical effectiveness evaluation (DAS28, HAQ, ACR20), rheumatoid factor, anti-CCP antibodies, T cel subsets, Th cytokine were detected;for patients with second cel therapy, T cel subsets and Treg were detected at 8 months after treatment.
RESULTS AND CONCLUSION:(1) At 3 months after treatment, the DAS28, HAQ and ACR20 scores were significantly lower in the cel treatment group than the control group (P<0.01). (2) At 3 and 6 months after cel therapy, the DAS28 and HAQ scores were significantly decreased in the cel treatment group (P<0.01), and these scores were decreased continuously after second cel therapy (P<0.01). (3) Interferon-γlevel in cel s did not change obviously at 3-6 months after treatment, but the interleukin-4 level was gradual y increased at 6 months after treatment (P<0.05). (4) The number of Treg cel s was significantly increased at 3-6 months after treatment (P<0.01), which was closely related to ACR, especial y ACR70 percentage (P<0.05);the ratio of CD4+Treg was increased significantly at 3 months after treatment (P<0.05), and this increasing trend was also maintained at 6 and 8 months after treatment, but there was no significant difference (P>0.05). (5) B cel levels were significantly decreased at 6 months after treatment (P>0.05);the rheumatoid factor value was significantly decreased at 3-6 months after treatment (P<0.05). (6) There was no change in anti-CCP antibody and interleukin-17 levels at 3-6 months after treatment. These findings indicate that after treatment with umbilical cord mesenchymal stem cel s, the Th1/Th2 tends to balance and Treg level is elevated in rheumatoid arthritis patients, which are directly related to clinical trials and symptomatic relief. Therefore, standard rheumatism medication combined with umbilical cord mesenchymal stem cel transplantation can improve immune network effects, adjust the immune tolerance and prevent il ness progress in rheumatoid arthritis patients.

Objective To observe the effect of rhBMP-2 (bone Guide) in the treatment of femoral neck fracture. Methods In our hospital from January 2016 to May 2017, 86 patients with femoral neck fracture were randomly divided into observation group and control group, 43 cases in each group. The observation group was treated with closed reduction and cannulated screw fixation compared with cannulated screw tunnel rhBMP-2 (recombinant human bone morphogenetic protein-2) implantation for the treatment of the control group. Observe the curative effect and adverse reaction. Results The observation group's bone healing rate and hip joint function score higher than the control group, and intraoperative blood loss and postoperative bed time, bed time, fracture healing time, time, the incidence of femoral head necrosis, incidence of complications were lower than those in control group. The difference was significant (P＜0.05); there was no significant difference between the two group operation time (P＞0.05). Conclusion The treatment of femoral neck fracture with bone guide and percutaneous screw placement has good therapeutic effect, and it can prompt patients to recover as early as possible and reduce the occurrence of osteonecrosis of the femoral head.