BACKGROUND:In view of the unavoidable problems of autogenous and al ogenous bone grafts, it is an urgent need to develop biodegradable bone substitute materials, among which is calcium phosphate material that has become a hot spot in the domestic and foreign research. OBJECTIVE:To develop a biodegradable calcium phosphate material for bone repair based on tetracalcium phosphate (TTCP). METHODS:The biodegradable calcium phosphate cement made from TTCP, dicalcium phosphate anhydrous and different constituents of curing liquids was prepared under room temperature (about 25 ℃). The effects of solid components, liquid components as well as calcinations and drying temperature on the physical and biological performances were detected through X-ray diffraction test, hardness test, decay in a simulated body fluid, hemolysis and cytotoxicity tests, respectively, to select the bone repair material with excel ent performances. RESULTS AND CONCLUSION:When the calcination temperature was lower than 1300 ℃, TTCP was rarely available;only close to 1400 ℃, the relatively pure TTCP was gained. A large number of pure TTCP were gained by rapid cooling because of avoidance of the moisture impact, but slow cooling made the main products to be hydroxyapatite, suggesting that rapid cooling is essential to obtain pure TTCP. With the increase of the proportion of citric acid solution in the liquid phase, the pH values and the hemolysis rate in the bone cement soak solution were increased gradually, illustrating that citric acid solution is easy to induce hemolysis. In vitro cel experiments showed that the hemolysis rate of bone cement with a solution of 2:1 NH4/Na ratio was the lowest, and the biocompatibility was the best, which was the most favorable to cel growth. Cements was made of calcined powders sieved at 1400 ℃ and showed the shortest initial setting time, least effect on pH values, lowest disintegration rate and hemolysis rate, and slightest inhibition effect on the cel proliferation, indicating that the bone cements made of sieved powder after 1400 ℃ calcination is more suitable for clinical application.

BACKGROUND: Exercise has been proved to accelerate the proliferation of intervertebral disc cells and extracellular matrix production in healthy rats. For the degenerative intervertebral disc, whether exercise also has positive effects on its cell proliferation, extracellular matrix production or pain relief remains unclear. OBJECTIVE: To investigate the effect of exercise on the extracellular matrix production in a rat model of intervertebral disc degeneration.METHODS: A rat model of intervertebral disc degeneration was prepared by Freund's complete adjuvant injection into the intervertebral disc at L5-6 levels. Then, the model rats were allowed to have a rest for 2 weeks. All rats were then randomly divided into exercise and control groups. Rats in the exercise group were forced to run every day, while the controls allowed free activities in the cage. The behavioral tests were performed at 7, 14, 28, 42, 56 and 70 days after modeling; meanwhile, the intervertebral disc samples were collected used for alcian blue staining and immunohistochemical staining to detect the levels of proteoglycan, aggrecan and collagen type Ⅱ in the intervertebral disc cells, respectively.RESULTS AND CONCLUSION: Vocalization threshold on the rat back of punctured disc was significantly decreased, while grooming and wet-dog shaking were significantly increased at 7 days after modeling compared with the baseline (P < 0.05), suggesting that Freund's complete adjuvant injection successfully induces disc degeneration, hyperalgesia and abnormal behaviors. Further, the vocalization threshold and wet-dog shaking in the exercise group showed significant improvement compared with the control group after 14 days of exercise (P < 0.05), while the grooming was significantly reduced until the 28th day (P < 0.01), indicating that exercise can alleviate pain caused by disc degeneration in model rats. At 21 days after modeling, the levels of proteoglycan, aggrecan and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus were significantly decreased compared with the baseline (P < 0.01), indicating the occurrence of disc degeneration. After 14 days of training, the levels of proteoglycan, aggrecan, and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus in the exercise group were significantly increased compared with the control group (P < 0.01). Moreover, after 8-week exercise, the level of proteoglycan in the nucleus pulposus and annulus fibrosus in the exercise group was increased by 4-5 times compared with the control group, and levels of aggrecan and collagen type Ⅱ in the nucleus pulposus in the exercise group also was increased by 3-4 times compared with the control group. To conclude, exercise can promote extracellular matrix increased by production by increasing the levels of proteoglycan, aggrecan, and collagen type II in the degenerative intervertebral disc.

Objective: To investigate the effect of brucea javanica oil emulsion (BJOE) on the proliferation, collagen synthesis and ERK1/2 MAPK singaling pathway of hypertrophic scar fibroblasts (HSFs). Methods: The human hypertrophic scar tissues were collected, and HSFs were isolated, cultured and identified in vitro. Cells were treated with BJOE under the concentration of 0.5, 1, 5, 10, 20 and 50 mg/ml for 24 h respectively; the half inhibitory concentration(IC50)of 24 h was calculated. The experimental groups were treated for 24, 48, 72 h by BJOE at the IC50, the control group was conventionally cultured without BJOE. Cell proliferation was detected by CCK-8 assay and cell cycle was determined by flow cytometry (FCM). The morphological changes of cells treated with BJOE at a concentration of IC50 for 24 h were observed. The protein expression levels of collagen Ⅰ, vimentin, ERK1/2 and p-ERK1/2 were measured by Western blot. Results: The IC50 of BJOE was 1.176 mg/ml, so the concentration of 1 mg/ml was selected for the subsequent experiment. After 24, 48, 72 h treated with BJOE at a concentration of 1 mg/ml, the inhibition rates of BJOE on HSFs were (53.13±2.40)%, (75.07±2.67)%and (88.65±0.32)%, respectively. The difference was significant (P<0.05). Under the effect of BJOE, the number of HSFs significantly decreased, the interval between cells widened, cell protrusions were significantly shortened or even disappeared, and the cells became round. The percentage of cells decreased in S phase. Expression of type Ⅰ collagen, vimentin and p-ERK1/2 in HSF was significantly inhibited (P<0.05), while there was no significant difference in the expression of ERK1/2(P>0.05). Conclusions BJOE inhibites the proliferation of HSF and the synthesis of type Ⅰ collagen, and its mechanism is related to the inhibition of ERK1/2 phosphorylation and vimentin expression.

This article reports a case, happened in July 2019, of 9 severed segments of 2nd-5th fingers in left hand treated in the Department of Repair and Microsurgery, Zhengzhou Renji Hospital. Through the unified management before surgery, team surgery, three or four fixed-point mattress eversion suture and close observation after surgery. It can effectively prevent the occurrence of vascular compromise. All the replanted fingers survived after the surgery. And the function of the fingers recovered well at 2 years after surgery through early and continuous rehabilitation exercise.

Objective To investigate biomechanical properties of double eyelid surgery and its clinical application in upper blepharoplasty .Methods In the mild ptosis correction combined with double eyelid surgery ,the main force from levator was assigned to upper tarsus to open eyes .At the same time ,not only it could ensure the enough height of palpebral fissure ,but also had relatively sta-ble and persistent double eyelid .For those who had sunken upper eyelid ,were given fat transposition and/or autologous fat grafting .For those who had medial epicanthal fold ,to achieve a pleasing eye ap-pearance ,we performed epicanthoplasty .Results After 6 months to 2 years of follow-up ,15 cases had unsatisfactory results and underwent secondary surgery .The revision reason was as follows :7 pa-tients had asymmetry double eyelid width ,3 patients had insufficient correction for ptosis ,2 patients had shallower and narrower double eyelid line .In 3 cases ,the correction of the upper sunken was in-sufficient .The remaining 164 patients with mild ptosis were well corrected ,and the double eyelid was stable and natural ,and the results were satisfactory .There were no major complications .Conclusions During mild blepharoptosis correction combined with double eyelid surgery ,reasonable treatment of the biomechanical balance has certain clinical significance for avoiding postoperative complications and improving the effect of double eyelid surgery .