The management of periprosthetic fracture following total knee arthroplasty (TKA) remains a challenging problem. Periprosthetic fractures are increased with increasing TKA times,aging,and increased activity after TKA. Periprosthetic fractures after TKA involves the femur,tibia,or patella,in particular at the supracondylar region of the femur. In addition,periprosthetic fractures can also occur in operation. According to fracture morphology,various cause factors,and the timing of fracture,a number of treatment options are available to treat this complex problem. Appropriate fracture classification would assist clinical physicians to evaluate fracture site,type,bone loss and prosthesis fixation. Because of the complexity,periprosthetic fractures often require tailored treatment to attain a more individualized treatment strategy to promote fracture healing,reconstruct bone mass and maintain joint function. Recently,with improving internal fixation materials and surgical techniques,the methods of surgical treatment of periprosthetic fracture have made great progress.

[Objective]To investigate the treatment and results of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty(TKA).[Method]Nine patients(12 knees)of reconstruction with composite type metal raiser block of proximal tibia AORI type Ⅱ bone defect in TKA were followed from August 2004 to May 2008.There were 3 males with 3 knees and 6 females with 9 knees.The average age was 69 years ranging from 48 to 76 years.[Result]The average follow-up time was 26 months,ranging from 6 to 42 months.All genu varum and genu valgum were corrected.Pain disappeared and the motion of the knee was satisfactory.The HSS knee score improved from preoprative 14.5(range 10-25)to postoprative 85.5(range 74-95).The movement range improved from preoprative 74.6?(range 15?-100?)to postoprative 110.3?(range 80?-155?).[Conclusion]The appliance of composite type metal raiser block for proximal tibia AORI type Ⅱ bone defect in total knee arthroplasty is helpful for the constancy of prothesis and the achievement rate of opration.

Objective: To investigate the effects of nerve growth factor(NGF) on the differentiation of goat bone marrow mesenchymal stem cells (BMSCs) into osteoblasts. Methods: The goat BMSCs were cultured in vitro and the marker proteins on the BMSCs surface were identified by flow cytometry. The third passage of BMSCs were randomly divided into blank control group, osteoblasts control group, NGF group and experimental group. The activities of alkaline phosphatase (ALP) and osteocalcin (0C) were examined and the of von Kossa staining method was used to observe the osteogenic differentiation. Results: CD90 and CD105 were strong positive while the CD34 and CD45 were negatively expressed in BMSCs. The activities of ALP and OC was significantly higher in the experimental group than that in the other three groups(P<0.05). The staining of von Kossa was positive and the black calcium nodules were appeared in the the osteoblasts control group. The number and the area of the calcium nodules were greater in the experimental group. But there were no significant differences of each index between the NGF group and the blank control group. Conclusion: NGF can′t induce goats BMSCs to osteoblasts, but can clearly promote the differentiation of goats BMSCs.

BACKGROUND:The prosthesis fusion rate after total hip replacement is closely related to the reconstruction process of bone,which is affected by the factors around the implant of patient.Trace elements are strongly associated with the ossification.Thus,the content of trace elements in proximal femur may affect the bone fusion and survival rate of the prosthesis.OBJECTIVE:To analyze the correlation of trace elements and bone fusion surrounding the prosthesis in proximal femur.METHODS: Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement.Trace element (calcium,magnesium,zinc,parathyroid hormone,activated vitamin D3) contents were detected aftervitro cel culture.Bone mineral density was tested surrounding the prosthesis at 1 week,3 and 6 months after replacement by dual energy X-ray absorption method with a bone density meter.The difference in trace elements was compared in patients at different ages and different genders.The correlation between above five kinds of trace elements and bone mineral density was analyzed.RESULTS AND CONCLUSION:No significant difference in trace element contents was detected in different age groups and different gender groups (P＞ 0.05).Zinc content was positively correlated with parathyroid hormone and magnesium contents (P＜ 0.05).Zinc was positively associated with bone mineral density in the region 7 (P＜ 0.05).The further studies concerning the trace elements in proximal femur can be used to predict and intervene in the longevity of hip prosthesis.

Objective To evaluate prenatal sonograpic findings and clinical value in fetus with congenital portal-hepatic venous shunt.Methods The prenatal ultrasonographic characteristic of ten cases of congenital portal-hepatic venous shunt were analyzed and summarized.Results Three cases had portal vein-left hepatic venous shunt,two cases with portal vein-right hepatic venous shunt,two cases with situs inversus of left right portal vein,and three cases with multiple shunt among portal and hepatic veins.All the 10 cases with portal-hepatic venous shunt had common sonographic features,①Two-dimensional ultrasound revealed the distal hepatic veins.The hepatic vein and portal vein were both visualized on the same plane and connected by an anechoic area.②Vascular signal were noted inside the anechoic area.③Blood flow inside the anechoic area demonstrated by spectral Doppler was similar to that of the portal vein.Conclusions Prental ultrasonography is valuable in the diagnosis of fetal portal-hepatic venous shunt.

BACKGROUND:The correlation of zinc with Stro-1+cells and bone morphogenetic protein 7 surrounding the prosthesis may affect the bone fusion and survival rate in hip prosthesis. ＜br> OBJECTIVE:To analyze the correlation of zinc content with Stro-1+cells and bone morphogenetic protein 7 in proximal femur. ＜br> METHODS:Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement. Bone marrow mesenchymal stem cells were cultured in vitro. At 14 days after culture, Stro-1+cells in bone marrow mesenchymal stem cells were detected using flow cytometry. Bone morphogenetic protein 7 expression in cellsupernatant was detected using enzyme-linked immunosorbent assay. Zinc content in supernatant was measured using radio-immunity assay. ＜br> RESULTS AND CONCLUSION:No significant difference in the zinc content was detected in different age groups and different gender groups. Zinc content was positively associated with Stro-1+cells and bone morphogenetic protein 7 expression. The further study of the trace element zinc in proximal femur can predict and intervene the longevity of hip prosthesis.

Objective:To determine the plasma level of apelin in patients of maintenance hemodialysis (MHD) and to explore the relationship between apelin level and carotid atherosclerosis (AS) in MHD patients.Methods:A total of 92 MHD patients and 36 sex-and age-matched healthy subjects were enrolled in this study.The plasma level of apelin was evaluated by radiation immunoassay;serum endothelial injury markers including thrombomodulin,von Willebrand factor (vWF),and CD 146,and inflammatory factors including high sensitive C-reactive protein (hsCRP),IL-6 and TNF-α were determined by ELISA.Common Carotid arteries intima media thickness (CCA-IMT),cross-sectional calculated intima-media area (cIM area) area and atherosclerotic plaque were measured by non-invasive high-resolution B-mode ultrasonography.Results:The plasma levels of apelin was significantly decreased in MHD patients compared with healthy subjects (P＜0.01),accompanied with elevated plasma levels of thrombomodulin,vWF,CD 146,hsCRP,IL-6 and TNF-α (all P＜0.01).The plasma levels of apelinin in MHD patients with carotid artery plaques were obviously lower than those without plaques [(43.16± 10.12) pg/mL vs (61.43±16.25) pg/mL,P＜0.01].Plasma level of apelin was inversely related with CCA-IMT and cIM area (r=-0.355 and r=-0.297 respectively,all P＜0.01).Multiple stepwise regression analysis showed that plasma level of apelin was an independent risk factor for CCA-IMT and cIM area.Conclusion:The plasma apelin in MHD patients might take part in vascular endothelial injury and the progress of atherosclerosis.It plays an important role in the initiation and development of uremia associated atherosclerosis through elevating inflammatory factors including hsCRP,IL-6 and TNF-α levels.

When senescence induction is based on DNA damage, senescent cells display a unique phenotype, which has been termed “senescence-associated secretory phenotype”( SASP ) . SASP, including proinflammatory cytokines, growth factors, chemokines, matrix remodeling enzymes and other cytokines, may be an important driver of chronic inflammation and therefore may be part of a vicious cycle of inflammation, DNA damage and senescence. Senescence-associated secretory products released by such cells can affect the neighboring cells and further exacer-bate their regenerative capacity. SASP is associated with many chronic age-related diseases.

OBJECTIVEBy bioinformatics method, the effect in hematopoietic system of bioactive peptide HP-6, which was obtained from donkey serum albumin and is one of the major protein components from donkey-hide gelatin, was investigated.

METHODHuman bone marrow nucleated cells (hBMNCs) and murine bone marrow stromal cells (mBMSCs) were separated and cultured with different concentration of peptide HP-6 (0.000 15, 0.001 5, 0.015, 0.15, 1.5 micromol x L(-1)). The effect on promoting proliferation of cells related to hematopoiesis in bone morrow was detected and the ultrastructure of cells after treated by HP-6 was observed through transmission electron microscope. Hemorrhage anemia mouse model and anemia mouse model induced by cyclophosphamide were established, and randomly divided into peptide HP-6 groups which were administered respectively with different doses (1, 0.1, 0.01 mg x kg(-1)) by gavage, and control group which was administered with PBS by gavage. Peripheral blood components of all mice and bone morrow cells (BMC) number of mice induced by cyclophosphamide were evaluated.

RESULTPeptide HP-6 could concentration-related promote the proliferation of hBMNCs and mBMSCs, hBMNCs got the highest reproduction rate of 152.11% and mBMSCs also got 63.52% with the concentration of 0.15 micromol x L(-1), then the reproduction rate decreased while the concentration kept increasing. The transmission electron microscope showed that ultrastructure of cells was normal after treated by HP-6.1 mg x kg(-1) peptide HP-6 significantly increased peripheral platelet and protected mouse morrow injured by cyclophoshamide. 0.1 mg x kg(-1) peptide HP-6 significantly increased peripheral platelet with relative growth rate of 77.65%, increased peripheral white blood cells count and peripheral red blood cells count, also could protect mouse peripheral blood after treated by chemotherapeutics.

CONCLUSIONPeptide HP-6 could promote the proliferation of cells related to hematopoietic system, enhance mouse hemopoiesis function and the resistance to chemotherapeutic injury.

Anemia ; drug therapy ; Animals ; Cells, Cultured ; Dose-Response Relationship, Drug ; Equidae ; blood ; Female ; Gelatin ; pharmacology ; Hematopoiesis ; drug effects ; Hematopoietic System ; drug effects ; Humans ; Male ; Mice ; Peptides ; pharmacology ; Serum Albumin ; pharmacology

Objective: To evaluate the clinical value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate. Methods: Twenty fetuses diagnosed with fetal cleft lip and cleft palate by targeted ultrasonography and magnetic resonance imaging were enrolled in this study. Color Doppler was used during each ultrasound scan. All prenatal diagnoses were confirmed either by postnatal follow-up or autopsy. The location and degree of cleft lip and palate was also recorded. During inspiration or swallowing color signal acrossed the defects at the fetal palate was indicated cleft palate, and no color signal acrossed the defects at the fetal palate was indicated without cleft palate. Two dimensional ultrasound combined with color Doppler was used to diagnose cleft lip and palate in midsagittal plane or paratsagittal plane, then compared with the results of post-natal evaluation or abortion, and the value of color signal at the nasal lip in the diagnosis of fetal cleft palate was analyzed. Results: Twenty cases of postpartum fetus (including post-natal evaluation or abortion ) confirmed 15 cases of cleft lip and palate, 5 cases of cleft lip (2 cases with upper alveolar cleft). For prenatal diagnosis, 5 cases of cleft lip and 15 cases of cleft lip and palate were diagnosed by two-dimensional ultrasound, of which 3 cases of cleft lip and palate were misdiagnosed as cleft lip, whereas 3 cases of cleft lip were misdiagnosed as cleft lip and palate with 2 cases combined with upper alveolar cleft. Two-dimensional ultrasound in the diagnosis of cleft lip and palate is consistent with postnatal results by additional evaluation of the color signal in nasolabial area in median sagittal section. In the cleft lip and cleft lip with the alveolar cleft fetuses, the color signal in nasolabial area was undetectable during fetal respiratory-like movement or swallowing by ultrasound.However, it was detectable in cleft lip and palate fetuses. A total of 3 cases of simple cleft lip and 17 cases of cleft lip and palate were detected by magnetic resonance imaging(MRI). In 2 cases of cleft lip and palate diagnosed by MRI, no blood flow signal was detected at the nasolabial area. Conclusions The connected color signal in nasolabial area assessed by color Doppler ultrasound during fetal respiratory-like movement or swallowing showed an promising value for prenatal diagnosis of cleft palate. Cleft palate could be ruled out if the connected color signal was undetectable in nasolabial area.