Objective To observe the effect of T-2 toxin on growth and development of rat epiphyseal plate of left knee and metaphyseal bone of femur and tibia in normal and low nutritional status, to find out possible pathogenic factors of Kashin-Beck disease and provide experimental basis for early intervention. Methods Ninety 3-week-old Wistar rats, weighing 60 - 70 g, were randomly divided into three groups: control group(general feed), T-2 toxin + general feed group, T-2 toxin + low nutrition feed group, thirty rats in each group with equally sex ratio. T-2 toxin (1.0 mg/kg) was administered orally 5 times a week via a gavage needle for 4 weeks. The change of hair, activity and body weight was observed. After 1, 2, 4 weeks, the epiphyseal plate of left knee and metaphyseal bone of femur and tibia (including distal femur and proximal tibia) were collected. Specimens were processed with HE and Masson staining. The morphology of chondrocytes and matrix collagen content in epiphyseal plate was observed. Trabecular bone volume fraction in tibial metaphyseal bone was analyzed by Image-Pro Plus 6.0 software. Results In the control group, rats were in good movement and hair with light, but in T-2 toxin + general feed group and T-2 toxin + low nutrition feed group, rats were found with reduced activities and hair with dark color. Body weights(g) of the control group, the T-2 toxin + general feed group and the T-2 toxin + low nutrition feed group were 81.0 ± 6.2, 79.0 ±5.1, 77.0 ± 7.5, respectively, by the end of first week; 101.8 ± 6.7, 97.0 ± 6.8, 93.0 ± 5.3, respectively, by the end of second week; 151.1 ± 15.7, 126.5 ± 11.9, 106.5 ± 11.5, respectively, by the end of fourth week. There was significant difference in groups by second week and the fourth week (F = 9.72, 41.65, all P ＜ 0.05 ). There was significant difference among multi-groups by the fourth week(all P ＜ 0.01 ). Under light microscope, at the second weeks, coagulative necrosis of chondrocytes was found in hypertrophic zone in the two groups with T-2 toxin; at the fourth weeks, cell necrosis increased. Masson staining showed collagen staining in the two groups with T-2 toxin significantly turned to clear pale coloration, indicating that the collagen matrix was significantly reduced. Image analysis showed there was significant difference in groups at the second and fourth week(F= 9.72, 41.65, all P＜ 0.05)in tibial metaphyseal trabecular bone volume fraction. There was significant difference between T-2 toxin + low nutrition feed group[(0.55 ± 0.12)％, (0.21 ± 0.0)％] and control group[(0.67 ± 0.09)％, (0.51 ± 0.14)％] by the second and fourth week(all P ＜ 0.01 ). Conclusions Under normal nutritional status, T-2 toxin can induce hypertrophic epiphyseal cartilage necrosis, collagen content decreased in epiphyseal plate, metaphyseal trabecular bone formation disorders; in the low nutritional status, T-2 toxin can lead to rat epiphyseal necrosis and significant metaphyseal bone disorder, but whether the performance is related to Kaschin-Beck disease needs to be studied further.

Objective To evaluate mid-term(5-6 years)clinical and radiographic outcomes of cementless acetabular prosthesis in total hip arthroplasty(THA)and discuss the factors affecting postop- erative effect.Methods THA with cementless acetabular was used to treat 139 cases(148 hips)from January 1998 to May 1999.A retrospective study was done to analyze clinical effect and X-ray manifesta- tion of 109 cases(116 hips)that were followed up.Clinical evaluation was based on Harris hip score. The radiographical evaluation was performed according to orthotropia and lateral images of hip joint to ob- serve acetabular migration and bone changes around the hip and measure the polyethylene wear rate and direction of the acetabular polyethylene wear.Results The mean Harris score before operation was 44 points(10-70 points)but that after operation increased to 92.4 points(80-100 points)at latest follow up.Radiographical evaluation showed one hip with focal osteolysis,mean linear wear rate of 0.15 mm/ year and mean 10.4?for angle with vertical line.Abduction angel of the acetabula was mean 46?,with 10.5 mm for vertical distance and 8.7 mm for level distance.There was no revision of a fixed acetabulum component because of pelvic osteolysis secondary to polyethylene wear.No acetabular component was re- vised because of aseptic loosening or acetabular component migration at the latest follow up.Conclu- sions Cementless acetabular prosthesis in THA can successfully have good fixation.A long term follow up for cementless acetabular prosthesis is necessary because of potential factors like polyethylene wear and osteolysis.

Objective To evaluate the biocompatibility of vessel extracellular matrix (VECM) with bladder smooth muscle cells of rabbits,and to discuss the feasibility of vessel extracellular matrix as a matrix for urinary tract reconstruction.Methods Primary cuhured bladder smooth muscle cells (RBSMCs) iso- lated from New Zealand rabbits were implanted on VECM (1?10~6 cells/ml).The effect of VECM on meta- bolic activity,attachment,proliferation of RBSMCs were monitored in vitro by inverted light microscopy and scanning electron microscopy.The extracts of VECM and emulsion were prepared as experimental group and positive controls separately.The culture medium was used as negative control,and simple culture medium without cells was used as blank control.The cell viability was monitored by MTT method after 1-,3-,5-d see- ding.The in vivo tissue response to VECM was investigated by implanting into the subcutaneous sites of the rabbits.Results VECM exhibited nontoxic and bioactive effect on RBSMCs.RBSMCs could be attached to and proliferated on VECM and remained their morphologies.The cell proliferation rates of experimental group were 95.61%、98.34%、102.91%,respectively,after 1,3,5 d;those of negative control group were 100.00% ,respectively;and those of positive control group were 35.14%、38.95%、32.66%,respectively. There was significant difference in the rate between experimental group and positive control (P＜0.01),and no significant difference in the rate between experimental group and negative control (P＞0.05).In vivo, VECM demonstrated favorable tissue compatibility without tissue necrosis and fibrosis.Conclusions VECM exhibits nontoxic and bioactive effects on primary cultured bladder smooth muscle cells.It is a suit- able material for urinary tract reconstruction.

Objective To study treatment of Vancouver type-B periprosthetie femoral fractures after total hip arthroplasty.Methods There were 10 cases with Vancouver type-B periprosthetic femo- ral fractures after total hip arthroplasty being treatment,including three cases with type-B1 undergone open reduction and allografi strut to fix the fracture,two with type-B2 undergone open reduction and revi- sion with a long stem and five with type-B3 undergone open reduction,revision with a long stem and al- lograft strut to restore bone.The mean duration of follow-up was 27 months(8-36 months).The Harris Hip Score and radiographs were used to evaluate the outcome.Failure of the procedure.was defined as the need for revision surgery because nonunion of fracture,implant loosening,and infection.Results All cases obtained successful fracture healing,with no stem loosening or infection.Of all,nine cases were a- ble to walk by themselves but one needed aid in walking.The Harris Hip Score was 83 at the time of the final follow-up.Osseous union of the allograft to the host femur occurred in eight hips and mild graft re- sorption in two.The cotex thickness of host femur was increased more than 3-5 mm.Conclusions Stem stability and bone quality are important factors determining the outcome of treatment for periprosthet- ic femoral fracture after hip arthroplasty.Good outcome can be achieved by adopting different treatments according to sub-classification of Vancouver type-B fractures.The allograft strut for the treatment of a Vancouver type-B periprosthetic femoral fracture can not only provide fixation,but also make fracture heal fast and augment bone mass and strength.

ObjectiveTo explore the effect of estrogen on osteoblast apoptosis induced by serum hungry in vitro.MethodsOsteoblasts of second or third generation from newly born SD rats calvaria were divided randomly into the control group, serum hungry group and serum hungry with estrogen group. Cells of each group were incubated for 24 h, 48 h, 72 h, 5 d, 7 d and 14 d, then labeled using TUNEL staining and examined for morphological characteristics of apoptotic cell under light microscopy after incubated for 72 h. The rates of apoptotic cells of each group were examined with flow cytometry.ResultsThe cells of the control group showed normal appears, the serum hungry group had many cells with purple and blue particles in nuclei, but serum hungry with estrogen group had less such cells. The rate of apoptotic cell significantly increased in serum hungry group and decreased in serum hungry with estrogen group compared with the control group examined with flow cytometry (P<0.05).ConclusionEstrogen can repress osteoblasts apoptosis of rats induced by serum hungry.

OBJECTIVETo study the change and relationship among bone mineral density (BMD), collagen composition and biomechanical properties of the callus in the healing process of osteoporotic fracture.

METHODSThe osteoporotic rat model and fracture model were established through bilateral ovariectomy (OVX) and osteotomy of the middle shaft of the right hind tibiae, respectively. Ninety female SD rats were randomly divided into OVX group and sham group. With the samples of blood and callus, roentgenographic and histological observation were performed for the assessment of the healing progress of the fracture, and the serum concentration of TRAP-5b, proportion of type I collagen, BMD and biomechanical properties of the callus were measured.

RESULTSThe OVX group experienced a significant delay of fracture healing. The mean serum concentration of TRAP-5b of rats in the OVX group was much higher than that in the sham group after the operation (P less than 0.05), but the difference at the same time point after fracture was smaller than that before fracture (P less than 0.05). The BMD of the callus in both groups reached the peak value at the 6 th week after fracture while the proportion of the type I collagen and the biomechanical strength reached the peak at the 8th week.

CONCLUSIONSThe deficiency of estrogen after the ovariectomy could induce the up-regulation of the osteoclasts activities, whereas the potency of further activation after fracture was depressed. Although the synthesis of collagen together with its mineralization determines the biomechanical properties of new bone, the accumulation of collagen could be assessed as an index in the prediction of biomechanical strength of bones independent of the bone mineral deposition.

Acid Phosphatase ; blood ; Animals ; Biomechanical Phenomena ; Bone Density ; Bony Callus ; physiology ; Collagen ; chemistry ; Collagen Type I ; blood ; Fracture Healing ; physiology ; Isoenzymes ; blood ; Male ; Rats ; Rats, Sprague-Dawley ; Tartrate-Resistant Acid Phosphatase

OBJECTIVETo investigate the surgical indications and surgical techniques of revision total hip arthroplasty for the failed hemiarthroplasty.

METHODSFrom June 1997 to June 2000, 56 cases (31 males and 25 females) of failed hemiarthroplasty received the revision total hip arthroplasty. The age was from 64 - 75 years (mean 68 years). Among them, there were 29 cases with acetabular erosion, 14 cases with acetabular erosion and central dislocation of femoral head, 12 cases with stem loosening and 1 case with stem fracture. All the cases were revised in one stage, and bone grafts were adopted when necessary.

RESULTSForty-nine cases were followed up for 5 - 8 years (mean, 7 years), and 7 cases had lost. The mean Harris score increased from 37 (rang, 28 - 40) preoperatively to 88 (rang, 84 - 90) at last follow-up. No wound infection and neurovascular injury happened. Only 5 perioperative complications occurred, including 3 deep venous thrombosis, 1 dislocation and 1 cortical fracture. No cups or femoral stems needed re-revision. Radiographic analysis showed that the position of the artificial prosthesis was unchanged, and no loosening sign existed.

CONCLUSIONSThe acetabular erosion and central dislocation of femoral head are the main reasons for revision total hip arthroplasty after hemiarthroplasty. The medium-term follow-up results show that the clinical effects are encouraging if the surgical indications and surgical techniques are suitable.

Aged ; Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reoperation ; methods ; Retrospective Studies ; Treatment Outcome

Objective To describe the growth and development of Schistosoma japonicum in goat and the intensity and tem?poral distribution of eggs excreted by goat feces,so as to provide baseline data for the control and elimination of the role of goat in the transmission of schistosomiasis. Methods The goat animal models of schistosomiasis were established,and stool sam?ples were collected for parasitological examinations. The number of adult worms recovered,variation of schistosomes in goat at different time points post?infection,number of eggs in schistosomes,variation in number and temporal profiles of eggs excreted from goat feces were observed. Results Of the 6 schistosome?infected goat,415 adult worms were recovered,with a mean adult worm recovery of 34.58%(range,23.00%to 45.50%). Among the 5 goat infected with 200 cercariae each,47,93,77, 74 and 73 adult worms were recovered 2,5,8,11 and 14 months post?infection,respectively. There were(200.00 ± 42.33), (226.20±45.88),(168.20±25.85),(183.80±55.13)and(190.80±53.53)eggs detected in female schistosomes. The mean pre?patent period of eggs excreted by 10 infected goat was(37.7±3.02)d. From 2 to 14 months post?infection,7 batches of goat fe?ces were hatched,and there were 30,23,14,1 and 2 times for miracidium intensity of“++++”,“+++”,“++”,“+”and“-”, respectively,with 42.86%,32.86%,20.00%,1.43%and 2.86%constituent ratios of miracidium intensity. Conclusions Ap?proximately 1/3 S. japonicum cercariae may develop to adults in goats post?infection,and the prepatent period of eggs is(37.7± 3.02)d. There is no remarkable decrease seen in the number of adult worms,eggs in female schistosomes and eggs in goat feces within 14 months post?infection. Our findings suggest a long duration for infected goat in the transmission of schistosomiasis ,and there is no evidence to prove the“self?cure”phenomenon in goat,indicating that goat is an important source of infection for schistosomiasis japonica.

OBJECTIVETo summarize the surgical experience of acetabular reconstruction of total hip replacement in the treatment of dysplastic hip.

METHODSFrom April 1998 to April 2002, 96 adult cases with osteoarthritis secondary to dysplastic hip were adopted in the study. Among them, there were 89 females and 7 males, age from 27 approximately 68 years. According to Hartofilakidis classification system, there were dysplasia in 73 hips, low dislocation in 18 hips and high dislocation in 21 hips. All patients received total hip replacement, 16 cases with bilateral replacement and 80 cases with unilateral replacement. Kocher-LangenBeck approach was used during operation and all the acetabular cups were reconstructed at the original anatomic location. The fixation methods were as follows: cement cup for 16 hips, cementless cup for 96 hips and bone graft in 11 hips. The reconstructive methods were as follows: regular replacement for 83 hips; installing a smaller cup after deeper reaming the acetabulum for 27 hips; installing a smaller cup after autofemoral grafting on the superior lip for 2 hips.

RESULTSThe incision healed primarily and no infection or nerve injury occurred. Follow-up for 1 approximately 5 years (average for 3.5 years) in 85 patients, the Harris score increased from 33.9 preoperatively to 89.3 postoperatively, and 95 hips had good or excellent clinical results. Radiographically, the positions of the prostheses were normal, the average abduction angle of the cup was 44 degrees, the average superolateral bone coverage of the hips was 96.6%, no radiolucent line was observed at the acetabular side. All the bone grafts fused with the host bone successfully.

CONCLUSIONSTotal hip replacement is an effective operation in the treatment of osteoarthritis secondary to dysplastic hip. The four specific factors that should be considered in acetabular reconstruction are: (1) the surgical approach, (2) the reconstructive position of the acetabulum, (3) the reconstructive method of the acetabulum, (4) the leg-length discrepancies. It's a challenging to the orthopaedic surgeon. Careful preoperative preparation is recommended.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo report the clinical and radiological results of 24 total knee arthroplasty in which all-polyethylene tibial components were used.

METHODSBetween December 2000 and December 2002, 24 cemented total knee arthroplasty in 21 patients were performed using all-polyethylene tibial components. The mean age of the 21 patients (9 men and 12 women) at operation was 55 years, ranging 48-61 years. The mean preoperative hospital for special surgery (HSS) score was 40.2 (range, 36-43). The diagnoses were degenerative osteoarthritis in 15 patients, rheumatoid arthritis in 5 and traumatic arthritis in 1. All the operations were performed by the same surgeon group and there were unilateral operations in 18 patients and bilateral operations in 3.

RESULTSEighteen patients were followed up with a follow-up rate of 85.7%. The mean follow-up is 2.5 years (range, 1-3 years) and mean postoperative HSS scores was 87.5 (range, 83-89). Among them, 18 were excellent, 3 good, 3 poor and none was fair (the results of three lost patients were classified as poor). Of those reviewed, the prosthesis was all in situ and no revision occurred. Radiological assessment of these patients revealed 4 (16.67%) tibial components with radiolucent lines (mean width < or = 2 mm) distributed mainly in zone 1 and zone 4. None of these knees was symptomatic.

CONCLUSIONSThe result of total knee arthroplasty using all-polyethylene tibial components is encouraging. The operative techniques are similar to those in arthroplasty using metal-backed tibial component.

Arthritis ; diagnostic imaging ; surgery ; Arthroplasty, Replacement, Knee ; instrumentation ; Equipment Failure Analysis ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; diagnostic imaging ; physiopathology ; Knee Prosthesis ; Male ; Materials Testing ; Middle Aged ; Polyethylene ; Radiography ; Range of Motion, Articular ; Tibia