Objective To explore morphologic characterizatics of cellular processes from adult human nucleus pulposus cells. Methods The nucleus pulposus of adult human intervertebral disc were obtained from 8 patients(Thompson's grade Ⅰ-Ⅱ) and then the tissues specimens were carried out by frozen section and electron microscopic section as well as cell isolation and cultured,processes of nucleus pulposus cells were examined using light microscopy,laser scanning confocal microscopy and transmission electron microscopy. Results When examined at both the confocal and electron microscope level,all the cells possessed the processes and adjacent nucleus pulposus cells processes possessed a gap junction.The elongated and round cells were examined when NP cells became monolayer in vitro.The rate of elongated cells to round cells was 2.3 to 1.The elongated cells protruded along with the long axis of cell body without second processes.Dendritic processes of round cells protruded to all directions from the cell body with multiple-level processes.Conclusion Processes are one of the morphologic characteristics of intervertebral disc cells.The research on processes functions could be helpful to understand pathomechanism of intervertebral disc degradation.

Objective To observe the influence of intra-articular injection of lovastatin on cartilage degeneration and mRNA expres-sion of matrix metalloproteiase-1,-3 (MMP-1,-3) in cartilage and synovium of osteoarthritis (OA) model. Methods Thirty New Zeal-and rabbits underwent unilateral anterior cruciate ligament transection (ACLT) were random divided into two groups. The rabbits in experi-mental group received 0.1 mg/ml intra-articular lovastatin injection at 0.2 ml/kg of body weight immediately after surgery , once a week. Those in control group were treated with intra-articular injection of normal saline. At the 6th week after surgery, all rabbits were sacrificed. The articular cartilage degeneration of medial femoral condyle was evaluated under microscopy. Gene expression of MMP-1,-3 was detected by reverse transcription-polymerase chain reaction (RT-PCR). Results Cartilage degeneration in untreated group was significantly more severe than that in experimental group. In cartilage, no significant difference on the expression of MMP-1 and MMP-3 mRNA was found be-tween the experimental group and control group. In synovium, the expression of MMP-1 and MMP-3 mRNA was significantly suppressed in experimental group compared with control group. Conclusion During the development of experimental OA, intra-articular administration of lovastatin reduces the expression of matrix degrading enzyme, thus alleviate cartilage degradation.

Objective To evaluate the effectiveness of thoracoscopic techniqu es for the anterior correction of adolescent idiopathic scoliosis. Methods Betwe en March 2000 and November 2002, 33 patients with adolescent idiopathic scoliosi s were selected to undergo thoracoscopic instrumentation, correction, and fusion . There were 26 females and 7 males. The average age at surgery was 13.6 years ( range, 10 to 18 years). All patients had idiopathic thoracic curves of typeⅠacc ording to the Lenke classification system, 24 of whom were typeⅠA, and 9 typeⅠ B. The average preoperative Cobb angle of the primary thoracic curve was 57.4?( range, 43? to 68?), and that of the compensatory lumbar curve was 32.0?(range , 20? to 47?). 27 patients were an averaged 6.3? of hypokyphosis (range, 0? to 18?). All 33 patients underwent endoscopic anterior release, instrumentation , correction and intervertebral fusion using the CD Horizon Eclipse system. Para meters including coronal Cobb angle of the primary thoracic curve, the compensat ory lumbar curve and thoracic kyphosis, were measured to assess coronal and sagi ttal correction. Results The instrumented levels were from T4 to T12. The averag e number of levels instrumented for each patient was 7.4 (range, 5 to 9). Operat ive times averaged 3 h and 48 min (range, 2 h 40 min to 5 h 30 min). Blood loss averaged 308 ml (range, 100 to 500 ml). Hospitalization averaged 4.4 days (range , 3 to 9 days). The average follow-up period was 20.6 months (range, 6 to 36 mon ths). The correction for the primary thoracic curve averaged 60.2%, and the comp ensatory lumbar curve averaged 50.3%. Correction with hypokyphosis averaged 20.4 ?. One patient developed pseudoarthrosis and rod fracture. Two patients experie nced transient chest wall numbness. Conclusion Anterior thoracoscopic correction of adolescent idiopathic scoliosis has the advantages of minimal invasion and s horter rehabilitation period. It can also provide the same corrective effect com paring to conventional open thoracotomy.

Objective To clone VEGF gene and construct its eukaryotic expression vector for the evaluation of the possability of VEGF gene therapy in orthopedic disease. Methods Human vascular endothelial growth factor(hVEGF) cDNA was amplified by nested PCR method from the HL60 cells and cloned to expression vector pcDNA 3. The cDNA was identified by enzyme digestion and DNA sequencing. Rabbit osteoblasts were transfered with pCD-hVEGF165 plasmid by lipofectin mediated gene transfer method. The transient expression of VEGF were detected by Streptavidin-Biotin-enzyme Complex(SABC). Results The cloned cDNA was confirmed to be VEGF165 cDNA. It was observed that the expression of human VEGF gene was detected distinctly 72 h after transfering. Conclusion We successfully cloned hVEGF 165 gene and construced its eukaryotic expression vector, which provided the further foundation of VEGF gene therapy for ostenecrosis,bone defeat and fracture.

[Objective]To evaluate surgical outcomes of hemivertebra resection only via posterior approaches followed by short-segment transpedicular instrumentation for correction of the congenital scoliosos. [Method]A group of patients with a single hemivertebra between the ages 5-16 years who underwent operative treatment were evaluated.Hemivertebra resection through posterior approach and short-segment transpedicular instrumentation were used for correction of the scoliosis and kyphosis deformities.Radiographic evaluation were conducted before and after operation and at follow-up visits.Cobb's angles of the segmental curve,total main curve,cranial and caudal compensatory curves and kyphosis were measured on the posteroanterior and lateral radiographs.[Result]The cases in this study showed satisfied results.The mean Cobb's angle of segment curve was 41.5? before surgery and 15.1? after surgery with a 63.6% correction,and 14.7? at the lastest follow-up assessment with a 64.6% correction;total main curves improved from 46.9?to 18.4?,with a 60.8% correction;17.5?at last follow-up,with a 62.7% correction;the correction ratio for kyphosis was from 15.4?kyphosis to normal physical profile;cranial and caudal compensartory curves were obviously improved.[Conclusion]Hemivertebra resection and short-segment transpedicular instrumentation could be performed only through posterior approach,which had exerted satisfactory correction on congenital scoliosis.If the operation is performed before the maturity of the bone,it will effectively prevent the formation of secondly spinal deformities.

The study assessed the early functional outcomes with cemented titanium implants of radius in the treatment of comminuted fractures of radial heads. The functional outcomes of arthroplasty with cemented titanium implants of radius in the treatment of radial head fractures (Mason Type III: 6; Mason Type IV: 4) in 10 consecutive patients (mean age, 38 years) were evaluated over a mean time of 23.7 months (18-31 months). The patients were assessed on the basis of physical examination, functional rating (Mayo) and radiographic findings. The parameters evaluated included motion, stability, pain, and grip strength. Five patients were considered to have excellent results, 4 patients had good results and 1 patient had fairly good results. There were no cases of infection, prosthetic failure, heterotopic ossification or dislocation. When medial collateral ligament was injured, radial head became the main stabilizing structure of the elbow. Titanium radial head implant may provide the stability similar to that of native radial head. We believe that titanium radial head implants may be indicated for the Mason Type III and Mason Type IV radial head fractures.
Elbow Joint/surgery ; Fracture Fixation/*methods ; Fractures, Comminuted/*surgery ; Prostheses and Implants ; Radius Fractures/*surgery ; Titanium ; Treatment Outcome

Objective To compare the clinical effects between continuous renal replacement therapy (CRRT) and intermittent haemodialysis (IHD) for the treatment of sepsis-induced acute kidney injury (AKI). Methods A prospective study was conducted. Seventy-three patients with sepsis-induced AKI admitted to the intensive care units (ICUs) of Tianjin Hospital and Tianjin First Center Hospital from January to December in 2014 were enrolled. They were randomly divided into two groups: CRRT group (n = 35) and IHD group (n = 38). Data were recorded for the patients in two groups before treatment, including acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mean arterial pressure (MAP), urine volume, and the levels of C-reactive protein (CRP) and serum creatinine (SCr) before and 1 week after treatment, the time of recovery of urine volume, the length of ICU stay, the duration of organ support, and the incidence of cardiovascular events. Results There was no statistically significant difference in APACHE Ⅱ scores (21.63±2.46 vs. 21.34±2.46), MAP [mmHg (1 mmHg = 0.133 kPa): 71.26±10.70 vs. 75.74±15.17], urine volume (mL: 404.00±79.13 vs. 438.97±87.17), CRP (mg/L: 100.94±14.73 vs. 95.17±27.03), and SCr (μmol/L: 394.02± 50.26 vs. 390.47±54.42) before treatment between CRRT group and IHD group (all P > 0.05). One week after treatment, compared to the IHD group, CRRT could dramatically reduce the levels of CRP (mg/L: 41.05±10.15 vs. 60.21±14.78, t = 6.401, P < 0.001), SCr (μmol/L: 185.97±65.48 vs. 232.02±71.93, t = 2.862, P = 0.006), urine output recovery time (days: 7.94±3.06 vs. 11.08±3.71, t = 3.923, P < 0.001), the length of ICU stay (days: 9.54±3.39 vs. 13.42±3.89, t = 4.521, P < 0.001), organ support time (days: 3.23±2.70 vs. 6.34±3.36, t = 4.343, P < 0.001), and the incidence of cardiovascular events [23.53% (8/35) vs. 39.47% (15/38), χ2 = 5.509, P = 0.025]. Conclusion Compared to IHD, CRRT can more efficiently help patients with sepsis-induced AKI in removing excessive water, metabolic waste, and lower the levels of pro-inflammatory cytokines, maintain homeostasis of the internal environment, lower the adverse effects on cardiovascular system, so that it significantly improve the prognosis of patients, shorten the time of organ support and the length of ICU stay.

AIM: To prepare and evaluate the biocompatibility of a thermosensitive hydrogel poly-(N-isopropylacrylamide-co-N-hydroxymethylacrylamide) (P-NIPAAm-co-NHMPA) in vivo so as to appraise its safety as a medical implant in clinical use. METHODS: The experiments were carried out in the Central Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology(HUST) and the Key Laboratory of Biomedical Polymer Materials, Ministry of Education, College of Chemistry, Wuhan University between January and October in 2007. ① Preparation of thermosensitive hydrogel P-NIPAAm-co-NHMPA: Taking ammonium persulfate and tetramethyl ethylene diamine as oxidation-reduction initiation system, while N, N'-methylene bisacrylamide as cross-linking agent, P-NIPAAm-co-NHMPA was prepared with the addition of NHMPA in reaction system. Low critical solution temperature was determined by shrinking tests. ②A series of biocompatibility tests such as sensitization test, acute systemic toxicity test, genetic toxicity test and implantation test were conducted to evaluate the safety of the implant. RESULTS: ①Synthesized hydrogel showed thermosensitive character as expected, and the low critical solution temperature was 38 ℃.②In sensitization test, there was no sensitization proved in the material; in acute systemic toxicity test, the symptom of toxicity was not found; the genetic toxicity test suggested no teratogenic or mutagenic effects; in vivo implantation test showed that the inflammation around the material was mild and limited. CONCLUSION: Thermosensitive hydrogel P-NIPAAm-co-NHMPA has good biocompatibility and is a potential medical implant.

Objective To investigate the efficacy of transcutaneous injection of MIIGX3 artificial bone and methylprednisolone for recurrent bone cysts.Methods From January 2004 to March 2006,a total of 13 children with recurrent bone cysts received transcutaneous injection of methylprednisolone and MIIGX3 in our hospital.X-ray was employed to detect the degradation of MIIGX3 and formation of new bones.Results The operation time ranged from 30 to 95 minutes(mean 42 minutes).The patients were followed up for 1 to 3 years.None of them had recurrence of bone cysts during this period.The artificial bones were completely degraded and replaced by new bones in 1.5 years after the injection.Conclusions Transcutaneous injection of methylprednisolone and MIIGX3 is effective for recurrent bone cysts.Patients have shorter operation time and hospital stay after this treatment because the procedure is microinvasive.

Objective To investigate the effects of laparoscopic tube sparing operation in the treatment of tubal ectopic pregnancy. Methods Clinical data of 56 cases of tubal pregnancy undergoing laparoscopic conservative treatment were retrospectively reviewed. Results Salpingectomy was required in 8 cases because the electrocoagulation had proven ineffective for the bleeding of operated area, whereas the tube sparing surgery was accomplished successfully in the remaining 48 cases, in 3 of which one treatment course of MTX was administered on account of recurrent episodes. Hysterosalpingography with iodized oil at 1～2 postoperative months in 47 cases receiving conservative surgical treatment revealed that, the involved oviduct was patent in 36 cases, unobstructed but not patent in 8 cases, and obstructed in 3 cases, while the contralateral oviduct (which had been previously resected in 3 cases) was patent in 34 cases, unobstructed but not patent in 7, and obstructed in 3. Conclusions Under proper conditions, laparoscopic tube sparing operation is effective in the treatment of tubal ectopic pregnancy.