BACKGROUND: Animal experiments show that hormone can induce femoral capillaries poor filling, decrease capillaries density in unit area, and reduce capillaries in cancellous bone inferior to cartilage. However, the involved mechanism remains unclear.OBJECTIVE: To explore the changes of vascular endothelial growth factor (VEGF) during the progress of glucocorticoid induced osteonecrosis.METHODS: The Chinese white rabbits were randomly divided into horse serum plus prednisone group and pradnisone alone group. Typical osteonecrosis model was established by Matsui Method. 10 mL/kg horse serum was injected into horse serum plusprednisone group through the ear margin veins, followed by additional injection after 2 weeks and intraparit0neal injection of prednisone, 45 mg/kg per day for 5 consecutive days. The control group was only subjected to prednisona, 45 mg/kg per day for 5 consecutive days. The VEGF expression was observed by means of reverse transcription polymerase chain react.ion (RT-PCR)before, 7, 14 days after administration, 1, 3, 7, 21, 35 and 49 days following the first application of hormone. The capillaries were quantified.RESULTS ANDCONCLUSION: The VEGF was significantly increased 7 days following horse serum, and gradually decreased to levels before treatment 1 days following hormone. The VEGF mRNA, expression decreased with increasing hormone treatment, in particular at 7 and 21 days (P ＜ 0.05), but cannot restore to normal level. Micrevascular count was decreased gradually, and at 21 days decreased to the minimum, positively correlated with VEGF expression. Results show that adrenal glucocorticoid inhibited VEGF expression in bone tissue and restrained angiogenesis, resulting in ischemia and hypoxia of the local environment in bone tissue. VEGF expression highly correlates with microvascular count and osteonecrosis degree.

[Objective]To evaluate the effect of bone mesenchymal stem cells(BMSCs) on healing of tendon-bone junction in a bone tunnel and to provide experimental evidence of labeling and tracing the stem cell.[Method]BMSCs from rats were harvested by adherent separation screening method and labeled by SPIO and DiI.Thirty-nine 8-week-old rats were randomly divided into two groups,21 rats injected with double-labeled BMSCs and Pluronic F-127 as experimental group and 18 rats injected with Pluronic F-127 alone as control group.In each group,biomechanical analysis was carried out to assess the effect of healing at 2,4 and 8 weeks.The transplanted BMSCs were traced by fluorescence microscope at 2,4,8 weeks and 7.0T MR instantly,3 and 7days after operation.[Result]BMSCs were labeled effectively by SPIO and DiI.DiI-labeled positive cells were observed between tendon and bone with fluorescence microscope at 2,4 and 8 weeks.No significant signal changes of tendon-bone interface could be observed by 7.0 T MR.Biomechanically,maximum pullout load had no statistical difference between experimental group and control group at 2 weeks.At 4 and 8 weeks,the experimental group had significantly higher maximum pullout load compared with control group(P

Objective To study the effect of flushing the pelvis with normal saline at constant pressure on renal function to provide a theoretical basis of pathogenesis of renal injury during endoscopic procedures. Method Fifty rabbits underwent tube ureterocutaneostomy as a method of urinary diversion, the flushing group perfused immediately after ureterocutaneostomy, and the intrapelvic pressure is 60, 80, 100, 120cmH_2O, but the sham-operated group didn′t flush. Urinary protein excretion were examined every day after operation,we also got pathological examination of nephridial tissue continually. The urinary protein include immunoglobulin G, microalbuminuria and ?_2-microglobulin. Result All the flushed rabbits had the change of urinary protein, the difference of urinary protein was of statistical significance between the before and the first day after treatment(P

Objective To investigate the effects of the platelet activation and the endothelial cell impairment on the osteonecrosis. Methods The contents of TXB2,6-keto-PGF1a, GMP-140 and TM in different periods of animal models of adrenoglucocortisone-induced osteonerosis were measured by the radio-immunity method. ResultsThe contents in group B increased dramatically from 24h after the injection of adrenoglucocortisone, and the contents of GMP-140 and TM from 3d after injection increased with significant difference from group A. Conclusion The results suggest that the early emergence of the platelet activation and endothelial cell impairment models induced by horse serum and adrenoglucocortisone plays a role in the formation of the osteonecrosis.

Objective To observe the expression of vascular endothelial growth factor (VEGF) in synovial tissue during treatment of rabbit arthritis model with corticosteroids and explore its mechanism.Methods The expression and alteration of VEGF in different periods of treatment process of rabbit arthritis model with corticosteroids (after 1 h ,24 h,3,7,14,21 and 28 d treatment with lipopolysaccharide),were investigated by reverse transcript polymerase chain reaction (RT PCR).Results There were different expressive degrees of VEGF in synovial tissue during each period of the process of rabbit arthritis model by corticosteroid treatment and the expressive degree of VEGF had been strongly inhibited by corticosteroids.Conclusion It is indicated that corticosteroids decrease inflammatory reaction of arthritis by inhibiting the expression of VEGF.

BACKGROUND:Rehabilitation outcomes of patients with spinal cord injury are associated with degree of injury, therapeutic method, recovery time and subsequent treatment. Multidisciplinary, comprehensive, specialized rehabilitation unit can provide a better recovery after spinal cord injury. OBJECTIVE:To review the effect or combined effect of rehabilitation units after spinal cord injury. METHODS:A computer-based search of Springer and PubMed databases was done using the keywords of“spinal cord injury, rehabilitation practice, outcomes”, which appeared in the title and abstract. Final y, 44 English papers were included in result analysis. RESULTS AND CONCLUSION:Based on practical evidence, various rehabilitation practices are recognized, and then, the relevant information is connected with the outcomes to evaluate the efficacy of rehabilitation interventions. Studies have shown that age had no influence on rehabilitation outcomes in traumatic and non-traumatic mixed samples, and there is also little difference in the rehabilitation outcomes between male and female. Incidence of complications is lowest in the vast majority of patients with spinal cord injury who are initial y admitted to a specialist center of spinal cord injury. The hospital stay can be shorten in patients who can be admitted to a multidisciplinary, comprehensive, specialized division of spinal cord injury as early as possible. Patients who can receive regular, comprehensive outpatient fol ow-up show no significant differences in health perception, independence and depression, but the frequency and degree of certain secondary situations can be significantly reduced.

Objective To investigate the serum levels of hepatocyte growth factor (HGF) and granulocyte macrophage-colony stimulating factor (GM-CSF) in patients with psoriasis. Methods Serum samples were collected from 68 patients with psoriasis vulgaris and 42 healthy controls. The serum concentrations of HGF and GM-CSF were measured by a dual antibody sandwich enzyme-linked immunosorbent assay (ELISA). Clinical severity of psoriasis vulgaris was assessed by psoriasis area and severity index (PASI) score. Results Serum concentration of HGF of patients with psoriasis vulgaris in progressive stage (653.35 ? 109.26 pg/mL) was significantly higher than that of the normal controls (353.85 ? 162.63 pg/mL) (P 0.05). The serum concentration of GM-CSF was significantly higher in the patients with psoriasis vulgaris of progressive stage (115.95 ? 25.72 pg/mL) than that in the patients of stable stage (68.28 ? 24.22 pg/mL) (P

Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P<0.05).The daily oral administration amount of morphine at stable pain in the two groups respectively was (226.67±69.74) mg and (258.67±101.34) mg;the morphine related adverse reactions were mainly constipation, and there was no significant difference in the incidence (P>0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.

Objective To investigate the clinical outcomes of different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture.Methods From January 2010 to June 2014,33 cases of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture were treated with open reduction and internal fixation.According to the different managements of the complete rupture of the deltoid ligament,the patients were divided into 4 groups:9 cases in the non-repair group,7 cases in the superficial layer repair group,9 cases in the deep layer repair group,and 8 cases in the complete repair group.All the patients took anteroposterior,lateral and gravity stress radiographs preoperatively and postoperatively.The 4 groups were compatible in preoperative general data (P ＞ 0.05).The 4 groups were compared in terms of operation time,medial clear space and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.Results All the patients were followed up for 6 to 18 months (average,13.7 months).All wounds healed at the first stage without any infection.All fractures united primarily after 3 to 9 months (average,4.7 months).The operation time for the superficial layer repair group was significantly longer than for the non-repair group,but significantly shorter than for the deep layer repair and the complete repair groups (P ＜ 0.05).In gravity stress radiographs,there was no significant difference in medial clear space among the 4 groups (P ＞ 0.05),but there were significant differences before and after operation in the 4 groups (P ＜ 0.05).The postoperative AOFAS ankle-hindfoot score in the repair groups was significantly higher than in the non-repair group and the superficial layer repair group(P ＜ 0.05).Conclusion To achieve satisfactory outcomes for patients with complete rupture of the deltoid ligament associated with supination-external rotation ankle fractures,anatomic open reduction and rigid internal fixation is necessary,and repair of the deltoid ligament,especially its superficial layer,is a valuable contribution.

Most of the individuals with spinal cord injury (SCI) have nutritional problems in metabolism in energy, glucose, fat and vitamin after injury, which would influence the quality of life. Nutrition intervention program includes personalized nutrition consultation, correcting the imbalance of energy and lipid, supply of creatine and vitamins associated with energy metabolism, monitoring, and health promotion, are helpful to reduce the risk of complications related with metabolism.