BACKGROUND: In clinic, many orthopaedic diseases are related to abnormal increase of intraosseous pressure, such as, avascular necrosis of femoral head and osteoarthritis and so on. Percutaneous bone puncture and other methods can decrease intraosseous pressure and release clinical symptoms immediately. Analysis on the changes in intraosseous pressure and medullary blood rheology following drilling decompression can further recognize the occurrence and development of intraosseous pressure OBJECTIVE: To observe the changes in intraosseous pressure and medullary blood rheology following drilling decompression in rabbits.DESIGN: A randomized and controlled trial.SETTING: Department of Orthopaedics, Affiliated Hospital of Youjing Medical College for Nationalities.MATERIALS: This experiment was carried out at Orthopaedic Department, Affiliated Hospital of Youjing Medical College for Nationalities between March and December 2005. Totally 30 New Zealand purebred white rabbits, of either gender, weighing (2.16±0.35) kg, were provided by Experimental Animals Center of Guangxi Medical University.METHODS: ① Animals grouping and modeling: 30 rabbits were randomly divided into 2 groups: model group and experiment group with 15 in each group. Intraosseous pressure models of the proximal right tibia were created on the rabbits in the two groups and drilling decompression was performed in the proximal tibia of rabbits in the experiment group. ②Measurement of intraosseous pressure of proximal tibia: After rabbits were anesthetized, needle for measuring blood pressure was pricked into the medullary canal at 0.5 cm internal plane up at the tubercle of right tibia.Intraosseous pressure of two groups was measured before and 2 days after decompression with BL-410 biologic functional system. ③ Measurement of medullary blood rheology: Before and 2 days after drilling decompression,medullary blood was extracted and blood rheology was measured with Blood Perfusion Monitor R80 (Vertebral plate type, Version 5.0) in the experiment group.MAIN OUTCOME MEASURES: Value of intraosseous pressure and medullary blood rheology before and after drilling decompression in the proximal right tibia.RESULTS: All the 30 rabbits entered the stage of result analysis. ①Measurement of intraosseous pressure: intraosseous pressure was significantly lower after drilling decompression in the proximal right tibia in the experiment group than in the model group (P ＜ 0.01). It approached normal value of intraosseous pressure of control side [(2.50±0.39) kPa]. Intraosseous pressure in the experiment group was significantly lower after than before drilling decompression (P ＜ 0.01). ② Measurement of medullary blood rheology: Medullary blood viscosity, plasm viscisity, whole blood reduced low-shear viscosity, red cell rigidity index, whole blood high-shear relative viscosity, whole blood low-shear relative viscosity, erythrocyte deformation index and erythrocyte aggregation index at the proximal end of tibia following drilling decompression were significantly lower than those before drilling decompression (P ＜ 0.05 or 0.01). Medullary erythrocyte sediment rate and erythrocyte hematocrit did not change significantly (P ＞ 0.05).CONCLUSION: Drilling decompression in proximal right tibia can obviously decrease intraosseous pressure, dilute medullary blood and decrease blood viscosity.

Objective To study the microcirculation pattern of expanded skin and its influence on skin blood supply. Methods The microvessel diameter, blood velocity and blood volume were recorded under the microcirculatory imaging system and the microvessel density was measured by enzyme histochemical staining and medical imagine analysis. Results Compared with the control group, all the recorded values rose obviously in every expanded groups ( P

Objective To study the theraputic effect of rebuilt posterior ligamentous complex in the treatment of thoracolumbar fracture.Method From 2003 to 2007,60 patients who had simple thoracolumbar fractures were treated with rebuild of posterior ligamentous complex(group A).At the same time,50 patients with the same condition were treated with ablation of posterior ligamentous complex(group B).Modify Japanese orthopedic association low back pain score(M-JOA)score and Functional Rating scales for Low Back Pain(FRS)score for lumbar function were compared between two groups perioperatively.Results Preoperative M-JOA score for lumbar function of group A was from 19 to 30 score,on average of23.83.M-JOA score of group B was from 17 to 30 score on average of 21.68.There was no significant different between group A and group B(P＞0.05).Postoperative M-JOA score for lumbar function of group A was from 8 to 12 score,on average of 9.05.M-JOA score of group B was from 9 to 14 score.on average of 11.95.There was significant difference between group A and group B(P＜0.01).Preoperative FRS score was 28.85 in group A and 26.56 in group B averagely(P＞0.05)while postoperative FRS score was 68.22(46-84)in group A and 46.87(39-65)in group B(P＜0.05).Conclusion Management with rebuild of posterior ligamentous complex for thoracolumbar fractures contributes to the improvement of the postoperative lumbar function and clinical symptoms.

Objective To study the method and therapeutic efficacy of the combined iliac screw with pedicle screw system internal fixation and one-stage anterior interbody autograft with iliac crest bone after focal cleaning in lumbosacral tuberculosis. Methods We summarized our 12 cases with lumbosacral tuberculosis treated using iliac screw combined with pedicle screw system internal fixation and one-stage anterior focus elimination plus iliac crest bone grafting during 3 years. Results All the incisions were healed by first intention. All patients can off-bed activity wearing lower back protector two weeks after operation and above eight months after operation,the follow up X-ray film showed all bone-grafts obtained solid fusion. Conclusion It was a safe and reliable method to treat lumbosacral tu-berculosis by using ilisc screw combined with pedicle screw system internal fixation and one-stage anterior focus elimi-nation plus iliac crest bone grafting.

Objective To investigate the inhibition of Hedyotic diffusa injection on the proliferation of hu-man osteosarcoma cell line MG -63 in vitro.Methods The human osteosarcoma cell line MG -63 was subcultivated aseptically in vitro.Different concentration of Hedyotic diffusa injection (50μL/mL,100μL/mL,200μL/mL,400μL/mL) successively acted on such cell .A total three time points were selected to determine the activity and numbers of cells by MTT assay including 12h,24h and 48h.Results The cellular proliferation inhibition rates of human osteosarcoma cell line MG-63 in drug groups of 50μL/mL concentration holes were (2.87 ±2.22)%,(13.42 ±2.14)% and (30.80 ±3.67)%after 12 h,24 h and 48 h.The rates of 100μL/mL concentration holes were (22.25 ±1.58)%, (43.34 ±2.84)%and (66.46 ±2.64)%,after 12 h,24 h and 48 h.The rates gradually increased and had statis-tical meaning,t12h =12.319,t24h =14.573,t48h =12.319,P<0.05;the cell in drug groups of 200μL/ml and 400μL/ml concentration holes was totally dead , and pathological findings showed that there were circular and floating cells in which nucleoplasmic ratio decreased and small fragments of cells increased .Conclusion Hedyotic diffusa extract has a certain inhibition in vitro on the proliferation of human osteosarcoma cell line MG -63.Moreover,the strength of its inhibition is relevant probably with drug concentration ,which deserves a further research .

OBJECTIVETo study the change rule of the hemodynamics of expanded skins and research the transplant time of random-pattern flaps that are made of the expanded skin.

METHODS72 ears of 64 rabbits were used as a subject of experiment. Four items of the contrasted skin (n = 8) and expanded skin (n = 8 x 8), Which include the microvessel diameter, the microvessel density, the blood velocity and the blood volume, were observed and measured by the microcirculatory imaging computer analysis system, the enzyme histochemical dyeing and the more functions colored pathological imaging computer analysis system. The length -width proportion and the largest area of the flaps that had made of the expansive skin and survived were measured.

RESULTS(1) The four items of expanded skin, that the microvessel diameter, the microvessel density, the blood velocity and the blood volume are 13.43 +/- 0.98 micrometer, 0.0472 +/- 0.0022, 1012.70 +/- 65.51 micrometer/s, 14.71 +/- 0.74 micrometer(3)/s respectively, are much bigger or quicker than those of contrasted skin [(7.22 +/- 0.71) micrometer, 0.0108 +/- 0.0002, (327.01 +/- 65.51) micrometer/s, (1.46 +/- 0.41) micrometer(3)/s] and there is the significant difference between both (6.49 < t < 49.49, P < 0.01). (2) The blood velocity increases in the expanding phases and always keeps on higher level. The other items all change periodically. Span of the period is four weeks. The microvessel diameter and the blood volume have a peak value at third weekend of every period and in the later period enhance more on the basis of the former period. The microvessel density changes in definite range in every period. (3) The surviving area of the random skin flaps is the largest which were made of the expanded skin in third weekend of every period, it changes more than those of other weekends in same period and later period is superior to the former period. There is a significant difference compared with contrasted random skin flaps (q = 3.7215, P < 0.05; q = 5.5026, P < 0.01).

CONCLUSIONThe hemodynamics of the expanded skin changes periodically in expansive course. The time of peak value of the blood volume is the best opportunity that random-pattern skin flaps are made of the expanded skin in every period.

BACKGROUND: Clinical practice showed that there are certain correlations between postoperative C-reactive protein levels and bone graft fusion time following focal debridement,autologous iliac bone graft,with or without plate internal fixation,for the treatment of spinal tuberculosis.OBJECTIVE: To analyze the correlation between postoperative C-reactive protein levels and bone graft fusion time of spinal tuberculosis patients.METHODS: A total of 60 cases with spinal tuberculosis were selected from January 2007 to December 2009.All patients were underwent focal debridement,autologous iliac bone graft,with or without plate internal fixation,and confirmed by pathology.The C-reactive protein levels were determined at 1,7 and 14 days after operation,and then,according to average changes of C-reactive protein levels,the cases were assigned into 4 groups: 10-25 mg/L served as the mildly increase group,26-50 mg/L as the moderately increase group,51-100 mg/L as the highly increase group,and greater than 101 mg/L as the extremely increase group.Postoperative C-reactive protein levels were examined at 12,16,and 24 weeks after operation,the bone graft fusion was observed by X-ray or CT examination,in addition,bone block fusion time was recorded.All groups of patients with spinal tuberculosis postoperative C-reactive protein diversity and bone graft fusion time were analyzed by variability and correlation analysis.RESULTS AND CONCLUSION: There were 18 cases in the mildly increase group,21 cases in the moderately increase group,13 cases in the highly increase group,and 8 cases in the extremely increase group.The bone fusion time showed that: there were8 cases equal to or less than 12 weeks,34 cases equal to or less than 16 weeks,and 18 cases equal to or less than 24 weeks.There were significant differences among 4 groups in bone graft fusion times(X2=13.990,P=0.003).Spearman correlation analysis showed that,there was a positive correlation between postoperative C-reactive protein levels and bone fusion time(r=0.420,P=0.001).

BACKGROUND: Based on the multi-directional differentiation potential,the combined application of proper biological materials and growth factor can repair tissue defect.OBJECTIVE: To observe the growth characteristics of rabbit bone marrow-derived mesenchymal stem cells and their osteogenic potential under the induced condition.DESIGN: A single sample experiment.SETTING: The Department of Histology and Embryology of Youjiang Medical College for Nationalities; the Affiliated Hospital of Youjiang Medical College for Nationalities.MATERIALS: This experiment was conducted at the Department of Histology and Embryology of Youjiang Medical College for Nationalities in June 2004. Male new Zealand rabbits, with a body mass of 2.0 to 2.5 kg,were provided.METHODS: Rabbit bone marrow tissue was extracted. After gradient centrifugation, adherent cells were kept for cell passage. Culture medium was used for inducing culture of osteoblast when the passage was stable (50 mL/L of Dulbecco modified culture medium of bovine serum containing 10 mmol/L of β-sodium glycerophosphate, 10 nmol/L of dexamethasone, 50 mg/L of vitamine C). The culture medium was changed every other day. Osteogenic characteristics of the bone marrow-derived mensenchymal stem cells were observed under an inverted microscope after alkaline phosphatase immunohistological staining, osteonectin and osteopontin immunocytochemical staining.MAIN OUTCOME MEASURES: ① Morphological observation of bone marrow-derived mesenchymal stem cells; ② Osteogenic characteristics of bone marrow-derived mesenchymal stem cells.RESULTS: ① Morphological observation of bone marrow-derived mensenchymal stem cells: Primary rabbit bone marrow-derived mesenchymal stem cells could cover the Petri dish fully in 7 or8 days and could passage stably. Generative cells began to passage in 5 or 6 days. ② Osteogenic characteristics of bone marrow-derived mensenchymal stem cells:Alkaline phosphatase immunohistochemical staining showed a lot of brown particles in the kytoplasm, but no colored cells were found in the control group. Osteonectin and osteopontin immunohistochemical detection found that the nucleus was light blue and a lot of brown particles appeared in the kytoplasm, presenting obvious strong positive, but no brown particles appeared in the control group.CONCLUSION: After combined induced culture with dexamethasone, vitamine C and β-sodiumglycerophosphate, rabbit bone marrow mensenchymal stem cells showed the morphological and biological characteristics of osteoblasts with osteoblastic activity, and were able to supply autologous seed cells for constructing in vitro tissue engineered bone in a short period of time.

BACKGROUND: Tuberculosis clearance, bone graft, internal fixation with or without plate for patients with spinal tuberculosis always lead to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) changes, which are associated with bone graft union time to certain degree.OBJECTIVE: To analyze the correlation between CRP, ESR and bone graft union time in patients with spinal tuberculosis.METHODS: A total of 60 patients with spinal tuberculosis underwent tuberculose focus clearance, autologous iliac bone grafting, and internal fixation without or with plate, including 38 undergoing fixation and 22 not undergoing fixation. They were divided into mild elevation, moderate elevation, high elevation, and extremely high elevation groups according to CRP and ESR. Correlation between CRP, ESR and bone graft union time was analyzed.RESULTS AND CONCLUSION: (1) CRP: there were 18 cases of mild elevation, 21 of moderate elevation, 13 of high elevation and 8 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.420, P=0.001, indicating positive correlation between CPR and bone union time. (2) ESR: there were 16 cases of mild elevation, 20 of moderate elevation, 13 of high elevation and 11 of extremely high elevation. There were significant differences in bone union time among groups (P=0.003). Spearman correlation analysis showed a correlation coefficient r=0.414, P=0.001, indicating positive correlation between ESR and bone union time. (3) Bone union was rapider in fixation group compared with non-fixation group, indicating that immediate, strong fixation can benefit bone union.

BACKGROUND:Interleukin-12 (IL-12) may function as an immune regulator in the pathogenesis of osteoarticular tuberculosis. OBJECTIVE:To explore the association of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with susceptibility to osteoarticular tuberculosis and serum interleukin-12 levels in Guangxi Zhuang population. METHODS:The single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms were detected by polymerase chain reaction-single base extension technique and direct DNA sequencing in 150 patients with osteoarticular tuberculosis (disease group) and 165 healthy individuals (control group) in Guangxi Zhuang population. The genotype and al ele frequencies of IL-12 and the relationship of genotypes to the susceptibility to osteoarticular tuberculosis were analyzed. In addition, the association of genotypes of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with serum IL-12 levels were analyzed. RESULTS AND CONCLUSION:There was no significant difference in the genotype and al ele frequencies of IL-12A rs568408 G/A and IL-12B rs3212227 A/C between the disease group and the control group (P>0.05). Moreover, there was no difference in four haplotypes of IL-12 gene between the disease group and the control group (P>0.05). Serum IL-12 levels in subjects with osteoarticular tuberculosis carrying the variant rs568408 GA/AA genotypes and wild-type rs568408 GG genotypes were similar (P>0.05). Similarly, there was no significant difference in serum IL-12 levels between subjects with osteoarticular tuberculosis carrying the variant rs3212227 AC/CC genotypes and wild-type rs3212227 AA genotypes (P>0.05). These findings suggest that the single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms are not associated with susceptibility to osteoarticular tuberculosis in Guangxi Zhuang population.