[Objective]To investigate the morphological changes that take place in the subchondral cocortical bone in steroid-induced osteonecrosis and analyze the reasons leading to humeral head collapse in juvenile rabbits.[Method]Five-six month-old female rabbits were separated by two groups.A modified version of the methods was used to replicate steroid enhanced osteonecrosis anminal humeral head models with Shwartzman reaction in group A,and group B served as the single control.Each humeral head was obtained 10 weeks after the drugs injection.Subchondral cortical bone was observed,and the number of haversian canals was counted.The microcirculatory changes were also detected with scanning electron microscope.[Result]In group A,the Haversian canals in' subchondral area almost disappeared;the subchondral cortical bone disappeared with its arch,dome and bridge structures.Microcirculatory stasis happened in the subchondral vessels.Some humeral heads collapse were observed.While in group B,subchondral cortical bone is integrity and continuity,forming arch,dome and brige structures with subtrabecular bone.[Conclusion]The disappearance of the subchondral cortical bone is a major reason leading humeral head collapse,and ischemia is the critical reason of it.

[Objective]To evaluate the effect of massive bioactive bone substitute in repairing large animals bone defect and to know its degrading rate.[Method]The massive Polylevolactic acid?collage calcium phosphate(PLLA?cTCP) carrieres by rapid forming technology was making,and then compounding rhBMP-2 and carrieres in a ratio of 3mg rhBMP-2 to one carrier was compounded to prepare the massive bioactive bone substitutes for dogs bone defect.Then the massive bone substitutes were implanted into 2.0cm dogss radius defects in the experiment group,and the massive carriers were implanted into in the control group.The repairing effect was evaluated by radiography,histology and biomechanics,and the degrading rate of the substitues was calculated in an image analysis apparatus.[Result]Radiographically,in the experiment group,the defects were connected by callus in all dogs in 12 weeks postoperatively;in 24 weeks,the callus rebuilt well.But in the control group,there was no callus formed in 24 weeks postoperatively,and the defects were not repaired.Histologically,in 12 weeks postoperatively,the outer layer of the callus in the experiment groups was lamellar bone and the center were trabecular bone,myeloid tissue and partial degrading carrier;in 24 weeks,the lamellar bone was more compact,trabecular bone decreased,myeloid tissue increased,and the carrier degraded more.In the control group,in 12 weeks postoperatively,the fibrous tissue wrapped and infiltrated into carrier,at the same time,part of the carrier degraded;in 24 weeks,the carrier was divided up by fibrous tissue and degraded more.The degrading rate of the carder in 12 weeks in the experiment group was 43.2%,in the control group was 35.7%,in 24 weeks 58.4% and 45.4%.Biomechanics,in 24 weeks after postoperation,the radius strength in the experiment group was superior to that in the normal bone.[Conclusion]The massive bioactive bone substitutes have satisfactory repairing effect on the radius bone defects of the large animal,but its degrading rate needs improving.

Objective To investigate the biological effects of low intensity of pulsed ultrasound (LIPUS) on human periosteal cells and marrow stromal cells in vitro. Methods LIPUS of 30 mW/cm2 was used to stimulate the cultured human periosteal cells and marrow stromal cells for 5 min, 10 and 20 min per day, respectively, followed by the examination of cell proliferation and differentiation potential. Results Thymidine incorporation and total protein assay indicated that LIPUS had no significant effect on DNA and protein synthesis of the periosteal and marrow stromal cells, suggesting that LIPUS did not promote proliferation of these cells. However, ALP activity and osteocalcin secretion of the human periosteal cells were dramatically increased. Conclusion The results suggested that low intensity pulsed ultrasound stimulated periosteal cell proliferation and differentiation toward osteogenic lineage, this might contribute to the curing effect of low intensity pulsed ultrasound for fracture.

OBJECTIVE: To observe the effect of Fufang Sishen Decoction (FFSSD) on arrhythmia after virus myocarditis. METHODS: One hundred and two cases of arrhythmia after virus myocarditis were randomly divided into two groups. The treatment group was treated with FFSSD, 6 g, b.i.d.; and the control group with propafenone, 150 mg, q 8 h. The therapeutic effects were observed in 4 weeks. RESULTS: The total anti-arrhythmia effects of FFSSD and propafenone were 71.9% and 78.9% respectively (P>0.05). FFSSD took effects relatively slowly with mild and lasting effect. CONCLUSION: The curative effect of FFSSD in treating arrhythmia after virus myocarditis is confirmed. FFSSD has no obvious side effects.

Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375％ ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1％-2％),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.

Objective To investigate the dose-effect effects of th ree relating bone growth factors, dexamethasone, recombinant human basic fibro blastic growth factor (rhFGF) and recombinant human bone morphogenetic protein- 2 (rhBMP-2), on proliferation and differentiation of periosteal cells so as to provide experimental basis for their further application in bone tissue engineer ing. Methods Periosteal cells were isolated and cultured in vitro and then exposed to dexamethasone (10 -8 mol/L, 10 -7 mol/L and 10 -6 mol/L), rhFGF (50 ng/ml, 200 ng/ml and 500 ng/ml) and rhBMP-2 (50 n g/ml, 500 ng/ml and 1 000 ng/ml) respectively. At the 4th and 7th days respectiv ely, the culture stopped and the total protein and alkaline phosphatase (ALP) ac tivities were measured. ResultsDexamethasone at concentratio n of 10 -6 mol/L significantly inhibited protein synthesis without obvious effects on ALP expression. The rhFGF at various concentrations significantly pro moted cell proliferation but inhibited ALP activity. The rhBMP-2 at various con centrations exerted insignificant effect on cell proliferation. In comparison, A LP expression was significantly enhanced by treatment of rhBMP-2 at concentrati on of 500 ng/ml and 1 000 ng/ml ( P

Bone Diseases ; complications ; Humans ; Intestinal Polyposis ; complications ; congenital ; Metaplasia ; complications ; Neoplastic Syndromes, Hereditary ; complications

Objective To investigate the setup errors of super chest segment of esophageal cancer patients before radiotherapy delivery by KV cone beam CT,and evaluate the margin from CTV to PTV.Methods From 2010 to 2012,13 patients with super chest segment of esophageal cancer whose IMRT planning CT images were included in this study.Delineate target on the CT images of treatment planning and enlarge the margin of CTV to form ITV,then enlarge the margin of ITV gradually 10 times by 1 mm each time to form varied PTV,and create the plan according to the size of the PTV,simulate setup errors in the new plan to obtain the simulation of the actual exposure curve and find a suitable PTV to assure 95％ ITV volume as ever to approach the prescription dose,obtained the outside enlarge distance of CTV → PTV.Results The maximum setup errors in the direction of the anterior and posterior positioning was (3.42 ±2.19) mm.The margin of ITV→PTV is 5 mm which was figured out by PTN enlarging method.Compared to the original plan that under the condition of draw up the radiotherapy plan that based on the method of PTV enlarging obtained the CTV→PTV and simulate the actual dose distribution according to the setup errors:total lung V5,spinal cord D1cm3,increased by about 0.87％,4.95 Gy,heart V40,PTV D95,PTV V100,ITV D95,ITV V100 were reduced about 0.62％,4.95 Gy,8.38％,1.84 Gy,1.87％,all of them have statistically difference.Conclusions Range of external expansion of the left to right,superior to inferior and anterior to posterior is 7 mm,8 mm and 7 mm respectively,according to the method of PTV enlarging obtained the margin of CTV→PTV of super chest segment of esophageal cancer patients.

BACKGROUND: For xenogeneic bone transplantation, immune rejection is the major problem that affects the prognosis. However, the understanding about the expression and regulation of the immune factors in heterogenic bone transplantation is limited. Interleukin-1 (IL-1), interleukin-6 (IL-6)and tumor necrosis factor alpha (TNF-α) are important immune factors, and are closely related with post-transplantation rejection.OBJECTIVE: To observe the regional expressions of mRNA and protein of IL-1α, IL-6 and TNF-α in xenogeneic bone transplantation, and to in vestigate the effect of transforming growth factor (TGF)-β on these immune factors.DESIGN: A randomized controlled experiment. SETTING: The Orthopaedic Institute of Xijing Hospital of the Fourth Military Medical University of Chinese PLA MATERIALS: Totally 72 male Balb/c mice, with a body mass of 20 to 25 g, were randomly divided into 3 groups: combined bovine cancellous bone (bCB) granule group (Group A), simple bCB granule group (Group B) and blank control group (Group C) with 24 mice in each group.INTERVENTIONS: This experiment was conducted at the Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical Univessity of Chinese PLA from June 2003 to June 2004. In Group A, one bCB combined TGF-β was implanted into the muscles of left thigh of each mouse. In Group B, one bCB alone was implanted, and in Group C, no bCB was implanted. The number of proliferation of cells in bone implantation area or adjacent tissues of the operated area was observed at postoperative 4, 7, 14 and 21 days; and the regional expressions of several immune factors in im plants were detected with in situ hybridization and immunocytochemistry methods.MAIN OUTCOME MEASURES: Histological observation and detection of regional cellular density of the implants of the mice in each group; the regional expressions of mRNA and protein of IL-1α,IL-6 and TNF-α in the implants RESULTS: ①) Histological observation and detection of regional cellular density of the implants of the mice in each group: on day 7, the cellular density of the proliferated tissues was significantly higher in the Group A than in the Group B [(470.63±132.89), (311.46±93.69)/field,P ＜ 0.01];But on days 14 and 21, there was no significant difference. ②The regional expressions of mRNA and protein of IL-lα, IL-6 and TNF-α of the im plants of the mice in each group. On days 7 and 14 after xenografts were implanted, the regional expressions of IL-1α, IL-6 was respectively lower the xenografts combined with TGF-βthan in the simple xenogeneic bone (day 7: IL-1α 42.55±9.65 vs 67.95±17.82,IL-6 48.26±11.17 vs 77.21±15,16;day 14: IL-1α mRNA 84.77 ±7.42 vs 112.94±7.02,78.1 ±17.22 vs 121.18±15.44,P ＜ 0.01) ,but for the TNF-α, there was no significant difference (P ＞ 0.05).CONCLUSION: In the region of bone xenograft, a variety of cells express mRNAs and proteins of IL-1α, IL-6 and TNF-α, and their expressions are regulated by TGF-β. It may imply a kind of regulation of the immunity of bone xenograft by TGF-β.

Objective To observe pathological features of peripheral vessel injury caused by ex-plosion shock wave so as to provide theoretical basis for emergency treatment, prevention and complication reduction of war extremity injuries. Methods A total of 18 rabbits were randomly divided into three groups (six rabbits in each group) and placed respectively at 1, 2 and 3 m away from the explosion cen-ter. The animal model with blast injury was made by using fluid dynamite that electrically exploded at 60 cm above the ground. The physical parameters of blast wave were recorded using pressure transducers (PCB, UAS). After explosion, the femoral arteries were examined grossly, histologically and immunohis-tochemically. Results The results showed that vascular endothelial cells were denudated, the spaces of contractile fiber cells increased and appeared puff, the vassular elastic fibers ruptured, flexed and de-formed visibly. Some parts of the vessel wall ruptured completely or partly, leading to bleeding. TUNEL staining and fluorescence microscope found large number of apoptotic cells in endothelium layer, smooth muscle layer and membrana adventitia layer of the blood vessels. Conclusion Explosion shock wave can result in severe large blood vessel injury, which should be paid much attention during treatment of ex-plosion shock injury.