Objective To access the relationship between the polymorphism of G protein-coupled receptor kinases 4(GRK4,including R65L,A486V and A142V) and essential hypertension.Methods All the literature on the subjects was searched by keywords such as essential hypertension,hypertension,G protein-coupled receptor kinases 4 gene,and polymorphism in the electronic databases,Medline of Year 1997 to 2006.RevMan 4.2 software was used for Meta analysis.Results A total of 857 cases and 913 controls from 4 studies were included.The ORs of genotypes of R65L,A142V and A486V were 0.97(0.75 to 1.25,P=0.81),0.81(0.30 to 2.08,P=0.65) and 1.48(1.16 to 1.8,P=0.001) respectively.Conclusion GRK4 gene polymorphism A486V is significantly associated with susceptibility of essential hypertension.People who carries A486V have a higher risk to be subject to essential hypertension.

BACKGROUND: Re-injury of organism and sufficient of materials exist in the autologous transplantation of tendon to treat defected tendon following trauma. Carbon fiber artifical tendon, human hair tendon and other artifical tendons are also proved to be transplantable. But immunological rejection and biomechanical inadaptability exist following artifical tendons are transplanted. Therefore, the development of new human tendon substitute is the major problem to be solved at present.OBJECTIVE: To observe the porcine small intestinal submucosa as artificial tendon to repair 2 cm tendon defect of the 3rd toe of the left and right feet of chicken, and the immunological rejection and biomechanical adaptability following repair.DESIGN: A randomized and controlled animal experiment.SETTING: Department of Orthopaedics, Sixth Hospital Affiliated to Shanghai Jiaotong University.MATERIALS: Totally 45 Leghorn chickens, aged 12 weeks, of either gender, with body mass of 4.0 to 4.4 kg, were chosen.METHODS: This experiment was conducted at the Department of Orthopaedics, Sixth Hospital Affiliated to Shanghai Jiaotong University from September 2002 to June 2003. ① Totally 45 Leghorn chicken, aged 12 weeks, were randomly divided into 3 groups. The third toe of the left and right feet was chosen from 20 chicken respectively of autologous transplantation group and porcine small intestinal submucosa group, flexor digitorum profundus muscle tendon was cut off at middle phalanx, and 2 cm tendon defect model was created. The defected tendon in the autologous transplantation group was performed in situ suture; the defected tendon in the porcine small intestinal submucosa transplantation group was repaired with porcine small intestinal submucosa; There was not any treatment on the 5 Leghorn chicken in the blank control group. ② Histomorphologyl, transplantation immunology, biomechanics and functional recovery were measured at 3,6 and 9 weeks following tendon transplantation.MAIN OUTCOME MEASURES: ① Gross observation of operated toes of chicken and optical observation of grafts in each group. ② White blood cell (WBC) differential count at 3 days preoperation,3 days postoperation,and 1 week and 2 weeks postoperation. ③ Biomechanical test and functional recovery test of chicken in each group.RESULTS: Totally 45 chicken entered the stage of result analysis. ① At 9 weeks after operation, morphology of porcine small intestinal submucosa was basically the same as that of normal tendon by naked eyes; Under optical microscope, fibroblasts on the porcine small intestinal submucosa arranged in order along long-axis and collagen extracellular matrix appeared.② Within 2 weeks after operation, there was no significant difference of WBC measurement between porcine small intestinal submucosa transplantation group and autogolous transplantation group (P ＞ 0.05), suggesting that porcine small intestinal submucosa, as xenogenic material, has no obvious immunological rejection. ③ In the biomechanical test, biomechanical adaptability at postoperative 12 weeks was superior in the porcine small intestinal submucosa group to in the autologous transplantation group [(22.22±0.90),(20.78±0.94) ,P ＜ 0.05]. ④ In the test of functional recovery, there was no obvious difference of activity of metecarpophalangeal joint (P ＞ 0.05), the activity of proximal interphalangeal joint was superior in the blank control group to in the porcine small intestinal submucosa group and autologous transplantation group [(21.0±1.6)°, (15.1±1.7)° , (16.0±2.1)° ,P ＜ 0.05].CONCLUSION: There is no evidence of immunological rejection after porcine small intestinal submucosa is transplanted into the body of chicken. Therefore, porcine small intestinal submucosa can be used as the xenogenic material to repair tendon defect.

is lesion size and staging in pre-operative and etiologies are the risk factors associated with postoperative progression.

BACKGROUND:Studies has confirmed that platelet-rich plasma(PRP) can affect the proliferation and differentiation of bone marrow mesenchymal stem cells and adipose derived stem cells. OBJECTIVE:To observe the effects of PRP on the proliferative and osteogenetic activity of skeletal muscle stem cells(SMSCs) in vitro,in addition,to elucidate the potential mechanism by which PRP affects SMSCs. DESIGN,TIME AND SETTING:A randomized controlled animal experiments was completed in the Center Laboratory of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from June to October in 2008. MATERIALS:Nine New Zealand,ordinary grade rabbits,weight of 2.5-3.0 kg,1 year old,irrespective of gender. METHODS:The right soleus was dissected and cultured for SMSCs. PRP was prepared with central artery of rabbits’ ears. The cells were randomly divided into the experimental group and the control group. In the experimental group,the SMSCs were interfused with PRP(special culture media including 12.5% PRP) . There was no intervention in the control group. MAIN OUTCOME MEASURES:①Morphological observation. ②The proliferative ability of the cells was detected with MTT. ③ The osteogenetic ability was measured with alkaline phosphatase(AKP) staining,alizarin red staining and osteocalcin immunofluorescence assay. RESULTS:MTT method showed that the proliferative activity of the experimental group was obviously stronger than that of the control group(P

Platelet-rich plasma (PRP) is a concentrated source of autologous platelets after centrifugation, being used widely in plastic surgery and oral-maxillofacial surgery. Recent studies have showed that PRP can improve bone repair, vasculogenesis, and soft tissue repair. Composite of PRP and stem cells is applied in the field of orthopedics and tissue engineering. As a matter of fact, PRP has become a hot research topic. In addition, PRP plays an important role in the healing of chronic wound. This paper briefly introduces the main components of PRP and its clinical application, the mechanism for bone healing and soft tissue repair, as well as the latest research achievement and discussion in the shortcoming of PRP in clinical application.

0.05). ③The entrance point of screw was designed based on the obtained data. Sixty screws were all inserted into pedicles successfully. CONCLUSION: L1-5 superior margin root of spinous process locates in superior and inferior planes of vertebral pedicle with stable anatomic relationship; in addition, there are no significant differences between plain tomography and CT films. It provides anatomic data for pedicular operation.

Objective To report the preliminary results of treatment of fracture nonunion at the distal femur and the proximal tibia with Less Invasive Stabilization System (LISS). Methods From February 2003 to August 2004, LISS fixation and bone grafting were employed to treat 5 cases of fracture nonunion at the distal femur and 4 cases of fracture nonunion at the proximal tibia. The nonunion had resulted from failure of internal fixation in 7 cases, failure of external fixation in 1 and infection in 1. The history of nonunion lasted from 10 to 111 months (mean 29m). Results All the 9 patients were followed up for an average of 8 (6 to 16) months only to reveal solid bone union in all the fractures, with a mean healing time of 4.7 months (ranging from 4 to 6 months). No loosening or breakage of the implants occurred in this series. Conclusion Due to its advanced design, LISS can be used to treat effectively fracture nonunion at the distal femur and the proximal tibia.

OBJECTIVE: To review the development and mechanism of platelet-rich plasma (PRP) and the unsolved problems so as to provide reference for the clinical application of PRP.DATA SOURCES: Articles on effects of platelet-rich plasma on bone repair are searched from Medline between January 1995 and June 2005 on computer. The key words were platelet rich plasma, bone, and repair.Meanwhile, the same search was conducted to determine the correlated articles during January 1998 to June 2005 from Wanfang database with key words of platelet-rich plasma, bone and repair in Chinese.STUDY SELECTION: Literatures at home and abroad on the PRP and bone repair were chosen; Non-randomized controlled literatures were included.DATA EXTRACTION: Totally 40 out of 49 reports related to PRP and bone repair met the criteria. 9 reports were excluded due to the repeated same research. The rest 40 reports were sorted out and conducted literature review.DATA SYNTHESIS: Platelet-rich plasma was originally used in clinic to repair mandibular defect in 1998, by adding PRP to grafts with a radiographic maturation rate 1.62 to 2.16 times that of grafts without PRP. Up to now, PRP has been used in many medical areas to accelerate tissue healing due to its advantages of safety, simple, low-cost. But some problems still remain to be studied and solved.CONCLUSION: PRP includes many sorts of growth factors and has been proved to be beneficial to the maturation of both bone tissue and soft tissues. PRP is autologous and can be produced easily and safely from autologous blood, without the concerns of transmissions and immunological rejection of various diseases.

Objective To investigate the clinical outcome of tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail in treatment of severe posttraumatic tibiotalar and talocalcaneal arthritis.Methods A total of 17 cases of severe posttraumatic tibiotalar and subtalar arthritis were treated with tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail between June 2003 and June 2006.Patients were evaluated by a standardized follow-up examination using ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society(OFAS)score. Results Of all,14 cases were followed up postoperatively,with a mean follow-up period of 14.6 months(6-23 months).Bony fusion was achieved in 12 cases (86%)after an average of 11.6 weeks(8-19 weeks)but a delayed union in 2 after 17-19 weeks.Two cases(12%)complained heel pain at the nail entry point at initial stage of operation.The average anklehindfoot score improved from 47 points(43-55 points)preoperatively to 75 points(69-86 points)postoperatively. Conclusion Tibiotalocalcancal arthrodesis plus retrograde intramedullary nailing is proved to be effective in treating severe posttraumatic tibiotalar and talocalcaneal arthritis by marked relief from pain and improvement of life quality.