Objective To observe the therapeutic effect of arthroscopic synovectomy for tuberculous synovitis of the knee. Methods Ten patients with tuberculous synovitis received arthroscopic biopsy and synovectomy. Postoperatively, isoniazid was injected into the articular cavity, and systemic antituberculosis drugs were administrated. Results These patients received continuous passive motion (CPM) from the second postoperative day. In 9 patients, the flexion ranges of the knee were improved from 90??5? before the surgery to 120??14? after the surgery, and the extension limit of the knee, from 20??3? before the surgery to 5??1? after the surgery, with statistical significant differences ( t =6.9 and 6.3, respectively; P

[Objective]To investigate the rlpairing effect on articular cartilage defects by composite of cocultures of autogenic bone marrow-derived mesenchymal stem cells(BMSCs) and chondrocytes with allogenic fully deproteinized bone(FDB),in order to provide basis for optimizing seeding cells resources.[Method]Seeding cells were collected from two-passaged BMSCsand chondroeytes and then cocultured at the rate of 2 to 1.Full thickness articular cartilage defects in the knee joints of rabbits repaired by cocultured cells seeded into allogenic FDB were served as experimental group A,by simple FDB as control group B and by nothing as blank control group C.Repaired tissues were evaluated with macroscopic views,histological scores and immunohistochemistrical stains at 8 and 16 weeks postoperatively.[Result]Chondrocytes cocultured riched in extracellular matrix and proliferated promptly.In A regenerated tissues represented hyaline-like,smoothness and flat.In group B and C,repaired tissues were fiberous and no repaire in group C.Histological scores of experimental group A excelled group B and C with statistically significant differences(P0.05).Immunohistochemistrical stains showed that cells in the zones of repaired tissues were larger in size,arranged columnnedly,riched in type-Ⅱ collagen matrix and integrated satisfactorily with native adjacent cartilages and subchondral bones in the experimental group A at 16 weeks postoperatively.[Conclusion]Cocultures of autogenic BMSCS with chondrocytes can promote proliferation of chondrocytes and production of chondral matrix.Cocultures as seeding cells can save a number of chondrocytes,shorten culturing periods and reduce subcultured times.Cocultures embedded into FDB can repair articular cartilage defects effectively.

Objective To review an arthroscopic technique using suture fixation for repair of the tibial eminence fractures.Methods A review of 33 patiernts with 11 Meyers and McKeever type Ⅱ,19Ⅲand 3 Ⅳ fractures of the tibial eminence treated with arthroscopic suture fixation were conducted.Results Mean follow-up time was 7 months(range,6 to 12 months).At follow-up evaluation,the range of motion retum to their previous normal levels(rang,0°to 130°).All patients underwent X-ray examination that confirmed the fracture have been healed in 2 months except 2 cases, and pulled out fixation in 12 months.Conclusion The technique of arthroscopic internal fixation of avulsed tibial eminence fractures in 33 cases is very useful in dealing with the fractures in simple fixation,minimal trauma,quick recovery.

Objective To explore the clinical effect of microgranular fat obtained by mechanical injection of autologous fat tissues in the treatment of lacrimal trough deformity.Methods Ten patients in this group were women,and the average age was 28 years.With tumescent technique,the thigh fat granules were aspirated;after the separation and purification using cell sorting screen,fat particles were obtained with uniform size and without fibrous tissue.Through mechanical pushing of the fat particles,the fat granules became chylomicron-like.The fat particles without fibrous tissue were injected into the superficial layer and deep layer of the orbicularis oculi muscle with depressed deformity.3-12 months after operation,the clinical efficacy was evaluated by doctors,patients and the third party.Results In 10 cases of lacrimal groove deformity,9 cases were transplanted once,and 1 case did twice.After 3 to 12 months follow-up the appearance of tear trough deformity was significantly improved,the texture of the ditch of eyelid and cheek skin was soft,and appeared young plump appearance.There were no complications,such as infection,hematoma,fat liquefaction,pigmentation and induration,and satisfactory results were obtained.Conclusions Ultrafine particles of fat are obtained using improved purification method in the treatment of lacrimal groove deformity,and the efficacy is satisfactory.

Objective To investigate the effects of extracellular ATP on the recovery of motor function after spinal cord injury in rats.Methods Twenty healthy adult rats were randomly divided into two groups after contusion injury was performed by the weight drop method at T10 with Allen impactor.Group A(ATP group) and group B(control group) each had ten rats.At days 1,3,7,14 and 28 after injury,the recovery of motor function after spinal cord injury in rats was assessed with modified Tarlov scores and slanting board test.Results Modified Tarlov scores and slanting board test were better in group A than in group B after spinal cord injury in rats.Significant difference was found in modified Tarlov scores and slanting board test between the two groups at days 14 and 28 after injury(P

BACKGROUND: There is still no affirmative conclusion on the proliferative characteristics and the sources of neural progenitor cells after chronic compressive injury of spinal cord in adult mammals and the effects of astrocytes in this process.OBJECTIVE: To investigate the proliferative characteristics and the sources of neural progenitor cell and the effects of astrocytes by means of analyzing the changes of expression of nestin and glial fibrillary acidic protein after chronic compressive injury of spinal cord and after decompression in adult rats.DESIGN: Completely randomized control trial.SETTING: Orthopaedics Research Institute, the Second Hospital of Lanzhou University.MATERIALS: The experiment was completed in Orthopaedics Research Institute of the Second Hospital of Lanzhou University from March to October 2003. A total of 50 adult healthy Wistar rats were selected and randomly divided into normal control group, moderate chronic compressive spinal cord injury group (compressive mass occupied 40% of the diameter of spinal canal), severe compression group (compressive mass occupied 60% of the diameter of spinal canal). Three-day and 10-day decompression groups (depression after 24-hour severe compressive injury) with 10 in each group.MAIN OUTCOME MEASURES: ① Grey value of positive expression of nestin in grey and white matter in spinal cord segment near compression (5 mm to the edge of compression) in rats of each group. ② Expression of glial fibrillary acidic protein in spinal cord of rats in each group.RESULTS: All the 50 rats entered experimental analysis. ①There were significant expressions of nestin in moderate compression group (white matter 235.33±6.48, grey matter 196.28±6.55), severe compression group (white matter 190.45±4.91, grey matter 173.15±5.98), 3-day decompression after severe compressive injury group (white matter 198.39±3.24, grey matter 180.38±4.51) and 10-day decompression group (white matter 202.55±3.54) (P ＜ 0.05), especially in severe compression group (P ＜ 0.01).Compared with the normal control group, the difference between the ex pression of nestin in grey matter and that in ependymal cells on the central canal of spinal cord in 10-day decompression group has no significance (P ＞ 0.05). ②Compared with normal control group, the expression of glial fibrillary acidic protein in spinal cord increased in each injury group,and the amount of positive cells of glial fibrillary acidic protein went up and cell soma was hypertrophic, and the processes became thicker and longer.CONCLUSION: There is neural progenitor cell proliferation in the early stage of chronic compressive injury of spinal cord and after decompression in adult rats. Astrocyte participates in proliferation and migration of neural progenitor cells and has important trophic and repair effects on spinal cord.

Objective To discuss the clinical application of different particle size of grain fat sieved by the homogenizing fat extractor.Methods A lot of 68 patients in this group were women,and the average age was 28 years.With the aid of tumescent technique,anterior and lateral thigh fat granules were extracted using liposuction needle;after the homogenizing fat extractor and sieve purification,fat particles were obtained with uniform particle size and no fibrous tissue for different sizes of 2.00 mm,0.90 mm,0.50 mm and 0.28 mm,respectively.After choosing corresponding diameter of fat transplantation needle and appropriate injection level according to fat particle size,the multiple spot and multiple track tunnels,multi-level injection for the facial soft tissue deficiency or cavity were then carried out.With long-term postoperative follow-up,evaluation of different grades were given for the complication,fat survival rate and satisfaction.Results The results were followed up for 3-12 months postoperatively;as responding,the facial appearance of graft field deformity or deficiency was significantly improved and the skin of the recipient area was soft;wrinkles was relieved,and so that they appeared young plump well-pleasing appearance.And there were no complications,such as infection,hematoma,fat liquefaction,pigmentation,induration and so on.Satisfactory results were obtained.Conclusions The treatment of facial soft tissue deficiency or deficiency,by choosing corresponding diameter of fat transplantation needle and appropriate injection level according to the differences of fat particle size sieved by the homogenizing fat extractor,can acheive a high fat survival rate,and stable long-term effect.Thus,this safe and ideal method for rejuvenation of facial treatment is worth promoting.

Objective:To investigate the effects and mechanism of exosomes secreted by human umbilical cord-derived mesenchymal stem cells （hUC-MSCs） in repair of tendon cell injury.Methods:The hUC-MSCs which were stably subcultured were isolated and purified by a tissue block adherent method，and the immunophenotype of hUC-MSCs was detected by flow cytometry. The induction media was employed to induce the differentiation of hUC-MSCs to osteoblasts，chondroblasts and adipocytes，and cell identification was performed subsequently. The secreted exosomes of MSCs （MSCs-exosomes） were extracted using an ultracentrifugation method. The exosomes were detected by Western blot and electron microscopy，and the fusion ability of the exosome membrane was detected by PKH67 staining fluorescence. Forty Wistar rats were divided into tendon injury group （ n = 20） and normal group （ n = 20） according to the random number table. In tendon injury group，the rats were sacrificed with 100 mg/kg pentobarbital sodium one week after Achilles tendon transection，and the injured tendon cells were obtained following digestion of the Achilles tendon. In normal group，the rats were sacrificed without any treatment and the normal tendon cells were obtained concurrently. After the exosomes were co-cultured with tendon cells in vitro for 12，24，48，72 hours，the proliferation of tendon cells was detected by CCK-8 assay. After the tendon cells were treated with hUC-MSCs exosomes for 24 hours，the effects of exosomes on transforming growth factor β （TGF-β），bone morphogenetic protein （BMP），vascular endothelial growth factor （VEGF），fibroblast growth factor （FGF），interleukin（IL）-1β and tumor necrosis factor-α （TNF-α） were detected by Western blot，qPCR and immunofluorescence. Results:The hUC-MSCs were identified and hUC-MSCs-exosomes were isolated successfully. The cultured MSCs were fusiform and positive for Alanine aminopeptidase （CD13），integrin β-1 （CD29），ECTO-5'-nucleotidase （CD73），thymocyte surface antigen （CD90） and endothelin （CD105），but negative for human leukocyte DR antigen （HLA-DR），hematopoietic progenitor cell antigen （CD34） and leukocyte common antigen （CD45）. The exosomes isolated showed a round disc shape and a diameter of 30-100 nm with a depressed internal structure under the electron microscope which was verified via PKH67 staining and the motility-related protein-1 （CD9） and lysosomal associated membrane protein 3 （CD63） were highly expressed. The CCK-8 assay showed the cell viability in tendon injury group was markedly higher than that in normal group at 12 h，24 h，48 h，and 72 h following treatment of tendon cells （ P < 0.01）. The results of qPCR revealed that the mRNA expressions of TGF-β （1.850 ± 0.127），BMP （2.133 ± 0.398），FGF （1.610 ± 0.223） and VEGF （2.207 ± 0.059） in tendon injury group were markedly higher than those in normal group（1.004 ± 0.105，1.007 ± 0.145，1.007 ± 0.140，1.001 ± 0.065，respectively） （ P < 0.05）. However，the mRNA expressions of IL-1β （0.102 ± 0.009） and TNF-α （0.130 ± 0.013） in tendon injury group was markedly lower than those in normal group （1.004 ± 0.113，1.006 ± 0.134） （ P < 0.01）. The results of Western blot were consistent with those of qPCR. Conclusions:The exosomes secreted by hUC-MSCs can promote the growth of tendon cells and repair of tendon cell injury by up-regulating the expression of growth factors TGF-β，BMP，VEGF and FGF，and inhibiting the expression of inflammatory factors IL-1β and TNF-α.

Objective:To investigate the surgical method and clinical outcome of using nasal septal cartilage combined with auricular cartilage for management of nasal tip shape.Methods:A clinical study was conducted from April 2014 to June 2019, in which we managed nasal tip shape with nasal septal cartilage and auricular cartilage, and these materials were used as septal extension graft, spreader graft and cap graft. In total, 622 patients (28 males, 594 females; age from 18 to 42 years, mean age 27.47 years) were assessed for eligibility.Results:The follow-up period was from 6 months to 6 years. Nasal shape of all 622 patients was improved significantly after the operation. The nasal tip was natural and round, and there were no complications such as damage of nasal septum mucosa, exposure of prosthesis and infection of surgical site. Only 12 patients were found downward rotation of nasal tip, and 610 patients achieved satisfactory aesthetic results.Conclusions:Using septal cartilage combined with auricular cartilage is a safe, effective and suitable method for management of nasal tip shape.

Objective:To measure and analyze the morphological parameters of nasal septal cartilage obtained by rhinoplasty in Chinese, so as to provide theoretical guidance for clinical acquisition and application of nasal septal cartilage.Methods:From March 2014 to June 2021, 732 patients were received rhinoplasty in Myoung Beaucare Clinic of Beijing-Cosmetic Surgery. During the operation, 12 mm L-shaped nasal septal cartilage scaffold was obtained from nasal septal cartilage for transplantation. Measurement of the length, width, area, maximum thickness and minimum thickness of nasal septal cartilage was performed for further analysis.Results:For nasal septal cartilage obtained from comprehensive rhinoplasty, its length was 1.2 to 3.5 cm, with an average of 2.16 cm; the width was 1 to 3 cm, with an average of 1.84 cm; the area was 1.43 to 10.5 cm 2, with an average of 4.04 cm 2, with a maximum thickness of 0.5 to 3 mm, with an average of 1.92 mm and a minimum thickness of 0.2 to 0.5 mm, with an average of 0.92 mm. Conclusions:In the comprehensive rhinoplasty of nasal septal cartilage for Chinese, the 12 mm L-shaped nasal septal cartilage scaffold is retained, and the average length, width and area of nasal septal cartilage for transplantation are 2.16 cm, 1.84 cm, 4.04 cm 2, 1.92 mm and 0.92 mm respectively.