BACKGROUND:Studies have shown that bone morphogenetic proteins play a key role in skeletal development. Platelet-rich plasma alone in animal or clinical trials cannot significantly promote bone graft healing.
OBJECTIVE:To investigate the osteogenesis effect of bone morphogenetic protein-4 compounded with platelet-rich plasma the bone defect area.
METHODTwenty-four New Zealand white rabbits were selected to establish maxil ary bone defect models, and then were randomly divided into four groups, six rats in each group. Group A was blank control group;Group B wasβ-tricalcium phosphate (0.1 g)+Bio-gide group;group C wasβ-tricalcium phosphate (0.1 g)+Bio-gide+platelet-rich plasma (1 mL) group;and group D wasβ-tricalcium phosphate (0.1 g)+Bio-gide+platelet-rich plasma (1 mL)+bone morphogenetic protein-4 (5μg). Gross observation, histological observation and imaging analysis were performed for analysis of new bone formation at weeks 4, 8, 12 after modeling.
RESULTS AND CONCLUSION:After 4 weeks, group D had more new bone and vessels formed in the bone defect area than the group B (P<0.01);however, the amount of new bone was higher in the group B than the group A (P<0.01). After 4, 8, 12 weeks, the amount of new bone in the bone defect area was higher in the group D than the groups B and C (P<0.01), and lowest in the group A (P<0.01). In theβ-tricalcium phosphate scaffold, platelet-rich plasma combined with bone morphogenetic protein can significantly promote the healing of bone defects.

Objective To evaluate the effect of alendronate on osteoprotegerin (OPG) and receptor of activator of nuclear factor κB-ligand (RANKL) expression in human marrow stroma cells (hMSCs) in vitro. Methods hMSCs were isolated from haman marrow, cultured in vitro, and randomly divided into two groups: alendronate group, hMSCs culture fluid containing 1×10-7 mol/ L alendronate; control group, no special treatment but culturing hMSCs in DMEM. Two weeks after treatment, the expressions of OPG and RANKL were evaluated by RT-PCR and Western blot.Results hMSCs became uniform spindle-shaped fibroblasts. As cells proliferated, they formed colonies and showed whirlpool arrangement. After one week's treatment, hMSCs in alendronate group had reduced processes and gradually showed disc shape, which did not happen in control group but kept fibroblast shape and just increased in density. In RT-PCR, the ratio of OPG/RANKL in alendronate group and control group was 8.77±1.16 and 4.58±1.27, respec-tively. In Western blot, the ratio of OPG/RANKL in alendronate group and control group was 2.58±0.47 and 1.52±0.32, respectively. The ratio of OPG/RANKL was higher in alendronate group than in control group (P<0.01).Conclusion Alendronatc enhances OPG expression and inhibits RANKL expression of hMSCs in vitro.

Objective To compare the clinical effects of treating cervical prolapse of intervertebral disc by using Solis cage, titanium cage and autogenous iliac crest graft (AICG) combined with titanium plate. Methods 64 cases of cervical prolapse of intervertebral disc were analyzed retrospectively. All the patients were followed up for about one year. Group A is composed of 20 patients (30 intervertebral spaces) treated with microdiscectomy and Solis cage fusion;group B is composed of 21 patients(22 intervertebral spaces) treated with titanium cage and group C is involved of 23patients(28 intervertebral spaces) which were dealt with AICG combined with titanium plate. The differences in the to-tal X ray exposure time, time working on iliac bone, incidence of complications, fusion rate, incidence of JOA score recovery rate more than 50 % and rehabilitation time of the three groups are analyzed. Results All indexes from group A and B were more satisfactory than those from group C (P＜0. 05). The statistic analysis results of the incidence of complications of cervical part, rehabilitation time in group A are 5.0± 1.8, 5.1 ± 1.2; and that is 14.3±2.6, 7.5 ± 1.6and 26.1±6.2, 8.6±2.3 in group B and group C respectively. There is significant difference between group A and group B on the incidence of complications of cervical part and rehabilitation time (P＜0.05). Results of the incidence of JOA score recovery rate ＞ 50 % in group A(95.8 ± 3.2) was more satisfactory than that in group B(93.6 ± 2.9),while there was no statistical difference between group A and group B (P＞0.05). Conclusion The Solis cage is better in treating the cervical prolapse of intervertebral disc than other ways. Also, it makes the operation easier, rehabilitation time shorter, and it causes fewer complications.

Objective To investigate T-bet mRNA expression on peripheral blood mononuclear cells (PBMCs) and its relations with allergen specific IgE (SIgE), eosinophile cationic protein (ECP) levels, and allergic symptom in patients with allergic rhinitis (AR). Methods The allergen, SIgE, and ECP in serum of patients with AR were detected by Unicap CAP system. Blood samples were taken from 15 healthy controls and 35 house dust mite allergic patients. PBMC was isolated by density gradient centrifugation and one part of them was cultured with mite allergen at a concentration of 50 μg/mL. PBMC was subjected to analysis of T-bet mRNA expression using semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Results The ratio of T-bet to β-actin mRNA levels was 0.418 ± 0. 101 in patients of AR and 0.706 ± 0.091 in healthy controls and the difference was significant (P ＜ 0.01). The expression intensity of T-bet mRNA was not related to varying severity of allergic symptom and ECP levels ( r = - 0.227, - 0.033, P ＞ 0.05). However, there was an inverse correlation between expression intensity of T-bet mRNA and SIgE concentration (r = -0.375, P ＜ 0.05). There was a positive correlation between SIgE and allergic symptom scores ( r = 0.426, P ＜ 0.05). After that PBMC was stimulated by mite allergen, the expression intensity of T-bet mRNA, ECP, and SIgE changed very little ( P ＞ 0.05). Conclusion Down-regulated expression of T-bet mRNA in mite-AR patients is not related to serum ECP and symptom scores but one of important links in the mechanism of imbalance of Th1/Th2 in the occurrence of AR. Specific allergen has no effect on T-bet mRNA, ECP, and SIgE of children and adults with AR in vitro. The level of SIgE objectively and directly indicates the severity of allergic symptom, but T-bet did not. T-bet may be one of indirect factors which affect the level of IgE.

Objective To investigate the serum levels of β-amyloid precursor protein (β-APP) and hypersensitive-cross-reactive protein(hs-CRP) after acute spinal cord injury(SCI) in rats at different time points and study their roles in secondary spinal cord injury. Methods Ninety healthy adult female SD rats were randomly assigned into 3 even groups.Improved Allen method was used to create models of complete SCI (group A) and models of incomplete SCI (group B).In group C only laminectomy was performed without SCI.The serum was collected at 12 hours,24 hours,3 days,7 days,and 14 days after operation through femoral vein to detect levels of β-APP and hs-CRP by ELISA. ResultsThe serum level of β-APP reached the peak value 24 hours after acute SCI,and the serum level of hs-CRP reached the peak 3 days after acute SCI.There were significant differences between groups A and C in β-APP and hs-CRP levels at all time points( P ＜ 0.05).There were also significant differences between groups B and C in β-APP and hs-CRP levels at all time points (P ＜0.05) except at 14 days (P＞ 0.05). Conclusions The serum levels of β-APP and hs-CRP are positively associated with the severity of traumatic SCI.β-APP may be a more sensitive indicator than hs-CRP in a certain time.The dynamic changes of serum β-APP and hs-CRP suggest involvement of the 2 proteins in the secondary spinal cord injury.

ts the shear stress, thus, facilitates the union of fracture and the restoration of function.

Objective:To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans ( Aa ) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls , unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa ( PCR method) .Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay ( ELISA) .Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%.The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1 ±1.9 vs.9.1 ±1.8, P<0.01).There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients .Serum IgG titers to Aa serotype c in the Aa-positive AgP patients ( the patients who were Aa-positive in subgingival plaque or saliva ) were sig-nificantly higher than those of the Aa-negative patients (11.9 ±1.3 vs.10.7 ±2.1, P<0.05).Con-clusion:Serotype c was the main serotype of Aa in Chinese patients with AgP .Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients .

Objective To investigate the impact of PET-CT on the target volume delineation and precise radiothera?py planning for patients with advanced non-small cell lung cancer (NSCLC). Methods PET-CT scanning was performed in 30 histologically proved NSCLC patients. The gross tumor volume (GTV) was delineated, and radiotherapy planning was es?tablished with identical parameters based on the CT image and PET-CT fused image, respectively. The differences of doses between GTV, planning target volume (PTV) and organsat rise (OAR) were compared. Results PET-CT image results changed the target volume delineation in 30 patients with 8 increased and 22 decreased. There were no differences in GTV and PTV between the VGTV and VPTV statistically, although PET-CT image changed conventional CT image size sketch of GTV and PTV. The V20 of total lung decreased in the PlanPET-CT compared with that of PlanCT (P<0.05), but no differences were found in the V30 of total lung, mean lung dose (MLD), the data of spinal cord, esophagus and heart. Conclusion PET-CT may reduce the radiation injuries in the lung and improve the target dose.

Objective To investigate the repair effects of co-expression of the VEGF and BMP genes via an adeno-as-sociated viral vector on early steroid-induced avascular necrosis of the femoral head in rabbits. Methords To construct ani-mal model of early SANFH and screen by MRI. The SANFH animal were divided into rAAV-IRES-hrGFP(AAV-GFP), rAAV-hVEGF165-IRES-hrGFP(AAV-VEGF), rAAV-hBMP-7-IRES-hrGFP(AAV-BMP)and rAAV-hVEGF165-IRES-hBMP-7(AAV-VEGF/BMP)groups. The four group virus vectors were injected into core decompression region at the dose of 25μl/site after core decompression operation directly. Repair effects of rAAV vector on early SANFH in rabbits were evaluated by Western blot assay, HE staining, immunohistochemical staining, MRI, radionuclide bone scan, blood vessel counting detected by ink perfusion and fro-zen section, Micro-CT and biomechanical strength detection on the 12th week post-injection. Results Model success ratio was 73.33%. rAAV-hVEGF165-IRES-hBMP-7 virus vector efficiently expressed hVEGF165 and hBMP-7 genes on the 12th week after rAAV injection. hVEGF165 protein secreted in vivo promoted metabolism in core decompression region by increasing the quantity of new vessels and improving the blood supply;hBMP-7 protein secreted in vivo promoted new bone formation in core decompres-sion region by increasing bone mineral density and improving bone biomechanical strength. The AAV-VEGF/BMP group can pro-mote repair effects more effectively than AAV-VEGF group or AAV-BMP group. Conclusion The adeno-associated viral vectors co-expressing hVEGF165 and hBMP-7 can promote repair effects on early SANFH in rabbits by increasing the blood supply and strengthening the bone quality of femoral head.

Objective To identify and assess whether circumferential electrocautery is useful to improve outcomes after primary total knee replacement.Methods We searched MEDLINE,EMBASE,PubMed,SpringerLink,Web of Knowledge,OVID CINAHL,OVID EBM and Google Scholar,and included articles published through January 2014.This study used the methods of meta-analysis to assess whether circumferential electrocautery could improve anterior knee pain and knee function after total knee replacement,and identified the function of circumferential electrocautery in total knee replacement.Results A total of eight articles met the inclusion criteria.Among the 1 048 cases included in the analysis,526 cases had patellar denervation,and 522 cases were in the control group.The meta-analysis revealed no significant difference in the incidence of anterior knee pain (P =0.18) and visual analogue scale (VAS) (P =0.23) between two groups.However,patellar score (P =0.01),Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score (P ＜ 0.01),and range of motion (ROM) (P ＜ 0.01) indicated that circumpatellar electrocautery improved clinical outcomes compared to non-electrocautery groups.Conclusions The results indicated that circumferential electrocautery of the patellar did not significantly improve anterior knee pain relative to non-electrocautery techniques.However,circumferential electrocautery significantly improved patients' knee function after surgery.Therefore,circumferential electrocautery might be beneficial to the outcome of primary total knee replacement surgery without patella replacement.