BACKGROUND:With the development of stem cellresearch and regenerative medicine, a growing number of technique applications of bone marrow mesenchymal stem cells have been used for treatment of femoral head necrosis. Simple grafting and injection of bone marrow mesenchymal stem cells has a poor effect, which is combined with scaffold materials as cells carrier plays a better role.
OBJECTIVE:To review the research progress of bone marrow mesenchymal stem cells and carriers in the treatment of femoral head necrosis and to look into the future development prospects.
METHODS:A computer-based online search of PubMed (1989/2013) and CNKI (1989/2013) was performed for articles with the key words“osteonecrosis of the femoral head, avascularnecrosis, bone marrow mesenchymal stem cells, carrier or scaffold material”in English and Chinese, respectively. The advantages and limits of various carries and scaffolds were summarized.
RESULTS AND CONCLUSION:Ideal carriers can promote and induce ability of bone marrow mesenchymal stem cells to repair the femoral head. There is a variety of existing carriers, including autologous cancellous bone, al ograft bone, natural biological materials, organic materials, bio-ceramic, nano-materials. Since each material has its own advantages and limitations, composite materials have begun to be used in searching for ideal carriers and scaffolds, and there are however stil some issues that remain to be solved, such as lacking of unified standard of production, specification and making process;how to control and prevent the immune response and inflammation after implantation;how to ensure that the degradation rate of scaffold matches the generation rate of bone and cartilage in the femoral head;and how to identify the cytotoxicity, biocompatibility and therapeutic effects after implantation.

BACKGROUND: Currently, therapies for spinal cord injury include steroid pulse therapy, surgical decompression and stem cel therapy. A lot of work has been focused on stem cel therapy for spinal cord injury which has become a hot spot. OBJECTIVE: To summarize the research status and progress in induced pluripotent stem cells for treatment of spinal cord injury. METHODS: A computer-based online search of PubMed (1980-01/2011-11) was performed for articles in English using the keywords of “spine injury, induced pluripotent stem cells, IPS”RESULTS AND CONCLUSION: A total of 35 articles were included in result analysis, in which, stem cel therapy for treatment of spinal cord injury is agreed or supported. Induced pluripotent stem cells are isolated directly from the body, which solves ethical and moral issues in the transplantation of stem cells, meanwhile avoids al ograft rejection and also provides a large source of cells. Stem cel therapy for spinal cord injury is widely used in animal experiments but few in clinical application. However, stem cel therapy has a good effect in the animal experiments, and shows a higher safety. The existing problems of induced pluripotent stem cells to treat spinal cord injury mainly include immature differentiating method of induced pluripotent stem cells and more complications. Therefore, induced differentiation and security of induced pluripotent stem cells for treatment of spinal cord injury wil become a research key.

Objective To investigate surgical techniques for tibial plateau fractures involving the posterior column and the corresponding clinical effect.Methods From March 2009 to January 2012,32 patients with tibial plateau fracture involving the posterior column underwent surgical treatment in our hospital,including 21 males and 11 females,aged from 23 to 60 years (average,40.4 years).There were 30 cases of closed fracture and 2 cases of open fracture.Two patients combined with anterior cruciate ligament avulsion fracture,and 3 patients with posterior cruciate ligament avulsion fracture.Posterolateral and anteromedial approaches were used in 6 patients with posterolateral and medial columns fracture.Posteromedial and anterolateral approaches were used in 7 patients with posteromedial,medial and lateral columns fracture; a small anteromedial incision was added in 2 of them.Posteromedial and anterolateral approaches were used in 11 patients with posteromedial and lateral columns fracture.Posteromedial and posterolateral approaches were used in 2 patients with posteromedial and posterolateral columns fracture,while a single posteromedial approach was used in another patient with same fracture.Posteromedial and anterolateral approaches were used in 3 patients with posteromedial,posterolateral and lateral columns fracture,while posterolateral and anterolateral approaches were used in other 2 patients with same fracture.Results All patients obtained satisfactory exposure and reduction.They were followed up for 5 to 24 months (average,10.7 months).The average bone union time was 15.9 weeks,and the average time from operation to full weight-bearing was 18.1 weeks.The average range of motion of knee was 113.3°.According to HSS (Hospital for Special Surgery) score,the results were excellent in 22 cases,good in 6 cases,fair in 3 cases and bad in 1 case; the total excellent and good rate was 87.5％.Conclusion For tibial plateau fractures involving posterior column,satisfactory reduction and fixation can be obtained via posteromedial and posterolateral approaches which have many advantages such as earlier functional exercise,fewer complications and excellent clinical results.

Objective To study the curative effect of CT-guided percutaneous acetic acid injection(PAI)combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary heaptocellular carconima.Methods 52 cases with primary heaptocellular carconima were divided into two groups.26 cases were treated with TACE and PAI,combined group comparing with other 26 cases treated with TACE group.Results Decrease of AFP,shrinkage of tumor mass and survival rate of 1-2 years of the combined group and TACE group were 78.3% vs 50.0%,65.4%(17/26) vs 38.5%(10/26)and 73.1%(19/26),52.6%(10/19) vs 57.7%(15/26),33.3%(5/15),respectively;with statistical significance(P

The naturally occuring antibiotic resistance in twentyseven strains from 7 different serotypes of Bacillus sphaericus was investigated. The antibiotics used in this experiment are Streptomycin, Ampicilline, Tetracycline, Chloramphenicol, Kanamycin, Erythromycin, Qingdamycin, Midecamycin, Ribostamycin, Acriflavin, Rifampicin, Sulphanilamide and Azide. All strains are resist to streptomycin and azide at higher concentration and chloramphenicol at lower concentration. Most of strains are resist to tetracycline at lower concentration.

Objective To investigate the influence of endothelial progenitor cells on the proliferation and differenti-ation of neural stem cells in vitro under the condition of co-culture. Methods We used the mature methods of iso-lation, culture and identification on cells to get the spinal cord NSCs and peripheral blood EPCs from the SD rats, and then put them together in the Transwell chamber in vitro. Set the untreated NSCs as a control group. On the 4th day, we calculated the number and diameter of neurospheres. After that, removing the insert of transwell with EPCs, and inducing the NSCs to differentiate. On the 7th day, we conducted MAP-2 immunofluorescence staining on the cells of induced-differentiation group with fluorescence microscopy, then observed the expression of the anti-gen and calculated the percentage of the differential neurons in the NSCs. All the data were analyzed using statisti-cal method. Results The average number of neurosphere in co-culture group was 10.3±2.2,it was significantly more than that in the control group, and the diameter was under the same situation,the average diameter was up to (49.0±5.3)μm. The percentage of the cells which differentiated into neurons in the co-culture group was signifi-cantly higher than that in the control group, the percentage was(32.1±1.8)%. Conclusion EPCs promote the proliferation of NSCs and induce the differentiation of NSCs into neurons in vitro.

ObjectiveTo search for the optimal treatment of hydronephrosis after spinal cord injury .Methods46 cases were treated by indwelling catheter, intermittent catheterization and drug therapy, and comprehensive therapy respectively. The course of treatment and the recurrence rate were observed after hydronephrosis remitted. Results There were no differences in the course of treatment among the three different kinds of therapy. The recurrence rate of the detrusor sphincter dyssynergia(85.7%) was higher than that of the detrusor hyperreflexia (35%) and the detrusor hyporeflexia(25%).ConclusionsThe optimal therapy on slight and moderate hydronephrosis should be intermittent catheterization and drug therapy to avoid the complications of long term indwelling catheter. SCI hydronephrosis is indistinct and recurrent easily. B ultrasound for kidneys is helpful in discovering SCI hydronephrosis on early stage. The earlier the treatment, the better the prognosis. Urodynamics plays an important role in the management of SCI hydronephrosis.

Objective: To compare the anterior capsule opacification and contraction of lens following femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract patients with diabetes. Methods: A non-randomized control study was carried out.Eighty-five eyes of 85 cataract patients with diabetes were included from March 2015 to August 2016 in Xiamen Eye Center.The patients were divided into 2 groups based on the different surgeries.Forty-three eyes of 43 patients in the femtosecond laser group received femtosecond laser-assisted phacoemulsification and completed the 5.3 mm capsulorhexis using the Alcon LenSx femtosecond laser platform.Forty-two eyes of 42 patients in the conventional surgery group underwent conventional phacoemulsification group and performed 5.3 mm continuous circular capsulorhexis under the guidance of Alcon VERION.Anterior capsule opacification (ACO) was graded according to Werner's method.The area of anterior capsular opening was calculated by using Image Pro Plus 6 software.The number of eyes in different grades of ACO and anterior capsule opening area between two groups were compared at 1 month, 3 months and 6 months after operation. Results: Initial anterior capsular opening area was not significantly different between the femtosecond laser group and the conventional phacoemulsification group (t=0.003, P=0.958). The anterior capsule opening area in the two groups among different time-points after operations was significantly different (F_group=73.602, P<0.001; F_time=378.895, P<0.001), and anterior capsule opening areas were smaller in the conventional phacoemulsification group than those in the femtosecond laser group at various time points after operation (all at P<0.001). At 1 month after suigery, grade Ⅰ of the ACO was found in 29 eyes (67.4%) in the femtosecond laser group and 26 eyes (61.9%) in the conventional phacoemulsification group, and there was no significant difference between two groups (P=0.133). At 3 months after surgery, the incidence rate of grade Ⅱ of ACO was 11.6% (5/43) in the femtosecond laser group, which was lower than than that in the conventional phacoemulsification group(66.7%, 28/42), showing a significant difference between them (P<0.001). At the 6th month after operation, the incidence rate of grade Ⅲ of ACO in the femtosecond laser group was 14.0%(6/43), which was lower than that in the conventional phacoemulsification group(73.8%, 31/42), with a significant difference between them (P<0.001). Conclusions Femtosecond laser-assisted cataract surgery for cataract is a good choose patients with diabetes mellitus because of reducing the occurrence of ACO and the contraction of anterior capsule.

bThis study explored whether the transplantation of modified marrow stromal cells (MSCs) has angiogenic effects in a left middle cerebral artery occlusion infarction/reperfusion (MCAO I/R) rat model and preliminarily examined the mechanism of angiogenesis following cerebral infarction. MSCs were isolated by using a direct adherent method and cultured. Vascular endothelial growth factor (VEGF) was transfected into MSCs by employing the liposome transfection. The transfection efficiency was measured by the optical density method. The protein expression of VEGF gene before and after transfection was measured by Western blotting. SD rat model of transient occlusion of the left middle cerebral artery was established by using an approach of intra-luminal occlusion. Tetrazolium (TTC) and HE staining were performed to observe the cerebral infarction. ELISAs were used to measure the levels of VEGF in the rat cerebral tissues. The expression patterns of angiopoietin-2 (Ang-2) and CD34 in cells surrounding the area of infarction were immunohistochemistrically observed. Ang-2 protein expression in the tissue surrounding the area of infarction was measured by Western blotting. VEGF expression in the MSCs increased after transfection at a rate of approximately 28%±3.4%. ELISA showed that the expression of VEGF in the cerebral tissue was significantly increased after induction of infarction, peaking on the 4th day and decreasing to the levels of the sham surgery group (normal) within 7 to 10 days. The VEGF level was significantly higher at each time point in the VEGF-MSC and MSC groups compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than in the MSC group and stayed relatively high until the 10th day. The immunohistochemical results showed that 10 days after the infarction, the number of Ang-2 and CD34-expressing cells in the area surrounding the infarction was significantly higher in the VEGF-MSC group and the MSC group compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than the MSC group. A similar trend in Ang-2 protein expression was revealed by Western blotting. In the MCAO rat model transfected with modified MSCs over-expressing VEGF, compared to the MSC transplantation group, the concentration of VEGF was significantly increased in the brain tissue after cerebral infarction. In addition, the level of Ang-2 was up-regulated, with angiogenesis promoted, the blood supply to the areas surrounding the cerebral infarction increased, and neurological function improved. We are led to speculate that the synergistic effects of VEGF and Ang-2 may be responsible for the angiogenesis following cerebral infarction.