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Distrabution and migration of olfuctory ensheathing cells transplanted into the contused spinal cord of rats

Yue LI ; Hualin YU ; Lifa CHEN ; Jieyuan ZHANG ; Bingcang LI

Chinese Journal of Trauma.2011;27(1):78-82. doi:10.3760/cma.j.issn.1001-8050.2011.01.024

Objective To observe the migration and distribution of OECs in injured spinal cord and discuss their relation with the recovery of spinal cord function. Methods The rats were contused by a force of 10 g · 25 mm with NYU-impactor at T10 level. The OECs acutely isolated from green fluorescence protein (GFP) rats were purified, identified and then transplanted into the injured site and the rostral and caudal parts of the spinal cord one week after injury, with total volume of the transplanted OECs for 90 000/μl. Within 13 weeks after transplantation, the migration and distribution of OECs were qualitatively observed on the cryo-sections under fluorescence light microscope. The area and the length of OECs distribution were semi-quantitatively determined. The locomotor function of the spinal cord was appraised by BBB score. Results OECs were located collectively in the transplanted site at early stage after transplantation and then spread gradually mainly along the long axis of the cord. OECs could be found in the cavity of the contused spinal cord. The area and the length of OECs distribution were increased from 1.33 mm2 and 4.23 mm respectively at one week to 3.30 mm2 and 7.68 mm respectively at 13 weeks after transplantation. In the meantime, the locomotor function was gradually improved. Conclusion OECs can migrate within the contused spinal cord, as may contribute to the recovery of locomotor function.

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Establishment of road traffic crash & traffic injury database

Jun QIU ; Zhiquan JIANG ; Liang ZHANG ; Yang LI ; Guoling LI ; Jihong ZHOU

Chinese Journal of Trauma.2011;27(1):60-63. doi:10.3760/cma.j.issn.1001-8050.2011.01.020

Objective To establish a road traffic crash (RTC) & traffic injury (RTI) database database with scientific and reasonable structure. Methods ( 1 ) A set of scientific and standard RTC&RTI survey form was made and a software for collection of data on RTC&RTI developed. (2) The general data on RTI&RTI of China was obtained from traffic management departments of China and the data of some districts in Chongqing from 2000 to 2006 were obtained. All the data were input into the database for analysis. Results A TRC&RTI database software V1. 0 was developed based on the survey form. The input items included data about the areas where the accidents occurred, the general situation of the specific accident, the road conditions, the accident causes and responsibilities, the vehicle and the injury to persons. We obtained the RTC and RTI data of China during past 13 years and collected data on 33 987 cases of RTC and 52369 RTI of four districts in Chongqing. The RTC&RTI database was established. Conclusions The database has involved detailed data of general road crashes and injury as well as individual crash, which provides a good support for further study of RTC and RTI.

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Epidemiological distribution characteristics of hip fractures in 448 patients

Bo ZENG ; Hongyan XIONG ; Jianzhong XU ; Zhao XIE ; Hui LIN ; Guorong HUANG

Chinese Journal of Trauma.2011;27(1):56-59. doi:10.3760/cma.j.issn.1001-8050.2011.01.019

Objective To study the epidemiological characteristics of the hip fractures of the inpatients so as to provide a scientific basis for strategic study on the prevention and treatment of the hip fractures. Methods The study involved 448 patients (217 males and 231 females) with hip fractures admitted to the Southwest Hospital of Third Military Medical University from January 2004 to December 2009. The characteristics, injury time and causes, fracture types and treatment approaches were collected and reviewed retrospectively. SPSS 13.0 software was used for statistical analysis. Results There were significant differences in distribution of the hip fractures in terms of age, cause, gender and treatment approach (P ＜ 0.05 ). Patients with age ≥60 years accounted for 68.8%. Slip was the leading cause of the hip fracture ( 69.6% ). As for gender distribution, femoral neck fractures usually occurred in the females while intertrochanteric hip fractures in the males. Surgery was the predominant management approaches,accounting for 83.1%. Conclusion The distribution of the hip fractures of the inpatients has unique characteristics in aspects of individual character, injury cause injury site and treatment approach, which is worthy of further strategic study on prevention and treatment of the hip fractures.

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Percutaneous CT-guided hollow screw fixation for treatment of sacroiliac complex injury

Jun YANG ; Zhendong ZHOU ; Jianjun LI ; Hailun GU ; Chuanhui ZHANG

Chinese Journal of Trauma.2011;27(1):44-48. doi:10.3760/cma.j.issn.1001-8050.2011.01.015

Objective To evaluate the safety, feasibility and efficacy of CT-guided percutaneous hollow screw fixation in the treatment of patients with sacroiliac complex injury. Methods Forty-five patients (at age range of 15-58 years) with sacroiliac complex injuries including 20 males and 25 females were enrolled in this study. There were 28 traffic injuries and 17 fall injuries. Fourteen patients with sacral fractures ( 15 patients with Dennis type Ⅰ fractures and nine with Dennis type Ⅱ fractures), 12 with sacroiliac joint dislocation, six with sacral fracture combined with sacroiliac joint dislocation and nine with sacroiliac joint complex injury. All patients were treated by CT-guided percutaneous hollow screw fixation. The functional exercise was performed early after operation. Results Seventy-two hollow screws were installed in 45 patients, with the operation time for 21-68 minutes ( average 37 minutes) and the operative blood loss for 30-75 ml. Of all, 38 patients were followed up for 6-26 months. According to the Majeed functional criteria, the score of the patients was 72-96 points (average 90. 3 points ), which showed that the results were excellent in 33 patients and good in two, with excellence rate of 92%. No iatrogenic nerve injury, incision infection or screw fracture were detected. Conclusion CT-guided percutaneous hollow screw fixation takes advantages of precise direction, stable fixation and safe operation and hence is one of safe and effective methods for treatment of sacroiliac complex injury.

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Clinical study of expert tibial nail in treatment of distal tibial fractures

Dong ZHOU ; Luming NONG ; Nanwei XU

Chinese Journal of Trauma.2011;27(1):41-43. doi:10.3760/cma.j.issn.1001-8050.2011.01.014

Objective To study the clinical effect of expert tibial nail (ETN) in the treatment of distal tibial fractures. Methods From October 2007 to June 2008,ETN was performed in 13 patients with distal tibial fractures. There were eight males and five females, at age range of 25-47 years (33.8 on average). According to AO/ASIF classification, there were three patients with 43-A1 fractures, four with 43-B1 fractures, four with 43-B2 fractures and two with 43-C1 fractures. All the patients were with close fractures except for three patients with Gustilo-Anderson type Ⅰ fractures. Their clinical data were analyzed for assessing the clinical effect of ETN. Results All patients were followed up for a mean time of 8.4 months (range 3-13 months), which showed that all the fractures obtained stable fixation and sound healing, with no complications like breakage of ETN, wound infection, fracture nonunion or limb shortening. According to Johner-Wruhs standard, the functional results were excellent in 10 patients and good in three. Conclusion ETN has advantages of minimal invasion, shorter operation time, stronger fixation,better soft tissue protection and better functional recovery for distal tibial fractures in comparison with traditional open reduction and buttress plate fixation.

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Comparison of three grading systems for mangled extremity syndrome: amputation versus salvage

Yilin SU ; Linfeng XU ; Gang WANG

Chinese Journal of Trauma.2011;27(1):38-40. doi:10.3760/cma.j.issn.1001-8050.2011.01.013

Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.

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Biomechanical study of rigid internal fixation for maxillary LeFort Ⅰ fracture

Jian ZHOU ; Genglin SUN ; Wei WU ; Chongtao XU ; Penglin WANG

Chinese Journal of Trauma.2011;27(1):26-29. doi:10.3760/cma.j.issn.1001-8050.2011.01.009

Objective To biomechanically study the fixation stability of different numbers and shapes of the titanium miniplates (L-shaped and straight four-hole miniplates) in the treatment of maxillary LeFortⅠ fracture by using three-dimensional finite element method so as to provide reference for clinical treatment of the fractures. Methods Three-dimensional finite element model of maxillary LeFortⅠ fracture was established with four kinds of rigid internal fixation (RIF) methods to calculate the stress of the maxilla and the RIF as well as the displacement of the fracture segment under three kinds of occlusion.Then, the fixation stability of different methods was compared. Results Under the same occlusion condition, the decreasing order of the displacement of the fracture segment was the L-shaped plate fixation at both buttress of the maxillary and nasal maxillary zygomatic, the straight four-hole miniplates fixation at both buttress of the maxillary and nasal maxillary zygomatic, the L-shaped plate fixation at the zygomatic maxillary buttress and the L-shaped plate fixation at naso-maxillary buttress. Under the same fixation method, the decreasing order of the displacement of the fracture segment was molar occlusion, premolar oeclusion and incisor occlusion. Conclusions The fixation stability of the L-shaped plate fixation is better than the straight four-hole miniplate fixation for the treatment of LeFortⅠ fracture. Fixation at the zygomaticmaxillary buttress is better than at the naso-maxillary buttress. Use of only two miniplates to fix the LeFort Ⅰ fracture may not be stable. Molar occlusion is not good for fracture healing.

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Dynamic change of serum myoglobin and its clinical significance in multiple trauma patients

Shanxiang XU ; Mao ZHANG ; Jianxin GAN ; Shaowen XU

Chinese Journal of Trauma.2011;27(1):12-16. doi:10.3760/cma.j.issn.1001-8050.2011.01.004

Objective To investigate the dynamic change of serum myoglobin and assess its relation with injury severity in multiple trauma patients. Methods The concentration of serum myoglobin in 41 multiple trauma patients (ISS ≥16 points) was detected at days 1,3,7 and 14 after injury. In the meantime, injury severity score ( ISS), Glasgow coma score ( GCS), simplified acute physiology score Ⅱ( SAPS Ⅱ ), percentage of the injured muscle and soft tissue to entire body, shock on admission and ultimate outcomes were recorded at day 1 after injury. All patients were divided into ISS ≥25 group or ISS ＜ 25 group, survival group or death group based on the injury severity and ultimate outcomes. The dynamic changes of the serum myoglobin were observed and compared between the groups. The correlation of the serum myoglobin concentration with ISS, GCS, SAPS Ⅱ score, shock and the percentage of injured muscle and soft tissue was investigated. Results The serum myoglobin concentration in ISS ≥ 25group was decreased more slowly than that in the ISS ＜ 25 group, with higher concentration of the serum myoglobin concentration in the ISS ≥ 25 group than that in the ISS ＜ 25 group at all time points. The serum myoglobin concentration in the death group was increased first, then slowly declined and reached peak at day 3. While in survival group, the serum myoglobin concentration was continuously decreased, with lower serum myoglobin concentration than that in the death group at all time points. The serum myoglobin concentrations were positively correlated with the SAPS Ⅱ score at all time points, with ISS at days 7 and 14, with the percentage of the injured area at day 1 and with the shock at days 1 and 3, while the serum myoglobin concentration was negatively correlated with GCS at days 3,7 and 14. Conclusions The dynamic changes of the serum myoglobin concentration in multiple trauma patients may reflect the severity,trends and prognosis of the injury, and hence can be used as effective index for monitoring the disease.

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Expression of Y1 receptor during osteogenic differentiation of bone marrow mesenchymal stem cells

Zhao WANG ; Dan JIN ; Yonghua TUO ; Xiaolei GUO ; Jun WEN

Chinese Journal of Trauma.2011;27(1):72-77. doi:10.3760/cma.j.issn.1001-8050.2011.01.023

Objective To compare the expression changes of neuropeptide Y (NPY) receptor Y1 in different stages of osteoblast differentiation of rat bone marrow mesenchymal stem cells (BMSCs).Methods The rBMSCs were isolated in vitro from Sprague-Dawley (SD) rats using whole bone marrow adherence method and cultured. Then, the rBMSCs were divided into osteoblast-induced group and noninduced group. In different periods of culture at 1, 2 and 3 weeks, identification of the osteoblasts was performed by using immunocytochemistry and Western blot. Expressions of mRNA and protein of Y1 receptor were detected by real time reserve transcriptase-polymerase chain reaction (RT-PCR) and Western blot. Results RT-PCR demonstrated that osteoblast-induced group had a lower expression of Y1 receptor than non-induced group at the same time point and the expression of Y1 receptor was increased in a time-dependent manner in both groups. Western blot demonstrated higher expression of Y1 receptor in osteoblast-induced group compared with non-induced group at the same time point and a decreased expression of Y1 receptor in a time-dependent manner in both groups. Conclusions During the process of osteoblastic differentiation of rat BMSCs, the expressions of mRNA and protein of NPY Y1 receptor show different trends, when NPY may mediate the inhibition of osteoblastic differentiation of BMSCs through Y1 receptor pathway.

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Effect of brain-derived neurotrophic factor on environmental nutrition and neural differentiation of the transplanted stem cells under hypothermia

Sai ZHANG ; Xiaozhi LIU ; Hongtao SUN ; Yue TU ; Shixiang CHENG

Chinese Journal of Trauma.2011;27(1):68-71. doi:10.3760/cma.j.issn.1001-8050.2011.01.022

Objective To study the effect of brain-derived neurotrophic factor (BDNF) on the environmental nutrition and neural differentiation of the transplanted stem cells under hypothermia.Methods The BDNF gene mediated by liposome was transfected into 293T cell line, and ELISA assay was applied to find the peak time of BDNF expression. When BDNF was highly expressed, the supernatant was collected for establishment of SD rat models of brain injury. The rats were divided into Group A (stem cell transplantation group) and Group B (stem cell transplantation and BDNF group). Rats in both groups were under hypothermia treatment for five days. Four and eight days later ( three days from rewarming), rat brain tissues were obtained to detect the expressions of proliferating cell nuclear antigen (PCNA), nestin, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) by immunohistochemical method and to detect the apoptosis by in situ hybridization. Finally, the nerve function scores were obtained for evaluation of the nerve function. Results The ELISA showed that the high level of BDNF expression was at 48 to 60 hours after gene transfection. PCNA and nestin were highly expressed, while NES and GFAP showed nil or low level of expression in both groups at the fourth day after hypothermia, with little apoptotic cells especially in the Group B (P ＜0.05). The expressions of PCNA and nestin were decreased, but the expressions of NSE and GFAP were increased at the third day after rewarming. The positive rate of NSE expression in the Group B was much higher and the apoptotic cells were much less compared with the Group A ( P ＜ 0. 05 ). A better nerve score was obtained in the Group B. Conclusion BDNF can enhance the survival rate of the transplanted stem cells and induce their differentiation into neurons under hypothermia.

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