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Relationship between P-glycoprotein,Survivin expression and chemotherapy outcome in osteosarcomas

Orthopedic Journal of China.2006;0(09):-.

[Objective]To explore the relationship between Pglycoprotein,survivin expression and chemotherapy outcome.[Method]The expressions of P-glycoprotein,and of survivin were examined by the immunohistochemistry in 38 specimens of preoperation biopsy of osteosarecomas.[Result]The response rate of the P-glycoprotein positive group was lower than that of P-glycoprotein negative group.The response rate of the survivin overexpression group was significant lower than survivin was found to be more valuable in predicting chemotherapy results.[Conclusion]The expressions of P-glycoprotein,and of survivin are clearly associated with osteosarcomas response to chemotherapy in osteosarecoma and survivin is a more valuable parameter.

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Effect of simvastatin on the osteoclastic resorption stimulated by PTHrP and anabolism with murine calvarial organ culture in vitro

Luyu HUANG ; Yunyu HU ; Huiren TAO

Orthopedic Journal of China.2006;0(09):-.

[Objective]To study the effect of simvastatin in the osteoclastic resorption stimulated by PTHrP and murine bone anabolism in vitro.[Method]The bone resorption activities of the osteoclast stimulated by PTHrP were evaluated after treatment with simvastatin for 8 days in vitro;the concentration of Ca~(2+) in the supernatant was also detected by atomic absorption spectrometer.The concentration of ALP and Ca~(2+) of the supematant in murine calvarial organ culture were detected.The histology of calvaria was observed.[Result]Simvastatin greatly inhibited the osteoclastic bone resorption stimulated by PTHrP in vitro and reduced the release of Ca~(2+).Simvastatin increased the ALP activities and bone mineralization of murines calvarial organ culture in vitro.[Conclusion]Simvastatin may inhibit the osteoclasric resorption stimulated by PTHrP and promote osteoblast differentiation and bone mineralization in vitro,thus play an important role in the prevention and treatment of osteoporosis.

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Study of the osteogenic ability of mesenchymal stem cells in vivo

Zhanghua LI ; Hao PENG ; Wen LIAO

Orthopedic Journal of China.2006;0(09):-.

[Objective]To investigate the osteogenic ability in vivo of mesenchymal stem cells(MSCs).[Method]Ten-fifteen ml bone marrow aspirates were harvested from the iliac crest of sheep and enriched for MSCs by density gradient centrifugation over a Percoll cushion(1.073 g/ml).After cultured and proliferated,the tissue-engineered bones were constructed with these cells and seeded onto porous 13-tricalcium phosphate ceramics(13-TCP).Then,the constructs were implanted into left metatarsus defect(21 mm in length)of 8 sheep as an experimental group.Porous ?-TCP composed with bone marrow was implanted into defects of same size and position in 8 sheep as a control group.Sheep were sacrificed in the 6th,12th,and 24th week postoperatively,and the implanted samples were examined by radiograph,histology,and biomechanical analysis.[Result]New bone tissue was observed either radiographically or histologically at the defect area of experimental group as early as the 6th week postoperatively;but was not observed in the control group.Because of the new bone formed in a direct manner without progression through a cartilaginous process intermediately,osteoid tissue,woven bone and lamellar bone,occurred earlier in the experimental group than in the control group,in which the bone defects were repaired in a "creep substitution" manner.At the 24th week,radiographs and biomechanical tests revealed an almost complete repair of the defect in experimental group,but only a partial repair in the control group.[Conclusion]MSCs have good reproductive activity not only in vitro,but also in vivo.The new bone formed in a direct manner without progression through a cartilaginous process intermediately when MSCs were transplanted in vivo.The results demonstrated that MSCs was an excellent seed cells for bone tissue engineering.

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Biomechanical efficacy of calcium phosphate cement in augmentation and restoration of anterior cervical unicortical screw fixation

Yueping CHEN ; Yong ZHU ; Ruzhuan LIU

Orthopedic Journal of China.2006;0(09):-.

[Objective]To evaluate the biomechanical efficacy of calcium phosphate cement(CPC)in augmentation and restoration of anterior cervical unicortical screw fixation.[Method]Anterior cervical unicortical screw were fixed in the cervical vertebra(C_(3~6)),pull-out test and cyclic bending test was performed and anti-shear test after cyclic bending.[Result]The pull out strength(pos)of restoration group and augmentation group were significantly higher than that in the control group,the statistic difference was also significant(P

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Diagnosis and treatment of acute knee gout arthritis under arthroscopy

Yufei ZHANG ; Dazheng WANG ; Fusheng WANG

Orthopedic Journal of China.2006;0(09):-.

[Objective]To introduce the knowledge for the diagnosis of acute gout arthritis that attacked initially in the knee and improve its early treatment.[Method]Seventeen cases with acute gout arthritis in the knee were diagnosed and treated under arthroscopy since 2000.The experiences were analysed retrospectively and the therapatic results were observed through a follow-up of more than 6 months.[Result]Before arthroscopy,only 5 cases were considered as acute gout arthritis,the other 12 cases were given a misdiagnosis.All the patients were diagnosed and given a debridment simutaneously under arthoscopy.Then,the patients were given an postoperative systematic drugs therapy.The follow-up(ranged from 10 to 24 months)showed that all the patients acquired a short-term and long-term satisfactory therapeutic effect.[Conclusion]The acute gout arthritis attacked initially in the knee is rare and its misdiagnosis rate is very high.The significant improvement and extensive application of arthroscopic techniques will improve its diagnosis rate and provide a new way for its early surgical treatment.

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Advanced alcoholic osteonecrosis of femoral head

Yuchen LUO ; Gang XIAO ; Jin CHEN

Orthopedic Journal of China.2006;0(09):-.

[Objective]To discuss the relation-ship between AAONFH(advanced alcoholic osteonecrosis of femoral head)and extended overdose drinking.[Method]Reviewed 165 cases of total hip arthroplasty,to analyzed the clinical data among 27 AAONFH cases,reviewed the literatures,discussed the pathogenesis of AAONFH and the relation-ship between blood biochemistry and blood cloting funtion and compared the experimental results among literatures.[Result]Theres various factors resulted in osteonecrosis of the femoral head associated with alcohol long-term over intake.Individuals consuming more than 750 ml of alcohol daily were at greater risk of double or half ONFH,Theres no change in biochemical test,but blood clotting funtion in this case would degrade,osteoarthritis of hip would synchronize.[Conclusion]Individuals consuming more than 750 ml of alcohol daily have the potentiality of ONFH;Its no specificity significance in biochemical test,the necrosis extent of the femoral head is relative to the capacity and times of alcohol intake.THR(total hip replacement)is the best treatment for AAONFH,but theres more staxis potentiality in this cases.

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Clinical study of total hip arthroplasty in treating 56 cases with ankylosing spondylitis

Xu CUI ; Boxun ZHANG ; Jingdong LI

Orthopedic Journal of China.2006;0(09):-.

[Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).[Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.[Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).[Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.

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Clinical effect comparison of three different methods of anterior cervical decompression and reconstruction for the treatment of multi-level cervical myelopathy

Junhai LIU ; Deyu CHEN ; Ning XIE

Orthopedic Journal of China.2006;0(09):-.

[Objective]To assess the clinical effect and radiological results of three methods of anterior cervical decompression and reconstruction for the treatment of multilevel cervical myelopathy.[Method]Fifty-two patients with continuous multilevel cervical myelopathy treated by the same team were divided into three groups.Group Ⅰ was performed the twosegment-corpectomy and reconstructed with a long titanium mesh and plate.Group Ⅱ was performed the three-level-discectomy and fused with three cages.Group Ⅲ was performed the combination with corpectomy and discectomy.The parameters included intervertebral height,JOA score.The data was compared statistically with Student s T-test or ANOVA.[Result]JOA score in all groups was improved post operation,but there was no significant difference among the three groups.The post-operation intervertebral height lose of group Ⅰ was more significant than other two groups,three cases of titanium meshs subsidence happened in group Ⅰ and one same case happened in group Ⅲ.[Conclusion]All the three surgical methods of anterior decompression and fusion can procure wonderful clinical effect,but group Ⅱ and Ⅲ were better than group Ⅰ in the stability and the maintenance of intervertebral height post operation.

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Diagnosis and surgical treatment of spinal myeloma

Feibin XIE ; Jianmin LI ; Jianrong QIAN

Orthopedic Journal of China.2006;0(09):-.

[Objective]To discuss the diagnosis and surgical treatment of spinal myeloma.[Method]To make a retrospective analysis of cliniacal history and operation results of 13 patients with spinal myeloma from 1999 to 2004.There were 5 males and 8 females with average age of 47.67 years.They were diagnosed by X-ray,CT,MRI,ECT and biopsy.Resection of tumor was performed in all cases,of which 7 cases was through anterior approach,4 cases through posterior approach,2 cases through combined approach.[Result]The pain was decreased and neurological function was improved in all cases after the surgery.Three death and one recurrence was found during the follow-up time.[Conclusion]X-ray,CT and MRI are essential for diagnosis,ECT may help found multiple lesions,biopsy is reliable diagnosable method.Surgery can relived the symptoms obviously,but should be associated with adjuvant treatments.

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Intramedullary nails for correction of deformity in the lower limbs in children with osteogenesis imperfecta

Zhenhong ZHU ; Xiaodong WANG ; Kewen WANG

Orthopedic Journal of China.2006;0(09):-.

[Objective]To explore the application of the intramedullary nails for correction of deformity in the lower limbs and decrease the opportunity of refracture in children with osteogenesis imperfecta.[Method]From Jan.2000 to Aug.2004,8 patients(3 males and 5 females),with 13 femurs and 3 tibias totally,with deformity in lower limps were corrected by multi-osteotomy and fixed with intramedullary nails,2 for K-wires;3 for Ender nails;and 3 for flexible intramedullary nails.[Result]All deformities were perfectly corrected.All patients were available at final follow up,for 9 months to 60 months,mean 30 months.None of the complications occurred postoperatively,such as infection in the incision or pin tract,nonunion,and refracture.One patient can walk by a stick from wheel-chair help preoperatively and one K-wire was disrupted near the end.[Conclusion]Multi-osteotomy and fixed intramedullary nails,can correct the deformity in the lower limbs perfectly and decrease the opportunity of refracture in children with osteogenesis imperfecta,which has been proved to be a reliable method.

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