Objective To analyze the correlation between venous thromboembolism(VTE)and traditional Chinese medicine(TCM)constitution types in elderly frail patients.Methods A retrospective study was conducted on 1 428 elderly frail patients admitted to the Second Comprehensive Department of Guangdong Provincial Hospital of Chinese Medicine from January 2019 to June 2023.Patients were divided into a venous thrombsis(VT)group(n=187)and a non-VT group(n=1 241)based on VTE occurrence.Baseline data,including age distribution,Padua scores,Wells scores,and TCM constitution types,were compared between the two groups.Multivariate logistic regression analysis was performed to identify factors for influencing VTE in elderly frail patients.Results(1)Compared with the non-VT group,the VT group had significantly higher total hospitalization costs,length of stay,age,Fried scores,Padua scores,and Wells scores,with statistically significance(P＜0.001).(2)Compared with the non-VT group,the VT group had a higher proportion of high VTE-risk individuals and those with Wells scores of 2 points,with statistically significance(P＜0.001).(3)The age distribution of VTE patients showed an increasing trend in the age groups of 60-69,70-79,80-89,and ≥90-year-old,with a significant difference compared to the non-VT group(P＜0.001).(4)The VT group had a higher proportion of qi-deficiency,blood-stasis,and qi-depression constitutions than the non-VT group(P＜0.05 or P＜0.001).(5)Multivariate logistic regression analysis(after adjusting age,gender,frailty,and other scores)showed that qi-deficiency and yang-deficiency constitutions were non-susceptible,while damp-heat,blood-stasis,and qi-depression constitutions were susceptible to VTE in elderly frail patients(P＜0.05 or P＜0.01).Conclusion VTE in elderly frail patients is significantly correlated with TCM constitution types.Deviated constitutions are characteristic of TCM constitution types in elderly frail patients,and damp-heat,blood-stasis,and qi-depression constitutions are risk factors for VTE in this population.

The objective of this program is to investigate the biological effect of dynamic strain on human periosteal cells in vitro. Using a well-established model, the Flexercell unit, we placed mechanical stress (50,000 microstrain, 1 Hz and sine wave) on human periosteal cells grown in collagen coated flexible membrane. The time points of proliferative and differentiative properties were assessed by means of cell counting, thymidine incorporation, synthesis of alkaline phosphatase and osteocalcin, and long term of mechanical load induced calcium nodules formation was also demonstrated. The results showed that the application of highly controlled strains exerted a significant effect on human periosteal cells by up regulation of osteogenic properties rather than exercised an influence on proliferation. The results suggested that the promoting effects of dynamic strain on human periosteal cells probably contribute to the biological function of mechanical loading bearing.
Biomechanical Phenomena ; Cell Proliferation ; Cells, Cultured ; Humans ; Periosteum ; cytology ; Stress, Mechanical ; Ulna ; cytology ; Weight-Bearing

BACKGROUND: Scaffolds are an important part in bone tissue engineering. However, no perfect scaffolds have been developed for bone tissue engineering yet.OBJECTIVE: To evaluate the repair of rabbit radial defects by poly (L-lactic acid)/tricalcium phosphate(PLLA/TCP) scaffolds prepared by rapid prototyping(RP) technology so as to find a new carrier for growth factors.DESIGN: A completely randomized controlled study was conducted. SETTING: Orthopaedic institute of a military medical university.MATERIALS: The study was conducted in the General Orthopedic Institute,Fourth Military Medical University of Chinese PLA, from May 2001 to February 2002. Twenty clean New Zealand rabbits with body mass of(2.5 ±0. 5) kg for this study were obtained from the Experiment Animal Center of Fourth Military Medical University of Chinese PLA. The animals were divided into experiment group and control group with 10 rabbits in each group.INTERVETIONS: PLLA/TCP scaffolds prepared by RP technology and loaded with or without bovine bone morphogenetic protein (BMP) were used to repair the rabbit radial defects of 15 mm.MAIN OUTCOME MEASURES: Main outcomes: ① microscopic observation results of transplanted materials of the two groups; ② degradation rate of scaffolds. Secondary outcomes: ① gross observation; ② radiographic results; ③ bone density.RESULTS: At week 12, bone defect healing in experiment group was good. X-ray examination showed continuous bone callus and partial molding of different degrees. Degradation rate of scaffolds was 39.6%, and bone density in the defected part reached 70% of the normal level. All the indexes of experiment group were superior to those of control group, and no healing was found in the defected area in control group.CONCLUSION: PLLA/TCP scaffolds prepared by RP technology and loaded with bovine BMP can repair radial defects of 15mm in rabbits.

Objective To investigate the biological effects of low intensity of pulsed ultrasound (LIPUS) on human periosteal cells and marrow stromal cells in vitro. Methods LIPUS of 30 mW/cm2 was used to stimulate the cultured human periosteal cells and marrow stromal cells for 5 min, 10 and 20 min per day, respectively, followed by the examination of cell proliferation and differentiation potential. Results Thymidine incorporation and total protein assay indicated that LIPUS had no significant effect on DNA and protein synthesis of the periosteal and marrow stromal cells, suggesting that LIPUS did not promote proliferation of these cells. However, ALP activity and osteocalcin secretion of the human periosteal cells were dramatically increased. Conclusion The results suggested that low intensity pulsed ultrasound stimulated periosteal cell proliferation and differentiation toward osteogenic lineage, this might contribute to the curing effect of low intensity pulsed ultrasound for fracture.

OBJECTIVETo assess possible beneficial effect in prevention of osteomyelitis by anti-infective reconstituted bone xenograft (ARBX) in the rabbit.

METHODSA proximal tibia osteomyelitis rabbit model was used in which staphylococcus aureus was injected through a bony window, followed by immediate implantation of three ARBX pellets containing 30 mg of slowly-delivered gentamicin in group A, three pellets of RBX in conjunction with intramuscular gentamicin (30 mg) for 5 days in group B, three pellets of RBX without antibiotic in group C. Specimens were harvested 8 weeks postoperatively for gross observation, radiological, histological and bacteriological evaluation, comparing the three groups with regard to the beneficial effect of the above procedures in preventing osteomyelitis.

RESULTS(1) Bacteria counting, modified Norden scoring, and gross and microscopic evidence for osteomyelitis in group B were less than those in group C (P < 0.01). (2) In group A, bacteria culture and counting yielded 0 values at 8 weeks, while radiologically modified Norden scoring for osteomyelitis gave by far the smallest values among all three groups (P < 0.01) with no evidence of osteomyelitis found in gross and histological examinations.

CONCLUSIONS(1) Conventional systemic administration of antibiotics are reasonably effective in prevention of infection, but the anti-infective effect usually is not strong enough to prevent osteomyelitis when used along with primary bone grafting. (2) Apart from its osteoconductive and osteoinductive effects, ARBX is capable of slowly delivering antibiotics, thus being highly anti-infective when administered locally, so it could be used for primary grafting to repair a contaminated bone defect for effective prevention of osteomyelitis.

Animals ; Bone Transplantation ; methods ; Cattle ; Colony Count, Microbial ; Female ; Gentamicins ; administration & dosage ; Male ; Osteomyelitis ; prevention & control ; Postoperative Complications ; prevention & control ; Rabbits ; Staphylococcal Infections ; prevention & control ; Tibia ; surgery ; Transplantation, Heterologous

Objective To evaluate the relationship between the immune rejection and the osteoinductive potential of bone allograft.Methods Allogeneic and syngeneic fresh bone, autolyzed antigen-extracted bone, bone matrix gelatin and demineralized bone matrix were implanted into the muscle of mice, and immunological tests, histological observation and alkaline phosphatase assay were performed.Results Three and 6 weeks after implantation, all kinds of allogeneic implants activated immune rejection, among them, fresh bone induced the most vigorous immune rejection and bone matrix gelatin caused the weakest response. Allogeneic autolyzed antigen-extracted bone, bone matrix gelatin and demineralized bone matrix inhibited proliferation of the lymphocytes in vitro and bone matrix gelatin had the most powerful inhibiting effect. Both allogeneic and syngeneic autolyzed antigen-extracted bone, bone matrix gelatin, and demineralized bone matrix induced heterotopic osteogenesis in vivo and bone matrix gelatin had the best osteoinductive capacity.Conclusion There is a negative correlation between immune rejection to bone allograft and osteoinductive capacity of the graft.

To develop a biodegradable implant with both the ossific and anti infectious abilities. Antigen extracted bovine cancellous bone combined with bBMP as the center carrier was coated with either gelatin or poly ? caprolaton (PCL). They were then compounded with gentamicin. Their in vivo gentamycin releasing characteristics were assayed. There was an initial phase of rapid release of gentamycin within 24 hours, followed by a second phase of sustained but gradual diminution of drug release. Effective release of gentamicin from the PCL encapsulated RBX G LDDS may last 30 days in vivo . There was no significant difference in releasing rate between 30% gelatin and 40% gelatin in statistic. The results showed that RBX gentamycin possessed a fine in vivo gradual release property. Collaborated with its ossification activity, it could be considered as an ideal repair material for open fracture with bone defect.