Severe tendon injury will impair the mobility and quality of life of ordinary patients and come as a major blow to the career of professional athletes. As the current surgical treatment of tendon injury cannot achieve satisfactory results, the injury is still challenging for clinicians. The discovery of tendon stem/progenitor cells (TSPCs) and the continuous in-depth study of them provide a new direction for tendon repair and regeneration, and promote the continuous development of tendon tissue engineering. This article systematically summarizes the characteristics, aging, isolation and culture of TSPCs in tendon repair, and progress in their related applications as well. The research direction of TSPCs is also analyzed and prospected.

Objective:To explore the psychological state and affected factors of elderly patients with hip fractures.Methods:A retrospective analysis of 156 elderly hip fracture patients(>65 years) admitted to the Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University from January 2016 to August 2019 was performed. General and psychological information were collected by questionnaire.General information included age, gender, education, whether surgery, length of stay.SCL-90, a self-assessment scale, was chosen as the psychological test to analyzed the elderly hip fracture patients′ psychological status during hospitalization and the norms of SCL-90 in Chinese which were established in 1986 were used as the control group. The prognostic factors were examined by univariate and multivariate analysis.Results:Somatization, interpersonal sensitivity, depression, anxiety, paranoid factor scores, and total scores of the elderly hip fracture patients were significantly higher than control group(all P=0.00).Univariate analysis and logistic regression analysis showed that non-surgery treatment and more than 10 days of hospitalization were independent prognostic factors that affected the psychological state of elderly hip fracture patients (all P=0.00). Conclusion:Elderly patients hospitalized with osteoporosis and hip fractures are prone to have negative emotional and psychological changes.The length of hospitalization and the choice of treatment can affect patients′ psychological state, suggesting that effective psychological intervention is necessary.

Objective:To explore the psychological state and affected factors of elderly patients with hip fractures.Methods:A retrospective analysis of 156 elderly hip fracture patients(>65 years) admitted to the Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University from January 2016 to August 2019 was performed. General and psychological information were collected by questionnaire.General information included age, gender, education, whether surgery, length of stay.SCL-90, a self-assessment scale, was chosen as the psychological test to analyzed the elderly hip fracture patients′ psychological status during hospitalization and the norms of SCL-90 in Chinese which were established in 1986 were used as the control group. The prognostic factors were examined by univariate and multivariate analysis.Results:Somatization, interpersonal sensitivity, depression, anxiety, paranoid factor scores, and total scores of the elderly hip fracture patients were significantly higher than control group(all P=0.00).Univariate analysis and logistic regression analysis showed that non-surgery treatment and more than 10 days of hospitalization were independent prognostic factors that affected the psychological state of elderly hip fracture patients (all P=0.00). Conclusion:Elderly patients hospitalized with osteoporosis and hip fractures are prone to have negative emotional and psychological changes.The length of hospitalization and the choice of treatment can affect patients′ psychological state, suggesting that effective psychological intervention is necessary.

White matter lesion (WML) can lead to decreased cognitive ability ,postural balance disorder and abnor‐mal emotion etc .,which affects quality of life and is closely related to treatment of stroke .In recent years ,roles of vessel‐related risk factors and atherosclerosis in WML received considerable attention .The present article made a re‐view on it ,aiming at providing thinking for prevention and treatment of WML .

Objective To analyze the risk factors of cortical micro-infarcts (CMIs) in patients with acute ischemic stroke and to evaluate the diagnostic value of 3.0 Tesla (T) magnetic resonance imaging (MRI) using double inversion recovery (DIR) sequence and 3-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence in CMIs in vivo.Methods One hundred and ten consecutive patients with acute ischemic stroke within 7 d of onset were chosen from August 2014 to July 2015;these patients were classified into CMIs group and non-CMIs group by results of 3.0 conventional T MRI,DIR-MRI and 3D-FLAIR-MRI.Baseline characteristics and risk factors were analyzed to investigate the independent risk factors of CMIs.The presence of CMIs was evaluated based on conventional T MRI,DIR-MRI and 3D-FLAIR-MRI.Results Of the 110 enrolled patients with acute ischemic stroke,CMIs were presented in 23.6％ patients (26/110).The age of patients from the CMIs group was significantly older as compared with that of patients from the non-CMIs group (67.65±10.37 vs.58.52± 11.24 years old,P=0.009).Patients from the CMIs group had significantly higher percentages of age＞65 years,age of 76-80 years,hypertension,history of cerebral ischemia and intracranial atherosclerosis than patients from non-CMIs group (P＜0.05).Multivariate Logistic regression analysis indicated that age＞65 years (OR=1.982;95％CI:1.362-2.889,P=0.010) and hypertension (OR=1.326;95％CI:1.022-1.682,P=0.026) were the independent risk factors of CMIs.The prevalence of CMIs detected by conventional sequence (10.9％) was significantly lower than that detected by DIR sequence (23.6％) or 3D-FLAIR sequence (20.9％,P=0.013 and P=0.043).Conclusions Age＞65 years and hypertension are independent risk factors of CMIs.DIR and 3D-FLAIR sequences at 3.0 T MRI substantially improve the sensitivity of detection of CMIs as compared with conventional MRI sequence.

ObjectiveTo investigate the clinical effects of systems integrative rehabilitation therapy for cervival spdylotsis myelopathy.MethodsFrom April 2002 to October 2004, 68 cases were intervened with the integrative rehabilitation treatment, which linked up the pre- and post-operational rehabilitation interventions into a continuum. The cases were followed up, and serial radiological evaluations were applied. Then the height of involved interspinal space was measured preoperatively and 12 months after operation, and the spinal function was evaluated according to the standard of Japanese Orthopeadic Association (JOA).ResultsAll the cases were followed up, of which 49 were better, 1 was improved, none was worsened. 12 months after operation, roentgenographic appearance showed that the allograft healing and interbody fusion of all patients were achieved, and the reserving height of involved interspinal space and JOA evaluation postoperatively were significantly superior to preoperatively. There was no complications such as cervical spinal cord injury, internal fixation loosening and hematoma turned up.ConclusionThe integration rehabilitation therapy has satisfactory effects in the cervical spondylotsis myelopathy.

AIM: To investigate the effect of insulin on vascular smooth muscle cells (VSMCs) proliferation and to evaluate the intracellular signaling pathways involved. METHODS; VSMCs separated from Sprague - Dawley rats were used in this study. The proliferation of VSMCs induced by insulin was assayed by [~3H ] - thymidin incorporation. The protein expression and activity of p -ERK1/2 were determined by immunblot and [~(γ-32)P]ATP incorporation. RESULTS: Insulin induced cell proliferation in a concentration - dependent manner. The proliferative effect of insulin on VSMCs was inhibited partly by LY294002 (48.8% ) , an inhibitor of PI -3 kinase, and the ERK1/2 inhibitor PD98059 (43.6% ) , respectively. Moreover, phosphorylation of ERK1/2 and activity of ERK1/2 induced by insulin were also inhibited partly by LY294002.CONCLUSION: PI -3 kinase and ERK1/2 are involved in insulin induced VSMCs proliferation.

BACKGROUND:Myocardial fibrosis following myocardial infarction is an important mechanism of ventricle reconstitution. However, there are few reports concerning effects of myocardial transplantation related to stern cells on this process. OBJECTIVE: To investigate the effects of auto-skeletal muscle satellite cells implanted into ischemic myocardium on myocardial fibrosis in rats with myocardial infarction and their mechanisms.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Third Research Room, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from July to September 2007. MATERIALS: A total of 45 Wistar rats, of both genders, weighing 150-200 g, were used in this study. Of them, 30 rats were used to establish models of myocardial infarction.METHODS: A total of 45 rats were assigned to 3 groups (n=15). Rats in the myocardial infarction group received ligation of the left anterior descending coronary artery to induce myocardial infarction. 2 weeks later, 0.2 mL serum-free M199 medium was infused into the juncture between infarct region and normal myocardium through multiple points. In the transplantation group, following model induction, 0.2 mL auto-skeletal muscle satellite cells in rats after 2-weeks in vitro culture were transplanted into the surrounding of infarct region. Rats in the sham operation group were not induced to create models, only injected with 0.2 mL saline in the heart anterior wall surrounding the left anterior descending branch through multiple points. MAIN OUTCOME MEASURES: Four weeks after injection, vascular endothelial growth factor mRNA and vascular endothelial growth factor protein expression in the ischemic myocardium was demonstrated. Capillary density changes in the ischemic myocardium were detected. Growth and proliferation of myocardial cells in the infarct region were observed using hematoxylin-eosin staining.RESULTS: Vascular endothelial growth factor mRNA and vascular endothelial growth factor protein expression was significantly decreased in the sham operation and myocardial infarction groups compared with the transplantation group at 4 weeks following satellite cell transplantation (P<0.01). Capillary density was greater in the myocardial infarction group compared with the sham operation group (P<0.05). Capillary density was significantly higher in the rat ischemic myocardium in the transplantation group compared with the sham operation and myocardial infarction groups (P<0.01). Hematoxylin-eosin staining demonstrated that myocardial morphology was normal in rats of the sham operation group, with clear structure, orderly myocardial fibrosis. There were no fibroblastaggregation and hyperplasia among myocardial fibrosis. Fibroblast hyperplasia and collagent formation were found in the rat myocardium in the myocardial infarction group, with disorderly myocardial structure. Myocardial cells with transverse striation and many nuclei were observed in the rat infarct region of the transplantation group, with orderly arrangement. Fibrous tissue was significantly less in the transplantation group compared with the myocardial infarction group.CONCLUSION: Satellite cells can proliferate and differentiate into striated muscle-like cells with flexible and systolic functions in the infarct region. Satellite cells secrete vascular endothelial growth factor and promote blood capillary hyperplasia in ischemic myocardium by autocrine and paracrine, which finally effectively inhibits fibrosis progress in the ischomic myocardium.

Objective Impedance control plays an important role in stability.This paper intends to explore such mechanism through modeling human reaching movement.Method Implemented with revised model,we ap-ply optimal control theory to neuro-muscle-skeleton model to calculate the stiffness ellipses.Result Com-pared with the original model and experimental figures,the model we proposed could overcome the shortage of monotonous changing of the original one and fit the data better.Conclusions So that this paper concludes that co-contraction contributes to impedance control even during free upper limb planar movement.

Objective To explore the clinical application of lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft taken from the groin area for reconstruction of the distal one third of anterior tibia,.around the ankle. Methods A distally based lesser saphenous.sural nerve adipofag.cial flap accompanied with a full-thickness skin graft which was taken from the groin area was studied and used to treat 12 patients with soft tissue defects in the distal one third of anterior tibia,3 cases with soft tissue defects and tibia osteomyelitis,2 cases with soft tissue defects and tibia osteomyelitis.The size of the soft tissue defects ranged from 3 cm×5 cm to 9 cm×13 cm,and the biggest donor flap was 13 cm×18 cm.The donor sites at the posterior aspect of the leg and at the groin area were closed primarily. Results All 17 patients were followed up for 6-12 months(average 9 months).All 17 flaps had good perfusion and survived completely,which successfully treated all 17 patients with soft tissue defects or with both soft tissue defects and osteomyelitis.The donor and recipient sites of adipofascial flaps and the groin area healed primarily,and satisfactory appearance and function were achieved.Conclusion Distally based lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft which was taken from the groin area can reconstruct the distal one third of anterior tibia,around the ankle,and even treat osetomyelitis successfully,in the same time,which can preserve the function and appearance of the involved limb to the utmost.