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ABSTRACT: Celecoxib, a selective cox-2 inhibitor, has been shown to prevent the heterotopic ossification following total hip arthroplasty. However, the effects of celecoxib on heterotopic ossification at other locations remain unclear. This study aimed to investigate the effect of celecoxib on heterotopic ossification in the rat model with Achilles tenotomy. Forty male Sprague-Dawley rats, which were randomly divided into 2 groups (n = 20), underwent midpoint Achilles tenotomy on left legs through a posterior approach under aseptic condition. Experimental group was treated with the saline solution of celecoxib (10 mg/kg) per day, while control group was treated by normal saline (0.9%). At 3, 5 and 10 postoperative weeks, all animals were examined by X-ray to assess new bone formation in the Achilles tendon. At 10 weeks after surgery, all animals were killed and Achilles tendons were taken for hematoxylin-eosin (HE) and immunohistochemical staining. Heterotopic ossification developed in 3 rats (15%) in experimental group and 20 rats (100%) in control group by postoperative 10 weeks. The incidence of heterotopic ossification was significantly lower in experimental group than in control group (P < 0.05). Our findings suggest that celecoxib inhibits HO development in rat model with Achilles tenotomy.
European Journal of Orthopaedic Surgery & Traumatology 02/2013; 23(2):145-8. · 0.10 Impact Factor
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Jia Liu,
Jian Chen,
Bin Liu,
Cuilan Yang,
Denghui Xie,
Xiaochen Zheng,
Song Xu,
Tianyu Chen,
Liang Wang,
Zhongmin Zhang,
Xiaochun Bai, Dadi Jin
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ABSTRACT: The stem cell-based experimental therapies are partially successful for the recovery of spinal cord injury (SCI). Recently, acellular spinal cord (ASC) scaffolds which mimic native extracellular matrix (ECM) have been successfully prepared. This study aimed at investigating whether the spinal cord lesion gap could be bridged by implantation of bionic-designed ASC scaffold alone and seeded with human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) respectively, and their effects on functional improvement. A laterally hemisected SCI lesion was performed in adult Sprague-Dawley (SD) rats (n=36) and ASC scaffolds seeded with or without hUCB-MSCs were implanted into the lesion immediately. All rats were behaviorally tested using the Basso-Beattie-Bresnahan (BBB) test once a week for 8weeks. Behavioral analysis showed that there was significant locomotor recovery improvement in combined treatment group (ASC scaffold and ASC scaffold+hUCB-MSCs) as compared with the SCI only group (p<0.01). 5-Bromodeoxyuridine (Brdu)-labeled hUCB-MSCs could also be observed in the implanted ACS scaffold two weeks after implantation. Moreover, host neural cells (mainly oligodendrocytes) were able to migrate into the graft. Biotin-dextran-amine (BDA) tracing test demonstrated that myelinated axons successfully grew into the graft and subsequently promoted axonal regeneration at lesion sites. This study provides evidence for the first time that ASC scaffold seeded with hUCB-MSCs is able to bridge a spinal cord cavity and promote long-distance axon regeneration and functional recovery in SCI rats.
Journal of the neurological sciences 01/2013; · 2.32 Impact Factor
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ABSTRACT: To evaluate the mid-term effectiveness of Oxford Unicompartmental Knee system Phase III for medial unicompartmental knee osteoarthritis (OA).
Between December 2008 and August 2010, 26 patients (32 knees) with medial unicompartmental knee OA were treated. Of 26 patients, 11 were followed up more than 2 years, including 7 males and 4 females (14 knees, 6 left and 8 right knees) with an average age of 62.4 years (range, 50-74 years). All patients had load suffering and tenderness of medial unicompartmental knee, and complicated by varus deformity without limitation of flexion and extension; the disease duration ranged 5-23 years (mean, 11.6 years). According to Ahlback staging, 4 knees were at stage II and 10 knees at stage III. Cemented unicompartmental knee arthroplasty (Oxford Unicompartmental Knee system Phase III) was performed by minimally invasive technique.
All the incisions were primary healing after operation. Five cases suffered from local ache in the pes anserinus during the first 3 months after operation, which was cured after conservative therapy. Of them, 11 patients were followed up 27.5 months on average (range, 24-30 months). During follow-up, no complication of prosthesis loosening, displacement, arthropathy in the opposite department, or the patellofemoral joint occurred. The range of motion was significantly improved from (109.2 +/- 8.7) degrees preoperatively to (123.5 +/- 6.7) degrees at last followup (P < 0.05); knee society score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores were all significantly improved (P < 0.05). At last follow-up, the femoro-tibial angle was significantly improved (P < 0.05); tibial plateau and the tibial anatomical axis increased, showing no significant difference (P > 0.05); and posterior tibial slope was significantly decreased (P < 0.05).
Oxford Unicompartmental Knee system Phase III has satisfactory mid-term effectiveness in treating medial unicompartmental knee OA with the advantages of little trauma and rapid recovery, but long-term effectiveness is expected for further follow-up.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 01/2012; 26(1):17-20.
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ABSTRACT: Anti-diabetic drug metformin has been shown to enhance osteoblasts differentiation and inhibit osteoclast differentiation in vitro and prevent bone loss in ovariectomized (OVX) rats. But the mechanisms through which metformin regulates osteoclastogensis are not known. Osteoprotegerin (OPG) and receptor activator of nuclear factor κB ligand (RANKL) are cytokines predominantly secreted by osteoblasts and play critical roles in the differentiation and function of osteoclasts. In this study, we demonstrated that metformin dose-dependently stimulated OPG and reduced RANKL mRNA and protein expression in mouse calvarial osteoblasts and osteoblastic cell line MC3T3-E1. Inhibition of AMP-activated protein kinase (AMPK) and CaM kinase kinase (CaMKK), two targets of metformin, suppressed endogenous and metformin-induced OPG secretion in osteoblasts. Moreover, supernatant of osteoblasts treated with metformin reduced formation of tartrate resistant acid phosphatase (TRAP)-positive multi-nucleated cells in Raw264.7 cells. Most importantly, metformin significantly increased total body bone mineral density, prevented bone loss and decreased TRAP-positive cells in OVX rats proximal tibiae, accompanied with an increase of OPG and decrease of RANKL expression. These in vivo and in vitro studies suggest that metformin reduces RANKL and stimulates OPG expression in osteoblasts, further inhibits osteoclast differentiation and prevents bone loss in OVX rats.
Journal of Cellular Biochemistry 05/2011; 112(10):2902-9. · 2.87 Impact Factor
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Rongping Zhou,
Zhongmin Zhang,
Li Zhao,
Chunhong Jia,
Song Xu,
Qiguang Mai,
Ming Lu,
Mingjun Huang,
Liang Wang,
Xiaokai Wang, Dadi Jin,
Xiaochun Bai
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ABSTRACT: Oleanolic acid (OA), a pentacyclic triterpenoid exhibits potent anti-tumor activity against many tumor cell lines. But the mechanisms through which OA inhibits osteosarcoma cells are not known. The mammalian target of rapamycin (mTOR) serves as a central regulator of cell growth, proliferation, survival, and metabolism by integrating intracellular and extracellular signals. In this study, we examined effects of OA on proliferation, cell cycle progression, apoptosis in osteosarcoma cells, and involvement of mTOR signaling in this process. OA inhibited cell proliferation and colony formation, induced G1 arrest in osteosarcoma MG63 and Saos-2 cells dose and time dependently. The protein level of cyclin D1, which plays critical role in G1 to S phase transition and servers as a downstream target of mTOR complex 1 (mTORC1) was down-regulated by OA. Phosphorylation of p70 ribosomal S6 kinase 1 (p70 S6K1) (T389) and S6 (S235/236), mediators of mTORC1 signaling in controlling protein translation and cell growth, was also inhibited by OA. Furthermore, OA inhibited phosphorylation of Akt, a pro-survival factor and substrate for mTORC2. Inactivation of Akt correlated with pro-apoptotic role of OA in osteosarcoma cells, as manifested by an increase in annexin V-FITC binding, cleavage of poly (ADP-ribose) polymerase (PARP) and activation of caspases 3. Our results suggest that OA is a promising agent for treatment of osteosarcoma and mTOR signaling may contribute to its anti-tumor effects on osteosarcoma cells.
Journal of Orthopaedic Research 01/2011; 29(6):846-52. · 2.81 Impact Factor
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ABSTRACT: To evaluate an improving operative procedure and the clinical results of arthroscopically assisted treatment for acute patellar dislocation.
Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, release of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The disease duration was 1-10 days with an average of 5.9 days. All patients had lateral dislocation; of them, 14 patients showed reduction without treatment, and 8 patients showed dislocation at admission and were given close manipulative reduction. The results were positive for apprehension test in all patients with the limitation of passive motion and for Ballottable Patella Sign in 15 cases. Lysholm score, visual analogue scale (VAS) score, and Insall scale were adopted to evaluate the effect.
All incisions healed by first intention. All the patients were followed up 12-36 months (17 months on average). During the first 3 months after operation, sunken skin in the puncture point medial to the patella was observed in 12 knees; 10 knees suffered pain of the soft tissue lateral to the patella; 15 knees felt tense in the soft tissue medial to the patella, however, all these problems disappeared or recovered gradually after rehabilitation and conservative treatment. No recurrence of dislocation was observed during the follow-up. Lysholm score was significantly improved from preoperative 67.3 +/- 5.7 to postoperative 96.6 +/- 4.5 (t = 3.241, P = 0.003) and VAS score from 6.5 +/- 0.5 to 1.8 +/- 0.4 (t = 2.154, P = 0.040). According to Insall scale, the results were excellent in 18 knees, good in 5 knees, and fair in 2 knees at 1 year after operation with an excellent and good rate of 92%.
The improving procedure of arthroscopically assisted treatment for acute patellar dislocation is a minimally invasive operation and has a number of benefits. Its short-term clinical outcome was satisfactory.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 01/2011; 25(1):9-12.
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ABSTRACT: To discuss the resection of tumors of pelvic ring and its reconstruction of defects.
From January 1999 to December 2006, 48 patients with tumors in pelvic ring were treated and defects were reconstructed. There were 32 males and 16 females, aged 14-72 years (mean 45.1 years), including 12 cases of benign tumor and 36 cases of malignant tumor. Fourteen cases had lesions in region I, 11 cases in region II, 12 cases in region III, 3 cases in region IV and 8 cases had two or more regions. The selection of surgical method: benign tumor in wing of ilium or in sacro-iliac articulation was curettaged, malignant tumors were resected radically or boardly. Benign or malignant tumor in pubis, ischium or pubic symphysis was resected radically, defects were reconstructed with plastic plate or not. For tumor affecting aceta bulum resection of tumor and replacement of the peri-pelvic prothetic or artificial hip joint replacement were performed to reconstruct the function of hip joint.
Twelve patients with benign tumors were followed up 12-72 months and could walk well, only 1 case relapsed locally. Thirty-six patients with malignant tumor were followed up 6-72 months, the survival time was 6-12 months in 2 cases (5.6%), 12-24 months in 2 cases (5.6%), 24-36 mongths in 6 cases (16.7%), 36-72 months in 14 cases (38.8%), and more than 72 months in 12 cases (33.3%); 28 patients (77.8%) could walk normally, 6 (16.7%) could walk with the help of walking stick, 2 (5.5%) needed wheel chair to move. Complications occurred in 6 cases (including 2 venous thrombus, 1 anoxic encephalopathy, 2 wound delayed healing, and 1 dislocation after total hip joint replacement); the patients' condition took a turn for the better.
Operation is a favorable way for the treatment of pelvic tumor. Selecting convenient operation methods to resect tumors or reconstruction defects according the position of the tumor will do good favor to good results, increase the survival time and improve quality of life.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2008; 22(1):63-5.
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ABSTRACT: To study the mechanism of ectopic osteogenesis of nacre/Polylactic acid (N/P) artificial bone combined with allogenic osteoblasts, and to explore the possibility as a scaffold material of bone tissue engineering.
The allogenic osteoblasts seeded onto N/P artificial bone were co-cultured in vivo 1 week. The N/P artificial bone with allogenic osteoblasts were implanted subcutaneously into the left back sites of the New Zealand white rabbits in the experimental group and the simple N/P artificial bone into the right ones in the control group. The complexes were harvested and examined by gross observation, histologic analysis and immunohistochemical investigation 2, 4 and 8 weeks after implantation respectively.
In experimental group, the osteoid formed after 4 weeks, and the mature bone tissue with bone medullary cavities formed after 8 weeks; but in control group there was no new bone formation instead of abundant fibrous tissue after 4 weeks, and more fibrous tissue after 8 weeks.
N/P artificial bone can be used as an optical scaffold material of bone tissue engineering.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 03/2005; 19(2):114-7.
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ABSTRACT: To evaluate the clinical effect of Halo-vest in treatment of unstable upper cervical spine.
From March 1997 to October 2002, 16 cases of unstable upper cervical spines were treated and immobilized by Halo-vest, aged from 14 to 53 years. There were 3 cases of isolated Jefferson fractures, 4 cases of isolated Hangman fractures and 1 case of Anderson type I fracture. The 8 cases were immobilized for 3-4 months by Halo-vest. There were 3 cases of old odontoid fractures with dislocations treated by occipitocervical plate fixation and fusion, 1 case of C1 malignant tumor by posterior resection and internal fixation, 2 cases of C2 malignant tumor by anterior resection, fusion, and internal fixation; these cases were immobilized by Halo-vest during surgery. There were 1 case of C2.3 tuberculosis were treated by anterior debridement and fusion, and 1 case of gooseneck deformity by anterior decompression, fusion and screw fixation after resection of C2.7, the 2 cases were immobilized for 3 months by Halo-vest. Of 16 cases, there were 8 cases accompanied with spinal cord syndrome.
Fifteen cases were followed up 6 months to 5 years. Anterior arch ununion and posterior arch osseous healing occurred in 1 case of Jefferson fracture. Other fractures and embedded bones became osseous fusion. One case of C2 malignant tumor recurred 8 months after operation. Spinal cord syndrome of all patients disappeared.
Halo-vest immobilization is an effective method for conservative treatment and stable reconstruction of unstable upper cervical spine.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 10/2004; 18(5):399-401.
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ABSTRACT: There are few articles in the literature concerning anterior instrumentation in the surgical management of spinal tuberculosis in the exudative stage. So we report here 23 cases of active thoracolumbar spinal tuberculosis treated by one-stage anterior interbody autografting and instrumentation to verify the importance of early reconstruction of spinal stability and to evaluate the results of one-stage interbody autografting and anterior instrumentation in the surgical management of the exudative stage of throracolumbar spinal tuberculosis. Twenty-three patients, including two children (9 and 15 years old, respectively) and 21 adults with thoracolumbar spinal tuberculosis were treated surgically. T9 to L4 spinal segments were affected, and MRI/CT showed evident collapse of the vertebrae because of tuberculous destruction and paravertebral abscess. Neurological deficits were found in 15 patients. Before surgery, patients received standard anti-tuberculosis chemotherapy for 2 to 3 weeks. Under general endotracheal anaesthesia, the patients were placed in right recumbent positions, and a transthoracic, lateral extracavitary or extrapleural approach was chosen according to the tuberculosis lesion segment. After exposure, the tuberculous lesion region, including the collapsed vertebrae and in-between intervertebral disc, was almost completely resected in order to release the segmental spinal cord. Then, autologous iliac, rib or fibular graft was harvested to complete interbody fusion, and an anterior titanium-alloy plate-screw system was used to reconstruct the stability of the affected segments. Anti-tuberculosis chemotherapy was continued for at least 9 months, and the patients were supported with thoracolumbosacral orthosis for 6 months after surgery. All patients were followed up for an average of 2 years. All 23 cases were healed without chronic sinus formation or any recurrence of tuberculosis during the follow-up period. Spinal fusion occurred at a mean of 3.8 months after surgery. Of all patients with neurological deficits, 14 patients showed obvious improvement; only one patient with Frankel C lesion remained unchanged, but none of the patients got worse. During the follow-up period, a mean of 18 degrees of kyphosis correction was achieved after surgery in the adult group. Moderate progressive kyphosis because of this procedure fusion occurred postoperatively in a 9-year-old child after 2 1/2 years; another 15-year-old child did not demonstrate this phenomenon. Except for the early loosening of one screw in two cases (which did not affect the reconstruction of spinal stability), no other complications associated with this procedure were found during follow-up. Early reconstruction of spinal stability plays an important role in the surgical management of spinal tuberculosis. One-stage anterior interbody autografting and instrumentation in the surgical management of the exudative stage of spinal tuberculosis show more advantages in selected patients, but supplementary posterior fusion should be considered to prevent postoperative kyphosis when this procedure is performed in children.
European Spine Journal 04/2004; 13(2):114-21. · 1.97 Impact Factor
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ABSTRACT: A clinical follow-up study was performed to evaluate lumbar disc nucleus replacement clinically and functionally. The objective was to assess the clinical efficacy of the prosthetic disc nucleus (PDN) for treatment of lumbar disc herniation. The PDN was designed to treat patients suffering from disc herniation and/or degeneration. Clinical trials for PDN were first conducted in 1996, and the results showed that the PDN device was effective in most of the patients who were implanted. These studies had been carried out with patients who were implanted with a pair of the devices. The main complication was device migration. Therefore, a follow-up study based on a single PDN device implantation was designed to evaluate its clinical result. Forty-five patients with lumbar disc herniation were implanted with one PDN device from March 2002 to December 2002. Thirty (66.7%) patients came to the clinical, functional, and radiographic 6-month follow-up examinations. Independent analysis was performed by careful review of the charts, operative notes, preoperative and postoperative radiographs, magnetic resonance images, and follow-up records of all patients. After implantation, significant proportions of patients experienced pain relief. Improvements were noted in pain intensity, walking distance, lumbar mobility, neurologic weakness, Oswestry and Prolo scores, and intervertebral disc height. No difference in work status after PDN implantation could be detected. Compared with the preoperative height, the intervertebral disc had gained 19.7% (P < 0.001). Device migration, failure, and dislocation were not noticed in any patient. A few patients had minor complications such as transient low-grade fever. Clinically, a single PDN is preferred and can effectively increase the height of the intervertebral disc in patients with lumbar disc herniation. However, long-term follow-up of PDN implantation needs to be studied.
Journal of Spinal Disorders & Techniques 08/2003; 16(4):331-7. · 1.50 Impact Factor
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ABSTRACT: A case is reported.
To report and discuss a case of multiple cystic tuberculous skeletal lesions.
Multiple cystic tuberculosis lesions of the skeleton, or Jüngling disease, is a rare variety of tuberculosis reported extensively 30 to 40 years ago. No such severe type of tuberculosis has been reported in recent years. The patient was a 43-year-old woman with a history of steroid treatment, whose cervical lesions caused C2 and C3 destruction and spinal cord impingement.
Medical history, laboratory data, radiographs, bone scan, and MRI were studied. The bone scan showed lesions in both the axial and peripheral skeletons. As shown on the radiographs and MRI, the C2-C3 vertebral bodies were extensively destroyed.
An open biopsy of the right clavicle confirmed the diagnosis of tuberculosis. Because of the neurologic involvement, the patient was treated with C2-C3 anterior radical resection and fusion combined with standard antituberculosis chemotherapy. During a follow-up period of 12 months, no progression in other skeletal lesions was observed. Follow-up radiographs showed fusion in the C2-C3 lesions.
Although the prognosis of Jüngling disease is good, radical surgical treatment should be chosen when there is neurologic involvement. To prevent such a severe type of tuberculosis, it is recommended that steroid therapy should be withheld until tuberculosis is excluded in the diagnosis.
Spine 05/2003; 28(8):E155-7. · 2.08 Impact Factor
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ABSTRACT: To discuss the long-term effect of inducible nitric oxide synthase inhibitor S-methylisothiourea (SMT) on repair of articular cartilage defects.
Twenty-four adult New Zealand White rabbits with full-thickness defects of cartilage created in the trochlear groove of their bilateral femurs were divided into three groups randomly, 8 in each group: (1) control group in which nothing was filled into the defects; (2) BMP group in which the defects were filled with collagen fibrin gel impregnated with recombinant human bone morphogenic protein (rhBMP); and (3) SMT group in which the defects were filled with collagen fibrin gel impregnated with rhBMP and hypodermic injection of SMT (5 mg .(-1) 12 h(-1)) was given. The animals were killed one year later. The gross appearance of the defects was assessed. The amount of released NO and the activity of NOS were examined by chemical colorimetry. The distribution of collagen was examined by immunohistochemistry. The proteoglycan synthesis and cell activity was assessed by incorporation of radiolabelled sodium sulphate Na(2)(35)SO(4) and bromodeoxyuridine.
One year after the defects in SMT group showed greater improvement in margin integration, cellular morphology, and architecture within defect than those in BMP group and control group (P < 0.01). Immunohistochemistry showed that there was less type-I collagen and more type-II collagen in SMT group than in the other two groups. Radiolabelled sodium sulphate (Na(2)(35)SO(4)) incorporation test showed that the proteoglycan synthesis in defects was higher in SMT group than in the other two groups (P < 0.01). BrdU incorporation test showed cells in repaired tissue with remarkable proliferous activity.
iNOS inhibitor SMT significantly improves the quality of repair of defected cartilage and delays its degradation.
Zhonghua yi xue za zhi 01/2002; 82(1):23-6.
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ABSTRACT: OBJECTIVE: To compare the biomechanical differences among the atlantoaxial transarticular screw fixation (Magerl) and other posterior fixation techniques. METHODS: Seven preserved atlantoaxial-complex specimens were harvested and fixated with Magerl, Magerl plus Gallie wiring, Magerl plus Brooks wiring, pure Brooks, pure Gallie, and Halifax interlaminar clamping fixation, respectively. The torque for every fixation technique was measured at the point of five-degree rotation of the atlantoaxial joint. RESULTS: The torque for Magerl was 6.59 Nmplus minus1.14 Nm, which was significantly higher than any other pure posterior techniques including Gallie (1.74 Nmplus minus0.31 Nm). Brooks (4.06 Nmplus minus0.48 Nm) and Halifax (3.44 Nmplus minus0.87 Nm) (P<0.01), but less than Magerl plus brooks (9.94 Nmplus minus1.45 Nm) (P<0.01). No statistically significant difference was found between Magerl and Magerl plus Gallie wiring (7.61 Nmplus minus1.10 Nm) or between Brooks and Halifax. CONCLUSIONS: Compared with other pure posterior fixation techniques the atlantoaxial transarticular screw fixation technique provides more torsion-resistance capacity. It is also suggested that combined Gallie wiring do not add any biomechanical superiority to this technique.
Chinese Journal of Traumatology (English Edition) 05/2000; 3(2):89-92.
