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miRNA-22 (miR-22) has been showed to involve in a variety of cancers; however, the association between miR-22 expression level and the prognosis of osteosarcoma is also poorly unknown. Fifty-two patients with surgically resected paired osteosarcoma and non-neoplastic disease between 2008 and 2014 were involved in this study. Real-time PCR was performed to examine the expression level of miR-22 in osteosarcoma tissues and noncancerous bone tissues. Then the association between miR-22 expression and clinical-pathological parameters were further evaluated. Kaplan-Meier analysis and Cox proportional hazards regression models were explored to reveal the correlations of miR-22 expression with survival of patients. The results indicated that miR-22 was downregulated in osteosarcoma tissues in comparison with noncancerous bone tissues. In addition, there is statistically significance between miR-22 expression level and recurrence, metastasis, and chemotherapy response. The patients with lower miR-22 expression level had both poorer overall survival and disease-free survival. The multivariant analysis revealed that the miR-22 expression level and metastasis status are independent prognosis factors for osteosarcoma. In conclusion, miR-22 was downregulated in osteosarcoma and its expression level was correlated with a variety of important clinical-pathological parameters. Moreover, miR-22 may serve as a promising biomarker for predicting the prognosis of osteosarcoma.

To determine modulus of elasticity (MOE) of the whole full-sized medium density fiberboard (MDF) by using vibration method in the future, this paper studies MDF vibration characteristics. To solve modal parameters of full-sized MDF in the condition of free vibration, the writers conducted calculation modal analysis and experimental modal analysis of the full-sized MDF with three different thicknesses respectively, compared and analyzed the first three order modal shapes and frequencies. It is found that the full-sized MDF with three different thicknesses showed the same vibration modal forms: the first and second vibration modes had bending vibration along the length direction, while the third one had bending vibration along the width direction; the frequency obtained through calculation modal analysis and experimental modal analysis had a certain difference—the first calculation modal frequency was slightly lower than the first experimental modal frequency, and the second and third calculation modal frequencies higher than the corresponding experimental modal frequencies. However, there is a good correlation between calculation modal frequency and test experimental modal frequency with the determination coefficient reaching 0.9816.

By using self-designed non-thermal plasma reactor, the influences of discharge power, initial concentration of C3H6 and O2 concentration on NO pro-oxidation in C3H6/NO/N2/O2 mixture were studied. The obtained results indicate that with the increasing of discharge power, NO2/NOx ratio grows firstly and then decreases after reaching a peak value, while NOx conversion efficiency and N2O concentration gradually rise. Increasing initial concentration of C3H6 or O2 concentration would help to enhance NO oxidation efficiency. With the same discharge power, NOx conversion efficiency grows with the increasing of C3H6 initial concentration while reduces with the increasing of O2 concentration. Controlling the concentration of C3H6 and O2 in exhaust gas can lead the NO2/NOx ratio to reach 50%, which is benefit to NOx conversion with SCR system.

Diesel particulate filter (DPF) are considered to be the most effective means to reduce particulate emissions, and the key of DPF lies in their regeneration. O3 and O which have strong oxidability can be produced by non-thermal plasma (NTP) reactor. PM can be decomposed by these active substances to generate CO and CO2. The results show that PM deposited in the DPF can be removed by NTP technology without any catalyst and DPF can be completely regenerated at a lower temperature.

Characteristics of a water-cooled non-thermal plasma (NTP) reactor used to reduce diesel emissions were experimentally studied. The effects of working voltage, operating frequency and air flow rate on discharge power and concentrations of O3 and NO2 generated by NTP system were investigated at different surface temperatures of discharge zone. The experimental results show that, the discharge power of the reactor would increase with the increasing of working voltage, operating frequency and surface temperatures; air flow rate had little influence on discharge power; variation of O3 and NO2 concentration were different with the increasing of working voltage and operating frequency at different surface temperatures of discharge zone; when the surface temperature of discharge zone was constant, concentrations of O3 and NO2 increased firstly and then declined with the increasing of air flow rate; and concentrations of O3 and NO2 were higher at lower temperature.

Pulmonary metastasis is the major challenge for clinical treatment of osteosarcoma patients. Recent studies indicated that visfatin, a 52kDa adipocytokine, can trigger the cell motility of various cancers, while its role in the progression of osteosarcoma remains not clear. Our present study revealed that visfatin can significantly promote the in vitro migration and invasion of osteosarcoma MG-63 and HOS cells and up regulate the expression of matrix metalloproteinase-2 (MMP-2) and fibronectin (FN). Furthermore, visfatin treatment also increased the expression of IL-6 in both MG-63 and HOS cells via a time dependent manner, while anti-IL-6 antibody can significantly attenuate visfatin induced cell invasion and up regulation of MMP-2 and FN. It suggested that up regulation of IL-6 mediated visfatin induced in vitro motility of osteosarcoma cells. Visfatin treatment can increase the phosphorylation of both p65 and ERK1/2 in MG-63 and HOS cells, while only the inhibitor of NF-κB, BAY 11-7082, can abolish visfatin induced up regulation of IL-6. BAY 11-7082 also attenuated visfatin induced upregulation of MMP-2 and FN in MG-63 cells. Western blot analysis revealed that visfatin treatment can significantly increase the phosphorylation of IκBα and IKKβ in MG-63 cells. ACHP, the inhibitor of IKK-β, blocked visfatin induced expression of IL-6 mRNA in both MG-63 and HOS cells. Collectively, our data suggested that visfatin can increase the motility of osteosarcoma cells via up regulation of NF-κB/IL-6 signals. It indicated that visfatin might be a potential therapeutic target of osteosarcoma treatment.

It remains controversial whether degenerative posterior longitudinal ligaments should be removed during anterior decompression procedures for cervical spondylotic myelopathy. Few data are available from studies that have compared removing and retaining the degenerative posterior longitudinal ligament. The goal of this retrospective study was to evaluate the benefit of degenerative posterior longitudinal ligament removal during such operations. Clinical data on 130 patients with confirmed degenerative posterior longitudinal ligament who underwent anterior cervical decompression surgery were retrospectively reviewed. All procedures were performed by the same senior orthopedic surgeon at the authors’ spinal surgery center. The degenerative posterior longitudinal ligament was removed in 62 patients (group A) and retained in 68 patients (group B). The 130 patients were followed for 36 months. The Japanese Orthopedic Association score improved from 9.0±2.7 to 14.7±1.5 in group A and from 9.4±2.6 to 14.1±1.7 in group B ( P =.028). The recovery rate for spinal cord neurologic function was 66.7% in group A and 61.3% in group B ( P =.031). Operating time was longer ( P =.002) and the sagittal median diameter of the vertebral canal was enhanced in group A ( P P =.044). No significant difference was found in the rates of common complications between groups. Removal of the degenerative posterior longitudinal ligament in anterior decompression procedures for cervical spondylotic myelopathy appeared to be beneficial and provided more complete decompression and better postoperative outcomes than surgery without removal of the ligament. Although this procedure was generally safe, it required longer operating times, was more technically challenging, and required more experienced surgeons than surgery without removal of the ligament. [ Orthopedics . 2015; 38(1):e54–e61.]

Objective To observe the apoptosis of osteosarcoma MG-63 cells induced by As2O3 and to explore its possible mechanisms. Methods The flowcytometric analysis and transmission electronmicroscope were performed to investigate the inducing apoptosis and inhibitative of As2O3 on osteosarcoma MG-63 cells. In order to study mechanism of apoptosis in MG-63 cells treated with As2O3, microarray was performed. The down-regulated gene was confirmed by RT-PCR, Northern-blotting. Results After treated with As2O3, hypodiploid peak before G0/G1 phase was observed in MG-63 cells through FCM analysis. Loss of microvilli, condensation and fragmentation of nuclear chromatin, condensation of cytoplasmic organelles, dilatation of the endoplasmic reticulum shrinkage of cells and alterations in cell membranes and apoptosis bodies which were observed in MG-63 cells treated with As2O3 by transmission electronmicroscope. The results of microarray show that As2O3 induced MG-63 cell apoptosis involves down-regulation of IEX-1 and the down-regulated gene is confirmed by RT-PCR and Northern-blotting. Conclusion The results show that As2O3 selectively inhibits growth of the solid tumor MG-63 cells by triggering apoptosis and indicates MG-63 induced by As2O3 cell apoptosis may through the IEX-1 pathway.

Objective To investigate the migratory, metabolic and proliferative ability of rabbit fibrochondrocytes in meniscal fragments of different sizes under an in vivo subcutaneous environment. Methods Adult, male, New Zealand white rabbit menisci were harvested and the inner two-thirds of each were minced into different sizes: 0.5 × 0.5 × 0.5 mm (group A); 1.0 × 1.0 × 1.0 mm (group B); 2.0 × 2.0 × 2.0 mm (group C). Meniscal fragments were packed into a fascia sheath, then implanted subcutaneously. At weeks 1, 2 and 3 postimplantation, meniscal fragments were harvested; cell migration and viability were then evaluated by confocal laser scanning microscopy and haematoxylin and eosin staining. Aggrecan was detected using Safranin O and Fast Green staining, and protein levels of types I and II collagen, and proliferating cell nuclear antigen (PCNA), were evaluated by immunohistochemistry. Results Protein levels of types I and II collagen and PCNA, and fibrochondrocyte migration, were highest in group A compared with groups B and C, but aggrecan staining remained the same across the groups. Conclusion There was an inverse relationship between the migratory, metabolic and proliferative abilities of rabbit fibrochondrocytes and meniscal fragment size.

Original and nonthermal plasma treated particulate matters (PM) samples of a diesel were obtained and characterized by Raman spectroscopy. A five-bands model was adopted for Raman spectrum curve fitting. As parameters involving most information about carbon structure, variation of FWHM of D1 band and D3 relative intensity were analyzed. It was found that original PM presented higher graphical structural order and lower chemical heterogeneity with the increase in the diesel load. After the treatment of NTP, the graphical structural order and chemical heterogeneity of PM kept at a relative stable level, affected very slightly by diesel load. Meanwhile, the amount of molecular carbon in PM increased. Further study for relation between structural evolution and chemical reactivity of PM with chemical kinetics would make Raman spectroscopy of great promise to become an important method for PM characterization, which could provide basis for more effective removal.

The experimental system of NO conversion in N2/NO mixtures by non-thermal plasma (NTP) based on spectroscopy diagnosis was established. The NO chemical mechanism was analyzed by combining with emission spectroscopy diagnosis of dielectric barrier discharge (DBD). The impact of NTP system operating parameters and N2 volume flow rate on NO conversion rate was also studied. The ratio between N2 emission spectral intensity and NO emission spectral intensity and the spectral intensity of N2 second positive bands increase as applied voltage rises, which indicates increasing concentration of high-energy electrons in the discharge gap. As a result, more N2 molecules are dissociated into N atoms which promote the reduction of NO. With the increasing of N2 volume flow rate, the conversion rate of NO reduces and the concentration of NO2 increases.

Ahead of Print article withdrawn by publisher.

With the increasing advocacy for total disc replacement (TDR) as a potential alternative to fusion in the management of lumbar degenerative disc disease, intradiscal pressures (IDPs) and facet joint stresses at the adjacent levels of spine have generated considerable interest. The purpose of this study was to compare adjacent-level IDPs and facet joint stresses among TDR, discectomy, and fusion.Ten fresh human cadaveric lumbar specimens (L2-S1) were subjected to an unconstrained load in axial torsion, lateral bending, flexion, and extension by using multidirectional flexibility test. Four surgical treatment modes-control (disc intact), discectomy, TDR, and fusion-were tested in sequential order at L4-5. During testing, the IDPs and facet forces following each treatment were calculated at the adjacent vertebral levels (L3-4 and L5-S1).Intradiscal pressures and facet force pressures were similar between the intact condition and the TDR reconstruction at the L3-4 and L5-S1 levels under all loading conditions (p0.05). Compared with the intact and TDR groups, the discectomy and fusion groups had higher IDPs at the L3-4 and L5-S1 levels under all loading conditions (p0.05). No significant difference in the facet force pressure was noted among the intact, discectomy, and TDR groups at the L3-4 and L5-S1 levels under any loading conditions (p0.05). However, the facet force pressure produced for fusion was significantly higher than the mean values obtained for the intact, discectomy, and TDR groups at the L3-4 and L5-S1 levels under all loading conditions (p0.05).Lumbar TDR maintained adjacent-level IDPs and facet force pressures near the values for intact spines, whereas adjacent-level IDPs tended to increase after discectomy or fusion and facet forces tended to increase after fusion.

The goal of this study was to evaluate the array of causative organisms for septic arthritis in children and their antibiotic resistance patterns over a 20-year period at a single medical center. The medical records of children younger than 16 years with septic arthritis admitted to a hospital in China from 1989 to 2008 were retrospectively reviewed. A total of 158 cases of septic arthritis were studied, 70 from 1989 to 1998 and 88 from 1999 to 2008. Between the first and second decades, occurrence of serious illnesses decreased significantly from 44.3% to 28.4% ( P Staphylococcus aureus (MRSA) increasing significantly. Staphylococci remained the major causative organisms for joint infection. The percentage of Staphylococcus aureus resistance to various antibiotics increased: 85% to 100% for penicillin, 58.8% to 75% for erythromycin, 0% to 31.3% for cefazolin, and 15% to 29.4% for multi-resistance. In the second decade, 4 MRSA stains were multi-resistant. However, gentamincin resistance remained at the same level. Antibiotic resistance of coagulase-negative staphylococci and gram-negative bacilli changed little. The incidences of osteomyelitis and joint dislocation decreased significantly, from 15.7% to 6% and 28.6% to 14.8%, respectively ( P

The objective of this study was to investigate in vivo effects of lipoic acid (LA) in preventing steroid-induced osteonecrosis and the possible pathway in a rabbit model. Sixty rabbits were divided into 2 groups: rabbits were intraperitoneally injected with LA aqueous solution at 36 mg/kg of body weight per day for 4 weeks in Group A and rabbits were injected with physiologic saline (PS) as a control in Group B. At 2 weeks after starting treatment, they were intramuscularly injected once with 20 mg/kg of methylprednisolone acetate (MPSL). The femora were histopathologically examined for the presence of osteonecrosis. The plasma levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glutathione (GSH), endothelin (ET) and malondialdehyde (MDA) were assayed at 2 weeks after the injection of MPSL. The incidence of osteonecrosis was significantly higher in Group B (73.1%) than in Group A (20.8%). The GSH level was higher in Group A than in Group B after the LA injection. The plasma MDA and ET levels were lower in Group A than in Group B at 2 weeks after the MPSL administration. Lipoic acid can prevent the development of steroid-induced osteonecrosis in rabbits. Inhibited oxidative stress and amendment of vascular endothelial dysfunction is a possible mechanism for this effect.

To explore the feasibility of directionally inducing human adipose-derived mesenchymal stem cells (hAD-MSCs) towards inner ear hair cells.Mesenchymal stem cells from human adipose tissue were isolated, purified and cultured in vitro. hAD-MSCs were induced to neural stem/progenitor-like cell, and then co-cultured with embryonic chick otic vesicle cells. Processed hAD-MSCs were tested by immunostaining to ascertain whether they expressed characteristic hair cell markers.Morphologically, hAD-MSCs were induced to differentiate into neural stem/progenitor cells and expressed specific neural markers. After being co-cultured with embryonic chick otic vesicle cells, hAD-MSCs expressed specific surface markers of inner ear hair cells.hAD-MSCs can be directionally induced to differentiate towards hair cell-like cells in vitro.

To develop a new internal fixation device and the matching tools for subtrochanteric fracture, investigate the biomechanical features thereof, and compare its effects with those of other instruments.A new internal fixation device, static three dimensional screw-plate system: (STDSP) was developed based on the anatomical parameters and the biomechanical characteristics of proximal femur and combined with the biomechanical advantages of the model of three-dimensional plate and multiple-screws plate fixation. Sixteen paired cadaveric adult femurs were randomly divided into 2 equal groups: fracture healing group undergoing insertion of implant and then taking out thereof with a nail left, and fracture group with a trapezoid defect to mimic subtrochanteric fracture 4 of which were fixed with dynamic hip screw (DHS) and STDSP or Gamma nail and STDSP. All the specimens underwent A-P position four point bending test, axial compression test, torsion test, and destroyable test.(1) In the fracture group, A-P position four point bending test showed that the stretch displacement of STDSP group was (0.221 +/- 0.089) mm, significantly smaller than that of the Gamma nails group [(0.506 +/- 0.086) mm, t = 38.278 P = 0.000]; Axial compression test showed that the inferior displacement of the STDSP group was (2.804 +/- 0.585) mm, significantly larger than that of the Gamma nail group [(1.874 +/- 0.549) mm, t = -5.454, P = 0.012]; Torsion test showed that the torque values at 50 and 100 of the STDSP group were (3.78 +/- 0.84) J and (2.3 +/- 1.08) J, both significantly larger than those of the Gamma nail groups [(2.3 +/- 1.08) J and (4.35 +/- 1.81) J, t = -4.729 P = 0.018, and t = -3.227 P = 0.048] and those of the DHS group [(7.3 +/- 1.273) J and (4.325 +/- 0.88) J respectively, t = -3.242 P = 0.048]; and torsion destroyable test showed that the torque values at 200 of the STDSP group was (21.88 +/- 2.51) J, significantly larger than those of the Gamma nail and DHS groups, [(14.36 +/- 5.01) J and (15.475 +/- 1.924) J and (12.075 +/- 1.179) J, t = -3.323 P = 0.048, t = - 3.732 P = 0.034]. (2) In the fracture healing specimens, A-P position four point bending test showed that the radial degree displacement of the STDSP group was (1. 050 +/- 0.316) mm, significantly smaller than that of the DHS group [(1.261 +/- 0.364) mm, t = 3.4 P = 0.042].More capable of resisting bending than DHS and less capable of resisting axial compression, STDSP is an excellent internal fixator with good biomechanical feature in treating subtrochanteric femoral fracture.

To analyze the expressional variability of IMP3 between osteosarcoma and osteochondroma and explore its clinical significance.Paraffin sections from 68 patients with osteosarcoma and 20 patients with osteochondroma were examined for the expression of IMP3 by SP immunohistochemistry.The negative, weak positive, moderate positive and strong positive expression rates of IMP3 in 68 patients with osteosarcoma were 4.41% (3/68), 22.06% (15/68), 22.74% (19/68), 45.59% (31/68), respectively, which were significantly higher than those in 20 cases of osteochondroma tissues (P0.01). The positive expression of IMP3 in osteosarcoma was negative correlation with the 3-year survival rate of osteosarcoma patients after the operation (P0.01).The results suggest that IMP3 plays important roles in the tumorigenesis, progress and prognosis of osteosarcoma, and the expression of IMP3 may be an important feature of osteosarcoma.

To evaluate the influence of perioperative nutritional support on nutritional status of patients with thoracolumbar spinal tuberculosis.Forty-eight patients with thoracolumbar spinal tuberculosis (male 25 and female 23, aged from 35 to 60 years, with an average of 48.25 years) were randomized into two groups. Twenty-four patients nutritional support were increased intravenously for 14 days (7 days before and after operation) in experimental group. Twenty-four patients in control group were supplied with routine diet. The body weight, plasma concentrations of albumin and ESR were detected on the 7th day before operation and on the 7th day after operation. The total wound drainage was recorded and compared.Body weight and plasma concentrations of albumin on the 7th day after operation and those on the 7th day before operation were not significantly different in experimental group (P0.05). In control group, body weight and plasma concentrations of albumin on the 7th day after operation was lower than those on the 7th day before operation (P0.05). The total wound drainage of experimental group was less than that of control group (P0.05). ESR on the 7th day after operation was lower than that on the 7th day before operation in two groups (P0.05); but the decrease of ESR in experimental group was more than that in control group (P0.05).Nutritional support is beneficial to alleviating innutrition caused by tubercle bacillus and operation. It can promote the effects of operation and anti-tuberculotic drugs.

To evaluate the mechanical properties of artificial lumbar intervertebral disc by finite-element (FE) analysis, to predict the mechanical influence of loading on the prosthesis after placement, especially after the long-term employment,and to offer the mechanical basis and technological means for the design optimization.A 3-dimensional solid model was built according to the geometry of the prosthesis; finite-element analysis was applied to determine the effect of the implanted artificial disc prosthesis on the biomechanical behavior; and the data of its mechanical responses were calculated in 3 compression modes which simulated its different load conditions in vivo. Simulations were conducted in a new specially designed manner, preferably simulated load conditions in vivo.A finite-element model was established by generating mesh out of the prosthesis geometry. The analysis was conducted in employing models of the disc prosthesis under 3 types of emulational realism loading conditions, obtaining the distributing characteristics and data of displacement-stress-strain-energy in the structure, which are difficult to measure exactly by conventional methods.Implanted loading strongly influences prosthesis in its internal distribution of displacement-stress-strain-energy in the structure, suggesting that the disc prosthesis allows correctly reproducing a profitable motion and cushion at the implanted level. Predictive wear may occur in special parts according to the designed prosthesis mechanical structure. When implanting an artificial disc, proper size should be taken in choosing disc and the higher core could provide better mechanical characteristics. The Results may assist in optimizing artificial lumbar disc replacement primarily from a biomechanical point of view.

To design and manufacture a new type instrument and its matching tools for the proximal femur.A new type instrument of subtrochanterical fracture-static 3-dimensional screw-plate system(STDSP)was designed and manufactured. The different types of accessory instruments which adapted to STDSP,the aiming guide, and the accessory tools were also designed and manufactured, and they were tested on bones.STDSP included 3 special lag screws and 1 anatomic plate. The lag screws distributed in femoral neck like "or"shape. There was 135 degree between the lag screws and femoral shaft. The shape of the plate was similar to the anatomic structure of the proximal thighbone. The posterior screw was stably connected to the plate. The plate was affixed crosswise to the lateral and anterior side by bicortical screws. The aiming guides and all kinds of accessory tools could help to install STDSP exactly and conveniently,which was verified on cadavers and X-ray photographs.STDSP has the function of dynamic compressing in 3-dimensional space, and can match with the structure of the proximal femur preferably. STDSP may be a suitable instrument to the subtrochanteric fractures. The accessory apparatus of STDSP has simple configuration,and can let the STDSP be installed accurately, conveniently and rapidly.

To evaluate the operative method and the clinical efficacy of volar Barton's fracture treated by internal fixation with T type titanium plate.We performed the operation of the open reduction and internal fixation with T type titanium plate in 18 patients with volar Barton's fracture.The 18 patients were followed up after the operation at the average time of 13 months (6 to 31 months). X radiographs showed that all patients achieved solid bone union. Mehara's evaluation for volar Barton's fracture revealed excellent outcome in 12 patients, good in 5 patients, and fair in 1 patients. The excellent and good rate of clinical results was 94.4%. X-radiographs showed that the volar tilting angle was 8-18 (mean=11.0) degree, and the ulnar inclining angle was 16-26 (mean=22.4) degree. There was no shortening of the radius.The operative treatment with titanium T type plate fixation for volar Barton's fracture is in favor of fracture anatomic reduction, solid internal fixation, and catagmatic concrescence. It is beneficial for functional recovery of the wrist at the utmost. The outcome in the near future is satisfactory. It is an ideal method for volar Barton's fracture.

To analyze the relation between the clinical outcome and the integrity of the facets after a lumbar operation,and to provide a reference for choosing operative method and clinical prognosis.Forty-three patients with complete data underwent uni-segment discectomy were enrolled. There were 3 surgical interventions: open-window discectomy, full or semi-laminectomy. Groups were divided based on the integrity of the facets after the operation, and the clinical symptoms and signs were evaluated using the Japanese Orthopaedic Association Back (JOA) scores at 24-month follow-up.Preoperative JOA scores were not significantly different among the groups (P0.05). Compared with the facet intact group at 24-month follow-up,JOA scores were descended statistically in total uni-facetectomy group and total uni-facetectomy plus partial opposite facetectomy group (P0.01).Keeping facets integrated plays an important role in achieving good clinical results,and the damage of facet should be avoided in the lumbar operation.

To detect the mutations of EXT2 gene in hereditary multiple exostoses (HME) families and to investigate the sensitivity of denaturant gradient gel electrophoresis (DGGE) in screening the mutations in EXT2 gene.Five HME families and 3 sporadic patients were screened for the mutation detection in all exons of EXT2 gene covering the coding sequence and the flanking intronic sequence by DGGE, and DNA sequencing was performed for products with abnormal conformation.Among these HME patients, we found 2 disease-causing mutations: A313T (nonsense mutation) and 319 insGT (frameshift mutation).Two mutations of EXT2 gene are identified in the sample. DGGE can be an ideal choice for gene diagnoses of HME.

To construct the recombinant baculovirus Ac-cytomegalovirus (CMV)-hSox9 for gene therapy of intervertebral disc degeneration.Bac-to-Bac system was used for the construction of baculovirus Ac-CMV-hSox9. The cDNA of hSox9 was first cloned into a plasmid vector under the control of CMV promotor to generate the donor plasmid pFastBacDuljgreen fluorescene protein (GFP)-CMV (pFGC)-hSox9. The resultant plasmid was transformed into DH10Bac cells and then the transformation mixture was spread on Luria-Bertani (LB) agarose culture medium containing isopropyl-beta-D-thiogalactoside (IPTG), X-gal, gentamicin, kanamycin and tetracycline. The white colonies were selected and cultured for amplification, and the hSox9Bacmid DNA was extracted. After verification, recombinant baculovirus Ac-CMV-hSox9 was obtained through transfecting Sf 21 cells. The expression of hSox9 gene in the intervertebral disc cells in rabbits was determined by Western blotting and immunohistochemical staining.Polymerase chain reaction (PCR) confirmed the presence of hSox9 gene in the recombinant baculovirus and the Sf 21 cells transfected by the baculovirus showed the expression of fluorescence protein. Western blotting and immunohistochemical staining analysis indicated that exogenous hSox9 gene was expressed in the disc cells.The successful construction of the recombinant baculovirus Ac-CMV-hSox9 and the confirmation of the target gene expression provides a novel expression vector system for basic research and clinical treatment of intervertebral degenerative disc disease.

To explore the results of repairing widespread defects of traumatic soft tissue in heel by microvascular anastomotic anterolateral thigh flaps.Twenty-six consecutive free anterolateral thigh flaps in 26 patients were transplanted for repairing widespread defects of traumatic soft tissue in heel from October 1997 to March 2005, suturing the descending branch of the lateral circumflex femoral vascular and posterior tibial vascular to reconstruct the blood supply of transplanted flaps, repairing lateral femoral cutaneous nerve to recover their sensation, fixing tensor fasciae in the calcaneum to add their stabilization.All flaps survived completely,the wounds healed in the initial treatment, follow up 3 to 48 months, twenty-six cases achieved partial sensation, good contour and stabilization.The anterolateral thigh flap is an ideal flap for repairing widespread defects of traumatic soft tissue in heel, because it has such advantages as adequate blood supply, big dermatosis area and covert donor site, furthermore, nervi cutaneous femoris lateralis and tensor fasciae offer the good sensation and adequate stabilization.

To detect the changes of mitochondrion DNA (mtDNA) sequence in articular chondrocytes of cartilage affected by osteoarthritis and to clarified the pathogenetic mechanism of osteoarthritis.We analyzed the mtDNA 4,977 bp deletion mutations of articular chondrocytes in 10 patients with osteoarthritis and 3 normal cartilages using the gap-PCR amplification method. We designed a two round PCR detection method, in which total DNA was isolated from articular chondrocytes as the template of the first round PCR reaction and products from the first round were the template in the second round reaction.The results of the first rounds of PCR reaction showed the mtDNA 524 bp amplified products in the osteoarthritis group and in the corresponding peripheral blood samples were not detected, but the 533 bp products were detected. However,the results of the second round reaction revealed that the 524 bp zones were detected in 2 of the 10 osteoarthritis patients and the corresponding peripheral blood samples were not detected. The 533 bp products were detected in all specimens. The mtDNA 524 bp amplified products in all the normal articular chondrocytes and the corresponding peripheral white blood cells contrast were not detected in both rounds PCR.This was the first study to evaluate the mtDNA 4799 bp large fragment deletion mutational accumulation between nt8,470 - nt13,447 of articular chondrocytes in osteoarthritic cartilage. Osteoarthritis may be related to mtDNA mutation of articular chondrocytes.

To determine the influence of artificial disc replacement on the stability of lumbar.Ten fresh human cadaveric lumbar spine specimens (9 males, 1 female) were tested. The donors had a mean age of 29.3 years old. The segments were fixed on a special testing device mounted in a universal testing machine. Physiological load with a maximum of 10 Nm was applied in the flexion, extension, right and left side bending. Moments were applied in 6 load steps: 0, 2, 4, 6, 8, and 10 Nm. Linearity migration and angle migration were recorded,and the mean flexibility coefficients were calculated. Four procedures of measurement were performed in every specimen: intact segments, segments after discectomy, segments after the artificial disc replacement, and segments after the artificial disc replacement with cutting posterior longitudinal ligament locally.The indexes we calculated of the segments after the discectomy were statistically different compared with the intact segments (P0.05, P0.01). The linearity migration,angle migration and mean flexibility coefficient in flexion/extension direction of the segments after the artificial disc replacement were statistically different compared with the segments after the discectomy (P0.05, P0.01), and there was a statistically significant increase in angle migration and mean flexibility coefficient in the extension direction compared with the intact situation (P0.05). There was no statistically significant difference in 4 directions between the segments after the artificial disc replacement and the segments after the artificial disc replacement with cutting posterior longitudinal ligament locally (P0.05).Artificial intervertebral disc replacement could keep the stability of the lumbar functional spine unit. There was no harmful effect of cutting posterior longitudinal ligament locally on the stability of lumbar while performing artificial intervertebral disc replacement when it is necessary.

To evaluate the curative effects of AO clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle.We retrospectively analyzed the clinical data of 39 patients with acromioclavicular joint dislocation or distal clavicle fractures treated with clavicular hook plate: 16 suffered from dislocation of acromioclaviculr joint, 18 suffered from far end collarbone fractures, and 5 patients had both symptoms.The 39 patients were followed up for 12 months averagely. All patients got good reduction and fixation. The acromioclavicular joint subluxation, breakage, and loosening of the clavicular hook plate were not observed. The acromioclavicular joint recovered quickly.AO clavicular hook plate is a good choice for acromioclavicular joint dislocation and distal clavicular fracture.

To explore the curative effect of surgical treatment for lumbar discogenic low back pain.Forty-two patients with lumbar discogenic low back pain were treated with disc excision and lumbar interbody fusion: 12 of them were treated with posterior lumbar interbody fusion (PLIF), 30 with afront lumbar interbody fusion (ALIF). The clinical results were evaluated by pre- and post-operative visual analogue scale (VAS), and the fusion rates of the lumbosacral spine were evaluated by X-ray.The average follow-up period was 18 months, ranging from 6 to 36 months. Low back pain basically disappeared in 11 patients treated with PLIF, with mild back pain in one patient; VAS after the operation decreased significantly in comparison with that preoperatively (P0.01). Low back pain basically disappeared in 28 patients treated with ALIF; VAS after the operation decreased significantly in comparison with that preoperatively (P0.01). The fusion rate was 90% in patients treated with PLIF, and 93% in patients with ALIF.Disc excision and interbody fusion is effective in the treatment of lumbar discogenic low back pain, but the operation indications should be paid attention to.

To retrospectively explore the diagnosis and treatment of postoperative lumbar intervertebral disc infection.Twelve patients who suffered from postoperative lumbar intervertebral disc infection between April 1995 and September 2004 were confirmed doubtlessly by the diagnosis. They were treated with early immobilization combined with early and sufficient antibiotics and adequate corticosteroid. Patients with severe symptoms were managed by percutaneous puncture and washing discectomy such as rising temperature and perivertebral muscle spasm besides nostalgia, and early debridement of all necrotic tissue was done.Six were healed by non-operation and operation in the other 6. All had gotten locomotion with corset after the operation for 6-8 weeks and were followed-up from 6 months to 3 years. They have achieved excellent outcomes.When a postoperative disc space infection occurs, early diagnosis and treatment should be undertaken to achieve excellent outcomes.

To research the biomechanic property of 4 tendon grafts.The biomechanic properties of profound hypothermua froze tendon allogeneic grafts, profound hypothermua froze and dried allogeneic tendon grafts, autologous tendon grafts and allogeneic tendon grafts without intervention were tested.The biomechanic property of allogeneic tendon grafts with profound hypothermua freezing and profound hypothermua freezing and dying was better than that of allogeneic tendon grafts without intervention (P0.05). No significant difference was seen between the former 2 grafts and dried autologous tendon grafts (P0.05).Allogeneic tendon grafts with profound hypothermua freezing and profound hypothermua freezing and drying, have the same biomechanic property as dried autologous tendon grafts and can be used in clinical practice.

To evaluate the clinical outcome of ZEPHIR plate in treating cervical spondylotic myelopathy(CSM).We retrospectively analyzed 18 patients undergoing anterior decompression fusion and internal fixation with ZEPHIR plate. Follow-up period ranged from 3 to 12 months (an average of 9 months). The bone graft fusion rate, rehabilitation of neurological deficits, and the complications of the hardware were observed. We assessed the clinical effect with JOA score.Rehabilitation of neurological deficits were observed in 16 patients, The JOA score after the operation significantly increased than before the operation. The fusion rate was 100%, the intervertebral height were maintained, and no complications related to the plate were found.ZEPHIR plate in the treatment of cervical spondylotic myelopathy may increase the fusion rate of the bone graft significantly with low incidence of complication.

To determine the effect of ligustrazine on the expression of Bcl-2 protein and apoptosis in rabbit articular chondrocytes in monolayer culture.We separated chondrocytes from the rabbit articular cartilage and cultured them in vitro. We divided them into 2 groups. One group was added the injective ligustrazine hydrochloride(LH), and the other was added the same quantity of culture medium as the comparison. The expression of Bcl-2 in every group was examined with immunohistocytochemistry technique, and the apoptosis was observed with TUNEL.The two groups both expressed Bcl-2 protein, but the expression in the LH group was significantly higher than that in the comparison group (P0.01). The two groups both had apoptosis, the rate of which in the LH group was significantly lower than that in the comparison group (P0.01).Ligustrazine may repair the cartilaginous lesion.

To discuss the clinical properties, operative results of thoracic spinal stenosis and factors correlating with prognosis.From September 1992 to January 2001, 16 patients who suffered from thoracic spinal stenosis caused by degeneration, ossified ligamentum flavum, diffuse idiopathic hyperostosis and trauma, were decompressed by operation. The operative method was selected according to the compressed position of spinal cord. All patients were followed up 6 months to 9 years. The pain severity, ambulatory status and paraplegia index were compared between before operation and after operation. The correlation between prognosis and ages, the length of stenosis and the duration of disease was studied.The results of Wilcoxon Signed Ranks Test show significant difference in pain severity, ambulatory status and paraplegia index between before operation and after operation (P0.01). The results of partial correlation analyzing show that only the duration of disease was correlated with paraplegia index (P0.05).Thoracic spinal stenosis frequently develops in the lower-thoracic segments in middle and old aged men. Decompression by operation early can achieve a good clinical result. Duration of disease affects the prognosis.

To study the apoptotic effect of arsenic trioxide(As2 O3) on human ostrosarcoma MG-63 cells.The MTT reduction test, transmission electron microscopy and agarose gel electrophoresis were applied to observe the apoptotic changes of human osteosarcoma line MG-63 induced by As2 O3.Typical apoptotic cellular changes were found after As2 O3 treatment. Transmission electron miroscopy showed that nucleolus disappeared and chromatin condensed under the nucleonic membrane. Agarose gel electrophorsis showed a "ladder" strand of DNA, a special phenomenon of cellular apoptosis. The above-mentioned changes were not found in the control group.As2 O3 can induce apoptosis of human osteosarcoma MG-63 cells. Further studies are to be carried out on its mechanism.

To observe the effect of nicotine on the secretion of TNF of human peripheral blood mononuclear cells (PBMC) in vitro, and explore the possible mechanism of the high level of TNF caused by smoking.Twenty-one non-smokers and 19 smokers were studied. The PBMCs isolated from each volunteer's blood sample were distributed to three groups, and cultured for 72 hours in supplemented RMPI 1640 alone or in supplemented RPMI 1640 containing 50 ng.ml-1 nicotine or 500 ng.ml-1 nicotine respectively. The level of TNF in supernate was quantified with the immuno-radioassay, and PBMC proliferation was observed.The level of TNF spontaneously secreted by PBMCs in smokers was significantly higher than that in non-smokers (P0.05). When the concentrations of nicotine were 50 ng.ml-1 and 500 ng.ml-1, the level of TNF increased significantly in non-smokers (P0.05, P0.01). In smokers, the level of TNF significantly increased when the concentration of nicotine was 50 ng.ml-1; however, the level of TNF significantly decreased (P0.05), and the proliferation of PBMCs was inhibited when the concentration of nicotine was 500 ng.ml-1 (P0.05, P0.05). The level of TNF was positively correlated to the multiple of PBMC proliferation (r = 0.93, P0.05). The linear regression equation was Y = 2.913X - 2.955.Nicotine can induce PBMCs to secrete more TNF, and the magnitude of the effect is strongly related to the dosage of nicotine, but a great dose of nicotine will inhibit the production of TNF.

Dear Sir, We read with interest the article entitled "Posterior wall reconstruction using iliac crest strut graft in severely comminuted posterior acetabular wall fracture" [6]. In the study, the authors used iliac crest strut graft for reconstruction of the comminuted posterior acetabular wall fracture. A series of eight patients were evaluated clinically by Merle d’Aubigne and Postel score and radiologically by Matta score at their final follow-up. The outcome after a mean follow-up of 3.34 years (minimum two years and maximum five years) showed a good-to-excellent result in seven patients (87.5%) clinically and in five patients (62.5%) radiologically [6]. We appreciate the described technique using iliac crest strut graft for reconstruction of the comminuted posterior acetabular wall fracture, and also the medium-term clinical and radiological results of this technique are satisfactory. However, in their discussion, the authors concluded “Iliac crest strut graft can be better compared to a single fragment of posterior acetabulum wall which has lost its soft tissue attachment”; we have doubts about this conclusion. There is consensus that good prognosis is clearly related to anatomical reduction and stable fixation of posterior wall fractures. Only 30% of posterior-wall acetabular fractures involve a single large fragment. The majority are multifragmentary or have areas of impaction, where open reduction is often necessary with elevation of the depressed articular fragments [1]. Whether the fragments have soft-tissue attachments or not was rarely mentioned in published reports. In our experience, although soft-tissue stripping was done extremely carefully intra-operatively, we often found fragments became free after elevation and reduction in severely comminuted posterior acetabular wall fractures. This has also been mentioned by Giannoudis et al. in their report [3]. Using primary severely comminuted fragments, which may be without soft tissue attachment, to reconstruct the posterior wall produced good results for different authors. The following patients were all evaluated clinically by modified Merle d’Aubigne and Postel score and radiologically by Matta score at their final follow-up. Im et al. retrospectively examined 15 patients with a single fragmented or moderately comminuted posterior acetabular wall fracture using screws alone, whereby 14 patients (94%) had a good-to-excellent result clinically after a follow-up period of more than two years [4]. Ebraheim et al. retrospectively studied 32 comminuted posterior acetabular wall fractures combining a spring plate and reconstruction plate to reconstruct the posterior wall; the average follow-up was 43 months (range 24–70 months), and clinical evaluation gave a good-to-excellent result in 24 patients (76%) and radiologically in 23 patients (73%) [2]. Recently, Giannoudis et al. reported a two-level reconstruction technique using subchondral miniscrews for the stabilisation of comminuted posterior wall marginal acetabular fragments before applying lag screws and a buttress plate to the main overlying posterior fragment. The clinical outcome was graded as a good-to-excellent result in 27 patients (93%), and radiological outcome was graded as a good-to-excellent result in 25 patients (86%) at a mean follow-up of 35 months (range 24–90) [3]. No complication in the form of non-union, loss of fixation and absorption of fragments was noticed. As the Spearman correlation between the original and modified Merle d’Aubigne-Postel Score was R = 0.89, it is equivalent to using the two grading systems clinically [5]. From these data, we therefore favour using primary severely comminuted fragments to generate better results. Whether the iliac crest strut graft is better than a single fragment without soft-tissue attachment or not, requires further study. Furthermore in our opinion, to ensure the blood supply of the bone graft, using muscle pedicle bone graft is a reliable and easy technique in the clinical setting. However, in the study of Sen et al., the authors did not mention whether the iliac crest strut graft had a muscle pedicle or not, but Fig. 3b in that article shows a free iliac crest strut graft. In conclusion, only with muscle pedicle iliac crest strut graft application in this study, can we conclude that it is better than a single fragment of posterior acetabulum wall which has lost its soft tissue attachment. The word “definative” in the last paragraph, it should be “definitive”.