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Rhizoma drynariae is used commonly in the treatment of osteoporosis and bone nonunion in traditional Chinese medicine. Modern pharmacological research indicates that naringin is the main effective component of rhizoma drynariae, which can induce the expression of the osteogenic marker in the osteoblast cell line. However, no former study has described its effect on bone mesenchymal stem cells (BMSCs). In our experiment, we co-cultured human BMSCs with different concentrations of naringin solution, then the osteogenic differentiation markers and proliferation ability were analyzed. The results indicated that a certain concentration (1–100 μg/ml) of the naringin solution may enhance the proliferation and osteogenic differentiation of human BMSCs. Also, our research explains excellently the anti-osteoporotic and bone nonunion treatment mechanism of rhizoma drynariae, thus contributing to the exploration of osteogenic differentiation agents from Chinese herbs.

A 3-dimensional flow perfusion system has been created in our laboratory to provide continuous and homogeneous nutrient supply inside the critical-size beta-tricalcium phosphate (beta-TCP) scaffold and permit cell proliferation during long-term incubation. The critical-size porous cylindrical scaffold (14 mm in diameter, 30 mm in length) with a central tunnel was impregnated with sheep mesenchymal stem cells. In the flow perfusion group, the hybrid scaffolds were continuously perfused with complete alpha-minimum essential medium via a peristaltic pump for 7, 14, and 28 days. In the static culture group, the hybrid composites were immersed in the medium without perfusion for 14 and 28 days. The daily glucose consumption was much higher in the flow perfusion group than in the static group (p < 0.001). In the flow perfusion group, glucose consumption increased dramatically in the first 14 days, and the increase slowed in the last 14 days. In the static group, the increase occurred only in the first 14 days. Cell viability via MTT colorimetry increased with time, which coincided with the results of glucose consumption. Histological study showed that the cells proliferated through the whole scaffolds under the flow perfusion culture. While under the static culture, the cells survived and proliferated only inside the first to third rows of the macropores under the scaffold surface. The cell quantity increased with time under flow perfusion culture. The results suggest that flow perfusion culture is superior to static culture for mesenchymal stem cell proliferation in the critical-size porous scaffold. This perfusion culture system permits a constant nutrition supply into the center of a large-scale scaffold for at least 4 weeks. Determination of D-glucose in the culture medium is a noninvasive way to survey cell proliferation in this system.

In the present paper, a general review of clinical application of NiTi shape memory alloy in bone implantation, orthodontics and interventional treatment in China is given with some of typical topics introduced in detail.

Mortality rates for patients with gas gangrene from trauma or surgery are as high as 25%, but they increase to 50%-80% for patients injured in natural hazards. Early diagnosis and treatment are essential for these patients.We retrospectively analyzed the clinical characteristics and therapeutic results of 19 patients with gas gangrene of the limbs, who were injured in the May 2008 earthquake in the Wenchuan district of China's Sichuan province and treated in our hospital, to seek how to best diagnose and treat earthquake-induced gas gangrene.Of 226 patients with limbs open injuries sustained during the earthquake, 53 patients underwent smear analysis of wound exudates and gas gangrene was diagnosed in 19 patients. The average elapsed time from injury to arrival at the hospital was 72 hours, from injury to definitive diagnosis was 4.3 days, and from diagnosis to conversion of negative findings on wound smear analysis to positive findings was 12.7 days. Anaerobic cultures were also obtained before wound closure. The average elapsed time from completion of surgery to recovery of normal vital signs was 6.3 days. Of the 19 patients, 16 were treated with open amputation, two with closed amputation, and 1 with successful limb salvage; 18 patients were successfully treated and one died.In earthquakes, rapid, accurate screening and isolation are essential to successful treatment of gas gangrene and helpful in preventing nosocomial diffusion. Early and thorough debridement, open amputation, and active supportive treatment can produce satisfactory therapeutic results.

Thirty-six metatarsal osteotomies using internal fixation of a shape memory metal compression staple for hallux valgus were performed in 21 women with a mean age of 42.3 years (30-66 years). The time for return to light work averaged 19.0 days, and to full work and normal walk 41.2 days after the operation. Twenty patients (35 feet) had complete relief from pain. Only in one foot, the pain was transferred under the second metatarsal head. The appearance of the feet was apparently improved and the width of the forefeet was decreased by a mean of 0.90 cm after the operation. Radiographic analysis of feet showed that all osteotomies united, and the average angle of hallux valgus was improved from 31.2 degrees to 16.3 degrees and the mean intermetatarsal angle from 12.0 degrees to 6.4 degrees. No external fixation of plaster splintage was needed and the distal fragment during healing of the osteotomy was stable. The time of bone healing was shortened and patients were allowed to bear weight at an early time.

Determination of the proper orientation of the knee articular surface is required both for correction of knee malalignment by osteotomy and for correct component alignment in knee arthroplasty. We sought to determine whether the patients' sex and lower extremity alignment (hip-knee-ankle angle) affects proper knee realignment in osteotomy or component alignment in total knee arthroplasty.We examined 199 healthy adult knees with malalignment of5° to determine the mechanical medial distal femoral angle, mechanical medial proximal tibial angle, surgical transepicondylar axis angle, and discrepancies between bone-cut orientations of osteotomy or total knee arthroplasty and the joint line of the distal femoral condyles, posterior femoral condyles and proximal tibial plateaus, using a three-dimensional computed tomography model.The mean mechanical medial distal femoral angle and mean mechanical medial proximal tibial angle were (94.4 ± 1.9)° and (87.6 ± 1.8)° respectively for women and (93.8 ± 2.0)° and (87.1 ± 1.4)° respectively for men. The surgical transepicondylar axis angle was (2.9 ± 1.6)° for women and (3.2 ± 1.7)° for men. Independent of sex, the hip-knee-ankle angle was closely related to the mechanical medial distal femoral angle and mechanical medial proximal tibial angle, but not to the surgical transepicondylar axis angle. A slightly more valgus alignment of the knee and a more valgus angulation of the distal femoral joint line were found in women, whereas a more varus angulation of the proximal tibial joint line was found in men. Sex had the greatest effect on knee joint line orientation when the lower extremity was valgus in alignment.A more valgus femoral joint line can be expected in women and in persons with valgus lower extremity alignment; a more varus tibial joint line can be found in men and in persons with varus lower extremity alignment.

Assessing the radiographic features of knee osteoarthritis (OA), especially joint space narrowing, is important for evaluating disease progression. The purpose of this study was to quantitatively analyze joint space narrowing by measuring 2 new variables: the average joint space width (aJSW) and the articulate angle (AA) on X-ray films, and to evaluate the relationship between the 2 variables, knee function and OA symptoms.Using the web-based radiology viewer (Cedara I-Reach™ 4.1.1), we measured the 2 variables in 50 knees of 41 patients with knee OA participating in the Shanghai OA Study. We also evaluated the Kellgren-Lawrence (K-L) grade, the Western Ontario and McMaster Universities OA Index (WOMAC), and additional questionnaire in OA knees. The study was approved by the ethics committee of Shanghai Ninth People's Hospital (No. 2009 - 28).The aJSW correlated with the K-L grade (r = -0.57, P0.001), kneeling (r = -0.29, P = 0.04), sitting cross-legged on the floor (r = -0.31, P = 0.03), WOMAC pain (r = -0.31, P = 0.03), WOMAC disability (r = -0.35, P = 0.01), pain while squatting (r = -0.37, P = 0.01), and defecating in a squatting position (r = -0.39, P = 0.01). The AA correlated with defecating in a squatting position (r = 0.29, P = 0.05), WOMAC disability (r = 0.30, P = 0.04) and K-L grade (r = 0.44, P = 0.003). The K-L grade also correlated with pain while squatting (r = -0.40, P = 0.005) and defecating in a squatting position (r = -0.34, P = 0.02), WOMAC pain (r = 0.30, P = 0.04), and WOMAC disability (r = 0.30, P = 0.04).The aJSW closely correlated with knee OA symptoms and function scores, and was more sensitive to knee OA related disabilities than K-L grade and the AA. The aJSW could be used as a new variable for knee OA evaluation.

The natural non-spherical incongruent hip joint cartilage surface is normally assumed as spherical in shape, which has been extensively applied in orthopedic clinic, hip joint simulation studies and hip joint prosthesis design. The aim of the study was to investigate the contributions of non-spherical incongruent hip joint cartilage surface to the hip joint contact stress, and to assess the effect of simplified spherical assumption on the predicted contact stress. Based on our previous anatomic studies that the acetabular cartilage surface was demonstrated as rotational ellipsoid in shape, three finite element (FE) models involving the natural hip joint cartilage shape, the hip joint cartilage shape replaced by the rotational ellipsoid and the sphere, respectively, were developed using the computed tomography (CT) image data of healthy volunteers. The FE predictions of contact stress on the replaced hip joint cartilage surface were compared with that on the natural hip joint cartilage surface. The result showed that the non-spherical hip joint cartilage surface contributed to the optimal contact stress magnitude and distribution. The replaced fitting spherical surface led to the increased contact stress of hip joint and the uneven distributed patterns of contact stress, whereas the replaced fitting rotational ellipsoid surface was comparatively more consistent with the natural results than the sphere one. The surface fitting error of the replaced rotational ellipsoid was fewer than that of the replaced sphere. These results indicate that the simplified spherical assumption will lead to misestimating the contact mechanics of hip joint, and the rotational ellipsoid model rather than the sphere model may represent the hip joint contact surface applied in the hip joint simulation study and the hip joint prosthesis design.

Knee osteoarthritis (OA) is a major cause of pain and functional limitation. Short-term Baduanjin () exercise had been testified to be beneficial to the disease. This study conducted an initial assessment of the one-year Baduanjin exercise on knee OA.The recruited patients practiced Baduanjin at the community recreational center. Sessions were held for 30 min five times a week for one year. Knee pain, stiffness, physical disability, general health, knee extensors and flexors strength, and aerobic ability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Medical Outcomes Study Short Form-36 (SF-36), the 6-Minute Walk Test (6-MWT), and the Isokinetic Strength of the Knee Extensors and Flexors (ISKEF). Body mass index (BMI) was also calculated before and after the study period for comparison.Twenty-eight patients signed the informed consent. Six patients withdrew from the trial. Twenty-two patients (29 knees) completed the one-year study. After one-year Baduanjin exercise, WOMAC pain (132.0±69.6 vs. 56.2±67.6, P=0.000), stiffness (64.7±54.8 vs. 22.3±34.6, P=0.000), and physical function subscales (386.1±275.8 vs. 182.0±235.7, P=0.003); SF-36 body pain (45.7±20.0 vs. 57.4±17.9, P=0.005), general health (50.5±20.0 vs. 62.1±16.1, P=0.004), role emotional (64.4±26.1 vs. 73.5±21.3, P=0.047), and health transition (3.3±1.0 vs. 2.6±1.0, P=0.008); BMI (25.0±2.9 vs. 24.4±2.9, P=0.032); 6-MWT (565.7±94.6 vs. 610.5±66.7, P=0.036); and ISKEF Peak Torque (the Knee Extensors: 60.5±25.5 vs. 76.8±31, P=0.000; the Knee Flexors: 29.3±15.9 vs. 37.1±15.8, P=0.001) were significantly improved. No adverse effects resulted from the exercise.It suggested that the long-term Baduanjin could be a feasible and safe exercise option for knee OA.

Synovium-derived stem cells (SDSCs) with higher chondrogenic potential are attracting considerable attention as a cell source for cartilage regeneration. We investigated the effect of bone morphogenetic protein 2 (BMP-2) on transforming growth factor beta3 (TGF-β3)-induced chondrogenesis of SDSCs isolated from human osteoarthritic synovium in a pellet culture system.The clonogenicity, stem cell marker expression and multi-differentiation potential of isolated SDSCs were determined by colony forming unit assay, flow cytometry and specific staining including alizarin red S, Oil red O and alcian blue staining, respectively. SDSCs pellet was cultured in chondrogenic medium with or without TGF-β3 or/and BMP-2. At day 21, the diameter and the weight of the pellets were measured. Chondrogenic differentiation of SDSCs was evaluated by Safranin O staining, immunohistochemical staining of collagen type II, sulfated glycosaminoglycan (sGAG) synthesis and mRNA expression of collagen type II, aggrecan, SOX9, link-protein, collagen type X and BMP receptor II.Cells isolated under the optimized culturing density (10(4)/60 cm(2)) showed clonogenicity and multi-differentiation potential. These cells were positive (99%) for CD44, CD90, CD105 and negative (10%) for CD34 and CD71. SDSCs differentiated to a chondrocytic phenotype in chondrogenic medium containing TGF-β3 with or without BMP-2. Safranin O staining of the extracellular matrix was positive and the expression of collagen type II was detected. Cell pellets treated with TGF-β3 and BMP-2 were larger in diameter and weight, produced more sGAGs, and expressed higher levels of collagen type II and other chondrogenic markers, except COL10A1, than medium with TGF-β3 alone.SDSCs could be isolated from human osteoarthritic synovium. Supplementation with BMP-2 significantly promoted the in vitro TGF-β3-induced chondrogenic differentiation of SDSCs.

The acetabular cartilage is normally represented as a spherical shape in orthopedic clinic and related researches. The aim of the study was to present a new mathematic representation with better fit to the acetabular cartilage surface and to investigate the role of its shape on the hip joint contact stress.

With advance of age, alterations in bone quality, quantity and microarchitecture render osteoporotic trabecular bone become more sensitive to local failure. The aims of the present study were to clarify the extent to which the distribution of tissue-level stresses and strains was affected by structural changes and the extent to which osteoporotic acetabular trabecular bone was damaged at small strains.Using a DAWING 4000A supercomputer, nonlinear micro-finite element (microFE) analyses were performed to calculate the tissue-level strains and stresses for each element in the trabecular bone of one osteoporotic acetabulum at small strains to quantify the tissue-level damage accumulation and mechanical properties.In contour plots of the tissue, maximum principal logarithmic strains, high tissue-level strains, both compressive and tensile, were observed in the osteoporotic trabecular bone at small apparent strains from 0.2% to 0.5% strain. The compressive apparent stress-strain curve showed typical nonlinear behavior and tangent modulus reduction with increasing strains. The microdamage curve suggested that microdamage began at 0.2% apparent strain in the osteoporotic trabecular bone and increased sharply, although very few microfractures occurred. The quartiles of the maximum principal logarithmic strains, minimum principal logarithmic strains and Von Mises stresses increased nonlinearly. For the inter-quartile range of the Von Mises stresses, a leap occurred at small strains ranging from 0.2% to 0.3% while microdamage commenced.Extensive microdamage was primarily responsible for the large loss in apparent mechanical properties that occurred in the trabecular bone of the osteoporotic acetabulum at small strains. With increasing apparent strains, continuous nonlinear increments of tissue-level strains and stresses resulted in microdamage that propagated throughout the specimen with very few microfractures.

To explorer the effectiveness of enriched bone marrow stem cells technique for lumbar fusion.With the randomization and control principles, 2 graft materials [Enrichment bone marrow mesenchymal stem cells hybridized with beta-tri calcium phosphate (composite graft group), autologous iliac crest bone graft (autograft group)] were compared in posterior lumbar fusion procedures. 56 patients with degenerative disc disease, lumbar instability or spinal stenosis, were included. The volume of cells suspension in pre- and post-enrichment and the number of nucleated cells (NCs) were identified. The number of osteoprogenitor cells was estimated by counting the colony-forming units which express alkaline phosphatase (CFUs/ALP+). Then the efficiency of the enrichment was evaluated. Clinical follow-up with roentgenogram and Oswestry scale scores was performed for outcome evaluation.(249 +/- 31) ml bone marrow per patient from bilateral iliac crests was aspirated peri-operatively. About (43 +/- 11) ml enriched bone marrow was collected. The number of NCs was concentrated from (15.9 +/- 3.3) x 10(6)/ml to (44.1 +/- 10.8) x 10(6)/ml, CFUs/ALP+ was significantly increased from (118 +/- 86)/ml to(486 +/- 305)/ml. The follow-up was about (26.3 +/- 7.5) months. There was no significant differences in age, gender, disease and fusion segments between the two groups. The fusion rate was 93.3% and 96.2% for composite graft group and autograft group, respectively (chi2 = 0.2146, P = 0.6432). There was no difference in operation time between the two group (t = 0.5243, P = 0.6022), but blood loss in composite graft group was more than that in autograft group (t = 6.4664, P0.01). Cell salvage for auto-transfusion could transfuse back half of the blood loss during operation. No hematoma or chronic soreness in the bone marrow donor sites of composite graft group occurred, but a little exudation or moderate swelling in the wound happened in 4 cases which disappeared under medical treatment. Meanwhile, 15.4% patients had hematoma in the iliac bone donor site and 26.9% patients had chronic soreness, but no case had wound problem in autograft group. As for Oswestry scale scores, there was no significant difference between the two groups.The enrichment technique of autologous bone marrow stem cells can greatly increase the concentration of MSCs. It is a rapid and safe method used peri-operatively. The composite material of enriched MSCs and porous beta-TCP is a good bone substitute in posterior spinal fusion.

Computer-assisted orthopedic diagnosis and preoperative planning have been recognized as efficient tools to improve the accuracy of clinic diagnosis and surgical procedure. In orthopedic clinic, such practices are heavily relied on the patient-specific medical image data.

The major clinical consequence of osteoporosis in older people is osteoporotic fracture, which is difficult for fixation and poorer prognosis. Quality of life of patients after surgical intervention is largely affected. How the osteoporotic fracture healing differs from those of normal fracture healing or the nature of the characteristics of healing mechanism of osteoporotic fracture and its healing mode, have not been fully understood. In addition, there are no standards available to evaluate the quality of osteoporotic fracture repair, and the present clinical treatment for osteoporotic fracture is generally the same as that used for general traumatic fracture. Our research focused on studying healing mechanism and quality of osteoporotic fracture systemically at cellular, matrix, tissue, and organ levels compared between osteoporotic fracture rats and non-osteoporotic rats. These studies included evaluations of material property, geometrical morphology, microstructure, bone mineral metabolism, bone density, and mechanical strength of callus evaluated at different fracture healing stages. In order to provide above comprehensive information, we employed evaluation technologies, including transmit and polarized microscopy for histomorphometry, dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD), and mechanical testing. In addition, the results of our histological evaluations indicated both endochondral bone formation and intramembrane bone formation in osteoporotic fracture repair, yet endochondral bone formation and its ossification played a major role in the repair process. As compared with normal fracture healing, osteogenesis and endochondral ossification were delayed, whereas hard callus remodeling was accelerated, i.e., a faster bone turnover resulting in more bone resorption and less bone formation. In addition, the collagen fibers in the hard callus appeared loosely disorganized and irregular with regard to the direction of the principal stress. The abnormal change of the organizational constitution, microstructure, bone mineral metabolism, and bone mass in osteoporotic fracture repair could result in the decrease of its mechanical strength.

To determine the operation procedure of total hip arthroplasty (THA) for Crowe type-IV developmental dysplasia of hip and its relationship with nerve injury.A consecutive series of 39 THAs was performed for Crowe type-IV developmental dysplasia of hip in 35 patients (all female). The mean age of the patients at the time of surgery was 46 years (range 36 - 56 years). Thirty-five hips in 31 patients were followed up. The average follow-up period of the whole series was 4 years (range 1 - 8 years). All procedures were carried out through a lateral-posterior approach. In 33 of 35 hips, the cup was inserted in the "true" acetabulum. All the prostheses used were cementless, except for 5 cemented femoral stems in 5 patients. Each patient was evaluated clinically and by radiographs before the operation and during the follow-up period, according to the Harris hip score (HHS).None of the cups and stems were revised for aseptic loosening, dislocation or infection during the follow-up period. The mean preoperative HHS was 43 compared with the postoperative HHS of 87. The mean amount of postoperative leg lengthening was 5 cm (range 4 - 6 cm).The reconstruction of the hip at the level of the "true" acetabulum through a lateral-posterior approach is a safe and effective procedure of THA for Crowe type-IV developmental dysplasia of hip in adults. Acute leg lengthening of less than 6 cm could not cause nerve injury.

To investigate the feasibility of using perfusion culture bioreactor for bone mesenchymal stem cell proliferation in large scale beta-tricalcium phosphate (beta-TCP) scaffold.In the dynamic perfusion culture group, the porous beta-TCP cylindrical scaffolds combined with the sheep mesenchymal stem cells were continuously perfused with the complete alpha-MEM medium by a peristaltic pump for 1, 2 and 4 weeks. While in the static culture group, the hybrid constructs were immersed in the medium without perfusion for 2 and 4 weeks. The cell proliferation and distribution were examined by the daily glucose consumption, the cell viability and undecalcified histological study.The daily glucose consumption increased with time. The increase was much more evident in the first 2 weeks than in the last 2 weeks. The daily glucose consumption was higher in the dynamic culture group than in the static culture group. The cell viability also increased with time. It was higher in the dynamic culture group. In comparison to 2-week culture, the cell viability was significantly higher after 4-week culture in the dynamic culture group (P0.05), while it was not significantly different after 4-week culture in the static culture group (P0.05). Under dynamic perfusion culture, the mesenchymal stem cells survived and proliferated through the scaffolds. However, the mesenchymal stem cells survived and proliferated only in the peripheral pores of the scaffolds under static culture. Histomorphometrical study indicated that there were much more cells in dynamic culture group than in the static group. The cell/pore rate was not significantly different between 2-week static culture and 4-week static culture (P0.05). However, the cell/pore rate was significantly higher after 4-week dynamic culture than after 2-week dynamic culture (P0.05).Perfusion culture permitted the persistent nutrition supply and gas exchange into the centre of large scaffold. This perfusion bioreactor makes the mesenchymal stem cells survive and proliferate through a large three-dimensional scaffold.

To set up three-dimensional reconstruction of acetabulum bone structure from CT scanned image in computer with software of CAD and study quantitatively the morphologic features of the acetabulum.Through the process of CT scanning, and edge recording of the CT image, we made use of CAD software and Unigraphics software to reconstruct the 40 normal acetabulum bones for the radius of acetabulum (R), minimum thickness of medial wall of acetabulum (L), depth of Harris fossa (D) and maximum opening rim width in cross-sectional plane (W).The average R was 30.48 +/- 2.05 mm. The average L was 2.35 +/- 1.13 mm. The average D was 5.71 +/- 1.21 mm. The average W was 63.06 +/- 2.05 mm. There was a linear relationship between the R and the W, but no correlation between the R, the L and the D.There was a significance linear relationship between the R and the W in normal adult acetabulum. However no correlation between the R, the L and the D.

To investigate the effects of bone morphogenetic protein-2 (BMP-2) gene therapy on the bone-implant interface in the reconstruction of periprosthetic bone defect.Transverse defects were caused in the external condylae of both femurs of 14 adult Beagle dogs. Titanium alloy implants were inserted and a bone defect 3 mm wide around the titanium alloy implant was preserved. Then the total 28 defects were divided into 4 groups: 8 bone defects remained untreated (blank control group); 8 bone defects were implanted with heterogeneous freeze-dried bone by impaction grafting technique (non-cell group); 8 bone defects were implanted with heterogeneous freeze-dried bone loaded with autogenous bone marrow stromal cells (BMSCs) from the greater trochanter of the same dog (cell group); and 10 bone defects were implanted with freeze-dried allograft loaded with autogenous BMSCs from the greater trochanter of the same dog which were transfected by Adv-BMP-2 gene (gene group). Three, 6, and 12 weeks after implantation X-ray examination was carried out to observe the place of the implant and the absorption of the implants. Six and 12 weeks after the dogs were killed and their bone defects were taken out to undergo histological, histomorphometric and biomechanical examination to observe the healing and oseeointegration of the bone-implant interface.Histological examination showed that 6 weeks after implantation new bone formation was found on the implant surface and there was point contact between the bone and implant in the gene group with the bone-to-impact contact (BIC) of about 10%; and continuous soft tissue was found at bone-implant interface in all other groups. Twelve weeks after, there was thick soft tissue membrane between the new bone and implant in the blank control group; most of the interface was connective fibrous tissue in the non-cell group and cell group with point contact between the bone and implant and a BIC lower than 10%; and in the gene group the interface consisted mainly of bone tissue and continuous bone-implant contact was found with the BIC of 50%, significantly higher than those of the other 2 groups (both P0.01). The mechanical strength of interface increased time-dependently in all groups, that of the gene group being significantly higher than those of the other 2 groups at any time-points (both P0.01).BMP-2 gene therapy can improve the osseointegration of bone-implant interface.

To evaluate the osteogenic potential of bone morphogenetic protein (BMP)-2 gene transfected goat bone marrow-derived mesenchymal stem cells (MSCs).Goat bone marrow-derived MSCs were transfected by Adv-human bone morphogenetic protein (hBMP)-2 gene (Group 1), Adv-beta gal transfected MSCs (Group 2) and uninfected MSCs (Group 3). Western blot analysis, alkaline phosphatase staining, Von Kossa staining and transmission electron microscopy were adopted to determine the phenotype of MSCs. Then the cells were injected into thigh muscles of the nude mice. Radiographical and histological evaluations were performed at different intervals.Only Adv-hBMP-2 transfected MSCs produced hBMP-2. These cells were positive for alkaline phosphatase staining at the 12th day and were positive for Von Kossa staining at the 16th day after gene transfer. Electron microscopic observation showed that there were more rough endoplasmic reticulum, mitochondria and lysosomes in Adv-hBMP-2 transfected MSCs compared to MSCs of other two groups. At the 3rd and 6th weeks after cell injection, ectopic bones were observed in muscles of nude mice of Group 1. Only fibrous tissue or a little bone was found in other two groups.BMP-2 gene transfected MSCs can differentiate into osteoblasts in vitro and induce bone formation in vivo.

Objective To study the effect of melittin on apoptsis and necrosis of osteosarcoma cell line U2 OS in vitro. Methods Osteosarcoma cell line U2 OS was treated with melittin. The growth and proliferation was observed by MTT assay and cell counting, and the necrosis was estimated by Trypan blue staining. The cell apoptsis, Fas and Apo2. 7 expression were detected by cytometer. Results The data showed that melittin could inhibit the proliferation of U2 OS dose-dependently at 16 and 64 mg/L. Cell apoptsis was detected by cytometer, when the cells were treated by 16 mg/L and 32 mg/L of melittin respectively, and the percentages of Fas and Apo2. 7 positive cells were increased. Conclusion Melittin inhibits the proliferation of osterosarcoma cell line through up-regulating Fas expression and inducing apoptsis.

To clarify the mechanisms of the signal transduction of bone morphogenetic proteins (BMPs) inducing bone formation and to provide theoretical basis for basic and applying research of BMPs.We looked up the literature of the role of Smads and related transcription factors in the signal transduction of BMPs inducing bone formation.The signal transduction processes of BMPs included: 1. BMPs combined with type II and type I receptors; 2. the type I receptor phosphorylated Smads; and 3. Smads entered the cell nucleus, interacted with transcription factors and influenced the transcription of related proteins. Smads could be divided into receptor-regulated Smads (R-Smads: Smad1, Smad2, Smad3, Smad5, Smad8 and Smad9), common-mediator Smad (co-Smad: Smad4), and inhibitory Smads (I-Smads: Smad6 and Smad7). Smad1, Smad5, Smad8, and probable Smad9 were involved in the signal transduction of BMPs. Multiple kinases, such as focal adhesion kinase (FAK), Ras-extracellular signal-regulated kinase (ERK), phosphatidylinositol 3-kinase (PI3K), and Akt serine/threonine kinase were related to Smads signal transduction. Smad1 and Smad5 related with transcription factors included core binding factor A1 (CBFA1), smad-interacting protein 1 (SIP1), ornithine decarboxylase antizyme (OAZ), activating protein-1 (AP-1), xenopus ventralizing homeobox protein-2 (Xvent-2), sandostatin (Ski), antiproliferative proteins (Tob), and homeodomain-containing transcriptian factor-8 (Hoxc-8), et al. CBFA1 could interact with Smad1, Smad2, Smad3, and Smad5, so it was involved in TGF-beta and BMP-2 signal transduction, and played an important role in the bone formation. Cleidocranial dysplasia (CCD) was thought to be caused by heterozygous mutations in CBFA1. The CBFA1 knockout mice showed no osteogenesis and had maturational disturbance of chondrocytes.Smads and related transcription factors, especially Smad1, Smad5, Smad8 and CBFA1, play an important role in the signal transduction of BMPs inducing bone formation.

In order to meet the requirements of customized artificial joint design, and to reduce the production cycle and cost, we present a method to generate the complex surface of an artificial knee joint by co-ordinate measuring machine (CMM) from the normative prosthesis, and form the model data base. First, this paper describes how to plan the measure method to get the better data points and how to deal with the point cloud data. Then, the free-form surfaces are constructed from the point cloud data using the reverse engineering software-Surfacer. Lastly, the solid CAD model of the artificial knee joint is created from the surfaces by extension, intersection and so on. These models formed the data base of the prosthesis, in which we can select a suitable kind of artificial knee joint model to customize for the patient. That is, we only need to change the local data of the corresponding CAD model to meet the different requirements of the patient.

To evaluate the effectiveness of the tissue-engineered bone substitute loaded with adenovirus mediated human bone morphogenetic protein-2 gene (Adv-hBMP-2) transfected bone marrow derived mesenchymal stem cells (BMSC) in the repair of diaphyseal segmental bone defect of large animal.The right tibial bone defects (2.6 cm) model of 26 goats were established and divided into 5 groups: I. Adv-hBMP-2 transfected BMSC/calcined bone (CB) group (n = 9); II. adenovirus-beta-galactosidase (Adv-betagal) gene transfected BMSC/CB group (n = 6); III. untransfected BMSC/CB group (n = 6); IV. single CB group (n = 3); VI. untreated group (n = 2). The above tissue-engineered bone substitutes were implanted in the bone defects respectively except group VI. Roentgenography, histomorphometrical analysis and biomechanical measurement were studied at various times.X-ray: at 4 - 8th weeks after implantation, more bony callus was found in the bone defects of group I. The complete healing rates of group I, II, III, IV, and V were 5/8, 1/5, 0/5, 0/2, 0/1 respectively at 26th week after implantation. Histomorphometrical analysis showed much more new bony callus including cortical bone formed in group I than those of other groups. The compression strength of the implanted bone substitute of group I is significantly higher than those of group II and III.The tissue-engineered bone substitute loaded with human BMP-2 gene transfected BMSC can repair diaphyseal segmental bone defect of large animal (goat).

To determine which organisms most commonly cause infection after natural disasters, we cultured specimens from injured earthquake survivors in Wenchuan, China, 2008. Of 123 cultures, 46 (59%) grew only 1 type of pathogenic bacteria. Smear was more effective than culture for early diagnosis of gas gangrene. Early diagnosis and treatment of wounds are crucial.

Since 1978, 10 intercostal nerve-cauda equina anastomoses and 11 intercostal nerve-lumbar anastomoses were performed for thoracolumbar spinal cord transection. Three to four pairs of intercostal nerves above the traumatic level of the cord were anastomosed with two to four pairs of cauda equina or lumbar nerve roots below the traumatic level, using microsurgical technique. The surgical techniques used for the latter 11 cases were performed through an extraperitoneal approach. The operative technique is described in detail. These 21 cases have been followed-up for six to 48 months. Electromyography (EMG) shows that action potentials are present in several previously paralyzed muscles in 11 cases. Muscle strength of some previously paralyzed muscles in three cases recovered to Grades 1 to 3. There is evidence that intercostal-lumbar-spinal nerve anastomoses provide a chance for neuronal regeneration, but unsatisfactory functional results are still questions for further study.

A new biomaterial made of nickel and titanium with its shape-memory characteristics has been manufactured, investigated, and used in Shanghai, China. Since 1981, this biomaterial has been used in 265 cases clinically, among which 71 involved orthopedic surgery. Results are satisfactory without failure in our short-term follow up. This preliminary report of the use of this new biomaterial with the unique characteristic of being able to recover to its original shape with particular transformation temperatures indicates its potential for opening a new field for investigation in surgery. Research to discover appropriate ratios of nickel and titanium for specific usage is underway. The Interest and cooperation between the medical and engineering professions may eventually solve the problems through mutual efforts and result in improved shape-memory biomaterials.