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Zhangjiakou, China

Yuan J.-G.,251 Hospital of Chinese PLA | Zhou Z.-L.,Hebei Northern College | Liu Y.-F.,Hebei Northern College | Zhu Z.-A.,Shanghai University
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2010

BACKGROUND: The bone marrow stem cell (MSC) transplant treatment have the obvious superiority to tradition graft treatment for bone nonunion, but how to obtain the concentrated and highly effective bone marrow mesenchymal stem cell, as well as the dose-effect relations to fracture healing need further discussions. OBJECTIVE: To observe the curative effect of bone nonunion by using autologous MSC transplant treatment, and to compare with autologous iliac bone graft. DESIGN, TIME AND SETTING: Randomized controlled analysis was performed from January 1999 to June 2005 in the Affiliated Second Hospital of Hebei Northern College. PARTICIPANTS: The admitting 140 patients with humerus and tibia fracture were divided into 2 groups at random, autologous iliac bone graft group and autologous MSC transplant group, with 70 patients in each group. METHODS: Under aseptic condition, autologous MSC transplant group received puncture through posterior superior iliac spine, extracting bone marrow 10-20 mL from different spots, separating MSC using the density gradient centrifugation method, and counting as 4×109 nucleated cells/mL under the microscope for later use. In the autologous iliac bone graft group, bone fracture end was implanted with the suitable amount of iliac bone, while autologous MSC transplant group with the mixture of decalcified bone matrix and MSC, followed by suture. After the transplantation, external fixation may assist for 4-6 weeks according to the fixed degree of internal fixation. MAIN OUTCOME MEASURES: 1 Bone callus formation and pain conditions in 2 groups at different time points after transplantation. 2 Comparison of bone healing time between 2 groups. ? Adverse events and side effects. RESULTS: According to intention-treatment analysis, experimental adopted 140 patients of humerus and tibia fractures, who all entered the final analysis. 1 Bone callus formation and pain at different time points post-surgery: At 1 month after transplantation, bone callus formation in the fracture end was not obvious in autogenous iliac bone graft group, and could be seen in autologous MSC transplant group, both groups of fractures exhibited tenderness. At 2 months after transplantation, bone callus formation was observed in autogenous iliac bone graft group, fracture tenderness was relieved compared with the previous condition; in autologous MSC transplant group, a large number of bone callus formed, fracture tenderness was not obvious. At 3 months after transplantation, there were a large number of bone callus formations in autogenous iliac bone graft group, with slight fracture tenderness; in the autologous MSC transplant group, continuous bone callus formation appeared, without fracture tenderness. 2 Bone healing time: The average healing time of autologous MSC transplant group was significantly shorter than autogenous iliac bone graft group [(5.5±1.5), (8.0±2.0) months, P < 0.05]. 3 Adverse events and side effects: Except 4 patients had iliac bone pain, all patients during the treatment had no infection and other complications, there were no re-fracture occurred at the follow-up of 8 months. CONCLUSION: The autologous MSC transplant treatment of exhibits a short duration and good effect for bone non-union, has obvious advantages over traditional bone graft.

Wan Y.-x.,Jilin Medical College | Meng X.-y.,251 Hospital of Chinese PLA
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2011

BACKGROUND: Wear particles are the important potential factor leading to periprosthetic osteolysis, but the cause of periprosthetic osteolysis and its development process are still unclear. OBJECTIVE: To analyze the vale of pathological examination in the diagnosis of infection after total joint arthroplasty based on review of pathological sections after total joint arthroplasty. METHODS: The first author searched PubMed and CNKI databases (1990/2008) for articles about loosening bone around the implanted hip prosthesis and relevant pathological changes. RESULTS AND CONCLUSION: The gap between the prosthesis and bone is filled with the interface membrane, and wear particles induce the interface membrane to release inflammatory cytokines leading to loosening prosthesis. To minimize wear debris generation can reduce the release of inflammatory neurotransmitters. The incidence of loosening prosthesis after total joint arthroplasty can be reduced by decreasing the osteolytic changes of the interface membrane.

Zhao Y.-H.,251 Hospital of Chinese PLA | Hu J.-P.,Hebei North University
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2010

BACKGROUND: With wide application of biotechnological substitute materials, pelvic repair and reconstruction develop to a certain degree. Biomaterial patch is a major substitute for repairing injured pelvic fascia tissue, so it is widely used for pelvic reconstruction. OBJECTIVE: To investigate the feasibility, efficacy, and clinical value of biomaterial patch to pelvic reconstruction in the females. METHODS: Articles related to pelvic functional disorder, pelvic reconstruction, and application of patch implant were retrieved from PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and (http://www.wanfangdata. com.cn) with the key words of "reconstruction of whole pelvic floor, mesh, synthetic mesh implants" in both Chinese and English between 1990 and 2008. Duplication studies were excluded. A total of 54 articles were initially retrieved, and 17 ones were included in the final analysis. RESULTS AND CONCLUSION: Pelvic organ prohpse, which was a major symptom of pelvic disorder in the females, caused by defect of pelvic supporting structure, injury, and functional disorder. Traditional operation could not solve fundamental question. At present, substitute materials for pelvic repair and reconstruction mainly include biomaterial patch (self-substitute materials, homogeneity substitute materials, and heterogeneity substitute materials) and artificial patch. All of them could substitute the injured pelvic fascia tissue; therefore, they were major substitute materials of pelvic tissue and widely used for pelvic reconstruction. Patch which was used for pelvic reconstruction realized the recovery of anatomic structure and caused functional recovery, with simple and easy processing. Additionally, patch application did not prolong operative time and cause complication, but induced well tolerance, security and reliability, and remarkable short-term effect on patients. However, the long-term efficacy should be further studied. The modified pelvic reconstruction is clinically valuable for patients with varying prolapsed sites.

Jia W.-D.,251 Hospital of Chinese PLA | Bai G.-Y.,251 Hospital of Chinese PLA | Yang F.,251 Hospital of Chinese PLA | Yang B.-G.,251 Hospital of Chinese PLA | And 4 more authors.
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2010

BACKGROUND: The treatment of upper cervical spine disorders through a posterior pedicle fixation approach have been carried out in some domestic large hospitals, but this surgery is still considered as a difficulty of cervical spine surgery. In order to minimize the risk of surgery, the authors designed a program of individual operations, and combined with self-developed pedicle locating and directing speculum to determine precise intraoperative position of pedicle screws, and no report is found by searching related database in China. OBJECTIVE: To improve the one-time success rate of internal fixation screws, to investigate the biomechanical effect of the implant, to formulate a simple, practical, individual protocol for atlantoaxial pedicle screw-plate system based on related data. METHODS: A total of 31 patients were recruited from Department of Orthopaedics in the 251 Hospital of Chinese PLA, between January 2002 and September 2006. Under the guidance of self-made atlantoaxial locating and directing speculum, the entrance point and angle for screw insertion, as well as screw diameter and length were determined according to the results of X-ray and CT measurement. Atlas pedicle screw was inserted at left (19.93±1.32) mm, and right (19.16±1.3) mm; Atlas pedicle screw insertion angle to inside was left (23.72±2.09)°, and right (23.35±1.91)°; Atlas pedicle screw insertion angle to side of head was (9.00±1.20)°. Axis pedicle screw was inserted at left (13.14±0.82) mm, and right (13.85±0.79) mm; Axis pedicle screw insertion angle to inside was left (24.52±1.26)°, and right (20.42±1.42)°; Axis pedicle screw insertion angle to side of head was (25.00±3.00)°. RESULTS AND CONCLUSION: ?Totally 124 pedicle screws were implanted into 31 patients, and 122 screws were of one-time success. The precision rate was 98.39%. Two screws were secondly inserted because of cutting lateral cortical bone of pedicle for deviation of inward angle. ?Occipital neuralgia was found in 2 cases postoperatively and cured after one month of treatment; screws penetrated atlas left vertebral lateral wall in 2 cases, no spinal or vertebral artery injury was found. ?Radiographs showed that atlas was completely reduced in all patients, and apposition of dentoid process of axis fracture was good. CT films showed the screws a good location to the vertebrarterial spinal cord. ?The follow-up visit was averaged of 10.5 months. Bony fusion was found in all patients. No screw-plate breakage was found. No inflammatory or rejection reactions occurred. ?By JOA scale, there were 16 cases of excellent, 12 cases of good, 2 cases of fine, and 1 case of poor. The excellent and good rate was 90%. It is suggested that the success rate of atlantoaxial pedicle screw-plate implantation can be improved through a biomechanical angle.

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