Repair Segmental Defect of Long Bone

Objective To compare the osteogenetic effects of three methods of repairing long bone defects with nerves implants of autologous mesenchymal stem cells seeded into beta-tricalcium phosphate in a rabbit model in vivo and study the relations between neurotization and osteogenesis. Methods 24 New Zealand rabbits were divided into 4 groups randomly and equally： tissue-engineering group （A）, sensory nerve tract group（B）, motor nerve tract group（C） and vessel tract group（D）. A segmental left femur defect of 1.5 cm long was made in each animal. After plate fixation, the defects were implanted respectively with the engineered bones prepared in 4 ways mentioned above. The implanted nerves were respectively from saphenous nerves and muscular branches of femoral nerves. The implanted blood vessels were femorals. were taken anteroposterior radiographs on the left femur. The At 4, 8 and 12 weeks post-operatively, all animals reparative effects of bone were evaluated according to radiological analysis. Results After implanting of sensory nerve tract or vessel tract into the tissue-engineered bone, the reparative effects were obviously superior to both those of tissue-engineering group and motor nerve tract group; neither osteogenetic difference between group C and group A nor between other groups were found. Conclusion Implantation of sensory nerve tract into tissue-engineered bone can improve osteogenesis, but implantation of the motor nerve tract cannot achieve the same effect according to this exneriment.     

Osteogenic differentiation of bone mesenchymal stem cells regulated by osteoblasts under EMF exposure in a co-culture system

This study examined the osteogenic effect of electromagnetic fields （EMF） under the simulated in vivo conditions. Rat bone marrow mesenchymal stem cells （BMSCs） and rat osteoblasts were co-cultured and exposed to 50 Hz, 1.0 mT EMF for different terms. Unexposed single-cultured BMSCs and osteoblasts were set as controls. Cell proliferation features of single-cultured BMSCs and osteoblasts were studied by using a cell counting kit （CCK-8）. For the co-culture system, cells in each group were randomly chosen for alkaline phosphatase （ALP） staining on the day 7. When EMF exposure lasted for 14 days, dishes in each group were randomly chosen for total RNA extraction and von Kossa staining. The mRNA expression of osteogenic markers was detected by using real-time PCR. Our study showed that short-term EMF exposure （2 h/day） could obviously promote prolifera- tion of BMSCs and osteoblasts, while long-term EMF （8 h/day） could promote osteogenic differen- tiation significantly under co-cultured conditions. Under EMF exposure, osteogenesis-related mRNA expression changed obviously in co-cultured and single-cultured cells. It was noteworthy that most osteogenic indices in osteoblasts were increased markedly after co-culture except Bmp2, which was increased gradually when ceils were exposed to EMF. Compared to other indices, the expression of Bmp2 in BMSCs was increased sharply in both single-cultured and co-cultured groups when they were exposed to EMF. The mRNA expression of Bmp2 in BMSCs was approximately four times higher in 8-h EMF group than that in the unexposed group. Our results suggest that Bmp2-mediated cellular interaction induced by EMF exposure might play an important role in the osteogenic differ- entiation of BMSCs.     

Role of Sclerostin in the Bone Loss of Postmenopausal Chinese Women with Type 2 Diabetes

Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass index, and duration of menopause matched healthy controls were enrolled into this cross-sectional study according to criteria of inclusion and exclusion.     

Influences of IL-6R antibody on PMMA bone cement-mediated expression of OPG and RANKL in synovial fibroblasts

Effect of interleukin-6 receptor （IL-6R） antibody on polymethyl methacrylate （PMMA） bone cement-mediated expression of osteoprotegerin （OPG） and ：receptor activator of nuclear fac- tor-kappaB ligand （RANKL） in synovial fibroblasts was investigated. Synovial tissue obtained from to- tal knee arthroplasty was digested and cultured. Inverted microscope was employed to observe the synovial cells and immunocytochemistry （SABC method） staining was used to identify synovial fibro- blasts. This experiment was divided into three groups according to different culture media： PMMA group （75μg/mL PMMA bone cement particles）, IL-6R antibody group （10 ng/mL IL-6R antibody＋75 μg/mL PMMA bone cement particles）, and control group （no IL-6R antibody or PMMA bone cement particles）. Influence of IL-6R antibody and PMMA on proliferation of synovial fibroblasts was meas- ured by cell counting kit-8 （CCK-8）. ELISA method was used to measure OPG and RANKL levels in culture solution. Fluorescence quantitative real-time PCR （FQ-PCR） was used to detect the expression of OPG and RANKL mRNA. After three consecutive passages, more than 95% of the primary synovial cells became long spindle fibroblast-like cells. SABC staining results showed that the fibroblast-like cells were negative for anti-CD68 antibody and positive for anti-vimentin antibody, with brown madder stained. CCK-8 test demonstrated that the absorbance （A） value at 450 nm was significantly lower in IL-6R antibody group than in PMMA group and control group （P〈0.01）, but there was no statistically significant difference in A value at 450 nm between the control group and PMMA group （P〉0.05）. Re- suits of ELISA indicated that the expression of OPG was significantly higher in IL-6R antibody group than in PMMA group and control group （P〈0.01）. The expression of RANKL was inhibited （P〈0.05）, and the ratio of OPG/RANKL was significantly increased in IL-6R antibody group as compared with PMMA group and control group. There was no significant difference in the expression of OPG between control group and PMMA group （P〉0.05）, but the expression of RANKL was higher in PMMA group than in control group （P〈0.05）, and there was a significant difference in the ratio of OPG/RANKL be- tween them （P〈0.05）. Results of FQ-PCR revealed the expression of RANKL mRNA was significantly inhibited （P〈0.01） and the expression of OPG mRNA was significantly increased （P〈0.01） in IL-6R an- tibody group as compared with PMMA group and control group. The expression of RANKL mRNA was higher in PMMA group than in control group （P〈0.05）, but the expression of OPG mRNA had no sig- nificant difference between them （P〉0.05）. IL-6R antibody could significantly increase the expression of OPC~ but inhibit the expression of RANKL, which might provide a theoretical basis of molecular bi- ology for the prevention and treatment of aseptic loosening of prosthesis.     

肝移植术后噬血细胞综合征

Hemophagocytic syndrome (HPS) is recognized as a disorder characterized by a variety of symptoms including fever,jaundice,skin rash,lymphadenopathy,and hepatosplenomegaly related to uncontrolled systemic T-cell activation.1 Two forms of HPS have been characterized:primary/familial hemophagocytic lymphohistiocytosis and secondary/reactive HPS.Reactive HPS was first described in 1979 by Risdall et al.     

儿童恶性血液肿瘤合并骨髓坏死

1病历摘要 患儿,女性,10岁,因＂双下肢疼痛2个月,反复发热1个月＂于2007-12-04入院。 患儿2个月前无明显诱因出现左小腿疼痛,逐渐进展为双小腿及大腿疼痛,表面无红肿,无皮疹。1个月后出现反复高热,体温38.5℃～39.6℃,高热时双下肢疼痛加剧,尤以左膝关节为甚,不能行走及站立。     

Association of the MTHFR C677T polymorphism and bone mineral density in postmenopausal women：a meta-analysis

Osteoporosis is a condition characterized by low bone mineral density （BMD） and micro-architectural changes in the bone tissue.The risk of osteoporosis is partly determined by genetic factors.The role of C677T polymorphism of methylenetetrahydrofolate reductase （MTHFR） gene has been investigated in postmenopausal osteoporosis.However,the relationship between MTHFR polymorphism and BMD is still controversial.We carried out a meta-analysis of 5,833 subjects to evaluate the association of MTHFR and BMD in postmenopausal women.Databases of MEDLINE,Web of Science,Scopus and CNKI were retrieved for all publications relating to MTHFR polymorphism and BMD in postmenopausal women.Five eligible studies were selected for meta-analysis.All these articles studied the association of MTHFR polymorphism and BMD of the femoral neck and lumbar spine in postmenopausal women.Our analysis suggested that postmenopausal women with the TT genotype had lower femoral neck BMD than the women with the CC/CT genotype,and the weighted mean difference （WMD） was-0.01 g/cm 2 [95% confidence interval （CI）：（-0.01,-0.01）,P 0.01].However,BMD of the lumbar spine of postmenopausal women with the TT genotype was not significantly different from that of women with the CC/CT genotype.In the random effects model,the WMD between the TT and TC/CC genotype was-0.01 g/cm 2 [95% CI：（-0.04,0.01）,P=0.32].The C677T polymorphism of the MTHFR gene is associated with BMD of the femoral neck in postmenopausal women.Women with the TT genotype of the MTHFR gene have lower BMD,suggesting that the TT genotype may be a risk factor for postmenopausal osteoporosis.     

Human adipose-derived mesenchymal stem cells: a better cell source for nervous system regeneration

Background In order to suggest an ideal source of adult stem cells for the treatment of nervous system diseases,MSCs from human adipose tissue and bone marrow were isolated and studied to explore the differences with regard to cell morphology,surface markers,neuronal differentiation capacity,especially the synapse structure formation and the secretion of neurotrophic factors.Methods The neuronal differentiation capacity of human mesenchymal stem cells from adipose tissue （hADSCs） and bone marrow （hBMSCs） was determined based on nissl body and synapse structure formation,and neural factor secretion function.hADSCs and hBMSCs were isolated and differentiated into neuron-like cells with rat brain-conditioned medium,a potentially rich source of neuronal differentiation promoting signals.Specific neuronal proteins and neural factors were detected by immunohistochemistry and enzyme-linked immunosorbent assay analysis,respectively.Results Flow cytometric analysis showed that both cell types had similar phenotypes.Cell growth curves showed that hADSCs proliferated more quickly than hBMSCs.Both kinds of cells were capable of osteogenic and adipogenic differentiation.The morphology of hADSCs and hBMSCs changed during neuronal differentiation and displayed neuronlike cell appearance after 14 days＇ differentiation.Both hADSCs and hBMSCs were able to differentiate into neuron-like cells based on their production of neuron specific proteins including β-tubulin-Ⅲ,neuron-specific enolase （NSE）,nissl bodies,and their ability to secrete brain derived neurotrophic factor （BDNF） and nerve growth factor （NGF）.Assessment of synaptop hysin and growth-associated protein-43 （GAP-43） suggested synapse structure formation in differentiated hADSCs and hBMSCs.Conclusions Our results demonstrate that hADSCs have neuronal differentiation potential similar to hBMSC,but with a higher proliferation capacity than hBMSC.Adipose tissue is abundant,easily available and would be a potential ideal source of adult stem cells for neural-related clinical research and application.     

Malignant transformation of aneurysmal bone cysts: a case report

An aneurysmal bone cyst is a non-neoplastic, .destructive and expansile lesion consisting of a＂blood-filled sponge＂ that is defined to represent a benign reactive vascularity. Szendroi et al suggested that the aneurysmal bone cyst corresponds to a haemodynamic disturbance that is primary or secondary venous malformation of the bones. The association with trauma including fracture has also been noted and 25%-71% of such patients have a history of trauma. Conventionally, malignant transformation of aneurysmal bone cysts is perceived as a rare occurrence except those induced by irradiation. Both malignant fibrous histiocytoma and osteosarcoma have been reported in the malignant transformation cases.     

Relapse of acute lymphoblastic leukemia in the pancreas after allogeneic bone marrow transplantation

The occurrence of metastatic lesions in the pancreas of patients with cancer, including hematological cancers,is uncommon （1.6%-37.5%） and of these, the majority of patients will have widespread disease.1-7 Isolated potentially resectable pancreatic metastases are rarely seen. Resection of metastatic tumors of the pancreas has been reported, but its role in improving survival rates or quality of life is not clear.7,8 However,     

Arterial embolization of primary sacral aneurysmal bone cyst

Aneurysmal bone cyst （ABC） is a rare and benign disease that demonstrates active biological behavior,can promptly expand,and exhibits an invasive or destructive capability.1 Currently,the major therapy for ABC is complete curettage of the lesion.1,2 However,the therapy for sacral ABC has risks such as severe bleeding and nerve root damage.2 Arterial embolization is used to treat large sacral giant cell tumors and ABCs and can promptly relieve pain,reduce lesion volume,and promote osteogenesis.3     

Osteostimulation of bioglass

Bioglass, with the code name 45S5, contains 45% silica, 24.5% CaO, 24.5% Na2O and 6% P2O5 in weight percent. All of these oxides are mixed together and melted at around 1350℃ to form a homogeneous silica network glass.1 Bioglass possesses fast biological response and fast bioactivity, when implanted in living tissue. Since Hench et alI reported over 35 years ago that the bioglass composition could chemically bind to bone,     

Treatment of scaphoid nonunion: Pedicled vascularized bone graft vs. traditional bone graft

The clinical results of the application of pedicled vascularized bone graft （VBG） from Lister＇s tubercle vs. traditional bone graft （TBG） were evaluated and compared. Thirteen cases of symptomatic scaphoid nonunion were treated between January 2011 and December 2012, including 7 cases subject to VBG and the rest 6 cases to TBG, respectively. Outcomes were assessed by modified Mayo wrist score system. All cases were followed up for an average period of 3.5 months after opera- tion. The results showed that total scores in VBG group were 86.4i9.4 after operation with excellent result in 4 cases, good in 2 and acceptable in one, and those in TBG group were 71.7±9.3 after operation with good result in 2 cases, acceptable in 3 and disappointing in one. Total score of wrist function was significantly improved in VBG group as compared with TBG group （P〈0.05）. Our study suggests that VBG method is more effective for treating scaphoid nonunion than TBG method.     

痘苗病毒天坛株的减毒与其作为疫苗载体研究进展

1痘苗病毒天坛株的历史天花是人类历史上最可怕的传染病之一。天花由天花病毒（variola virus）引起,人是该病毒的惟一宿主。人感染天花病毒后的死亡率达到30%~40%[1]。世界上公认的对天花最早的准确记录来自中国,晋代药学家葛洪于公元430年左右,在《肘后备急方》中对天花有清楚的描述[1]。     

Isoniazid-induced rhabdomyolysis in a patient with chronic heart failure: a case report

Rhabdomyolysis is one of the identified uncommon .but potentially lethal complications of isoniazidintoxication, which can be secondary to severe muscle exertion due to generalized seizures or can be caused by direct toxicity of either the drug or one of its metabolites on muscles.1＇2 ^However, as widely used anti-tuberculosis drug in China, isoniazid induced rhabdomyolysis appears to be very rare. To our knowledge, there is no report indicating association between rhabdomyolysis and isoniazid intoxication in Chinese population. We presented herein a case report of isoniazid-induced rhabdomyolysis in a Chinese man with chronic heart failure.     

Saffron （Crocus sativus L.） and major depressive disorder： a meta-analysis of randomized clinical trials

Due to safety concerns and side effects of many antidepressant medications, herbal psychopharmacology research has increased, and herbal remedies are becoming increasingly popular as alternatives to prescribed medications for the treatment of major depressive disorder （MDD）. Of these, accumulating trials reveal positive effects of the spice saffron （Crocus sativus L.） for the treatment of depression. A comprehensive and statistical review of the clinical trials examining the effects of saffron for treatment of MDD is warranted. OBJECTIVE： The purpose of this study was to conduct a meta-analysis of published randomized controlled trials examining the effects of saffron supplementation on symptoms of depression among participants with MDD. SEARCH STRATEGY： We conducted electronic and non-electronic searches to identify all relevant randomized, double-blind controlled trials. Reference lists of all retrieved articles were searched for relevant studies. INCLUSION CRITERIA： The criteria for study selection included the following： （1） adults （aged 18 and older） with symptoms of depression, （2） randomized controlled trial, （3） effects of saffron supplementation on depressive symptoms examined, and （4） study had either a placebo control or antidepressant comparison group. DATA EXTRACTION AND ANALYSIS： Using random effects modeling procedures, we calculated weighted mean effect sizes separately for the saffron supplementation vs placebo control groups, and for the saffron supplementation vs antidepressant groups. The methodological quality of all studies was assessed using the Jadad score. The computer software Comprehensive Meta- analysis 2 was used to analyze the data. RESULTS： Based on our pre-specified criteria, five randomized controlled trials （n = 2 placebo controlled trials, n = 3 antidepressant controlled trials） were included in our review. A large effect size was found for saffron supplementation vs placebo control in treating depressive symptoms （M ES = 1.62, P 〈 0.001）, revealing that saffron supplementation significantly reduced depression symptoms compared to the placebo control. A null effect size was evidenced between saffron supplementation and the antidepressant groups （M ES = -0.15） indicating that both treatments were similarly effective in reducing depression symptoms. The mean Jadad score was 5 indicating high quality of trials. CONCLUSION： Findings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD. Larger clinical trials, conducted by research teams outside of Iran, with long-term follow-ups are needed before firm conclusions can be made regarding saffron＇s efficacy and safety for treating depressive symptoms.     

Chinese infant recovers from bird flu infection

It has been well documented that bone morphogenetic .proteins （BMPs）, a group of proteins belonging to the transforming growth factor-β （TGFβ） superfamily, can induce bone formation, both in vivo and in vitro. Bone morphogenetic protein-2 （BMP2） is a potent osteoinductive factor and is being evaluated as a bone growth inducer for orthopedic applications.1 Vascular endothelial growth factor （VEGF）, the best-characterized angiogenic factor,     

Differentiation of marrow-derived islet-like cells and their effects on diabetic rats

In recent years, islet transplantation for diabetes has shown signs of the treatment efficacy, but its application is limited due to lack of donor organizations, sources and immune rejection. Bone marrow mesenchymal stem cells （BMSCs） have become a new resource of islet cell substitutes. One focus of the current research is the application of a specific inducing agent or a culture system to get directed differentiation of BMSCs, which may have part characteristics of islet cells and then be used in autologous transplantation for the treatment of diabetes.