Alcoholic and isocaloric diet,but not ovariectomy,influence the apoptosis of bone cells within the alveolar bone crest of rats

ObjectiveStudies suggest that chronic alcoholism as well as oestrogen deficiencies may affect bones in general, including alveolar bone and, by doing so, increase individuals’ susceptibility to develop progressive periodontal disease. This paper aims to verify the influence of chronic alcoholism and/or oestrogen deficiencies in the apoptosis of bone cells of the alveolar bone crest region in rats.DesignInitially, 54 rats were divided into ovariectomized (Ovx) and Sham operated (Sham) groups. Thirty days after surgery, these two groups were equally sub-divided, and received, for 56 days, the following dietary intervention: alcoholic diet (with 20% alcohol solution,), isocaloric diet and ad libitum diet (free diet). Analysis was undertaken by immunohistochemistry, using an antibody to detect apoptosis (anti PARP p-85).ResultsWhen comparing the six experimental groups, no significant differences were observed in the apoptosis of bone cells. Also, there was no significant difference in the quantity of cells undergoing apoptosis when the animals from Ovx groups were compared with those from Sham groups. However, when comparing only different dietary groups, differences were observed between the groups ad libitum and isocaloric, to osteoblasts (p = 0.045); and ad libitum and alcohol, to osteocytes (p = 0.007).ConclusionIt is concluded that ovariectomy was not able to influence the rate of apoptosis of bone cells of the alveolar bone crest region in rats and that a possible influence of diet on apoptosis of osteoblasts and osteocytes cannot be ruled out.     

TRALL联合IFN-γ诱导骨肉瘤细胞凋亡实验研究

目的观察干扰素(IFN)-γ协同肿瘤坏死因子相关凋亡诱导配体(TRAIL)诱导骨肉瘤细胞(MG-63)凋亡的作用,初步探讨协同作用机制,并观察联合用药时对成纤维细胞的毒性作用。方法应用相差显微镜和电镜观察MG-63细胞经TRAIL、IFN-γ及TRAIL联合IFN-γ作用后细胞形态学变化;进行四唑盐比色试验观察不同实验组MG-63细胞和成纤维细胞抑制率;流式细胞仪观察细胞凋亡情况;逆转录-聚合酶链反应法观察IFN-γ作用后TRAIL膜受体表达情况。结果TRAIL联合IFN-γ应用时,随着IFN-γ作用时间的延长,细胞悬浮、空泡化等现象逐渐明显,且在作用24小时最为显著,电镜显示细胞凋亡的特征性变化;联合用药组细胞抑制率较单独TRAIL组增加,两者有显著性差异(P<0.01);联合用药组细胞凋亡率显著增加(P<0.01);应用IFN-γ前后,TRAIL死亡受体(DR)4的相对表达量增加,IFN-γ作用24小时表达量最大,两者有显著性差异(P<0.01);联合用药组对成纤维细胞的毒性,与单独TRAIL组相比没有显著增加(P>0.05)。结论IFN-γ可协同TRAIL诱导MG-63细胞凋亡,DR4表达量增加可能是协同作用的缘故。联合用药不会增加对成纤维细胞的毒副反应。     

Multifidus muscle fatty infiltration as an index of dysfunction in patients with single-segment degenerative lumbar spinal stenosis: A case-control study based on propensity score matching

The multifidus muscle morphology and its relation to the function of patients with degenerative lumbar spinal stenosis (DLSS) remains unclear. This study aimed to investigate the multifidus muscle morphology in patients with DLSS and to determine its relations to the patients function. Sixty-two patients with single-segment DLSS at L4-5 and sixty control patients with non-spinal-derived low back pain were retrospectively enrolled and further matched based on propensity scores. The Oswestry Disability Index (ODI) and bodily pain using the Short-Form Health Survey were evaluated. The cross-sectional area (CSA), CSA of fatty free (CSAF), and fatty infiltration rate [FIR; i.e., (1- CSAF/CSA) × 100%] of the multifidus muscle were measured on magnetic resonance images using ImageJ software. Adjustment for confounders was performed using generalized linear models.The FIR at L5-S1 in controls was statistically significant but slightly less than the DLSS group. The between-groups difference was 5% (p < 0.001), and 2.8% (p = 0.036) in the complete and matching cohorts, respectively, after adjustment. Statistically significant differences were not observed in other multifidus muscle parameters between the groups. FIR > 20% at L5-S1 was independently associated with ODI ≥ 41 in patients with DLSS [Retaining demography as control block or not, Odds ratio (OR) = 8.4, p = 0.023; OR = 12.3, p = 0.030]. The multifidus muscle at L5-S1 demonstrated slightly greater fatty infiltration in patients with L4-5 single-segment DLSS than controls. Significant fatty infiltration in the multifidus muscle at L5-S1 may be correlated with poor function in patients with L4-5 single-segment DLSS.     

The potential of stem cells in the treatment of knee cartilage defects

Cartilage is frequently damaged but only shows a limited capacity for repair. There are a number of treatment strategies currently available for the repair of articular cartilage defects including abrasion chondroplasty, subchondral drilling, microfracture and mosaicplasty but these show variable results. For the younger patients, there is great interest in the potential of cell-based strategies to provide a biological replacement of damaged cartilage using autologous chondrocytes. The results of clinical studies using these cell-based techniques do not conclusively show improvement over conventional techniques. These techniques also do not consistently result in the formation of the desired hyaline cartilage rather than fibrocartilage. Mesenchymal stem cells present a promising cell source for cartilage repair. Mesenchymal stem cells have been isolated from a number of adult tissues including the bone marrow and the synovial fat pad. These cells have the ability to proliferate in culture and differentiate down different pathways including the chondrogenic pathway. In the first instance, differentiated stem cells can be used for the repair of localised cartilage defects by producing hyaline cartilage. In the future, this strategy has the potential to be extended to treat more generalised cartilage defects, especially as the cell source is not a limiting factor. The use of cell-based therapies also allows the versatility of using scaffolds and growth factors, with recombinant proteins or gene therapy. A number of challenges however still need to be overcome including further work on identifying the optimal source of stem cells, along with refining the conditions that enhance expansion and chondrogenesis.     

Effects of TGF-β3 and preculture period of osteogenic cells on the chondrogenic differentiation of rabbit marrow mesenchymal stem cells encapsulated in a bilayered hydrogel composite

In this work, injectable, biodegradable hydrogel composites of crosslinked oligo(poly(ethylene glycol) fumarate) and gelatin microparticles (MPs) were used to fabricate a bilayered osteochondral construct. Rabbit marrow mesenchymal stem cells (MSCs) were encapsulated with transforming growth factor-β3 (TGF-β3)-loaded MPs in the chondrogenic layer and cocultured with cells of different periods of osteogenic preculture (0, 3, 6 and 12 days) in the osteogenic layer to investigate the effects of TGF-β3 delivery and coculture on the proliferation and differentiation of cells in both layers. The results showed that, in the chondrogenic layer, TGF-β3 significantly stimulated chondrogenic differentiation of MSCs. In addition, cells of various osteogenic preculture periods in the osteogenic layer, along with TGF-β3, enhanced gene expression for MSC chondrogenic markers to different extents. In the osteogenic layer, cells maintained their alkaline phosphatase activity during the coculture; however, mineralization was delayed by the presence of TGF-β3. Overall, this study demonstrated the fabrication of bilayered hydrogel composites which mimic the structure and function of osteochondral tissue, along with the application of these composites as cell and growth factor carriers, while illustrating that encapsulated cells of different degrees of osteogenic differentiation can significantly influence the chondrogenic differentiation of cocultured progenitor cells in both the presence and absence of chondrogenic growth factors.     

Ankle arthroscopy in industrial injuries of the ankle

Industry-related injuries to the foot and ankle are not uncommon. These cases are often difficult to evaluate with respect to degree of damage and even more difficult to quantitate with regard to functional impairment. This article represents an attempt to determine the role of ankle arthroscopy in the evaluation of ankle injuries that involve compensation or liability. A retrospective review was conducted. The study group consisted of 40 patients who underwent a total of 42 arthroscopic procedures. The patients were evaluated with regard to the mechanism of injury and clinical manifestations. Pain and swelling were the most common preoperative symptoms. The majority of patients had pain localized to the lateral and anterolateral ankle. There were a high percentage of positive bone scans that correlated well with bone pathology but poorly with soft-tissue pathology. Computed tomography (CT) scans were equivalent to tomograms in the demonstration of bone pathology. Follow-up was obtained in 24 patients. At least 50% of the patients had some improvement in their symptoms. Thirty-three percent believed there was no change, and 17% said they were worse. Over 70% of the patients were able to return to work, although 20% had to change their occupation. Fifteen percent were considered disabled. In patients without a specific diagnosis, ankle arthroscopy was helpful in establishing a diagnosis. Ankle arthroscopy allows a direct assessment of intra-articular damage or arthrosis that may guide the clinician in further treatment and aid in the assessment of functional impairment.     

下肢骨折手术固定技术的选择与思考

<正>下肢是成人骨折的常见部位。随着我国人口老龄化进程加快,髋关节周围骨折的发生率逐步上升。与此同时,城市化、公路交通和建筑业的繁荣伴随着意外事故的增加,使得下肢长骨骨干骨折、粉碎性骨折、开放骨折等高能量创伤更为常见,骨科医生面临更大的挑战。下肢骨折治疗的主要目标是恢复肢体力线、促进愈合、恢复关节功能与行走。大部分下肢骨折很难通过保守治疗获得满意的临床结果而需要手术固     

Surgical site marking will not affect sterility of the surgical field

Surgical site marking has been recommended to prevent wrong site surgery (WSS). According to the Universal Protocol promulgated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the mark must be made using an indelible marker that is sufficiently permanent to remain visible after completion of the skin preparation. However, in clinical practice, one skin marker always is non-sterile and used on several patients. Therefore, in theory, there is a risk of contamination of the surgical site from a surgical marker. We hypothesize that the surgical site marking used by the marker which is non-sterile and reused on multiple patients, may affect the surgical preparation and potentially contaminate the surgical field. After a review of the available evidences, we conclude that surgical site marking does not affect the sterility of the surgical field. Surgeons should be more confident in confirming preoperative marking as an effective component in preventing WSS.     

Malunited calcaneal fracture fragments causing tarsal tunnel syndrome: A rare cause

This is a report of tarsal tunnel syndrome (TTS) due to a specific malunited calcaneal fracture fragment in a 46-year-old man. He was treated non-operatively for extra-articular calcaneal fracture. Four months later he presented with pain, tingling and hypoaesthesia over the medial aspect of the heel. He had a positive Tinel's sign and a positive dorsiflexion-eversion test. Radiography revealed malunited calcaneal fracture along medial wall producing bony prominence. The tarsal tunnel was surgically decompressed by excising the malunited fragments. The branches of the posterior tibial nerve were stretched over these fragments intra-operatively.There was symptomatic improvement with surgical excision of the fragment, however, the hypoesthesia did not resolve completely. Appropriate initial treatment will help to prevent this complication.