定制旋转铰链式膝关节假体置换治疗膝关节周围侵袭性骨肿瘤的临床观察

Objective To evaluate the clinical efficacy of knee joint replacement with patienttailored rotating hinge prosthesis in patients with invasive perigenual bone tumor.Methods Between January 2000 and January 2005, clinical data of 27 patients with invasive perigenual bone tumor were retrospectively analyzed, including 13 cases of distal femoral tumor and 14 of proximal tibial tumor,comprising 16 cases of giant cell tumors, 9 of osteosarcomas, 1 of synovial sarcomas and 1 of malignant fibrous histiocytomas.All the patients received resection of the tumor, knee-joint replacement with patienttailored rotating hinge prosthesis and postoperative rehabilitation.Patients with malignant tumor also underwent routine chemotherapy after surgery.MSTS scoring was used to evaluate the knee joint function in patients during the postoperative follow-up.Results All the patients were followed up for 11 to 122 months, with median time of 64.5 months.All the patients survived 6 months of follow-up, with a mean MSTS score of 22.2±3.5 and the rate of good knee joint function being 81.5% (22/27).In a recent follow-up, 23 patients were alive and 4 patients dead.Prosthesis-related complications developed in 4 patients.The mean MSTS score was 21.0 ±2.3, and the rate of good knee joint function was 72.7% (16/22) in 22 surviving patients.The overall rate of survival in all the patients was 85.2% (23/27) at five years after treatment.Conclusion The knee-joint replacement with patient-tailored rotating hinge knee prosthesis is associated with a good efficacy in treatment of invasive perigenual bone tumor.     

Deluxe-PS型与PFC Sigma RP型假体在膝关节置换中的比较

BACKGROUND: During artificial knee replacement for all kinds of severe knee disease or conservative treatment for end-stage knee disease, Deluxe-PS knee prosthesis and PFC Sigma RP knee prosthesis have their advantages. OBJECTIVE:To compare and analyze the matching of the Deluxe-PS and PFC Sigma RP knee prostheses with bone cross section. METHODS: According to the use of the knee prosthesis, 87 gonarthritis patients undergoing bilateral knee replacement were divided into two groups. 46 cases in the test group received Deluxe-PS knee prosthesis replacement. 41 cases in the control group received PFC Sigma RP knee prosthesis replacement. Operation time and intraoperative blood loss were compared between the two groups. American Knee Society score, knee score of American Special Surgical Hospital and knee joint range of motion were used to evaluate knee joint function before replacement, 3 months after replacement and during final follow-up. Anteroposterior X-ray films were obtained after replacement to measure valgus angle and flexion angle of femoral prosthesis. RESULTS AND CONCLUSION:(1) Operation time and intraoperative blood loss were significantly better in the test group than in the control group (P < 0.05). (2) No significant difference in American Knee Society score, knee score of American Special Surgical Hospital and knee joint motion was detected between the two groups before replacement and 3 months after replacement (P > 0.05). Above indexes were significantly improved in both groups at 3 months after replacement and during final follow-up (P < 0.05). (3) No significant difference in valgus angle and flexion angle of femoral prosthesis was identified between test and control groups during final follow-up (P > 0.05). (4) These findings indicate that effect of Deluxe-PS type artificial knee prosthesis was identical to that of PFC Sigma RP knee prosthesis in knee osteoarthritis patients receiving bilateral knee joint replacement. Deluxe-PS type artificial knee prosthesis can perfectly realize high-accuracy combination of the prosthesis and the bone cross section, and enhance the fusion suitability of the prosthesis and the bone surface. Deluxe-PS type artificial knee prosthesis has the advantage of operation. This advantage is possibly because Deluxe-PS type artificial knee prosthesis is more in line with the anatomical structure of the knee joint of Chinese.  中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

Observations on Cardiac Output in Animal Experiments and Clinical Application of Jiuling Bileaflet Mechanical Valve Prosthesis

Objective:To observe the cardiac output(CO)in animals and patients undergone valve replacement with Jiuling bileaflet mechanical valve prosthesis.Methods: 1.Animal experiments:6 sheep that subjected to mitral replacement with a 21-mm-valve prosthesis were measured by open cardiac catheterization intraoperatively. Echocardiographic and open cardiac catheterization under dobutamine stress were performed on 2 sheep survival for 30 months post-operation.2.Patient measurements:CO of 14 cases of aortic valve and 10 cases of mitral valve was measured by open cardiac catheterization,and after 12 months,it was measured by echocardiography.Results:1. Animal experiments:The mean CO of 6 sheep was 2.5 L/min intraoperatively by catheterization,and that of 2 sheep survival for 30 months post-implant was 3.0 L/min by echocardiography and 2.9 L/min by catheterization,respectively.2.Patient measurements: The mean cardiac index of 4 patients with 21 mm valve replacement was(2.55±0.27) L/min/m2by catheterization,and was(2.84±0.13)L/min/m2 by echocardiography after 12 months.Conclusion:This study demonstrates that cardiac function on animals and patients return to normal activity after undergone the valve replacement,and the newly valve prosthesis shows excellent hemodynamic performance.     

3D-printed prostheses for large bone defect reconstruction following bone tumor surgery北大核心

BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects atumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the follow-up period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

多孔复合材料PHBV-SGBG的体外细胞相容性和体内成骨性

Objective To study the cytocompatibility of poly (3-hydroxybutyrate-co-3 -hydroxyvalerate)/sol-gel bioactive glass (PHBV/SGBG)composite with bone marrow stromal cells in vitro, and the in vivo osteogenesis efficiency of PHBV/SGBG composite under periosteal flap in bone defect animal models. Methods The cytocompatibility of PHBV/SGBG composite was tested by MTT assay and direct contact assay. Of established tibial defect canine models, PHBV/SGBG composite was embedded into the defects of the experimental group, while no treatment was given to the control group. Samples were harvested at weeks 2,4, 8, and 12 post-surgery. The effect of osteogenesis was inspected by scanning electron microscope observation and energy-dispersive X-ray analysis. Results The cytotoxicity score of PHBV/SGBG composite in the serial dilution extract and different culture time ranked from grades 0 to 1. Marrow stem cells (MSCs) attached to and then adhered firmly on the surface of PHBV/SGBG composite, and proliferated rapidly, with obvious cell prominences stretching into the micro-pores structure. In the experimental group, formation of new bone islands was observed at week 2 post-surgery, and mature bone regeneration at week 12. Scanning electron microscopy and energy-dispersive X-ray analysis showed increasing calcium peak in the experiment group. At week 4 Ca/P ratio was 1.086±0.034 in experiment group and 0.793±0.053 in control group. At week 12 Ca/P ratio was 1.603±0.067 in experiment group and 1.456±0.036 in control group (P<0.05). Conclusions PHBV/SGBG shows no cytotoxicity to MSCs, and possesses good osteo-conductibility and regeneration capability. It may be a promising composite for bone tissue engineering.     

自体髂骨植骨联合自体骨髓干细胞移植治疗骨折术后骨不连

BACKGROUND: Bone nonunion is a common complication in the orthopedic treatment, and its morbidity reached 5%-10%, which results in the long-term functional disturbance of the limbs, and even disability. Autogenous iliac crest graft has been commonly used to treat bone nonunion, but some limitations still exist. OBJECTIVE: To investigate the treatment outcomes of autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion after fracture surgery. METHODS: Clinical and follow-up data from 69 patients with bone nonunion were analyzed retrospectively. All patients were allotted to combination (n=37) and iliac (n=32) groups, followed by treated with autologous iliac crest graft combined with autologous bone marrow stem cell transplantation or  autologous crest graft, respectively. Afterwards, the hospitalization time, fracture healing time, bone mineral density and Fereadez-Esteve callus scores were detected and compared between groups. RESULTS AND CONCLUSION: The hospitalization time did not differ significantly between groups (P > 0.05). The fracture healing time in the combination group was significantly shortened compared with the iliac group (P < 0.05). The bone mineral density and Fereadez-Esteve callus scores in the combination group were significantly higher than those in the iliac group at 3 and 6 months after surgery (P < 0.05). The excellent and good rate of the affected limb function in the combination group was significantly higher than that in the iliac group (P < 0.05). These results suggest that autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion can accelerate fracture healing, promote porosis and improve the functional recovery of affected limbs. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

锥形束CT数字成像分析牙槽嵴裂植骨修复的成骨效果

BACKGROUND:In alveolar cleft patients, the amount of bone stock after alveolar bone grafting is mostly measured and analyzed by two-dimensional imaging, which can result in a large error.OBJECTIVE:To evaluate the 6-month osteogenesis of alveolar bone graft in alveolar cleft patients using cone beam CT.METHODS: Alveolar bone grafting was performed in 25 patients with unilateral complete alveolar cleft. The patients were followed up for 6 months after surgery and the osteogenesis of the bone graft was evaluated by CBCT.RESULTS AND CONCLUSION: After the surgery, the labial bone support was better than the palatal one. There were significant differences in the alveolar bone thickness of the cleft region and the normal region of the central incisor as well as the alveolar bone thickness of the cleft region and the normal region of the canine tooth 0 mm distant to the alveolar crest. These findings indicate that the palatal bone support is less than the labial one, and the bone support of the central incisor is not satisfactory, which provide the basis for the tooth movement in the alveolar bone grafting and the orthodontics treatment.  中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Blood Serum Levels of IL-2, IL-6, IL-8, TNF-α and IL-1β in Patients on Maintenance Hemodialysis

Cytokines are essential mediators of immune response and inflammatory reactions. Patients with chronic renal failure (CRF) commonly present with abnormalities of immune function related with impaired kidney function and the accumulation of uremic toxins in addition to bioincompatibility of dialyzer membranes. During a hemodialysis (HD) session, cytokines are released mainly by monocytes activated by endotoxin-type compounds in dialyzer fluid, complement factors and direct contact with dialyzer membrane. The study included 15 CRF patients, aged 36.4±2.9 years, on regular HD maintenance therapy for mean 68±10 months and 15 healthy controls. It was designed to assess serum levels of a panel of inflammatory cytokines: IL-1β, IL-2, IL-6, IL-8 and TNF-αin CRF patients on regular maintenance HD before, 20, 60 and 240 minutes of a single HD session in parallel with C-reactive protein (CRP) as an additional parameter. CRP concentration was increased in HD patients when compared with healthy controls. The concentrations of IL-1, IL-6, IL-8 and TNF-αwere increased, whereas the serum level of IL-2 was not altered during a single HD session.     

Activity of recombinant human interleukin-15 against tumor recurrence and metastasis in mice

Transplantable experimental tumor models were constructed to study the activities of recombinant human interleukin-15 （rhIL-15） against tumor recurrence and metastasis. The results showed that tumor nodule formation was retarded and tumor growth was inhibited in the subcutaneous tumor model of LA795 lung adenocarcinoma after treatment with rhIL-15, and the survival rate of T739 tumor-bearing mice treated with rhIL-15 was much higher than that of mice treated with either saline or with the same dose of rhIL-2. This indicats that rhIL-15 had better antitumor effect than rhIL-2 at the same dose level. In some rhIL-15 treated mice, the tumor cells inoculated subcutaneously were eradicated and there was no tumor formation even 138 days after tumor cell inoculation. The tumor-free mice were rechallenged with live tumor cells and no tumor reoccurred in the following two months in all of these mice, indicating that long-lasting antitumor systemic immunity developed. It was also shown that tumor recurrence and metastasis were inhibited markedly after treatment with rhIL-15, but not with the same dose of rhIL-2, in both subcutaneously and intravenously disseminated tumor models of LA795 lung adenocarcinoma. Simultaneously, the CTL and NK cell activities of the splenocytes obtained from tumor-bearing mice that had been treated with either rhIL-15 or rhIL-2 were both markedly enhanced. However, the enhancement of CTL and NK cell activities was more significant in rhIL-15 treated mice than that in rhIL-2 treated mice. This suggests that the anti-tumor effect of rhIL-15 in vivo was achieved by enhancing the CTL and NK cell activities in tumor immune response.     

Dysfunction of murine dendritic cells induced by incubation with tumor cells

In vivo studies showed that dendritic cell （DC） dysfunction occurred in tumor microenvironment. As tumors were composed of many kinds of cells, the direct effects of tumor cells on immature DCs （imDCs） are needed for further studies in vitro. In the present study, bone marrow-derived imDCs were incubated with lymphoma, hepatoma and menaloma cells in vitro and surface molecules in imDCs were determined by flow cytometry. Then, imDCs incubated with tumor cells or control imDCs were further pulsed with tumor lysates and then incubated with splenocytes to perform mixed lymphocyte reaction. The DC-dependent tumor antigen-specific T cell proliferation, and IL-12 secretion were determined by flow cytometry, and enzyme-linked immunosorbent assay respectively. Finally, the DC-dependent tumor-associated antigen-specific CTL was determined by enzyme-linked immunospot assay. The results showed that tumor cell-DC incubation down-regulated the surface molecules in imDCs, such as CD80, CD54, CDIIb, CDIIa and MHC class II molecules. The abilities of DC-dependent antigen-specific T cell proliferation and IL-12 secretion were also decreased by tumor cell incubation in vitro. Most importantly, the ability for antigenic-specific CTL priming of DCs was also decreased by incubation with tumor cells. In the present in vitro study demonstrated that the defective abilities of DCs induced by tumor cell co-incubation and the co-incubation system might be useful for future study of tumor-immune cells direct interaction and for drug screen of immune-modulation. Cellular ＆ Molecular Immunology.