Mesenchyme cells degrade epithelial basal lamina glycosaminoglycan

We investigated whether turnover of basal lamina glycosaminoglycan (GAG), an active process during epithelial morphogenesis, involves the mesenchyme. Fixed, prelabeled, isolated mouse embryo submandibular epithelia were prepared retaining radioactive surface components, as determined by autoradiographic and enzymatic studies, and a basal lamina, as assessed by electron microscopy. Recombination of mouse embryo submandibular mesenchyme with these epithelia stimulates the release of epithelial radioactivity when the labeled precursor is glucosamine or glucose but not when it is amino acid. The release is linear with time during 150 min incubation. Augmented release of epithelial label requires living mesenchyme which must be close proximity with the epithelia. Although heterologous mesenchymes, including lung, trachea, and jaw, stimulate the release of submandibular epithelial label, epithelial tissues do not. The label released by intact submandibular mesenchyme from prelabeled epithelia is in GAG and in two unique fractions: heterogeneous materials of tetrasaccharide or smaller size and N-acetylglucosamine. Enzymatic treatment of the heterogeneous materials revealed the presence of glycosaminoglycan-derived oligosaccharides. These unique products were not obtained by incubating prelabeled epithelia with a mesenchymal cell extract, suggesting that intact mesenchymal cells are required. N-Acetylglucosamine was also released when mesenchyme was recombined with living prelabeled epithelia which contained labeled basal laminar GAG. Our results establish that submandibular epithelial basal lamina GAGs are degraded by submandibular mesenchyme. We propose that one mechanism of epithelial-mesenchymal interaction is the degradation of epithelial basal laminar GAG by mesenchyme.     

盐酸右美托咪定联合瑞芬太尼在骨科手术中的应用效果及对呼吸功能的影响

本研究考察了盐酸右美托咪定联合瑞芬太尼(观察组,n=68)和丙泊酚联合瑞芬太尼(对照组,n=68)在我院136例骨科手术患者中的应用效果,应用警觉/镇静观察评分(OAA/S)评价患者用药前(T0)、用药10 min后(T1)、用药20 min后(T2)、用药30 min后(T3)和清醒后(T4)的镇静效果,并比较了两组患者在不同时间点的呼吸频率(RR)、血氧饱和度(SpO2)、心率(HR)和平均动脉压(MAP)。研究结果显示,两组患者在T0、T1和T4时间点的OAA/S评分无统计学差异(p>0.05),观察组在T2和T3时间点的OAA/S评分明显小于对照组(p<0.05)。两组患者在T0、T1和T4时间点的RR无统计学差异(p>0.05),观察组在T2和T3时间点时的RR明显大于对照组(p<0.05)。观察组在T2时间点时的SpO2明显大于对照组(p<0.05)。两组患者的SpO2在其他时间段时无明显差异(p>0.05)。两组患者的HR和MAP均未表现出明显差异(p>0.05)。观察组的不良反应发生率为2.94%,明显高于对照组的11.76%(p=0.049)。本研究结论初步表明,与丙泊酚联合瑞芬太尼相比,盐酸右美托咪定联合瑞芬太尼在骨科手术中具有更好的镇静效果,可有效保障患者的呼吸功能,具有良好的血流动力学稳定性和安全性。     

Isolation and characterization of mesenchymal stem cells in orthopaedics and the emergence of compact bone mesenchymal stem cells as a promising surgical adjunct

The potential clinical and economic impact of mesenchymal stem cell (MSC) therapy is immense. MSCs act through multiple pathways: (1) as “trophic” cells, secreting various factors that are immunomodulatory, anti-inflammatory, anti-apoptotic, proangiogenic, proliferative, and chemoattractive; (2) in conjunction with cells native to the tissue they reside in to enhance differentiation of surrounding cells to facilitate tissue regrowth. Researchers have developed methods for the extraction and expansion of MSCs from animal and human tissues. While many sources of MSCs exist, including adipose tissue and iliac crest bone graft, compact bone (CB) MSCs have shown great potential for use in orthopaedic surgery. CB MSCs exert powerful immunomodulatory effects in addition to demonstrating excellent regenerative capacity for use in filling boney defects. CB MSCs have been shown to have enhanced response to hypoxic conditions when compared with other forms of MSCs. More work is needed to continue to characterize the potential applications for CB MSCs in orthopaedic trauma.     

Approaches to promoting bone marrow mesenchymal stem cell osteogenesis on orthopedic implant surface

Bone marrow-derived mesenchymal stem cells(BMSCs) play a critical role in the osseointegration of bone and orthopedic implant. However, osseointegration between the Ti-based implants and the surrounding bone tissue must be improved due to titanium's inherent defects. Surface modification stands out as a versatile technique to create instructive biomaterials that can actively direct stem cell fate. Here, we summarize the current approaches to promoting BMSC osteogenesis on the surface of titanium and its alloys. We will highlight the utilization of the unique properties of titanium and its alloys in promoting tissue regeneration, and discuss recent advances in understanding their role in regenerative medicine. We aim to provide a systematic and comprehensive review of approaches to promoting BMSC osteogenesis on the orthopedic implant surface.     

非甾体抗炎药在骨科手术超前镇痛中的临床应用研究

目的:研究非甾体抗炎药的超前镇痛在骨科手术中的效果。方法:按照入选标准和排除标准选取2014年1月至2014年6月收治入院行骨科手术的各类骨折患者。记录每名患者人口统计学资料,骨折类型和部位,手术和麻醉方式,镇痛治疗方案,术前和术后疼痛评分,心理评分,用药期间不良反应,患者满意度评分。结果:本研究共纳入241名行骨折手术患者,分为超前镇痛组(n=115)和对照组(n=126),超前镇痛组术前使用非甾体抗炎药(主要为帕瑞昔布、塞来昔布)进行镇痛,对照组术前不使用非甾体抗炎药镇痛,两组术前疼痛评分无显著性差异。超前镇痛组和对照组在术后6 h、12 h、48 h、72 h视觉疼痛评分(visual analogue scale,VAS)、不良反应发生率和满意度评分差别有统计学意义(P0.05)。超前镇痛组心理评分低于对照组,不良反应发生率少于对照组,满意度较高。结论:非甾体抗炎药超前镇痛运用于骨科手术中,能够有效缓解手术切口疼痛,减轻炎症反应,减少不良反应的发生,患者满意度高。     

血浆D-二聚体、纤维蛋白原水平与骨创伤患者创伤程度的相关性

目的:分析骨创伤患者的血浆D-二聚体、纤维蛋白原水平及其与创伤程度的相关性。方法:收集2015年1月至2016年1月我院收治的骨创伤患者180例作为观察组,选择同期接受体检的健康者100例作为对照组。动态监测两组受检者入院后第1、3、6、10 d的血浆D-二聚(DD)和纤维蛋白原(FIB)的水平,并分析DD和FIB水平与骨创伤程度的相关性。结果:入院后第1、3、6、10 d,观察组的FIB和DD水平均出现下降趋势,但均显著高于对照组,差异具有统计学意义(P0.05)。重度创伤组和中度创伤组患者的FIB水平显著高于轻度创伤组,且重度创伤组FIB水平显著高于中度创伤组,组间比较差异均具有统计学差异(P0.05)。从入院第1 d至10 d,3组患者的FIB水平均出现显著降低(P0.05)。轻度创伤组患者的DD水平最低,其次是中度创伤组,重度创伤组最高,组间比较差异均具有统计学差异(P0.05)。从入院第1 d至10 d,3组患者的DD水平均出现显著降低(P0.05)。此骨创伤患者创伤严重程度与FIB和DD的水平均呈现出显著正相关关系(r=0.64,P=0.003;r=0.71,P=0.002)。结论:骨创伤患者的血浆FIB和DD水平显著高于健康人,与创伤程度呈显著正相关,可能作为骨创伤患者病情程度和预后评估的生物指标。     

Activation Status of Receptor Tyrosine Kinases as an Early Predictive Marker of Response to Chemotherapy in Osteosarcoma

Receptor tyrosine kinases (RTKs) are membrane receptors that play a vital role in various biological processes, in particular, cell survival, cell proliferation, and cell differentiation. These cellular processes are composed of multitiered signaling cascades of kinases starting from ligand binding to extracellular domains of RTKs that activate the entire pathways through tyrosine phosphorylation of the receptors and downstream effectors. A previous study reported that, based on proteomics data, RTKs were a major candidate target for osteosarcoma. In this study, activation profiles of six candidate RTKs, including c-Met, c-Kit, VEGFR2, HER2, FGFR1, and PDGFRα, were directly examined from chemonaive fresh frozen tissues of 32 osteosarcoma patients using a multiplex immunoassay. That examination revealed distinct patterns of tyrosine phosphorylation of RTKs in osteosarcoma cases. Unsupervised hierarchical clustering was calculated using Pearson uncentered correlation coefficient to classify RTKs into two groups—Group A (c-Met, c-Kit, VEGFR2, and HER2) and Group B (FGFR1 and PDGFRα)—based on tyrosine phosphorylation patterns. Nonactivation of all Group A RTKs was associated with shorter overall survival in stage IIB osteosarcoma patients. Percentages of tumor necrosis in patients with inactive Group A RTKs were significantly lower than those in patients with at least one active Group A RTK. Paired primary osteosarcoma cells with fresh osteosarcoma tissue were extracted and cultured for cytotoxicity testing. Primary cells with active Group A RTKs tended to be sensitive to doxorubicin and cisplatin. We also found that osteosarcoma cells with active Group A RTKs were more proliferative than cells with inactive Group A RTKs. These findings indicate that the activation pattern of Group A RTKs is a potential risk stratification and chemoresponse predictor and might be used to guide the optimum chemotherapy regimen for osteosarcoma patients.     

矫形鞋垫联合踝关节持续被动运动用于偏瘫型脑瘫患儿步态稳定性控制的临床研究

目的:探讨矫形鞋垫联合踝关节持续被动运动(CPM)用于偏瘫型脑瘫患儿姿势控制的临床价值。方法:选择2016年6月~2017年6月在我院康复科就诊的56例偏瘫型脑瘫患儿,随机均分成两组。对照组患儿每日行物理治疗(PT)训练,每次共30分钟,每日一次,每周五次。治疗组患儿常规物理治疗训练同对照组,并同时运用足部生物力学矫形技术及踝关节CPM治疗,每次15分钟,角度恒定为-45-45度,每天一次。两组治疗疗程为三个月。治疗结束后,比较两组患儿的儿平衡能力总有效率、GMFM(E功能区评分)、肢体运动功能、踝关节张力及踝关节活动范围的改善情况。结果:两组患儿平衡能力总有效率(显效率与有效率之和)分别为92.9%和67.9%,治疗组明显优于对照组(P0.05)。治疗组治疗后GMFM(E功能区评分比较)明显高于对照组(P0.01),患侧肢体运动功能改善、踝关节张力、踝关节活动范围改善情况均明显优于对照组(P0.05)。结论:矫形鞋垫联合踝关节CPM明显有助于偏瘫型脑瘫患儿姿势控制的治疗。     

Peri-implant Bone Remodeling after Total Hip Replacement Combined with Systemic Alendronate Treatment: A Finite Element Analysis

In order to decrease the peri-implant bone loss during the life-time of the implant, oral use of anti-osteoporosis drugs (like bisphosphonates) has been suggested.

In this study, bone remodeling parameters identified from clinical trials of alendronate were used to simulate the effect of those drugs used after total hip arthroplasty on the peri-implant bone density. Results of the simulation show that the oral administrated drugs increase bone density around the implant and decreases, at the same time, the micromovements between the implant and the surrounding bone tissue.

Incorporation of drug effect in numerical studies of bone remodeling is a promising tool especially to predetermine safe bisphosphonate doses that could be used with orthopedic implants.     

Effects of seating load magnitude and load orientation on seating mechanics in 5°40′ mixed-alloy modular taper junctions

BackgroundMechanically-assisted crevice corrosion of modular tapers continues to be a concern in total joint replacements. Surgical factors that may affect taper seating mechanics include seating load magnitude and load orientation. Seating mechanics is defined as the seating load versus displacement behavior. In this study, mixed-alloy (CoCrMo/Ti-6Al-4V) modular head-neck 5°40′ taper junctions were seated over a range of axially-oriented loads and off-axis orientations, capturing load-displacement during seating. The goals of the study were to assess the effects of seating load magnitude and load orientation on seating mechanics and correlate those findings with the taper pull-off load.MethodsA testing fixture measured head-neck seating displacement as the load was quasistatically applied. Motion was captured using two non-contact differential variable reluctance transducers which were mounted to the neck targeting the head. Seating experiments ranged from 1000 N to 8000 N. Load orientation ranged from 0° to 20° at 4000 N.ResultsSeating load-displacement behavior at different seating loads showed a consistent characteristic behavior. Testing demonstrated increased seating displacement with seating load. Pull-off loads increased with seating load and were approximately 44% of the seating load across the range of seating loads investigated. Seating load orientation up to 20° had no significant effect on seating displacement and taper pull-off load.ConclusionIncreased seating load magnitude increased seating displacement, work of seating and pull-off loads in mixed-alloy 5°40′ head-neck tapers. Altering load orientation up to 20° off-axis had no significant effect. Direct measurements of seating mechanics provides insights into the locking of taper junctions.