Intra-Articular Steroid Injection for Patients with Hip Osteoarthritis: A Systematic Review and Meta-Analysis.

PURPOSE: The aim of this current review was to confirm the efficacy of intra-articular steroid therapy (IAST) for patients with hip osteoarthritis (OA) and discuss the duration and influential factors of IAST. METHODS: Online databases (Medline, EMBASE, and Web of Science) were searched from inception to May 2019. Both randomized controlled trials (RCTs) and noncontrolled trials assessing the efficacy of hip IAST on pain were included. Common demographics data were extracted using a standardized form. Quality was assessed on the basis of Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. RESULTS: 12 trials met the inclusion criteria. According to data from individual trials, IAST had significant efficacy on hip OA in both immediate and delay pain reduction, which persisted up to 12 weeks after IAST. The influences of the baseline severity of hip OA or synovitis and injection dose or volume on the clinical outcome of IAST were still controversial. The IAST appeared to be well tolerant by most of the participants. CONCLUSION: IAST was proved to be an efficacious therapy in both immediate and delay pain reduction for hip OA patients within 12 weeks. The longer follow-up data of efficacy and safety and potentially influential factors are still unclear and needed further confirmation.

[Clinical outcome analysis on using extensor digitorum communis splitting approach for the treatment of radial head fractures].

OBJECTIVE: To explore the clinical outcomes of internal fixation or replacement for the treatment of radial head fractures through the extensor digitorum communis splitting approach. METHODS: From July 2012 to May 2015, 25 patients with radial head fractures were reviewed. There were 17 males and 8 females, ranging in age from 20 to 67 years old, with a mean age of 39 years old. Twenty-one patients were treated with reconstruction of plate internal fixation, and 4 patients were treated with radial head replacement. According to Mason classification, 19 cases were type II and 6 cases were type III. All the patients underwent internal fixation or replacement through the extensor digitorum communis splitting approach. The patients were followed up clinically and radiographically until the beginning of fracture union and the entrance of function recovery of elbow motion into a plateau. The functional status of the elbow was evaluated using the Mayo Elbow Performance Index(MEPI). Radiographic signs of post-traumatic arthritis were rated according to the Broberg and Morrey system. RESULTS: All the patients were followed up, and the average duration was 29 months (ranged, 12 to 56 months). The average range of flexion and extension was 120°, the extension was limited by 10°, and the flexion was 135°. The average forearm rotation range was 142°, pronation was 75°, supination was 67°. The mean MEPI was 93±7(ranged, 80 to 100 scores); according to the MEPI scoring criceria, 19 patients got an excellent functional result, 6 good. According to the Broberg and Morrey systems of traumatic arthritis, 19 patients were in grade 0, 6 in grade 1, and no patients in grade 2 or 3. No patients with nonunion of the radial head and failure of internal fixation were found. There were no complications of nerve or vascular injuries, and obvious limitation of elbow rotation. Heterotopic ossification around the elbow occurred in 4 cases, but the motion was not significantly limited. There were no complications such as prosthesis loosening and infection in 4 cases after radial head prosthesis replacement. CONCLUSIONS: The extensor digitorum communis splitting approach is an effective exposure method for internal fixation or replacement in the treatment of radial head fractures.

A comparison of the clinical effect of two fixation methods on Hoffa fractures.

INTRODUCTION: Hoffa fractures are rare and difficult to treat for orthopaedic surgeons. The mechanism of injury of Hoffa fracture is still unknown and the operation approch and fixation method are still controversial. The aim of this study is to compare the clinical effect between two fixation methods on Hoffa fractures. CASE DESCRIPTION: From April 2004 to July 2013, we treated eleven patients (new method group) with Hoffa fracture using the new fixation method (fixed with intercondylar screw and crossed screws) and sixteen patients (traditional method group) using the traditional fixation method (fixed with anteroposteriorly placed screws). All documents from their admission until the last followup in December 2015 were reviewed, data regarding complications collected and results were evaluated using the Knee Society Score. DISCUSSION AND EVALUATION: After an average follow-up period of 27.1 months (range 24-32 months), all fractures had healed. The average healing time of the new method group was 11.36 weeks (range 9-14 weeks) and the average healing time of the traditional method group was 11.88 weeks (range 9-14 weeks). According to the Knee Society Score, the average score of the new method group was 176.36 points (range 125-199 points), and the average score of the traditional method group was 171.19 points (range 148-197 points). Statistical analysis (t test, t = 0.76, P > 0.05) showed that the difference of both the healing time (t test, t = 0.94, P > 0.05) and the score between these two groups was not significant. CONCLUSIONS: These results indicate that the new fixation method for Hoffa fracture is as effective as the traditional method and may provide a new way to treat Hoffa fractures.

Experimental study of high-energy fractures delayed operation in promote bone healing.

To investigate role of delayed operation to stimulate growth of strong external callus in high-energy fractures, and explore a new way for bone healing. Twenty adult dogs were employed, and randomly divided into four groups, including group A-D. The dogs underwent osteotomy by wire saw in middle of femur, electric coagulation damaged surrounding periosteum, forming a 1 cm defect. Group A were internal fixed 14 days after osteotomy (higher-energy fractures delayed operation), Group B and C were internal fixed immediately (no delayed operation), Group D were internal fixed 14 days after osteotomy (delayed operation, but resected granulations around extremities). The results showed that groups of early fixed have no external callus growth and almost no growth in internal callus, these conditions leads to atrophy nonunion. On contrary, the porosis was strong and callus union was steady in group A and D, which have a delayed operation. In conclusion, early surgical fixation of high-energy fracture restrains external callus growth, easily lead to poor callus healing phenomenon of low-quality. Delayed surgical fixation can begin to repair soft tissues injury, stimulate external callus growth and improve fracture healing, so a small incision open reduction produce more robust growth effect than closed reduction.

Evolution of the mir-155 family and possible targets in cancers and the immune system.

The mir-155 family is not only involved in a diversity of cancers, but also as a regulator of the immune system. However, the evolutionary history of this family is still unclear. The present study indicates that mir-155 evolved independently with lineage-specific gain of miRNAs. In addition, arm switching has occurred in the mir-155 family, and alternative splicing could produce two different lengths of ancestral sequences, implying the alternative splicing can also drive evolution for intragenic miRNAs. Here we screened validated target genes and immunity- related proteins, followed by analyzation of the mir-155 family function by high-throughput methods like the gene ontology (GO) and Kyoto Eneyclopedin of Genes and Genemes (KEGG) pathway enrichment analysis. The high-throughput analysis showed that the CCND1 and EGFR genes were outstanding in being significantly enriched, and the target genes cebpb and VCAM1 and the protein SMAD2 were also vital in mir-155-related immune reponse activities. Therefore, we conclude that the mir-155 family is highly conserved in evolution, and CCND1 and EGFR genes might be potential targets of mir-155 with regard to progress of cancers, while the cebpb and VCAM1 genes and the protein SMAD2 might be key factors in the mir-155 regulated immune activities.

[Treating Neer two- and three-part of proximal humeral fractures through anterolateral acromial approach and deltopectoral approach].

OBJECTIVE: To compare clinical results of treating Neer two- and three-part of proximal humeral fractures between anterolateral acromial approach and deltopectoral approach. METHODS: From January 2009 to December 2012, 49 patients with Neer two- and three-part of proximal humeral fractures were treated with locked plate fixation. In anterolateral acromial approach group, there were 22 patients including 9 males and 13 females with an average of (63.2±7.6) years old, while 27 patients in deltopectoral approach including 12 males and 15 females with an average of (62.9±7.0) years old. Operative time, blood loss during operation, fracture healing time and complications were observed and compared, postoperative Constant-Murley scoring and VAS scoring were applied for evaluate function of shoulder joint and pain at 3 months, 1 and 2 years respectively. RESULTS: All patients were followed up from 24 to 41 months with an average of 34.5 months. Operative time, blood loss, fracture healing time in anterolateral acromial approach group was (68.20±7.04) min, (151.30±20.57) ml, (10.88±4.90) weeks respectively, and better than that of in deltopectoral approach group which was (75.81±13.70) min, (242.10±37.25) ml and (13.60±2.45) weeks. Three months after operation, Constant-Murley scoring and VAS score in anterolateral acromial approach group was 88.32±5.45, 0.41±0.63 and better that of in deltopectoral approach group which was 63.53±8.31, 1.65±1.02. There was no significant differences between two groups in Constant-Murley scoring and VAS score at 1 and 2 years after operation. Each group has one case occurred loss of length humerus head height, and there was 1 case with subacromial impingement, 1 case with bolt loose and 2 cases with delayed union in deltopectoral approach. No axillary nerve injury, humeral head necrosis and breakage of internal fixation occurred both of two groups. CONCLUSION: Both of anterolateral acromial approach and deltopectoral approach are effective in treating Neer two- and three-part of proximal humeral fractures, and can obtain excellent outcomes. Moreover, anterolateral acromial approach has advantage of less trauma, less blood loss, shorter operative time, rapid recovery of shoulder joint function and fracture.

[Cause analysis of 280 case of fractures nonunion].

OBJECTIVE: To research many clinical data of nonunion cases and discover the reasons for low capacity of bone growth. METHODS: From October 1999 to April 2009,the source material of 280 nonunion cases were conducted and followed up. The data of the study included 230 males and 50 females,with an average age of 39.4 years old ranging from 19 to 62 years. The fracture position was femur in 129 cases,tibia in 83 cases,humerus in 47 cases, feet radius bone in 21 cases, the ratio was 46:29.6:16.8:7.5. The survey included primary injury process,damage degree and the effect of first treatment,hospital level of first treatment,timing of surgery for the first time, the early callus growth conditions and whether there were obvious technical errors. RESULTS: There were 129 femoral nonunion cases with complete data,121 cases derived from closed fractures, 8 cases from open fractures; 111 cases was aseptic nonunion. 90% of femoral aseptic nonunion had no obvious callus growth, 80% of first treatment performed intraday surgical internal fixation, 10% were undergone operation within three days and 90% was early surgery totally. CONCLUSION: Low quality of bone callus growth is the main reason for current nonunion and the early surgical fixation has much to do with low quality of bone callus growth.

Management of hangman's fracture with percutaneous transpedicular screw fixation.

PURPOSE: This study describes a percutaneous technique for C2 transpedicular screw fixation and evaluates its safety and efficacy in the treatment of patients with hangman's fracture. METHODS: Ten patients with hangman's fracture were treated by percutaneous C2 transpedicular screw fixation. There are six males and four females, who were, based on the classification of Levine and Edwards, sorted as follows: type I fracture, three cases; type II, five cases; type IIa, two cases. The causes of injury were road traffic accident in six patients and falling injury in four patients. Other associated lesions included rib fractures (7 patients), head injuries (4 patients), and fractures of extremities (6 patients). RESULTS: The new technique was performed successfully in all cases. The average operation time was 98 min (range 60-130 min) and the estimated blood loss was 25 ml (range 15-40 ml). No complications such as vascular or neural structures injuries were found intraoperatively. Postoperative CT scans demonstrated that 17 (85 %) of 20 screws were placed satisfactorily, and 3 (15 %) screws showed perforations of the pedicle wall (<2 mm). These patients were asymptomatic and no further intervention was required postoperatively. After 8-25 months follow-up (mean 15.3 months), solid fusion was demonstrated by computed tomography. All cases got well-sagittal alignment and no angulation or dislocation was found at the segment of C2-C3. There was no loss of fixation. Clinical examination showed a full range of motion in the neck in all patients. CONCLUSIONS: The fluoroscopically assisted percutaneous C2 transpedicular screw fixation method is a technically feasible and minimally invasive technique for hangman's fracture.

The projection of nerve roots on the posterior aspect of spine from T11 to L5: a cadaver and radiological study.

STUDY DESIGN: A cadaver and radiological study. OBJECTIVE: To investigate the projection of nerve roots on the posterior aspect of the spine from T11 to L5. SUMMARY OF BACKGROUND DATA: Understanding the projection of nerve roots on the posterior lamina will help to determine the decompressing areas of lamina and avoiding unnecessary bony resection. It can prevent segmental instability and postoperative scar formation. No studies regarding this subject are available. METHODS: Fifteen formalin-preserved spine specimens were used for this study. After exposing the dural sac and bilateral nerve roots, small pieces of stainless steel wires were placed along the root sleeves from their points of origin, and then standard anteroposterior and lateral radiographs were taken. Parameters were measured directly on radiographs using the picture archiving communication system. Measurements included: (1) take-off angles of the nerve roots at the coronal (CA) and sagittal planes (SA); (2) distance from the origin of the root sleeve to the posterior midline (DM); (3) distance from the origin of the root sleeve to the superior (DS) and inferior margin (DI) of its corresponding lamina; and (4) distance between the origins of neighboring nerve roots (DR). RESULTS: The CA statistically decreased from T11 (52.4° ± 3.13°) to L5 (25.8° ± 3.10°). An opposite variation tendency was observed in SA. The DS increased from 1.8 ± 0.32 mm for T11 to 5.84 ± 1.05 mm for L5. No consistent change was found at DI. The DR was largest at the L1-L2 interval (33.9 ± 1.40 mm) and it decreased progressively to L4-L5 (25.5 ± 2.40 mm). DM statistically increased from T11 (8.9 ± 1.51 mm) to L1 (10.9 ± 1.11 mm) and then progressively decreased until it reached a minimum at L5 (8.1 ± 0.83 mm). CONCLUSION: The precise projection of nerve roots to the posterior aspect of spine and intraspinal take-off angles at the sagittal plane have been presented. Surgical interventions of the lumbar disc and nerve root may benefit from this quantitative anatomical study.

Comparison of percutaneous compression plating and short reconstruction nail for treatment of intertrochanteric fracture.

OBJECTIVE: To compare percutaneous compression plating (PCCP) with Trigen short reconstruction nail (Trigen SRN) for the treatment of intertrochanteric hip fracture. METHODS: Eighty-four patients with intertrochanteric hip fracture admitted to our hospital from January 2007 to June 2008 were included in this retrospective study. Thirty-six patients were treated with PCCP and 48 with Trigen SRN. Information regarding age, surgical time, blood loss, length of follow-up, mortality, fracture impaction, time to union, complications, Harris score and visual analog scale (VAS) were all recorded. RESULTS: The mean follow-up time was 16.3 ± 3.2 months (13-19 months). The mean time to achieve radiological fracture healing was 3.6 ± 0.8 and 4.1 ± 1.0 months for the PCCP and Trigen SRN groups, respectively (P= 0.020); the mean Harris hip scores were 78.1 ± 4.8 and 74.1 ± 5.2 (P= 0.001); and the mean fracture impaction was 3.6 ± 2.3 and 3.3 ± 2.6 mm (P= 0.023). There were no statistical differences between the two groups in duration of surgery (P= 0.131) and blood loss (P= 0.268). The amount of nail in the inferior-central quadrants was greater in the PCCP group than in the Trigen SRN group. CONCLUSION: PCCP achieves earlier pain release and better fracture reduction than Trigen SRN.

Local lipopolysaccharide injection: a potential novel treatment for heterotopic ossification.

Heterotopic ossification (HO) is a frequent complication after musculoskeletal trauma and surgical procedures. It usually decreases joint mobility and eventually causes loss of joint function. However, there is no satisfied treatment available for HO. Lipopolysaccharide (LPS) is traditionally recognized as an endotoxin. Recently, studies found LPS was associated with loss of bone during bacterial infection and periprosthetic osteolysis after total joint replacement. Cell and molecular biology studies further found that LPS initiated the osteoclast formation, stimulated osteoclast activity and inhibited osteoblast differentiation. Given HO is an abnormality in bone modeling which increases bone mass within extraskeletal soft tissues, we herein hypothesize that local LPS injection might be a potential novel treatment for HO.

Long-term high salt diet causes hypertension and alters renal cytokine gene expression profiles in Sprague-Dawley rats.

OBJECTIVE: The present study examines whether a long-term high salt diet causes hypertension and renal injury in normal subjects [Sprague-Dawley (SD) rats] and alters renal cytokine-related gene expression profiles. METHODS: Four 10 week old male SD rats received a high salt diet (HS, 8%) and the other 4 SD rats received a normal salt diet (NS, 0.5%) for 8 weeks. Mean arterial pressure (MAP) and renal damages such as albuminuria and histological renal injury were determined. The relative mRNA levels of 514 cytokine-related genes (normalized by beta-actin) in rat kidneys following NS or HS were determined quantitatively through analysis of 4 sets of gene expression profiles using the mouse cDNA membrane microarrays. RESULTS: We demonstrated that 8 weeks of HS diet increased MAP [(140.0+/-5.3) vs (112.0+/-2.2) mmHg; 1 mmHg=0.133 kPa, P<0.01], albuminuria [(41.4+/-3.2) vs (20.1+/-4.5) mg/d; P<0.01], and caused histological renal injury in SD rats, compared to NS group. Of the 514 genes in the array, there were 27 (5.25%) genes with significantly different expression in the kidney of SD rats with HS compared to those of SD rats with NS. Functional clustering analysis indicated the following functional pathways related to high salt diet-induced hypertension: (1) pro-inflammatory response ( upward arrowIL-17, CCL28; downward arrow NFkappabib); (2) endothelial dysfunction ( downward arrowVEGF-A, VEGF-B, endoglin); (3) pro-matrix formation ( upward arrowosteopontin, IGFBP-5; downward arrow IFN-gamma); and (4) attenuated cell survival and differentiation ( downward arrowCNTF, IGF-II R, ephrin-B1). Northern blot confirmed that 8 weeks of HS diet significantly decreased renal expression of VEGF mRNA, compared to NS group (P<0.01). ELISA showed that HS diet significantly decreased renal protein levels of VEGF and CCL28. CONCLUSION: These findings support the hypothesis that hypertension can be induced in normal rats by a long-term high salt diet, which is associated with increased renal injury and marked changes in renal cytokine gene expression profiles that are closely related to the pro-inflammatory response, pro-matrix formation, endothelial dysfunction, and attenuated cell survival and differentiation.

Biomechanical research on anterior double-plate fixation for vertically unstable sacroiliac dislocations.

OBJECTIVE: To determine the best method for anterior internal fixation by comparing the biomechanical characteristics of various anterior fixation methods for vertically unstable sacroiliac dislocations. METHODS: Eight pelves with Tile C fracture with vertical loading were measured separately. Three- and two-hole anterior double plates were fixed at different angles and compared with sacroiliac screws. RESULTS: For two-hole anterior double plates, with increasing angle, axial stability increases while lateral stability decreases. For three-hole plates with an angle of 60°, axial stability is clearly better when placed horizontally, while lateral stability shows no obvious differences. CONCLUSION: For fixing sacroiliac dislocations, three-hole anterior double plates placed at about 60° produce excellent stability, which would be greatly increased if screws were added on the iliac side.

The role of skin and subcutaneous tissues in Dupuytren's contracture: an electron microscopic observation.

OBJECTIVE: To determine the relationship between the overlying tissues and recurrence of Dupuytren's contracture. METHODS: Forty-three patients (68 hands) who accepted surgical treatment were divided into two groups according to treatment methods: partial fasciectomy or dermofasciectomy and full-thickness skin graft. Diseased palmar fascia, subcutaneous tissues and skin obtained during surgery were then assessed by electron microscopy. RESULTS: All patients were followed up. None of the hands which accepted dermofasciectomy and full-thickness skin grafting recurred, while 46.4% of the hands which accepted partial fasciectomy recurred. Under electron microscopic observation, myofibroblasts were found in the skin and subcutaneous tissues. CONCLUSION: The overlying tissues play an important role in Dupuytren's contracture, which may be a reason for recurrence of this condition after surgical treatment.

[The treatment of knee joint peripheral fractures and/or dislocations with vascular injury].

OBJECTIVE: To investigate the effect and influence factors on knee joint peripheral fractures and/or dislocations with an associated vascular injury through retrospectively study. METHODS: From March 2002 to November 2007 31 patients with knee joint peripheral fractures and/or dislocations with an associated vascular injury were treated, including 24 males and 7 females with a mean age of 41 years (range from 21 to 62 years). Definite diagnosis of vascular injury by combining colored ultrasonic, CTA, operative exploration with clinical signs, fixing fractures and/or dislocations with fixators, plates and screws, reconstructing blood circulation based on the condition of the vascular injury by vascular repair, homograft vein or artificial vascular grafting separately and analysing the effects of PSI, diagnosis and treatment methods on salvage lower extremities. RESULTS: Successful reconstruction was carried out in 31 cases, however there were 1 death because of mult-fractures and brain injury and 6 amputation, 24 cases successful salvage followed up mean 24.2 months, 6 cases bone nonunion and infected bone defect were cured by delayed bone planting or bone transportation. Ligaments repair reconstruction of 7 cases knee joint dislocation were done in delayed 3 or 4 weeks after first operation, the good functional rate was 71.4%. CONCLUSIONS: The patients of PSI under 10 grades in knee joint peripheral fractures and/or dislocations with an associated vascular injury should been carried out treatment, early definite diagnosis and blood circulation reconstruction are the key factors of successful salvage treatment.

[Stress test and clinical application of the minimal-invasive dynamic hip screw].

OBJECTIVE: To recognize the effect of minimal-invasive dynamic hip screw (MIDHS) on the treatment of intertrochanteric fracture of the hip by biomechanical test and preliminary clinical application. METHODS: Ten artifical made intertrochanteric fractures of femoral specimen from five cadavers were divided into two groups randomly. The fractures in first group were fixed by MIDHS and other group were fixed by dynamic hip (DHS). Biomechanical characteristics of two different devices were compared with the biomechanical character of load-straining, load-displacing, rigidity and strength of femur by statistic analysis. According to the Harris evaluation, healing effect of intertrochanteric fractures was evaluated clinically on the 15 cases. RESULTS: Straining changes of MIDHS were 14% and 11% less than that of DHS on the tensile side and the pressure side respectively; Sinking and horizontal displacement, were 19% and 22% less than that of DHS respectivly. But external and internal stress intensity,axial and bending rigidity were all higher than that of DHS, they were 12%, 11%, 19% and 37%. Maximal destroyed twisting moment (15%) and average twisting rigidity (15%) were both higher than that of DHS, but twisting angle was 18% less. Under the force, of 1 800 N, the open angle of the fracture on transverse section was 2.28 degrees,while the DHS's was 3.60 degrees . The data above were significant differences statistically (P < 0.01). The average Harris score of the 15 cases with intertrochanteric fractures treated by MIDHS was 91, excellent and good rate was 92.7%, without complications of internal fixation failure,postoperative infection and so on. CONCLUSION: The design of minimal-invasive dynamic hip screw is reasonable and effective against rotating, shearing and varus stress force of the fracture, and it provides possibility of implanting the internal fixation with minimal incision. So it is an ideal internal fixation device for the treatment of intertrochanteric fractures.

[Treatment of acute and chronic osteomyelitis with negative pressure wound therapy].

OBJECTIVE: To investigate the treatment of acute and chronic osteomyelitis with negative pressure wound therapy. METHOD: Thirty cases of acute and chronic osteomyelitis were treated with negative pressure wound therapy, assisted with debridement, autodermoplasty and myo-cutaneous flap surgery. RESULTS: No evidence of relapse was found in all cases treated with negative pressure wound therapy. All the patients were followed up, range from 6 to 23 months, the average was 13.6 months. CONCLUSION: The negative pressure wound therapy maybe a simple, effective and inexpensive method, and could be one of the favorable therapy in the treatment of acute and chronic osteomyelitis.

Ex vivo expansion and transplantation of hematopoietic stem/progenitor cells supported by mesenchymal stem cells from human umbilical cord blood.

Human mesenchymal stem cells (MSCs) are multipotential and are detected in bone marrow (BM), adipose tissue, placenta, and umbilical cord blood (UCB). In this study, we examined the ability of UCB-derived MSCs (UCB-MSCs) to support ex vivo expansion of hematopoietic stem/progenitor cells (HSPCs) from UCB and the engraftment of expanded HSPCs in NOD/SCID mice. The result showed that UCB-MSCs supported the proliferation and differentiation of CD34+ cells in vitro. The number of expanded total nucleated cells (TNCs) in MSC-based culture was twofold higher than cultures without MSC (control cultures). UCB-MSCs increased the expansion capabilities of CD34+ cells, long-term culture-initiating cells (LTC-ICs), granulocyte-macrophage colony-forming cells (GM-CFCs), and high proliferative potential colony-forming cells (HPP-CFCs) compared to control cultures. The expanded HSPCs were transplanted into lethally irradiated NOD/SCID mice to assess the effects of expanded cells on hematopoietic recovery. The number of white blood cells (WBCs) in the peripheral blood of mice transplanted with expanded cells from both the MSC-based and control cultures returned to pretreatment levels at day 25 posttransplant and then decreased. The WBC levels returned to pretreatment levels again at days 45-55 posttransplant. The level of human CD45+ cell engraftment in primary recipients transplanted with expanded cells from the MSC-based cultures was significantly higher than recipients transplanted with cells from the control cultures. Serial transplantation demonstrated that the expanded cells could establish long-term engraftment of hematopoietic cells. UCB-MSCs similar to those derived from adult bone marrow may provide novel targets for cellular and gene therapy.

Ex vivo expansion and pluripotential differentiation of cryopreserved human bone marrow mesenchymal stem cells.

This study is aimed at investigating the potentials of ex vivo expansion and pluri-differentiation of cryopreservation of adult human bone marrow mesenchymal stem cells (hMSCs) into chondrocytes, adipocytes and neurocytes. Cryopreserved hMSCs were resuscitated and cultured for 15 passages, and then induced into chondrocytes, adipocytes and neurocytes with corresponding induction medium. The induced cells were observed for morphological properties and detected for expressions of type II collagen, triglyceride or neuron-specific enolase and nestin. The result showed that the resuscitated cells could differentiate into chondrocytes after exposure to transforming growth factor beta(1) (TGF-beta(1)), insulin-like growth factor I (IGF-I) and vitamin C (V(C)), and uniformly changed morphologically from a spindle-like fibroblastic appearance to a polygonal shape in three weeks. The induced cells were heterochromatic to safranin O and expressed cartilage matrix-procollagenal (II) mRNA. The resuscitated cells cultured in induction medium consisting of dexamethasone, 3-isobutyl-1-methylxanthine, indomethacin and IGF-I showed adipogenesis, and lipid vacuoles accumulation was detectable after 21 d. The resuscitated hMSCs were also induced into neurocytes and expressed nestin and neuron specific endolase (NSE) that were special surface markers associated with neural cells at different stage. This study suggested that the resuscitated hMSCs should be still a population of pluripotential cells and that it could be used for establishing an abundant hMSC reservoir for further experiment and treatment of various clinical diseases.