[Surgical treatment of the complex bicondylar tibial plateau fracture using a midline longitudinal incision].

Objective: To explore the outcomes after treatment of the complex bicondylar tibial plateau fracture through a midline longitudinal approach. Methods: A review of fifteen patients with an average age of (51.3±12.3) years old (range17-65yers;7 males, 8 females) surgically treated from October 2013 to Febuary 2018 were included. Sahatker Ⅴ in 10, Sahatker Ⅵ in 5; fractures of medial and lateral columns in 9, fractures of three columns in 6. All the patients were adopt a midline longitudinal approach combined with the posterior approach and bone grafting were conducted. Results: All cases were followed-up for (14.4±3.8) month, with an average of 12-24 month. All patients gained bone union during 12-16 weeks after operation, with an average of (15.2±1.3) weeks. There were significant differeces in both tibial plateau angle and posterior slope angle on radiography between preoperation and postoperation (P<0.05), there were no significant differeces in either tibial plateau angle or posterior slope angle on radiography between immediate postoperation and 12 months postoperation (P>0.05). At final follow-up,both the Lachman test and the Pivot-shift test were negative. All patients had complete knee extension, knee flexion angle 100°-135°, with an average of 117.7°±11.3°. The HSS (the Hospital for Special Surgery) score were 66-98, with an average of 85.1±9.3, six cases were excellent and seven cases were good, two cases was fair, the excellent and good rate was 86.7%. The Rasmussen radiological evaluationre were 9-18, with an average of 15.1±2.5, three cases were excellent and eleven cases were good, one cases was fair, the excellent and good rate was 93.3%. 1 patient had fat liquefactionof in antero incision, and got good outcomes after debridement dressing. Conclusion: The treatment of the complex bicondylar tibial plateau fracture through a midline longitudinal approach combined with the posterior approach can result in good exposure and satisfying knee function in short-term.

[Haploidentical hematopoietic stem cell transplantation in the treatment of acquired aplastic anemia in children: a single center retrospective analysis].

Objective: To investigate the safety and efficacy of haploidentical hematopoietic stem cell transplantation with different intensity conditioning regimen in the treatment of childhood aplastic anemia (AA) . Methods: Thirty-seven AA patients who underwent haploidentical transplantation in BaYi Children's Hospital Affiliated to PLA Army General Hospital from January 2013 to January 2017 were enrolled. According to the dosage of conditioning regimen, 34 patients excluding 3 other conditioning regimens were divided into high-dosage group (regimen 2, 22 cases) and low-dosage group (regimen 3, 12 cases). The data of Engraftment, graft-vs-host disease (GVHD), hematopoietic reconstitution, relapse, infection, overall survival (OS) were analyzed. The comparison between the two groups was tested by χ(2) test. Results: A total of 35 of 37 patients achieved primary engraftment; 2 cases died of regimen-related toxicity and severe infection before the infusing of the grafts. The activation rate of CMV and EBV was 60% (21/35) . Post-transplant lymphocyte disease (PTLD) of lung occurred in one case. The cumulative incidences of acute GVHD grade Ⅰ-Ⅳ and chronic GVHD were 29% (10/35) and 34% (12/35) respectively and the incidence of extensive chronic GVHD was 6% (2/35) . The median follow-up time was 18.8 (2.9-44.1) months, the OS was 92% (34/37) .All survived patients were no longer dependent on blood transfusion and none of them had recurrence. Comparing the rates of overall survival(86%(19/22) vs.100%(12/12)) and rates of chronic GVHD(40%(8/20) vs. 17%(2/12)) in regimen 2 and regimen 3 group, there were no significant difference (χ(2)=1.742, 1.841, all P>0.05) . Significant difference was found at the incidence of Ⅰ-Ⅳ acute GVHD (10% (2/20) vs. 50% (6/12) ,χ(2)=6.200, P=0.013). Conclusions: Haploidentical hematopoietic stem cell transplantation is effective and safe. It is suitable for patients who are not eligible for matched donor transplantation. Application of reduced dose preconditioning in haploid transplantation is worth exploring.

Effects of parathyroid hormone-related protein on osteogenic and adipogenic differentiation of human mesenchymal stem cells.

OBJECTIVE: This work aims to investigate the effects of parathyroid hormone-related peptide (PTHrP) (1-86) on osteogenic and adipogenic differentiation of human mesenchymal stem cells (hMSCs) and the related mechanisms. MATERIALS AND METHODS: hMSCs were isolated and cultured in vitro. They were divided into control group, osteogenesis group, adipogenesis group, osteogenesis+PTHrP group and adipogenesis+PTHrP group. The cell proliferation and differentiation, and expression levels of osteopontin (OPN) and lipoprotein lipase (LPL) mRNA were observed. RESULTS: The proliferation rates of hMSCs in osteogenesis+PTHrP and adipogenesis+PTHrP group were significantly higher than that in control group, respectively (p < 0.01). The alkaline phosphatase (ALP)-positive osteoblasts firstly appeared in osteogenesis+PTHrP group, and Sudan IV-positive adipocytes firstly appeared in adipogenesis group. The expression level of OPN mRNA in osteogenesis+PTHrP group was significantly higher than that in osteogenesis group (p < 0.05), and that in adipogenesis+PTHrP group was also higher than adipogenesis group (p < 0.05). The expression level of LPL mRNA in osteogenesis+PTHrP group was significantly lower than that in osteogenesis group, and that in adipogenesis+PTHrP group was also lower than adipogenesis group (p < 0.05). CONCLUSIONS: The osteogenesis and adipogenesis are related to each other during the induced differentiation of hMSCs. PTHrP (1-86) can promote the osteogenic differentiation and inhibits the adipogenic differentiation for hMSCs.

[Quantitative stereologic analysis of metabolize dynamic of protein and DNA during somatic embryogensis in Lycium barbarum L].

The protein and DNA content in somatic embryos of Lycium barbarum L were analysed using quantitative stereologicai procedure formed from Cell Morphometry. The photos were transformed into digital images by the Sharp JX-610 scanner. Then the quantity of protein and DNA was count applying digital images processing software. By the result we discuss the relationship between changes in protein and DNA metabolize dynamic and somatic embryogensis.