RESUMO
<p><b>OBJECTIVE</b>To compare the clinical effects between hip anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery and posterior K-L approach combined with quadratus femoris bone flap transplantation for the treatment of femoral neck fracture of Garden III-IV in young and middle-aged patients.</p><p><b>METHODS</b>From January 2004 to January 2011,46 patients with femoral neck fractures were treated by two kinds of operation. Among them, 20 cases were treated with anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery, included 12 males and 8 females with an average age of (32.1 ± 7.3) years old, involved 12 cases of Garden III and 8 cases of Garden IV. The other 26 cases were treated with posterior K-L approach combined with quadratus femoris bone flap transplantation, included 20 males and 6 females with an average age of (37.8 ± 6.9) years old, involved 16 cases of Garden III and 10 cases of Garden IV. The index of hospitalization (hospitalization time, total cost, operative time, intraoperative blood loss, postoperative complications), the quality index of operation (fracture reduction, position of internal fixation, fracture healing time, nonunion and femoral head necrosis) of two groups were observed and compared. Hip joint function were evaluated by Harris score.</p><p><b>RESULTS</b>All patients were followed up from 28 to 41 months with an average of 36 months. The intraoperative blood loss of group S-P (92.3 ± 10.4) ml was less than that of group K-L (132.4 ± 11.2) ml, there was significant difference between two groups (P < 0.05). The operation time of group S-P (81.4 ± 9.2) min was more than that of group K-L (67.1 ± 4.5) min, the difference was statistically significant (P < 0.05). One case in group S-P and 9 cases in group K-L appeared postoperative complications, there was significant difference between two groups (P < 0.05). The fracture healing time of S-P group (83.5 ± 7.3) d was shorter than that of group K-L (103.2 ± 12.6) d, there was significant difference between two groups (P < 0.05). At 30 months after operation, there were significant difference in Harris scoring between two groups (P < 0.05).</p><p><b>CONCLUSION</b>Anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery for treatment of femoral neck fracture of Garden III-IV of young and middle-aged patients, it has characteristics in clear anatomic and easy to operate. As compared with K-L approach, S-P approach can better reserve residual blood supply of femoral neck. While combining with the iliac bone flap transplantation with deep circumflex iliac artery, it could better reconstruct the blood supply of femoral neck to promote fracture healing.</p>
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Fraturas do Colo Femoral , Cirurgia Geral , Consolidação da Fratura , Artéria Ilíaca , Retalhos Cirúrgicos , TransplanteRESUMO
<p><b>OBJECTIVE</b>To study the compatibility between human adipose-derived mesenchymal stem cells and porcine bone scaffolds.</p><p><b>METHODS</b>Porcine bone tissues were co-cultured with adipose-derived mesenchymal stem cells, and the complex was observed under scanning electron microscope. The viability and alkaline phosphatase (ALP) activity of the cells were examined with the cells co-cultured with human bone scaffold as the control.</p><p><b>RESULTS</b>At 4 and 10 days after the co-culture, the adipose-derived mesenchymal stem cells were observed to extend pseudopodia to adhere to the two scaffold materials. MTT assay showed that the cell proliferation on both of the materials increased with time, and the two cell complexes exhibited similar pattern of changes in ALP activity.</p><p><b>CONCLUSION</b>As the seed cells, human adipose-derived mesenchymal stem cells exhibit good comparability with porcine bone scaffold, suggesting their potential of constructing tissue-engineered bone graft.</p>
Assuntos
Adulto , Animais , Humanos , Tecido Adiposo , Biologia Celular , Fosfatase Alcalina , Metabolismo , Osso e Ossos , Biologia Celular , Metabolismo , Proliferação de Células , Técnicas de Cocultura , Teste de Materiais , Células-Tronco Mesenquimais , Biologia Celular , Metabolismo , Microscopia Eletrônica de Varredura , Suínos , Fatores de Tempo , Alicerces TeciduaisRESUMO
<p><b>OBJECTIVE</b>To observe the effect of acupuncture on the expression of extracellular signal-regulated protein kinases 1/2 (ERK1/2) in the subcutaneous fascia of SD rats.</p><p><b>METHODS</b>Eighteen SD rats were randomly divided into 6 groups (n=3) including 5 acupuncture groups and a control group. The rats in the 5 acupuncture groups received electro-acupuncture therapy in the regions of the inguinal groove, and at 0, 1, 6, 12, and 36 h after the last therapy, the superfacial fascia surrounding the acupuncture point (about 1.5 cm in diameter) were collected. The fascia tissues at the corresponding sites and at the acupoint Zusanli (ST36) were obtained from the control rats. The expression of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the tissues were detected by Western blotting.</p><p><b>RESULTS</b>ERK1/2 and p-ERK1/2 expressions were detected in the tissues harvested from both the acupoint and the non-acupoint in the control rats with similar expression intensities. In the rats of each acupuncture group, ERK1/2 expression was significantly increased on the acupuncture side in comparison with the control side.</p><p><b>CONCLUSION</b>The normal loose connective tissue may participate in tissue proliferation and differentiation possibly via phosphorylation of ERK. Acupuncture can promote the signal transduction pathway of ERK, which can be a possible mechanism for the effect of acupuncture in modulating the physiopathological conditions.</p>