Objective To evaluate the fixation technique of using the cervical lateral mass plate in the cervical posterior approach operation. Methods Eight patients in this group were admitted from September 2001 to November 2006. Among the 8 patients, there were 6 males and 2 females, with their ages ranging from 28 to 78 years. Cervical vertebral fracture with dislocation was found in 4 patients, C2 spinal cord injury in 1, C1 fracture in 1, cervical spinal stenosis in 1, and C2-5 spinal cord neurofibroma in 1. Muscle strength 3-4. TheFrankel grading system was usedin 6 patients with traumatic injury. Before operation, Grade C was observed in 2patients，Grade D in 3，and Grade E in 1. All the operations were performed according to requirements of the Margel’s method. We positioned 40 screws in all the patients, including 4 screws at C2，6 screws at C3，12 screws at C4，4 screws at C5，4 screws at C6，2 screws at C7，and 6 screws at T1. Results The followingup for an average of 14.1 months (range,645 months) revealed that there was no malposition of the screws in the patients. One of the 8 patients developed spinal instability in the fixed segment at 3 months after operation. The headchestbrace was applied to the patient for 3 months, and the spinal fusion was achieved. The further followingup to 45 months indicated that there was no instability occurring. The remaining patients recovered to their spinal stability by the spinal fusion. The patients also recovered in their neurological function after operation. The Frankel assessment showed that 1 patient had Grade E, 3 from Grade D to Grade E, 1 from Grade C to Grade D, and 1 from Grade C to Grade E. Conclusion The cervical lateral mass plate fixation can provide the immediate and b segmental immobilization for the good cervical spine stability.
OBJECTIVE: To study the effect of platelet-rich plasma in the repair of bone defect. METHODS: Segmental bone defects of 1 cm were created in the mid-upper part of bilateral radius of 24 New Zealand white rabbits. One side was randomly chosen as the experimental side, which was filled with artificial bone with platelet-rich plasma (PRP). The other side filled with artificial bone without PRP as the control. After 2, 4, 8 and 12 weeks of implantation, the gross, radiological, histological observations, and computer graphic analysis were performed to investigate the bone healing of the defect in both sides. RESULTS: Two weeks after operation, new bone and fibrous tissue formation in both the experimental and the control sides were observed only in the areas adjacent to the cut ends of the host bone, but the amount of new tissue in the experimental side was much more than that in the control side. In the 4th and 8th weeks, the surface of the artificial bone was covered with a large amount of new bones, the artificial bone was bridged tightly with the host bone by callus in the experimental side, while new bone was limited mainly in the cut ends and was less mature in the control side. In the 12th weeks, bone defects were entirely healed in the experimental side, which were covered completely with cortical bone, while new bone formation was only observed in the ends of artificial bone and there were not continuous bone callus on the surface in the control side. CONCLUSION: Artificial bone with PRP is effective in the repair of segmental bone defects, and PRP could improve the healing of bone defect.
Objective To investigate the effects of platelet-derived growth factor(PDGF) on the expression of α-smooth muscle actin(α-SMA) of cultured human retinal pigment epithelium cells(RPE). Methods Cultured human RPE cells of the 4-6 th passages were divided into two groups: Delbecco′s modified Eagle′s medium (DMEM) and 2%DMEM (20 g/L foeta calf serum+DMEM). PDGF (0,1,50 ng/ml) was added to medium.The expression of α-SMA was detected and quantitatively analyzed by image process of immunofluorescence.Results PDGF stimulated the expression of α-SMA of human RPE cells.In group of DMEM, The rate of RPE of α-SMA expression was 40%-50% and the intension of fluorescence was 8.08 without PDGF. After stimulated by PDGF(1 ng/ml,50 ng/ml), the rates were 80% and 90% respectively, and the intension of fluorescence were 12.35 and 17.23. In 2%DMEM group, The rates of RPE of α-SMA expression were 85% without PDGF, and 95% ,100% respectively treated with PDGF (1 ng/ml,50 ng/ml). The intension of fluorescence was 14.79 without PDGF, and after stimulated by PDGF, they were 16.28 at 1 ng/ml and 21.36 at 50 ng/ml，which was 2 .7 times ber than that in DMEM group without PDGF. Conclusion PDGF could stimulate RPE cells to express α-SMA. (Chin J Ocul Fundus Dis，2003，19：201-268)
OBJECTIVE The effect of platelet-derived wound healing factor (PDWHF) on wound healing in diabetic rats was studied. METHODS Forty-four male SD rats were randomly divided into 2 groups. Thirty-two rats of experimental group accepted intraperitoneal injection of alloxan (1.5 mg/10 g body weight). Within one or two days after injection, while the blood sugar of the rats was higher than 180 mg/dl, the animal model of diabetic rat should have been established. Then a dorsal incision was given to every rat. After the addition of PDWHF (the experimental group) or bovine albumin (the control group), the incision was sutured up. Seven, ten and fourteen days after operation, the breaking strength of the wound was measured. On another hand, specimen from the wound was taken for the culture of fibroblasts. When the cultured fibroblasts have been incubated with 10% PDWHF for 4, 8 and 12 hours, the procollagen I (alpha 1) mRNA levels were examined respectively, and compared with those of control. RESULTS Significant difference in wound breaking strength had been observed between PDWHF-treated incisions and the control on 7, 10 and 14 days after wounding (P lt; 0.01). Experiment in vitro demonstrated that the procollagen I (alpha 1) mRNA levels in wound fibroblasts incubated with 10% PDWHF for 4, 8 and 12 hours were 0.9, 3.7 and 2.2 folds higher than those in fibroblasts in control. CONCLUSION It was suggested that direct stimulation of procollagen I (alpha 1) gene expression was one of the ways that PDWHF played its role in accelerating wound healing.
Objective To research the biomechanical effect of different length bone plates on treatment of tibial shaft fracture. Methods Forty-five tibia specimens from fresh adult corpse (20-40 years old) were donated (30-38 cm in length, 34 cm on average) and were divided into 3 groups randomly (n=15). Under the following three conditions, the experiment was made separately. Compression stress-strain indexes of whole tibia were determined under the reverse, three spots curving and compression. The vertical elastic strain was 0-1 000 N, the reverse angle was 0-3º, and three bending stresswas 0-400 N. Then the center-section squint non-damage bone fracture model was made, fracture was fixed by 6, 10, 14stainless steel AO LC-DCP, respectively. The compression stress-strain indexes were determined under reverse angle, three spots curving and compression, statistical analysis was done. Results The vertical direction strain value of 6, 10 and 14 hole steel plate under vertical compressions, was 0.449 ± 0.241, 0.093 ± 0.003, 0.139 ± 0.005, respectively ; showing significant difference between 10 and 14 hole steel plates and 6 steel plate (P lt; 0.01) and no significant difference between 10 and 14 hole steel plate (P gt; 0.05). The lateral strain value of 6, 10 and 14 hole steel plate was 0.120 0 ± 0.000 4, 0.127 5 ± 0.010 0, 0.237 0 ± 0.000 6 respectively, indicating a significant difference between stell plates of 6 and 10 hole and 14 hole steel plate (P lt; 0.01) and no difference between 6 and 10 hole steel plate (P gt; 0.05). The torque of 6, 10 and 14 hole steel plate was (5.066 ± 2.715) × 10-3, (5.671 ± 2.527) × 10-3 and (4.570 ± 2.228) × 10-3 Nm, respectively and three spot curving vertical direction strain value was 0.049 ± 0.009, 0.124 ± 0.017, 0.062 ± 0.009, respectively. There were significant differences between various steel plates (P lt; 0.01). Conclusion For the fixation of tibial obl ique fracture, 14 hole steel plate’s stabil ities of anti-vertical compression, anti-reverse and anti-curving are better than those of 6 hole steel plate under the condition of the same material qual ity, thickness, width and screw quantity used.
ObjectiveTo observe and explore the feasibility and effectiveness of platelet-rich fibrin (PRF) membrane packing and air filling in the treatment of refractory macular holes. MethodsA retrospective clinical study. From January 2019 to January 2020, 17 patients with refractory macular hole (17 eyes) who diagnosed in Renmin Hospital of Wuhan University were included in the study. Among them, there were 7 males (7 eyes) and 10 females (10 eyes), with the age of 55.18±7.91 years. All eyes underwent 23G minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF packing, and air filling was performed at the end of the operation. The best corrected visual acuity (BCVA) and optical coherence tomography angiography were performed in all eyes before surgery and at 1 week and 1, 3 months after surgery. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution visual acuity during statistics. Taking 3 months after surgery was as the time point to judge the efficacy, the changes of BCVA, superficial retinal vascular density (SVD), foveal avascular zone (FAZ) area and central foveal thickness (CFT) before and after surgery were compared. Paired t-test was used to compare the indicators before and after surgery. ResultsAmong the 17 eyes, there were 6, 7, and 4 eyes with giant macular hole, high myopia macular hole, and recurrent macular hole, respectively; the hole diameter was 723.94±38.30 μm. Three months after surgery, all holes were closed. Compared with before surgery, the BCVA (t=4.458) and SVD (t=2.675) increased, and the CFT (t=6.329) and FAZ area (t=4.258) decreased at 3 months after surgery, and the differences were statistically significant (P<0.05). At the last follow-up, there was no complications such as intraocular hypertension and retinal detachment in all eyes.ConclusionMinimally invasive vitrectomy combined with internal limiting membrane stripping and PRF tamponade in the treatment of refractory macular holes can increase the closure rate, improve visual acuity and retinal blood perfusion.
Objective To examine an effect of the locally-used platelet derived growth factor-BB (PDGF-BB) on the healing of the medial collateral ligament (MCL) in the knee joints of rats. Methods Forty-eight rats were equally randomly divided into 2 groups: the experimental group (group A) and the control group(group B). MCL of all the rats were ruptured to establish the wound models. In group A, 5 μg of PDGF-BB was locally injected in the wound of each rat and then the wound was sutured; but in group B, the wound was only sutured. After 2 weeks, histological evaluations were performed to determine whether PDGF-BB could promote the healing of MCL. Results There were significantly more fibroblasts formed during the ligament healing process in group A than in group B (213.44±15.32 vs. 180.42±12.78, Plt;0.01). The fibroblasts were more mature andmore regularlyarranged in group A than in group B. The type, content, and crosslink of the collagen were improved to a greater extent in group A than in group B (Plt;0.01). Conclusion PDGF can promote the healing of the injured ligament.
ObjectiveTo explore the early outcome of 3 different operation methods in the treatment of multi-segmental cervical spondylotic myelopathy (CSM). MethodsA retrospective analysis was made on the clinical data of 74 patients with multi-segmental CSM treated between January 2011 and March 2013. The patients were divided into 3 groups according to operation methods:open-door expansive laminoplasty by plate was used in 21 patients (group A), open-door expansive laminoplasty by anchor fixation in 28 patients (group B), and conventional unilaterally open-door expansive laminoplasty in 25 patients (group C). There was no significant difference in gender, age, disease druation, affected segments, preoperative Japanese Orthopaedic Association (JOA) score, and cervical curvature of C2-7 among 3 groups (P > 0.05). The peration time, intraoperative blood loss, and JOA score, cervical curvature, incidence of axial symptoms were recorded. ResultsThere was no significant difference of operation time and intraoperative blood loss between group A and group B (P > 0.05). All incisions healed by first intention. Cerebrospinal leak occurred in 2 cases (1 case of group B and 1 case of group C) and C5 nerve root palsy in 4 cases (2 cases of group A, 1 case of group B, and 1 case of group C); all the symptoms disappeared after symptomatic treatment. The patients were followed up 12-39 months (mean, 18.3 months). The position of internal fixation was good without loosening and pulling out in groups A and B. Reclosed open-door was observed in 2 cases of group C, which disappeared after the second surgery. The JOA scores were significantly increased at 6 months after operation when compared with preoperative scores in groups A, B, and C (P < 0.05). The cervical curvature of C2-7 at postoperation was significantly improved when compared with preoperative one in groups B and C (P < 0.05) except group A (P > 0.05). There were significant differences in JOA score and the cervical curvature among 3 groups at 6 months after operation (P < 0.05). The incidence of axial symptoms were 4.76% (1/21), 35.71% (10/28), and 72.00% (18/25) in groups A, B, and C respectively, showing significant differences (P < 0.017). ConclusionOpen-door expansive laminoplasty by plate has better early outcome than open-door expansive laminoplasty by anchor fixation and conventional unilaterally open-door expansive laminoplasty in the treatment of multi-segmental CSM.
Objective To investigate the effect of removing the implanted plate-rod system for scol iosis (PRSS) on maintaining scol iosis curve correction and preserving spinal mobil ity in patients with scol iosis. Methods From June 1998 to February 2002, 119 cases of scol iosis were treated with the implant of PRSS, which was removed 26-68 months later (average46.8 months). Complete follow-up data were obtained in 21 patients, including 6 males and 15 females aged 11-17 years old (average 13.8 years old). The disease course was 9-16 years (average 12.1 years). There were 2 cases of congenital scol iosis and 19 cases of idiopathic scol iosis, which included 5 cases of IA, 2 of IB, 1 of IIA, 2 of IIB, 2 of IIC, 2 of IIIA, 3 of IIIB, and 2 of IVA according to Lenke classification. There were 13 cases of thoracic scol iosis and 8 of thoracolumbar scol iosis. AP view and the lateral and anterior bending view of X-ray films before and at 3 to 6 months after removing PRSS were comparatively analyzed, the coronal and the sagittal Cobb angle were measured, and the height of vertebral body on the concave side and the convex side were measured, so as to know the effect of PRSS on the growth of the vertebral endplates. Results All the implants were removed successfully with an average operation time of 2.5 hours (range 2-4 hours) and a small amount of intraoperative blood loss. Twenty-one cases were followed up for 6-72 months (average 34.4 months). The coronal Cobb angle before and after the removal of PRSS was (20.25 ± 8.25)° and (23.63 ± 8.41)°, respectively, indicating there was no significant difference (P gt; 0.05); while the sagittal Cobb angle was (39.44 ± 12.38)° and (49.94 ± 10.42)°, respectively, indicating there was a significant difference (P lt; 0.05). The height of the top vertebral body on the concave side before and after the removal of PRSS was (1.78 ± 0.40) cm and (2.08 ± 0.35) cm, respectively, and there was a significant difference (P lt; 0.01); while the height on the convex side was (2.16 ± 0.47) cm and (2.18 ± 0.35) cm, respectively, indicating no significant difference was evident (P gt; 0.05). All the 21 patients had good prognosis and no major operative compl ication occurred. Conclusion PRSS is an effective instrumentation for the management of scol iosis. After the removal of the PRSS, the correction of scol iosis can be maintained, and the spinal mobil ity can be protected and restored.
ObjectiveTo investigate the effect of platelet rich plasma (PRP) in promoting wound healing of total hip arthroplasty (THA). MethodsBetween January 2011 and January 2012, 80 patients scheduled for THA and accorded with the inclusion criteria were divided into 2 groups:wounds were treated with PRP in 40 patients (PRP group) and with normal saline in 40 patients (control group). There was no significant difference in gender, age, disease duration, injury causes, sides, fracture type, and preoperative Harris hip scores between 2 groups (P>0.05). Routine drainage and functional exercise were performed after operation. ResultsThe postoperative drainage volume of PRP group[(137±26) mL] was significantly lower than that of control group[(424±39) mL] (t=38.726, P=0.000). At 4 days after operation, no inflammatory reaction was observed in 34 cases of PRP group and in 30 cases of control group, mild inflammatory reaction in 5 cases of PRP group and in 6 cases of control group, moderate inflammatory reaction in 1 case of PRP group and in 4 cases of control group; there was no significant difference between 2 groups (χ2=2.141, P=0.343). Wound healed by first intention in 40 patients of PRP group and in 39 patients of control group, showing no significant difference between 2 groups (P=1.000). The average follow-up period was 9 months (range, 6-12 months). The Harris hip scores of PRP group (90.2±2.5) and control group (89.3±3.1) at last follow-up were significantly better than those before operation (39.6±8.9 and 39.2±9.2 respectively) (t=34.618, P=0.000; t=32.638, P=0.000), but no significant difference was found between 2 groups (t=1.429, P=0.153). ConclusionUsing PRP in THA wound can reduce postoperative drainage volume, improve the healing of operation incision. It is a safe, effective, and promising procedure in treatment of THA wound.