ObjectiveTo investigate the regulation of human bone marrow mesenchymal stem cells (hBMSCs) osteogenic and adipogenic differentiations mediated by Wnt10b adenoviral vector in vitro. MethodsThe hBMSCs from ilial bone tissue in adults at passage 4 were infected by Wnt10b gene expression adenoviral vector (group A), Wnt10b-shRNA adenoviral vector (group B), and empty vector (group C), and non-transfected hBMSCs served as the blank control group. Then the cells were cultured separately in the circumstance of osteogenic induction, adipogenic induction, and non-induction. The alkaline phosphatase (ALP) staining, alizarin red staining, and oil red O staining were used to detect the osteogenic and adipogenic differentiations; real-time fluorescent quantitative PCR and Western blot were used to analyze the expressions of osteoblast and adipocyte genes and proteins. ResultsThe results of ALP staining were positive after osteogenic induction, group A showed strong staining, and group B showed the weakest staining. The results of alizarin red staining showed that there were a lot of patchy confluent brown mineralized nodules in group A; a few punctate brown mineralized nodules were seen in group B; and many punctuate brown mineralized nodules were found in groups C and D. The results of oil red O staining showed strong staining in groups B, C, and D after adipogenic induction, especially in group B; scattered or small clustered staining was observed in group A. The expressions of osteoblast genes and proteins were significantly higher in group A than groups B, C, and D, and in groups C and D than group B by real-time fluorescent quantitative PCR and Western blot test; however, the expressions of adipocyte genes and proteins showed a contrary tendency. ConclusionThe high level expression of Wnt10b can enhance osteogenic differentiation of hBMSCs, and the low level expression of Wnt10b can increase adipogenic differentiation of hBMSCs.
ObjectiveTo analyze the correlation between the trabecular microstructure and the clinical imaging parameters in the fracture region of osteoporotic hip so as to provide a simple method to evaluate the trabecular microstructure by a non-invasive way. MethodsBetween June 2012 and January 2013, 16 elderly patients with femoral neck fracture underwent hip arthroplasty were selected as the trial group; 5 young patients with pelvic fracture were selected as the control group. The hip CT examination was done, and cancellous bone volume/marrow cavity volume (CV/MV) was analyzed with Mimics 10.01 software in the control group. The CT scan and bone mineral density (BMD) measurement were performed on normal hips of the trial group, and cuboid specimens were gained from the femoral necks at the place of the tensional trabeculae to evaluate the trabecular microstructure parameters by Micro-CT, including bone volume fraction (BV/TV), trabecular number (Tb. N), trabecular spacing (Tb.Sp), trabecular thickness (Tb.Th), connect density (Conn.D), and structure model index (SMI). The correlation between imaging parameters and microstructure parameters was analyzed. ResultsIn the trial group, the BMD value was 0.491-0.698 g/cm2 (mean, 0.601 g/cm2); according to World Health Organization (WHO) standard, 10 cases were diagnosed as having osteoporosis, and 6 cases as having osteopenia. The CV/MV of the trial group (0.670 1±0.102 0) was significantly lower than that of the control group (0.885 0±0.089 1) (t=-4.567, P=0.000). In the trial group, CV/MV had correlation with BV/TV, Tb.Th, and SMI (P<0.05); however, CV/MV had no correlation with Tb.N, Tb.Sp, or Conn.D (P>0.05). BV/TV had correlation with Tb.Th, Tb.N, Tb.Sp, and SMI (P<0.05), but it had no correlation with Conn.D (P=0.075). There was no correlation between BMD and microstructure parameters (P>0.05). ConclusionCV/MV obviously decreases in the osteoporotic hip, and there is a correlation between CV/MV and the microstructure parameters of BV/TV, Tb.Th, and SMI, to some extent, which can reflect the variety of the microstructure of the trabeculae. There is no correlation between BMD of femoral neck and microstructure parameters.
ObjectiveTo investigate the clinical efficiency of pelvic and sacrum tumor surgery using sizing balloon occlusion of the lower abdominal aorta. MethodsFrom January 2005 to June 2011, 156 patients were diagnosed to have sacrum or pelvic tumor and underwent surgery in our institution. Temporary balloon occlusion of abdominal aorta was used in 51 patients during the resection of sacrum and pelvic tumors (balloon group). Another 105 patients received the traditional surgery resection (control group). The results of the whole operation time, the volume of blood loss and transfusion, the complication and the total days of stay in hospital in the two groups were compared with each other. ResultsAfter the abdominal aorta was occluded, 92.2% of the patients in the balloon group had holistic resection or edge resection, while the number was 86.7% for the control group. In the balloon group, the average operation time was (171.96±65.16) minutes, the average intraoperative blood loss was (746.86±722.73) mL, and the blood transfusion was (411.76±613.73) mL. The postoperative lead flow was (294.50±146.09) mL, and the postoperative tube removal was within (2.98±1.07) days. Improvement of patients'condition was significantly better than the control group (P<0.05). No significant difference was found in the total days of stay in hospital and the postoperative complications between the two groups (P>0.05). ConclusionUsing abdominal aorta occlusion can effectively control intraoperative hemorrhage, and show the operation field clearly. It also can reduce operation time and control the blood transfusions. Appropriately extended balloon blocking time can obviously improve the tumor removal rate and the safety of the operation.
ObjectiveTo compare Crohn disease(CD) with intestinal tuberculosis(ITB) in clinical and multislice CT(MSCT) features that may be helpful for the differential diagnosis. MethodsThirty-eight patients with CD and 13 with ITB proved surgically and pathologically were recruited for this study. The clinical symptoms, laboratory, and MSCT findings in these patients were retrospectively analyzed. ResultsThe MSCT changes helpful in distinguishing CD from ITB included:①CD presented symmetrical intestinal wall thickening in most cases, while ITB were asymmetric (P < 0.05).②The irregular stricture was more common usually shown in CD groups, while coaxial in ITB(P < 0.05).③The lymphadenopathy with obvious enhancement and tortuously mesenteric vessels were frequently found in ITB group (P < 0.05). The clinical features of CD including abdominal pain, diarrhea, fever, anemia, hematochezia, weight loss, and intestinal complications were similar with ITB, and similar results were detected in the laboratory examination including the acceleration of erythrocyte sedimentation rate, postive C-reactive protein, and the reduction of albumin. The feature of hematochezia was more common in CD than in ITB, while concomitant pulmonary tuberculosis was more revealed in ITB(P < 0.05). ConclusionsThe MSCT findings of CD and ITB are characteristic. Combined with the similar clinical and laboratory features, the features of MSCT maybe helpful for definitive diagnosis.
ObjectiveTo explore the value of the long time lower abdominal aorta balloon block technology in the pelvis or sacrum tumor surgery. MethodsFrom January 2005 to June 2013, the sacrum or pelvic tumor patients underwent the long time lower abdominal aorta balloon block technology in the Orthopedics Department of West China Hospital of Sichuan University were enrolled. According to the balloon blocking time, patients were divided into A (<90 mins), B (90 to 180 mins), and C (>180 mins) groups. The intraoperative blood loss, blood transfusion amount, average lengths of hospital stay, postoperative volume of drainage, and postoperative complications were compared among the three groups. ResultsA total of 78 patients were included, of which 21 were in group A, 38 were in group B and 19 were in group C. All patients received en bloc resection, and did not experience intraoperative balloon shift and abdominal aorta flow leakage. Comparing the three groups, there were significant differences in intraoperative blood loss (P=0.026) and average lengths of hospital stay (P=0.021). Further pairwise comparison showed the intraoperative blood loss and average lengths of hospital stay in group C were significantly higher than those in group A and group B. In addition, there were no statistical differences among the three groups in blood transfusion amount, postoperative volume of drainage and postoperative complications. ConclusionIn the pelvis and sacrum tumor surgery, extending the time of abdominal aorta balloon block can reduce bleeding, save blood, increase the safety of surgery without increasing in postoperative complications.