ObjectiveTo separate peripheral blood mesenchymal stem cells (PBMSC) and peripheral blood endothelial progenitor cells (PBEPC) from peripheral blood, and investigate the biological characteristics of composite cell sheets of PBMSC and PBEPC.MethodsThe peripheral blood of healthy adult New Zealand white rabbits was extracted and PBMSC and PBEPC were separated by density gradient centrifugation. Morphological observation and identification of PBMSC and PBEPC were performed. The 3rd generation of PBMSC and PBEPC were used to construct a composite cell sheet at a ratio of 1∶1, and the 3rd generation of PBMSC was used to construct a single cell sheet as control. The distributions of cells in two kinds of cell sheets were observed by HE staining. In addition, the expression of alkaline phosphatase (ALP), osteocalcin (OCN), and vascular endothelial growth factor (VEGF) in the supernatants of cell sheets were observed by ELISA at 1, 5, and 10 days after osteogenic induction.ResultsThe morphology of PBMSC was spindle-shaped or polygonal, and PBMSC had good abilities of osteogenic and adipogenic differentiation. The morphology of PBEPC was paved stone-like, and the tube-forming test of PBEPC was positive. Two kinds of cell sheets were white translucent. The results of HE staining showed that the composite cell sheet had more cell layers and higher cell density than the single cell sheet. The expressions of ALP, OCN, and VEGF in the supernatant of the two groups of cell sheets increased with the time of induction. The expression of OCN in the group of composite cell sheet was significantly higher than that in the group of single cell sheet on the 5th and 10th day, ALP on the 10th day was significantly higher than that in the group of single cell sheet, VEGF expression on the 1st, 5th, and 10th day was significantly higher than that in the group of single cell sheet, all showing significant differences (P<0.05), and there was no significant difference between the two groups at other time points (P>0.05).ConclusionPBMSC have stable differentiation ability, and they have good application prospects because of their minimally invasive access. Composite cell membranes constructed by co-culture of two kinds of cells and induction of membrane formation provides a new idea and exploration for tissue defect repair.
Objective To observe the effectiveness of locking compression hook plate in treatment of humeral greater tuberosity fractures. Methods Between March 2014 and September 2017, 16 patients with isolated humeral greater tuberosity fractures were terated with open reduction and internal fixation with locking compression hook plates. There were 11 males and 5 females, with an average age of 38.4 years (range, 22-67 years). The cause of injury was falling injury in 13 cases and sport injury in 3 cases. All patients were closed fractures. Of all patients, 14 patients accompanied with shoulder joint dislocations. CT scan showed the average displacement of fragment was 12.6 mm (range, 8-21 mm) after reduction. All patients began passive functional exercise at 3 days after operation. Results Primary healing of the incisons achieved in all patients, without complications such as infection and nerve injury. All patients were followed up 12-20 months (mean, 15.3 months). At 3 months after operation, X-ray film showed that all fractures achieved bone union, all of which met the imaging anatomical reduction standard. According to the Neer scoring criteria, 11 cases were excellent and 5 cases were good at last follow-up. One patint presented slight pain of shoulder joint and mild activity limitation, which relieved after 1 year. Conclusion The method of open reduction and locking compression hook plate internal fixation for isolated humeral greater tuberosity fractures has advantages, such as less intraoperative hemorrhage, mild postoperative pain, firm fixation, and allowing patients to perform functional exercise earlier, which is conducive to shoulder functional recovery and obtain satisfactory effectiveness.
Objective
To explore the effect of early weight-bearing exercise on the recovery of elderly patients with intertrochanteric fractures after internal fixation.
Methods
The clinical data of 50 patients with unstable intertrochanteric fractures (AO 31-A2 or A3) who underwent proximal femoral nail treatment between February and August 2015 were collected. Among them, 25 patients underwent early weight-bearing exercise after surgery (the observation group), and 25 patients underwent routine recovery after surgery (the control group). Demographic data of patients, modified Barthel Index, and EuroQOL Five Dimensions Questionnaire (EQ-5D) scores were collected, and mortality was assessed by telephone follow-up one year after surgery.
Results
In the observation group, the modified Barthel Index before injury, within 48 hours , 6 weeks , 12 weeks, and 1 year after surgery was 49.56±2.00, 26.40±3.11, 44.04±3.92, 47.92±3.13, and 48.76±3.07, respectively; in the control group, the modified Barthel Index at the above mentioned time points was 49.92±0.40, 26.52±3.34, 40.92±2.62, 45.44±2.36, and 49.16±1.75, respectively. The difference between the observation group and the control group at 6 and 12 weeks after surgery was a statistically significant (P<0.05), and the observation group was better than the control group; there was no statistical difference between the two groups in the modified Barthel Index before surgery, within 48 hours after surgery or one year after surgery (P>0.05). None of the patients died within the first one year after surgery.
Conclusion
The early weight-bearing exercise after hip fracture in the elderly has a positive effect on the recovery of the patients.
