Objective To evaluate the cl inical results of allogeneic bone graft for interbody fusion in cervical tuberculosis. Methods Between January 2000 and January 2008, 30 cases of cervical tuberculosis were treated with allogeneic (group A, n=15) or autologous (group B, n=15) il iac crest bone graft combined with anterior fixation after radical debridement. In group A, there were 8 males and 7 females with an average age of 38 years; the disease duration was 6 to 14 months; the preoperative kyphosis Cobb angle was (8.6 ± 11.3)°; the preoperative Japanese Orthopaedic Association (JOA) score was 13.0 ± 3.1 for neurological function; and the length of bone graft was 32 mm on average. In group B, there were 9males and 6 females with an average age of 42 years; the disease duration was 4 to 17 months; the preoperative kyphosis Cobb angle was (4.9 ± 7.4)°; the preoperative JOA score 12.3 ± 4.2; and the length of bone graft was 34 mm on average. There was no significant difference in general data between 2 groups (P gt; 0.05). Results The operation time and bleeding volume in group A were significantly less than those in group B (P lt; 0.05). Wound effusion were found in 2 cases of group A, and the other incisions healed by first intention. No infection occurred in group B. In group A, 13 cases were followed up 12-48 months; in group B, 14 cases were followed up 13-46 months. The time of bone graft heal ing in group A [(7.6 ± 2.1) months] was significantly longer than that in group B [(4.2 ± 1.1) months] (t=2.773, P=0.005). The kyphosis Cobb angles were significantly improved at 6 months and last follow-up after operation in 2 groups when compared with that before operation (P lt; 0.05), but no significant difference was found between 2 groups at different time after operation (P gt; 0.05). There was no significant difference in JOA score at 6 months after operation between group A (14.1 ± 2.6) and group B (14.3 ± 2.4) (t=1.655, P=0.162). The improvement rate for neural function were 83.7% in group A and 87.8% in group B, showing no significant difference (χ2=3.150, P=0.071). There was no loosening of internal fixation and recurrence of tuberculosis in 2 groups during follow-up. Five cases had chronic pain at il iac donor sites in group B. According to Bridwell et al. evaluation standard, the bone fusion was satisfactory in 11 cases (84.6%) and unsatisfactory in 2 cases (15.4%) in group A, and was satisfactory for all in 14 cases (100%) in group B. The satisfactory rate of bone fusion showed no significant difference between 2 groups (χ2=2.680, P=0.115).Conclusion Allogeneic bone grafting has a good cl inical result for spinal fusion in cervical tuberculosis surgery, which can treat tuberculosis bone defect effectively.
【 Abstract 】 Objective To observe the effect of disruption of hypoxia inducible factor-1 α (HIF-1 α ) pathway by small hairpin RNA (shRNA) on chemosensitivity of human hepatocellular carcinoma (HCC) cells and to reveal the correlative mechanisms. Methods Plasmid of pshRNA-HIF-1α was transfected into HepG2 cells by lipofectamine. HepG2/pshRNA-HIF-1α (HepG2/pshRNA) cell lines were obtained by selection of HepG2 cells in G418. Meanwhile, plasmid of empty vector (pHK) was transfected as a control (HepG2/pHK). The mRNA and protein expression levels of HIF-1α and mdr1 were investigated by RT-PCR and Western blot respectively. Using CoCl2 to simulate the hypoxia condition, growth inhibition and apoptosis rates of HepG2 cells under different dosages of chemotherapeutic agents (adriamycin) were measured by MTT assay and flow cytometry (FCM) ． ResultsCompared with HepG2/pHK cells, the mRNA and protein expression levels of HIF-1αand mdr1 were obviously down-regulated in HepG2/pshRNA cells. At the same time, the proliferation inhibition and apoptosis rates were evidently increased after transfection with pshRNA-HIF-1α(P＜0.05)，which decreased the expression of HIF-1αto 82.18% at mRNA level and 75.51% at protein level. There was no significant effect of transfection pHK (Pgt;0.05). Conclusion These data demonstrates that HIF-1α interference by shRNA increased the sensitivity of HCC chemotherapy and the reversal of multidrug resistance, which may be done by down-regulating the transcription of mdr1 and the translation of P-gp. Blocking HIF-1αin HCC cells may offer an new avenue for gene therapy．