Objective To evaluate sex determining region of the Y (Sry) as a engrafting track of the transplanted BMSCs survival and new bone formation in the osteonecrosis of the femoral head (ONFH) of rabbit. Methods Fortynine 4-5-month-old New Zealand White rabbits were included, weighing 2.0-2.5 kg, 48 females and 1 male. BMSCs of the rabbits were isolated by density gradient separation method, the third passage cells were marked by 1, 1’-dioctadecyl-3, 3, 3’, 3’-tetramethyl indocarbocyanine perchlorate (DiI) and the concentration of cell suspension was 2.5 × 108/ mL. The animal model of ONFH were establ ished with 48 female rabbits by injecting l iquid nitrogen, and femoral head was not dislocated.The animal model were divided into 3 groups, 16 rabbits in each group. Group A only establ ished animal model as control. Autologous BMSCs (4 μL) marked by DiI was transplanted in the ONFH models of the group B. Allogenic BMSCs (4 μL) marked by DiI was transplanted in ONFH models of the group C. The femoral head were observed by X-ray, HE staining and Masson staining, and the regenerating trabecular volume percentages was determined at 2, 4, 6 and 8 weeks after operation respectively. The examples of the heart, lung, l iver, spleen and kidney were obtained. The transplanted BMSCs were traced by fluorescence microscope, the Sry gene expression was detected by PCR for cells survival. Results All rabbits survived till the end of experiment. The X-ray showed gradual necrosis in the femoral head of group A. HE and Masson staining results indicated that compared with the group A, the recovery condition of the necrotic femoral head in the groups B and C was better. At each time of groups B and C, the regenerating trabecular volume percentages were higher than that of the group A significantly (P lt; 0.01). There was no significant difference between groups B and C (P gt; 0.05). The cells marked by DiI were not founded in the tissues of the heart, lung, l iver, spleen and kidney in groups B and C at each time. PCR showed that the expression of Sry gene were not observed at the heart, lung, l iver, spleen and kidney of three groups at each time. The expression of Sry gene was clearly identified in the femoral head of all 16 rabbits in the group C at each time point. Conclusion Allografting of BMSCs transplanted into the femoral head can survive and induce new bone formation without redistribution.
Objective To investigate the characteristics of patients with crush injury in Wenchuan earthquake and the corresponding operational methods. Methods From May 12th 2008 to June 18th 2008, 202 patients with crush injury of soft tissue were treated, including 110 males and 92 females. Twenty-five patients aged 19 months to 16 years, 129 patients aged 17-60 years and 48 patients aged above 61 years. The crushed time was 30 minutes to 154 hours. Sixty cases of openinjuries were treated by debridement and dressing or suture; 16 cases of damaged extremities (18 l imbs) and 6 cases of acute renal failure due to crush syndrome (8 l imbs) received amputation; 32 cases of interfascial space syndrome crisis (42 l imbs) were treated by fascia cavity decompression; 15 cases received the resection of necrotic muscle for 31 times; and 9 cases received continuous renal replacement therapy (CRRT). Results All the wounds healed except 2 cases which died from intestinal bleeding and intracranial hemorrhage during the treatment of CRRT. Two cases were discharged 8 months after treatment, while the other 198 cases recovered and were discharged 15-120 days after treatment. The average hospital ization time was 53 days. Twenty-two cases (26 l imbs) were fixed with artificial l imbs 3-6 months after amputation and achieved good functional outcome. Conclusion The treatment principle of crush injury is “be active to decompress and be prudent to amputate”, the hardening muscle and the increasing level of creatine kinase and blood potassium are the golden indicators of fascia cavity decompression. Decompression at an earl ier period is preferred when there is a dilemma to choose, and open amputation should be performed when the necrotic muscle is hard to clear or the necrosis boundary is not distinct.