Objective To study the clinical application ofheterogenous bone graft combined with auto-marrow. Methods Deproteinated and degreased heterogenouscancellous bone combined with auto-marrow was used in 21 cases of anterior cervical interbody fusion. Among them, 2 cases were treated by bone graft only, and the other 19 cases were further treated by anterior plate fixation. Results The follow-up time was 12-36 months with an average of 21 months. After operation, posteroanterior and lateral radiograph of all the cases revealed that the reduction and the position of the grafting bone were good without inflammation or other complications. After 6 months of operation, the radiograph of 2 cases of cervical disk herniation, which were treated by bone graft only, showed the bones lost their height and the curve of the cervical spine returned to the state of preoperation. For the other cases, the grafting bonesremained their original figure without dislocation of the bone or fracture of the plate or the screw. The nervous function recovered variously. Before operation, 10 cases were ranked as grade A,7 cases grade C, 4 cases grade D according to Frankel classification. After operation, in grade A cases, 5 cases did not recover, 3 cases recovered to grade B, 2 cases to grade C; in grade C cases, 5 to grade D, 2 to grade E; all ofgrade D 4 cases to grade E. Conclusion Heterogenous bone combined with auto-marrow can be used as grafting material in the anterior cervical interbodyfusion, but its mechanical rigidity need to be improved or the fusion shouldbe aided with rigid internal fixation.
OBJECTIVE: To explore the possibility of prefabricate a vascularized artificial bone-muscular flap, a compound of xenogenic inorganic bone and auto-marrow, with capability of osteogenesis. METHODS: Twelve 6-month New Zealand rabbits were divided into two groups, compound of xenogenic inorganic bone and auto-marrow implanted into the muscle near to radia and ulna of left forefoot as experimental group. Simple xenogenic inorganic bone implanted into the same site of right side as control group. After 2, 8, 12 weeks, x-ray examination, gross evaluation and histological observation were carried out. RESULTS: X-ray film showed that the implant had a cancellus-like density, and no variance with time. Since 2 weeks after implantation, gross observation showed a complete fusion formed between the implant and the host muscular tissue, with obvious blood vessels on the surface of the muscular flap in which the compound was encapsulated. No necrosis was observed in the following 30 minutes after the compound was dissected from its surrounding tissues. The histological investigation showed a contact connection between implant and its surroundings. In the experimental group, no new bone formed but in-growth of blood vessels was observed at the end of the 2nd week, and a little new bone formed along the edge of xenogenic inorganic bone at the end of the 8th week, while at the end of 12th week, more new bone formed in the compound with osteocytes in bone lacuna, plenty blood vessels in bone matrix, and lots of osteoblasts surrounded by un-differentiated mesenchymal cells at the fringe of the new bone. While in the control group, there were only loose connective tissue with blood vessels grew into xenogenic inorganic bone with no new bone formation until 12 weeks. CONCLUSION: The compound of xenogenic inorganic bone and auto-marrow can promote the formation of vascularized myo-bone flap with new bone formation.
Objective To analyze the prevalence rate of chronic obstructive pulmonary disease in people over 40 years old in China plateau (altitude≥1 000 m) in recent years. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, VIP databases and Chinese Medical Database were searched, and the articles published between January 1, 2010 and December 5, 2022 were collected. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included articles. Meta-analysis was performed with Stata 17.1. Results A total of 13 articles were included, with a total sample size of 37 230 people, including 3 697 chronic obstructive pulmonary disease patients. The prevalence rate of chronic obstructive pulmonary disease in people over 40 years old in China plateau was 9.0% [95% confidence interval (0.07, 0.11), P<0.001]. The results of subgroup analysis showed that males (12.4%), smokers (13.4%), 61-70 years old (15.1%), primary school and below (10.3%), low body weight (12.2%) and Yunnan (11.5%) had the highest prevalence rates within the subgroup (P<0.05). Conclusions The prevalence of chronic obstructive pulmonary disease in China plateau is still high. Gender, age, smoking, education level, body mass index and region are still important influencing factors of chronic obstructive pulmonary disease.