Objective To observe the effect of pilose antler polypeptides(PAP)on the apoptosis of rabbit marrow mesenchymal stem cells (MSCs) differentiated into chondrogenic phenotype by interleukin 1β (IL-1β) so as to optimize the seeding cells in cartilage tissue engineering. Methods The MSCs were separated from the nucleated cells fraction of autologus bone marrow by density gradient centrifuge and cultured in vitro. The MSCs were induced into chondrogenic phenotype by transforming growth factor β1(TGF-β1) and basic fibroblast growth factor(bFGF). According to different medias, the MSCs were randomly divided into four groups: group A as black control group, group B(100 ng IL-1β)，group C(10 μg/ml PAP+100 ng IL-1β) and group D(100 ng/ml TGF-β1 +100 ng IL-1β). The samples were harvested and observed by morphology, flow cytometry analysis, RT-PCR and ELISA at 24, 48 and 72 hours. Results The intranuclear chromatin agglutinated into lump and located under nulear membranes which changed into irregular shapeat 24 hours. The intranuclear chromatin agglutinated intensifily at 48 hours. Then the nucear fragments agglutinated into apoptosic corpuscles at 72 hours in group B. The structure change of cells in groups C and D was later than that in group B, and the number of cells changed shape was fewer than that in group B. The structure change of cells in group A was not significant. The apoptosic rate of cells, the mRNA expression of Caspase-3 and the enzymatic activity of Caspase-3 gradually increased in group B, and there were significant differences compared with groups A,C and D(Plt;0.01). Conclusion Caspase-3 is involved in aoptosis of the MSCs differentiated into chondrogenic phenotype cultured in vitro. PAP could prevent from or reverse apoptosis of these MSCs by decreasing the expression of Caspase-3 and inhibiting the activity of Caspase-3.
Objective To compare the curative effect of posterior lumbar interbody fusion with autologous il iac crest to that of interbody fusion cage for adult instabil ity of lower lumbar. Methods From February 2003 to October 2006,60 inpatients with lower lumbar instabil ity were treated. Patients were randomized into 2 groups: bone-graft group (n=28) was treated with posterior lumbar interbody fusion with two autologous il iac crests, while cage group (n=32) was treated with posterior lumbar interbody fusion with two quadrate cages. In the bone-graft group, 17 males and 11 females aged (52.78 ± 10.50) years with 3-16 months of disease course, there were 12 cases of degenerative instabil ity, 14 isthmus sl it ol isthe and 2 iatrogenic instabil ity, including 1 case of L3,4, 17 cases of L4,5 and 10 cases of L5, S1. Relative disc space height was (23.24 ± 6.62) mm, disc space activity was (10.50 ± 5.07)º, sagittal saw sl ippage distance was (4.50 ± 1.15) mm and the JOA score was 18.56 ± 2.68. In the cage group, 19 males and 13 females aged (51.75 ± 10.44) years with 3.5-14.0 months of disease course, there were 16 cases of degenerative instabil ity, 14 isthmus sl it ol isthe and 2 iatrogenic instabil ity, including 16 cases of L4,5 and 16 cases of L5, S1. Relative disc space height was (24.34 ± 7.22) mm, disc space activity was (11.12 ± 5.67)º, sagittal saw sl ippage distance was (4.38 ± 0.75) mm and the JOA score was 19.00 ± 4.12. There was no significant difference between the two groups in termsof age, gender, JOA score, disc space activity and relative disc space height preoperatively (P gt; 0.05). Results All patients received the follow-up at the 1st, 3rd, 6th and 12th month postoperatively. There was no significant difference in operation time and hemorrhage amount between the two groups (P gt; 0.05), but significant difference in the cost of operation (P lt; 0.01). Two cases in the bone-graft group suffered donor site pain and received no treatment. Three cases in the bone-graft group and 2 cases in the cage group had symptom of nerve injury 1-2 days after surgery, which were cured after expectant treatment. There were no pseudoarticulation formation, intervertebral space infection and cage aversion in both groups. Significant difference of relative disc space height was found in each group pre- and post- operatively (P lt; 0.01) and significant differences were evident between the two groups at any of the time points (P lt; 0.01). One month after operation, there was significant difference between the two groups (P lt; 0.05). There was also significant difference at the 3rd, 6th and 12th month after operation (P lt; 0.01). No sign offusion was found in each group at the 1st and 3rd month after operation. In bone-graft group, there were 7 vertebral fusion cases 6 months after operation and 23 vertebral fusion cases 12 months after operation. In cage group, there were 8 vertebral fusion cases 6 months after operation and 29 vertebral fusion cases 12 months after operation. There was no significant difference in the rate of fusion at 6 and 12 months follow-up between the two groups (P gt; 0.05). Significant difference of JOA scores was found in each group pre- and post- operatively (P lt; 0.05). And no significant difference in JOA scores at 1, 3, 6, and 12 months follow-up was evident between the two groups (P gt; 0.05). Conclusion There is no significant difference between the two groups in the fusion time, the fusion rate and the cl inical symptoms alleviation, indicating autologous il iac crest is appl icable to interbody fusion for the treatment of adult instabil ity of lower lumbar and good therapeutic effect can be achieved with no immunoreaction and lower cost.