The aim of this study was to explore the mechanism underlying the promotive effect of morroniside on rat mesenchymal stem cell (RMSC) proliferation and to provide an experimental basis for the development of potential new drugs. RMSCs were obtained from the bone marrow of Sprague-Dawley rats aged 3-4 months. The proliferation of primary and subcultured RMSCs in the high‑, medium‑ and low‑concentration morroniside intervention and blank control groups was observed using light microscopy. Cell proliferation and survival conditions were detected using methyl thiazolyl tetrazolium (MTT) colorimetric tests. Light microscopy and the MTT assay revealed that RMSC adherence time in the morroniside groups was shorter compared with that of the control group. Twelve hours after the media of primary RMSCs were changed, the number of adherent cells in the morroniside groups increased and an elongated cell morphology was observed. The cells at the fourth passage in the morroniside groups fused completely 12‑16 h after inoculation and then rapidly entered into the logarithmic phase. The primary RMSCs of the morroniside intervention groups grew into typical bone marrow mesenchymal stem cell (BMSC) colonies after 4 days of morroniside treatment and their fusion rate had reached 80% after 9‑11 days. By contrast, the cell fusion rate of the control group only reached 75-80% after 14 days of morroniside treatment. Morroniside exhibited a similar promotive effect on proliferation in primary and subcultured RMSCs. Morroniside may promote RMSC proliferation through secreted factors, cell-to-cell interactions and/or the interactions between cellular adhesion molecules and extracellular matrices (ECMs). However, the specific mechanism underlying this effect remains to be fully elucidated.

This retrospective study assessed the outcomes of segmental subtotal corpectomy with titanium cage reconstruction and anterior plate fixation for multilevel ossification of the posterior longitudinal ligament. The study included 34 patients with multilevel ossification of the posterior longitudinal ligament who underwent segmental subtotal corpectomy with titanium cage reconstruction and anterior plate fixation from June 2005 to May 2011. Clinical and radiologic data were obtained. Neurologic function was evaluated by Japanese Orthopedic Association scores before and after surgery. No death, paralysis, or other surgically associated injuries occurred. After surgery, the bone graft fusion was firm, with no cases of lack of postoperative bone fusion, broken or loose titanium plate and screws, dislodged titanium cage, or injury to the vertebral artery, nerve root, or spinal cord. Cerebrospinal fluid leakage occurred in 2 cases. Japanese Orthopedic Association scores improved from 6.74±1.82 preoperatively to 11.33±3.5 postoperatively (P<.05). Neurologic outcomes were excellent or good in 84.21% of patients at follow-up of 1 to 6 years. No postoperative cerebrospinal fluid leakage occurred. Reasonable and skilled operation of the pneumatic drill is the key to successful surgery. Anterior corpectomy with titanium cage reconstruction and plate fixation and drilling applications can directly remove the hypertrophy and ossification of the posterior longitudinal ligament and relieve spinal cord compression. This technique retained the integrity of the vertebrae, increasing the possibility of bone graft healing. Segmental subtotal corpectomy with titanium cage reconstruction and anterior plate fixation can be used for the treatment of multilevel ossification of the posterior longitudinal ligament. [Orthopedics. 2016; 39(6):e1140-e1146.].

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Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by symmetric, relapsing, or chronic destructive synovitis. The aim of this retrospective study was to assess the clinical benefits of TKA in patients with severe osteoporosis and moderate genu valgum.Methods: This was a retrospective study of patients with RA, osteoporosis, and genu valgus treated using TKA at the Fourth Affiliated Hospital of Harbin Medical University between 05/2016 and 05/2019. Posterior stable prostheses were used in all patients. The Knee Society Scoring System (KSS) was used.Results: There were eight males with 10 knees involved and 24 females with 34 knees involved. Healing by first intention was achieved in all patients. All patients received follow-up, with the mean follow up time of 2.9 (1-4) years. At the last follow-up, the KSS clinical score was improved from 32.1±9.8 to 82.0±5.8, (P<0.001). The KSS functional score of the patients was improved from 38.3±9.3 to 88.1±10.7 (P<0.001). The flexion-extension ROM of the knee joint was improved from 81.8°±27.9° to 105.8°±17.0° (P<0.001). The femorotibial angle (FTA) was changed from 23.1°±2.8° to 6.8°±1.9° (P<0.001). Common peroneal nerve paralysis and periarticular infection each occurred in one patient.Conclusion: TKA via the medial parapatellar approach with proper osteotomy and soft tissue balancing could restore the knee function in patients with RA, severe osteoporosis, and genu valgum.

Cervical spondylosis is a disease that occurs with age and affects the discs and joints in the cervical spine located in the neck. The hydroxyapatite (HA) bone graft substitutes can used as a potential bone-forming agent, however, the efficacy of using HA is challenging in cervical reconstruction. In this regard, nano-based HA was used in this study to explore its sagittal parameters and clinical potency in relative to titanium (TiO2) cage in patient with cervical spondylosis. 50 patients suffering from cervical spondylosis were divided in two groups and were grafted with either TiO2 cage or nano-HA. The sagittal parameters, including cervical spine lateral radiographs (C0−2Coob and C2−7Coob) were taken pre- and post-operation (3-month, one-year and two-year). The clinical potency was also done based on the JOA scores. Angle analysis indicated that the C0−2Cobb and C2−7Cobb angles were significantly changed after the operation in both TiO2 cage and nano-HA groups, whereas no significant changes was determined in nano-HA relative to TiO2 cage condition. Also, it was shown that JOA scores were significantly higher after the operation than pre-operation, indicating a potential cervical reconstruction after surgery in both groups which slightly were higher for nano-HA groups.