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The effects and mechanisms of soybean isoflavone on osteoblast (OB) proliferation in vitro were investigated. Fifty female Wistar rats were randomly divided into five groups with 10 rats in each group. Rat OBs were separated and cultured. The first generation of OBs cultured for 48 hr at various concentrations of isoflavone were set as the experimental groups, the OBs exposed to estradiol (E 2 ) culture were considered as positive control group. The biological characterization of OBs was investigated by phase contrast microscopy and alkaline phosphatase (ALP) histochemistry. The concentrations of interleukin (IL-1), osteoprotegerin (OPG), transforming growth factor (TGF), granulocytemacrophage colony-stimulating factor (GM-CSF), and vascular endothelial growth factor (VEGF) in isoflavone culture solutions were determined. Proliferation rate of OBs was increased in experimental group comparing that in the blank group. ALP activity in experimental group was higher than that in blank group. No significant differences of ALP activity were observed between E 2 culture group and isoflavone group at concentrations of 10 −5 and 10 −7 mM (P > 0.05). Furthermore, in the experimental groups at low isoflavone concentrations, the concentrations of OPG, TGF, and VEGF were increased and positively correlated with OB proliferation. However, the concentrations of IL-1, GM-CSF were decreased at higher concentration of isoflavone and were negatively correlated with OB proliferation. Soybean isoflavone could promote the growth and proliferation of rat OB, it might act as the stimulator of OPG, TGF, and VEGF pathway, and the inhibitor of IL-1, GM-CSF pathway as well.

The technique described is a safe and novel right infraaxillary thoracotomy approach to provide direct access from vertebral bodies T2-T6 and to provide adequate room for upper thoracic vertebral decompression and fusion surgery. However, a suitable fixation implant should be designed. These slides can be retrieved under Electronic Supplementary Material.