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Ossification Mechanism of Bone Bridge Formation after Physis Injury and Prevention of Growth Arrest by Different Interpositions into Physeal Injury

Author: ZuoQiang
Tutor: HuYunYu
School: Fourth Military Medical University
Course: Surgery
Keywords: Epiphyseal Chondrocytes Membrane bone Cartilage bone Ihh Osteopontin Fibrin glue Micro CT VEGF
CLC: R683
Type: PhD thesis
Year: 2008
Downloads: 98
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Abstract


The first part: the purpose of osteopontin in the rat proximal tibial epiphyseal injuries molecular mechanisms: the proximal tibia metaphyseal epiphyseal injury rat model of bone bridge formation mechanism of molecular pathology. Methods: by Alcian Blue staining observed injury model, the healing process as well as bone bridge formation. Tunel kit for in situ detection of apoptosis understand the damage zone around the cell apoptosis. BrdU labeling of proliferating cells with BrdU antibody to detect clear whether the damage zone around chondrocyte proliferation activity changed. Immunohistochemistry, in situ hybridization experiments to observe whether the damage zone around the hypertrophic zone chondrocytes change detection damage zone cartilage cells to produce, and to determine whether the damage the surrounding cartilage cells survived detect Ihh expression and the Ptch1 expression of positive cells, damage area have its expression, and whether the normal expression of the surrounding uninjured cartilage. Results: found epiphyseal injuries after bone bridge formation process completely damaged zone center no chondrocyte-specific factor Col Ⅱ and Col X-, and Indian Hedgehog (Ihh) and Ptch1 of expression, chondrocyte proliferation, but found completely damage area and the surrounding normal cartilage between the cross-session secondary damage to the cartilage area, there is cartilage apoptosis, Col X expression of BrdU and Vimentin detected the abnormal proliferation of normal hypertrophic zone cartilage cells in this area and the surrounding normal cartilage differentiation from fibroblast-like cells forming cartilage outer membrane-like structure, secondary damage area and cartilage adventitia gradually replaced Osteopontin, Col1, Ptch1 and Ihh the expression of cartilage outer membrane-like structure exists in this process, suggesting that is secreted by chondrocytes contributed The bone formation-related growth factor Ihh may be involved in the process of bone bridge formation. Conclusion: The proposed bone bridge formation is the result of joint participation by the two osteogenesis mechanism, damage the central area of ??membrane bone mechanism in this process, the edge of the area cartilage bone mechanism exists. Second part: the rat proximal tibial epiphyseal injuries prevention of bone bridge formation purpose: the use of the proximal tibia metaphyseal epiphyseal injury rat model by comparing the different methods to repair the therapeutic effect of the growth plate injury evaluation fibrin The plastic materials used in the feasibility of minimally invasive treatment method. Methods: immature rats produced proximal tibial epiphysis injury model. By histochemical staining injury model, the healing process as well as bone bridge formation. 28 rats with unilateral proximal tibial epiphyseal injuries to the side of the right side of the injury, the normal controls on the left side. 28 rat proximal tibial epiphysis bilateral damage to the left implanted fat right side of the implantation of the fibrin glue. Postoperative drawn first micro-CT examination, further histological examination. Compare fibrin glue, fat as a filler material the prevention and treatment of bone bridge formation in the rat proximal tibial epiphyseal injuries, as well as the the rat tibial length and proximal angle changes. Results: The amount of high density low density mixed after 16 weeks and 24 weeks, the fibrin glue and fat-filled group the damaged area, the damaged area of ??the CMW group showed significantly osteopontin. Histological examination showed that the damaged area of ??the fibrin glue and fat-filled group gradually replaced by fibrous tissue, the damaged area of ??the CMW group osteopontin tissue replacement. The fibrin glue filling treatment group deformities in the control of the proximal tibial epiphysis after injury than the fat filling treatment group, but no significant differences. Avoid irreversible bone bridge damage zone, with the the fat filling treatment group effect close to (p gt; 0.05). Significant difference (p lt; 0.05) between the fibrin glue filled group CMW group, there is a very significant difference between fat the filling group with simple injury group (p lt; 0.01). Conclusions: Fibrin glue Country of Origin widely, simple surgery, the effect of treatment with traditional fat filling nearly thus presumably as a new biological material introduced into clinical bone bridge formation after epiphyseal injury prevention. Micro-CT can be used to epiphyseal injuries after bone bridge formation observational study. Objective: To observe the VEGF Part III: VEGF epiphyseal injuries osteopontin in rat proximal tibia formed bone bridge formation process, the theoretical basis of the new minimally invasive method of study prevention of bone bridge formation. Methods: immature rats produced proximal tibial epiphysis injury model. 32 rats with unilateral proximal tibial epiphyseal injuries, the side of the right side of the injury, the normal controls on the left side. 20 rat proximal tibial epiphysis bilateral damage to the simple implantation on the left side of anti-VEGF-Flt. Postoperative drawn first micro-CT examination, further histological examination. Using in situ hybridization experiments detected expression of VEGF in the injured area. Prevention of anti-VEGF-Flt filled using micro-CT observation by histochemical staining healing process as well as bone bridge formation in rat proximal tibia bone bridge formation of epiphyseal injuries, as well as changes in the rat tibial length and proximal angle . The results: 10 days after the injury in the damage zone VEGF expression. Simple injection of anti-VEGF-Flt 16 weeks and 24 weeks the damaged area show The hypodense mixed an increase in the amount of high density and bone bridge. Histological examination showed that the anti-VEGF-Flt group gradually fibrous tissue and bone tissue filling the damaged area of ??the CMW group osteopontin tissue replacement. Irreversible bone bridge and prevention of rat tibial epiphyseal injuries avoid damage zone of proximal deformities, anti-VEGF-Flt group in early better inhibitory effect late ineffective. Conclusion: VEGF signaling pathways involved in bone bridge formation by inhibiting VEGF signaling can inhibit bone bridge formation in the early, but late inhibitory effect weakened. Part IV: anti-VEGF-Flt composite FS formation purpose of osteopontin in rat proximal tibial epiphyseal injury prevention: a combination of VEGF features and fibrin glue, the development of injectable repair materials, the establishment of a minimally invasive biological treatment, the feasibility study prevention of bone bridge formation and therapeutic effect. Methods: immature rats produced proximal tibial epiphysis injury model. 20 rats with unilateral proximal tibial epiphyseal injuries, the side of the right side of the injury, the normal controls on the left side. 20 rat proximal tibial epiphysis bilateral damage to the left side implanted fat, implanted fibrin glue on the right side. The 20 rat proximal tibial epiphysis bilaterally injury, simple implantation on the left side of anti-VEGF-Flt, the right side of the implanted composite fibrin glue anti-of VEGF-Flt. Postoperative based micro-CT examination. Compare composite fibrin glue of anti-VEGF-Flt, the prevention and treatment of the rat proximal tibial epiphyseal injuries after a simple anti-VEGF-Flt, fibrin glue, fat-filled bone bridge formation and rat tibial bone length and proximal angle changes. Results: proximal deformities in rat tibial epiphyseal injury prevention, although not much different in the early, but significantly better than in late composite fibrin glue to fill a group of anti-VEGF-Flt fibrin glue alone filled group and simple anti-VEGF-Flt group better than fat filled group. Very obviously avoid the damage zone the irreversible bone bridge, composite fibrin glue treatment group effect of anti-VEGF-Flt filled group and fat filled no difference (p gt; 0.05), both between simple injury group differences (p lt; 0.01). Conclusion: anti-VEGF-Flt the fibrin glue transplant method has a more significant to avoid the early angular and shortening deformity, and the final deformity reduction advantage, simple, clear hemostatic effect, can be used as a new type of biological treatment application the prevention of bone bridge formation at the epiphyseal injury prevention, clinical treatment of early epiphyseal closure.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Fracture,bone damage
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