Li Bing Cang, Zhang Jian Jun, Xu Chuan, Zhang Liang Chao, Kang Jian Yi, Zhao Hui
Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
J Trauma. 2009 Feb;66(2):450-6. doi: 10.1097/TA.0b013e3181848cd6.
Firearm bone fractures are difficult to treat compared with general ones as both soft tissue and bone are injured more extensively and severely with contamination in the wound track. The bone morphogenetic protein (BMP) and transforming growth factor (TGF)-beta play an important role in bone fracture healing. Therefore, BMP-4 combined with TGF-beta1 was used to improve and accelerate the repair of rabbit femoral defect resulting from firearm.
Femoral defect was made with 0.375 g steel ball fired at 350 m/s. At 6 hours after wounding, the debridement and irrigation were performed, followed by trimming the ends of defected bone at day 7. Plasmid-encoded BMP-4 gene identified in vitro and TGF-beta1 were injected into the tissue of upper and lower parts and the epicenter of the defected area at 2 weeks after wounding, again TGF-beta1 was given at 5 weeks. At 3, 7, 11, and 15 weeks after wounding, the expression of mRNA and protein of BMP-4 were detected by reverse transcription-polymerase chain reaction and Western blot. The activity of alkaline phosphatase and calcium content were measured for describing osteogenetic ability. The course and quality of osteogenesis were determined quantitatively by pathohistological and X-ray examinations.
In vivo BMP-4 mRNA and protein could be continually expressed for 8 weeks. The determination of alkaline phosphatase activity and calcium content showed osteogenetic ability was significantly enhanced by BMP-4 gene combined with TGF-beta1. The pathohistological and X-ray examinations revealed that osteogenetic speed was prominently accelerated, and the quality was improved after the treatment.
The repair of rabbit femoral defect resulting from firearm can be significantly improved and accelerated by BMP-4 gene combined with TGF-beta1.
与一般骨折相比,火器性骨折的治疗较为困难,因为软组织和骨骼损伤更广泛、更严重,且伤口通道存在污染。骨形态发生蛋白(BMP)和转化生长因子(TGF)-β在骨折愈合中起重要作用。因此,使用BMP-4联合TGF-β1来改善和加速兔火器所致股骨缺损的修复。
用0.375 g钢球以350 m/s的速度发射造成股骨缺损。受伤后6小时进行清创和冲洗,在第7天修剪缺损骨的两端。在受伤后2周,将体外鉴定的质粒编码BMP-4基因和TGF-β1注入缺损区域上下部组织及缺损中心,在第5周再次给予TGF-β1。在受伤后3、7、11和15周,通过逆转录-聚合酶链反应和蛋白质印迹法检测BMP-4的mRNA和蛋白表达。测量碱性磷酸酶活性和钙含量以描述成骨能力。通过病理组织学和X线检查定量确定成骨过程和质量。
在体内BMP-4的mRNA和蛋白可连续表达8周。碱性磷酸酶活性和钙含量的测定表明,BMP-4基因联合TGF-β1可显著增强成骨能力。病理组织学和X线检查显示,治疗后成骨速度明显加快,质量得到改善。
BMP-4基因联合TGF-β1可显著改善和加速兔火器所致股骨缺损的修复。