Professor Ning Yagong’s Academic Experience For Middle-Late ANFH And Experimental Research

Objective: Summarize professor Ning Yagong’s academic experience for ANFH, to explore a method for treatment combined traditional Chinese and western medicine in preserving femoral head for middle-late ANFH, and provide experimental basis for it.Method:1. Through studying followed tutor and consulted his theses, monograph, to summarize tutor’s academic experience for middle-late ANFH, to elaborate theoretically on tutor’s viewpoint in dialectical treatment for ANFH, to summarize professor Ning Yagong’s academic experience for ANFH2.50mediate-late ANFH rabbit models were induced by thermal injury in combination with liquid nitrogen freezing.2rabbit will be randomly selected to observe their gross anatomy1,2,4,6and8weeks after operation. Tissue sections were observed under optical microscopy and examined by X-ray and MRI. Evaluation and confirm that necrosis degree of femoral head already reach Ⅲ period above.3. The40remainder of animals which were molded should be examined by MRI, in order to make sure the necrotic degree of all moled femoral head already reach Ficat Ⅲ period above. After that, divide d them into the blank group(A), the BMSCs group(B), the TCM group(C) and the TCM combined with BMSCs group(D), with each group containing10rabbits. Group A without any treatment. Group B with Hip cavity injection of autologous BMSCs, just one time during the whole course of treatment. Group C with forcing to take TCM, once a day for two months. Group D with Hip cavity injection of autologous BMSCs just one time, then forcing to take TCM once a day for two months.5rabbits will be selected randomly from each group to do above-mentioned examination, and evaluate the therapeutic effect of each group.Results:1. Utilizing tutor’s experience to conduct clinical treatment could improve the clinical effect.2. At week8after molded by thermal injury in combination with liquid nitrogen freezing, fragmentation, narrow, and osteoarthritis change appeared in the femoral head. This is in line with the performance of middle-late ANFH.3. General observation After treatment1,2month, the rabbits Limb function in group B,C,D was superior to that of group A.4. Imaging examination after one-month treatment, Group A femoral head continue to collapse, Group B sclerosis and cystic changes could be seen within femoral head after1month treatment, Group C scattered cystic changes could be seen, Group D cords shaped cystic changes appeared in the femoral head. To the end of two-month treatment, Group A some animals appeared dislocation, Group B sclerosis band became blurred, Group C bone mineral density tend to be homogeneous, Group D bone mineral density was homogeneous.5. Anatomical observation after one-month treatment, Group A collapse was around with a small amount of proliferative tissue, Group B articular cartilage had repairing response, Group C bone tissue under cartilage had obvious repairing response, Group D both articular cartilage and bone tissue under cartilage had repairing response. To end of two-month treatmen, Group A proliferation became more obvious, Group B Joint surface was smooth relatively, Group C reactive remodeling could be seen, Group D the femoral head shape had no significant difference compared with the contralateral.6. Biopsy histopathology observation after one-month treatment, Group A extensive bone trabeculae necrotized, Group B growth of abundant cartilage and perichondral bone could be seen, Group C perichondral bone could be seen, but the reaction was not violent compared with Group B, sequestrum couldn’t be found. Group D both intramembranous ossification and perichondral bone could be seen. To end of two-month treatmen, Group A bone trabeculae necrosis still existed, around the sequestrum, repairing reaction occurred. Group B scattered perichondral bone could be seen, under which bone trabeculae necrosis was still obvious, Group C active woven bone tissue formed by perichondral bone could be seen, renascent bone marrow arose. Group D cartilage actively grew, woven bone tissue formed by perichondral bone existed, renascent bone marrow could be seen in medullary cavity.Conclusion:1. Tutor’s experience correspond to clinical truth, combination of disease and syndrome, prescriptions corresponding to syndromes, his experience improved the clinical effect.2. Thermal injury in combination with liquid nitrogen freezing can be used to establish rabbit mediate-late ANFH model.3. In short-term, Single treatment of hip joint injection of autologous BMSCs play a significant role on the repair of articular cartilage.4. Single treatment of forcing to take TCM “Bushenhuogu soup” has obvious repair effect of osteonecrosis under articular surface, with administration time prolonging, the curative effect of TCM “Bushenhuogu soup” could be further improved.5. TCM combined with Hip cavity injection of autologous BMSCs could apply to clinical treatment as a new therapy, because of its effective repair effect on necrotic femoral head’s articular cartilage and osteonecrosis area under the cartilage.