| Objective1.Evaluation of platelet-rich plasma combined with suigical dislocation of the hip in the treatment of femoral head necrosis during peri-suibsidence peirod2.Objective to investigate the effect of platelet-rich plasma with gu sui bu of total flavonoids on the proliferation of rabbit bone marrow mesenchymal stem cells.Methods1.Clinical Research: 2016.03-2017.02 patients with avascular osteonecrosis of the femoral head in the Linyi People's Hospital of Shandong Province were selected,through the inclusion and exclusion criteria,35 cases of 40 hips were selected,according to the randomized digital table method,the control group was divided into two groups,17 cases 20 simple hip joint surgery dislocation iliac bone grafting,observation Group 18 cases 20 hips in control group Based on the use of platelet-rich plasma,follow-up 12 months,preoperative and postoperative 3 months,6-month,12-month hip Harris score,the good rate of the last follow-up Harris score,preoperative and postoperative visual analogue scoring of the 1th,5,7,14 days,imaging data,postoperative lead flow,preoperative and postoperative 1th,5,7,14 days of C-reactive protein,the 14 th day of operation incision healing grade for statistical analysis.2.Expermetal Research: Rabbit bone marrow mesenchymal stem cells were isolated and purified by density gradient centrifugation and cell wall-sticking method.In vitro culture and proliferation,to be transmitted to the 3rd generation after the group,respectively(control group,Group A: 0.5ml prp,Group B: 0.5ml 10mg/L gu sui bu of total flavonoids,Group C: 0.5 ml PRP and 0.5ml 10mg/ L gu sui bu of total flavonoids)Bone marrow mesenchymal stem cells cultured in vitro by gu sui bu of total flavonoids in the culture,the morphological characteristics of bone marrow mesenchymal stem cells were observed by inverted microscope and the cytological identification was performed with he staining,CD34?CD90 and CD44 immunohistochemical staining,and the proliferation of each group was measured by MTT assay,and the growth curve was plotted and analyzed statistically.Results1.Clinical part: Both groups were followed up for 12 months,and were not statistically significant and comparable to the age,sex,preoperative Harris score,VAS score,acro staging and statistical analysis of the two groups before operation.P>0.05 The results of postoperative observation indicators showed that: repeated measurement variance analysis of the two groups of hip joint Harris score showed that the hip Harris score of the two groups of patients were statistically significant compared with each other,F=276.25,P=0.00,It was indicated that the hip Harris score of the two groups had significant difference at different time points.The hip Harris score of the two groups was statistically significant compared with F=7.60,P=0.01,which indicated that there were significant differences in the hip Harris score between the two groups of patients.Whether time and group have interaction,F=7.42,P=0.00,indicating the interaction between time and group;According to the good rate of the Harris score of the last follow-up Mann-whitney U Test,Z=-1.980,P=0.048,the excellent rate of the observation group was higher than that of the control group,It was statistically significant and the improvement rate of the observation group was higher than that in the control group,and theZ=-2.62,P=0.01 was statistically significant.The VAS score of the two groups was compared by the analysis of repeated measurement variance,and the VSA score of the two groups was compared with each time point,F=147.96,P= 0.00,it is statistically significant that the VAS score of the two groups has significant difference at different points in time;the VAS score and F=4.39,P=0.04 of the two groups were statistically significant,indicating that the VAS score was significantly different between the two groups,and whether time and group had interaction,F= 5.30,P=0.00,it is statistically significant,indicating that time and group have interaction;the T-Test,t=-4.061,P=0.000,and the quantity of observation group is less than that of the control group,which is statistically significant.Two groups of C-reactive protein after repeated measurement variance analysis showed that the C-reactive protein value of the two groups of patients compared with each time point,F=20319.39,P=0.00,statistically significant,indicating that the C-reactive protein in the two groups of patients with a significant difference in different time points The C-reactive protein value of two groups of patients was statistically significant,which indicated that the C-reactive protein value of the two groups was significantly different,and that the interaction between time and group was F=190.59,P=0.00 and statistically significant,The results showed that time and group had an interactive effect,each time point was higher than before operation,the 5th day after operation was the highest,the 1th and 5 days were gradually increased,and the 5th,7 and 14 days decreased gradually after operation,2 cases of postoperative observation group had slight swelling without exudate,and 3 cases had red swelling without exudate in the control group,The 14 th day incision Grade A healing rate control group was lower than the observation group,Z=-0.47,P=0.64,no statistically significant.2.Expermental part: The method of separating and culturing rabbit bone marrow stromal cells by bone marrow culture is reliable,cells in vitro growth and stability,can be a certain proportion of passage,cell proliferation faster,adaptable,can be in a short period of time wall growth,the primary bone marrow mesenchymal stem cells He staining showed uniformity of staining,CD44 and CD90 expression positive,The CD34 expression was negative,and the cells in the four groups showed "S" linear curve growth,on the 2nd day,the Group A,B and C have been maintaining high proliferative activity,the curve has risen a lot,which is obvious in Group C,the rapid growth period of growth curve,the time of multiplication is short,about 30 h,the control group showed rapid multiplication on the 3rd day,A rapid growth period that forms the growth curve,the time of multiple growth,about the 2nd day of the 42H;MTT detection method,the OD value between the four groups was statistically analyzed(P>0.05),there was no statistical significance,the 3rd day control group was lower than the OD value of a,B and C Group(P<0.05),which was statistically significant.On the 4th day,the OD value of Group A and B was low(P<0.05),which had the significance of unification,and the OD value of Group B in the 6th day was high,(P<0.05),which was statistically significant.Conclusion1.Platelet-rich plasma combined with surgical dislocation of hip joint bone grafting for treatment of femoral head necrosis in the peri-subsidence period is superior to the simple hip surgery dislocation iliac bone grafting,which provides a new adjuvant therapy for platelet-rich treatment of femoral head necrosis.2.Platelet-rich plasma and gu sui bu total flavonoids have synergistic effects on the proliferation of bone marrow mesenchymal stem cells,and the function of platelet-rich plasma is higher than that of total flavonoids. |
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