Analysis Of Callus NGF And PDGF Levels In Bone Fracture Affiliating Cerebral Trauma Patients

Objective: There is a commonly clinical phenomenon:if a fractured patient has traumatic brain injury (TBI) at the same time,bone callus were bigger and faster formed than those in the groups of only fracture and heterotopic ossification can be found,it seems that TBI can accelerate the fracture healing process.There were some clinical reports and a few experimental studies about this phenomenon,lots of hypotheses were made but the mechanism in it isn't clear so far. There was clinical test confirm that serum nerve growth factor (NGF) and platelet-derived growth factor(PDGF) levels of cerebral trauma affiliating bone fracture patients were significantly higher than the levels of simple fracture patient. It suggests that serum NGF and PDGF levels after cerebral trauma significantly increase,NGF and PDGF are the growth factor to accelerate fracture healing and promot fracture healing after cerebral trauma. Detect the contents of NGF and PDGF in callus of the two groups and search for the key factor during fracture healing to provide theory for clinical treatment.Methods:1 standard to be selected:(1)male and female,age:14-55 years; without elementary disease.(2) fracture site: long bone of upper limb.(3)diagnostic criteria: determining fracture site by x light. (4) treatment method: external fixation2 Sample collection:after fracture parts external fixation of the patients,we get osteotylus at the fracture parts(between7 to4 weeks).Then we put the samples into Polyoxymethylene (4%),and number it.We choosse 15 sepecimens, which were divided into 2 groups:simple bone fracture group(5 cases) and bone fracture afflilating cerebral trauma group(10 cases).3 Assaying:we use HE dyeing to observe histological anatomy,and immunohistochemistry stain to detect the expression of NGF and PDGF.4 Image analysis: multifunction color image analysis management system was used to analyses .SPSS 17.0 statistic software was used for statistical treatment. Results:1 H.Estain1.1 The simple bone fracture group:a great of granulation tissue, connective tissue,blood capillary fibroblast,secretory collagen fibers and cartilage cell were investigated in callus .There was no newly bone trabecula.1.2 The bone fracture affiliating cerebral trauma group: granulation tissue, chondrification and newly bone trabecula were investigated in callus.2 Immunohistochemistry2.1 In the simple fracture:a little PDGF and NGF can be deteced at the connective tissue,peripheral zone of cartilage corpuscle, fibroblast osteoblast and osteoclast in osteotylus.The expression of PDGF and NGF were not obviously in neoformative cartilage corpuscle.2.2 The bone fracture affiliating cerebral trauma group: PDGF and NGF can be deteced obviously at the connective tissue and peripheral zone of cartilage corpuscle. The expression of PDGF and NGF were not obviously in neoformative cartilage corpuscle.The bone cell,fibroblast and neoformative bone base had the positive staining.The expression was not good at cartilage cell.3 Analysis treatment:3.1 Between the simple fracture group and bone fracture affiliating cerebral trauma group,there was no significant differences at the time to get osteotylus(p>0.05).3.2 The immunohistochemistry score of PDGF in bone fracture affiliating cerebral trauma group is higer than the simple fracture group.There was significant difference between the simple fracture group and bone fracture affiliating cerebral trauma group(p<0.01).3.3 At the same time The immunohistochemistry score of NGF in bone fracture affiliating cerebral trauma group is higer than the simple fracture group (P<0.05).3.4The expresion of PDGF and NGF had no correlation with age (r=0.194,0.185;p>0.05).3.5 The expresion of bony callus PDGF was higher than NGF(P<0.01). Conclusions:1 This experiment has showed that the expression of NGF and PDGF were the factors to accelerate the speed of fracture healing in the the bone fracture with cerebral injury.2 Multiple factors have participated in and coordinat the fracture healing.PDGF and NGF may be important factors in fracture healing.3 The expresion of bony callus PDGF and NGF had no correlation with age.