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By co-culturing humm mesenchymal stem cells (hMSCs) and human umbilical rein endothelial cells (HUVECs) under hypoxia and creating a microenvironment similar to that of transplanted hMSCs for the treatment of avascular ni ANFH,the effect of hMSCs on survival,apoptosis,migration and angiogenesis of human umbilical vein endothelial cells (HUVECs) under the hypoxic condition were investigated in vitro.hMSCs and HUVECs were cultured and identified in vitro.Three kinds of conditioned media,CdM-CdMNOR,CdM-CdMHYP and HUVEC-CdMHYP were prepared.HUVECs were cultured with these conditioned media under hypoxia.The survival rate,apoptosis rate,migration and angiogenesis of HUVECs were respectively detected by CCK-8,flow cytometry,Transwell and tube formation assay.The content of SDF-1α,VEGF and IL-6 in CdM was determined by ELISA.Our results showed that hMSCs and HUVECs were cultured and identified successfully.Compared with MSC-CdMNOR and HUVEC-CdMHYP groups,the survival rate,migration and angiogenesis of HUVECs in MSC-CdMHYP group were significantly increased while the apoptosis rate was declined (P＜0.05).Moreover,the expression of SDF-1a VEGF and IL-6 in MSC-CdMHYP group was up-regulated.Under hypoxia,the apoptosis of HUVECs was inhibited while survival,migration and angiogenesis were improved by co-culture of hMSCs and HUVECs.The underlying mechanism may be that hMSCs could secrete a number of cytokines and improve niche,which might be helpful in the treatment of femoral head necrosis.