A simple technique to strengthen the initial and mid-term to long-term stability of the cup during total hip arthroplasty in developmental dysplasia of the hip.

OBJECTIVES: To assess the effects of a technique of cup blocking screws combined with impaction bone grafting during total hip arthroplasty (THA) for patients with developmental dysplasia of the hip (DDH). METHODS: From August 2011 to July 2015, 53 patients (59 hips) with DDH in our hospital were treated with THA using the technique of cup blocking screws combined with impaction particulate bone grafting. These patients were prospectively followed, and the clinical and imaging results were collected. RESULTS: Harris hip score (HHS) was raised from 41.24 before surgery to 91.49 at the latest follow-up (p less than 0.001). Length discrepancy (LLD) was reduced from 28.97 mm before surgery to 6.08 mm after surgery (p less than 0.001). No loosening of the cup was detected at the last follow-up. The differences were insignificant in cup inclination and rate of cup coverage among the 3 groups of Crowe type II, type III, and type IV DDH (p greater than 0.05). CONCLUSION: The technique of cup blocking screws combined with impaction particulate bone grafting is simple and reliable, and it not only simplifies the attainment of initial stability, but also strengthens the mid-term to long-term stability during THA in DDH.

Targeting osteosarcoma vasculature with peptide obtained by phage display.

AIM OF THE STUDY: Tumour endothelial cells have been proven to have molecular markers distinct from normal endothelial cells. These specific molecular markers allow for targeting of the tumour vasculature with specific pharmacological vehicles to direct diagnostic or therapeutic modalities at the endothelial cells. By performing a phage display-based screening, this study aimed to identify a certain short peptide that could specifically bind to osteosarcoma vasculature. MATERIAL AND METHODS: We performed in vivo screening in the murine models of osteosarcoma with annular Ph.D.-C7C library in the present study. To explore the in vivo binding specificity of the retrieved peptide, we conjugated the peptide with fluorescein isothiocyanate (FITC) and injected it intravenously into osteosarcoma-bearing BALB-c mice. RESULTS: CTKPDKGYC was the dominant sequence isolated from in vivo screening and was named as NF-1. Fluorescence staining found that FITC-NF-1 peptide could be specifically homed to osteosarcoma vasculature while being almost undetectable in the heart, brain, lung and liver. Simultaneously, a small amount of fluorescence could also be detected in the renal glomerulus and renal tubule but not in renal vascular endothelium, indicating that FITC-NF-1 peptide might be excreted mainly through the renal-urinary route. CONCLUSIONS: Our data suggest that, with high binding specificity to osteosarcoma vasculature, peptide NF-1 may have potential value in early diagnosis or targeted therapy for osteosarcoma.

Comparison in clinical features and life impact between juvenile-onset and adult-onset ankylosing spondylitis.

BACKGROUND/AIM: To compare the differences in clinical characteristics and disease impact on life between patients with juvenile-onset ankylosing spondylitis (JoAS) and patients with adult-onset AS (AoAS). MATERIALS AND METHODS: Demographic and clinical data were collected from 139 AS patients. Disease activity was defined with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional status was assessed with the Bath Ankylosing Spondylitis Functional Index (BASFI). Status of quality of life was evaluated with the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. RESULTS: There were 50 patients with JoAS (36.0%) and 89 with AoAS (64.0%). The JoAS group showed more onset with peripheral joints involvement (P < 0.001), significant diagnosis delay (P < 0.001), worse functional status (P = 0.002), and poorer quality of life (P = 0.002). Patients with JoAS also showed a significantly lower rate in college education (P = 0.037) and marriage (P = 0.013). The rate of employment in the JoAS group was lower than that in the AoAS group. Although the difference in employment did not reach a significant level, the JoAS group included more patients who had not been employed since reaching adulthood (P = 0.015). CONCLUSION: Compared to patients with AoAS, patients with JoAS may need more specific clinical interventions as well as social assistance.

Management of hip involvement in ankylosing spondylitis.

Ankylosing spondylitis (AS) is an inflammatory rheumatologic disease characterized by inflammation and progressive structural damage of the affected joints. Hip involvement often results in severe deformities and significant impairment on function. Although, tremendous progress has been made in conservative management for AS, effective prevention strategies for hip involvement and long-term need for total hip arthroplasty (THA) remain indefinite. When hip involvement has progressed to intractable pain and disability, THA is still the most effective treatment strategy to relieve pain and restore function. However, certain AS-specific problems regarding "preoperative preparation," "intraoperative difficulties," "perioperative pharmacological management," "postoperative physiotherapy," "operation benefits," and "operation complications" need more concern and further discussion.

[Screening and identification of peptides specifically binding to human osteosarcoma cells].

OBJECTIVE: To obtain the peptide that specifically binds to human osteosarcoma MG-63 cells from Ph. D. 7TM phage display peptide library. METHODS: Human osteosarcoma MG-63 cells were used as the target cells with human embryonic kidney 293T cells as the control for screening the peptide from Ph. D. 7TM phage display peptide library. The enriched specially binding peptides were verified by cell enzyme-linked immunosorbent assay (ELISA). The location of the peptide in MG-63 cells was investigated using cell fluorescence staining, and targeting of the peptide was tested by organ immunohistochemistry with Osteosarcoma model. RESULTS: The specifically binding peptides were enriched after 4 rounds of screening. The sequence SLTNLSK was confirmed as the most frequent peptide by DNA sequencing and showed strong specificity verified by cell ELISA, fluorescent staining and organ immunohistochemistry. CONCLUSION: A peptide that specifically binds to MG-63 cells has been screened from Ph. D. 7TM phage display peptide library to serve as a potential candidate for osteosarcoma-targeting therapy.

[Comparison of two different methods for establishing nude mouse model bearing osteosarcoma].

OBJECTIVE: To compare two different methods, namely orthotopic implantation and armpit implantation, for establishing nude mouse model bearing osteosarcoma in light of the tumor formation rate and time, tumor growth changes and lung metastasis. METHODS: Osteosarcoma cells were inoculated in the left armpit or the femoral medullary canal of nude mice, and the tumor growth was observed 6 weeks later. The differences in the pulmonary metastasis were examined macroscopically and microscopically. RESULTS: Armpit implantation allowed easy operation and fast tumor growth, but tumors often sustained damages by frictions on the surface (P<0.05), and avascular necrosis occurred earlier in the tumors (P<0.05). With this approach, the pulmonary metastasis rate was only 40% (P<0.05), and the metastases in the lungs were sparser (P<0.05) and small. Orthotopic transplantation could well simulate the original growth environment of osteosarcoma, and resulted in milder avascular necrosis and greater pulmonary metastasis rate (100%) with larger and denser metastatic foci. But orthotopic transplantation required more complicated operation for establishing osteosarcoma-bearing models. CONCLUSION: The two methods both result in high tumor growth rate, but orthotopic transplantation is superior in inducing pulmonary metastasis of osteosarcoma and reducing friction injury of the tumor and avascular necrosis in the tumor.