CENPA promotes clear cell renal cell carcinoma progression and metastasis via Wnt/ß-catenin signaling pathway.

Clear cell renal cell carcinoma (ccRCC) is the most common malignant tumor of the kidney. New and reliable biomarkers are in urgent need for ccRCC diagnosis and prognosis. The CENP family is overexpressed in many types of cancers, but its functions in ccRCC have not been fully clarified. In this paper, we found that several CENP family members were highly expressed in ccRCC tissues. Also, CENPA expression level was related to clinicopathological grade and prognosis by weighted gene co-expression network analysis (WGCNA). CENPA served as a representative CENP family member as a ccRCC biomarker. Further in vitro experiments verified that overexpression of CENPA promoted ccRCC proliferation and metastasis by accelerating the cell cycle and activating the Wnt/ß-catenin signaling pathway. The elevated ß-catenin led by CENPA overexpression translocated to nucleus for downstream effect. Functional recovery experiment confirmed that Wnt/ß-catenin pathway was essential for ccRCC progression and metastasis. Developing selective drugs targeting CENPA may be a promising direction for cancer treatment.

Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer.

Background: For metastatic prostate cancer (mPCa), radical prostatectomy (RP) and radiation therapy (RT) may improve overall survival (OS) and cancer-specific survival (CSS). Compared with RT, RP shows significant advantages in improving patient outcomes. External beam radiation therapy (EBRT) even slightly elevates CSM with no statistical difference in OS compared with no local treatment (NLT). Objective: To evaluate OS and CSS after local treatment (LT) (including RP and RT) versus NLT in mPCa. Design, setting, and participants Within the Surveillance, Epidemiology and End Results (SEER) database (2000-2018), 20098 patients with metastatic prostate cancer were selected in this study, of which 19433 patients had no local treatment, 377 patients with radical prostate treatment, and 288 patients with RT. Outcome measurements and statistical analysis: Multivariable competing risks regression analysis after propensity score matching (PSM) was used to calculate CSM. Multivariable Cox regression analysis was used to identify the risk factors. Kaplan-Meier methods were used to calculate OS. Results and limitations: A total of 20098 patients were included: NLT (n = 19433), RP (n=377) and RT (n=288). In a competing risk regression analysis after PSM (ratio 1:1), RP resulted in a significantly lower CSM (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.29-0.45) than NLT, while RT showed a slightly lower CSM (HR 0.77, 95% CI 0.63-0.95). In a competing risk regression analysis after PSM (ratio 1:1), RP led to a lower CSM (HR 0.56, 95% CI 0.41-0.76) versus RT. As for all-cause mortality (ACM), RP (HR 0.37, 95% CI 0.31-0.45) and RT (HR 0.66, 95% CI 0.56-0.79). also showed a downward trend. In terms of OS, RP and RT significantly improved the survival probability compared with NLT, with the effect of RP being more pronounced. Obviously, older age, Gleason scores ≥8, AJCC T3-T4 stage, AJCC N1, AJCC M1b-M1c were all associated with higher CSM (P <0.05). The same results held true for ACM. The limitation of this article is that it is not possible to assess the effect of differences in systemic therapy on CSM in mPCa patients and clinical trials are needed to verify the results. Conclusions: For patients with mPCa, both RP and RT are beneficial to patients, and the efficacy of RP is better than RT from the perspective of CSM and ACM. Older age, higher gleason scores and the more advanced AJCC TNM stage all put patients at higher risk of dying. Patient summary: A large population-based cancer database showed that in addition to first-line therapy (hormonal treatment), RP and radiotherapy can also benefit patients with mPCa.

circPTPN12 promotes the progression and sunitinib resistance of renal cancer via hnRNPM/IL-6/STAT3 pathway.

Renal cell carcinoma (RCC) is characterized by the difficulties in early diagnosis and the propensity to metastases. For advanced RCC, sunitinib targeted therapy is the clinically recommended first-line drug and the major challenge of sunitinib treatment is adaptive resistance. Therefore, it is imperative to research the mechanisms underlying sunitinib resistance. In this study, we discovered that circPTPN12 was highly expressed in RCC tissues and was associated with poorer clinical outcomes. circPTPN12 could promote the proliferation, migration, invasion, and sunitinib resistance of RCC cells. Mechanistically, circPTPN12 was found to form a complex with hnRNPM, which was involved in the regulation of mRNA processing. The combination with circPTPN12 enhanced the ability of hnRNPM to maintain the stability of IL-6 mRNA and further activated the STAT3 signaling pathway. The study revealed that circPTPN12/hnRNPM/IL-6/STAT3 axis promoted RCC progression and sunitinib resistance, which might be a promising therapeutic target for relieving sunitinib resistance in RCC.

Case report: Single-session double-Ilizarov lengthening technique in the treatment of a child with congenital fibular deficiency.

Background: Congenital fibular deficiency is a rare disease with a broad spectrum of deformities. Associated anomalies complicate the symptoms of patients and, consequently, individualized treatments that aim at normal function and acceptable appearance. Case presentation: We present a case of congenital femoral and fibular shortening in the right lower limb with foot anomaly at school age. The patient underwent limb lengthening procedure in a single session on the right femur and tibia at the same time using a double-Ilizarov frame. The functional and cosmetic of his right lower extremity achieved a good outcome. Complications were minimal except for the superficial infection. Treatment lasted for 9.2 months, allowing for returning the patient to functional activity as soon as possible. Conclusion: A satisfactory result was obtained with limb lengthening in a single session using double Ilizarov external fixators in a school-aged patient with congenital fibular deficiency.

External fixation in the treatment of displaced supracondylar femoral fracture in children: A retrospective case series.

OBJECTIVE: The aim of this study was to evaluate the clinical and radiological outcomes and complications of external fixation use in the treatment of children with displaced supracondylar femoral fractures.. METHODS: In this retrospective study, 14 children (6 boys, 8 girls; mean age = 7.3 years; age range = 3.9 - 10.3 years) who underwent external fixation for the treatment of a displaced supracondylar femoral fracture from 2010 to 2017 were included. Their medical records were reviewed for general information and surgery details. Postoperative information, such as time to radiographic union, time to regain walking ability, Knee Society Scores (KSS) postoperative score, and KSS functional score were collected. Radiographic images were examined for the measurement of leg length discrepancy and valgus deformity. RESULTS: The mean follow up was 34 (range = 24-50) months. The mean time to radiographic union was 12.3 (range = 10-16) weeks, and the mean time to regain walking ability was 11.8 (range = 11-13) weeks. Leg length discrepancies were all less than 0.8 cm, and valgus deformity was all limited in 10°. The mean KSS postoperative score was 97.5 (range = 93-100), and the mean KSS functional score was 97.1 (range = 90-100). None of the patients exhibited functional deficiency. Neither deep infection nor refracture was detected postoperatively. CONCLUSION: External fixation seems to be an acceptable alternative modality for treatingdisplaced supracondylar femoral fractures in children, with favorable clinical and radiological outcomes as well as a low complication rate. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

Closed reduction with crossed Kirschner wire fixation for displaced supracondylar femoral fractures in young children.

Supracondylar femoral fractures are uncommon in children, but may result in various deformities. Though many approaches have been used to manage them, there is no literally approved standard yet.From 2015 to 2017, 12 young children at the average age of 2.5 years old (range 3.6-1.6) with displaced supracondylar fractures were admitted to our department and received closed reduction with crossed Kirschner wire (K-wire) fixation as treatment. After the surgeries, we performed follow-up to every patient at the average length of 26 months (range 24-30) and used the Knee Society Score scale to evaluate the outcome.Fracture healing was observed within 10 weeks for all patients and walking was resumed between 10 to 13 weeks. No patient reported a valgus deformity more than 10°, neurovascular injury or knee infection. The average limb length discrepancy was 0.4 cm at the end of our follow-up. Every patient had perfect score on the Knee Society Score scale.Our study suggests that closed reduction with percutaneous crossed Kirschner wire is a favorable method for displaced supracondylar femoral fractures in young children.

Locking plate versus external fixation in the treatment of displaced femoral supracondylar fracture in children.

BACKGROUND: Displaced supracondylar femoral fractures (SFF) are difficult injuries to treat in children. Several techniques have been widely used but few studies have compared the merits and drawbacks of each surgical intervention in order to analyze clinical values. The aim of this study was to (1) evaluate postoperative and functional conditions after treatments with locking plate (LP) or external fixation (EF), (2) observe adverse events associated with these two techniques, and (3) evaluate the clinical value of these two techniques. METHODS: Twenty-eight patients less than 14 years of age were included in this study with supracondylar femoral fractures. They underwent locking plate or external fixation in authors' hospital. The postoperative healing and functional outcome were elevated according to radiographic and clinical measures, including American Knee Society Score (KSS). Fisher's exact test and independent samples t test were used for statistical analysis. RESULTS: All fractures healed without delayed union. The KSS scoring results of locking plate and external fixation groups were both excellent. The alignment of lower limbs was acceptable with knee valgus less than 2° for all involved patients. In addition, leg length discrepancy was less than 1 cm. No acute or severe complications were noted. There was significant difference in union time (p = 0.03), operating time (p< 0.001), intraoperative blood loss (p< 0.001), and limb length discrepancy (p = 0.04) between LP group and EF group. CONCLUSIONS: External fixation is superior than locking plate in terms of union, operation time phrases, and intraoperative blood loss. EF techniques are better options for treating displaced supracondylar femoral fracture in children. LEVEL OF EVIDENCE: Retrospective comparative study; level III.

External fixation and Kirschner wires in the treatment of paediatric displaced supracondylar femur fractures.

PURPOSE: Kirschner-wire fixation (KF) and external fixation (EF) for the treatment of displaced supracondylar femur fractures (SFFs) were demonstrated respectively in previous reports. However, there is no paucity of convincing information on better treatment options for children. The aim of this study was to show results of KF and EF in the treatment of paediatric SFFs according to clinical and radiological outcome. METHODS: A retrospective analysis including 22 displaced closed SFFs was performed. A total of 12 patients were treated with KF, other ten patients were treated with EF. All patients were followed up for at least 24 months. Demographic data, surgical outcomes and postoperative knee function using the Knee Society Score (KSS) scale were evaluated in this research. RESULTS: The patients in the KF group were significantly younger than in the EF group (p < 0.001). The KF group had superiority in operative time (p = 0.001), blood loss (p = 0.027) and length of hospital stay (p = 0.001). Clinical healing outcome did not differ between the two groups. The KF group achieved radiological union in a shorter period (p < 0.001), with a better range of movement (ROM) and KSS postoperative score. CONCLUSION: Both KF and EF can achieve excellent outcomes for paediatric SFFs. KF has many advantages in younger children. LEVEL OF EVIDENCE: IV.