Computer-assisted cannulated screw internal fixation versus conventional cannulated screw internal fixation for femoral neck fractures: a systematic review and meta-analysis.

OBJECTIVE: To compare the effects between computer-assisted and traditional cannulated screw internal fixation on treating femoral neck fracture. METHODS: The search was conducted in Embase, Pubmed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database from the beginning to August 2020. RevMan5.4 software, which was provided by the International Cochrane Group, was used for the meta-analysis comparing the differences in operation time, intraoperative bleeding volume, fluoroscopy frequency, fracture healing time, total drilling times, Harris score, fracture healing rate, and femoral head necrosis rate between computer-assisted and traditional methods groups. RESULTS: A total of 1028 patients were included in 16 studies. Primary outcome indicators: Compared with the traditional method group, the computer-assisted group had less operative time (2RCTs, P < 0.00001; 8 non-RCTs, P = 0.009; Overall, P < 0.00001), intraoperative bleeding (1 RCTs, P < 0.00001; 9non-RCTs, P < 0.00001; Overall, P < 0.00001), femoral head necrosis rate (1 RCT, P = 0.11;7 non-RCTs, P = 0.09; Overall, P = 0.02) and higher Harris scores (1 RCT, P < 0.0001; 9 non-RCTs, P = 0.0002; Overall, P < 0.0001), and there were no significant differences in fracture healing rate between the two groups (5 non-RCTs, P = 0.17). Secondary outcomes indicators: The computer-assisted group had a lower frequency of intraoperative fluoroscopy and total number of drills compared with the traditional method group, while there was no significant difference in fracture healing time. CONCLUSION: Compared with the traditional hollow screw internal fixation on the treatment of femoral neck fracture, computer-assisted percutaneous cannulated screw fixation can shorten the operation time and improve the operation efficiency and reduce the X-ray injury of medical staff and help patients obtain a better prognosis. Therefore, computer-assisted percutaneous cannulated screw fixation is a better choice for the treatment of femoral neck fracture. Study registration PROSPERO registration number CRD42020214493.

PCAT6 may be a new prognostic biomarker in various cancers: a meta-analysis and bioinformatics analysis.

BACKGROUND: LncRNA prostate cancer-associated transcript 6 (PCAT6) has been reported to be dysregulated in several cancers and is associated with tumor progression. Here, we have performed a meta-analysis to assess the general prognostic role of PCAT6 in malignancies. METHODS: Four public databases (Embase, Pubmed, Web of Science, Cochrane Library) were used to identify eligible studies, then data was extracted and associations between prognostic indicators and clinical characteristics were combined to estimate hazard ratio (HR) or odds ratio (OR) with a 95% confidence interval (CI). Publication bias was measured using the Begg's test, and the stability of the combined results was measured using sensitivity analysis. Subsequently, results were validated using Gene Expression Profiling Interactive Analysis (GEPIA) and the National Genomics Data Center (NGDC). RESULTS: Ten studies were considered eligible for inclusion. In total, 937 patients and eight types of cancer were included. Our results revealed that overexpression of PCAT6 was significantly associated with a shorter OS (HR = 1.82; 95% CI, [1.40, 2.38]; P < 0.0001) and progression-free survival (PFS) (HR = 1.66; 95% CI, [1.22, 2.25]; P < 0.0001) in cancer patients, and that PCAT6 overexpression was significantly associated with individual tumor clinicopathological parameters, including TNM stage (OR = 0.29; 95% CI, [0.09, 0.94]; P = 0.04), gender (OR = 1.84; 95% CI, [1.31, 2.59]; P = 0.0005), and whether the tumor was metastatic (OR = 5.02; 95% CI, [1.36, 18.57]; P = 0.02). However, PCAT6 overexpression was not correlated with patient age and tumor differentiation. PCAT6 expression was significantly up-regulated in four types of cancer, which was validated using the GEPIA cohort. Combining OS and disease-free survival (DFS) of these four types of cancer revealed a shorter OS and DFS in patients with PCAT6 overexpression. PCAT6 expression in various types of cancer was also validated in NGDC. A total of eight cancers were analyzed and PCAT6 was highly expressed in all eight cancers. Further functional predictions suggest that PCAT6 is correlated with tumor prognosis, and that PCAT6 may be useful as a new tumor-specific marker. CONCLUSIONS: LncRNA PCAT6 is highly expressed in multiple cancer types and its upregulation was significantly associated with patient prognosis and poorer clinical features, thereby suggesting that PCAT6 may be a novel prognostic factor in multiple cancer types.

circRNA_0006393 promotes osteogenesis in glucocorticoid­induced osteoporosis by sponging miR­145­5p and upregulating FOXO1.

Glucocorticoids are the most common cause of glucocorticoid­induced osteoporosis (GIOP). Moreover, the role of circular RNAs (circRNAs) in the regulation of bone metabolism remains unclear. Therefore, in the present study, it was hypothesized that hsa_circ_0006393 may play an important role in GIOP. To investigate the role of circRNAs in GIOP, treatment with dexamethasone or transfection with a vector overexpressing hsa_circ_0006393 were performed using in vitro cell and in vivo mouse models. Reverse transcription­quantitative PCR, fluorescence in situ hybridization and western blotting were performed to investigate the function of hsa_circ_0006393 in vitro. In addition, the effects of hsa_circ_0006393 on osteogenesis were investigated. Dual­energy X­ray absorptiometry analysis was performed to examine the osteogenic potential of hsa_circ_0006393 in vivo. Moreover, the mechanism underlying hsa_circ_0006393­mediated bone metabolism regulation via the microRNA (miR)­145­5p/forkhead box O1 (FOXO1) pathway was investigated. The present results suggested that the expression level of hsa_circ_0006393 was decreased in patients with GIOP. Furthermore, the overexpression of hsa_circ_0006393 increased the expression level of genes associated with osteogenesis. Moreover, hsa_circ_0006393 was identified to be localized mainly in the cytoplasm and nucleus of bone marrow mesenchymal stem cells. miR­145­5p was found to be directly targeted by hsa_circ_0006393. Collectively, hsa_circ_0006393 increases the expression levels of osteogenic genes during bone remodeling by sponging miR­145­5p and upregulating FOXO1.

Efficacy of intravenous acetaminophen in multimodal management for pain relief following total knee arthroplasty: a meta-analysis.

BACKGROUND: The efficacy of intravenous acetaminophen in multimodal pain management in patients undergoing total knee arthroplasty (TKA) is controversial. The purpose of this meta-analysis was to compare the efficacy of intravenous acetaminophen versus placebo in TKA. METHODS: Randomized controlled trials (RCTs) or retrospective cohort studies (RCSs) concerning related topics were retrieved from PubMed (1996-June 2018), Embase (1980-June 2018), and the Cochrane Library (CENTRAL June 2018). Any studies comparing intravenous acetaminophen with a placebo were included in this meta-analysis. Meta-analysis results were collected and analyzed by Stata 12.0. Subgroup analysis was performed according to the general characteristics of the patients. RESULTS: In total, the patients from six studies met the inclusion criteria. Our meta-analysis results indicated that compared with a control group, intravenous acetaminophen was associated with reductions in total morphine consumption and visual analogue scale (VAS) score at postoperative day (POD) 3. However, there was no significant difference in morphine consumption at POD 1 or in VAS at POD 1 or POD 2. Moreover, there was no significant difference in the length of hospital stay. CONCLUSIONS: Based on our results, intravenous acetaminophen in multimodal management has shown better efficacy in pain relief at POD 3 and has morphine-sparing effects. High-quality studies with more patients are needed in the future.

The association between risk of limb fracture and type 2 diabetes mellitus.

BACKGROUND: Recently, increasing reports showed that the risk of fracture may be correlated with type 2 diabetes mellitus (T2DM). However, their results still remained controversial. Thus we performed a meta-analysis including 11 studies to estimate the risk factor of limb fracture in type 2 diabetes mellitus. MATERIALS AND METHODS: Databases including PubMed, Embase, Cochrane Library and Web of Science were searched to September, 2017. Risk Ratio (RR) with its 95% confidence intervals (CI) was used to evaluate the association between risk of limb fracture and type 2 diabetes mellitus. Two reviewers assessed the quality of all the included studies and extracted data for analysis independently. RESULTS: A total of 11 studies including 663,923 participants were included in this meta-analysis. Our analysis results showed that patients with type 2 diabetes mellitus had a significant association with risk of limb fracture (RR 1.18; 95% CI 1.02-1.35), including leg or ankle fracture (RR 1.80; 95% CI 1.13-2.87). Subgroup analysis showed individuals with type 2 diabetes had almost two-fold excessive risk of leg/ankle fracture in women and the pooled RR of leg/ankle fracture was 2.03 (95% CI 1.36-3.05; P = 0.0006). CONCLUSIONS: The results of the present meta-analysis showed that individuals with type 2 diabetes mellitus had higher risk of limb fractures, and this relationship is more pronounced in leg or ankle fracture.

Melt-metaphyseal and diphyseal osteotomy for correction of infantile Blount's disease: a long-term follow-up study.

Blount's disease is an uncommon disorder of postero-medial proximal tibial physis. Blount described infantile and adolescent types. This study aims to describe using femur, tibia and fibula osteotomies to treat infantile Blount's disease. From May 1992 to May 2005, 7 patients of Blount's disease (3 males, 4 females) were included, whose age was range from 17 to 62 months. Femorotibial angle (FTA) was 31 ± 6° (range from 27° to 41°). Metaphyseal-diaphyseal angle (MDA) was 16 ± 4° (range from 13° to 24°). The femoral vara angle was 10 ± 4° (range from 2° to 23°). According to Langenskiold's classification, 3 patients were in stage II, 7 patients in stage III, and 2 patients in stage IV. Five cases were affected bilateral and 2 unilaterally, treated by famur, tibia and fibula valgus osteotomies, and a hip spica cast were used for 6 weeks after operation. Results indicated that all patients were followed up 3 to 16 years. FTA, MDA and femur diaphysis were measured, FTA was 2 ± 7°valgus (from 4° vara to 13° valgus). MDA was 1 ± 2°valgus (range from 0° to 12°). Femoral diaphyseal angle was 1 ± 3°valgus (range from 3° vara to 7° valgus). Six patients could walk without any knee pain, except for 1 patient with bilateral disorder feels his left genu uncomfortable after long time stand or work. His MDA was 12°, and FAT was -4°. In conclusion, femur, tibia and fibula osteotomies are useful for correction of Blount's disease. Recurrence and complication are less than those reported for Blount's disease.

Terahertz wave generation from hyper-Raman lines in two-level quantum systems driven by two-color lasers.

Based on spatial-temporal symmetry breaking mechanism, we propose a novel scheme for terahertz (THz) wave generation from hyper-Raman lines associated with the 0th harmonic (a particular even harmonic) in a two-level quantum system driven by two-color laser fields. With the help of analysis of quasi-energy, the frequency of THz wave can be tuned by changing the field amplitude of the driving laser. By optimizing the parameters of the laser fields, we are able to obtain arbitrary frequency radiation in the THz regime with appreciable strength (as strong as the typical harmonics). Our proposal can be realized in experiment in view of the recent experimental progress of even-harmonics generation by two-color laser fields.

Anti-osteosarcoma effects and mechanisms of 4-O-amino-phenol-4'-demethylepipodophyllotoxin ether.

The purpose of this study was to investigate the anti-osteosarcoma effects and mechanisms of 4-O-amino-phenol-4'-demethylepipodophyllotoxin ether (ODE), a new derivative of podophyllotoxin. The results showed that ODE inhibited proliferation of K562, OS-9901, CNE, BGC-823 and Tca-8113 cells in a time- and concentration-dependent manner as determined by microculture tetrazolium (MTT) assay. OS-9901 and K562 cells treated with ODE for 24 h showed cell cycle arrest at G(2)/M and a parallel decrease in G(0)/G(1) and S phase as detected by flow cytometry (FCM). Meanwhile, a fraction of cells with hypodiploid DNA content representing apoptosis were detected by FCM. Morphology observation also revealed typical apoptotic features, including shrinkage of cellular and nuclear membranes, condensed heterochromatin around the nuclear periphery and cytoplasmic vacuolation in OS-9901 cells. Under a confocal laser scanning microscope, intracellular Ca2+ and Mg2+ concentrations were greatly increased whereas the pH value, mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) were markedly reduced in OS-9901 cells after treatment with ODE. Taken together, these results suggest that the anti-osteosarcoma mechanisms of ODE are attributed to apoptosis through increasing intracellular Ca2+ and Mg2+ concentrations, and reducing pH value, MMP and ROS.