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1.
J Mater Chem B ; 12(25): 6164-6174, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38828762

RESUMO

Catalytic therapy based on nanozymes is promising for the treatment of bacterial infections. However, its therapeutic efficacy is usually restricted by the limited amount of hydrogen peroxide and the weak acidic environment in infected tissues. To solve these issues, we prepared polyvinyl alcohol (PVA)-polyacrylic acid (PAA)-iron oxide (Fe3O4)/polyvinyl alcohol (PVA)-zinc peroxide (ZnO2) double-layer electrospun nanofibers (PPF/PZ NFs). In this design, PVA serves as the carrier for ZnO2 nanoparticles (NPs), Fe3O4 NPs, and PAA. The double-layer structure of nanofibers can spatially separate the PAA and ZnO2 to avoid their reaction with each other during preparation and storage, while in the wet wound bed, PVA can dissolve and PAA can provide H+ ions to promote the generation of hydrogen peroxide and subsequent conversion to hydroxyl radicals for bacteria killing. In vitro experimental results demonstrated that PPF/PZ NFs can reduce the methicillin-resistant Staphylococcus aureus by 3.1 log (99.92%). Moreover, PPF/PZ NFs can efficiently treat the bacterial infection in a mouse wound model and promote wound healing with negligible toxicity to animals, indicating their potential use as "plug-and-play" antibacterial wound dressings. This work provides a novel strategy for the construction of double-layer electrospun nanofibers as catalytic wound dressings with hydrogen peroxide/acid self-supplying properties for the efficient treatment of bacterial infections.


Assuntos
Antibacterianos , Peróxido de Hidrogênio , Staphylococcus aureus Resistente à Meticilina , Nanofibras , Infecção dos Ferimentos , Óxido de Zinco , Nanofibras/química , Animais , Camundongos , Peróxido de Hidrogênio/química , Peróxido de Hidrogênio/farmacologia , Catálise , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Antibacterianos/química , Antibacterianos/farmacologia , Infecção dos Ferimentos/tratamento farmacológico , Óxido de Zinco/química , Óxido de Zinco/farmacologia , Álcool de Polivinil/química , Resinas Acrílicas/química , Resinas Acrílicas/farmacologia , Cicatrização/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/tratamento farmacológico , Tamanho da Partícula
2.
Comput Biol Med ; 177: 108608, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38796880

RESUMO

BACKGROUND AND OBJECTIVE: Cardiac computed tomography angiography (CTA) is the preferred modality for preoperative planning in aortic valve stenosis. However, it cannot provide essential functional hemodynamic data, specifically the mean transvalvular pressure gradient (MPG). This study aims to introduce a computational fluid dynamics (CFD) approach for MPG quantification using cardiac CTA, enhancing its diagnostic value. METHODS: Twenty patients underwent echocardiography, cardiac CTA, and invasive catheterization for pressure measurements. Cardiac CTA employed retrospective electrocardiographic gating to capture multi-phase data throughout the cardiac cycle. We segmented the region of interest based on mid-systolic phase cardiac CTA images. Then, we computed the average flow velocity into the aorta as the inlet boundary condition, using variations in end-diastolic and end-systolic left ventricular volume. Finally, we conducted CFD simulations using a steady-state model to obtain pressure distribution within the computational domain, allowing for the derivation of MPG. RESULTS: The mean value of MPG, measured via invasive catheterization (MPGInv), echocardiography (MPGEcho), and cardiac CTA (MPGCT), were 51.3 ± 28.4 mmHg, 44.8 ± 19.5 mmHg, and 55.8 ± 25.6 mmHg, respectively. In comparison to MPGInv, MPGCT exhibited a higher correlation of 0.91, surpassing that of MPGEcho, which was 0.82. Moreover, the limits of agreement for MPGCT ranged from -27.7 to 18.7, outperforming MPGEcho, which ranged from -40.1 to 18.0. CONCLUSIONS: The proposed method based on cardiac CTA enables the evaluation of MPG for aortic valve stenosis patients. In future clinical practice, a single cardiac CTA examination can comprehensively assess both the anatomical and functional hemodynamic aspects of aortic valve disease.


Assuntos
Angiografia por Tomografia Computadorizada , Hemodinâmica , Humanos , Angiografia por Tomografia Computadorizada/métodos , Masculino , Feminino , Idoso , Hemodinâmica/fisiologia , Pessoa de Meia-Idade , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Valvopatia Aórtica/diagnóstico por imagem , Valvopatia Aórtica/fisiopatologia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/fisiopatologia , Modelos Cardiovasculares , Ecocardiografia/métodos
3.
Int J Biol Macromol ; 271(Pt 1): 132378, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38750853

RESUMO

Gelatin and hydroxyapatite were assembled into polylactide porous matrix to prepare multicomponent porous composites for bone repair (PLA-gH). PLA-gH possessed a superior ability of mineralization. During simulated body fluids (SBF), the spherical Ca-P depositions on surface of PLA-gH became bulk as Ca/P decreased, while they locally turned into the rod with different variation in Ca/P during SBF containing bovine serum albumin (SBF-BSA), indicating that the mineralization of PLA-gH could be regulated by BSA. Meanwhile, PLA-gH possessed good degradation behaviour, especially in SBF-BSA, the degradation of PLA porous matrix was higher than that in SBF after 14-day immersion, whose crystallinity (Xc) decreased to a slightly lower level. Gelatin and hydroxyapatite endowed PLA-gH with good osteogenic property, characterized by obvious osteogenic differentiation and bone regeneration. In terms of predicting the cytocompatibility, osteogenic differentiation and new bone mineralization of PLA-gH by in vitro methods, applying SBF-BSA may be more reliable than SBF.


Assuntos
Regeneração Óssea , Osteogênese , Poliésteres , Poliésteres/química , Animais , Porosidade , Regeneração Óssea/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Calcificação Fisiológica/efeitos dos fármacos , Durapatita/química , Diferenciação Celular/efeitos dos fármacos , Soroalbumina Bovina/química , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Gelatina/química , Alicerces Teciduais/química , Camundongos , Coelhos
4.
Cell Signal ; 118: 111142, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38508350

RESUMO

OBJECTIVE: To elucidate the molecular mechanism of overloading-induced osteoarthritis (OA) and to find a novel therapeutic target. METHODS: We utilized human cartilage specimens, mouse chondrocytes, a destabilization of the medial meniscus (DMM) mouse model, and a mouse hindlimb weight-bearing model to validate the role of overloading on chondrocyte senescence and OA development. Then, we observed the effect of PIEZO1-miR-155-5p-GDF6-SMAD2/3 signaling axis on the preservation of joint metabolic homeostasis under overloading in vivo, in vitro and ex vivo by qPCR, Western blot, enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, immunofluorescence, SA-ß-gal staining, CCK8 assay, et al. Finally, we verified the therapeutic effects of intra-articular injection of miR-155-5p inhibitor or recombinant GDF6 on the murine overloading-induced OA models. RESULTS: Chondrocytes sensesed the mechanical overloading through PIEZO1 and up-regulated miR-155-5p expression. MiR-155-5p mimics could copy the effects of overloading-induced chondrocyte senescence and OA. Additionally, miR-155-5p could suppress the mRNA expression of Gdf6-Smad2/3 in various tissues within the joint. Overloading could disrupt joint metabolic homeostasis by downregulating the expression of anabolism indicators and upregulating the expression of catabolism indicators in the chondrocytes and synoviocytes, while miR-155-5p inhibition or GDF6 supplementation could exert an antagonistic effect by preserving the joint homeostasis. Finally, in the in vivo overloading models, intra-articular injection of miR-155-5p inhibitor or recombinant GDF6 could significantly mitigate the severity of impending OA and lessened the progression of existing OA. CONCLUSION: GDF6 overexpression or miR-155-5p inhibition could attenuate overloading-induced chondrocyte senescence and OA through the PIEZO1-miR-155-5p-GDF6-SMAD2/3 signaling pathway. Our study provides a new therapeutic target for the treatment of overloading-induced OA.


Assuntos
MicroRNAs , Osteoartrite , Animais , Humanos , Camundongos , Apoptose , Condrócitos/metabolismo , Fator 6 de Diferenciação de Crescimento/metabolismo , Fator 6 de Diferenciação de Crescimento/farmacologia , Fator 6 de Diferenciação de Crescimento/uso terapêutico , Canais Iônicos/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Osteoartrite/metabolismo , Transdução de Sinais , Proteína Smad2/metabolismo , Estresse Mecânico
5.
Adv Healthc Mater ; 13(4): e2302626, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37943252

RESUMO

Diabetic wounds are more likely to develop into complex and severe chronic wounds. The objective of this study is to develop and assess a reactive oxygen species (ROS)-responsive multifunctional injectable hydrogel for the purpose of diabetic wound healing. A multifunctional hydrogel (HA@Cur@Ag) is successfully synthesized with dual antioxidant, antibacterial, and anti-inflammatory properties by crosslinking thiol hyaluronic acid (SH-HA) and disulfide-bonded hyperbranched polyethylene glycol (HB-PBHE) through Michael addition; while, incorporating curcumin liposomes and silver nanoparticles (AgNPs). The HA@Cur@Ag hydrogel exhibits favorable biocompatibility, degradability, and injectivity. The outcomes of in vitro and in vivo experiments demonstrate that the hydrogel can effectively be loaded with and release curcumin liposomes, as well as silver ions, thereby facilitating diabetic wound healing through multiple mechanisms, including ROS scavenging, bactericidal activity, anti-inflammatory effects, and the promotion of angiogenesis. Transcriptome sequencing reveals that the HA@Cur@Ag hydrogel effectively suppresses the activation of the tumour necrosis factor (TNF)/nuclear factor κB (NF-κB) pathway to ameliorate oxidative stress and inflammation in diabetic wounds. These findings suggest that this ROS-responsive multifunctional injectable hydrogel, which possesses the ability to precisely coordinate and integrate intricate biological and molecular processes involved in wound healing, exhibits notable potential for expediting diabetic wound healing.


Assuntos
Curcumina , Diabetes Mellitus , Nanopartículas Metálicas , Humanos , Espécies Reativas de Oxigênio , Ácido Hialurônico/farmacologia , Lipossomos , Prata , Hidrogéis/farmacologia , Inibidores da Angiogênese , Antibacterianos , Anti-Inflamatórios
6.
Small ; 20(16): e2306721, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38018340

RESUMO

The study investigated whether both the osteogenic and angiogenic potential of Exos (Exosomes) can be enhanced by overexpression of exosomal miRNA (microRNA) and to confirm whether Exos loaded in HMPs (Hydrogel microparticles) exert long-term effects during new bone formation. BMSCs and Exos are successfully obtained. In vitro and in vivo experiments confirmed that HDAC4 (Histone deacetylase 4) is inhibited by miR-29a overexpression accompanied by the upregulation of RUNX2 (Runt-related transcription factor 2) and VEGF (Vascular Endothelial Growth Factor), thereby enhancing osteogenic and angiogenic capabilities. The HMP@Exo system is synthesized from HB-PEGDA (Hyperbranched Poly Ethylene Glycol Diacrylate)- and SH-HA (Sulfhydryl-Modified Hyaluronic Acid)-containing Exos using a microfluidic technique. The HMP surface is modified with RGD (Arg-Gly-Asp) peptides to enhance cell adhesion. The system demonstrated good injectability, remarkable compatibility, outstanding cell adhesion properties, and slow degradation capacity, and the sustained release of Agomir-29a-Exos (Exosomes derived from Agomir-29a transfected BMSCs) from HMPs enhanced the proliferation and migration of BMSCs and HUVECs (Human Umbilical Vein Endothelial Cells) while promoting osteogenesis and angiogenesis. Overall, the findings demonstrate that the HMP@Exo system can effectively maintain the activity and half-life of Exos, accompanied by overexpression of miR-29a (microRNA-29a). The injectable system provides an innovative approach for accelerating fracture healing by coupling osteogenesis and angiogenesis.


Assuntos
Exossomos , Células-Tronco Mesenquimais , MicroRNAs , Humanos , Osteogênese/genética , Exossomos/metabolismo , Hidrogéis , Angiogênese , Fator A de Crescimento do Endotélio Vascular/metabolismo , Neovascularização Fisiológica , Regeneração Óssea , MicroRNAs/metabolismo , Células Endoteliais da Veia Umbilical Humana/metabolismo
7.
Mater Today Bio ; 23: 100813, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37822452

RESUMO

Exosomes (Exos) secreted by adipose-derived stem cells (ADSCs) have shown potential in alleviating osteoarthritis (OA). Previous studies indicated that infrapatellar fat pad (IPFP) derived stem cells (IPFSCs) may be more suitable for the treatment of OA than subcutaneous adipose tissue (ScAT) derived stem cells (ScASCs). However, it remains unclear which type of Exos offers superior therapeutic benefit for OA. This study first compared the differences between Exos derived from IPFP stem cells (ExosIPFP) and ScAT stem cells (ExosScAT) in OA treatment. Results suggested that ExosIPFP significantly inhibit the degradation of cartilage extracellular matrix (ECM) than ExosScAT, following this, the differences in microRNA (miRNA) expression between the two types of Exos using small RNA sequencing were performed. Subsequently, miR-99 b-3p was chosen and over-expressed in ExosScAT (ExosScAT-99b-3p), both in vivo and in vitro experiments demonstrated its efficacy in inhibiting the expression of ADAMTS4, promoting the repair of the ECM in OA. Finally, microfluidic technology was performed to fabricate a hyaluronan-based hydrogel microparticles (HMPs) for encapsulating Exos (HMPs@exos), the injectability, sustained release of Exos and long-term therapeutic effect on OA were validated. In summary, these results suggest miR-99 b-3p regulates the degradation of cartilage ECM by targeting ADAMTS4, the upregulation of miR-99 b-3p in ExosScAT would enable them to exhibit comparable or even superior effectiveness to ExosIPFP for OA treatment, making it a promising approach for OA treatment. Considering the abundant resources of ScAT and the limited availability of IPFP, ScAT harvested through liposuction could be genetically engineered to yield Exos for OA treatment. Furthermore, the encapsulation of Exos in HMPs provides an injectable sustained local drug release system, which could potentially enhance the efficacy of Exos and hold potential as future therapeutic strategies.

9.
JAMA Intern Med ; 183(7): 732-733, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37273200

RESUMO

This case report describes a patient in their 60s with a history of hypertension who experienced sudden chest pain radiating to the back and sweating for 2 hours without relief.


Assuntos
Infarto do Miocárdio , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Diagnóstico Ausente , Artefatos , Infarto do Miocárdio/diagnóstico , Eletrocardiografia , Erros de Diagnóstico , Dor no Peito/diagnóstico
10.
BMJ ; 381: e073562, 2023 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-37024119
11.
ACS Appl Mater Interfaces ; 15(15): 18720-18733, 2023 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-37018422

RESUMO

Implant infections are difficult to cure by traditional antibiotic therapy due to bacterial biofilm-induced antibiotic tolerance and impaired immune responses. To efficiently treat implant infections, therapeutic agents need to kill bacteria and regulate the inflammatory response of immune cells during the biofilm elimination process. Herein, multifunctional smart hollow Cu2MoS4 nanospheres (H-CMS NSs) with pH-responsive enzyme-like activities were prepared for self-adaptively eliminating biofilms and regulating the inflammation of macrophages in implant infections. During biofilm infection, the tissue microenvironment around implants is acidic. H-CMS NSs with oxidase (OXD)/peroxidase (POD)-like activities can catalyze reactive oxidative species (ROS) generation for directly killing bacteria and polarizing macrophages to a proinflammatory phenotype. Moreover, the POD-like activity and antibacterial property of H-CMS NSs can be further enhanced under ultrasound (US) irradiation. After the elimination of biofilms, the tissue microenvironment around implants shifts from acidic to neutral. H-CMS NSs show catalase (CAT)-like activity and eliminate excessive ROS, which polarizes macrophages to anti-inflammatory phenotype and promotes healing of infected tissue. This work provides a smart nanozyme with self-adaptive regulation of the antibiofilm activity and immune response by regulating ROS generation/elimination according to the different pathological microenvironments in implant infections during the different therapeutic stages.


Assuntos
Nanosferas , Humanos , Espécies Reativas de Oxigênio/farmacologia , Biofilmes , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Complicações Pós-Operatórias , Bactérias
12.
Sci Adv ; 9(4): eade5446, 2023 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-36696490

RESUMO

Efficient treatment of chronic lung infections caused by Pseudomonas aeruginosa biofilms is a great challenge because of drug tolerance and immune evasion issues. Here, we develop ultrasound-responsive catalytic microbubbles with biofilm elimination and immune activation properties to combat chronic lung infection induced by P. aeruginosa biofilms. In these microbubbles, piperacillin and Fe3O4 nanoparticles form a drug-loaded shell surrounding the air core. Under ultrasound stimulation, the microbubbles can physically disrupt the structure of biofilms and enhance the penetration of both Fe3O4 nanoparticles and piperacillin into the biofilm. Then, Fe3O4 nanoparticles chemically degrade the biofilm matrix and kill the bacteria with the assistance of piperacillin. Fe3O4 nanoparticles can activate the immune response for biofilm elimination by polarizing macrophages into a pro-inflammatory phenotype. These ultrasound-responsive catalytic microbubbles efficiently treat chronic lung infections in a mouse model by combining physical/chemical/antibiotic biofilm elimination and immune activation, thus providing a promising strategy for combating bacterial biofilm infections.


Assuntos
Infecções Bacterianas , Microbolhas , Animais , Camundongos , Biofilmes , Antibacterianos/farmacologia , Piperacilina/metabolismo , Pulmão , Pseudomonas aeruginosa
14.
Nanoscale ; 14(27): 9796-9805, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35770918

RESUMO

The extensive usage of antibiotics causes the rapid evolution of drug-resistant bacteria, which seriously threaten human health. Thus, efficient strategies for treating drug-resistant bacterial infections are urgently needed. Herein, MoS2-Cu2WS4 nanosheets (MS-CWS NSs) are prepared as a near-infrared (NIR) light responsive nanozyme to effectively combat methicillin-resistant Staphylococcus aureus (MRSA) infections by catalytic/photothermal effects. By integrating oxidase (OXD)- and peroxidase (POD)-mimic catalytic activity, MS-CWS NSs have the ability to inactivate MRSA without the addition of H2O2. Moreover, the reactive oxygen species (ROS) produced from MS-CWS NSs are further enhanced by NIR light irradiation, which remarkably causes the death of MRSA. MS-CWS NSs show 4.4 log (99.996%) bacterial inactivation efficiency of MRSA in vitro under NIR light irradiation (0.8 W cm-2, 5 min). In an MRSA infected wound mouse model, MS-CWS NSs inactivate the MRSA by more than 5.2 log (>99.999%) and effectively promote wound healing. This work provides an NIR-responsive 2D nanozyme for efficient treatment of MRSA infections.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Animais , Antibacterianos/farmacologia , Humanos , Peróxido de Hidrogênio/farmacologia , Camundongos , Molibdênio/farmacologia , Terapia Fototérmica
15.
Injury ; 52(10): 3085-3090, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34303508

RESUMO

BACKGROUND: The tension band technique is the most common method for internal fixation of transverse patellar fractures. Titanium cable and high-strength sutures have been successfully applied in this treatment; however, few studies have compared the Nice knot technique using sutures with the standard cable technique. Whether the suture technique (Nice knot) provides preferable results compared with those of the cable technique is unclear. METHODS: Forty patients with transverse patellar fractures participated in this study. Twenty patients underwent sutures tension band fixation (Nice knot), and the others were managed with cable tension bands. All patients were followed up at 1, 3, 6, and 12 months. Pain was measured by VAS scores, flexion and extension of the knee were measured in degrees by goniometry, and knee function was evaluated using the Böstman clinical grading scale. RESULTS: The two groups had equal distributions in age, gender, injured side, and fracture classification. The mean operation time in the suture group was shorter (55.75±9.77 minutes versus 64.25±9.63 minutes). The VAS score was comparable in the two groups at the 1-month, 3-month, and 6-month follow-ups; however, the score was lower at 12 months postoperatively in the suture group (P=0.037). No significant difference was found in flexion, extension, Böstman score, or fracture healing time in either group (P>0.05). Postoperative complications were higher in the cable group (9 versus 2) (P = 0.031) but were mostly related to symptomatic soft tissue irritation. CONCLUSION: The suture tension band technique using braided polyester nonabsorbable sutures tied with Nice knot was as effective as the cable tension band technique for transverse patellar fracture management. However, more convenient operations, less cost and fewer complications were found in suture fixation (Nice knot).


Assuntos
Fraturas Ósseas , Patela , Fios Ortopédicos , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Humanos , Patela/cirurgia , Poliésteres , Suturas , Resultado do Tratamento
16.
J Foot Ankle Surg ; 59(4): 768-773, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32238296

RESUMO

The aim of this study is to compare the clinical outcomes of posteroanterior (PA) lag screws versus posterior buttress plate fixation in treatment of posterior malleolar fragments (PMFs) in spiral tibial shaft fracture, and provide guidance for surgeons selecting a treatment strategy. A total of 48 eligible patients with PMFs associated with spiral tibial shaft fracture surgically treated from March 2009 to January 2016 were included in the study. They were divided into the screw group (n = 24) and the plate group (n = 24). All operations were performed via a posterolateral approach by a senior orthopedic surgeon. The American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), and assessment of ankle range of motion (ROM) were used for clinical evaluation. The radiographic evaluation of posttraumatic arthritis scale was determined by Bargon reference criteria. At the mean follow-up period of 29.5 ± 4.3 and 30.4 ± 4.1 months, respectively (p > .05), all patients in both groups had bone union without severe wound problems or complications. There were no significant differences in AOFAS (92.5 ± 5.3 vs 94.7 ± 5.6, p = .129) and VAS (2.4 ± 0.8 vs 2.2 ± 0.9, p = .196) scores between the groups at final follow-up. No significant differences were found between the groups in injured/contralateral ankle ROM or posttraumatic ankle arthritis scale postoperatively (p > .05). For PMFs in spiral tibial shaft fracture, PA lag screws or posterior buttress plate fixation via a posterolateral approach can achieve good and equivalent clinical and radiological outcomes with minimal complications.


Assuntos
Fraturas do Tornozelo , Fraturas da Tíbia , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/cirurgia , Placas Ósseas , Parafusos Ósseos , Fixação Interna de Fraturas , Humanos , Estudos Retrospectivos , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/cirurgia , Resultado do Tratamento
17.
Medicine (Baltimore) ; 99(9): e19380, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118785

RESUMO

INTRODUCTION: The "logsplitter injury" is a special type of ankle fractures that results from high energy violence with combined rotational forces and axial loads. So far, the diagnose and treatment of "logsplitter injury" remain largely unsettled and related literature is rare. PATIENT CONCERNS: An 18-year-old male fell from a fence and got his left ankle injured with severe malformation and swollen condition. No open wound was observed. DIAGNOSIS: Logsplitter injury, ankle fracture (AO/OTA classification 44C1.1, Lauge-Hansen classification: pronation-external rotation). INTERVENTIONS AND OUTCOMES: The patient was initially treated by internal fixation of fibular, repair of deltoid ligaments, and 1 syndesmotic screw fixation. When the X-ray applied after surgery, another 2 syndesmotic screws were performed to enhance stability. The syndesmotic screws were removed at 12-week and 16-week respectively. The patient was allowed for full weight-bearing immediately. However, the syndesmotic space was slightly increased compared to the contralateral side in CT views at 1-year follow-up, the function outcome was satisfied. CONCLUSION: The logsplitter injury is a high-energy ankle fracture that requires both axial and rotational load. It is categorized as 44B or 44C by the AO/OTA classification. In the classification scheme of Lauge-Hansen, our case is in line with the pronation-external rotation classification. Anatomic reduction and fixation of ankle syndesmotic injuries are required to restore the biomechanics of the ankle joint so that long-term complications can be prevented. How to fixation the syndesmosis, whether to reconstruct the deltoid ligament remains in debate in the treatment of logsplitter injury, whether and when to remove the syndesmotic screws were still debated. Correct surgical intervention is successful in the treatment of "logsplitter injury", however, the optimal fixation of syndesmosis and repair of deltoid ligaments need further investigate.


Assuntos
Fraturas do Tornozelo/cirurgia , Procedimentos Ortopédicos/normas , Acidentes por Quedas , Adolescente , Humanos , Fixadores Internos , Masculino , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/estatística & dados numéricos , Radiografia/métodos
18.
J Knee Surg ; 33(7): 646-654, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30919388

RESUMO

The purpose of this study was to introduce a modified surgical approach for the treatment of posterior column tibial plateau fractures. Fifteen patients with posterior column fractures with or without other column fractures were included and treated with this approach between July 2015 and June 2016. The patients were followed up for 18 to 24 months (20.9 ± 1.8 months). Outcomes included neural or vascular injuries, wound complications, nonunion, plate loosening or breakage, and Hospital for Special Surgery (HSS) scores. Bone union was observed in all cases, and the average time for bone union was 13.5 ± 1.4 weeks (11-16 weeks). No neurovascular injuries, malunion, nonunions, or plate loosening or breakages were observed. The average HSS score was 94.7 ± 4.1 (range: 84-100). The modified direct posterior midline approach can provide excellent exposure and facilitate reduction and internal fixation of posterior column fractures of the tibial plateau, including split and depressed fractures. We expect that this approach can be used as a new effective method for managing complex posterior tibial fractures.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas da Tíbia/cirurgia , Adulto , Idoso , Placas Ósseas , Feminino , Seguimentos , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade
19.
Biomed Pharmacother ; 112: 108695, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30797154

RESUMO

To elucidate the potential function of lncRNA SNHG3 in the development of osteosarcoma. Quantitative real-time polymerase chain reaction was conducted for detection of SNHG3, miRNA-151a-3p and RAB22 A in osteosarcoma tissues and cells. Receiver operating characteristic curve was introduced to analyze the diagnostic potential of SNHG3 in osteosarcoma. Correlation between SNHG3 expression and the overall survival of osteosarcoma patients was evaluated using Kaplan-Meier method. Invasive and migratory potentials of osteosarcoma cells were examined by Transwell assay. Furthermore, dual-luciferase reporter gene assay, RNA-pull down and RIP assay were used to verify the binding of SNHG3/RAB22 A to miRNA-151a-3p. The function of SNHG3/miRNA-151a-3p/RAB22 A axis in osteosarcoma was finally confirmed by rescue experiments. SNHG3 and RAB22 A were highly expressed in osteosarcoma patients, while miRNA-151a-3p was lowly expressed. The overall survival of osteosarcoma patients with high expression of SNHG3 was shorter than those with low expression. SNHG3 overexpression markedly promoted invasive and migratory potentials of osteosarcoma cells. Through dual-luciferase reporter gene assay, both SNHG3 and RAB22 A could bind to miRNA-151a-3p. RAB22 A expression was positively regulated by SNHG3, but negatively regulated by miRNA-151a-3p. Finally, rescue experiments confirmed that RAB22 A overexpression could reverse the promotive effects of miRNA-151a-3p knockdown on invasive and migratory potentials of osteosarcoma cells. SNHG3 is highly expressed in osteosarcoma, and promotes the invasive and migratory potentials of osteosarcoma cells by absorbing miRNA-151a-3p to upregulate RAB22 A expression.


Assuntos
Movimento Celular/fisiologia , Regulação Neoplásica da Expressão Gênica , MicroRNAs/biossíntese , Osteossarcoma/metabolismo , RNA Longo não Codificante/biossíntese , Proteínas rab de Ligação ao GTP/biossíntese , Linhagem Celular Tumoral , Humanos , MicroRNAs/genética , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Osteossarcoma/genética , Osteossarcoma/patologia , RNA Longo não Codificante/genética , Proteínas rab de Ligação ao GTP/genética
20.
Exp Ther Med ; 17(1): 803-811, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30651866

RESUMO

The purpose of the present study was to identify the key long non-coding (lnc)RNAs in the occurrence and development of osteoporosis (OP) and to explore the associated molecular mechanism. First, the Gene Expression Omnibus (GEO) datasets, with key words 'osteoporosis' and 'HG-133A', were screened. RankProd R package was used to calculate the dysregulated lncRNAs in OP. Following this, bone marrow mesenchymal stem cells (BM-MSCs) harvested from 3-week-old Sprague Dawley rats were employed for detection of osteoblast differentiation. Following overexpression or interference with X-inactive specific transcript (XIST), osteogenesis-associated genes and proteins in BM-MSCs were detected using reverse transcription-quantitative polymerase chain reaction and western blot analysis. Alkaline phosphatase (ALP) and Alizarin Red S staining were also performed to measure the osteogenic ability of BM-MSCs. Results from the two datasets indicated that 6 lncRNAs were dysregulated in OP. Notably, XIST is key lncRNA in diverse diseases, and was subsequently selected for analysis. It was revealed that XIST was significantly upregulated in plasma and monocytes from patients with OP compared with the normal controls. Furthermore, results indicated that overexpression of XIST significantly inhibited osteoblast differentiation in BM-MSCs, as evidenced by the decreased expression of ALP, bone γ-carboxyglutamic acid-containing protein and runt related transcription factor 2, reduced ALP activity and a decreased number of calcium deposits. However, interference of XIST exhibited the opposite biological effects in BM-MSCs. Taken together, XIST was highly expressed in the serum and monocytes of patients with OP. In addition, the findings suggested that XIST could inhibit osteogenic differentiation of BM-MSCs.

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