[Research status of acetabular reconstruction in Crowe type â ¡ and â ¢ developmental dysplasia of the hip].

Developmental dysplasia of the hip (DDH) is a major cause of hip arthritis and ultimately total hip arthroplasty. Due to the dysplastic acetabulum, how to place the acetabular cup becomes a challenge in acetabular reconstruction for such patients. Especially in the acetabula classified as Crowe typeⅡand type Ⅲ, the dislocation of the femoral head causes bone defects above the true acetabulum, which will affect the stability of the acetabular cup when the acetabular reconstruction is performed at the true acetabulum. Many acetabular reconstruction methods such as bone grafting, the use of small acetabular cups, socket medialization technique, and high hip center technique are used to increase the host bone coverage of the cup. However, each method has its own shortcomings that can not be ignored so that there is no unified conclusion on the acetabular reconstruction methods for Crowe typeⅡand type Ⅲ hip dysplasia. This article summarized and evaluated various reconstruction methods in combination with the acetabular morphology of DDH, and put forward the research direction in the future.

[Research progression in the pathogenesis of osteoarthritis].

Osteoarthritis(OA) is one of the most common joint diseases. As Chinese society enters the age of aging, the incidence of OA has been soar year by year, and research on its pathogenesis has been continuously valued by researchers. Studies have found that inflammatory cytokines, mainly interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α), were responsible for the construction of OA inflammatory networks. It was also found that the overexpression of proteases, mainly matrix metalloproteinases(MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), was the direct cause of OA cartilage deficiency. What's more, signaling pathways such as stromal cell derived factor-1 (SDF-1) and Wnt, chondrocytic senescence and the senescence-associated secretory phenotype (SASP), chondrocyte apoptosis and autophagy, and estrogen all play significant roles in OA pathogenesis. This paper extensively reviews the research literature relevant to the pathogenesis of OA in recent years, and systematically expounds the pathogenesis of OA from two aspects:molecular level and cell level. At the end of the paper, we discussed and predicted some potential directions in the future clinical diagnosis and treatment of OA.

Zinc finger X-chromosomal protein promotes growth and tumorigenesis in human osteosarcoma cells.

OBJECTIVE: To investigate the role of Zinc finger X-chromosomal protein (ZFX) in oncogenesis of Osteosarcoma tumor. METHODS: Here, we first conducted an expression analysis of ZFX in Osteosarcoma cell lines. Then, we constructed ZFX-specific small interfering RNA (siRNA)-lentiviral vector that is capable of effectively inhibiting the expression of ZFX gene in human Osteosarcoma Saos-2 cells, and investigated systemically the impacts of ZFX silence on the growth and invasive ability of the cancer cells in vitro. Furthermore, we determined the effects of ZFX knockdown on the cell cycle distribution and apoptosis of Saos-2 cells. RESULTS: We found that ZFX inhibition resulted in significantly impaired proliferation and colony formation as well as mitigated invasiveness of Saos-2 cells. Importantly, si-ZFX infected cells exhibited a greater portion of cells at G1 phase, but a minor portion of S and G2/M phase cells. Moreover, a greater portion of sub-G1 apoptotic cells was observed in si-ZFX infected cells. CONCLUSIONS: These results strongly suggest that ZFX is a novel proliferation regulator that promotes growth of Osteosarcoma cells, and downregulation of ZFX expression induces growth suppression of Saos-2 cells via arrested G0/G1 phase cell cycle and apoptosis pathways, thereby indicating that ZFX may serve as a new molecular target for Osteosarcoma tumor therapy.

7,8-Dihydroxycoumarin inhibits A549 human lung adenocarcinoma cell proliferation by inducing apoptosis via suppression of Akt/NF-κB signaling.

The Akt/NF-κB pathways are involved in numerous anti-apoptotic and drug-resistance events that occur in non-small cell lung cancer (NSCLC). In the present study, the role of 7,8-dihydroxycoumarin in the regulation of the anti-apoptotic Akt and NF-κBp65 signaling pathways was explored. A549 human lung adenocarcinoma cells were exposed to 7,8-dihydroxycoumarin with a final concentration of 25, 50 and 100 µmol/l for 48 h. Quantitative polymerase chain reaction (PCR) and western blotting were performed to detect mRNA and protein expression, respectively. The MTT assay was performed to detect cell proliferation. The results demonstrated that anti-apoptotic phospho-Akt1 (pAkt1), phospho-IκBα (pIκBα), NF-κBp65 and Bcl-2 were inhibited and pro-apoptotic caspase-3 was upregulated in a concentration-dependent manner. At a concentration of 100 µmol/l, the anti-apoptotic NF-κBp65 and Bcl-2 mRNA expression levels decreased 0.12 (5.82/48.5, treated/control)-fold and 0.17 (6.7/39.4, treated/control)-fold, respectively. The pro-apoptotic caspase-3 mRNA was upregulated 4.43 (39.4/8.9, treated/control)-fold. The anti-apoptotic pAkt1, pIκBα, NF-κBp65 and Bcl-2 proteins were downregulated, with blot grayscale values of 7.3 (vs. 52.4 control), 4.3 (vs. 42.2 control), 5.08 (vs. 44.5 control) and 5.92 (vs. 38.5 control), respectively. The proapoptotic caspase-3 was upregulated to a blot grayscale value of 27.8 (vs. 5.8 control). The proliferative activity of A549 cells was reduced significantly compared with that of the control cells (83.7, 27.2 and 9.5 vs. 100%, respectively; P<0.05 for each). 7,8-Dihydroxycoumarin plays an important role in the induction of apoptosis via suppression of Akt/NF-κB signaling in A549 human lung adenocarcinoma cells in a concentration-dependent manner. 7,8-Dihydroxycoumarin may be a candidate naturally-occurring drug for the treatment and prevention of lung adenocarcinoma.

Treatment of multilevel degenerative lumbar spinal stenosis with spondylolisthesis using a combination of microendoscopic discectomy and minimally invasive transforaminal lumbar interbody fusion.

Degenerative lumbar spinal stenosis (DLSS) has become increasingly common and is characterized by multilevel disc herniation and lumbar spondylolisthesis, which are difficult to treat. The current study aimed to evaluate the short-term clinical outcomes and value of the combined use of microendoscopic discectomy (MED) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the treatment of multilevel DLSS with spondylolisthesis, and to compare the combination with traditional posterior lumbar interbody fusion (PLIF). A total of 26 patients with multilevel DLSS and spondylolisthesis underwent combined MED and MI-TLIF surgery using a single cage and pedicle rod-screw system. These cases were compared with 27 patients who underwent traditional PLIF surgery during the same period. Data concerning incision length, surgery time, blood loss, time of bed rest and Oswestry Disability Index (ODI) score prior to and following surgery were analyzed statistically. Statistical significance was reached in terms of incision length, blood loss and the time of bed rest following surgery (P<0.05), but there was no significant difference between the surgery time and ODI scores of the two groups. The combined use of MED and MI-TLIF has the advantages of reduced blood loss, less damage to the paraspinal soft tissue, shorter length of incision, shorter bed rest time, improved outcomes and shorter recovery times and has similar short-term clinical outcomes to traditional PLIF.

BAP1 is a good prognostic factor in advanced non-small cell lung cancer.

PURPOSE: Non-small cell lung cancer (NSCLC) is the leading worldwide source of cancer-related deaths. Although some drugs targeting epidermal growth factor receptor (EGFR) mutations have been developed, most advanced NSCLC is still incurable and new targets for anticancer drugs are in demand. BRCA1-associated protein-1 (BAP1) is a component of the ubiquitin proteasome system (UPS). UPS has emerged as a potential target for anticancer drugs. The aim of the present study was to investigate the expression of BAP1 protein in patients with NSCLC. METHODS: BAP1 expression was measured using Western blot analysis in 103 cases patients with advanced NSCLC. RESULTS: Results revealed 49 (47.5%) patients were classified with high expression of BAP1. Squamous cell carcinomas were more likely to be observed in BAP1 high expressers compared with adenocarcinomas (55.8% vs. 32.3%, p = 0.001). High BAP1 expression was associated with no lymph node metastasis (p = 0.002). There was also a significant association between BAP1 expression and histological type (p = 0.014), while expression of BAP1 was not correlated with other clinical or pathological characteristics. Kaplan-Meier survival analysis showed that patients with high BAP1 expression had a longer median survival compared with patients with low BAP1 expression (23.2 vs. 14.7 months, p = 0.021). Multivariate analysis revealed that high BAP1 expression was an independent lower risk for all 103 patients (HR = 0.61, 95% CI 0.32-0.71, p = 0.003). CONCLUSIONS: BAP1 may be a useful prognostic factor of NSCLC patients and potential target for anticancer drugs.

Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor.

BACKGROUND: The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases. The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor. METHODS: Clinical manifestations, physical, and radiological findings of 10 patients, whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor, were reviewed and compared with those of cervical radiculopathy. RESULTS: Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement. Physical examination showed almost normal cervical spine range of motion. Spurling's neck compression test was negative in all patients. Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case. The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI. CONCLUSIONS: By the method of combination of history, physical examination, and radiological findings, superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy. Normal motion range of the cervical spine, negative Spurling's neck compression test, and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considered as indications for further chest radiograph examinations.

Regulation of cofilin activity by CaMKII and calcineurin.

Cofilin promotes actin filament turnover by severing and depolymerizing actin filaments. Cofilin is inactivated by phosphorylation on Ser-3 by LIM-kinase1 (LIMK1) and is activated when protein phosphatase Slingshot-1L (SSH1L) dephosphorylates this residue. The authors have shown that Ca-induced cofilin dephosphorylation is mediated by calcineurin (Cn)-dependent activation of SSH1L. In this study, Ca/calmodulin-dependent protein kinase II (CaMKII) is shown to negatively regulate SSH1L activity and bind to SSH1L in a complex with 14-3-3. Phosphorylation of LIMK1 by CaMKII and its subsequent activation regulates the subcellular localization of SSH1L. Based on these findings, the authors suggest that CaMKII and Cn provide a switch-like mechanism that controls Ca-dependent LIMK1, SSH1L and cofilin activation, and subsequently actin cytoskeletal reorganization.

[Effect of tissue factor in extravascular migration of fibrosarcoma cells].

OBJECTIVE: To evaluate the effect of tissue factor (TF) in extravascular migration of fibrosarcoma cells and hematogenous metastasis. METHODS: The expression of tissue factor in fibrosarcoma HT1080 cells was analyzed by flow cytometry. The extravascular migration of fibrosarcoma cells was observed in a constructed monolayer vascular endothelial cells and extra-cellular matrix model. RESULT: Tissue factor was highly expressed in HT1080 cells. HT1080 migrated and passed through the monolayer vascular endothelial cells to the collagen gel in a time-dependent manner. Anti-TF antibody inhibited extravascular migration of fibrosarcoma cells and the inhibition was concentration-dependent (P<0.05). CONCLUSION: Tissue factor may enhance hematogenous metastasis through extravascular migration of fibrosarcoma cells.

Surgical treatment of adult idiopathic scoliosis: long-term clinical radiographic outcomes.

More adults are suffering from adult idiopathic scoliosis and seeking treatment for their spinal deformities. Adult idiopathic scoliosis can lead to painful spinal osteoarthritis, progressive deformity, spinal stenosis with radiculopathy, muscle fatigue from coronal and sagittal plane imbalance, and psychological effects with a visible deformity. Primary treatment of such conditions is conservative; however, some patients are resistant to conservative treatment or are not candidates for it, and they require surgery. Back pain is likely the most common indication for surgical treatment of scoliosis in adult patients. Pedicle screws offer 3-column purchase and a longer arm compared with hook placement on the lamina. This study is a retrospective analysis of a consecutive series of patients with adult idiopathic scoliosis who were treated with pedicle screw placement. Significant back pain relief and satisfaction can be achieved and maintained over the long term. Restoration of coronal and sagittal balance, or improvement thereof, was achieved in all patients with balance problems. This study clarified several important characteristics of adult scoliosis, and we believe that useful conclusions can be drawn regarding its surgical indications and strategies: (1) pedicle screw construct can gain effective results for treatment of adult idiopathic scoliosis due to its perceived superior power of correction; (2) younger patients present for surgery for different reasons than older patients (progressive deformity or pain); and (3) pain improvement is a more reliable outcome in older patients than younger patients, although younger patients rarely have severe pain symptoms.

Differentiation of human mesenchymal stem cells: the potential mechanism for estrogen-induced preferential osteoblast versus adipocyte differentiation.

INTRODUCTION: Bone marrow-derived mesenchymal stem cells (MSCs) are capable of differentiating into osteoblasts and adipocytes. This critical balance between osteoblast and adipocyte differentiation plays a significant role in maintaining normal bone homeostasis. In osteoporosis, a metabolic bone disease seen mainly in postmenopausal women because of estrogen deficiency, the concomitant occurrence of increased bone marrow adipocyte production with diminished production of osteoblasts, points to the potential role of estrogen in shifting the balance of MSC differentiation. METHODS: We established an in vitro differentiation model of isolated human MSCs (hMSCs) and examined the role of distinct estrogen signaling pathways in regulating the differentiation of hMSCs. RESULTS: Estrogen promoted the differentiation of hMSCs to osteoblasts in contrast to adipocytes, the former of which was mediated through the PI3K/SSH1L but not the mitogen-activated protein kinase pathway. CONCLUSION: This study provides a novel mechanistic understanding of estrogen-related osteoporosis and identifies potential targets for antiosteoporosis therapies.

Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques.

The technique of computer-assisted pedicle screw installation and its clinical benefit as compared with conventional pedicle screw installation was evaluated. Twenty-two patients had thoracic screw insertion under 3-dimentional computer-assisted navigation (92 screws) and 20 patients under conventional fluoroscopic control (84 screws). The 2 groups were compared for accuracy of screw placement, screw insertion time by postoperative thin-cut computed tomography scans, and statistical analysis. The cortical perforations were graded by 2-mm increments. In the computer group, 88 (95.65%) were grade I (good), 4 (4.35%) were grade II (<2 mm), and 0 were grade III (>2 mm) violations. There were 4 cortical violations (3.57%). In the conventional group, there were 14 cortical violations (16.67%), 70 (83.33%) were grade I (good), 11 (13.1%) were grade II (<2 mm), and 3 (3.57%) were grade III (>2 mm) violations (P<.001). The number (19.57%) of upper thoracic pedicle screws (T1-T4) inserted under 3-dimensional computer-assisted navigation was significantly higher than that (3.57%) by conventional fluoroscopic control (P<.001). Average screw insertion time in the conventional group was more than in the computer group (P<.001). Three-dimensional computer-assisted navigation pedicle screw placement can increase accuracy, reduce surgical time, and be performed safely and effectively at all levels of the thoracic spine, particularly the upper thoracic spine.

Pedicle screw placement in the thoracic spine: a randomized comparison study of computer-assisted navigation and conventional techniques.

OBJECTIVE: To evaluate the accuracy of computer-assisted pedicle screw installation and its clinical benefit as compared with conventional pedicle screw installation techniques. METHODS: Total 176 thoracic pedicle screws placed in 42 thoracic fracture patients were involved in the study randomly, 20 patients under conventional fluoroscopic control (84 screws) and 22 patients had screw insertion under three dimensional (3D) computer-assisted navigation (92 screws). The 2 groups were compared for accuracy of screw placement, time for screw insertion by postoperative thin-cut CT scans and statistical analysis by X(2) test. The cortical perforations were then graded by 2-mm increments: Grade I (good, no cortical perforation), Grade II (screw outside the pedicle less than 2 mm), Grade III (screw outside the pedicle larger than 2 mm). RESULTS: In computer assisted group, 88 (95.65%) were Grade I (good), 4 (4.35%) were Grade II (less than 2mm), no Grade III (larger than 2 mm) violations. In conventional group, there were 14 cortical violations (16.67%), 70 (83.33%) were Grade I (good), 11 (13.1%) were Grade II (less than 2 mm), and 3 (3.57%) were Grade III (larger than 2 mm) violations (P less than 0.001). The number (19.57%) of upper thoracic pedicle screws ( T(1)-T(4) ) inserted under 3D computer-assisted navigation was significantly higher than that (3.57%) by conventional fluoroscopic control (P less than 0.001). Average screw insertion time in conventional group was (4.56+/-1.03) min and (2.54+/-0.63) min in computer assisted group (P less than 0.001). In the conventional group, one patient had pleura injury and one had a minor dura violation. CONCLUSIONS: This study provides further evidence that 3D computer-assisted navigation placement of pedicle screws can increase accuracy, reduce surgical time, and be performed safely and effectively at all levels of the thoracic spine, particularly upper thoracic spine.

[Mechanism of endothelial Rho/Rho kinase in extravascular migration of fibrosarcoma cell].

OBJECTIVE: To study the mechanism of endothelial Rho/Rho kinase in extravascular migration of fibrosarcoma cell. METHODS: We used an in vitro model of fibrosarcoma cell transmigration across a monolayer of human umbilical vein endothelial cell (HUVEC) cultured on collagen gel to observe extravascular migration of fibrosarcoma cells, and then calculated the electrical resistance of HUVEC monolayer and endothelial myosin light chain (MLC) phosphorylation in extravascular migration of fibrosarcoma cells. RESULTS: Fibrosarcoma cells migrated through endothelial cells into collagen gel. The electrical resistance of a HUVEC monolayer reduced and endothelial MLC phosphorylation enhanced in the extravascular migration of fibrosarcoma cells. Endothelial Rho inhibitor (C3 transferase) and Rho kinase inhibitor (Y-27632) inhibited the extravascular migration of fibrosarcoma cells and inhibited the reduction of electrical resistance of a HUVEC monolayer and the enhancement of endothelial MLC phosphorylation in extravascular migration of fibrosarcoma cells. CONCLUSION: Endothelial Rho/Rho kinase may regulate fibrosarcoma cell transendothelial migration through MLC phosphorylation.

[Radiation exposure to spine surgeon: a comparison of computer-assisted navigation and conventional technique].

To analyze the radiation exposure of surgeon in spine surgery and compare computer-assisted navigation and conventinal technique. While performing spine surgery, the surgeon is exposed to a significant amount of radiation. Spinal surgeons should be considered as workers of radiational occupation accordingly. Methods of reducing radiation exposure should be strongly recommended. Comparing with conventional fluoroscopic technique,the computer-assisted navigtion can reduce surgical time, radiation exposure, and has become an increasingly accepted and practiced from of intraoperative spinal navigation.

[Therapeutic effects of small interfering RNA targeting MDM2 on human osteosarcoma cells].

OBJECTIVE: To investigate the inhibitory effect of the small interfering RNA targeting mdm2 gene on the growth of osteosarcoma cells. METHODS: PGCsilencerTM-mdm2 siRNA was constructed and transfected into the osteosarcoma cell line U2OS cells. The inhibitory effects on mdm2 were determined by RT-PCR and Western blot analysis. The cell growth activity was determined by MTT assay, and the cell apoptosis was examined by flow cytometry. The therapeutic effects of simdm2 was assessed on the nude mouse model of transplanted tumor. RESULTS: The simdm2 plasmid was successfully constructed. After simdm2 being transfected into the U2OS cells, the expressions of mdm2 gene and protein were significantly inhibited. The ability of cell growth activity decreased greatly and cell apoptosis occurred apparently. There was no significant difference between the negative control group and non-transfected group. The growth of xenograft tumor in simdm2 transfected nude mice was inhibited and the expressions of mdm2 gene and protein were down-regulated remarkably. CONCLUSION: siRNA targeting mdm2 gene inhibits the mdm2 expression in osteosarcoma U2OS cells and the growth of osteosarcoma in nude mice.

[Protective effect of velvet antler polypeptide (VAP) on rats with the spinal cord injury].

OBJECTIVE: To investigate the protective effect of antler polypeptide on the rats with spinal cord injury (SCI). METHODS: The model rats were treated with different doses of antler polypeptide, and its effect on motor function, ethology and pathological changes of spinal cord of the rats observed. RESULTS: Seven days after treatment with different doses of antler polypeptide, rat's motor activity was recovered in some extent. Significant difference (P < 0.001)was found between the antler polypeptide treatment group and operation group. The effect could be enhanced by increase of the doses. We observerd the effect on the pathological change of spinal cord in rat, and found the tissue edema and inflammatory infiltration were relieved after treatment with different doses of antler polypeptide, especially in the dose of 15 mg antler polypeptide. CONCLUSION: Antler polypeptide can promote the motor function recovery in SCI rats, and its action is dose-dependent.

[Application of heterogenous bone combined with auto-marrow in anterior cervical interbody fusion].

OBJECTIVE: To study the clinical application of heterogenous bone graft combined with auto-marrow. METHODS: Deproteinated and degreased heterogenous cancellous bone combined with auto-marrow was used in 21 cases of anterior cervical interbody fusion. Among them, 2 cases were treated by bone graft only, and the other 19 cases were further treated by anterior plate fixation. RESULTS: The follow-up time was 12-36 months with an average of 21 months. After operation, posteroanterior and lateral radiograph of all the cases revealed that the reduction and the position of the grafting bone were good without inflammation or other complications. After 6 months of operation, the radiograph of 2 cases of cervical disk herniation, which were treated by bone graft only, showed the bones lost their height and the curve of the cervical spine returned to the state of preoperation. For the other cases, the grafting bones remained their original figure without dislocation of the bone or fracture of the plate or the screw. The nervous function recovered variously. Before operation, 10 cases were ranked as grade A, 7 cases grade C, 4 cases grade D according to Frankel classification. After operation, in grade A cases, 5 cases did not recover, 3 cases recovered to grade B, 2 cases to grade C; in grade C cases, 5 to grade D, 2 to grade E; all of grade D 4 cases to grade E. CONCLUSION: Heterogenous bone combined with auto-marrow can be used as grafting material in the anterior cervical interbody fusion, but its mechanical rigidity need to be improved or the fusion should be aided with rigid internal fixation.