High expression of ACKR1 predicts a good prognosis and suppresses sarcoma cell progression via regulating the tumor immune microenvironment.

Sarcoma is a malignant tumor originating from mesenchymal tissue with a poor prognosis. Atypical chemokine receptor 1 (ACKR1) is found closely related to cancer progression. However, the effects of ACKR1 in soft tissue sarcoma have not been well investigated. Therefore, our present study is devoted to analyze the functions of ACKR1 in sarcoma progression and its potential mechanism. We detected the expression of ACKR1 in the Cancer Genome Atlas (TCGA)-pan-cancer database, TCGA-Sarcoma from TCGA databases, and GSE21122 from Gene Expression Omnibus (GEO) database. The relationships between ACKR1 expression, clinicopathological data, and survival status were evaluated in the TCGA-Sarcoma database. Moreover, overexpression negative control (OE-NC) and overexpression ACKR1 (OE-ACKR1) were used to further verify the effects of ACKR1 overexpression in the progression of sarcoma cells by using Reverse Transcription-Quantitative Polymerase Chain Reaction (RT-qPCR), cell counting kit-8 (CCK-8), 5-Ethyny-2'-Deoxyuridine (EdU), wound healing, transwell assay, and flow cytometry assays. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) analyses were carried out to explore the potential enriched biological process of ACKR1 expression in sarcoma. Furthermore, tumor-immune system interactions databases (TISIDB) were applied to further confirm the relations between ACKR1 and tumor immune microenvironment in sarcoma. Our study found that ACKR1 is downregulated in multiple cancers (including sarcoma), and low expression of ACKR1 is related to poor survival status in sarcoma. The biological experiments found that promoting expression of ACKR1 can suppress sarcoma cell proliferation, migration, invasion, promote cell apoptosis, and arrest cell cycle. The GO-KEGG, GSEA, and TISIDB analysis showed that ACKR1 is related to the tumor immune microenvironment. In conclusion, low expression of ACKR1 presented as an independent prognostic biomarker in sarcoma. Overexpression of ACKR1 can significantly suppress cell progression ability in sarcoma by regulating the immune microenvironment.

[Effect of screw blade position on proximal femoral nail anti-rotation internal fixation for unstable intertrochanteric fractures in the elderly].

OBJECTIVE: To investigate the effect of the screw blade position on the effectiveness of proximal femoral nail anti-rotation (PFNA) internal fixation for unstable intertrochanteric fractures in the elderly. METHODS: A clinical data of 131 elderly patients with unstable intertrochanteric fractures who were treated with PFNA internal fixation between January 2010 and January 2017 was retrospectively analyzed. According to the anteroposterior X-ray films, the screw blades were placed in the middle of the femoral neck in 72 patients (group A) and at one-third of the femoral neck in 59 patients (group B). There was no significant difference between the two groups ( P>0.05) in the gender, age, bone density, classification of fractures, other medical diseases, and the time between injury and operation. Multiple treatment indexes were analyzed, including complications, hip Harris score, the healing status of fracture, tip-apex distance (TAD), and the height of the tail nail. RESULTS: All patients were followed up 11-14 months, with an average of 12.1 months. All incisions healed by first intention with no complications. All fractures healed and no significant difference in bone healing time between the two groups ( Z=-0.190, P=0.849). At 6 months after operation, TAD was (2.23±0.07) cm in group A and (2.85±0.12) cm in group B, showing significant difference ( t=-47.643, P=0.000); and the height of the tail nail was (1.72±0.14) cm in group A and (0.53±0.26) cm in group B, showing significant difference ( t=31.031, P=0.000). According to the Harris score, the hip functions were rated as excellent in 48 cases, good in 15 cases, and poor in 9 cases in group A, while as excellent in 38 cases, good in 16 cases, and poor in 5 cases in group B, with no significant difference between the two groups ( Z=-0.075, P=0.941). CONCLUSION: For the unstable intertrochanteric fracture in the elderly, the PFNA internal fixation with appropriated TAD and the screw blades placed in the middle or at one-third of the femoral neck can obtain good effectiveness.

Adjacent two-level anterior cervical discectomy and fusion versus one-level corpectomy and fusion in cervical spondylotic myelopathy: Analysis of perioperative parameters and sagittal balance.

OBJECTIVES: The optimal surgical strategy for cervical spondylotic myelopathy (CSM) remains controversial; thus, the current study was designed to compare the outcomes of two different anterior approach surgeries for two-level CSM, namely, adjacent two-level anterior cervical discectomy and fusion (ACDF) and one-level anterior cervical corpectomy and fusion (ACCF). PATIENTS AND METHODS: A total of 53 patients who underwent adjacent two-level ACDF and 68 patients who underwent one-level ACCF in the Spinal Surgery Department from January 2010 to October 2017 were retrospectively analyzed. Independent sample t tests and chi-square tests were used to compare perioperative parameters (hospital stays, bleeding amounts and operation times), clinical parameters (Neck Disability Index scores and Visual Analog Scale scores for neck and arm pain), and radiologic parameters (difference in segmental height, T1 slope, C2-7 sagittal vertical axis, C2-7 lordosis, segmental angle, and fusion rate). RESULTS: The length of hospital stay (p < 0.01), bleeding amount (p < 0.01), operation time (p < 0.001) and difference in segmental height (p < 0.001) were significantly greater in the ACCF group than in the ACDF group, whereas C2-7 lordosis (p < 0.05) and the segmental angle (p < 0.001) were significantly lower in the ACCF group than in the ACDF group. Other parameters were not significantly different between the two groups. CONCLUSION: Both ACDF and ACCF provided satisfactory clinical outcomes and fusion rates for CSM. However, adjacent two-level ACDF was associated with shorter hospital stays, less blood loss, shorter operative times, fewer differences in segmental height and greater improvement in segmental lordotic curvature. On most occasions, when either surgical method could be selected, adjacent two-level ACDF as a surgical treatment for CSM may be a worthwhile alternative method to one-level ACCF.

[Effectiveness analysis of distal radius microplate locking plate for treatment of displaced fracture of medial clavicle].

OBJECTIVE: To investigate and evaluate the effectiveness of the distal radius microplate locking plate for the treatment of displaced fracture of medial clavicle. METHODS: Between January 2013 and June 2017, 18 cases of obvious displaced fracture of medial clavicle were treated with distal radius microlocking plate. There were 10 males and 8 females, with an average age of 51.4 years (range, 18-88 years). Causes of injury included traffic accident injury in 15 cases, heavy object injury in 3 cases; all of them were closed injury. According to Edinburgh classification, 15 cases were ⅠB1 type and 3 cases were ⅠB2 type. Fracture displacement was 12-21 mm (mean, 16.3 mm). The time from injury to operation was 3-7 days (mean, 4.3 days). After operation, the clinical healing and complications of fracture were observed, and shoulder function was evaluated according to Rockwood's scoring criteria. RESULTS: No incisional infection, neurovascular injury, or other early complications occurred. All 18 patients were followed up 8-15 months (mean, 12 months). All fractures reached clinical osseous union, and the healing time was 8-24 weeks (mean, 16.6 weeks). Postoperative plate loosening occurred in 1 case, which was removed surgically, while other patients did not suffer from complications such as bone nonunion, displacement, internal fixator loosening, and loss of reduction. At last follow-up, according to Rockwood's scoring criteria, the results were excellent in 12 cases and good in 6 cases. CONCLUSION: The distal radius microplate locking plate is effective for the treatment of displaced medial clavicle fracture, which has few complications, and is feasible for early functional exercise, and is helpful for the recovery of shoulder joint function.