Global Transcriptomic Study of Circular-RNA Expression Profile in Osteoclasts Infected by Intracellular Staphylococcus aureus.

Osteomyelitis is difficult to cure, and the rapidly rising morbidity is a thorny problem accompanied by a large number of joint replacement applications. Staphylococcus aureus is the main pathogen of osteomyelitis. Circular RNAs (circRNAs), as emerging noncoding RNAs, play important roles in multiple physiopathological processes which could provide novel insights into osteomyelitis. However, little is known about the roles of circRNAs in the pathogenesis of osteomyelitis. Osteoclasts, considered bone sentinels, are the resident macrophages in bone and may play the immune defense roles in osteomyelitis. It has been reported that S. aureus can survive in osteoclasts, but the function of osteoclast circRNAs in response to intracellular S. aureus infection remains unclear. In this study, we investigated the profile of circRNAs in osteoclasts infected by intracellular S. aureus through high-throughput RNA sequencing. In total, 24 upregulated and 62 downregulated differentially expressed circRNAs were identified and subsequently analyzed to demonstrate their potential functions. On this basis, three circRNAs (chr4:130718154-130728164+, chr8:77409548-77413627-, and chr1:190871592-190899571-) were confirmed as potential novel biomarkers for the diagnosis of osteomyelitis through the murine model of osteomyelitis. Most importantly, we verified that the circRNA chr4:130718154-130728164+ named circPum1 could regulate the host autophagy to affect the intracellular infection of S. aureus through miR-767. In addition, circPum1 could serve as a promising serum biomarker in osteomyelitis patients caused by S. aureus infection. Taken together, this study provided the first global transcriptomic profile analysis of circRNAs in osteoclasts infected by intracellular S. aureus and first proposed a novel perspective for the pathogenesis and immunotherapy of S. aureus-induced osteomyelitis from the term of circRNAs.

Identification of key serum biomarkers for the diagnosis and metastatic prediction of osteosarcoma by analysis of immune cell infiltration.

BACKGROUND: The role of circular RNAs (circRNAs) and microRNAs (miRNAs) in osteosarcoma (OS) development has not been fully elucidated. Further, the contribution of the immune response to OS progression is not well defined. However, it is known that circRNAs and miRNAs can serve as biomarkers for the diagnosis, prognosis, and therapy of many cancers. Thus, the aim of this study was to identify novel key serum biomarkers for the diagnosis and metastatic prediction of OS by analysis of immune cell infiltration and associated RNA molecules. METHODS: Human OS differentially expressed circRNAs (DEcircRNAs), differentially expressed miRNAs (DEmiRNAs), and differentially expressed mRNAs (DEmRNAs) were identified by analysis of microarray data downloaded from Gene Expression Omnibus (GEO) datasets. Further, characteristic patterns of OS-infiltrating immune cells were analyzed. On this basis, we identified statistically significant transcription factors. Moreover we performed pathway enrichment analysis, constructed protein-protein interaction networks, and devised competitive endogenous RNA (ceRNA) networks. Biological targets of the ceRNA networks were evaluated and potential OS biomarkers confirmed by RT-qPCR analysis of the patients' serum. RESULTS: Seven differentially expressed circRNAs, 166 differentially expressed miRNAs, and 175 differentially expressed mRNAs were identified. An evaluation of cellular OS infiltration identified the highest level of infiltration by M0 macrophages, M2 macrophages, and CD8+ T cells, with M0 macrophages and CD8+ T cells as the most prominent. Significant patterns of tumor-infiltrating immune cells were identified by principal component analysis. Moreover, 185 statistically significant transcription factors were associated with OS. Further, in association with immune cell infiltration, hsa-circ-0010220, hsa-miR-326, hsa-miR-338-3p, and FAM98A were identified as potential novel biomarkers for OS diagnosis. Of these, FAM98A had the most promise as a diagnostic marker for OS and OS metastasis. Most importantly, a novel diagnostic model consisting of these four biomarkers (hsa-circ-0010220, hsa-miR-326, hsa-miR-338-3p, and FAM98A) was established with a 0.928 AUC value. CONCLUSIONS: In summary, potential serum biomarkers for OS diagnosis and metastatic prediction were identified based on an analysis of immune cell infiltration. A novel diagnostic model consisting of these four promising serum biomarkers was established. Taken together, the results of this study provide a new perspective by which to understand immunotherapy of OS.

Identify an innovative ferroptosis-related gene in hepatocellular carcinoma.

BACKGROUND: SLC1A5 has been demonstrated to be associated with the progression of other tumors; however, studies are lacking in hepatocellular carcinoma (HCC). Here, we identify SLC1A5, as a novel ferroptosis factor, for HCC patients. METHODS: The core biomarkers were identified by univariate and multivariate Cox regression analysis, and the genes present in liver cancer were validated using the public database. Then, gene set enrichment analysis (GSEA) was performed to explore the underlying molecular mechanisms. In addition, we explore the relationship between SLC1A5 and clinical factors. Finally, we determine the effect of SLC1A5 on HCC cells using real-time PCR, cell scratch analysis, transwell analysis, and CCK8 analysis in molecular biology experiments. RESULTS: Cox regression model shows that SLC1A5 was an independent risk factor for HCC patients. GSEA results indicated high expression of SLC1A5 related to the fatty acid metabolism pathway. Clinical correlation analysis demonstrates that alpha-fetoprotein (AFP) expression was positively correlated with SLC1A5 (p = 8e-05), and the higher tumor stage means the higher expression of SLC1A5 (p = .02). In addition, SLC1A5 expression was also positively correlated with vascular infiltration of HCC (p = .04). Furthermore, the SLC1A5 function deficiency experiment explored its underlying impact on the biological function of HCC. qPCR, also called quantitative polymerase chain reaction, confirmed that SLC1A5 was highly expressed in liver cancer when compared with normal tissues. Studies have also shown that downregulation of SLC1A5 can inhibit wound healing, invasion, and proliferation of HCC cells. CONCLUSION: In conclusion, ferroptosis factor SLC1A5 is a new therapeutic target for hepatocellular carcinoma.

Chromatin Regulator-Related Gene Signature for Predicting Prognosis and Immunotherapy Efficacy in Breast Cancer.

Background: Many studies have found that chromatin regulators (CRs) are correlated with tumorigenesis and disease prognosis. Here, we attempted to build a new CR-related gene model to predict breast cancer (BC) survival status. Methods: First, the CR-related differentially expressed genes (DEGs) were screened in normal and tumor breast tissues, and the potential mechanism of CR-related DEGs was determined by function analysis. Based on the prognostic DEGs, the Cox regression model was applied to build a signature for BC. Then, survival and receiver operating characteristic (ROC) curves were performed to validate the signature's efficacy and identify its independent prognostic value. The CIBERSORT and tumor immune dysfunction and exclusion (TIDE) algorithms were used to assess the immune cells infiltration and immunotherapy efficacy for this signature, respectively. Additionally, a novel nomogram was also built for clinical decisions. Results: We identified 98 CR-related DEGs in breast tissues and constructed a novel 6 CR-related gene signature (ARID5A, ASCL1, IKZF3, KDM4B, PRDM11, and TFF1) to predict the outcome of BC patients. The prognostic value of this CR-related gene signature was validated with outstanding predictive performance. The TIDE analysis revealed that the high-risk group patients had a better response to immune checkpoint blockade (ICB) therapy. Conclusion: A new CR-related gene signature was built, and this signature could provide the independent predictive capability of prognosis and immunotherapy efficacy for BC patients.

Factors Associated with Shoulder Range of Motion After Arthroscopic Rotator Cuff Repair: A Hospital-Based Prospective Study.

OBJECTIVE: To assess the factors associated with outcomes of arthroscopic surgical repair of rotator cuff tears (RCTs). METHOD: This prospective study recruited patients, at least 18 years old, who underwent arthroscopic rotator cuff repair for full-thickness RCTs at the First People's Hospital of Hangzhou Xiaoshan between July 2019 and October 2020. Patient demographics, lifestyle habits, and medical histories were collected preoperatively; RCT sizes and affected tendons were determined intraoperatively. Outcomes were assessed by shoulder range of motion (ROM) determinations 1.5 and 3 months postoperatively. The factors associated with ROM were determined using a binary logistic regression analysis, and the results were expressed as adjusted relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: A total of 132 patients with RCTs underwent arthroscopic surgery. Five were lost to follow-up, leaving 127 patients (mean age, 59 years; 58.3% women) who were included in the study analysis. The majority of the patients (54.5%) had RCTs that were classified as large or massive, and approximately 20% had tears involving multiple tendons; 80.3% of the patients had tears involving only a single tendon. Moreover, 29.9% of the patients had hypertension and 11.0% had diabetes. Among the patients, 23.0% were smokers and 34.6% drank alcohol. According to the multivariate analysis, none of the assessed factors were associated with shoulder ROM at the 1.5-month follow-up. At the 3-month follow-up, RCTs involving a single tendon demonstrated 3-fold better abduction (RR = 4.00; 95% CI, 1.30-12.33; P = 0.016) and 3.15-fold better internal rotation (RR = 3.15; 95% CI, 1.19-8.36; P = 0.021) than did RCTs involving multiple tendons. Patients who did not drink alcohol demonstrated 6.08-fold better anteflexion (RR = 7.08; 95% CI, 2.11-23.73; P = 0.002) and nearly 4-fold better abduction (RR = 4.97; 95% CI, 1.62-15.23; P = 0.005) than patients who drank alcohol. CONCLUSION: To improve outcomes, the results indicate that more targeted measures should be directed toward patients with multiple-tendon RCTs and that preoperative alcohol abstinence education is needed for patients with RCTs.

Comparison of surface properties, cell behaviors, bone regeneration and osseointegration between nano tantalum/PEEK composite and nano silicon nitride/PEEK composite.

Both tantalum (Ta) and silicon nitride (SN) exhibit osteogenic bioactivity and antibacterial property. In addition, as a biomaterial for bone repair, polyetheretherketone (PEEK) has outstanding biocompatibility and mechanical performances while it is biologically inert. In this study, by blending PEEK with Ta and SN nanoparticles, respectively, Ta/PEEK composite (TPC) and SN/PEEK composite (SPC) were fabricated for load-bearing bone repair. The surface roughness, hydrophilicity and surface energy of TPC containing Ta nanoparticles were higher than SPC containing SN nanoparticles and PEEK. In addition, TPC with Ta nanoparticles exhibited low antibacterial property while SPC with SN nanoparticles showed high bacterial property. Moreover, the MC3T3-E1 cells responses (e.g. proliferation and differentiation) to TPC was the highest while PEEK was the lowest in vitro. Furthermore, new bone formation and osseointegration for TPC was the highest while PEEK was the lowest in vivo. In conclusion, compared with PEEK, addition of Ta and SN nanoparticles into PEEK fabricated bioactive composites of TPC and SPC with optimized surface property, which played crucial roles in inducing cellular response/bone regeneration. Although the osteogenic activity of SPC was lower than TPC, SPC exhibited osteogenic activity and good antibacterial property, which could prevent infection from bacterial. Therefore, SPC would have better potential for bone substitute.

Clinical Observation on the Treatment of Rotator Cuff Injury with Modified Buyang Huanwu Decoction and Rotator Cuff Repair.

In this paper, we have evaluated the clinical efficacy of rotator cuff surgery combined with Chinese medicine Buyang Huanwu Decoction (adding medicine) in the treatment of patients with rotator cuff injury. For this purpose, sixty patients with rotator cuff injury and shoulder arthroscopic surgery were selected in this hospital (where 57 cases were finally screened). The patients were divided into a control group (28 cases) and a study group (29 cases) by the envelope method. The control group received conventional treatment after the operation, whereas the study group was combined with Buyang Huanwu Decoction after the operation. The clinical efficacy of the two groups, particularly after treatment, was compared in terms of self-care ability and Constant-Murley scores before and after treatment, that is, 4 w, 8 w, and 12 w. The total effective rate of treatment in the study group was significantly higher than that of the control group after 4 weeks of treatment (P < 0.05). There was no significant difference in the FIM self-care scores of the two groups before treatment (P > 0.05). In the study group patients, after treatment for 4 w and 8 w, the FIM self-care score was significantly improved (P < 0.05). The FIM self-care score of the patients in the study group, after 12 w of treatment, had no significant difference compared with the control group (P > 0.05). The Constant-Murley scores of the two groups were compared before treatment where no significant difference is observed (P > 0.05) and the Constant-Murley score of the study group patients was significantly higher than that of the control group, after 4 w and 8 w treatment (P < 0.05). Additionally, Constant-Murley score of the study group was not significantly higher than that of the control group after 12 w of treatment difference (P > 0.05). The proposed combined treatment program has value of promotion and implementation in the clinical treatment of patients with rotator cuff injury.

Correlation of osteoarthritis or rheumatoid arthritis with bone mineral density in adults aged 20-59 years.

BACKGROUND: It is reported that osteoporosis commonly occurs among patients with rheumatoid arthritis (RA), whereas the association between osteoporosis and osteoarthritis (OA) remains controversial. Our aim in this study was to investigate the association between BMD, as a marker of osteoporosis, and OA and RA among adults 20-59 years of age, using a population-based sample from the National Health and Nutrition Examination Survey (NHANES). METHODS: Our analysis was based on the NHANES data collected between 2011 and 2018. Data regarding arthritis status and the type of arthritis (OA or RA) were obtained from questionnaires. Lumbar BMD was measured by dual-energy X-ray absorptiometry. The association between OA, RA, and lumbar BMD was evaluated using logistic regression models. Subgroup analyses, stratified by gender and race, were performed. The association between duration of arthritis and lumbar BMD was also investigated. RESULTS: A total of 11,094 adults were included in our study. Compared to the non-arthritis group, participants with OA had a higher lumbar BMD (ß = 0.023, 95% CI 0.011-0.035), with no significant association between lumbar BMD and RA (ß = 0.014, 95% CI - 0.003 to 0.031). On subgroup analyses stratified by gender, males with OA had a higher lumbar BMD compared to those without OA (ß = 0.047, 95% CI 0.028-0.066). In females, OA was not associated with lumbar BMD (ß = 0.007, 95% CI - 0.008 to 0.021). There was no association between lumbar BMD and RA in both males (ß = 0.023, 95% CI - 0.003 to 0.048) and females (ß = 0.008, 95% CI - 0.015 to 0.031). Duration of arthritis was not associated with lumbar BMD for both OA (ß = - 0.0001, 95% CI - 0.0017 to 0.0015) and RA (ß = 0.0006, 95% CI - 0.0012 to 0.0025). CONCLUSIONS: Lumbar BMD was associated with OA but not with RA. While a higher lumbar BMD was associated with OA in males, but not in females. Our findings may improve our understanding between OA, RA, and bone health.

KIF15 knockdown suppresses gallbladder cancer development.

Gallbladder cancer (GBC) is commonly regarded as one of the most lethal malignant tumor types with poor prognosis. Kinesin family member 15 (KIF15) is reported to be tightly related with progression of multiple cancer types which, however, has not been clarified in GBC so far. KIF15 was significantly up-regulated in clinical GBC tissues compared with that in para-carcinoma tissues and the expression level was also correlated with tumor malignancies. In addition to tissues, GBC cells also exhibited a high expression abundance of KIF15. After down-regulating KIF15 via lentiviral transfection, GBC cell proliferation and migration were both inhibited, while cell apoptosis was promoted markedly. Likewise, silencing KIF15 significantly interfered the growth of nude mouse xenografts. Our experiments in GBC cell lines also demonstrated that KIF15 overexpression accelerated cell proliferation but lessened cell apoptosis in both GBC-SD and SGC-996 cells. Further investigation of the mechanism occurring in GBC inhibition mediated by KIF15 knockdown revealed that KIF15 deficiency led to decreased activity of several signaling pathways (TNF, PI3K/AKT and MAPK), a reduction of CDK6 expression regulated by enhanced p21, and HSP60 absence. Following the treatment of shCtrl- and shKIF15-transfected cells with AKT activator, we found that anti-tumor effects resulting from KIF15 deficiency could be relieved by AKT activator in both experimental cells. Overall, for the first time, we demonstrated that KIF15 was overexpressed in GBC and displayed a close relationship between KIF15 levels and GBC clinical stages. Furthermore, low expression of KIF15 resulted in obvious anti-tumor effects.

Capsular Healing in Interportal and Periportal Capsulotomy Methods of Hip Arthroscopy.

OBJECTIVE: To evaluate the midterm outcomes and the capsular healing in patients who had interportal capsulotomy versus periportal capsulotomy of hip arthroscopy. METHODS: Retrospectively reviewed 33 patients with labral tear received hip arthroscopy, with an average age of 41 (27-67) years, including 13 cases of Cam deformity and three cases of Pincer deformity. All patients had positive sign of flexion adduction internal rotation or flexion abduction external rotation. With MRI and radiographic (CT, X plain) imageological examination. MRI showed that all patients had labral tear. Radiographic finding (CT, X plain) showed the pathological changes of acetabular and femoral neck osteophyte. One group with 23 patients were treated with periportal capsulotomy. Another group with 10 patients were treated with interportal capsulotomy. All patients did not close the capsule. Clinical outcomes were measured with the Hip Outcome Score Activities of Daily Living (HOS-ADL) and the modified Harris Hip Score (mHHS), patient satisfaction measured with visual analogue scale (VAS). The healing of the capsule was evaluated by MRI. MRI showed continuous capsular indicated healing, discontinuous capsular indicated unhealing. Postoperatively 6 months, mHHS and HOS-ADL were obtained. Randomized controlled trials were used in this study for analysis. RESULTS: All patients were followed up with average time of 9.3 months(3-29 months). The postoperative symptoms were obviously relieved, the VAS decreased from (4.9 ± 0.6) to (1.2 ± 0.2) after 3 months postoperative. Follow up 6 months post-operation, patients in the interportal group, the mHHS and HOS-ADL scores improvement were respectively 69.4 ± 9.3 & 70 ± 8.8 pre-operation, and 92.5 ± 5.0 & 86.6 ± 5.4 post-operation (P < 0.05); Patients in the periportal group, the mHHS and HOS-ADL scores improvement were respectively 69.9 ± 15.8, 68.1 ± 15.0 pre-operation, and 90.1 ± 9.3 & 86.7 ± 7.9 post-operation (P < 0.05).The differences were statistically significant. Six months after operation, MRI showed that 23 patients with periportal capsulotomy, the capsule have healed, without other complications. Three of the ten patients with interportal capsulotomy were healed and seven were not. CONCLUSION: Interportal and periportal capsulotomy had good outcomes. The technique of periportal capsulotomy had little damage to the joint capsule. Although the capsule did not close, the capsule healed well in postoperative follow-up. The nonunion rate of the joint capsule was high in the interportal capsulotomy without close the capsule.

Study on injectable and degradable cement of calcium sulphate and calcium phosphate for bone repair.

Injectable calcium sulphate/phosphate cement (CSPC) with degradable characteristic was developed by introduction of calcium sulphate (CS) into calcium phosphate cement (CPC). The setting time, compressive strength, composition, degradation, cells and tissue responses to the CSPC were investigated. The results show that the injectable CSPC with optimum L/P ratio exhibited good injectability, and had suitable setting time and mechanical properties. Furthermore, the CSPC had good degradability and its degradation significantly faster than that of CPC in Tris-HCl solution. Cell culture results indicate that CSPC was biocompatible and could support MG63 cell attachment and proliferation. To investigate the in vivo biocompatibility and osteogenesis, the CSPC were implanted in the bone defects of rabbits. Histological evaluation shows that the introduction of CS into CPC enhanced the efficiency of new bone formation, and CSPC exhibited good biocompatibility, degradability and osteoconductivity with host bone in vivo. It can be concluded that the injectable CSPC had a significant clinical advantage over CPC, and might have potential to be applied in orthopedic, reconstructive and maxillofacial surgery, especially for minimally invasive techniques.

Hepatocellular carcinoma with tumor thrombus in bile duct: A proposal of new classification according to resectability of primary lesion.

BACKGROUND: Hepatocellular carcinoma (HCC) with tumor thrombus in the bile duct (BDTT) is easily misdiagnosed or mistreated due to the clinicopathological diversity of the thrombus and its relationship with primary lesions. AIM: To propose a new classification for HCC with BDTT in order to guide its diagnosis and treatment. METHODS: A retrospective review of the diagnosis and treatment experience regarding seven typical HCC patients with BDTT between January 2010 and December 2019 was conducted. RESULTS: BDTT was preoperatively confirmed by computed tomography/magnetic resonance imaging in only four patients. Three patients with recurrent HCC and one patient with first-occurring HCC had no visible intrahepatic tumors; of these, misdiagnosis occurred in two patients, and three patients died. One patient was mistreated as having common bile duct stones, and another patient with a history of multiple recurrent HCC was misdiagnosed until obvious biliary dilation could be detected. Only one patient who received hepatectomy accompanied by BDTT extraction exhibited disease-free survival during the follow-up period. A new classification was proposed for HCC with BDTT as follows: HCC with microscopic BDTT (Type I); resectable primary or recurrent HCC mass in the liver with BDTT (Type II); BDTT without an obvious HCC mass in the liver (Type III) and BDTT accompanied with unresectable intra- or extrahepatic HCC lesions (Type IV). CONCLUSION: We herein propose a new classification system for HCC with BDTT to reflect its pathological characteristics and emphasize the significance of primary tumor resectability in its treatment.

Influences of niobium pentoxide on roughness, hydrophilicity, surface energy and protein absorption, and cellular responses to PEEK based composites for orthopedic applications.

To improve the bio-performances of polyetheretherketone (PEEK) for orthopedic applications, submicro-particles of niobium pentoxide (Nb2O5) were synthesized using a sol-gel method, and PEEK/Nb2O5 composites (PNC) with a Nb2O5 content of 25v% (PNC25) and 50v% (PNC50) were fabricated by utilizing a process of pressing-sintering. The results showed that the Nb2O5 particles were not only dispersed in the composites but also exposed on the surface of the composites, which formed submicro-structural surfaces. In addition, the hydrophilicity, surface energy, surface roughness and absorption of proteins of the composites were improved with increasing Nb2O5 content. Moreover, the release of Nb ions with the highest concentration of 5.01 × 10-6 mol L-1 from the composite into the medium displayed no adverse effects on cell proliferation and morphology, indicating no cytotoxicity. Furthermore, compared with PEEK, the composites, especially PNC50, obviously stimulated adhesion and proliferation as well as osteogenic differentiation of bone mesenchymal stem cells of rats. The results suggested that the incorporation of Nb2O5 submicro-particles into PEEK produced novel bioactive composites with improved surface properties, which played important roles in regulating cell behaviors. In conclusion, the composites, especially PNC50 with good cytocompatibility and promotion of cellular responses, exhibited great potential as implantable materials for bone repair.

Propyl isothiocyanate induces apoptosis in gastric cancer cells by oxidative stress via glutathione depletion.

Isothiocyanates are a group of compounds that exist in the majority of cruciferous plants. A number of isothiocyanates have been demonstrated to exhibit anticancer effects; however, antitumor properties of propyl isothiocyanate (PITC) have not been evaluated previously. In this study, the possible effects of PITC on gastric cancer (GC) cells were investigated, and the potential underlying mechanisms were explored. The results demonstrated that PITC inhibited cell viability of two GC cell lines and induced cell cycle arrest and apoptosis. Treatment with PITC promoted total glutathione depletion in GC cell lines, leading to reactive oxygen species accumulation and DNA damage, which activated the mitochondria-dependent and p53 signaling pathways to trigger apoptosis in GC cells. The effects of PITC were reversed by N-Acetyl-L-cysteine. The results of the present study revealed the potential mechanisms of PITC on apoptosis induction in GC cells, which may be mediated by mitochondria-dependent apoptosis and DNA damage.

A hierarchical nanostructural coating of amorphous silicon nitride on polyetheretherketone with antibacterial activity and promoting responses of rBMSCs for orthopedic applications.

Silicon nitride (SN) with good osteoconductivity has been introduced as an implantable biomaterial for joint replacement and interbody fusion devices. In this study, SN was coated on a polyetheretherketone (PEEK) surface by inductively coupled plasma-enhanced chemical vapor deposition (ICPECVD). The results showed that a dense coating (thickness of about 500 nm) of amorphous SN was closely combined with a PEEK substrate (PKSN) with a binding strength of 6.88 N. In addition, the coating surface showed hierarchical nanostructures containing many spherical bulges (sizes about 150 nm), which were composed of many small humps (sizes about 10 nm). Moreover, the roughness, hydrophilicity, surface energy, surface charge and adsorption of bovine serum albumin (BSA) of PKSN were obviously higher than those of PEEK. After immersion into simulated body fluid (SBF), the Si ions were gradually released from PKSN into SBF and a weak alkaline environment was created. Antibacterial experiments showed that PKSN exhibited a greater antibacterial activity than that of PEEK. Moreover, compared with PEEK, PKSN significantly promoted adhesion, proliferation, differentiation and expression of osteogenic related genes of the rat bone marrow stromal cells (rBMSCs). In conclusion, the SN coating of PKSN with hierarchical nanostructures exhibited excellent antibacterial activity and cytocompatibility, which would make it a great candidate for orthopedic applications.

Naringin promotes cellular chemokine synthesis and potentiates mesenchymal stromal cell migration via the Ras signaling pathway.

Directional migration of mesenchymal stem cells (MSCs) is known to serve roles in bone fracture healing. Naringin is a traditional medicine used in China to treat bone injury and has been confirmed to act as a chemoattractant to MSCs. In the present study, the secretion of chemokines and stimulation of relevant signaling pathways by naringin were detected to determine the molecular mechanism of naringin-induced MSC migration. In these experiments, Quantibody® arrays were used to detect chemokines secreted by MSCs with or without the addition of naringin. The results revealed differential naringin-induced chemokine secretion of C-X-C motif chemokine (CXCL)5, CXCL6 and C-C motif chemokine 20. Furthermore, the Ras signaling pathway was markedly activated in the naringin-treated groups, suggesting that naringin may enhance the migrational ability of MSCs via Ras activation. Furthermore, naringin was able to promote the secretion of various chemokines derived from MSCs, which would, in turn, increase the mobility of MSCs. The aim of the present study was to provide novel candidate agents for clinical orthopedics and theoretical basis for the future improvement of adjunctive medication for bone fracture healing.

[Choices of the internal fixation and approaches on unstable pelvic ring fractures].

OBJECTIVE: To discuss the suitable surgical approach and the internal fixation of unstable pelvic pelvic fractures. METHODS: From May 2010 to May 2015, 45 patients with unstable pelvic fractures were treated with different approaches and fixations, including 38 males and 7 females with an average age of 45 years ranging from 21 to 61 years. The course was within 2 weeks. According to Young-Burg classification, 23 patients were lateral compression injuries, 6 patients were vertical shearing injuries, 16 patients were anterior-posterior compression injuries. All patients had hip pain and limitation of motion, the X-rays showed the pelvic ring fracture. RESULTS: All wounds healed well without complications, 45 cases were followed up for a mean period of 13 months (ranged 9 to 21 months). Patients with hip pain had a good postoperative pain relief. The post-operative X-rays showed the reduction was satisfied and the pelvic ring shaped well. According to Majeed standards, the final follow-up score was 93.5±11.6, 35 cases got excellent results, 8 were good, 2 were fare. CONCLUSIONS: The unstable pelvic and acetabular fractures are always with compound injury. Beside the reduction, to decrease the second surgery trauma should take into consideration as well, the intra-articular reduction and the stability of the pelvic were especially valued, so combined the different approach with minimal invasive technique can get good clinical result.

Development of nanofluorapatite polymer-based composite for bioactive orthopedic implants and prostheses.

Fluorapatite with low solubility is a promising biomaterial due to its structure, which is similar to hydroxyapatite. In this study a bioactive composite of nanofluorapatite (n-FA) and polyamide 12 (PA12) was fabricated. The results revealed that the mechanical properties (such as compressive strength and elastic modulus), hydrophilicity, and antibacterial properties of n-FA/PA12 composite were obviously improved by adding n-FA into PA12 as compared with PA12. In addition, cell proliferation of MC3T3-E1 cells cultured on n-FA/PA12 composite was significantly higher than with PA12, and alkaline phosphatase activity of MC3T3-E1 cells on the n-FA/PA12 composite was expressed at obviously higher levels as compared with PA12. The results suggest that n-FA/PA12 composite could support cell proliferation and differentiation, showing good cytocompatibility. Histological evaluation indicates that n-FA/PA12 composite enhances the efficiency of new bone formation with the introduction of n-FA into PA12, and the quantity of the newly formed bone for n-FA/PA12 composite is significantly higher than with PA12. In conclusion, n-FA/PA12 composite exhibits good biocompatibility and osteogenesis, which might be used for various orthopedic prostheses and dental implants.

[Anatomical study on the treatment of complex acetabular fractures with self-designed 3-dimensional anatoimical locking plate].

OBJECTIVE: To design a new 3-dimensional anatomical locking plate internal fixation on the basis of anatomic character of acetabulum for treating complex acetabular fractures except the posterior wall and posterior column fracture, and to investigate its advantages and disadvantages. METHODS: Five fresh adult cadavers and 40 biopsy specimens of pelvic cavity were collected. The length and radian of iliopectineal crest and pecten pubis,the distance from acetabular index to iliopectineal crest were measured to guide the research and development of the 3-dimensional anatomical locking plate internal fixation for complex acetabular fractures through the ilioinguinal approach or combined with Stoppa approach. RESULTS: The average lengths of iliopectineal crest of male and female were (54.12+/-5.42) mm and (58.24+/-6.60) mm;and the radians were (64.26+/10.28)degrees and(60.32+/-12.26)degrees. The lengths of bow pubic were(122.21+/-8.02) mm and(126.52+/-7.84) mm;and the radians were (66.24+/-13.10)degrees and(63.25+/-12.10) degrees. The distance from acetabular index to iliopectineal crest of male and female were (18.6 + 2.2) mm and (18.9+/-2.5) mm. The 3-dimensional anatomical locking plate was used to treat compound acetabular fractures through ilio-inguinal groove incision or combined with Stoppa incision,including dislocated acetabular fractures at quadratic district,but not including paries posterior and columma posterior fractures. CONCLUSION: The self-designed 3-dimensional anatomical locking plate internal fixation has the characteristics of operational convenience, accurate fixation, mini operational trauma,short operational time and low operational risk,therefore it is especially suit for the complex acetabular fractures except the posterior wall and posterior column fracture which is difficult to be solved by contentional internal fixation.

[Choice of operative approaches for complex fractures of the quadrilateral area of acetabular].

OBJECTIVE: To compare different surgical approaches in order to obtain better surgical exposure and more reliable reset fixation according to the different types of quadrilateral area fractures of acetabular. METHODS: From January 2006 to January 2011, 58 patients with the quadrilateral area fractures of acetabular were treated by surgical operation through the simple Kocher-Langenbeck (KL) approach, ilioinguinal approach, modified Stoppa approach, or combined surgical approach, or a combination of anterior column screw fixation percutaneously and modify Stoppa approach. RESULTS: Forty-nine patients were followed up for an average time of 32 months ranging from 2 to 6 years. One patient with deep infection cured after treatment of effective antibiotics and drainage, 2 patients had a sciatic nerve injury, 2 cases of avascular necrosis of the femoral head. Among them, 36 cases were anatomical reducted, 8 were good and 5 were poor according to Matta's radiographic assessment system. According to the mean Merle d'Aubigne and Postel Score,32 patients got excellent result, 12 good,4 fair and 1 bad,the average score was (15.3 +/- 2.5). CONCLUSION: Single classic surgical approach can only use for some types of the complex quadrilateral area fractures of acetabular while combination approach may need for some fractures. Modified Stoppa approach combined with ilioinguinal approach or a combination of anterior column acetabular screw fixation are the most effective surgical approaches for complex quadrilateral area fractures of acetabular.