RESUMEN
OBJECTIVE: To investigate the short term clinical efficacy of direct anterior approach(DAA) total hip arthroplasty for the treatment of ankylosing spondylitis with hip flexion deformity. METHODS: From September 2014 to June 2017, 15 cases of ankylosing spondylitis with flexion deformity of the hip were treated with total hip arthroplasty through DAA approach including 12 males(17 hips) and 3 females(4 hips) with an average age of 34.4 years old ranging from 21 to 57 years old. Harris score system was used before and after operation to evaluate hip function, total hip activity and visual analogue scale (VAS) were used to evaluate the clinical efficacy. RESULTS: All 15 patients were followed up for an average of 26.2 months. In the operation, 1 case of great trochanter avulsion was given wire binding, and 1 case of linear split of the femur were given by wire binding. There were no hematoma, nerve injury and deep vein thrombosis of lower extremity. No prosthesis loosening and sinking were observed in the follow-up of X-ray film after operation. There was no heterotopic ossification after operation. After operation, 18 hips pain were relieved completely, and 3 hips pain were found when walking, which all satisfied with the daily life self-care requirements. Harris hip score, total hip motion and VAS score at 1 week after operation were significantly different from those before operation(P<0.05). There was no significant difference in the scores of HHS, total hip motion and VAS at 1, 6 months after operation(P>0.05). At the final follow-up, the Harris score was 91.2±5.3, the total hip mobility was (217.1±29.7)°, and the postoperative VAS pain score was 1.2±0.5, which was significantly different from the preoperative score(P<0.05). CONCLUSIONS: DAA approach THA has good effect in treating AS hip nonfunctional ankylosis with less trauma, less pain and quick recovery. It has a good short term effect, which can effectively improve the quality of life of patients.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Espondilitis Anquilosante , Adulto , Antivirales , Femenino , Hepatitis C Crónica , Articulación de la Cadera , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Rango del Movimiento Articular , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
The aberrant expression of microRNA (miR)214 contributes to the regulation of normal and cancer cell biology, and is associated with human malignancies, however, it can operate in a contradictory manner. The role of miR214 in osteosarcoma remains to be fully elucidated. The aim of the present study was to investigate the effects of miR214 on osteosarcoma progression and tumor cell proliferation, and examine the molecular mechanism underlying osteosarcoma. The level of miR214 was determined using reverse transcriptionquantitative polymerase chain reaction (RTqPCR) analysis in osteosarcoma and matched paracancerous tissues, and in human osteosarcoma cancer cell lines. The roles of miR214 in cell proliferation, survival and cell cycle were analyzed using miR214 lentivirus (LVmiR214)infected osteosarcoma cells. In addition, the downstream target proteins in the Wnt/ßcatenin signaling pathway were evaluated using western blot analysis in the LVmiR214infected cells. The LVmiR214infected MG63 cells were also treated with exogenous ßcatenin for 24, 48 and 72 h, respectively, following which the expression of ßcatenin was measured using western blot analysis and survival was determined using a 3(4,5cimethylthiazol2yl)2,5diphenyl tetrazolium bromide (MTT) assay. The results of the RTqPCR analysis showed that the expression level of miR214 was significantly higher in the osteosarcoma tissues, compared with that in the matched paracancerous tissues, and the same was observed in the osteosarcoma cell lines. The MG63, Saos2 and U2OS cells were infected with the hsamir214 lentivirus for 48 h, and the levels of miR214 were significantly upregulated in the human osteosarcoma cancer cells. The overexpression of miR214 in the MG63 and Saos2 cells promoted cell growth, and treatment of the cells with specific antisensemicroRNA oligonucleotides (AMOs) for miR214 for indicated durations reversed the effects of miR214. Additionally, the AMOtreated MG63 cells showed G0/G1 phase arrest, suggesting that miR214 contributed to regulation of the cell cycle. In addition, the results of western blot analysis showed that, in the miR214 lentivirusinfected cells, the levels of cyclinD1, cmyc and lymphoid enhancerbinding factor1 were significantly increased, compared with those in the control lentivirusinfected cancer cells. Of note, infection with the miR214 lentivirus did not affect the levels of Wnt1, Wnt2, Wnt4, Axin or glycogen synthase kinase ß in the U2OS cells, whereas the expression levels of ßcatenin in the MG63 cells and Saos2 cells were significantly increased. The addition of exogenous ßcatenin effectively reversed the efficiency of miR214specific AMOs, which was detected using an MTT assay. These data suggested the critical role of miR214 in human osteosarcoma via regulation of the Wnt/ßcatenin signaling pathway and demonstrated that miR214 is as an oncogene for human osteosarcoma.