The efficacy of oral vitamin D supplements on fusion outcome in patients receiving elective lumbar spinal fusion-a randomized control trial.

BACKGROUND: Previous studies have reported that vitamin D supplement could improve fracture healing, but evidence regarding the role of vitamin D supplements in spinal fusion was limited. Thus, this study aimed to evaluate the effectiveness of oral vitamin D supplements on fusion outcomes in patients undergoing lumbar spinal fusion. METHODS: This randomized, double-blind, parallel-designed, active-control trial included the patients who planned for elective lumbar spinal fusion. Eligible patients were randomly assigned to receive either daily vitamin D3 (cholecalciferol) 800 IU and daily calcium citrate 600 mg (experimental group) or only daily calcium citrate 600 mg (control group). All supplements were given from postoperative day 1 and lasted for 3 months. Primary outcome was postoperative 1-year fusion rate, and secondary outcomes included time to fusion, Oswestry Disability Index (ODI), and visual analogue scale (VAS) for pain. RESULTS: Among the included 34 patients (21 in the experimental group and 13 in the control group), baseline 25-hydroxyvitamin D (25[OHVitD) level was 26.7 (10.4) ng/ml. Preoperative prevalence of vitamin D deficiency and insufficiency were 23.5% and 47.1%, respectively. Postoperative 1-year fusion rate was not significantly different between the two groups (95.2% vs. 84.6%, P = 0.544). The experimental group had significantly shorter time to fusion (Kaplan-Meier estimated: 169 days vs. 185 days [interquartile range: 88-182 days vs. 176-324 days], log-rank test: P = 0.028), lower postoperative 6-month ODI (P < 0.001), and lower postoperative 6-month VAS (P < 0.001) than the control group. Time to fusion was significantly and negatively correlated with preoperative, postoperative 3-month, and 6-month 25(OH)VitD levels (all P < 0.01). CONCLUSION: The patient with vitamin D supplements had shorter time to fusion, better spinal function and less pain after elective spinal fusion. Further research is warranted to identify the patients who can benefit the most from vitamin D supplements and the appropriate dose of vitamin D supplements. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05023122. Registered 20 August 2021. Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT03793530 .

Magnolol Suppresses ERK/NF-κB Signaling and Triggers Apoptosis Through Extrinsic/Intrinsic Pathways in Osteosarcoma.

BACKGROUND/AIM: Osteosarcoma is an aggressive primary malignant bone tumor that occurs in childhood. Although the diagnostic and treatment options have been improved, osteosarcoma confers poor prognosis. Magnolol, an active component of Magnoliae officinalis cortex, has been widely applied in herb medicine and has been shown to have multiple pharmacological activities. However, whether magnolol possesses anti-osteosarcoma capacity remains unknown. MATERIALS AND METHODS: We examined magnolol is cytotoxicity, and whether it regulates apoptosis and oncogene expression using MTT, flow cytometry and Western blotting assays in osteosarcoma cells. RESULTS: Magnolol exerted toxicity towards U-2 OS cells by inducing intrinsic/extrinsic apoptosis pathways. Additionally, treatment of U-2 OS cells with magnolol inhibited MAPK1 mitogen-activated protein kinase 1 (ERK)/Nuclear factor kappa B (NF-B) signaling involved in tumor progression and reduced the expression of anti-apoptotic and metastasis-associated genes. CONCLUSION: Magnolol may induce apoptosis and inactivate ERK/NF-B signal transduction in osteosarcoma cells.

Reinforcement of Sorafenib Anti-osteosarcoma Effect by Amentoflavone Is Associated With the Induction of Apoptosis and Inactivation of ERK/NF-κB.

BACKGROUND/AIM: Sorafenib has been reported to show anti-osteosarcoma (anti-OS) efficacy by inhibiting metastasis; however, a phase II trial suggested that further combination with other agents could be necessary to achieve permanent remission. Herein, we aimed to identify whether amentoflavone, an abundant natural bioflavonoid found in many medicinal plants, can improve the treatment efficacy of sorafenib in OS. MATERIALS AND METHODS: Cell viability, metastasis, apoptosis, and nuclear translocation of NF-κB after amentoflavone combined with sorafenib were assayed by MTT, transwell migration/invasion, western blotting, flow cytometry, and immunofluorescence staining, respectively. RESULTS: The sorafenib-induced cytotoxicity and apoptosis of U-2 OS was enhanced by combining treatment with QNZ (NF-κB inhibitor) or amentoflavone. NF-κB nuclear translocation, NF-κB phosphorylation, and metastasis capacity of U-2 OS cells were inhibited by amentoflavone combined with sorafenib. CONCLUSION: Amentoflavone may sensitize OS to sorafenib treatment by inducing intrinsic and extrinsic apoptosis and inhibiting ERK/NF-κB signaling transduction.

Osteoporotic burst fracture with spinal canal compromise treated with percutaneous vertebroplasty.

OBJECTIVE: There has been minimal literature reporting on results of osteoporotic burst fracture with spinal canal compromise treated with percutaneous vertebroplasty. Vertebroplasty for treatment of osteoporotic burst fracture is controversial. We want to clarify whether the osteoporotic burst fracture with spinal canal compromise is a contraindication to percutaneous vertebroplasty. To compare the clinical and radiological results between osteoporotic burst and compression fractures treated with percutaneous vertebroplasty. PATIENTS AND METHODS: From 2005 through 2006, 23 osteoporotic burst fracture patients with asymptomatic spinal canal compromise and 41 osteoporotic compression fracture patients underwent percutaneous vertebroplasty. Pre- and post-operative pain scores, functional and radiographic results and complications were analyzed. RESULTS: The average canal compromise in study group was 15% (5-49%). The mean post-operative Oswestry Disability Index (ODI), Visual Analogue Score (VAS), kyphotic angle, vertebral body height measurement from the anterior, central and posterior part of the body are all significantly improved in both the study and control groups when compared to pre-operative data. However, there was no significant difference between study and control groups in pre- and post-operative ODI, VAS, kyphotic angle and improvement of body height. There were no significant differences (P=0.3797) in cement leakage rate between burst and compression groups (47.8% vs 36.6%). All the leakages were minor and without neurological deficit. The percentage of adjacent fractures in both groups also had no significant differences (39.1% in burst and 41.5% in compression group). CONCLUSIONS: Osteoporotic burst fracture with asymptomatic spinal canal compromise is not a contraindication for percutaneous vertebroplasty. This procedure is suitable for both osteoporotic burst and compression fracture with careful surgical technique.

Bis{1-[(E)-o-tolyl-diazen-yl]-2-naphtho-l-ato}copper(II).

In the title complex, [Cu(C(17)H(13)N(2)O)(2)], the Cu(II) atom is tetra-coordinated by two N atoms and two O atoms from two bidentate 1-[(E)-o-tolyl-diazen-yl]-2-naphtho-late ligands, forming a slightly distorted square-planar environment. The two N atoms and two O atoms around the Cu(II) atom are trans to each other, with an O-Cu-O bond angle of 177.00 (9)° and an N-Cu-N bond angle of 165.63 (10)°. The average distances between the Cu(II) atom and the coordinated O and N atoms are 1.905 (2) and 1.995 (2)Å, respectively.

(E)-2-(2H-Benzotriazol-2-yl)-4-methyl-6-(phenyl-imino-meth-yl)phenol.

In the title compound, C(20)H(16)N(4)O, the non-H atoms of the benzotriazole ring system and those of the methyl-phenol group are essentially coplanar, with an r.m.s. deviation of 0.004 (2) Å. The mean plane of these atoms forms a dihedral angle of 60.9 (2)° with the phenyl ring. There is an intra-molecular O-H⋯N hydrogen bond between the phenol and benzotriazole groups.

Periprosthetic femoral supracondylar fracture after total knee arthroplasty with navigation system.

We report 1 patient with a supracondylar periprosthetic fracture 1 month after computer-assisted total knee arthroplasty. The fracture line extended from previous anchoring pinholes into the supracondyle area. Intramedullary nailing of the left femur was performed under close reduction. The possible complication of pinhole fracture to total knee arthroplasty with navigation system should be kept in mind.