Quercetin-3-O-ß-D-glucuronide attenuates osteoarthritis by inhibiting cartilage extracellular matrix degradation and inflammation.

Objective: Osteoarthritis (OA) is a chronic degenerative joint disease characterized by cartilage damage. In order to find a safer and more effective drug to treat OA, we investigated the role of quercetin-3-O-ß-D-glucuronide (Q3GA) in OA. Methods: We used qRT-PCR and western blots to detect the effects of Q3GA on extracellular matrix (ECM) and inflammation related genes and proteins in interleukin-1ß (IL-1ß) induced chondrocytes. We determined the effect of Q3GA on the NF-κB pathway using western blots and immunofluorescence. Moreover, the effect of Q3GA on the Nrf2 pathway was evaluated through molecular docking, western blots, and immunofluorescence experiments and further validated by transfection with Nrf2 siRNA. Subsequently, we established a rat model of OA and injected Q3GA into the joint cavity for treatment. After 5 weeks of Q3GA administration, samples were obtained for micro-computed tomography scanning and histopathological staining to determine the effects of Q3GA on OA rats. Results: We found that Q3GA reduced the degradation of ECM and the expression of inflammatory related proteins and genes in primary chondrocytes of rats induced by IL-1ß, as well as the expression of nitric oxide (NO) and reactive oxygen species (ROS). It inhibited the activation of the NF-κB pathway by increasing the expression of Nrf2 in the nucleus. In addition, Q3GA inhibited cartilage degradation in OA rats and promoted cartilage repair. Conclusion: Q3GA attenuates OA by inhibiting ECM degradation and inflammation via the Nrf2/NF-κB axis. The translational potential of this article: The results of our study demonstrate the promising potential of Q3GA as a candidate drug for the treatment of OA and reveal its key mechanisms.

Primary study of the relative and compound biological effectiveness model for boron neutron capture therapy based on nanodosimetry.

BACKGROUND: The current radiobiological model employed for boron neutron capture therapy (BNCT) treatment planning, which relies on microdosimetry, fails to provide an accurate representation the biological effects of BNCT. The precision in calculating the relative biological effectiveness (RBE) and compound biological effectiveness (CBE) plays a pivotal role in determining the therapeutic efficacy of BNCT. Therefore, this study focuses on how to improve the accuracy of the biological effects of BNCT. PURPOSE: The purpose of this study is to propose new radiation biology models based on nanodosimetry to accurately assess RBE and CBE for BNCT. METHODS: Nanodosimetry, rooted in ionization cluster size distributions (ICSD), introduces a novel approach to characterize radiation quality by effectively delineating RBE through the ion track structure at the nanoscale. In the context of prior research, this study presents a computational model for the nanoscale assessment of RBE and CBE. We establish a simplified model of DNA chromatin fiber using the Monte Carlo code TOPAS-nBio to evaluate the applicability of ICSD to BNCT and compute nanodosimetric parameters. RESULTS: Our investigation reveals that both homogeneous and heterogeneous nanodosimetric parameters, as well as the corresponding biological model coefficients α and ß, along with RBE values, exhibit variations in response to varying intracellular 10B concentrations. Notably, the nanodosimetric parameter M 1 C 2 $M_1^{{{\mathrm{C}}}_2}$ effectively captures the fluctuations in model coefficients α and RBE. CONCLUSION: Our model facilitates a nanoscale analysis of BNCT, enabling predictions of nanodosimetric quantities for secondary ions as well as RBE, CBE, and other essential biological metrics related to the distribution of boron. This contribution significantly enhances the precision of RBE calculations and holds substantial promise for future applications in treatment planning.

[Clinical characteristics and treatment analysis of three cases of congenital ulnar collateral flexor contracture of the forearm].

Objective: To report the clinical characteristics and treatment analysis of 3 cases of congenital ulnar collateral flexor contracture of the forearm and take a reference for clinic. Methods: A total of 3 patients with congenital ulnar collateral flexor contracture of the forearm were admitted between February 2019 and August 2021. Two patients were male and 1 was female, and their ages were 16, 20, and 16 years, respectively. The disease durations were 8, 20, and 15 years, respectively. They all presented with flexion deformity of the proximal and distal interphalangeal joints of the middle, ring, and little fingers in the neutral or extended wrist position, and the deformity worsened in the extended wrist position. The total action motion (TAM) scores of 3 patients were 1 and the gradings were poor. The Carroll's hand function evaluation scores were 48, 55, and 57, and the grip strength indexes were 72.8, 78.4, and 30.5. Preoperative CT of case 2 showed a bony protrusion of the flexor digitorum profundus tendon at the proximal end of the ulna; and MRI of case 3 showed that the ulnar flexor digitorum profundus presented as a uniform cord. After diagnosis, all patients were treated with operation to release the denatured tendon, and functional exercise was started early after operation. Results: The incisions of 3 patients healed by first intention. Three patients were followed up for 12, 35, and 12 months, respectively. The hand function and the movement range of the joints significantly improved, but the grip strength did not significantly improve. At last follow-up, TAM scores were 3, 4, and 4, respectively, among which 2 cases were excellent and 1 case was good. Carroll's hand function evaluation scores were 95, 90, and 94, and the grip strength indexes were 73.5, 81.3, and 34.2, respectively. Conclusion: Congenital ulnar collateral flexor contracture is a rare clinical disease that should be distinguished from ischemic muscle contracture. The location of the contracture should be identified and appropriate surgical timing should be selected for surgical release. Active postoperative rehabilitation and functional exercise can achieve good hand function.

Fibrinogen, albumin-to-globulin ratio, and fibrinogen to albumin-to-globulin ratio may be potential diagnostic biomarkers for infected tibial nonunion.

AIM: The accurate preoperative diagnosis of infected tibial nonunion remains challenging. Hence, we evaluated the diagnostic potential of novel biomarkers for infected tibial nonunion. METHODS: This single-center retrospective study was conducted in 252 patients divided into two groups: infected tibial nonunion (67 patients) and aseptic tibial nonunion (185 patients). The preoperative clinical biomarkers included D-dimer, fibrinogen, albumin, globulin, total protein, and C-reactive protein (CRP) levels; albumin-to-globulin ratio (AGR); erythrocyte sedimentation rate (ESR); and white blood cell (WBC) count. Receiver operating characteristic (ROC) curves, sensitivity, and specificity were utilized to compare the biomarkers' diagnostic potential. RESULTS: The area under the curve (AUC) values for fibrinogen and AGR were 0.829 and 0.821, respectively, suggesting similarly good diagnostic potentials for infected tibial nonunion. Fibrinogen and AGR were better diagnostic biomarkers for infected tibial nonunion than the WBC count; ESR; D-dimer, albumin, globulin, CRP, and total protein levels, whose AUC values were 0.623, 0.684, 0.741, 0.797, 0.765, 0.715, and 0.554, respectively. The sensitivity and specificity of fibrinogen with a cut-off value of 3.35 g/L were 71.64% and 84.86%, respectively. The corresponding values for AGR with a cut-off value of 1.33 were 73.13% and 86.49%. Moreover, the fibrinogen-AGR (FAGR), i.e., the combination of fibrinogen and AGR, had the highest diagnostic accuracy for infected tibial nonunion (AUC = 0.906). The optimal FAGR cut-off was 2.69, with fair sensitivity (74.63%) but the highest specificity (94.59%). CONCLUSION: Fibrinogen, AGR, and FAGR are promising biomarkers for the diagnosis of infected tibial nonunion.

Combination of albumin-to-globulin ratio and plasma fibrinogen is a sensitive tool for preoperative screening of infected nonunion in patients undergoing reoperation after open reduction and internal fixation: a retrospective study.

BACKGROUND: Accurate preoperative diagnosis of infected nonunion remains a challenge. Here, we evaluated the diagnostic potential of novel biomarkers for infected nonunion. METHODS: A cohort of 275 patients who underwent surgery for suspected septic nonunion after open reduction and internal fixation were enrolled. Preoperatively analyzed clinical parameters included white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, plasma fibrinogen, platelet count (PC), monocyte-lymphocyte ratio (MLR), neutrophil-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Receiver operating characteristic (ROC) curves, sensitivity, and specificity were utilized to compare the diagnostic potential of those biomarkers. RESULTS: The WBC count and levels of CRP, ESR, NLR, MLR, PLR, PC, plasma D-dimer, plasma fibrinogen, and globulin in infected nonunion patients were significantly higher (p < 0.05) than those in aseptic patients. The albumin and AGR levels of the infected nonunion group were significantly lower (p < 0.05) than the aseptic group. The ROC curve analysis showed that the diagnostic accuracy of AGR and plasma fibrinogen was good. The combination of AGR with plasma fibrinogen had the highest area under the curve (AUC) (0.916). The sensitivity and specificity were 70.27% and 91.04% for AGR, and 67.57% and 84.08% for plasma fibrinogen, respectively. The combination of AGR with plasma fibrinogen showed a sensitivity of 86.49% and specificity of 92.54%. In patients with comorbidities, the diagnostic accuracy of the combination of AGR with plasma fibrinogen was also good. CONCLUSIONS: AGR and plasma fibrinogen are promising biomarkers to improve the diagnosis of infected nonunion. The combination of AGR with plasma fibrinogen is a sensitive tool for screening infected nonunion.

Diagnostic value of platelet indices in infected nonunion: a retrospective study.

BACKGROUND: The diagnostic value of platelet indices has been evaluated in various infectious diseases but not in infected nonunion. The purpose of this study was to assess the usefulness of platelet indices for diagnosis of infected nonunion after open reduction and internal fixation. METHODS: This retrospective study was performed in patients who underwent primary fracture nonunion revision surgeries from January 2016 to December 2021. A total of 297 patients were included in the study: 96 with infected nonunion (group A) and 201 with aseptic nonunion (group B). Receiver operator characteristic (ROC) curve analysis was performed to evaluate diagnostic value of each index. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated and compared. RESULTS: Demographic characteristics were comparable between the two groups. White blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen, plasma D-dimer, platelet count (PC), plateletcrit, and ratio of platelet count to mean platelet volume (PC/MPV) were significantly higher, and MPV and platelet distribution width (PDW) significantly lower, in group A than in group B (P < 0.05). ROC analysis showed PC/MPV and plasma fibrinogen to have better diagnostic value than the other coagulation indicators (AUC of 0.801 and 0.807, respectively). The combination of ESR, plasma fibrinogen, and PC/MPV had good sensitivity and specificity for diagnosis of infected nonunion. PC/MPV had better diagnostic value than ESR and plasma fibrinogen in the subgroup of patients with coagulation-related comorbidities. CONCLUSIONS: Plasma fibrinogen and PC/MPV ratio might be useful parameters for early diagnosis of infected nonunion.

Reconstruction of Soft Tissue Defect With a Free Vascularized Anterolateral Thigh Flap After Resection of Soft Tissue Sarcoma in Extremities.

OBJECTIVE: This study aims to determine outcomes and complications in functional reconstruction of soft tissue defects after surgical resection for soft tissue sarcomas (STSs) of extremities. METHODS: A retrospective chart review was performed on patients with STSs of extremities from May 2015 to April 2019 who underwent radical resection of STSs and reconstruction of soft tissue defect with free vascularized anterolateral thigh flap (FVALTP). A minimum 3-month follow-up was required for all the patients. Patient demographics and comorbidities, flap characteristics, postoperative complications, and time to heal were recorded. The functional outcomes of the reconstructed limbs were assessed by the Musculoskeletal Tumour Society（MSTS） scoring system. RESULTS: A total of 11 patients (four males and seven females) were included in the study. The mean age was 62 years (range: 29-84 years). The mean surface area was 151.4 cm2 (range: from 64 cm2 to 418cm2 ). The mean operation time was 126 min (range: 95-296 min). The mean follow-up was 17.5 months (range: 6-34 months). The mean score of MSTS at last follow-up was 26.2 (range: 12-29). Incision healed by first intention in eight patients. Incision healed by second intention in three patients. A patient who had received preoperative radiotherapy experienced delayed union. After debridement, the patient successfully got union. Another two patients experienced marginal necrosis of flap due to vascular crisis. After 3-week dressing changes, the patients also got satisfactory union. One case suffered from vascular crisis during surgery in which the procedure was changed into skin grafting to cover resection site. CONCLUSION: FVALTP technique can be effectively applied to the reconstruction of soft tissue defect after STSs resection. The short-term follow-up indicated satisfactory functional outcome and low incidence of previously known complications. It was necessary to further validate its efficacy in reconstruction of soft tissue defect after malignant extremity soft tissue sarcoma resection.

Experimental and Numerical Studies on the Direct Shear Behavior of Sand-RCA (Recycled Concrete Aggregates) Mixtures with Different Contents of RCA.

Recycled concrete aggregate (RCA) is a typical construction and demolition (C&D) material generated in civil engineering activities and has been widely used as the coarse-grained filler added to sand for roadbed fillings. The effect of RCA content on the mechanical behavior of sand-RCA mixtures is complicated and still not fully understood. To explore the effect of RCA content on the macroscale and microscopic behavior of the sand-RCA mixtures with various RCA contents, laboratory direct shear tests and numerical simulations using the 3D discrete element method were performed. Experimental direct shear tests on sand-RCA mixtures with different contents of RCA were first carried out. Numerical direct shear models were then established to represent the experimental results. The particle shape effect was also considered using a new realistic shape modeling method to model the RCA particles. Good agreement was observed between the DEM simulation and experimental results, verifying the ability of the numerical direct shear models to represent the direct shear behavior of sand-RCA mixtures. The macroscopic responses of both experimental and numerical tests showed that all samples presented an initial hardening followed by a post-peak strain softening. The peak-state friction angles increased with the RCA content for samples under the same vertical stress. The effect of RCA content on the microscopic behavior based on DEM simulation was also found. The microscopic properties of RCA-sand mixtures, such as coordination numbers, PDFs and contact force transformation features, were analyzed and related to the macroscopic results.

Discrete Element Modelling of the Mechanical Behavior of Sand-Rubber Mixtures under True Triaxial Tests.

Sand-rubber mixtures (SRMs) consisting of stiff sand particles and soft rubber particles are typical binary mixture materials that possess a variety of complicated properties. The complexity of the properties of sand-rubber mixtures is increased when complex stress path is involved. This study investigates the mechanical behavior of sand-rubber mixtures under generalized loading conditions using the discrete element method. A series of numerical true triaxial shear tests were conducted on pure sand and sand-rubber mixtures. The effect of rubber content and loading path on both of the macroscopic and microscopic performances of sand-rubber mixtures was investigated, and the associated microscale mechanism was also discussed. Numerical simulations show that the relationship between the peak friction angle ϕp and the intermediate principal stress ratio b is influenced by the addition of rubber particles, and a suggested explanation of this phenomenon is that the rubber particles mainly affect the inherent stability of the strong network. Particle-scale observations, including the coordinate number, the proportion of strong contacts, and the fabric anisotropy, are also presented in this study. Microscopic results confirm the explanation above, and explore the force transmission characteristics of sand-rubber mixtures under generalized loading conditions. This research can provide a reference for the constitutive model development of sand-rubber mixtures.

Protective effect and mechanism of microRNA-146a on ankle fracture.

The present study investigated the expression and role of microRNA-146a (miR-146a) on ankle fracture, and explored the underlying mechanism. miR-146a levels in the blood of patients with ankle fracture was measured using reverse transcription-quantitative PCR (RT-qPCR). Expression of pro-inflammatory factors in the peripheral blood of ankle fracture patients was also detected using ELISA. Oxidative stress biomarkers including malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) were additionally investigated. The role of miR-146a in ankle fracture was investigated in vitro where MG-63 cells were transfected with miR-146a mimic or miR-146a inhibitor for 2 h, then treated with 1 µg/ml bradykinin for 24 h. An MTT assay was then performed to assess cell viability and pro-inflammatory factors were detected via RT-qPCR and western blot analysis. Finally, activation of the TNF receptor associated factor 6 (TRAF6)/NF-κB pathway was determined via western blotting and RT-qPCR. The results demonstrated that miR-146a was significantly downregulated in the blood of patients with ankle fracture. The protein levels of tumor necrosis factor (TNF-α), interleukin (IL)-1ß and IL-6 were significantly upregulated in patients with ankle fracture. In addition, MDA content significantly increased, and SOD and CAT activity significantly decreased in patients with ankle fracture. In vitro experiments demonstrated that miR-146a overexpression significantly enhanced cell viability. miR-146a mimic suppressed BK-induced upregulation of TNF-α, IL-1ß, IL-6 and MDA, and increased SOD and CAT activity. Finally, miR-146a mimic inhibited activation of the TRAF6/NF-κB pathway whilst miR-146a inhibitor had the opposite effect. In conclusion, miR-146a may be a potential therapeutic target for the treatment of ankle fracture by inhibiting the inflammatory response and attenuating oxidative stress.

Clinical Outcome of Free Vascularized Fibula Graft in the Surgical Treatment of Extremity Osteosarcoma.

OBJECTIVE: To determine the clinical outcome and complications associated with use of free vascularized fibular graft (FVFG) in the resection and reconstruction of extremity osteosarcoma (OS). METHODS: This is a retrospective study recruiting a consecutive series of 18 patients who had undergone resection of extremity OS between May 2009 and June 2017 in our clinic center. Reconstruction of the bone defect with FVFG was performed for each patient. Surgery-related complications and time of bone union were recorded at the follow-up visit. The functional outcome of the reconstructed limb was assessed with the musculoskeletal tumor society (MSTS) scoring system. Patients were further classified into low extremity group and upper extremity group according to the tumor location. The Student t-test was used to compare the surgical outcome between the two subgroups. RESULTS: There were 11 males and seven females with an average age of 25.9 ± 14.2 years. The mean length of the bone resection was 11.9 ± 4.1 cm. The mean follow-up duration was 3.1 ± 1.2 years. As for tumor location, six cases were located in the femur, five in the tibia, four in the humerus, two in the ulna, and one in the radius. All the patients had successful graft healing at an average of 4.9 months after surgery. At the 2-year follow-up, an excellent functional outcome was observed in 88.9% of the patients (n = 16). The mean score of MSTS was 27.0 ± 4.6. Screw loosening and autograft fracture were observed in one patient with femur tumor, who had a low MSTS score of 11. Besides, there were three cases with delayed incision healing. Patients with lower extremity OS were found to have significantly longer duration of hospital stay and more blood loss than those with upper extremity OS. The incidence of postoperative complication was higher in the lower extremity group but with marginal significance (0% vs 36.3%, P = 0.1). There was no significant difference regarding time to bone union and the functional outcome as indicated by MSTS score. CONCLUSIONS: FVFG technique can be effectively applied to the reconstruction of bone defects after OS resection with satisfactory functional outcome and low incidence of complications.

[Turning over rough surface of aponeurosis of gastrocnemius with fascia lata graft for Achilles tendon rerupture].

OBJECTIVE: To explore clinical effects of turning over rough surface of aponeurosis of gastrocnemius with fascia graft for Achilles tendon rerupture. METHODS: From July 2013 to April 2017, 11 patients with Achilles tendon reruptures were repaired by turning over rough surface of aponeurosis of gastrocnemius with fascia graft, including 10 males and 1 female aged from 25 to 48 years old. The patients were all manifested weakness of plantar flexion strength injured foot, and positive of single heel rise test before operation. Postoperative complications was observed, and AOFAS score at 6 months after operation was applied to evaluate clinical efficacy. RESULTS: All patients were followed up for 6 to 11 months. All wound were healed at stage I without skin necrosis, wound infection, deep vein thrombosis and rerupture. The length of tendon defect ranged from 4 to 7 cm, the full weight-bearing time ranged from 8 to 11 weeks. Postoperative AOFAS score at 6 months was for 79 to 100, and 9 patients got excellent results, and 2 good. CONCLUSIONS: For patients with recurrent ruptures of Achilles tendon, turning over rough surface of aponeurosis of gastrocnemius with fascia graft has advantages of stable repair, less complications and good recovery of function.

Oxygen-Valve Formed in Cobaltite-Based Heterostructures by Ionic Liquid and Ferroelectric Dual-Gating.

Manipulation of oxygen vacancies via electric-field-controlled ionic liquid gating has been reported in many model systems within the emergent fields of oxide electronics and iontronics. It is then significant to investigate the oxygen vacancy formation/annihilation and migration across an additional ferroelectric layer with ionic liquid gating. Here, we report that via a combination of ionic liquid and ferroelectric gating, the remote control of oxygen vacancies and magnetic phase transition can be achieved in SrCoO2.5 films capped with an ultrathin ferroelectric BaTiO3 layer at room temperature. The ultrathin BaTiO3 layer acts as an atomic oxygen valve and is semitransparent to oxygen-ion transport due to the competing interaction between vertical electron tunneling and ferroelectric polarization plus surface electrochemical changes in itself, thus resulting in the striking emergence of new mixed-phase SrCoO x. The lateral coexistence of brownmillerite phase SrCoO2.5 and perovskite phase SrCoO3-δ was directly observed by transmission electron microscopy. Besides the fundamental significance of long-range interaction in ionic liquid gating, the ability to control the flow of oxygen ions across the heterointerface by the oxygen valve provides a new approach on the atomic scale for designing multistate memories, sensors, and solid-oxide fuel cells.

A Network Meta-analysis of Outcomes of 7 Surgical Treatments for Distal Radius Fractures.

To determinate the optimal treatment for distal radius fractures (DRF) by comparing the pin-track infection (PTI) rates in patients treated with 7 surgical techniques [bridging external fixation (EF), nonbridging EF, K-wire fixation, plaster fixation, dorsal plating, dorsal and volar plating, and volar plating]. After an exhaustive search of electronic databases for relevant published studies, high-quality randomized controlled trails were selected for the present network meta-analysis based on predefined selection criteria. Statistical analyses of the extracted data were conducted using Stata 12.0 software. After careful selection, 19 randomized controlled trails were included in our network meta-analysis and contained a combined total of 1805 subjects who underwent various surgical procedures. The network meta-analysis results showed that compared with bridging EF for treating DRF, the nonbridging EF, plaster fixation, volar plating, and dorsal and volar plating showed statistically significant differences in PTI rates. Importantly, the surface under the cumulative ranking curve values of the surgical interventions revealed that the PTI rates of plaster fixation and of dorsal and volar plating were the lowest, suggesting that these 2 surgical techniques are optimal for DRFs treatment, compared with the other methods. Our results suggest that plaster fixation and dorsal and volar plating are the best surgical treatments for DRFs compared with 5 other most common techniques. Thus, plaster fixation and dorsal and volar plating emerge as the most effective and credible treatments in consideration of PTI rates.

Antibiotic-impregnated cement spacer as definitive management for osteomyelitis.

BACKGROUND: Osteomyelitis is a challenge for orthopaedic surgeons. There is a lack of scientific evidence to guide treatment. The purpose of this study was to report the clinical outcome of unplanned retention of antibiotic-impregnated cement spacer (ACS) in the management of osteomyelitis. METHODS: Eight patients (7 with tibial infections and 1 with a calcaneal infection) with osteomyelitis received radical debridement and insertion of an ACS into the bone defect as the definitive management. The mean follow-up period was 2 years (6 months to 4 years). All of these patients had a cement spacer in place. RESULTS: No patient exhibited radiographic evidence of excessive bone loss. The patients reported no or occasional mild pain and exhibited complete weight-bearing abilities, with the exception of one patient who required a crutch because of a spinal cord injury. Signs of recurrence of the osteomyelitis were not noted in any of the patients, and no fractures occurred at last follow-up. CONCLUSION: Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.

Magnetoelectric Coupling Induced by Interfacial Orbital Reconstruction.

Reversible orbital reconstruction driven by ferroelectric polarization modulates the magnetic performance of model ferroelectric/ferromagnetic heterostructures without onerous limitations. Mn-d(x2-y2) orbital occupancy and related interfacial exotic magnetic states are enhanced and weakened by negative and positive electric fields, respectively, filling the missing member-orbital in the mechanism of magnetoelectric coupling and advancing the application of orbitals to microelectronics.

Soft tissue repair for tibialis anterior tendon ruptures using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation.

BACKGROUND: Traumatic ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. This study aimed to evaluate the feasibility of a surgery for soft tissue repair of traumatic rupture of the tibialis anterior tendon by using a plate and screw fixation repair in combination with the free anterolateral thigh flaps transplantation. METHODS: Eight consecutive patients with anterior tibialis tendon ruptures who visited orthopedics departments from February 2008 to February 2012 were included in our study. The ruptured tendon was reconstructed with plate and screw fixation technique, and the tissue defects were repaired with anterolateral thigh free flaps. The complications and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were evaluated. Postoperative manual strength test was performed using a 0 to 5 scale. RESULTS: All flaps survived without any complications. The average preoperative and postoperative AOFAS ankle-hindfoot scores of the patients were 51 and 95, respectively. Good ankle dorsiflexion strength against strong resistance was observed in eight ankles postoperatively (manual strength of one patient was 4/5, the others were 5/5), and a substantial improvement in strength was noted compared with the preoperative examination. CONCLUSION: Soft tissue repair for tibialis anterior tendon rupture using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation is a feasible technique and yield satisfactory results.

Charge Transfer and Orbital Reconstruction in Strain-Engineered (La,Sr)MnO3/LaNiO3 Heterostructures.

We investigate charge transfer, orbital reconstruction, and the emergence of exchange bias in (La,Sr)MnO3/LaNiO3 heterostructures. We demonstrate that charge transfer from Mn(3+) ions to Ni(3+) ions is accompanied by the formation of hybridized Mn/Ni 3z(2) - r(2) orbits at the interface, instead of strain-stabilized Mn and Ni x(2) - y(2) orbits in the bulk films. In the heterostructures with ultrathin LaNiO3, orbital reconstruction induced by charge transfer results in magnetization frustration of (La,Sr)MnO3 at the interface. But the strain effect exerted by the growth of the LaNiO3 top layer plays a dominant role on orbital reconstruction in the heterostructures with thick LaNiO3, stabilizing 3z(2) - r(2) orbits. In this case, robust spin glass, associated with larger magnetization frustration, accounts for the exchange bias effect. Our work builds a bridge between the microscopic electronic structure and the macroscopic magnetic property, providing the possibility of manipulating the exotic states with the aid of strain engineering in oxide-based electronics.

MicroRNA-26b inhibits cell proliferation and cytokine secretion in human RASF cells via the Wnt/GSK-3ß/ß-catenin pathway.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic auto- immune disease characterized by joint synovitis. Recent evidence suggests that rheumatoid arthritis synovial fibroblasts (RASFs) promote joint destruction. In this study, we investigated the role of microRNA-26b (miR-26b) in cell proliferation and inflammatory cytokine secretion using patient-derived Rheumatoid arthritis fibroblast-like synoviocyte (RAFLS) to understand pathways influencing rheumatoid arthritis. METHODS: RAFLS were cultured in vitro and transfected with miR-26b mimics (experimental group) and negative sequence (control group). The protein levels of Wnt4, Wnt5ɑ, GSK-3ß, CyclinD1, Ser9-GSK-3ß and ß-catenin were detected by western blot analysis. Tumor Necrosis Factor-ɑ (TNF-ɑ), IL- 1ß, and IL-6 levels were quantified by Enzyme-linked Immunosorbent Assay (ELISA). RAFLS proliferation and apoptosis were measured by 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide (MTT) assay and flow cytometry, respectively. RESULTS: GSK-3ß and CyclinD1 expression levels were lower in miR-26b mimic group compared to Mock group and negative control (NC) group. Conversely, GSK-3ß and CyclinD1 expression levels were markedly higher in the miR-26b inhibitor group compared to Mock and NC group (P < 0.05). Transfection of miR-26b mimics significantly increased the, levels of Ser9-GSK-3ß and ß-catenin in comparison to Mock and NC groups, while transfection of miR-26b inhibitors showed the opposite effect. In miR-26b mimic group, TNF-α, IL- 1ß and IL-6 levels were lower than the Mock and NC groups, while in miR-26b inhibitor group, these cytokine levels were higher than the Mock and NC groups (P < 0.05). Transfection of miR-26b mimics significantly reduced the cell proliferation of RAFLS, compared to the Mock and NC groups, and miR-26b inhibitors increased the proliferative capacity of RAFLS compared to Mock and NC groups (P < 0.05). The miR-26b mimic group exhibited higher RAFLS apoptosis rate compared to Mock and NC group and miR-26b inhibitor group showed significantly lower RAFLS apoptosis rate compared to Mock and NC groups (P < 0.05). CONCLUSIONS: MiR-26b regulates ß-catenin and CyclinD1 levels by inhibiting GSK-3ß expression, which in-turn alters the Wnt/GSK-3ß/ß-catenin pathway to lower RAFLS proliferation and elevate cell apoptosis and the secretion of TNF-α,IL-1ß and IL-6 cytokines. Therefore, our results show that miR-26B plays a central role in inhibiting the inflammation associated with rheumatoid arthritis. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9063056861547150.

A retrospective study of end-to-side venous anastomosis for free flap in extremity reconstruction.

INTRODUCTION: The success of end-to-side (ETS) venous anastomosis primarily depends on several mandatory factors including recipient vessel selection and reconstruction site. This retrospective study was designed to analyze the success rate of ETS venous anastomosis for free flap extremity reconstruction. METHODS: Between 2009 and 2011, ETS venous anastomosis was performed in 117 patients to reconstruct soft tissue defects of extremity at Nanjing Drum Tower Hospital. The patients were divided into three groups: (1) only one large recipient vein left, (2) two deep venas, (3) one deep vein and one superficial vein. Medical records and the follow-up data were retrospectively reviewed. The success rates of the three groups were compared with Chi-squared test. RESULTS: Totally, 5, 52, and 60 patients were included in Group 1, Group 2, and Group 3, respectively. The overall surgery success rate was 96.6% (113/117) with four failures: zero in Group 1, two in Group 2 (2/52, 3.8%) and two in Group 3 (2/60, 3.3%), due to venous thrombosis. The re-anastomosis rate in re-exploration in Group 1, 2 and 3 was 0%, 1.9% (1/52), and 1.7% (1/60), respectively. No complication was observed during the operation. DISCUSSION: No statistical difference was observed in flap failure rate among the three different types of ETS anastomosis. This suggests that differences of the ETS anastomosis surgical site might not affect the surgery success rate. CONCLUSION: These results confirmed that the success rate of ETS anastomosis was not affected by the local conditions of surgery site.