A RBM47 and IGF2BP1 mediated circular FNDC3B-FNDC3B mRNA imbalance is involved in the malignant processes of osteosarcoma.

BACKGROUND: Circular RNAs (circRNAs) are a class of noncoding RNAs that are involved in the progression of many human cancers. The precise gene locus and the roles of circular RNA from Fibronectin type III domain containing 3B (FNDC3B) in OS and its mechanisms of action have not been fully explored. MATERIALS AND METHODS: qRT-qPCR assay was used to determine gene expressions. CCK8 Assay, EdU assay, wound-healing assay, transwell invasion assay and in vivo xenograft assay were used to perform functional investigations. RNA-FISH, immunofluorescence, RIP assay, RNA stability analysis were applied in mechanistic studies. RESULTS: We found that circFNDC3B downregulated and FNDC3B mRNA upregulated in OS, and might be potential biomarkers for indicating disease progression and prognosis of OS patients. CircFNDC3B acted as a tumor suppressor gene to restrain OS progression and FNDC3B functioned as an oncogene to promote OS progression in vitro and in vivo. RNA binding protein RNA binding motif protein 47 (RBM47) could bind to the flanking introns of circFNDC3B to facilitate the generation of circFNDC3B, resulting in the reduction of FNDC3B mRNA and the circFNDC3B-FNDC3B mRNA imbalance. CircFNDC3B also inhibited FNDC3B mRNA expression by reducing its stability via competitively binding to Insulin-like growth-factor-2 mRNA binding protein (IGF2BP1). CONCLUSION: This study demonstrated that RBM47 and IGF2BP1 mediated circular FNDC3B/FNDC3B mRNA imbalance was involved in the malignant processes of OS.

The pediatric proximal ulna: a radiographic study.

INTRODUCTION: The proximal ulna has been comprehensively described in the anatomic literature and imaging studies. However, to the best of our knowledge, the anatomy of the proximal ulna in children has not been fully described in the literature. METHODS: The present study was conducted on 189 children aged between 0 and 12 years (4.7 ± 2.7) by analysis of lateral X-rays of the forearm. Proximal ulna dorsal angulation (PUDA), tip-to-apex (TTA), and total ulnar length (TUL) were measured. The correlation between age and the various X-ray measurements was recorded and then compared with gender differences and adult measurements. Three orthopedic surgeons independently examined the X-ray films and confirmed the reliability of the original observations through intra-group correlation coefficients. RESULTS: There was a strong positive correlation between age and TUL (r = 0.834), and a moderately negative correlation between age and PUDA (r = - 0.405). No significant differences were observed between different genders (p > 0.05). Compared with adults, all measurements were smaller except for PUDA, all such measurements statistically significantly different between children and adults (p < 0.05). Interobserver and intraobserver reliability were "very good" for TUL (0.81-1.00), and "good" for PUDA, TTA, and TTA% (0.61-0.80). CONCLUSIONS: Good understanding of the anatomy of the pediatric proximal ulna will help to increase the knowledge base in pediatric orthopedic surgeons allowing them to provide improved treatment of fractures. Restoration of the correct forearm anatomy should result in superior clinical and functional results.

lncRNA HCG11 suppresses human osteosarcoma growth through upregulating p27 Kip1.

Osteosarcoma (OS) is a common malignant bone cancer threatening children and young adults. Emerging evidence indicates that long non-coding RNAs (lncRNAs) play crucial roles in the progression of OS. Herein, we want to clarify the roles of lncRNA human leukocyte antigen complex group 11 (HCG11) in OS. Our data revealed that HCG11 expression is decreased in OS, which is a result of transcriptional repression of YY1. Low HCG11 level is closely associated with larger tumor size and shorter overall survival of OS patients. HCG11 negatively regulates cell proliferation, cell cycle, DNA replication in vitro and tumor growth in vivo. HCG11 can raise p27 Kip1 expression via binding to miR-942-5p and IGF2BP2, and p27 Kip1 acts as a key effector for HCG11 exerting biological functions. In conclusion, HCG11 is downregulated in OS, and restrains OS growth both in vitro and in vivo by raising p27 Kip1 expression via binding to miR-942-5p and IGF2BP2.

Medial cortical positive support: A key factor for the postoperative stability of proximal humerus fractures.

ABSTRACT: Treatments for proximal humerus fractures (PHFs) often fail to achieve anatomical reduction. The purpose of this study was to evaluate the role of positive medial cortical support (PMCS) in the nonanatomical reduction of PHFs.A retrospective analysis was performed of 78 patients with PHFs who underwent surgery from August 2014 to September 2017 and whose treatments did not achieve anatomical reduction. Based on the results of standard AP radiographs of the shoulders 3, 6, and 12 months after surgery, the patients were divided into PMCS or negative medial cortical support (NMCS) groups. The postsurgical change in head-shaft angle (HSA) between the 2 groups was compared. Shoulder joint function and visual analog scale (VAS) scores of the 2 groups were also compared at the same time.Of the 78 patients analyzed, 37 were in the PMCS group and, 41 in the NMCS group. There was no statistically significant difference in any of the characteristics of the 2 groups (P > .05), or in postsurgical HSA. However, the HSA of the 2 groups had become significantly different (P < .05) 3, 6, and 12 months following surgery. The changes in HSA of the 2 groups were different at various time points (P < .05). One year after surgery, the shoulder function score of the PMCS group was significantly better than that of the NMCS group, as was the VAS score (both P < .05).Patients whose surgery for PHF does not achieve anatomical reduction during surgery can undergo PMCS to achieve improved results, postoperatively. NMCS should be avoided as far as possible.

Association of the presence and its types of lamina fractures with posterior dural tear and neurological deficits in traumatic thoracic and lumbar burst fractures.

INTRODUCTION: The appropriate and optimal treatment for thoracic and lumbar (TL) burst fractures remains a topic of debate. Characterization of vertical laminar fractures (coronal cross-sectional imaging) is presented in this study to determine the severity and treatment options in TL burst fractures. METHODS: A retrospective evaluation of 341 consecutive patients with TL burst fractures was divided into Group I (whole), Group II (partial), and Group III (intact) based on the vertical laminar fracture morphology from coronal images on computed tomography (CT) scans. The presence of preoperative neurological status was reviewed, and several radiological parameters were measured. In addition, the incidence of dural tears was calculated in patients that underwent a decompression with posterior approach. RESULTS: In total, 270 lumbar and 71 thoracic burst fractures were analyzed. Compared with the intact group, the two other groups had significantly shorter central canal distance, wider interpedicular distance, and smaller spinal canal area, in particular, Group III. The incidences of preoperative neurological deficits in Groups I to III were 63.0, 22.2, and 6.3%, respectively. The incidences of dural tears in Groups I to III were 25.6, 6.3, and 0%, respectively. CONCLUSION: The morphology of vertical laminar fractures observed across the coronal plane was important. Patients with "whole", "partial" and "intact" laminar fractures indicated different severity of TL burst fractures. Due to the high probability of dural tears, decompression is recommended as a primary intervention for patients with "whole" laminar fractures. However, for patients without vertical laminar fractures, minimally invasive technique might be a better choice to avoid approach-related complications.

Clinical short-term outcomes of articular-sided and bursal-sided partial-thickness rotator cuff tears of less than 50% in a single surgeon series: A protocol of randomized controlled trial.

BACKGROUND: There have been no published randomized clinical trial to assess the clinical outcomes between the articular-sided and bursal-sided tears. Therefore, a comparative analysis of evaluating and comparing the functional outcomes following arthroscopic repair of bursal-sided versus articular-sided partial-thickness rotator cuff tearsis essential. METHODS: This study is a present randomized controlled trial which is conducted in our hospital. Consecutive patients with symptomatic articular-sided or bursal-sided partial-thickness rotator cuff tears underwent arthroscopic repair between June 2020 and January 2022. The institutional review board approved the study proposal (with number 10012030), and informed consent was obtained from all patients. Inclusion criteria were existence of an articular- or bursal-sided tear involving <50% of the tendon thickness-confirmed intraoperatively and treated with arthroscopic debridement with or without other decompression surgery (acromioplasty/distal clavicle resection)-and a minimum follow-up of 2 years. All patients followed the same postoperative rehabilitation program. The patients were assessed at baseline preoperatively, and at 1 year and 2 years postoperatively. Outcome parameters were measured at each respective follow-up, which included active range of motion in forward flexion and abduction of the affected shoulder, pain score as measured on the Numeric Pain Rating Scale, as well as outcome scores in terms of the Constant-Murley Score, and Oxford Shoulder Score. RESULTS: Table 1 and Table 2 describe the data indicators that this article wants to evaluate and collect. CONCLUSIONS: We hypothesize that both groups of patients will show improvement in range of motion, functional outcome scores, and pain at 2 years, and that results would be similar between the two groups. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry6496).

Effect of different geometrical structure of scapula on functional recovery after shoulder arthroscopy operation.

BACKGROUND: There are no published studies of the influence of geometry of the scapula on the postoperative recovery of rotator cuff injuries. Our aim was to explore the relationship between the critical shoulder angle (CSA), acromion index (AI), glenoid inclination (GI), and postoperative repair outcomes in shoulder joints after arthroscopic supraspinatus tendon repair. METHODS: Sixty two patients suffering a supraspinatus tear were analyzed retrospectively following failure of conservative treatment and subsequent shoulder arthroscopy in our hospital. Standard anterior and posterior X-rays of the injured shoulder had been performed prior to surgery, with follow ups for at least 2 years (24-43 months). Magnetic resonance imaging (MRI) was performed 2 years after surgery to assess repair of the supraspinatus tendon. Patients were divided into either the intact or re-tear group, according to the MRI results. In addition, assessments using the Constant Shoulder Score (CSS), the American Shoulder and Elbow Surgeon (ASES) Shoulder Assessment Form, the University of California at Los Angeles (UCLA) score and visual analog scale (VAS) score were performed to establish shoulder function at the 2-year evaluation for each patient. RESULTS: The mean CSA of all patients was 35.79° ± 3.59°, mean AI was 0.72 ± 0.05, and mean GI was 15.87° ± 3.62°. The CSA, AI, and GI in the intact group were statistically significantly different than the re-tear group (p < 0.05). There was no correlation between the magnitude of the CSA, AI, or GI and any shoulder function score (p > 0.05). CONCLUSIONS: The geometry of the scapula had no significant effect on the recovery of postoperative function of patients with rotator cuff injury, but the value of the CSA, AI, and GI affected the risk of rotator cuff re-tear.

Correction to: Geniposide Suppresses Interleukin-1ß-Induced Inflammation and Apoptosis in Rat Chondrocytes via the PI3K/Akt/NF-κB Signaling Pathway.

The original version of this article contained mistakes, and the authors would like to correct them. The correct details are given below: • Fig.4 A. In the GPO group, the S-O and H-E staining pictures were used incorrectly. This is our mistake. Now correct the correct pictures.

The impact of varus angulation on proximal fractures of the ulna.

BACKGROUND: We studied anteromedial varus angulation (VA) in the proximal third of the ulna. The importance of restoration of the anatomical orientation of the ulnar after a proximal fracture is unclear. The purpose of this study was to evaluate the impact of minimal proximal ulna malunion on elbow function after a proximal ulna fracture. METHODS: We reviewed the follow-up of 60 patients who had undergone open reduction with internal fixation (ORIF) of a proximal fracture of the ulna. Patients were divided into two groups, defined as either more or less than 5° of the difference between the VA of the fractured and contralateral ulna. The range of motion(ROM)of elbow flexion, extension and forearm rotation on both sides, Mayo Elbow Performance Score (MEPS) and Visual Analogue Scale (VAS) were measured. RESULTS: The average postoperative time was 3.1 years (1-5 years). Mean VA of the fractured arm was different from the normal side (7.8 ± 3.0 vs 12.7 ± 3.0). Compared to the unfractured arm there was a loss in mean elbow flexion (14.2 ± 4.9 vs 18.0 ± 5.9), extension ROM (7.1 ± 2.5 vs 9.3 ± 1.9, p < 0.05) and forearm rotation ROM (15.6 ± 8.6 vs 21.8 ± 9.5) that were statistically significant (p < 0.05). There were no statistically significant differences in the MEPS and VAS score results between the two groups (p > 0.05). CONCLUSIONS: The function of the elbow and forearm was restricted after VA malunion in the proximal ulna, but the quality of life of these patients had not been significantly affected. We suggest that orthopedic surgeons should assess whether the specialized structures of the proximal ulna are damaged or not before surgery. If the anatomy of the fractured bone cannot be restored through manipulation of the connected end directly, it is better to image the anatomical structure of the healthy side from using an elbow X-ray before surgery, and then reset using a pre-shaped plate to prevent malunion.

Geniposide Suppresses Interleukin-1ß-Induced Inflammation and Apoptosis in Rat Chondrocytes via the PI3K/Akt/NF-κB Signaling Pathway.

Osteoarthritis (OA) is a chronic degenerative joint disease that is principally characterized by progressive joint dysfunction and cartilage degradation. Inflammation and apoptosis play critical roles in the progression of OA. Geniposide (GPO), one of the principal components of the fruit of Gardenia jasminoides Ellis, has been reported to have anti-inflammatory and other pharmacological effects. In this study, we performed in vitro experiments on rat chondrocytes to examine the therapeutic effects of GPO on OA and investigated its effects in vivo in a rat model of OA induced by medial meniscal tear (MMT). The results suggest that GPO can inhibit the expression of INOS, COX-2, and MMP-13 in vitro, and promote the expression of collagen II in rat chondrocytes stimulated with interleukin-1ß (IL-1ß). In addition, we also found that GPO can inhibit the expression of pro-apoptotic proteins such as Bax, Cyto-c, and C-caspase3 and increase the expression of the anti-apoptotic protein Bcl-2. These changes may be related to GPO-induced inhibition of the IL-1ß-induced activation of the PI3K/Akt/NF-κB signaling pathway. In vivo, we also found that GPO can limit the development of OA in a rat model. Taken together, the above results indicate that GPO has potential therapeutic value for treating OA.

Comparison of three different fixation constructs for radial neck fractures: a biomechanical study.

BACKGROUND: Fixation of radial neck fractures can be achieved with a plate and screw construct or with two screws. This study evaluated the biomechanical properties of three different fixation methods following radial neck fractures. METHODS: Twenty-four fourth-generation composite radii were sawed to simulate an unstable radial neck fracture. They were then instrumented with a plate and screw construct or two different orientations (crossed and parallel) of screw fixation. Implants were tested under bending and torsional loads via a tension torsion composite test system. Bending and torsional failure loads were added to the remaining implant-radius constructs if they did not fail during the previous tests. RESULTS: During the bending loading test, the crossed-screw group showed the greatest stiffness, followed by the parallel-screw group, the plate group demonstrating the weakest stiffness. There was no significant difference between the crossed- and the parallel-screw groups. However, there was a significant difference between the two screw groups and the plate group. During the bending failure test, the largest stiffness was found for the crossed-screw group, while the plate group exhibited the smallest stiffness. There was a significant difference between the three groups. During the torsion loading test, the highest stiffness was observed for the crossed-screw group, while the plate group showed the lowest stiffness. In the torsion failure test, the failure torques were 11.97 ± 2.659, 8.531 ± 1.768, and 7.079 ± 1.666 N m respectively for the crossed-screw, parallel-screw, and plate groups. There was a significant difference between the crossed-screw group and the two other groups. CONCLUSIONS: Crossed screws and plate fixation are commonly used in clinical practice to treat simple radial neck fractures. While the present study shows that the parallel-screw method results in similar biomechanical strength as the two other techniques, it has the advantages of reaching limited wound exposure and having the implant buried. Therefore, it may be widely used in clinical practice.

Effect of different orientations of screw fixation for radial head fractures: a biomechanical comparison.

BACKGROUND: Screw fixation is a common method used for the treatment of Mason type II radial head fractures. The purpose of our study was to evaluate the mechanical properties of three different screw orientations used for fixation of Mason type II radial head fractures. METHODS: We sawed 24 medium-frequency fourth-generation Synbone radial bones to simulate unstable radial head fractures, which we then fixed with three different screw orientations. Implants were tested under axial load by the tension-torsion composite test system. If the implant-radial constructs did not fail after the axial load test, an axial failure load was added to the remaining constructs. RESULTS: The stiffness of the divergent group was the highest of the three orientations, and this group had statistically significant difference from the other two groups (p < 0.05). However, there was no statistically significant difference between the convergence group and the parallel group (p > 0.05). When the displacement reached 2 mm, the load of the divergent screw was still larger than the other two groups (p < 0.05). CONCLUSIONS: The divergent screw orientation was the most stable and had the greatest control of Mason type II fractures of these three groups. Therefore, it can be better applied in clinical settings.

Alpha-Mangostin protects rat articular chondrocytes against IL-1ß-induced inflammation and slows the progression of osteoarthritis in a rat model.

Osteoarthritis (OA) is a joint disease characterized by inflammation and cartilage degradation. α-Mangostin (α-MG), which can be isolated from the fruit of the tropical evergreen tree Garcinia mangostana-L, is known to have anti-inflammatory properties. The aim of the study was to investigate the use of α-MG in the treatment of OA, using both rat chondrocytes and an OA rat model induced by destabilization of the medial meniscus (DMM). Rat chondrocytes were pretreated with α-MG (0, 1.25, 2.5, and 5.0µg/ml for 24h) prior to stimulation with interleukin-1ß (IL-1ß) (10ng/ml for 24h). Nitric oxide (NO) production was determined using the Griess method and prostaglandin E2 (PGE2) was assessed using an enzyme-linked immunosorbent assay (ELISA). The expression of inducible nitric oxide synthase (INOS), cyclooxygenase-2 (COX-2), matrix metalloproteinase-3, -9, and -13 (MMP-3, MMP-9, and MMP-13), Collagen II, and Aggrecan were detected by both quantitative real-time PCR (qRT-PCR) and a western blot analysis. Nuclear factor-κB (NF-κB) signaling molecules were detected by western blot analysis. Detection of p65 nuclear translocation of NF-κB was examined using immunofluorescence staining. The OA rats received intraperitoneal injections of α-MG (10mg/kg) or saline every other day. Hematoxylin and eosin and Safranin-O-Fast green staining were used to evaluate the severity of cartilage lesions up to 8weeks following surgery. α-MG inhibited the production of NO and PGE2. The elevated expression of INOS, COX-2, MMP-3, MMP-9, and MMP-13, and the degradation of Collagen II and Aggrecan, were reversed by α-MG in IL-1ß-stimulated chondrocytes. In addition, IL-1ß induced considerable phosphorylation of the NF-kB signaling pathway, which was inhibited by α-MG. Furthermore, the immunofluorescence staining demonstrated that α-MG could suppress IL-1ß-induced p65 nuclear translocation. In vivo, cartilage treated with α-MG showed attenuated degeneration and had low Osteoarthritis Research Society International (OARSI) scores compared with the control group. Taken together, these results show that α-MG has potential therapeutic value in the treatment of OA.

Alpha-Mangostin suppresses interleukin-1ß-induced apoptosis in rat chondrocytes by inhibiting the NF-κB signaling pathway and delays the progression of osteoarthritis in a rat model.

Osteoarthritis (OA) is a chronic degenerative joint disease that is characterized by progressive joint dysfunction and pain. Apoptosis and catabolism in chondrocytes play critical roles in the development of OA. Alpha-Mangostin (α-MG), one of the main components of the mangosteen, has been reported to have anti-apoptotic, anti-inflammatory and antioxidant effects. We investigated the therapeutic effects of α-MG on OA through experiments on rat chondrocytes in vitro and in a rat model of OA induced by destabilization of the medial meniscus (DMM). In vitro, we provided experimental evidence that α-MG inhibits the expression of MMP-13 and ADAMTs-5, and promotes the expression of SOX-9 in rat chondrocytes stimulated with interleukin-1ß (IL-1ß). In addition, we also found that α-MG can inhibit the expression of pro-apoptotic proteins such as Bax, Cyto-c, and C-caspase3, and increase the expression of the anti-apoptotic protein Bcl-2. These changes may be related to an α-MG induced inhibition of the IL-1ß-induced activation of the NF-kB signaling pathway. In vivo, we also found that α-MG can limit the development of OA in rat models. The above results show that α-MG has a potential therapeutic effect on OA, and that this effect may be achieved by inhibiting the mitochondrial apoptosis of chondrocytes induced by an activation of the NF-kB pathway.