Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly (version 2023) / 中华创伤杂志

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Expert consensus on rehabilitation strategies for traumatic spinal cord injury / 中华创伤杂志

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

MicroRNA-150 inhibits osteosarcoma cell proliferation by targeting RUNX2 gene / 中南大学学报(医学版)

To investigate the microRNA (miR)-150 expression level in human osteosarcoma cell lines (Saos-2, MG-63) and its function in cell proliferation, and to explore the potential molecular mechanisms. 
 Methods: MiR-150 expression levels in human osteosarcoma cell lines (Saos-2, MG-63) and normal osteoblast cell line (NHOst) were detected by relative quantitative real-time PCR (qRT-PCR). MiR-150 was overexpressed in Saos-2 and MG-63 cells by lentivirus infection. Cell proliferation rates were monitored by MTS assay. RUNX2 and β-actin protein levels were examined by Western blot. Inhibitory effect of miR-150 on binding RUNX2 3'-UTR was detected by Dual-Luciferase assay.
 Results: MiR-150 expression level is lower in human osteosarcoma cell lines (Saos-2, MG-63) compared to the normal osteoblast cell line (NHOst) (0.23±0.02 and 0.32±0.03 vs 1.00±0.02), which showed statistical significance (P<0.01). After lentivirus infection, miR-150 level increased in Saos-2 (P<0.01) and MG-63 cells (P<0.01). Overexpression of miR-150 decreased cell proliferation and RUNX2 protein level in Saos-2 and MG-63 cells. The binding of miR-150 to RUNX2 3'-UTR decreased luciferase activity by 69% in Saos-2 cells (P<0.05) and 59% in MG-63 cells (P<0.05). Administration of exogenous RUNX2 recovered the cell proliferation in miR-150 overexpressed Saos-2 and MG-63 cell lines (P<0.01).
 Conclusion: MiR-150 inhibites proliferation in human osteosarcoma cell lines through binding to RUNX2 3'-UTR, resulting in the reducion of RUNX2 protein level.

miR-181a promotes the proliferation and metastasis of osteosarcoma cells by targeting RASSF1A / 中南大学学报(医学版)

OBJECTIVE@#To investigate the role of miR-181a in promoting the proliferation and metastasis of osteosarcoma cells by targeting RASSF1A.
@*METHODS@#The level of miR-181a in 30 human osteosarcoma tissues and corresponding bone tissues was detected by real-time PCR, and the correlation between the level of miR-181a and clinicopathological characteristics of osteosarcoma was analyzed. Osteosarcoma cells MG-63 were transfected with chemically-synthesized miR-181a mimics and inhibitors, and the proliferation, migration and invasion of MG-63 cells were detected by MTT and Transwell assay. The specific binding ability of miR-181a to RASSF1A 3'-UTR was theoretically predicted and detected by the dual luciferase reporter gene assay.
@*RESULTS@#The level of miR-181a in osteosarcoma tissues was statistically higher than that in the corresponding bone tissues (P0.05). MTT and Transwell assays showed that the growth rate, migration and invasion ability of MG-63 cells with up-regulation of miR-181a was significantly increased compared with negative control (P<0.05), while the growth rate, migration and invasion ability of MG-63 with down-regulated miR-181a was significantly decreased compared with negative control (P<0.05). Luciferase reporter gene assay showed that miR-181a targeted the 3'-UTR of RASSF1A and regulated the expression of RASSF1A.
@*CONCLUSION@#MiR-181a promotes the proliferation and metastasis of osteosarcoma cells through specifically binding to RASSF1A 3'-UTR and subsequent down-regulation of RASSF1A.

Comparison of the clinical efficacy between simple vertebral canal decompression and decompression plus laminoplasty / 中南大学学报(医学版)

OBJECTIVE@#To observe the clinical efficacy of the simple expansion of the spinal canal decompression, decompression plus hydroxyapatite/polyamide artificial lamina reconstruction, and decompression plus titanium mesh reconstruction in the treatment of spinal canal stenosi.@*METHODS@#A total of 39 patients with lumbar spinal stenosis (with or without disc herniation, spondylolisthesis less than I degree), who received therapy of surgery from January, 2011 to January, 2012, were retrospectively analyzed. All patients were divided into 3 groups: a laminectomy surgery alone group (group A, n=15), a decompression plus hydroxyapatite/polyamide artificial lamina reconstruction group (group B, n=14), and a laminectomy decompression plus reconstruction with titanium mesh group (group C, n=10). Intraoperative situation, the postoperative excellent rate and JOA score were analyzed.@*RESULTS@#The duration and blood loss in surgery in group A was much less than that in the group B and C (P0.05). Twelve months after the surgery, the group B and C showed advantage over the group A (P0.05); the group B and C showed advantage over the group A in 12 months after the operation (P<0.05). No serious complications were related to the surgery in the 3 groups. Imaging changes were not significant difference.@*CONCLUSION@#The decompression plus hydroxyapatite/polyamide artificial lamina reconstruction and the decompression plus titanium mesh reconstruction show advantages in long-term effect over the simple vertebral canal decompression.

Surgical correction of post-traumatic thoracolumbar kyphotic deformity with posterior transpedicular limited osteotomy technique / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the clinical outcome of surgical management for post-traumatic thoracolumbar kyphotic deformity with single-stage posterior transpedicularlimited osteotomies.@*METHODS@#From March 2007 to May 2010, 17 patients with post-traumatic thoracolumbar kyphotic deformity treated with posterior limited transpedicular osteotomy were admitted. The preoperative Cobb angle was 41°-62°(52.5° ±6.4°). Sagittal balance was evaluated by the standing lateral films measuring the C7 plumb line distance (C7 PLD) from the posterior superior corner of S1. The C7 PLD was 18-58 (41.2 ±12.4) mm in the sagittal plane. The preoperative oswestry disability index (ODI) was 42-50 (45.7 ±2.7), and the average preoperative visual analogue scale (VAS) was 8-10 (8.8 ±0.7). The American Spinal Injury Association (ASIA) impairment scale was used to assess the neurological deficits, and grade C in 1 patient, grade D in 7 and grade E in 9 patients. The operation time, blood loss, complications, post-operative Cobb angle, ODI and VAS score at the follow-up were collected and analyzed.@*RESULTS@#The average duration of postoperative follow-up was 24-53 (34.5 ±7.1) months. The operation time was 180-400 (287.1 ±65.9) min, with an blood loss of 350-1 300 (838.2 ±276.4) mL. The postoperative kyphotic angle was 3°-12° (6.1° ±3.0°), and it was 7.5° ±2.6° at the final follow-up evaluation. The postoperative C7PLD was (3.6 ±3.9) mm and it was (3.4 ±2.3) mm at the final follow-up evaluation. Postoperatively, the ASIA impairment scale was grade D in 4 and grade E in 13 patients. At the final follow-up ODI and VAS were reduced to an average of 5.2 ±2.4 and 2.4 ±1.0, respectively. Cerebrospinal fluid leakage was found in 2 patients, deep wound infection in 1, and intercostal neuralgia in 2. All the complications were relieved after conservative medical therapy. One patient received additional surgery at postoperative 12 weeks due to breakage of posterior implants. Another screw pullout case was treated with reinsertion of larger screws at postoperative 4 months. Solid fusion was confirmed by plain film and CT scan in all patients within 1 year after the surgery.@*CONCLUSION@#Single-staged posterior transpedicular limited osteotomies is safe and effective to correct post-traumatic thoracolumbar kyphotic deformity.

Studying the protein expression in human B lymphoblastoid cells exposed to 1.8-GHz (GSM) radiofrequency radiation (RFR) with protein microarray.

In the present study, the protein microarray was used to investigate the protein expression in human B-cell lymphoblastoid cells intermittently exposed to 1.8-GHz GSM radiofrequency radiation (RFR) at the specific absorption rate (SAR) of 2.0 W/kg for 24 h. The differential expression of 27 proteins was found, which were related to DNA damage repair, apoptosis, oncogenesis, cell cycle and proliferation (ratio >1.5-fold, P<0.05). The results validated with Western blot assay indicated that the expression of RPA32 was significantly down-regulated (P<0.05) while the expression of p73 was significantly up-regulated in RFR exposure group (P<0.05). Because of the crucial roles of those proteins in DNA repair and cell apoptosis, the results of present investigation may explain the biological effects of RFR on DNA damage/repair and cell apoptosis.

The change of expression of c-fos and c-jun gene when using IN-1 alone or combination with NT-3 after spinal cord injury / 中国医师杂志

Objective To study the change of expression of c-fos and c-jun when using IN-1 alone or combination with NT-3 after spinal cord injury. Methods 120 adult health Sprague-Dawley (SD) rats were random divided into three groups, including control group, IN-1 group, and IN-1 combination with NT-3 group. All rats were killed at the scheduled time and its myeloid tissues were taken out. In each group, the expression of c-fos and c-jun gene was detected by using reverse transcription- polymerase chain reaction technique ( RT-PCR ). Result The transcriptional levels of c-fos decreased and c-jun increased when using IN-1 alone, and the levels changed more when using IN-1 combination with NT-3. The peak of c-fos reached to 0. 974 ±0. 126 in control group, 0. 834 ±0. 047 in IN-1 group, and 0. 698 ±0. 052 in IN-1 combination with NT-3 group, and the peak of c-jun reached 0. 642 ±0. 048, 0. 712 ±0. 050, and 0. 814 ±0. 041, respectively. Conclusion One of the mechanisms of IN-1 and NT-3 to protect the spinal cord might be through inhibiting the expression of c-fos and enhancing the expression of c-jun.

Impact of 1.8-GHz radiofrequency radiation (RFR) on DNA damage and repair induced by doxorubicin in human B-cell lymphoblastoid cells.

In the present in vitro study, a comet assay was used to determine whether 1.8-GHz radiofrequency radiation (RFR, SAR of 2W/kg) can influence DNA repair in human B-cell lymphoblastoid cells exposed to doxorubicin (DOX) at the doses of 0microg/ml, 0.05microg/ml, 0.075microg/ml, 0.10microg/ml, 0.15microg/ml and 0.20microg/ml. The combinative exposures to RFR with DOX were divided into five categories. DNA damage was detected at 0h, 6h, 12h, 18h and 24h after exposure to DOX via the comet assay, and the percent of DNA in the tail (% tail DNA) served as the indicator of DNA damage. The results demonstrated that (1) RFR could not directly induce DNA damage of human B-cell lymphoblastoid cells; (2) DOX could significantly induce DNA damage of human B-cell lymphoblastoid cells with the dose-effect relationship, and there were special repair characteristics of DNA damage induced by DOX; (3) E-E-E type (exposure to RFR for 2h, then simultaneous exposure to RFR and DOX, and exposure to RFR for 6h, 12h, 18h and 24h after exposure to DOX) combinative exposure could obviously influence DNA repair at 6h and 12h after exposure to DOX for four DOX doses (0.075microg/ml, 0.10microg/ml, 0.15microg/ml and 0.20microg/ml) in human B-cell lymphoblastoid cells.

Experimental study on changes of CGRP-immunoreactive positive nerve fibers innervation in bone tissue of ratsand its significance / 中国医师杂志

Objective To observe the changes of calcitonin gene-related peptide(CGRP) -immunoreactive positive nerve fibers innervation in bone tissue of femoral heads during the pathological process of early steroid-induced avascular necrosis of the femoral head (SANFH), and explore its significance.Methpathological group of SANFH was induced.Immunohistochemical technique was used and the changes of CGRP-immunoreactive positive nerve fibers innervation in weight bearing area of the femoral heads during the pathological process of early SANFH were observed.Result The number of CGRP-immunoreactive nerves increased first and then decreased ( Peaked at 6 weeks, 10.28 ± 0.66 ), but it was more than that ofnormal control group.There was significant difference between two groups ( P ＜ 0.01 ).Conclusion There were changes in the distribution of CGRP-immunoreactive positive nerves fiber during the process of bone repair after SANFH.CGRP-immunoreactive positive nerves fiber might take part in the process of bone repair in SANFH.

Relationship between inflammatory cytokines and traumatic brain injury / 国际外科学杂志

A medical studies have indicated that there would be a defense response from human body after TBI,which mainly comes with inflammatory reaction. Human body's resistance seems likely to be enhanced,during this process, by inflammatory cytokines leading to rehabilitation of the cellular organization.However,a strong Inflammation from the whole human body may be caused due to the excessive activation,which, instead, worsens secondary brain injury. This article discusses the relationship between cytokines and traumatic brain injury.

Influence of 1.8-GHz (GSM) radiofrequency radiation (RFR) on DNA damage and repair induced by X-rays in human leukocytes in vitro.

In the present study, the in vitro comet assay was used to determine whether 1.8-GHz radiofrequency radiation (RFR) can influence DNA repair in human leukocytes exposed to X-rays. The specific energy absorption rate (SAR) of 2 W/kg (the current European safety limit) was applied. The leukocytes from four young healthy donors were intermittently exposed to RFR for 24 h (fields on for 5 min, fields off for 10 min), and then irradiated with X-rays at doses of 0.25, 0.5, 1.0 and 2.0 Gy. DNA damage to human leukocytes was detected using the comet assay at 0, 15, 45, 90, 150 and 240 min after exposure to X-rays. Using the comet assay, the percent of DNA in the tail (% tail DNA) served as the indicator of DNA damage; the DNA repair percentage (DRP) served as the indicator of the DNA repair speed. The results demonstrated that (1) the DNA repair speeds of human leukocytes after X-ray exposure exhibited individual differences among the four donors; (2) the intermittent exposures of 1.8-GHz RFR at the SAR of 2 W/kg for 24 h did not directly induce DNA damage or exhibit synergistic effects with X-rays on human leukocytes.

Expression of Oct4 and Wnt2 in human glioma tissues and its clinical significance / 中国肿瘤生物治疗杂志

Objective:To investigate the expression of Oct4 and Wnt2 in human glioma tissues and its relationship with the clinicopathological features of glioma. Methods: Fifty-six paraffin blocks were obtained from glioma patients receiving surgery. The diagnosis of these patients were confirmed by pathology in our hospital from 2006-2009. Immunohistochemi-cal staining was used to examine Oct4 and Wnt2 expression in the brain tissues of 10 patients with acute brain injury and 56 glioma tissues (including 15 recurrent cases). Results: The normal brain tissues were negative of Oct4, with only one case showing weak Wnt2 expression. Thirty-four of the 56 glioma tissues showed positive expression of Oct4 (60.7%), and 40 showed positive expression of Wnt2 (71.4%). Positive expression rates of Oct4 and Wnt2 in low-grade and high-grade glioma tissues were 46.2 %, 73.3% and 57.7 %, 83.3%, respectively (P < 0.05). Oct4 positive rates in the recrudescence and newly diagnosed glioma tissues were 86.7% and 51.2%, respectively (P < 0.05). Oct4 expression in the glioma tissues was positively correlated with that of Wnt2 (r = 0.537, P < 0.01). Conclusion: Expression of Oct4 and Wnt2 is associated with the malignant degrees of glioma, and Oct4 expression is related to the recurrence of glioma. Oct4 might participate in the development and progression of brain glioma through Wnt signaling pathway.

Role of CT,MRI and cerebral spine fluid immunoassay in the diagnosis of cerebral schistosomiasis / 中国血吸虫病防治杂志

Objective To explore the clinical characteristics and diagnostic methods of cerebral schistosomiasis.Methods The data of CT,MRI and the cerebral spine fluid(CSF) immunoassay in 42 patients with cerebral schistosomiasis were analyzed retrospectively.Results Forty cerebral schistosomiasis patients were diagnosed by the iconography and immunoassay,1 by the postoperative pathological examination and 1 by diagnostic treatment with praziquantel.Conclusions CT and MRI are of great value to determination of the position and nature of the cerebral schistosomiasis.The sensitivity and accuracy of MRI are better for indicating the main pathological changes of the disease than those of CT.The CSF immunoassay plays an important role in the differential diagnosis of cerebral schistosomiasis.

Variation of ATM protein expression in response to irradiation of lymphocytes in lung cancer patients and controls.

The aim of this research work was to study the cellular response to ionizing radiation (IR) and its relationship with the ATM protein expression levels in lung cancer patients. Heparinized blood samples were collected from 22 controls and 22 lung cancer patients. Each sample was divided into two parts: non-irradiated sample and irradiated sample, which was exposed to 3 Gy X-ray. The spontaneous and IR-induced genetic damage in both lung cancer patients and controls was measured with comet assay and micronucleus (MN) assay, and the ATM protein expression levels of non-irradiated samples in lung cancer patients and controls were detected by Western blotting. The results indicated that the baseline values of average mean tail moment (MTM) and micronucleus rate (MNR) in lung cancer patients were 0.86 and 11.41 per thousand, respectively, which was significantly higher than those (0.64 and 6.77 per thousand) of controls (P<0.05 for MTM, P<0.01 for MNR). The IR-induced average MTM and MNR in lung cancer patients were 1.23 and 77.64 per thousand, respectively, which was also significantly higher than those (0.71 and 66.05 per thousand) of controls (P<0.05 for MTM, P<0.01 for MNR). The results of Western blotting showed that the ATM protein expression levels in lung cancer patients and controls were 0.64 and 1.71, respectively, and there was significant (P<0.01) difference between lung cancer patients and controls. In present investigation, it was found that the genetic instability measured with comet assay and MN assay in lung cancer patients were significantly higher than those in controls, on the contrary, ATM protein expression level in lung cancer patients were significantly lower than that in controls. However, no good correlation was found either between ATM protein expression and IR-induced MTM or between ATM protein expression and IR-induced MNR in lung cancer patients.

Detecting the cytogenetic effects in workers occupationally exposed to vincristine with four genetic tests.

To study the human genetic damage induced by vincristine (VCR), the cytogenetic effects in workers occupationally exposed to vincristine were studied with micronucleus (MN) test, comet assay, hypoxantinepho-guanine phosphoribosyl-transferase (hprt) gene mutation assay and T-cells receptor (TCR) gene mutation assay. Fresh peripheral blood samples were collected from the workers and controls. Fifteen workers from a plant producing antineoplastic drug (vincristine) and 15 controls were matched according to age, gender and smoking. The results of MN test showed that the mean micronuclei rate (MNR) and mean micronucleated cells rate (MCR) in 15 workers were 17.80+/-1.88 per thousand and 13.67+/-1.56 per thousand, respectively, which were significantly higher than those (3.73+/-0.80 per thousand and 3.13+/-0.59 per thousand) in controls (P<0.01). It was found in the comet assay that the mean tail length (MTL) of 15 workers and 15 controls were 1.72+/-0.15 microm and 0.71+/-0.01 microm, respectively, there was significant difference between workers and controls for MTL (P<0.05), but the difference between the mean tail moment (MTM, 0.29+/-0.03) of 15 workers and MTM (0.17+/-0.05) of 15 controls was not significant (P>0.05). The results of hprt gene mutation assay showed that the average mutation frequency of hprt (Mf-hprt) in workers was 1.03+/-0.02 per thousand, which was significantly higher than that (0.87+/-0.01 per thousand) in controls (P<0.05). Meanwhile, the results of TCR gene mutation assay indicated that Mfs-TCR of workers and controls were 2.52+/-0.34 x 10(-4) and 1.51+/-0.11 x 10(-4), respectively, there was a significant difference between workers and controls (P<0.01). It is found in the results of our study that the genetic damage is detectable in 15 workers occupationally exposed to vincristine.