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1.
Biomater Sci ; 8(21): 6069-6081, 2020 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-33000773

RESUMO

Over the past few years, tissue-engineering technology provided a new direction for bone defects therapy, which involved developing applicable biological materials composite with seed cells to repair bone defects tissue. However, as one of the commonest seed cells for tissue engineering, BMSCs (bone marrow mesenchymal stem cells), are still lacking an efficient and accurate differentiation ability into functional osteoblast. Given these facts, the development of a novel tissue engineering technology integrated BMSCs and scaffold materials have become an urgent need for bone defects repair. In this work, we found that miR-19b-3p could suppress the expression of Smurf1 which is a negative regulator of osteogenesis. By employing lentivirus pLVTHM-miR-19b-3p transfected BMSCs, we verified that miR-19b-3p could promote BMSCs osteogenic differentiation via suppressing Smurf1 expression. Furthermore, we designed a new porous PLLA/POSS scaffold combined with BMSCs for tissue engineering. In vitro experiment showed that miR-19b-3p modified BMSCs facilitated the expansion and proliferation of BMSCs when culturing with the PLLA/POSS scaffold. We established rats calvarial critical-sized defect model, after transplanting the BMSCs/PLLA/POSS for 3 month, the pathology, immunohistochemical and Micro-CT results showed that miR-19b-BMSCs/PLLA/POSS significantly facilitated the osteogenesis differentiation, enhanced the bone density of defect area and accelerated the repair of bone defect. We elucidated the mechanism that miR-19b-3p suppressed the expression of Smurf1 and provided a novel tissue engineering strategy for using microRNA gene-modified BMSCs combined with PLLA/POSS scaffold in bone tissue engineering.

2.
J Orthop Surg Res ; 15(1): 474, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059739

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) has broken out and spread rapidly nationwide at the beginning of 2020, which has brought huge impacts to people and work. The current situation of prevention and control is severe and urges guidance for clinicians, especially for medical systems. In the hope of providing a reference and recommendation for the prevention and control of the COVID-19, we carried out research to improve the quality of patient care and prevention during this epidemic. METHODS: All of the staff were trained rapidly to master personal protection in our department. We reviewed the patients' discharged records who underwent surgery in our department during January 1 to March 1, 2019, and January 1 to March 1, 2020. The management of the surgery patients and flow charts were described and analyzed. Post-operation outcomes of the patients include duration, complications, surgical site infection (SSI), system infection, re-operation, and mortality. Both chi-squared test and Student's t test were performed to determine the relationship between the two periods in terms of post-operation outcomes. RESULTS: Descriptive statistics analysis revealed that demographic of the patients between the two periods is similar. We had benefited from the strict flowcharts, smart robot, and protection equipment during the perioperative managements for orthopedic patients. With the help of the strict flow charts and smart equipment, post-operation outcomes of the patients revealed that the rates of the complications and re-operation had been reduced significantly (p < 0.05), while duration of operation, SSI, and system infection had no significant difference between two periods (p > 0.05). No patient and staff caught COVID-19 infection or mortality during the epidemic. CONCLUSIONS: Our study indicated that medical quality and efficiency were affected little with the help of strategies described above during the epidemic, which could be a reference tool for medical staff in routine clinical practice for admission of patients around the world. What is more, the provided strategies, which may evolve over time, could be used as empirical guidance and reference for orthopedic peers to get through the pandemic and ensure the normal operation of the hospital.


Assuntos
Infecções por Coronavirus/epidemiologia , Eficiência Organizacional , Procedimentos Ortopédicos , Assistência Perioperatória , Pneumonia Viral/epidemiologia , Garantia da Qualidade dos Cuidados de Saúde , Betacoronavirus , China/epidemiologia , Feminino , Unidades Hospitalares , Humanos , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Pandemias , Equipamento de Proteção Individual , Complicações Pós-Operatórias , Reoperação , Estudos Retrospectivos , Robótica , Fluxo de Trabalho
4.
J Orthop Surg Res ; 14(1): 343, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694690

RESUMO

OBJECTIVES: The purpose of this study is to identify the factors that influence the length of stay (LOS) in total knee arthroplasty (TKA) patients with an enhanced recovery after surgery (ERAS) program. METHODS: Information from 167 patients (31 males and 136 females, range from 43 years to 88 years old) who underwent the unilateral elective primary TKA from January 2017 to January 2019 were reviewed retrospectively. Factors were analyzed by single-factor variance and multi-factor linear regression. RESULTS: By single-factor variance analysis, American Society of Anesthesiologists (ASA) physical status classification system, pre-operation albumin, pre-operation erythrocyte sedimentation rate (ESR), primary and merge diseases, hidden blood loss, and length of operation were correlated with LOS (P < 0.05). Multi-factor linear regression results suggested that gender, ASA class, pre-operation Alb, and pre-operation ESR were associated with LOS (P < 0.05). Moreover, ASA class 3 (B value 4.84), pre-operation Alb < 30 g/L (B value 18.33), and pre-operation ESR > 15 mmol/h (B value 2.21) could increase the LOS, while males (B value - 3.56) had a shortened LOS. CONCLUSIONS: Overall, our research found that female, ASA class 3, pre-operation Alb < 30 g/L, and pre-operation ESR > 15 mmol/h could extend LOS in TKA patients with ERAS.


Assuntos
Artroplastia do Joelho/tendências , Recuperação Pós-Cirúrgica Melhorada , Tempo de Internação/tendências , Recuperação de Função Fisiológica/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/efeitos adversos , Sedimentação Sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
5.
Orthop J Sports Med ; 7(3): 2325967119829736, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30886875

RESUMO

Background: Failure of hip arthroscopy procedures and the need for subsequent total hip arthroplasty (THA) have been estimated to be as high as 16%. Prior literature has shown that failed ipsilateral knee arthroscopy may have a negative impact on the functional outcome of subsequent total knee arthroplasty. To date, there is limited information regarding the impact of failed hip arthroscopy on the clinical outcomes of subsequent primary THA. Purpose: To compare clinical outcomes in primary THA between patients with and without prior arthroscopic hip surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Patients undergoing primary THA with a history of ipsilateral hip arthroscopy were matched and compared in a 1:2 manner with patients undergoing primary THA without a history of hip arthroscopy. Patient-reported clinical outcomes were measured with the modified Harris Hip Score, the University of California-Los Angeles Activity Score, and 3 subscales from the Western Ontario and McMaster Universities Osteoarthritis Index (Pain, Stiffness, and Physical Function). Results: At a mean follow-up of 42 months, there was no significant difference in any of the outcome measures between the 58 study hips and 116 matched controls. Additionally, both groups exhibited an absolute change in outcome scores that exceeded the minimum clinically important difference. Conclusion: Prior ipsilateral arthroscopic hip surgery does not adversely affect the clinical outcome of subsequent THA.

6.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 30(2): 170-175, 2018 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-29402369

RESUMO

OBJECTIVE: To observe the protein expression related to cognitive and learning memory function, and to investigate the effect of aquaporin 4 (AQP4) silence on learning and memory function in traumatic brain injury (TBI) rats. METHODS: Ninety-six healthy adult male Wistar rats were divided into groups according to the random number table. (1) Forty-eight rats were divided into sham operation (sham) group, TBI group (by using modified Feeney method), AQP4 RNA interference (RNAi) negative group [TBI+meaningless small interfering RNA (siRNA)-AQP4 liposome solution 10 µL], and AQP4 RNAi group (TBI+siRNA-AQP4 liposome solution 10 µL). In each group, brain tissues of 4 rats were harvested at 1, 6 and 12 hours respectively. The protein expressions of hippocampus AQP4, general control nonderepressible 2 kinase (GCN2), cyclic adenosine monophosphate response element binding protein (CREB) and phosphorylated CREB (p-CREB) were detected by Western Blot. (2) In addition, 48 rats were divided into normal control group (control group), sham group, TBI group and AQP4 RNAi group, brain water content were measured in 6 of them after 12 hours of injury, and 6 were used in Morris water maze test. RESULTS: (1) The protein expressions of hippocampus AQP4 and GCN2 in TBI group were significantly higher than those in sham group, and increased gradually with time with statistical difference at 12 hours (AQP4 protein: 5.03±0.09 vs. 1, GCN2 protein: 4.01±0.13 vs. 1, both P < 0.01); the protein expressions of hippocampus CREB and p-CREB were significantly lower than those in sham group, and decreased gradually with time with statistical difference at 12 hours (CREB protein: 0.38±0.03 vs. 1, p-CREB protein: 0.38±0.03 vs. 1, both P < 0.01). Compared with TBI group, the protein expressions of AQP4 in AQP4 RNAi group was significantly decreased (1 hour: 1.02±0.04 vs. 2.23±0.05, 6 hours: 1.23±0.03 vs. 2.59±0.04, 12 hours: 2.20±0.08 vs. 5.03±0.09, all P < 0.01), but there were no significant difference in the expressions of GCN2, CREB or p-CREB. There was no significant difference in the expression of protein between AQP4 RNAi negative group and TBI group. (2) The brain water content in TBI group was significantly higher than that in control group and sham group [(83.7±0.4)% vs. (76.2±0.2)%, (76.2±0.3)%, both P < 0.01]. The brain water content in AQP4 RNAi group [(78.8±0.3)%] was significantly decreased as compared with that in TBI group (P < 0.01). The latency of Morris water maze test was significantly prolonged in the day 11, 13 and 15 after the injury of the TBI group and AQP4 RNAi group, and the exploration time was significantly shortened. Compared with TBI group, the incubation period of AQP4 RNAi group was significantly shortened at 15 days (s: 60.2±11.1 vs. 62.0±11.5, P < 0.05), and the exploration time was significantly prolonged (s: 37.0±8.5 vs. 32.7±9.2, P < 0.05). CONCLUSIONS: The impairment of cognitive and learning memory function in rats after TBI was significantly related to the changes in CREB and GCN2 in cognitive and learning memory function. After RNAi treatment, the cognitive and learning and memory function of rats was not improved obviously, but the brain edema could be alleviated.


Assuntos
Lesões Encefálicas Traumáticas , Animais , Aquaporina 4 , Masculino , Ratos , Ratos Sprague-Dawley , Ratos Wistar
7.
J Cereb Blood Flow Metab ; 37(3): 967-979, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27174997

RESUMO

Inflammation mediated by the peripheral infiltration of inflammatory cells plays an important role in intracerebral hemorrhage (ICH) induced secondary injury. Previous studies have indicated that regulatory T lymphocytes (Tregs) might reduce ICH-induced inflammation, but the precise mechanisms that contribute to ICH-induced inflammatory injury remain unclear. Our results show that the number of Tregs in the brain increases after ICH. Inducing Tregs deletion using a CD25 antibody or Foxp3DTR-mice increased neurological deficient scores (NDS), the level of inflammatory factors, hematoma volumes, and neuronal degeneration. Meanwhile, boosting Tregs using a CD28 super-agonist antibody reduced the inflammatory injury. Furthermore, Tregs depletion shifted microglia/macrophage polarization toward the M1 phenotype while boosting Tregs shifted this transition toward the M2 phenotype. In vitro, a transwell co-culture model of microglia and Tregs indicated that Tregs changed the polarization of microglia, decreased the expression of MHC-II, IL-6, and TNF-α and increased CD206 expression. IL-10 originating from Tregs mediated the microglia polarization by increasing the expression of Glycogen Synthase Kinase 3 beta (GSK3ß), which phosphorylates and inactivates Phosphatase and Tensin homologue (PTEN) in microglia, TGF-ß did not participate in this conversion. Thus, Tregs ameliorated ICH-induced inflammatory injury by modulating microglia/macrophage polarization toward the M2 phenotype through the IL-10/GSK3ß/PTEN axis.


Assuntos
Hemorragia Cerebral/complicações , Inflamação/imunologia , Linfócitos T Reguladores/imunologia , Animais , Técnicas de Cocultura , Glicogênio Sintase Quinase 3 beta/metabolismo , Inflamação/etiologia , Inflamação/patologia , Interleucina-10/metabolismo , Macrófagos/fisiologia , Camundongos , Microglia/fisiologia , PTEN Fosfo-Hidrolase/metabolismo , Fenótipo
8.
J Immunol ; 198(2): 820-831, 2017 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-27986908

RESUMO

Reducing excessive inflammation is beneficial for the recovery from intracerebral hemorrhage (ICH). Here, the roles and mechanisms of A20 (TNFAIP3), an important endogenous anti-inflammatory factor, are examined in ICH. A20 expression in the PBMCs of ICH patients and an ICH mouse model was detected, and the correlation between A20 expression and neurologic deficits was analyzed. A20 expression was increased in PBMCs and was negatively related to the modified Rankin Scale score. A20 expression was also increased in mouse perihematomal tissues. A20-/- and A20-overexpressing mice were generated to further analyze A20 function. Compared with wild-type (WT) mice, A20-/- and A20-overexpressing mice showed significant increases and decreases, respectively, in hematoma volume, neurologic deficit score, mortality, neuronal degeneration, and proinflammatory factors. Moreover, WT-A20-/- parabiosis was established to explore the role of A20 in peripheral blood in ICH injury. ICH-induced damage, including brain edema, neurologic deficit score, proinflammatory factors, and neuronal apoptosis, was reduced in A20-/- parabionts compared with A20-/- mice. Finally, the interactions between TRAF6 and Ubc13 and UbcH5c were increased in A20-/- mice compared with WT mice; the opposite occurred in A20-overexpressing mice. Enhanced IκBα degradation and NF-κB activation were observed in A20-/- mice, but the results were reversed in A20-overexpressing mice. These results suggested that A20 is involved in regulating ICH-induced inflammatory injury in both the central and peripheral system and that A20 reduces ICH-induced inflammation by regulating TRAF6 polyubiquitination. Targeting A20 may thus be a promising therapeutic strategy for ICH.


Assuntos
Hemorragia Cerebral/patologia , Inflamação/metabolismo , Fator 6 Associado a Receptor de TNF/metabolismo , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/metabolismo , Adulto , Idoso , Animais , Apoptose/fisiologia , Western Blotting , Hemorragia Cerebral/imunologia , Hemorragia Cerebral/metabolismo , Ensaio de Desvio de Mobilidade Eletroforética , Feminino , Imunofluorescência , Técnicas de Silenciamento de Genes , Humanos , Imunoprecipitação , Inflamação/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/imunologia , Ubiquitinação
9.
Medicine (Baltimore) ; 96(52): e9426, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29384921

RESUMO

RATIONALE: For traumatic upper limb amputees, the prohibitive cost of a custom-made prosthesis brings an insufferable financial burden for their families in developing countries. Three-dimensional (3D) printing allows for creating affordable, lightweight, customized, and well-fitting prosthesis, especially for the growing children. PATIENT CONCERNS: We presented a case of an 8-year-old boy, who suffered a traumatic right wrist amputation as result of a mincing machine accident. The patient was immediately sent to the emergency orthopedics department after the accident. DIAGNOSES: He was diagnosed as severed mangled limb crash injury at the level of the right wrist with a Mangled Extremity Severity Score of 8. INTERVENTIONS: A wrist disarticulation was performed and a 3D-printed prosthetic hand was designed and manufactured for this child. A personalized prosthetic rehabilitation training was applied after the prosthesis installation at 6 months postoperatively. The function of the prosthesis was evaluated at 1-month and 3-month follow-up using the Children Amputee Prosthetics Projects (CAPP) score and the University Of New Brunswick Test Of Prosthetic Function for Unilateral Amputees (UNB test). OUTCOMES: The materials cost <20 dollars. The printing took <8 hours and the component assembling was completed within 20 minutes. During the 3-month follow-up, the child's parents were satisfied with the prosthesis and the UNB test showed the significantly improved function of the prosthesis. LESSONS: This novel 3D-printed upper limb prosthesis in a child with the traumatic wrist amputation might serve as a practical and affordable alternative for children in developing countries and those lacking access to health care providers. A personalized prosthetic rehabilitation needs to be undertaken and more clinical studies are warranted to validate the potential superiority of similar 3D-printed prostheses.


Assuntos
Amputação Traumática/terapia , Membros Artificiais , Impressão Tridimensional , Desenho de Prótese , Criança , Mãos , Humanos , Masculino
10.
J Am Heart Assoc ; 5(10)2016 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-27729335

RESUMO

BACKGROUND: Neuroinflammation plays a key role in intracerebral hemorrhage (ICH)-induced secondary brain injury, but the specific roles of peripheral inflammatory cells such as macrophages and lymphocytes remain unknown. The purpose of this study was to explore the roles of macrophages, T lymphocytes, and the cytokines they secrete as potential targets for treating secondary brain injury after ICH. METHODS AND RESULTS: Our results showed that peripheral macrophages and T lymphocytes successively infiltrated the brain, with macrophage counts peaking 1 day after ICH and T-lymphocyte counts peaking after 4 days. These peaks in cellular infiltration corresponded to increases in interleukin (IL)-23 and IL-17 expression, respectively. We found that hemoglobin from the hematoma activated IL-23 secretion by infiltrating macrophages by inducing the formation of toll-like receptor (TLR) 2/4 heterodimer. This increased IL-23 expression stimulated γδT-cell production of IL-17, which increased brain edema and neurologic deficits in the model mice as a proinflammatory factor. Finally, we found that sparstolonin B (SsnB) could ameliorate brain edema and neurologic deficits in ICH model mice via inhibition of TLR2/TLR4 heterodimer formation, and notably, SsnB interacted with myeloid differentiation factor 88 Arg196. CONCLUSIONS: Together, our results reveal the importance of the IL-23/IL-17 inflammatory axis in secondary brain injury after ICH and thus provide a new therapeutic target for ICH treatment.


Assuntos
Edema Encefálico/imunologia , Hemorragia Cerebral/imunologia , Interleucina-17/imunologia , Interleucina-23/imunologia , Macrófagos/imunologia , Linfócitos T/imunologia , Animais , Modelos Animais de Doenças , Hemoglobinas/imunologia , Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Masculino , Camundongos , Receptores de Antígenos de Linfócitos T gama-delta/metabolismo , Linfócitos T/metabolismo , Receptor 2 Toll-Like/efeitos dos fármacos , Receptor 2 Toll-Like/metabolismo , Receptor 4 Toll-Like/efeitos dos fármacos , Receptor 4 Toll-Like/metabolismo
11.
Circulation ; 134(14): 1025-1038, 2016 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-27576776

RESUMO

BACKGROUND: Disturbance of brain iron metabolism after intracerebral hemorrhage (ICH) results in oxidative brain injury and cognition impairment. Hepcidin plays an important role in regulating iron metabolism, and we have reported that serum hepcidin is positively correlated with poor outcomes in patients with ICH. However, the roles of hepcidin in brain iron metabolism after ICH remain largely unknown. METHODS: Parabiosis and ICH models combined with in vivo and in vitro experiments were used to investigate the roles of hepcidin in brain iron metabolism after ICH. RESULTS: Increased hepcidin-25 was found in serum and primarily in astrocytes after ICH. The brain iron efflux, oxidative brain injury, and cognition impairment were improved in Hepc-/- ICH mice but aggravated by the human hepcidin-25 peptide in C57BL/6 ICH mice. Data obtained in in vitro studies showed that increased hepcidin inhibited the intracellular iron efflux of brain microvascular endothelial cells but was rescued by a hepcidin antagonist, fursultiamine. Using parabiosis ICH models also shows that increased serum hepcidin prevents brain iron efflux. In addition, Toll-like receptor 4 (TLR4)/MyD88 signaling pathway increased hepcidin expression by promoting interleukin-6 expression and signal transducer and activator of transcription 3 phosphorylation. TLR4-/- and MyD88-/- mice exhibited improvement in brain iron efflux at 7, 14, and 28 days after ICH, and the TLR4 antagonist (6R)-6-[N-(2-chloro-4-fluorophenyl) sulfamoyl] cyclohex-1-ene-1-carboxylate significantly decreased brain iron levels at days 14 and 28 after ICH and improved cognition impairment at day 28. CONCLUSIONS: The results presented here show that increased hepcidin expression caused by inflammation prevents brain iron efflux via inhibition of the intracellular iron efflux of brain microvascular endothelial cells entering into circulation and aggravating oxidative brain injury and cognition impairment, which identifies a mechanistic target for muting inflammation to promote brain iron efflux and to attenuate oxidative brain injury after ICH.


Assuntos
Lesões Encefálicas/metabolismo , Hemorragia Cerebral/metabolismo , Disfunção Cognitiva/metabolismo , Hepcidinas/metabolismo , Ferro/metabolismo , Fator 88 de Diferenciação Mieloide/metabolismo , Receptor 4 Toll-Like/metabolismo , Animais , Lesões Encefálicas/complicações , Disfunção Cognitiva/etiologia , Células Endoteliais/metabolismo , Inflamação/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fator 88 de Diferenciação Mieloide/genética , Transdução de Sinais/fisiologia , Receptor 4 Toll-Like/genética
12.
Chin J Traumatol ; 19(6): 330-332, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28088936

RESUMO

PURPOSE: Traumatic optic neuropathy (TON) is a serious complication of head trauma with the incidence rate of 0.5%-5%. The aim of this study was to investigate the therapeutic efficacy of endoscopic decompression of the optic canal for optic nerve injuries. METHODS: In this study, 11 patients treated in our hospital from January 2009 to January 2015 with the visual loss resulting from TON were retrospectively reviewed for preoperative vision, visual evoked potential (VEP) scan, surgical approach, postoperative visual acuity, complications, and follow-up results. RESULTS: All these patients received endoscopic decompression of the optic canal. At the 3-month follow- up, the visual acuity improvement rate of the 11 patients was 45.5%. The vision acuity of 2 cases improved from hand movement to 0.08 and 0.3 after operation. Another patient's vision acuity returned to 0.05 compared to light sensation preoperatively. Two cases had finger counting before surgery but they had a vision acuity of 0.4 and light sensation respectively after surgery. However, the other 6 cases' vision did not improve after surgery. CONCLUSION: Endoscopic decompression of the optic canal is an effective way to cure TON. VEP could be used as an important reference for preoperative and prognosis evaluation. Operative time after trauma is only a relative condition that may affect the therapeutic effect of optic canal decompression. Poor results of this procedure may be related to the severity of the optic nerve injury.


Assuntos
Descompressão Cirúrgica/métodos , Traumatismos do Nervo Óptico/cirurgia , Adolescente , Adulto , Idoso , Endoscopia , Potenciais Evocados Visuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos do Nervo Óptico/fisiopatologia , Acuidade Visual
13.
J Arthroplasty ; 31(2): 429-33, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26410552

RESUMO

BACKGROUND: In a new health care economy, there is an emerging need to understand and quantify predictors of total hip arthroplasty (THA) outcomes. We investigated the association between preoperative radiographic disease (as measured quantitatively by joint space width [JSW]) and patient-reported function, activity, pain, and quality of life after THA. METHODS: We retrospectively analyzed 146 patients (146 hips) 55 years or younger with a diagnosis of osteoarthritis who underwent cementless THA between January 2009 and December 2010. Preoperative pelvic radiographs were measured by 1 author blinded to clinical outcomes to establish JSW, defined as the shortest distance between the femoral head margin and the superolateral weight-bearing portion of the acetabulum. The JSW value was treated as a continuous variable when applied to statistical modeling. The relationship between the JSW and the improvement of clinical outcome was examined via a general linear modeling approach with adjustments for patients' age, body mass index, and sex. RESULTS: We identified an inverse relationship between preoperative JSW and improvements in functional, activity, pain, and quality of life. We found that, as JSW decreased by 1 mm, the outcome measure improvements were modified Harris Hip Score of 6.3 (p<0.001); SF-12 physical: 2.1 (p=0.027); WOMAC-pain: 4.8 (p=0.01); and UCLA Activity: 0.44 (p=0.02). CONCLUSIONS: Our results demonstrate that patients with greater preoperative joint space have less predictable improvement in terms of function, pain relief, and activity. These findings suggest that THA in young patients with a JSW less than 1.5 to 2 mm provides more predictable improvements in pain and functional outcomes.


Assuntos
Artroplastia de Quadril/estatística & dados numéricos , Articulação do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/diagnóstico por imagem , Acetábulo/cirurgia , Adulto , Índice de Massa Corporal , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/cirurgia , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/cirurgia , Avaliação de Resultados em Cuidados de Saúde , Medição da Dor , Avaliação de Resultados da Assistência ao Paciente , Qualidade de Vida , Radiografia , Estudos Retrospectivos , Suporte de Carga
14.
Toxicol Lett ; 240(1): 68-80, 2016 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-26478571

RESUMO

Berberine (BBR) has recently been reported to be extensively used for musculoskeletal disorders such as osteoporosis through enhancing osteogenic differentiation, inhibiting osteoclastogenesis and bone resorption and repressing adipogenesis. Although canonical Wnt signaling plays a crucial role in suppressing bone marrow-derived mesenchymal stem cells (MSCs) commitment to the chondrogenic and adipogenic lineage and enhancing osteogenic differentiation, no previous reports have shown an association between BBR-induced osteogenesis and Wnt/ß-catenin signaling pathway. In this study, we aimed to investigate the stimulatory effect and the mechanism of BBR on osteogenic differentiation of human bone marrow-derived MSCs. MSCs were isolated from bone marrow specimens and treated with different concentration of BBR. Cell viability was measured by the WST-8 assay. Effects of BBR on osteogenic differentiation of MSCs were assessed by von Kossa staining, ALP staining and ALP activity. Osteogenic specific genes, chondrogenic and adipogenic related marker genes were determined by quantitative real-time polymerase chain reaction analysis. Western blot and Immunofluorescence staining were performed to analyze OCN and OPN, and ß-catenin expression in the presence or absence of BBR combined with DKK-1 or ß-catenin siRNA transfection. Increasing concentration of BBR (3, 10 and 30 µM) promoted osteogenic differentiation and osteogenic genes expression after incubation for various days compared with DMSO group, whereas expression levels of chondrogenic and adipogenic related marker genes were dramatically suppressed. After treated with 10µM BBR for 7 days, ß-catenin, OPN and OCN expression were significantly induced, which could be effectively suppressed by the addition of DKK-1 or ß-catenin siRNA ß-catenin. Interestingly, the expression level of Runx2 gene was also decreased by inhibiting the transduction of Wnt/ß-catenin signaling. These findings suggest that BBR can stimulate osteogenic differentiation of MSCs not only by enhancing Runx2 expression but also by activating canonical Wnt/ß-catenin signaling pathway, and canonical Wnt/ß-catenin signaling pathway is in part responsible for BBR-induced osteogenic differentiation of MSCs in vitro. BBR is a potential pharmaceutical medicine by enhancing osteogenic differentiation for bone disorders, such as osteoporosis.


Assuntos
Berberina/farmacologia , Diferenciação Celular/efeitos dos fármacos , Células-Tronco Mesenquimais/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Via de Sinalização Wnt/genética , Fosfatase Alcalina/metabolismo , Medula Óssea/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Relação Dose-Resposta a Droga , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Osteocalcina/antagonistas & inibidores , Osteocalcina/genética , Osteocalcina/metabolismo , Osteopontina/antagonistas & inibidores , Osteopontina/genética , Osteopontina/metabolismo , Osteoporose/tratamento farmacológico , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Sais de Tetrazólio/farmacologia , Regulação para Cima , beta Catenina/antagonistas & inibidores , beta Catenina/genética , beta Catenina/metabolismo
15.
J Arthroplasty ; 30(7): 1105-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25865812

RESUMO

The Bernese periacetabular osteotomy, as originally described by Dr. Reinhold Ganz, is an effective treatment for symptomatic acetabular dysplasia in the pre-arthritic young adult hip. This technique has experienced several recent modifications in an attempt to optimize the clinical outcomes of these patients. We will review the clinical presentation of acetabular dysplasia, indications for surgery, contemporary refinements in technique and clinical results following periacetabular osteotomy. In well-selected patients, this reconstructive osteotomy should be considered safe and effective in alleviating pain and improving hip function.


Assuntos
Acetábulo/cirurgia , Luxação Congênita de Quadril/cirurgia , Osteotomia/métodos , Adulto , Artroscopia/métodos , Feminino , Humanos , Masculino , Osteotomia/tendências , Resultado do Tratamento , Adulto Jovem
16.
J Huazhong Univ Sci Technolog Med Sci ; 34(2): 241-246, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24710939

RESUMO

Effect of interleukin-6 receptor (IL-6R) antibody on polymethyl methacrylate (PMMA) bone cement-mediated expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in synovial fibroblasts was investigated. Synovial tissue obtained from total knee arthroplasty was digested and cultured. Inverted microscope was employed to observe the synovial cells and immunocytochemistry (SABC method) staining was used to identify synovial fibroblasts. This experiment was divided into three groups according to different culture media: PMMA group (75 µg/mL PMMA bone cement particles), IL-6R antibody group (10 ng/mL IL-6R antibody+75 µg/mL PMMA bone cement particles), and control group (no IL-6R antibody or PMMA bone cement particles). Influence of IL-6R antibody and PMMA on proliferation of synovial fibroblasts was measured by cell counting kit-8 (CCK-8). ELISA method was used to measure OPG and RANKL levels in culture solution. Fluorescence quantitative real-time PCR (FQ-PCR) was used to detect the expression of OPG and RANKL mRNA. After three consecutive passages, more than 95% of the primary synovial cells became long spindle fibroblast-like cells. SABC staining results showed that the fibroblast-like cells were negative for anti-CD68 antibody and positive for anti-vimentin antibody, with brown madder stained. CCK-8 test demonstrated that the absorbance (A) value at 450 nm was significantly lower in IL-6R antibody group than in PMMA group and control group (P<0.01), but there was no statistically significant difference in A value at 450 nm between the control group and PMMA group (P>0.05). Results of ELISA indicated that the expression of OPG was significantly higher in IL-6R antibody group than in PMMA group and control group (P<0.01). The expression of RANKL was inhibited (P<0.05), and the ratio of OPG/RANKL was significantly increased in IL-6R antibody group as compared with PMMA group and control group. There was no significant difference in the expression of OPG between control group and PMMA group (P>0.05), but the expression of RANKL was higher in PMMA group than in control group (P<0.05), and there was a significant difference in the ratio of OPG/RANKL between them (P<0.05). Results of FQ-PCR revealed the expression of RANKL mRNA was significantly inhibited (P<0.01) and the expression of OPG mRNA was significantly increased (P<0.01) in IL-6R antibody group as compared with PMMA group and control group. The expression of RANKL mRNA was higher in PMMA group than in control group (P<0.05), but the expression of OPG mRNA had no significant difference between them (P>0.05). IL-6R antibody could significantly increase the expression of OPG, but inhibit the expression of RANKL, which might provide a theoretical basis of molecular biology for the prevention and treatment of aseptic loosening of prosthesis.


Assuntos
Osteoprotegerina/biossíntese , Ligante RANK/biossíntese , Receptores de Interleucina-6/metabolismo , Líquido Sinovial/imunologia , Anticorpos/administração & dosagem , Anticorpos/imunologia , Cimentos para Ossos , Fibroblastos/imunologia , Expressão Gênica/efeitos dos fármacos , Humanos , Osteoprotegerina/genética , Polimetil Metacrilato/administração & dosagem , Próteses e Implantes , Ligante RANK/genética , Ligante RANK/metabolismo , Receptores de Interleucina-6/imunologia , Líquido Sinovial/metabolismo
17.
Zhongguo Gu Shang ; 24(4): 295-8, 2011 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-21604524

RESUMO

OBJECTIVE: To compare the levels of STAT4 tyrosine phosphorylation in peripheral T-lymphocytes induced by IL-12 in rheumatoid arthritis (RA) and osteoarthritis (OA). METHODS: From May 2007 to August 2009, peripheral blood mononuclear cells (PBMCs) were isolated from RA patients [RA group, all the cases were female, the age was from 28 to 55 years with an average of (45.0 +/- 13.0) years] and OA patients [OA group, all the cases also were female; the age was from 55 to 75 years with an average of (67.0 +/- 9.6) years]. The purity of T-lymphocytes from PBMCs was accredited by flow cytometry. The IL-12 of 50 ng/ml added in T-lymphocytes, the levels of STAT4 tyrosine phosphorylation were detected by western blot after different time intervals (0, 10, 30, 60 min). RESULTS: The purity of T-lymphocytes were above 91% through diremption and depuration for peripheral blood monouclear cells. The levels of STAT4 tyrosine phosphorylation in T-lymphocytes from RA induced by IL-12 were higher than that from OA in the different times (10, 30, 60 min); after 30 min, its levels from RA and OA achieved to crest value. CONCLUSION: STAT4 in peripheral T-lymphocytes of rheumatoid arthritis was more easily to be activated than osteoarthritis.


Assuntos
Artrite Reumatoide/imunologia , Interleucina-12/farmacologia , Osteoartrite/imunologia , Fator de Transcrição STAT4/metabolismo , Linfócitos T/efeitos dos fármacos , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Fosforilação , Polimorfismo de Nucleotídeo Único , Fator de Transcrição STAT4/genética , Linfócitos T/metabolismo , Tirosina/metabolismo
19.
Artigo em Inglês | MEDLINE | ID: mdl-17219988

RESUMO

The ultrasonographic appearances of osteosarcomas and the roles of ultrasonography in the diagnosis and surgical staging of osteosarcomas were investigated. A comparative study was performed on 45 cases of osteosarcomas by ultrasonography and radiography. Bony changes, periosteal reaction and soft tissue mass were evaluated for each lesion. The results showed that ultrasonography revealed a solid mass around bone in 42 patients, bone destruction in 24 patients and periosteal reaction in 16 patients. Plain radiographs showed bony changes in 44 patients and no bony change in remaining one patient, shadowing of soft tissue swelling in 30 patients, and pulmonary metastases in 3 patients. Surgical biopsy and pathological examination confirmed osteosarcoma in all 45 patients. Soft tissue mass was confirmed in 42 patients surgically. The diagnostic accuracy of soft tissue masses by ultrasonography and radiography was 100 % (42/42) and 71.4 % (30/42), respectively. The positive rate of ultrasonography and radiography in displaying bony changes was 53.3 % (24/45) and 97.8 % (44/45), respectively. In conclusion, in the detection of soft tissue mass of osteosarcoma, ultrasonography is superior to radiography, and in displaying bony changes of osteosarcomas, radiography is superior to ultrasonography. So it may come to a conclusion that plain radiography combined with ultrasonography can completely display the bony and soft tissue lesion of osteosarcomas.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteossarcoma/diagnóstico por imagem , Adolescente , Adulto , Criança , Feminino , Neoplasias Femorais/diagnóstico por imagem , Humanos , Masculino , Radiografia , Tíbia/diagnóstico por imagem , Ultrassonografia , Adulto Jovem
20.
Chin J Traumatol ; 6(4): 229-33, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12857517

RESUMO

OBJECTIVE: To elucidate the effects of exogenous basic fibroblast growth factor (bFGF) on biological characteristics of rat osteoblasts cultured in vitro. METHODS: The osteoblasts isolated from a Sprague-Dawley rat and cultured in vitro were treated with different concentrations of bFGF (5-50 ng/ml) respectively. At 24 hours after treatment, the proliferating cell nuclear antigen was measured with immunocytochemistry, alkaline phosphatase (ALP) activity was determined and the expression of transforming growth factor beta 1 (TGF-beta(1)) was detected to observe the effects of bFGF on growth and differentiation of osteoblasts. RESULTS: bFGF (5-50 ng/ml) could obviously promote the growth of osteoblasts. The intracellular expression of TGF-beta(1) mRNA increased significantly, but the intracellular ALP content decreased. CONCLUSIONS: bFGF can obviously stimulate the proliferation of osteoblasts and promote the synthesis of TGF-beta(1), but cannot promote the differentiation of osteoblasts.


Assuntos
Fator 2 de Crescimento de Fibroblastos/farmacologia , Osteoblastos/efeitos dos fármacos , Fosfatase Alcalina/metabolismo , Animais , Células Cultivadas , Osteoblastos/metabolismo , Antígeno Nuclear de Célula em Proliferação/análise , RNA Mensageiro/análise , Ratos , Ratos Sprague-Dawley , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta1
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