Black phosphorus quantum dots camouflaged with platelet-osteosarcoma hybrid membrane and doxorubicin for combined therapy of osteosarcoma.

BACKGROUND: Osteosarcoma (OS) is the most prevalent primary malignant bone tumor. However, single-agent chemotherapy exhibits limited efficacy against OS and often encounters tumor resistance. Therefore, we designed and constructed an integrated treatment strategy of photothermal therapy (PTT) combined with chemotherapy and used a surface-encapsulated platelet-osteosarcoma hybrid membrane (OPM) that enhances circulation time and enables OS-specific targeting. RESULTS: The OPM functions as a shell structure, encapsulating multiple drug-loaded nanocores (BPQDs-DOX) and controlling the release rate of doxorubicin (DOX). Moreover, near-infrared light irradiation accelerates the release of DOX, thereby extending circulation time and enabling photostimulation-responsive release. The OPM encapsulation system improves the stability of BPQDs, enhances their photothermal conversion efficiency, and augments PTT efficacy. In vitro and ex vivo experiments demonstrate that BPQDs-DOX@OPM effectively delivers drugs to tumor sites with prolonged circulation time and specific targeting, resulting in superior anti-tumor activity compared to single-agent chemotherapy. Furthermore, these experiments confirm the favorable biosafety profile of BPQDs-DOX@OPM. CONCLUSIONS: Compared to single-agent chemotherapy, the combined therapy using BPQDs-DOX@OPM offers prolonged circulation time, targeted drug delivery, enhanced anti-tumor activity, and high biosafety, thereby introducing a novel approach for the clinical treatment of OS.

Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT) in Old Hip Fracture Patients.

BACKGROUND The aim of this study was to identify whether iliac vein compression syndrome (IVCS) is a risk factor for left-sided deep venous thrombosis (DVT) in hip fracture patients and the influence IVCS may have on the treatment of DVT. MATERIAL AND METHODS A retrospective study was carried out among 424 hip fracture patients admitted to our hospital from 2011 to 2016. Clinical data were analyzed, and all patients were classified into the DVT group and the non-DVT group based on plasmin D-Dimer concentration and results of Doppler ultrasound of the left lower limb. Also, a 50% intraluminal constriction of the left iliac vein in the venography image was considered as IVCS. Comparison of IVCS prevalence was made between the DVT group and the non-DVT group. Patients in the DVT group were further divided into the DVT+/IVCS+ group and the DVT+/IVCS- group to evaluate the influence IVCS may have on the treatment of DVT. RESULTS There were 204 patients in the DVT group and 220 patients in the non-DVT group. No statistically significant differences were found regarding the mean age, sex distribution, fracture type, and accompanying risk factors between the two groups. A total of 70 patients (34.3%) were diagnosed with IVCS in the DVT group, while confirmed IVCS was found in 52 patients (23.6%) in the non-DVT group (P=0.02). Postoperatively, the incidence of symptomatic DVT in the DVT+/IVCS+ group and the DVT+/IVCS- group was 30.0% and 11.9%, respectively (P=0.002). CONCLUSIONS IVCS is an under-recognized risk factor for left-sided DVT in hip fracture patients. What's more, anticoagulation alone is insufficient for the treatment of DVT when it is complicated with IVCS. More aggressive measures have to be taken to achieve a favorable outcome.

Clinical Outcome Evaluation of Primary Total Knee Arthroplasty in Patients with Diabetes Mellitus.

BACKGROUND The aim of this study was to evaluate the safety and clinical outcome of primary total knee arthroplasty in patients with diabetes mellitus. MATERIAL AND METHODS Among the patients who were treated with total knee arthroplasty, there were 98 patients (116 knees) associated with diabetes. Osteoarthritis was diagnosed in 90 patients and rheumatoid arthritis was diagnosed in 8 patients. Various degrees of preoperative knee deformities were found in 82 knees. The average fasting blood glucose was 9.8±3.6 mmol/L at admission. RESULTS The clinical efficacy of TKA was satisfactory in patients with diabetes mellitus. Diabetic patients do not seem to have a significantly higher risk for infection and DVT after TKA. At the final follow-up time point, no prosthesis loosening was found and no revision was needed in any patients. The mean HSS scores increased and the excellent rate was 100%. CONCLUSIONS Using perioperative comprehensive assessment of heart and lung function, and by preventing infection and the formation of DVT, we achieved satisfactory early clinical efficacy of TKA in patients with diabetes mellitus.

Intermittent pneumatic compression devices combined with anticoagulants for prevention of symptomatic deep vein thrombosis after total knee arthroplasty: a pilot study.

OBJECTIVES: To investigate the effectiveness of intermittent pneumatic compression (IPC) devices combined with anticoagulants for the prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA). PATIENTS AND METHODS: In total 120 patients were involved in this pilot study. Patients in the control group received 10 mg of rivaroxaban per day after surgery. In addition to the prescription of rivaroxaban, IPC devices were used in the experimental group. The diagnosis of DVT was made by compression duplex ultrasound on postoperative day 9. RESULTS: The incidence rates of overall, proximal, distal, and intermuscular DVT were 8.3%, 0%, 1.67%, and 6.67% in the experimental group; and 18.3%, 0%, 5%, and 13.33% in the control group, respectively. The incidence rates of total, distal, and intermuscular DVT in TKA patients was significantly lower in the experimental group than in the control group. For patients with DVT, enoxaparin was used instead of rivaroxaban, and DVT was found to have disappeared 10-14 days postoperatively. CONCLUSION: Compared with the use of rivaroxaban alone, IPC devices combined with anticoagulants can significantly reduce the incidence rate of distal DVT and intermuscular DVT in the early postoperative period after TKA.

Effect of leptin combined with CoCl2 on healing in Sprague Dawley Rat fracture model.

To evaluate the effect of leptin combined with CoCl2 on rat femur fracture healing. 48 male Sprague Dawley rats were randomly divided into two main groups. Then standardized femur fractures were created to all rats. Control group rats were treated with 0.5 mL physiological saline, and experimental group rats were treated with 5 µg/Kg.d leptin and 15 mg/Kg.d CoCl2 along with 0.5 mL physiological saline for 42 days intraperitoneally. Each main group was divided into three subgroups for each evaluation at second, fourth and sixth weeks, each subgroup included eight rats. The radiological evaluation showed that the fracture healing progress of experimental group was superior to control group from second week. At fourth week, experimental group had better fracture healing progress than control group significantly. Results of biomechanics show the ultimate load (N) and deflection ultimate load (mm) of experimental group was significantly increased than that in control group from fourth week. The present result demonstrated that leptin combined with CoCl2 significantly increased the mRNA expression levels of HIF1A, Vegfa, Runx2, Bmp2, Bglap and Alpl. It suggested that leptin combined with CoCl2 have a positive effect on rat femur fracture healing by activating the HIF1A pathway.

[Effect of indianhedgehog gene transfection into rabbit bone marrow mesenchymal stem cells in promoting chondrogenic differentiation and inhibiting cartilage aging in rotary cell culture system].

OBJECTIVE: ?To investigate the effect of overexpressing the Indianhedgehog (IHH) gene on the chondrogenic differentiation of rabbit bone marrow mesenchymal stem cells (BMSCs) in a simulated microgravity environment. METHODS: ?The 2nd generation BMSCs from rabbit were divided into 2 groups: the rotary cell culture system (RCCS) group and conventional group. Each group was further divided into the IHH gene transfection group (RCCS 1 group and conventional 1 group), green fluorescent protein transfection group (RCCS 2 group and conventional 2 group), and blank control group (RCCS 3 group and conventional 3 group). RCCS group cells were induced to differentiate into chondrocytes under simulated microgravity environment; the conventional group cells were given routine culture and chondrogenic induction in 6 well plates. During differentiation induction, the ELISA method was used to detect IHH protein expression and alkaline phosphatase (ALP) activity, and quantitative real-time PCR to detect cartilage and cartilage hypertrophy related gene expressions, and Western blot to detect collagen type Ⅱ, agreecan (ANCN) protein expression; and methylene blue staining and Annexin V-cy3 immunofluorescence staining were used to observe cell slide. RESULTS: ?After transfection, obvious green fluorescence was observed in BMSCs under fluorescence microscopy in RCCS groups 1 and 2, the transfection efficiency was about 95%. The IHH protein levels of RCCS 1 group and conventional 1 group were significantly higher than those of RCCS 2, 3 groups and conventional 2, 3 groups (P<0.05); at each time point, ALP activity of conventional 1 group was significantly higher than that of conventional 2, 3 groups (P<0.05); ALP activity of RCCS 1 group was significantly higher than that of RCCS 2 and 3 groups only at 3 and 7 days (P<0.05). Conventional 1 group expressed high levels of cartilage-related genes, such as collagen type Ⅱ and ANCN at the early stage of differentiation induction, and expressed high levels of cartilage hypertrophy-related genes, such as collagen type X, ALP, and Annexin V at the late stage (P<0.05). RCCS 1 group expressed high levels of cartilage-related genes and low levels of cartilage hypertrophy-related genes at all stages. The expression of collagen type Ⅱ protein in conventional 1 group was significantly lower than that of conventional 2 and 3 groups at 21 days after induction (P<0.05); RCCS 1 group expressed high levels of collagen type Ⅱ and ANCN proteins at all stages (P<0.05). Methylene blue staining indicated conventional 1 group was stained lighter than conventional 2 and 3 groups at 21 days after induction; while at each time point RCCS 1 group was significantly deeper than RCCS 2 and 3 groups. Annexin V-cy3 immunofluorescence staining indicated the red fluorescence of conventional 1 group was stronger than that of conventional 2 and 3 groups at each time point. The expression of red fluorescence in each RCCS subgroup was weak and there was no significant difference between the subgroups. CONCLUSIONS: ?Under the simulated microgravity environment, transfection of IHH gene into BMSCs can effectively promote the generation of cartilage and inhibit cartilage aging and osteogenesis. Therefore, this technique is suitable for cartilage tissue engineering.

Transfection of the IHH gene into rabbit BMSCs in a simulated microgravity environment promotes chondrogenic differentiation and inhibits cartilage aging.

The effect of overexpressing the Indian hedgehog (IHH) gene on the chondrogenic differentiation of rabbit bone marrow-derived mesenchymal stem cells (BMSCs) was investigated in a simulated microgravity environment. An adenovirus plasmid encoding the rabbit IHH gene was constructed in vitro and transfected into rabbit BMSCs. Two large groups were used: conventional cell culture and induction model group and simulated microgravity environment group. Each large group was further divided into blank control group, GFP transfection group, and IHH transfection group. During differentiation induction, the expression levels of cartilage-related and cartilage hypertrophy-related genes and proteins in each group were determined. In the conventional model, the IHH transfection group expressed high levels of cartilage-related factors (Coll2 and ANCN) at the early stage of differentiation induction and expressed high levels of cartilage hypertrophy-related factors (Coll10, annexin 5, and ALP) at the late stage. Under the simulated microgravity environment, the IHH transfection group expressed high levels of cartilage-related factors and low levels of cartilage hypertrophy-related factors at all stages of differentiation induction. Under the simulated microgravity environment, transfection of the IHH gene into BMSCs effectively promoted the generation of cartilage and inhibited cartilage aging and osteogenesis. Therefore, this technique is suitable for cartilage tissue engineering.