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Hereditary multiple exostoses (HME) are benign bone tumors characterized by autosomal dominant inheritance, which can cause skeletal malformation in adolescents, seriously affecting the body's aesthetic and motor functions. Currently, there are no guidelines for diagnosing and treating HME, and the main treatment is surgical treatment to remove the tumor and correct the deformity. However, osteochondroma is multiple and difficult to be completely resected. Therefore, more and more scholars are exploring the method of conservative treatment. However, the current understanding of the pathogenesis of HME is limited, and there are no safe and effective drugs in the clinic. Most hypotheses regarding the pathogenesis of HME are based on genetic mutations. Patients with HME may have EXT tumor suppressor gene mutations and function loss caused by secondary mutations such as loss of gene heterozygosity, which ultimately induce abnormal proliferation and differentiation of cartilage in growth plates. Abnormal EXT gene expression causes a decrease in the level of heparan sulphate (HS), leading to abnormalities in multiple molecular pathways that regulate the development and differentiation of growth plate chondrocytes, which together participate in the entire process of HME development and progression. This paper reviews the relevant studies on the pathogenesis of HME in recent years, in order to better understand the pathological process of HME, provide a theoretical basis for the diagnosis and treatment of HME, and also provide ideas for the development of drugs targeting HME.
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Osteosarcoma needs to continuously induce angiogenesis to satisfy its own nutritional supply in the process of development. Therefore, the inhibition of osteosarcoma cell-induced angiogenesis as a target has become a research hot in recent years. Currently, vascular inhibitors targeting mRNA-encoded protein have been applied in clinic, but the efficacy is poor. Non-coding RNA (ncRNA) is a type of RNA molecules that do not participate in protein coding. ncRNA can regulate the angiogenesis of osteosarcoma by regulating the secretion of vascular factors such as vascular endothelial growth factor, angiogenin-2 and hypoxia-inducible factor 1 or the interaction between ncRNAs. This article reviews the role of ncRNA in the angiogenesis of osteosarcoma to provide references for clinical targeted therapy strategies for osteosarcoma.
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The Kickstand technique is an extension added to the basic frame of modern external fixation to elevate an affected extremity. It is an affordable and modified external fixation in orthopedic trauma. Orthopedic physicians use this technique to prevent formation of pressure sores and relieve swelling in lower extremity of patients who require prolonged bed rest, because this technique makes the heel apart from the supporting surface and promotes circulation of venous blood lymph fluid. This paper briefly introduces the development of this technique and its efforts to improve quality of care and solve a clinical problem. To relieve the burden of healthcare for pressure sores and swelling in an affected lower extremity after surgery, this technique should be popularized.
ABSTRACT
The Kickstand technique is an extension added to the basic frame of modem external fixation to elevate an affected extremity.It is an affordable and modified external fixation in orthopedic trauma.Orthopedic physicians use this technique to prevent formation of pressure sores and relieve swelling in lower extremity of patients who require prolonged bed rest,because this technique makes the heel apart from the supporting surface and promotes circulation of venous blood lymph fluid.This paper briefly introduces the development of this technique and its efforts to improve quality of care and solve a clinical problem.To relieve the burden of healthcare for pressure sores and swelling in an affected lower extremity after surgery,this technique should be popularized.
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Perthes disease is a hip lesion caused by vascular disorders in the femoral head of children.Although the disease is a self-limited disease,but often residualvary degrees of femoral head deformity,leading to early osteoarthritis.It is currently believed that the lesions of Perthes disease are mainly located in the femoral head.However,some studies demonstrated that patients with Perthes disease also appearvary degrees of acetabular morphological changes.In recent years,the acetabular retroversions were found in 31-60％ of patients with Perthes disease.The acetabular retroversion is a pathological anatomical variation of the acetabulum in the horizontal plan.It is related to the occurrence of the femoracetabular impingement and osteoarthritis.Many studies showed that the patients with poor prognosis (Stulberg Ⅲ,Ⅳ or Ⅴ) are associated with a higher prevalence of acetabular retroversion.The grading and the age of onset of Perthes disease are important factors affectingprognosis.Although existing studies illustrate that the lateral column grading,gender and age are not associated with the acetabular retroversion of Perthes disease significantly,the cases of the studies are limited and further researches are expected.Surgery containment therapy is an important wayto treat Perthes disease.The pelvic osteotomy can directly change the shape of the acetabulum and cause the acetabular retroversion,which result inthe femoracetabular impingement.The acetabular retroversion should be avoided as much as possible intraoperatively.Further research should be focused on whether the surgical interventions and the subsequent biomechanical changes could induce the acetabular retroversion.The cause of the acetabular retroversion in patients with Perthes disease is unclear.In order to elucidate the occurrence and development of acetabular retroversionin Perthes disease,some scholars found thataccompanying femoral head deformity,acetabular anteversion angleand inclinationdecreased significantly,and thecoverage angle in the superior,posterior,and inferior quadrants alsogradually reduced in animal studies.This is similar to clinical observations.This article reviews the progress of acetabular retroversion in Perthes disease by summarizing the relevant literatures.We hope to givenew insights for the etiology and pathology of Perthes disease,and provide new ideas for the treatment and prevention of the femoracetabular impingement and early osteoarthritis.
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Objective To study the distribution and the characteristic of elbow fractures in children according to the age,sex,year,season and anatomical location.Methods The data of pediatric elbow fractures which were treated either in outpatient department or hospitalized in the First Affiliated Hospital of Guangxi Medical University between January 2011 and December 2016 were collected.The distribution and characteristics of the fractures were analyzed by using SPSS 18.0 software and Excel 2010.Results A total of 613 patients with elbow fractures (628 different anatomical sites) were registered.The incidence seemed to increase by each year.Among them,414 cases were male and 199 cases were female (male/female ratio 2.08 ∶ 1.00).There were 3 distinct peaks which were respectively at the ages of 1,3 and 5.The fractures happened frequently from April to October.The most common type was supracondylar fracture of humerus(71.29％,437/613 cases),followed by lateral condylar fracture of humerus(14.68％,90/613 cases),olecranon fracture(3.26％,20/613 cases) and radial neck fracture (2.28％,14/613 cases).The most common cause of injury was falling on the same level (67.54％,414/613 cases),followed by dropping from heights (16.64％,102/613 cases),then sports injury (7.83％,48/613 cases),traffic accidents (5.55％,34/613 cases) as well as some intentional injuries (0.65％,4/613 cases).Conclusions The highest incidence of elbow fracture was found in children around 1 year,and 3-6 years.Boys are more affected than girls,probably attributed to their active nature.Fractures are more frequent in summer in which supracondylar fracture of humerus is the most common type.Most fractures occur after falling on the same level,indicating how easy it is to get injured in children.So careful examination is necessary to all the pediatric cases who came with a history of fall.Attention should be paid to intentional injuries especially so as to rule out if the cases belong to brutal abuse.
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Objective To study the protective effects of parathyroid hormone (PTH) on radiationinduced hematopoietic damage in mice.Methods A total of sixty male C57 mice were irradiated by 60Co γ-rays to induce hematopoietic injuries,and then the mice were randomly divided into PTH and control group.The PTH-treated group was treated with PTH ( 80 μg· kg- 1 · d - 1 ) intraperitoneally everyday.The control group was given equivalent volume saline.Peripheral blood cell number,bone marrow mononuclear cell number,granulocyte-macrophage colony forming units ( CFU-GM ) and CD34 positive cells in bone marrow were detected.Results With the whole post-irradiation period,the WBC and bone marrow mononuclear cell numbers in PTH-treated mice were significantly higher than those in saline-treated mice (t=6.32,9.19,11.18,7.44 and 4.42,P ＜ 0.05).The RBC numbers in PTH-treated mice were significantly higher than those in control mice at 10 d,15 d and 20 d post-irradiation (t =6.48,3.66 and 4.98,P ＜0.05 ).The PLT numbers in PTH-treated mice were significantly higher than those in control group at 5 and 30 d post-irradiation ( t =2.57 and 3.10,P ＜ 0.05 ).PTH increased CD34 positive cell and CFU-GM numbers in bone marrow after irradiation ( t =16.12,7.82 and 20.00,P ＜ 0.05 ).Conclusions PTH could improve the hematopoietic recovery after irradiation.
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BACKGROUND:To construct tissue engineering cartilage would open up a novel way for the repair of cartilage damage in avoidance of the disadvantages of traditional therapeutic method.OBJECTIVE: To probe the techniques for the isolation of mesenchymal stem cells (MSCs) from bone marrow, as well as the in vitro differentiation into chondrocytic phenotype in a specific culture fluid.DESIGN:A complete randomized experimentSETTING:The Department of Traumatic Orthopedics and Hand Surgery of the First Affiliated Hospital of Guangxi Medical University, and Teaching and Research Faculty of Histology and Embryology of Guangxi Medical University.METHODS: The experiment was carried out at Guangxi Medical University between August 2002 and April 2003. Twenty SD neonatal weaning rats were selected. Bone marrow was aspirated from the bones of rat limbs and was isolated by gradient centrifugation in Percoll, and MSCs could be obtained in combination with adherent screening method, which were then cultured in DMEM-LG with 15% fatal bovine serum (FBS) in the incubator of 37℃ with 5% CO2 for 10-14 days. The passage cells were induced in DMEM-HG with 15% FBS (containing TGF-β1 10 μg/L, 10-7 mol/L dexamethasone, 50 mg/L VitC).MAIN OUTCOME MEASURES :The morphology, growth, as well as proliferation and specific expression of chondrogenic matrix of in vitro cultured MSCs due to specific induction.RESULTS: Totally 20 SD rats were observed and analyzed with no loss SCs grew in visible symmetric colonies, displaying a long-spindle shape,and the morphological characteristics of marrow-derived MSCs had no obvious changes during passage-culture, but its proliferation time was found from a shuttle fibroblastic appearance to polygonal shape, displaying posiHC staining of type Ⅱ collagen of cartilage specific matrix.bronectin adherent screening technique is a convenient, effective and practical method to separate and collect MSCs from rat bone marrows in chondrogenic phenotype when induced by a specific medium and can secrete cartilage specific matrix, and they can be the optimal seed cells for cartilage tissue engineering.
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Objective To investigate the effect of vitamin D (VD) on macrophage to phagocytize Staphylococcus aureus (SA). Method Macrophoge cell lines RAW264.7 were allocated into 3 groups:control group(C),bacterium group(B),active vitamin D+ bacterium group (VD+B). Cells in the VD+B group were incubated with 10-8mol/L active vitamin D for 24h,then cells in the VD+B group and the B group were cultured with SA for 1h,and phagocytosis rate,mitochondrial membrane potential,[Ca～(2+)]i,reactive oxygen species were determined by flow cytometry (FCM). Results The phagocytizing activity of macrophage in VD+B group was significantly higher than that in B group 1h after infection,At the same time,the mitochondrial member potential and [Ca～(2+)]i of macrophage in VD+B group were distinctly lower than that in B group; but reactive oxygen species of macrophage in the VD+B group was insignificantly different from B group. Conclusion Vitamin D can reinforce the phagocytizing activity of macrophage and inhibit the apoptosis of macrophage after phagocytize Staphylococrcus aureus.