Internal fixation of lateral and medial borders for displaced scapular body fractures via minimally invasive approach:results of 23 cases / 浙江大学学报·医学版

OBJECTIVE: To evaluate the efficacy of internal fixation of lateral and medial borders for displaced scapular body fractures via the minimally invasive approach. METHODS: The internal fixation of lateral and medial borders via minimally invasive approach was applied in surgical treatment of 23 patients with scapular body comminuted fractures from January 2014 to June 2018. The lateral approach was made straightly orienting over the lateral border of scapula. The dissection was taken down to the deltoid fascia. The deltoid was retracted cephalically, revealing the external rotators. Blunt dissection was used down to the lateral border between infraspinatus and teres minor, exposing the fracture site. The medial incision was done along the medial border of the scapula over site of the fracture. Dissections were taken down to the fascia and the periosteum. A subperiosteal dissection was then performed to elevate the infraspinatus to the degree necessary to visualize the fracture. The medial and lateral borders of scapula body were fixed with plates and screws in a frame-like way. RESULTS One patient developed the delayed healing of the incisions due to liquefactive fat necrosis. The other 22 patients showed no complications of the incisions. The glenopolar angle (GPA) of fractured scapula was increased from preoperative (25±12) degrees to postoperative (41±5) degrees (P<0.01). The healing time of fractures healed was 3-8 months, with an average time of (4.4±1.3) months. CONCLUSIONS The lateral-medial combined fixation through minimally invasive surgical approach for the scapula body fractures allows visualization of fracture reduction without extensive muscular or subcutaneous flaps, and is associated with successful fracture healing and high functional scores of the shoulder.

miR-1301/TRIAP1 Axis Participates in Epirubicin-Mediated Anti-Proliferation and Pro-Apoptosis in Osteosarcoma

PURPOSE: Epirubicin is one of the most effective drugs against osteosarcoma. miR-1301 is involved in the occurrence and development of osteosarcoma. Whether miR-1301 is responsible for the chemosensitivity of osteosarcoma cells to epirubicin remains largely unknown. MATERIALS AND METHODS: U2OS and SAOS-2 cells were treated with various concentrations of epirubicin. Flow cytometry was employed to evaluate cell apoptotic rate. Cell proliferation was measured by Cell Counting Kit-8 assay. Western blot and quantitative real-time polymerase chain reaction were utilized to detect the expressions of B-cell lymphoma-2 (Bcl-2), Bcl-2 assaciated X protein (Bax), cleaved-caspase-3, cleaved-poly (ADP-ribose) polymerases (PARP1), TP53-regulated inhibitor of apoptosis 1 (TRIAP1), and microRNA-1301 (miR-1301). The relationship between miR-1301 and TRIAP1 was determined by luciferase reporter assay. RESULTS: Epirubicin inhibited proliferation in a dose-dependent manner, induced apoptosis, decreased the expression of Bcl-2, and increased the expressions of Bax, cleaved-caspase-3, and cleaved-PARP1 in osteosarcoma cells. miR-1301 was downregulated in U2OS and SAOS-2 cells. Importantly, epirubicin significantly increased the levels of miR-1301. Overexpression of miR-1301 suppressed proliferation and promoted apoptosis. Interestingly, those effects were enhanced by epirubicin. In contrast, miR-1301 depletion attenuated the epirubicin-mediated anti-osteosarcoma effect. miR-1301 negatively regulated the expression of TRIAP1 in U2OS and SAOS-2 cells. Furthermore, epirubicin inhibited the mRNA and protein levels of TRIAP1 by upregulating miR-1301 levels. Epirubicin suppressed cell proliferation by downregulating TRIAP1. CONCLUSION: miR-1301 was implicated in the chemosensitivity of osteosarcoma to epirubicin by modulating TRIAP1.

A meta-analysis of unilateralversus bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer complications. OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software. RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24); MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.

Relationships of plasma homocysteine levels and other clinical indexes with the polymorphisms of MTHFR gene C677T among the young people in Shenzhen area / 中国组织工程研究

BACKGROUND:Hyperhomocysteine can be caused by 5,10-methylene tetrahydrofolate reductase (MTHFR) gene mutation, and HHcy is the independent risk factor for cerebral stroke. OBJECTIVE:To study the correlation between plasma homocysteine level and polymorphisms of MTHFR gene C677T of young people in Shenzhen area, and to explore the relationships of plasma hyperhomocysteine level with other clinical indicators. METHODS:A total of 101 cases with hyperhomocysteine were col ected as experimental group, and 101 cases with normal homocysteine level served as control group (20-45 years old). Genomic DNA was extracted with magnetic nanoparticles method from mouth swab samples of 202 cases. Then the DNA was amplified into target gene fragment by PCR, and amplification product was then sequenced. RESULTS AND CONCLUSION:The frequencies of CC, CT, TT genotype of MTHFR C677T showed significant differences between the experimental group and the control group (P<0.01). This evidence indicates that the polymorphisms of MTHFR gene C677T can influence plasma homocysteine level of young people in Shenzhen area;TT genotype frequencies and T al ele frequencies in the experimental group were higher than that of control group. Besides, the plasma homocysteine level of TT genotype was significantly higher than that of CT genotype and CC genotype in the experimental group (P<0.05). We can conclude that TT genotype can improve the homocysteine level more than CT genotype;The systolic blood pressure and diastolic blood pressure in the experimental group were significantly higher than that in the control group (P<0.05). It indicated that hyperhomocysteine can induce the elevation of blood pressure level;but it is not sure that hyperhomocysteine can increase cholesterol level in our study.