Molecular biological mechanism of acquired heterotopic ossification / 中国组织工程研究

BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

Neuroprotective effects of salvianolic acid B against Schwann cell injury induced by lipopolysaccharide / 中国组织工程研究

BACKGROUND:Salvianolic acid B is an effective monomer component of Salvia miltiorrhiza, which has been shown in recent years to have neuroprotective role and to promote nerve recovery, but its mechanism is not clear. OBJECTIVE: To explore the protective mechanism of salvianolic acid B on Schwann cels in rats with spinal cord injury. METHODS: Schwann cels of Sprague-Dawley rats were cultured and divided into normal control group, model group, 10 μmol/L methylprednisolone group and salvianolic acid B group (0.1, 1, 10, 100 μmol/L). Models of Schwann cel injury induced by lipopolysaccharide were established in al the groups except the normal control group. After intervention, growth curve and proliferative activity of Schwann cels were detected, and protein and gene expressions of β-catenin and nuclear factor-κB were observed. RESULTS AND CONCLUSION: At 48, 72, 96 hours after intervention, the cel viability of the model group was significantly lower than that of the normal control group (P < 0.01). Compared with the model group, the cel viability of salvianolic acid B group (10 μmol/L) was significantly increased at 72 and 96 hours (P < 0.05); the expressions of nuclear factor-κB protein and mRNA in the methylprednisolone group and salvianolic acid B group were declined significantly (P < 0.01), but the expressions of β-catenin mRNA and protein in the salvianolic acid B group significantly increased (P < 0.05). These results suggest that salvianolic acid B improves the viability of Schwann cels which are stimulated with lipopolysaccharide, suppresses expression of nuclear factor-κB mRNA and protein, and promotes the expression of β-catenin mRNA and protein. Above may be one of the mechanisms which salvianolic acid B protects Schwann cels.

Sensitivity and efficacy of intraoperative electromyography monitoring in combination with 3D imaging modality during complex lumbosacral procedures / 中国组织工程研究

MAIN OUTCOME MEASURES: Free running EMG and stimulus triggered EMG, including time, frequency, amplitude, muscle group were observed and recorded simultaneously. Never root functional injury and restoration after surgery were detected.RESULTS: 378 pedicle screws in 74 patients were monitored intraoperatively, and only 3 pedicle screw malposition (2 of L_4, 1 of L_5) was detected and then replaced with the help of C-arm fluoroscopic examination. Myoelectricity appeared when the current intensity was less than 10 mA. The correct rate of implantation was 99.2%. Nerve root impingement was found in two cases during laminectomy for L_5 and S_1 decompression and never root solution, which alerted the surgical team of critical neural structures. Nerve symptoms of the lower limb were aggravated after surgery and restored following 2-4 weeks of conventional treatment. The error injury rate of nerve root was 2.7%. In all reported cases, no irreversible neurological deficit was observed 2-4 weeks after operation.CONCLUSION: Intraoperative EMG monitoring can find improperly placed screws and detect impending nerve root injury promptly. Combined EMG and 3-D imaging modality monitoring is a reliable and practicable method that can be used to protect neural structures during complex lumbosacral surgery.

Preliminary evaluation of posterior dynamic lumbar stabilization in lumbar degenerative disease / 中国矫形外科杂志

[Objective] To evaluate the early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease.[Methods]The clinical outcomes of 31 patients with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion were retrospectively studied,and assessed with visual analogue scale(VAS)and spinal operative standard of Chinese Medical Association.The early effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded.[Results]The operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive.The VAS scores were 7.9?2.0,2.6?1.2 and 1.7?0.8 at one day preoperatively,two week postoperatively and final follow-up,respectively.The good to excellent result was 94.4% at the lastest follow-up.No compliction related with Wallis posterior dynamic lumbar stabilization was found.[Conclusion]It is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease,and the early effect is good.The Wallis system provides an alternative for treatment of lumbar degenerative disease.