Protective effect and mechanism of zonisamide on oxygen-glucose deprivation cell model of traumatic brain injury / 中华急诊医学杂志

Objective:To explore the protective effect of zonisamide (ZNS) on oxygen-glucose deprivation (OGD) cell model of traumatic brain injury (TBI), and its underlying mechanism.Methods:Human neuroblastoma cells (SH-SY5Y) were cultured in vitro and divided into the control group, OGD group, and drug administration group (OGD+ZNS group) according to the random number table method. The OGD method was used to establish a TBI cell model. After modeling, the cell activity, the release of lactate dehydrogenase (LDH), and β-galactosidase staining were detected to evaluate cell function and senescence. Additionally, mitochondrial morphology and potential membrane changes were observed using Mito Tracker Red and JC-1 mitochondrial membrane potential staining. ATP concentration was measured, and protein was extracted from SH-SY5Y cells and then subjected to Western blot analysis to detect endoplasmic reticulum stress-related markers, including glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), protein disulfide isomerase (PDI), and β-actin.Results:The OGD group had a significantly lower cell survival rate compared to the control group ( P<0.01), while the OGD+ZNS group had a significant higher cell survival rate than the OGD group ( P<0.01). The LDH release rate was significantly higher in the OGD group than in the control group ( P<0.01), while the OGD+ZNS group had a significant lower LDH release rate compared to the OGD group ( P<0.01). Moreover, the cell staining results indicated that compared to the control and OGD+ZNS groups, the cells in the OGD group exhibited significant damage and senescence with darker staining while the mitochondrial staining results demonstrated a significant reduction in mitochondrial linear junctions and decreased mitochondrial activity in the OGD group compared to the control and OGD+ZNS groups. Compared to the control and OGD+ZNS groups, the OGD group exhibited a significant reduction in mitochondrial staining red fluorescence, a significant increase in green fluorescence, and a significant decrease in mitochondrial membrane potential. The OGD group demonstrated a significant decrease in ATP concentration compared to the control group ( P<0.01), whereas the OGD+ZNS group exhibited a significant higher ATP concentration compared to the OGD group ( P<0.01). Western blot analysis revealed significant upregulation of GRP78, CHOP, and PDI in the OGD group compared to the control group (all P<0.05), while in the OGD+ZNS group, the expression levels of these proteins were significantly downregulated compared to the OGD group (all P<0.05). Conclusions:Zonisamide can protect OGD TBI cell model by preserving mitochondrial activity and inhibiting endoplasmic reticulum stress.

Comparison of dynamic hip screw plus anti-rotation screw versus three cannulated compression screws in treatment of femoral neck fractures with comminuted posterior wall / 中华创伤骨科杂志

Objective:To compare the efficacy of 2 fixation modes [dynamic hip screw (DHS) plus anti-rotation screw versus 3 cannulated compression screws (CCS)] in the treatment of femoral neck fractures complicated with comminuted posterior wall.Methods:The data were analyzed retrospectively of the 109 patients who had been treated for femoral neck fractures complicated with comminuted posterior wall at Department of Orthopaedics, Shenzhen Hospital, University of Chinese Academy of Sciences from February 2017 to December 2019. They were divided into 2 groups according to 2 fixation modes. There were 42 males and 16 females with an age of 48.5 (40.0, 55.3) years in CCS group of 58 cases subjected to fixation with 3 CCSs; there were 31 males and 20 females with an age of 47.0 (38.0, 53.0) years in DHS group of 51 cases subjected to fixation with DHS plus anti-rotation screw. The length of incision, operation time, intraoperative bleeding, weight-bearing time for the affected limb, visual analog scale (VAS), hip Harris score, and incidence of postoperative complications were compared between the 2 groups.Results:The comparison of preoperative general data between the 2 groups was not statistically significant, showing comparability between groups ( P>0.05). In the CCS group, the incision length [3.0 (2.9, 4.5) cm] and operation time [90.0 (73.8, 125.0) min] were significantly shorter than those in the DHS group [10.0 (9.0, 12.0) cm and 135.0 (110.0, 165.0) min], the intraoperative bleeding [40.0 (10.0, 100.0) mL] was significantly less than that in the DHS group [200.0 (150.0, 300.0) mL], the partial and complete weight-bearing durations of the affected limb [12.0 (12.0, 13.0) weeks and 24.0 (21.0, 25.0) weeks] were significantly longer than those in the DHS group [11.0 (10.0, 12.0) weeks and 19.0 (18.0, 20.0) weeks], and the perioperative VAS pain score [2.0 (2.0, 3.0) points] was significantly lower than that in the DHS group [5.0 (4.0, 6.0) points], but the incidence of follow-up complications [56.9% (33/58)] was significantly higher than that in the DHS group [33.3% (17/51)] (all P<0.05). There was no significant difference between the DHS group and the CCS group in the excellent and good rate of Harris hip score at one year after operation [94.1% (48/51) versus 91.4% (53/58)] ( P>0.05). Conclusions:In the treatment of femoral neck fractures complicated with comminuted posterior wall, DHS plus anti-rotation screw and 3 CCSs can both result in fine therapeutic outcomes but a relatively high incidence of complications at late follow-up. However, the former fixation mode can shorten the weight-bearing time for the affected limb and reduce complications but is more invasive than the latter fixation mode.

Progress in research into tendon-to-bone attachment, from structure, development, treatment to animal models / 中华创伤骨科杂志

Tendon-to-bone attachment, the junction of tendon and bone, is a special complex structure which spreads stress from skeletal muscles to bone, effectively reducing the stress concentration and balancing elastic modulus between tendon and bone. Injury to its interface is a kind of trauma in sports, such as rotator cuff tear, ACL/PCL tear and the Achilles tendon injury. The enthesis is not regenerated after injury and the healing enthesis consists of disorganized scar tissue, resulting in a high rate of rupture recurrence. Given a high incidence of tendon and ligament injuries and complex structural and cellular composition of the native enthesis, the reparative strategies for tendon-to-bone attachment are facing great dificulties. Although injury to tendon-to-bone attachment is always a major concern and challenge in sports medicine, not much is known about its pathogenesis. In this review, we summarize the recent literature published at home and abroad from 4 perspectives of structure, development, treatment and animal models of enthesis. We hope this review may help clinical professionals understand more about the tendon-to-bone attachment.

Progress in research into tendon-to-bone attachment, from structure, development, treatment to animal models / 中华创伤骨科杂志

Tendon-to-bone attachment,the junction of tendon and bone,is a special complex structure which spreads stress from skeletal muscles to bone,effectively reducing the stress concentration and balancing elastic modulus between tendon and bone.Injury to its interface is a kind of trauma in sports,such as rotator cuff tear,ACL/PCL tear and the Achilles tendon injury.The enthesis is not regenerated after injury and the healing enthesis consists of disorganized scar tissue,resulting in a high rate of rupture recurrence.Given a high incidence of tendon and ligament injuries and complex structural and cellular composition of the native enthesis,the reparative strategies for tendon-to-bone attachment are facing great dificulties.Although injury to tendon-to-bone attachment is always a major concern and challenge in sports medicine,not much is known about its pathogenesis.In this review,we summarize the recent literature published at home and abroad from 4 perspectives of structure,development,treatment and animal models of enthesis.We hope this review may help clinical professionals understand more about the tendon-to-bone attachment.

Current research on tendon calcification / 中华创伤骨科杂志

Tendon calcification,a common clinical disease,is often complicated after tendon injury or surgery,or as a special manifestation of tendinopathy.It is also one manifestation of acquired heterotopic ossification.However,there are no preventive measures for tendon calcification in clinical treatment as its pathogenesis is still unclear.In addition,the domestic orthopedic surgeons have paid little attention to this issue yet.To enhance understanding of tendon calcification,we have summarized the relevant literature published in recent years.

Combination of bone cement filling and plate internal fixation with limb salvage is used for metastatic malignant bone tumors☆ / 中国组织工程研究

BACKGROUND:Currently, limb salvage therapy has become the standard treatment of malignant bone tumors way, but improper treatments wil result in tumor recurrence, secondary infection, internal fixation or prosthesis loosening. OBJECTIVE:Based on the traditional surgical principle for metastatic bone tumors of the limbs, this study designed a user-friendly, individualized, simplistic pal iative treatment regimen from the actual conditions of patients to observe the reasonability, clinical efficacy and prognosis of bone cement fil ing combined with internal fixation in the treatment of metastatic malignant bone tumors. METHODS:Thirty-one patients with metastatic malignant bone tumors who required salvage treatment were screened from the Department of Orthopedics, the 421 Hospital of Chinese PLA, and their clinical data were retrospectively analyzed. Al the 31 patients were divided into two groups:tumor removal+internal fixation group (non-chemoradiotherapy group, n=11) treated with bone cement fil ing plus plate internal fixation (pal iative treatment);tumor removal+internal fixation+chemoradiotherapy group (chemoradiotherapy group, n=20), treated with radiotherapy before internal fixation plus plate internal fixation with limb salvage. The fol ow-up period was 4-38 months, averagely 18 months. RESULTS AND CONCLUSION:The fol ow-up results showed that in the non-chemoradiotherapy group, al the 11 patients survived, who could live independently and have good motor functions;in the chemoradiotherapy group, 17 of the 20 patients survived and the rest three patients died of tumor metastasis, their poor conditions and complications at 9 and 13 months after internal fixation. In patients undergoing tumor removal+plate internal fixation with limb salvage, the integrated scores for nerve and motor functions were increased by more than level 1. These findings confirm that a simple pal iative therapy of bone cement fil ing and internal fixation without chemoradiotherapy is better for metastatic malignant bone tumors patients who require limb salvage.