[Comparison of clinical outcomes between arthroscopic modified Mason-Allen repair and suture-bridge repair for medium-size rotator cuff tears].

OBJECTIVE: To observe and compare the clinical outcomes between arthroscopic modified Mason-Allen repair and suture-bridge repair for medium-size rotator cuff tears. METHODS: From January 2017 to January 2018, 22 patients with medium-size rotator cuff tears underwent arthroscopic modified Mason-Allen repair. There were 9 males and 13 females with an average age of (57.14±10.26) years. From February 2018 to January 2019, 20 patients with medium-size rotator cuff tears underwent arthroscopic suture-bridge repair. There were 6 males and 14 females with an average age of (57.75±7.57) years. The preoperative and postoperative clinical function was assessed by American Shoulder and Elbow Surgeons (ASES) and Constant score system. The healing status of repaired rotator cuff was assessed using MRI. RESULTS: All patients were followed up, and the duration ranged from 24 to 33 months, with a mean of (26.38±2.29) months. In modified Mason-Allen group, AS###ES score and Constant score increased from (45.22±7.58) and (58.72±9.26) preoperatively to (96.89±3.49) and (93.18± 3.20) postoperatively. In suture-bridge group, ASES score and Constant score increased from(47.33±7.50) and (60.05±11.76) scores to (97.58±3.43) and (93.85±3.15). There were no significant differences in ASES score and Constant score between the two groups before and after operation. There were no significant differences in rotator cuff healing between the two groups. CONCLUSION: Both arthroscopic modified Mason-Allen and suture-bridge repair for treatment of medium-size rotator cuff tears could obtain good clinical outcomes, and there were no significant differences in clinical outcomes between the two techniques.

Bacillus subtilis revives conventional antibiotics against Staphylococcus aureus osteomyelitis.

As treatment of Staphylococcus aureus (S. aureus) osteomyelitis is often hindered by the development of antibiotic tolerance, novel antibacterial therapeutics are required. Here we found that the cell-free supernatant of Bacillus subtilis (B. subtilis CFS) killed planktonic and biofilm S. aureus, and increased S. aureus susceptibility to penicillin and gentamicin as well. Further study showed that B. subtilis CFS suppressed the expression of the genes involved in adhesive molecules (Cna and ClfA), virulence factor Hla, quorum sensing (argA, argB and RNAIII) and biofilm formation (Ica and sarA) in S. aureus. Additionally, our data showed that B. subtilis CFS changed the membrane components and increased membrane permeabilization of S. aureus. Finally, we demonstrated that B. subtilis CFS increased considerably the susceptibility of S. aureus to penicillin and effectively reduced S. aureus burdens in a mouse model of implant-associated osteomyelitis. These findings support that B. subtilis CFS may be a potential resistance-modifying agent for ß-lactam antibiotics against S. aureus.

Extracellular Vesicles: A Potential Biomarker for Quick Identification of Infectious Osteomyelitis.

Effective management of infectious osteomyelitis relies on timely microorganism identification and appropriate antibiotic therapy. Extracellular vesicles (EVs) carry protein and genetic information accumulated rapidly in the circulation upon infection. Rat osteomyelitis models infected by Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli were established for the present study. Serum EVs were isolated 3 days after infection. The size and number of serum EVs from infected rats were significantly higher than those from controls. In addition, bacterial aggregation assay showed that the S. aureus and E. coli formed large aggregates in response to the stimulation of serum EVs from S. aureus-infected and E. coli-infected rats, respectively. Treatment of EVs-S. epidermidis led to large aggregates of S. epidermidis and E. coli, whereas stimulation of EVs-P. aeruginosa to large aggregates of S. aureus and P. aeruginosa. To evaluate the changes in EVs in osteomyelitis patients, 28 patients including 5 S. aureus ones and 21 controls were enrolled. Results showed that the size and number of serum EVs from S. aureus osteomyelitis patients were higher than those from controls. Further analysis using receiver operating characteristic curves revealed that only the particle size might be a potential diagnostic marker for osteomyelitis. Strikingly, serum EVs from S. aureus osteomyelitis patients induced significantly stronger aggregation of S. aureus and a cross-reaction with P. aeruginosa. Together, these findings indicate that the size and number of serum EVs may help in the diagnosis of potential infection and that EVs-bacteria aggregation assay may be a quick test to identify infectious microorganisms for osteomyelitis patients.

Interleukin-6 suppression reduces tumour self-seeding by circulating tumour cells in a human osteosarcoma nude mouse model.

Tumour self-seeding by circulating tumour cells (CTCs) enhances tumour progression and recurrence. Previously, we demonstrated that tumour self-seeding by CTCs occurs in osteosarcoma and revealed that interleukin-6 (IL-6) may promote CTC attraction. Here, we investigated the underlying mechanisms of IL-6 in tumour self-seeding by CTCs. IL-6 suppression inhibited in vitro cell proliferation, migration, and invasion. In addition, rhIL-6 activated the Janus-activated kinase/signal transducers and activators of transcription 3 (JAK/STAT3) and mitogen-activated protein kinase/extracellular-signal regulated kinase1/2 (MAPK/ERK1/2) pathways in vitro. Both pathways increased cell proliferation, but only the JAK/STAT3 pathway promoted migration. Suppressing IL-6 inhibited in vivo tumour growth and metastasis. IL-6 suppression or JAK/STAT3 pathway inhibition reduced CTC seeding in primary tumours. Collectively, IL-6 promotes tumour self-seeding by CTCs in a nude mouse model. This finding may provide a novel strategy for future therapeutic interventions to prevent osteosarcoma progression and recurrence.

Meta-Analysis of Outcomes of a Single-Radius Versus Multi-Radius Femoral Design in Total Knee Arthroplasty.

BACKGROUND: Although the single-radius (SR) femoral design is known to have theoretical advantages in many aspects, studies of clinical outcomes that compare the SR with the multiple-radius (MR) femoral design are controversial. We performed a meta-analysis to address the hypothesis that a SR femoral design in primary total knee arthroplasty improves patient outcomes. METHODS: The meta-analysis identified 15 articles reporting the clinical outcomes of 2212 knee replacements using the SR (n = 948) compared with the multiradius (MR; n = 1361) femoral design. Comparing SR with MR, we examined the Knee Society Score for the knee (KSS-knee), KSS-function, knee flexion, range of motion, complications, isometric peak torque of knee, and survival rate. RESULTS: The range of motion of SR knees was lower than that of MR knees. No differences were found in the analyses of KSS-knee, KSS-function, knee flexion, complications, isometric peak torque of the knee, and survival rate. CONCLUSION: Our meta-analysis does not provide clinical support for the previously reported theoretical advantages of the SR implant design.

Experimental study on new self and mutual-aiding occlusive dressing for wound.

BACKGROUND: Self and mutual-aiding occlusive dressing is a novel method to treat with the wounds in special circumstances. This study aims to prepare a new antimicrobial adhesive for the dressing and evaluate the application effects of the adhesive. METHODS: The main component of the new antimicrobial adhesive was 5% triclosan / cyanoacrylate (CA) antimicrobial adhesive. The adhesive was modified with carboxylic multi-walled carbon nanotubes (MWCNTs-COOH), multi-walled carbon nanotubes (MWCNTs), hydrophobic nano-silica, nitrile rubber, epoxy resin and polymethyl methacrylate (PMMA) respectively. The bond strength, toughness and viscosity of the modified adhesive in different concentrations were examined to select the optimal modifying material and the best ratio to prepare the new antimicrobial adhesive according to the results. After that, the antimicrobial property of the new antimicrobial adhesive was tested by filter paper method. At last, we disposed the injury models in rats using the new antimicrobial adhesive to examine the application effects. RESULTS: In individual tests, the bond strength modification performance of 0.064% MWCNTS-COOH is the best, the bond strength is (14.71 ± 1.48) Mpa. 8% nano-silica shows the best toughness modification performance, the Tg is (1.10 ± 0.24)°C. The viscosity modification performance of 8% nano-silica is the best, the viscosity is (15 536.68 ± 28.4) cP. However, consolidating three test results, 6% nano-silica/antimicrobial adhesive has the balanced bond strength, toughness and viscosity. Its bond strength is (14.03±1.92) Mpa, the Tg is (3.60 ± 0.68)°C, and the viscosity is (5 278.87 ± 31.68) cP. The inhibition zone diameter of 6% nano-silica/antimicrobial adhesive and antimicrobial adhesive group in Day 5 is (28.61 ± 0.91) mm versus (28.24 ± 2.69) mm (P > 0.05). In animal studies, both in blood routine test and pathological section, 6% nano-silica/antimicrobial adhesive group shows lower white blood cells count than gauze bandage group (P < 0.05). CONCLUSIONS: 6% nano-silica has the optimal effect of bond strength modification, toughness modification and viscosity modification, and the antimicrobial adhesive modified with it has a good antimicrobial property (resistant staphylococcus aureus).