Clinical effect of cement-enhanced APFN in the treatment of elderly osteoporotic intertrochanteric fractures.

OBJECTIVE: To explore the clinical effect of bone cement-enhanced Asian proximal femoral anti-rotation intramedullary nail (APFN) internal fixation in the treatment of elderly osteoporotic intertrochanteric fractures of the femur and provide it as a more robust treatment to elderly patients with osteoporotic intertrochanteric femoral fractures. PATIENTS AND METHODS: Between January 2017 and January 2019, 42 patients with osteoporotic intertrochanteric fractures in our hospital were selected. All patients were randomly divided into the proximal femoral anti-rotation intramedullary nail (PFNA) group and APFN group. The PFNA group received conventional PFNA internal fixation, and the APFN group received bone cement-enhanced APFN internal fixation. The operation time, intraoperative blood loss, average fracture healing time, weight bearing time, and hip function recovery of the two groups of patients were evaluated. RESULTS: All patients were followed up. There was no significant difference in intraoperative blood loss between the two groups. Compared with the PFNA group, the weight-bearing time and hospital stay of the APFN group were significantly shorter. According to the Harris score of hip joint function, the excellent and good rate of the APFN group was better than that of the PFNA group. CONCLUSIONS: Compared with conventional PFNA internal fixation, cement-enhanced APFN internal fixation has the advantage of early functional reconstruction in the treatment of osteoporotic femoral intertrochanteric fractures. It can significantly shorten the time required for patients to get out of bed and bear weight. It is an effective method for the treatment of osteoporotic femoral intertrochanteric fracture.

Wnt5a promotes differentiation of human dental papilla cells.

AIM: To investigate the role of Wnt5a in the process of differentiation of human dental papilla cells (HDPCs). METHODOLOGY: Recombinant adenovirus encoding full-length Wnt5a cDNA was constructed to investigate the biological role of Wnt5a on the differentiation of HDPCs. The effect of Wnt5a on HDPCs differentiation was determined by ALP activity assay, ALP staining and mineral induction assay. Mineralization-related gene expressions were assessed by RT-PCR. RESULTS: Immunostaining revealed Wnt5a expression in the odontoblast layer and dental papilla tissue. Over-expression of Wnt5a by transfecting HDPCs with an Wnt5a-carrying construct increased ALPase activity and the formation of mineralized nodules of HDPCs. RT-PCR analysis showed that the expressions of mineralization-related genes, such as bone sialoprotein, collagen type I, osteonectin, osteopontin (OCN), dentine matrix protein-1 were up-regulated by Wnt5a. CONCLUSIONS: Wnt5a promoted differentiation of HDPCs.

Expression of Wnt5a in tooth germs and the related signal transduction analysis.

OBJECTIVE: Wnt5a is generally considered a non-canonical Wnt family member and plays an important role in the development of several tissues through regulation of cell fate, proliferation, migration, polarity and death. This study investigates its expression mode in human tooth development and the involved cell signal transduction pathways, as they remain unclear. DESIGN: The expression of Wnt5a was analyzed by immunohistochemistry method. Recombinant adenovirus encoding full-length Wnt5a cDNA was constructed to investigate four cell signal pathways and nine dentinogenesis nuclear transcription factors in response to Wnt5a in human dental papilla cells (HDPCs). RESULTS: Immunostaining revealed that Wnt5a was expressed in enamel epithelium cells from the bud stage, and in odontoblast layers and dental papilla tissues from early bell stage of human tooth development onward. Western blot analysis indicated that p42/44 MAPK, p38 MAPK, JNK and AKT signal pathways could be phosphorylated by WNT5A. RT-PCR analysis showed that Wnt5a increased the expression of DLX1, DLX2, LEF1, MSX2, PAX9 and RUNX2 mRNA, but decreased BARX1 and PITX2 mRNA. CONCLUSIONS: It was concluded that WNT5A is expressed in human tooth development, and that p42/44 MAPK, p38 MAPK, JNK and AKT signal pathways and DLX1, DLX2, LEF1, MSX2, PAX9, RUNX2 could be activated by Wnt5a.

WNT5A inhibits human dental papilla cell proliferation and migration.

WNT proteins are a large family of cysteine-rich secreted molecules that are linked to both canonical and non-canonical signal pathways, and have been implicated in oncogenesis and tissue development. Canonical WNT proteins have been proven to play critical roles in tooth development, while little is known about the role of non-canonical WNT proteins such as WNT5A. In this study, WNT5A was localized to human dental papilla tissue and human dental papilla cells (HDPCs) cultured in vitro, using immunochemistry and RT-PCR. Recombinant adenovirus encoding full-length Wnt5a cDNA was constructed to investigate the biological role of WNT5A on HDPCs. The BrdU incorporation assay, the MTT assay and flow cytometric analysis showed that over-expression of Wnt5a strongly inhibited the proliferation of HDPCs in vitro. Wound healing and transwell migration assays indicated that over-expression of WNT5A reduced migration of HDPCs. In conclusion, our results showed that WNT5A negatively regulates both proliferation and migration of HDPCs, suggesting its important role in odontogenesis via controlling the HDPCs.