Skimmianine as a novel therapeutic agent suppresses proliferation and migration of human esophageal squamous cell carcinoma via blocking the activation of ERK1/2.

Esophageal squamous cell carcinoma (ESCC), one of the main histopathological subtypes of esophageal cancer (EC), is characterized by high morbidity and mortality. Clinical treatment for ESCC lacks specific molecular targets and effective therapeutic drugs. Skimmianine (SK), one of the natural fluroquinolone alkaloids, is widely present in Rutaceae family plants. Here, we mainly used CCK-8 assay, clone formation, flow cytometry analysis, wound-healing assay, Transwell assay, western blot, quantitative real-time PCR (qRT-PCR), molecular docking analysis, tumor xenograft assay, and immunohistochemistry (IHC) staining to investigate the potential anti-tumor effect of SK on ESCC. We demonstrated that SK inhibited the proliferation of TE-1 and Eca109 cells via inducing the G0/G1 phase cell cycle arrest, prevented the migration and invasion of tumor cells via regulating epithelial-mesenchymal transition (EMT) in vitro. In addition, SK obviously suppressed the growth of xenografted Eca109 tumors in nude mice. The anti-tumor mechanism of SK could be blocking the activation of extracellular signal-regulated kinases 1/2 (ERK1/2) in the mitogen-activated protein kinase (MAPK)/ERK signaling pathway. Our basic research suggests that SK can be a potential therapeutic agent for ESCC.

The Management of Missed Median Nerve Laceration After Pediatric Both-Bone Forearm Fracture: A Case Report.

CASE: A 12-year-old girl presented with a both-bone forearm fracture after a fall. Fracture healing occurred, but nerve injury was not addressed until 18 months after injury. Magnetic resonance imaging and electromyography yielded a median nerve injury, and she underwent nerve reconstruction with sural nerve grafting. She improved but continued to have deficits beyond her 1-year follow-up. CONCLUSION: Both-bone forearm fractures are a common fracture pattern with rare complications. Clinicians should have a high index of suspicion with persistent nerve symptoms and consider further investigation, given the importance of early nerve repair.

Entrapment of the Extensor Indicis Proprius Tendon after Open Reduction and Internal Fixation of Distal Ulna: Case Report and Discussion of the Diagnosis and Surgical Result.

Entrapment of the extensor indicis proprius (EIP) after open reduction and internal fixation (ORIF) of the distal ulna with a plate and screw construct is rare. By literature review, we found evidence of such complication associated with distal radius fracture, but no past reports relating to the distal ulna. ORIF of the distal ulna is a common procedure for both fracture treatment and deformity correction. Due to the EIP muscle originating primarily from the dorsoradial surface of the distal ulna and the adjacent interosseous membrane, the muscle may be damaged or compressed by a fixation plate during ORIF, resulting in entrapment. We present two case reports of this rare complication, describing the method of clinical diagnosis, surgical treatment, and outcome. Our accompanying cadaver dissection provides an explanation for proper plate positioning during ORIF of the ulna to reduce the risk of EIP entrapment.

Modified V-Y Turndown Flap Augmentation for Quadriceps Tendon Rupture Following Total Knee Arthroplasty: A Retrospective Study.

BACKGROUND: Quadriceps tendon rupture following total knee arthroplasty (TKA) is an infrequent but potentially devastating adverse event. Although uncommon, the long-term sequelae of this injury can result in permanent inability to walk. Despite the severity of this injury, there is no single accepted treatment, with various surgical methods producing mixed results. Therefore, the purpose of this study was to assess the efficacy of a modified V-Y turndown flap as a viable alternative method of treatment for this injury. METHODS: Twenty-four quadriceps tendon ruptures in 23 patients (10 men and 13 women) who underwent TKA (8 primary and 15 revision), including 1 tendon rerupture, were treated with use of a modified V-Y turndown. The average patient age at the time of the V-Y flap repair was 61 years (range, 41 to 86 years). Knee Society scores, range of motion, strength, medical comorbidities, nature of the procedure (i.e., primary versus revision), and the ability to walk were all recorded before and after the quadriceps reconstruction, along with general satisfaction and adverse events following the procedure. RESULTS: Twelve patients (52%) had predisposing comorbidities, including obesity, diabetes, chronic dialysis, and steroid dependence. Prior to repair with the V-Y flap, none of the patients were able to walk independently, requiring either a wheelchair or walker. No patient had quadriceps strength greater than 3 (of 5), although all had full passive extension. Following the repair procedure, patients had significant (p < 0.0001) improvements in mean Knee Society knee score (88.7; range, 45 to 95) and mean strength (4.8; range, 3 to 5), and all were able to walk without assistive devices. Twenty knees exhibited active range of motion of 0° to 120°, whereas 4 had residual extensor lag of ≥5° (range, 5° to 35°). Major adverse events were limited to a single hematoma and an unacceptable extensor lag (35°) after repair. CONCLUSIONS: The modified V-Y quadriceps tendon turndown flap was a reliable alternative treatment for achieving restoration of the extensor mechanism after complete quadriceps tendon rupture following TKA. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Selective Denervation for Persistent Knee Pain After Total Knee Arthroplasty: A Report of 50 Cases.

BACKGROUND: Despite the general success of total knee arthroplasty (TKA), up to 20% of patients report dissatisfaction following surgery. One potential cause of this dissatisfaction is residual pain secondary to neuroma formation in the sensory nerve branches that innervate the knee. We found, after performing a retrospective review, that up to 9.7% of patients following primary TKA and up to 21% of revision cases exhibited persistent knee pain attributable to neuroma formation. Despite the high incidence of this pathology, little is known about the effective diagnosis or treatment of neuroma formation following TKA. METHODS: Between 2011 and 2014, 50 patients with persistent symptomatic neuroma pain following TKA underwent selective denervation. These patients had demonstrated the appropriate selection criteria and had failed conservative management. Patients were evaluated by the visual analog scale pain score and the Knee Society Score to determine the outcome of the described treatment. RESULTS: Thirty-two patients (64%) rated their outcome as excellent, 10 (20%) as good, 3 (6%) as fair, and 2 (4%) reported no change. The mean visual analog scale pain score was improved from 9.4 ± 0.8 to 1.1 ± 1.6 following surgery (P ≤ .001). The mean Knee Society Scores increased from 45.5 ± 14.3 to 94.1 ± 8.6 points (P ≤ .0001). Three patients (6%) required the second neurectomy due to recurrent pain and received excellent pain relief postoperatively. There were 2 complications of superficial skin peri-incisional hyperemia related to dressings. Average follow-up duration was 24 months (range, 16-38 months). CONCLUSION: Our study suggests that selective denervation provides an effective and long-lasting option for the management of this pathology.

Knockdown of PFTK1 Expression by RNAi Inhibits the Proliferation and Invasion of Human Non-Small Lung Adenocarcinoma Cells.

PFTK1 (PFTAIRE protein kinase 1), also named CDK14 (cyclin-dependent kinase 14), is a member of the cell division cycle 2 (CDC2)-related protein kinase family. It is highly expressed in several malignant tumors. However, the role of PFTK1 in the progression of non-small cell lung cancer (NSCLC) is still elusive. In this study, we aimed to explore the expression and function of PFTK1 in NSCLC cells. Our results showed that PFTK1 was significantly upregulated in human NSCLC cell lines. Silencing the expression of PFTK1 inhibited the proliferation of NSCLC cells. In addition, silencing the expression of PFTK1 endowed NSCLC cells with decreased migration and invasion abilities, as well as epithelial-mesenchymal transition (EMT) progress in A549 cells. A mechanistic study showed that knockdown of PFTK1 inhibited the expression of ß-catenin, cyclin D1, and c-Myc in A549 cells. In summary, we report that small interfering RNA (siRNA)-PFTK1 might inhibit the proliferation and invasion of NSCLC cells by suppressing the Wnt/ß-catenin signaling pathway. Therefore, PFTK1 may represent a novel therapeutic target for the treatment of NSCLC.

Increased osteopontin protein expression may be correlated with poor prognosis in non-small-cell lung cancer: A meta analysis.

AIM: The present meta-nalysis investigates the prognostic value of osteopontin. (OPN) expression in patients with non-small-cell lung cancer. (NSCLC). MATERIALS AND METHODS: The Web of Science (1945 ~ 2013), the Cochrane Library Database (Issue 12, 2013), PubMed (1966 ~ 2013), EMBASE (1980 ~ 2013), CINAHL (1982 ~ 2013), and the Chinese Biomedical Database (CBM) (1982 ~ 2013) were searched, without language restrictions, to retrieve studies related to OPN and NSCLC. We compiled carefully selected data and a meta-analysis was conducted using STATA software (Version 12.0, Stata Corporation, and College Station, Texas USA). Hazard ratios (HR) with corresponding 95% confidence interval (95%CI) were calculated. RESULTS: Ten clinical cohort studies were selected for statistical analysis, representing a total of 1,133 NSCLC patients. The main findings of our meta-analysis are that patients who were OPN-positive had significantly shorter overall survival than OPN-negative patients. (HR = 1.47, 95%CI = 1.15. ~ 1.79,P< 0.001). Ethnicity.stratified analysis revealed a significant correlation between expression levels of OPN and poor prognosis of NSCLC patients among both Caucasians and Asians. (Asians: HR = 1.53, 95%CI = 0.95. ~ 2.11, P < 0.001; Caucasians: HR = 1.56, 95%CI = 1.08. ~ 2.03, P < 0.001; respectively). CONCLUSIONS: The present meta-analysis is consistent with the hypothesis that increased expression of OPN protein may be significantly associated with poor prognosis in patients with NSCLC.