The isolation, structural characterization and anti-osteosarcoma activity of a water soluble polysaccharide from Agrimonia pilosa.

A homogenous polysaccharide (APP), with a molecular weight of 120 kDa, was isolated from the dried aerial parts of Agrimonia pilosa. Gas chromatography (GC) and GC-MS analysis revealed that APP has a backbone of 1,3-linked Glcp and 1,3, 6-linked Glcp, and branched with 1-linked Glcp terminal along the main chain in a relative ratio of 2:1:1. We investigated the response of human osteosarcoma U-2 OS cells to APP treatment. MTT result showed that APP significantly inhibited cell viability in a concentration dependent manner via induction of apoptotic death in U-2 OS cells, as determined by annexin V/propidium iodide (PI) staining. Western blot analysis also indicated that APP CRA increased in Bax/Bcl-2 ratios by up-regulating Bax expression and triggered the release of cytochrome c from mitochondria into the cytoplasm. Moreover, APP supplement induced the activation of caspase-3, and -9, but not caspase-8 in U-2 OS cells. Likewise, APP administration significantly suppressed tumor growth in BALB/C nude mice bearing U-2 OS xenograft tumors. All these results indicate that APP-induced apoptosis is associated with the activation of a caspase-3-mediated mitochondrial pathway.

Cable pin system versus K-wire tension band fixation for patella fractures in Chinese Han population: A meta-analysis.

This meta-analysis compared the therapeutic effect of cable pin system (CPS) with K-wire tension band (KTB) in the treatment of patella fractures among Chinese Han population. The databases of PubMed, Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese WanFang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis (426 fractures treated with CPS and 506 fractures treated with KTB). There were significant differences in duration of hospital stay [mean difference (MD)=-1.07; 95% confidence interval (CI):-1.71 to-0.43], fracture healing time (MD=-1.23; 95% CI:-1.68 to-0.77), flexion degree of knee joint at 6th month after operation (MD=14.82; 95% CI: 10.93 to 18.71), incidence of postoperative complication [risk ratio (RR)=0.16; 95% CI: 0.09 to 0.27] and excellent-good rate of Böstman score (RR=1.09; 95% CI: 1.03 to 1.16) between the CPS group and KTB group, while no significant difference was found in operative time between the two groups (MD=-4.52; 95% CI:-11.70 to 2.67). For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6th month after operation, incidence of postoperative complication and excellent-good rate of Böstman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.

Bioinformatics analysis of fibroblasts exposed to TGF­ß at the early proliferation phase of wound repair.

The aim of the current study was to identify gene signatures during the early proliferation stage of wound repair and the effect of TGF­ß on fibroblasts and reveal their potential mechanisms. The gene expression profiles of GSE79621 and GSE27165 were obtained from GEO database. Differentially expressed genes (DEGs) were identified using Morpheus and co­expressed DEGs were selected using Venn Diagram. Gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of DEGs were performed using the Database for Annotation, Visualization and Integrated Discovery (DAVID) online tool. Protein­protein interaction (PPI) networks of the DEGs were constructed using Cytoscape software. PPI interaction network was divided into subnetworks using the MCODE algorithm and the function of the top one module was analyzed using DAVID. The results revealed that upregulated DEGs were significantly enriched in biological process, including the Arp2/3 complex­mediated actin nucleation, positive regulation of hyaluronan cable assembly, purine nucleobase biosynthetic process, de novo inosine monophosphate biosynthetic process, positive regulation of epithelial cell proliferation, whereas the downregulated DEGs were enriched in the regulation of blood pressure, negative regulation of cell proliferation, ossification, negative regulation of gene expression and type I interferon signaling pathway. KEGG pathway analysis showed that the upregulated DEGs were enriched in shigellosis, pathogenic Escherichia coli infection, the mitogen­activated protein kinase signaling pathway, Ras signaling pathway and bacterial invasion of epithelial cells. The downregulated DEGs were enriched in systemic lupus erythematosus, lysosome, arachidonic acid metabolism, thyroid cancer and allograft rejection. The top 10 hub genes were identified from the PPI network. The top module analysis revealed that the included genes were involved in ion channel, neuroactive ligand­receptor interaction pathway, purine metabolism and intestinal immune network for IgA production pathway. The functional analysis revealed that TGF­ß may promote fibroblast migration and proliferation and defend against microorganisms at the early proliferation stage of wound repair. Furthermore, these results may provide references for chronic wound repair.

Intra-articular versus intravenous tranexamic acid application in total knee arthroplasty: a meta-analysis of randomized controlled trials.

BACKGROUND: The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). METHODS: A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included. Main outcomes of the two methods were collected and analyzed by using Review Manager 5.3. RESULTS: There were 16 randomized controlled trials with 1308 cases met the criteria. Compared with IV TXA, IA TXA had similar blood volume of drainage, hidden blood loss, transfusion rate and complications (P > 0.05). IA TXA had lower total blood loss than IV TXA, and there was significant difference (P < 0.05). Subgroup analysis of total blood loss based on times of IV TXA administration showed that repeat dose of IV TXA had a higher total blood loss and postoperative hemoglobin drop (P < 0.05) than IA TXA. However, single dose of IV TXA had a similar efficacy on total blood loss and postoperative hemoglobin drop (P > 0.05) when compared with IA TXA. CONCLUSIONS: Both IA TXA and single dose of IV TXA are effective in reducing total blood loss and postoperative hemoglobin drop without increasing complications of DVT or PE. The current meta-analysis suggests that 1.5 g TXA by IA administration or 1 g TXA by IV administration 10 min before tourniquet deflation is effective and safe in patients undergoing TKA.

Is combined use of intravenous and intraarticular tranexamic acid superior to intravenous or intraarticular tranexamic acid alone in total knee arthroplasty? A meta-analysis of randomized controlled trials.

BACKGROUND: Tranexamic acid (TXA) has been proven to be effective in reducing blood loss and transfusion rate after total knee arthroplasty (TKA) without increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Recently, an increasing number of studies have been interested in applying combined intravenous (IV) with intraarticular (IA) tranexamic acid in total knee arthroplasty. The purpose of this meta-analysis was to compare the blood loss and complications of combined TXA with IV TXA or IA TXA on TKA. METHODS: Systematic search of literatures were conducted to identify related articles that were published in PubMed, MEDLINE, Embase, the Cochrane Library, SpringerLink, ClinicalTrials.gov, and Ovid from their inception to September 2016. All studies that compare blood loss and complications of combined TXA and IV TXA or IA TXA on TKA were included. Main outcomes were collected and analyzed by the Review Manager 5.3. RESULTS: Five studies were included in the present meta-analysis. There was significant difference in total blood loss and blood volume of drainage when compared combined TXA group with IV TXA group or IA TXA group (P < 0.05). There was no difference in transfusion rate and thromboembolic complications when comparing combined TXA with IV TXA or IA TXA alone (P > 0.05). CONCLUSIONS: Compared with administration of IA TXA or IV TXA alone on TKA, combined use of TXA has advantages in reducing total blood loss and blood volume of drainage without increasing the incidence of thromboembolic complications. We recommend combined TXA as the preferred option for patients undergoing TKA.

Cable Pin System versus K-wire Tension Band Fixation for Patella Fractures in Chinese Han Population: A Meta-analysis / 华中科技大学学报（医学）（英德文版）

This meta-analysis compared the therapeutic effect of cable pin system (CPS) with K-wire tension band (KTB) in the treatment of patella fractures among Chinese Han population.The databases of PubMed,Cochrane library,China National Knowledge Infrastructure (CNKI),Chinese WanFang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population.Literatures were screened according to the inclusion and exclusion criteria.The quality of the studies was assessed,and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.3 software.A total of 932 patients from 15 studies were included in this meta-analysis (426 fractures treated with CPS and 506 fractures treated with KTB).There were significant differences in duration of hospital stay [mean difference (MD)=-1.07;95％ confidence interval (CI):-1.71 to-0.43],fracture healing time (MD=-l.23;95％ CI:-1.68 to-0.77),flexion degree of knee joint at 6th month after operation (MD=14.82;95％ CI:10.93 to 18.71),incidence of postoperative complication [risk ratio (RR)=0.16;95％ CI:0.09 to 0.27] and excellent-good rate of B(o)stman score (RR=1.09;95％ CI:1.03 to 1.16) between the CPS group and KTB group,while no significant difference was found in operative time between the two groups (MD=-4.52;95％ CI:-11.70 to 2.67).For the treatment of patella tractures among Chinese Han population,limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay,fracture healing time,flexion degree of knee at 6th month after operation,incidence of postoperative complication and excellent-good rate of B(o)stman joint score.Due to the limitation of high quality evidence and sample size,more large-scale randomized controlled trials are needed to validate the findings in the future.

Z-plasty for severe gluteal muscle contracture in children.

PURPOSE: To review the records of 363 patients with severe gluteal muscle contracture to determine its mechanism, underlying pathology, and treatment outcome. METHODS: Records of 136 males and 227 females aged 5 to 18 (mean, 12.2) years who underwent Z-plasty for bilateral (n=347) or unilateral (n=16) severe gluteal muscle contracture were reviewed. Severe gluteal muscle contracture was classified as typical (n=52) or special (n=311). The typical type is associated with symptoms of positive out-toe gait, Ober sign, back-extending test, cross-leg test, squatting with knee side-by-side test, and hip dysfunction. It is further subdivided into mild (n=0), moderate (n=40), or severe (n=12). The special type is associated with additional symptoms of pelvic tilt and leg length discrepancy (<2 cm in 181 hips, 2-4 cm in 82 hips, and >4 cm in 48 hips). 311 hips had pelvic tilt and 47 hips had lumbar compensatory scoliosis. Treatment outcome was assessed at 6 months. Hip functional score was assessed at the final follow-up. RESULTS: The mean hospitalisation period was 11 days. After a mean follow-up of 1.5 years, the mean hip functional score improved from 8.03 to 11.69; improvement was higher in children (age 5-13 years) than in adolescents (age 14-18 years) [3.7 vs. 2.9, p<0.001]. At 6 months, outcome was excellent in 280 hips, good in 80, fair in 3 hips, and poor in 0. The 3 hips with fair outcome had persistent slight pelvic tilt and swaying gait. Two of them had preoperative leg length discrepancy >4 cm, and intra-operatively the contracture band severely affected the joint capsule. The third patient did not comply with postoperative exercises. CONCLUSION: Surgical treatment for severe gluteal muscle contracture achieved good outcome.

Treatment of chronic ulcer in diabetic rats with self assembling nanofiber gel encapsulated-polydeoxyribonucleotide.

OBJECTIVE: This study aims to explore the treatment effects of chronic ulcer in diabetic rats with self assembling nanofiber gel encapsulated-polydeoxyribonucleotide. METHODS: Diabetic skin ulcer mouse model was established in this study. They were divided into control group, common wound group and infectious wound group. Human embryonic fibroblast cells and vascular endothelial cells were treated with short poly-N-acetyl glucosamine nanofibers and polydeoxyribonucleotide. Their effects on cell proliferation, revascularization and inhibiting infection were detected by RT-PCR, western-blotting, HE staining and immunohistochemical methods respectively. RESULTS: The expression levels of cytokines and angiogenic factors increased in the treatment groups especially in sNAG encapsulated-PDRN group. HE staining results indicated that PDRN, sNAG and sNAG encapsulated-PDRN could improve the wound healing, immunohistochemical results showed that PDRN, sNAG and sNAG encapsulated-PDRN promoted cell proliferation and new vessel formation especially sNAG encapsulated-PDRN. CONCLUSIONS: sNAG encapsulated-PDRN may have a potential application in the treatment of diabetic ulcers and chronic wound healing.