[Three-dimensional finite element analysis of Kirschner wire fixation configuration for supracondylar fracture of humerus fracture in children].

OBJECTIVE: To establish a new mechanical model of distal humerus in children with epiphysial cartilage, stimulate supracondylar humerus fracture and perform three dimensional finite elements, and study effect of pins numbers, pin tract, outlet height and pin configurations on stability of fixation. METHODS: Three dimensional computed tomography (CT) data of 6-year-old boy with distal humerus was downloaded from picture archiving and communications systems software (PACS), the data of picture was imported into Simpleware and SolidWorks 2016 software to establish distal humerus fracture in children contained ossific nucleus of the capitellum (ONC) and distal cartilage. Normal extense supracondylar humerus fracture model was established to stimulate configurations of crossed and lateral pinning fixation, 30 N was added on the direction of flexion extension and varus valgus, while 50 N was added on the direction of internal and external turning. Stability was analyzed by displacement degree of distal fracture. RESULTS: Among 2-pin configurations, 2-crossed pins were more stable against rotation forces which could resist rotation stress over 2 585 Nmm/ °, while low position through ONC of 2-divergent lateral pins were more stable, which could resist stress of 45 N /mm and 190 N /mm during the test of resistant strains and varus-valgus stress. The third pins was added into the more stable lateral 2-pins, the stability in all directions were increased obviously, and 3 crossed pins is the most stable, stress of flexion-extension, varus-valgus and internal-external turning were 198 N /mm, 395 N /mm and 6 251 Nmm/ °. CONCLUSION: Two-divergent lateral pins could provide enough stability for supracondylar humerus fracture in children. In two-crossed pins, the upper border of MDJ could provide the best stability. Three-crossed pins could offer the best stability against both translation and rotation forces.

Sodium cantharidate targets STAT3 and abrogates EGFR inhibitor resistance in osteosarcoma.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Overactive EGFR signaling is frequently seen in osteosarcoma cells, and represents a potential therapeutic target. However, feedback activation of STAT3 after EGFR inhibition is linked to treatment resistance, suggesting that combined EGFR/STAT3 inhibition may be needed to overcome this effect. Cantharidin and its analogues have shown strong anticancer effects, including STAT3 inhibition, in several tumor cells. Therefore, we investigated the effects of sodium cantharidate (SC), either as monotherapy and in combination with the EGFR inhibitor erlotinib, on STAT3 activation and osteosarcoma cell growth. Cell viability, migration, and apoptosis assays were performed in human MG63 and U2OS cells, and MG63 xenografts were generated in nude mice to verify the suppression of tumor growth in vivo. Additionally, western blotting and immunohistochemistry were used to verify the STAT3 and EGFR phosphorylation statuses in xenografts. We found that SC repressed cell viability and migration and induced apoptosis in vitro, while combined SC and erlotinib treatment enhanced osteosarcoma growth suppression by preventing feedback activation of STAT3. These data support further development of cantharidin-based combination therapies for metastatic and recurrent/refractory osteosarcoma.

CXCL13 Promotes Osteogenic Differentiation of Mesenchymal Stem Cells by Inhibiting miR-23a Expression.

CXC chemokines are essential for osteogenic differentiation of bone mesenchymal stem cells (BMSCs) for use in bone tissue engineering and regenerative medicine in clinical settings. However, an accurate understanding of the underlying mechanisms is still needed. In this study, we analyzed the effects of CXC chemokine ligand-13 (CXCL13) on osteogenic differentiation of rat BMSCs and initiated a preliminary discussion on possible mechanisms. BMSCs were isolated from bone marrow of rat and incubated with CXCL13 recombinant protein in differentiation medium. The main osteogenesis indexes were alkaline phosphatase (ALP) activity and calcium nodes. Expression of Runx2 and CXCR5 was determined using western blot, while miRNAs were determined with quantitative-RT-PCR. Si-CXCR5 was transfected into MSCs to silence CXCR5. A miRNA-23a mimic was transfected into BMSCs for overexpression of miRNA-23a. Recombinant CXCL13 induced ALP activity, deposition of calcium salts, and formation of calcium nodes, and it also increased expression of Runx2. The expression of recombinant CXCL13 suppressed expression of miRNA-23a. Overexpression of miR-23a reversed CXCL13 induced-osteogenic differentiation of BMSCs and expression of Runx2. Recombinant CXCL13 attenuated the interaction of miRNA-23a with the Runx2 3'UTR. Silencing of CXCR5 abrogated recombinant CXCL13-induced downregulation of miRNA-23a expression. In summary, CXCL13 promotes osteogenic differentiation of BMSCs by inhibiting miR-23a expression.

CXCL13 promotes the effect of bone marrow mesenchymal stem cells (MSCs) on tendon-bone healing in rats and in C3HIOT1/2 cells.

OBJECTIVES: Mesenchymal stem cells (MSCs) are potential effective therapy for tissue repair and bone regeneration. In present study, the effects of CXC chemokine ligand-13 (CXCL13) were evaluated on tendon-bone healing of rats. METHODS: Tendon bone healing of the rat model was established and biomechanical testing was performed at 2, 4, 8 weeks after surgery. Murine mesenchymal cell line (C3HIOT1/2 cells) was cultured. The expression of miRNA-23a was detected by real-time PCR. The protein expression of ERK1/2, JNK and p38 was detected by western blotting. MiR-23a mimic and inhibitor were used to overexpress or silence the expression of miR-23a. RESULTS: MSCs significantly elevated the levels of ultimate load to failure, stiffness and stress in specimens of rats, the effects of which were enhanced by CXCL13. The expression of miR-23a was down-regulated and the protein of ERK1/2 level was up-regulated by CXCL13 treatment in both in vivo and in vitro experiments. ERK1/2 expression was elevated by overexpression of miR-23a and reduced by miR-23a inhibitor. CONCLUSIONS: These findings revealed that CXCL13 promoted the tendon-bone healing in rats with MSCs treatment, and implied that the activation of ERK1/2 via miR-23a was involved in the process of MSCs treated bone regeneration.

The neuroprotective mechanism of puerarin in the treatment of acute spinal ischemia-reperfusion injury is linked to cyclin-dependent kinase 5.

Puerarin is shown to exert a variety of pharmacological effects including neuroprotective properties. However, mechanisms of the action are not fully understood. This study was designed to explore the mechanism of puerarin in treatment of acute spinal ischemia-reperfusion injury in rats. Acute spinal ischemia-reperfusion injury was conducted by aortic occlusion in twenty-eight male Sprague-Dawley rats, weighting 230-250 g. The animals were randomly divided into four groups. In the animals with puerarin treatment, 50 mg/kg of puerarin was injected intraperitoneally after reperfusion, and followed by the same dose of injection every 24h for 2 days. In the animals with roscovitine pre-treatment, 30 mg/kg roscovitine was intravenously administrated 60 min before spinal ischemia started. After spinal ischemia for 60 min followed by 48 h of reperfusion, the motor function, spinal infarction volume, apoptosis indices and the activities of Cdk5 and p25 were examined. Acute spinal ischemia-reperfusion resulted in an injury of the spines associated with motor deficit, elevation of Cdk5 and p25 activities, and increase in the spinal apoptosis number and spinal infarction volume. Puerarin improved motor function associated with the decreased apoptosis number, spinal infarction volume, and Cdk5 and p25 activities. The present study indicated that reduction of spinal injury was associated with inhibition of Cdk5 and p25, and that inhibition of Cdk5 and p25 was one of the neuroprotective mechanisms in the puerarin treatment of acute ischemia/reperfusion-induced spinal injury in rats.

The neuroprotective mechanism of puerarin treatment of acute spinal cord injury in rats.

Puerarin extracted from radix puraeriae is shown to exert a variety of pharmacological effects including neuroprotective properties. However, its mechanisms of action are needed to further explore. The study was designed to investigate the mechanism of puerarin treatment of acute spinal cord ischemia-reperfusion injury (SCI/RI) in rats. SCI/RI was conducted in male Sprague-Dawley rats, and 50mg/kg of puerarin was injected intraperitoneally at 1, 2, 4 and 6h after reperfusion, followed by the same dose of injection every 24h for 2 days. Glutamate level, metabotropic glutamate receptors (mGluR) mRNA expression, and apoptosis indices were examined. Neurologic function was assessed at 48 h of reperfusion. SCI/RI caused extensive motor deficit associated with an elevation of glutamate level and mGluRs-1 mRNA expression, while puerarin administration improved motor deficit, and decreased glutamate level and inhibited mGluRs-1 mRNA expression. The present study demonstrated that administration of puerarin reduced the spinal ischemia/reperfusion injury, and suggested that the neuroprotective mechanism of puerarin involved a decrease in glutamate release and mGluRs-1 mRNA expression.

The optimal therapeutic timing and mechanism of puerarin treatment of spinal cord ischemia-reperfusion injury in rats.

AIM OF THE STUDY: The purpose of this study was to explore the optimal therapeutic timing and mechanism of puerarin treatment of spinal cord ischemia-reperfusion injury. MATERIALS AND METHODS: The spinal ischemia-reperfusion injury was conducted in male Sprague-Dawley rats, and 50mg/kg of puerarin was injected intraperitoneally at 1, 2, 4 and 6h after the injury. Motor function was measured 48 h after reperfusion started. Thioredoxin expression and apoptosis indices were determined. RESULTS: Improvement of motor function at 1, 2, and 4h was demonstrated in the animals with puerarin treatment. Ischemia-reperfusion injury resulted in a decrease in the expression of thioredoxin, while puerarin administration elevated the expression of thioredoxin-1/thioredoxin-2 mRNA. Apoptosis indices were significantly reduced by puerarin administration. CONCLUSIONS: We conclude that administration of puerarin within 4h of spinal ischemia-reperfusion injury reduces ischemic reperfusion damage, and that the neuroprotective effect of puerarin involves an increase in the transcription of thioredoxin and a reduction of apoptosis.

Plastic repair for a case with synpolydactyly.

On March 23, 2010, we successfully treated a boy with synpolydactyly who had a total of 31 fingers and toes. Although there was bone syndactyly both the hands of the boy, one-step correction of four extremities was successful, this operation lasted 5 h and 20 min and intraoperative bleeding was about 50 ml. Skin grafting was successful after operation and all incisions healed well. The appearance and function of hands and feet were satisfactory.