Case report: pulsed radiofrequency surgery combined with platelet-rich plasma injection in the treatment of supraspinatus injury.

RATIONALE: The shoulder joint is the most movable joint of the human body, and the incidence of aseptic inflammation of the muscles and tendons around the shoulder joint and acute and chronic muscle injuries is relatively high. Pulsed radiofrequency neuromodulation technology is gradually being used in shoulder joint diseases. Platelet-rich plasma (PRP) is a high-power platelet plasma solution obtained by centrifugation of autologous blood. Platelet cells contain many growth factors that promote tissue repair. PATIENT CONCERNS: Shoulder soreness, limited movement of the shoulder joint, abduction of the upper limbs, and aggravation of pain during flat lifting. The pain radiates to the deltoid muscle stop and forearm. INTERVENTIONS: In this study, radiofrequency pulses combined with PRP were used to treat supraspinatus muscle injury and explore new methods for the treatment of shoulder joint muscle and tendon injuries represented by supraspinatus muscle injury. DIAGNOSIS: We reported 4 patients with supraspinatus injury who received radiofrequency pulse combined with PRP treatment in our hospital. OUTCOMES: After treatment, the patients were followed up at the first month, the third month, and the sixth month, and the Constant-Murley shoulder score and visual analog scale were used to comprehensively evaluate the postoperative improvement of the patients. There was no significant increase in postoperative pain, the Constant-Murley shoulder Score was significantly increased, the range of movement of the shoulder joint was significantly improved, and there were no postoperative complications. LESSONS: The combined application of the 2 treatments can make full use of the analgesic effect of pulsed radiofrequency technology and the repairing effect of PRP, and can maximize the advantages of the 2 more advanced treatment methods in the field of minimally invasive.

A case report of ultrasound-guided knee nerve pulse radiofrequency combined with platelet-rich plasma in the treatment of knee osteoarthritis.

RATIONABLE: Knee osteoarthritis (KOA) is a disease characterized by noninflammatory degenerative changes of articular cartilage. The main clinical manifestations are joint pain and stiffness. Pulsed radiofrequency (PRF) is thought to treat pain by destroying nerve tissue and changing the physical characteristics of nerve tissue membrane. PATIENT CONCERNS: The patients presents with joint pain and tenderness. Touching around the knee joint will induce pain and joint stiffness when the hand is pressed hard. INTERVENTIONS: Four patients with knee osteoarthritis underwent pulsed radiofrequency thermocoagulation in the knee joint cavity under ultrasound guidance and injected 2 mL of 10 mg/mL platelet-rich plasma into the joint cavity once a week for a total of 4 times. Record the patient's Visual Analogue Scale (VAS) score and the degree of knee movement limitation before treatment, 1, 3, and 6 months after treatment. DIAGNOSES: Four patients with knee osteoarthritis. OUTCOMES: After treatment, the patient's VAS score improved, and the knee joint mobility function recovered well. Ultrasound-guided knee nerve pulse radiofrequency combined with intra-articular injection of platelet-rich plasma can effectively improve the knee joint function and reduce the pain of the patient. The clinical effect is significant, and it is worthy of clinical application.

Biomechanics Analysis of the Lower Limbs in 20 Male Sprinters Using the International Society of Biomechanics Six-Degrees-of-Freedom Model and the Conventional Gait Model.

BACKGROUND This biomechanics study of the lower limbs aimed to compare the use of the International Society of Biomechanics Six-Degrees-of-Freedom (ISB-6DOF) model and the conventional gait model (CGM), formerly known as the Helen Hayes model, in 20 male sprinters who habitually used the forefoot (FF) or rearfoot (RF) strike modes. MATERIAL AND METHODS We used a motion capture system to compare the difference in lower-extremity joint mechanics between sprinters' forefoot or rearfoot strike mode during unplanned sidestepping (UPSS). Twenty elite sprinters participated in a motion capture test under 2 models. Each of the 10 participants were classified as having a habitual forefoot strike mode or rearfoot strike mode during unplanned sidestepping. Joint mechanics and gait parameters were calculated according to the designed movement. RESULTS Comparison of the 2 models showed that the knee joint angles were inconsistent (P<0.05), highlighting the difficulty of the Helen Hayes model in anatomical recognition. The results of the 2 models show that during the unplanned sidestepping, the sprinter using the habitual rearfoot strike mode had a greater load through the knee joint (P<0.05). Sprinters who used the habitual forefoot strike mode experienced greater load through their ankle joints (P<0.05). CONCLUSIONS The findings from this biomechanics study showed that when compared with the ISB-6DoF model, the findings from the CGM were more reproducible for the evaluation of FF and RF strike during unplanned sidestepping.

Simvastatin-Incorporated Drug Delivery Systems for Bone Regeneration.

Local drug delivery systems composed of biomaterials and osteogenic substances provide promising strategies for the reconstruction of large bone defects. In recent years, simvastatin has been studied extensively for its pleiotropic effects other than lowering of cholesterol, including its ability to induce osteogenesis and angiogenesis. Accordingly, several studies of simvastatin incorporated drug delivery systems have been performed to demonstrate the feasibility of such systems in enhancing bone regeneration. Therefore, this review explores the molecular mechanisms by which simvastatin affects bone metabolism and angiogenesis. The simvastatin concentrations that promote osteogenic differentiation are analyzed. Furthermore, we summarize and discuss a variety of simvastatin-loaded drug delivery systems that use different loading methods and materials. Finally, current shortcomings of and future development directions for simvastatin-loaded drug delivery systems are summarized. This review provides various advanced design strategies for simvastatin-incorporated drug delivery systems that can enhance bone regeneration.

Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking.

BACKGROUND We analyzed the effect of limitation of movement of the first metatarsophalangeal joint (FMJ) on the biomechanics of the lower limbs during walking. MATERIAL AND METHODS Eight healthy college students completed walking under barefoot (BF) and FMJ constraint (FMJC) conditions. We synchronously collected kinematics and dynamics data, and calculated the torque, power, and work of hip, knee, and ankle joints. RESULTS Compared with normal conditions, when the FMJ is restricted from walking, the maximum ankle dorsiflexion angle is significantly increased (P<0.001), the maximum plantar flexion angle is significantly reduced (P<0.001), the maximum plantar flexion torque (P<0.001) and the maximum dorsiflexion torque (P<0.05) increased significantly, the maximum power increased significantly (P<0.001), the minimum power decreased significantly (P<0.001), and the negative work increased significantly (P<0.001). The torque of hip and knee joints increased significantly (P<0.05). CONCLUSIONS After the movement of the FMJ is restricted, the human body mainly compensates and transfers compensation by increasing the angle of dorsiflexion, increasing work and the activity level of surrounding muscles through the ankle joint, thereby increasing the torque load of the knee and hip joints to maintain the dynamic balance of kinematics. FMJC condition increases the energy consumption of the human ankle, knee, and hip joints during walking. The load is compensated by the gradual attenuation of the ankle, knee, and hip. Long-term limitation may cause damage to the posterior calf muscles and increase the incidence of knee arthritis.

A secondary discoid lupus erythematosus induced by scald of edible oil: An illustration of Koebner phenomenon.

BACKGROUND: Discoid lupus erythematosus (DLE) is a most well-known clinical variation of chronic cutaneous lupus erythematosus inside the spectrum of lupus erythematosus (LE). Cutaneous trauma remains a significant and peculiar causative factor for DLE. AIMS: We present a case wherein the patient demonstrated unilateral distribution of DLE on a clinically normal appearing occult facial scald of edible oil, representing Koebner phenomenon (KP) i.e. occurrence of a new skin disease at the site of an unrelated and already healed one. PATIENT/METHODS: The 53 years old female patient was unique because she experienced DLE on the nasal back. RESULTS: The injury was totally settled following a month treatment of oral hydroxychloroquine and topical 0.03% tacrolimus ointment. After three months, she encountered an accidental edible oil scald on the right upper cheek. Several small vesicles appeared on a soybean-sized erythema base with a burning sensation. CONCLUSION: We review the literature and conclude by discussing important histologic highlights to think about while endeavoring to perceive the fundamental character and pathogenicity of such sores.

Accurate Potential Energy Surfaces for the Three Lowest Electronic States of N(2D) + H2(X1∑g +) Scattering Reaction.

The three lowest full three-dimensional adiabatic and three diabatic global potential energy surfaces are reported for the title system. The accurate ab initio method (MCSCF/MRCI) with larger basis sets (aug-cc-pVQZ) is used to reduce the adiabatic potential energies, and the global adiabatic potential energy surfaces are deduced by a three-dimensional B-spline fitting method. The conical intersections and the mixing angles between the lowest three adiabatic potential energy surfaces are precisely studied. The most possible nonadiabatic reaction pathways are predicted, i.e., N(2D) + H2(X1∑g +) → NH2(22A') → CI (12A'-22A') → NH2(12A') → CI (12A″-12A') → NH2(12A″) → NH(X3∑-) + H(2S). The products of the first excited state (NH(a1Δ) + H(2S)) and the second excited state (NH(b1∑g +) + H(2S)) can be generated in these nonadiabatic reaction pathways too.

GATA1 gene silencing inhibits invasion, proliferation and migration of cholangiocarcinoma stem cells via disrupting the PI3K/AKT pathway.

Background/aims: Intrahepatic cholangiocarcinoma (CCA) is the second most prevalent type primary liver malignancy, accompanied by an increasing global incidence and mortality rate. Research has documented the contribution of the GATA binding protein-1 (GATA1) in the progression of liver cancer. Here, we aim to investigate the role of GATA1 in CCA stem cells via the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway. Methods: Initially, microarray-based gene expression profiling was employed to identify the differentially expressed genes associated with CCA. Subsequently, an investigation was conducted to explore the potential biological significance behind the silencing of GATA1 and the regulatory mechanism between GATA1 and PI3K/AKT pathway. CCA cell lines QBC-939 and RBE were selected and treated with siRNA against GATA1 or/and a PI3K/AKT pathway inhibitor LY294002. In vivo experiment was also conducted to confirm in vitro findings. Results: GATA1 exhibited higher expression in CCA samples and was predicted to affect the progression of CCA through blockade of the PI3K/AKT pathway. siRNA-mediated downregulation of GATA1 and LY294002 treatment resulted in reduced proliferation, migration and invasion abilities of CCA stem cells, together with impeded tumor growth, and led to increased cell apoptosis and primary cilium expression. Additionally, the siRNA-mediated GATA1 downregulation had an inhibitory effect on the PI3K/AKT pathway. LY294002 was manifested to enhance the inhibitory effects of GATA1 inhibition on CCA progression. These in vitro findings were reproduced in vivo on siRNA against GATA1 or LY294002 injected nude mice. Conclusion: Altogether, the present study highlighted that downregulation of GATA1 via blockade of the PI3K/AKT pathway could inhibit the CCA stem cell proliferation, migration and invasion, and tumor growth, and promote cell apoptosis, primary cilium expression.

Trichostatin A inhibits proliferation of PC3 prostate cancer cells by disrupting the EGFR pathway.

Prostate cancer (PC) is the most common type of malignancy to exist in men within developed countries. Androgen deprivation therapy is performed for metastatic and advanced PC. However, the majority of cases of prostate cancer become refractory during therapy, leading to castration-resistant PC (CRPC). Histone deacetylases (HDACs) are key factors in regulating gene transcription and have been associated with cancer development. In the present study the small molecule inhibitor trichostatin A (TSA), which targets HDACs, was demonstrated to inhibit the proliferation of CRPC PC3 cells by disrupting the epidermal growth factor receptor (EGFR)-STAT3 pathway. The expression of EGFR and STAT3 was downregulated following TSA treatment, and cell cycle arrest was induced by downregulating the expression of cyclin D1 and CDK6, and via retinoblastoma protein phosphorylation. Furthermore, the transcription of cyclin D1 and CDK6 was suppressed by TSA. Apoptosis of PC3 cells treated with TSA was also investigated, and it was revealed that TSA induced apoptosis by upregulating BAX and downregulating BCL-2. The combination of TSA with doxorubicin exerted a synergistic inhibitory effect on PC3 cell proliferation through the induction of apoptosis. The results of the present study revealed a promising epigenetic-based therapeutic strategy that could be implemented in cases of CRPC.

Epigenetic silencing of sonic hedgehog elicits antitumor immune response and suppresses tumor growth by inhibiting the hedgehog signaling pathway in metastatic spine tumors in Sprague-Dawley rats.

BACKGROUND: Patients with metastatic spine tumors may suffer from pain or neurologic deficit, and the disease may be detected in patients with a known malignancy. Sonic hedgehog (SHH) has received special attention due to its role in cancers. Therefore, this study investigated the effects of epigenetic silencing of SHH on antitumor immune response and tumor growth by regulating the hedgehog (Hh) signaling pathway in metastatic spine tumors. METHODS: Rat models of metastatic spine tumors were successfully established. We first calculated the tumor volume and the inhibition rate of tumor growth to investigate the effect of SHH on tumor growth. Afterwards, immunohistochemistry was used to determine whether proliferation was delayed by SHH depletion, and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was conducted to test the changes in the lymphocyte transformation rate in the spleen triggered by SHH silencing. Then, the influence of SHH depletion on immune function was investigated. Later, quantitative reverse transcription polymerase chain reaction and Western blot assay were performed to explore the Hh signaling pathway-related factors. Finally, we added the Hh signaling pathway inhibitor, GDC-0449, to confirm the role of the pathway in tumor progression. RESULTS: Initially, we observed that SHH depletion was a negative factor for tumor growth. Afterwards, it was revealed that epigenetic silencing of SHH served as an inhibitor factor for the function of spleen lymphocyte transformation and inflammation while promoting antitumor immune function. CONCLUSION: Our preliminary results indicate that epigenetic silencing of SHH elicits an antitumor immune response and suppresses tumor growth by inhibiting the Hh signaling pathway in metastatic spine tumors.

Resveratrol Protects Murine Chondrogenic ATDC5 Cells Against LPS-Induced Inflammatory Injury Through Up-Regulating MiR-146b.

BACKGROUND/AIMS: Resveratrol (RSV) has been reported as a promising oral supplementation for osteoarthritis treatment, while the mechanism of its action is still unclear. The specific aim of this study is to decode one of the mechanisms by which RSV protects chondrocyte. METHODS: Mouse chondrogenic cell line ATDC5 was treated with 30 µM RSV for 24 h, and 10 µg/ml LPS for 12 h, after which cell viability, apoptosis, and the release of pro-inflammatory cytokines were assessed. The expression of miR-146b in ATDC5 cells was silenced by the specific inhibitor transfection, and then cell viability, apoptosis and inflammation were re-assessed. RESULTS: The IC50 value of LPS in ATDC5 cells was about 10.27 µg/ml. LPS with a dosage of 10 µg/ml repressed cell viability, induced apoptosis, and increased the release of IL-1ß, IL-6 and TNF-α. RSV pre-treatment (30 µM) significantly alleviated LPS-induced apoptosis and inflammation. More importantly, miR-146b was up-regulated by RSV, and the protective functions of RSV on ATDC5 cells were attenuated by miR-146b silence. Further, NF-κB and p38MAPK pathways were activated by LPS, and were deactivated by RSV. Besides, RSV-induced the deactivation of NF-κB and p38MAPK pathways was reversed by miR-146b silence. CONCLUSIONS: Our findings suggest that RSV protects ATDC5 cells from LPS-induced inflammatory and apoptotic injury via up-regulation of miR-146b and thereby deactivation of NF-κB and p38MAPK pathways.

Evaluating the effect of obesity on total knee arthroplasty: A longitudinal study.

OBJECTIVE: To evaluate the effect of obesity on total knee arthroplasty, and on patient-reported outcomes. METHODS: The longitudinal study was conducted from September 2013 to August 2015 at The Second Hospital of Jinlin University, Changchun, Jinlin, China, a tertiary hospital. Using universal sampling method, all patients who underwent elective total knee arthroplasty were included in the study. Data was collected using a semi-structured questionnaire, Oxford Knee Score, and Short Form 12 Questionnaire. SPSS 19 was used for statistical analysis. RESULTS: Of the 183 patients, 104(57%) were obese and 79(43%) were non-obese. The mean age was 63.7 ± 8.4 years and 65.0 ± 8.8 years in obese and normal patients respectively (p=0.31). A statistically significant association was observed with regard to Oxford knee score in both groups of patients (p<0.05). Overall, 7(8.9%) patients from the non-obese category and 23(22.1%) from the obese category presented with local complications, while another 7(3.8%) patients had to undergo a revised surgery. CONCLUSIONS: It is very important to equate the outcomes of the surgery in obese and normal individuals.