LEP and LEPR polymorphisms in non-Hodgkin lymphoma risk: a systematic review and pooled analysis.

PURPOSE: The purpose of this systematic meta-analysis was to evaluate the association between leptin (LEP) and leptin receptor (LEPR) gene polymorphisms and non-Hodgkin lymphoma (NHL) risk. METHODS: All studies published up to July 2014 on the association between LEP and LEPR polymorphisms and NHL risk were identified by searching PubMed, Web of Science, EMBASE, and Google Scholar. Odds ratios (ORs) with 95% confidence intervals (CIs) for LEP and LEPR polymorphisms and NHL were calculated with fixed-effects and random-effects models. RESULTS: LEP G2528A polymorphism was associated with increased, yet not statistically significant risk of NHL (homozygote comparison, OR=1.27, 95% CI=1.01-1.60, p=0.63; heterozygote comparison, OR=1.13, 95% CI=0.86-1.49, p=0.14; dominant model, OR=1.18, 95% CI=0.99-1.41, p=0.21; recessive model, OR=1.18, 95% CI=0.97-1.43, p=0.78; additive model, OR=1.14, 95% CI=1.01-1.28, p=0.52). Significant decrease of NHL risk was found in LEP A19G polymorphism, while no links were detected with the LEPR polymorphisms studied. In subgroup analysis, the pooled results showed that LEP A19G polymorphism was associated with decreased risk of follicular lymphoma (FL) (homozygote comparison, OR=0.56, 95% CI=0.37-0.85, p=0.69). However, no evidence of a significant association was observed in diffuse large B-cell lymphoma (DLBCL) for variant genotypes of all single nucleotide polymorphisms (SNPs). CONCLUSIONS: LEP G2548A polymorphism contributes to NHL susceptibility. Also, our results provide evidence that LEP A19G polymorphism is associated with decreased risk of NHL, especially in FL. Further large-scale and well-designed studies are needed to confirm this association.

The impact of COX-2 on invasion of osteosarcoma cell and its mechanism of regulation.

BACKGROUND: Recently, cyclooxygenase-2 (COX-2) has become an important new target in the field of tumor metastasis. However, the relationship between COX-2 gene expression and the behavior of osteosarcoma metastasis is largely unknown. The study is to investigate how antisense oligonucleotides (ODNs) of COX-2 inhibit the invasion of human osteosarcoma cell line OS-732 and their mechanism of regulation. METHODS: A COX-2 antisense oligonucleotide was designed, synthesized, and transfected into OS-732 human osteosarcoma cells. RT-PCR and western blotting were performed to determine the transfection efficiency. A modified Boyden-transwell assay was used to measure the inhibition rate of tumor cell invasion. In OS-732 cells transfected with COX-2 antisense ODNs, RT-PCR was used to examine the mRNA expression of urokinase-type plasminogen activator (uPA) and that of its receptor, uPAR. RESULTS: Both the mRNA and protein expression levels of COX-2 were significantly reduced when cells were transfected with COX-2 antisense ODNs, which significantly reduced the invasive ability of OS-732 cells in a dose-dependent manner. The expression levels of uPA and uPAR were also significantly reduced (p < 0.01). CONCLUSION: COX-2 antisense ODNs significantly inhibited the invasion of OS-732 cells, primarily by decreasing the mRNA expression of uPA and uPAR.

Determination of the apoptotic index in osteosarcoma tissue and its relationship with patients prognosis.

BACKGROUND: Nowadays it remains a controversial issue whether a correlation exists between the apoptosis rate of tumor tissue and the prognosis of the patients. We aimed to explore the prognostic significance of apoptosis index of human osteosarcoma tissue. METHODS: The technique of terminal DNA breakpoints in situ 3 - hydroxy end labeling (TUNEL) was used to detect and analysis apoptosis index in 56 osteosarcoma specimens. The relationships between apoptosis index of tumor tissue and long term survival of patients as well as pathologic classification, tumor clinical stages, tumor size and level of serum alkaline phosphatase were analyzed. RESULTS: Our studies showed the cases with high apoptosis index had significantly longer survival time. Apoptosis index in osteosarcoma tissue was correlated with tumor size and level of serum alkaline phosphatase but not with pathologic classifications and clinical stages of tumor. CONCLUSION: Our results demonstrated that apoptosis index of osteosarcoma tissue combined with serum alkaline phosphatase could used as valid indicators to predicate the malignant level and prognosis of osteosarcoma cases, which would contribute to enhance efficacy of clinical treatments for osteosarcoma.

Treatments for acute and old distal radius fracture with lunate dislocation.

PURPOSE: Our study was undertaken to determine the correct treatment protocol for distal radius fracture with lunate anterior dislocation. METHODS: From 2000 to 2007, 58 patients (36 with acute injury and 22 with old injury) with distal radius fracture with lunate anterior dislocation were enrolled in the study. Among acute injury patients, 15 were treated through manipulative reduction and plaster fixation and 21 were treated through minimal invasive poking reduction followed by Kirschner wire and plaster fixation. Among old injury patients, 8 underwent operative reduction of lunate dislocation through the palmar approach and Kirschner wire and plaster fixation, whereas 14 patients underwent operative reduction and fixation through the dorsal approach combined with reparation of the dorsal radiolunate ligament. Lidstrom wrist function scores and the morbidity of lunate necrosis and osteoarthritis were documented and evaluated. RESULTS: Lidstrom wrist function scores revealed that the rate of excellent and good scores was higher in acute injury patients than in old injury patients (91.7 versus 54.5%, respectively; P = 0.018). The lunate necrosis rate was lower in acute injury patients than in old injury patients (0 versus 27.2%, respectively; P = 0.027). For old injury patients, the lunate necrosis rate was higher in those treated with the palmar approach than in those treated with the dorsal approach (50 versus 14.3%, respectively; P = 0.033). CONCLUSIONS: The key points for resolving distal radius fracture with lunate dislocation are prompt and precise diagnosis and treatment of lunate dislocation to prevent old lunate dislocation. We recommend that the surgical procedure is performed through the dorsal approach with reparation of the dorsal radiolunate ligament.

Modified hemiarthroplasty for four-part fractures of the proximal humerus.

BACKGROUND: Hemiarthroplasty is used to treat patients with Neer four-part fractures but the post-operative complication rate remains high, particularly with regard to shoulder joint instability. This study was aimed at evaluating the efficacy of a modified rotator cuff reconstruction and balance technique by comparing it with conventional rotator cuff restoration surgery for Neer four-part fractures. METHODS: This retrospective therapeutic study included 67 patients with Neer four-part fractures. Forty-five patients underwent the modified surgery and 22 control patients underwent conventional surgery. All patients were followed up for more than 3 years. Outcome was assessed by grading clinical outcome and pain and strength, measuring range of motion, and radiographic analysis. RESULTS: The Neer score was higher in the modified surgery group (84 versus 75; P = 0.009). The rate of satisfaction (Neer score ≥80) in the modified surgery group was higher than in the conventional surgery group (71.11% versus 40.91%; P = 0.017). Range of motion for active abduction, external rotation, internal rotation and active forward elevation was greater in the modified surgery group (all P < 0.01). The morbidity rate of post-operative instability of the shoulder joint in the modified surgery group was much lower than that in the conventional surgery group (2.22% versus 18.2%; P < 0.01). CONCLUSION: The modified hemiarthroplasty procedure for treatment of Neer four-part fractures prevents post-operative instability of the shoulder joint and improves function of the shoulder more effectively than the conventional hemiarthroplasty procedure.

The effect of the microgravity rotating culture system on the chondrogenic differentiation of bone marrow mesenchymal stem cells.

We investigated the influence of the microgravity rotating culture system on the chondrogenic differentiation of bone marrow mesenchymal stem cells (MSCs). During chondrogenic induction, MSCs combined with polyglycolic acid (PGA) were cultured by static culture or microgravity rotating culture and chondrocyte formation was confirmed by toluidine blue staining. Furthermore, the mRNA and protein expressions of a specific cartilage extracellular matrix protein (collagen type II and Aggrecan) were evaluated by real-time RT-PCR and western blot, respectively. Toluidine blue staining indicated the OD values of proteoglycans semi-determination were higher in the microgravity rotating culture group than the static culture group. Following chondrogenic induction, mRNA and proteins of collagen type II and Aggrecan were more significantly expressed in cells of the microgravity rotating culture group compared with the controls. Compared with routine three-dimensional static culture, the microgravity rotating culture system was more effective for the construction of tissue-engineered cartilage in vitro.

The techniques of soft tissue release and true socket reconstruction in total hip arthroplasty for patients with severe developmental dysplasia of the hip.

PURPOSE: Total hip arthroplasty (THA) is an effective procedure for developmental dysplasia of the hip (DDH); however, it is sometimes difficult to complete for severe cases because of femoral head dislocation, dysplasia of the acetabulum and the femur, disparity in limb length, soft tissue contraction, and muscular atrophy. We aimed at exploring the efficiency of the techniques of release and balance of soft tissues and reconstruction of true socket THA for patients with severe DDH. METHODS: From January 2000 to January 2009, 46 adult patients with severe DDH (50 hips) were included in this study. According to the classification system, there were 26 type III and 24 type IV. Among them there were 32 women and 14 men, aged from 38 to 77 years. THA was performed via a lateral approach. All acetabular sockets were reconstructed at the original anatomical location following a meticulous technique of soft tissue release and balance around the hip to restore limb length, to strengthen the abductor and improve its function. RESULTS: All patients had restoration of limb length (range, 2.5-5.5 cm; 30 limbs of more than 4 cm) without injury to the sciatic nerve. One postoperative dislocation occurred due to slight enlargement of the angle of abduction of the acetabulum. The follow-up ranged from 2.2 to 11.5 years (median 6.4 years) in 46 patients, and the Harris score increased from 40.2 preoperatively to 86.5 (P = 0.027). All hips were pain free with good function at the latest follow-up. CONCLUSION: The meticulous techniques of soft tissue release and balance can be recommended to ensure anatomical reconstruction of the true acetabular socket and to improve abductor function during arthroplasty for DDH.

Expressions of p53, c-MYC, BCL-2 and apoptotic index in human osteosarcoma and their correlations with prognosis of patients.

BACKGROUND: Nowadays it remains a controversial issue whether a correlation exists between the apoptosis rate of tumor tissue and the prognosis of the patients. The aim of the study is to investigate the relationships of apoptotic genes and apoptotic index of osteosarcoma tissue to prognosis of the patients, meanwhile to explore the valid prognostic biomarkers of osteosarcoma that will enhance efficacy of clinical treatments for osteosarcoma. METHODS: In our studies, the immunohistochemical ABC and terminal DNA breakpoints in situ 3-hydroxy end labeling (TUNEL) techniques were used to detect the expressions of p53, c-MYC, BCL-2 and apoptotic index in 56 osteosarcoma specimens. The relationships between apoptotic genes expression and apoptotic index in osteosarcoma tissue and their correlations with pathologic classification and prognosis of osteosarcoma cases were analyzed. RESULTS: We found that the expressions of p53, c-MYC, and BCL-2 were negatively correlated with apoptotic index of osteosarcoma tissue, were not correlated with pathological types of osteosarcoma, and were closely related to prognosis of the patients. Moreover, apoptotic index of osteosarcoma tissue was positively correlated with the long term survival of the patients. CONCLUSION: We concluded that the expressions of p53, c-MYC, BCL-2 protein and apoptotic index could be used as potential biomarks for predicting the progression and prognosis of osteosarcoma, and for optimizing clinical treatments.

Outcomes, and factors affecting outcomes, following shoulder hemiarthroplasty for proximal humeral fracture repair.

BACKGROUND: Hemiarthroplasty has been applied to treat proximal humeral fracture with variable outcomes. The purpose of this retrospective study was to assess factors affecting outcome in patients following hemiarthroplasty for proximal humeral fracture (PHF) repair. METHODS: Patients with proximal humeral fractures treated over a 6-year period were included. Indications for hemiarthroplasty were severe three-part fractures associated with osteoporosis; four-part fractures with or without dislocation; splitting of the humeral head, or >45% collapse of the humeral head. Surgery outcome and postoperative complications were main outcome measures in this study. RESULTS: Thirty-three of 47 patients were included in the final analysis (mean age 64.3 years, range 43-82). Mean postoperative follow-up was 44.4 (range 36-57) months. Postoperative complications (shoulder dislocation, mild shoulder subluxation, heterotopic ossification) occurred in seven patients. Healing of the greater and lesser tubercles was abnormal or poor in 18 patients. These patients had significantly higher pain scores (4.0 ± 1.1 vs. 2.2 ± 1.1) and significantly lower capacities for active lifting (79.3 ± 9.6 vs. 121.7 ± 24.3), external rotation (20.7 ± 3.7 vs. 39.2 ± 10.3), and Neer scores (79.2 ± 5.7 vs. 90.6 ± 3.6) versus patients who exhibited complete healing (all P < 0.001). Patient age, type of surgical approach, and fracture type were not major influencers of outcome. CONCLUSION: In conclusion, the healing of the greater and lesser tubercles is the major determinant of outcome following hemiarthroplasty for PHF repair.

Soft tissue balancing in total hip arthroplasty for patients with adult dysplasia of the hip.

OBJECTIVE: To summarize our surgical experience of release and balance of soft tissues around the hip in total hip arthroplasty (THA) for patients with adult dysplasia of the hip (ADH). METHODS: From January 2001 to January 2006, 29 adult patients with dysplastic hips (31 hips) were included in this study. Among them, there were 19 women and 10 men, aged from 38 to 65 years. According to the Crowe classification system, there were 8 type I, 12 type II, 6 type III and 5 type IV. THA was performed via a lateral approach. All acetabular cups were reconstructed at the original anatomic location through soft tissue releasing around the hip to restore limb length, and techniques of balance of soft tissue were applied to extend the strength of the hip abductor and improve its function. RESULTS: All patients had restoration of limb length (range, 1.5-4.5 cm). One postoperative dislocation occurred due to slight enlargement of the angle of abduction of the acetabulum. At 1.5-year follow-up (mean, 3.2 years) in 29 patients, the Harris score had increased from 42.6 preoperatively to 85.4. All hips were pain free with good function. CONCLUSION: In order to restore the anatomic structure and physiologic function of the affected hip, the technique of release and balance of soft tissues around the hip should be applied cautiously in arthroplasty of ADH.

[Reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus].

OBJECTIVE: To explore the effective skills of reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus in order to avoid postoperative complications of joint instability and great tubercle displacement. METHODS: From June 2002 to June 2006, 25 patients with Neer four-part fracture of the proximal humerus were adopted in the study which included 15 females and 10 males, with the mean age of 66 years (ranged from 56 years to 80 years). They were treated with humeral head replacement and should joint reparation simultaneously by modified operation approach and reconstruction and balance skills of soft tissue. RESULTS: The mean duration of follow-up was 2.3 years (ranged from 1 to 4.5 years). No infection, nerve damage and prosthesis loosing were found in all cases. Two cases of infra-forward dislocation or subluxation occurred due to affected limb placed on abduction splint postoperatively. One case occurred prosthesis upward displacement due to early active abduction exercise but no complains. Neither joint instability nor displacement and malunion of great tubercle were found in other patients. According to Neer scoring system, 6 cases were rated as excellent, 15 as good and 5 as fair. The good and excellent rate was 84%. CONCLUSION: In hemi-shoulder replacement for patients with Neer four-part fracture the modified operation approach and reconstruction and balance of soft tissue skills combined with rational rehabilitation exercise can prevent postoperative shoulder joint instability and displacement and malunion of great tubercle.

[Release and balance of the soft tissue in total hip arthroplasty for patients with Crowe III and IV type developmental dysplasia of hip].

OBJECTIVE: To summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia. METHODS: From January 2001 to January 2006, 29 patients (31 hips) of adult dysplasia of hip were included in the study. Among them, there were 22 females and 7 males, age from 38 to 65 years with average of 53 years. According to Crowe classification system, there were 22 in type III, 9 in type IV, and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach. All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length, and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function. RESULTS: All the patients had restoration of limb length (ranged from 2.5 cm to 4.5 cm). One case of postoperative dislocation was occurred due to slight large of acetabular obtuse angle. Follow-up for 1-5 years (average 3.2 years) in 29 patients, the Harris score increased to 85.4 postoperatively. All hips had released from pain and functioned well. CONCLUSIONS: In order to restoration anatomic structure and physiologic function of affected hip, the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastic hip.