Effect of low-intensity pulsed ultrasound combined with Rhodiola rosea on proliferation and differentiation of osteoblasts.

Osteoblasts (OB), as the mesenchymal progenitor cells differentiated from the inner and outer periosteum and the stroma in bone marrow, can specifically secrete a variety of bioactive substances, thereby regulating and influencing the process of bone formation and reconstruction. Therefore, promoting the proliferation and differentiation of OB plays an important role in promoting bone formation. Based on this, this study studied the proliferation and differentiation of OB by low-intensity pulsed ultrasound (LIPUS) combined with Rhodiola rosea to provide a reliable theoretical basis for bone repair. In this study, rat OB was used as the research material and divided into groups A, B, C and D according to different intervention methods after osteogenic culture. Joint Salvia miltiorrhiza LIPUS ever seen from the results of the study promotes the strongest OB proliferation, at the same time, effectively reduces the apoptosis rate of the OB and apoptosis-related proteins expression, and promotes the OCN and ALO protein expression, indicated by LIPUS Salvia miltiorrhiza can effectively promote the osteoblast proliferation, differentiation, in order to promote cartilage repair and bone strengthen provides an effective means.

Baicalein inhibits cell development, metastasis and EMT and induces apoptosis by regulating ERK signaling pathway in osteosarcoma.

Background: Osteosarcoma is a highly malignant primary tumor. Baicalein has broad-spectrum anti-tumor effects. This study aimed to study the specific molecular regulatory mechanism of baicalein in anti-osteosarcoma and the possible regulatory signaling network involved.Methods: In vitro experiment, MG-63 cells treated with 0, 50, 75, and 100 µM of baicalein. Cell viability, proliferation, migration, invasion, cycle, apoptosis, and morphology were detected using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazoliumbromide (MTT), clone formation, wound healing, Transwell, flow cytometry, Hoechst staining, wound healing and microscopic observation. In addition, cycle, apoptosis and EMT-related proteins and p-ERK/ERK expression level were analyzed using western blotting. In vivo experiments were performed by BALB/c-nude mice model establishment to detect mice and tumor weight, tumor volume, positive rate and p-ERK/ERK expression when mice treated with 100 µM of baicalein.Results: Firstly, the IC50 of baicalein was 67.57 µM. Then, baicalein decreased cell viability, proliferation, migration, invasion, and the expression of CDK2, Cyclin D1, Cyclin E1, Bcl-2, N-cad, Vimentin, MMP-2, MMP-9, p-ERK/ERK, while increased G1 phase numbers, apoptosis and the expression level of p21, p27, cleaved caspase 3/9, Bax, E-cad, ZO-1 in a dose-dependent manner in MG-63 cells. Also, baicalein reduced the body weight, tumor weight and volume and relative expression level of p-ERK/ERK in vivo.Conclusion: Baicalein inhibits cell development, metastasis, and EMT progress and induces cell cycle arrest and apoptosis by regulating ERK signaling pathway in osteosarcoma, and has a visible anti-osteosarcoma effect in vivo.

One-stage Debridement via Oblique Lateral Interbody Fusion Corridor Combined with Posterior Pedicle Screw Fixation in Treating Spontaneous Lumbar Infectious Spondylodiscitis: A Case Series.

OBJECTIVE: Surgery is indicated when antibiotic treatment fails in pyogenic spondylodiscitis, which is caused by pathogens such as the Staphylococcus species. The aim of the present study was to investigate the efficacy and safety of the oblique lateral interbody fusion (OLIF) corridor approach combined with posterior pedicle screw fixation for treating pyogenic spondylodiscitis. METHODS: This was a retrospective case series study. A total of 11 patients with an average age of 60.7 years (range, 40-70 years; 10 males and 1 females) with lumbar pyogenic spondylodiscitis who underwent single-stage debridement and reconstruction using the OLIF corridor combined with posterior pedicle screw fixation were recruited in our study from June 2016 to July 2017. All patients had single-level pyogenic spondylodiscitis between T12 and L5 . The baseline data, perioperative outcomes (operative time, intra-operative blood loss, and intra-operative complication), postoperative laboratory tests (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], white blood count [WBC], and tissue culture results), long-term complications (recurrence, fixation failure, and bony non-fusion rates), and duration of antibiotic administration were reviewed. Outcomes evaluated using a variety of scales including visual analog scale (VAS) score and Oswestry disability index (ODI), were compared pre-operatively and post-operatively. RESULTS: The mean follow-up period of time was 18.3 months. The average operative time and intra-operative blood loss were 217.0 ± 91.91 min and 220.9 ± 166.10 mL, respectively. There were no intra-operative complications, except in 1 patient who encountered somatosensory evoked potentials changes and 1 patient who had motor evoked potentials changes, both without post-surgery neurological deficits. Causative organisms were identified in 4 patients: Staphylococcus aureus in 1 patient and Streptococcus in 3 patients. At approximately 8.8 weeks after surgery, WBC, CRP, and ESR had returned to normal levels. All patients were pain free with no recurring infection. There was no fixation failure during follow up. Solid bony fusions were observed in all cases within 6 months. At the final follow up, the mean VAS (0.6 ± 0.69) and ODI (14.4 ± 4.27) were significantly lower than those before surgery (P < 0.05). CONCLUSION: One-stage debridement with autogenous iliac bone graft through the OLIF corridor combined with posterior pedicle screw fixation is effective and safe for single-level spontaneous lumbar pyogenic spondylodiscitis after antibiotic treatment fails.

Sirtuin 6 contributes to migration and invasion of osteosarcoma cells via the ERK1/2/MMP9 pathway.

Dysregulation of sirtuin 6 (SIRT6) is actively involved in tumor progression. High levels of SIRT6 have been associated with hepatocellular carcinoma and non-small cell lung cancer, and SIRT6 facilitates growth and metastasis of cancer cells. However, the clinical significance and biological function of SIRT6 are not known for osteosarcoma (OS). Here, we report that SIRT6 was notably overexpressed in OS tissues compared with non-cancerous specimens. The high level of SIRT6 was prominently correlated with malignant clinical parameters and poor prognosis of OS patients. SIRT6 was also up-regulated in OS cells. SIRT6 knockdown inhibited the invasion and migration of Saos-2 and U2OS cells in vitro, while SIRT6 restoration increased these cellular biological behaviors in MG-63 cells. Mechanistically, SIRT6 up-regulated expression of matrix metallopeptidase 9 (MMP9) in OS cells. MMP9 restoration partially abolished the effects of SIRT6 knockdown on OS cells, with increased cell migration and invasion. MMP9 knockdown reduced migration and invasion of SIRT6-overexpressing MG-63 cells. Furthermore, SIRT6 positively modulated the levels of phosphorylated extracellular signal-regulated kinases 1 and 2 (ERK1/2). PD098059 and PD0325901, inhibitors of mitogen-activated protein kinase kinase (MEK), blocked the regulatory effects of SIRT6 on p-ERK1/2 and MMP9 levels, suggesting that SIRT6 regulated MMP9 abundance probably through the MEK-ERK1/2 pathway. These results suggest that SIRT6 may act as a prognostic predictor and a drug target for OS patients.

[Case-control study on effect of anterolateral and posterolateral approaches on early postoperative hip abductor strength in total hip arthroplasty].

OBJECTIVE: To compare the difference of early postoperative hip abductor strength and function between improved Gibson anterolateral approach (group A) and conventional Gibson posterolateral approach (group B) in patients who had underwent total hip arthroplasty (THA). METHODS: Among 149 patients performing total hip arthroplasty,130 patients were followed up and were randomly divided into two groups (19 unqualified cases were excluded). Group A included 65 cases who underwent anterolateral approach, and the other group included 65 cases who underwent posterolateral approach. In the group A, male:female = 26:39,with an average age of (72.5 ± 8.3) years old, BMI of (24.7 ± 3.7) kg/m², and hip abductor strength of (1.08 ± 0.49) N · m/kg. In the group B, male:female = 30:35, with an average age of (71.6 ± 7.1) years old, BMI of (25.5 ± 3.9) kg/m², and hip abductor strength of (1.05 ± 0.51) N · m/kg. In the age-related control group, male:female = 33:32, with an average age of (73.1 ± 7.5) years old, BMI of (24.2 ± 3.8) kg/m², and hip abductor strength of (1.17 ± 0.53) N · m/kg. The age, BMI, hip abductor strength, anatomy of surgical approach, hip abduction angles and Harris score in all patients were evaluated at the day before surgery and at 1, 2, 3, 6, and 12 months after surgery. All preoperative clinical data (age, BMI and abductor strength of the uninjured side limb ) of these cases had no significant differences. RESULTS: At 1, 2, 3, 6, and 12 months after surgery, the hip abductor strength in group A were (0.53 ± 0.13), (0.66 ± 0.21), (0.85 ± 0.15), (0.95 ± 0.19), (1.03 ± 0.13) N · m/kg respectively, while in group B were (0.46 ± 0.14), (0.57 ± 0.18), (0.78 ± 0.12), (0.85 ± 0.18), (0.98 ± 0.14) N · m/ kg respectively.The differences between the two groups at the 6th months after operation were significant; the hip abduction angles in group A were (25.35 ± 4.31)°, (36.53 ± 5.13)°, (48.07 ± 1.62)°, (61.53 ± 1.77)°, (68.62 ± 3.16)°,while in group B were (23.47 ± 2.41)°, (33.42 ± 4.23)°, (46.64 ± 2.51)°, (60.96 ± 1.75)°, (67.47 ± 4.36)°. The differences between the two groups at the 3rd month after operation were significant. Harris score in the group A were 72.23 ± 2.57, 79.36 ± 3.91, 84.75 ± 3.17, 88.63 ± 2.16, 95.21 ± 1.37 repectively ; while in the group B were 71.58 ± 3.62, 78.96 ± 2.21, 83.97 ± 3.57, 87.92 ± 2.94, 94.83 ± 1.62 respectively. There were no significant differences between them. CONCLUSION: Owing to less muscles interrupted, the THA with improved Gibson anterolateral approach offers a better improvement in earlier hip abductor strength and abduction angle compared with the conventional surgery.

Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials.

PURPOSE: There is still debate over whether vertebroplasty (VP) or kyphoplasty (KP) is superior for the treatment of osteoporosis vertebral compression fractures (VCFs). We performed a systematic review and meta-analysis of randomised and non-randomised controlled trials comparing VP with KP to reach a relatively conclusive answer. METHODS: We searched computerised databases comparing efficacy and safety of VP and KP in osteoporotic fractures. These trials reported pain relief (Visual Analogue Scale), disability (Oswestry disability score) and complications (i.e., cement leakage, incident fractures) as the primary outcome. RESULTS: Eight studies involving 848 patients were identified. The outcome showed that VP is more effective in the short-term (no more than seven days) pain relief. Kyphoplasty had a superior capability for intermediate-term (around three months) functional improvement. As for long-term pain relief and functional improvement, there is no significant difference between these two interventions. Consistently, both interventions have similar risk for subsequent fracture and cement leakage. CONCLUSION: Thus considering the higher cost of the KP procedure, we recommend VP over KP for the treatment of osteoporotic VCFs.