CircBBS9 accelerates the malignant progression of osteosarcoma through sponging miR-485-3p/HMGB1 axis.

BACKGROUND: Osteosarcoma (OS) is a leading malignant tumor reported with high mortality and morbidity. Dysexpression of CircBBS9 has been reported to exhibit a critical functional role in various diseases. However, the underlying molecular mechanisms of CircBBS9 in osteosarcoma are poorly characterized. METHODS: The present study aims to investigate the impacts of CircBBS9 on the progression of osteosarcoma. RESULTS: The findings of the study demonstrated the up-regulated expression of CircBBS9 in osteosarcoma. The Actinomycin D and RNase R treatment experiments confirmed that circBBS9 is indeed a circRNA. In addition, the knockdown of circBBS9 negatively impacted the migration, proliferation and invasion of osteosarcoma cells. Further investigations illustrated that circBBS9 controlled miR-485-3p and miR-485-3p might directly interact with HMGB1. miR-485-3p had a negative regulatory role in HMGB1's gene expression. Through rescue assays, it was verified that CircBBS9 promoted osteosarcoma progression through the miR-485-3p/HMGB1 axis. Finally, circBBS9 knockdown attenuated the in-vivo growth of osteosarcoma. CONCLUSIONS: Conclusively, our study is the first time to examine the possible functional mechanism and regulation roles of CircBBS9 in osteosarcoma. The findings explained that CircBBS9 promoted the malignant osteosarcoma's progression by sponging miR-485-3p/HMGB1 and proposed CircBBS9 as a prognostic biomarker and therapeutic candidate for osteosarcoma patients.

Exploration of Contributory Factors to an Unpleasant Bracing Experience of Adolescent Idiopathic Scoliosis Patients a Quantitative and Qualitative Research.

BACKGROUND: To obtain a better understanding of the wearing habits and preferences of Adolescent Idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment, we examine what factors contribute to patients' perceived discomfort during the treatment. METHODS: Seventeen AIS patients treated with a rigid brace were recruited. We asked them to complete a questionnaire and participate in an interview study. Finally, we measure the interface corrective force and perceived discomfort with the participants for different positions and assess the correlation. RESULTS: Our survey reveals that participants scored the lowest in the domains of environmental factors, psycho-spiritual factors, satisfaction, and self-image. Appearance anxiety, physical and psychological discomfort and inconvenience were the three most frequently mentioned problems in the interviews on participants' daily bracing experiences. A significant, moderately positive relationship between corrective force and discomfort level was found only when participants were lying on their left side, but not in any of the other positions. No significant correlation between treatment length and perceived discomfort was found. CONCLUSIONS: Future work should focus on reducing the psychological burden and the inconvenience of wearing a brace, rather than on reducing physical discomfort resulting from the corrective force.

Validity of the Roussouly classification system for assessing distal junctional problems after long instrumented spinal fusion in degenerative scoliosis.

PURPOSE: To evaluate the validity of the Roussouly classification system for assessing distal junctional problems (DJP) after long instrumented spinal fusion in degenerative scoliosis. METHODS: Sixty-four patients with degenerative scoliosis and long-segment fixation receiving treatment at our hospital between December 2012 and December 2018 were retrospectively analyzed. Patients were classified preoperatively and postoperatively (Roussouly classification) and divided into DJP and control groups. We observed whether patients restored to their preoperative Roussouly classification (based on pelvic incidence [PI]) postoperatively. RESULTS: The incidences of DJP were 11.11% and 50% in patients who did and did not match their sagittal Roussouly classification immediately postoperatively, respectively. The adjusted Chi-square test that showed whether the sagittal profile matched the Roussouly classification immediately after surgery was statistically significant (P = 0.012). PIs were 55.83 ± 4.94 and 47.21 ± 10.81 in the DJP and non-DJP groups, respectively (t' = 4.367, P < 0.001). Distal junctional kyphosis angles were 6.33 ± 4.19° and 11.56 ± 5.02° in the DJP and non-DJP groups, respectively (t = - 2.595, P = 0.015). Preoperative PI-lumbar lordosis values were 29.14 ± 13.82 and 16.67 ± 11.39 in the DJP and non-DJP groups, respectively (t = - 2.626, P = 0.013). The logistic regression model showed that patients whose Roussouly classification did not match the postoperative PI value were more likely to have DJP (odds ratio [OR] = 4.01, 95% confidence interval [CI]: 0.51-31.61) and preoperative distal junctional kyphotic changes. CONCLUSION: If the postoperative sagittal profile can be restored to match the patient's own PI value, use of the Roussouly classification can greatly reduce the possibility of postoperative DJP.

Comparison of manual versus automated measurement of Cobb angle in idiopathic scoliosis based on a deep learning keypoint detection technology.

PURPOSE: The present study compared manual and automated measurement of Cobb angle in idiopathic scoliosis based on deep learning keypoint detection technology. METHODS: A total of 181 anterior-posterior spinal X-rays were included in this study, including 165 cases of idiopathic scoliosis and 16 normal adult cases without scoliosis. We labeled all images and randomly chose 145 as the training set and 36 as the test set. Two state-of-the-art deep learning object detection models based on convolutional neural networks were used in sequence to segment each vertebra and locate the vertebral corners. Cobb angles measured from the output of the models were compared to manual measurements performed by orthopedic experts. RESULTS: The mean Cobb angle in test cases was 27.4° ± 19.2° (range 0.00-91.00°) with manual measurements and 26.4° ± 18.9° (range 0.00-88.00°) with automated measurements. The automated method needed 4.45 s on average to measure each radiograph. The intra-class correlation coefficient (ICC) for the reliability of the automated measurement of the Cobb angle was 0.994. The Pearson correlation coefficient and mean absolute error between automated positioning and expert annotation were 0.990 and 2.2° ± 2.0°, respectively. The analytical result for the Spearman rank-order correlation was 0.984 (p < 0.001). CONCLUSION: The automated measurement results agreed with the experts' annotation and had a high degree of reliability when the Cobb angle did not exceed 90° and could locate multiple curves in the same scoliosis case simultaneously in a short period of time. Our results need to be verified in more cases in the future.

Systematic review of intervertebral disc repair: a bibliometric analysis of the 100 most-cited articles.

STUDY DESIGN: A bibliometric review of the literature. OBJECTIVE: To identify the most frequently cited articles relating to the repair of intervertebral disc (IVD) and to summarize the key points and findings of these highly cited works, to quantify their impact on the developments of the disc disease treatment. IVD repair is an ever-growing and multi-disciplinary innovating treatment method for disc diseases. There are numerous literatures and related studies about it, promoting the development of the field. A comprehensive review and analysis of the most influential articles can help clarify the most effective strategy of IVD repair, and discover the promising directions for future research. METHODS: The Thomson Reuters Web of Knowledge was searched for citations of all literatures relevant to IVD repair. The number of citations, key points, categories, authorships, years, journals, countries, and institutions of publications were analyzed. RESULTS: The most highly cited articles in IVD Repair were published over 30 years, between 1991 and 2017. Most works (No. 41) were published between 2005 and 2009. The most-cited article was Sakai's 2003 article which described the possibility of combining MSC and gel to repair IVD. The three most popular categories involved were Orthopedics [44], Clinical Neurology [34], Engineering, and Biomedical [24]. The three most common topics were regenerative medicine and the progenitor cells [33], biomaterials and cellular scaffolds [29], application of growth factors [25]. Author Masuda and the partners have 4 articles in the top 100 list. The Rush University has 12 articles in the top 100 list. CONCLUSION: This report identifies the top 100 articles in IVD repair and acknowledges those individuals who have contributed the most to the study of the IVD repair and the body of knowledge used to the repair strategy making. It allows insight into the trends of this innovative and interdisciplinary subspecialty of spine surgery.