Low-energy shock waves promote the cisplatin chemosensitivity of human osteosarcoma MNNG/HOS cells via the P2X7/Akt/mTOR pathway.

Background: The current dilemma of osteosarcoma treatment is the resistance of chemotherapeutic drugs after long-term usage, which also introduces life-threatening side effects. Methods and results: To minimize chemoresistance in osteosarcoma patients, the authors applied shock waves (SWs) to human osteosarcoma MNNG/HOS cells, then evaluated the cell viability and extracellular ATP levels, and further investigated the effect of SWs on cisplatin (DDP) cytotoxicity in MNNG/HOS cells. The authors' results showed that 400 SW pulses at 0.21 mJ/mm2 exhibited little influence on the MNNG/HOS cell viability. In addition, this SW condition significantly promoted the extracellular ATP release in MNNG/HOS cells. Importantly, low-energy SWs obviously increased Akt and mammalian target of rapamycin (mTOR) phosphorylation and activation in MNNG/HOS cells, which could be partially reversed in the presence of P2X7 siRNA. The authors also found that low-energy SWs strongly increased the DDP sensitivity of MNNG/HOS cells in the absence of P2X7. Conclusions: For the first time, the authors found that SW therapy reduced the DDP resistance of MNNG/HOS osteosarcoma cells when the ATP receptor P2X7 was downregulated. SW therapy may provide a novel treatment strategy for chemoresistant human osteosarcoma.

Reduction of acute posterior shoulder dislocation with the FARES method: A case report and a review of the literature.

Posterior shoulder dislocation is a rare entity in clinical practice. The FARES (Fast, Reliable, Safe) method is a well-validated, effective, and rapid approach to achieve reduction of anterior shoulder dislocation, but its use for posterior shoulder dislocation has not been reported previously. A 46-year-old man was admitted to our hospital with acute posterior shoulder dislocation due to a fall experienced while inebriated. We used the FARES method to achieve successful reduction of this case of acute posterior shoulder dislocation without general anesthesia.

A novel technique to prevent guide wire related complications while inserting the 4.0 mm cannulated screws.

BACKGROUND: Cannulated screws (4.0 mm) provide inter-fragmentary compression and stability to fractures. A guide wire is used to define the screw trajectory and hold the fracture fragment while the screw is being inserted. The cannulated shaft typically accommodates a 1.25 mm guide pin. Since the guide pin is very slender and undergoes elastic deformation during insertion, there is a high probability of pin breakage. METHODS: The authors have devised a new way to place the 4.0 mm cannulated screws in a manner that prevents the intraoperative complication of guide wire breakage. For this technique, predrilling was achieved using a 2.0 mm K-wire which was subsequently replaced with a 1.25 mm guide pin under the protection of sleeve. 4.0 mm cannulated screws were then inserted into a defined trajectory over the guide pin. RESULTS: Using the technique, over 20 patients were managed in our department over a period of two years without any complications. CONCLUSION: We have observed that patients treated with this method experience short operation time, combined with good clinical outcome and we recommend its use in cases where cannulated screw use is warranted.

A retrospective comparison of the modified tension band technique and the parallel titanium cannulated lag screw technique in transverse patella fracture.

OBJECTIVE: To compare efficacy between the modified tension band technique and the parallel titanium cannulated lag screw technique for the transverse patella fracture. METHODS: Seventy-two patients were retrospectively analyzed aged 22 to 79 years (mean, 55.6 years) with transverse patella fractures, among whom 37 patients underwent the modified tension band and 35 patients received the titanium cannulated lag screw. Patients were followed up for 1-3 years. We analyzed the difference of operation time, complications, fracture reduction, fracture healing time, and the Iowa score for knee function between both groups. RESULTS: In modified tension band group, five patients had skin irritation and seven suffered wire migration, two of whom required a second operation. In comparison, there were no complications in the titanium cannulated lag screw group, which also had a higher fracture reduction rate and less operation time. CONCLUSION: The parallel titanium cannulated lag screw technique has superior results and should be considered as an alternative method to treat transverse patella fracture.

Shock waves increase T-cell proliferation or IL-2 expression by activating p38 MAP kinase.

Shock waves were elicited by transient pressure disturbances, which could be used to treat musculoskeletal disorders. In present studies, we investigated whether the low-density shock waves (LDSWs), which are able to damage plasma membrane without impairing the vimentin or other organelles, might augment T-cell proliferation as well as IL-2 expression, and if mitogen activated protein kinase p38 (p38 MAPK) might be an underlying mechanism through which the LDSWs enhanced T-cell function. We found that the LDSWs increased activation of p38 MAPK in Jurkat T cells. The LDSWs alone didn't result in the T-cell proliferation and IL-2 expression. However, in combination with other stimuli, LDSWs could augment the T-cell proliferation and IL-2 expression. Inhibition of p38 MAPK using SB203580 reduced the stimulatory effects of the LDSWs, which indicated that the LDSWs enhanced IL-2 expression through a mechanism that involved p38 MAPK activation. We concluded that the p38 MAPK activation played a key role in the regulation of T cells function by the LDSWs.