ObjectiveRice body synovitis reports have been rarely reported in children under three years of age. We aimed to explore the clinical characteristics and treatment experience of rice body-like synovitis in children's knees.MethodsWe retrospectively analyzed the clinical and imaging data of 4 cases (5 knees) of rice body-like synovitis in children treated at our hospital from January 2014 to December 2021. Among the patients, 1 was male and 3 were female, with an average age of 22.5 months. The average length of symptoms before admission was 1.86 months. Clinical presentations included swelling and limping, with no fever or rash.ResultsThree patients with unilateral onset and one patient with bilateral onset underwent unilateral arthroscopic excision of synovial lesions. All 4 patients had pathological findings consistent with chronic inflammation, leading to a postoperative diagnosis of juvenile idiopathic arthritis (JIA). Postoperatively, all patients received standardized pharmacological treatment and were followed for 24 to 48 months in collaboration with the rheumatology department. None of the 4 knees undergoing surgery experienced recurrence, and the symptoms of the knee treated conservatively resolved spontaneously. In the last follow-up session, MRI and ultrasound showed only mild synovial thickening, with effusion and loose bodies disappearing.ConclusionRice body-like synovitis may be a specific manifestation of JIA. It can be observed in younger children, presenting with insidious symptoms. Arthroscopic debridement combined with post-operative standard medical treatment can offer satisfactory therapeutic outcomes.

OBJECTIVE:Studies focusing on bone and joint infections (BJIs) in young infants are rare. Some cases of BJI are accompanied by sepsis. This study aimed to identify the clinical and bacteriological features of sepsis in neonates and young infants with BJIs.METHODS:Neonates and infants younger than 3 months diagnosed with BJI in the present institution from 2014 to 2021 were retrospectively reviewed. Patient characteristics, clinical data, and outcomes were documented and compared between those with and without sepsis.RESULTS:Twenty-five patients with a mean age of 34.8 days were included. Nine BJI cases had concomitant sepsis (group A), and 16 had BJI without sepsis (group B). Within group A, staphylococcus aureus was the major pathogenic germ (5 cases, of which 4 were of the methicillin-resistant staphylococcus aureus (MRSA) type). There was no statistical difference in male-to-female ratio, age, history of hospitalization, anemia, birth asphyxia, peripheral leukocyte counts, C-reactive protein on admission, and sequelae between groups. Univariate analyses indicated a significant difference in the incidence of septic arthritis (SA) combined with osteomyelitis (OM) (88.9% vs 37.5%), congenital deformities (44.4% vs 0%), and mean duration of symptoms (2.83 days vs 9.21 days) in comparisons between groups A and B.CONCLUSION:Staphylococcus aureus is the main pathogenic bacteria in BJI cases complicated with sepsis in neonates and young infants. Among infants younger than 3 months diagnosed with BJI, those with concurrent SA and OM, MRSA infection, or congenital deformities are more likely to develop sepsis.

There are no universal guidelines for rehabilitation after saucerization for children with discoid lateral meniscus. This study determined if short-term knee splint immobilization and delayed rehabilitation produces the same benefit as early rehabilitation after saucerization in children, in terms of knee function and pain intensity. A retrospective review was performed by categorizing patients into 2 groups depending on whether a splint immobilization was adopted postoperatively: for group A, rehabilitation began early without splint immobilization after surgery, and for group B, a knee splint was immobilized for 2 weeks. Numerical rating scale scores were collected in patients 1, 3, and 7 days, Lysholm scores were measured at 4 and 8 weeks postoperatively, and the gradual return to normal activities was documented. Forty-eight patients and 53 knees were included: group A had 30 patients with 31 knees, and group B had 18 patients with 22 knees. There was no improvement in numerical rating scale scores on the 1st (P=.519), 3rd (P=.421), and 7th (P=.295) postoperative days in group B. The Lysholm scores of group A (62.94 ± 8.68) was higher than that of group B (46.68 ± 9.82) measured 4 weeks following surgery, but there was no difference at 8 weeks (P=.237), and both groups had similar time to return to normal activities (P=.363). For discoid lateral meniscus patients who underwent isolated saucerization, short-term splint immobilization did not significantly help relieve postoperative pain. There was a comparable time-course for return to normal activities in both study groups.

Objective:To explore the clinical characteristics and treatment outcomes of lower tibial fracture plus proximal fibula fracture in children.Methods:The clinical and radiological data were retrospectively reviewed for 9 children with lower tibial fracture plus proximal fibula fracture from January 2015 to December 2020.There were 5 boys and 4 girls with an average age of 9.7 years.The mechanism of injury included traffic accident (n=3) and sports activities (n=6). The specific fractures were closed (n=8) and open (n=1). Missed diagnosis was detected in 2 cases, including peroneal nerve injury (n=1). There were lower one-third diaphyseal fracture of tibia (n=8) and tibial shaft fracture plus distal tibial epiphysis fracture (n=1). On radiograph, tibial fracture line was oblique with high outside and low inside.Except for greenstick fractures (n=3), racture line of fibula was high anterolaterally and low posteromedially (n=6). Radiography was performed for evaluating the status of reduction and healing.And Johner-Wruh's criteria were applied for evaluating the clinical outcomes during postoperative follow-ups.Results:The procedures included cast fixation (n=4) and surgery for tibia with internal fixation (n=5). The latter included intramedullary nailing (n=4) and intramedullary nailing plus Kirschner wire (n=1). Cast immobilization was performed for fibula fracture.The mean follow-up period was 16.7(12-24) months.All fibula and tibial fractures healed without wound infection, fracture re-displacement or osteofascial compartment syndrome.The symptoms of peroneal nerve injury disappeared at Month 2 post-injury.At the last follow-up, according to the Johner-Wruh criteria of tibial fracture evaluation, the outcomes were excellent (n=8) and decent (n=1).Conclusions:In children with oblique fracture of lower tibia, proximal fibular fracture mayt be missed.Meticulous physical examinations and proper selections of appropriate radiographic sites should be performed to minimize its occurrence.Restoring alignment and stabilizing tibial fracture is a major therapeutic goal.Surgical fixation is generally not required for proximal fibula fractures.

Objective To investigate clinical effects of retrograde Kirschner wire fixation combined with suture fixation for comminuted tibial spine fractures（TSFs） in children. Methods From January 2015 to December 2020, 11 children with comminuted TSFs were treated under arthroscopy in our department. With the assistance of anterior cruciate ligament guide, the large and thick fragment were fixed by retrograde K-wires, and the small and thin cartilage fractures were fixed by sutures. ResultsAnatomic reduction of fractures was achieved in all the patients. All the patients achieved fracture healing without neurovascular injury, fracture displacement, early closure of epiphysis or other complications. The mean follow-up time was 14.3 months（range, 12-18 months）. The Lachman test, drawer test and axial shift test were negative in 10 patients at the last follow-up, 1 patient showed positive Lachman test result without subjectively laxity of the knee. The Lysholm score at the last follow-up was（91.4±2.1） points.Conclusion Retrograde Kirschner wire fixation combined with suture fixation can effectively fix the comminuted TSFs in children.

Background Although most paediatric radial neck fractures can be treated with closed reduction, some severely displaced fractures require open reduction. The purpose of this study is to compare the effects of ESIN and KW fixation in open reduction of radial neck fracture in children. Methods Twenty-four patients with mean age of 8.5 years were included. Four of the patients had a Judet type III fracture and 20 had a Judet type IV fracture. Ten patients who underwent percutaneous KW fixation were assigned to group A, while 14 patients who underwent ESIN fixation were assigned to group B. Variables of interest included age, sex, fracture type, associated lesions, surgical time, fracture reduction, cost, follow-up, healing time, X-rays, clinical outcomes, and complications. Results There were no significant between-group differences in sex, age, additional injuries, fracture type, and quality of reduction. Costs were significantly lower in Group A. Fracture healing was achieved in 23 of 24 patients (10/10 in group A and 13/14 in group B). In a postoperative elbow function assessment based on the Steele and Graham classification, 80% of patients in group A had a score of excellent or good, compared to 78.6% of patients in group B. Two cases of nail shifting and joint protrusion were observed in group B, one of which also presented with nonunion during follow-up. Conclusions Both KW and ESIN may achieve good clinical outcomes, but KW is associated with lower costs, easier implant removal (without the need for a secondary surgery), and lower iatrogenic complications.

目的 探讨不同方法治疗儿童股骨远端骨骺骨折的疗效.方法 11例儿童股骨远端骨骺骨折患儿中,2例Ⅰ型均行闭合复位克氏针固定;3例Ⅱ型中2例行闭合复位克氏针固定,1例行闭合复位空心钉固定;1例Ⅲ型行闭合复位空心钉固定;5例Ⅳ型中2例行闭合复位空心钉固定,1例行闭合复位克氏针固定,2例行切开复位空心钉结合克氏针固定.根据Thomson标准评价功能.结果 患儿均获得随访,时间12～37(22.8±8.1)个月.3例骨骺生长正常,8例出现骨骺生长障碍.末次随访根据Thomson标准评价功能:优6例,良3例,差2例,优良率9/11.结论 根据儿童股骨远端骨骺骨折类型的不同,行闭合或切开复位,采用克氏针、空心钉或两者相结合进行固定,手术损伤较小,术后膝关节功能恢复满意.

We here showed that ADCK1 (AarF domain-containing kinase 1), a mitochondrial protein, is upregulated in human osteosarcoma (OS) tissues and OS cells. In primary and established OS cells, ADCK1 shRNA or CRISPR/Cas9-induced ADCK1 knockout (KO) remarkably inhibited cell viability, proliferation and migration, and provoked apoptosis activation. Conversely, ectopic ADCK1 overexpression exerted pro-cancerous activity by promoting OS cell proliferation and migration. ADCK1 depletion disrupted mitochondrial functions in OS cells and induced mitochondrial membrane potential reduction, ATP depletion, reactive oxygen species production. Significantly, ADCK1 silencing augmented doxorubicin-induced apoptosis in primary OS cells. mTOR activation is important for ADCK1 expression in OS cells. The mTOR inhibitors, rapamycin and AZD2014, as well as mTOR shRNA, potently decreased ADCK1 expression in primary OS cells. In nude mice, the growth of subcutaneous pOS-1 xenografts was largely inhibited when bearing ADCK1 shRNA or ADCK1 KO construct. Moreover, ADCK1 KO largely inhibited pOS-1 xenograft in situ growth in proximal tibia of nude mice. ADCK1 depletion, apoptosis activation and ATP reduction were detected in pOS-1 xenografts bearing ADCK1 shRNA or ADCK1 KO construct. Together, the mitochondrial protein ADCK1 is required for OS cell growth and is a novel therapeutic target of OS.

BACKGROUND:Glucocorticoids (GCs) are widely used to treat inflammatory or autoimmune diseases. However, several studies have reported that the use of GCs can lead to numerous complications, the most serious of which are osteoporosis and osteonecrosis of the femoral head (ONFH). Osteoblast apoptosis has been identified as an important event in the development of GC-induced osteoporosis and ONFH. However, the mechanisms underlying the regulation of these processes have not yet been explored.OBJECTIVES:To observe the effect of dexamethasone (Dex) on the apoptosis of osteoblasts and explore its mechanism, as well as provide a new therapeutic idea for GC‑induced osteoporosis and ONFH.MATERIAL AND METHODS:Cell proliferation and apoptosis of MC3T3-E1 cells after Dex treatment were determined using the CellTiter-Glo® Luminescent Cell Viability Assay kit and Annexin V-FITC/PI Double Staining Apoptosis Detection Kit, respectively. The expression of caspase-3/cleaved caspase-3 and poly(ADP-ribose) polymerase (PARP)/cleaved PARP in MC3T3-E1 cells after Dex treatment was determined with western blotting. The expression of p53 and checkpoint kinase 2 (Chk2) in MC3T3-E1 cells after Dex treatment was analyzed using western blotting and polymerase chain reaction (PCR). The effects of p53 knockdown and Chk2 knockdown on Dex-induced apoptosis of MC3T3-E1 cells were also characterized.RESULTS:Dexamethasone remarkably inhibited cell growth and induced the apoptosis of MC3T3-E1 cells. We also observed that Dex induced osteoblast apoptosis by promoting p53 expression. The regulatory effect of Dex on p53 expression is mediated by the upregulation of Chk2, which interacted with p53 and inhibited p53 degradation. The knockdown of p53 alleviated Dex-induced MC3T3-E1 cell apoptosis by decreasing the expression of cleaved caspase-3 and cleaved PARP.CONCLUSIONS:We demonstrated that Dex increased Chk2 protein expression, which stabilized the protein expression of p53, and in turn promoted osteoblast apoptosis.

BACKGROUND Femoral head fracture is extremely rare in children. This may be the youngest patient with femoral head fracture ever reported in the literature. There are few pediatric studies that focus on cases treated with open reduction via the modified Hardinge approach. CASE SUMMARY A 14-year-old female adolescent suffered a serious traffic accident when she was sitting on the back seat of a motorcycle. A pelvic radiograph and computed tomography revealed a proximal femoral fracture and slight acetabular rim fracture. This was diagnosed as a Pipkin type IV femoral head fracture. An open reduction and Herbert screw fixation was performed via a modified Hardinge approach. After 1-year follow-up, the patient could walk without aid and participate in physical activities. The X-ray results showed that the fractures healed well with no evidence of complications. CONCLUSION Open reduction and Herbert screw fixation is an available therapy to treat Pipkin type IV femoral head fractures in children.

[目的]介绍在关节镜下应用改良克氏针固定法治疗儿童胫骨髁间棘骨折的手术技术和初步临床结果.[方法]2016年9月—2019年3月,本院采用关节镜下经皮克氏针复位固定胫骨髁间棘骨折共18例.镜下清创,复位胫骨髁间棘骨折块.在前交叉韧带导向器引导下,将2枚克氏针在胫骨结节内侧及外侧分别经皮钻入,穿过骨折块.镜下使用持针器夹持克氏针尖下约0.5 cm,折弯克氏针约90°,然后回抽拉紧,使骨折块加压固定.[结果]18例骨折在3个月内均获得愈合,未见骨不连、畸形愈合、针道感染等并发症.末次随访患膝Lysholm功能评分平均为(92.91±6.65)分.[结论]此改良后关节镜下经皮克氏针固定是治疗儿童胫骨髁间棘骨折简单有效的方法.

Precartilaginous stem cells (PCSCs) are able to initiate chondrocyte and bone development. The present study aimed to investigate the role of miR-143 and the underlying mechanisms involved in PCSC proliferation. In a rat growth plate injury model, tissue from the injury site was collected and the expression of miR-143 and its potential targets was determined. PCSCs were isolated from the rabbits' distal epiphyseal growth plate. Cell viability, DNA synthesis, and apoptosis were determined with MTT, BrdU, and flow cytometric analysis, respectively. Real time PCR and western blot were performed to detect the mRNA and protein expression of the indicated genes. Indian hedgehog (IHH) was identified as a target gene for miR-143 with luciferase reporter assay. Decreased expression of miR-143 and increased expression of IHH gene were observed in the growth plate after injury. miR-143 mimics decreased cell viability and DNA synthesis and promoted apoptosis of PCSCs. Conversely, siRNA-mediated inhibition of miR-143 led to increased growth and suppressed apoptosis of PCSCs. Transfection of miR-143 decreased luciferase activity of wild-type IHH but had no effect when the 3'-UTR of IHH was mutated. Furthermore, the effect of miR-143 overexpression was neutralized by overexpression of IHH. Our study showed that miR-143 is involved in growth plate behavior and regulates PCSC growth by targeting IHH, suggesting that miR-143 may serve as a novel target for PCSC-related diseases.

Objective:To compare the presentation and postoperative results of children treated for open and Gartland type Ⅲ supracondylar fractures of the humerus.Methods:From June 2011 to June 2019, 19 patients with open and 38 patients with Gartland type Ⅲ supracondylar fractures of the humerus were evaluated. Intravenous antibiotics were used for open supracondylar fracture patients as early as possible. Patients with Gustilo types Ⅲ and Ⅱ open supracondylar fracture of the humerus were treated by emergency operation. Gustilo type Ⅰ open supracondylar fracture patients were treated by disinfection, bandage, reduction, temporary plaster fixation, emergency or sub emergency operation. Gartland type Ⅲ supracondylar fracture patients were treated by reduction, temporary plaster fixation, and operation within the time limit. The wound characteristics, combined injuries, operation timing, operation time, clinical efficacy, and complications were analyzed.Results:The two groups were similar with respect to age and sex. All the patients were followed for 6-27 months, with an average of 19 months. The mean operative time of Gustilo type Ⅰ patients was (35.18±4.67) min, and that of Gartland type Ⅲ patients was (40.77±2.68) min; the difference between them was not statistically significant (P=0.273). The mean operative time of Gustilo type Ⅱ patients was (41.25±5.15) min, which was longer than that of Gartland type Ⅲ patients, but with no statistically significant difference (P=0.063). The mean operative time of Gustilo type Ⅲ patients was (200.00±61.64) min, which was longer than that of Gartland type Ⅲ patients (P=0.037). The incidence of postoperative infection was 5.3% in open fracture patients and 2.6% in Gartland type Ⅲ patients, and the difference between them was not statistically significant (χ2=0.259, P=0.611). The incidence of nerve injury was 28.9% in Gartland type Ⅲ patients and 42.1% in open fracture patients, and there was no significant difference between them (χ2=0.987, P=0.321). At the last follow-up, 36 cases (94.7%) achieved excellent results and 2 cases (5.3%) achieved good results in Gartland type Ⅲ patients and the corresponding figures in open fracture patients were 16 (84.2%) and 3 (15.8%), respectively, there was no significant difference between them (χ2=1.754, P=0.185).Conclusion:Open supracondylar fracture of the humerus in children can be cured with antibiotics, timely debridement, and effective fixation. The treatment effect of open supracondylar fractures of the humerus in children is similar to that of Gartland type Ⅲ supracondylar fractures. The therapeutic effect is excellent.

目的 探讨锁骨钩钢板内固定治疗肩锁关节脱位的疗效及对患者Constant-Murley评分、Neer评分和生活质量的影响.方法 回顾性分析2015年1月—2020年1月苏州大学附属张家港医院骨科收治的100例肩锁关节脱位患者,男性55例,女性45例;年龄18～58岁,平均32.0岁;体质量指数(BMI)(23.04±0.73)kg/m2;道路交通伤63例,跌伤26例,重物砸伤11例;受伤至手术时间3～8d,平均5.4d.根据手术方法分为双Endobutton钢板组(行Endobutton钢板内固定复位)和锁骨钩钢板组(行锁骨钩钢板内固定治疗)各50例.比较两组患者治疗前后的Constant-Murley评分、Neer评分和生活质量.结果 术后3个月,两组Constant-Murley评分、Neer评分均有提高,且锁骨钩钢板组的疼痛等级、日常生活活动(ADL)、关节活动度(ROM)、徒手肌力检查(MMT)、肩关节运动范围等评分分别为(14.8±1.1)、(18.5±1.5)、(38.3±2.8)、(23.4±1.7)、(28.7±1.8)分,均显著高于双Endobutton钢板组的(12.7±1.0)、(14.5±1.2)、(32.1±2.4)、(20.8±1.8)、(26.9±0.9)分(t=13.245、9.963、10.115、12.682、15.037,P<0.05);术后3个月,两组西安大略肩关节不稳指数(WOSI)评分均有降低,且锁骨钩钢板组患者的身体症状、工作娱乐、生活方式、情绪满意度评分分别为(21.2±3.0)、(20.5±2.5)、(18.7±2.6)、(21.7±2.8)分,均显著低于双Endobutton钢板组的(32.5±2.5)、(24.4±2.3)、(26.9±2.9)、(27.4±2.6)分(t=9.245、12.963、-8.296、-10.002,P<0.05).结论 锁骨钩钢板内固定治疗肩锁关节脱位可显著缓解疼痛,促进肩关节功能恢复,提高生活质量,值得临床推广.

Background: The treatment for displaced Salter-Harris Ⅱ distal tibia fractures remains controversial. The purpose of this study was to evaluate the rate of premature physeal closure (PPC) and to identify the risk factors treated by open reduction and internal fixation. Methods: We reviewed the charts and radiographs of patients with Salter-Harris Ⅱ fractures of the distal tibia with displacement >3mm between 2012 and 2019. Open reduction and internal fixation was performed for all patients. Patients were followed up for a minimum of 4 months. Contralateral ankle radiograph or CT scans were obtained if there was any evidence of premature physeal closure. Any angular deformity or shortening of the involved leg was documented. Results: A total of 85 patients with a mean age of 12.3years were included in the study. The mean initial displacement was 8.5 mm. All patients but one were treated within seven days after injury and the mean interval was 3.7 days. SER injuries occurred in 65 patients (76.5%), PER in 17 (20.0%), and SPF in three (3.5%). The rate of PPC was 29.4% and two patients with PPC had varus deformities. The rate of PPC was significantly greater in patients with associated fibular fracture as compared with those with intact fibular ( P =0.005). Patient age, gender, injured side, mechanism of injury (only SER vs PER), amount of initial displacement, interval from injury to surgery, or energy of injury did not affect the rate of PPC significantly. Conclusions: PPC is a common complication for displaced S-H Ⅱ distal tibia physeal fractures. We suggest that open reduction internal fixation is an effective choice to reduce the risk of PPC. The presence of concomitant fibula fracture was associated with PPC.

我在给刚出生3周的孙子洗澡时发现其颈部一侧有一肿块,有些硬,去医院检查后,被诊断为先天性肌性斜颈.请问,先天性肌性斜颈该怎么治? 河南焦作刘长青

Background: New surgical techniques have challenged traditional guidelines for nonsurgical treatment in pediatric and adolescent distal forearm fractures. This study was performed to compare outcomes and costs between closed reduction with percutaneous pinning (CRPP) and closed reduction with casting in the treatment of complete distal forearm fractures in children 8 to 14 years old. Methods: A retrospective cohort study was performed of 175 displaced distal forearm fractures treated with 2 different methods in the emergency department of a children’s trauma center. One hundred and fourteen children were managed using CRPP. The remaining 61 were treated with closed reduction and casting. All patients had initial follow-up radiographs. The quality of reduction and the residual angulation in both the coronal and sagittal planes were recorded. Outcomes included the angulation after reduction, residual angulation at final follow-up, radiation exposure, total immobilization time, days absent from school, total costs, and postoperative complications. Results: The postreduction sagittal plane angulation was significantly lower in the CRPP group (P=0.037). While residual deformity between the groups at the 6-month final follow-up was not significantly different in either the sagittal or coronal planes (P=0.486, 0.726), patients in the nonoperative group received greater radiation than those in the operative group (P<0.001). Patients in the nonoperative group missed fewer classes and sustained lower costs (P<0.001, <0.001). The mean immobilization time in each group was not significantly different (31.4±4.4 vs. 32.8±5.9 d; P=0.227). Conclusions: Although the postreduction quality was a little better and radiation exposure was less in the CRPP group, there was no difference between the 2 groups in angulation, total immobilization time, or complication rates after 6 months. The cost and time absent from school of patients in the nonoperative group was significantly lower than in the operative group. There is no clear advantage to CRPP treatment on outcomes. Therefore, closed reduction and casting is recommended in complete distal forearm fractures of children 8 to 14 years old. Level of Evidence: Level III—therapeutic study.

Osteosarcoma (OS) is the most common primary bone malignancy in the adolescent population. MAFG (v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog G) forms a heterodimer with Nrf2 (NF-E2-related factor 2), binding to antioxidant response element (ARE), which is required for Nrf2 signaling activation. We found that MAFG mRNA and protein expression is significantly elevated in human OS tissues as well as in established and primary human OS cells. In human OS cells, MAGF silencing or knockout (KO) largely inhibited OS cell growth, proliferation, and migration, simultaneously inducing oxidative injury and apoptosis activation. Conversely, ectopic overexpression of MAFG augmented OS cell progression in vitro. MicroRNA-4660 (miR-4660) directly binds the 3′ untranslated region (UTR) of MAFG mRNA in the cytoplasm of OS cells. MAFG 3′ UTR luciferase activity and expression as well as OS cell growth were largely inhibited with forced miR-4660 overexpression but augmented with miR-4660 inhibition. In vivo, MAGF short hairpin RNA (shRNA) or forced overexpression of miR-4660 inhibited subcutaneous OS xenograft growth in severe combined immunodeficient mice. Furthermore, MAFG silencing or miR-4660 overexpression inhibited OS xenograft in situ growth in proximal tibia of the nude mice. In summary, MAFG overexpression-driven OS cell progression is inhibited by miR-4660. The miR-4660-MAFG axis could be novel therapeutic target for human OS.

Background Osteosarcoma was the most common primary bone malignancy in children and adolescents. It was imperative to identify effective prognostic biomarkers for this cancer. This study was aimed to identify potential crucial genes of osteosarcoma by integrated bioinformatics analysis. Methods Identification of differentially expressed genes from public data gene expression profiles (GSE42352), functional and pathway enrichment analysis, protein–protein interaction (PPI) network construction and module analysis, Cox regression and survival analysis was conducted. Results Totally 17 co-differential genes were found to be differentially expressed. These genes were enriched in biological processes, Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis (GSEA) pathway of inflammatory immune response. PPI network was constructed with 63 differentially expressed genes that co-existed between the test set and the validation set. The area under the receiver operating characteristic curve (AUC value) was 0.855, which indicated that the expression of PODN had a good diagnostic value for osteosarcoma. Furthermore, Cox regression and survival analysis revealed 5 genes were statistically significant. Conclusions PODN was regarded as a potential biomarker for the diagnosis and prognosis of osteosarcoma, ACTA2, COL6A1, FAP, OLFML2B and COL6A3, can be used as potential prognostic indicators for osteosarcoma.

Precartilaginous stem cells (PCSCs) are adult stem cells that can initiate chondrocytes and bone development. In the present study, we explored whether miR-132/212 was involved in the proliferation of PCSCs via Hedgehog signaling pathway. PCSCs were isolated and purified with the fibroblast growth factor receptor-3 (FGFR-3) antibody. Cell viability, DNA synthesis and apoptosis were measured using MTT, BrdU and flow cytometric analysis. The mRNA and protein expression were detected by real-time PCR and Western blot, respectively. The target gene for miR-132/212 was validated by luciferase reporter assay. Results showed that transfection with miR-132/212 mimic significantly increased cell viability and DNA synthesis, and inhibited apoptosis of PCSCs. By contrast, miR-132/212 inhibitor could suppress growth and promote apoptosis of PCSCs. Luciferase reporter assays indicated that transfection of miR-132/212 led to a marked reduction of luciferase activity, but had no effect on PTCH1 3'-UTR mutated fragment, suggesting that Patched1 (PTCH1) is a target of miR-132/212. Furthermore, treatment with miR-132/212 mimics obviously increased the protein expression of Indian hedgehog (Ihh) and parathyroid hormone related protein (PTHrP), which was decreased after treatment with Hedgehog signaling inhibitor, cyclopamine. We also found that inhibition of Ihh/PTHrP signaling by cyclopamine significantly suppressed growth and DNA synthesis, and induced apoptosis in PCSCs. These findings demonstrate that miR-132/212 promotes growth and inhibits apoptosis in PCSCs by regulating PTCH1-mediated Ihh/PTHrP pathway, suggesting that miR-132/212 cluster might serve as a novel target for bone diseases.