Background & Objective: Steroid-induced avascular necrosis of the femoral head (SANFH) is a serious complication of the overuse of glucocorticoids. Platelet-rich plasma (PRP) is a regenerative technique that has shown to effectively repair damaged blood vessels, promote angiogenesis, restore normal blood supply, and promote osteogenesis of the femoral head. This study aimed to analyze the effect of PRP combined with a commonly used simvastatin in treating SANFH. Methods: In this retrospective single-center study clinical data of all SANFH patients who received simvastatin or PRP combined with simvastatin in The Affiliated Hospital of Qingdao University from June 2022 to April 2024 were retrospectively reviewed. Baseline characteristics, recovery of joint function, treatment effect, and incidence of adverse reactions (ARs) were analyzed. Results: Clinical data of 146 patients who received simvastatin alone (n=75) or PRP combined with simvastatin (n=71) under the guidance of the treating physician were included in the analysis. After the treatment, the recovery of joint function and the rate of excellent and good therapeutic effect in patients who received PRP combined with simvastatin were significantly higher than in patients who received simvastatin treatment alone (P<0.05). Combined treatment was associated with significantly lower levels of total procollagen Type-I N-terminal propeptide (T-PINP), N-terminal molecular fragment (N-MID), and β-isomerized C-terminal telopeptide of Type-I collagen (β-CTX), and higher post-treatment levels of 25 hydroxyvitamin D (25-(OH)-D) compared to simvastatin alone (P<0.05). No significant difference was found in the incidence of ARs between the two groups (P>0.05). Conclusions: PRP combined with simvastatin can more effectively restore joint function, regulate bone metabolism state, and improve treatment efficiency in patients with SANFH. doi: https://doi.org/10.12669/pjms.41.5.11518 How to cite this: Chu Y, Rong C, Qu H, Zhang H, Fang Y. Effect of platelet-rich plasma combined with simvastatin in the treatment of steroid-induced avascular necrosis of the femoral head. Pak J Med Sci. 2025;41(5):1280-1284. doi: https://doi.org/10.12669/pjms.41.5.11518 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Defective renal excretion and increased production of uric acid engender hyperuricemia that predisposes to gout. However, molecular mechanisms underlying defective uric acid excretion remain largely unknown. Here, we report a rare genetic variant of gout-unprecedented NUMB gene within a hereditary human gout family, which was identified by an unbiased genome-wide sequencing approach. This dysfunctional missense variant within the conserved region of the NUMB gene (NUMBR630H) underwent intracellular redistribution and degradation through an autophagy-dependent mechanism. Mechanistically, we identified the uric acid transporter, ATP Binding Cassette Subfamily G Member 2 (ABCG2), as a novel NUMB-binding protein through its intracellular YxNxxF motif. In polarized renal tubular epithelial cells (RTECs), NUMB promoted ABCG2 trafficking towards the apical plasma membrane. Genetic loss-of-function of NUMB resulted in redistribution of ABCG2 in the basolateral domain and ultimately defective excretion of uric acid. To recapitulate the clinical situation in human gout patients, we generated a NUMBR630H knock-in mouse strain, which showed marked increases of serum urate and decreased uric acid excretion. The NUMBR630H knock-in mice exhibited clinically relevant hyperuricemia. In summary, we have uncovered a novel NUMB-mediated mechanism of uric acid excretion and a functional missense variant of NUMB in humans, which causes hyperuricemia and gout.

Objective:To observe the influence of neuronal pentraxin 1(NPTX-1) gene on the proliferation and metastasis of keloid fibroblasts after lumbar back surgery.Methods:From September 2018 to September 2020, 6 cases of keloid tissues were collected from patients who underwent internal fixation after lumbar process in the West Coast District of Qingdao University Affiliated Hospital. The patients were all womens whose age was between 40-50 years old. The keloid fibroblasts were separated and cultured in vitro and then divided into experimental group (group A) and control group (group B), in which group A was transfected with small interfering RNA (siRNA) to knockout NPTX-1 gene and group B was transfected with negative control NC. Real-time quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) was performed to measure the messenger ribonucleic acid(mRNA) expression of NPTX-1 and proliferating cell nuclear antigen(PCNA) in groups A and B. Western blotting was used to measure the protein expression of NPTX-1 and PCNA in groups A and B. Cell counting kit-8 (CCK-8) assay was applied to test the fibroblast proliferation ability in both groups and verify the effect of NPTX-1 gene on keloid fibroblast proliferation. Transwell assay was conducted to measure the number of migrating fibroblasts in both groups and verify the effect of NPTX-1 gene on the migration of keloid fibroblasts. The independent samples t test was used to compare the means of the two groups. Results:RT-qPCR and Western blotting showed that as compared with group B, the mRNA and protein expression of NPTX-1 gene decreased significantly in group A (0.18±0.03 vs. 1.56±0.04, 0.29±0.04 vs. 0.68±0.01, t=49.691, 15.302, P<0.01). The results of CCK-8 assay revealed that the A490 nm value in group A at 24, 48 and 72 hwas significantly lower than that in group B (0.93±0.04 vs. 1.06±0.05, 1.42±0.05 vs. 1.66±0.08, 1.65±0.06 vs. 1.99±0.07, t=4.469, 4.958, 6.192, P<0.01) and the proliferation ability decreased obviously, which also showed a significant difference in statistics. RT-qPCR and Western blotting results showed that the mRNA and protein expression of PCNA in group A was significantly lower than that in group B (0.36±0.02 vs. 0.96±0.01, 0.25±0.04 vs. 0.45±0.03, t=55.164, 6.871, P<0.05). Transwell assay results revealed that the amount of migrating fibroblasts and metastasis ability decreased obviously in group A as compared with group B (138.67±4.51 vs. 275.00±5.00, t=35.072, P<0.01). Conclusion:The down-regulation of NPTX-1 gene can inhibit the proliferation and metastasis ability of the keloid fibroblast and the expression of PCNA.

BACKGROUND:C5 nerve root paralysis is a nonnegligible complication after posterior cervical spine surgery (PCSS). The cause of its occurrence remains controversial. The purpose of this study was to analyse the incidence of and risk factors for C5 nerve root paralysis after posterior cervical decompression.METHODS:We retrospectively analysed the clinical data of 640 patients who underwent PCSS in the Department of Orthopaedics, Affiliated Hospital of Qingdao University from September 2013 to September 2019. According to the status of C5 nerve root paralysis after surgery, all patients were divided into paralysis and normal groups. Univariate and multivariate analyses were used to determine the independent risk factors for C5 nerve root paralysis. A receiver operating characteristic (ROC) curve was used to demonstrate the discrimination of all independent risk factors.RESULTS:Multivariate logistic regression analysis revealed that male sex, preoperative cervical spine curvature, posterior longitudinal ligament ossification, and preoperative C4/5 spinal cord hyperintensity were independent risk factors for paralysis, whereas the width of the intervertebral foramina was an independent protective factor for paralysis. The area under the curve (AUC) values of the T2 signal change at C4-C5, sex, cervical foramina width, curvature and posterior longitudinal ligament ossification were 0.706, 0.633, 0.617, 0.637, and 0.569, respectively.CONCLUSIONS:Male patients with C4-C5 intervertebral foramina stenosis, preoperative C4-C5 spinal cord T2 high signal, combined with OPLL, and higher preoperative cervical spine curvature are more likely to develop C5 nerve root paralysis after surgery. Among the above five risk factors, T2 hyperintensity change in C4-C5 exhibits the highest correlation with C5 paralysis and strong diagnostic power. It seems necessary to inform patients who have had cervical spine T2 hyperintensity before surgery of C5 nerve root paralysis after surgery, especially those with altered spinal cord T2 signals in the C4-C5 segment.

Epidural fibrosis is the main cause of failed back surgery syndrome. To investigate the role of miR-146 in the diagnosis and development of epidural fibrosis. Lumbar disc tissues were collected from 72 lumbar disc herniation patients (45 developed epidural fibrosis and 27 did not). The expression of miR-146 in collected tissues and isolated epidural fibroblasts was detected by RT-qPCR. The relative levels of pro-inflammatory cytokines were analyzed by ELISA. The effect of miR-146 on the proliferation of fibroblasts was evaluated by MTT assay. miR-146 was significantly upregulated in epidural fibrosis patients compared with control patients. The expression of miR-146 was closely associated with the location, lower limb symptom and duration of disease of epidural fibrosis patients, and was positively correlated with the relative levels of pro-inflammatory cytokines. Moreover, miR-146 could discriminate epidural fibrosis patients from control patients. In isolated epidural fibroblasts, the overexpression of miR-146 dramatically enhanced its proliferation and the inflammatory response. miR-146 serves as a diagnostic biomarker for the early detection of epidural fibrosis. The upregulation of miR-146 enhanced the fibroblasts proliferation and inflammatory response in epidural fibrosis. This study provides a novel potential therapeutic target for epidural fibrosis.

Blumea balsamifera (L.) DC., a medicinal plant with high economic value in the Asteraceae family, is widely distributed in China and Southeast Asia. However, studies on the population structure or phylogenetic relationships with other related species are rare owing to the lack of genome information. In this study, through high-throughput sequencing, we found that the chloroplast genome of B. balsamifera was 151,170 bp in length, with a pair of inverted repeat regions (IRa and IRb) comprising 24,982 bp, a large single-copy (LSC) region comprising 82,740 bp, and a small single-copy (SSC) region comprising 18,466 bp. A total of 130 genes were identified in the chloroplast genome of B. balsamifera, including 85 protein-coding, 37 transfer RNA, and 8 ribosomal RNA genes; furthermore, sequence analysis identified 53 simple sequence repeats. Whole chloroplast genome comparison indicated that the inverted regions (IR) were more conserved than large single-copy and SSC regions. Phylogenetic analysis showed that B. balsamifera is closely related to Pluchea indica. Conclusively, the chloroplast genome of B. balsamifera was helpful for species identification and analysis of the genetic diversity and evolution in the genus Blumea and family Asteraceae.

Objective:Explore the effect of applying lateral anterior approach to treat senile osteoporotic fractures and vertebral collapse without nerve injury.Methods:21 patients who treated in our hospital between January 2015 to December 2018, with senile osteoporotic thoracolumbar fractures and vertebral collapse, were collected. All were classified as E grade by the American Spinal Injury Association (ASIA) before surgery, and were underwent the lateral anterior approach to complete reconstruction of the anterior structure of the fracture and the posterior internal fixation in one stage, and the follow-up was carried out for at least 12 months. We collect the general information of the patients and the visual analogue scale (VAS), cobb angle, the compression percentage of anterior and central edge of the injured vertebra, the vertebral body angle in the pre-operation, 1 week post-operation, and the last follow-up and the operation time, blood loss, and continuous observation of complications. Analysis of Variance was used in repeated measurement data.Results:The operation time: (4.12±0.74) hours; the blood loss: (662.38±115.37) ml; the follow-up time (20.33±6.40) months. The VAS in the 1 week post-operation and the the last follow-up were significantly improved compared with the pre-operation ( F=853.022, P<0.05); the cobb angle, the compression percentage of the anterior and central edge of the injured vertebra, and the vertebral body angle were significantly different ( P<0.05)between pre- and post-operation, and between pre-operation and the last follow-up. There was no significantly different ( P>0.05) between post-operation and the last follow-up ( F=352.704, 4 691.359, 4 451.951, 5 869.033). Conclusion:The lateral anterior approach has less surgical trauma, and patients can achieve early pain relief and early landing. This study found that the approach has a significant efficacy on the treatment of senile osteoporotic thoracolumbar fractures and vertebral collapse without nerve injury, satisfactory correction of kyphosis, and firm fixation. It is an approach worth promoting.

Background Through the comparison of three-dimensional CT reconstruction between the supine position and the prone position, the relative position of thoracolumbar great vessels and vertebral body was studied, and the shortest safe distance between them was measured to improve the safety of bicortical pedicle screw insertion and reduce the risk of vascular injury. Methods Forty adults were selected to participate the research. Three-dimensional reconstruction of thoracolumbar (T9-L3) CT was performed in the prone position and the supine position. The relative distance between the Aorta/Inferior Vena Cava (IVC) and vertebral body was obtained as AVD/VVD respectively. The relative angle of the Aorta/ IVC and the vertebral body was calculated as ∠AOY/∠VOY. Self-controlled experiments were carried out in the prone and the supine positions, and the data obtained were analyzed using SPSS 22.0 statistical software. Results The AVD of the prone position and the supine position was the shortest at T12 (3.18 ± 0.68 mm), but the difference was not statistically significant. The aorta of the T9-L3 segment was shifted from the anterolateral to the anteromedial. The ∠AOY of the other groups differed significantly between the prone and supine positions in all vertebrae except T12 and L1 ( P < 0.05), and the aorta in the prone position was more anteromedial than that of supine position. With regard to VVD/∠VOY, there was no significant difference between the prone and supine positions ( P ≥ 0.05), and the minimum VVD of L3 segment is greater than 5.4 mm. The IVC has no obvious mobility and is fixed in the range of 20 ° ~ 30 ° near the midline. Conclusion When using bicortical anchoring of pedicle screws, it is safe to ensure that the protruding tips of the screw is less than 3 mm. Due to the mobility of the aorta in different postures and individual differences in anatomy, the prone position CT can help doctors to make better preoperative plans and decisions.

Objective:The distance and position of the great vessels and thoracolumbar spine were measured by three-dimensional CT reconstruction in supine and prone position. These measurements help to determine the safety of pedicle screw bicortical placement and reduce the risk of vascular injury.Methods:The experiment involved 20 men and 20 women between ages of 21 and 76 with a mean age of 53.4 years old. The subjects underwent three-dimensional CT reconstruction twice in prone position and supine position. The shortest distance between the aorta/inferior vena CA-AV (IVC) and vertebral body was obtained as D-AV/D-VV respectively. The relative angle of the aorta/IVC and the vertebral body was calculated as A-AV/A-VV. Self-controlled experiments were carried out in the prone and the supine positions.Results:The shortest D-AV in prone and supine position was (3.39±0.99) and (3.18±0.68) mm respectively at T 12, and the difference was not statistically significant ( t=1.736, P>0.05). Tthe D-AV values measured at the T 9, T 10, T 11 and L 2 vertebral bodies differed significantly between the prone and the supine positions [T 9: (5.94±1.73) mm vs. (5.07±1.25) mm, t=3.956, P<0.05; T 10: (5.93±1.86) mm vs. (4.65±1.50) mm, t=5.867, P<0.05; T 11: (4.71±2.55) mm vs. (3.87±1.11) mm, t=3.115, P<0.05; L 2: (4.09±1.58) mm vs. (4.61±1.98) mm, t=-3.739, P<0.05]. The aorta at the T 9-L 3 segments was shifted from the anterolateral to the anteromedial. The A-AV of the other groups differed significantly between the prone and supine positions in all vertebrae except T 12 and L 1 [T 9: (19.47±10.49)° vs. (32.07±11.33)°, t=-10.619, P<0.05; T 10: (18.47±10.93)° vs. (22.79±8.48)°, t=-2.219, P<0.05; T 11: (11.85±8.60)° vs. (16.19±8.40)°, t=-6.245, P<0.05; L 2: (10.70±7.61)° vs. (13.58±7.38)°, t=-7.806, P<0.05; L 3: (5.30±5.68)° vs. (8.85±3.80)°, t=-7.489, P<0.05], and the aorta in the prone position was more anteromedial than that of supine position. With regard to D-VV/A-VV, there was no significant difference between the prone and supine positions [L 1: (27.23±4.91)° vs. (26.26±3.72)°, t=1.480, P>0.05; L 2: (29.07±7.06)° vs. (27.20±4.93)°, t=1.988, P>0.05; L 3: (24.88±8.21)° vs. (23.21±4.47)°, t=2.795, P>0.05], and the minimum D-VV of L 3 segment was (5.74±1.95) and (5.50±2.17) mm respectively. The IVC had no obvious mobility and was fixed in the range of 20°- 30° near the midline. Conclusion:When using bicortical fixation, it is safe to ensure that the protruding tips of the screw is less than 3 mm. When judging the shortest distance, the measurement in the supine position is safer, but the prone position CT should be referred to when choosing the implantation direction TSA, which is of great significance for make better preoperative decisions.

Objective:To study the clinical effect of lateral extracavitary approach for patients with thoracolumbar tuberculosis.Methods:The clinical data of 32 thoracolumbar tuberculosis patients who underwent surgery between September 2010 and September 2018 in the Affiliated Hospital of Qingdao University were analyzed. According to the surgery, patients were divided into two groups. There were 17 patients who received combined anterior and posterior approach (control group) and 15 patients who received lateral extracavitary approach (experimental group). Operative data, in-hospital data, postoperative complications were compared between two groups. We also compared the preoperative, postoperative one month, and last follow up outcome of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Cobb angle, Japanese Orthopaedic Association (JOA) score, VAS score and improvement in neurological function. Paired t test was used for comparison between groups. Results:The operative time [control group: (285.24±89.21) min; experimental group: (221.56±64.89) min, t=2.281, P<0.05], blood loss [control group: (644.21±166.65) ml; experimental group: (541.88±101.49) ml, t=2.062, P<0.05] and hospital stay (control group: 16.78±2.88; experimental group B: 14.01±2.62, t=2.831, P<0.05) in experimental group were significantly reduced as compared with those in control group. There was no significant difference in hospitalization expense between two groups. In both groups, significant differences were observed in ESR and CRP before and one month postoperation (for ESR, control group: t=4.463, P<0.05; experimental group: t=5.557, P<0.05. for CRP, control group: t=9.486, P<0.05; experimental group: t=7.525, P<0.05), and between postoperative one month and last follow-up (for ESR, control group: t=4.899, P<0.05; experimental group: t=4.418, P<0.05. for CRP, control group: t=6.781, P<0.05; experimental group: t=4.735, P<0.05). There was no significant difference in ESR and CRP between two groups at each time point. In both groups, the Cobb angle (control group: t=5.401, P<0.05; experimental group: t=5.700, P<0.05), JOA scores (control group: t=-7.541, P<0.05; experimental group: t=-7.913, P<0.05) and VAS scores (control group: t=10.027, P<0.05; experimental group: t=10.107, P<0.05) in the last follow-up were significantly lower than those before operation. There was no significant difference in Cobb angle, JOA scores and VAS scores between two groups at each time point ( t=0.696, 0.204, and 1.602, P>0.05). There was one case of Frankel grade B, 4 cases of grade C, 7 cases of grade D and 5 cases of grade E in control group before surgery, and one case of grade C, 2 cases of grade D and 14 cases of grade E after surgery. In experimental group, there were 4 cases of grade C, 8 cases of grade D and 3 cases of grade E before surgery, and one case of grade D, and 14 cases of grade E after surgery. In both groups, there were significant differences before and after operation (control group: Z=-3.015, P<0.05; experimental group: Z=-3.944, P<0.05). The incidence of complications in the experimental group was slightly lower than that in control group ( χ2=0.209, P>0.05). Conclusion:Lateral anterior approach has the advantages of less blood loss, faster postoperative recovery, shorter hospital stay, no access to the chest and abdominal cavity, lower incidence of complications and allowing the same incision for internal fixation.

The pathogenesis of isthmic spondylolisthesis and degenerative spondylolisthesis is different. It is unclear whether there is a difference between the anatomical factors and the site of the disease. To investigate whether there is a difference between the anatomical factors and the location of the disease in patients with degenerative spondylolisthesis and adult lumbar spondylolisthesis. A retrospective analysis of 183 cases of degenerative spondylolisthesis with complete imaging data and adult lumbar spondylolisthesis from May 2012 to February 2015, including 92 cases of degenerative spondylolisthesis (degeneration group) 91 cases of isthmic spondylolisthesis (isthmic fissure group). The lumbar spondylolisthesis, the slippage rate and the slippage distance of the two groups were measured, and the comparison between groups was performed. The age of the isthmus fissure group, the lumbar lordosis angle, and the width of the vertebral isthmus were smaller than that of the degenerative group (P<0.05). The angle between the articular surface of the facet joint and the sagittal plane and the slip index were larger than those of the degenerative group (P<0.05). There was no significant difference in the inclination angle of the tibia between the two groups (P>0.05). The difference in the prevalence of isthmus spondylolisthesis and degenerative spondylolisthesis was statistically significant (P<0.05). Patients with isthmic spondylolisthesis have a good L5. Degenerative spondylolisthesis occurs in L4. The spondy index of patients with isthmic spondylolisthesis is greater than that of degenerative lumbar spondylolisthesis. Vertebral isthmus dysplasia or morphological changes (slim) is schizophrenia important factor in the pathogenesis of lumbar spondylolisthesis L4. The smaller angle between the intervertebral articular surface and the sagittal plane, and the increase of lumbar lordosis angle play a role in the formation of degenerative lumbar spondylolisthesis L5.

Background: Three-dimensional CT reconstruction of prone position could measure the relative position between the Great vessels and the thoracolumbar vertebrae. The Great vessels positions of the thoracic and lumbar segments were studied to improve the accuracy of pedicle screw insertion, reduce the risk of vascular injury. Methods: Twenty-four adults participated in the present study. Three-dimensional reconstruction of thoracolumbar (T9–L3) CT was performed in the prone and supine positions. The relative distance between the arteriovenous vessels and vertebrae distance (AVD/VVD) was obtained, respectively. The relative position angle of the arteriovenous vessel and the vertebral body was calculated as ∠AOY/∠VOY. Self-controlled experiments were carried out in the prone and supine positions. The data obtained were analyzed using SPSS 22.0 statistical software. Results: With regard to AVD, The AVD of the T12 was the smallest,> 3.2 mm. The difference among the T9, T10, L2 level was statistically significant (P < 0.05). And AVD was greater in the prone position than in the supine position; while the value of ∠AOY is the descending from T9-L3 gradually, there were statistically significant differences in ∠AOY between T9-T12, L2 and L3 in prone and supine position (P < 0.05). The aorta in the prone position was closer to the midline than that of the supine position, varying from 0°to 30°near the Y axis. With regard to VVD, there was no significant difference in contrast between the prone and supine positions (P≥0.05), and the VVD was the smallest in the L3 level> 5.4 mm. Conclusion: The pre-vertebral position of the aorta may change from T9 to L3 due to changes in body position. When the T9-L3 thoracolumbar spine disease was treated with pedicle screw double cortical fixation, the screw was safe and reliable within a range of≤ 3 mm when broken the pre-cortex .The three-dimensional reconstruction of prone position CT could be used to more accurately assess the relative position of the vertebral body and the blood vessel.

Osteosarcoma (OS) is the most common bone tumor in children and young adults, and is an aggressive tumor with poor prognosis. MicroRNAs (miRNAs) are aberrantly expressed in various types of cancer, and contribute to cancer tumorigenesis and progression. In the present study, the potential prognostic value and biological function of miRNA-136 (miR-136) in OS was investigated. Reverse transcription-quantitative polymerase chain reaction analysis was used to evaluate the expression of miR-136 in OS tissues and cell lines. Kaplan-Meier survival analysis and Cox regression analysis were conducted to investigate the prognostic significance of miR-136. Various in vitro cell based assays were used to evaluate the effects of miR-136 on the biological behavior of OS cells. A luciferase assay was performed to determine the key miR-136 targets associated with OS. The expression of miR-136 was significantly downregulated in osteosarcoma tissues and cells compared with the normal controls (all P<0.05). Decreased miR-136 expression was significantly associated with Enneking staging (P=0.030) and distant metastasis (P=0.016). Decreased miR-136 expression in patients was associated with shorter overall survival compared with patients with increased expression levels (log-rank test; P<0.05). The expression of miR-136 was indicated as an independent prognostic factor for the patients (hazard ratio=0.496; 95% confidence interval=0.250-0.987; P=0.046). MTT, transwell and Matrigel assays demonstrated that upregulation of miR-136 decreased proliferation, migration and invasion of OS cells. Bioinformatics and luciferase assays demonstrated that migration and invasion enhancer 1 (MIEN1) is a direct target of miR-136. Together, the results suggested that miR-136 functions as a tumor suppressor gene to regulate proliferation, migration and invasion of OS cells. MIEN1 was a potential target of miR-136. Additionally, miR-136 may serve as a prognostic biomarker for OS.

Osteosarcoma (OS) has a high incidence, malignity, and frequency of recurrence and metastasis. In this study, we aimed to explore the potential anti-cancer effects of Astragalus polysaccharides (APS) on human OS MG63 cells as well as underlying mechanisms. Viability of MG63 cells was assessed by CCK-8 assay to determine the adequate concentration of APS. Then, effects of APS on MG63 cell proliferation, cell cycle distribution, apoptosis, and migration and invasion were analyzed by BrdU incorporation, PI staining, flow cytometry, and transwell assays, respectively. The expression levels of proteins involved in these physiological processes were assessed by western blot analysis. Afterwards, miR-133a level in APS-treated cells was determined by qRT-PCR, and whether APS affected MG63 cells through regulation of miR-133a was determined. Finally, the activation of c-Jun N-terminal protein kinase (JNK) pathway was detected. We found that APS treatment suppressed the viability, proliferation, migration, and invasion of MG63 cells, as well as induced cell apoptosis. Moreover, APS enhanced the expression of miR-133a in MG63 cells. Knockdown of miR-133a reversed the APS treatment-induced MG63 cell proliferation, migration and invasion inhibition, as well as cell apoptosis. Furthermore, APS inactivated JNK pathway in MG63 cells. Knockdown of miR-133a reversed the APS treatment-induced inactivation of JNK pathway in MG63 cells. To conclude, APS repressed proliferation, migration, and invasion while induced apoptosis of OS MG63 cells by up-regulating miR-133a and then inactivating JNK pathway.

Objective The screw insertion and parameters of S3 ala-iliac screw fixation were introduced by 3 D printing spinal pelvis model and computer software-assisted navigation.Methods Determine the nailing space of the S3 segment by 3D printing model and computer software related data,and select the position of the iliac screw into the needle point.Twenty of the male and female adult patients who had undergone three-dimensional pelvic CT reconstruction scans were randomly selected.The screw point O was selected,the horizontal section X was the coronal or sacral horizontal cross-section.Spherical probe into the minimum angle of the needle angle range A,the maximum angle range B and the optimal range of nailing angle Z was measured,and the needle point screwed into the screw pin length and width.The accuracy and safety of this new method of nailing were confirmed in the corresponding adult 3D printing model.Results The needle angle is within the range of the minimum angle OA to the maximum angle OB.If the narrowest diameter is more than 7 mm,the fixation can be safely done with a universal Iliac screw (average length 80-90 mm).The range of needle angle was (47.1 ± 1.9) °-(56.7 ± 1.4) ° for the male X-OA-OB plane and (52.3 ± 1.1) ° for the optimal angle.The X-OA-OB plane for women was 49.6 ± 0.8) °-(59.9 ± 1.1) °,the best angle X-OZ range (53.7 ± 0.8) °.The range of nail path length was (91.4 ±2.3) mm for OA,(89.5 ±4.6) mm for OB and (94.2 ±2.1) mm for OZ.The OA level of female was (90.4 ± 1.9) mm,(85.6 ± 2.3) mm,OZ plane range (96.4 ± 1.7) mm.The statistical results showed that in the best setting angle OZ,nail angle differences (F =4.276,P ＜ 0.05) and nail length were statistically significant (F =3.647,P ＜ 0.05) in men and women in comparison;OA,men and women,nail angle The difference was statistically significant (F =5.268,P ＜ 0.05),nail length lost statistical significance (F =1.513,P ＞ 0.05).OB,male and female,nail angle differences (F =8.153,P ＜ 0.05) and nail length were statistically significant (F =3.341,P ＜ 0.05).There was no significant difference in the values of trailing declination angles between adult men and women of the same sex on the same nail plane (P＞ 0.05).Conclusion The iliac bone screw can be safely and effectively inserted into the iliac bone via the S3 block.In theory,the iliac bone screw is safe and stable through the O-Z needle entry point.The O-Z angle is also the best in Spinal pelvis fixation.

卵黄囊瘤是一种少见的起源于生殖细胞的生殖细胞瘤,常见于儿童及青少年,多发于卵巢、睾丸及骶尾部,主要沿身体中线分布,发生于其他部位少见,颅内及椎管内者极为罕见。我们收治1例颅内及椎管内髓外卵黄囊瘤患者,报道如下。患者女性,28岁。因"腰腿痛1月余,加重1周"于2016年11月28日收入我院。患者既往体健,曾于1个月前因腰痛伴右下肢疼痛,来我院就诊,初步检查后考虑"肌筋膜炎",给予对症治疗,效果较差,伴随双下肢进行性肌

Objective To investigate the clinical efficacy of posterior stabilization of thoracolumbar spinal fracture using transpedicular internal fixation and nonfusion technique.Methods Twenty-four patients with thoracolumbar spinal fractures received the treatment of transpedicular internal fixation and nonfusion technique was selected.After 10 to 18 months,the implants were removed from all patients after initial fracture fixation.All cases were followed up for at least 12 months.The compressibility of vertebral anterior edge,the cobb angle and the stabilities and motions of thoracolumbar spinal in flexion/extension,right-left bending view were measured radiologically.Clinical aspects,subjective feelings and degrees of satisfaction were also investigated.Results Before using transpedicular internal fixation and nonfusion technique,the compressibility of vertebral anterior edge,the cobb angle and the visual analogue scale (VAS) score were respectively (52.24 ± 0.13)％,(13.19 ± 17.66) ° and (7.33 ± 1.37) scores.At final follow-up,the above three indices were improved respectively to (27.31 ± 0.10)％,(8.21 ±9.92) ° and (0 ± 0) scores.And the differences between the two phases were statistically significant (P ＜0.05).Conclusion The nonfusion internal fixation technique can get better clinical efficacy in managing thoracolumbar spinal fractures.

BACKGROUND:Cervical Open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation are both procedures that treat cervical spondylotic myelopathy by expanding the space available for the spinal cord. Effectiveness and safety of two operative methods remain unclear. OBJECTIVE:To investigate the biocompatibility of implant and host between open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation to treat multi-segment cervical spondylotic myelopathy. METHODS: Data of 117 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments) were retrospectively analyzed. Sixty-five cases underwent open-door laminoplasty with unilateral mass screw fixation (laminoplasty group). Fifty-two cases underwent laminectomy with bilateral mass screw fixation (laminectomy group). Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system and by recovery rate. Cervical curvature index and cervical range of motion were assessed by X-ray films in both groups. RESULTS AND CONCLUSION:The average folow-up time was 28 months (range 12-59 months) in both groups. No C5 nerve root palsy occurred in the two groups. Japanese Orthopaedic Association scores were greater during final folow-up than pre-fixation in both groups (P < 0.01). No significant difference in Japanese Orthopaedic Association score, recovery rate, and final folow-up cervical curvature index was detected in both groups (P > 0.05). Cervical range of motion was lower during final folow-up than pre-fixation in both groups (P < 0.01). Results confirmed that open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation have similar effectiveness in the improvement of neurological function, relieving pain and reducing complications, but wil greatly reduce the cervical range of motion.

目的 研究基底膜蛋白多糖对成骨细胞增殖及其分泌骨形态发生蛋白2(BMP-2)的影响.方法 体外培养大鼠成骨细胞,随机分为基底膜蛋白多糖抑制剂组(A组)、空白对照组(B组)、低氧状态下基底膜蛋白多糖抑制剂组(C组)、低氧状态下对照组(D组).各组分别进行相应处理,培养24、48、72、96 h.采用细胞增殖检测方法(CCK-8法)和ELISA法,检测并比较各组成骨细胞增殖和分泌BMP-2的变化.结果 培养24、48 h,A组与B组比较、C组与D组比较成骨细胞增殖活性均降低,差异有显著性(t=4.51～18.04,P＜0.05);培养72 h,各组差异无显著性(P＞0.05).培养96 h内,A组与B组比较、C组与D组比较成骨细胞分泌BMP-2降低,差异有显著性(t =6.61～30.50,P＜0.05).结论 在成骨细胞增殖早期基底膜蛋白多糖对成骨细胞增殖活性有显著影响,并对成骨细胞分泌BMP-2有促进作用.