Objective To evaluate the feasibility and effectiveness of a novel locking anatomical plate designed for the acromial end of the clavicle(hereinafter referred to as the"novel locking plate")in the treatment of Neer type Ⅱ b and type Ⅴ distal clavicle fractures.Methods Between February 2024 and January 2025,a total of 12 patients with Neer type Ⅱb and type Ⅴ distal clavicle fractures resulting from trauma were treated using the novel locking plate.The cohort comprised 7 males and 5 females,with ages ranging from 22 to 65 years(mean,49.6 years).According to the Neer fracture classification system,9 cases were classified as type Ⅱ b and 3 cases as type Ⅴ.The interval from injury to operation ranged from 2 to 6 days(mean,3.9 days).After achieving anatomical reduction of the fracture,the novel locking plate was applied for internal fixation,accompanied by anatomical reconstruction of the coracoclavicular ligament.The operation time,intraoperative blood loss,and incision healing were meticulously documented.During follow-up,the radiographic examinations were taken to assess fracture healing,and the shoulder joint function was evaluated using the Constant-Murley score criteria.Results All 12 operations were completed.The operation time ranged from 55 to 90 minutes(mean,74 minutes),and intraoperative blood loss ranged from 50 to 100 mL(mean,85 mL).All incisions healed by first intention.All patients were followed up 6-18 months(mean,11.6 months).At last follow-up,the radiographic examination demonstrated that all fractures had achieved bony union;the Constant-Murley score ranged from 92 to 96(mean,94.3),all rated as excellent.Conclusion For Neer type Ⅱb and type Ⅴ distal clavicle fractures,the combination of the novel locking plate fixation and anatomical reconstruction of the coracoclavicular ligament provides reliable internal fixation,promotes fracture healing,and yields highly satisfactory effectiveness.

Objective We aimed to evaluate the utility of preoperative D-dimer and plasma fibrinogen (PF) levels as useful markers for predicting the clinical value of patients with osteosarcoma. Methods 145 enrolled patients with osteosarcoma were studied retrospectively. We determined the critical values of D-dimer and PF by receiver operating characteristic curve analysis. Cox regression analysis was used to assess prognostic role of the D-dimer and PF levels among osteosarcoma patients. Results The critical values of D-dimer and PF were calculated to be 0.46 µg/mL and 3.34 mg/mL, respectively. Upregulation of D-dimer and PF showed positive correlations with a higher clinical stage, tumour metastasis and recurrence. Survival curve results confirmed that osteosarcoma patients with higher levels of D-dimer and PF predicted worse overall survival (OS) and progression-free survival (PFS). Moreover, only a high D-dimer level was associated with a shorter OS (P = 0.013) and PFS (P = 0.042) in both the univariate and multivariate analysis. Conclusion Elevated preoperative D-dimer levels are correlated with aggressive clinicopathological features and poor survival outcomes, which indicates that assessment of the D-dimer could be a useful prognostic marker in osteosarcoma.

Osteosarcoma (OS) is a malignant tumor originating from primitive mesenchymal tissue that occurs mostly in children and adolescents. It is the most common type of malignant tumor originating from bone. The combination of chemotherapy and surgery is an important treatment strategy for OS; however, multidrug resistance frequently leads to failure of chemotherapy for OS. Autophagy is considered an important mechanism through which bone tumor cells escape apoptosis; inhibition of autophagy may significantly increase the sensitivity of tumor cells to chemotherapeutic drugs. The present review discusses the relationship between chemotherapy resistance and autophagy-related genes, the regulation of autophagy in OS, as well as drugs that inhibit protective autophagy in tumors or cause autophagic death of OS cells or increase their sensitivity to chemotherapy drugs, thereby reducing chemotherapy resistance and increasing efficacy.

OBJECTIVE To compare the clinical efficacy of distal radius T-plate combined with suture anchor and distal clavicle anatomical locking plate combined with suture anchor in the treatment of Neer Ⅱb distal clavicle fracture. METHODS From June 2014 to June 2018, 42 patients with Neer Ⅱb distal clavicle fractures were retrospectively analyzed. According to different surgical methods, they were divided into the observation group (T-shaped plate combined with suture anchor) and the control group (anatomical locking plate combined with suture anchor). There were 22 patients in the observation group and 20 patients in the control group. In the observation group, there were 13 males and 9 females, aged from 22 to 70 (45.78± 14.44) years old, 12 cases on the left side and 10 cases on the right side, 8 cases of traffic accident injury and 14 cases of fall. In the control group, there were 12 males and 8 females, aged from 24 to 66 (44.17±15.58) years, 13 cases on the left side and 7 cases on the right side, 6 cases of traffic accident injuryand 14 cases of fall. The operation time, intraoperative blood loss and fracture healing time were compared between the two groups, and Constant Murley score was used to evaluate shoulder joint function. RESULTS The patients in both groups were followed up for 18 to 24 (20.96±2.02) months. The incisions of both groups were healed at stageⅠ. The fracture ends of both groups were bony healed at the last follow up. There was no significant difference in operation time, intraoperative blood loss and fracture healing time between two groups (P>0.05);there was no significant difference in shoulder joint function between two groups at 3 months after operation (P>0.05). CONCLUSION The two methods can obtain satisfactory results in the treatment of Neer Ⅱb distal clavicle fractures, especially suitable for patients with comminuted distal clavicle fractures or osteoporosis; the clinical effect of the treatment of NeerⅡb distal clavicle fractures with T type distal radius plate combined with suture anchor is satisfactory, which provides another feasible treatment scheme for clinic.

Acute kidney injury (AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. Our study was aimed at clarifying the prevalence and risk factors of AKI after hip fracture surgery. Pubmed, Embase, and Web of Science were systematically searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using Stata version 12.0. A total of 11 studies with 16,421 patients was included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17% (95%CI, 14%-21%) with substantial heterogeneity (I-2 = 95%). Postoperative serum albumin (OR 1.80; 95%CI, 1.38-2.36) was a significant predictor for AKI. Age (OR 1.01; 95%CI, 0.95-1.07) and ACE inhibitors (OR 1.38; 95%CI, 0.92-2.07) were associated with increased the risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests (Egger's test, p = 0.258 and Begg's test, p = 0.087). In conclusion, our findings indicated that the pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.

系统评价TNF-α抑制剂治疗强直性脊柱炎的疗效及安全性.计算机检索PubMed、Cochrane library、EM-Base、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库.根据纳入排除标准筛选文献,纳入TNF-α抑制剂治疗强直性脊柱炎的随机对照试验,由两名评价员独立提取资料,并对其方法学进行质量评价,对符合纳入标准的研究采用RevMan5.3软件进行Meta分析.共纳入17个随机对照试验,共2499例患者.Meta分析结果显示:TNF-α抑制剂能有效提高达到ASAS20的病例数[OR=4.55,95％CI(3.40,6.10)],达到ASAS40的病例数也明显提高[OR=6.92,95％CI (5.00,9.59)],同时改善Bath强直性脊柱炎活动指数[OR=3.83,95％CI(3.01,4.88)],降低红细胞沉降率及C反应蛋白水平.在不良反应方面,TNF-α与安慰剂比较,较常见的不良反应包括注射部位不良反应[OR=3.01,95％CI(0.96,9.44)],以及出现感染[OR=1.45,95％CI(1.10,1.90)],其他不良反应的差异无统计学意义.TNF-α抑制剂可有效改善强直性脊柱炎患者的症状,缓解疾病活动,较常见的不良反应为注射部位不良反应(红肿、瘙痒较为常见)及感染(上呼吸道感染较为常见).

Receptor interacting protein kinase 4 (RIPK4) is a serine/threonine kinase that plays an important role in the regulation of cell proliferation, invasion and metastasis in several malignancies; however, its clinical significance and biological function in osteosarcoma (OS) remains unknown. In the present study, the RIPK4 expression level was significantly upregulated in OS tissues and cell lines. High RIPK4 expression was positively associated with larger sized tumors, advanced Enneking stage and poor prognosis in patients with OS. Furthermore, the results revealed that RIPK4 knockdown in the OS cell lines MG-63 and U2OS reduced cell migration and invasion via the inhibition of epithelial-mesenchymal transition (EMT) process, whereby E-cadherin expression was increased and N-cadherin and vimentin expression decreased. Mechanistically, RIPK4 knockdown inhibited EMT by inactivating the Wnt/beta-catenin signaling pathway. These findings suggest that RIPK4 may be a novel potential therapeutic target for the treatment of metastases in patients with OS.

Osteosarcoma is a malignant tumor that occurs in children and adolescents. Although treatments for osteosarcoma have improved, the likelihood of survival remains low for most patients with metastasis and recurrence. Elucidating the mechanism underlying the development of osteosarcoma and chemotherapy resistance will be important to improve diagnosis and treatment. Long non-coding RNAs (lncRNAs), which are longer than 200 nucleotides in length and do not encode for proteins, have been shown to play a regulatory role in the occurrence and development of osteosarcoma, and are expected to serve as biomarkers and molecular targets. This review discusses the progress in the study of the role of lncRNAs in osteosarcoma, and highlights the recent developments in this field.

目的:观察腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折的临床疗效.方法:自2010年3月至2017年8月,对28例旋后-内收型Ⅱ度踝关节骨折患者,采用腓骨远端解剖钢板固定内踝骨折,术后评估其临床疗效.结果:本组28例患者均获得6～24个月随访,平均随访时间14个月.所有患者伤口均I期愈合,术后1,3,6及12个月复查踝关节X线片,28例患者骨折均获得愈合,平均愈合时间16.8周.根据AOFAS踝-后足评分系统评价:术后评分75～94分,优16例,良9例,可3例.结论:采用腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折,固定坚固,对软组织损伤较小,并发症少,临床效果满意.

目的 探讨Wnt5a在骨肉瘤组织中的表达及其与血管生成的关系.方法采用免疫组化法检测45例骨肉瘤组织及15例骨软骨瘤组织中Wnt5a和CD34的表达,根据CD34染色结果进行微血管密度(microvessel density,MVD)计数,并分析Wnt5a表达和MVD计数与骨肉瘤患者临床病理特征及预后的关系.结果 骨肉瘤组织中Wnt5a和CD34表达(阳性率分别为60.0％和71.1％)明显高于骨软骨瘤(阳性率分别为13.3％和20.0％)(P均＜0.05).在骨肉瘤中,Wnt5a表达和MVD计数与Enneking分期和远处转移密切相关(P均＜0.05),与患者性别、年龄、肿瘤部位、组织学类型等无关.Spearman相关分析表明,Wnt5a蛋白表达与MVD计数呈正相关(r =0.380,P=0.010).Kaplan-Meier生存分析发现,Wnt5a和MVD阳性患者的生存时间明显短于阴性患者(P均＜0.05).结论 骨肉瘤中Wnt5a呈高表达,可能与肿瘤血管生成相关,Wnt5a有望成为骨肉瘤抗血管生成治疗中新靶向分子.

目的:探讨干扰受体酪氨酸激酶样孤核受体1 (receptor tyrosine kinase-like orphan receptor 1,ROR1)基因表达对骨肉瘤MG-63细胞上皮-间质转化(epithelial-mesenchymal transition,EMT)的影响.方法:将特异性靶向ROR1基因的siRNA(即ROR1-siRNA)转染至ROR1相对高表达的骨肉瘤MG-63细胞中,蛋白质印迹法检测ROR1基因表达下调情况.然后采用划痕愈合实验及Transwell小室法检测MG-63细胞迁移和侵袭能力的变化,倒置光学显微镜下观察细胞形态的变化.最后,采用蛋白质印迹法和免疫荧光染色法检测MG-63细胞中EMT相关蛋白E-钙黏蛋白(E-cadherin)和波形蛋白(vimentin)以及肿瘤转移相关蛋白锌指E盒结合同源盒蛋白1 (zinc finger E-box binding homeobox protein 1,ZEB1)、基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)和MMP-9的表达情况.结果:转染ROR1-siRNA可明显下调骨肉瘤MG-63细胞中ROR1蛋白的表达水平(P＜0.05).下调ROR1基因表达后,MG-63细胞的迁移和侵袭能力均明显降低(P值均＜ 0.05),细胞形态由间质细胞形向上皮细胞形转变,E-cadherin表达水平明显上调(P＜0.05),而vimentin表达水平明显下调(P＜0.05),另外ZEB1、MMP-2和MMP-9的表达水平均明显降低(P值均＜ 0.05).结论:RNA干扰ROR1基因表达可通过抑制EMT的发生,降低骨肉瘤MG-63细胞的迁移和侵袭能力.

WNT5A, a representative ligand of activating several non-canonical WNT signal pathways, plays significant roles in oncogenesis and tumor inhibition. It has been shown that the non-receptor tyrosine kinase SRC is required for WNT5A-induced invasion of osteosarcoma cells. However, the precise molecular mechanism underlying WNT5A/SRC-mediated osteosarcoma cells invasion remains poorly defined. The study was designed to explore the role of ERK1/2 in WNT5A/SRC-induced osteosarcoma cells invasion and the downstream target of the SRC/ERK1/2 signalings. We found that WNT5A (100 ng/mL) remarkably stimulated migration and invasion of human osteosarcoma MG-63 cells, whereas inhibiting either SRC kinase activity by siRNA-mediated SRC silence or ERK1/2 phosphorylation by PD98059 treatment suppressed these effects, which suggested that the activation of SRC and ERK1/2 is essential for WNT5A-induced MG-63 cells migration and invasion. Furthermore, ERK1/2 phosphorylation induced by WNT5A was dramatically blocked by SRC siRNA. Additionally, our study further demonstrated that MMP-14 was upregulated after exposure to WNT5A in MG-63 cells, and the increased expression was blocked by SRC siRNA or PD98059. Collectively, these results indicate that WNT5A activates SRC/ERK1/2 signal pathway, leading to the upregulation of MMP-14 expression and MG-63 cells migration and invasion.

AIM:To explore the time-dependent change of Ski protein expression in normal and activated astrocytes in rats.METHODS:The astrocytes were obtained from rat cerebral cortex and cultured in vitro.The astrocytes were treated with LPS and scratch injury for activation.Western blot analysis was used to determine glial fibrillary acidic protein (GFAP) and Ski protein levels in activated astrocytes at a series of time points.The indirect immunofluorescence staining method was performed to detect the location of Ski protein in the astrocytes.RESULTS:The protein of GFAP was naturally expressed in the astrocytes, beginning to increase after treated with LPS and scratch injury.Little protein expression of Ski in the normal astrocytes was observed.The Ski protein expression began to increase after treated with 1 mg/L LPS, peaked at 4 d (P<0.05) and then deceased, but was stills higher than that in the normal cells.The protein expression level of Ski after scratch injury was highly consistent with above mentioned.Ski was mainly observed in the nucleus of the normal cells and the cells treated with LPS for 6 d, while it was observed in the cytoplasm 2 and 4 d after treated with LPS.CONCLUSION:The protein of Ski is expressed in the astrocytes, and the expression level is increased in activated astrocytes,mainly located in the nucelus.Ski may plays an essential roles in the processes of activation and proliferation of astrocytes.

Objective:To investigate the extracellular signal-regulated kinase 5 (ERK5) and matrix metallo proteinase-9 (MMP-9) expres-sion levels in osteosarcoma tissues and their clinical significance. Methods:The ERK5 and MMP-9 expression levels in 71 specimens of osteosarcoma tissue and 40 specimens of normal bone tissue were detected by immunohistochemistry. The relationship between ERK5 and MMP-9 expression levels, their clinical characteristics, and prognosis of patients with osteosarcoma were analyzed. Results:The positive expression of ERK5 and MMP-9 in osteosarcoma tissues was 85.9%(61/71) and 74.65%(53/71), respectively, which were significantly higher than those in normal bone tissues at 12.5%(5/40) and 10.0%(4/40) (all P<0.05). The positive expression of ERK5 and MMP-9 was associated with Enneking stage and metastasis (all P<0.05). Kaplan-Meier analysis showed that the survival duration of patients with positive ERK5 and MMP-9 expression levels was shorter than those of the patients in the negative expression groups (all P<0.05). Univariate analysis of COX proportional hazards regression model revealed that tumor size, Enneking stage, metastasis, and positive ERK5 and MMP-9 expression levels are relevant to the overall survival of patients with osteosarcoma (all P<0.05). Multi-variate analysis of COX proportional hazards regression model confirmed that Enneking stage, metastasis, and positive ERK5 and MMP-9 expression levels can act as independent prognostic factors for osteosarcoma patients (all P<0.05). Conclusion:The ERK5 and MMP-9 expression levels are high in osteosarcoma tissues and are related to the clinical characteristics and prognosis of patients with osteo-sarcoma. Thus, ERK5 and MMP-9 expression levels may play important roles in osteosarcoma development and progression.

Objective:To investigate the effect of receptor interacting protein kinase 4 (RIPK4) gene silencing on tumor necrosis factor-α (TNF-α)-induced apoptosis of human osteosarcoma MG-63 cells.Methods:The specific siRNA targeting RIPK4 gene (RIPK4-siRNA) was transfected into MG-63 cells by liposome (named as RIPK4-siRNA group),while the MG-63 cells were transfected with negative control-siRNA (NC-siRNA) as the negative control (named as NC-siRNA group).Then the MG-63 cells transfected with RIPK4-siRNA were treated with human recombinant TNF-α (named as RIPK4-siRNA+TNF-α group),while the MG-63 cells were only treated with TNF-α as the positive control (named as TNF-α group).The proliferation of MG-63 cells was detected by 5-ethynyl-2'-deoxyuridine (EdU) method.The apoptosis of MG-63 cells was detected by Hoechst 33258 staining.The expressions of RIPK4,Bax,Bcl-xL and caspase-3 proteins in MG-63 cells were examined by Western blotting.Results:The expression level of RIPK4 protein in MG-63 cells was significantly down-regulated after transfection of RIPK4-siRNA (P ＜ 0.05).The EdU positive rates of RIPK4-siRNA,NC-siRNA,TNF-α and RIPK4-siRNA+TNF-α groups were 60.7％,39.6％,43.3％ and 16.7％,respectively.The proliferation of MG-63 cells in RIPK4-siRNA group was lower than that in NC-siRNA group (P ＜ 0.05).Furthermore,the proliferation in RIPK4-siRNA+TNF-α group was lower than those in other three groups (all P ＜ 0.05).The apoptosis of MG-63 cells in RIPK4-siRNA groups was significantly higher than that in NC-siRNA group (P ＜ 0.05).Furthermore,the apoptotic rate in RIPK4-siRNA+TNF-α group was significantly higher than those in other three groups (all P ＜ 0.05).The expression levels of Bax and caspase-3 proteins in RIPK4-siRNA group were significantly higher than those in NC-siRNA group (P ＜ 0.05),but the expression level of Bcl-xL protein in RIPK4-siRNA group was significantly lower than that in NC-siRNA group (P ＜ 0.05).The expression levels of Bax and caspase-3 proteins in RIPK4-siRNA+TNF-α group were significantly increased,but the expression of Bcl-xL protein was significantly decreased as compared with other three groups (all P ＜ 0.05).Conclusion:RIPK4 gene silencing can induce the apoptosis of MG-63 cells,and may increase the sensitivity of apoptosis induced by TNF-α.

Objective To investigate the expression and clinical significance of Wnt5a and receptor tyrosine kinase-like orphan receptor 1 (ROR1) proteins in human osteosarcomatous tissues.Methods The expression of Wnt5a and ROR1 in 35 specimens of osteosarcoma tissues and 15 specimens of osteochondroma tissues was detected by immunohistochemical SP method.The correlation of Wnt5a and ROR1 expression with clinicopathological characteristics and prognosis of the patients with osteosarcoma was analyzed.Results The positive expression rates of Wnt5a and ROR1 in osteosarcoma tissues were 62.9％ (22/35)and 57.1％ (20/35),significantly higher than 13.3％ (2/15) and 6.7％ (1/15) of osteochondroma tissues,and the difference was statistically significant (P＜ 0.05).The expression of Wnt5a and ROR1 was positively related to Enneking clinica1 stages and metastasis (P＜0.05).The expression of Wnt5a was positively correlated with ROR1 protein (r=0.888,P＜0.001).Kaplan-Meier analysis showed that the median overall survival of osteosarcoma patients with positive Wnt5a and ROR1 expression were 23 months and 27 months,significantly shorter than 41 months and 42 months of negative expression patients(P＜0.05).Conclusion Wnt5a and ROR1 were highly expressed in osteosarcoma and associated with the development and progression of osteosarcoma.Combined detection of Wnt5a and ROR1 is of great significance in judging the progress and prognosis of osteosarcoma.

目的 系统评价Ezrin表达水平预测骨与软组织肉瘤预后的价值.方法 计算机检索PubMed、EMbase、The Cochrane Library (2016年2期)、CNKI、CBM、VIP和WanFang Data数据库,搜集Ezrin表达对骨与软组织肉瘤相关性的队列研究,检索时限均为建库至2016年5月.由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入17个队列研究,共1 460例.Meta分析结果显示:在骨与软组织肉瘤患者中Ezrin高表达组的总生存率[HR=1.90,95％CI(1.70,2.13),P＜0.00001]、无事件生存率[HR=2.42,95％CI(1.53,3.84),P=0.0002]、无转移生存率[HR=2.09,95％CI(1.10,3.97),P=0.02]明显低于低表达组.进一步按肿瘤类型和种族对总生率进行亚组分析也得到相似的结果.结论 Ezrin高表达可作为骨与软组织肉瘤预后不良的预测因子.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究加以验证.

Objective To explore the expression and clinical significance of E-cadherin and β-catenin in osteosarcoma tissues.Methods From April 2012 to October 2015,54 specimens of osteosarcoma tissues and 22 specimens of osteochondroma tissues were enrolled.Immunohistochemistry was used to detect the expression of E-cadherin and β-catenin in those above tissues.The correlation of the expression of E-cadherin,β-catenin and clinical parameters of osteosarcoma were analyzed.Results In 54 specimens of osteosarcoma tissues,the positive rate of E-cadherin protein was 35.2％ (19/54),significantly lower than 68.2％ (15/ 22) in osteochondroma tissues (P＜0.05).However the positive rate of β-catenin protein was 68.5％ (37/54),significantly higher than 9.1％ (2/22) in osteochondroma tissues (P＜0.05).The expression of E-cadherin protein was associated with Enneking stage and metastasis (P＜0.05).The expression of β-catenin protein was associated with tumor size,Enneking stage and metastasis (P＜0.05).Moreover,the expression of E-cadherin and β-catenin was negatively correlated (r=-0.764,P＜0.05).Conclusion E-cadherin and β-catenin are abnormally expressed in osteosarcoma tissues,and they are correlated to Enneking stage and metastasis.Both of them play a role in the development and progression of osteosarcoma.

Objective: To investigate the expressions of receptor interacting protein kinase 4 (RIPK4), β-catenin and P-glycoprotein (P-gp) in osteosarcoma tissues and their clinical significance. Methods: The expressions of RIPK4, β-catenin and P-gp in 36 specimens of osteosarcoma tissues and 15 specimens of osteochondroma tissues were detected by immunohistochemistry. The correlations of RIPK4, β-catenin and P-gp expressions with clinical characteristics and prognosis of the patients with osteosarcoma were analyzed. Results: The positive expression rates of RIPK4, β-catenin and P-gp in osteosarcoma tissues were 63.9%, 75.0% and 61.1%, respectively, which were higher than those in osteochondroma tissues (6.7%, 20.0% and 0.0%, respectively) (all P < 0.05). The expression of RIPK4 was associated with tumor size and Enneking stage of osteosarcoma (both P < 0.05). The expression of β-catenin was associated with Enneking stage of osteosarcoma (P < 0.05). The expression of P-gp was associated with Enneking stage and metastasis of osteosarcoma (both P < 0.05). There were positive correlation between RIPK4 and β-catenin (γ = 0.634, P < 0.01),  β-catenin and P-gp (γ = 0.461, P < 0.01), and RIPK4 and P-gp (γ = 0.468, P < 0.01) in osteosarcoma tissues. Kaplan-Meier analysis showed that the survival time of patients with RIPK4-, β-catenin- or P-gp-positive expression was shorter than that of the negative expression group (all P < 0.05). Univariate analysis of COX proportional hazards regression model revealed that age, Enneking stage, metastasis, RIPK4- and P-gp-positive expressions were relevant to the overall survival of patients with osteosarcoma (all P < 0.05). Multivariate analysis of COX proportional hazards regression model confirmed that age, metastasis and P-gp-positive expression could be as independent prognostic factors of osteosarcoma patients (all P < 0.05). Conclusion: The expressions of RIPK4, β-catenin and P-gp are high in osteosarcoma tissues and being related to the clinical characteristics of osteosarcoma. The three proteins may play important roles in the development and progression of osteosarcoma, and they can affect the prognosis of osteosarcoma patients. DOI:10.3781/j.issn.1000-7431.2016.33.205