Background This study aims to evaluate the value of the femoral anterior tangent (FAT) as a reference axis for the rotation of femoral prostheses on computed tomography (CT) and magnetic resonance imaging (MRI). Methods We retrospectively included 66 patients (83 knees) with primary knee osteoarthritis. FAT, clinical transepicondylar axis (cTEA), surgical transepicondylar axis (sTEA), anterior-posterior axis (APA), perpendicular axis to the posterior-anterior axis of the femoral condyles (pAPA), and posterior condylar axis (PCA) were measured on CT and MRI. The rotation angles of FAT, pAPA, and PCA relative to cTEA and sTEA were measured on the same layer. Patients were further subgrouped based on Kellgren-Lawrence (K-L) grade and gender to assess the variance of different rotational reference axes. Results The mean values of FAT/cTEA, FAT/sTEA, and pAPA/cTEA measured on CT were significantly lower, indicating greater internal rotation, than those measured on MRI (P < 0.05). There were no statistical differences between FAT/sTEA, FAT/cTEA, pAPA/cTEA, and PCA/cTEA among genders (P > 0.05). The CT measurement of pAPA/cTEA in K-L grade 3 knees was -1.1 degrees +/- 3.7 degrees, significantly higher than in K-L grade 4 knees (P = 0.036). FAT/cTEA, FAT/sTEA, and PCA/cTEA demonstrated higher stability in various subgroups of knee osteoarthritis. Conclusion The rotational angles of femoral prostheses measured by CT for FAT and other reference axes show increased internal rotation compared to MRI measurements. Both measurement methods provide relatively stable values for FAT measurements. Clinicians should be cautious of the numerical differences between MRI and CT measurements in clinical applications and should consider modality-specificreference values for pre-operative planning.

As a leading cause of disability worldwide, osteoarthritis (OA) progressively degrades articular cartilage. The incomplete understanding of OA's molecular mechanisms hinders development of disease-modifying treatments. We analyzed GEO database knee OA datasets to track TRIM3 expression dynamics throughout disease progression. Western blot and IHC quantified TRIM3 protein differences between OA and normal cartilage. TRIM3-knockdown chondrocytes showed altered Bcl-2/Bax ratios via qRT-PCR/Western blot, with p-AKT/p-mTOR levels indicating AKT/mTOR activation. To establish functional dependency, siTRIM3 cells were treated with mTOR inhibitor followed by reevaluation of Bcl-2/Bax balance. Apoptotic responses to IL-1β stimulation were quantified by flow cytometry, while collagen II (COL2A1) preservation was visualized via immunofluorescence. Integrated bioinformatics and IHC analyses demonstrated significant TRIM3 upregulation in OA cartilage compared to healthy controls (P = 0.043). TRIM3 depletion exerted dual protective effects: (1) modulating apoptotic regulators by decreasing Bax while increasing Bcl-2 expression, and (2) enhancing AKT/mTOR pathway activation evidenced by elevated p-AKT/p-mTOR levels.Notably, mTOR inhibition abolished these effects, restoring pro-apoptotic Bax expression and suppressing anti-apoptotic Bcl-2 (p < 0.01), confirming pathway mediation. Functionally, siTRIM3 conferred 40

Different techniques have been described for glenoid fractures, there is still a need for safe and effective agents to promote outcomes. From January 2016 to April 2021, the clinical data of 17 patients with pulley type IA fractures treated by the V-shaped fixation technique under shoulder arthroscopy were retrospectively analyzed. Preoperative X-ray, CT, and MRI examinations were completed. The functional score of the shoulder joint, such as the visual analog scale (VAS), Constant score, and Modified Rowe score, was used to evaluate the preoperative and final follow-up clinical outcomes. The active shoulder range of motion (ROM) was also collected preoperatively and at the final postoperative follow-up. Accordingly, intraoperative and postoperative complications were also observed. The mean follow-up was 49.52 months (16-79 months). The patients’ follow-up exams showed that shoulder joint flexion, abduction, external rotation, internal rotation, and pain were not significantly different from those of the contralateral side ( p > .05). The mean Constant score was 83.52 (58-98), and the average Modified Rowe score was 94.29 (70-100). X-ray and CT films of all cases showed good healing without articular depression or steps. Three patients had traumatic arthritis, with VAS <3 pain. No postoperative complications, such as infections, nerve or vessel damage, or suture anchor problems occurred during the follow-up period. Using the Double-pull, V-shaped fixation technique can stabilize the reduction of glenoid fractures while reducing the possibility of bone destruction. It is a good solution and provides an opportunity to treat rotator cuff tears associated with the procedure.

BackgroundThis study aimed to evaluate the reference value of the femoral anterior tangent (FAT) line as a guidance of distal femoral rotation on magnetic resonance images (MRI).MethodsWe retrospectively included 81 patients (106 knees) diagnosed as ailing from primary knee osteoarthritis. The indirect rotational axes including the FAT line, the perpendicular line to the anteroposterior axis (pAPA), and the posterior condylar axis (PCA) were identified on MRI, and their angles related to the clinical transepicondylar axis (cTEA) or surgical transepicondylar axis (sTEA) were measured. The patients were further divided into subgroups according to the Kellgren–Lawrence (K–L) grades, the joint-line convergence angle (JLCA), and the arithmetic hip-knee-ankle angle (aHKA) to assess the variance of different rotational reference axes.ResultsThe FAT line was −11.8° ± 3.6° internally rotated to the cTEA and −7.5° ± 3.6° internally rotated to the sTEA. The FAT/cTEA angle and the FAT/sTEA angle shared a similar frequency distribution pattern but a little greater variance to the pAPA/cTEA angle and the PCA/cTEA angle. The PCA/cTEA angle in the JLCA |x| ≥ 6° subgroup was significantly smaller than in the two other JLCA subgroups. The pAPA/cTEA angle and the PCA/cTEA angle also presented statistical significance within the aHKA subgroups. While the FAT/cTEA angle and the FAT/sTEA angle demonstrated superior stability among the different K–L grades, JLCA subgroups, and aHKA subgroups.ConclusionThe FAT line was less affected by the degree of knee osteoarthritis and lower limb alignment, which could serve as a reliable alternative reference axis for the distal femoral rotational alignment in total knee arthroplasty.

目的:观察老年全髋关节置换术后恐动症危险因素分析及相关护理方案.方法:样本共计100例,均来自我院2020年12月至2023年1月,分组一比一方式,观察组行心理疏导模式,对照组开展常规护理模式,单因素采用非参数检验,以单因素分析有统计意义的变量进行多元线性回归分析,将两组病患恐动症危险因素、恐动症发生率、生活水平及情绪状态进行对比.结果:观察组情绪及T恐动症发生率与对照组直观对比差异较为显著,经计算后为P<0.05;观察组生活水平与对照组直观对比差异较为显著,经计算后为P<0.05;经分析结果显示,老年病

Background: Different techniques have been described for glenoid fractures, there is still a need for safe and effective agents to promote outcomes. To evaluate the clinical effect of the Double-pulley, V-shaped fixation technique under arthroscopy in the treatment of Ideberg Type IA glenoid fractures. Methods: From January 2016 to April 2021, the clinical data of 17 patients with pulley type IA fractures treated by the V-shaped fixation technique under shoulder arthroscopy were retrospectively analyzed. Preoperative X-ray, CT, and MRI examinations were completed, and the average defect area of glenoid fracture was 25%. The functional score of the shoulder joint, such as the visual analog scale (VAS), Constant score, and Modified Rowe score, was used to evaluate the preoperative and final follow-up clinical outcomes. The active shoulder range of motion (ROM) was also collected preoperatively and at the final postoperative follow-up (forward flexion and abduction). Accordingly, intraoperative and postoperative complications were also observed. Results: The mean follow-up was 49.52 months (16-79 months). The patients’ follow-up exams showed that shoulder joint flexion, abduction, external rotation, internal rotation, and pain were not significantly different from those of the contralateral side (p > 0.05). The mean Constant score was 83.52 (58-98), and the average Modified Rowe score was 94.29 (70-100). X-ray and CT films of all cases showed good healing without articular depression or steps. Three patients had traumatic arthritis, with VAS<3 pain. No postoperative complications, such as infections, nerve or vessel damage, or suture anchor problems occurred during the follow-up period. Conclusions:Using the Double-pull, V-shaped fixation technique can stabilize the reduction of glenoid fractures while reducing the possibility of bone destruction. It is a good solution and provides an opportunity to treat rotator cuff tears associated with the procedure. However, there is an extended learning curve for shoulder arthroscopy.

肩胛盂与肱骨头骨缺损的准确测量对于肩关节前方不稳的临床治疗具有重要指导意义,不同骨缺损程度决定了不同的手术方式.但是目前尚无统一的骨缺损测量办法,随着影像技术的发展也不断涌现出新的测量方案.鉴于大部分测量方案是在三维CT上进行的,本文梳理总结目前已发表的三维CT测量肩胛盂与肱骨头骨缺损的方法,为优化测量方案、指导临床应用提供依据.

目的 评价肩关节镜下改良“Chinese-way技术”在较大-巨大肩袖撕裂修补术中的应用价值.方法 回顾性分析2017-06 ～ 2019-07行改良“Chinese-way技术”肩袖修补的19例较大-巨大肩袖撕裂患者的临床资料.术中对肩袖Footprint新鲜化并止点内移,将肱二头肌长头腱从结节间沟松解后,实施肱二头肌长头腱肌腱向后外不切断改良转位移植,然后对肩袖裂口行Suture-Bridge修补术.于术后6周及2、3、6、12、18、24个月随访记录患者疼痛视觉模拟量表(VAS)评分、加州大学洛杉矶分校(UCLA)评分、Constant-Murley评分及肩关节活动度以评估治疗效果.结果 所有患者获得随访,术前VAS评分为5[4,8]分,Constant-Murley评分为(42.65±6.61)分,UCLA评分为(11.21 ±3.10)分.术后VAS评分为1[[0,2]分,Constant-Murley评分为(78.15 ±7.25)分,UCLA评分为(31.52±3.64)分,术后与术前比较差异有统计学意义(P＜0.01).术前前屈上举平均为62.7.,体侧外旋平均为12.2.,内旋后伸基本达到L4水平,前屈抗阻肌力平均为健侧的11.4％;术后前屈上举平均为154.6.,体侧外旋平均为32.3.,内旋后伸基本达到T12水平,前屈抗阻肌力平均为健侧的64.0％.结论 利用肩关节镜下改良“Chinese-way技术”修补较大-巨大肩袖撕裂,在2年随访中可获得较为满意的临床治疗效果,且具有技术门槛低、简便易行的优点,但仍需要进一步进行前瞻性、大样本和多中心研究对该技术的长期疗效进行验证.

Rehabilitation is crucial for postoperative patients with low back pain (LBP). However, the implementation of traditional clinic-based programs is limited in developing countries, such as China, because of the maldistribution of medical resources. Mobile phone–based programs may be a potential substitute for those who have no access to traditional rehabilitation. The aim of this study was to examine the efficacy of mobile phone–based rehabilitation systems in patients who underwent lumbar spinal surgery. Patients who accepted spinal surgeries were recruited and randomized into 2 groups of rehabilitation treatments: (1) a mobile phone–based eHealth (electronic health) program (EH) or (2) usual care treatment (UC). The primary outcomes were (1) function and pain status assessed by the Oswestry Disability Index (ODI) and (2) the visual analog scale (VAS). Secondary outcomes were (1) general mental health and (2) quality of life (Likert scales, EuroQol-5 Dimension health questionnaire, and 36-item Short-Form Health Survey). All the patients were assessed preoperatively and then at 3, 6, 12, and 24 months postoperatively. A total of 168 of the 863 eligible patients were included and randomized in this study. Our analysis showed that the improvement of primary outcomes in the EH group was superior to the UC group at 24 months postoperatively (ODI mean 7.02, SD 3.10, P<.05; VAS mean 7.59, SD 3.42, P<.05). No significant difference of primary outcomes was found at other time points. A subgroup analysis showed that the improvements of the primary outcomes were more significant in those who completed 6 or more training sessions each week throughout the trial (the highest compliance group) compared with the UC group at 6 months (ODI mean 17.94, SD 5.24, P<.05; VAS mean 19.56, SD 5.27, P<.05), 12 months (ODI mean 13.39, SD 5.32, P<.05; VAS mean 14.35, SD 5.23, P<.05), and 24 months (ODI mean 18.80, SD 5.22, P<.05; VAS mean 21.56, SD 5.28, P<.05). This research demonstrated that a mobile phone–based telerehabilitation system is effective in self-managed rehabilitation for postoperative patients with LBP. The effectiveness of eHealth was more evident in participants with higher compliance. Future research should focus on improving patients’ compliance. Chinese Clinical Trial Registry ChiCTR-TRC-13003314; http://www.chictr.org.cn/showproj.aspx?proj=6245 (Archived by WebCite at http://www.webcitation.org/766RAIDNc)

The purpose of this study was to evaluate the effect of salmon calcitonin (sCT) on improving fibrosis-related indicators in frozen shoulder synovial/capsular fibroblasts (SCFs) and detect the potential downstream pathway. Quantitative real-time polymerase chain reaction and cell-substrate adhesion assays were used to measure alterations in fibrosis-related molecule expression and the cell adhesion ability of frozen shoulder SCFs after treatment with range concentrations of sCT. The presence of calcitonin receptors (CTRs) in shoulder joint synovial/capsular tissue samples was detected by immunohistochemistry (IHC). The downstream pathways of sCT in SCFs were further explored by utilizing three classical pathway inhibitors. With the addition of sCT to the culture medium of frozen shoulder SCFs, the messenger RNA (mRNA) expression of collagen type I (COL1A1), COL3A1, fibronectin 1, laminin 1, transforming growth factor-β1 (TGF-β1), and interleukin-1α (IL-1α) showed a descending trend as the sCT concentration increased. Treatment with sCT increased the expression of vascular endothelial growth factor and IL-6 in a dose-dependent manner. The enhanced adhesion ability of frozen shoulder SCFs gradually diminished with increasing concentrations of sCT. By using IHC, the CTR was detected extensively in the frozen shoulder joint synovium and capsule. Blocking the protein kinase C (PKC) pathway reversed the sCT-mediated suppression of COL1A1 production. Blocking the PKC or protein kinase A (PKA) pathway eliminated the sCT-induced inhibition of TGF-β1 production. This study demonstrated that sCT effectively improved the mRNA expression of fibrosis-related molecules and decreased the enhanced cell-substrate adhesion ability of frozen shoulder SCFs. sCT might achieve these effects by interacting with the CTR that is expressed on the SCF surface and by activating the downstream PKC or PKA pathway.

Tendinopathy is a common clinical disease, which causes great economic burden to the society. Platelet-rich plasma(PRP)injection is one of the methods to combat the development of tendinopathy, which may bring new options for the treatment of tendinopathy. However, tendinopathy is a general category of diseases, and there is obvious heterogeneity among its specific types. At the same time, there are many kinds of PRP in the market. Therefore, this article reviewed the literature on the application of PRP in tendinopathy in order to scientifically evaluate the therapeutic effect of PRP on tendinopathy. For chronic tendinitis patients who fail to respond to conventional conservative treatment, multiple ultrasounds-guided PRP injection prepared by multiple enrichment procedures still has therapeutic potential, among which patella tendinitis and external humeral epicondylitis are the most obvious ones. Key words: Platelet-rich plasma; Tendinopathy

Objective To evaluate the clinical efficacy of salmon calcitonin intranasal spray combined with routine treatments in patients with frozen shoulder.Methods Between January 2016 and March 2017,primary frozen shoulder patients visited the shoulder clinic of Sun Yat -sen Memorial Hospital were evaluated.Patients received at least six weeks analgesia and physiotherapy treatments without significant improvement and had not underwent articular injection were suitable to enter our study.Patients with calcific tendinitis,shoulder joint osteoarthritis or rotator cuff tears,examined by X-ray or MRI,were excluded.The eligible patients might enter the study and choose to use calcitonin intranasal spray or not in their treatments. Patients in the control group received physiotherapy,Celecoxib and single intra -articular injection.Patients in the calcitonin group utilized the same therapeutic scheme as control group and combined the application of nasal calcitonin spray for three months.Patients' pain measured by visual analog scale(VAS),and shoulder range of motion were evaluated before treatment and at one, two, three and six months after the initial treatment.Constant score and ASES score were assessed regularly.Independent Student's t test and repeated measures ANOVA were used to compare the statistic differences between the two groups at each time point. Results There were 39 patients in the calcitonin group and 37 patients in the control group.At the first month after initial treatment, the VAS score in calcitonin group(2.9 ±0.7)was significantly lower than control group(4.5 ±1.0)(t =-8.120,P <0.01).At the second month, the shoulder range of motion in flexion, abduction, external rotation and internal rotation in the calcitonin group were(121.7 ±18.5)°, (105.8 ±9.6)°,(30.6 ±7.7)°,(11.6 ±3.2)°, respectively .However,the shoulder range of motion in flexion,abduction,external rotation and internal rotation in the control group were(104 .9 ±19 .0)°,(91.5 ± 9 .2)°,(21.5 ±6.4)°,(13.9 ±2.8)°, respectively.Patients received calcitonin achieved much apparent shoulder range of motion improvement than control group(flexion:F =38.855; abduction:F =41.204;external rotation:F=55 .341; internal rotation, F =7 .963; all P<0 .05) .At the final follow -up, the Constant score and ASES score in the calcitonin group were nearly normal, better than the control group (Constant score:F =55.161; ASES score:F =70.576, both P <0 .05) .Conclusion Based on the conventional treatments,adding salmon calcitonin intranasal spray can alleviate frozen shoulder patient's pain faster and restore shoulder function better.

This study compared knee stability and alterations in the composition of synovial fluid among patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction with either a hamstring autograft or a hamstring allograft. This prospective cohort study enrolled 175 patients. Of these patients, 90 underwent hamstring tendon autograft ACL reconstruction. The remaining patients (n=85) underwent hamstring tendon allograft ACL reconstruction. All of the patients had a minimum of 1 year of follow-up (mean, 2.5 years). Side-to-side differences and the proportion of mononuclear cells in knee joint synovial fluid were measured at 5 time points (preoperatively and at postoperative weeks 1, 3, 6, and 12). During the early postoperative phase, side-to-side knee laxity was greater among the allograft group compared with the autograft group (P<.001). Additionally, among the allograft group, the proportion of mononuclear cells remained high at weeks 6 and 12 (mean, 90.0% and 88.9%, respectively) compared with a normal level in the autograft group (mean, 45.1% and 65.7%, separately). However, no significant difference was found between the 2 groups at final follow-up for range of motion, results of the Lachman test, results of the anterior drawer test, results of the pivot shift test, Lysholm score, bone tunnel enlargement, and graft failure rate (P>.05). These findings showed that, in the early postoperative phase, ACL reconstruction with a hamstring allograft resulted in greater knee laxity and immunologic response compared with the hamstring autograft group. However, at relatively long-term follow-up, both grafts achieved similar objective and subjective outcomes. [Orthopedics. 2017; 40(5):e892-e897.].

Synovium-derived mesenchymal stromal cells (SMSCs) may play an important role in the pathogenesis of rheumatoid arthritis (RA) and show promise for therapeutic applications in RA. In this study, a whole-genome microarray analysis was used to detect differential gene expression in SMSCs from RA patients and healthy donors (HDs). Our results showed that there were 4828 differentially expressed genes in the RA group compared to the HD group; 3117 genes were upregulated, and 1711 genes were downregulated. A Gene Ontology analysis showed significantly enriched terms of differentially expressed genes in the biological process, cellular component, and molecular function domains. A Kyoto Encyclopedia of Genes and Genomes analysis showed that the MAPK signaling and rheumatoid arthritis pathways were upregulated and that the p53 signaling pathway was downregulated in RA SMSCs. Quantitative real-time polymerase chain reaction was applied to verify the expression variations of the partial genes mentioned above, and a western blot analysis was used to determine the expression levels of p53, p-JNK, p-ERK, and p-p38. Our study found that differentially expressed genes in the MAPK signaling, rheumatoid arthritis, and p53 signaling pathways may help to explain the pathogenic mechanism of RA and lead to therapeutic RA SMSC applications.

Objective To examine the multipotent differentiation and immunosuppression of knee synovium-derived mesenchymal stem cells ( SMSCs ) from patients with osteoarthritis ( OA ) .Methods The synovial membranes were obtained with arthroscope and the SMSCs were separated and purified .CCK-8 assay was used to detect cell proliferation ability .Osteogenesis , chondrogenesis and adipogenesis were induced, and the cells were stained with alizarin red , toluidine blue and oil red O respectively .Peripheral blood mononuclear cells ( PBMC) stimulated with anti-human CD3 and anti-human CD28 were co-cultured with SMSCs , and the cell proliferation rate of PBMC was examined with flow cytometry .Results among groups were analyzed by one-factor analysis of variance ( ANOVA ) followed by Bonferroni correction . Results After SMSCs inoculation, the latent phase was 1-2 days, the logarithmic phase was 3-6 days and the stagnate phase began from the 7th day.After osteogenesis, chondrogenesis and adipogenesis inductions , the cells were positive for alizarin red , toluidine blue and oil red O staining .The cell proliferation rate of PBMC at the 5th day without anti-human CD3 and anti-human CD28 stimulation was (3.8 ±0.4)%, while it was ( 80.9 ±8.1 )% with anti-human CD3 and anti-human CD28 stimulation.However, when co-cultured with SMSCs at the 5 th day, the cell proliferation rate of PBMC stimulated with anti-human CD3 and anti-human CD28 was (52.3 ±5.1)%, which was significantly lower than that one with anti-human CD3 and anti-human CD28 stimulation only ( t =8.97, P <0.01).Conclusion Because of multipotent differentiation and immunosuppression , SMSCs from the patients with osteoarthritis could become potentially ideal seed cells for the tissue engineering .

目的:探讨肩关节镜下应用带线锚钉技术同期修复骨性Bankart损伤合并肩袖损伤的手术策略和术后疗效.方法:2008年6月至2015年1月共收治18例同时合并骨性Bankant损伤和肩袖损伤的患者,其中女性8例,男性10例,患者平均年龄57.9岁(40～72岁).患者均有外伤性肩关节前脱位病史,11例急诊复位后因再脱位就医,7例因存在持续肩关节疼痛就医.18例患者均通过MRI结合X线和三维CT确诊同时存在全层肩袖损伤和骨性Bankart损伤.所有患者均于关节镜下一期修复两种损伤,手术中采用带线锚钉先固定骨性Bankart损伤,再用单排锚钉修复撕裂肩袖.结果:18例患者平均随访时间22.5个月(12～38个月).术后3月、6月随访肩关节前屈上举和体侧外旋活动度较健侧比较差异具有统计学意义(P＜0.05).术后1年两侧活动度差异无统计学意义(P＞0.05).末次随访时,患侧vs健侧ASES肩关节评分为91.6±6.7分vs 93.6±4.8分,Constant-Murley评分为89.9±6.8分vs 92.0±7.9分,Rowe评分为89.3±7.1 vs 91.1±6.7,两侧比较差异无统计学意义(P＞0.05).末次随访外展肌力双侧无显著性差异,VAS疼痛评分较术前显著改善(1.4±1.1 vs 6.2±1.9).随访过程中1例患者曾出现半脱位,3例出现术后僵硬,经肌力和功能训练后改善,无感染、再脱位等并发症.结论:肩关节脱位同时存在骨性Bankart损伤和肩袖撕裂时,全关节镜下修复骨性Bankart损伤后再修复肩袖损伤,治疗全面,疗效肯定.

Bone marrow-derived mesenchymal stem cells (BMSCs) are being broadly investigated for treating numerous inflammatory diseases. However, the low survival rate of BMSCs during the transplantation process has limited their application. Autophagy can maintain cellular homeostasis and protect cells against environmental stresses. Tumor necrosis factor-α (TNF-α) is an important inflammatory cytokine that can induce both autophagy and apoptosis of BMSCs. However, the actual role of autophagy in TNF-α-induced apoptosis of BMSCs remains poorly understood. In the current study, BMSCs were treated with TNF-α/cycloheximide (CHX), and cell death was examined by the Cell Counting Kit-8, Hoechst 33342 staining, and flow cytometric analysis as well as by the level of caspase-3 and caspase-8. Meanwhile, autophagic flux was examined by analyzing the level of microtubule-associated protein light chain 3 B (LC3B)-II and SQSTEM1/p62 and by examining the amount of green fluorescent protein-LC3B by fluorescence microscopy. Then, the cell death and autophagic flux of BMSCs were examined after pretreatment and cotreatment with 3-methyladenine (3-MA, autophagy inhibitor) or rapamycin (Rap, autophagy activator) together with TNF-α/CHX. Moreover, BMSCs pretreated with lentiviruses encoding short hairpin RNA of beclin-1 (BECN1) were treated with TNF-α/CHX, and then cell death and autophagic flux were detected. We showed that BMSCs treated with TNF-α/CHX presented dramatically elevated autophagic flux and cell death. Furthermore, we showed that 3-MA and shBECN1 treatment accelerated TNF-α/CHX-induced apoptosis, but that Rap treatment ameliorated cell death. Our results demonstrate that autophagy protects BMSCs against TNF-α-induced apoptosis. Enhancing the autophagy of BMSCs may elevate cellular survival in an inflammatory microenvironment.

OBJECTIVE:To investigate the anti-apoptotic ability of synovium-derived mesenchymal stem cells (SMSCs) by comparing the apoptosis induced by tumor necrosis factor α (TNF-α) between SMSCs and bone marrow mesenchymal stem cells (BMSCs).METHODS:SMSCs and BMSCs were isolated with tissue adhering and density gradient centrifugation respectively, and cells at passages 3-5 were used in further experiments. After immunophenotype identification and differentiation induction, cells were divided into 4 groups. In the experimental groups, apoptosis of SMSCs and BMSCs were induced by 20 ng/mL TNF-α and 10 µg/mL cycloheximide, and cells were cultured in normal culture medium in the control groups. Cellular morphology were observed by inverted phase contrast microscope. After apoptosis induction for 24 hours, cell viability was determined by cell counting kit 8 assay and apoptotic index was detected by flow cytometer. Moreover, the level of Cleaved Caspase-8, 3 were determined by Western blot.RESULTS:Both SMSCs and BMSCs accorded with the definition criteria of MSCs according to results of immunophenotype identification and differentiation induction. After apoptosis induction, cells became shrinking and partially floated and cellular morphologies became worse than those in the control groups. After apoptosis induction for 24 hours, cell viabilities of SMSCs and BMSCs in the control groups were both 100%, and no apoptotic cells were observed. However, cell viabilities of SMSCs and BMSCs in the experimental groups were 60.13% ± 8.63% and 46.55% ± 10.54% respectively, which were both significantly lower than those in the control groups (P < 0.05), and cell viability in the SMSCs experimental group was significantly higher than that in the BMSCs experimental group (t = 3.152, P = 0.006). The apoptotic index was 36.54% ± 8.63% in the SMSCs experimental group and was 53.77% ± 11.52% in the BMSCs experimental group, both were significantly higher than the control groups (1.12% ± 0.24% and 1.35% ± 0.31%) (P < 0.05). What's more, it was significantly lower in SMSCs experimental group than that in BMSCs experimental group (t = 3.785, P = 0.001). Moreover, no expression of Cleaved Caspase-8, 3 was detected in the control groups. But the levels of Cleaved Caspase-8, 3 were significantly enhanced in the experimental groups and they were lower in SMSCs than in BMSCs (t = 13.870, P = 0.000; t = 7.309, P = 0.000).CONCLUSION:TNF-α induced apoptosis is lower in SMSCs than in BMSCs, which means that SMSCs may have stronger anti-apoptosis ability than BMSCs.