Osteosarcoma (OS) is a type of primary malignant cancer occurring in the bone and poses a threat to the lives of children and young adults. Long non‑coding RNAs (lncRNAs) have been certified to play important roles in various human malignant tumors, including OS. lncRNA KCNQ1OT1 has been investigated in certain types of cancer; however, its role and molecular mechanisms in OS remain to be determined. In the present study, a high KCNQ1OT1 expression was detected in human OS tissues and cell lines. Moreover, patients with OS with a high expression of KCNQ1OT1 presented a worse prognosis. Loss‑of‑function assays demonstrated that KCNQ1OT1 silencing suppressed cell proliferative, migratory and invasive abilities in OS. Importantly, the knockdown of KCNQ1OT1 suppressed the Wnt/β‑catenin signaling pathway in OS. In vivo assays displayed the inhibitory role of the silencing of KCNQ1OT1 in OS tumor growth. As regards the underlying mechanisms, KCNQ1OT1 could sponge miR‑3666, and its expression was negatively associated with that of miR‑3666 in OS tissues. Thereafter, Kruppel‑like factor 7 (KLF7), upregulated in OS tissues and cells, was discerned as a target gene of miR‑3666. Furthermore, KLF7 expression negatively correlated with miR‑3666 expression, whereas it positively correlated with KCNQ1OT1 expression. A rescue assay delineated that the overexpression of KLF7 counteracted the KCNQ1OT1 knockdown‑induced suppression of OS cell proliferation, migration, invasion and Wnt/β‑catenin signaling. Collectively, the present study demonstrates that KCNQ1OT1 facilitates OS progression and activates Wnt/β‑catenin signaling by targeting the miR‑3666/KLF7 axis.

Background: 5-fluorouracil (5-FU) is a widely used drug for cancer treatment, but its effect and underlying mechanisms on osteosarcoma (OS) cells remain unclear. Methods: U2OS and MG63 cells were treated with 0, 50, 100, and 500 μM 5-FU. MTS and flow cytometry were used to examine the effect of 5-FU on cell viability and apoptosis, respectively. Circular RNA (circRNA) expression was detected using RNA sequencing and quantitative real-time PCR (qPCR). Differentially expressed circRNAs were further subjected to the Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) analysis to predict their functions. A circRNA–miRNA–mRNA interaction network was generated to analyze the regulatory networks of 5-FU–induced differentially expressed circRNAs. Western blotting (WB) was used to verify the protein in the downstream of circRNAs. Results: 5-FU inhibited the cell viability of the MG63 cells in a concentration-dependent manner. The most significant effect was observed in the cells treated with 500 μM 5-FU. Apoptosis was also increased in the MG63 cells after 500 μM 5-FU treatment for 3 days. RNA sequencing results showed that 183 differentially expressed circRNAs (172 upregulated and 11 downregulated) in 5-FU–treated cells. KEGG and GO analysis showed that the differentially expressed circRNAs were primarily enriched in proliferation-, apoptosis-, and metabolism-related functions. qPCR was used to verify the most upregulated and downregulated circRNAs. The circRNA–miRNA–mRNA interaction network showed that these 8 circRNAs had a sizable regulatory network that links a series of genes involved in tumor suppression. Conclusion: 5-FU treatment resulted in the differentially expressed circRNAs that were proliferation- and apoptosis-associated and were involved in the 5-FU–induced inhibition of tumor proliferation in OS cells.

目的 比较交锁髓内钉与经皮锁定钢板治疗胫骨远端关节外骨折的临床疗效.方法 回顾性分析2011年1月至2015年1月因胫骨远端关节外骨折接受内固定手术治疗的90例患者的临床疗效,根据内固定方式将90例患者分为微创经皮锁定钢板固定组(钢板组)和交锁髓内钉固定组(髓内钉组),每组45例.术后比较两组患者的平均手术时间、平均骨折愈合时间、临床疗效及并发症发生情况,采用Johner-Wruhs胫骨干骨折疗效标准评价临床疗效.结果 所有患者均获随访,髓内钉组手术时间(64.0±10.1)min,骨折愈合时间(29.5±7.6)周;钢板组手术时间(68.0±12.1)min,骨折愈合时间(31.6±10.3)周,两组比较,差异均无统计学意义(P>0.05).钢板组优良率[95.6％(43/45)]及并发症发生率[13.3％(6/45)]与髓内钉组[分别为93.3％(42/45)、6.7％(3/45)]比较,差异均无统计学意义(P>0.05).结论 采用交锁髓内钉及经皮锁定钢板内固定治疗胫骨远端关节外骨折,均能达到良好治疗效果,在骨折愈合时间及并发症发生率方面,两组无明显差异.

目的 通过分析雌激素受体(ER)基因型在绝经期腱鞘炎女性患者、绝经期健康女性和非绝经期健康女性的分布情况,研究ER基因与女性腱鞘炎发病的关联性.方法 选取2012年8月至2015年12月中山大学附属第八医院门诊收治的绝经期女性111例,其中48例为腱鞘炎患者(A组),63例绝经期健康女性(B组);另选取63例非绝经期健康女性(C组)作为对照.采集三组研究对象早晨空腹外周静脉血,采用聚合酶链反应技术检测ER基因型分布,并进行相关性分析.结果 A组患者ER基因型分布及ER基因多态性与B、C组比较,差异均无统计学意义(P>0.05).结论 ER基因多态性与绝经期女性腱鞘炎发病无明显关系.

目的探讨多向克氏针治疗桡骨小头骨折Mason Ⅲ骨折的可行性及疗效。方法 2009年3月~2012年3月收治单纯桡骨小头MasonⅢ型骨折24例,男性15例,女性9例,年龄23~45岁,均为MasonⅢ型骨折,采用肘后外侧切口,复位骨折后采用多向克氏针固定。结果随访12周~1年,所有患者伤口均一期愈合,无骨不连发生。经Mayo肘关节功能评分标准（MEPS）评分,24例中优16例,良4例,中4例,差0例。结论多向克氏针固定治疗桡骨小头Mason Ⅲ型骨折损伤小,固定可靠,费用低廉,是一种简单有效的治疗方法。

BACKGROUND: At present, for the treatment of humeral fracture, there has not yet been formed uniform treatment mode which is fixed and accepted by most scholars, and there are disagreements on the indications and surgical timing of humeral fracture treated with intramedul ary nail internal fixation. OBJECTIVE: To analyze the pathological anatomy, healing process and injury typing of humeral fracture and to investigate the indications and surgical timing of humeral fracture treated with intramedul ary nail internal fixation. METHODS: The purpose of the treatment of complex humeral fractures was to restore the necessary functional or anatomical bits, achieve stable fixation and placement, thus get the early-stage functional exercise. The articles concerning the treatment of humeral fractures with intramedul ary nail internal fixation were summarized to find out the cases with the similar treatment objects and the same curative effect evaluation criteria for the comparative study, in order to provide basis for the clinical treatment of humeral fractures. RESULTS AND CONCLUSION: For the treatment of humeral fractures, it is important to critical y assess the type of fracture and bone quality and to select the suitable intramedul ary nail during the treatment of humeral fractures. Understanding the type of intramedul ary nail and the manner of internal fixation, recognizing the value of different types of intramedul ary nail placement for the treatment of humeral fractures as wel as taking the effective measures to prevent the related complications during the treatment of humeral fractures with intramedul ary nail internal fixation can help to obtain the satisfactory results during the treatment of humeral fractures.

Objective To dynamically detect the changes of growth hormone(GH) in patients suffered from severe craninocerebral trauma with extremities fractures and simple extremities fractures,and discuss the effect of GH on the healing of fracture,to provide the choice of operation timing.Methods From March 2010 to March 2012,22 cases in the two groups respectively joined the observation.Group A suffered from severe craninocerebral trauma(GCS 5~8) with extremities fractures and group B suffered from simple extremities fractures.The GH level of serum was detected at 1st,3rd,7th,9th and 14th day respectively,the results were analyzed statistically.Results Compared with group B,the GH level of group A rose at 3rd day and rose to the peak at 7th day,descended at 9th day and gradually to normal at 14th day.The level of GH in Group B was normal all the time.There was statistical significance at 3rd,7th and 9th day.Conclusion The level of GH in severe craninocerebral trauma with extremities fractures group rose compared with that of control group in two weeks,coincidence with the formation of early callus.Hence,fracture operation should be performed in two weeks in group A if the general conditiond is stable.We may refer that a small dosage of rhGH could promote the healing of fracture.

Objective To investigate the expression of miR-155 and miR-146a in peripheral blood mononuclear cells (PBMC) and plasma of rheumatoid arthritis (RA) patients.Methods PBMC and plasma were separated from the peripheral blood of 34 RA patients and 15 healthy individuals.Total RNAs were isolated and miRNAs were purified.The levels of miR-155 and miR-146a were determined by quantitative reverse transcription PCR (qRT-PCR).U6 was used as housekeeping control.The amount of target miRNA was normalized relative to the amount of U6 (ΔCt=ΔCtmiRNA-ΔCtU6).Relative expression levels were expressed as 2 △-ΔCt.Data were analyzed using SPSS 13.0 software.The test of homogeneity of variance and unpaired t-test was used to compare between groups.P values (2-tailed) less than 0.05 were considered as statistically significant.Results The expressions of PBMC and plasma miR-155 were higher in RA patients than those in the healthy control individuals (0.08±0.08 vs 0.05±0.03,t=-2.225,P＜0.05; 5.9±6.7 vs 1.3±2.0,t=-3.677,P＜0.05).The expression of miR-146a in PBMC and plasma of RA patients and controls were (1.3±1.2 vs 0.8±0.6,t=-2.154,P＜0.05)and (741±1001 vs 300±295,t=-1.669,P＞0.05).According to their DAS28 value,RA patients were divided into high activity group (23 cases,DAS28≥5.0) and low disease activity group( 11cases,DAS28＜5.0).The plasma miR-155 and miR-146a expressions were significantly higher in high activity group than those in low activity group.There were no significant differences in the expression of PBMC miR-155 and miR-146a between the two groups.Conclusion The expression of PBMC and plasma miR-155 and miR-146a are higher in RA patients.The expression of plasma miR-155 and miR-146a are associated with RA patients' activity.Plasma miR-155 and miR-146a may be potential non-invasive biomarkers for RA diagnosis anddisease activity assessment.

BACKGROUND: In vitro injection of osteogenic growth peptide (OGP) can regulate the peripheral blood and proliferation of bone marrow cells to increase bone formation and accelerate fracture healing, but it can not be worldly used for its instability and inconvenience of injection. OBJECTIVE: To prepare the OGP chitosan-alginate microsphere by emulsion crosslinking, and to detect its particle size, drug loading, in vitro release, physical and chemical properties. METHODS: The OGP loaded chitosan-alginic acid microsphere was prepared using an emulsion cross-linking method with glutaral as the cross-linking agent. Microscopy and scanning electron microscopy were used to evaluate the morphological properties and particle size distribution. The drug loading, entrapment efficiency and in vitro drug release kinetics were detected by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION: The OGP loaded chitosan-alginic acid microspheres were spherical in shape, and showed a asperity surface with many micropores and a higher encapsulation efficiency (> 72%). From the in vitro release experiment, the OGP was controlled to release from the chitosan microsphere over 49 days and the release property of microspheres in vitro was well and the overall release rate was > 85%. It is indicated that the OGP loaded chitosan-alginic acid microsphere that is prepared by emulsion cross-linking method shows a good controlled release property.

Objective To proverb a finger ending mutilation treatment with suture in situ plus press package.Methods From July 2006 to September 2011,33 cases of finger ending mutilation were treated with suture in situ or free flap transplant plus press package,after 12~14 days,dermal sutures out to observe the efficacy.Results 32 cases were primary healing.One case with free flap had a minor margin necrosis and healed by change dressing.A period of three months to one year’s follow-up showed that the appearance of fingers was excellent and the two point discrimination was good.There were no deformed fingernails.Conclusions The finger ending mutilation treatment with suture in situ plus press package is simple and effective.

BACKGROUND: Growth hormone may act directly on the peripheral tissues such as cartilage, bone, and adipose tissue, etc., and it can promote fracture healing. OBJECTIVE: To observe the therapeutic effects of recombinant human growth hormone on small-segment radial bone defects in rabbits. METHODS: Twenty radial bone defect models were made in 10 New Zealand rabbit forelimbs and were randomly divided into treatment and control groups. The treatment group was subcutaneously injected recombinant human growth hormone after the operation for 2 weeks; in the same method and duration, the control group was injected the same amount of isotonic saline as a placebo. RESULTS AND CONCLUSION: The treatment group was obviously superior to the control group in callus growth, differentiation of cell morphology and calcinosis. Blood glucose level of the treatment group was slightly higher than that of the controlled group during the treatment, and recovered when the treatment was finished. These findings indicate that recombinant human growth hormone has an effective treatment effect on fractures as well as bone defects and no side effect is observed.

目的探讨和总结不取钉的锁定钢板内固定治疗胫骨骨折术后骨不连的疗效。方法采用不取钉的锁定钢板内固定治疗胫骨骨折术后骨不连15例。结果随访6~15个月,均获得骨性愈合,平均愈合时间4.5个月。结论不取钉的锁定钢板内固定是治疗胫骨骨折髓内钉内固定术后骨不连的良好选择,具有疗效确切、操作简便、手术时间短、创伤小的优点。

Objective To analyze and explore the operative effect of coraccid process basilar part fractures combined injury of ligamental structure. Methods Use ilium-fascia lata complex tissue to reconstruct coronoid process of ulna and medial collateral ligament, recoverd anterior and wall horn anatomic structure of elbow joint. Total 9 cases of ulna coracoid process fractures concomitancy with elbow posterior dislocation . Among these one with olec-ranon fracture,five patients with head of radius fracture. Anterior trance joint approach was used,removal bone chips, restore defect with ilium-fascia lata complex tissue after cuting and trimming. Once reduction was achieved,fixed with screw. Repaird the collateral ligament and anterior joint capsule use the fascia lata, If there were combined fracture of the radius head or olecranon fracture,fixed through lateral approach,All injured extremities were treated with a posterior plaster splint with functional position for 3 weeks followed by elbow rehabilitation training. Results According to Moneys evaluation method,2 patients were classified as excellent ,5 as good,l as fair and 1 as poor. The excellent and good rate was 77. 8%. Two patients with gently ossifying myositis but no patients with wound infection,internal fixation loosening or break,elbow joint destabilizing orcorpus libemm. Conclusions Coracoid process basilar part fractures was simultaneous with the instability of osteal frame and soft tissue. To attain the favourable anatomical foundation for elbow joint functional recovery, it should rebuild the height and shape of coronoid process first and think highly of repair or rebuild medial collateral ligament and joint capsule. It reconstructed the coronoid process osteal frame and soft tissue instability at the same time to use ilium-fascia lata complex tissue. The operative procedure is simplify with reliability effect and fine functional rehabilitation.

Objective To investigate the therapeutic methods and short-term effects of arthroscopic surgery for the treatment of injury of knee discoid meniscus.Methods From January 2005 to June 2009,45 cases with injury of knee discoid meniscus were analyzed retrospectively.Among them,partial,subtotal and total meniscectomy were performed by arthroscopy in 24,15 and 6 cases respectively.At the same time,the medial plica resection and repair of cartilage surface were performed in 5 and 2 cases respectively.According to specific surgical procedure , the individuated rehabilitation was performed after operation.Results No obvious arthroncus was found in all cases after operation.The hydrarthrosis was in 5-20 ml.No articular infection was found.The articular activity was not limited.The postoperative follow-up was got in 43 cases.Follow-up time ranged from 6-23 months(average 14 months).The average Lysholm score was elevated from 61.8±3.2 to 93.5±2.8 score (P<0.01).Conclusion According to the actual position of injury, the correlated therapeutic method can be used in the diagnosis and treatment of discoid meniscus injury by arthroscopy.It has a high-accuracy, less trauma,quick recovery of postoperative function of joint and few postoperative complications.At the same time,it can treat other lesion and avoid missed diagnosis and would get a good short-term efficacy.

Objective To improve the operation method of rupture of Achilles tendon for decreasing complication. Methods Total 39cases with closed rupture of Achilles tendon were selected in this study. Short incision was made at achilles tendon wall, reveal and anneal the broken ends, using Kirschner wire and steel-wire to make rectangle frame ,intradermic fixation of fracture away from the broken ends, then sutured ends with rarities and smoothing,functional exercise after 6weeks ankle rest position fixation. Results According to the Arner Lindholm evaluation system,the treatment outcome were excellent in 34 cases ,and good in 5cases. No complication including re-rupture skin ,tendon necrosis and infection were found after operation. Conclusion Repaired closed rupture of Achilles tendon with short incision and rectangle frame, assisted with ankle rest position fixation after operation wasa worthy way for treating closed rupture of a chilles tendon.

Objective To improve the surgical techniques of closed Achilles tendon ruptures and mode of activity restraint and to reduce the incidence of complications.Methods A small incision was made medial to Achilles tendon so as to reveal and rearrange the ruptured ends for end-to-end anastomosis.Kirschner wire and steel-wire were used to make steel-wire rectangular framework with percutaneous fixation away from the distal ruptured ends,which were sutured with sparsity and smoothness.Postoperative activity restraint of the ankle joint was prescribed with rest position.Results Postoperative follow-ups of a total of 39 patients showed 34 patients(87.18%) were rated as excellent and 5 patients(12.82%) were rated as good,according to Arner-Lindholm rating system.There were no complications such as re-rupture,skin or tendon necrosis or deep wound infection.Conclusion A good treatment for closed Achilles tendon ruptures is exemplified by the use of rectangular frame with minor incisions and activity limitation of the ankle joint with rest position after operation.

BACKGROUND: Current approaches for diagnosis of osteoarthritis include imaging and arthroscopy. However, both of them have some limitations. Therefore, a specific, sensitive, high diagnostic rate and operable method is needed. OBJECTIVE: To explore the relationship between the level of EKGPDP peptide in urine and the severity of cartilage degradation in knee osteoarthritis patients. METHODS: A total of 60 patients with knee osteoarthritis (KOA), including 45 undergoing joint debridement and 15 undergoing knee replacement, were selected from Department of Orthopaedics, Fourth People’s Hospital of Shenzhen (Futian Hospital, Guangdong Medical University) between January 2006 and April 2008. In addition, 40 healthy volunteers were selected as controls. The EKGPDP peptide concentration in urine was measured with competitive enzyme-linked immunoassay (ELISA). The pathologies of the synovium and cartilage in knee osteoarthritis were observed with arthroscopy; the degree of synovitis and cartilage degradation under arthroscopy was graded with Ayral’s score system and Outbridge’s score system, respectively. RESULTS AND CONCLUSION: EKGPDP peptide level in KOA was greater than control group (P < 0.001). The EKGPDP peptide level in KOA was correlated positively with Outbridge’s score and body mass index (P < 0.001), but had no correlation with accumulative Ayral’s score (P > 0.05). Half a year after total knee replacement, the level of EKGPDP peptide decreased significantly (P < 0.05); arthroscopic debridement remained unchanged (P > 0.05). The EKGPDP peptide level in urine can reflect the degree of cartilage degradation, and it is a sensitive marker for the diagnosis of KOA.

Objective To evaluate the clinical results of titanium plate internal fixation in the treatment of displaced intra-articular calcaneal fractures.Methods From January 2006 to April 2009, open reduction and internal fixation with anatomic titanium plate internal fixation combined with bone graft were performed on 28 cases(30 feet)of displaced intra-articular calcaneal fractures through the lateral extended incision.Results All cases were followed up for 4 months to 36 months(mean 18.5 months).All fractures were healed for 12 weeks to 18 weeks(mean 14.5 weeks).The mean preoperative angle of Bohler,s and Gissane,s was 9.7°,103.2°respectively,which was improved to 34.5°,132.5°respectively in 6 months after operation.According to the Maryland sore system criterion,the excellent was in 22 patients,good in 4 and fair in 4.Excellent and good rate were in 86.7%.Conclusion The Calcaneal anatomic type titanium plate has reliable fixation.Therefore,it is a ideal method in the treatment of displaced intra-articular calcaneal fracture.

Objective To evaluate treatment outcome of mitek bone anchor and wire lock for reconstruction of central slip avulsions.Methods Total 18 fingers were received mitek bone anchor treatment(anchor group)and 20 fingers wire lock treatment(wire lock group).curative effect evaluated by Dargan functional assessment after operation.Re-sults Over a 2 ~ 6years period follow-up,the fingers function in anchor group excellent 16,good 2;the fingers function in wire lock group excellent 10,good 4,general 4 and bad 2.Conclusions Reconstruction of central slip insertion using mitek bone anchor is a safter and move secure procedure than traditional wire lock.

目的观察输卵管妊娠腹腔镜下保守手术后应用药物预防持续性异位妊娠(PEP)的临床疗效。方法回顾性分析我院行腹腔镜下保守手术的输卵管妊娠患者122例,其中单纯手术组(n=35),仅行腹腔镜下保守手术;手术+甲氨蝶呤组(n=47),行腹腔镜下保守手术治疗同时术中向患侧输卵管局部注射甲氨蝶呤(MTx)20 mg;手术+米非司酮组(n=40),行腹腔镜下保守手术治疗术后服用米非司酮300 mg。结果手术+甲氨蝶呤组及手术+米非司酮组PEP发生率均较单纯手术组低(P<0.05),术后72小时血β-hCG值下降幅度均均大于单纯手术组(P<0.05),术后血β-hCG值恢复到正常的时间短于单纯手术组(P<0.05)。结论对输卵管妊娠患者行腹腔镜下保留患侧输卵管的保守性手术后,术中局部注射甲氨蝶呤和术后服用米非司酮均可降低PEP的发生率,效果显著。