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miRNA-22 (miR-22) has been showed to involve in a variety of cancers; however, the association between miR-22 expression level and the prognosis of osteosarcoma is also poorly unknown. Fifty-two patients with surgically resected paired osteosarcoma and non-neoplastic disease between 2008 and 2014 were involved in this study. Real-time PCR was performed to examine the expression level of miR-22 in osteosarcoma tissues and noncancerous bone tissues. Then the association between miR-22 expression and clinical-pathological parameters were further evaluated. Kaplan-Meier analysis and Cox proportional hazards regression models were explored to reveal the correlations of miR-22 expression with survival of patients. The results indicated that miR-22 was downregulated in osteosarcoma tissues in comparison with noncancerous bone tissues. In addition, there is statistically significance between miR-22 expression level and recurrence, metastasis, and chemotherapy response. The patients with lower miR-22 expression level had both poorer overall survival and disease-free survival. The multivariant analysis revealed that the miR-22 expression level and metastasis status are independent prognosis factors for osteosarcoma. In conclusion, miR-22 was downregulated in osteosarcoma and its expression level was correlated with a variety of important clinical-pathological parameters. Moreover, miR-22 may serve as a promising biomarker for predicting the prognosis of osteosarcoma.

To determine modulus of elasticity (MOE) of the whole full-sized medium density fiberboard (MDF) by using vibration method in the future, this paper studies MDF vibration characteristics. To solve modal parameters of full-sized MDF in the condition of free vibration, the writers conducted calculation modal analysis and experimental modal analysis of the full-sized MDF with three different thicknesses respectively, compared and analyzed the first three order modal shapes and frequencies. It is found that the full-sized MDF with three different thicknesses showed the same vibration modal forms: the first and second vibration modes had bending vibration along the length direction, while the third one had bending vibration along the width direction; the frequency obtained through calculation modal analysis and experimental modal analysis had a certain difference—the first calculation modal frequency was slightly lower than the first experimental modal frequency, and the second and third calculation modal frequencies higher than the corresponding experimental modal frequencies. However, there is a good correlation between calculation modal frequency and test experimental modal frequency with the determination coefficient reaching 0.9816.

Pulmonary metastasis is the major challenge for clinical treatment of osteosarcoma patients. Recent studies indicated that visfatin, a 52kDa adipocytokine, can trigger the cell motility of various cancers, while its role in the progression of osteosarcoma remains not clear. Our present study revealed that visfatin can significantly promote the in vitro migration and invasion of osteosarcoma MG-63 and HOS cells and up regulate the expression of matrix metalloproteinase-2 (MMP-2) and fibronectin (FN). Furthermore, visfatin treatment also increased the expression of IL-6 in both MG-63 and HOS cells via a time dependent manner, while anti-IL-6 antibody can significantly attenuate visfatin induced cell invasion and up regulation of MMP-2 and FN. It suggested that up regulation of IL-6 mediated visfatin induced in vitro motility of osteosarcoma cells. Visfatin treatment can increase the phosphorylation of both p65 and ERK1/2 in MG-63 and HOS cells, while only the inhibitor of NF-κB, BAY 11-7082, can abolish visfatin induced up regulation of IL-6. BAY 11-7082 also attenuated visfatin induced upregulation of MMP-2 and FN in MG-63 cells. Western blot analysis revealed that visfatin treatment can significantly increase the phosphorylation of IκBα and IKKβ in MG-63 cells. ACHP, the inhibitor of IKK-β, blocked visfatin induced expression of IL-6 mRNA in both MG-63 and HOS cells. Collectively, our data suggested that visfatin can increase the motility of osteosarcoma cells via up regulation of NF-κB/IL-6 signals. It indicated that visfatin might be a potential therapeutic target of osteosarcoma treatment.

It remains controversial whether degenerative posterior longitudinal ligaments should be removed during anterior decompression procedures for cervical spondylotic myelopathy. Few data are available from studies that have compared removing and retaining the degenerative posterior longitudinal ligament. The goal of this retrospective study was to evaluate the benefit of degenerative posterior longitudinal ligament removal during such operations. Clinical data on 130 patients with confirmed degenerative posterior longitudinal ligament who underwent anterior cervical decompression surgery were retrospectively reviewed. All procedures were performed by the same senior orthopedic surgeon at the authors’ spinal surgery center. The degenerative posterior longitudinal ligament was removed in 62 patients (group A) and retained in 68 patients (group B). The 130 patients were followed for 36 months. The Japanese Orthopedic Association score improved from 9.0±2.7 to 14.7±1.5 in group A and from 9.4±2.6 to 14.1±1.7 in group B ( P =.028). The recovery rate for spinal cord neurologic function was 66.7% in group A and 61.3% in group B ( P =.031). Operating time was longer ( P =.002) and the sagittal median diameter of the vertebral canal was enhanced in group A ( P P =.044). No significant difference was found in the rates of common complications between groups. Removal of the degenerative posterior longitudinal ligament in anterior decompression procedures for cervical spondylotic myelopathy appeared to be beneficial and provided more complete decompression and better postoperative outcomes than surgery without removal of the ligament. Although this procedure was generally safe, it required longer operating times, was more technically challenging, and required more experienced surgeons than surgery without removal of the ligament. [ Orthopedics . 2015; 38(1):e54–e61.]

Objective To investigate the migratory, metabolic and proliferative ability of rabbit fibrochondrocytes in meniscal fragments of different sizes under an in vivo subcutaneous environment. Methods Adult, male, New Zealand white rabbit menisci were harvested and the inner two-thirds of each were minced into different sizes: 0.5 × 0.5 × 0.5 mm (group A); 1.0 × 1.0 × 1.0 mm (group B); 2.0 × 2.0 × 2.0 mm (group C). Meniscal fragments were packed into a fascia sheath, then implanted subcutaneously. At weeks 1, 2 and 3 postimplantation, meniscal fragments were harvested; cell migration and viability were then evaluated by confocal laser scanning microscopy and haematoxylin and eosin staining. Aggrecan was detected using Safranin O and Fast Green staining, and protein levels of types I and II collagen, and proliferating cell nuclear antigen (PCNA), were evaluated by immunohistochemistry. Results Protein levels of types I and II collagen and PCNA, and fibrochondrocyte migration, were highest in group A compared with groups B and C, but aggrecan staining remained the same across the groups. Conclusion There was an inverse relationship between the migratory, metabolic and proliferative abilities of rabbit fibrochondrocytes and meniscal fragment size.

The goal of this study was to evaluate the array of causative organisms for septic arthritis in children and their antibiotic resistance patterns over a 20-year period at a single medical center. The medical records of children younger than 16 years with septic arthritis admitted to a hospital in China from 1989 to 2008 were retrospectively reviewed. A total of 158 cases of septic arthritis were studied, 70 from 1989 to 1998 and 88 from 1999 to 2008. Between the first and second decades, occurrence of serious illnesses decreased significantly from 44.3% to 28.4% ( P Staphylococcus aureus (MRSA) increasing significantly. Staphylococci remained the major causative organisms for joint infection. The percentage of Staphylococcus aureus resistance to various antibiotics increased: 85% to 100% for penicillin, 58.8% to 75% for erythromycin, 0% to 31.3% for cefazolin, and 15% to 29.4% for multi-resistance. In the second decade, 4 MRSA stains were multi-resistant. However, gentamincin resistance remained at the same level. Antibiotic resistance of coagulase-negative staphylococci and gram-negative bacilli changed little. The incidences of osteomyelitis and joint dislocation decreased significantly, from 15.7% to 6% and 28.6% to 14.8%, respectively ( P

The objective of this study was to investigate in vivo effects of lipoic acid (LA) in preventing steroid-induced osteonecrosis and the possible pathway in a rabbit model. Sixty rabbits were divided into 2 groups: rabbits were intraperitoneally injected with LA aqueous solution at 36 mg/kg of body weight per day for 4 weeks in Group A and rabbits were injected with physiologic saline (PS) as a control in Group B. At 2 weeks after starting treatment, they were intramuscularly injected once with 20 mg/kg of methylprednisolone acetate (MPSL). The femora were histopathologically examined for the presence of osteonecrosis. The plasma levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glutathione (GSH), endothelin (ET) and malondialdehyde (MDA) were assayed at 2 weeks after the injection of MPSL. The incidence of osteonecrosis was significantly higher in Group B (73.1%) than in Group A (20.8%). The GSH level was higher in Group A than in Group B after the LA injection. The plasma MDA and ET levels were lower in Group A than in Group B at 2 weeks after the MPSL administration. Lipoic acid can prevent the development of steroid-induced osteonecrosis in rabbits. Inhibited oxidative stress and amendment of vascular endothelial dysfunction is a possible mechanism for this effect.

Dear Sir, We read with interest the article entitled "Posterior wall reconstruction using iliac crest strut graft in severely comminuted posterior acetabular wall fracture" [6]. In the study, the authors used iliac crest strut graft for reconstruction of the comminuted posterior acetabular wall fracture. A series of eight patients were evaluated clinically by Merle d’Aubigne and Postel score and radiologically by Matta score at their final follow-up. The outcome after a mean follow-up of 3.34 years (minimum two years and maximum five years) showed a good-to-excellent result in seven patients (87.5%) clinically and in five patients (62.5%) radiologically [6]. We appreciate the described technique using iliac crest strut graft for reconstruction of the comminuted posterior acetabular wall fracture, and also the medium-term clinical and radiological results of this technique are satisfactory. However, in their discussion, the authors concluded “Iliac crest strut graft can be better compared to a single fragment of posterior acetabulum wall which has lost its soft tissue attachment”; we have doubts about this conclusion. There is consensus that good prognosis is clearly related to anatomical reduction and stable fixation of posterior wall fractures. Only 30% of posterior-wall acetabular fractures involve a single large fragment. The majority are multifragmentary or have areas of impaction, where open reduction is often necessary with elevation of the depressed articular fragments [1]. Whether the fragments have soft-tissue attachments or not was rarely mentioned in published reports. In our experience, although soft-tissue stripping was done extremely carefully intra-operatively, we often found fragments became free after elevation and reduction in severely comminuted posterior acetabular wall fractures. This has also been mentioned by Giannoudis et al. in their report [3]. Using primary severely comminuted fragments, which may be without soft tissue attachment, to reconstruct the posterior wall produced good results for different authors. The following patients were all evaluated clinically by modified Merle d’Aubigne and Postel score and radiologically by Matta score at their final follow-up. Im et al. retrospectively examined 15 patients with a single fragmented or moderately comminuted posterior acetabular wall fracture using screws alone, whereby 14 patients (94%) had a good-to-excellent result clinically after a follow-up period of more than two years [4]. Ebraheim et al. retrospectively studied 32 comminuted posterior acetabular wall fractures combining a spring plate and reconstruction plate to reconstruct the posterior wall; the average follow-up was 43 months (range 24–70 months), and clinical evaluation gave a good-to-excellent result in 24 patients (76%) and radiologically in 23 patients (73%) [2]. Recently, Giannoudis et al. reported a two-level reconstruction technique using subchondral miniscrews for the stabilisation of comminuted posterior wall marginal acetabular fragments before applying lag screws and a buttress plate to the main overlying posterior fragment. The clinical outcome was graded as a good-to-excellent result in 27 patients (93%), and radiological outcome was graded as a good-to-excellent result in 25 patients (86%) at a mean follow-up of 35 months (range 24–90) [3]. No complication in the form of non-union, loss of fixation and absorption of fragments was noticed. As the Spearman correlation between the original and modified Merle d’Aubigne-Postel Score was R = 0.89, it is equivalent to using the two grading systems clinically [5]. From these data, we therefore favour using primary severely comminuted fragments to generate better results. Whether the iliac crest strut graft is better than a single fragment without soft-tissue attachment or not, requires further study. Furthermore in our opinion, to ensure the blood supply of the bone graft, using muscle pedicle bone graft is a reliable and easy technique in the clinical setting. However, in the study of Sen et al., the authors did not mention whether the iliac crest strut graft had a muscle pedicle or not, but Fig. 3b in that article shows a free iliac crest strut graft. In conclusion, only with muscle pedicle iliac crest strut graft application in this study, can we conclude that it is better than a single fragment of posterior acetabulum wall which has lost its soft tissue attachment. The word “definative” in the last paragraph, it should be “definitive”.