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The study investigates the positive effects of phillygenin on intestinal tight junction via the let-7b signaling pathway and the regulation of intestinal microbiota. The expression levels of tight junction proteins are determined through PCR and Western blot. DSS-induced mice colitis is used to verify the protective effects of phillygenin on intestinal barrier and tight junction. Fecal microbiota transplantation is used to verify the role intestinal microbiota. let-7b is detected in the colon tissues of patients with acute stercoral obstruction. Phillygenin could promote the expression of occludin, which might be inhibited by let-7b inhibitor. DSS-induced mice colitis showed that phillygenin could lower the colonic permeability and maintain the tight junction-associated proteins. The effects of phillygenin could be deprived by anti-let-7b and rescued by FMT of normal intestinal microbiota. Clinical samples verified a lower level of let-7b in stercoral obstruction patients. Phillygenin could protect the intestinal barrier from dysfunction via the signaling pathway of let-7b by regulating intestinal microbiota.

The preferential attachment of the Barabási–Albert model has been playing an important role in modeling practical complex networks. The preferential attachment mechanism describes the role of many real systems, which follows the characteristic “the rich get richer.” However, there are some situations that are ignored by the preferential attachment mechanism, one of which is the existence of the limited resource. Vertices with the largest degree may not obtain new edges by the highest probability due to various factors, e.g., in social relationship networks, vertices with quite a lot of relationships may not connect to new vertices since their energy and resource are limited. Hence, the limit for degree growing is proposed in our new network model. We adjust the attachment rule in light of the population growth curve in biology, which considers both attraction and restriction of the degree. In addition, the unaware–aware–unaware opinion diffusion is studied on our proposed network. The celebrity effect is taken into consideration in the opinion diffusion process.

Background This meta-analysis was designed to investigate the long-term efficacy and safety between cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) in treating cervical disc degenerative diseases (CDDDs). Methods Literature search was performed on Pubmed, Embase, Cochrane Library, and Web of Science before Jan 2019. Surgical details, clinical outcomes, range of motion (ROM), complications, and reoperation rates between CDA and ACDF groups were compared and analyzed. A fixed- or random-effects model was applied based on different heterogeneity. STATA (Version 11.0) software was used to perform data analysis. Results A total of 13 randomized controlled trial studies with more than 60 months of follow-up (mean 83.1 months) were enrolled in this meta-analysis. Pool results indicated that the CDA group exhibited significantly better outcomes in clinical scores (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.15–2.08, p = 0.004) and preservation of ROM (mean difference = 1.77, 95% CI: 1.60–1.95, p p = 0.001) and occurrence of reoperation (OR = 0.41, 95% CI: 0.25–0.69, p = 0.001) were lower in the CDA group than in the ACDF group. Conclusions At long-term follow-up, CDA showed better efficacy in terms of clinical outcomes, ROM, ASD, and reoperation than ACDF for treating CDDDs. However, our results require further validation in large-sample and high-quality studies.

Yin Zhang,1,* Bin Pi,2,* Xianlin Xu,1 Ying Li,3 Xiangfan Chen,3 Ningxi Yang4 1Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, People’s Republic of China; 2Department of Orthopedics, Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China; 3School of Health Science, Wuhan University, Wuhan, Hubei, People’s Republic of China; 4College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ningxi YangCollege of Humanities and Social Sciences, Harbin Engineering University, No. 145 Nantong Street, Harbin, Heilongjiang, People’s Republic of ChinaTel +86-18819268616Fax +86 451-82569608Email yangningxi@bjmu.edu.cnBackground: Inflammatory bowel disease arthritis (IBDA) threatens patients’ physical and mental health. Therefore, patients need not only physical therapy, but also adequate health education and psychological support. This study was designed to explore the effect of health education based on narrative medicine combined with an online patient mutual assistance group that was based on the physical and mental health of patients with IBDA.Methods: A total of 120 patients with IBDA were randomly divided into four groups (30 patients per group). Patients in the control group were given routine health education on the premise of routine treatment. The three treatment groups were given health education based on narrative medicine, online patient mutual assistance group intervention, or combined intervention. Depression, sleep, arthralgia, irritable bowel syndrome (IBS) symptoms, and inflammatory factors were measured and compared before and 1 month after the intervention.Results: Before the intervention, no significant differences were observed in baseline data between the four groups. However, after the intervention, the physical and mental health of patients who received health education based on narrative medicine or online patient mutual assistance groups was improved. Our data showed that patients in the combined intervention group experienced a better outcome.Conclusion: Narrative medicine-based health education combined with an online patient mutual assistance group is beneficial to the physical and mental health of IBDA patients. Taken together, this model needs to be further deepened and popularized in clinical practice.Keywords: IBDA, narrative medicine, online patient mutual assistance group, health education

Objective To investigate the influence of tranexamic acid (TXA) on blood loss and blood transfusion in multiple-level spine surgery and evaluate whether hemoglobin and platelet levels are altered as a result. Method This meta-analysis conducted an exhaustive search of literature from Pubmed, Embase, Cochrane Library, Web of Science, and CNKI databases. Stata 11.0 was used to analyze the pooled data. Mean differences (MD) of blood loss, transfusion volume, hemoglobin and platelet levels, and odds ratio (OR) of proportion of transfusion were extracted and compared between the TXA group and controls. Publication bias and sensitivity analysis were also performed. Result A total of 11 studies (6 RCTs and 5 retrospective studies) were enrolled in this meta-analysis according to the inclusion criteria. The data showed that administration of TXA can decrease intraoperative blood loss and perioperative blood transfusion compared to controls (standard mean difference = −0.50; 95% confidence interval [CI]: −0.84, −0.16; I2 = 52.9%; P = 0.004) (OR = 0.48; 95% CI: 0.29, 0.78; I2 = 0%; P = 0.003). Moreover, TXA can maintain a superior hemoglobin level after surgery in contrast to the control group (standard mean difference = −0.27; 95% CI: 0.07, 0.47; I2 = 0%; P = 0.009). The above results were also observed and verified after accounting for publication bias and sensitivity analysis. Conclusion The application of TXA can effectively reduce intraoperative blood loss and perioperative blood transfusion in patients undergoing multiple-level spine surgery, and it can restore hemoglobin levels after surgery.

The properties of polymethyl methacrylate (PMMA) bone cement make it a popular bone filling material. However, its disadvantages, such as lack of biodegradability and osteogenesis, restrict its clinical application. Studies have indicated the osteogenic properties of N-acetyl cysteine (NAC) and the biodegradability of 2-methylene-1,3-dioxepane/methyl methacrylate-based (MDO/MMA) copolymers. In this study, we developed bioactive PMMA cements through modification with fixed concentrations of NAC and different proportions of MDO. The purpose of this study was to compare the mechanical properties, morphology, NAC release, biocompatibility, degradability and mineralization capability of modified bone cements with those of conventional cement. The specific-modified specimens (NAC-p (5% MDO-co-MMA)) exhibited a lower bending modulus but had little effect on compressive strength. This material was morphologically compact and nonporous, similar to conventional PMMA bone cement. NAC could be released from NAC-p (5% MDO-co-MMA) continuously and appropriately. NAC-p (5% MDO-co-MMA) was biologically safe and showed satisfactory tissue compatibility. Ester was introduced into the polymer, which reinforced the degradation properties of NAC-p (5% MDO-co-MMA). NAC-p (5% MDO-co-MMA) enhanced the mineralization capability of osteoblastic cells.

Background: Patients with inflammatory bowel disease-peripheral arthritis (IBD-PA) often accompany by sleep problems, but few studies have used polysomnography to investigate the objective sleep characteristics of IBD-PA.Methods: Patients in IBD-PA group, inflammatory bowel disease (IBD) group, healthy control (HC) group were examined by polysomnography (PSG) and the sleep characteristics were compared. PSG and Pittsburgh Sleep Quality Scale (PSQI) indices were compared between active and remission IBD-PA patients. The correlation between disease activity and sleep quality in IBD-PA patients was analyzed. The influencing factors of sleep efficiency of IBD-PA patients were analyzed.Results: The total sleep time (TST), rapid-eye-movement sleep (REM) time, slow wave sleep (S3 + S4) and sleep efficiency (SE) in the IBD-PA group were significantly less than those in the HC group and IBD group (P < 0.05), while the number and time of wake after sleep onset (WASO) and sleep latency (SL) were significantly longer than those in the HC group and IBD group (P < 0.05). To IBD-PA patients, the disease activity was negatively related to sleep quality. There was a significant difference in SE, the number of WASO, S1, S3+S4 of PSG, as well as the PSQI total score between active and remission patients. Abdominal pain, joint pain, depression, and C-reactive protein were the influencing factors of sleep efficiency.Conclusions: The sleep quality of patients with IBD was poor than the control group, and that of patients with IBD-PA was even worse. Therefore, sleep management should be included in IBD management.

Evolutionary game on complex networks provides a new research framework for analyzing and predicting group decision-making behavior in an interactive environment, in which most researchers assumed players as profiteers. However, current studies have shown that players are sometimes conformists rather than profit-seeking in society, but most research has been discussed on a simple game without considering the impact of multiple games. In this paper, we study the influence of conformists and profiteers on the evolution of cooperation in multiple games and illustrate two different strategy-updating rules based on these conformists and profiteers. Different from previous studies, we introduce a similarity between players into strategy-updating rules and explore the evolutionary game process, including the strategy updating, the transformation of players' type, and the dynamic evolution of the network structure. In the simulation, we implement our model on scale-free and regular networks and provide some explanations from the perspective of strategy transition, type transition, and network topology properties to prove the validity of our model.

To evaluate the safety and efficacy of PKP under O-arm navigation system guidance for treating middle thoracic OVCF (T6~T9). A retrospective study was conducted for 44 consecutive T6~T9 OVCF patients who received PKP assisted with O-arm navigation (n = 20) or fluoroscopy (n = 24) from January 2016 to December 2017. Demographic data, radiographic parameters, and clinical outcomes were collected and analyzed at pre-operative, post-operative, and final follow-up period. Complications including tissue lesion, needle malposition, and leakage of bone cement were also recorded amid operation. A total of 44 patients (4 males and 40 females, with mean age of 71.1 ± 8.7) were enrolled in this study, and the mean follow-up time was 14.4 months. In surgical details, navigation system could obtain more satisfactory volume of injected cement and less loss of blood, as well did not increase surgical time compared with fluoroscopy. Both radiological and clinical outcomes improved significantly at post-operative and final follow-up, while did not differed between two groups. For adverse events, the incidence of cement leakage was similar between two groups. However, O-arm navigation can achieve lower rate of complications than fluoroscopy. Our preliminary study demonstrated that PKP assisted with O-arm navigation is a safe and effective procedure that applied for middle thoracic OVCF (T6~T9), which can achieve favourable radiological and clinical outcomes, and low rate of complications.

Background: The increasing prevalence of chronic kidney disease (CKD) in recent years and its impact on renal dysfunction on orthopedic surgery continues to draw more attention to orthopedic surgeons. The purpose of this study is to investigate the influence of CKD on comorbidities and complications in patients who underwent elective low limbs surgery. Material and Methods: Until August 2018, Pubmed, Embase, Cochrane library, and Web of science were used to search relevant literature. After reviewing the article title, the abstract, and the full text, a total of 11 articles were identified in the qualitative synthesis. Demographic data, comorbidities, and complications were assessed between CKD and non-CKD patients. Review Manager 5.3 was used for the statistical analysis, and forest plots were constructed for each variable. Results: A total of 137,436 patients (10,732 patients with CKD and 126,704 patients without CKD) from 11 studies were enrolled in this meta-analysis. CKD patients showed worse health conditions in comparison to non-CKD patients. The incidence of several preoperative comorbidities (hypertension, diabetes, and cardiac-cerebral disease) and postoperative complications (infection, transfusion, deep vein thrombosis, and early mortality) were higher in CKD patients. Conclusions: In elective hip and knee surgery, compared with non-CKD patients, CKD patients showed worse health conditions. Due to a higher rate of comorbidities and complications in CKD patients, they should be treated carefully during perioperative periods.

Osteoarthritis (OA) is characterized by the progressive destruction of articular cartilage, which is involved in the imbalance between extracellular matrix (ECM) synthesis and degradation. MicroRNA-140-5p (miR-140) is specifically expressed in cartilage and plays an important role in OA-induced matrix degradation. The aim of this study was to investigate (1) whether intra-articular injection of melatonin could ameliorate surgically induced OA in mice and (2) whether melatonin could regulate matrix-degrading enzymes at the posttranscriptional level by targeting miR-140. In an in vitro OA environment induced by interleukin-1 beta (IL-1β), melatonin treatment improved cell proliferation of human chondrocytes, promoted the expression of cartilage ECM proteins (e.g., type II collagen and aggrecan), and inhibited the levels of IL-1β-induced proteinases, such as matrix metalloproteinase 9 (MMP9), MMP13, ADAMTS4 (a disintegrin and metalloproteinase with thrombospondin motifs 4), and ADAMTS5. Both the microarray and polymerase chain reaction (PCR) experiments revealed that miR-140 was a melatonin-responsive microRNA and melatonin upregulated miR-140 expression, which was suppressed by IL-1β stimulation. In vivo experiments demonstrated that intra-articular injection of melatonin prevented disruptions of cartilage matrix homeostasis and successfully alleviated the progression of surgery-induced OA in mice. Transfection of miR-140 antagomir completely counteracted the antiarthritic effects of melatonin by promoting matrix destruction. Our findings demonstrate that melatonin protects the articular cartilage from OA-induced degradation by targeting miR-140, and intra-articular administration of melatonin may benefit patients suffering from OA.

Purpose: The purpose of this study was to investigate the sagittal balance of the cervical spine and the clinical outcomes of anterior cervical discectomy and fusion (ACDF) for the treatment of cer...

To investigate the impact of obesity on the restoration of sagittal balance after posterior lumbar interbody fusion (PLIF). To examine the correlation between obesity and sagittal balance and their influence on clinical efficacy. A total of 183 patients who underwent PLIF for degenerative lumbar diseases between Jan 2015 and Dec 2015 were enrolled in this study. Based on their BMI, patients were divided into three groups: normal weight group (Group A), overweight group (Group B), and obesity group (Group C). Demographic data, intraoperative data, sagittal balance parameters, and clinical function scores were compared between each group. Correlation analysis was conducted between the BMI scores and each sagittal balance parameter. Multiple linear regression was used to assess the impact of each variable on clinical outcomes. All patients finished an average of 22.3 months follow-up. Group C had significantly higher blood loss and longer operations than Group A. SL and PT improved significantly in Group A while did not change in Group C. Compared with Group C, Group postoperative pelvic tilt (PT) was better restored in Group A. BMI was significantly correlated with change of lumbar lordosis (LL) and PT. Multiple linear regression analysis indicated that BMI and change of PT had a great influence on ODI improvement. Obesity may hinder the correction of sagittal balance and improvement of clinical efficacy in patients who undergo PLIF. Restoration of PT should be paid more attention to during surgery, as it may be associated with satisfactory clinical outcomes especially for obesity.

The properties of polymethyl methacrylate (PMMA) bone cement make it a popular bone filling material. However, its disadvantages, such as lack of biodegradability and osteogenesis, restrict its clinical application. Studies have indicated the osteogenic properties of

Percutaneous vertebral augmentation (Percutaneous vertebroplasty, PVP and Percutaeous kyphoplasty, PKP) for the treatment of metastatic spinal lesions has been considered as a preferred alternative to relieve pain and rebuild spinal stabilization relying on minimally invasive procedure. However, there have been few reports on clinical outcomes of percutaneous kyphoplasty in the treatment of osteolytic and osteoblastic metastatic vertebral fracture. We report our experience for 81 kyphoplasty procedures performed in 45 patients with thoracic and lumbar vertebral lesions caused by metastases. 4 out of the 45 patients were withdrawn at 1-year follow-up. 41 patients demonstrated good clinical result. The osteoblastic group performed a better pain relief in visual analog scale (VAS) score after the treatment than the osteoclastic group 3 days, 1 month, 3 months and 1 year after the KP. And the Oswestry Disability Index (ODI) scores of the osteoblastic group is lower than that of the osteoclastic group just in 3 days after the KP. And there were no significant difference between the two groups of ODI scores 1 month, 3 month and 1 year after the KP. And there were no statistical differences of the radiographic parameters including VB height variation and local kyphosis angle (LKA) between the two groups. Kyphoplasty results in an effective, minimally invasive procedure for the stabilization of thoracic and lumbar metastatic vertebral lesions, including both osteoblastic and osteoclastic types, which achieves statistically significant pain relief, function improvement, preventing further local kyphotic deformity, and VB height.

Yes-associated protein (YAP) and extracellular signal-regulated kinase (ERK) have been considered as key regulators in tissue homeostasis, organ development, and tumor formation. However, the roles of YAP and ERK in the mediating strain mechanosensing in the growth plate cartilage have not been determined. In this study, chondrocytes obtained from the growth plate cartilage of 2-week-old Sprague-Dawley rats were subjected to the mechanical strain with different magnitudes and durations at a frequency of 0.5 Hz. We found that YAP and ERK activation in response to mechanical strain was time and magnitude dependent. Pretreatment with a RhoA inhibitor (C3 toxin) or a microfilament cytoskeleton disrupting reagent (cytochalasin D) could suppress their activation. In addition, activated YAP and ERK were able to induce cell cycle progression by up-regulating the expression of cell cycle-related genes. These results shed new light on the function of YAP and ERK in mechanical strain-promoted growth plate development. Our results also provided evidence that RhoA and cytoskeletal dynamics are required for this mechanotransduction. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1121-1129, 2016.

Background: Curative effect following the locking plate fixation of proximal humeral fractures in the elderly have been inconsistent, factor that contributes to the outcomes remains unknown. This study aims to analyse the factors influencing the curative effect of locking plate fixation in proximal humeral fractures of the elderly. Methods: A retrospective analysis was conducted for 72 elderly patients of proximal humeral fractures who had been treated from January 2010 to August 2013. Among the patients, 26 were male and 46 were female. The patients’ age ranged from 60 years old to 78 years old, with an average age of 70.2 years. Constant score was used as clinical outcome measure. Gender, fracture type, plate position, varus of the head-shaft angle, associated injury, and the time to begin functional training after operation were identified as prognostic factors. Results: The patients were followed up for 18 months to 48 months with a mean period of 30.4 months. The constant score ranged from 33 to 91, with an average of 79.1. Shoulder joint function had a significant correlation with fracture type, plate position, and varus of the head-shaft angle. No significant difference was found between shoulder joint function and gender, associated injury, and the time to begin functional training after operation. Conclusions: Fracture type, plate position, and varus of the head-shaft angle were key factors affecting the shoulder function after operation.

High brittleness and lack osteogenesis are two major limitations of calcium phosphate cement (CPC) in application in bone defect reconstruction. Here we prepared a composite calcium phosphate cement by mixing N-acetyl cysteine loaded silk fibroin solution with α-tricalcium phosphate. In vitro cytology experiment revealed that SF-NAC/α-TCP could significantly increase the activity of exocrine ALP and up-regulated expression of bone-related genes. However, NAC up-regulated gene expression could be significantly suppressed by DKK1. We propose that NAC functioning as osteogenic factor by activating the Wnt/β-catenin signaling pathway may be the possible mechanism of up-regulation of osteogenic genes. Bone regeneration in vivo shown in a rat femur defect was enhanced by the addition of NAC in SF/α-TCP. In addition, the combination intensity of cement-bone interface was improved. The combination SF-NAC/α-TCP might be developed into a promising tool for bone tissue repair in the clinic.

The reinforcement of calcium phosphate materials with silk fibroin (SF) has been one of the strategies to overcome the brittleness. However, the lack of osteoinductivity may still restrict their further use. This study aimed to investigate the biocompatibility and osteogenesis capacity of a novel Semaphorin 3A-loaded chitosan microspheres/SF/α-tricalcium phosphate composite (Sema3A CMs/SF/α-TCP) in vitro. Sema3A was first incorporated into CMs, and the Sema3A CMs/SF/α-TCP composite was then prepared. The morphology of the CMs was observed using SEM. The in vitro release kinetics, cytotoxicity, and cell compatibility were evaluated, and the real-time quantitative polymerase chain reaction (RT-qPCR) and activity of alkaline phosphatase (ALP) were used to evaluate the osteogenesis capacity of the composite. The in vitro release of Sema3A from the Sema3A CMs/SF/α-TCP composite showed a temporally controlled manner. The extract of the Sema3A CMs/SF/α-TCP composite presented no obvious side effect on the MC3T3-E1 cell proliferation, nor promote cell proliferation. The MC3T3-E1 cells were well-spread and presented an elongated shape on the Sema3A CMs/SF/α-TCP composite surface; the ALP activity and the osteogenic-related gene expression were higher than those seeded on the surface of the CMs/SF/α-TCP and SF/α-TCP composites. In conclusion, Sema3A CMs/SF/α-TCP has excellent biocompatibility and contributes to the osteoblastic differentiation of MC3T3-E1 cells.

To search for new bioactive materials which can be used as the substitute of bone repairing and drug carriers, Sema3A-loaded chitosan microspheres (SLCM) and silk fibroin (SF) were mixed with calcium sulfate cement (CSC). SEM, particle size analysis and swelling rate determination were performed to study properties of the microspheres. The drug loading, encapsulation efficiency and drug release rate were determined by ELISA. Microspheres with different SLCM weight contents (0.5%, 1% and 5%) were prepared to determine which one has the strongest mechanical properties and the appropriate setting time. It was revealed that CSC/SF/0.5SLCM has satisfactory mechanical properties, and its in vitro biocompatibility was assessed by MTS. Chitosan microspheres (5–18 μm) were globular, the surface was smooth, and the swelling rate is (77.02 ± 5.57)%. With this formula, the setting time was increased with the addition of SLCM in CSC/SF, and the cumulative drug release rate is 44.62% in 28 d. XRD results demonstrate that the main component is calcium sulfate. Also it was found that CSC/SF/0.5SLCM supports the growth of MC3T3 cells. Thus the preparation of CSC/SF/0.5SLCM was reliable, and the products had good structures, physical properties and biocompatibility, appearing to be a promising bone substitute material.

Central nervous system (CNS) presents a complex regeneration problem due to the inability of central neurons to regenerate correct axonal and dendritic connections. However, recent advances in developmental neurobiology, cell signaling, cell-matrix interaction, and biomaterials technologies have forced a reconsideration of CNS regeneration potentials from the viewpoint of tissue engineering and regenerative medicine. The applications of a novel tissue regeneration-inducing biomaterial and stem cells are thought to be critical for the mission. The use of peptide nanofiber hydrogels in cell therapy and tissue engineering offers promising perspectives for CNS regeneration. Self-assembling peptide undergo a rapid transformation from liquid to gel upon addition of counterions or pH adjustment, directly integrating with the host tissue. The peptide nanofiber hydrogels have mechanical properties that closely match the native central nervous extracellular matrix, which could enhance axonal growth. Such materials can provide an optimal three dimensional microenvironment for encapsulated cells. These materials can also be tailored with bioactive motifs to modulate the wound environment and enhance regeneration. This review intends to detail the recent status of self-assembling peptide nanofiber hydrogels for CNS regeneration.

To compare the postoperative sagittal balance and occurrence of axial symptoms between anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for the treatment of two-level cervical spondylotic myelopathy (CSM). A total of 71 consecutive patients who underwent ACCF or ACDF for two-level CSM in our institution from January 2014 to December 2016 were retrospectively reviewed. Of these patients, 30 (17 males, 13 females) were subjected to ACCF, and 41 (20 males, 21 females) were treated with ACDF. Perioperative data, radiographic parameters, clinical outcomes, and axial symptom occurrence were compared between the two groups. The average follow-up durations were 13.7 ± 3.9 months in the ACCF group and 13.4 ± 3.3 months in the ACDF group. The volume of blood loss was significantly lower in the ACDF group than in the ACCF group, and the operation time of the former was significantly shorter than that of the latter. The postoperative global lordotic angle and T1 slope were significantly larger in the ACCF group than in the ACDF group in each follow-up. The occurrence of postoperative axial symptoms was significantly lower in the ACDF group than in the ACCF group. The volume of blood loss was lower and the operation time was shorter in ACDF than in ACCF for the treatment of two-level CSM. Sagittal balance was better in the ACDF group than in the ACCF group, and this observation may lead to a reduced occurrence of axial symptoms.

Background: Multiple sclerosis (MS) is a common autoimmune disease of the central nervous system (CNS), and is associated with genetic factors. FOXP3 gene polymorphism has been reported as the risk factor for MS, however, previous studies have showed conflicting results. The purpose of this study is to investigate the impact of FOXP3 gene polymorphism on the MS susceptibility through a meta-analysis. Methods: Pubmed, Embase, library of Cochrane, and Web of Science were used to search the eligible articles up to 1 Oct 2018. The odds ratio (ORs) and its 95 % confidence intervals (CI) were used to evaluate the strength of association. Allele model, homozygote model, heterozygote model, dominant model, and recessive model were used to evaluate the association between FOXP3 gene polymorphism and MS. Results: A total of 5 studies contained 1276 MS patients and 1447 controls (for rs3761548) and 600 MS patients and 640 controls (for rs2232365) were enrolled in this meta-analysis. The association showed significant differences in allele and dominant model for rs3761548 polymorphism. In addition, a clear tendency to significance was detected in homozygote and recessive model for rs3761548 (p = 0.052). Subgroup analysis indicated a significant risk of MS in all genotype models but heterozygotes in Asians. Conclusion: FOXP3 gene polymorphism rs3761548 was associated with a higher MS risk, especially in Asians. This conclusion needs to be validated in more large samples and multiracial studies. Keywords: FOXP3 gene, single nucleotide polymorphism, multiple sclerosis, meta-analysis.

Yes-associated protein (YAP) and extracellular signal-regulated kinase (ERK) have been considered as key regulators in tissue homeostasis, organ development, and tumor formation. However, the roles of YAP and ERK in the mediating strain mechanosensing in the growth plate cartilage have not been determined. In this study, chondrocytes obtained from the growth plate cartilage of 2-week-old Sprague-Dawley rats were subjected to the mechanical strain with different magnitudes and durations at a frequency of 0.5 Hz. We found that YAP and ERK activation in response to mechanical strain was time and magnitude dependent. Pretreatment with a RhoA inhibitor (C3 toxin) or a microfilament cytoskeleton disrupting reagent (cytochalasin D) could suppress their activation. In addition, activated YAP and ERK were able to induce cell cycle progression by up-regulating the expression of cell cycle-related genes. These results shed new light on the function of YAP and ERK in mechanical strain-promoted growth plate development. Our results also provided evidence that RhoA and cytoskeletal dynamics are required for this mechanotransduction. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1121-1129, 2016.

Calcium phosphate cements (CPCs) are popular bone filling materials and drug carriers. However poor mechanical properties and lack of osteoinduction restrict their clinical applications. Recent studies suggested the osteogenic properties of NAC. In our study, we incorporated NAC with α-TCP/SF. We found that the compressive strength of α-TCP/SF-NAC composites increased with increase in NAC concentration, possibly due to complex three-dimensional networks of SF induced by NAC, which was large and chemically heterogeneous and induced compact oriented growth of HA crystals. However the setting time increased slightly with the addition of NAC, due to the ruptured disulfide bonds in SF. The α-TCP/SF-NAC composites also showed decent biocompatibility in vitro. As a result, these composites hold great potential as bone filling materials for clinical applications, including minimally invasive surgeries.

Purpose:To introduce the intraoperative O-arm-assisted pedicle screw insertion without any navigation system in the treatment of thoracic vertebrae fracture and compare it to conventional fluoroscopy (C-arm)-assisted pedicle screw insertion technique.Methods:About 156 pedicle screws were inserted in 23 patients (C-arm group), and 208 pedicle screws were inserted in 30 patients (O-arm group). The postoperative computed tomography images were analyzed for pedicle violation based on Gertzbein classification. The total surgery time, the average time required for inserting a screw, the mean action times of adjusting guide probe and pedicle screw, and the hospitalization time were compared in both groups, respectively. The American Spinal Injury Association (ASIA) was used for evaluating the health outcomes pre- and postoperatively.Results:There are the higher accuracy rate of satisfactory pedicle screw placement (grades 0 and 1) and the less incidence of medial perforation in the O-arm group compared to the C-arm group ( p < 0.05). The average time required for inserting a screw, the action times of adjusting the guide probe and pedicle screw, and the hospitalization time in the O-arm group are less than the respective ones in the C-arm group ( p < 0.05). There was no significant difference for the total surgery time between both groups. No further damage of the nerve function postoperatively is found according to the ASIA grade.Conclusion:The O-arm-assisted pedicle screw insertion without navigation we described provides higher accuracy of pedicle screw placement and better clinical efficacy compared to conventional fluoroscopy (C-arm) technique.

We explored the expression of a newly identified potassium channel tetramerisation domain containing 9 (KCTD9) protein in 113 blood and 81 liver samples, from patients with mild chronic hepatitis B (CHB) or HBV-induced acute-on-chronic liver failure (HBV-ACLF). KCTD9 was highly expressed in peripheral and hepatic NK cells from HBV-ACLF patients compared with mild CHB patients, and this correlated positively with the severity of liver injury. The role of KCTD9 was further investigated in NK92 cells in vitro. KCTD9 overexpressed NK92 cells exhibited a marked increase in CD69 expression, cytotoxicity, IFN-γ secretion and a significant decrease in NKG2A receptor expression. Inhibition of KCTD9 by shRNA resulted in reduced cytotoxic function. These results suggest the involvement of KCTD9 in NK cell activation and provide additional insight into a potential therapeutic target for molecular manipulation for HBV-ACLF patients.

To explore the mechanisms of a novel potassium channel gene named KCTD9 (potassium channel tetramerization domain containing 9) in model of fulminant viral hepatitis induced by murine hepatitis virus 3 (MHV-3).78 BALB/cJ mice(6 male) were randomly and equally assigned to two groups, model group of fulminant viral hepatitis induced by MHV3 and its control. 75 C3H/HeJ female mice were done into two groups, 39 for model group of chronic hepatitis induced by MHV3, 36 for control. Various samples including spleen, liver and lymphocytes from mice of two model groups and the controls were examined for KCTD9 expression by real time quantitative PCR and Immunohistochemistry. Independent-samples T test or one-way ANOVA were carried out in different groups.Increased expressions of KCTD9 mRNA was observed in livers of both model mice of fulminant viral hepatitis and chronic hepatitis. Compared with the control mice, the expressions of KCTD9 mRNA were up-regulated by 577.1-, 8.8-, 59.4- and 10.8-fold in hepatic NK cells, CD4+ T cells, CD8+ T cells and splenic NK cells respectively in model mice of fulminant viral hepatitis 48 hr post MHV-3 infection, whereas down-regulation by 43% and 69% in splenic CD4 + T cells and CD8+ T cells were found respectively. In contrast, in model mice of chronic viral hepatitis the expressions of KCTD9 mRNA were down-regulated by 71% and 51% in hepatic CD4+ T cells and NK cells, respectively. The expression of KCTD9 protein was mainly evidenced in infiltrative mononuclear cells of liver as shown by immunohistochemistry. Basal expression was also investigated and showed constitutive expression of KCTD9 in brain, thymus and other organs in BALB/cJ mice.A novel potassium channel gene KCTD9 was highly expressed in hepatic NK cells and T cells of fulminant hepatitis mice induced by MHV-3.

Studies have shown that potassium channel plays a pivotal role in T cell activation. The expression of potassium channel gene KCTD9 was evidenced being highly upregulated in patients with severe hepatitis B (SHB). To understand this phenomenon further, tissue and cellular expression profiles of KCTD9 were investigated in patients with SHB.A rabbit peptide polyclonal antibody was prepared. Various samples including peripheral blood mononuclear cells (PBMCs); livers from patients with SHB or mild chronic hepatitis B, were examined for KCTD9 expression by quantitative real time PCR and immunohistochemistry staining (IHC). Confocal microscopy was used to illustrate the localizations of the expressions.Increased expression of KCTD9 was observed in PBMC in over 35.7% of the patients with SHB when compared with that of patients with mild chronic hepatitis B. In all patients, the relative value of increased KCTD9 mRNA was positively correlated with alanine aminotransferase, aspartate aminotransferase, total bilirubin and direct bilirubin but negatively with serum albumin. The expression was mainly located in hepatocytes, bile duct epithelial cells, Kupffer cells and inflammatory cells, and in the cytoplasm of PBMCs from the healthy individuals and patients with mild chronic hepatitis B, whereas in both cytoplasm and nuclei in those from patients with SHB.The increased expression of potassium channel gene KCTD9 correlates with disease severity in patients with viral hepatitis B.

To compare the mucA gene sequence, biofilm formation, growth rate and antibiotic resistance of a mucoid Pseudomonas aeruginosa strain 'PA17' with those of the nonmucoid strain PAOI.The mucA genes of PA17 and PAOI were amplified and the PCR products were sequenced. Biofilm was established and detected with scanning electron microscope 8 h, 24 h, 3 d and 6 d later. Clones counting method was used to compare the growth curves of PA17 and PAOI. International standard plate dilution method was used to detect the susceptibility of common antibiotics for PA17 and PAOI in vitro.There was a 166-333 deletion mutation in mucA gene of PA17. The biofilm formation rate and growth rate of PA17 were noticeably lower than those of PAOI. The antibiotic resistance profile of PA17 was identical to that of PAOI.A mucoid Pseudomonas aeruginosa with a new type of mutation of mucA gene is discovered. The biologic characteristics of this strain are different from those of the mucoid Pseudomonas aeruginosa strain reported previously, which may be related with the newly discovered mutation of mucA gene.