Search

Kashin-Beck disease (KBD) is a chronic and endemic osteochondral disease and the etiology and pathogenic mechanism of KBD are still unknown. This study aimed to elucidate and screen KBD-associated proteins, which were differentially expressed between KBD patients and healthy controls. We combined protein fractionation and liquid chromatography-tandem mass spectrometry (LC-MS/MS) with a high-resolution mass spectrometer coupled with tandem mass tags (TMTs) to quantitatively analyze and screen KBD-associated proteins, which were differentially expressed between KBD patients and healthy controls. In addition, we used parallel reaction monitoring (PRM) to quantify proteins in serum from patients with KBD and healthy controls in order to verify the differentially expressed proteins in patients with KBD. We identified 224 differentially expressed proteins, including 11 up-regulated and 213 down-regulated proteins. Catalase (CAT) was observed to be significantly elevated in patients with KBD compared with control patients. Further, the fold difference of CAT is significantly elevated in PRM compared with label-free quantification. The results in this study suggest that CAT may be the reflection of the dynamic nature of KBD and could be considered as a novel pathogenic indicator for patients with KBD.

Aim Deep vein thrombosis (DVT) is a common complication of orthopedic surgery. Multiple lines of evidence indicate that genetic factors play an important role in the development of DVT following orthopedic surgery (DVTFOS). Recent evidence suggested that the solute carrier family 44 member 2 (SLC44A) gene may contribute to the risk of DVT. In this study, we aimed to investigate the associations of SLC44A2 and DVTFOS in Chinese Han individuals. Methods In the study, 2,655 subjects, including 689 DVTFOS patients and 1,966 controls, were recruited. Eighteen SNPs were genotyped in the study. Genetic association analyses were performed at both the single marker and haplotype levels. Bioinformatics analyses were conducted to predict the functional consequences of significant SNPs. Results SNP rs2288904 of SLC44A2 was identified as being significantly associated with DVTFOS (P=0.0003, OR [95%CI]=1.28[1.12-1.46]). Allelic analyses showed that the G allele of this SNP significantly elevated the risks of DVTFOS, which was replicated in the genotypic association analyses. Moreover, a two-SNP haplotype, including rs2288904, was found to be strongly correlated with the risk of DVTFOS (P=4.15×10－11). Widespread effects in the expression quantitative trait loci were identified for rs2288904 in multiple tissues. Conclusion In summary, our results provide further supportive evidence of the association of SLC44A2 with the risk of DVTFOS, which also provide clues for understanding the important roles of the SLC44A2 gene in the pathogenesis of DVTFOS and in the development of preventive strategies.

We present a case of a 13-year-old female with severe varus deformity and limb discrepancy resulting from epiphyseal fracture. The preoperative tibial articular surface angle was 64.1°, and the affected tibia was 14 mm shorter than the contralateral tibia. She underwent a medial open osteotomy and fibular osteotomy with gradual distraction correction using Ilizarov fixator. The deformity was corrected at 3 months, and the external fixator was removed when bony union was achieved 6 months postoperatively. At 9 months after surgery, the patient could play basketball without feeling pain. At the last follow-up, namely 36 months after the operation, the American Orthopaedic Foot and Ankle Society hindfoot-ankle score was improved from 58 to 90, the patient was pain free, and the radiological measurements were nearly normal. Ilizarov fixator gradual distraction correction for distal tibial severe varus deformity is a safe and cost-effective method that can yield excellent radiological and clinical outcomes.

In this paper, we study the nonhomogeneous Dirichlet problem concerning general semilinear elliptic equations in divergence form. We establish that the boundary Lipschitz regularity of solutions under some more weaker conditions on the coefficients, the boundary, the boundary function and the nonhomogeneous term. In particular, we assume that the nonhomogeneous term satisfies Dini continuity condition and Lipschitz Newtonian potential condition, which will be the optimal conditions to obtain the boundary Lipschitz regularity of solutions., arXiv admin note: text overlap with arXiv:2105.06271

Background There have been debates on the necessity of fibular osteotomy (FO) in supramalleolar osteotomy (SMOT) for the treatment of varus ankle osteoarthritis. The purpose of the current study was to compare the clinical and radiological outcomes between SMOT with and without FO in the treatment of varus ankle osteoarthritis. Methods The SMOT group included 39 patients, and the SMOT with FO group included 24 patients. The basic information reached no significant difference between groups. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Osteoarthritis Scale (AOS), modified Takakura stage and range of motion (ROM) were used for the functional evaluation. The radiologic parameters were assessed at the last follow-up to compare the degree of talar reduction between the two groups. Results Both groups achieved significant improvements in AOFAS scores, modified Takakura stage, as well as AOS pain and functional scores (P P = 0.022). In both groups, all of the radiological parameters were significantly improved (P P P P = 0.001). The medial displacement of the talus (MDT) was better reduced in the SMOT with FO group (P = 0.006). Conclusion SMOT is a promising procedure for functional improvement and malalignment correction in varus ankle osteoarthritis but reduces ankle range of motion. If SMOT is combined with FO, talar tilt and medial displacement will be better reduced.

Background: Autologous osteochondral transplantation (AOT) is one of the most effective treatments for osteochondral lesions of the talus (OLTs). Normally, medial malleolar osteotomy is used to expose posteromedial lesions. However, medial malleolar osteotomy causes additional ankle injuries and a risk of persistent pain in the ankle joint. The purpose of the current study was to evaluate a new medial malleolar triplane osteotomy method and the functional outcomes of AOT from a non-weight-bearing area of the talus for OLTs.Methods: Twenty-three patients (23 ankles), including 14 males and 9 females, received AOT with triplane osteotomy of the medial malleolus for symptomatic OLTs between September 2015 and December 2017. The mean age was 35.6 years. The mean size of the lesion area was 141.5 mm2. The visual analog scale (VAS) for pain during walking and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for the pre- and postoperative evaluations. In addition, the incorporation of the grafts was assessed by computed tomography (CT).Results: All patients had a minimum follow-up of 22 months, with an average of 37.1 months. The mean time from osteotomy to full weight-bearing activity was 8.1±2.3 weeks (range, 5-12 weeks). The VAS score improved from 4.34 preoperatively to 0.53 postoperatively (P Conclusions: AOT combined with medial malleolus triplane osteotomy is a viable option for OLTs. Patients could perform weight-bearing exercise and return to sport as early as possible, with few complications at the osteotomy site and donor site.

Background The purpose of the current study was to retrospectively clarify the anatomic character and evaluate the mid-term operative outcomes for vertical medial malleolar fractures (MMFs). Methods A total of 53 patients with supination adduction (SAD) type II MMFs treated with open reduction and internal fixation (ORIF) between March 2009 and June 2013 were included. We reviewed the patients' preoperative X-ray and computed tomography (CT) to determine the pathoanatomic characteristics of medial malleolus fractures. Buttress plate lag screws fixation had been applied. Complications and treatment failures were recorded; the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS) were used to evaluate the functional outcomes. Results For the 53 patients, only 39.6% cases with simple vertical MMFs. The mean distal tibial articular surface (DTAS) involvement in the MMF was 16.5%±11.6% (range, 0-47%). The mean follow up time was 62.4±14.1 [44-91] months. There were 7 cases of traumatic osteoarthritis (TOA), and 3 cases of failure were reported in the screw fixation group. The mean AOFAS score was 80.6±15.8 points, and the mean VAS score was 2.1±1.7 points, with a good to excellent rate (GTE) of 81.1%. No significant difference was found in comparing the AOFAS, VAS, GTE, incision relative complication rate, infection rate, loss of reduction (LoR) rate, and TOA rate between groups (P>0.05). The participants in the buttress plate group reached a shorter mean full weight-bearing (FWB) time (P=0.04). Conclusions More than 60% vertical MMFs are with one or more characteristics of medial cortex comminuted fractures, or die-punch fragments, or medial joint compression. And patients with die-punch fragment, medial joint compression, LoR, large DTAS involvement and small fracture line angle (FLA) were positively correlated with the fair to poor results. Lag screw fixation should be cautiously used in vertical MMF patients with comminuted medial cortex.

The heavy use of glyphosate during the cultivation of glyphosate-resistant crops, would trigger the so called "pseudo-persistent" glyphosate in soil, thereby threatening agricultural environment, crop production, and human health through food safety. Such that, there is pressing need for the development of strategies for the effective management of glyphosate contamination in soil to promote cleaner agricultural production. In this study, as witnessed via characterizing the bioavailability and phytotoxicity of glyphosate to cowpea plants in soils applied with or without earthworm casts (EWCs), EWCs could significantly facilitate glyphosate desorption from soil, thus enhance its bioaccessibility, nonetheless, sharply decreased rather than increased the accumulation of glyphosate in cowpea plants via reducing the residue pool of glyphosate in the soil. Consequently, in comparison with the glyphosate-alone group, EWCs involvement triggered the increase of chlorophyll content, alleviation of ROS accumulation and lipid peroxidation of membrane, and in turn reduced the activity of a series of stress-tolerance enzymes by means of down-regulating the expression of the corresponding mRNA; ultimately, helped plants to reverse the glyphosate-induced growth suppression. Our findings demonstrated that, EWCs were promising candidate for the cost-effective and easy-to-operate remediation and reuse of glyphosate-contaminated soil, while also being able to improve the quality of the cultivated land and promote crop growth and resistance as a nutrients supplier.

Background Understanding the position of the normal ankle is the key before every successfully surgical planning. The aims of our study were to quantify the normal ankle angles, measures and reference points systematically on ankle radiographs. Methods A total of 900 angles and 300 basic information were measured on 100 healthy ankles. The radiographic measurements were performed on standard weight-bearing anteroposterior (AP) and lateral view of the ankle. A total of 6 angles were made from the AP view, 3 angles from the lateral view. All angles were measured by 2 foot and ankle surgeons, independent of each other. For intraobserver reliability, after six weeks, the same angles were measured by each observer. Results A total of 900 angles and 300 basic information were measured on 100 healthy ankles. The mean age of the subjects was 33.0 ± 9.1years, with 57 females(57%) and 43 males(43%), with 44 left feet(44%) and 56 right feet(56%). Intraobserver is reliability greater than 0.8 and the interobserver reliability greater than 0.8. The following angles were measured from the AP of ankle: TAS’s angle, TT’s angle, TC’s angle, TMM’s angle, TLM’s angle, MA’s angle. The following angles were measured from the lateral view: TLS’s angle, Kite angle, TTA’s angle. Conclusions Our study will provide a set of standard angle measures. The range of angles can be used as a reference for preoperative design and intraoperative and postoperative evaluations.

Background: Although several treatment options described in paper, Haglund’s Syndrome (HS) is a challenging common lower extremity disorder. This study reported the clinical outcomes of Zadek osteotomy (ZO) for the treatment of HS.Methods: This retrospective study included 19 patients who underwent ZO from January 2016 to June 2018. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Visual Analogue Scale (VAS), ankle range of motion (AROM), and Chauveaux-Liet (CL) angle preoperatively and at final follow-up visit (16.3±4.2) months. Postoperative complications of patients were also recorded.Results: The ZO exhibited a significant improvement (P＜0.05) in preoperative to postoperative AOFAS (from 53.2±5.4 to 86.4±6.5), VAS ( from 6.3±2.1 to 0.9±1.2 ) scores and CL angle (from 18.2±1.3 to 9.4±2.1 ) degrees, the dorsiflexion of AROM (DAROM) (from 23.4±2.3 to 29.4±1.2) degrees. The planter flexion of AROM (PAROM) (from 32.5±3.5 to 33.2±3.4) degrees (P＞0.05). One postoperative complication was observed: a case of hardware pain in healthy patient. The overall rate of satisfaction after surgery was (94.7%).Conclusions: ZO is effective and safe procedure for the treatment of HS. This method can be a good option for those patients of HS.

Background: The indications for surgery, timing, and procedure in children with flexible flatfoot deformity remain controversial. For marked deformities, combined procedures are preferred to correct multiple plane deformities. Thus, this study aimed to evaluate the outcomes of osteotomies combined with soft tissue procedures in children with flexible flatfoot aged 9-14 years.Methods: From July 2014 to October 2017, 28 children (47 feet) with flexible flatfoot with an average age of 11.7±2.1 (range 9-14) years underwent osteotomy combined with soft tissue surgery. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Foot and Ankle Outcome Score (FAOS) were used to evaluate the preoperative and postoperative clinical outcomes. The talo-navicular coverage angle (TNCA) and talar–first metatarsal angle (T1MA) on the foot anteroposterior view, calcaneal pitch angle and Meary’s angle on the foot lateral view, and calcaneus valgus angle (CVA) on the Saltzman view were also observed.Results: All patients were followed up for an average duration of 29.7±8.6 months. Mean AOFAS and FAOS significantly improved from 56.6±8.0 and 47.4±9.5 preoperatively to 88.4±3.9 and 83.2±6.8 at final follow-up (P,s angle (PConclusion: Osteotomies combined with soft tissue procedures are an effective strategy for flexible flatfoot deformity in children, as it results in favorable radiographic and functional outcomes.

OBJECTIVE: To compare the clinical and radiographic outcomes of bioabsorbable screw and metallic screw for Maisonneuve fracture. METHODS: The clinical data of 68 patients of Maisonneuve fracture treated with open reduction and internal fixation between October 2012 and October 2016 were retrospectively analyzed. Metallic screw fixation was used in 37 cases (group A) and absorbable screw fixation was used in 31 cases (group B). There was no significant difference in age, gender, weight, operated side, cause of injury, time from injury to operation, and complications between the two groups (P>0.05). At last follow-up, the tibiafibular clear space (TFCS), tibiafibular overlap (TFO), medial clear space (MCS), and syndesmotic malreduction rate were recorded. And the dorsiflexion and plantar-flexion range of motion, pain visual analogue scale (VAS) score, ankle and hind foot score of American Orthopaedic Foot and Ankle Society (AOFAS), and Olerud-Molander (OM) score were recorded. RESULTS: All patients were followed up 25-43 months, with an average of 32.3 months. There was no significant difference in the operation time between the two groups (t=1.229, P=0.282). All the fractures healed, and there was no significant difference in fracture healing time between the two groups (t=1.367, P=0.413). At last follow-up, the syndesmotic malreduction rate of group A was 16.2% (6/37), showing no significant difference when compared with group B [6.2% (2/31)] (χ(2)=1.549, P=0.213). There were 3 complications in group A, 1 was superficial wound infection, 1 was local heterotopic ossification due to failure to remove the screws in time, 1 was local heterotopic ossification of the screws; and there were 2 complications in group B, 1 was rejection and 1 was local heterotopic ossification of the screws. There was no significant difference in the incidence of complications between the two groups (χ(2)=0.068, P=0.794). There was no significant difference in TFCS, MCS, TFO, ankle dorsiflexion and plantar-flexion range of motion, AOFAS score, OM score, and VAS score between the two groups at last follow-up (P>0.05). CONCLUSION: Compared with metallic screw, absorbable screws provide adequate fixation and functional recovery with avoiding screw removal and lower syndesmotic malreduction.

To explore the effectiveness of modified internal fixation and fusion in treatment of type Ⅱ painful accessory navicular (PAN) in adults.Between January 2016 and December 2017, 29 patients (37 feet) with type Ⅱ PAN were treated with modified internal fixation and fusion. There were 12 males and 17 females with an average age of 41.4 years (range, 18-50 years). The injury caused by sprain in 24 cases and no obvious inducement occurred in 5 cases. All patients received conservative treatment for more than 6 months with no significant improvement. The effectiveness was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score before operation and at last follow-up. The inclination angle of calcaneus, the first metatarsal angle of talus, the inclusion angle of talonavicular joint, and the second metatarsal angle of talus were measured on X-ray films.Superficial infection of incision occurred in 1 case after operation, and the incision healed after enhanced dressing change. The incisons of the other patients healed by first intention. There was no deep infection or osteomyelitis. All patients were followed up 12-33 months (mean, 25.1 months). X-ray films showed that the articular surfaces healed at 2-5 months after operation, with an average of 3.4 months. No loosening or rupture of internal fixator was found during the follow-up. At last follow-up, the pain, function, alignment scores, and total score of AOFAS were significantly improved when compared with those before operation (Modified internal fixation and fusion in treatment of type Ⅱ PAN can effectively relieve the symptoms and obtain good recovery of feet function with less complications.探讨改良内固定融合术治疗成人Ⅱ型痛性足副舟骨（painful accessory navicular，PAN）的疗效。.2016 年 1 月—2017 年 12 月，采用改良内固定融合术治疗 29 例（37 足）Ⅱ型 PAN。其中男 12 例，女 17 例；年龄 18～50 岁，平均 41.4 岁。扭伤 24 例，无明显诱因 5 例。患者均行 6 个月以上保守治疗，症状无明显改善。术前及末次随访时采用美国矫形足踝协会（AOFAS）中足评分评估临床疗效；X 线片测量跟骨倾斜角、距骨第 1 跖骨角、距舟关节包容角、距骨第 2 跖骨角。.术后 1 例出现切口浅表感染，经加强换药后愈合；其余患者切口均Ⅰ期愈合，无深部感染或骨髓炎发生。29 例均获随访，随访时间 12～33 个月，平均 25.1 个月。X 线片示关节面均于术后 2～5 个月愈合，平均 3.4 个月。随访期间未见内固定物松动或断裂。末次随访时，AOFAS 疼痛、功能、力线评分及总分以及距舟关节包容角、距骨第 1 跖骨角和距骨第 2 跖骨角均较术前显著改善，差异有统计学意义（采用改良内固定融合术治疗成人Ⅱ型 PAN 可有效缓解症状，患足功能恢复良好，并发症少。.

Based on the proper improvement and development of the basic principle of digital image correlation method, a 3D-DIC measurement system is built. Its measurement principle and application process can be divided into four steps: camera calibration, image acquisition, image matching and three-dimensional reconstruction. The measurement system can realize non-contact and full-field measurement and has the advantages of not being affected by the test environment, not imposing additional mass on the test model, and high signal-to-noise ratio of the measured data. Taking the elastic plate model as an example, the accuracy and reliability of the measurement system in the measurement of static and dynamic displacement response are verified by using the measurement results of laser displacement meter as a reference. In addition, the tensile strain of the projectile aluminum alloy tail model and the ground mode of the elastic plate are tested to further verify the practicability of the test system.

Circular RNAs (circRNAs) have been implicated in the pathological regulation of human diseases by acting as microRNA (miRNA) sponges to affect gene expression. CircRNA Fragile Mental Retardation 2 (circ_AFF2) was dysregulated in rheumatoid arthritis (RA), but little is known about its specific function and hidden molecular mechanism in RA. Circ_AFF2, miR-375 and TAK1-binding 2 (TAB2) expression levels were determined through the quantitative real-time polymerase chain reaction (qRT-PCR). Flow cytometry was performed to analyze cell cycle and apoptosis. Cell proliferation detection was conducted by 3-(4, 5-dimethylthiazol-2-y1)-2, 5-diphenyl tetrazolium bromide (MTT) assay. The protein levels were measured using western blot. Inflammatory response was evaluated by enzyme-linked immunosorbent assay (ELISA). RNA pull-down assay was used to select the miRNA target of circ_AFF2. The interaction between miR-375 and circ_AFF2 or TAB2 was analyzed using the dual-luciferase reporter assay. Contrasted to normal samples and fibroblast-like synoviocytes (FLS), circ_AFF2 expression was upregulated in RA blood samples and FLS-RA cells. Cell cycle, proliferation and inflammatory response were blocked while apoptosis was promoted in FLS-RA after the downregulation of circ_AFF2. In addition, circ_AFF2 could interact with miR-375 and the function of circ_AFF2 was achieved by sponging miR-375 in FLS-RA cells. Moreover, TAB2 was a target of miR-375 and miR-375 repressed RA progression by decreasing TAB2 expression in FLS-RA cells. More importantly, circ_AFF2 promoted the expression of TAB2 by targeting miR-375. These findings clarified that circ_AFF2 induced cell progression, inflammatory response in FLS-RA cells via the miR-375/TAB2 axis. Circ_AFF2 could be used as a biomarker in the diagnosis and treatment of RA.

Concentrations as high as thousands of milligrams per kilogram (dry weight) of nonylphenol (NP), an endocrine-disrupting chemical of great concern, have been reported in soil. Soil is considered one of the primary pathways for exposure of crop plants to NP. However, there have been few studies on the toxicity of soil NP to crop plants, especially with comprehensive consideration of the application of organic fertiliser which is a common agricultural practice. In this study, tomato plants were grown in soils treated with NP in the presence and/or absence of earthworm casts (EWCs). After four weeks, we tested the physiological and biochemical responses (accumulative levels of hydrogen peroxide (H2O2) and superoxide anion radicals (O2-·), total chlorophyll content, degree of membrane lipid peroxidation, activities of defence-related enzymes, and level of DNA damage) and the changes in plant growth (elongation and biomass). The growth inhibition, reactive oxygen species (H2O2 and O2-·) accumulation, decrease in chlorophyll content, increase in activity of defence-related enzymes (including superoxide dismutase, peroxidase, catalase, ascorbate peroxidase, glutathione S-transferase and glutathione reductase), enhancement of membrane lipid peroxidation, and DNA damage in NP-treated seedlings were clearly reversed by the intervention of EWCs. In particular, the suppressed elongation, biomass, and chlorophyll content in tomato plants exposed to NP alone were significantly restored by EWCs to even greater levels than those of the undisturbed control. In other words, EWCs could efficiently invigorate the photosynthesis of crops via up-regulating the chlorophyll content, thereby overwhelming the NP stress on plant growth. Accordingly, except for reducing the bioavailability of soil NP as reported in our previous study, EWCs could also help crop plants to cope with NP stress by strengthening their stress resistance ability. Our findings are of practical significance for the formulation of strategies to relieve the negative effects of soil NP on crop growth.