Qining Wu

Long Noncoding RNA CRNDE Promotes Multiple Myeloma Cell Growth by Suppressing miR-451

It has been determined that long noncoding RNAs (lncRNAs) are identified as a potential regulatory factor in multiple tumors as well as multiple myeloma (MM). However, the role of colorectal neoplasia differentially expressed (CRNDE) in the pathogenesis of MM remains unclear. In this study, we found that the CRNDE expression level, in MM samples and cell lines, is higher than that in the control detected by real-time qPCR, which is also closely related to tumor progression and poor survival in MM patients. Knockdown of CRNDE significantly inhibits the proliferative vitality of MM cells (U266 and RPMI-8226), induces cell cycle arrest in the G0/G1 phase, and promotes apoptosis. After being transfected with siRNA, miR-451 expression observably increases. Bioinformatics analysis and luciferase assay reveal the interaction by complementary bonding between CRNDE and miR-451. Pearsons correlation shows that CRNDE is negatively correlated to miR-451 expression in human MM samples. Subsequently, miR-451 inhibitor rescues the inhibited tumorigenesis induced by CRNDE knockdown. Our study illustrates that lncRNA CRNDE induces the proliferation and antiapoptosis capability of MM by acting as a ceRNA or molecular sponge via negatively targeting miR-451, which could act as a novel diagnostic marker and therapeutic target for MM.

Posterior atlantoaxial fixation: a review of all techniques

BACKGROUND CONTEXT Posterior atlantoaxial fixation is an effective treatment for atlantoaxial instability. Great advancements on posterior atlantoaxial fixation techniques have been made in the past decades. However, there is no article reviewing all the posterior atlantoaxial fixation techniques yet. PURPOSE The aim was to review the evolution and advancements of posterior atlantoaxial fixation. STUDY DESIGN This was a literature review. METHODS The application of all posterior fixation techniques in atlantoaxial stabilization, including wiring techniques, interlaminar clamp fixation, transarticular fixation, screw-plate systems, screw-rod systems, and hook-screw systems, are reviewed and discussed. Recent advancements on the novel technique of atlantoaxial fixation are described. The combination of the C1 and C2 screws in screw-rod systems are described in detail. RESULTS All fixation techniques are useful. The screw-rod system appears to be the most popular approach. However, many novel or modified fixation methods have been introduced in recent years. CONCLUSIONS Great advancements on posterior atlantoaxial fixation techniques have been made in the past decades. The wiring technique and interlaminar clamps technique have fallen out of favor because of the development of newer and superior fixation techniques. The C1-C2 transarticular screw technique may remain the gold standard for atlantoaxial fusion, whereas screw-rod systems, especially the C1 pedicle screw combined with C2 pedicle/pars screw fixation, have become the most popular fixation techniques. Hook-screw systems are alternatives for atlantoaxial fixation.

One-stage anterior release and reduction with posterior fusion for treatment of irreducible atlantoaxial dislocation

Objective:  To analyze the approach and feasibility of one‐stage anterior release and reduction with posterior fusion for irreducible atlantoaxial dislocation.

Occipitocervical fusion: Fix to C2 or C3?

OBJECTIVE The objective of this study was to explore the differences in clinical outcome between short-segment fixation (SSF; occiput-C2) and multi-segment fixation (MSF; occiput-C2, 3). METHODS From January 2008 to January 2012, patients who underwent surgery for instability at the occipitocervical junction were included in the study. Two different groups of surgeons using two different management options completed the surgeries. One group performed SSF, whereas the other group performed MSF. A total of 53 patients met the criteria (33 SSF, 20 MSF). Mean follow-up was 33.9 months (range, 12-62 months). Fusion was demonstrated by plain radiographs and computed tomography imaging. Neurological status, pillow neck pain, operative time, blood loss during operation, and perioperative complications were compared between the SSF and MSF groups. RESULTS The fusion rate was 97% in the SSF group and 100% in MSF the group. There was no statistically significant difference in the fusion rate between the two groups (P>0.05). One patient (3%) in the SSF group and two patients (10%) in the MSF group experienced perioperative complications. Of the 25 patients who had neurological symptoms, 22 (88%) showed improvement after the operation in the SSF group and 14 (87.5%) of 16 showed improvement in MSF group. In addition, patients who suffered from pillow neck pain achieved varying degrees of improvement after the operation. CONCLUSION SSF may be the better choice for treating occipitocervical instability when no subaxial instability is present. Overall, modern instrumentation can provide the stability needed for successful clinical fusion.

The in vitro and in vivo effects of microRNA-133a on intervertebral disc destruction by targeting MMP9 in spinal tuberculosis

AIMS We aim to investigate the role of microRNA-133a (miR-133a) in intervertebral disc destruction by targeting MMP9 in spinal tuberculosis (TB). MAIN METHODS Rabbit models with spinal TB were established and assigned to the blank, miR-133a mimic, miR-133a inhibitor and negative control (NC) groups. Primary notochordal cells were extracted and separately transfected with miR-133a mimics, miR-133a inhibitor, miR-nonsense sequence control (NC), si-NC and si-MMP9. QRT-PCR and Western blot assay were used to detect the expression of MMP-9, Collagen I, Collagen II and Collagen-X. Gelatin Zymography was performed to detect MMP9 activity. Immunohistochemistry was used to detect the expression of Collagen I, Collagen II and Collagen-X proteins. Osteoclast morphology and the number of osteoclast cells were observed after Tartrate resistant acid phosphatase staining. KEY FINDINGS MMP9, Collagen-X and Collagen I expression and MMP9 activity were higher while the expression of Collagen II was lower in the miR-133a mimic group than the miR-NC group. MMP9, Collagen-X Collagen I and MMP9 activities were lower and Collagen II expression was higher in the miR-133a inhibitor group than the miR-NC group. Compared with the si-NC group, the si-MMP9 group showed increased Collagen II expression but decreased expression of MMP9, Collagen-X and Collagen I and MMP9 activity. A reduced amount of osteoclast cells exhibited in the miR-133a mimic group while an increased number was seen in the miR-133a inhibitor group compared to the blank group. SIGNIFICANCE MiR-133a could inhibit Collagen degradation by down-regulating MMP-9 expression to attenuate the destructive effects of spinal TB on intervertebral disc.

Three-Dimensional Printed Model-Assisted Screw Installation in Treating Posterior Atlantoaxial Internal Fixation

The aim of this study was to evaluate the efficacy and feasibility of a life-size 3-dimensional printing assisted posterior internal fixation. We performed a retrospective review of 138 patients who received posterior atlantoaxial internal fixation from October 2009 to March 2015 with a minimum follow-up period of 12 months. Group A included 76 patients who received the conventional free-hand technique. Group B included 62 patients who were treated with internal fixation assisted by 3D printing. The placement accuracy of the screw was evaluated in the computed tomography images according to the methods of Hojo and clinical outcomes were evaluated using the visual analogue scale, the Japanese Orthopedic Association Score, and the Neck Disability Index score. There were no significant differences in the clinical results at any of the follow-up time points regarding the JOA, VAS, or NDI scores between two group. However, compared to Group A, Group B had better results for screw installation (P = 0.003), shorter surgery time (P = 0.001), and less blood loss (P = 0.037). Compared to the conventional free-hand technique, 3D printed model–assisted is helpful to screw placement in atlantoaxial internal fixation, which can be used as a common tool to provides important guidance for upper cervical surgery.

An innovative technique for osteoporotic vertebral compression fractures – vertebral osteotome with side-opening cannula

Objective This study is to assess an innovative technique – a vertebral osteotome (VO) combined with side-opening injection cannula for percutaneous vertebroplasty (PVP). Methods A retrospective study by propensity score matching. From January 2016 to April 2016, 63 patients who were diagnosed with monosegmental osteoporotic vertebral compression fracture received the innovative technique. The epidemiologic data, surgical indexes, and recovery outcomes were collected in the follow-up period. Propensity score matching identified 63 pairs form historical controls by traditional unilateral PVP approach in 2015 using six independent variables: age, sex, preoperative visual analog score (VAS), Oswestry Disability Index (ODI), body mass index, and bone mineral density. Results The surgical duration and cement distribution were longer and larger in patients by VO method. Besides, postoperative VAS and ODI in the VO group were lower than those in the control group. However, there were no differences in radiation exposure times, improvement of Cobb angle, cement leakage, or adjacent vertebral fracture between two groups. Cement volume in the VO group was less than that in the control group. Conclusion This new innovative technique makes PVP safe and effective. Although it lasts longer, the restoration rate of vertebral height and cement distribution can be improved, which contributes to a better pain relief.

Is percutaneous kyphoplasty the better choice for minimally invasive treatment of neurologically intact osteoporotic Kümmell’s disease? A comparison of two minimally invasive procedures

PurposeThe purpose of this study was to compare and evaluate the safety and efficacy of percutaneous vertebroplasty at a hyperextension position (PVPHP) and percutaneous kyphoplasty at a hyperextension position (PKPHP) for the treatment of osteoporotic Kümmell’s disease.MethodsThis study was a retrospective, single-centre study. There were 35 patients with osteoporotic Kümmell’s disease who were analyzed. Twenty-two of them underwent PVPHP and the other 13 patients underwent PKPHP from January 2013 to January 2015. The volume of bone cement injection and operation costs were compared. We compared the visual analogue score (VAS) and vertebral Cobb’s angle at pre-operation, the second day after operation, and the final follow-up. We compared the Oswestry disability index (ODI) score at the pre-operation and the final follow-up.ResultsThere were no significant differences in gender, age, course of disease, bone mineral density (BMD), and mean follow-up time between the two groups (P > 0.05). Regarding the costs of the operation, the PKPHP group was significantly higher than the PVPHP group (P < 0.05). Compared with the pre-operation (P < 0.05), the post-operative ODI score, VAS, and Cobb’s angle of the two groups were improved significantly. Even though the correction of Cobb’s angle in the PKPHP group was slightly better than the PVPHP position group, there were no significant differences between two groups (P > 0.05). At the final follow-up, the Cobb’s angle was increased in both groups, but there was no significant difference (P > 0.05). There was no significant difference in the bone cement leakage rate between the two groups (P > 0.05).ConclusionFor the treatment of Kümmell’s disease, PVPHP and PKPHP are both safe and effective, but PVPHP is more economical and can be considered a preferred method of treatment.

Multilayered Scaffold with a Compact Interfacial Layer Enhances Osteochondral Defect Repair

Repairing osteochondral defect (OCD) using advanced biomaterials that structurally, biologically, and mechanically fulfill the criteria for stratified tissue regeneration remains a significant challenge for researchers. Here, a multilayered scaffold (MLS) with hierarchical organization and heterogeneous composition is developed to mimic the stratified structure and complex components of natural osteochondral tissues. Specifically, the intermediate compact interfacial layer within the MLS is designed to resemble the osteochondral interface to realize the closely integrated layered structure. Subsequently, macroscopic observations, histological evaluation, and biomechanical and biochemical assessments are performed to evaluate the ability of the MLS of repairing OCD in a goat model. By 48 weeks postimplantation, superior hyalinelike cartilage and sound subchondral bone are observed in the MLS group. Furthermore, the biomimetic MLS significantly enhances the biomechanical and biochemical properties of the neo-osteochondral tissue. Taken together, these results confirm the potential of this optimized MLS as an advanced strategy for OCD repair.

Bone Grafting of Atlantoaxial Joints and Occipitocervical or Atlantoaxial Fusion for the Reduction and Fixation of Basilar Invagination with Atlantoaxial Dislocation by a Posterior Approach: A Preliminary Study

BACKGROUND Basilar invagination (BI) with atlantoaxial dislocation (AAD) is a complex disease to manage. We have developed a new technique of bone grafting the atlantoaxial joints and occipitocervical fusion using a posterior approach for the reduction and fixation of BI with AAD with complete retention of the C2 nerve root. METHODS Thirty-two patients underwent bone grafting of the atlantoaxial joints and occipitocervical fusion for the reduction and fixation of BI with AAD by the posterior approach in our department between January 2015 and February 2016. All patients underwent plain radiography, computed tomography (CT) scanning, and magnetic resonance imaging evaluation. The atlantodens interval and cervicomedullary angle were evaluated preoperatively and 5 days after surgery on sagittal reconstructed CT scans to evaluate BI with AAD. CT scans of sagittal reconstruction were acquired at each follow-up until bone fusion was confirmed. RESULTS All patients were followed up for 6-19 months. No patient required re-exploration for failure of implant fixation. At the last follow-up, all patients had achieved fusion (32/32). Japanese Orthopedic Association score, atlantodens interval, and cervicomedullary angle were significantly improved in these patients compared with preoperative measurements (P < 0.05). The duration of symptoms ranged from 5 days to 11 months (mean duration, 2 months). No serious complication was observed. CONCLUSIONS In this preliminary study, our operation technique could treat BI with AAD by using only a posterior approach, which could retain C2 nerve roots and fuse atlantoaxial joints. This technique may be extended to other diseases requiring treatment by C1-C2 fusion.