Shoufeng Wang

Increased expression of insulin-like growth factor-1 receptor is correlated with tumor metastasis and prognosis in patients with osteosarcoma.

The aim of this study was to investigate the association of insulin‐like growth factor‐1 receptor (IGF‐1R) with metastasis and prognosis of osteosarcoma patients.

Histomorphological study of the spinal growth plates from the convex side and the concave side in adolescent idiopathic scoliosis

Asymmetrical growth of the vertebrae has been implicated as one possible etiologic factor in the pathogenesis of adolescent idiopathic scoliosis. The longitudinal vertebral growth derives from the endochondral ossification of the vertebral growth plate. In the present study, the growth plates from the convex and concave side of the vertebrae were characterized by the method of histology and immunohistochemistry to evaluate the growth activity, cell proliferation, and apoptosis. Normal zoned architectures were observed in the convex side of the growth plate and disorganized architectures in the concave side. The histological grades were significantly different between the convex and the concave side of the growth plate in the apex vertebrae (P < 0.05). The histological difference was also found significant statistically between end vertebrae and apex vertebrae in the concave side of vertebral growth plates (P < 0.05). The proliferative potential indexes and apoptosis indexes of chondrocytes in the proliferative and hypertrophic zone in the convex side were significantly higher than that in the concave side in the apex vertebral growth plate (P < 0.05). There was a significant difference of the proliferative potential index (proliferating cell nuclear antigen, PCNA index) between convex side and concave side at the upper end vertebra (P < 0.05). The difference of the proliferative potential index and apoptosis index were found significant statistically in the concave side of the vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). The same result was also found for the apoptosis index (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labeling assay, TUNEL index) in the convex side of vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). Some correlation were found between radiographic measurements and proliferation and apoptosis indexes. The difference in histological grades and cellular activity between the convex and concave side indicated that the bilateral growth plate of the vertebrae in AIS patients have different growth kinetics which may affect the curve progression.

Histologic, Risser Sign, and Digital Skeletal Age Evaluation for Residual Spine Growth Potential in Chinese Female Idiopathic Scoliosis

Study Design. A prospective study. Objective. To ascertain the correlation between histologic grades (HGs) of vertebral growth plates and Risser grades as well as DSA stages in the Chinese female idiopathic scoliosis (IS) patients; to identify whether digital skeletal age (DSA) is a reliable indicator for accurate evaluation of the spinal residual growth potential. Summary of Background Data. DSA is considered one of the more important indicators for representing the peak height velocity (PHV) typically and predicting spinal growth potential. The correlation between HGs of growth plates and DSA stages in IS patients is unclear. Methods. Thirty-nine Chinese female patients were available for this study. Superior and inferior growth plates were obtained at each level when anterior approach surgeries were performed. Histologic examinations were conducted after the specimens were processed. Of these patients, 28 cases were evaluated by DSA stages in this study. Correlations between histologic grades, Risser grades, menarchal status, and chronologic age were analyzed in 39 patients. Correlations between histologic grades, DSA, menarchal status, and chronologic age were analyzed in 28 patients. Results. There was a negative correlation between the following: HGs and Risser grades in 39 patients (r = −0.645, P = 0.000–0.05), HGs and menarchal status in patients in Risser 4 (r = −0.710, P = 0.002–0.05), HGs and DSA stages in 28 cases (r = −0.541, P = 0.003–0.05), and HGs and menarchal status in patients in DSA Stage III (r = −0.591, P = 0.006–0.05). Statistical significance of growth activity of growth plates was found between patients in Risser Grades 0 to 1 and those in Risser Grades 2 to 5 (P = 0.020–0.05) and patients in DSA Stage II and those in DSA Stage III (P = 0.014–0.05). Conclusion. DSA may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronologic ages.

Adolescent thoracolumbar scoliosis secondary to ganglioneuroma: a two case report.

Study Design. Case report with review of literature. Objective. To report 2 cases of adolescent thoracic scoliosis secondary to paraspinal ganglioneuroma. Summary of Background Data. There are many types of scoliosis caused by known etiological factors. However, to our knowledge, adolescent thoracic scoliosis caused by paraspinal ganglioneuroma is seldom reported. Methods. Case report. Results. The deformity of these 2 patients was well corrected, and the tumor mass of ganglioneuroma was resected intact. Minor loss of correction was recorded in the 2 patients at 6-month and 2.5-year follow-up, respectively. No recurrence of tumor was found. Conclusion. Combination of scoliosis correction and tumor mass resection was a successful treatment for this kind of clinicopathological entity.

Characteristics of the pelvic axial rotation in adolescent idiopathic scoliosis: a comparison between major thoracic curve and major thoracolumbar/lumbar curve

BACKGROUND CONTEXT As the biomechanical foundation of the spine, the pelvis was found to display rotation in the transverse plane in adolescent idiopathic scoliosis (AIS). However, the possible factors influencing the pelvic axial rotation (PAR) and its mechanism in patients with AIS remain unclear. PURPOSE To characterize the PAR in AIS patients with right major thoracic (MT) or major left thoracolumbar/lumbar (TL/L) curve and to explore the associated influencing factors and probable mechanism of compensation by analyzing the association between PAR and other spinal radiographic parameters. STUDY DESIGN Retrospective study. PATIENT SAMPLE All patients with the primary diagnosis of AIS from January 2008 to November 2009 were retrieved from our scoliosis database. OUTCOME MEASURES Age, Cobb angle, and apex rotation of the main curve and the compensatory curve, curve flexibility, and PAR. METHODS One-hundred thirty-two patients with right MT (14.7±1.8 years, 48±6.9°) and 83 patients with left major TL/L (14.7±1.5 years, 46±6.6°) were retrospectively reviewed. On standing full-spine posteroanterior radiographs, the PAR was quantified by the left/right hemi-pelvis width ratio (L/R ratio); then the subjects in both MT and major TL/L groups were divided into two subgroups: L/R ratio ≤1 (pelvis rotated to the right, R-PAR group); and L/R ratio >1 (pelvis rotated to the left, L-PAR group). Comparisons of all variables were performed between the L- and R-PAR subgroups; correlation and regression analysis were carried out to identify the influencing factors of PAR. RESULTS The majority of the MT and major TL/L patients (75.8% vs. 60.2%) displayed right pelvic rotation, which was in the same direction as the thoracic curve. The incidence of R-PAR was greater in the MT patients than the major TL/L ones (p=.016). Lumbar flexibility in MT patients with R-PAR was greater than in MT patients with L-PAR (0.96±0.27 vs. 0.81±0.33, p=.038), which was contrary to the findings in the major TL/L patients (L-PAR>R-PAR, 0.79±0.15 vs. 0.70±0.22, p=.024). In the MT patients with R-PAR, the L/R ratio showed significant positive correlations with the lumbar Cobb angle (r=0.424) as well as with the apex rotation (r=0.488), which was further identified as an influencing factor (R=0.418) of the PAR. Significant positive correlations between L/R ratio and thoracic apex rotation (r=0.361) also were detected. CONCLUSION The majority of AIS patients with right MT or left major TL/L curves were found to have PAR to the right, in the same direction as the thoracic curve. The lumbar flexibility and apex rotation significantly influenced the PAR direction and magnitude. Moreover, the pelvis might be involved in compensation for the MT deformity through its connection with the lumbar spine.

Expression of Runx2 and Type X Collagen in Vertebral Growth Plate of Patients with Adolescent Idiopathic Scoliosis

The different expression of type X collagen and Runx2 between the convex and concave side of vertebral growth plate in scoliosis may help to improve our understanding of the role that growth plate tissue play in the development or progression of idiopathic scoliosis. In this investigation, there were significant differences of the total expression of type X collagen, Runx2 protein, and Runx2 mRNA between convex side and concave side growth plates of the apex vertebrae (p < 0.05). The total expression of type X collagen in the concave side growth plates of the lower end vertebrae was higher than that in the same side growth plates of apex (p < 0.05). The total expression of Runx2 in the concave side growth plates in the upper and lower end vertebrae were higher than that in the concave side growth plates of apex (p < 0.05). The expression of type X collagen, Runx2, and Runx2 mRNA, the cell density of type X collagen and Runx2 positive chondrocytes, and histological changes between convex side and concave side of the vertebral growth plate indicated that the vertebral growth plate was affected by mechanical forces, which was a secondary change and could contribute to progression of adolescent idiopathic scoliosis.

Distal Femoral Fractures in Post-poliomyelitis Patients Treated with Locking Compression Plates

Treatment of distal femoral fracture in post‐polio patients is difficult because the bone is usually osteopenic, small and deformed. This retrospective study aimed to investigate the outcomes of distal femoral fracture in post‐polio patients treated by locking compression plates (LCP).

Comparison of disc and vertebral wedging between patients with adolescent idiopathic scoliosis and Chiari malformation-associated scoliosis.

Study Design A comparative study. Objective To investigate the difference of disc and vertebral wedging between patients with adolescent idiopathic scoliosis (AIS) and Chiari malformation-associated scoliosis (CMS). Summary of Background Data The wedging of disc and vertebral wedging of AIS are well investigated. However, the comparison of that wedging between AIS and CMS is not found in the literature. Method This study included 35 cases of AIS and 31 cases of CMS. The disc and vertebral wedging was measured by Cobb method. The percentage of single disc and vertebral wedging in the whole thoracic or lumbar curve was calculated. The difference between disc and vertebral wedging, the apical vertebra and average adjacent vertebrae wedging, the apical discs and adjacent discs wedging in the same curve location, same diagnosis and similar Cobb angle group was compared. The difference of disc or vertebral wedging between AIS and CMS, Cobb angle <60 degrees and ≥60 degrees was also compared. The correlation between the apical vertebral wedging angle and Cobb angle was performed by Pearson correlation analysis. Results The difference between disc and vertebral wedging in the same curve location, same diagnosis, and similar Cobb angle group was statistically significant (P<0.05). No significant difference of the disc or vertebral wedging was found between AIS and CMS in the same curve location and the similar Cobb angle group (P>0.05). No significant difference of the disc or vertebral wedging was found between Cobb angle <60 degrees and ≥60 degrees groups in the same curve location and the same diagnosis (P>0.05). There was a positive correlation between the apical vertebra wedging angle and Cobb angle in AIS patients and CMS patients. The wedging of apical vertebra and disc was more than that in the adjacent disc and vertebra in the same curve. Conclusions The relative wedging of intervertebral disc and vertebrae with AIS patients is similar to that of scoliosis with known cause (CMS). The wedging of discs and vertebrae in AIS patients may be an adaptive change secondary to some extravertebral factors.

Cross-cultural adaptation and validation of the Chinese version of Toronto Extremity Salvage Score for patients with extremity sarcoma

ObjectiveAs a widely used instrument for patients with extremity sarcoma, the Toronto Extremity Salvage Score (TESS) has never been cross-culturally adapted for Chinese population. The objective of our study was to investigate the comprehensibility, reliability and validity of the Chinese version of TESS for use in patients with extremity sarcoma.MethodsA consensus version of the Chinese TESS was developed under the review of a committee according to international guidelines. 64 patients were recruited to complete the Chinese TESS, the Musculoskeletal Tumor Society (MSTS) Rating Scale, and the Quality of Life Questionnaire Core 30 (QLQ-C30). Reliability was assessed using the intra-class correlation coefficient (ICC) and Cronbach’s α. Validity was assessed with Pearson’s correlation between the similar domains of the two questionnaires.ResultsThe ICCs for the test–retest reliability was 0.932 for the upper extremity questionnaire and 0.893 for lower extremity questionnaire, respectively. The Cronbach’s α was 0.953 for the lower extremity questionnaire and 0.921 for the upper extremity questionnaire, respectively. Convergent validity of the TESS based on Pearson correlation coefficients indicated significantly moderate to high correlations between the TESS and the MSTS as well as the QLQ-C30, with r ranging from 0.535 to 0.782.ConclusionsThe Chinese TESS is a comprehensible, reliable, and valid instrument that can be utilized for future cross-cultural international studies of extremity sarcoma.

CEP55 promotes the proliferation and invasion of tumour cells via the AKT signalling pathway in osteosarcoma

The molecular mechanisms underlying the development of osteosarcoma (OS) are not fully understood. In this study, we investigated for the first time the clinical significance and biological activity of centrosomal protein 55 (CEP55) in OS. We found that CEP55 was overexpressed in OS, and the CEP55 expression level in OS was correlated with metastasis and poor prognosis. Through in vitro experiments, we confirmed that CEP55 knockdown significantly induced cell cycle arrest at G1 phase and suppressed OS cell proliferation, migration and invasion. In addition, CEP55 knockdown suppressed OS tumour growth in nude mice. Global gene expression profiling of CEP55-silenced MNNG/HOS cells showed that the AKT pathway might be involved in the regulation of OS cell activity. Two downstream factors of AKT signalling, CCND1 and FN1, were found to have significantly higher expression in tumour tissues, and their mRNA expression levels were strongly correlated with CEP55 expression. To conclude, our data suggest that CEP55 can be used as a prognostic marker for OS, highlighting the significance of CEP55 signalling as a putative therapeutic target.