Xiaoshan Guo

Silibinin promotes osteoblast differentiation of human bone marrow stromal cells via bone morphogenetic protein signaling

Silibinin is the major active constituent of the natural compound silymarin; several studies suggest that silibinin possesses antihepatotoxic properties and anticancer effects against carcinoma cells. However, no study has yet investigated the effect of silibinin on osteogenic differentiation of human bone marrow stem cells (hBMSCs). The aim of this study was to evaluate the effect of silibinin on osteogenic differentiation of hBMSCs. In this study, the hBMSCs were cultured in an osteogenic medium with 0, 1, 10 or 20 μmol/l silibinin respectively. hBMSCs viability was analyzed by cell number quantification assay and cells osteogenic differentiation was evaluated by alkaline phosphatas (ALP) activity assay, Von Kossa staining and real time-polymerase chain reaction (RT-PCR). We found that silibinin promoted ALP activity in hBMSCs without affecting their proliferation. The mineralization of hBMSCs was enhanced by treatment with silibinin. Silibinin also increased the mRNA expressions of Collagen type I (COL-I), ALP, Osteocalcin (OCN), Osterix, bone morphogenetic protein-2 (BMP-2) and Runt-related transcription factor 2 (RUNX2). The BMP antagonist noggin and its receptor kinase inhibitors dorsomorphin and LDN-193189 attenuated silibinin-promoted ALP activity. Furthermore, BMP-responsive and Runx2-responsive reporters were activated by silibinin treatment. These results indicate that silibinin enhances osteoblast differentiation probably by inducing the expressions of BMPs and activating BMP and RUNX2 pathways. Thus, silibinin may play an important therapeutic role in osteoporosis patients by improving osteogenic differentiation of BMSCs.

Comparison of traditional surgery and surgery assisted by three dimensional printing technology in the treatment of tibial plateau fractures

PurposeThis study was conducted to compare traditional surgery and surgery assisted by 3D printing technology in the treatment of tibial plateau fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients.MethodsSeventy two patients with tibial plateau fractures were enrolled in the study from April 2014 to October 2015. They were divided into two groups: 34 cases of 3D model group, 38 cases of traditional surgery group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan. Operation time, blood loss, and number of intra-operative fluoroscopy were recorded. Through the follow-up, the recovery of patients were observed. Besides, we designed questionnaires to verify the satisfaction for both surgeons and patients.ResultsThe average operation time, average amount of blood loss, and number of intra-operative fluoroscopy for 3D model group was 85.2±0.9 minutes, 186.3± 5.5ml, 5.3± 0.2 times, and for traditional surgery group was 99.2±1.0 minutes, 216.2 ±6.9 ml,7.1 ± 0.2 times respectively. There was statistically significant difference between the traditional surgery group and 3D model group (P < 0.05). Via follow-up, we can see that the 3D printing group has a better clinical efficacy. The average score of the questionnaires to Patient and doctors were 7.3 ± 0.1 points and 8.5± 0.1 points respectively.ConclusionThis study suggested the clinical feasibility of 3D printing technology in treatment of tibial plateau fractures.

Management of distal third tibial fractures: comparison of combined internal and external fixation with minimally invasive percutaneous plate osteosynthesis.

PurposeThe objective of this study was to compare combined internal and external fixation (CIEF) with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of distal third tibial fractures, and explore the benefits and defects of these two techniques.MethodsFrom April 2004 to February 2012, a total of 44 patients were randomised to operative stabilisation either by two closed titanium elastic nails combined with an external fixator (CIEF, 22) or by minimally invasive percutaneous osteosynthesis with a locking plate (MIPPO, 22). Pre-operative variables included the patients’ age, sex, fracture side, cause of injury, Tscherne classification of soft tissue injury, fracture pattern, presence of open fracture and interval from injury to surgery. Peri-operative variables were the operating time and the radiation time. Postoperative variables were wound problems, bone union time, time of recovery to work, the functional American Orthopaedic Foot and Ankle surgery (AOFAS) score and removal of hardware.ResultsThere was no significant difference in the time to union, the time of recovery to work, function, alignment and total AOFAS scores between the two groups (Pu2009=u20090.704, 0.835, 0.551, 0.716 and 0.212, respectively). The mean operating time and radiation time were longer in the MIPPO group than in the CIEF group (85.3u2009±u200912.5 vs. 73.2u2009±u200912.0xa0minutes, Pu2009=u20090.002, and 3.1u2009±u20091.5 vs. 2.1u2009±u20091.2xa0minutes, Pu2009=u20090.019, respectively). Wound complications were more common in the MIPPO group (18.2xa0% vs. 0xa0% with CIEF, Pu2009=u20090.105). There was a trend for patients with MIPPO to have a higher incidence of ankle pain (31.8xa0% vs. 9.1xa0% with CIEF, Pu2009=u20090.135). Painful implants were removed in 31.8xa0% of patients with MIPPO versus 9.1xa0% with CIEF (Pu2009=u20090.135). Of the 165 self-tapping locking screws of the locking plates seven (four patients) were removed with some difficulty because of stripping of the hexagonal recess.ConclusionsOur results indicated that both CIEF and MIPPO were all efficient methods for treating distal third tibial fractures. However, CIEF had the advantages of a shorter operating and radiation time, less wound complication and ankle pain, less secondary operations for implant removal and easier removal of the implants.

Surgical treatment of unstable pelvic fractures with concomitant acetabular fractures

PurposeTo explore the diagnosis, treatment, and clinical prognosis of patients with both unstable pelvic fractures and concomitant acetabular fractures.Material and methodsWe retrospectively analyzed 21 cases of unstable pelvic fractures with concomitant acetabular fractures treated between January 2013 and December 2014. All 21 patients (18 males, 3 females), aged 43.5–55xa0years (range: 21–55xa0years), underwent surgery within four to 15xa0days (averagexa0=xa06.5xa0days) after injury. We evaluated the pre-operative diagnoses, surgical approaches, types of fixation used, and prognoses.ResultsAll 21 patients were followed-up for six to 18xa0months. The quality of post-operative pelvic fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 12, and fair in four. The clinical outcomes at the final follow-up (scored using the Majeed criteria) were excellent in ten cases, good in eight, and fair in three. The quality of post-operative acetabular fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 11, and poor in five. Hip joint function was evaluated at the final follow-up (using the D’Aubigné scoring system) and was excellent in eight cases, good in nine, and fair in four. The healing time was 12–18xa0weeks for pelvic fractures and 12–22xa0weeks for acetabular fractures. Post-operative wound infections in two patients were controlled after second operations featuring debridement and irrigation. We found no instance of heterotopic ossification, ischemic necrosis of the femoral head, or iatrogenic vascular or nerve injury.ConclusionsGood therapeutic outcomes in patients with unstable pelvic fractures and concomitant acetabular fractures can be achieved via accurate diagnosis, careful pre-operative planning, a well-performed operation, effective reduction and surgical fixation, and appropriate exercise to allow functional rehabilitation.

Phosphoserine promotes osteogenic differentiation of human adipose stromal cells through bone morphogenetic protein signalling

Phosphoserine has potential effectiveness as a simple substrate in preparing bone replacement materials, which could enhance bone forming ability. However, there is a need to investigate the independent effect of phosphoserine on osteogenic differentiation of human adipose stem cells (hADSCs). hADSCs were cultured in an osteogenic medium with phosphoserine. Cell proliferation was analysed by CCK8 and osteogenic differentiation was measured by alkaline phosphatase (ALP) activity, von Kossa staining and real time‐polymerase chain reaction (RT‐PCR). No stimulatory effect of phosphoserine on cell proliferation was noted at Days 1, 4 and 7. Deposition of calcium increased after the addition of phosphoserine. mRNA expression of type I collagen (COL‐I), alkaline phosphatase (ALP), osteocalcin (OCN), Osterix, bone morphogenetic protein‐2 (BMP‐2) and RUNX2 increased markedly with phosphoserine treatment. The BMP‐2 antagonist, noggin, and its receptor kinase inhibitors, dorsomorphin and LDN‐193189, attenuated phosphoserine‐promoted ALP activity. BMP‐responsive and Runx2‐responsive reporters were activated by phosphoserine treatment. Thus phosphoserine can promote osteogenic differentiation of hADSCs, probably by activating BMP and Runx2 pathways, which could be a promising approach for enhancing osteogenic capacity of cell‐based construction in bone tissue engineering.

SeMet Inhibits IL-1β-Induced Rheumatoid Fibroblast-Like Synoviocytes Proliferation and the Production of Inflammatory Mediators

Previous studies demonstrated that Se has anti-inflammatory activities and that it plays an important role in maintaining normal cartilage metabolism. Nevertheless, little is known about the effects of Se on the production of inflammatory mediators in rheumatoid fibroblast-like synoviocytes (FLSs). The objective of this study was to determine the effects of Se on the interleukin-1β (IL-1β)-induced proliferation of FLSs and production of matrix metalloproteinases (MMPs) and inflammatory mediators by FLSs. In this study, the proliferation of FLSs was assessed using the MTT assay after cultured with/without the presence of IL-1β and SeMet. Human FLSs were pretreated with SeMet (0.5xa0μM) and subsequently stimulated with IL-1β (5xa0ng/ml) for 24xa0h. Production of NO and PGE2 were evaluated by the Griess reaction and ELISA. Gene expression of MMP-3, MMP-13, iNOS, and COX-2 was measured by real-time PCR. MMP-3 and MMP-13 proteins in culture medium were determined using cytokine-specific ELISA. Western immunoblotting was used to analyze the iNOS and COX-2 protein production in the culture medium and the activity of phosphorylation of P38 MAPK pathways. We found that SeMet significantly inhibits IL-1β-induced proliferation of FLSs. SeMet also inhibited the production of PGE2 and NO induced by IL-1β. SeMet significantly decreased IL-1β-stimulated gene expression and production of MMP-3, MMP-13, iNOS, and COX-2 in human FLSs. In addition, we found SeMet partly inhibited the IL-1β-induced activation of p38 MAPK pathways. The present report is first to demonstrate that SeMet inhibits IL-1β-induced expression of MMPs and production of inflammatory factors in cultured FLSs, indicating that SeMet may be a potential agent in the treatment of rheumatoid arthritis.

Factors associated with a failed closed reduction for supracondylar fractures in children

PURPOSE OF THE STUDYnThe aim of this retrospective study is to analyze the risk factors causing the failure of closed reduction of children supracondylar fracture.nnnPATIENTS AND METHODSnThe children with supracondylar humerus fractures who were treated in our hospital from February 2008 to February 2013, were recorded as well as their age, sex, BMI, injured side, mechanism of injury, associated injuries, fracture type, delay from injury to surgery. Mean comparisons or Chi(2) test were used for univariate analysis of the above factors, and then multivariate logistic regression analysis was used to analyse the possible risk factors, in order to elicit the risk factors associated with a failed closed reduction for supracondylar fractures in children.nnnRESULTSnUnivariate analysis showed that BMI, fracture type, duration from injury to surgery, and mechanism of injury had statistically significant association with the failure of closed reduction for children supracondylar fracture (*P=0.021, 0.044, 0.000 and 0.037 respectively). Multivariate logistic regression analysis demonstrated that fracture type (P=0.027, OR=1.177), time from injury to surgery (P=0.022, OR=2.003), and mechanism of injury (P=0.044, OR=4.182) were independent risk factors of a failed closed reduction for paediatric supracondylar fractures.nnnDISCUSSIONSnGartland type III supracondylar fractures, the peak period of soft tissue swelling and high-energy injury are significant risk factors to warrant open reduction. Treating surgeons should preoperatively carefully evaluate these risk factors and be prepared to treat these injuries accordingly.nnnLEVEL OF EVIDENCEnLevel IV retrospective study.

Retraction notice to "A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures" [Injury 45 (2014) 1990 - 1995].

Retraction notice Retraction notice to ‘‘A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures’’ [Injury 45 (2014) 1990 1995] Liao-Jun Sun, Xian-Bin Yu, Cheng-Qian Dai, Wei Hu, Xiao-Shan Guo, Hua Chen Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children’ Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China