Publications by authors named "Dianming Jiang"

140 Publications

Enhancement of the bone-implant interface by applying a plasma-sprayed titanium coating on nanohydroxyapatite/polyamide66 implants in a rabbit model.

Sci Rep 2021 Oct 7;11(1):19971. Epub 2021 Oct 7.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Solid fusion at the bone-implant interface (BII) is considered one of the indicators of a satisfactory clinical outcome for spine surgery. Although the mechanical and physical properties of nanohydroxyapatite/polyamide66 (n-HA/PA66) offers many advantages, the results of long-term follow-up for BIIs remain limited. This study aimed to improve the BII of n-HA/PA66 by applying plasma-sprayed titanium (PST) and assessing the mechanical and histological properties. After the PST coating was applied to n-HA/PA66 implants, the coating had uneven, porous surfaces. The compression results were not significantly different between the two groups. The micro-CT results demonstrated that at 6 weeks and 12 weeks, the bone volume (BV), BV/tissue volume (TV) and trabecular number (Tb.N) values of the n-HA/PA66-PST group were significantly higher than those of the n-HA/PA66 group. The results of undecalcified bone slicing showed that more new bone appeared to form around n-HA/PA66-PST implant than around n-HA/PA66 implant. The bone-implant contact (BIC) and push-out test results of the n-HA/PA66-PST group were better than those of the n-HA/PA66 group. In conclusion, after PST coating, direct and additional new bone-to-implant bonding could be achieved, improving the BII of n-HA/PA66 implants. The n-HA/PA66-PST implants could be promising for repair purposes.
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http://dx.doi.org/10.1038/s41598-021-99494-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497622PMC
October 2021

A Scoring System for Outpatient Orthopedist to Preliminarily Distinguish Spinal Metastasis from Spinal Tuberculosis: A Retrospective Analysis of 141 Patients.

Dis Markers 2021 29;2021:6640254. Epub 2021 May 29.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

Objective: Spinal tuberculosis (TB) misdiagnosed of spinal metastasis was not rarely reported, especially in outpatients department. This study was aimed to establish an outpatient scoring system to preliminarily distinguish spinal metastasis from spinal TB.

Methods: We retrospectively reviewed consecutive 141 patients with a pathological diagnosis of spinal metastasis (82 cases) or spinal TB (59 cases) in our hospital from January 2017 to June 2018. The following clinical characteristics which can be obtained by outpatient orthopedist were recorded and analyzed: age, gender, malignant tumor history, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and imaging features including distribution characteristics of vertebral lesions, subligamentous spread, paravertebral or psoas abscess, involved vertebral element, intervertebral disc, and sequestra formation. The prevalence of clinical characteristics in spinal metastasis was evaluated, and the scoring system was established using logistic regression analysis. The performance of the scoring system was also prospectively validated.

Results: The outpatient scoring system was based on five clinical characteristics confirmed as significant predictors of spinal metastasis, namely, malignant tumor history, subligamentous spread, posterior element lesions, preserved discs, and no sequestra formation. Spinal metastasis showed a significant higher score than spinal TB (8.17 points 1.97 points, = 18.621, < 0.001), and the optimal cut-off value for the scoring system was 5 points. The sensitivity and specificity of the scoring system for predicting spinal metastasis were 97.85% and 88.33%, respectively, in the validation set.

Conclusion: Spinal lesions with the score of 5 to 10 would be considered a diagnosis of spinal metastasis, while the score of 0 to 4 may be spinal TB. Because the scoring system is mainly based on the clinical characteristics that can be obtained by an outpatient orthopedist, it is suitable to be used as a diagnostic tool in the outpatient department.
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http://dx.doi.org/10.1155/2021/6640254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179772PMC
May 2021

Improving in vitro and in vivo corrosion resistance and biocompatibility of Mg-1Zn-1Sn alloys by microalloying with Sr.

Bioact Mater 2021 Dec 19;6(12):4654-4669. Epub 2021 May 19.

The Third Affiliated Hospital of Chongqing Medical University, No.1 Shuanghu Road, Yubei District, Chongqing, 401120, People's Republic of China.

Magnesium (Mg) and its alloys have attracted attention as potential biodegradable materials in orthopedics due to their mechanical and physical properties, which are compatible with those of human bone. However, the effect of the mismatch between the rapid material degradation and fracture healing caused by the adverse effect of hydrogen (H), which is generated during degradation, on surrounding bone tissue has severely restricted the application of Mg and its alloys. Thus, the development of new Mg alloys to achieve ideal degradation rates, H evolution and mechanical properties is necessary. Herein, a novel Mg-1Zn-1Sn-xSr (x = 0, 0.2, 0.4, and 0.6 wt%) quaternary alloy was developed, and the microstructure, mechanical properties, corrosion behavior and biocompatibility in vitro/vivo were investigated. The results demonstrated that a minor amount of strontium (Sr) (0.2 wt %) enhanced the corrosion resistance and mechanical properties of Mg-1Zn-1Sn alloy through grain refinement and second phase strengthening. Simultaneously, due to the high hydrogen overpotential of tin (Sn), the H release of the alloys was significantly reduced. Furthermore, Sr-containing Mg-1Zn-1Sn-based alloys significantly enhanced the viability, adhesion and spreading of MC3T3-E1 cells in vitro due to their unique biological activity and the ability to spontaneously form a network structure layer with micro/nanotopography. A low corrosion rate and improved biocompatibility were also maintained in a rat subcutaneous implantation model. However, excessive Sr (>0.2 wt %) led to a microgalvanic reaction and accelerated corrosion and H evolution. Considering the corrosion resistance, H evolution, mechanical properties and biocompatibility in vitro and in vivo, Mg-1Zn-1Sn-0.2Sr alloy has tremendous potential for clinical applications.
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http://dx.doi.org/10.1016/j.bioactmat.2021.04.043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164010PMC
December 2021

Comparison of Granular Bone Grafts and Transverse Process Bone Grafts for Single-Segmental Thoracic Tuberculosis: A Retrospective Single-Center Comparative Study.

Front Surg 2021 14;8:602513. Epub 2021 May 14.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

To compare the clinical efficacy of granular bone grafts and transverse process bone grafts for single-segmental thoracic tuberculosis (TB). The clinical records of 52 patients who were diagnosed with single-segmental thoracic TB and treated by one stage posterior debridement, bone graft fusion, and internal fixation in our department from 2015 to 2018 were retrospectively analyzed. Among them, 25 cases were in the granular bone graft group and 27 cases in the transverse processes bone graft group. Outcomes including the visual analog scale (VAS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neurological function, operative time, operative blood loss, hospital stay, Cobb angle, bone graft fusion time, and postoperative complications were all recorded and analyzed. There were no significant differences in operative time, operative blood loss, and hospital stay between the two groups ( > 0.05). With an average follow-up of 18-33 months, all patients in the two groups showed significant improvement in VAS score, ESR, CRP, and neurological function compared with preoperative measurements ( < 0.05), however, no significant differences were found for the last follow-up ( > 0.05). The two groups showed similar Cobb angle correction ( > 0.05), but the granular bone graft group had a larger Cobb angle loss than the transverse processes bone graft group ( < 0.05). The bone graft fusion time of the granular bone graft group was shorter than that of the transverse processes bone graft group ( < 0.05). No significant difference was found in the postoperative complications rate between the two groups ( > 0.05). Granular bone grafts and transverse process bone grafts may achieve comparable clinical efficacy for single-segmental thoracic TB, but the former method had a shorter bone fusion time.
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http://dx.doi.org/10.3389/fsurg.2021.602513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160445PMC
May 2021

One-stage posterior laminectomy with instrumented fusion and foraminotomy for cervical ossification of posterior longitudinal ligament with radiculopathy pain.

J Orthop Surg Res 2021 Apr 26;16(1):277. Epub 2021 Apr 26.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, 1st Youyi Road, Chongqing, 400016, People's Republic of China.

Objective: To explore the clinical efficacy of posterior LFF for cervical OPLL with radicular pain of upper limbs METHODS: Between January 2014 and January 2018, 48 OPLL patients with radicular pain symptoms of upper limbs who underwent a one-stage posterior laminectomy and instrumented fusion with/without foraminotomy were reviewed retrospectively and divided into two groups: LF group (laminectomy with instrumented fusion without foraminotomy) and LFF group (laminectomy with instrumented fusion and foraminotomy). Clinical data were assessed and compared between the two groups. The radicular pain of upper limbs and neck was measured using the visual analog scale (VAS). The neurological function was evaluated with the American Spinal Injury Association (ASIA) scale. Changes of sagittal alignment were investigated by postoperative plain x-ray or computed tomography (CT). Moreover, the decompression of the spinal cord was evaluated based on postoperative MRI.

Results: All the 48 patients were followed up for 24-42 months with an average follow-up time of 31.1±5.3 months. A total of 56 cervical intervertebral foramens were enlarged in 48 patients, including 40 cases (83.3%) with 1 intervertebral foramen enlargement and 8 cases (16.7%) with 2 intervertebral foramen enlargements. There were no significant differences in intraoperative blood loss, postoperative drainage amount, Japanese Orthopaedic Association (JOA) scores, JOA recovery rates, VAS scores for neck pain, and ASIA grade between two groups. The mean operative time was shorter in the LF group compared with the LFF group. The VAS score for arm pain was significantly lower while the surgical duration was longer in group B. No statistical difference was observed between the two groups in terms of C2-C7 SVA, cervical lordosis, focal angulation at the foraminotomy segment, and local spinal cord angle. Compared with the LF group, there was no segmental kyphosis or instability where the additional posterior foraminotomy was performed in the LFF group.

Conclusions: One-stage posterior LFF can achieve satisfied clinical efficacy in improving neurological function and relieving the radicular pain of the upper limbs for OPLL patients with radiculopathy symptoms.
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http://dx.doi.org/10.1186/s13018-021-02431-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074402PMC
April 2021

Oblique Lateral Interbody Fusion versus Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis: A Single-Center Retrospective Comparative Study.

Biomed Res Int 2021 20;2021:6693446. Epub 2021 Mar 20.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China.

Objective: To compare the efficacy of oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in single-level degenerative lumbar spondylolisthesis (DLS).

Methods: A retrospective analysis of patients who underwent single-level DLS surgery in our department from 2015 to 2018 was performed. According to the surgical method, the enrolled patients were divided into two groups, namely, the OLIF group who underwent OLIF combined with percutaneous pedicle screw fixation (PPSF) and the TLIF group. Clinical outcomes included operation time, operation blood loss, postoperative drainage, hospital stay, visual analog scale (VAS) score, Oswestry disability index (ODI), and complications, and imaging outcomes included upper vertebral slip, intervertebral space height (ISH), intervertebral foramen height (IFH), intervertebral space angle (ISA), lumbar lordosis (LL), and bone fusion rate. All outcomes were recorded and analyzed.

Results: A total of 65 patients were finally included, and there were 28 patients and 37 patients in the OLIF group and the TLIF group, respectively. The OLIF group showed shorter operation time, less blood loss, less postoperative drainage, and shorter hospital stay than the TLIF group ( < 0.05). The ISH, IFH, ISA, and LL were all larger in the OLIF group at postoperative and last follow-up ( < 0.05), but the degree of upper vertebral slip was found no difference between the two groups ( > 0.05). The bone graft fusion rate of OLIF group and TLIF group at 3 months, 6 months, and last follow-up was 78.57%, 92.86%, and 100% and 70.27%, 86.49%, and 97.30%, respectively, and no significant differences were found ( > 0.05). Compared with the TLIF group, the OLIF group showed a superior improvement in VAS and ODI at 1 month, 3 months, and 6 months postoperative ( < 0.05), but no differences were found at 12 months postoperative and the last follow-up ( > 0.05). There was no significant difference in complications between the two groups, with 4 patients and 6 patients in the OLIF group and TLIF group, respectively ( > 0.05).

Conclusions: Compared with TLIF, OLIF showed the advantages of less surgical invasion, better decompression effect, and faster postoperative recovery in single-level DLS surgery.
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http://dx.doi.org/10.1155/2021/6693446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007343PMC
May 2021

In Vitro Studies on Mg-Zn-Sn-Based Alloys Developed as a New Kind of Biodegradable Metal.

Materials (Basel) 2021 Mar 25;14(7). Epub 2021 Mar 25.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.

Mg-Zn-Sn-based alloys are widely used in the industrial field because of their low-cost, high-strength and heat-resistant characteristics. However, their application in the biomedical field has been rarely reported. In the present study, biodegradable Mg-1Zn-1Sn and Mg-1Zn-1Sn-0.2Sr alloys were fabricated. Their microstructure, surface characteristics, mechanical properties and bio-corrosion properties were carried out using an optical microscope (OM), X-ray diffraction (XRD), electron microscopy (SEM), mechanical testing, electrochemical and immersion test. The cell viability and morphology were studied by cell counting kit-8 (CCK-8) assay, live/dead cell assay, confocal laser scanning microscopy (CLSM) and SEM. The osteogenic activity was systematically investigated by alkaline phosphatase (ALP) assay, Alizarin Red S (ARS) staining, immunofluorescence staining and quantitative real time-polymerase chain reaction (qRT-PCR). The results showed that a small amount of strontium (Sr) (0.2 wt.%) significantly enhanced the corrosion resistance of the Mg-1Zn-1Sn alloy by grain refinement and decreasing the corrosion current density. Meanwhile, the mechanical properties were also improved via the second phase strengthening. Both Mg-1Zn-1Sn and Mg-1Zn-1Sn-0.2Sr alloys showed excellent biocompatibility, significantly promoted cell proliferation, adhesion and spreading. Particularly, significant increases in ALP activity, ARS staining, type I collagen (COL-I) expression as well as the expressions of three osteogenesis-related genes (runt-related transcription factor 2 (Runx2), osteopontin (OPN), and osteocalcin (Bglap)) were observed for the Mg-1Zn-1Sn-0.2Sr group. In summary, this study demonstrated that Mg-Zn-Sn-based alloy has great application potential in orthopedics and Sr is an ideal alloying element of Mg-Zn-Sn-based alloy, which optimizes its corrosion resistance, mechanical properties and osteoinductive activity.
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http://dx.doi.org/10.3390/ma14071606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036630PMC
March 2021

Overexpression of hsa_circ_0094742 inhibits IL-1β-induced decline in CHON-001 cell viability by targeting microRNA-127-5p.

Histol Histopathol 2021 Feb 5;36(2):207-216. Epub 2021 Mar 5.

Department of Orthopaedic Trauma, the Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot, Inner Mongolia, China.

Osteoarthritis (OA) is a public health problem that affects 240 million people globally; however, the current treatment options for OA are not effective. Therefore, there is still an urgent need to identify novel strategies to reduce the incidence and progression of OA. The circular RNA hsa_circ_0094742 was reported to be downregulated in patients with OA. However, the underlying mechanism remains unclear. The levels of hsa_circ_0094742 in CHON-001 were detected by reverse transcription quantitative polymerase chain reaction. Moreover, Cell Counting Kit-8 assay and Ki67 staining were used to determine the cell viability. The protein expression of biomarkers was detected by western blot analysis. In addition, the putative downstream target of hsa_circ_0094742 was predicted using the Circinteractome and TargetScan online databases. The putative targeting relationship was verified by dual luciferase reporter assay and fluorescence in situ hybridization. Next, cell apoptosis was determined by Annexin V/PI staining. hsa_circ_0094742 overexpression (OE) inhibited interleukin (IL)-1β-induced decline in the viability of CHON-001 cells and primary human chondrocytes. Furthermore, IL-1β-induced alterations in aggrecan, matrix metallopeptidase 13, X-linked inhibitor of apoptosis protein (XIAP), Bax and active caspase 3 were reversed by hsa_circ_0094742 OE. Luciferase reporter assay indicated that miR-127-5p was the downstream target of hsa_circ_0094742, and latexin was the target of miR-127-5p. hsa_circ_0094742 OE inhibited IL-1β-induced decline in CHON-001 cell viability by targeting miRNA-127-5p. The findings of the present study revealed the biological rational of the use of hsa_circ_0094742 OE as an anti-IL-1β effector in human chondrocytes. These findings may prompt further research on hsa_circ_0094742 as a potent circRNA target for the treatment of OA.
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http://dx.doi.org/10.14670/HH-18-325DOI Listing
February 2021

Magnetic transfection with superparamagnetic chitosan-loaded IGFBP nanoparticles and their biosafety.

R Soc Open Sci 2021 Jan 13;8(1):201331. Epub 2021 Jan 13.

Department of Traumatic Joint Center, The Third Affiliated Hospital of Chongqing Medical University (General Hospital), No 1 Shuanghu Road, Yubei District, Chongqing 401120, People's Republic of China.

We prepared the superparamagnetic chitosan nanoparticles (SPCIONPs) to study the application of them as gene vectors using a magnetic transfection system for the targeted treatment of lung metastasis of osteosarcoma. The SPCIONPs were characterized by transmission electron microscopy, Fourier transform infrared spectrometry, superconducting quantum interference device and atomic force microscopy. Their biosafety was determined by cell counting kit-8 (CCK8) and live-dead staining assays. The transfection was detected by laser confocal microscopy. SPCIONPs, which can bind closely to plasmids and protect them from DNA enzyme degradation, were prepared with an average particle size of approximately 22 nm and zeta potential of 11.3 mV. The results of the CCK8 and live-dead staining assays showed that superparamagnetic chitosan nanoparticles loaded with insulin-like growth factor-binding protein 5 (SPCIONPs/pIGFBP) induced no significant cytotoxicity compared to the control group. The result of transfection suggested that pIGFBP emitted a greater amount of red fluorescence in the SPCIONPs/pIGFBP group than that in the chitosan-loaded IGFBP (CS/pIGFBP) group. In conclusion, the prepared SPCIONPs had good biosafety and could be effectively used to transfer pIGFBP into 143B cells, and they thus have good application prospects for the treatment of lung metastasis of osteosarcoma.
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http://dx.doi.org/10.1098/rsos.201331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890493PMC
January 2021

A novel biocomposite scaffold with antibacterial potential and the ability to promote bone repair.

J Biomater Appl 2021 Sep 17;36(3):474-480. Epub 2021 Feb 17.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Yuzhong, People's Republic of China.

Clinical treatment of bone defects caused by trauma, tumor resection and other bone diseases, especially bone defects that can lead to infection, remains a major challenge. Currently, autologous bone implantation is the gold standard for treatment of bone defects, but it is limited by secondary trauma and insufficient autologous material. Moreover, postoperative infection is an important factor affecting bone healing.AcN-RADARADARADARADA-CONH2 (RADA) is a new type of self-assembling peptide(SAP) composed of Arg,Ala,Asp and other amino acids was designed and prepared. The "RADA" self-assembling peptide hydrogels has excellent biological activity and it's completely biodegradable and non-toxic.It is also have been confirmed to promote cell proliferation, wound healing, tissue repair, and drug delivery. To promote bone regeneration and simultaneously prevent bacterial infection, we designed biocomposite scaffolds comprising RADA and calcium phosphate cement (CPC), termed RADA-CPC. The morphological features of the scaffold were characterized by scanning electron microscopy (SEM). In vitro studies demonstrated that RADA-CPC enhances osteoblast proliferation, differentiation and mineralization. In addition, the scaffold was used as a drug delivery system to treat postoperative infections by sustained release of ciprofloxacin (CIP). The RADA-CPC scaffold may have potential application prospects in orthopedics field because of its role in promoting bone repair and as a sustained-release drug carrier to prevent infections.
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http://dx.doi.org/10.1177/0885328221994448DOI Listing
September 2021

One-stage posterior debridement, autogenous spinous process bone graft and instrumentation for single segment lumbar pyogenic spondylitis.

Sci Rep 2021 02 4;11(1):3065. Epub 2021 Feb 4.

Department of Rehabilitation, The First Affiliated Hospital of Chongqing Medical University, 1st Youyi Road, Chongqing, 400016, People's Republic of China.

To compare the surgical outcomes of autogenous spinous process with iliac bone graft in managing single segment lumbar pyogenic spondylitis (PS) after posterior debridement and instrumentation. We performed a retrospective study for adult patients with single level lumbar PS. 60 patients with single segment lumbar PS underwent one-stage posterior debridement, autogenous bone graft and instrumentations. The patients were divided into Group A (autogenous iliac bone) and Group B (autogenous spinous process). Preoperative Charlson comorbidity index (CCI) was analyzed to assess the comorbidity. Low back pain was evaluated using the visual analog scale (VAS). Neurological status was assessed with the American Spinal Injury Association (ASIA) scale. Clinical infection index including the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) was also reviewed. Moreover, fusion and changes of sagittal alignment were investigated radiologically. There was a significantly longer operative time, hospital stay and greater blood loss in group A. The VAS scores improved significantly at each follow-up interval and post-operative VAS score was significantly lower in group B. At the last follow-up, ESR and CRP returned to normal for all patients. There was at least one grade level improvement in ASIA score. No statistical difference in corrected rate, loss of sagittal angle and lumbar lordosis was found between the two groups. There was no significant difference in fusion rate, mean fusion time and complications between the two groups. Compared with iliac bone graft, the autogenous spinous process bone graft can be less invasive and painful for the single segment lumbar PS. One-stage posterior debridement, autogenous spinous process bone graft and instrumentation can provide satisfactory results for appropriate cases.
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http://dx.doi.org/10.1038/s41598-021-82695-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862586PMC
February 2021

Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients.

J Int Med Res 2021 Jan;49(1):300060520982780

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Objective: This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB).

Methods: Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed.

Results: The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment.

Conclusions: Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.
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http://dx.doi.org/10.1177/0300060520982780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871065PMC
January 2021

A Study on the Anatomical Relationship of the Lumbar Extrapedicular Puncture Approach with the Spinal Nerve and its Branches.

Spine (Phila Pa 1976) 2021 Jun;46(11):E611-E617

Department of Spine Surgery, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Mini: The anatomical relationship of the extrapedicular approach with the spinal nerve and its branches was researched in cadavers. Three types of extrapedicular paths were simulated: puncture inside the medial branch (MB), puncture outside the MB, and puncture outside the lateral branch (LB). At L1-L3, puncture outside the LB could avoid damage to these nerves.
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http://dx.doi.org/10.1097/BRS.0000000000003947DOI Listing
June 2021

Combined application of adductor canal block and local infiltration anesthesia in primary total knee arthroplasty: an updated meta-analysis of randomized controlled trials.

Arch Orthop Trauma Surg 2021 Jan 8. Epub 2021 Jan 8.

Department of Orthopaedic Surgery, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, 1# Shuanghu Road, Yubei District, Chongqing City, 401120, China.

Background: Perioperative pain after total knee arthroplasty (TKA) may seriously affect the rapid recovery of patients. The purpose of this study was to assess whether the combined use of adductor canal block (ACB) and local infiltration anesthesia (LIA) can further reduce postoperative pain and improve early functional recovery.

Materials And Methods: PubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) comparing ACB + LIA and LIA alone in primary TKA. The primary outcomes were visual analog scale (VAS) scores at rest and walking, morphine consumption, range of motion (ROM) at 24 and 48 h postoperatively and distance walked. The secondary outcomes were the length of stay, the incidence of nausea and vomiting, and the total complications. Subgroup analyses were performed on the VAS at rest and walking, morphine consumption, and distance walked at 24, 48, and 72 h postoperatively.

Results: A total of 10 RCTs involving 797 patients were enrolled in this meta-analysis. The results demonstrated that the combined application of ACB + LIA had a lower resting VAS at 24 h postoperatively (p = 0.02) and the walking score at 24 (p = 0.0002) and 48 h (p = 0.02) postoperatively compared with LIA alone. Similarly, the combined ACB + LIA group also had less morphine consumption at 48 h postoperatively (p = 0.0005) and had a higher ROM score at 24 h (p = 0.01) postoperatively compared to the LIA group. There were no statistical differences in length of stay, distance walked, and incidence of nausea and vomiting.

Conclusion: The current meta-analysis showed that ACB + LIA significantly reduced postoperative walking pain and morphine consumption and promoted rapid recovery in the early postoperative period. There is no statistical difference in the length of stay and ROM after 72 h in the two groups.
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http://dx.doi.org/10.1007/s00402-020-03706-xDOI Listing
January 2021

Chewing gum promotes bowel function recovery in elderly patients after lumbar spinal surgery: a retrospective single-center cohort study.

Ann Palliat Med 2021 Feb 20;10(2):1216-1223. Epub 2020 Oct 20.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Postoperative paralytic ileus is not a rare complication after lumbar spinal surgery especially in elderly patients. Chewing is a kind of sham feeding that has been reported to stimulate bowel motility, but so far there was no study showed these positive results may or may not be extrapolated to the spinal surgery population. We sought to determine whether chewing gum facilitates bowel function recovery in elderly patients undergoing lumbar spine surgery.

Methods: Sixty consecutive elderly patients (over 60 years old) with lumbar degenerative diseases undergoing posterior lumbar fusion surgery between September 2017 and April 2019 were respectively included and divided into two groups. The chewing gum group (30 patients) started chewing gum after they were awakened from anesthesia until the first defecation occurred, while the control group (30 patients) chewed nothing. The time to first flatus, first bowel sounds heard and first defecation, the length of hospital stay and postoperative complications were all recorded and analyzed.

Results: Compared with control group, the chewing gum group had less time to the first flatus (12.4±2.9 vs. 17.8±2.2 h; P<0.001), first bowel sounds heard (17.3±2.8 vs. 25.0±2.5 h; P<0.001) and first defecation (51.9±5.2 vs. 76.1±3.8 h; P<0.001), but no significant differences were found in the length of hospital stay (11.7±2.1 vs. 11.9±2.5 d; P=0.697) and the postoperative complications (P=0.501).

Conclusions: This study demonstrated that chewing gum can promote bowel function recovery in elderly patients after lumbar spinal surgery.
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http://dx.doi.org/10.21037/apm-20-1077DOI Listing
February 2021

Imaging evaluation of nano-hydroxyapatite/polyamide 66 strut in cervical construction after 1-level corpectomy: a retrospective study of 520 patients.

Eur J Med Res 2020 Sep 1;25(1):38. Epub 2020 Sep 1.

Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: The application of nano-hydroxyapatite/polyamide 66(n-HA/PA66) struts has become reliable in anterior cervical corpectomy and fusion (ACCF) as a source of sufficient segmental stability. This was a retrospective and long-term imaging evaluation of the n-HA/PA66 strut in 1-level ACCF.

Methods: The patients between June 2006 and December 2014, who underwent 1-level ACCF using an n-HA/PA66 strut, were reviewed. The neurological status was assessed using the Japanese Orthopedic Association (JOA) score and axial pain was evaluated using a Visual Analogue Scale (VAS) score and the radiographic parameters were determined by X-ray and 3-D CT examinations when necessary for the evaluation of bone fusion using the Brantigan scale and imaging characteristics.

Results: A total of 520 patients underwent one-level ACCF, with a mean follow-up (FU) duration of 72.38 ± 24.56 months. The level of surgery was C4 in 58 cases, C5 in 173 cases, C6 in 208 cases, and C7 in 81 cases. According to the Brantigan scale, on X-ray examination, the bony fusion rate was observed to be 40%, 70%, 93%, and 98% at 3 months, 6 months, 1 year and the final FU. An interesting radiographic appearance of the bone graft growth pattern was classified into three types. 95% of the patients accounted for types a and b. No significant differences were observed in age, hospitalization duration, surgical haemorrhage volume, or fusion rate among the types except in the percentage and sex of the patients among the types. Type a had better cervical lordosis, and less subsidence than types b and c (P < 0.05). No significant difference was found in segment angle between type a and type b. Type c was more often observed with subsidence rate, segmental angle loss and cervical alignment loss than types a and b (P < 0.05). Type a also had a slightly higher fusion rate, than types b and c, but there were no significant differences. The overall mean JOA score at the final follow-up among the groups were significantly improved comparing that preoperatively and no significant differences were found among the groups, no matter pre-operation or final follow-up. The overall mean VAS score at the final follow-up among the groups were significantly improved comparing that preoperatively and no significant differences in preoperative VAS score were found among the groups. However, the VAS score at the final follow-up of type a or type b was better than type c. No patients received revision surgery.

Conclusions: The type a bone graft growth pattern could allow a lower incidence of subsidence and better maintenance of local and global alignment to be achieved and is thus proposed for surgeons.
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http://dx.doi.org/10.1186/s40001-020-00440-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466497PMC
September 2020

Diffusion tensor imaging and electrophysiology as robust assays to evaluate the severity of acute spinal cord injury in rats.

BMC Neurol 2020 Jun 9;20(1):236. Epub 2020 Jun 9.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.

Background: Diffusion tensor imaging (DTI) is an effective method to identify subtle changes to normal-appearing white matter (WM). Here we analyzed the DTI data with other examinations, including motor evoked potentials (MEPs), histopathological images, and behavioral results, to reflect the lesion development in different degrees of spinal cord injury (SCI) in acute and subacute stages.

Method: Except for 2 Sprague -Dawley rats which died from the anesthesia accident, the rest 42 female rats were randomized into 3 groups: control group (n = 6), moderate group (n = 18), and severe group (n = 18). Moderate (a 50-g aneurysm clip with 0.4-mm thickness spacer) or severe (a 50-g aneurysm clip with no spacer) contusion SCI at T8 vertebrae was induced. Then the electrophysiological assessments via MEPs, behavioral deterioration via the Basso, Beattie, and Bresnaha (BBB) scores, DTI data, and histopathology examination were analyzed.

Results: In this study, we found that the damage of WM myelin, MEPs amplitude, BBB scores and the decreases in the values of fractional anisotropy (FA) and axial diffusivity (AD) were more obvious in the severe injury group than those of the moderate group. Additionally, the FA and AD values could identify the extent of SCI in subacute and early acute SCI respectively, which was reflected in a robust correlations with MEPs and BBB scores. While the values of radial diffusivity (RD) showed no significant changes.

Conclusions: Our data confirmed that DTI was a valuable in ex vivo imaging tool to identify damaged white matter tracts after graded SCI in rat, which may provide useful information for the early identification of the severity of SCI.
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http://dx.doi.org/10.1186/s12883-020-01778-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282236PMC
June 2020

TNFAIP8 influences the motor function in mice after spinal cord injury (SCI) through meditating inflammation dependent on AKT.

Biochem Biophys Res Commun 2020 07 30;528(1):234-241. Epub 2020 May 30.

Department of Orthopedics, Gansu Provincial Hospital, Lanzhou, 730000, China. Electronic address:

Spinal cord injury (SCI) is a devastating disease and causes tissue loss and neurologic dysfunction, contributing to high morbidity and disability among human. However, the underlying molecular mechanisms still remain unclear. Tumor necrosis factor-α-induced protein 8 (TNFAIP8) is a member of the TNFAIP8/TIPE family, and has been implicated in different diseases associated with inflammation, infection, and immunity. Nevertheless, its effects on SCI have not been well investigated. In our study, we found time course of TNFAIP8 following SCI in mice, along with time-dependent increases of pro-inflammatory cytokines. The in vitro results confirmed the up-regulation of TNFAIP8 induced by lipopolysaccharide (LPS). Subsequently, we found that reducing TNFAIP8 by transfection with its specific siRNA (siTNFAIP8) markedly alleviated cell viability and inflammatory response caused by LPS in mouse microglial BV2 cells. Importantly, LPS-enhanced activation of inhibitor of κBα/nuclear factor-κB (IκBα/NF-κB) and phosphoinositide 3-kinase/serine-threonine kinase (PI3K/AKT) signaling pathways was considerably blunted by siTNFAIP8. Intriguingly, our results further showed that siTNFAIP8-restrained inflammation and IκBα/NF-κB in LPS-stimulated BV2 cells were almost abolished by the pre-treatment of AKT activator SC-79, demonstrating that TNFAIP8-regulated inflammatory response was largely dependent on AKT activation. Then, the in vivo studies were performed using the wild type (WT) and TNFAIP8-knockout (KO) mice with or without SCI operation. Results showed that TNFAIP8-KO mice exhibited improved neuron injury and locomotor function along with decreased microglial activity. Furthermore, compared with the WT/SCI mice, the expression of pro-inflammatory cytokines in spinal cords was markedly down-regulated by TNFAIP8-deficiency through blocking IκBα/NF-κB and PI3K/AKT signaling pathways. Taken together, these findings elucidated the novel role of TNFAIP8 in regulating SCI via the AKT signaling, and thus TNFAIP8 may be served as a promising therapeutic target for SCI treatment.
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http://dx.doi.org/10.1016/j.bbrc.2020.05.029DOI Listing
July 2020

Controlled release of basic fibroblast growth factor from a peptide biomaterial for bone regeneration.

R Soc Open Sci 2020 Apr 1;7(4):191830. Epub 2020 Apr 1.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, Yuzhong District 400016, People's Republic of China.

Self-assembled peptide scaffolds based on D-RADA16 are an important matrix for controlled drug release and three-dimensional cell culture. In this work, D-RADA16 peptide hydrogels were coated on artificial bone composed of nano-hydroxyapatite/polyamide 66 (nHA/PA66) to obtain a porous drug-releasing structure for treating bone defects. The developed materials were characterized via transmission electron microscopy and scanning electron microscopy. The proliferation and adhesion of bone mesenchymal stem cells (BMSCs) were examined by confocal laser microscopy and CCK-8 experiments. The osteogenic ability of the porous materials towards bone BMSCs was examined by staining with Alizarin Red S and alkaline phosphatase, and bioactivity was evaluated . The results revealed that nHA/PA66/D-RADA16/bFGF reduces the degradation rate of D-RADA16 hydrogels and prolongs sustained release of bFGF, which would promote BMSCs proliferation, adhesion and osteogenesis and bone repair . Thus, it deserves more attention and is worthy of further research.
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http://dx.doi.org/10.1098/rsos.191830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211882PMC
April 2020

3D-printed titanium implant-coated polydopamine for repairing femoral condyle defects in rabbits.

J Orthop Surg Res 2020 Mar 11;15(1):102. Epub 2020 Mar 11.

Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.

Background: Large segmental bone defects are still one of the challenges for orthopaedic surgeons. Although 3D-printed porous titanium is a potential bone substitute material because of its porous structure simulating natural bone, the titanium surface has low bioactivity, integrates with bone tissue through the simple mechanical interlock. The study aims to investigate the capability and osteogenesis of 3D-printed porous titanium (3D PPT)-coated polydopamine (PDA) for repairing bone defects.

Methods: Fifteen 6-month New Zealand white rabbits were implanted with PDA-3D PPT to repair 6 mm × 10 mm defects on the femoral condyle compared with the group of 3D PPT and comparing with the blank group. After 6 weeks and 12 weeks, micro-CT and histological examination were performed to observe bone growth.

Results: All the PDA-3D PPT group, the 3D PPT group and the blank group recovered in good condition. The images showed that the boundaries between the implant area and the surrounding area were obscure in the three groups. The results of micro-CT demonstrated that at 6 weeks and 12 weeks, the bone volume (BV) values of PDA-3D PPT implants group were significantly higher than those of the 3D PPT implants group and blank group (P < 0.05), the BV/tissue volume (TV) and the trabecular number (Tb.N) of PDA-3D PPT implants were significantly higher than those of the 3D PPT group and blank group (P < 0.05). The results of un-decalcified bone slicing showed that ore new bone appeared to form around the PDA-3D PPT than that of 3D PPT and blank group. The bone-implant contact (BIC) of PDA-3D PPT was better (P < 0.05) than that of 3D PPT group.

Conclusion: PDA-3D PPT could improve the bioactivity and promote the growth and healing of bone tissue and can be a promising repairing material.
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http://dx.doi.org/10.1186/s13018-020-01593-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065349PMC
March 2020

Postoperative bone marrow edema lasts no more than 6 months after uncomplicated arthroscopic double-row rotator cuff repair with PEEK anchors.

Knee Surg Sports Traumatol Arthrosc 2021 Jan 14;29(1):162-169. Epub 2020 Feb 14.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.

Purpose: To assess the natural evolution of the osseous reaction following arthroscopic double-row rotator cuff repair with PEEK anchors and to analyze its correlation with clinical shoulder function.

Methods: Between 2015 and 2017, 159 patients received arthroscopic double-row rotator cuff repair with PEEK anchors and underwent serial clinical and radiological follow-up (3, 6, 12, and 24 months). Radiological results were analyzed by tendon integrity, bone marrow edema, and peri-implant osteolysis. Clinical shoulder function was evaluated with the Constant score.

Results: One-hundred and seventeen patients were enrolled; among them, 63% demonstrated bone marrow edema around the anchors on postoperative 3-month MRI. The edema area percentage was 41% ± 7%. At 6 months, edema was only seen in 12% of cases, with an area percentage of 18% ± 5%. At 12 and 24 months, edema was rarely present. Fluid signals around the anchor were observed in 17.6%, 42.7%, 33.3%, and 21.0% of patients at 3, 6, 12, and 24 months, respectively; the tunnel widening values were 1.1 ± 0.4 mm, 1.8 ± 0.5 mm, 2.3 ± 0.6 mm, and 2.2 ± 0.7 mm at each follow-up, respectively. The sign of osteolysis was significantly more obvious around the lateral anchor than around the medial anchor. The presence of an osseous reaction was not correlated with worse clinical outcome.

Conclusion: Osseous reactions following arthroscopic rotator cuff repair are common and significant even with PEEK anchors. Bone marrow edema does not last more than 6 months in patients without complications. Peri-implant osteolysis is more evident around the lateral anchor than around the medial anchor and improves gradually over time. The sign of osteolysis is not correlated with clinical shoulder function. Based on these findings, surgeons should be cautious about bone marrow edema lasting more than 6 months following arthroscopic rotator cuff repair.

Level Of Evidence: Level IV.
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http://dx.doi.org/10.1007/s00167-020-05897-7DOI Listing
January 2021

HOTAIR-induced apoptosis is mediated by sponging miR-130a-3p to repress chondrocyte autophagy in knee osteoarthritis.

Cell Biol Int 2020 Feb 12;44(2):524-535. Epub 2019 Nov 12.

Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China.

Knee osteoarthritis (KOA) is a multifactorial disease characterized by the loss of articular cartilage. Hox transcript antisense intergenic RNA (HOTAIR) long non-coding RNA (lncRNA) is highly expressed in some cases of OA; however, its role in chondrocyte apoptosis in KOA and the mechanism by which HOTAIR mediates apoptosis in chondrocytes are not completely understood. Here, we evaluated the effects of HOTAIR on chondrocyte apoptosis in KOA. Our results showed that HOTAIR expression was significantly upregulated in cartilage tissues located at the femoral condyles or tibial plateaus of OA resection regions when compared with control regions in patients with normal non-weight-bearing area femoral condyle articular cartilage. Overexpression of HOTAIR caused a sharp increase in apoptosis rates and a reduction in the viability of chondrocytes. These effects were accompanied by the upregulation of Bax expression and the proteolytic cleavage of caspase 3 expression and downregulation of survivin and Bcl-2 expression. The silencing of HOTAIR produced the opposite effects. Moreover, the cartilaginous expression of miR-130a-3p was notably reduced in the OA resection regions of KOA patients. Luciferase assays showed that HOTAIR-adsorbed and reduced the levels of miR-130a-3p in chondrocytes. Further, inhibition of miR-130a-3p remarkably promoted the apoptosis of chondrocytes and repressed cell growth, while the silencing of HOTAIR could rescue the apoptosis mediated by miR-130a-3p inhibition. Chondrocyte autophagy was suppressed in a HOTAIR-dependent, miR-130a-3p inhibitor-mediated manner. Overall, our data revealed that aberrantly high expression of HOTAIR resulted in massive apoptosis events caused by the sponging of miR-130a-3p to suppress autophagy in chondrocytes, which, in turn, might trigger KOA. Therefore, inhibition of HOTAIR-mediated apoptosis might be a potential mechanism that can be targeted by gene therapy of KOA.
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http://dx.doi.org/10.1002/cbin.11253DOI Listing
February 2020

2,4-Dihydroxy-3'-methoxy-4'-ethoxychalcone suppresses cell proliferation and induces apoptosis of multiple myeloma the PI3K/akt/mTOR signaling pathway.

Pharm Biol 2019 Dec;57(1):641-648

Department of Orthopaedics, The Yongchuan Affiliated Hospital, Chongqing Medical University , Chongqing , P.R. China.

Kom. (Fabaceae), a commonly used folk medicine, has been found to possess antitumor effects. However, the antiproliferative effect of 2,4-dihydroxy-3'-methoxy-4'-ethoxychalcone (DMEC) derived from against multiple myeloma (MM) has never been investigated. This study systematically evaluates the antiproliferative effect of DMEC against MM cells. The antiproliferative effect of DMEC (1, 2, 4, 8, 16, 32, and 64 μM) on MM cells lines, including RPMI8226, MM.1S, and U266, was examined using Cell counting kit-8 (CCK-8) assay after 24 h incubation. The proapoptotic effect of DMEC (20 μM) was determined using fluorescent microscope and flow cytometer, and its possible underlying mechanisms were further studied by using western blotting analysis. The half maximal inhibitory concentrations (IC) of DMEC on RPMI8226, MM.1S, and U266 cells were calculated as 25.97, 18.36, and 15.02 μM, respectively. The inhibitory effect of DMEC on MM cells was related to mitochondria-mediated apoptosis upregulation of the cleaved-caspase-3 (C-3), cleaved-caspase-9 (C-9), Bad, and cytochrome C (Cyto C), but downregulation of the Bcl-2 and poly ADP-ribose polymerase (PARP). Furthermore, DMEC (5, 10, and 20 μM) reduced the expression of phosphatidylinositol-3-kinase (PI3K), phosphorylated (p)-protein kinase B (Akt), and p-mammalian target of rapamycin (p-mTOR), which were further evidenced by pretreatment with IGF-1, a PI3K activator. Collectively, our results indicate that the DMEC could be treated as a new candidate for treatment of multiple myeloma in the future. Also, an study is warranted in the future.
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http://dx.doi.org/10.1080/13880209.2019.1662814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781472PMC
December 2019

Superparamagnetic Chitosan Nanoparticles for a Vancomycin Delivery System: Optimized Fabrication and Characterization.

J Biomed Nanotechnol 2019 Oct;15(10):2121-2129

To develop a vancomycin-loaded superparamagnetic chitosan nanoparticles (Vm-SPMCNs) system for the treatment of chronic pyogenic osteoarthrosis to avoid the critical side effects caused by the systemic administration of vancomycin, the preparation process of Vm-SPMCNs was optimized by the orthogonal array design method; the optimum parameters were 1.2 g of chitosan, 0.2 g of vancomycin, 0.3 g of magnetite (Fe₃O₄), 12 mL of glutaraldehyde and stirring at 400 rpm. The drug loading and encapsulation efficiencies of the optimum Vm-SPMCNs were 10.30 ± 0.42% and 79.02 ± 1.81%, respectively. The Fourier transform infrared spectra confirmed that vancomycin was successfully bound to the magnetic chitosan nanoparticles. The Vm-SPMCNs were superparamagnetic particles with a diameter of 207.2 nm. The results of release tests suggested that the Vm-SPMCNs could constantly release vancomycin to maintain the concentration above the minimum inhibitory concentration for ten days, and noninvasive external magnetic stimulation could modulate the release profile according to the actual therapeutic requirements.
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http://dx.doi.org/10.1166/jbn.2019.2831DOI Listing
October 2019

Hypoxia-responsive miRNA-21-5p inhibits Runx2 suppression by targeting SMAD7 in MC3T3-E1 cells.

J Cell Biochem 2019 10 20;120(10):16867-16875. Epub 2019 May 20.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Sustained hypoxia inhibits osteogenesis and osteoblast differentiation by downregulating the expression of runt-related transcription factor 2 (Runx2). MicroRNAs (miRNAs) have been shown to regulate osteogenesis and osteoblast differentiation. In the present study, we profiled miRNAs, with microRNA array and quantitative real-time polymerase chain reaction (RT-PCR) methods, in mouse osteoblast (MC3T3-E1) cells under hypoxia. Then, we investigated regulation by miRNA-21-5p on the expression of Runx2 and other osteoblast differentiation-associated markers via gain-of-function and loss-of-function strategies. We found that expression of miRNA-21-5p, miRNA-210-5p, and other eight miRNAs was upregulated significantly in hypoxia-treated MC3T3-E1 cells. miRNA-21-5p overexpression downregulated the expression of the mRNA and protein of suppressor of mothers against decapentaplegic (SMAD7) markedly, the 3'-untranslated region (3'-UTR) of which was highly homologous with the miRNA-21-5p sequence. miRNA-21-5p overexpression upregulated the protein expression of Runx2 in hypoxia-treated MC3T3-E1 cells, although mRNA expression of Runx2 and other osteoblast differentiation-associated molecules (eg, osteocalcin, procollagen type 1 amino-terminal propeptide, P1NP) were not regulated by it; such upregulation was SMAD7-dependent. In conclusion, hypoxia-responsive miRNA-21-5p promoted Runx2 expression (at least in part) by targeting the 3'-UTR and downregulating SMAD7 expression. Our study suggests a protective role of miRNA-21-5p in promoting osteoblast differentiation under hypoxia.
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http://dx.doi.org/10.1002/jcb.28944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766843PMC
October 2019

A novel technique using a pedicle screw and bucking bar for the treatment of hangman's fracture.

Orthop Traumatol Surg Res 2019 06 19;105(4):709-711. Epub 2019 Apr 19.

Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, 646000 Sichuan, China.

The treatment of hangman's fracture is controversial. If treated with a traditional surgical procedure, there will likely be many complications, such as kyphosis, pseudarthrosis and nonunion. Our present study aims to describe a bucking bar method with pedicle screw fixation to treat hangman's fracture. Thirty-two patients with an unstable hangman's fracture who underwent posterior C2-3 pedicle lag screw fixation surgery assisted by a bucking bar between May 2004 and Jan 2017 were evaluated. All the participating patients were successfully treated using this novel technique, and follow-up revealed anatomical fusion in 27 patients, incomplete fusion in 4 patients, and C2-3 angular deformity healing in 1 patient. No patient developed throat wall edema or pseudomembrane formation. Satisfactory reduction, fixation and fusion of C2 pedicle fractures can be achieved using a pedicle screw assisted with the transoral bucking bar technique. LEVEL OF EVIDENCE: IV, retrospective case-series study.
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http://dx.doi.org/10.1016/j.otsr.2019.03.005DOI Listing
June 2019

Biomechanical analysis of the computer-assisted internal fixation of a femoral neck fracture.

Genes Dis 2020 Sep 23;7(3):448-455. Epub 2019 Apr 23.

Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Rd, Chongqing, 400016, PR China.

The number and spatial configuration of the screws will affect the stability and prognosis of the fractures. In our study, we assessed the biomechanical effects of the double-head cannulated compression screw (DhCCS) and ordinary cannulated compression screw (OCCS) for the treatment of femoral neck fractures by using computer finite element analysis. The original digital imaging and communications in medicine (DICOM)data of a proximal femur were imported into Materialise's interactive medical image control system (MIMICS)software for modeling. Both DhCCS and OCCS 3D-models were obtained by using the 3D scan technique. Using the fracture model and internal fixation assembly model with an inverted triangle, two horizontal and vertical distribution were established in UG software. Next, the displacement and stress distribution were calculated in ANSYS software. The displacement value of the femoral head in the DhCCS group was smaller than that in the OCCS group, and the displacement value in the two horizontal groups was smaller than that in the vertical group. The stress distribution in the DhCCS group was concentrated on the screw rod at the fracture block and thread end, while only at the fracture block in the OCCS group. The stress in the horizontal group was more dispersed on the screws than that in the vertical group. DhCCS has reliable stability for the fixation of femoral neck fractures and applied in the clinical work and 2 horizontal fixation can be used when two screws are selected.
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http://dx.doi.org/10.1016/j.gendis.2019.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452504PMC
September 2020

D-RADA16-RGD-Reinforced Nano-Hydroxyapatite/Polyamide 66 Ternary Biomaterial for Bone Formation.

Tissue Eng Regen Med 2019 04 5;16(2):177-189. Epub 2019 Jan 5.

1The First Affiliated Hospital of Chongqing Medical University, No 1 Medicine Road, Yuzhong District, Chongqing, 400016 People's Republic of China.

Background: Nano-hydroxyapatite/polyamide 66 (nHA/PA66) is a composite used widely in the repair of bone defects. However, this material is insufficient bioactivity. In contrast, D-RADA16-RGD self-assembling peptide (D-RADA16-RGD sequence containing all D-amino acids is Ac-RADARADARADARADARGDS-CONH) shows admirable bioactivity for both cell culture and bone regeneration. Here, we describe the fabrication of a favorable biomaterial material (nHA/PA66/D-RADA16-RGD).

Methods: Proteinase K and circular dichroism spectroscopy were employed to test the stability and secondary structural properties of peptide D-RADA16-RGD respectively. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to characterize the surface of these materials. Confocal laser scanning (CLS), cell counting kit-8 tests (CCK-8), alizarin red S staining, cell immunofluorescence analysis and Western blotting were involved . Also biosafety and bioactivity of them have been evaluated .

Results: Proteinase K and circular dichroism spectroscopy demonstrated that D-RADA16-RGD in nHA/PA66 was able to form stable-sheet secondary structure. SEM and TEM showed that the D-RADA16-RGD material was 7-33 nm in width and 130-600 nm in length, and the interwoven pore size ranged from 40 to 200 nm. CLS suggests that cells in nHA/PA66/D-RADA16-RGD group were linked to adjacent cells with more actin filaments. CCK-8 analysis showed that nHA/PA66/D-RADA16-RGD revealed good biocompatibility. The results of Alizarin-red S staining and Western blotting as well as vivo osteogenesis suggest nHA/PA66/D-RADA16-RGD exhibits better bioactivity.

Conclusion: This study demonstrates that our nHA/PA66/D-RADA16-RGD composite exhibits reasonable mechanical properties, biocompatibility and bioactivity with promotion of bone formation.
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http://dx.doi.org/10.1007/s13770-018-0171-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439056PMC
April 2019

Increased glycolysis mediates Wnt7b-induced bone formation.

FASEB J 2019 07 26;33(7):7810-7821. Epub 2019 Mar 26.

Department of Orthopedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA.

Wingless/integrated (Wnt) signaling has emerged as a major mechanism for promoting bone formation and a target pathway for developing bone anabolic agents against osteoporosis. However, the downstream events mediating the potential therapeutic effect of Wnt proteins are not fully understood. Previous studies have indicated that increased glycolysis is associated with osteoblast differentiation in response to Wnt signaling, but direct genetic evidence for the importance of glucose metabolism in Wnt-induced bone formation is lacking. Here, we have generated compound transgenic mice to overexpress Wnt family member 7B (Wnt7b) transiently in the osteoblast lineage of postnatal mice, with or without concurrent deletion of the glucose transporter 1 (Glut1), also known as solute carrier family 2, facilitated glucose transporter member 1. Overexpression of Wnt7b in 1-mo-old mice for 1 wk markedly stimulated bone formation, but the effect was essentially abolished without Glut1, even though transient deletion of Glut1 itself did not affect normal bone accrual. Consistent with the results, Wnt7b increased Glut1 expression and glucose consumption in the primary culture of osteoblast lineage cells, and deletion of Glut1 diminished osteoblast differentiation . Thus, Wnt7b promotes bone formation in part through stimulating glucose metabolism in osteoblast lineage cells.-Chen, H., Ji, X., Lee, W.-C., Shi, Y., Li, B., Abel, E. D., Jiang, D., Huang, W., Long, F. Increased glycolysis mediates Wnt7b-induced bone formation.
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http://dx.doi.org/10.1096/fj.201900201RRDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593878PMC
July 2019

Polydopamine-induced hydroxyapatite coating facilitates hydroxyapatite/polyamide 66 implant osteogenesis: an in vitro and in vivo evaluation.

Int J Nanomedicine 2018 30;13:8179-8193. Epub 2018 Nov 30.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China,

Background: Hydroxyapatite/polyamide 66 (HA/P66) has been clinically used for several years owing to its good biocompatibility and bioactivity. However, it has been found that the osseointegration process of the HA/P66 implant takes a large amount of time because of the small amount of HA on its surface.

Methods: To increase the amount of HA and aid faster osseointegration, we prepared a HA coating using a biomimetic process assisted by polydopamine (PDA) on the HA/P66 substrate. The surface properties of the substrate modified by PDA and HA were characterized, and the capacity of biomaterials for osteogenic induction was investigated both in vitro and in vivo.

Results: The HA coating was successfully prepared on the HA/P66 substrate and verified by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and X-ray diffraction (XRD). The HA coating remained firmly attached to the underlying PDA-HA/P66 substrate even after strong ultrasound treatment for 1 h, and the calcium and phosphorus of the HA coating was continuously released in vitro in a slow manner. The formation of the HA coating on the PDA film greatly increased the hydrophilicity and surface roughness of HA/P66. In cell-based experiments, as compared with the HA/P66 substrate, the HA coating formation on the PDA film could facilitate the functions of C3H10T1/2 cells, including cell adhesion, proliferation, spreading, alkaline phosphatase activity, calcium nodule formation, and expression of osteogenic differentiation-related proteins. In addition, the HA/P66 scaffolds modified with PDA and HA coatings were implanted in rabbit femoral condyles. At 8 weeks after surgery, micro-computed tomography scanning (micro-CT) and hematoxylin-eosin (HE) staining revealed that more new bones were formed around the HA/P66 scaffold that was modified with a PDA-assisted HA coating.

Conclusion: These results indicate that the preparation of a PDA-assisted HA coating by using a biomimetic process significantly improves the capacity of biomaterials for osteogenic induction.
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http://dx.doi.org/10.2147/IJN.S181137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280913PMC
January 2019
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