Publications by authors named "Qinwei Guo"

25 Publications

  • Page 1 of 1

Midterm Outcomes of Talocalcaneal Coalition Arthroscopic Resection in Adults.

Foot Ankle Int 2022 Aug 26;43(8):1062-1069. Epub 2022 May 26.

Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China.

Background: Arthroscopic resection of the talocalcaneal coalition (TCC) has been reported to be associated with good short-term outcomes. However, the midterm outcomes of this approach remain uncertain.

Methods: We performed a retrospective study of patients who underwent arthroscopic resection for symptomatic TCC. The patients were divided into 2 groups (group P, patients with isolated posterior facet coalition; and group MP, patients with both middle and posterior facet coalition). The preoperative and postoperative visual analog scale (VAS) scores for pain and American Orthopaedic Foot & Ankle Society (AOFAS) scale scores were calculated. The postoperative AOFAS and VAS scores between the 2 groups were analyzed. Patient satisfaction was also assessed.

Results: Thirty-two patients were included in this study. The mean age at the time of surgery was 26.0±8.5 years, and the mean follow-up period was 56.9±18.0 months. Thirteen (41%) patients were in group P, whereas 19 (59%) patients were in group MP. Postoperative VAS and AOFAS scores improved more significantly than preoperative scores. At the final follow-up, excellent and good subjective outcomes were attained in 26 patients (81%), fair and poor outcomes in 6 patients (19%). There were no statistical differences in the postoperative AOFAS (91.0±7.0 vs 85.8±10.8, = .532) and VAS score (2.1±1.7 vs 4.0±2.6, = .537) between patients with the ratio of coalition/posterior facet more than or less than 50%. There were no statistical differences in postoperative VAS score (1.8±1.3 vs 2.6±2.2, = .236) and AOFAS score (92.5±5.6 vs 89.2±8.7, = .297) between group P (n=13) and group MP (n=19), either. Three patients (9.4%) had complications, including these notable findings: 1 patient complained of restricted dorsal flexion, 1 with computed tomography-proven coalition recurrence, and 1 with partial tibial nerve injury.

Conclusion: We found that TCC arthroscopic resection was generally associated with reasonable outcomes at midterm follow-up.

Level Of Evidence: Level IV, case series.
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http://dx.doi.org/10.1177/10711007221092756DOI Listing
August 2022

Distal insertion rupture of lateral ankle ligament as a predictor of weakened and delayed sports recovery after acute ligament repair: mid-term outcomes of 117 cases.

BMC Musculoskelet Disord 2022 Mar 28;23(1):294. Epub 2022 Mar 28.

Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China.

Background: For lateral ankle ligament rupture, surgical repair has been considered for patients requiring return to high-demanding sports. However, there is a lack of systematic research regarding arthroscopic treatment followed by ligament repair for severe acute ankle sprain. The purpose of this study was to analyze the mid-term outcomes of arthroscopy followed by open anatomic lateral ankle ligament repair surgery for acute lateral ankle sprain and the impact of ligament rupture site on the outcomes.

Methods: Professional or amateur athletes with clinically- and radiologically-confirmed grade III acute lateral ankle ligament injuries undergoing ankle arthroscopy followed by open anatomic ligament repair between June 2007 and May 2017 were reviewed. Intra-articular lesions and the location of rupture were first examined under arthroscopy. Simple suture repair was performed for mid- substance ligament rupture (middle group), while suture repair with anchors were used for the ruptures near the ligament attachment site on the fibular (proximal group), talar or the calcaneal side (distal group). Outcomes were evaluated at final follow-up, including visual analog scale (VAS) pain score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Tegner score, time to return to sports, resumption of pre-injury sports level, sprain recurrence and range of motion (ROM).

Results: A total of 117 patients were included for analysis, with a mean follow-up duration of 46.4 ± 16.1 months. There were 48 (41%) cases in the proximal group, 41 (35%) cases in the middle group and 28 (24%) cases in the distal group respectively. At final follow-up, all of the VAS score, AOFAS score and the Tegner score were significantly improved from the pre-operative level (p < 0.001). 12 (10%) patients complained of sprain recurrence during follow-up. 14 (12%) patients reported mild ROM restriction and 7 (6%) patients experienced transient skin numbness. The average time to return to pre-injury sports was 4.34 ± 1.11 months. The smallest proportion (86% ± 13%) of resumption of pre-injury sports level was reported from the distal group, compared with 93% ± 12% for the proximal group and 89% ± 14% for the middle group (p = 0.037). Time to return to sports was significantly longer for the distal group, with an average of 4.59 ± 1.27 months compared to 3.99 ± 1.09 months for the proximal group and 4.58 ± 0.90 months for the middle group (p = 0.009).

Conclusions: Ankle arthroscopy followed by open anatomic ligament repair is a reliable procedure for patients requiring return to high demanding sports after severe acute ankle sprains. Distal rupture near the talar or calcaneal end was associated with delayed return-to-sport and inferior performance in resuming pre-injury sports level.
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http://dx.doi.org/10.1186/s12891-022-05260-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961918PMC
March 2022

Comparison of Autologous Osteoperiosteal and Osteochondral Transplantation for the Treatment of Large, Medial Cystic Osteochondral Lesions of the Talus.

Am J Sports Med 2022 Mar 20;50(3):769-777. Epub 2022 Jan 20.

Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Haidian District, Beijing, China.

Background: Autologous osteoperiosteal transplantation (AOPT) using graft harvested from the iliac crest is used to treat large cystic osteochondral lesions of the talus (OLTs). However, no studies have compared clinical and radiologic outcomes between AOPT and autologous osteochondral transplantation (AOCT) using graft harvested from the nonweightbearing zone of the femoral condyle of the ipsilateral knee in patients with large cystic OLTs.

Purpose: To compare clinical and radiologic outcomes between patients undergoing AOPT and those undergoing AOCT for large cystic OLTs.

Study Design: Cohort study; Level of evidence, 3.

Methods: Between March 2015 and March 2018, patients who underwent AOCT and AOPT to treat medial large cystic OLTs (>10 mm) were retrospectively evaluated. For comparability, the 2 groups were matched 1:1 based on their characteristics, including sex, age, body mass index, side of injury, follow-up period, and the preoperative cyst volume. After propensity score matching, 23 patients were enrolled in each group for the analysis. Clinical outcomes were assessed using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Tegner score. Donor-site morbidity was recorded according to the symptoms, including pain, stiffness, swelling, and discomfort. In addition, the Lysholm score was used to assess the most common knee donor-site morbidity. Radiologic outcomes were evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) score, and the International Cartilage Regeneration & Joint Preservation Society (ICRS) score was obtained during second-look surgery.

Results: The mean follow-up period was about 48 months. There were no significant differences in patient characteristics and lesion volumes between groups. Postoperative ankle pain VAS score, AOFAS score, and Tegner score were not significantly different between groups at final follow-up. Total donor-site morbidity ( = .004) and discomfort morbidity ( = .009) were significantly lower in the AOPT group than in the AOCT group. However, the Lysholm score showed no significant difference between the donor knee and the opposite knee ( = .503) in the AOCT group. The MOCART and ICRS scores were not significantly different between groups.

Conclusion: Clinical and radiologic outcomes of patients who underwent AOPT from the iliac crest were found to be comparable with those of patients who underwent AOCT from the ipsilateral knee for the treatment of medial large cystic OLTs. These results may be helpful for orthopaedic surgeons to decide appropriate treatments for patients with large cystic OLTs.
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http://dx.doi.org/10.1177/03635465211068529DOI Listing
March 2022

Ankle-Injury Patients Perform More Microadjustments during Walking: Evidence from Velocity Profiles in Gait Analysis.

Appl Bionics Biomech 2022 6;2022:3057270. Epub 2022 Jan 6.

School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China 100083.

Introduction: We evaluated the velocity profiles of patients with lateral collateral ligament (LCL) injuries of the ankle with a goal of understanding the control mechanism involved in walking.

Methods: We tracked motions of patients' legs and feet in 30 gait cycles recorded from patients with LCL injuries of the ankle and compared them to 50 gait cycles taken from normal control subjects. Seventeen markers were placed on the foot following the Heidelberg foot measurement model. Velocity profiles and microadjustments of the knee, ankle, and foot were calculated during different gait phases and compared between the patient and control groups.

Results: Patients had a smaller first rocker percentage and larger second rocker percentage in the gait cycle compared to controls. Patients also displayed shorter stride length and slower strides and performed more microadjustments in the second rocker phase than in other rocker/swing phases. Patients' mean velocities of the knee, ankle, and foot in the second rocker phase were also significantly higher than that in control subjects. . Evidence from velocity profiles suggested that patients with ligament injury necessitated more musculoskeletal microadjustments to maintain body balance, but these may also be due to secondary injury. Precise descriptions of the spatiotemporal gait characteristics are therefore crucial for our understanding of movement control during locomotion.
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http://dx.doi.org/10.1155/2022/3057270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758300PMC
January 2022

A new classification of talocalcaneal coalitions based on computed tomography for operative planning.

BMC Musculoskelet Disord 2021 Aug 11;22(1):678. Epub 2021 Aug 11.

Department of Sports Medicine, Peking University Third Hospital. Institute of Sports Medicine of Peking University. Beijing Key Laboratory of Sports Injuries, 49 North Garden Road, Haidian District, Beijing, 100191, China.

Background: Current classifications emphasize the morphology of the coalition, however, subtalar joint facets involved should also be emphasized.

Objective: The objective of this study was to develop a new classification system based on the articular facets involved to cover all coalitions and guide operative planning.

Methods: Patients were diagnosed with talocalcaneal coalition using a CT scan, between January 2009 and February 2021. The coalition was classified into four main types according to the shape and nature of the coalition: I, inferiorly overgrown talus or superiorly overgrown calcaneus; II, both talus and calcaneus overgrew; III, coalition with an accessory ossicle; IV, complete osseous coalition (I-III types are non-osseous coalition). Then each type was further divided into three subtypes according to the articular facets involved. A, the coalition involving the anterior facets; M, the coalition involving the middle facets, and P, the coalition involving the posterior facets. Interobserver reliability was measured at the main type (based on nature and shape) and subtype (articular facet involved) using weighted Kappa. Results There were 106 patients (108 ft) included in this study. Overall, 8 ft (7.5%) were classified as type I, 75 ft (69.4%) as type II, 7 ft (6.5%) as type III, and 18 ft (16.7%) as type IV. Twenty-nine coalitions (26.9%) involved the posterior facets only (subtype-P), 74 coalitions (68.5%) involved both the middle and posterior facets (subtype-MP), and five coalitions (4.6%) simultaneously involved the anterior, middle, and posterior facets (subtype-AMP). Type II-MP coalition was the most common. The value of weighted Kappa for the main type was 0.93 (95%CI 0.86-0.99) (p<0.001), and the value for the subtype was 0.78 (95%CI 0.66-0.91) (p<0.001).

Conclusion: A new classification system of the talocalcaneal coalition to facilitate operative planning was developed.
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http://dx.doi.org/10.1186/s12891-021-04567-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356385PMC
August 2021

Open Versus Endoscopic Osteotomy of Posterosuperior Calcaneal Tuberosity for Haglund Syndrome: A Retrospective Cohort Study.

Orthop J Sports Med 2021 Apr 19;9(4):23259671211001055. Epub 2021 Apr 19.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injury, Peking University Third Hospital, Beijing, People's Republic of China.

Background: Although endoscopic calcaneoplasty and retrocalcaneal debridement have been extensively applied to treat Haglund syndrome, evidence of the value of the endoscopic procedure remains to be fully established.

Purpose/hypothesis: The purpose of this study was to compare the postoperative outcomes and the amount of osteotomy between open and endoscopic surgery for the treatment of Haglund syndrome. It was hypothesized that endoscopic calcaneoplasty would lead to higher patient satisfaction and lower complication rates compared with open surgical techniques.

Study Design: Cohort study; Level of evidence, 3.

Methods: The following postoperative outcomes were compared between the open surgery group (n = 20) and the endoscopic surgery group (n = 27): visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, Foot Function Index, Tegner score, Ankle Activity Score, and 36-Item Short Form Health Survey; postoperative complications; and duration of surgery. To determine the extent of resection, the authors compared the calcaneal height ratio, calcaneal resection ratio, calcaneal resection angle, pitch line, and Haglund deformity height between groups. The learning curve for endoscopic calcaneoplasty was also calculated.

Results: There were no significant differences between the open and endoscopic groups on any outcome score. Two patients in the open group reported temporary paresthesia around the incisional site, indicating sural nerve injuries; no complication was reported in the endoscopy group. None of the parameters for extent of resection were statistically significant between the groups. The duration of surgery was 44.90 ± 10.52 and 65.39 ± 11.12 minutes in the open and endoscopy groups, respectively ( = .001). Regarding the learning curve for endoscopic calcaneoplasty (6 surgeons; 27 follow-up patients; 9 patients lost to follow-up), the duration of surgery reached a steady point of 55.68 ± 4.19 minutes after the fourth operation.

Conclusion: The results of this study indicated that the endoscopy procedure was as effective as the open procedure. The endoscopic procedure required significantly more time than the open procedure, and the duration of the endoscopic procedure was shortened only after the fourth operation, suggesting that it requires high technical skills and familiarity with the anatomic relationships.
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http://dx.doi.org/10.1177/23259671211001055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058802PMC
April 2021

A novel transverse talar tunnel achieved less vessel damage and better drilling safety for ATFL reconstruction: a cadaveric study with three-dimensional microCT.

Am J Transl Res 2020 15;12(12):8050-8058. Epub 2020 Dec 15.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital Beijing 100191, P. R. China.

Purpose: To introduce a novel transverse tunnel (TT) in anterior talofibular ligament (ATFL) reconstruction, and assess whether it was superior to the tunnels currently used.

Methods: Thirteen fresh cadaveric lower extremities were perfused with lead-based contrast. Talar tunnels were drilled from the ATFL insertion in the following directions: transversely towards the medial side (TT), towards the talar neck (TNT), and towards the anterior, distal, and posterior points of the medial malleolus (AMMT, DMMT, and PMMT, respectively). MicroCT was used to reconstruct the tali, and virtual transosseous and 20-mm blind-ended tunnels were generated. The graft bending angle, vascular compromise caused by the tunnels, and the minimum distances from the tunnels to the chondral surfaces were evaluated.

Results: The bending angles between the ATFL and the TT, TNT, AMMT, DMMT, and PMMT were 47.3±7.9°, 41.5±7.7°, 57.0±6.0°, 63.9±11.7°, and 87.9±6.2°, respectively. The proportion of damaged intraosseous vessels was significantly less for the TT (7.8±2.7%) compared with the AMMT (10.0±5.2%), DMMT (15.5±6.5%), and PMMT (16.9±3.9%). Both the TNT and the AMMT carried a high risk of joint penetration, with respective minimum distances of 2.2±1.7 mm and 1.4±1.0 mm from the tunnel to the cartilage; in contrast, the TT, DMMT, and PMMT had larger safety margins, with minimum distances of 5.4±0.8 mm, 8.9+2.7 mm, and 6.0±1.2 mm. The blind-ended tunnels caused less vascular compromise and had larger minimum distances to the cartilage (better drilling safety) than the transosseous tunnels for all tunnel directions.

Conclusion: The TT achieves a superior graft bending angle and intraosseous blood supply protection than the AMMT, DMMT, and PMMT, and is less likely to result in cartilage damage than the TNT. The 20-mm blind-ended tunnels achieve less vessel damage and better drilling safety than transosseous tunnels.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791527PMC
December 2020

Both Magnetic Resonance Imaging and Computed Tomography Are Reliable and Valid in Evaluating Cystic Osteochondral Lesions of the Talus.

Orthop J Sports Med 2020 Sep 17;8(9):2325967120946697. Epub 2020 Sep 17.

Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.

Background: Compared with computed tomography (CT), magnetic resonance imaging (MRI) might overestimate the condition of osteochondral lesions of the talus (OLTs) owing to subchondral bone marrow edema and the overlying cartilage defect. However, no study has compared MRI and CT directly in evaluating OLTs with subchondral cysts.

Purpose: To compare the reliability and validity of MRI and CT in evaluating OLTs with subchondral cysts.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: An institutional radiology database was queried for inpatients diagnosed with OLTs with subchondral cysts who had undergone surgical treatment between May 2015 and October 2019. A total of 48 patients met the inclusion criteria. Based on our measurement method, 2 experienced observers who were blinded to the study independently measured the length, width, and depth of the cysts using MRI and CT. The classification of cystic lesions was also performed based on MRI and CT findings.

Results: Interobserver reliability was almost perfect, with intraclass correlation coefficients (ICCs) ranging from 0.935 to 0.999. ICCs for intraobserver reliability ranged from 0.944 to 0.976. The mean size of cysts measured on MRI (length, 13.38 ± 4.23 mm; width, 9.28 ± 2.28 mm; depth, 11.54 ± 3.69 mm) was not significantly different to that evaluated on CT (length, 13.40 ± 4.08 mm; width, 9.25 ± 2.34 mm; depth, 11.32 ± 3.54 mm). The size of subchondral cysts was precisely estimated on both MRI and CT. The MRI classification and CT classification revealed almost perfect agreement (kappa = 0.831).

Conclusion: With our measurement method, both MRI and CT were deemed to be reliable and valid in evaluating the size of subchondral cysts of OLTs, and the MRI classification was well-correlated with the CT classification. The presented measurement method and classification systems could provide more accurate information before surgery.
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http://dx.doi.org/10.1177/2325967120946697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503027PMC
September 2020

Autologous Fractionated Adipose Tissue as a Natural Biomaterial and Novel One-Step Stem Cell Therapy for Repairing Articular Cartilage Defects.

Front Cell Dev Biol 2020 31;8:694. Epub 2020 Jul 31.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China.

Articular cartilage damage remains a tough challenge for clinicians. Stem cells have emerged promising biologics in regenerative medicine. Previous research has widely demonstrated that adipose-derived mesenchymal stem cells (ADSCs) can promote cartilage repair due to their multipotency. However, enzymatic isolation and monolayer expansion of ADSCs decrease their differentiation potential and limit their clinical application. Here, a novel adipose tissue-derived product, extracellular matrix/stromal vascular fraction gel (ECM/SVF-gel), was obtained by simple mechanical shifting and centrifugation to separate the fat oil and concentrate the effective constituents. This study aimed to evaluate the therapeutic effect of this natural biomaterial on the repair of articular cartilage defects. Scanning electron microscopy showed that the fibrous structure in the ECM/SVF-gel was preserved. ADSCs sprouted from the ECM/SVF-gel were characterized by their ability of differentiation into chondrocytes, osteoblasts, and adipocytes. In a rabbit model, critical-sized cartilage defects (diameter, 4 mm; depth, 1.5 mm) were created and treated with microfracture (MF) or a combination of autologous ECM/SVF-gel injection. The knee joints were evaluated at 6 and 12 weeks through magnetic resonance imaging, macroscopic observation, histology, and immunohistochemistry. The International Cartilage Repair Society score and histological score were significantly higher in the ECM/SVF-gel group than those in the MF-treated group. The ECM/SVF-gel distinctly improved cartilage regeneration, integration with surrounding normal cartilage, and the expression of hyaline cartilage marker, type II collagen, in comparison with the MF treatment alone. Overall, the ready-to-use ECM/SVF-gel is a promising therapeutic strategy to facilitate articular cartilage regeneration. Moreover, due to the simple, time-sparing, cost-effective, enzyme-free, and minimally invasive preparation process, this gel provides a valuable alternative to stem cell-based therapy for clinical translation.
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http://dx.doi.org/10.3389/fcell.2020.00694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438948PMC
July 2020

Calcaneoplasty coupled with an insertional Achilles tendon reattachment procedure for the prevention of secondary calcaneal impingement: a retrospective study.

Ther Adv Chronic Dis 2020 3;11:2040622320944793. Epub 2020 Aug 3.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injury, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, PR China.

Background: Posterior heel pain may occur after an Achilles insertional rupture reattachment procedure and could be attributed to an impingement between the calcaneal tuberosity and Achilles tendon, which could be observed using postoperative magnetic resonance imaging (MRI). Moreover, such impingement, which may be associated with postoperative pain symptoms, could be relieved by calcaneoplasty.

Methods: Postoperative Visual Analog Pain Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, Foot Function Index (FFI), Ankle Activity Score (AAS), and Tegner score were obtained and compared between 10 patients who underwent calcaneoplasty (calcaneoplasty group) and 11 patients who did not receive calcaneoplasty (non-calcaneoplasty group). Several signs of calcaneal tuberosity impingement identified in MRI were also compared between the two groups, which included retrocalcaneal bursitis, postoperative tendinopathy, tendon calcification, bone marrow edema, increased Achilles tendon diameter, and bony spurs.

Results: The VAS score was 2.00 ± 1.41 and 2.18 ± 1.83 ( = 0.803), the AOFAS score was 90.60 ± 4.22 and 81.82 ± 7.77 ( = 0.005), the FFI was 5.00 ± 2.86 and 17.18 ± 15.92 ( = 0.028), the AAS was 5.50 ± 2.55 and 5.82 ± 2.04 ( = 0.750), and the Tegner score was 4.30 ± 1.49 and 4.45 ± 1.21 ( = 0.797) in the calcaneoplasty and non-calcaneoplasty groups, respectively. The AOFAS score and FFI were significantly different between the groups. MRI findings revealed that the non-calcaneoplasty group had significant signs of calcaneal impingement compared with the calcaneoplasty group.

Conclusions: Secondary calcaneal impingement due to insertional tendon enlargement may occur, and prophylactic calcaneoplasty coupled with an insertional reattachment procedure could achieve promising postoperative outcomes for patients with insertional Achilles tendon rupture.
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http://dx.doi.org/10.1177/2040622320944793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832320PMC
August 2020

Genomic Organization and Comparative Phylogenic Analysis of NBS-LRR Resistance Gene Family in and .

Evol Bioinform Online 2020 6;16:1176934320911055. Epub 2020 Mar 6.

State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Vegetables, Zhejiang Academy of Agricultural Sciences, Hangzhou, China.

NBS-LRR (nucleotide-binding site and leucine-rich repeat) is one of the largest resistance gene families in plants. The completion of the genome sequencing of wild tomato provided an opportunity to conduct a comprehensive analysis of the NBS-LRR gene superfamily at the genome-wide level. In this study, gene identification, chromosome mapping, and phylogenetic analysis of the NBS-LRR gene family were analyzed using the bioinformatics methods. The results revealed 245 NBS-LRRs in total, similar to that in the cultivated tomato. These genes are unevenly distributed on 12 chromosomes, and ~59.6% of them form gene clusters, most of which are tandem duplications. Phylogenetic analysis divided the NBS-LRRs into 2 subfamilies (CNL-coiled-coil NBS-LRR and TNL-TIR NBS-LRR), and the expansion of the CNL subfamily was more extensive than the TNL subfamily. Novel conserved structures were identified through conserved motif analysis between the CNL and TNL subfamilies. Compared with the NBS-LRR sequences from the model plant , wide genetic variation occurred after the divergence of and . Species-specific expansion was also found in the CNL subfamily in . The results of this study provide the basis for the deeper analysis of NBS-LRR resistance genes and contribute to mapping and isolation of candidate resistance genes in .
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http://dx.doi.org/10.1177/1176934320911055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065440PMC
March 2020

New Insights into Evolution of Plant Heat Shock Factors (Hsfs) and Expression Analysis of Tea Genes in Response to Abiotic Stresses.

Plants (Basel) 2020 Mar 2;9(3). Epub 2020 Mar 2.

Wulanchabu Academy of Agricultural and Husbandry Sciences, Wulanchabu 012000, Inner Mongolia, China.

Heat shock transcription factor (Hsf) is one of key regulators in plant abotic stress response. Although the Hsf gene family has been identified from several plant species, original and evolution relationship have been fragmented. In addition, tea, an important crop, genome sequences have been completed and function of the Hsf family genes in response to abiotic stresses was not illuminated. In this study, a total of 4208 Hsf proteins were identified within 163 plant species from green algae () to angiosperm (monocots and dicots), which were distributed unevenly into each of plant species tested. The result indicated that Hsf originated during the early evolutionary history of chlorophytae algae and genome-wide genetic varies had occurred during the course of evolution in plant species. Phylogenetic classification of Hsf genes from the representative nine plant species into ten subfamilies, each of which contained members from different plant species, imply that gene duplication had occurred during the course of evolution. In addition, based on RNA-seq data, the member of the Hsfs showed different expression levels in the different organs and at the different developmental stages in tea. Expression patterns also showed clear differences among species, indicating that regulation of Hsf genes expression varied between organs in a species-specific manner. Furthermore, expression of most Hsfs in response to drought, cold and salt stresses, imply a possible positive regulatory role under abiotic stresses. Expression profiles of nineteen Hsf genes in response to heat stress were also analyzed by quantitative real-time RT-PCR. Several stress-responsive Hsf genes were highly regulated by heat stress treatment. In conclusion, these results lay a solid foundation for us to elucidate the evolutionary origin of plant Hsfs and Hsf functions in tea response to abiotic stresses in the future.
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http://dx.doi.org/10.3390/plants9030311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154843PMC
March 2020

Comparison of autologous osteoperiosteal cylinder and osteochondral graft transplantation in the treatment of large cystic osteochondral lesions of the talus (OLTs): a protocol for a non-inferiority randomised controlled trial.

BMJ Open 2020 02 9;10(2):e033850. Epub 2020 Feb 9.

Institute of Sports Medicine, Peking University Third Hospital, Beijing, China

Introduction: Large cystic osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after reparative techniques such as bone marrow stimulation. Autologous osteochondral transplantation has been viewed as an alternative choice for treating these lesions, but donor-site morbidity has limited its application. Excellent clinical outcomes have been shown in repairing these types of lesions with autologous osteoperiosteal grafts, and these outcomes are achieved at a low cost and without donor-site morbidity in the normal knee joint. This will be the first randomised controlled trial to compare the two surgical techniques, and recommendations for the treatment of patients with large cystic OLTs will be provided.

Methods And Analysis: A non-inferiority randomised controlled trial will be conducted. A total of 70 participants with clinically diagnosed large cystic OLTs will be randomly allocated to either the experimental group or the control group at a ratio of 1:1. The experimental group will be treated with autologous osteoperiosteal cylinder graft transplantation, while the control group will be treated with autologous osteochondral transplantation. The primary outcome measure will be the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score and the Short Form 12 (SF-12) questionnaire. Secondary outcome measures will include the secondary arthroscopy International Cartilage Repair Society score, the Magnetic Resonance Observation of Cartilage Repair Tissue score, the Tegner activity level score, the visual analogue scale, routine X-rays, CT and complications. These parameters will be evaluated preoperatively, as well as at 3, 6, 12, 24, 36 and 60 months postoperatively. In this trial, we hypothesised that both procedures offer good results for the treatment of patients with large cystic OLTs, and occurrence of donor-site morbidity in autologous osteoperiosteal cylinder graft transplantation group is less than that in autologous osteochondral transplantation group.

Ethics And Dissemination: The current study was approved by the board of research ethics of Peking University Third Hospital Medical Science Research Ethics Committee. The results of this study will be presented at national and international conferences and published in peer-reviewed journals.

Trial Registration Number: NCT03347877.
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http://dx.doi.org/10.1136/bmjopen-2019-033850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045089PMC
February 2020

Evolutionary Conservation and Expression Patterns of Neutral/Alkaline Invertases in .

Biomolecules 2019 11 21;9(12). Epub 2019 Nov 21.

State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Institute of Vegetables, Zhejiang Academy of Agricultural Sciences, Hangzhou 310021, China.

The invertase gene family in plants is composed of two subfamilies of enzymes, namely, acid- and neutral/alkaline invertases (cytosolic invertase, CIN). Both can irreversibly cleave sucrose into fructose and glucose, which are thought to play key roles in carbon metabolism and plant growth. CINs are widely found in plants, but little is reported about this family. In this paper, a comparative genomic approach was used to analyze the CIN gene family in , including , , , and . A total of 40 CINs were identified in five plants, and sequence features, phylogenetic relationships, motif compositions, gene structure, collinear relationship, and expression profile were further analyzed. Sequence analysis revealed a remarkable conservation of CINs in sequence length, gene number, and molecular weight. The previously verified four amino acid residues (D188, E414, Arg430, and Ser547) were also observed in 39 out of 40 CINs in our study, showing to be deeply conserved. The CIN gene family could be distinguished into groups α and β, and α is further subdivided into subgroups α1 and α2 in our phylogenetic tree. More remarkably, each species has an average of four CINs in the α and β groups. Marked interspecies conservation and collinearity of CINs were also further revealed by chromosome mapping. Exon-intron configuration and conserved motifs were consistent in each of these α and β groups on the basis of analysis. Expression analysis indicated that CINs were constitutively expressed and share similar expression profiles in all tested samples from and . In addition, in CIN genes of the tomato and potato in response to abiotic and biotic stresses, phytohormones also performed. Overall, CINs in were encoded by a small and highly conserved gene family, possibly reflecting structural and functional conservation in . These results lay the foundation for further expounding the functional characterization of CIN genes and are also significant for understanding the evolutionary profiling of the CIN gene family in .
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http://dx.doi.org/10.3390/biom9120763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995568PMC
November 2019

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data.

Orthop J Sports Med 2019 Sep 23;7(9):2325967119873852. Epub 2019 Sep 23.

Department of Sports Medicine, Huashan Hospital Fudan University, Shanghai, China.

Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered.

Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI.

Study Design: A consensus statement of the Chinese Society of Sports Medicine.

Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized.

Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded.

Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.
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http://dx.doi.org/10.1177/2325967119873852DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757505PMC
September 2019

Optimal Outcomes for Acute Avulsion Fracture of the Achilles Tendon Treated With the Insertional Reattachment Technique: A Case Series of 31 Cases With Over 2 Years of Follow-up.

Am J Sports Med 2019 10 3;47(12):2993-3001. Epub 2019 Sep 3.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injury, Peking University Third Hospital, Beijing, China.

Background: Avulsion fracture of the Achilles tendon is a less common but debilitating disorder. There is a paucity of literature on this problem.

Purpose: To present a retrospective case series assessing the clinical outcomes of avulsion fracture of the Achilles tendon after a reattachment procedure and to identify potential factors predicting postoperative outcomes.

Study Design: Case series; Level of evidence, 4.

Methods: A consecutive case series of 35 patients with acute insertional rupture of the Achilles tendon who received a reattachment procedure between 2011 and 2017 were reviewed. All patients were measured and classified by magnetic resonance imaging (MRI) and surgical findings. Patient-reported outcomes were evaluated using the visual analog scale (VAS) for pain, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale, Foot Function Index (FFI), Tegner score, and Ankle Activity Score (AAS). The range of motion and single-legged heel raise test were also conducted for both ankles.

Results: Thirty-one out of 35 (88.57%) patients were followed up for an average of 43.65 months. The VAS pain score and AOFAS Ankle-Hindfoot score improved from 4.87 ± 1.61 preoperatively to 2.07 ± 1.57 postoperatively and from 58.32 ± 18.66 preoperatively to 87.32 ± 7.53 postoperatively, respectively (both < .001). The mean FFI, AAS, and Tegner scores after the operation were 11.84 ± 1.62, 5.71 ± 2.18, and 4.61 ± 1.31, respectively. Compared with the intact ankle, the mean deficit in dorsiflexion in the involved ankle was 9.54°± 6.25° (range, 0.59°-23.70°; < .001) and the mean deficit in plantarflexion in the involved ankle was 6.31°± 4.02° (range, 0.24°-14.92°; < .001). Thirty patients could perform the single-legged heel raise on the operative leg. A larger body mass index was associated with worse postoperative AOFAS and FFI outcomes. Longer follow-up predicted statistically significantly better FFI scores. Better postoperative dorsiflexion was associated with better postoperative FFI, AAS, and Tegner scores, and a statistically significant interaction was found between the VAS score and plantarflexion deficit. Age, preoperative insertional tenderness, Haglund deformity, and MRI classification showed little association with postoperative outcomes.

Conclusion: This study demonstrated that the reattachment procedure for acute avulsion fracture of the Achilles tendon can achieve firm fixation and promising outcomes.
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http://dx.doi.org/10.1177/0363546519869952DOI Listing
October 2019

Vascular Compromising Effect of Drilling for Osteochondral Lesions of the Talus: A Three-Dimensional Micro-Computed Tomography Study.

Arthroscopy 2019 10 19;35(10):2930-2937. Epub 2019 Aug 19.

Department of Human Anatomy and Histology and Embryology, Peking University, Beijing, P. R. China. Electronic address:

Purpose: To explore an optimal drilling depth and direction for osteochondral lesions of the talus based on a 3-dimensional vascular microarchitecture model constructed with micro-computed tomography (microCT).

Methods: Twelve tali were perfused with the contrast agent and then scanned with microCT. The talar dome was divided into 9 zones, and the vessel densities were measured at the subchondral depths of 0 to 5 mm, 5 to 10 mm and 10 to 15 mm in each zone. The anterolateral (AL) and posterolateral (PL) approaches of retrograde drilling were simulated and the vascular compromising effect was evaluated.

Results: The vessel density of the 0- to 5-mm depth was lower than that of the 5- to 10-mm (P = .001) and 10- to 15-mm (P = .007) depths, but no significant difference was found between the 5- to 10-mm and 10- to 15-mm depths (P > .9999). The vessel density in the 5- to 10-mm depth of medial talar dome was similar to that of the adjacent zones (P = .05). Vessel density in the 5- to 10-mm depth around the lateral talar dome was higher in the anterior and medial side. The anterolateral approach disturbed the main intraosseous vessels from the tarsal canal-tarsal sinus, causing extensive vascular compromise in the talus neck and body, whereas the posterolateral approach disturbed only the vessels near the tunnel.

Conclusions: The vessel density changed greatly from the subchondral 0- to 5-mm to the 5- to 10-mm depth. The vessel densities of the 5- to 10-mm depth around the medial talar dome were similar, whereas the anterior and medial side of the lateral talar dome was better vascularized. The posterolateral approach caused less vascular damage than the anterolateral approach.

Clinical Relevance: The anterograde drilling depth was preferable to the subchondral 5- to 10-mm depth. There was no preferred drilling direction for the osteochondral lesion in the medial talar dome, whereas it is preferable to drill anteriorly or medially in the lateral dome. The posterolateral approach might be a safer alternative for retrograde drilling.
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http://dx.doi.org/10.1016/j.arthro.2019.05.021DOI Listing
October 2019

Reattachment of the superior peroneal retinaculum versus the bone block procedure for the treatment of recurrent peroneal tendon dislocation: two safe and effective techniques.

Knee Surg Sports Traumatol Arthrosc 2019 Sep 22;27(9):2877-2883. Epub 2019 Mar 22.

Institution of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Purpose: Clinical outcomes between reattachment of the superior peroneal retinaculum (SPR) and the bone block procedure were compared in this study to elucidate which procedure was safer and more effective.

Methods: From 2012 to 2016, 25 patients with recurrent peroneal tendon dislocation underwent the bone block procedure (group A), and another 22 patients underwent reattachment of the SPR (group B). American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Activity Score (AAS), time to return to sports activity, rate of return to sports level, range of motion (ROM) of the ankle, rate of recurrence, and overall patient satisfaction were collected to evaluate outcomes between the two groups.

Results: In group A, 24 patients followed up at a mean period of 42.5 ± 16.7 months. The mean postoperative AOFAS score was 92.9 ± 3.9. The median time to return to sports activity was 6.0 months (IQR 4.3-6.0 months) with 19 patients (79.2%) returning to their previous sports level. Two patients experienced recurrent dislocation, and 22 patients (91.7%) were satisfied with the procedure. In group B, 20 patients followed up at a mean period of 35.8 ± 15.3 months. The mean postoperative AOFAS score was 95.0 ± 4.2. The median time to return to sports activity was 5.0 months (IQR 4.0-5.0 months) with 18 patients (90.0%) returning to their previous sports level. No recurrence was reported, and 18 patients (90.0%) were satisfied with the procedure. The time to return to sports activity in group B was significantly shorter than that in group A. There was no significant difference in complications or clinical outcomes between the two procedures.

Conclusion: Both procedures offered satisfactory results for recurrent peroneal tendon dislocation with low rates of recurrence and complications. However, the time to return to sports activity after the reattachment of the SPR was shorter than that after the bone block procedure.

Level Of Evidence: Retrospective Comparative Study, Level III.
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http://dx.doi.org/10.1007/s00167-019-05479-2DOI Listing
September 2019

The Hsp70 Gene Family in Solanum tuberosum: Genome-Wide Identification, Phylogeny, and Expression Patterns.

Sci Rep 2018 11 9;8(1):16628. Epub 2018 Nov 9.

State Key Laboratory Breeding Base for Zhejiang Sustainable Pest and Disease Control, Institute of Vegetables, Zhejiang Academy of Agricultural Sciences, Hangzhou, China.

Heat shock protein 70 (Hsp70) family members play important roles in protecting plants against abiotic stresses, including salt, drought, heat, and cold. In this study, 20 putative StHsp70 genes were identified in potato (Solanum tuberosum L.) through the integration of the gene structures, chromosome locations, phylogenetic relationships, and expression profiles. These StHsp70 genes were classified into five sub-families based on phylogenetic analysis. Chromosome mapping revealed that they were unevenly and unequally distributed on 10 of the 12 chromosomes. Furthermore, segmental and tandem duplication events contributed to the expansion of the StHsp70 genes. Phylogenetic tree of the HSP70 genes from potato and other plant species revealed multiple sub-families. These findings indicated a common ancestor which had generated diverse sub-families prior to a mono-dicot split. In addition, expression analysis using RNA-seq revealed that the majority of these genes were expressed in at least one of the tested tissue, and were induced by Phytophthora infestans. Then, based on qRT-PCR analysis, the results showed that the transcript levels of some of the StHsp70 genes could be remarkably induced by such abiotic and hormone stresses, which indicated their potential roles in mediating the responses of potato plants to both abiotic and biotic stress conditions.
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http://dx.doi.org/10.1038/s41598-018-34878-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226454PMC
November 2018

Results and recurrence of pigmented villonodular synovitis of the ankle: does diffuse PVNS with extra-articular extension tend to recur more often?

Knee Surg Sports Traumatol Arthrosc 2018 Oct 7;26(10):3118-3123. Epub 2017 Apr 7.

Institute of Sports Medicine, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Purpose: The aim of this study was to provide the outcomes and to analyze the recurrence of Pigmented Villonodular Synovitis (PVNS) of the ankle joint treated by surgical synovectomy.

Methods: Thirty-one PVNS cases of the ankle, including 5 localized PVNS cases and 26 diffuse PVNS cases, were treated in our institute between 2004 and 2015. The median age was 35 (range 18-63) years. The 5 localized PVNS cases were treated with partial synovectomy (group I); 10 diffuse PVNS cases limited to intra-articular synovium received arthroscopic comprehensive synovectomy (group II); and 16 cases with diffuse PVNS spreading to extra-articular tendon sheaths underwent combined arthroscopic and open synovectomy (group III). Adjuvant radiotherapy was provided in groups II and III. The American Orthopaedic Foot and Ankle Society (AOFAS) score and subjective grading of procedure were used to evaluate the results.

Results: Twenty-seven patients were followed with a median of 54 (range 15-108) months. In the three groups, the average AOFAS score improved from 75 (in all three groups) points preoperatively to 100 (group I), 97 (group II), and 90 points (group III) postoperatively. The rate of good-to-excellent result was 100% in group I and II and 73.3% in group III. Only in group III, recurrence occurred in five cases.

Conclusions: Diffuse PVNS of the ankle can be successfully managed with surgical synovectomy and adjuvant radiotherapy. Radiotherapy is not needed for localized PVNS. The recurrence rate in PVNS patients with extra-articular extension is higher.

Level Of Evidence: IV.
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http://dx.doi.org/10.1007/s00167-017-4488-8DOI Listing
October 2018

Similarity of Center of Pressure Progression during Walking and Jogging of Anterior Cruciate Ligament Deficient Patients.

PLoS One 2017 10;12(1):e0169421. Epub 2017 Jan 10.

Institute of Sports Medicine, Peking University Third Hospital, Beijing, People's Republic of China.

Objective: To evaluate the center of pressure (COP) progression similarity and its change during walking and jogging in Anterior Cruciate Ligament deficient (ACLD) patients.

Methods: A study was performed in 64 unilateral ACLD subjects and 32 healthy volunteers who walked and jogged on footscan® system at a self-selected speed. COP trajectory during walking and jogging was calculated. The robustness and similarity scores of COP (SSCOP, similarity scores with respect to corresponding COP trajectories) were computed, and then the Analysis of Variance test was employed to compare among different conditions (left or right side, within a subject or between subjects, walking or jogging).

Results: (1) During the same motion status (walking or jogging), SSCOP were higher than 0.885. However, SSCOP between walking and jogging were lower than 0.25 in both the healthy and ACLD group. SSCOP between the intrasubjects were statistically higher than those between the intersubjects (p<0.01). (2) SSCOP in the ACLD group were statistically significantly reduced to 0.885±0.074 compared to 0.912±0.057 in healthy volunteers during walking, and 0.903±0.066 in the ACLD group compared to 0.919±0.050 in the healthy group during jogging (p<0.01).

Conclusions: SSCOP can distinguish walking from jogging, and SSCOP of ACLD patients would be different from that of healthy controls. The study protocol was approved by the Institutional Research Board of Peking University Third Hospital (IRB00006761-2012010).
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169421PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224873PMC
August 2017

Anterior cruciate ligament rupture is associated with abnormal and asymmetrical lower limb loading during walking.

J Sci Med Sport 2017 May 30;20(5):432-437. Epub 2016 Sep 30.

Institute of Sports Medicine, Peking University Third Hospital, PR China. Electronic address:

Objectives: Anterior Cruciate Ligament (ACL) deficiency may result in abnormal lower limb loading with increased foot pronation. This study evaluated spatiotemporal parameters and plantar pressure distribution during walking in participants with and without an ACL rupture.

Design: Cross-sectional.

Methods: Plantar pressure was measured in 42 unilateral ACL deficient (ACLD) participants and 32 healthy controls while walking barefoot. Spatiotemporal parameters, pressure distribution and center of pressure (CoP) during foot roll off were determined. Differences in spatiotemporal parameters and pressure distribution were analyzed using a Linear Mixed Model. CoP position was analyzed with one-way ANOVA.

Results: ACLD participants had a longer contact time and earlier forefoot contact compared to controls. The ACLD side showed a shorter contact time and a faster roll off toward the forefoot compared to the ACL intact side. Compared to controls, ACLD participants had increased pressure under the medioproximal side of the midfoot. Within ACLD participants, the ACLD side had decreased pressure under the heel and increased pressure under the forefoot. Foot pronation was not different between groups or within ACLD participants. CoP of the ACLD participants was significantly more toward the toes during initial contact and toward the heel during foot flat.

Conclusions: Changes in lower limb loading during barefoot walking in ACLD participants are due to changes in roll off pattern, most likely in order to reduce anterior shear forces on the knee. Dynamic plantar pressure measurements may assist in evaluating and guiding interventions aimed at normalizing lower limb and knee biomechanics in ACL deficiency.
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http://dx.doi.org/10.1016/j.jsams.2016.09.010DOI Listing
May 2017

Transcriptome comparison of global distinctive features between pollination and parthenocarpic fruit set reveals transcriptional phytohormone cross-talk in cucumber (Cucumis sativus L.).

Plant Cell Physiol 2014 Jul 14;55(7):1325-42. Epub 2014 Apr 14.

State Key Laboratory of Crop Genetics and Germplasm Enhancement, Nanjing Agricultural University, Nanjing 210095, China

Parthenocarpy is an important trait determining yield and quality of fruit crops. However, the understanding of the mechanisms underlying parthenocarpy induction is limited. Cucumber (Cucumis sativus L.) is abundant in parthenocarpic germplasm resources and is an excellent model organism for parthenocarpy studies. In this study, the transcriptome of cucumber fruits was studied using RNA sequencing (RNA-Seq). Differentially expressed genes (DEGs) of set fruits were compared against aborted fruits. Distinctive features of parthenocarpic and pollinated fruits were revealed by combining the analysis of the transcriptome together with cytomorphological and physiological analysis. Cell division and the transcription of cell division genes were found to be more active in parthenocarpic fruit. The study also indicated that parthenocarpic fruit set is a high sugar-consuming process which is achieved via enhanced carbohydrate degradation through transcription of genes that lead to the breakdown of carbohydrates. Furthermore, the evidence provided by this work supports a hypothesis that parthenocarpic fruit set is induced by mimicking the processes of pollination/fertilization at the transcriptional level, i.e. by performing the same transcriptional patterns of genes inducing pollination and gametophyte development as in pollinated fruit. Based on the RNA-Seq and ovary transient expression results, 14 genes were predicted as putative parthenocarpic genes. The transcription analysis of these candidate genes revealed auxin, cytokinin and gibberellin cross-talk at the transcriptional level during parthenocarpic fruit set.
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http://dx.doi.org/10.1093/pcp/pcu051DOI Listing
July 2014

Repair of articular cartilage defects in the knee with autologous iliac crest cartilage in a rabbit model.

Knee Surg Sports Traumatol Arthrosc 2015 Apr 27;23(4):1119-27. Epub 2014 Feb 27.

Institute of Sports Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China.

Purpose: To demonstrate that iliac crest cartilage may be used to repair articular cartilage defects in the knees of rabbits.

Methods: Full-thickness cartilage defects were created in the medial femoral condyle on both knees of 36 New Zealand white rabbits. The 72 defects were randomly assigned to be repaired with ipsilateral iliac crest cartilage (Group I), osteochondral tissues removed at defect creation (Group II), or no treatment (negative control, Group III). Animals were killed at 6, 12, and 24 weeks post-operatively. The repaired tissues were harvested for magnetic resonance imaging (MRI), histological studies (haematoxylin and eosin and immunohistochemical staining), and mechanical testing.

Results: At 6 weeks, the iliac crest cartilage graft was not yet well integrated with the surrounding articular cartilage, but at 12 weeks, the graft deep zone had partial ossification. By 24 weeks, the hyaline cartilage-like tissue was completely integrated with the surrounding articular cartilage. Osteochondral autografts showed more rapid healing than Group I at 6 weeks and complete healing at 12 weeks. Untreated defects were concave or partly filled with fibrous tissue throughout the study. MRI showed that Group I had slower integration with surrounding normal cartilage compared with Group II. The mechanical properties of Group I were significantly lower than those of Group II at 12 weeks, but this difference was not significant at 24 weeks.

Conclusion: Iliac crest cartilage autografts were able to repair knee cartilage defects with hyaline cartilage and showed comparable results with osteochondral autografts in the rabbit model.
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http://dx.doi.org/10.1007/s00167-014-2906-8DOI Listing
April 2015

Treatment of large cystic medial osteochondral lesions of the talus with autologous osteoperiosteal cylinder grafts.

Arthroscopy 2013 Aug;29(8):1372-9

Institute of Sports Medicine, Beijing, China.

Purpose: To investigate the clinical, radiologic, and second-look arthroscopic outcomes of autologous iliac crest osteoperiosteal cylinder graft transplantation for medial osteochondral lesions of the talus (OLTs) with large subchondral cysts.

Methods: Between January 2008 and December 2010, 17 consecutive cases of medial OLT with a subchondral cyst larger than 10 mm in diameter received transplantation of autologous osteoperiosteal cylinder graft, which was harvested from the ipsilateral iliac crest. The visual analog scale score for pain during daily activities, American Orthopaedic Foot & Ankle Society hindfoot and ankle scores, and subjective satisfaction survey rating were obtained. Plain radiographs and magnetic resonance imaging of the ankle were obtained before and after surgery. In 13 cases second-look arthroscopy was performed 12 months postoperatively and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society.

Results: Sixteen patients were available for follow-up at a mean of 32.6 months (range, 24 to 48 months). The mean visual analog scale score decreased from 5.51 ± 0.83 preoperatively to 0.98 ± 0.98 at the latest follow-up, and the median American Orthopaedic Foot & Ankle Society score improved from 75 preoperatively to 90 at the latest follow-up. Seven patients resumed sporting activities. Overall, 7 patients rated the result as excellent, 8 as good, and 1 as fair. The radiolucent area of the cysts disappeared on the plain radiographs in all cases. The mean Magnetic Resonance Observation of Cartilage Repair Tissue score was 60 ± 9.4 points, whereas subchondral bone edema persisted on the postoperative magnetic resonance images in 16 cases. The mean International Cartilage Repair Society arthroscopic score for cartilage repair at second-look arthroscopy was 9 ± 1.4 points.

Conclusions: Autologous iliac crest osteoperiosteal cylinder graft transplantation with supplemental bone grafting is a simple, safe, and effective procedure for treatment of large cystic medial OLT. It can successfully fill the subchondral cyst and repair the cartilage defect.

Level Of Evidence: Level IV, therapeutic case series.
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http://dx.doi.org/10.1016/j.arthro.2013.05.014DOI Listing
August 2013
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