Regional difference in microRNA regulation in the skull vault

Ap-2β regulates cranial osteogenic potential via the activation of Wnt/β-catenin signaling pathway

The skull is a fundamental bone that protects the development of brain and consists of several bony elements, such as the frontal and parietal bones. Frontal bone exhibited superior in osteogenic potential and regeneration of cranial defects compared to parietal bone. However, how this regional difference is regulated remains largely unknown. In this study, we identified an Ap-2β transcriptional factor with a higher expression in frontal bone, but its molecular function in osteoblasts needs to be elucidated. We found that Ap-2β knockdown in preosteoblasts leads to reduced proliferation, increased cell death and impaired differentiation. Through RNA-seq analysis, we found that Ap-2β influences multiple signaling pathways including the Wnt pathway, and overexpression of Ap-2β showed increased nuclear β-catenin and its target genes expressions in osteoblasts. Pharmacological activation of Wnt/β-catenin signaling using LiCl treatment cannot rescue the reduced luciferase activities of the β-catenin/TCF/LEF reporter in Ap-2β knockdown preosteoblasts. Besides, transient expression of Ap-2β via the lentivirus system could sufficiently rescue the inferior osteogenic potential in parietal osteoblasts, while Ap-2β knockdown in frontal osteoblasts resulted in reduced osteoblast activity, reduced active β-catenin and target genes expressions. Taken together, our data demonstrated that Ap-2β modulates osteoblast proliferation and differentiation through the regulation of Wnt/β-catenin signaling pathway and plays an important role in regulating regional osteogenic potential in frontal and parietal bone.

Observation of the therapeutic effect of auricular bean pressing on early knee osteoarthritis pain: A randomized controlled trial

BACKGROUND

In the treatment of knee osteoarthritis (KOA), there is a need for the long-term use of therapeutic drugs that reduce joint pain and have fewer adverse effects.

OBJECTIVE

This study aimed to investigate the therapeutic effect of bean pressing on ear points on early KOA pain.

METHODS

One hundred patients with KOA recruited at the Wenzhou Hospital of Traditional Chinese Medicine between February 2019 and May 2022 were divided randomly into a treatment group (n= 50) and control group (n= 50). Patients in the treatment group received regular rehabilitation combined with auricular bean-pressing treatment, while patients in the control group only received conventional rehabilitation treatment. The measurement indicators - knee swelling, tenderness, range of motion sign score, C-reactive protein, and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) indexes - were recorded before and after treatment.

RESULTS

On day 5 following the start of treatment, the visual analog scale (VAS) and WOMAC scores of the treatment group were significantly lower than those of the control group (P< 0.05), and the VAS and WOMAC scores in the treatment group after treatment were significantly lower than those before treatment (P< 0.05). At week 4 after the start of treatment, the dosage of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment group was significantly lower than that in the control group (P < 0.05). No adverse events were observed during the treatment.

CONCLUSIONS

Auricular bean-pressing therapy had an analgesic effect and could also alleviate mild to moderate KOA swelling, joint stiffness, and other symptoms, effectively reducing the demand for NSAIDs and improving both knee function and quality of life. The results suggested that auricular bean-pressing therapy has promising prospects in the treatment of early KOA pain.

Clinical manifestation score and characterization of cytokines and lymphocytes of dimethylacetamide-induced toxic hepatitis in spandex workers

Occupational exposure to dimethylacetamide (DMAc) has been reported to cause toxic hepatitis. Sixty spandex workers were included in this study to research the clinical manifestations and expression of cytokines and lymphocytes in DMAc-induced toxic hepatitis. Chinese drugs (reduced glutathione and Hugan tablets) were used to treat them. The manifestations including jaundice, asthenia, appetite, nausea, emesis, abdominal distension, yellow urine, and dizziness were scored. The percentages of patients rated as 0-3, 4-6, 7-9, and 10-12 points were 33.3%, 43.3%, 21.7%, and 1.7%, respectively, before treatment, and all patients showed 0-3 points after the treatment. The ultrasonic and CT imaging revealed diffuse intrahepatic hypodensity, intrahepatic calcification, signs of liver injury, and splenomegaly, which improved after therapy. Blood analysis showed that ALT, AST, TBIL, IL-6, IL-10, TNF-α, IFN-γ, CD3⁺%, and CD4⁺/CD8⁺ statistically decreased after drug treatment. Correlation analysis demonstrated positive linear correlations between ALT and TBIL, AST and TBIL, IL-10 and ATL, IL-10 and AST, IL-10 and TBIL, IFN-γ and IL-6, IFN-γ and TNF-α, and CD3⁺% and ALT. Pro-inflammatory cytokines and lymphocytes in DMAc-induced toxic hepatitis reflected an active immune state that decreased after treatment. IL-10 may inhibit the immune response in this disease, as a protective mechanism.

Auricular acupressure for treating early stage of knee osteoarthritis: a randomized, sham-controlled prospective study

OBJECTIVE

We examined whether auricular acupressure (AA) at four specifically preselected AA points can alleviate knee pain and decrease non-steroidal anti-inflammatory drugs (NSAIDs) consumption and its adverse effects for osteoarthritis patients.

METHODS

Sixty-two patients (more than 40 years) with knee osteoarthritis of Kellgren-Lawrence grades of I or II upon radiographic classification were enrolled in this randomized, sham-controlled prospective study, and divided into two groups (AA group and control group). The AA group received true AA by embedding vaccaria seeds at four specific AA points (knee joint, shenmen, subcortex and sympathesis) ipsilateral to the knee osteoarthritis site, while the control group received four nonacupuncture points on the auricular helix. Visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, the number of patients who needed celecoxib pills and adverse effects were recorded.

RESULTS

VAS and WOMAC scores in the AA group were significantly lower than that in the control group (P < 0.05) at Days 3 and 7 postsugery. The VAS and WOMAC score were significantly decreased after the treatment in the AA group compared with that before the treatment (P < 0.05). The use of celebrex is significantly lower in the AA group than in the control group (P < 0.05), no major side effects were observed during the auricular acupressure treatment.

CONCLUSION

Auricular acupressure plays a role in analgesic effect and can effectively decrease NSAIDs requirements without causing adverse events for the treatment of human knee osteoarthritis.

The efficacy and safety of auricular point pressing therapy for knee osteoarthritis: A protocol for systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of auricular point pressing therapy for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of auricular point pressing therapy for treating KOA.

METHODS

Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched. All randomized controlled trials related to auricular point pressing therapy for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale. Risk of bias will be assessed using the Cochrane Collaboration tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed by 2 independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development.

RESULTS

The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy on KOA.

CONCLUSION

The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy for KOA patients.

ETHICS AND DISSEMINATION

For this review, ethical approval is not required. Patients will not be involved. The findings will be published in a peer-reviewed journal.

INPLASY REGISTRATION NUMBER

INPLASY 202220077.

Effect of the combinative use of acupotomy therapy and ultrasonic drug penetration in treating knee joint osteoarthritis

BACKGROUND/INTRODUCTION

Knee joint osteoarthritis is a chronic disease that affects the health in aging population.

AIM

We explore a minimally invasive surgery combining the use of ultrasonic drug penetration to treat early stage of knee joint osteoarthritis.

DESIGN

In total, 75 patients were participated in acupotomy therapy and ultrasonic drug penetration to treat joint osteoarthritis.

METHODS

The WOMAC (the Western Ontario and McMaster Universities Osteoarthritis Index) scores were used to assess the performance.

RESULTS

There was a significant difference in the WOMAC score between the two groups of patients (P < 0.05). The total performance rate was about 86.4% and 50% in experiment and control groups.

CONCLUSION

The combination of acupotomy therapy and ultrasonic drug penetration has demonstrated to be effective and promising to treat knee joint osteoarthritis.

Shaping modern human skull through epigenetic, transcriptional and post-transcriptional regulation of the RUNX2 master bone gene

RUNX2 encodes the master bone transcription factor driving skeletal development in vertebrates, and playing a specific role in craniofacial and skull morphogenesis. The anatomically modern human (AMH) features sequence changes in the RUNX2 locus compared with archaic hominins' species. We aimed to understand how these changes may have contributed to human skull globularization occurred in recent evolution. We compared in silico AMH and archaic hominins' genomes, and used mesenchymal stromal cells isolated from skull sutures of craniosynostosis patients for in vitro functional assays. We detected 459 and 470 nucleotide changes in noncoding regions of the AMH RUNX2 locus, compared with the Neandertal and Denisovan genomes, respectively. Three nucleotide changes in the proximal promoter were predicted to alter the binding of the zinc finger protein Znf263 and long-distance interactions with other cis-regulatory regions. By surface plasmon resonance, we selected nucleotide substitutions in the 3'UTRs able to affect miRNA binding affinity. Specifically, miR-3150a-3p and miR-6785-5p expression inversely correlated with RUNX2 expression during in vitro osteogenic differentiation. The expression of two long non-coding RNAs, AL096865.1 and RUNX2-AS1, within the same locus, was modulated during in vitro osteogenic differentiation and correlated with the expression of specific RUNX2 isoforms. Our data suggest that RUNX2 may have undergone adaptive phenotypic evolution caused by epigenetic and post-transcriptional regulatory mechanisms, which may explain the delayed suture fusion leading to the present-day globular skull shape.

Use of a Percutaneous Needle Release Technique for Trigger Thumb: A Retrospective Study of 11 Patients from a Single Center

Background

Trigger finger is a very common disorder that occurs in both adults and children. Trigger finger presents mainly as pain and limited movement of the affected digit. This report describes a modified percutaneous needle release and an evaluation of its clinical efficacy to treat trigger thumb.

Material/Methods

Trigger thumb of 11 patients was released percutaneously using a specially designed needle (0.8×100 mm) with a planus tip. Complete release was ensured when no more grating sound was heard and the needle moved freely at the tip. Pain-related functional score was evaluated preoperatively and at 3 months postoperatively. Resolution of Notta’s node, triggered or locked, Quinnell’s criteria, and patient satisfaction were also assessed at 3 months after the operation.

Results

After the percutaneous trigger thumb release, the overall visual analog scale (VAS) and pain-related functional scores declined significantly (P<0.01). There was no recurrence of thumb locking or triggering or Notta’s node. Only the first patient had incomplete release of the first annular pulley, and all patients showed high satisfaction with the procedure at 3 months after their operation. During the study, patients did not experience any complications such as inflammation, edema, or digital nerve injury.

Conclusions

This study demonstrated that the percutaneous technique is effective, less time-consuming, and safe for treating trigger thumb. Our release technique using a specially designed percutaneous needle is a valuable treatment for trigger thumb.

Contribution of miRNAs and lncRNAs in osteogenesis and related disorders

Non-coding RNAs have been found to regulate several developmental processes among them is osteogenesis. Although these transcripts have several distinct classes, two classes i.e. microRNAs and long non-coding RNAs have attained more attention. These transcripts regulate intramembranous as well as endochondral ossification processes. The effects of microRNAs on osteogenesis are mostly mediated through modulation of Wnt/β-catenin and TGFβ/BMP pathways. Long non-coding RNAs can directly affect expression of these pathways or osteogenic transcription factors. Moreover, they can serve as a molecular sponge for miRNAs. MALAT1/miR-30, MALAt1/miR-214, LEF1-AS1/miR-24-3p, MCF2L-AS1/miR-33a, MSC-AS1/miR-140-5p and KCNQ1OT1/miR-214 are examples of such kind of interaction between lncRNAs and miRNAs in the context of osteogenesis. In the current paper, we explain these two classes of non-coding RNAs in the osteogenesis and related disorders.

Performance of Double-Arm Digital Subtraction Angiography (DSA)-Guided and C-Arm-Guided Percutaneous Kyphoplasty (PKP) to Treat Senile Osteoporotic Vertebral Compression Fractures

Background

Osteoporotic vertebral compression fracture (OVCF) is a common fracture in the elderly. Conservative treatment requires prolonged bedding, which may lead to serious complications. To explore optimized use of percutaneous kyphoplasty (PKP) in the treatment of senile osteoporotic thoracolumbar vertebral compression fractures, in this study, we used C-arm-guided and double-arm digital subtraction angiography (DSA)-guided PKP to treat OVCF in elderly patients and analyzed the effective recovery.

Material/Methods

In all, 60 patients who presented with osteoporotic vertebral compression fractures at our hospital between July 2017 and February 2019 were analyzed. They were randomly divided into C-arm-guided group and the double-arm DSA-guided groups. Both groups were treated with percutaneous kyphoplasty.

Results

A pain VAS score analysis revealed that there was no significant difference between the two groups before surgery (P>0.05). After surgery, the VAS scores showed a significant difference between the C-arm-guided group and the double-arm DSA-guided PKP treatment group (P<0.01). Moreover, with respect to the bone cement dosage, vertebral correction height, operation time, cumulative radiation dose, percolation rate, and volume of bone cement, the double-arm DSA-guided PKP treatment showed significantly better results than the C-arm-guided PKP treatment (P<0.01).

Conclusions

Our data revealed that double-arm DSA-guided PKP was more accurate in treatment of senile osteoporotic thoracolumbar vertebral compression fractures, producing excellent performance with more accurate intraoperative evaluation, shorter operative time, lower incidence of bone cement leakage, less intraoperative radiation dose, and higher safety, and thus, could be extensively applied to clinical surgery.

miR-199 family contributes to regulation of sonic hedgehog expression during craniofacial development

BACKGROUND

The frontonasal ectodermal zone (FEZ) is a signaling center that regulates patterned development of the upper jaw, and Sonic hedgehog (SHH) mediates FEZ activity. Induction of SHH expression in the FEZ results from SHH-dependent signals from the brain and neural crest cells. Given the role of miRNAs in modulating gene expression, we investigated the extent to which miRNAs regulate SHH expression and FEZ signaling.

RESULTS

In the FEZ, the miR-199 family appears to be regulated by SHH-dependent signals from the brain; expression of this family increased from HH18 to HH22, and upon activation of SHH signaling in the brain. However, the miR-199 family is more broadly expressed in the mesenchyme of the frontonasal process and adjacent neuroepithelium. Downregulating the miR-199 genes expanded SHH expression in the FEZ, resulting in wider faces, while upregulating miR-199 genes resulted in decreased SHH expression and narrow faces. Hypoxia inducible factor 1 alpha (HIF1A) and mitogen-activated protein kinase kinase kinase 4 (MAP3K4) appear to be potential targets of miR-199b. Reduction of MAP3K4 altered beak development but increased apoptosis, while reducing HIF1A reduced expression of SHH in the FEZ and produced malformations independent of apoptosis.

CONCLUSIONS

Our results demonstrate that this miRNA family appears to participate in regulating SHH expression in the FEZ; however, specific molecular mechanisms remain unknown.

Dimethylacetamide-induced toxic hepatitis in spandex workers: clinical presentation and treatment outcomes

BACKGROUND

Dimethylacetamide (DMAc) exposure has been associated with toxic hepatitis, and no clinical treatment has been reported.

AIM

To investigate the clinical manifestations of DMAc-induced symptoms and how to rescue the functional loss due to occupational exposure.

DESIGN

Clinical observations of 60 spandex factory workers with the exposure to DMAc from January, 2017-19.

METHODS

Chinese drugs (reduced glutathione, polyene phosphatidylcholine, glycyrrhizin compound, Hugan tablets and ornithine aspartate) were used to evaluate the therapeutic improvements in DMAc-exposed patients.

RESULTS

Our data found that 58.3% patients had no distinct clinical symptoms, but 41.7% patients felt fatigue, and 21.7% patients suffered abdominal discomfort and appetite loss, and 8.3% patients had yellow skin and sclera. The ultrasonic and CT imaging revealed that some patients have fatty livers, intrahepatic calcifications, hepatomegaly, gallbladder wall edema and abdominal effusions. Biochemical analysis showed that the alanine aminotransferase (ALT) (P < 0.001), aspartate aminotransferase (AST) (P < 0.001), lactate dehydrogenase (LDH) (P < 0.001) and bilirubin (P < 0.01) statistically decreased after the drug treatment, but alkaline phosphatase (P >0.05) and glutamyl transpeptidase (P> 0.05) did not decrease. Twenty-nine out of the thirty-one patients' abnormal blood ammonia recovered. The risk factor of ALT on hospitalization time was significantly related (P < 0.01).

CONCLUSIONS

The drugs above are sufficient to rescue functional loss in DMAc-induced toxic hepatitis, in part via the regulations of ALT, AST, LDH, bilirubin and ammonia. Workers with the exposure to DMAc should receive specific drugs to maintain the health and prevent functional loss in the long term.

BMP Signaling in the Development and Regeneration of Cranium Bones and Maintenance of Calvarial Stem Cells

The bone morphogenetic protein (BMP) signaling pathway is highly conserved across many species, and its importance for the patterning of the skeletal system has been demonstrated. A disrupted BMP signaling pathway results in severe skeletal defects. Murine calvaria has been identified to have dual-tissue lineages, namely, the cranial neural-crest cells and the paraxial mesoderm. Modulations of the BMP signaling pathway have been demonstrated to be significant in determining calvarial osteogenic potentials and ossification in vitro and in vivo. More importantly, the BMP signaling pathway plays a role in the maintenance of the homeostasis of the calvarial stem cells, indicating a potential clinic significance in calvarial bone and in expediting regeneration. Following the inherent evidence of BMP signaling in craniofacial biology, we summarize recent discoveries relating to BMP signaling in the development of calvarial structures, functions of the suture stem cells and their niche and regeneration. This review will not only provide a better understanding of BMP signaling in cranial biology, but also exhibit the molecular targets of BMP signaling that possess clinical potential for tissue regeneration.