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Yang J, He J, Yang L. Advanced glycation end products impair the repair of injured tendon: a study in rats. BMC Musculoskelet Disord 2024; 25:700. [PMID: 39227794 PMCID: PMC11370031 DOI: 10.1186/s12891-024-07760-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/05/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND The AGEs levels in tissues of diabetics and elderly tend to be higher than in normal individuals. This study aims to determine the effects of AGEs on Achilles tendon repair. MATERIALS AND METHODS Thirty-six male eight-week-old Sprague Dawley rats were selected in this study. The rats were randomly divided into two experimental groups and a control group after the transection of the Achilles tendon. During the tendon repair, the experimental groups were injected around the Achilles tendon with 350mmol/L (low dose group) and 1000mmol/L (high dose group) D-ribose 0.2 ml respectively to increase the AGEs level, while in the control group were given the same amount of PBS. The injections were given twice a week for six weeks. Collagen-I, TNF-α, and IL-6 expression in the healed Achilles tendon was assessed. Additionally, macroscopic, pathological, and biomechanical evaluations of Achilles tendon repair were conducted. RESULTS The repaired Achilles tendons in the high dose group showed severe swelling and distinctive adhesions. The histological score went up with the increase of the AGEs in the Achilles tendon (p<0.001). TNF- α and IL-6 in the Achilles tendon increased (p<0.001, p<0.001), and the production of collagen-I decreased with the accumulation of AGEs in the repaired Achilles tendon (p<0.001). The tensile strength of Achilles tendon in the high dose group was impaired significantly. CONCLUSION In current study, the compromised tendon repair model induced by AGEs was successfully established in rat. The study demonstrated that AGEs significantly impair Achilles tendon repair.
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Affiliation(s)
- Juan Yang
- Department of Geriatrics, Shanghai Fourth People's Hospital Affiliated to Tongji University, No.1279 Sanmen Road, Shanghai, 200434, China
| | - Jirui He
- The Second Clinical Medical College, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, China.
| | - Ling Yang
- Department of Geriatrics, Shanghai Fourth People's Hospital Affiliated to Tongji University, No.1279 Sanmen Road, Shanghai, 200434, China.
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Finger LE, Hamaker MC, Singh-Varma A, Goitz RJ, Kaufmann RA, Fowler JR. Comparison of Fusion Rates/Complications Between Different Types of Thumb Metacarpophalangeal Fusion Techniques. Hand (N Y) 2024:15589447241235343. [PMID: 38516828 DOI: 10.1177/15589447241235343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Thumb metacarpophalangeal (MP) fusion is generally successful; however, complications have been reported to occur in 0% to 30% of cases, whereas nonunion rates vary by method but, overall, are reported to occur in 0% to 15% of cases. Many fixation techniques have been described, but there is no consensus on the optimal fusion technique. Our goal was to compare complication and union rates of different thumb MP arthrodesis techniques. METHODS We performed a retrospective review of patients who underwent primary thumb MP fusion between 2000 and 2022. Patients who underwent revision fusion, fusion for infection, or amputation were excluded. Fusions of MP joints of other fingers were also excluded. Data collection consisted of demographic data, complications, time to fusion, rate of delayed union and rate of nonunion. Five different fusion constructs were evaluated during our study period: staples, Kirschner wires (K-wires), cerclage, K-wires with cerclage, and intramedullary screw. RESULTS Forty-seven patients underwent fusion with staples, 16 with K-wires, 14 with cerclage, 9 with K-wires and cerclage, and 6 with an intramedullary screw. The individual complication and nonunion rates differed significantly among the groups with the intramedullary screw group having a statistically higher rate of nonunion (P = .004). Furthermore, smoking, diabetes, and being overweight were associated with nonunions. CONCLUSION Union rates were significantly lower in patients treated with an intramedullary screw and those who are smokers, diabetics, and/or overweight. Caution should be exercised when using intramedullary screw fixation for MP fusion, especially in patients with these comorbidities.
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Affiliation(s)
- Logan E Finger
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - Max C Hamaker
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - Anya Singh-Varma
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - Robert J Goitz
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - Robert A Kaufmann
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
| | - John R Fowler
- Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA
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Qiao Y, Yu L, Yang P, Chen M, Sun H, Wang L, Wu B, Oh C, Yang H, Bai J, Geng D. Spatiotemporal Immunomodulation and Biphasic Osteo-Vascular Aligned Electrospun Membrane for Diabetic Periosteum Regeneration. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302874. [PMID: 37973554 PMCID: PMC10754081 DOI: 10.1002/advs.202302874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Indexed: 11/19/2023]
Abstract
Under diabetic conditions, blood glucose fluctuations and exacerbated immunopathological inflammatory environments pose significant challenges to periosteal regenerative repair strategies. Responsive immune regulation in damaged tissues is critical for the immune microenvironment, osteogenesis, and angiogenesis stabilization. Considering the high-glucose microenvironment of such acute injury sites, a functional glucose-responsive immunomodulation-assisted periosteal regeneration composite material-PLA(Polylactic Acid)/COLI(Collagen I)/Lipo(Liposome)-APY29 (PCLA)-is constructed. Aside from stimulating osteogenic differentiation, owing to the presence of surface self-assembled type I collagen in the scaffolds, PCLA can directly respond to focal area high-glucose microenvironments. The PCLA scaffolds trigger the release of APY29-loaded liposomes, shifting the macrophages toward the M2 phenotype, inhibiting the release of inflammatory cytokines, improving the bone immune microenvironment, and promoting osteogenic differentiation and angiogenesis. Bioinformatics analyses show that PCLA enhances bone repair by inhibiting the inflammatory signal pathway regulating the polarization direction and promoting osteogenic and angiogenic gene expression. In the calvarial periosteal defect model of diabetic rats, PCLA scaffolds induce M2 macrophage polarization and improve the inflammatory microenvironment, significantly accelerating periosteal repair. Overall, the PCLA scaffold material regulates immunity in fluctuating high-glucose inflammatory microenvironments, achieves relatively stable and favorable osteogenic microenvironments, and facilitates the effective design of functionalized biomaterials for bone regeneration therapy in patients with diabetes.
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Affiliation(s)
- Yusen Qiao
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
- Department of Orthopedic SurgeryRush University Medical CenterChicagoIL60612USA
| | - Lei Yu
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Peng Yang
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Miao Chen
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Haifu Sun
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Lingjie Wang
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Bangzhao Wu
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Chun‐do Oh
- Department of Orthopedic SurgeryRush University Medical CenterChicagoIL60612USA
| | - Huilin Yang
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
| | - Jiaxiang Bai
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
- Department of Orthopedics, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei230022China
- National Center for Translational Medicine (Shanghai) SHU BranchShanghai UniversityShanghaiChina
| | - Dechun Geng
- Department of OrthopedicsThe First Affiliated Hospital of Soochow University188 Shizi RoadSuzhouJiangsu215006China
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Wu B, Fu Z, Wang X, Zhou P, Yang Q, Jiang Y, Zhu D. A narrative review of diabetic bone disease: Characteristics, pathogenesis, and treatment. Front Endocrinol (Lausanne) 2022; 13:1052592. [PMID: 36589835 PMCID: PMC9794857 DOI: 10.3389/fendo.2022.1052592] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Recently, the increasing prevalence of diabetes mellitus has made it a major chronic illness which poses a substantial threat to human health. The prevalence of osteoporosis among patients with diabetes mellitus has grown considerably. Diabetic bone disease is a secondary osteoporosis induced by diabetes mellitus. Patients with diabetic bone disease exhibit variable degrees of bone loss, low bone mineral density, bone microarchitecture degradation, and increased bone fragility with continued diabetes mellitus, increasing their risk of fracture and impairing their ability to heal after fractures. At present, there is extensive research interest in diabetic bone disease and many significant outcomes have been reported. However, there are no comprehensive review is reported. This review elaborates on diabetic bone disease in the aspects of characteristics, pathogenesis, and treatment.
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Affiliation(s)
| | | | | | | | | | | | - Dong Zhu
- Department of Orthopaedic Trauma, Center of Orthopaedics and Traumatology, The First Hospital of Jilin University, Changchun, China
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Pan J, Gao Y, Li J, Fan J, Yang T, Yang Z, Shuang J, Luo Z, Pan Z, Yuan Z. Autogenous bone-guided induced membrane technique in closed/small-sized open high-energy fractures in benign inflammatory environment: a case series. INTERNATIONAL ORTHOPAEDICS 2022; 46:2727-2734. [PMID: 36197460 DOI: 10.1007/s00264-022-05595-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Infection and nonunion are the two most challenging issues for high-energy fractures. This study aimed to explore the clinical effect of benign inflammation-cultivated bone growth activity in the treatment of closed/small-sized open and high-energy fractures. METHODS This study is a case series of closed/small-sized open and high-energy fractures of the lower limbs treated at our hospital from April 2009 to February 2017. All patients underwent debridement and external fixation in the early stage, followed by internal fixation in the second stage. After the operation, fracture healing was monitored by X-ray, and early-stage knee function training was initiated. Also, bone grafting was performed to stimulate the healing reaction, eliminating the atrophic nonunion factors. RESULTS The operation in all 75 cases was carried out after the inflammatory responses completely subsided, leading to secondary wound healing. Bony union appeared in 71 patients who did not suffer from any pain and could stand up and walk without any restriction. Among them, 68 patients could flex their knee > 100°, and three patients had knee flexion ranging from 80 to 100°. No infections occurred after the second operation. CONCLUSION This two-stage treatment for high-energy fractures could avoid the damage caused by excessive inflammatory responses that occurred following early-stage one-time internal fixation. This method protected benign inflammatory-callus reactions induced by the primary injury and utilized the advantages of closed reduction in AO fixation with open reduction, thereby avoiding potential infection and nonunion caused by one-time fixation during the early stage.
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Affiliation(s)
- Jingxin Pan
- Air Force Military Medical University, Xi'an, 710032, Shaanxi, China.
| | | | - Jing Li
- Air Force Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Junjun Fan
- Air Force Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Tao Yang
- Yulin Fourth Hospital of Shanxi Province, Yulin, China
| | - Zhenbang Yang
- Yulin First Hospital of Shanxi Province, Yulin, China
| | - Jiang Shuang
- Yulin First Hospital of Shanxi Province, Yulin, China
| | - Zhuojing Luo
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Zhijun Pan
- Yulin Fourth Hospital of Shanxi Province, Yulin, China.
| | - Zhi Yuan
- Air Force Military Medical University, Xi'an, 710032, Shaanxi, China
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Guo S, Dai X, Chen X, Zhao G, Xue Y, Zhang C, Liu J, Ouyang X, Li Z, Shi Y, Yao Q, Han L, Li B, Zhao B. Effect of transcutaneous electrical acupoint stimulation on bone loss for patients with foot and ankle fracture: a pragmatic randomized controlled trial. Am J Transl Res 2022; 14:8191-8203. [PMID: 36505292 PMCID: PMC9730072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim for this trial was to preliminarily evaluate the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for bone loss in patients with immobilization after surgical fixation of ankle and foot fractures. METHODS A total of 80 patients with immobilization after surgical fixation of ankle and foot fractures were randomly divided into an intervention group (n=40) or control group (n=40). The intervention group was given TEAS treatment combined with routine orthopedic treatment, and the control group was given only routine orthopedic treatment. The CT attenuation values, bone turnover markers (ALP, PINP, BGP, CTX, Ca/Cr), bone mineral density (BMD), blood phosphorus, and blood calcium were observed and compared between the two groups at 8 weeks. This was a prospective study. The protocol was registered in the Chinese clinical trial registry (No. ChiCTR2000039944). RESULTS The CT attenuation values of the intervention group decreased more than those of the control group (P<0.05), however the between group differences in ALP, BGP, Ca/Cr, CTX and BMD (all P>0.05) were not statistically significant. Three mild adverse events were recorded. CONCLUSION TEAS treatment may confer additional benefits for bone loss in patients with immobilization after surgical fixation of ankle and foot fractures. Since this was a pilot study, the efficacy of TEAS requires further evaluation through full-scale randomized controlled trials.
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Affiliation(s)
- Shiqi Guo
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Xiaoqian Dai
- China Astronaut Research and Training CenterBeijing 100094, China
| | - Xueming Chen
- Beijing Luhe Hospital, Capital Medical UniversityBeijing 100069, China
| | - Guozhen Zhao
- Evidence-based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityBeijing 100069, China
| | - Ying Xue
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Chunhui Zhang
- Beijing Luhe Hospital, Capital Medical UniversityBeijing 100069, China
| | - Jinyi Liu
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Xiali Ouyang
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Zhili Li
- China Astronaut Research and Training CenterBeijing 100094, China
| | - Yuqing Shi
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Qin Yao
- Department of School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese MedicineBeijing 100700, China
| | - Li Han
- Department of School of Traditional Chinese Medicine, Beijing University of Chinese MedicineBeijing 100700, China
| | - Bo Li
- Evidence-based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityBeijing 100069, China
| | - Baixiao Zhao
- Department of Dongzhimen Hospital, Beijing University of Chinese MedicineBeijing 100700, China
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Wu L, Su C, Yang C, Liu J, Ye Y. TBX3 regulates the transcription of VEGFA to promote osteoblasts proliferation and microvascular regeneration. PeerJ 2022; 10:e13722. [PMID: 35846885 PMCID: PMC9281600 DOI: 10.7717/peerj.13722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/22/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Osteochondral decellularization can promote local vascular regeneration, but the exact mechanism is unknown. The aim of this study is to study osteogenic microvascular regeneration in single cells. Methods The scRNA-seq dataset of human periosteal-derived cells (hPDCs) were analyzed by pySCENIC. To examine the role of TBX3 in osteogenesis and vascularization, cell transfection, qRT-PCR, western blot, and CCK-8 cell proliferation assays were performed. Results TCF7L2, TBX3, FLI1, NFKB2, and EZH2 were found to be transcription factors (TFs) most closely associated with corresponding cells. The regulatory network of these TFs was then visualized. Our study knocked down the expression of TBX3 in human osteoblast cell lines. In the TBX3 knockdown group, we observed decreased expression of VEGFA, VEGFB, and VEGFC. Moreover, Western blot analysis showed that downregulating TBX3 resulted in a reduction of VEGFA expression. And TBX3 stimulated osteoblast proliferation in CCK-8 assays. Conclusion TBX3 regulates VEGFA expression and promotes osteoblast proliferation in skeletal microvasculature formation. The findings provide a theoretical basis for investigating the role of TBX3 in promoting local vascular regeneration.
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Affiliation(s)
- Lichuang Wu
- Department of Trauma/Joint Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chenxian Su
- Department of Trauma/Joint Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chuanhua Yang
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Jinxing Liu
- Shanghai ninth people’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiheng Ye
- Department of Trauma/Joint Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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