Flat panel detector-based cone-beam volume CT angiography imaging: system evaluation

Preliminary evaluation of recently developed large-area flat panel detectors (FPDs) indicates that FPDs have some potential advantages: compactness, absence of geometric distortion and veiling glare with the benefits of high resolution, high detective quantum efficiency (DQE), high frame rate and high dynamic range, small image lag (< 1%), and excellent linearity (approximately 1%). The advantages of the new FPD make it a promising candidate for cone-beam volume computed tomography (CT) angiography (CBVCTA) imaging. The purpose of this study is to characterize a prototype FPD-based imaging system for CBVCTA applications. A prototype FPD-based CBVCTA imaging system has been designed and constructed around a modified GE 8800 CT scanner. This system is evaluated for a CBVCTA imaging task in the head and neck using four phantoms and a frozen rat. The system is first characterized in terms of linearity and dynamic range of the detector. Then, the optimal selection of kVps for CBVCTA is determined and the effect of image lag and scatter on the image quality of the CBVCTA system is evaluated. Next, low-contrast resolution and high-contrast spatial resolution are measured. Finally, the example reconstruction images of a frozen rat are presented. The results indicate that the FPD-based CBVCT can achieve 2.75-lp/mm spatial resolution at 0% modulation transfer function (MTF) and provide more than enough low-contrast resolution for intravenous CBVCTA imaging in the head and neck with clinically acceptable entrance exposure level. The results also suggest that to use an FPD for large cone-angle applications, such as body angiography, further investigations are required.

MR volumetric analysis of the human basal ganglia: normative data

RATIONALE AND OBJECTIVES

The authors undertook this study to identify a precise, semiautomated, reproducible magnetic resonance (MR) imaging technique for measuring the basal ganglia, to establish normative volumetric data, and to verify the presence of previously reported asymmetries.

MATERIALS AND METHODS

Twenty-eight healthy adults underwent cranial MR examination. The volumes of the various components of the basal ganglia were measured by means of a combination of thresholding and manual tracing techniques performed with specialized software. The validity of these measurements was assessed by fashioning, imaging, and measuring a practical basal ganglia phantom. Measurement accuracy was also established by means of inter- and intrarater reliability indexes. Normalized volumes were statistically analyzed with analysis of variance and paired t tests.

RESULTS

The absolute values of the various components of the basal ganglia varied widely even though the volumes were normalized to differences in intracranial volume. The right caudate nucleus volume was significantly (P < .000001) larger than the left in both men and women and in both right-handed and non-right-handed subjects. This asymmetry led to an increase in the overall volume of the basal ganglia on the right.

CONCLUSION

The authors have defined a precise, reproducible technique for measuring various components of the basal ganglia and have established normative data. The basal ganglia, similar to other brain structures, exhibit hemispheric lateralization.

Cone beam volume CT image artifacts caused by defective cells in x-ray flat panel imagers and the artifact removal using a wavelet-analysis-based algorithm

The application of x-ray flat panel imagers (FPIs) in cone beam volume CT (CBVCT) has attracted increasing attention. However, due to a deficient semiconductor array manufacturing process, defective cells unavoidably exist in x-ray FPIs. These defective cells cause their corresponding image pixels in a projection image to behave abnormally in signal gray level, and result in severe streak and ring artifacts in a CBVCT image reconstructed from the projection images. Since a three-dimensional (3-D) back-projection is involved in CBVCT, the formation of the streak and ring artifacts is different from that in the two-dimensional (2-D) fan beam CT. In this paper, a geometric analysis of the abnormality propagation in the 3D back-projection is presented, and the morphology of the streak and ring artifacts caused by the abnormality propagation is investigated through both computer simulation and phantom studies. In order to calibrate those artifacts, a 2D wavelet-analysis-based statistical approach to correct the abnormal pixels is proposed. The approach consists of three steps: (1) the location-invariant defective cells in an x-ray FPI are recognized by applying 2-D wavelet analysis on flat-field images, and a comprehensive defective cell template is acquired; (2) based upon the template, the abnormal signal gray level of the projection image pixels corresponding to the location-invariant defective cells is replaced with the interpolation of that of their normal neighbor pixels; (3) that corresponding to the isolated location-variant defective cells are corrected using a narrow-windowed median filter. The CBVCT images of a CT low-contrast phantom are employed to evaluate this proposed approach, showing that the streak and ring artifacts can be reliably eliminated. The novelty and merit of the approach are the incorporation of the wavelet analysis whose intrinsic multi-resolution analysis and localizability make the recognition algorithm robust under variable x-ray exposure levels between 30% and 70% of the dynamic range of an x-ray FPI.

Diosmetin inhibits cell proliferation and promotes apoptosis through STAT3/c-Myc signaling pathway in human osteosarcoma cells

BACKGROUND

Diosmetin is a bioflavonoid compound naturally abundant in citrus fruits. It is found to perform a variety of activities, while its antitumor property in osteosarcoma, a malignant tumor with unmet clinical treatment, remained unknown.

METHODS

Colony formation assay, cell cycle analysis and apoptosis analysis were conducted respectively to observe the effect of diosmetin on cell proliferation and apoptosis in human osteosarcoma cells. Western blot and immunoprecipitation were used to detect the expression of apoptotic molecules and activation of STAT3/c-Myc pathway in Saos-2 and U2SO cells.

RESULTS

Diosmetin significantly inhibited cell proliferation, induced cell cycle arrest at G2/M phase and promoted cell apoptosis in both Saos-2 and U2SO cells. Moreover, Diosmetin downregulated the expression of anti-apoptotic protein Bcl-xL while upregulated the levels of pro-apoptotic proteins including cleaved Caspase-3, cleaved-PARP and Bax. Furthermore, diosmetin dose-dependently inhibited STAT3 phosphorylation, reduced the expression of its downstream protein c-Myc and impeded the interaction between STAT3 molecules.

CONCLUSIONS

These results suggest that diosmetin exerts anti-osteosarcoma effects by suppressing cell proliferation and inducing apoptosis via inhibiting the activation of STAT3/c-Myc signaling pathway, which provide the possibility for diosmetin to be a chemotherapeutic candidate for osteosarcoma.

A cone beam filtered backprojection (CB-FBP) reconstruction algorithm for a circle-plus-two-arc orbit

The circle-plus-arc orbit possesses advantages over other "circle-plus" orbits for the application of x-ray cone beam (CB) volume CT in image-guided interventional procedures requiring intraoperative imaging, in which movement of the patient table is to be avoided. A CB circle-plus-two-arc orbit satisfying the data sufficiency condition and a filtered backprojection (FBP) algorithm to reconstruct longitudinally unbounded objects is presented here. In the circle suborbit, the algorithm employs Feldkamp's formula and another FBP implementation. In the arc suborbits, an FBP solution is obtained originating from Grangeat's formula, and the reconstruction computation is significantly reduced using a window function to exclude redundancy in Radon domain. The performance of the algorithm has been thoroughly evaluated through computer-simulated phantoms and preliminarily evaluated through experimental data, revealing that the algorithm can regionally reconstruct longitudinally unbounded objects exactly and efficiently, is insensitive to the variation of the angle sampling interval along the arc suborbits, and is robust over practical x-ray quantum noise. The algorithm's merits include: only 1D filtering is implemented even in a 3D reconstruction, only separable 2D interpolation is required to accomplish the CB backprojection, and the algorithm structure is appropriate for parallel computation.

Computer simulation of image intensifier-based computed tomography detector: vascular application

This present study reports the results of a computer simulation whose aim was to predict the low-contrast imaging performance of which a conventional x-ray image intensifier with charge coupled device (CCD) camera would be capable if incorporated into a computed tomography (CT) volume imager. A vascular imaging task was modeled in our simulation. The effects of detector noise, x-ray exposure levels, analog-to-digital conversion (ADC) precision and residual levels of detected x-ray scatter were considered. The results of this simulation indicate that the low-contrast imaging performance of an image intensifier-based CT system was most limited by the CCD detector readout noise. Given this limitation the detection of greater than about 100,000 detected photons/pixel/projection gave marginal improvement in low-contrast resolution. At these exposures 12 bit ADC precision resulted in little additional image noise. The effects of detecting scattered x rays are twofold; decreasing the signal-to-noise ratio associated with our modeled artery and introducing a cupping artifact. Based on the results from the simulation, it appears that an image intensifier-based CT system is a feasible concept from a noise viewpoint, if the anticipated imaging task is intravenous angiography.

Combination treatment of stroke with sub-therapeutic doses of Simvastatin and human umbilical cord blood cells enhances vascular remodeling and improves functional outcome

Human umbilical cord blood cells (HUCBCs) have been employed as a restorative treatment for experimental stroke. In this study, we investigated whether transplantation of sub-therapeutic doses of HUCBCs and Simvastatin enhances cerebral vascular remodeling after stroke. Adult male Wistar rats (n=34) were subjected to transient middle cerebral artery occlusion (MCAo) and treated with: phosphate-buffered solution (PBS, gavaged daily for 7 days); Simvastatin (0.5mg/kg, gavaged daily for 7 days); HUCBCs (1×10(6), injected once via tail vein); and combination Simvasatin with HUCBCs, starting at 24h after MCAo. There was no significant difference between Simvastatin- or HUCBC-monotherapy and MCAo-alone group. Combination treatment 24h post-stroke significantly increased the perimeter of von Willebrand factor (vWF)-positive vessels, the diameter and density of alpha smooth muscle actin (αSMA)-positive arteries, and the percentage of 5-bromodeoxyuridine (BrdU)-positive endothelial cells (ECs) in the ischemic boundary zone (IBZ) compared with MCAo-alone or HUCBC-monotherapy 14 days after MCAo (p<0.05, n=8/group); Combination treatment significantly increased the densities of vWF-vessels and αSMA-arteries as well as the densities of BrdU-ECs and BrdU-positive smooth muscle cells (SMCs) in vascular walls in the IBZ compared with Simvastatin-monotherapy. Moreover, the increased BrdU-ECs and BrdU-SMCs were significantly correlated with neurological functional outcome 14 days after MCAo. Combination treatment also significantly increased the expression of Angiopoietin-1 (Ang1), Tie2 and Occludin in the IBZ (p<0.05, n=8/group). The in vitro experiments showed that combination treatment and Ang1 significantly increased capillary-like tube formation and arterial cell migration; anti-Ang1 significantly reduced combination treatment-induced tube-formation and artery cell migration (p<0.05, n=6/group). These findings indicated that a combination of sub-therapeutic doses of Simvastatin and HUCBCs treatment of stroke increases Ang1/Tie2 and Occludin expression in the ischemic brain, amplifies endogenous angiogenesis and arteriogenesis, and enhances vascular remodeling which in concert may contribute to functional outcome after stroke.

Image intensifier-based computed tomography volume scanner for angiography

RATIONALE AND OBJECTIVES

A prototype volume computed tomography (CT) system for use in angiography was designed, constructed, and tested. The system consisted of a fixed X-ray tube, a conventional image intensifier (II) coupled to a charge-coupled device camera, and a computer-controlled turntable on which phantoms were placed. We wanted to predict, through phantom studies, the imaging performance of an II-based volume CT for direct three-dimensional (3D) reconstruction of vascular structures.

METHODS

To explore the imaging performance of the system for reconstructing a vascular structure, two sets of projection images of a vascular phantom, acquired over 250 projection angles with two different-sized IIs, were digitized and used for a direct 3D conebeam reconstruction. The signal-to-noise ratio (SNR) of each reconstructed image was measured. From these measurements, image quality was accessed as a function of the number of reconstructions averaged and the different orientations. The spatial resolution limits of the system were measured from the 3D reconstructed images of a specially designed resolution phantom for different orientations and locations.

RESULTS

The measured SNRs of all direct 3D reconstruction images were reasonably good, and back-ground noise levels measured from 3D reconstruction images were almost 30 Hounsfield units. The measured spatial resolution of the system was 0.5 line pairs per millimeter. However, spatial resolution was reduced around the edge of the II to nearly half that measured in the central area of the field of view.

CONCLUSION

An II-based volume CT scanner can produce direct 3D reconstructions of vascular structures with good image quality for intraarterial angiography.

A comparison of lateral fixation versus dual plating for simple bicondylar fractures

BACKGROUND

The best fixation method for bicondylar tibial plateau fracture is debated. The aim of this study was to compare the effect of a lateral locking plate with that of dual plates in the treatment of tibial plateau fracture with a relatively intact medial condyle fragment.

METHODS

Eighty-six patients diagnosed with a bicondylar tibial plateau fracture with a relatively intact medial condyle were assigned to groups treated with either dual buttress plates (DP group) or a lateral locking plate (LP group). Preoperative characteristics, surgical details, and postoperative complications were recorded and compared between groups. Hospital for Special Surgery Knee Scoring System score was used to evaluate clinical outcome.

RESULTS

Both groups displayed satisfactory clinical and radiographic results. There were no significant differences in associated preoperative conditions between the DP and LP groups. Durations of hospital stay and operation were significantly shorter, and blood loss significantly less, in the LP group than in the DP group (P=0.045;0.038;0.031). The rate of delayed-union was significantly lower in the LP group than in the DP group (P=0.023).

CONCLUSION

Both dual-plate and lateral locking-plate fixation can provide satisfactory treatment of bicondylar tibial plateau fractures if properly used. When the medial tibial condyle is relatively intact, a lateral locking plate can provide stability similar to that of dual plate while decreasing operative duration and soft-tissue complications, which can assist fracture healing and shorten hospital stay.

LEVEL OF EVIDENCE

I - Randomized controlled trial.

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Background

Deep vein thrombosis (DVT) of lower limb is one of the common complications after total hip arthroplasty(THA), we aimed to evaluate the potential risk factors of DVT of lower limb in patients with THA, to provide insights into the management of THA.

Methods

Patients who underwent THA in our hospital from January 1, 2017 to November 30, 2020 were included. The personal characteristics and clinical data of DVT and no-DVT patients were compared and analyzed. Logistic regression analyses were perfomed to identify the potential risk factors of DVT in patients with THA.

Results

A total of 182 THA patients were included, the incidence of DVT of lower limb in patients with THA was 19.78 %. There were significant differences in the age, BMI, diabetes, number of replacement, duration of surgery, type of prosthesis and duration of days in bed between DVT and no-DVT patients(all P < 0.05). And there were no significant differences in the gender, hypertension, hyperlipidemia, preoperative D-dimer, type of anesthesia and anticoagulant drugs use(all P > 0.05). Logistic regression analysis indicated that age > 70y(OR4.406, 95 %CI1.744 ~ 6.134), BMI ≥ 28(OR2.275, 95 %CI1.181 ~ 4.531), diabetes(OR3.949, 95 %CI1.284 ~ 5.279), bilateral joint replacements(OR2.272, 95 %CI1.402 ~ 4.423), duration of surgery ≥ 120 min(OR3.081, 95 %CI1.293 ~ 5.308), cemented prosthesis(OR2.435, 95 %CI1.104 ~ 4.315), and duration of days in bed > 3 days(OR1.566, 95 %CI1.182 ~ 1.994) were the risk factors of DVT of lower limb in patients with THA.

Conclusions

DVT in the lower limb after THA is common, and its onset is affected by many factors. In clinical work, attention should be paid to identify the risk factors for DVT and targeted interventions are highlighted to prevent the postoperative DVT.

A cone-beam reconstruction algorithm for circle-plus-arc data-acquisition geometry

In cone-beam computerized tomography (CT), projections acquired with the focal spot constrained on a planar orbit cannot provide a complete set of data to reconstruct the object function exactly. There are severe distortions in the reconstructed noncentral transverse planes when the cone angle is large. In this work, a new method is proposed which can obtain a complete set of data by acquiring cone-beam projections along a circle-plus-arc orbit. A reconstruction algorithm using this circle-plus-arc orbit is developed, based on the Radon transform and Grangeat's formula. This algorithm first transforms the cone-beam projection data of an object to the first derivative of the three-dimensional (3-D) Radon transform, using Grangeat's formula, and then reconstructs the object using the inverse Radon transform. In order to reduce interpolation errors, new rebinning equations have been derived accurately, which allows one-dimensional (1-D) interpolation to be used in the rebinning process instead of 3-D interpolation. A noise-free Defrise phantom and a Poisson noise-added Shepp-Logan phantom were simulated and reconstructed for algorithm validation. The results from the computer simulation indicate that the new cone-beam data-acquisition scheme can provide a complete set of projection data and the image reconstruction algorithm can achieve exact reconstruction. Potentially, the algorithm can be applied in practice for both a standard CT gantry-based volume tomographic imaging system and a C-arm-based cone-beam tomographic imaging system, with little mechanical modification required.

Neamine induces neuroprotection after acute ischemic stroke in type one diabetic rats

INTRODUCTION

Angiogenin is a member of the ribonuclease superfamily and promotes degradation of the basement membrane and the extracellular matrix. After stroke in type one diabetes (T1DM) rats, Angiogenin is significantly increased and the Angiogenin is inversely correlated with functional outcome. Neamine, an aminoglycoside antibiotic, blocks nuclear translocation of Angiogenin, thereby abolishing the biological activity of Angiogenin. In this study, we therefore investigated the effect and underlying protective mechanisms of Neamine treatment of stroke in T1DM.

METHODS

T1DM was induced in male Wistar rats by streptozotocin (60mg/kg, ip), and T1DM rats were subjected to embolic middle cerebral artery occlusion (MCAo). Neamine (10mg/kg ip) was administered at 2, 24 and 48h after the induction of embolic MCAo. A battery of functional outcome tests was performed. Blood-brain barrier (BBB) leakage, and lesion volume were evaluated and immunostaining, and Western blot were performed.

RESULTS

Neamine treatment of stroke in T1DM rats significantly decreased BBB leakage and lesion volume as well as improved functional outcome compared to T1DM-control. Neamine also significantly decreased apoptosis and cleaved caspase-3 in the ischemic brain. Using immunostaining, we found that Neamine treatment significantly decreased nuclear Angiogenin, nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) activity, advanced glycation endproducts receptor (RAGE) number, the positive area of toll-like receptor 4 (TLR4) and increased Angeopoietin-1 expression compared to T1DM-MCAo control rats. Western blot results are consistent with the immunostaining.

CONCLUSION

Neamine treatment of stroke is neuroprotective in T1DM rats. Inhibition of neuroinflammatory factor expression and decrease of BBB leakage may contribute to Neamine-induced neuroprotective effects after stroke in T1DM rats.

Radioimmunoassay of the anticonvulsant agent clonazepam

A simple and specific radioimmunoassay was developed for the determination of the anticonvulsant agent clonazepam directly in plasma without extraction. Antibodies to clonazepam were produced in rabbits after immunization with an immunogen prepared by covalently linking the 3-hemisuccinyloxy derivative of clonazepam to bovine serum albumin. When employing 3H-clonazepam as the tracer, the radioimmunoassay has a limit of sensitivity of 5 ng/ml using a 0.1-ml sample of plasma. The antibodies exhibited a high degree of specificity for clonazepam; no cross-reactivity was observed with its 7-amino and 7-acetylamino metabolites nor with a number of other widely prescribed anticonvulsant agents that might be administered in conjuction with clonazepam. Satisfactory agreement was obtained for the plasma levels of clonazepam in humans when samples were assayed by the radioimmunoassay and an established electron-capture GC technique. By virtue ot its simplicity, the radioimmunoassay offers a distinct advantage to the clinician for monitoring plasma clonazepam levels and the compliance of patients undergoing anticonvulsant therapy with the drug.

Staphylococcus aureus regulates secretion of interleukin-6 and monocyte chemoattractant protein-1 through activation of nuclear factor kappaB signaling pathway in human osteoblasts

OBJECTIVE

Activation of nuclear factor kappaB by diverse bacteria regulates the secretion of chemokines and cytokines. Staphylococcus aureus (S. aureus)-infected osteoblasts can significantly increase the secretion of interleukin-6 and monocyte chemoattractant protein-1. The aim of this study was to investigate whether S. aureus can activate nuclear factor kappaB in human osteoblasts, and whether the activation of nuclear factor kappaB by S. aureus regulates the secretion of interleukin-6 and monocyte chemoattractant protein-1.

METHODS

Immunoblot and electrophoretic mobility shift assay were used to detect the degradation of IκBa and activation of nuclear factor kappaB in human osteoblasts in response to S. aureus, respectively. Enzyme-linked immunosorbent assay was used to measure the secretion of interleukin-6 and monocyte chemoattractant protein-1 in the supernatants. Lastly, carbobenzoxyl-l-leucinyl-l-leucinyl-l-leucinal, an inhibitor of the nuclear factor kappaB, was used to determine if activation of nuclear factor kappaB by S. aureus in human osteoblasts regulates the secretions of interleukin-6 and monocyte chemoattractant protein-1.

RESULTS

Our results for the first time demonstrated that S. aureus can induce the degradation of IκBa and activation of nuclear factor kappaB in human osteoblasts in a time and dose-dependent manner. In addition, inhibition of nuclear factor kappaB by carbobenzoxyl-l-leucinyl-l-leucinyl-l-leucinal suppressed the secretion of interleukin-6 and monocyte chemoattractant protein-1 in the supernatants of S. aureus-infected human osteoblasts in a dose-dependent manner.

CONCLUSION

These findings suggest that S. aureus can activate nuclear factor kappaB in human osteoblasts, and subsequently regulate the secretion of interleukin-6 and monocyte chemoattractant protein-1. The nuclear factor kappaB transcription factor regulates a number of genes involved in a wide variety of biological processes. Further study of the effects of nuclear factor kappaB activation on S. aureus-infected human osteoblast may provide us new insights into discovery of the immune mechanisms in osteomyelitis.

Reconstruction of blood vessels from x-ray subtraction projections: limited angle geometry

Several algorithms have been investigated for reconstructing blood vessels from a limited number of x-ray subtraction projections, distributed over a limited range of angles. Both computer simulations and an in vivo animal study were carried out. The best reconstruction performance was achieved using an algorithm that folded in two pieces of a priori knowledge of the vascular density distributions: (1) the object is dilute, consisting mainly of a void; and (2) the density distribution in the reconstructions is most likely to be non-negative. Both the signal-to-noise ratio (SNR) and the signal to out-of-focus blur were quantitated. Compared to tomosynthetic reconstruction (backprojection), the amount of residual blur from out-of-focus planes was significantly reduced with only a small penalty in diminished SNR. The combined effect resulted in significant qualitative image improvement for real arterial distributions as demonstrated in a canine arterial imaging example.

Attachment of Staphylococcus aureus is required for activation of nuclear factor kappa B in human osteoblasts

Nuclear factor kappa B (NF-κB) plays a prominent role in the pathogenesis of infectious diseases. Staphylococcus aureus (S. aureus), which can attach to and invade human osteoblasts, is the most common causative agent of osteomyelitis. To determine whether S. aureus can activate NF-κB in human osteoblasts and explore the possible factors of activation in response to infection, we used flow cytometry, enzyme-linked immunosorbent assay, immunoblots, and electrophoretic mobility shift assays to quantify the invasion of bacteria, to measure the interleukin-6 (IL-6) of culture supernatants, and to investigate the IκBα degradation and NF-κB activation in human osteoblasts. Moreover, we explored the possible factors responsible for the activation of NF-κB by preventing S. aureus from physically touching human osteoblasts or inhibiting the invasion of S. aureus into human osteoblasts under co-culture conditions, by incubating proteinase K-treated or ultraviolet-killed S. aureus with human osteoblasts and by treating human osteoblasts with peptidoglycan (PGN) or lipoteichoic acid (LTA). We found that S. aureus induced the IκBα degradation and NF-κB activation, which could regulate IL-6 secretion in the culture supernatants of human osteoblasts in response to infection. In addition, the maximal IκBα degradation and NF-κB activation in human osteoblasts occurred prior to the maximal invasion of S. aureus. It was the attachment not invasion or the secreted soluble factor(s), PGN, LTA of S. aureus, that could induce the IκBα degradation and NF-κB activation in human osteoblasts. These results indicated that S. aureus can activate NF-κB in human osteoblasts and that the attachment of S. aureus is required for this activation in response to infection.

Long non-coding RNA MEG3 regulates the progress of osteoarthritis by regulating the miR-34a/Klotho axis

Background

Osteoarthritis (OA) is one of the most common chronic diseases today, and its prevalence and incidence are expected to increase as life expectancy increases. By investigating the inhibition of long non-coding RNA maternally expressed gene 3 (lncRNA MEG3) in OA, we hope to provide some new insights into the treatment of osteoarthritis.

Methods

By constructing an osteoarthritis model, the knee joint tissue of the model was observed using hematoxylin and eosin staining (HE) and computed tomography (CT). Detection of miR-34a and Klotho expression by fluorescent quantitative polymerase chain reaction (PCR) and Western blot. The lncRNA MEG3 overexpression vector was constructed and transfected into C28/I2 cells. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to detect the results of lncRNA MEG3 and miR-34a expression in each group of cells, and Western blot was used to detect the results of Klotho, recombinant fibroblast growth factor 23 (FGF23), B-cell lymphoma-2 (Bcl-2), BCL2-associated X (Bax), Transforming growth factor beta 1 (TGF-β1), cysteinyl aspartate specific proteinase 3 (Caspase3) and cysteinyl aspartate specific proteinase 8 (Caspase8) protein expression.

Results

Compared with the control group, HE and CT results showed significant pathological changes in the knee joint of the osteoarthritis model mice. and Klotho expression was significantly decreased and miR-34a expression was significantly increased in the model group (P<0.05). Compared with those in the control group, the expression levels of lncRNA MEG3, Klotho, FGF23, and Bcl-2 decreased significantly and the expression levels of microRNA-34a (miR-34a), Bax, TGF-β1, Caspase 3, and Caspase 8 increased sharply (P<0.05) in the lipopolysaccharides (LPS) group. Meanwhile, lncRNA MEG3 overexpression upregulated the expression of miR-34a, Bax, TGF-β1, Caspase3 and Caspase8, and downregulated the expression of Klotho, FGF23 and Bcl-2.

Conclusions

lncRNA MEG3 regulated the expression of FGF23, Bcl-2, Bax, TGF-β1, Caspase 3, and Caspase 8 by regulating the miR-34a/Klotho axis, thereby affecting the progress of OA.

Comprehensive analysis of arachidonic acid metabolism-related genes in diagnosis and synovial immune in osteoarthritis: based on bulk and single-cell RNA sequencing data

BACKGROUND

Osteoarthritis (OA) is one of degenerative-related arthritis, which can be aggravated by low-grade synovitis. It is known that arachidonic acid (AA) dysmetabolism brings OA synovitis. However, the impact of synovial AA metabolism pathway (AMP) related genes on OA remains uncovered.

METHODS

Here, we conducted a comprehensive analysis to explore the impact of AA metabolism genes in OA synovium. We obtained transcriptome expression profiles from three raw datasets related to OA synovium (GSE12021, GSE29746, GSE55235) and identified the hub genes of AA metabolism pathways (AMP) in OA synovium. An OA occurrence diagnostic model was constructed and validated based on the identified hub genes. Then, we explored the correlation between hub gene expression and the immune-related module using CIBERSORT and MCP-counter analysis. The unsupervised consensus clustering analysis and weighted correlation network analysis (WGCNA) were utilized to identify robust clusters of identified genes in each cohort. Moreover, the interaction between the hub genes of AMP and immune cells was elucidated through single-cell RNA (scRNA) analysis by scRNA sequencing data from GSE152815.

RESULTS

We found that the expression of AMP-related genes was up-regulated in OA synovium, and seven hub genes (LTC4S, PTGS2, PTGS1, MAPKAPK2, CBR1, PTGDS, and CYP2U1) were identified. The diagnostic model that combined the identified hub genes showed great clinical validity in diagnosing OA (AUC = 0.979). Moreover, significant associations were noticed between the hub genes' expression, immune cell infiltration, and inflammatory cytokine levels. The 30 OA patients were randomized and clustered into three groups using WGCNA analysis based on the hub genes, and diverse immune status was found in different clusters. Of interest, older patients were more likely to be classified into a cluster with higher levels of inflammatory cytokines IL-6 and less infiltration of immune cells. Based on the scRNA-sequencing data, we found that the hub genes had relatively higher expression in macrophages and B cells than other immune cells. Moreover, inflammation-related pathways were significantly enriched in macrophages.

CONCLUSION

These results suggest that AMP-related genes are closely involved in alterations of OA synovial inflammation. The transcriptional level of hub genes could serve as a potential diagnostic marker for OA.

Study on the effect of internet plus continuous nursing on functional recovery and medication compliance of patients with knee joint replacement

OBJECTIVE

To evaluate the effect of "Internet + " continuity of care on postoperative functional recovery and medication compliance in patients with knee arthroplasty.

METHODS

In this retrospective study, 100 patients who underwent knee replacement in our hospital between January 2021 and December 2022 were recruited and assigned to receive routine care (routine group) or "Internet + " continuity of care (continuity group), with 50 patients in each group. Outcome measures included knee function, sleep quality, emotional state, medication compliance, and self-care ability.

RESULTS

Patients in the continuity group showed better knee function after discharge and during follow-up versus those in the routine group (P < 0.05). Continuity care resulted in significantly lower Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores versus routine care (P < 0.05). Patients in the continuity group showed higher treatment compliance, ability of daily living (ADL) scores, and nursing satisfaction than those in the routine group (P < 0.05).

CONCLUSION

The "Internet + " continuity of care is highly feasible and can effectively promote the postoperative functional recovery of knee replacement patients, improve patients' medication compliance, sleep quality, and self-care ability, mitigate negative emotions, and provide enhanced home care.

Synthesis of Fe3O4/PDA Nanocomposites for Osteosarcoma Magnetic Resonance Imaging and Photothermal Therapy

Osteosarcomas commonly develop in the metaphysis of the long diaphysis, resulting in pronounced malignancy and high rates of early pulmonary metastasis. At present, osteosarcoma patients exhibit relatively poor survival rates owing these metastases and to the emergence of tumor chemoresistance. As such, there is an urgent need to identify other approaches to treating affected patients. Herein, we synthesized Fe₃O₄@PDA nanocomposites that exhibited excellent biocompatibility and low toxicity in human and animal model systems. The resultant nanoparticles were able to improve T2 magnetic resonance imaging and to enhance the signal-to-noise ratio associated with osteosarcoma tumors in animal models. Moreover, we were able to successfully leverage these Fe₃O₄@PDA particles as a photothermal agent capable of significantly inhibiting the growth of tumors and preventing their metastasis to the lung compartment. Together, these results highlight a novel therapeutic platform that has the potential to guide both the more effective diagnosis and treatment of osteosarcoma patients in clinical applications.

Efficacy and safety of erythropoietin in isolated spinal metastasis patients with total en bloc spondylectomy surgery: a case-control study

OBJECTIVE

The purpose of our study is to identify the effect of short-term and high-dose use of erythropoietin (EPO) in spinal isolated metastatic patients with Total en bloc spondylectomy (TES) surgery by assessing hematological parameters, transfusion volume, postoperative complications, recurrence-free survival (RFS), and overall survival (OS).

METHODS

From January 2015 and January 2022, 93 isolated spinal metastasis patients were selected and separated into 2 groups based on the treatment method used (EPO + TXA (Tranexamic acid) group, n = 47; and TXA group, n = 46). Indexes for evaluation included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, transfusion rate, and mean units transfused.

RESULTS

The average follow-up duration was 38.13 months. There was no significant difference (P > 0.05) in RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, and transfusion rate between the two groups. However, patients in EPO + TXA group have significantly higher Hb, Hct, and RBC values than those in the TXA group on postoperative days 1, 2, 3, and 5. Moreover, the mean transfusion volume in EPO + TXA group was significantly lower than those in the TXA group (P = 0.011).

CONCLUSIONS

Perioperative short-term and high-dose administration of EPO could improve the anemia-related hematological parameters and reduce the requirement for blood transfusion without increasing the risk of deep vein thrombosis and tumor progression in solitary spinal metastatic patients with TES surgery.

Tibial cortex transverse transport regulates Orai1/STIM1-mediated NO release and improve the migration and proliferation of vessels via increasing osteopontin expression

Background

Diabetic foot is a major complication of diabetes. The bone transverse transport method could be applied in clinics for treatment, which could improve the metabolism of the tissues via lasting distraction forces. However, the process' specific regulating mechanism is still unknown.

Methods

Based on the notion that the healing of bones involves the recruitment of calcium ions, in this study, we established the model of tibial cortex transverse transport (TTT) on rats and then used tissue immunologic detection, such as the double fluorescent staining to explore the expression of the calcium channels' calcium release-activated calcium modulator 1 (Orai1)/stromal interaction molecule 1 (STIM1), which belong to the store-operated calcium entry (SOCE) signaling pathways on the tissues around the bone transport area. By using the laser capture microdissection (LCM) tool, we acquired samples of tissues around the bone and endeavored to identify pivotal protein molecules. Subsequently, we validated the functions of key protein molecules through in vitro and in vivo experiments.

Results

After protein profile analysis, we found the differentially expressed key protein osteopontin (OPN). The in vitro experiments verified that, being stimulated by OPN, the migration, proliferation, and angiogenesis of human umbilical vein endothelial cells (HUVEC) were observed to be enhanced. The activation of Orai1/STIM1 might increase the activity of endothelial nitric oxide synthase (eNOS) and its effect on releasing nitric oxide (NO). Subsequently, the migration and proliferation of the HUVECs are improved, which ultimately accelerates wound healing. These signaling pathway was also observed in the OPN-stimulated healing process of the skin wound surface of diabetic mice.

Conclusion

This study identifies the molecular biological mechanism of OPN-benefited the migration and proliferation of the HUVECs and provides ideas for searching for new therapeutic targets for drugs that repair diabetes-induced wounds to replace invasive treatment methods.

The translational potential of this article

The OPN is highly expressed in the tissues surrounding the TTT bone transfer area, which may possibly stimulate the activation of eNOS to increase NO release through the SOCE pathway mediated by Orai1/STIM1. This mechanism may play a significant role in the angiogenesis of diabetic foot's wounds promoted by TTT, providing new therapeutic strategies for the non-surgical treatment for this disease.