Abstract Microcephaly with or without chorioretinopathy, lymphedema, or impaired intellectual development (MCLMR; OMIM 152950) is a rare autosomal dominant disorder, which is primarily characterized by defects in the central nervous system and retinal developmental anomalies. Kinesin‐5 KIF11 has been discovered as a major causative gene for MCLMR. It has been well established that KIF11 is essential for microtubule organization, centrosome separation, and spindle assembly during mitosis. However, cellular and molecular mechanisms in the physiopathology of MCLMR remain largely unknown. In this study, KIF11‐inhibition mouse models are generated, which reveal that chemical inhibition of KIF11 results in defects in retinal development, the formation of rosettes, photoreceptor ciliary alterations, and vision loss. Furthermore, it is demonstrated that KIF11 is essential for the formation, organization, and maintenance of primary cilia in photoreceptor cells, which further contributes to the organization of photoreceptor cells and the development of the retina. Using the developing mouse embryos as a model, it is revealed that KIF11 inhibition induces the formation of monopolar spindle and mitotic arrest, which further results in tetraploidy and apoptotic cell death. These findings uncover cellular mechanisms underlying the loss‐of‐function of KIF11 and retinopathy in MCLMR and further support the functions of KIF11 in development.
Abstract Background: There is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. The purpose of the study was to analyze the exact correlation between CT images of lateral plateau and lateral meniscus injuries in Schatzker II tibial plateau fractures. Methods: Two hundred and ninety-six Schatzker II tibial plateau fracture patients from August 2012 to January 2021 in two trauma centers were enrolled for the analysis. According to the actual situation during open reduction internal fixation (ORIF) and knee arthroscopic surgery, patients were divided into meniscus injury (including rupture, incarceration, etc.) and non-meniscus injury groups. By measuring the value of both lateral plateau depression (LPD) and lateral plateau widening (LPW) of lateral tibial plateau on the coronary CT images, the correlation of which and lateral meniscus injury was analyzed. Meanwhile, the relevant receiver operating characteristic (ROC) curve was drawn to evaluate the optimal operating point of these two indicators which could predict meniscus injury. Results: Meniscus injury group mainly showed injuries involving the mid-body and posterior horn of the meniscus (98.1%, 157/160). The average LPD was 13.2 ± 3.2 mm, while the average value of the group without meniscus injury was 9.4 ± 3.2 mm. The difference was statistically significant (P < 0.05). The average LPW was 8.0 ± 1.4 mm and 6.8 ± 1.6 mm in two groups with a significant difference (P < 0.05). The optimal operating point of LPD and LPW was 7.9 mm (sensitivity-95.0%, specificity-58.8%, area under the curve (AUC-0.818) and 7.5 mm (sensitivity-70.0%, specificity-70.6%, AUC-0.724), respectively. Conclusions: The mid-body and posterior horn of lateral meniscus injury is more likely to occur in patients who had Schatzker II tibial plateau fractures when LPD > 7.9 mm and/or LPW > 7.5 mm on CT manifestations and these findings will definitely provide guidance for orthopedic surgeons in treating such injuries. During the operation, more attention should be paid to the treatment of the meniscus and full consideration is needed be taken to situations such as meniscus rupture, incarceration and other possible fracture reduction difficulties, poor vertical line, etc., in order to achieve better surgical results.
Oral squamous cell carcinoma (OSCC) is the most frequently diagnosed oral malignancy and poses a great threat to public health. According to bioinformatics analysis, long noncoding RNA PCBP1-AS1 is downregulated in OSCC. In this work, the functions and mechanism of PCBP1-AS1 in OSCC were further investigated. PCBP1-AS1 expression in OSCC cells was measured by quantitative polymerase chain reaction. Cell viability and proliferation were detected using CCK-8 assays and colony-forming assays. TUNEL assays as well as flow cytometry analyses were carried out to detect OSCC cell apoptosis. Binding relationship between PCBP1-AS1 and miR-34c-5p or that between miR-34c-5p and ZFP36 in OSCC cells was identified using RNA immunoprecipitation assays, RNA pulldown assays, and luciferase reporter assays. Experimental results revealed that PCBP1-AS1 was downregulated in OSCC cells. PCBP1-AS1 overexpression hampered cell proliferation and enhanced cell apoptosis in OSCC. PCBP1-AS1 interacted with miR-34c-5p in OSCC and negatively regulated miR-34c-5p. ZFP36 3'untranslated region was targeted by miR-34c-5p. PCBP1-AS1 positively regulated ZFP36 expression. ZFP36 silencing abrogated the suppressive impact of PCBP1-AS1 on OSCC cell growth. In summary, PCBP1-AS1 suppresses cell growth in OSCC by upregulating ZFP36 through interaction with miR-34c-5p.
Objective
To compare the outcomes of bone marrow stimulation techniques -- drilling by a Kirschner needle versus microfracturing technique in the treatment of small osteochondral lesions of the talus.
Methods
From February 2014 to June 2017, 57 patients were treated at Department of Orthopaedics, Sun Yat-sen Memorial Hospital for small osteochondral lesions of the talus. Of them, 26 were treated by arthroscopic drilling with a Kirschner needle. They were 15 males and 11 females, aged from 20 to 57 years. The areas of osteochondral lesion ranged from 0.6 to 1.4 cm2. By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films, there were 9 cases of stage Ⅰ, 8 cases of stage Ⅱ, 6 cases of stage Ⅲ and 3 cases of stage Ⅳ. The other 31 patients of them were treated by arthroscopic microfracturing technique. They were 17 males and 14 females, aged from 24 to 55 years. The areas of osteochondral lesion ranged from 0.5 to 1.5 cm2. By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films, there were 10 cases of stage Ⅰ, 11 cases of stage Ⅱ, 8 cases of stage Ⅲ and 2 cases of stage Ⅳ. The 2 groups were compared in terms of visual analogue scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the ankle activity score (AAS) and the Berndt & Harty staging of osteochondral lesions based on ankle X-ray films at the final follow-up.
Results
All the 57 patients were followed up for 13 to 27 months. The VAS, AOFAS and AAS scores and Berndt & Harty stages at the final follow-up were significantly improved in all the patients compared with their preoperative values (P 0.05). There was no significant difference between the 2 groups either in the excellent and good rate by the AOFAS ankle-hindfoot scoring [88.5% (23/26) versus 90.3% (28/31)] at the final follow-up (χ2=0.052, P=0.820).
Conclusion
In the treatment of small osteochondral lesions of the talus, both arthroscopic drilling with a Kirschner needle and microfracturing technique can achieve satisfactory short-term curative effects, but the long-term effects need to be further studied.
Key words:
Ankle joint; Cartilage; Wounds and injuries; Arthroscopy, subchondral
Objective
To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.
Methods
A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017. A total of 28 cases were treated with autologous semitendinosus tendon (autologous group), including 19 males and 9 females, with an average age of 28.5±8.03 years (range, 16-46 years). A total of 27 cases were treated with allogenic tendon (allogenic group), including 17 males and 10 females, with an average age of 27.48±7.89 years (range, 16-46 years). ATFL/CFL was reconstructed by the same method in both groups. The reconstruction methods were the same between the groups. The talus and calcaneus were fixed with absorbable compression nails.
Results
The operation duration in the autologous group was 94.07±7.83 min, which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51, P<0.001). Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55, P<0.001). Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01, P<0.001). In the autologous group, 28 cases were followed up for 34.54±16.04 months, and 27 cases in the allograft group were followed up for 42.74±17.79 months. The mean AOFAS score improved from 63.64±11.20 before operation to 90.21±4.48 after operation in the autologous group, and that improved from 63.93±10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506, P=0.615). The mean VAS score decreased from 5.79±1.79 before operation to 1.54±1.35 after operation in the autologous group, and from 5.89±1.78 before operation to 2.04±1.32 after operation in the allogeneic group. There was no significant difference between the two groups after operation (t=-1.396, P=0.168). Tegner score increased from 4.07±1.39 to 6.43±1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333, P=0.740). Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group, 16.99°±3.78° to 7.14°±3.34° in the allogeneic group, and there was no significant difference between the two groups after operation (t=-1.382, P=0.171). Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group, from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group, and there was no significant difference between the two groups after operation (t=-0.326, P=0.746). No donor tendon dysfunction was found in the autologous group. At the end of follow-up, there was no difference in ankle dorsiflexion, plantar flexion and hind foot mobility between autologous group and allogeneic group.
Conclusion
Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results. The autologous tendon group was superior to the allogeneic group in terms of fever, wound healing time. However, there was no significant difference in clinical effects between the two groups.
Key words:
Arthroscopy; Lateral ligament, ankle; Transplantation, homologous
Objective
To explore the outcome of Dega osteotomy for developmental dislocation of the hip (DDH) in pre-school children aged 1.5-6 years and summarize the personalized application experience of acetabular arthroplasty.
Methods
A total of 34 involved hips of 28 pre-school DDH children with an average operative age of (28±10)(18-65)months from July 2007 to July 2012 were analyzed retrospectively.All 34 hips were dislocated and classified into 4 groups according to the shapes of false acetabula on preoperative radiography.Three hips of 3 children without false acetabula with conservative treatment previously were distributed into group A; 7 hips of 7 children with no false acetabula and without conservative treatment previously were distributed into group B; 9 hips of 6 children with obvious false acetabula pressing and eroding the true acetabula were distributed into group C; 15 hips of 12 children with extensive fusion of true and false acetabula(fused acetabula)were distributed into group D. Changes of morphologies and improvements of functions of involved hips and the incidence of avascular necrosis (AVN) were evaluated pre- and post-operation.
Results
Twenty-eight children with 34 involved hips were followed up successfully with an average period of(67±14)(48-96) months at an average age of(95±15)(73-126)months.Average acetabular index improved from 45°±6°(32°~57°) to 10°±7°(-6°~27°), average Reimer’s index improved from 0.95±0.12(0.53~1.00)to 0.15±0.11(-0.20~0.42)and average center edge angle was 23°±7°(11°~43°)postoperatively.All differences of changes were statistically significant pre- and postoperatively(t=26.375, 26.253 and -18.781, P<0.01). All Shenton lines of 34 hips were disrupted preoperatively and 31 of them became continuous at last with disruptions of 2 hips and reversed disruption of 1 hip.Modified Severin classification was applied for evaluating the radiographic improvement with 20 hips of type Ⅰ as excellent, 12 hips of type Ⅱ as good and 2 hips of type Ⅲ as moderate and the excellent-good rate was 94%(32/34 hips). Kalamchi & MacEwen classification was applied for evaluating the AVN of femoral heads with 9 hips of type Ⅱ and 25 hips without AVN and the incidence was 26%(9/34 hips). Modified McKay classification was applied for evaluating clinical functions with 29 hips as excellent, 4 hips as good and 1 hip as moderate.And the excellent-good rate was 97% (33/34 hips). No AVN was found in 5 hips of high-level Dega osteotomy in groups A & C, but 5/7 hips (71%) of low-level Dega osteotomy had AVN.The difference was statistically significant (P=0.028). AVN existed in all 3 hips of high-level Dega osteotomy in groups B & D, but only 1/19 hip (5%) of low-level Dega osteotomy had AVN.The difference was statistically significant (P=0.003).
Conclusions
The efficacy of Dega osteotomy is significant for pre-school DDH children.Such an operation is worth a wider clinical popularization.High-level Dega osteotomy with higher hinge and less range of suppressing of acetabular roof is applicable for correcting residual developmental dysplasia after conservative treatment and hips with obvious false acetabula.And low-level Dega osteotomy with lower hinge and greater range of suppressing of acetabular roof is applicable for true acetabula and fused acetabula.To acquire satisfactory coverage and forge matched containing femoral head with acetabulum are both basic requirements of acetabular arthroplasty.Corresponding operation may be performed according to different morphologies of acetabula to achieve personalized treatment for DDH.Each type of osteotomy has its own indication and should be applied discreetly.
Key words:
Dislocation of hip; Osteotomy; Ischemic necrosis of head of femur
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