Background: lncRNA, a type of non-coding RNA, plays an important role in the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BM-MSCs). In this study, lncRNA and mRNA microarrays were performed to study the change of gene expression during osteogenic differentiation of BM-MSCs. We focused on Hedgehog interacting protein (HHIP), because HHIP mRNA and lncRNA HHIP-AS1 were gradually down-regulated on days 0, 7, and 14 during osteogenic differentiation. In addition, the gene coding lncRNA HHIP-AS1 is located on the anti-sense of Hhip gene, implying the potential interaction between lncRNA HHIP-AS1 and HHIP mRNA. Methods: BM-MSCs with over-expressed or silenced lncRNA HHIP-AS1 were constructed to explore the biological role of HHIP-AS1 in osteogenic differentiation. BM-MSCs were lysed to determine the alkaline phosphatase activity. Fluorescence in situ hybridization and immunofluorescence were performed to analyze HHIP-AS1, HHIP, RUNX2 and osteocalcin. Results: Overexpression of lncRNA HHIP-AS1 increased HHIP expression, which suppressed Hedgehog signaling pathway, as indicated by the reduction of SMO, Gli1 and Gli2. The suppression of Hedgehog signal was associated with the inhibited osteogenesis. HHIP knockdown abolished the suppression of osteogenesis induced by lncRNA HHIP-AS1 overexpression. Through binding to HHIP mRNA, lncRNA HHIP-AS1 recruited ELAVL1 to HHIP mRNA, whereby increasing the mRNA stability and the protein level. Conclusions: This study revealed that down-regulation of HHIP due to lncRNA HHIP-AS1 reduction promoted the osteogenic differentiation of BM-MSCs though removing the suppression of Hedgehog signal.
Background There was a controversy about surgery approach of severe rigid congenital kyphoscoliosis in adolescence treatment. Aim of the study is to compare the clinical efficacy of surgical treatement by hemivertebra resection (HR) and hemivertebra resection combined with wedge osteotomy (HRWO) for severe rigid congenital kyphoscoliosis in adolescence. Methods Twenty-five patients with severe rigid congenital kyphoscoliosis between Jan 2006 and Dec 2011 were studied in our center. The patients were divided into hemivertebra resection group (group HR) or hemivertebra resection combined with wedge osteotomy group (group HRWO). The clinical and radiographic evaluation in terms of operation time, blood loss, correction rate, fusion time, hospital stay, complications and SRS-24 questionnaire score were compared between Group A and Group B. Results It is obvious that group HR achieved much better results in time of operation time, intra-operative blood loss, and hospital stay than group HRWO (P < 0.05). But meanwhile, group HRWO was significantly better than group HR in the times of coronal Cobb angle, kyphosis, the sagittal imbalance, coronal imbalance and SRS-24 questionnaire score (P < 0.05). There were no significant differences between the two groups in the age, mean flexibility, follow-up time, fusion time, and complications in the last follow-up (P > 0.05). Conclusion The outcomes of follow-up showed that the hemivertebra resection combined with wedge osteotomy approach obtained better clinical outcomes hemivertebra resection surgery. It might be a better surgical treatment for severe rigid congenital kyphoscoliosis in adolescence patients, but it needs longer operation time, more intra-operative blood loss, and extended hospital stay.
Background Three-dimensional (3D) printing is becoming increasingly important in spinal surgery, and few literatures have reported the surgical management for sacroiliac joint tuberculosis assisted by three dimensional printing technology. Purpose The study aim to assess the efficacy and feasibility of surgical treatment in sacroiliac joint tuberculosis (SJT) by posterior sacroiliac screws fixation, debridement and fusion, which assisted by three dimensional printing technology. Method Twenty-six patients with sacroiliac joint tuberculosis treated by surgery in our department between January 2008 and December 2015 . All the patients were divided into two group base on three dimensional printing technology: 11 cases in Group A underwent posterior debridement, fusion and sacroiliac screws fixation, and 15 cases in Group B underwent posterior debridement, bone graft, sacroiliac screws fixation, and three dimensional printing technology. Clinical and radiographic results for the two groups were analyzed and compared. Results All patients were followed up with an average 33.8±7.9 months (24–48 months). The sacroiliac joint tuberculosis was completely cured and the grafted bones were fused in all 26 patients. No injured nerve or other severe complications occurred in both groups. Group B achieved much better results in time of operation, intra-operative blood loss, and number of intra-operative fluoroscopy than group A ( p < 0.05). There were no significant differences between the two groups in ESR, fusion time, and VAS score in the last follow-up ( p >0.05). Conclusions The three dimensional printing technology can achieve the better effect in the treatment of sacroiliac joint tuberculosis. Posterior surgery assisted by three dimensional printing technology in the treatment of sacroiliac joint tuberculosis has the characteristics of shorter operative time, less bleeding, and less number of intra-operative fluoroscopy.
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