Objectives To elaborate on the relationship between degeneration grade and autophagy expression in human nucleus pulposus obtained from surgical procedures. Methods For the 16 patients included in the present study, we determined the Pfirrmann classifications of degenerative lesions by MRI. Western blot analysis, LC3, LAMP2, and p62 protein expressions were quantified in different degeneration grades of disc nucleus pulposus. Double immunofluorescence staining was used to show co‐localization of LC3 and LAMP2, and immunohistochemistry to show LC3 and p62 in the nucleus pulposus. Results In the western blot analysis, LC3‐II was highly expressed in grade III and decreased progressively from grade IV to V. In addition, LC3‐II expression in grade III was significantly higher than in grade II, IV, and V (P < 0.05). LAMP2 expression in grade V was significantly higher than that in grade II, III, and IV (P < 0.05). P62 increased with decreasing autophagy expression up through grade V. In the double staining, the LC3 level was highly expressed in grade III and decreased progressively from grades IV to V, as in the western blot analysis. LAMP2 rose with increasing disc degeneration grade through grade V. In the quantitative analysis of colocalization, grade III is significantly higher than grade II and V (P < 0.05). Immunohistochemical staining showed that LC3 was highly expressed in grade III but weakly expressed in other grades, with few positive areas around the nucleus pulposus. However, p62 increased progressively with increasing disc degeneration grade. Conclusion Pfirrmann grade III disc degeneration showed that autophagosomes were formed, which led to the reversible decomposition of degenerative substances. Thus, by analyzing the effect of autophagy on degenerative discs, we showed the possibility of reversing degenerative changes, but only in grades III and lower.

Corticosteroids are commonly used for pain control in rotator cuff tear. Deregulated NF-κB activation is a hallmark of chronic inflammatory diseases and has been responsible for the pathogenesis of rotator cuff tear. The Dexamethasone(DEXA) is a synthetic corticosteroid. The purpose of this study was to examine the exact effect of dexamethasone on NF-κB signaling in rotator cuff tear. We measured NF-κB expression in four groups: control, TNF-α-treated, DEXA-treated, and combined treatment with TNF-α and DEXA. Tenocytes were isolated from patients with rotator cuff tears and pre-incubated with TNF-α (10 ng/ml), DEXA (1 μM), or both of them for 10 min, 1 h, and 2 h. Expression of p65, p50, and p52 in the nuclei and cytosol was analyzed by western blotting and immunofluorescence imaging using confocal microscopy. We also evaluated nucleus/cytosol (N/C) ratios of p65, p50, and p52. In our study, the combined treatment with DEXA and TNF-α showed increased N/C ratios of p65, p50, and p52 compared with those in the TNF-α group at all time points. Additionally, in the DEXA group, N/C ratios of p65, p50, and p52 gradually increased from 10 min to 2 h. In conclusion, DEXA promoted the nuclear localization of p65, p50, and p52, but was not effective in inhibiting the inflammatory response of TNF-α-stimulated rotator cuff tear.

Purpose To evaluate the efectiveness of immediate arthroscopy and clinical outcomes following open reduction and internal ixation (ORIF) of tibial plateau fractures. Methods Sixty patients (36 men and 24 women, median age 56 (20-78) years) were divided into Group I (ORIF only: 26 patients, median age 58 (25-78) years) or Group II (ORIF with immediate arthroscopy: 34 patients, median age 55 (20-75) years) in tibial plateau fractures (Schatzker Type II-VI fractures). In the irst part of this study, ORIF only was performed without arthroscopic treatment. In the second part, ORIF with immediate arthroscopic examination and treatment was performed. Clinical outcomes, utilizing range of motion (ROM), International Knee Documentation Committee (IKDC) score and hospital for special knee score (HSS) were assessed. Results At the inal follow-up, HSS score was 81 ± 11 points in Group I and 83 ± 9 points in Group II. The IKDC score was 85 ± 8 points in Group I and 86 ± 6 points in Group II. In Group II, concomitant intra-articular lesions in 10 patients (29%) were found and treated simultaneously. However, there were no signiicant diferences in clinical scores or ROM between the two groups. Conclusion Immediate arthroscopy following ORIF for tibial plateau fracture is an efective procedure that provides accurate information for fracture reduction, leading to immediate treatment of concomitant intra-articular lesions without complications. Level of evidence III.