Osteosarcoma (OS) is the most common malignant bone tumor. In cancer cells, autophagy is related to epithelial-to-mesenchymal transition (EMT). Although microRNA (miR)-506-3p has been demonstrated to act as a tumor suppressor in OS, its role in regulating the EMT process and autophagy remains unknown. The results showed that miR-506-3p directly inhibited the expression of sphingosine kinase 1 (SPHK1) in 143B and SaOS-2 cells. The invasive capability of OS cells was reduced following miR-506-3p mimics transfection, and restored when SPHK1 was overexpressed simultaneously. Further, miR-506-3p mimics initiated mesenchymal-to-epithelial transition (MET) – E-cadherin expression was upregulated, whilst vimentin and fibronectin were downregulated. The basal autophagy flux (LC3II/I) was suppressed by miR-506-3p mimics. The alterations induced by miR-506-3p mimics were partly reversed by SPHK1 overexpression or treatment of rapamycin. Meanwhile, treatment of SPHK1-transfected cells with 3-methyladenine inhibited EMT. The data suggest that miR-506-3p initiates MET and suppresses autophagy in OS cells by targeting SPHK1.

ObjectiveTo investigate the effect of additional semiautomatic intermittent pneumatic compression device (IPCD) in the prevention of deep vein thrombosis (DVT) of lower extremity in these patients undergoing major orthopedic surgery, when compared with the conventional graduated compression stockings alone.MethodsThe data of 112 patients undergoing major orthopedic surgery were retrospectively analyzed. 51 patients who ever received IPCD and graduated compression stockings during major orthopedic surgery were taken as the experimental group, and 61 patients who only received the conventional graduated compression stockings during surgery were taken as the observation group. The Doppler sonography was utilized to detect the presence of DVT and pulmonary embolism pre- and postoperatively. Besides, the mean and peak velocity of blood flow in femoral vein were recorded before and after surgery. And then, the comparisons between the two groups were made, respectively.ResultsWhen compared with the conventional graduated compression stockings alone, the intraoperative application of IPCD and stockings contributed the significant reduction of DVT (3.92%, 2/51 versus 9.84%, 6/61, X2 = 5.632, P = 0.034). In terms of the mean and peak velocity of blood flow in femoral vein, the postoperative difference was higher in the observation group than those in the control group (149.56 ± 26.35 versus 130.15 ± 22.56 mm/s, P < 0.05). With respect to perioperative blood loss, the difference between the two groups was statistically significant (800.5 ± 320.7 versus 950.1 ± 305.9 ml, P = 0.031).ConclusionsIntraoperative application of IPCD could promote blood circulation of lower limbs, and significantly decrease the incidence of potentially fatal DVT in patients undergoing major orthopedic surgery, when compared with the conventional graduated compression stockings.

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Objective: Based on the observation of Computed Tomography (CT) image analysis technique, the efficacy of Proximal Femoral Nail Antirotation (PFNA) and Dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in the elderly was analyzed. Methods: Thirty-nine elderly patients with unstable intertrochanteric fractures were randomly divided into two groups: 19 patients in the DHS internal fixation group and 20 patients in the PFNA group. They were treated with DHS and PFNA internal fixation, and were observed based on CT image analysis techniques. The patient performs follow-up testing of the procedure before and after surgery. Results: There was a statistically significant difference in mean operative time and intraoperative blood loss between the groups (P < 0.01). The incidence of intraoperative and postoperative complications was statistically different between the two groups (P < 0.05). The incidence of postoperative and postoperative complications in the PFNA group was lower than that in the DHS group. The excellent and good rates of DHS group and PFNA group were 89.47% and 95.00%, respectively. There was no significant difference between the two groups (P > 0.05). There was a significant difference in fracture healing time between the PFNA group and the DHS group (P < 0.01). Discussion: Compared with DHS, PFNA has the advantages of short operation time, low bleeding volume and short hospital stay. There were 7 cases of internal fixation failure or non-union in the DHS group and 1 case of delayed healing in the PFNA group. Conclusion: DHS and PFNA were used to treat intertrochanteric fractures in the elderly. After observation by CT image analysis technique, there was no significant difference in efficacy. The average operative time of PFNA was the shortest, the intraoperative blood loss was the least, the incidence of intraoperative and postoperative complications was low, and the fracture healing time was short. PFNA has a lesser effect on the blood circulation and bone destruction at the fracture end, and it is more secure. It is a reasonable surgical method for the treatment of senile osteoporotic intertrochanteric fractures.

Objective: In this paper, we summarize computed tomography (CT) manifestations and characteristics of ankle fractures, and analyze the relationship between CT images and common ankle fracture classifications. Methods: A retrospective survey of 369 adult ankle fractures was performed. CT images of 1 cm horizontal cross-section above the ankle points and their characteristics were analyzed. Ankle fracture X-ray classification was performed, and the relationship between CT images and fracture X-ray classification was analyzed. Results: There is a correlation between CT images and Danis-Weber classification. The incidence of IOL fractures varies with the severity of Danis-Weber classification. After rank correlation test, the difference is statistically significant (Spearman R = 0.781,P < 0.001). CT images can detect IOL fractures that cannot be judged by X-ray fracture classification, and the incidence rate is 5.9%. Conclusions: The 1 cm horizontal cross-section CT image on the ankle point can clearly determine the combined tibiofibular IOL injury before surgery, and it has a good correlation with the Danis-Weber fracture classification, and can detect unexplainable IOL fractures in some radiographs.