Xinghuo Wu

Huazhong University of Science and Technology, Wu-han-shih, Hubei, China

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Publications (15)30.5 Total impact

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    ABSTRACT: Post-traumatic contracture is a common complication after elbow trauma. If conservative therapy fails to restore adequate elbow motion, surgical release is recommended. Increase in arthroscopy knowledge and skills, as well as technological advances in the passed decade of years, has made arthroscopic arthrolysis a safe and reliable treatment for patients with a post-traumatic elbow contracture. The aim of this study was to report on the clinical outcome and improvement of ROM in post-traumatic stiff elbow treated by arthroscopic arthrolysis. Between 2008 and 2012, 34 consecutive patients with post-traumatic stiffness were treated with arthroscopic arthrolysis. Active and passive elbow movement is encouraged the day after operation with the effective pain management. Mayo Elbow Performance Index (MEPI) and visual analogue scale were measured. At the final follow-up, the average arc of elbow motion increased from 48.6 ± 19.3 pre-operatively to 114.5 ± 25.7, with a mean improvement of 65.9°. The MEPI score improved from 68.2 ± 16.4 pre-operatively to 92.4 ± 21.6, with a mean improvement of 24.2 (p < 0.001). Results were good to excellent in 29 patients. Injuries are the most common cause of elbow stiffness requiring surgical release. The procedure of arthroscopic arthrolysis is a good option for the treatment of post-traumatic elbow stiffness as it restores normal elbow function. Early passive/active post-operative rehabilitation is very important. Case series, treatment study, Level IV.
    Knee Surgery Sports Traumatology Arthroscopy 05/2014; · 2.68 Impact Factor
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    ABSTRACT: The current trend is toward salvage of the extremity after tumor excision without compromising the extent of resection for bone tumor around the shoulders. The aim of this study was to evaluate functional outcome of patients treated with limb-salvage surgeries combined with shoulder abduction braces. Thirty-six patients with bone tumors around the shoulders, who had limb-sparing resection and reconstruction performed with a shoulder abduction brace, were retrospectively reviewed. Allograft transplantation and rigid internal fixation was performed in 22 patients and artificial prosthetic replacement was performed in 14 patients. Functional evaluation was performed based on the Musculoskeletal Tumour Society (MSTS) scoring system. The overall survival was 78.8% (26/33) at 2 years. The mean final functional score was (81.2 ± 19.6%). The MSTS of patients treated by allograft transplantation and prosthetic replacement were (79.4 ± 15.3%) and (81.9 ± 18.1%), respectively. The MSTS scores differed only slightly between these two groups (P > 0.05). All the patients regained good ROM of the shoulder joints. Satisfactory functional outcomes can be obtained by limb-salvage surgery for bone tumor around the shoulder. Postoperatively shoulder crutches with shoulder abduction brace are encouraged as the aid of reconstruction of shoulder joint function. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 01/2014; · 2.64 Impact Factor
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    ABSTRACT: Bone remodeling is regulated by secreted factors in the bone microenvironment. However, data regarding osteoclast-derived factors that influence osteoblast differentiation are lacking. Here, we show that HtrA1 is produced as a secreted protein during osteoclastogenesis, and negatively regulates osteoblast differentiation. Exogenous addition of recombinant HtrA1 attenuates osteoblast differentiation and BMP2-induced Smad1/5/8, ERK1/2 and p38 phosphorylation in pre-osteoblasts. Our studies imply a unique mode of crosstalk in which HtrA1 is produced by both osteoclasts and osteoblasts and negatively regulates osteoblast differentiation, suggesting that HtrA1 may mediate the fine tuning of paracrine and autocrine regulations during bone remodeling processes.
    FEBS letters 11/2013; · 3.54 Impact Factor
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    ABSTRACT: Mesenchymal stem cells (MSCs) are multipotent stem cells with the ability to migrate to sites of inflammation and injury, where they participate in tissue regeneration and repair. The present study aimed to investigate the effects of T cell activation and inflammation on the differentiation of MSCs. Human trabecular bone‑derived MSCs were isolated from patients undergoing total hip replacement, and T cells were isolated and purified from peripheral blood mononuclear cells (PBMCs) using CD3 MicroBeads. MSCs were co‑cultured with activated T cells to mimic the inflammatory microenvironment. MTS assay was used to detect cell proliferation.qRT‑PCR, western blotting, histology and immunohistochemical staining were used to detect the adipo‑/osteo‑specific gene expression and the relative signaling pathway. The MTS results showed that higher concentrations of T cells significantly increased the proliferation of MSCs. Expression of the inflammatory gene IL‑6 was upregulated, while expression of IL‑10 and INFγ was downregulated in MSCs exposed to activated T cells. The results also showed that PHA‑activated T cells significantly upregulated the expression of PPARγ and FABP4 (adipo‑specific genes) in MSCs, but no difference was noted in the expression of RUNX2, osteocalcin and ALP (osteo‑specific genes) at the protein level. T cell treatment and inflammation inhibited the protein expression of TGF‑β1 and the phosphorylation of Smad3, resulting in the weakening of the TGF‑β/Smad pathway and enhancing the adipogenic differentiation of MSCs. The results indicated that PHA‑activated T cells and inflammation could promote adipogenesis without affecting the late stage of osteogenesis of MSCs, by increasing the expression of key adipogenic genes through TGF‑β/Smad3 signaling.
    Oncology Reports 08/2013; · 2.30 Impact Factor
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    ABSTRACT: OBJECTIVES: Osteonecrosis is also known as avascular necrosis, and two types of cell death are included in the pathogenesis of osteonecrosis: necrosis and apoptosis. Apoptosis in the osteonecrosis of femoral head is thought to be the key determinant of glucocorticoid-induced cortical bone loss. The present study was implemented to evaluate the anti-apoptotic effect of Granulocyte colony-stimulating factor and stem cell factor (G-CSF/SCF) in rabbits with steroid-induced osteonecrosis. METHODS: In the experiment, osteonecrosis was induced by low-dose lipopolysaccharide and subsequent pulsed high-dose methylprednisolone. Rabbits in preventive medicine group were treated with100μg/kg/d G-CSF and 25μg/kg/d SCF. Then hematological and histomorphometric methods were used to investigate the treatment effects of osteonecrosis. Apoptosis was assessed via quantitative TUNEL staining and activated caspase-3 immunostaining and immunoblotting. RESULTS: The results showed that G-CSF/SCF treatment could increase the secretion of serum osteocalcin, but inhibit the expression of serum tartrate-resistant acid phosphatase (TRAP5b). The incidence of osteonecrosis was significantly decreased in Preventive group when compared with Steroid group (42.1% vs. 88.2%). Histomorphometric analysis showed that G-CSF/SCF pre-disposal treatment was able to increase trabecular mineral appositional rate (MAR) and bone formation rate (BFR). Quantitative TUNEL and activated caspase-3 levels showed lower apoptosis in the Preventive group. CONCLUSIONS: In conclusion, G-CSF/SCF treatment could inhibit caspase-3-dependent apoptosis in osteocytes to exert beneficial effects in preventing steroid-induced ON in rabbit models.
    Experimental and Molecular Pathology 06/2012; · 2.13 Impact Factor
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    ABSTRACT: OBJECTIVES: This study examined whether abnormalities of early EPCs and endothelial colony forming cells (ECFCs) are present and compared their functions in glucocorticoid (GC)-induced avascular osteonecrosis of the femoral head (ANFH). METHODS: Early EPCs and endothelial colony forming cells (ECFCs) were obtained from 33 patients with glucocorticoid-induced ANFH and 33 age- and sex-matched control subjects. Cells were isolated, in vitro cultured and studied by Flow Cytometry and Immunofluorescence. Colony-forming unit counts were observed from 33 patients and 33 healthy controls. Growth kinetics, migratory capacity to multiple chemo-attractants, in vitro tube formation capacity and cytokine (vascular endothelial growth factor and stromal cell-derived factor-1) levels in supernatants of two types of EPCs were assayed in ANFH patients and matched controls (n=4). RESULTS: Mean numbers of colonies formed by both types of EPCs were decreased in ANFH patients (Early EPCs: 2.42±1.46 versus 4.52±2.00, p<0.05; ECFCs: 0.62±0.55 versus 1.12±0.82, p<0.05,). Early EPCs from ANFH patients showed impaired migratory capacity (63.8±11.7 versus 152.3±12.4, p<0.001) and VEGF secretion (50.8±7.2pg/ml versus 62.8±10.1pg/ml, p<0.05). ECFCs from ANFH patients showed decreased tube formation capacity (7.1±2.7 versus 23.8±4.3, p<0.001) and proliferation. DISCUSSION: Early EPCs and ECFCs were impaired in number and function in GC-induced ANFH, and their distinct reduced capacity profiles might reflect different roles they played in endothelial dysfunction of GC-induced ANFH.
    Joint, bone, spine: revue du rhumatisme 04/2012; · 2.25 Impact Factor
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    ABSTRACT: To evaluate the therapeutic results of hemivertebra excision through combined anterior and posterior approach followed by short-segment spinal fusion with transpedicular instrumentation in children. Clinical and radiological evaluations were conducted before and after operation and at the follow-up examination. Cobb angles of segmental curve, total main curve, compensatory curves (cranial and cauda) and kyphosis were recorded. All the cases showed satisfactory results, the mean Cobb angle of segment curve was 45.3° before surgery and 14.9° after surgery with 67.1% correction, and 13.5° at the final follow-up assessment with 70.2% correction. Total main curves improved from 47.6 to 18.2° with 61.8% correction, and 16.0° at the final follow-up. Cranial and caudal compensatory curves were improved gradually during follow-up. Kyphosis of the spine also improved obviously. If the operation was performed before the maturity of bone, the secondary spinal deformities could be effectively avoided.
    Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 11/2010; 19(6):545-50. · 0.66 Impact Factor
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    ABSTRACT: Prospective cohort study. To comprehensively compare the intermediate and long-term results of posterior correction and fusion with segmental pedicle screw instrumentation versus those with hook constructs in idiopathic adolescent thoracic scoliosis. Posterior correction and fusion represent the current standard surgical treatment in progressive idiopathic thoracic scoliosis. The 3-column fixation of pedicle screws has been shown to be superior to all other posterior spinal fixation devices. A total of 168 patients with idiopathic thoracic scoliosis at a single institution who underwent a posterior spinal fusion with segmental pedicle screw (88) or a combination of hooks and pedicle screws (80) instrumentation. Patient's evaluation consisted of clinical and radiographic analysis preoperatively, postoperatively, and at final follow-up. All patients were prospectively evaluated with an average follow-up of 5 years (range 5 to 11 y). The average number of segments in the fusion was 9.1 (range 6 to 15) in the hook group and 8.5 in the screw group (range 5 to 12). At the final follow-up, the amount of loss of correction in thoracic curves averaged 8.4 in the hook group and 5.3 in the screw group. The difference between the mean postoperative Cobb angle and the final Cobb angle of the major curves with a preoperative value was statistically significant in the 2 groups (P<0.01). The frontal and sagittal plane correction can be satisfactorily obtained by the screw group versus the pedicle screw group. There were no cases of pseudarthrosis, deep wound infections, or any neurologic complications. Satisfactory correction and maintenance of scoliotic curves could be obtained by pedicle screw instrumentation compared with hook constructs. Thoracic and thoracolumbar pedicle screw instrumentation is a safe and reliable method for obtaining rigid segmental spinal fixation over the conventional hook and rod.
    Journal of spinal disorders & techniques 10/2010; 23(7):467-73. · 1.21 Impact Factor
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    ABSTRACT: Seventy-six patients with femoral head necrosis were allocated to a program of either core decompression (control group) or core decompression and implantation of a biomaterial-loaded allograft threaded cage (treatment group). All patients were followed up prospectively clinically and radiographically. In the control group, no significant improvement in Harris hip score was found, and 13 of the 22 hips had deteriorated to stage III. In the treatment group, the mean Harris hip score was improved from 62.8 to 81.6; the clinical success rate at 36 months postoperatively was 91%. Collapse was seen in 1 hip, and another 3 hips exhibited progressive collapse. The procedure is attractive as a minimally invasive and salvage procedure, which shows encouraging success rates and early clinical results in patients with Steinberg stage I-II osteonecrosis.
    The Journal of arthroplasty 10/2009; 25(8):1223-30. · 1.79 Impact Factor
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    ABSTRACT: To explore morphologic characterizatics of cellular processes from adult human nucleus pulposus cells, the nucleus pulposus of adult human intervertebral disc were obtained from 8 patients (Thompson's grade I~II) and then the tissues specimens were carried out by frozen section and electron microscopic section as well as cell isolation and cultured, processes of nucleus pulposus cells were examined using light microscopy, laser scanning confocal microscopy and transmission electron microscopy. When examined at both the confocal and electron microscope level, all the cells possessed the processes and adjacent nucleus pulposus cells processes possessed a gap junction. But elongated and round cells can be examined when NP cells were monolayer cultured. The rate of elongated cells to round cells is 2.3 to 1. The elongated cells protrude along with the long axis of cell body without second processes. Dendritic processes of round cells protrude to all directions from the cell body with multiple-level processes. Processes are one of the morphologic characteristics of intervertebral disc cells which are different from articular cartilage chondrocytes. The research on processes functions will be helpful to understand pathomechanism of intervertebral disc degradation and open a new approach for cytobiology treatment of the intervertebral disc diseases.
    Proc SPIE 12/2008;
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    ABSTRACT: Bone marrow-derived stem cells (BMSC) have been highlighted for the treatment of osteonecrosis (ON) before collapse of the femoral head. In our study, the potential of granulocyte colony-stimulating factor/stem cell factor (G-CSF/SCF)-mobilized BMSC to repair steroid-associated ON was assessed in rabbits. ON was induced by low-dose lipopolysaccharide and subsequent pulsed high-dose methylprednisolone. Rabbits in the treated group were subjected to subcutaneous injections of G-CSF at a dose of 100 microg/kg and SCF 25 microg/kg per day for 5 days; rabbits in the control group were given saline. Blood samples were collected and serum osteocalcin was detected by ELISA. Radiological analysis was performed by magnetic resonance imaging (MRI). Then bilateral femora and humeri were harvested and processed to paraffin sections and hard-tissue sections for immunohistochemical, histologic, and histomorphometric analysis. . The mean number of leukocytes and relative numbers of mononuclear cells increased significantly after mobilization. All rabbits displayed a marked increase in osteocalcin protein expression in response to G-CSF/SCF. MRI scans showed a reactive interface between the necrotic and reparative zones after G-CSF/SCF administration. Quantitative analysis showed that new vessel formation was 3.3-fold greater and vessel density was 2.6-fold greater in the treatment group than the control group. The histologic and histomorphometric analysis revealed that the new bone volume was significantly higher in the G-SCF/SCF group than in the control group at 4 weeks. G-CSF/SCF-induced mobilization of BMSC in the necrotic foci may represent a promising strategy for promoting functional bone repair of early-stage ON.
    The Journal of Rheumatology 10/2008; 35(11):2241-8. · 3.26 Impact Factor
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    ABSTRACT: Objectifs Les mécanismes pathogéniques impliqués dans l’ostéonécrose induite par les stéroïdes sont mal connus. Des modèles expérimentaux correspondant des maladies humaines sont indispensables pour la mise au point de modalités thérapeutiques efficaces des ostéonécroses. Méthodes Dans cette étude, nous avons conçu un nouveau modèle d’ostéonécrose induite par les stéroïdes chez le lapin en utilisant deux faibles doses de lipopolysaccharide (LPS) et trois fortes doses de méthylprednisolone (MPS) afin d’analyser le développement de l’ostéonécrose. Trente-huit lapins ont été utilisés et l’examen des tissus a été réalisé sur le tiers proximal et les condyles distaux des fémurs et des humérus obtenus six semaines après l’administration de LPS et de MPS. L’IRM de ces régions et la pression intraosseuse du fémur proximal ont été étudiées à zéro et six semaines. D’autres analyses, dont le rapport sérique de l’activateur/inhibiteur du plasminogène, le taux de cholestérol, le rapport LDL/HDL et le taux des triglycérides, ont été réalisées à différents temps. Résultats Ce travail a montré que l’induction de l’ostéonécrose avec ce protocole entraînait une faible mortalité animale (6,2 %), un fort taux d’ostéonécrose (90 %), l’induction d’un état thrombotique et une hypercholestérolémie/hyperlipidémie. Conclusions Dans l’ensemble, nous avons mis au point un nouveau modèle d’animal modifié d’ostéonécrose associée aux stéroïdes. Il pourrait s’avérer utile pour élucider la pathogénie de l’ostéonécrose induite par les stéroïdes et développer des stratégies préventives et thérapeutiques.
    Revue du Rhumatisme. 10/2008; 75(9):845–850.
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    ABSTRACT: The purpose of this study was to evaluate the efficacy of core decompression with a biomaterial-loaded allograft threaded cage (ATC) for the treatment of femoral head osteonecrosis in an established goat model. First, bilateral early-stage osteonecrosis was induced. After core decompression, the remaining goats were randomly divided into three groups: Group A, the goats were left without any treatment; Group B, the goats were treated with implanting a composite of autologous bone and decalcified bone matrix (DBM); Group C, the goats were treated using insertion of ATC loaded with DBM and autogenous bone graft. Then radiographic, histological and biomechanical analysis were taken in each group at 5, 10, and 20 weeks postoperation. In Group A, the classical signs of osteonecrosis of the femoral head were identified 10 weeks after the induction. Twenty weeks later, the density, surface and biomechanical stability of the femoral head were normal in Group C, while an irregular surface and an inhomogeneous microstructure or variation of density/hardness were identified in Group B. The specimens revealed a continuous trabaecular bone structure throughout the cage and extensive bone ingrowth and remodeling in Group C, while fibrous tissue was evident in Group B. Core decompression with a biomaterial loaded ATC almost uniformly delays or arrests the progression of the disease before articular collapse, and it could help to get the balance between bone resorption and new bone formation, strengthen structural mechanics of the femoral head, provide structure support of articular cartilage.
    Biotechnology and Bioengineering 07/2008; 100(3):560-6. · 3.65 Impact Factor
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    ABSTRACT: The pathogenetic mechanisms involved in steroid-induced osteonecrosis are poorly understood. Appropriate experimental models of the human disease are indispensable to the understanding of successful treatment modalities for osteonecrosis. In the present experiment we devised a novel rabbit model of steroid-induced osteonecrosis by use of two low-dose LPS and three high-dose MPS to investigate the development of osteonecrosis. Thirty eight rabbits were used and tissue assessments were performed on proximal third and distal condyles of femora and humeri obtained 6 weeks after the administration of LPS and MPS. MRI of these regions and intraosseous pressure of proximal femur were obtained at 0 and 6 weeks. Other assessments included serum plasminogen activator/inhibitor ratio, cholesterol level, LDL/HDL ratio, and triglyceride levels at various time points. The study showed that with this osteonecrosis induction protocol there was low animal mortality (6.2%), high rate of osteonecrosis (90%), induction of thrombotic state, and hypercholesterol/lipidemia. On the whole, this is a novel modified animal model of steroid associated osteonecrosis and it would be useful for elucidating the pathogenesis of steroid associated osteonecrosis and developing preventive and therapeutic strategies.
    Joint, bone, spine: revue du rhumatisme 06/2008; 75(5):573-8. · 2.25 Impact Factor
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    ABSTRACT: Our clinical study design was prospective, concurrently enrolled and single-center trial of the new functional intervertebral cervical disc prosthesis (Medtronic Sofamor Danek, Memphis, TN) in the treatment of patients with single-level and multiple-level degenerative disc disease of the cervical spine. The study was designed to investigate the surgical technology skills and clinical effects of Bryan cervical disc prosthesis in Chinese, and to observe the stability and range of movement in the early and immediate postoperative period. Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. Nineteen patients (23 discs) had spinal arthroplasty with placement of the Bryan cervical artificial disc prosthesis in our hospital. Clinical and radiologic follow-up was performed. The radiographic parameters evaluated included the treated segments and the overall curvature of the cervical spine. All the patients were observed up from 8 months to 42 months (average 24 months). According to Odom's scale, all of 19 patients (23 levels) had excellent to good outcome. The range of movement recovered to the preoperative value during the follow up. The treated segment ultimately showed preservation of movement when compared with preoperative levels. No prosthesis subsidence or excursion was identified. Arthroplasty using the Bryan disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although early and intermediate results are promising, this is also a relatively new approach, long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.
    Spine 06/2008; 33(12):E371-7. · 2.16 Impact Factor