Extracorporeal Shock Wave and Melatonin Alleviate Joint Capsule Fibrosis after Knee Trauma in Rats by Regulating Autophagy.

BACKGROUND: Joint contracture is a common clinical problem affecting joint function. Capsule fibrosis plays a pivotal role in the progression of Joint contracture. Previous studies have reported that autophagy plays a regulatory role in visceral fibrosis. OBJECTIVE: This study aimed to investigate whether extracorporeal shock wave therapy (ESWT) and melatonin alleviate joint capsule fibrosis in rats with extended knee joint contracture by regulating autophagy. METHODS: A rat knee joint extension contracture model was made. Then, the rats were treated with ESWT, melatonin, ESWT + melatonin, or ESWT + melatonin + mTOR agonist for 4 weeks. The range of motion (ROM) of the knee joints was measured. Joint capsules were collected and observed for pathological changes by H&E and Masson staining. LC3B protein expression was evaluated by immunofluorescence staining. TGF-ß1, MMP-1, Col-Ⅰ, Col-Ⅲ, LC3, ATG7, Beclin1, p-AMPK, p-mTOR and p-ULK1 protein expressions were measured by Western blot assay. RESULTS: The intervention groups had significantly improved ROM of knee joint (P < 0.05), significantly improved pathological changes on HE and Masson staining, significantly decreased protein expressions of TGF-ß1, MMP-1, Col-Ⅰ, Col-Ⅲ and pmTOR (P < 0.05), and significantly increased protein expressions of LC3B, LC3II/LC3I ratio, ATG7, Beclin1, p-AMPK, and p-ULK1 (P < 0.05). Among these groups, the effects demonstrated by the ESWT + melatonin group were the best. With the mTOR agonist supplement, the therapeutic effects of extracorporeal shock waves and melatonin were significantly reduced. CONCLUSION: ESWT plus melatonin alleviated knee joint capsule fibrosis in rats by regulating autophagy.

Preliminary study of extracorporeal shock wave alleviating joint capsule fibrosis caused by internal bleeding of knee joint in rats.

PURPOSE: Joint contracture is a common disease in clinical practice, joint bleeding is an important factor affecting the progression of joint contracture. This study aimed to explore the effect of extracorporeal shock wave on alleviating joint capsule fibrosis caused by intra-articular hemorrhage in rats. METHODS: Forty two SD rats were randomly divided into seven groups. Perform simple fixation and fixation after blood injection separately. Measure the range of motion of each group's knee joints and calculate the corresponding degree of contraction. Use HE staining and Masson staining to detect the number of anterior joint capsule cells and collagen deposition. Detection of changes in Wnt1, ß-catenin protein expression in joint capsule using Western blotting. RESULTS: Compared to group C, the degree of knee joint contracture in M1 and M2 groups of rats increased, and collagen deposition, cell number and Wnt1, ß-catenin protein expression also increased accordingly. Compared to M1 and M2 groups, the degree of knee contraction in E1 and E2 groups were reduced, while collagen deposition, cell number and Wnt1, ß-catenin protein expression were decreased, and the degree of joint contracture in NR1 and NR2 groups showed no significant improvement. Compared to NR1 and NR2 groups, the degree of knee contraction in E1 and E2 groups were reduced, while collagen deposition, cell number and Wnt1, ß-catenin protein expression were decreased. CONCLUSIONS: Both rat models of knee joint contracture were successful, and joint bleeding can exacerbate joint contracture. Extracorporeal shock waves alleviate joint capsule fibrosis caused by intra-articular bleeding in rats.

Therapeutic effects of electrical stimulation on overactive bladder: a meta-analysis.

BACKGROUND: To systematically evaluate the therapeutic effect of electrical stimulation (ES) on overactive bladder (OB). METHOD: We retrieved information by searching databases from PubMed, CBM-disc, The Cochrane Library, ScienceDirect (from Elsevier publishers) and Springer publishers up to March 2016. We looked for randomized controlled trials that studied ES in OB treatment with subject headings and keywords using literature searches and manual retrieval. References of included studies were reviewed. Literature was screened independently by two investigators according to inclusion and exclusion criteria. After extracting data and evaluating their quality, meta-analysis was undertaken with RevMan v5.2. RESULTS: Ten randomized controlled trials involving 719 patients were included. Meta-analysis results demonstrated ES to have better effects for improving bladder compliance, reducing residual urine, and decreasing the frequency of enuresis in OB patients compared with the control group. ES elicited significantly better effects for diminishing the maximum detrusor pressure in children than in controls, but there was no significant difference in the maximum detrusor pressure between adults and controls. The therapeutic effect of ES combined with other therapies for increasing the maximum bladder capacity was better compared with other therapies alone. No significant difference was noted between ES alone and other therapies alone. CONCLUSIONS: Based on current evidence, ES has certain effects on OBs. Severe adverse reactions are not observed. ES is safe, efficacious, and worthy of clinical use.