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1.
Article in Chinese | WPRIM | ID: wpr-743919

ABSTRACT

BACKGROUND:Mechanical stress plays an important role in the progressive collapse in osteonecrosis of the femoral head.Therefore,the bone structure of weight-bearing area may be the risk factor for collapse.OBJECTIVE:To investigate the relationship between the bone preservation of weight-bearing area and collapse progression in necrotic femoral head.METHODS:Eighty-seven patients (102 hips) with ARCO stage Ⅱ osteonecrosis of the femoral head,diagnosed by MRI,were enrolled.All patients underwent a natural progression.Collapse and bone involvement of the weight-bearing area were viewed by anteroposterior and frog-leg lateral radiographs.According to the location of the necrotic lesion on the anterolateral portion of the femoral head,the necrosis was divided into three types:type 1,the posteromedial and central portions;type 2,part of the anterolateral portion;type 3,the entire anterolateral portion.The collapse rate and the time to collapse in different types were assessed.RESULTS AND CONCLUSION:(1) All patients were followed up for 3-58 months.(2) Of the 60 hips with collapse,46 (76.7%) hip collapse was identified on anteroposterior radiograph.On frog-leg lateral radiograph showing collapsed femoral head could be identified in 57 (95.0%) hips,which was significantly different (P < 0.01).(3) In all 102 hips,the collapse rate in type 3 osteonecrosis of the femoral head was significantly higher than that of type 2 osteonecrosis of the femoral head (P < 0.001),and the time to collapse was markedly shortened.None collapse occurred in all six hips with type Ⅰ osteonecrosis of the femoral head during follow-up.(4) In summary,preservation of anterolateral portion is associated with potential collapse progression in necrotic femoral head.

2.
Article in Chinese | WPRIM | ID: wpr-743774

ABSTRACT

Objective We aimed to explor the correlation between the serum resistin levels and the collapse process of femoral head necrosis. Methods Eighty-eight patients with osteonecrosis of the femoral head were included in this study (26, 34 and 28 cases at ARCO stage Ⅱ, Ⅲ and Ⅳ, respectively). Fifty healthy controls were enrolled. The serum resistin levels were detected with ELISA method. We compared the serum resistin levels between the patient group and control group. The differences of serum resistin levels between different ARCO stagesand various disease causes were analyzed in the patient group. Results The resistin levels were significantly higher in patients with osteonecrosis of the femoral than healthy control group (P = 0.026). Compared with control group, the resistin levels significantly increased in patients at ARCO stage Ⅲ and ARCO stage Ⅳ respectively (P = 0.001).The resistin levels of procollapse group (ARCO stage Ⅲ and Ⅳ) were significantly higher than that of precollapse group (ARCO stage Ⅱ) (P = 0.000). There was no statistic difference between ARCO stage Ⅲ andⅣ in resistin levels (P> 0.05). No statistical significance was found between different disease causes. ROC curve analysis of resisrin level indicated theertain accuracy (AUC = 0.749) , sensitivity and significant specificity (77.4%, 61.5%, respectively) in the diagnosis of femoral head necrosis. Conclusions Resistin is closely related to the collapse process of femoral head necrosis. The level of resistin was significantly increased after the collapse of femoral head, which could be useful for the clinical diagnosis of the collapse of femoral head necrosis.

3.
Chinese Journal of Orthopaedics ; (12): 160-168, 2019.
Article in Chinese | WPRIM | ID: wpr-734426

ABSTRACT

Objective To investigate the global research status and trends ofrehabilitation after arthroplasty.Methods The Wed of Science database was used to search the publications on rehabilitation after arthroplasty from 1994 to 2018.The included publish items were statistically analyzed by bibliometrics.VOSviewer software was used to analyze the visual transformation of literature coupling (including author coupling,mechanism coupling and country coupling) and co-occurrence analysis.The research status and trends of rehabilitation after arthrop]asty in recent years were analyzed and predicted.Results A total of 1 702 studies were included in the present study.The number of literatures increased year by year globally,including 612 in the United States as the top number of studies in the world.The total citation frequency (15 433 times) and H index (61) of the research publications were also the highest in the world.China (79 literatures) ranked 6th in the number of global research publications,with total citation frequency (451 times) and H index (12) ranked 14th.The number of publications published by JOURNAL OF ARTHROPLASTY and ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION on rehabilitation after arthroplasty was the highest.The University of Pittsburgh and the University of Toronto were the biggest contributors to publications on rehabilitation after arthroplasty.The theme of rehabilitation after arthroplasty can be divided into five categories:pain management,functional exercise,hospital management,complications and clinical trials.Hospital management wasthe main research field recently and the orthopedic specialty hospital would become a hot research topic in the fulure.Conclusion According to the current global trends,rehabilitation study is deepening and the number of publications will increase continuously.The United States is the largest contributor in this area.The current researches focus on the "hospital management" after arthroplasty.The new type of orthopedic specialty hospital may be the next research hotspot for arthroplasty.

4.
The Journal of Practical Medicine ; (24): 2459-2464, 2017.
Article in Chinese | WPRIM | ID: wpr-611915

ABSTRACT

Objective To study whether the effects of bone mineral density by a kidney-tonifying herbal fufang treatment in senile osteoporosis mice (P6) is by the mechanism of improving the expression level of GH mRNA and IGF-1 mRNA. Methods The experimental points four groups as following:SAMR1 mice which feed saline lavage,SAMP6 divid as saline lavage group,subcutaneous injection of rhGH group and a kidney-tonifying herbal fufang treatment group. All intervention is one time everyday. After 3 months and 6 months intervention,we measure the BMD and the expression level of the GH mRNA and of IGF-1 mRNA. Results After 3 months intervention,the BMD of R1 group and the Kidney group were higher than the P6 blank group;but there is no difference in BMD between RhGH group and the P6 blank group. The effect of GH mRNA and IGF-1 mRNA expression levels:the R1 group,rhGH and kidney group were higher than the P6 blank group. After six months intervention,the BMD of the rhGH group and kidney group are higher than the P6 blank group. GH mRNA and IGF-1 mRNA expression levels:GH group and kidney group are higher than the P6 blank group. The expression level of GH mRNA and IGF-1 mRNA in four groups has positive correlation. After six months intervention ,we found the positive correlation between the expression level of GH mRNA and IGF-1 mRNA and each part of the whole body BMD. Conclusion A kidney-tonifying herbal fufang can improve the bone mineral density of P6,and its mechanism may be related to improve expression level of GH mRNA and IGF-1 mRNA.

5.
Article in Chinese | WPRIM | ID: wpr-667353

ABSTRACT

Postmenopausal osteoporosis(PMOP)is a primary metabolic disorder of bone in postmenopausal women which is characterized by osteopenia, destruction of bone microstructure, increased bone fragility and fracture.PMOP is the major cause of joint pain and disability in middle-aged and elderly women.The research shows that early biomarkers can provide clinical evidence for early diagnosis of PMOP, assess fracture risk and evaluate treatment effect.In this paper, the latest advances in the application of PMOP biomarkers are described from the aspects of PMOP hormone correlation index and bone metabolism.

6.
Article in Chinese | WPRIM | ID: wpr-663291

ABSTRACT

Objective To identify the plasma miRNAs which are differentially expressed in the patients with traumatic avascular necrosis of the femoral head by means of high-throughput screening so as to provide data for further research into the pathogenesis of traumatic avascular necrosis of the femoral head.Methods We selected 10 patients with femoral neck fracture who had been treated from January to April 2015 for traumatic avascular necrosis of the femoral head following manual reduction and internal fixation with percutaneous hollow screws (necrosis group) and another contemporary age-matched 10 patients with femoral neck fracture who had been treated in the similar way but did not develop traumatic avascular necrosis of the femoral head for over 2 years (control group).After the peripheral blood was obtained from the 20 patients,Axon GenePix 4000B chip scanner was used for peripheral blood chip screening to identify the miRNAs which were differentially expressed.QPCR technique was used to verify the top 5 miRNAs which were significantly up-regulated and the top 5 miRNAs which were significantly down-regulated.Results The Harris score for the necrosis group was significantly lower than that for the control group while the Visual Analog Scale score for the former significantly higher than that for the latter (P < 0.05).There were no significant differences between the 2 groups in general data (P > 0.05).In comparison of the 2 groups,the chip screening identified 95 miRNAs which were significantly up-regulated and 413 miRNAs which were significantly down-regulated.The "volcano" analysis screened out 147 miRNAs differentially expressed of which 35 were up-regulated genes and 112 down-regulated genes.Of the 10 genes selected,8 were found in line with the results of microarray screening:hsa-miR-93-5p,hsa-let-7i-5p,hsa-miR-320a,hsa-miR-25-3p,hsa-miR-16-2-3p,hsa-miR-122-5p,hsa-miR-4711-3p and hsa-miR-3191-5p.Conclusion This study indentified 8 differentially expressed miRNAs associated with traumatic osteonecrosis of the femoral head,providing data for further study.

7.
Article in Chinese | WPRIM | ID: wpr-486181

ABSTRACT

BACKGROUND: A variety of angiogenic factors are involved in bone healing after osteonecrosis of the femoral head. OBJECTIVE:To explore the role and mechanism of angiogenic factors in osteonecrosis of the femoral head. METHODS: A computed-based online search of PubMed, Google and SpringerLink databases was performed using the key words of “angiogenic factors, osteonecrosis of the femoral head, vascular endothelial growth factor, angiopoietin-1, fibroblast growth factor-2, hypoxia inducible factor-1, calcitonin gene related peptide and hypoxia inducible factor-1α” for literatures published from December 1980 to May 2015. RESULTS AND CONCLUSION:Finaly, 68 articles were included. Bone angiogenesis which is dependent on special signaling factors in the microenvironment is closely linked with bone repair. A variety of cytokines, such as vascular endothelial growth factor, angiopoietin-1, fibroblast growth factor-2, platelet-derived growth factor, calcitonin gene-related peptide, and hypoxia inducible factor-1α, have been identifiedto control angiogenesis in different ways and be involved in the repair of necrotic femoral head.

8.
Article in Chinese | WPRIM | ID: wpr-464707

ABSTRACT

Objective To investigate the concentration of 17β-estradiol in bone marrow stem cells (BMSCs) and different tissues of rats, and study the function of estradiol produced in extragonadal sites prelimi-narily. Methods (1) The concentration of 17β-estradiol in lysate of BMSCs and in supernatant cell culture media were detected by Elisa method after rats BMSCs were serum-free cultured in 0 h , 24 h and 48 h respective ly . (2) The tissues of organs were grinded and broken under ultrasonic wave , then washed and weighed. The con-centration of 17β-estradiol in different tissues was detected by Elisa method. Results Compared with the concen-tration of 17β-estradiol at 24 h, the concentration of 17β-estradiol at 48h significantly increased (P 0.05). Conclusions (1) 17β-estradiol can be secreted by BMSCs , and the concentration is proportional to the time to some degree. But whether the extragonadal estrogen can function locally is still unclear. (2) The concentration of 17β-estradiol is non- gonad dependent but whether it is secreted locally remains to be elucidated. The non- gonad estrogen could be the estrogen source of bone metabolism in order to sustain bone health after menopause.

9.
Article in Chinese | WPRIM | ID: wpr-477485

ABSTRACT

BACKGROUND:Estrogen signaling pathway for interaction between aromatase and estrogen-related receptor may exist in bone marrow mesenchymal stem cel s, which is used for regulating biological activity of bone marrow mesenchymal stem cel s. OBJECTIVE:To observe the expression of aromatase and estrogen-related receptors in adult bone marrow mesenchymal stem cel s during osteogenic differentiation. METHODS:Bone marrow mesenchymal stem cel s were respectively cultured in low-glucose DMEM medium (control group) and osteogenic induction medium (induction group). Cel proliferation and calcium deposition were determined by MTT assay and alizarin red staining, respectively. The expression of aromatase, estrogen receptorα, estrogen receptorβ, and estrogen-related receptorαduring osteogenic differentiation were determined by real-time PCR and western blot analysis. Estradiol levels in supernatants and lysates were detected by ELISA method. RESULTS AND CONCLUSION:In the induction group, the proliferation ability of bone marrow mesenchymal stem cel s was the strongest at 72 hours of culture;while there were a great amount of calcium nodules formed at 21 days of culture. Results from PCR and western blot assay showed that the expression of aromatase and estrogen receptorαwas improved in the induction group, but the expression of estrogen-related receptorαwas inhibited. There was no difference in the expression of estrogen receptorβbetween the two groups. ELISA results indicated that the level of estradiol in the supernatant of induction group was the highest. These findings indicate that aromatase, estrogen receptorα, estrogen receptorβand estrogen-related receptorαare al involved in osteogenesis of bone marrow mesenchymal stem cel s. Moreover, estradiol can be synthesized and secreted in bone marrow mesenchymal stem cel s, and most likely, promote the osteogenic differentiation of bone marrow mesenchymal stem cel s by related receptor pathway.

10.
Article in Chinese | WPRIM | ID: wpr-475188

ABSTRACT

Objective To compare the effects of gastric gavage and intramuscular injection of prednisone on the bone mineral density, skeletal biomechanical properties and bone metabolism in rats.Methods A total of 45 SPF rats were randomly divided into three groups:normal group, intragastric administration group, and intramuscular injection group.The normal group, as a control group, was administrated with normal saline 2 mL per day, both the intragastric administration group and i.m.injec-tion group received prednisone 0.5 mg/(kg.d) for 12 weeks.All rats were examined for bone mineral density (BMD) and the level of serum β-CTX and PINP.The femoral cortical biomechanical properties ( elastic load, maximal load, rupturing load) were measured by three point bending test.Results After 12 weeks, compared with the normal group, BMD and elastic load, maximal load, and rupturing load of the femur were significantly decreased.Compared with the intragastric gavage group, BMD was significantly decreased, while the elastic load, maximal load, and rupturing load of the femur were not significantly changed in the i.m.injection group (P<0.05 for all).Compared with the normal group, the level of serum β-CTX was significantly raised (P<0.05) and the level of serum PINP was significantly decreased (P<0.05).Compared with the intragastric gavage group, the level of serumβ-CTX was also significantly raised (P<0.05), the level of serum PINP was significantly decreased (P<0.05), the bone trabecula and hemopoietic tissue were obviously decreased, while the adipose tissue increased obviously. Conclusions Both intragastric gavage and intramuscular injection of prednisone affect the level of BMD, skeletal biomechanical properties and bone metabolism.However, i.m.injection of prednisone decreases the BMD and bone strength more significantly, leading to a higher bone turnover with increased bone resorption, and leads to osteoporosis earlier.Our results may suggest that oral administration of prednisone is more safe in clinical treatment.

11.
The Journal of Practical Medicine ; (24): 3932-3934, 2014.
Article in Chinese | WPRIM | ID: wpr-461740

ABSTRACT

Objective To investigate the relationship between the serum SRC-3 levels and the bone loss severity in postmenopausal women. Methods Fifty-eight PMW with osteopenia or osteoporosis and nineteen healthy PMW were enrolled in this study from June 2012 to September 2013. BMD at the lumbar spine and femoral neck were observed by DXA Lunar Prodigy Vision. The levels of serum SRC-3 were detected by ELISA. The diagnosis value was evaluated by the ROC curves analysis. Results The levels of serum SRC-3 were significant higher in the normal group than those in the osteopenia or the osteoporosis groups (P<0.001 for both), no statistical significance was found between the osteopenia and the osteoporosis group(P=0.056). The levels of serum SRC-3 were negatively correlated with the BMD diagnosis grading (r=-0.543, P < 0.001). By using the ROC curve analysis, the serum level of SRC-3 for PMW with osteoporosis and osteopenia were found to be 0.297 ng/mL and 0.347 ng/mL, respectively. The levels of serum SRC-3 were positively associated with BMI (r=0.395, P<0.001) and LS-BMD (r=0.503,P<0.001) in the postmenopausal women. Conclusion SRC-3 might be an useful index to reflect the severity of lumbar spine bone loss.

12.
Article in Chinese | WPRIM | ID: wpr-234704

ABSTRACT

The model of knee OA (KOA) was established in our laboratory with three-dimensional (3D) reconstruction technique based on the CT data. We then designed the unicompartmental prosthesis matching KOA model with parametric software Pro/e 5. 0. Finally, the models were used to mimic the operation of knee unicompantment replacement and the model of unicompartmental knee athroplasty (UKA) was analyzed using 3D finite element method. The results indicates that the approach for designing the model by 3D parametric is effective and meets the need of automation and efficacy to design unicompartmental prosthesis. The results proves that the model is vivid and precise, and the 3D parameteric modeling method can provide biomechanical research of unicompantment replacement with model foundation and new experimental method. It can be widely utilized in the clinics and research.


Subject(s)
Algorithms , Arthroplasty, Replacement, Knee , Methods , Computer-Aided Design , Finite Element Analysis , Humans , Imaging, Three-Dimensional , Methods , Knee Joint , Diagnostic Imaging , General Surgery , Knee Prosthesis , Prosthesis Design , Tomography, X-Ray Computed
13.
Article in Chinese | WPRIM | ID: wpr-271796

ABSTRACT

This paper is aimed to acquire high Geometric similar Subject-specific three-dimensional (3D) finite element mesh model of hip joint containing necrotic femoral head according to individual patient's X-ray, CT and MRI by using the image registration and fusion technology. We selected a middle-aged female patient with osteonecrosis of femoral head, obtained the X-ray, CT and MRI images respectively. Then we established 3D solid model separately based on these image data by using Mimics 13. 1 and Pro/E 5.1 software. We confirmed the match points and then proceed the 2D image registration after image projection conversion. Finally we showed the 3D finite element mesh model. A highly geometric similar subject-specific 3D finite element mesh model for osteonecrosis of femoral head has been established, which included normal cortical bone, cancellous bone, articular cartilage and necrotic zone, fractured trabecular bone within the femoral head. The model truly reflects the morphological characteristics and relationship of hip joint with osteonecrosis of femoral head, provides a relatively ideal research platform for further biomechanical analysis and surgical simulation.


Subject(s)
Female , Femur Head Necrosis , Diagnostic Imaging , Pathology , Finite Element Analysis , Humans , Image Processing, Computer-Assisted , Methods , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Middle Aged , Models, Anatomic , Tomography, X-Ray Computed
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