Effect of Bushen Chushi() decoction combined with platelet-rich plasma on regulating TGF-β1 and Smad-1 expression in serum of knee osteoarthritis patient / 中国骨伤

OBJECTIVE@#To investigate the effect of Bushen Chushi decoction combined with platelet-rich plasma(PRP) to treat knee osteoarthritis(KOA) in early and middle stage and its regulation on TGF-β1 and Smad-1 expression in serum.@*METHODS@#Total of 45 patients with KOA in early and middle stage from May 2020 to April 2022 were treated and divided into control group and observation group. In control group, there were 30 patients including 12 males and 18 females, aged from 43 to 69 years old with an average of(57.3±6.5) years old and disease duration ranged from 1.5 to 5.0 years with an average of(3.8±1.7) years, and there were 8 cases in gradeⅠ, 13 cases in gradeⅡ, and 9 cases in grade Ⅲ according to Kellgren-Lawrence Grade, PRP 5 ml was injected into knee joint on the first day of No1, 3 week together for 2 times. In the observation group, there were 15 cases including 7 males and 8 females, aged from 45 to 70 years old with an average of (56.7±6.2) years old and disease duration ranged from 1.8 to 5.7 years with an average of (4.0±1.8) years, there were 4 cases in gradeⅠ, 9 cases in gradeⅡand 4 cases in grade Ⅲ according to the Kellgren-Lawrence Grade, PRP 5 ml were injected into knee joints that the time and frequency were the same as those in the control group, and at the same time Bushen Chushi decoction orally were taken 1 dose per day with a total of 28 doses. All patients were treated for four weeks. Visual analogue scale(VAS) and Lequesne MG score before and after treatment were used to evaluate improvement of knee pain and joint function. The TGF-β1 and Smad-1 levels in serum were measured before and after treatment in two groups. The incidence of complications in two groups was observed.@*RESULTS@#All patients were followed up for 26 to 30 days with an average of (28.0±0.6) days. There was no significant difference in VAS and knee Lequesne MG scores between two groups before treatment(P>0.05). The scores of VAS and knee Lequesne MG on the first day after treatment in both groups were lower than those before treatment(P<0.05). The VAS and knee Lequesne MG scores in observation group were lower than those in control group(P<0.05) on the first day after treatment. The TGF-β1 level in serum after treatment were higher significantly than that before treatment in two groups(P<0.05). After treatment, TGF-β1 level in serum in observation group were lower than those in control group with statistically significant differences(P<0.05). The Smad-1 levels in serum after treatment in observation group were higher significantly than that in control group(P<0.05). The levels of Smad-1 were not statistically significant between before and after treatment(P>0.05). There was no significant difference in postopertaive complications between two groups (P>0.05).@*CONCLUSION@#The efficacy of Bushen Chushi decoction combined with PRP in treatment of early and middle KOA is better than that of PRP injection alone. The combined treatment could reduce TGF-β1 level and increase Smad-1 level in serum, which may be a mechanism to inhibit inflammation and alleviate cartilage degeneration to some extent.

Case-control study on Chinese medicine fumigation and massage therapy for the treatment of knee stability and func tional recovery after anterior cruciate ligament reconstruction operation / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical outcomes of Chinese medidine fumigation and massage therapy for the treatment of knee stability and functional recovery after anterior cruciate ligament reconstruction operation,and to explore the effect on tendon-bone healing.</p><p><b>METHODS</b>Total 50 patients were divided into two groups: the control group (normal rehabilitation therapy group),the treatment group (Chinese medicine fumigation and manipulation group). There were 25 patients in the control group, including 16 males and 9 females, who were treated with isometric muscle training, with the gradually enlarging amplitude of flexion and progressive loading of bearing training for knee recovery. There were 25 patients in the treatment group, including 15 males and 10 females,who were treated with the conventional rehabilitation therapy combined with Chinese medicine fumigation and massage therapy. The Chinese herbs named as Haitongpi decoction was steamed by a special equipment to fumigate the knee after operation; Based on the biomechanical parameters of the ligament reconstruction, the massage therapy was designed to control the degree of the knee flexion and release the adhesion for early recovery of knee functions. The Lysholm knee function evaluation system was used, and MRI examination was performed to measure the change in width of ligament tunnel in femur and tibia to evaluate the safety and stability of the treatment.</p><p><b>RESULTS</b>Lysholm system showed that two groups both had improving results from the 1st month after operation to the 3rd month (treatment group, F=36.54, P<0.05; the control group, F=28.12, P<0.05), and the results of the treatment group was better than that of the control group at the observation point (the 1st month, t=0.105, P<0.05; the 3rd month, t=5.361, P<0.01). There was no difference between the two groups when evaluating the bone and tendon healing 3 and 12 months after operation (P>0.05), indicating that Chinese rehabilitation therapy was a safety treatment without the influence on the loosing of tendon.</p><p><b>CONCLUSION</b>Chinese medicine fumigation and massage therapy can early improve the knee function after the anterior cruciate ligament reconstruction operation without the disturbance of the knee stability.</p>

Effect and mechanism of Danhong injection on isolated mesenteric arterial rings in rats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect and mechanism of Danhong injection on isolated mesenteric arterial rings in rats.</p><p><b>METHOD</b>An isolated vascular ring experiment was conducted to determine the changes in tension of vascular rings with a biological signal collection and analytical system.</p><p><b>RESULT</b>Danhong injection had no impact on the tension of vascular rings. Danhong injection showed a significant vasodilatation effect on treated arteria rings of norepinephrine, and no remarkable impact was made on the effect without endothium. It showed notable effect on blood vessels treated with Ca(2+) and no significant impact on those treated with caffeine. It could inhibit NE-induced intracellular calcium from releasing and external calcium from inflowing. No effects of potassium channel blockers on aorta ring tensile force were found.</p><p><b>CONCLUSION</b>Danhong injection shows significant vasodilation effect, which mainly works through vascular smooth muscle. Its vasodilation effect may be related to inhibitory receptor, voltage-dependent Ca(2+)-release and IP3 receptor-mediated Ca(2 +)-influx.</p>

Effect of treatment based on syndrome differentiation by Chinese medicine on post-traumatic elbow arthritis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy of treatment based on syndrome differentiation of Chinese medicine and modern conservative therapeutic program on post-traumatic elbow arthritis (PTEA) in order to provide the guidance in clinical practice.</p><p><b>METHODS</b>Seventy-six patients with PTEA requesting the conservative therapy were equally assigned to two groups randomly. The 38 patients in the treated group were administered with Chinese herbal medicines according to their syndrome typing for oral intake and external washing; while the other 38 patients in the control group were treated orally with glucosamine hydrochloride and Celecoxib, combined with intra-articular injection of sodium hyaluronate and peri-articular pain spot blocking with Triamcinolone Acetonaide Acetate injection. All were followed-up for six months with the therapeutic efficacy assessed by Japanese Orthopaedic Association (JOA) and the Hospital for Special Surgery (HSS) Scale scoring.</p><p><b>RESULTS</b>All the 76 patients completed the trial. The JOA and HSS scores in the two groups were not significantly different before treatment (P>0.05), but they did show significant difference after treatment in terms of total score, joint pain, range of motion, and daily activity (P<0.05). However, there was no difference between the two groups in the improvement of joint stability and deformity (P>0.05).</p><p><b>CONCLUSION</b>Both the Chinese drug therapy according to syndrome differentiation and modern conservative therapy are effective in treating PTEA, but the former shows more superiority, and so it is worthy of clinical spreading.</p>

Controlled clinical trials on the effects of Chinese traditional medicine for the treatment of osteoarthritis of knee joint at early stage and its MRI changes / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of Chinese traditional medicine for the treatment of osteoarthritis of knee joint at early stage, as well as to observe the changes of articular cartilage in MRI before and after the treatment.</p><p><b>METHODS</b>Sixty patients were divided into two groups according to Doll's law, 32 patients in the treatment group (6 male and 26 female, with an average age of 52.2 years, ranging from 43 to 65 years, 40 joints), 28 patients in the control group (5 male and 23 female, with an average age of 54.4 years, ranging from 42 to 65 years, 33 joints). The patients in the test group were given Chinese traditional medicine orally, and patients in the control group were given celecoxib and the glucosamine hydrochloride orally for three months. MR scan and ISOA score were given respectively before and after treatment. After the treatment, the articular cartilage changes of the weight bearing area were observed to evaluate the therapeutic effects.</p><p><b>RESULTS</b>All the patients were followed up ranging from 13 to 17 months, with an average of 15.3 months. According to MRI evaluation, 15 joints got an excellent result, and 17 joints got a good result in the treatment group, the total excellent and good rate was 80.0%; and in the control group, above data were 8, 11 and 57.6% respectively. The average ISOA score of the treatment group after treatment was 0.35 +/- 0.16, and in the control group was 3.68 +/- 0.18. There was significant differences between the two groups of ISOA score (t = 6.94, P<0.05).</p><p><b>CONCLUSION</b>Chinese traditional medicine can significantly alleviate or inhibit the cartilage degeneration of knee osteoarthritis at early stage and improve joint function. It had significant clinical effects.</p>

Effect of lugu Ganoderma lucidum on low-density lipoprotein oxidation and monocyte adhesion to endothelium / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of Lugu Ganoderma Lucidum (LGL) on low-density lipoprotein (LDL) oxidation and monocyte adhesion to endothelium (AdM-E) induced by oxydative LDL and advanced glycosylation endproducts (AGE) by using serum pharmacological technique.</p><p><b>METHODS</b>LDL oxidation was determined by measuring the thiobarbituric acid reactive substances in the supernatants, and AdM-E was determined by measuring myeloperoxidase activity of adherent monocyte.</p><p><b>RESULTS</b>Serum derived from rats 0.5 hrs, 1 hr, 2 hrs, 3 hrs after LGL administering 0.12 g/kg once and 0.5 hrs, 1 hr after LGL administering twice showed no significant effect on LDL oxidation, but the serum from rats 2 hrs, 3 hrs after LGL 0.12 g/kg administering twice or from rats after 10 successive days LGL administering in dose of 0.12 g/kg, 0.24 g/kg and 0.72 g/kg, all could lower the LDL oxidation (P < 0.05). Besides, the serum from rats with 10 days LGL administering of all dosages also could inhibit AdM-E induced by AGE (P < 0.05), and those of 0.24 g/kg and 0.72 g/kg could inhibit AdM-E induced by oxydative LDL (P < 0.05).</p><p><b>CONCLUSION</b>LGL could decrease LDL oxidation and AdM-E induced by AGE or oxydative LDL.</p>