Osthole Suppresses Knee Osteoarthritis Development by Enhancing Autophagy Activated via the AMPK/ULK1 Pathway.

Knee osteoarthritis (KOA) is an increasingly prevalent heterogeneous disease characterized by cartilage erosion and inflammation. As the main chemical constituent of Angelicae Pubescentis Radix (APR), an anti-inflammatory herbal medicine, the potential biological effects and underlying mechanism of osthole on chondrocytes and KOA progression remain elusive. In this study, the potential effect and mechanism of osthole on KOA were investigated in vitro and in vivo. We found that osthole inhibited IL-1ß-induced apoptosis and cartilage matrix degeneration by activating autophagy in rat chondrocytes. In addition, osthole could activate autophagy through phosphorylation of AMPK/ULK1, and AMPK serves as a positive upstream regulator of ULK1. Furthermore, KOA rats treated with osthole showed phosphorylation of the AMPK/ULK1 pathway and autophagy activation, as well as cartilage protection. Collectively, the AMPK/ULK1 signaling pathway can be activated by osthole to enhance autophagy, thereby suppressing KOA development. Osthole may be a novel and effective therapeutic agent for the clinical treatment of KOA.

A localization method for guide pin insertion points in the treatment of femoral neck fracture with closed reduction and percutaneous cannulated screw fixation.

Background: Closed reduction and percutaneous cannulated screw fixation is the preferred surgical method for treating femoral neck fractures in elderly patients under 70 years old. The key to the operation is the precise insertion of the guide pin after the successful reduction. However, there is no universally accepted standard for the localization of the guide pin insertion point. This study introduces our invention of a localization method for guide pin insertion points. Methods: We used fluoroscopic frequency, operative time, union rates, and complications to retrospectively evaluate the treatment and outcome of femoral neck fractures using our localization method for guide pin insertion points. The study included ten patients treated at Affiliated Hospital of Shandong University of Traditional Chinese Medicine between 2010 and 2014 for femoral neck fracture using our localization method for guide pin insertion points. Results: Our results showed that the mean number of fluoroscopies was 5 (range, 4-8), and the mean operative time was 32 minutes (range, 25-51 minutes). All 10 patients achieved union at an average of 3.4 months (range, 2.8-6.2 months) without complications after the operation. The average follow-up time was 13.2 months (range, 12.2-16 months). The treatment of femoral neck fracture with our localization method for guide pin insertion points resulted in satisfactory curative efficacy without complications. Conclusions: Our localization method offers distinct advantages, including the accuracy and simplicity of the operation, a low rate of complications, and adequate biomechanical stability. As such, it provides a feasible method for clinical treatment.

Cangxitongbi capsules protect the articular cartilage in the rat knee through the long non-coding RNA HOTAIR/p38MAPK pathway.

BACKGROUND: Knee osteoarthritis (KOA) is a leading cause of chronic pain and disability, and as such, it poses a significant economic burden. Traditional Chinese medicine (TCM), as well as complementary and alternative medicine, can offer safe and effective treatments for KOA. Cangxitongbi (CXTB) capsule is a Chinese patented medicine for KOA treatment and has a remarkable curative effect. This article evaluated the effects and mechanisms of CXTB in protecting joint cartilage in vivo. METHODS: The KOA model was constructed in rats using the modified Hulth method. CXTB (35 mg/kg) was administered intragastrically for 4 weeks. Hematoxylin and eosin (HE) staining of the knee articular were performed to evaluate the efficiency of CXTB. Western blot analysis, quantitative polymerase chain reaction (qPCR), and enzyme-linked immunosorbent assay (ELISA) were used to investigate the protective mechanisms of CXTB in joint cartilage. RESULTS: CXTB effectively improved the morphological structure of the cartilage and bone in the knee joint by enhancing autophagy and regulating the expression of related protease and inflammatory factors. Furthermore, CXTB downregulated the expression of the long non-coding RNA (lncRNA) Hox transcript antisense intergenic RNA (HOTAIR) and inhibited the activation of the p38MAPK pathway. Conversely, overexpression of lncRNA HOTAIR suppressed the protective effects of CXTB on the knee joint. CONCLUSIONS: CXTB capsules can protect the knee articular cartilage in rats through the lncRNA HOTAIR/p38MAPK pathway.

A comparison of the efficacy and safety of traditional Chinese medicine external treatment for the knee osteoarthritis: A protocol for systematic review and network meta-analysis.

BACKGROUND: Knee osteoarthritis (KOA), also known as degenerative osteoarthritis, is a common and frequently occurring disease in orthopedics with cartilage degeneration as the pathogenic cause and articular bone hyperplasia as the sign. Many studies have confirmed that KOA can be effectively treated by traditional Chinese medicine (TCM) external treatment. So we take advantage of the method of network meta-analysis to systematically compare the efficacy and safety of different types of TCM external treatment for the KOA. METHODS: We will research on external treatment of KOA by traditional Chinese medicine using randomized controlled trials (RCTs) in search database (EMBASE, PubMed, Web of Science, Chinese National Knowledge Infrastructure [CNKI], Weipu database [VIP], Wanfang, and China BioMedical Literature [CBM]). The data and evidence obtained will be processed using Stata 15.0 and WinBUGS 1.4.3. RESULTS: We will evaluate the efficacy and safety of traditional Chinese medicine external treatment for the knee osteoarthritis in this study. CONCLUSION: This study will provide a new regimen for KOA treatment. It has extremely high reference value. INPLASY REGISTRATION NUMBER: INPLASY2020120001. DOI NUMBER: : 10.37766/inplasy2020.12.0001.