Glaucocalyxin A suppresses osteoclastogenesis induced by RANKL and osteoporosis induced by ovariectomy by inhibiting the NF-κB and Akt pathways.

ETHNOPHARMACOLOGICAL RELEVANCE: Glaucocalyxin A (GLA), the most abundant active component of the aboveground sections of Rabdosia japonica (Burm. f.) Hara var. glaucocalyx (Maxim.) Hara, possesses various pharmacological activities, such as antioxidant, antithrombosis, anticoagulation, antibacterial, antitumor, anti-inflammatory activities. According to previous studies, inflammation is closely associated with osteoclast differentiation and activity. Although GLA has demonstrated effective anti-inflammatory properties, its effects on osteoclast differentiation remain unclear. AIM OF THE STUDY: To examine the possible inhibitory effects of GLA and its molecular mechanisms in osteogenesis induced by RANKL as well as ovariectomy (OVX)-induced osteoporosis (OP) in mice. MATERIALS AND METHODS: Tartrate-resistant acid phosphatase (TRAP) staining, F-actin staining, and a bone resorption pit assay were applied for identifying the effects of GLA on the differentiation of osteoclasts and the function of bone resorption. The mRNA expression of the genes related to osteoclast differentiation was measured by quantitative PCR. Protein expression of nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1), c-fos and phosphorylation of inhibitor of nuclear factor kappa B (IκBα), protein kinase B (AKT), c-Jun N-terminal kinase (JNK), extracellular signal-regulated kinase (ERK), and p38 in RANKL-induced osteoclasts was determined using western blotting. The effect of GLA on OP was studied using a mouse model of OVX. RESULTS: At nontoxic concentrations ≤0.5 µM in vitro, GLA suppressed the formation of osteoclasts induced by RANKL with the decreased number and area size of TRAP-positive multinuclear osteoclasts, and the resorption of bone function by reducing F-actin ring number and bone resorption pit areas. It also reduced the expression of the genes specific for osteoclasts, which included genes encoding NFATc1, cathepsin K, c-fos, TRAP, vacuolar-type ATPase d2, and dendritic cell-specific transmembrane protein. Moreover, GLA repressed NF-κB and Akt pathway activation induced by RANKL. Micro-CT analysis of femur samples indicated decreased bone loss and greater trabecular bone density after GLA treatment, which showed that GLA played a protective role by inhibiting bone loss in OVX-induced OP mice in vivo. CONCLUSIONS: Our study is the first to show that GLA has significant therapeutic potential in OP, which is the disease of osteoclast increase caused by estrogen deficiency.

[Manipulative reduction and internal fixation by percutaneous locking compression plate for the treatment of mid-distal tibiofibula shaft fractures].

OBJECTIVE: To investigate the clinical effects of manipulative reduction and percutaneous locking compression plate internal fixation for the treatment of mid-distal tibiofibula shaft fractures. METHODS: From January 2006 to October 2009,46 patients suffering from mid-distal tibiofibula shaft fractures were treated with closed manipulative reduction and LCP, involved 27 males and 19 females with an average age of 39 years old ranging from 17 to 56 years. According to AO classification, there were 12 cases of type A, 24 of type B, 10 of type C. The duration of visiting hospital were from 2 hours to 3 days after being injured for these patients. The injured limbs of the patients were swollen and painful,even with bony crepitus. The wound, function of the injured limb and union of fractures were observed after operation. RESULTS: All the patients were followed up from 12 to 18 months (averaged 15 months). It was found that the wound of all patients had primary healing without any infection. The fracture healing time was 12 to 18 weeks (means 14 weeks). The results were excellent in 40 cases,good in 4 and fair in 2. CONCLUSION: Less invasive, more stable fixation, shorter healing time and better functional rehabilitation are observed in the treatment of mid-distal tibiofibula shaft fractures after manipulative reduction and percutaneous locking compression plate internal fixation.

Manipulative reduction and internal fixation by percutaneous locking compression plate for the treatment of mid-distal tibiofibula shaft fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of manipulative reduction and percutaneous locking compression plate internal fixation for the treatment of mid-distal tibiofibula shaft fractures.</p><p><b>METHODS</b>From January 2006 to October 2009,46 patients suffering from mid-distal tibiofibula shaft fractures were treated with closed manipulative reduction and LCP, involved 27 males and 19 females with an average age of 39 years old ranging from 17 to 56 years. According to AO classification, there were 12 cases of type A, 24 of type B, 10 of type C. The duration of visiting hospital were from 2 hours to 3 days after being injured for these patients. The injured limbs of the patients were swollen and painful,even with bony crepitus. The wound, function of the injured limb and union of fractures were observed after operation.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 18 months (averaged 15 months). It was found that the wound of all patients had primary healing without any infection. The fracture healing time was 12 to 18 weeks (means 14 weeks). The results were excellent in 40 cases,good in 4 and fair in 2.</p><p><b>CONCLUSION</b>Less invasive, more stable fixation, shorter healing time and better functional rehabilitation are observed in the treatment of mid-distal tibiofibula shaft fractures after manipulative reduction and percutaneous locking compression plate internal fixation.</p>

[A randomized controlled trial study of pulmonary rehabilitation with respiratory physiology as the guide on prognosis in patients with chronic obstructive pulmonary disease].

OBJECTIVE: To observe the effect of pulmonary rehabilitation with respiratory physiology as guide in patients with chronic obstructive pulmonary disease (COPD). METHODS: Sixty patients of severe and very severe COPD as categorized by global proposed diagnostic criteria for COPD (GOLD, 2006) were enrolled for study. They were randomly divided into three groups, and with 20 patients in each group. The patients in group A were given pulmonary rehabilitation guided by respiratory physiology thrice a day, 15 minutes each time for 8 weeks. The patients in group B were given pulmonary rehabilitation with pursed lip respiration thrice a day, 15 minutes per time for 8 weeks. The patients in group C were given no pulmonary rehabilitation. Six minute-walk-distance (6MWD), medical research council (MRC) dyspnea scale, activities of daily living (ADL), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and quality of life (QOL) were determined before and after respective pulmonary rehabilitation course. RESULTS: (1) There were 3, 5, 5 patients in group A, group B, group C dropped off in the course of rehabilitation respectively. (2) The patients' MRC grade after pulmonary rehabilitation in group A and group B decreased compared with that before pulmonary rehabilitation (both P<0.01), but the difference was not significant between two groups (P>0.05). (3) 6MWD, ADL, MEP, MIP of patients in group A and group B increased after pulmonary rehabilitation compared with that before pulmonary rehabilitation, and 6MWD, ADL, MEP, MIP of patients in group A were increased after pulmonary rehabilitation more than those in group B (P<0.05 or P<0.01). (4)The patients' body status, shortness of breath, social activity, home chores in group A and group B, and uneasiness in group A after pulmonary rehabilitation were improved more than those before pulmonary rehabilitation (P<0.05 or P<0.01), but the difference in state of mind, headache, appetite was not markedly different before and after pulmonary rehabilitation in two groups (all P>0.05). The difference in QOL was not marked between group A and group B after pulmonary rehabilitation (all P>0.05). CONCLUSION: (1) The pulmonary rehabilitation with pursed lip respiration and the pulmonary rehabilitation with the guide of respiratory physiology ameliorates dyspnea, improves ADL, QOL, exercise tolerance, function of respiratory muscle in the severe and very severe COPD patients remarkably. (2) The effect of the pulmonary rehabilitation with the guide of respiratory physiology is better than that of the pulmonary rehabilitation with pursed lip respiration, and it can be considered as a more effective pulmonary rehabilitation method for the patients with severe and very severe COPD.