HSYA alleviates secondary neuronal death through attenuating oxidative stress, inflammatory response, and neural apoptosis in SD rat spinal cord compression injury.

BACKGROUND: Hydroxysafflor yellow A (HSYA) is a major active component of yellow pigment extracted from safflowers; this compound possesses potent neuroprotective effects both in vitro and in vivo. However, underlying mechanism of HSYA is not fully elucidated. The present study investigated the protective effects of HSYA in rat spinal cord compression injury model and related mechanisms involved. METHODS: Sprague-Dawley rats were divided as Sham, Control, and HSYA groups (n = 30 per group). Spinal cord injury (SCI) model was induced by application of vascular clips (force of 50 g, 1 min) to the dura at T9-T10 level of vertebra. Injured animals were administered with either HSYA (8 mg/kg at 1 and 6 h after injury, then 14 mg/kg, for a total of 7 days at 24-h time intervals) or equal volume of saline by intraperitoneal injection. RESULTS: From this experiment, we discovered that SCI in rats resulted in severe trauma, which is characterized by tissue damage, lipid peroxidation, neutrophil infiltration, inflammation mediator release, and neuronal apoptosis. However, HSYA treatment significantly reduced the following: (1) degree of tissue injury (histological score) and edema; (2) neutrophil infiltration (myeloperoxidase activity); (3) oxidative stress (superoxide dismutase, malondialdehyde, and nitric oxide); (4) pro-inflammatory cytokine expression (tumor necrosis factor-α, interleukin-6, inducible nitric oxide synthase, cyclooxygenase-2); (5) nuclear factor-κB activation; (6) apoptosis (terminal deoxynucleotidyl transferase dUTP nick end labeling staining and cysteine-aspartic protease-3 activity). Moreover, in a separate set of experiments, we clearly demonstrated that HSYA treatment significantly ameliorated recovery of limb function (as evaluated by Basso, Beattie, and Bresnahan behavioral recovery scores). CONCLUSIONS: Treatment with HSYA restrains development of oxidative stress, inflammation response, and apoptotic events associated with SCI of rats, demonstrating that HSYA is a potential neuroprotectant for human SCI therapy.

Apoptosis associated with Wnt/ß-catenin pathway leads to steroid-induced avascular necrosis of femoral head.

BACKGROUND: The objective of the current study was to establish a rat model to investigate apoptosis in steroid-induced femoral head osteonecrosis occurring via the Wnt/ß-catenin pathway. METHODS: Male Sprague-Dawley (SD) rats were randomly divided into a control group (group A), model group (group B) and sFRP1 group (group C), each consisting of 24 rats, and the rats were intravenously injected with LPS (10 µg/kg body weight). After 24 h, three injections of MPS (20 mg/kg body weight) were administered intramuscularly at 24-h intervals. The rats in group C were injected intramuscularly with 1 µg/kg sFRP1 protein per day for 30 days, beginning at the time of the first MPS administration. The group A rats were fed and housed under identical conditions but received saline injection. All animals were sacrificed at weeks 2, 4 and 8 from the first MPS injection. Histopathological staining was preformed to evaluated osteonecrosis. Apoptosis was detected via quantitative terminal deoxynucleotidyl transferase (TdT) deoxyuridine triphosphate nick-end labelling (TUNEL) staining, caspase-3 activity assay, and detection of Bcl-2 and Bax protein expression by immunohistochemistry and Western blotting. Wnt/ß-catenin pathway signalling molecules, including activated ß-catenin and c-Myc, were detected by immunohistochemistry and Western blotting. RESULTS: Typical osteonecrosis was observed in groups B and C. Apoptosis gradually increased with increasing time in both groups B and C. More severe osteonecrosis and apoptosis were observed in group C compared with group B. The expression levels of caspase-3 and Bax were higher while that of Bcl-2 was lower in group C compared with group B. The expression levels of activated ß-catenin and c-Myc gradually decreased with increasing time in both groups B and C, and they were lower in group C compared with group B. CONCLUSIONS: The Wnt/ß-catenin pathway is involved in the pathogenesis of early stage SANFH, as we have demonstrated in an SANFH rat model, and it may act through the regulation of c-Myc, which affects the cell cycle and cell apoptosis.

Partial greater trochanter osteotomy for hip reduction in total hip arthroplasty for high dislocated hip: a preliminary report.

BACKGROUND: Hip reduction in total hip arthroplasty for high dislocated hips is difficult. Various femur osteotomy procedures have been used for hip reduction, but these methods increase operative time and risk of nonunion. We investigated the efficacy of a novel partial greater trochanter osteotomy technique for hip reduction in total hip arthroplasty for patients with high hip dislocation. METHODS: Twenty-one patients (23 hips) with high dislocated hip were treated with total hip arthroplasty that included partial greater trochanter osteotomy, i.e., the upper 2/3 greater trochanter was resected, and the gluteus medius muscle attachment was spared. The clinical outcome was evaluated by comparing the Harris hip scores and radiographic exam results, obtained before surgery and at follow-ups. RESULTS: Follow-ups of 21 patients ranged from 13 to 56 months. The mean Harris hip score increased from preoperative 55.0 (36-69) to postoperative 86.1 (71-93; P = 0.00). The average preoperative leg length discrepancy in patients with unilateral high hip dislocation was 46 mm (28-65 mm); postoperatively leg length discrepancy was less than 1 cm in 11 patients, between 1 and 2 cm in 8 patients, and more than 2 cm in 2 patients. The average leg lengthening at the time of surgery was 36 mm (24-54 mm). Trendelenburg's gait changed from positive to negative in 20 hips by the last follow-up. No nerve injury occurred postoperative. CONCLUSION: Partial greater trochanter osteotomy is an effective method to render hip reduction in total hip arthroplasty for patients with high dislocation of the hip.

Negative pressure wound therapy reduces the incidence of postoperative wound dehiscence and surgical site infections after total knee arthroplasty in patients with obesity.

Obesity is a risk factor for total knee arthroplasty (TKA). Wound dehiscence and surgical site infections (SSIs) are the main complications of TKA in patients with obesity. They can profoundly affect patients because they often require readmission, additional surgical interventions, lengthy intravenous antibiotic administration, and delayed rehabilitation. Negative pressure wound therapy (NPWT) exposes the wound site to negative pressure, resulting in the improvement of blood supply, removal of excess fluid, and stimulation of cellular proliferation of granulation tissue. This study aims to assess the incidence of wound dehiscence and SSIs in patients with obesity undergoing TKA after the routine use of NPWT. This sduty enrolled adult patients with obesity who underwent TKA within 8 years. A total of 360 adult patients with obesity (NPWT: 150, non-NPWT: 210) underwent TKA, and the baseline characteristics were similar between the 2 groups. Compared with the non-NPWT group, the NPWT group had a 50% lower incidence of wound dehiscence (3.33% vs 9.52%; P < .05) and a significantly lower incidence of SSIs (11.33% vs 25.24%; P < .05), including prosthetic joint infection (4.0% vs 10.0%; P < .05) and superficial wound infection (7.33% vs 15.24%; P < .05). In addition, the NPWT group had a lower need to return to the operating room for new interventions for any reason (2.67% vs 9.05%; P = .0107) than the non-NPWT group. Conventional incision NPWT can significantly reduce the incidence of wound dehiscence and SSIs in patients with obesity after TKA.

Resveratrol prevents steroid-induced osteonecrosis of the femoral head via miR-146a modulation.

The purpose of this study was to investigate the possible use of resveratrol (Res) to reverse abnormal osteogenesis/osteoclastogenesis activity that occurs during femoral head osteonecrosis and to explore the detailed mechanisms. Application of Res to bone marrow-derived mesenchymal stem cells in vitro promoted survival, inhibited apoptosis, and downregulated expression of reactive oxygen species expression. Moreover, Res application was associated with elevated microRNA-146a (miR-146a) expression, osteogenic differentiation, and suppressed osteoclastic differentiation, which were markedly reversed by miR-146a inhibitor. Histopathological observations and micro-computed tomography scanning results indicated that the Res-treated group had lower incidence of osteonecrosis and better bone microstructure than the untreated group. Res inhibited osteoclastogenesis through altering the levels of sirtuin1 (Sirt1), nuclear transcription factor-κB (NF-κB), and receptor activator of NF-κB ligand (RANKL). Simultaneously, Res treatment improved bone formation and increased ß-catenin and runt-related transcription factor 2 (Runt2) expression levels, while reducing forkhead box class O (FOXO) family protein levels. The results of our study suggest that Res prevents steroid-induced osteonecrosis by upregulating miR-146a, and thereby stabilizes osteogenesis/osteoclastogenesis homeostasis via Wnt/FOXO and Sirt1/NF-κB pathways.

Angiopoiesis and bone regeneration via co-expression of the hVEGF and hBMP genes from an adeno-associated viral vector in vitro and in vivo.

AIM: To investigate the therapeutic potential of adeno-associated virus (AAV)-mediated expression of vascular endothelial growth factor (VEGF) and bone morphogenetic protein (BMP). METHODS: Four experimental groups were administered the following AAV vector constructs: rAAV-hVEGF(165)-internal ribosome entry site (IRES)-hBMP-7 (AAV-VEGF/BMP), rAAV-hVEGF(165)-GFP (AAV-VEGF), rAAV-hBMP-7-GFP (AAV-BMP), and rAAV-IRES-GFP (AAV-GFP). VEGF(165) and BMP-7 gene expression was detected using RT-PCR. The VEGF(165) and BMP-7 protein expression was determined by Western blotting and ELISA. The rabbit ischemic hind limb model was adopted and rAAV was administered intramuscularly into the ischemic limb. RESULTS: Rabbit bone marrow-derived mesenchymal stem cells (BMSCs) were cultured and infected with the four viral vectors. The expression of GFP increased from the 7th day of infection and could be detected on the 28th day post-infection. In the AAV-VEGF/BMP group, the levels of VEGF165 and BMP-7 increased with prolonged infection time. The VEGF(165) and BMP-7 secreted from BMSCs in the AAV-VEGF/BMP group enhanced HUVEC tube formation and resulted in a stronger osteogenic ability, respectively. In rabbit ischemic hind limb model, GFP expression increased from the 4th week and could be detected at 8 weeks post-injection. The rAAV vector had superior gene expressing activity. Eight weeks after gene transfer, the mean blood flow was significantly higher in the AAV-VEGF/BMP group. Orthotopic ossification was radiographically evident, and capillary growth and calcium deposits were obvious in this group. CONCLUSION: AAV-mediated VEGF and BMP gene transfer stimulates angiogenesis and bone regeneration and may be a new therapeutic technique for the treatment of avascular necrosis of the femoral head (ANFH).

Oral treatment with glycyrrhizin inhibits NLRP3 inflammasome activation and promotes microglial M2 polarization after traumatic spinal cord injury.

The inflammatory response induced by traumatic spinal cord injury (SCI) involves the activation of NLRP3 inflammasomes, which are closely related to the activation of microglia. Microglial polarization between M1/M2 phenotypes is a pivotal regulatory factor in neuroinflammatory responses to traumatic SCI-induced secondary injuries, and altering this polarization could be beneficial. Glycyrrhizin is a neuroprotective agent with a potent anti-inflammatory property in different neurological disorders and could potentially be useful in SCI. In this study, we investigated the potency of oral treatment with glycyrrhizin to reduce inflammation and improve functional recovery after traumatic SCI by inhibiting NLRP3 inflammasome activation and promoting microglial M2 polarization. After inducing traumatic SCI by dropping a 10 g impactor on the T9 and T10 spinal segments of male Sprague-Dawley rats, the animals were given glycyrrhizin orally immediately after injury and every 12 h for the next 3 d. Behavioral scores improved in glycyrrhizin-treated animals compared to the SCI group. The functional improvement in glycyrrhizin-treated rats paralleled the decreased expression of NLRP3 inflammasome components, such as ASC, NLRP3, and cleaved caspase-1, as well as IL-1ß and IL-18. At the histopathological level, oral treatment with glycyrrhizin diminished the SCI-enhanced production of Iba-1+CD86+ cells (M1 microglia) but improved the release of Iba-1+CD206+ cells (M2 microglia). Likewise, oral therapy with glycyrrhizin significantly enriched the protein expression levels of M2 microglia-related markers (CD206 and Arg-1) but reduced those of M1 microglia-related markers (CD86 and iNOS) in the injured spinal cord. These findings support and extend the knowledge on post-traumatic SCI glycyrrhizin-mediated neuroprotection. Glycyrrhizin's regulation of NLRP3 inflammasome activation and microglial polarization might be a new approach to understanding the anti-inflammatory potency of glycyrrhizin.

Evaluation of medial acetabular wall bone stock in patients with developmental dysplasia of the hip using a helical computed tomography multiplanar reconstruction technique.

BACKGROUND: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. PURPOSE: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). MATERIAL AND METHODS: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. RESULTS: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+/-2.1 mm and 7.1+/-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). CONCLUSION: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization.

[Total arthroscopic internal drainage technique for the treatment of popliteal cyst].

OBJECTIVE: To compare the clinical effects of total arthroscopic internal drainage and arthroscopic combined with posterior small incision in the treatment of popliteal cyst. METHODS: From January 2015 to January 2017, 60 patients with popliteal cyst were treated, including 29 males and 31 females, aged 30 to 65(47.8±2.5) years old, with a course of disease (8.5±4.2) months. Among them, 30 cases received total arthroscopic internal drainage for popliteal fossa cyst(total arthroscopic group), 30 cases received arthroscopic combined with posterior small incision for popliteal fossa cyst(arthroscopic combined with small incision group). The operation time, intraoperative bleeding volume, incision length, Rauschning and Lindgren grade 0 recovery rate and Lysholm score were compared between the two groups. RESULTS: Twenty-nine patients in total arthroscopy group were followed up, and 28 patients in arthroscopy combined with small incision group were followed up for 8 to 20(12.8±2.1) months. Operation time: total arthroscopic group(45.32±5.71) min, arthroscopic combined small incision group (44.56±3.85) min; Rauschning and Lindgren grade 0 recovery: 23 cases in total arthroscopic group, 22 cases in arthroscopic combined small incision group; postoperative Lysholm score: total arthroscopic group 84.5±11.2, arthroscopic combined small incision group 83.2±12.7; there was no significant difference between the two groups(P>0.05). Intraoperative bleeding volume: total arthroscopic group(5.32±1.25) ml, arthroscopic combined small incision group(20.75±8.18) ml; incision length: total arthroscopic group (1.51±0.34) cm, arthroscopic combined small incision group (7.34±0.75) cm; the difference between the two groups was significant(P<0.05). At the last follow-up, the knee joint was examined by magnetic resonance imaging, and no recurrence of cyst was found. CONCLUSIONS: Total arthroscopic internal drainage and arthroscopic combined with posterior small incision technique for popliteal fossa cyst with intra-articular lesions have the same clinical effect, but less trauma and faster recovery.

The effectiveness and safety of 3-dimensional printed composite guide plate for atlantoaxial pedicle screw: A retrospective study.

This study aims to evaluate the effectiveness and safety of the application of a 3-dimensional (3D)-printed composite guide plate for atlantoaxial pedicle screw.This was a retrospective study. A total of 43 atlantoaxial dislocation patients admitted in our hospital between January 2014 and October 2016 were retrospectively analyzed. According to the different methods of operation, patients were divided into 2 groups: 3D-printed plate group (n = 19) and traditional fixation group (n = 24). Placement time, operation duration, fluoroscopy number, intraoperative bleeding volume, and the neck and shoulder pain visual analog scale and Japanese Orthopaedic Association cervical nerve function scores were compared between pre- and postoperation.Differences in general data between these 2 groups were not statistically significant (P > .05). For patients in the 3D-printed plate group, a total of 68 assisting screws were placed at the pedicle, the accuracy rate of screw placement was 94.1%, placement time was 2.2 ±â€Š0.4 minutes, fluoroscopy number was 4.6 ±â€Š1.1 times, operation duration was 197 ±â€Š41 minutes, and intraoperative bleeding volume was 395 ±â€Š64 mL. In the traditional fixation group, a total of 76 screws were placed at the pedicle of patients, the accuracy rate of screw placement was 76.3%, placement time was 3.4 ±â€Š0.7 minutes, fluoroscopy number was 9.4 ±â€Š2.7 times, operation duration was 245 ±â€Š67 minutes, and intraoperative bleeding volume was 552 ±â€Š79 mL. Differences in accuracy rate, placement time, fluoroscopy number, operation duration, and intraoperative bleeding volume between these 2 groups were statistically significant (P < .05).The effectiveness and safety of 3D-printed composite guide plate for atlantoaxial pedicle screw were better than traditional method.

[Effects of different doses of puerarin on vascular endothelial cell proliferation in vitro].

OBJECTIVE: To explore the effects of different doses of puerarin on proliferation of cultured vascular endothelial cells in vitro. METHODS: The hearts of three new-born SD rats 5 days old were mechanically minced and enzymatically digested with collagenase and trypsin, then vascular endothelial cells were counted, washed and resuspended in Dulbecco's minimum essential medium (DMEM) added with 20% heat inactivated fetal calf serum, then inoculated in 2% gelatin-coated tissue culture flasks. Vascular endothelial cells at passage 3 were used in the experiment. Except for the normal control group, the vascular endothelial cells were cultured with puerarin in various concentrations (0.01, 0.1, 1, 10 and 100 micromol/L) for 24 hours, and the morphology and the number of the cultured endothelial cells were observed. Methyl thiazolyl tetrazolium (MTT) colorimetry was used to determine the proliferation of the cultured vascular endothelial cells. Flow cytometry (FCM) were used to detect the proliferation index (PI) of the vascular endothelial cells and the expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemical method. RESULTS: The cell morphology was normal under the inverted microscope in each group. The number and proliferation activities of vascular endothelial cells were significantly increased by 1, 10 and 100 micromol/L puerarin compared with those of the blank control group, especially the 100 micromol/L puerarin group, and there were no remarkable changes in with 0.1 micromol/L and 0.01 micromol/L puerarin groups. The same results were seen in the positive rate of PCNA expression and PI. CONCLUSION: Puerarin has dose-dependent effects on the proliferation activity of vascular endothelial cells.

Muscone exerts protective roles on alcohol-induced osteonecrosis of the femoral head.

Long-term alcohol abuse causes musculoskeletal disorders, among of which, alcohol-induced osteonecrosis of the femoral head (ONFH) is of concern due to its significant and severe complications. A variety of methods have been attempted to prevent alcohol-induced ONFH, and monomers extracted from Chinese herbs might benefit the disease profoundly. In the current study, muscone, the main ingredient of musk, was used to prevent alcohol-induced ONFH. In vitro, ethanol was used to affect the potential of osteogenesis and proliferation of human bone mesenchymal stem cells (hBMSCs), and beneficial role of muscone was investigated on hBMSCs. In vivo, following the establishment of alcohol-induced ONFH, muscone was employed to treat the diseased rats, which were analyzed by micro-CT scanning and a series of histologic staining. As a result, we found ethanol could significantly suppress osteogenic differentiation of hBMSCs, while muscone held the potential to promote ALP activity and mRNA expressions of COL1 and OCN under ethanol treatment. Meanwhile, imaging analysis revealed muscone could restore BV/TV ratio and bone mineral density of the necrotic femoral head, and the protective role of muscone on alcohol-induced ONFH was further confirmed by histologic examinations. Our study confirmed the protective effect of muscone against alcohol-induced ONFH both in vitro and in vivo. Therefore, muscone may be considered as a valuable therapeutic natural drug for alcohol-induced ONFH in humans.

Patient-specific core decompression surgery for early-stage ischemic necrosis of the femoral head.

INTRODUCTION: Core decompression is an efficient treatment for early stage ischemic necrosis of the femoral head. In conventional procedures, the pre-operative X-ray only shows one plane of the ischemic area, which often results in inaccurate drilling. This paper introduces a new method that uses computer-assisted technology and rapid prototyping to enhance drilling accuracy during core decompression surgeries and presents a validation study of cadaveric tests. METHODS: Twelve cadaveric human femurs were used to simulate early-stage ischemic necrosis. The core decompression target at the anterolateral femoral head was simulated using an embedded glass ball (target). Three positioning Kirschner wires were drilled into the top and bottom of the large rotor. The specimen was then subjected to computed tomography (CT). A CT image of the specimen was imported into the Mimics software to construct a three-dimensional model including the target. The best core decompression channel was then designed using the 3D model. A navigational template for the specimen was designed using the Pro/E software and manufactured by rapid prototyping technology to guide the drilling channel. The specimen-specific navigation template was installed on the specimen using positioning Kirschner wires. Drilling was performed using a guide needle through the guiding hole on the templates. The distance between the end point of the guide needle and the target was measured to validate the patient-specific surgical accuracy. RESULTS: The average distance between the tip of the guide needle drilled through the guiding template and the target was 1.92±0.071 mm. CONCLUSIONS: Core decompression using a computer-rapid prototyping template is a reliable and accurate technique that could provide a new method of precision decompression for early-stage ischemic necrosis.

Effects of periarticular injection on analgesic effects and NSAID use in total knee arthroplasty and total hip arthroplasty.

OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group. The study group received a periarticular multimodal drug injection during surgery. The control group received an equal volume of normal saline. All patients received an analgesia pump and a moderate dose of nonsteroidal anti-inflammatory drugs. Resting and motion Numeric Rating Scale scores, the Western Ontario and McMaster Universities Arthritis Index, knee or hip joint range of motion, length of postoperative hospital stay, patient satisfaction, total nonsteroidal anti-inflammatory drug consumption and side effects were recorded. RESULTS: Both study groups exhibited significant improvement in pain Numeric Rating Scale scores during rest and exercise several days after the surgery. The range of joint motion was greater in the study group, and the length of postoperative hospital stay was shorter than that in the control group. Patients in the study group consumed fewer nonsteroidal anti-inflammatory drugs and reported greater satisfaction with surgery. CONCLUSION: Intraoperative periarticular multimodal drug injection significantly relieved pain after surgery and reduced nonsteroidal anti-inflammatory drug consumption. These patient had a better postoperative experience, including satisfaction and rehabilitation.

Anti-apoptotic and neuroprotective effects of Tetramethylpyrazine following spinal cord ischemia in rabbits.

BACKGROUND: Tetramethylpyrazine (TMP) is one of the most important active ingredients of a Chinese herb Ligusticum wallichii Franchat, which is widely used in many ischemia disorders treatments. However, the exact mechanism by which TMP protects the spinal cord ischemia/reperfusion (I/R) injury is still unknown. For this purpose, rabbits were randomly divided into sham group, control group and TMP group. After the evaluation of neurologic function, the spinal cords were immediately removed for biochemical and histopathological analysis. Apoptosis was measured quantitatively by the terminal transferase UTP nick end-labeling (TUNEL) method and confirmed by electron microscopic examination, the expression of Bax and Bcl-2 was immunohistochemically evaluated and quantified by Western blot analysis. RESULTS: Neurologic outcomes in the TMP-group were significantly better than those in the control group (P < 0.05). TMP decreased spinal cord malondialdehyde (MDA) levels and ameliorated the down regulation of spinal cord superoxide dismutase (SOD) activity. TMP significantly reduced the loss of motoneurons and TUNEL-positive rate. Greater Bcl-2 and attenuated Bax expression was found in the TMP treating rabbits. CONCLUSION: These findings suggest that TMP has protective effects against spinal cord I/R injury by reducing apoptosis through regulating Bcl-2 and Bax expression.

[Arnebia root oil promotes wound healing and expression of basic fibroblast growth factor on the wound surface in rabbits].

OBJECTIVE: To observe the promoting effect of arnebia root oils on expression of basic fibroblast growth factor (bFGF) in skin wound of rabbits and the histomorphological changes in the wound surface, and to discuss its mechanism. METHODS: Bilateral round skin wounds were made on the back of 15 rabbits. The three wounds on one side of the back of each rabbit were treated with arnebia root oils, while the three wounds on the other side were treated with vaseline in order to promote the wound healing. The histomorphology and ultrastructure under electron microscopy of the wounds, and the rate of wound healing were examined at different time. Western blotting assay was used to detect the expression of bFGF in the wound surface. RESULTS: The healing rate of the arnebia root oils-treated wounds was evidently higher than that of the vaseline-treated wounds (P<0.05). The quantities of fibroblast, collagen and capillary in the arnebia root oils-treated wounds were much more than those in the vaseline-treated wounds, and the expression of endogenous bFGF in the arnebia root oils-treated wounds was enhanced obviously as compared with that in the vaseline-treated wounds in different period of wound healing. There existed a parallel correlation between the expression level of bFGF and the rate of wound healing. CONCLUSION: The promoting effect of arnebia root oils on wound healing may be related to increasing the expression level of basic fibroblast growth factor in the skin wound.

Effect of one versus two distal locking bolts on the biomechanics of tibial interlocking nail: a comparative study using a new model.

OBJECTIVE: To investigate the impact of one versus two distal locking bolts on the mechanical properties of tibial interlocking intramedullary nails. METHODS: Twenty 9-mm titanium alloy locking nails were divided into two equal groups in which the nails were fixed with only one and two distal locking bolts, respectively. Each group was further divided into two sub-groups for compression and torsion tests separately using a universal material-testing machine. RESULTS: In the compression tests, the average maximum strength of double bolts was greater than that of the single bolt (P<0.05), but the number of the bolts did not significantly affect the results of the torsion tests in terms of the either the maximum torsion moment or angle (P>0.05). CONCLUSION: One distal bolt is sufficient for fixing stable fractures and double bolts are recommended for management of serious fractures. The model we used is convenient and economic for examining the biomechanics of the tibial nails, especially for comparative purposes.

[Clinical observation on effects of qianggu capsules in treating radius distal osteoporotic fractures].

OBJECTIVE: To explore the effects of qianggu capsules (QGC) on the fracture healing and the bone mineral density (BMD) in radius distal osteoporosis fracture (RDOF) patients. METHODS: Bone mineral density (BMD) of femoral neck in 65 patients with RDOF was detected after the fracture was fixed manually. They were then randomly divided into two groups. Thirty-three patients in the treated group took QC, 1 capsule (180 mg) each time, three times a day, while 32 patients in the control group took D-Cal Biocal 2 tablets (1500 mg) each time, once daily. The therapeutic course for both groups was three months. X-ray examination on the broken end of the fractured bone was taken every month to observe the bony callus formation for comparing the curative effect, and BMD of femoral neck were detected again after patients were treated for 3 months. The bony callus appeared earlier, more in volume with thicker cortex in the treated group after 2 months of treatment versus that in the control group. The fracture healing time in the treated group was 9.4 +/- 2.5 weeks and that in the control group was 12.5 +/- 2.9 weeks, showing significant difference between them (P < 0.05). BMD in the treated group before treatment was 0.621 +/- 0.085 g/cm2, which was lower than that after treatment (0.646 +/- 0.090 g/cm2) with significant difference showing between them (P < 0.05), while no significant change of BMD was found in the control group between before and after treatment, and significant difference was found in BMD between the two groups after treatment (P < 0.05). CONCLUSION: QGC can promote the formation of bony callus ahead of time, increase the volume of bony callus and BMD, improve the bone structure, and thus the time of external fixation in treating RDOF could be reduced.

Repair effect of coexpression of the hVEGF and hBMP genes via an adeno-associated virus vector in a rabbit model of early steroid-induced avascular necrosis of the femoral head.

We investigated the repair effect of coexpression of the human vascular endothelial growth factor (hVEGF) and human bone morphogenetic protein (hBMP) genes via an adeno-associated virus (AAV) vector in a rabbit model of early steroid-induced avascular necrosis of the femoral head (SANFH). The following AAV vectors were constructed: AAV-green fluorescent protein, AAV-VEGF, AAV-BMP, and AAV-VEGF/BMP. The rabbit model was induced using lipopolysaccharide and methylprednisolone. Virus vector was injected into the core decompression region at a dose of 25 µL per side after core decompression operation in each group. hVEGF165 and BMP-7 expressions were determined by Western blotting and immunohistochemical staining, and the femoral head was examined by magnetic resonance image scan, histopathologic staining, ink vessel staining, microcomputed tomography scan, and biomechanical assessment to determine the repair effect. The vector AAV-VEGF/BMP successfully expressed hVEGF165 and BMP-7 at the gene and protein levels at 12 weeks after virus injection. The expression of hVEGF165 promoted metabolism of the necrotic region by inducing vessel formation. The expression of BMP-7 promoted osteogenesis by increasing the mineral density and biomechanical strength of the femoral head. The repair effect of the AAV-VEGF/BMP group was better than those of the AAV-VEGF and AAV-BMP groups in the rabbit early SANFH model. The AAV-VEGF/BMP vector improved the bone repair capacity of the necrotic femoral head by inducing angiogenesis and improving bone quality in the femoral head.

[Case-control study on effects of external fixation combined with limited internal fixation for the treatment of Pilon fractures of Rüedi-Allgower type III].

OBJECTIVE: To analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method. METHODS: The clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function. RESULTS: After 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P < 0.05): the external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (P< 0.05). CONCLUSION: Treatment of external fixation with limited internal fixation in the treatment of Pilon fracture of Rüedi-Allgower type III is effective and safe.