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08 November 2019, Volume 23 Issue 31 Previous Issue    Next Issue

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Effect of free iliac flap combined with vascularised greater trochanter bone grafting on preserving hip in young and middle-aged patients with ARCO III necrosis of the femoral head Wu Keliang1, Feng Wenjun2, Li Jie2, Zeng Jianchun2, Chen Jinlun2, Ye Pengcheng2, Jie Ke1, Zeng Yirong2 (1Guangzhou University of Chinese Medicine, Guangzhou 510405, 2019, 23 (31):  4921-4926.  doi: 10.3969/j.issn.2095-4344.1745 Abstract ( 244 )   PDF (27842KB) ( 90 )   Save BACKGROUND: Free iliac flap combined with or without vascularised greater trochanter bone grafting is adopted in the treatment of young and middle-aged patients with non-traumatic ARCO III necrosis of the femoral head. However, the efficacy of these two operation treatments is still unclear. OBJECTIVE: To compare the clinical outcomes of free iliac flap combined with or without vascularised greater trochanter bone graft in young and middle-aged patients with ARCO III necrosis of the femoral head. METHODS: Those ARCO III necrosis of the femoral head patients aged 18-45 years who were treated with free iliac flap combined with vascularised greater trochanter bone graft (group A) or with free iliac flap (group B) from January 2009 to November 2013 at the First Affiliated Hospital of Guangzhou University of Chinese Medicine were included in this study. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. The incision length, hospitalization time, operation time and blood loss were recorded. The Harris scores and Visual Analogue Scale scores at baseline and end of follow-up in ARCO III subtypes were compared. The good and excellent rate of hip joint and hip preserving rate were calculated. RESULTS AND CONCLUSION: (1) A total of 71 patients (group A 37 patients with 42 hips; group B 34 patients with 38 hips) were included. The follow-up time was 3.5-7 years. (2) The operation time and intraoperative blood loss in the group A were significantly higher than those in the group B (P < 0.05). (3) The Harris scores and Visual Analogue Scale scores were improved significantly after surgery in ARCO III subtypes of two groups. The Harris scores and Visual Analogue Scale scores in the group A were significantly superior to group B in necrosis of the femoral head patients with ARCO III b and c (P < 0.05). The Harris scores and Visual Analogue Scale scores had no significant difference between two groups in necrosis of the femoral head patients with ARCO III a (P > 0.05). (4) The hip preserving rate in the groups A and B was 91% and 74% (Z=3.9, P < 0.05), respectively. According to the result of Harris scores, the good and excellent rate of hip joint in the groups A and B was 82% and 75%, respectively. (5) There were no serious complications after surgery. (6) These results imply that free iliac flap combined with or without vascularised greater trochanter bone grafting is an effective treatment method for young and middle-aged patients with ARCO III necrosis of the femoral head. They can effectively improve the hip joint function and release joint pain. However, free iliac flap combined with vascularised greater trochanter bone grafting can achieve good clinical outcomes in young and middle-aged patients with ARCO III b and c necrosis of the femoral head. Figures and Tables | References | Related Articles | Metrics

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Precise reconstruction of digital joint defect by autogenous toe joint transplantation assisted by 3D printing technology He Zaopeng1, 2, Xu Jing2, Zhang Guodong3, Wei Chunrong1, 2, Liao Xianwan1, 2, Li Wei1, 2, Huang Wenhua2 2019, 23 (31):  4923-4938.  doi: 10.3969/j.issn.2095-4344.1983 Abstract ( 449 )   PDF (27325KB) ( 125 )   Save BACKGROUND: The types of hand injuries in modern industry have changed to small defects of soft tissue, bone or joint. Autogenous toe joint transplantation is still the most commonly method to repair the traumatic defect of the digital joint. OBJECTIVE: To investigate the surgical process of repairing the hand facet joint defect by digital experiment simulation with toe joint flap transplantation, and to realize the accurate interception and reconstruction of the transplanted joint through 3D printing navigation module. METHODS: Totally 13 cases with proximal interphalangeal joint defect (13 fingers) were included in this clinical study. Proximal interphalangeal joint defect of finger was repaired by free transplantation of vascularized osteoarthrocutaneous flaps of the ipsilateral second toe as planned. The implementation process was divided into digital design group and realistic surgery group. All patients signed informed consent. This study was approved by the Hospital Ethics Committee. Digital design group was implemented with digital simulation surgery. Virtual X-ray was used to measure parameters such as the axial length of the proximal middle phalanx, the inclination of proximal interphalangeal joint surface, and the rotation axis deviation. With the help of the coadapted reference osteotomy plane in digital design group, the navigation module of digital and phalangeal osteotomy was made and 3D printed into a solid tool. 3D printed osteotomy navigation was used in realistic surgery group to perform accurate osteotomy of finger and phalanges, and carries out joint transplantation, fixation and vascular anastomosis as planned. Postoperative CT scans were carried in realistic surgery group and the morphological parameters were measured using the virtual X-ray. Paired t-test was used to compare the postoperative morphological parameters of realistic surgery group with the digital design group. RESULTS AND CONCLUSION: (1) All the 13 fingers of 13 cases survived and achieved bone healing after bone flap transplantation. (2) Postoperative proximal interphalangeal joint range of motion was (55.0±14.0)°; straightening limitation was (18.5±9.0)°; excellent and good rate of total range of motion of joints was 84.6%. (3) Paired t-test results showed that there was no significant difference in proximal phalanx axial length, middle phalanx axial length, proximal interphalangeal joint surface inclination, and rotation axis deviation between the digital design group and realistic surgery group (P > 0.05). The inclination of the reconstructive finger and the joint surface of the second toe before surgery was significantly different (P < 0.05). (4) The principle of “Coadaptation” in digital design is advantageous to obtaining the best morphology and healing opportunity of reconstructed joints. By 3D printing-navigation, the digital design of morphology can be basically consistent in the actual operation, realizing the precise reconstruction of the digital joint and achieving better joint motion function. Figures and Tables | References | Related Articles | Metrics

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Body weight changes in children with Pierre Robin syndrome after distraction osteogenesis  Luo Dongyuan1, Zhou Niangou2, Chen Yiyang1, Wang Hongtao1, Li Fan1, Wu Wenli1, Liu Jiayu1, Hao Jiansuo1 2019, 23 (31):  4927-4931.  doi: 10.3969/j.issn.2095-4344.1498 Abstract ( 357 )   PDF (578KB) ( 128 )   Save BACKGROUND: Distraction osteogenesis can effectively improve airway obstruction in children with Pierre Robin syndrome. The growth inhibition of postoperative children can be significantly improved, especially in the growth of children’s body weight. However, there is no data to evaluate early distraction can benefit in body weight growth in children with post-osteogenesis. OBJECTIVE: To record changes in body weight percentile at different stages of the Pierre Robin syndrome and compare with those with cleft palate and undistracted osteogenesis column to evaluate the effect of early distraction osteogenesis on growth and development of child patients. METHODS: The clinical data of 56 cases of severe Pierre Robin syndrome in Guangzhou Women and Children’s Medical Center from 2015 to 2018 were collected, including 41 cases of mandibular distraction osteogenesis. The weight at 5 time points (birth, initial visit, before mandibular distraction osteogenesis, removal of distractor and cleft palate surgery) were recorded. The body weight of the child was converted into body weight percentile, and the growth rate curve of the child was made using statistical software. According to the age of the distraction osteogenesis, patients were divided into three groups (< 1 month; 1-3 months; 4-7 months). Simultaneously, body weight percentile of 21 cases of cleft palate (cleft palate group) and 15 cases of undistracted osteogenesis Pierre Robin syndrome (undistracted osteogenesis group) were collected and compared among groups. All the guardians of the children signed informed consent. This study was approved by the Hospital Ethics Committee. RESULTS AND CONCLUSION: (1) The mean body weight percentile decreased from 34.4 ± 23.0 at birth to 13.1 ± 15.3 before the mandibular distraction osteogenesis in the distraction osteogenesis group (P < 0.001). The body weight percentile increased to 28.2 ± 24.1 when the distractor was removed, showing significant difference as compared with that before mandibular distraction osteogenesis (P < 0.05). At follow-up, the body weight percentile increased to 42.4 ± 14.1 as compared with that after removal of the distractor (P < 0.001). (2) At 10.6 ± 2.6 months follow-up, the body weight percentile was significantly greater in the distraction osteogenesis group than in the undistracted osteogenesis group (P < 0.001). There was no significant difference between the cleft palate group and the distraction osteogenesis group (P > 0.05). (3) At the first visit, the body weight percentile in the group (1-3 months) and (4-7 months) was significantly lower than in the group (< 1 month) (P < 0.05). (4) It is indicated that distraction osteogenesis is effective to reduce the growth inhibition of the child's weight percentile in server Pierre Robin syndrome. The earlier the surgery, the better the growth of the child’s body weight is. Figures and Tables | Related Articles | Metrics

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Association between polymorphism of aggregate protein metabolic pathway gene and severity of lumbar disc herniation  Yang Jinfeng, Ma Sanhui 2019, 23 (31):  4939-4944.  doi: 10.3969/j.issn.2095-4344.1457 Abstract ( 395 )   PDF (19961KB) ( 94 )   Save BACKGROUND: Protrusion of intervertebral disc is a complex spinal disease, which is closely related to the degeneration of intervertebral disc. Candidate genes of aggregation proteoglycan metabolic pathway may be related to the severity of protrusion of lumbar intervertebral disc. OBJECTIVE: To assess the association between single nucleotide variants and proteoglycan metabolic pathways in the severity of lumbar disc herniation in patients with chronic mechanical low back pain. METHODS: Sixty patients were classified and described. T2-weighted median sagittal lumbar MRI scans were used to assess the severity of disc herniation and degeneration. Single nucleotide variants genotyping of 20 exons of two candidate genes (proteoglycan, matrix metalloproteinase 3) of lectin metabolic pathway was performed. Age, sex, body mass index and the degree of intervertebral disc degeneration were analyzed by multiple linear regression. The trial was approved by the Ethics Committee of People’s Hospital of Dingzhou on March 1, 2015 (approval No. 2015002). RESULTS AND CONCLUSION: The mutants and haplotypes of rs2272023, rs938609, rs2882676, rs698621, rs3825994, rs1042630 and rs3817428 of proteoglycan are related to the severity of lumbar disc herniation. The single nucleotide variants and its haplotype of proteoglycan are related to the severity of lumbar disc herniation. To determine the role of these important single nucleotide variants in the pathogenesis of intervertebral disc herniation, functional genetic studies are necessary. Figures and Tables | References | Related Articles | Metrics

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Measurement of hard and soft tissues of the zygomaticomaxillary region by multi-planner reconstruction Xie Hui1, Qin Bo2, Wang Souxin2, Mo Chaolun2, Zhang Junmei2 2019, 23 (31):  4945-4949.  doi: 10.3969/j.issn.2095-4344.1497 Abstract ( 435 )   PDF (17348KB) ( 188 )   Save BACKGROUND: Skeletal class III malocclusion has been shown to involve the whole eranio-maxillofacial soft and hard tissues, and severe cases require orthodonti-orthognathic surgery treatment. The zygomaticomaxillary complex, as an important bone support in the middle of the face, affects the facial appearance. Therefore, the morphological characteristics of soft and hard tissues in this part should be taken as an important reference in the design of orthodontic or orthodonti-orthognathic surgery. OBJECTIVE: To measure the morphological differences of soft and hard tissues in the zygomaticomaxillary complex between skeletal class III malocclusion with maxillary deficiency patients and the normal control group by cone-beam CT multi-planner reconstruction technique. METHODS: Thirty patients with skeletal class III malocclusion and maxillary deficiency were selected as the trial group and 30 normal people as the control group. Cone-beam CT images of all subjects were collected, and the Mimics 19.0 software was used to reconstruct the original image. A total of six horizontal and sagittal planes, intersection points were determined to analyze the thickness of hard and soft tissues and angle of zygomaticomaxillary complex. RESULTS AND CONCLUSION: (1) The thickness of hard tissue at each measurement site on the surface of zygomaticomaxillary complex in the trial group was less than that in the normal control group (P < 0.05), and there was no significant difference in soft tissue thickness (P > 0.05). (2) The measurement angles of sagittal maxillary angle, and sagittal zygomatic angle at S2, S3, and I1 in the trial group were smaller than those in the normal control group, but IMTA was larger than that in the normal control group (P < 0.05). (3) Compared with the normal control group, the development of the zygomaticomaxillary complex in the patients with skeletal class III malocclusion and maxillary deficiency was insufficient and zygomatic appearance was more flat. The difference in surface soft tissue thickness between the two groups was insignificant. Therefore, this difference should be considered in the preoperative diagnosis and analysis of orthodontics and orthodontics. Figures and Tables | References | Related Articles | Metrics

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Changes of osseous structure about temporal-mandibular joint pre/post-treatment for Angle III malocclusion through cone-beam computed tomography Wang Chaoran, Li Zhiqin, Shi Peiliang, Feng Chunyue, Yin Ye 2019, 23 (31):  4950-4955.  doi: 10.3969/j.issn.2095-4344.1465 Abstract ( 451 )   PDF (20406KB) ( 99 )   Save BACKGROUND: The changes of temporal-mandibular join before and after compensatory correction about Angle class III malocclusion are rarely reported. OBJECTIVE: To investigate the changes of osseous structure about temporal-mandibular joint pre/post-treatment for Angle III malocclusion through cone-beam CT (CBCT). METHODS: The study was in accordance with the ethical requirements of School of Stomatology of Tianjin Medical University. Thirty eligible Han patients with Angle class III malocclusion were enrolled, with the age of (16.5±2.6) years. All patients and their guardians signed the informed consents. The patients were treated by fixed appliance and class III traction and rocking-chair archwire. CBCT was conducted before and after treatment. CBCT data were measured and analyzed with the reconstructing image for comparing the glenoid morphology, condylar morphology, condylar axial and condylar growth. RESULTS AND CONCLUSION: (1) The joint nodules angle, condylar sagittal angle, articular fossa depth and condylar macroaxis angle were increased, the upper part of condyle was reduced and condylar process moved rearwards in patients with Angle III malocclusion after treatment (P < 0.05). (2) The difference of condylar minor axis and condylar inclination angle on coronal plane had no significant difference (P > 0.05), but condylar minor axis had increased tendency and condylar inclination angle on axial surface had decreased tendency. (3) To conclude, the morphology of temporal-mandibular joint in patients with class III malocclusion Angle pre/post-treatment is different to some extent. Figures and Tables | References | Related Articles | Metrics

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Effects of normoxic and hypoxic recovery on rat skeletal muscle focal adhesion complex after a single bout eccentric exercise  Chen Shengju, Wang Danni, Wang Jingtong, Yang Ning, Lei Binkai, Li Junping 2019, 23 (31):  4956-4961.  doi: 10.3969/j.issn.2095-4344.1483 Abstract ( 535 )   PDF (716KB) ( 77 )   Save BACKGROUND: Excessive training or non-adaptive high-intensity exercise makes negative effect on the skeletal muscle, and causes changes in ultrastructure of muscle fibers, thus causing damage. Exercise-induced mechanical stimuli can regulate gene expression by physical connection between cytoskeleton and nuclear matrix. OBJECTIVE: To investigate the effects of different recovery time and recovery conditions on the protein content of skeletal muscle focal adhesion complex after one eccentric exercise. METHODS: The study was approved by the Experimental Animal Ethics Committee of Beijing Sport University, approval number: 2014011. Fifty-six male Sprague-Dawley rats aged 8 weeks were randomly divided into control group, normoxic recovery group and hypoxic recovery group. Normoxic recovery group was subjected to a bout high-intensity eccentric exercise and hypoxia treatment (12.7% O2) while hypoxic recovery group performed exercise intervention. Hypoxic recovery and normoxic recovery groups were divided into 24-, 48- and 72-hour groups according to different time points after exercise. The gastrocnemius muscle was taken at the corresponding time phase. The expression levels of integrin α7 and β1, p-FAK and p-paxillin protein were detected by western blot assay. RESULTS AND CONCLUSION: (1) Compared with the control group, the expression level of integrin α7 in the 24-hour normoxic recovery group was significantly increased (P < 0.05), and restored to the level of control group with time. The expression level of integrin α7 in the 72-hour hypoxic recovery group was higher than that in the control group (P < 0.01). (2) The expression level of integrin β1 in the normoxic recovery and hypoxic recovery groups was on a rise, and the expression level in the normoxic recovery group was higher than that in the hypoxic recovery group. The expression level in the 48- and 72-hour normoxic recovery groups was significantly higher than that in the control group (P < 0.05, P < 0.01). (3) The expression level of p-FAK in the normoxic recovery and hypoxic recovery groups was on a descent, and the expression level in the normoxic recovery group was higher than that in the hypoxic recovery group. The expression level in the 48- and 72-hour normoxic recovery groups was significantly lower than that in the control group (P < 0.05). (4) The expression level of p-paxillin in the normoxic recovery and hypoxic recovery groups was firstly decreased and then increased, and the expression level in each group except for 24-hour normoxic recovery group was significantly lower than that in the control group (P < 0.05). (5) In summary, a single bout eccentric exercise can affect the protein expression of skeletal muscle focal adhesion complex. Different recovery conditions have different effects on focal adhesion complex. Normal oxygen is beneficial to the recovery of integrin α7, while hypoxia is beneficial to integrin β1, p-FAK and p-paxillin. Figures and Tables | References | Related Articles | Metrics

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Effect of maximum isokinetic centrifugal exercise training at fast and slow speeds on knee extensors Liu Yun 2019, 23 (31):  4962-4968.  doi: 10.3969/j.issn.2095-4344.1454 Abstract ( 512 )   PDF (746KB) ( 96 )   Save BACKGROUND: In lower steps, downhill running, and squatting training, the lower limb muscles are in centrifugal contraction, and it is easy to cause soreness of extensor muscles and minor muscle damage. However, there are few reports on the injury caused by the application of elbow flexor with the same centrifugal speed to extensor muscles. OBJECTIVE: To reveal the law of muscle injury by given maximum isokinetic eccentric contraction exercise at fast and slow speeds to the knee extensor. METHODS: The study was approved by the Ethics Committee of Chongqing Vocational College of Applied Technology. Sixteen untrained healthy male college students were selected and signed the informed consents. During the period of 2 weeks, the left and right legs of each participant were given 120 seconds of maximum isokinetic eccentric contraction exercise at slow ((30 (°)/s, 6 groups x 5 times)) and fast (210 (°)/s, 6 groups x 35 times) speeds, respectively. The degree of muscle soreness, thigh circumference, knee joint range of motion, maximum autonomic isometric muscle strength, and blood creatine kinase activity were measured before and after exercise. RESULTS AND CONCLUSION: (1) Muscle soreness peaked at 2-3 days after the end of training at different speeds, which showed that muscle soreness induced by rapid training was more serious than slow training, but both of them could recover to the level before training on day 5 after the end of exercise. (2) Thigh circumference increased at different speeds, but thigh circumference increased significantly faster than slow training and recovered more slowly. (3) The range of motion and maximum isometric muscle strength of knee joint after rapid training were significantly lower than those after slow training. The recovery speed of both was significantly different, which showed that range of motion of knee joint and maximum isometric muscle strength decreased slowly after slow training, and basically returned to the level after training on day 3 after the end of slow training. In fast condition, range of motion of knee joint and maximum isometric muscle strength decreased significantly, peaked later, and recovery was more significant, and took longer time to recover completely on day 5 after the training. (4) The creatine kinase activity induced by fast training was significantly higher than that induced by slow training, and the slow training could recover quickly, but the creatine kinase activity of fast training group was still increasing on day 5 after the end of training, which showed that the muscle damage caused by fast training was much higher than that caused by slow training. (5) These results imply that the difference of muscle soreness, thigh circumference, range of motion of knee joint, maximum isometric muscle strength, blood creatine kinase, maximal muscle strength and recovery time caused by centrifugal contraction may be related to the total amount of centrifugal training. On the premise of controlling the activation time of fast and slow speed muscles, the degree of muscle injury caused by rapid isokinetic centrifugal training is much higher than that caused by slow speed, which supports the conclusion that centrifugal contraction speed is related to muscle injury. It also confirms that rapid centrifugal exercise is more likely to cause muscle injury. Figures and Tables | References | Related Articles | Metrics

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Significance of gait analysis in the diagnosis of anterior cruciate ligament injury Luo Hong1, Liu Fang1, Li Shunhua1, Qiu Bing1, Liu Fuyao1, Zhang Yu2, Ma Limin3 2019, 23 (31):  4969-4973.  doi: 10.3969/j.issn.2095-4344.1971 Abstract ( 345 )   PDF (18408KB) ( 124 )   Save BACKGROUND: Gait analysis is a special subdiscipline in the field of biomechanics and has been widely used to evaluate the effects of gait disorders and orthopedic surgery. There is a lack of gait analysis in the diagnosis of anterior cruciate ligament injury. OBJECTIVE: To investigate the application value of gait analysis in the diagnosis of anterior cruciate ligament injury. METHODS: The study was in accordance with the ethical requirements of Guizhou Orthopedics Hospital, and the patients and their families signed the informed consents. Sixty patients with anterior cruciate ligament injury diagnosed by arthroscopic surgery were selected. The infrared optical navigation knee motion analysis system, gait analysis, and physical examination were performed to explore their diagnostic values of anterior cruciate ligament injury. RESULTS AND CONCLUSION: (1) The results showed that gait analysis (n=49) was superior to physical examination (n=29) and magnetic resonance imaging (n=35) in the diagnosis of anterior cruciate ligament injury (P < 0.05), especially in patients with mild anterior cruciate ligament injury (P < 0.05). There was no significant difference in moderate and severe anterior cruciate ligament injuries (P > 0.05). (2) Comparison between gait analysis and magnetic resonance examination showed that the area under the curve of ROC was 0.636 4 (95% confidence interval, 0.535 9-0.736 8, P=0.010). Comparison between gait analysis and physical examination, the area under the curve of ROC was 0.620 3 (95% confidence interval, 0.519 4-0.721 1, P=0.023 0). (3) In summary, gait analysis under optical navigation is another effective method for diagnosing anterior cruciate ligament injury. Figures and Tables | References | Related Articles | Metrics

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Reduction for developmental dysplasia of the hip in rabbits: expression levels of Caspase-3 and Bcl-2 in acetabular chondrocytes Xiong Fei1, Wei Yishan2 2019, 23 (31):  4974-4978.  doi: 10.3969/j.issn.2095-4344.0822 Abstract ( 346 )   PDF (687KB) ( 93 )   Save BACKGROUND: Abnormal increase in the number of apoptotic articular chondrocytes can induce cartilage degeneration, further deteriorate and develop into osteoarthritis. OBJECTIVE: To observe the expression of apoptosis-related factors in the treatment of developmental dysplasia of the hip by reduction. METHODS: Sixty 28-day-old New Zealand white rabbits (either sex) were randomly selected, then the right hind limbs were fixed with tubular gypsum in flexion of hip and extension of knee for 8 weeks to establish an animal model of developmental dysplasia of the hip, and the left hind limbs served as controls. Subsequently, the successful models were judged by the X-ray film, acetabular index, and dislocation of the femoral. Forty-eight model rabbits were equally randomized into group A (8 weeks of fixation), group B (10 weeks of fixation), group C (embolia at 2 weeks after 8 weeks of fixation). The morphology of chondrocytes at the acetabular cartilage was observed after hematoxylin-eosin staining. The expression levels of Caspase-3 and Bcl-2 in chondrocytes were detected by immunohistochemistry. The apoptosis rate in the acetabular cartilage was detected by TUNEL method, and the correlation was analyzed. RESULTS AND CONCLUSION: (1) The acetabular index in the groups A, B and C was significantly higher than that in the control group (P < 0.05). (2) The morphology of chondrocytes in control group after hematoxylin-eosin staining was regular, and the groups A and B appeared with vacuolate cells, part of the structure disappeared, and the structures of acetabular and femoral head articular cartilage were complete, with less vacuole in the group C. (3) TUNEL method found that the apoptosis rate in the group C was lower than that in the group B, but higher than that in the control group (P < 0.05), indicating the decreased apoptotic rate after reduction. (4) Correlation analysis showed that the apoptosis rate was positively correlated with the expression level of Caspase-3 and negatively correlated with Bcl-2 expression. (5) To conclude, the reduction group shows a highly expressed Bcl-2, decreased expression of Caspase-3 and reduced apoptosis rate. Therefore, the reduction method can reduce the apoptosis rate of acetabular chondrocytes in developmental dysplasia of the hip, delay the degeneration of cartilage, and slow the course of disease progression. Figures and Tables | References | Related Articles | Metrics

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Immunofluorescence staining of adeno-associated virus type 2 after subpial injection in rat models of spinal cord injury Bai Qiushi1, 2, Su Sheng1, 2, Wang Liangjia1, 2, Zheng Yangyang2, Kang Juanjuan2, Xu Jinying2, Chi Guangfan2 2019, 23 (31):  4979-4985.  doi: 10.3969/j.issn.2095-4344.1481 Abstract ( 457 )   PDF (30379KB) ( 129 )   Save BACKGROUND: The method of injecting adeno-associated virus subpial can limit the virus to a small area centered on the injection point, with less systemic toxicity and side effects, and save the amount of virus. However, there are no reports on the application of this method in spinal cord injury rats, and the transfection of astrocytes and neurons at the injured site is still unclear. OBJECTIVE: To investigate the transfection effect of subpial injection of adeno-associated virus 2 on astrocytes and neurons in the spinal cord injury site and the technical points of the surgical procedure. METHODS: The study was approved by the Experimental Animal Ethics Committee of Jilin University. Twenty-four Wistar rats were randomly divided into two groups: adeno-associated virus group and model group. Rats in both groups were used to establish the spinal cord injury model using the clamp method. The adeno-associated virus group received 60 μL of virus solution by subpial injection, and the model group received an equal amount of 5% dextran solution. At postoperative 7, 14, and 21 days, spinal cord specimens were taken for immunofluorescence staining to observe the distribution of astrocytes and the transfection of adeno-associated virus 2. RESULTS AND CONCLUSION: (1) After subpial injection of the virus, the virus solution evenly distributed in the range of about 1 cm above and below the injured site. (2) At 7 and 14 days after surgery, only a small amount of green fluorescent protein was expressed in the spinal cord injury area. Until day 21, a large number of reactive astrocytes were observed around the spinal cord injury cavity. The strongest expression was in the periphery of the spinal cord cavity, with obvious glial boundary membrane. It was also found that adeno-associated virus 2 could stably transfect astrocytes and neurons, in which astrocytes were concentrated around the periphery of the spinal cord cavity, while neurons were scattered within the scope of virus transfection. Only trace adeno-associated virus 2 transfection was found in normal tissues outside the scope of injection. (3) The method has the advantages of confining the virus to the injured site, targeting astrocyte and nerve cell transfection, low viral dosage, low systemic toxicity and side effects, and low cost. Figures and Tables | References | Related Articles | Metrics

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Effects of Buyang Huanwu decoction on the expression of collagen type I and IV after spinal cord injury  Lin Xiaomin1, Pan Weibin1, Wu Yuqiong1, Fan Xiao2 2019, 23 (31):  4986-4991.  doi: 10.3969/j.issn.2095-4344.1459 Abstract ( 466 )   PDF (26691KB) ( 122 )   Save BACKGROUND: Collagen type I and IV are shown to be beneficial for limb locomotion recovery after spinal cord injury. OBJECTIVE: To explore the mechanism of Buyang Huanwu decoction on the rehabilitation of limb locomotion of rats after spinal cord injury by observing the changes of limb locomotion and expression levels of collagen type I and IV. METHODS: The study was approved by the Experimental Animal Ethics Committee of Fujian University of Traditional Chinese Medicine, approval number: SYXK2013-005. Fifty-four Sprague-Dawley rats were divided into three groups, sham, model and Buyang Huanwu decoction groups (n=18/group). Rats in the sham group underwent the laminectomy and rats in the other groups were used for establishing the spinal cord injury model by NYU impactor. The rats in the Buyang Huanwu decoction group, and sham and model groups were administrated 1 mL of Buyang Huanwu decoction and normal saline via gavage, respectively, at 1 day post-injury. Basso, Beattie, and Bresnahan limb locomotion scores were evaluated at 1, 3, 5 and 7 days after injury. At 7 days after injury, samples were removed for Nissl staining to observe the morphology of spinal cord neurons and the expression levels of collagen type I and IV were detected by immunohistochemistry. The ultrastructures of medullary sheath were observed under transmission electron microscope. The expression levels of collagen type I and IV proteins were detected by western blot assay. RESULTS AND CONCLUSION: (1) The Basso, Beattie, and Bresnahan limb locomotion scores from the fifth day after modeling in the Buyang Huanwu decoction group were significantly higher than those in the model group (P < 0.05). (2) Nissl staining showed that in the Buyang Huanwu decoction group, the structure of neurons was complete, cell edema was slight, hemostasis area was small, and the recovery of neurons was better than that in the model group. (3) Transmission electron microscope showed that the structure of myelin sheath in the Buyang Huanwu decoction group was better than that in the model group, and with slight edema, which were similar with the Nissl staining results. (4) Immunohistochemistry results showed that the expression levels of collagen type I and IV in the Buyang Huanwu decoction group were significantly higher than those in the model group (P < 0.05). (5) Western blot assay results showed that expressions of collagen type I and IV proteins in the Buyang Huanwu decoction group were significantly higher than those in the model group (P < 0.05). (6) In summary, Buyang Huanwu decoction can promote the rehabilitation of limb locomotion of rats after spinal cord injury, possibly by up-regulating the expressions of collagen type I and IV. Figures and Tables | References | Related Articles | Metrics

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Hydrogen sulfide protects articular cartilage in rabbit models of knee osteoarthritis Li Xianan, Tian Shaoqi, Wang Yuanhe, Liu Jiangjun, Ding Tao, Chu Guoqing, Sun Kang 2019, 23 (31):  4992-4997.  doi: 10.3969/j.issn.2095-4344.1984 Abstract ( 311 )   PDF (980KB) ( 80 )   Save BACKGROUND: H2S is an important inflammatory regulator, which widely exists in various tissues and organs of human body and plays an important role in many systemic diseases. OBJECTIVE: To investigate the effect of H2S on articular cartilage degeneration in rabbit knee osteoarthritis model and to explore the therapeutic effect of H2S on osteoarthritis. METHODS: Thirty-two New Zealand white rabbits were randomly divided into four groups: blank control, osteoarthritis, H2S, and H2S inhibition groups (n=8/group). Blank control group was not treated, the other three groups were used to establish the osteoarthritis model by modified Hulth method, and were then injected with normal saline, NaHS diluent (60 μmol/L) and H2S synthase inhibitor (aminooxyacetic acid, 37.5 mg/kg; propargylglycine, 60 mg/kg) 1 mL each into the knee joint cavity once a week for 6 weeks. The study was approved by the Laboratory Animal Ethical Committee of Qingdao University, approval No. AHQU-MAL2018032. RESULTS AND CONCLUSION: (1) Pathological changes: the morphology of articular cartilage in the blank control group was normal; the degeneration of articular cartilage in the osteoarthritis group was serious; the degeneration of articular cartilage in the H2S group was mild; and the degeneration of articular cartilage in the H2S inhibition group was more serious than that in the osteoarthritis group. (2) Mankin’s score showed that the scores in the osteoarthritis, H2S and H2S inhibition groups were significantly higher than those in the blank control group (P < 0.05); the scores in the H2S group were lower than those in the osteoarthritis group, and the scores in the H2S inhibition group were significantly higher than those in the osteoarthritis group (P < 0.05). (3) Type II collagen staining showed that compared with the blank control group, the positive staining of type II collagen in the osteoarthritis group was significantly lower and unevenly distributed; the positive staining of type II collagen in H2S group was higher than that in osteoarthritis group; the positive staining of type II collagen in H2S inhibition group was significantly lower and the superficial layer was defective. (4) Compared with the osteoarthritis group, the mRNA expression levels of matrix metalloproteinase-1, matrix metalloproteinase-3 and matrix metalloproteinase-13 in articular cartilage were decreased in the H2S group, and increased in the H2S inhibition group compared with the osteoarthritis group. (5) These results show that H2S can inhibit the mRNA expression of matrix metalloproteinase-1, matrix metalloproteinase-3 and matrix metalloproteinase-13 in articular cartilage, reduce the degradation of type II collagen in articular cartilage, and protect articular cartilage in osteoarthritis. Figures and Tables | Related Articles | Metrics

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Changes of bone mineral density, bone metabolism and biomechanics in rat models of ovariectomy and dexamethasone-induced osteoporosis treated by Eucommia ulmoides combined with vibration training  Wang Xiaoxiao1, Luo Zhizhu2, Liu Haowei2 2019, 23 (31):  4998-5004.  doi: 10.3969/j.issn.2095-4344.1458 Abstract ( 349 )   PDF (730KB) ( 77 )   Save BACKGROUND: Long-term use of glucocorticoids in women after menopause is higher than other stages, and the incidence of osteoporosis is significantly increased. The use of exercise combined with traditional Chinese medicine to prevent and treat osteoporosis has gradually been adopted in the clinic. OBJECTIVE: To investigate the effects of Eucommia ulmoides extract combined with whole body vibration training on bone mineral density, bone metabolism and bone biomechanical properties in ovariectomized dexamethasone-induced osteoporotic rats. METHODS: Eighty female Sprague-Dawley rats were purchased and were randomly divided into model and sham groups. The rats in the model group underwent oophorectomy and dexamethasone. The rats in the sham group received sham operation and placebo intake. The modeling process was completed for 6 weeks. After the modeling, the osteoporotic rats were randomly divided into model control group, whole body vibration group, Eucommia ingestion group, and Eucommia inhalation + whole body vibration group, and 12 weeks of intervention was conducted. Within 24 hours after the end of intervention, all rats were placed in a metabolic cage for 24-hour urine collection. The next day, blood sample was collected, and all rats were sacrificed after analyzing bone metabolism. The left femur was scanned and bone biomechanical properties were detected. RESULTS AND CONCLUSION: (1) Before intervention, the rat body mass in the sham group was significantly lower than that in the other groups (P < 0.05). After intervention, the body mass in the whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups was significantly lower than that in the model control group (P < 0.05). The body mass in the model control, whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups was significantly higher than that in the sham group (P < 0.05). (2) The femoral bone mineral density and serum estradiol level in the model control group were significantly lower than those in the sham, whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups (P < 0.05). (3) Serum osteocalcin, alkaline phosphatase concentration, urine deoxypyridoline, Ca2+, and P3+ in the model control group were significantly higher than those in the sham, whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups (P < 0.05). (4) The maximum stress and maximum load in model control group were significantly lower than those in the sham, whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups (P < 0.05). (5) The elastic modulus in the model control group was significantly higher than those in the sham, whole body vibration, Eucommia ingestion and Eucommia inhalation + whole body vibration groups (P < 0.05). (6) To conclude, ingestion of Eucommia ulmoides extract, whole body vibration training, ingestion of Eucommia ulmoides extract combined with whole body vibration training can significantly improve the bone mineral density of ovariectomized rats combined with dexamethasone- induced osteoporosis, enhance the biomechanical properties of the femur, and improve bone metabolism indicators. Figures and Tables | References | Related Articles | Metrics

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Construction of SD rat scoliosis model and the effect of asymmetric tension on bone structure development Wang Zirun, Xiao Chengwei, Hu Jiang 2019, 23 (31):  5005-5009.  doi: 10.3969/j.issn.2095-4344.1464 Abstract ( 480 )   PDF (21386KB) ( 139 )   Save BACKGROUND: Scoliosis is a three-dimensional complex deformity occurring in the spine. It has been found that molecular mechanisms such as aggrecan, type II collagen, Sox9, and vascular endothelial growth factor protein are involved in the course of scoliosis, and may play a similar adverse role to the mechanical mechanism. However, there is no experimental study on the mechanism of scoliosis. OBJECTIVE: To construct the scoliosis model of SD rats and explore the effect of asymmetric tension on bone structure development. METHODS: Six SD rats were selected for operation and X-ray films were taken after feeding in high cage for 3 months. Three-dimensional reconstruction of the spine was performed to analyze the asymmetric tension distribution. Bone trabecular structure was examined by scanning. After the rats were killed, the epiphyseal cartilages of concave and convex vertebral bodies were extracted. The expression of aggrecan, type II collagen, Sox9, and vascular endothelial growth factor protein was detected.  RESULTS AND CONCLUSION: (1) All the 6 SD rats were successfully modeled, with obvious kyphosis and left thoracic deformity. (2) The stress of the vertebral body was asymmetric, and the stress in the vertical direction of the convex side was remarkably higher than that in the concave side. (3) Western blot assay results demonstrated that the expression levels of aggrecan, type II collagen, Sox9, and vascular endothelial growth factor protein on the convex side were significantly higher than those on the concave side. The corresponding convex integral optical density value was also significantly higher (P < 0.05). (4) There was significant asymmetry in the bone trabecular microstructures on both sides of convex and concave. Compared with the concave side, the volume fraction and number of trabeculae on convex side were significantly higher (P < 0.05), while the trabecular separation and structural model index were significantly lower (P < 0.05). (5) Asymmetric tension may promote the occurrence and development of scoliosis by affecting the changes of related proteins and bone trabecular structure. Figures and Tables | Related Articles | Metrics

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Extract of piper auritum can alleviate oxidative stress and inflammation of rat models of acute spinal cord injury  Cheng Jianping, Li Hua, Li Xiongjie 2019, 23 (31):  5010-5016.  doi: 10.3969/j.issn.2095-4344.1488 Abstract ( 556 )   PDF (868KB) ( 213 )   Save BACKGROUND: Extract of piper auritum plays a protective role in streptozotocin-induced diabetic rats, and the mechanism is associated with anti-oxidative damage. However, whether it can alleviate acute spinal cord injury by anti-oxidative stress is unknown. OBJECTIVE: To investigate the effects of extract of piper auritum on oxidative stress, inflammation and nerve injury of acute spinal cord injury rats. METHODS: One hundred rats (provided by Chengdu Dashuo Experimental Animal Company) were randomly divided into sham group, spinal cord injury group, and low-, moderate-, and high-dose extract of piper auritum groups. Except for sham group, the rats in the other groups were used to establish acute spinal cord injury model by Allen’s method. Afterwards, the rats in the extract of piper auritum groups were given 100, 200 and 400 mg/(kg•d) extract of piper auritum via gavage, respectively, for 28 consecutive days. Basso, Beattie Bresnahan scores and tilt board experiment were carried out at 3, 7, 14 and 28 days after administration. The concentrations of superoxide dismutase, glutathione peroxidase, malondialdehyde, interleukin-1β, interleukin-6 and tumor necrosis factor-α in serum were measured by ELISA. The protein levels of Bcl-2, Bax, Caspase-3, brain-derived neurotrophic factor, neuronal/glial cell antigen, IκBα, p-IκBα and NF-κB p65 were detected by western blot assay. Spinal cord tissues underwent hematoxylin-eosin staining and TUNEL staining. The study was approved by the Laboratory Animal Ethics Committee of Institute of Tropical Agriculture and Forestry, Hainan University, approval No. NR001803. RESULTS AND CONCLUSION: (1) Compared with the sham group, the Basso, Beattie Bresnahan scores and the maximal title angle in tilt board experiment in the spinal cord injury group were significantly decreased at different time points after administration (P < 0.01). Compared with the spinal cord injury group, the Basso, Beattie Bresnahan scores and the maximal title angle in tilt board experiment in the moderate- and high-dose extract of piper auritum groups were significantly at 7, 14 and 28 days after administration (P < 0.05, P < 0.01). (2) Compared with the sham group, the spinal cord injury was more serious in the spinal cord injury group, the apoptosis rate, the levels of Bax, Caspase-3, malondialdehyde, interleukin-1β, interleukin-6 and tumor necrosis factor-α, p-IκBα, NF-κB p65, brain-derived neurotrophic factor, and neuronal/glial cell antigen were significantly increased (P < 0.05, P < 0.01), and the levels of Bcl-2, IκBα, superoxide dismutase, and glutathione peroxidase were significantly decreased (P < 0.05, P < 0.01). Compared with the spinal cord injury group, the degree of spinal cord injury in each extract of piper auritum group was alleviated, the apoptosis rate, the levels of Bax, Caspase-3, malondialdehyde, interleukin-1β, interleukin-6 and tumor necrosis factor-α, p-IκBα, NF-κB p65, brain-derived neurotrophic factor, and neuronal/glial cell antigen were significantly decreased (P < 0.05, P < 0.01), and the levels of Bcl-2, IκBα, superoxide dismutase, and glutathione peroxidase were significantly increased (P < 0.05, P < 0.01). (3) These findings imply that extract of piper auritum can attenuate acute spinal cord injury by inhibiting inflammation and oxidative stress and also plays a neuroprotective role in spinal cord injury, and the mechanism may be related to inhibit the activation of NF-κB signaling pathway. Figures and Tables | References | Related Articles | Metrics

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Deep seawater promotes cutaneous wound healing in diabetic mice via activating Wnt/β-catenin pathway  Li Weiming, Sun Dali, Li Yijun, Li Shumin, Sun Yanbo, Cui Jin, Xu Pengyuan, Xu Qingwen 2019, 23 (31):  5017-5022.  doi: 10.3969/j.issn.2095-4344.1487 Abstract ( 488 )   PDF (841KB) ( 81 )   Save BACKGROUND: Deep seawater has been shown to effectively alleviate the process of diabetes in mice induced by high fat diet through activating AMPK pathway, but there are few studies about the role of deep seawater in the wound healing of diabetes mellitus. OBJECTIVE: To explore the mechanism of deep seawater on the cutaneous wound healing in diabetic mice. METHODS: Forty-eight healthy male Kunming mice (provide by Laboratory Animal Center of Kunming Medical University) were selected and were given intraperitoneal injection of streptozotocin to establish diabetic model. After 14 days of incubation, the back would model was established, and the mouse models were randomly divided into four groups: control group (purified water), tap water group, deep seawater group and inhibitor group (deep seawater + venous injection of Wnt/β-catenin inhibitor, XAV-939). Subsequently, the blood glucose and body mass of model mice were observed at 3, 7 and 10 days after wound modeling, and the healing of the wound was observed. The morphological changes of the wound were evaluated. The expression levels of β-catenin, GSK-3β and Rspo-3, malondialdehyde, superoxide dismutase and glutathione peroxidase in the serum were detected. The study was approved by the Laboratory Animal Ethics Committee of Kunming Institute of Zoology, China Academy of Sciences, approval No. KPRC-2017091. RESULTS AND CONCLUSION: (1) Deep seawater showed no significant effect on the body mass and blood glucose. (2) The wound healing rate in the deep seawater group was significantly higher than that in the tap water and control groups at different time points (all P < 0.01). (3) Western blot results showed that the expression levels of β-catenin and Rspo-3 were higher in the deep seawater group than the control and tap water groups, but GSK-3β was down-regulated. (4) Hematoxylin-eosin staining showed that compared with the control group, vascular endothelial cells, new capillaries and fibroblast cells proliferation in the deep seawater group were increased, but the number of inflammatory cells got opposite results. However, there was no significant difference between the deep seawater + XAV-939 group and control group (P > 0.05). The healing rate of wound at different time points in the deep seawater group was significantly higher than that in the tap water and control groups (all P < 0.01). (5) Compared with the control group, the expression levels of superoxide dismutase and glutathione peroxidase in serum in the deep seawater group were increased (P < 0.01 and P < 0.001), and malondialdehyde decreased (P < 0.05 and P < 0.01). There was no significant difference between deep seawater + XAV-939 and control groups (P > 0.05). (6) To conclude, deep seawater promotes cutaneous wound healing in diabetic mice via activating Wnt/β-catenin pathway. Figures and Tables | References | Related Articles | Metrics

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Construction of islet beta cell-specific PDHA1 knockout mice by Cre/loxP system Wang Xiao1, Lai Shuchang1, Ye Yanshi1, Xu Xuejuan1, Bai Xiaochun2, Shen Jie1 2019, 23 (31):  5023-5029.  doi: 10.3969/j.issn.2095-4344.1985 Abstract ( 441 )   PDF (62095KB) ( 96 )   Save BACKGROUND: In rodent models of type 2 diabetes mellitus and human, the expression level of pyruvate dehydrogenase complex is decreased, and PDHA1 deficiency is the most common cause of changed pyruvate dehydrogenase complex activity. OBJECTIVE: To construct and identify the inducible islet-specific PDHA1 knockout mice, so as to provide basis for the study on the role of PDHA1 in pathogenesis of diabetes mellitus. METHODS: The study was approved by the Ethics Committee of Southern Medical University. By using Cre-loxP recombination system, PDHA1flox/floxCre+/- mice were generated by crossing PDHA1flox/flox mice with Cre+/- mice. Genotypic identification was performed by PCR at the age of 3-4 weeks and the PDHA1flox/floxCre+/- mice were the required mouse model. PDHA1flox/floxCre+/- mice (βKO group, n=5) and Cre+/- mice (control group, n=5) at the age of 4 weeks were selected and received the same water and feed. Tamoxifen (50 mg/kg) was intraperitoneally injected at the age of 8 week to induce gene knockout. Three weeks later, pancreatic tissue, adipose tissue, and liver tissue were removed under anesthesia. qPCR, western blot and immunohistochemical staining were applied to identify the PDHA1 knockout effect and to observe the mouse  phenotype. RESULTS AND CONCLUSION: (1) PCR analysis selected PDHA1flox/floxCre+/- mice. (2) qPCR method was used to test the pancreas, fat and liver tissues of mice, and it was confirmed that the knockout effect had tissue specificity. The expression level of PDHA1 mRNA in islet in the βKO group was significantly lower than that in the control group. (3) The results of western blot and immunohistochemical scanning showed a significant decrease in PDHA1protein in the βKO group compared with the control group, suggesting the PDHA1 knockout effect was obvious. (4) In summary, the β cell-specific deletion of the PDHA1 gene is successfully constructed by Cre-loxP system, which provides a novel target for studying the pathogenesis of diabetes at animal level. Figures and Tables | References | Related Articles | Metrics

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Synergistic resistance of moderate-intensity endurance exercise and allicin to rat models of fatty liver induced by high-fat diet Yang Zhongming1, Jiang Manyi2, Xu Simao3 2019, 23 (31):  5030-5035.  doi: 10.3969/j.issn.2095-4344.1338 Abstract ( 386 )   PDF (26123KB) ( 114 )   Save BACKGROUND: The incidence of non-alcoholic fatty liver induced by high-fat diet and sports deficiency is on a rise. Endurance exercise and allicin can improve blood lipid metabolism, but the protective effect of endurance exercise combined with allicin from fatty liver formation in rats induced by high-fat diet is rarely reported. OBJECTIVE: To investigate the effect of moderate-intensity endurance exercise combined with allicin on the formation of fatty liver in rats fed with high-fat diet. METHODS: The study was approved by the Experimental Animal Ethics Committee of Guangxi Normal University. Sixty adult male Sprague-Dawley rats were randomly divided into normal diet control group, high-fat diet group, high-fat diet placebo (distilled water via gavage) group, high-fat diet exercise group, high-fat diet allicin group and high-fat diet exercise combined with allicin (allicin via gavage) group. The endurance exercise was performed for 30 minutes once daily, 6 days/week. The expression and activity of heme oxygenase-1 protein and malondialdehyde content in rat liver were detected. The concentration changes of alanine aminotransferase, glutamic oxalate aminotransferase, triglyceride, free fatty acid and total cholesterol in blood were measured. The morphological changes of liver tissue were observed and the activity integral of non-alcoholic fatty liver was calculated. RESUITS AND CONCLUSION: (1) High-fat diet significantly increased blood triglyceride, free fatty acid, total cholesterol, alanine aminotransferase and glutamic oxalate aminotransferase (P < 0.05), decreased liver heme oxygenase-1 activity and increased malondialdehyde content (P < 0.05), and increased liver steatosis and non-alcoholic fatty liver activity integral (P < 0.05). (2) Compared with the high-fat diet group, the expression level and activity of heme oxygenase-1 protein in the lipid liver of the high-fat diet exercise, high-fat diet exercise, high-fat diet exercise, high-fat diet allicin, and high-fat diet exercise combined with allicin groups were significantly increased (P < 0.05). (3) Compared with the high-fat diet group, in the high-fat diet exercise, high-fat diet combined with allicin group, the blood triglycerides, free fatty acid, total cholesterol, concentration of alanine aminotransferase and glutamic oxalate aminotransferase were decreased significantly (P < 0.05); the content of malondialdehyde in liver was decreased significantly (P < 0.05); the fatty degeneration of liver tissue was improved significantly; and the activity score of non-alcoholic fatty liver decreased significantly (P < 0.05). The above changes were most obvious in the high-fat diet and exercise combined with allicin group. (4) In summary, moderate-intensity endurance exercise and allicin have synergistic resistance to fatty liver formation in rats fed with high-fat diet, which may be related to the synergistic control of lipid peroxidation in liver, triglyceride, free fatty acid and total cholesterol concentration in blood. Figures and Tables | References | Related Articles | Metrics

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Salidroside can improve lung injury in mouse models of chronic intermittent hypoxia Huangfu Zhimin1, Xu Qian1, Wang Xiao2, Wang Enping2, Feng Yue2, Zeng Juan2, Zhu Rui2, Zhao Chunling1 2019, 23 (31):  5036-5040.  doi: 10.3969/j.issn.2095-4344.1490 Abstract ( 427 )   PDF (773KB) ( 146 )   Save BACKGROUND: Obstructive sleep apnea hypopnea syndrome and chronic obstructive pulmonary disease are common diseases in respiratory system. The incidence of coexistence is high, which is called “overlap syndrome” in clinical practice. Chronic intermittent hypoxia is the basic pathological process of overlap syndrome. OBJECTIVE: To investigate the mechanism of salidroside affecting the apoptosis and oxidative stress in lung injury caused by chronic intermittent hypoxia in mice. METHODS: The study was approved by the Ethics Committee of Laboratory Animal Center of Southwest Medical University. Wild-type C57BL/6 male mice were randomly divided into normal control group, salidroside group, chronic intermittent hypoxia group and chronic intermittent hypoxia+salidroside group. The mice in the latter two groups were placed in an anoxic chamber. The complete cycle of hypoxia was adjusted to the initial oxygen concentration of 8% to 10% for 1 minute, and then rapidly converted to normoxia (19%-21%) for 2 minutes. The daily cycle of hypoxia was 8 hours for 30 days. On the day of hypoxia, mice in the salidrosidel and salidrosidel groups were given salidroside (50 mg/(kg·d) for 30 consecutive days. The pathological changes of lung tissue were observed under a light microscope. Quantitative and qualitative detection of oxygen free radical activity in mouse lung tissue was performed by chemical fluorescence method. The apoptosis related protein caspase-3, Bax, Bcl-2 levels, and Bax/Bcl-2 ratio were detected by western blot assay.  RESULTS AND CONCLUSION: (1) The occurrence of chronic intermittent hypoxia activated the lung oxidative stress pathway and initiated cell apoptosis. The lung pathological damage in the chronic intermittent hypoxia group was more serious than that in the normal control group. Its pulmonary artery wall thickened in the normal control group, the alveolar size was uneven, the oxygen free radical activity was increased, the ratio of Bax/Bcl-2 and the protein level of caspase-3 were significantly increased (P < 0.05). However, the degree of lung pathological damage in the chronic intermittent hypoxia+salidroside group was significantly reduced and the above indicators in the chronic intermittent hypoxia+salidroside group were significantly lower than those in the chronic intermittent hypoxia group (P < 0.05). There was no significant difference in each indicator between normal control and salidroside groups (P > 0.05). (2) Therefore, salidroside may improve chronic intermittent hypoxic lung injury in mice by inhibiting oxidative stress response and apoptotic pathways. Figures and Tables | References | Related Articles | Metrics

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An en bloc paraffin embedding method for serial sectioning of carotid atherosclerotic plaque Cao Jingli1, 2, Marina S. Ferguson3, Sun Jie3, Zhang Dong1, Liu Li1, Li Zirui1, Wang Yajie1, Sui Binbin1, Shen Mi1, Gao Peiyi1, 4, Thomas S. Hatsukami3, Zhao Xihai5, Yuan Chun1, 3, 5 2019, 23 (31):  5041-5045.  doi: 10.3969/j.issn.2095-4344.1334 Abstract ( 427 )   PDF (21113KB) ( 149 )   Save BACKGROUND: Carotid atherosclerotic plaque with the length of about 3 cm completely embedding into paraffin block is a key step. OBJECTIVE: To clarify a method to embed carotid atherosclerotic plaque en bloc in paraffin. METHODS: Carotid atherosclerotic plaque was removed from the carotid endanerectomy at Beijing Tiantan Hospital, Capital Medical University. In order to facilitate the comparison between histological slices from serial sectioning and MRI, we need to embed carotid atherosclerotic plaque en bloc in paraffin. RESULTS AND CONCLUSION: With the guidance of the University of Washington Vascular Imaging Lab, we had established a simple embedding method according to the practice in our lab. With the method, we successfully overcame the technical difficulties in the en bloc embedding of carotid atherosclerotic plaque, which provides a reference for researchers with similar work needs. Figures and Tables | References | Related Articles | Metrics

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Plasma alpha-fetoprotein and other biochemical indicators for constructing early diagnosis models of potential biliary atresia in children Yang Tianqi1, Hu Xiaowen1, Zhou Kejun2, Wan Chunling1 2019, 23 (31):  5046-5051.  doi: 10.3969/j.issn.2095-4344.1426 Abstract ( 428 )   PDF (19648KB) ( 99 )   Save BACKGROUND: Biliary atresia is not suitable as a method for early diagnosis because it mainly depends on intraoperative diagnosis, and the operation is complicated, and there is a great injury to the child. Therefore, finding simple and effective blood biochemical diagnostic indicators will improve early diagnosis efficiency. OBJECTIVE: To measure the plasma alpha-fetoprotein level in children with biliary atresia and to investigate the application value of plasma alpha-fetoprotein level and blood biochemical indicators. METHODS: Blood samples were harvested from 48 infants with biliary atresia, 20 infants with neonatal hepatitis, and 9 healthy controls. Plasma alpha-fetoprotein level was measured by enzyme-linked immunosorbent assay. The correlation between plasma alpha-fetoprotein level and blood biochemical indicators was analyzed to establish a potential diagnosis model. This study was approved by the Ethics Committee of Xinhua Hospital, China (approval No. XHEC-D-2013-026). RESULTS AND CONCLUSION: Plasma alpha-fetoprotein level in infants with biliary atresia and neonatal hepatitis was significantly higher than that in the healthy controls (P < 0.001), but no significant difference in plasma alpha-fetoprotein level was observed between infants with biliary atresia and neonatal hepatitis (P > 0.05). There was no significant difference in plasma alpha-fetoprotein level between infants with different stages of cirrhosis (P > 0.05). Blood biochemical indexes indicated severe liver injury in infants with biliary atresia and neonatal hepatitis. There were significant differences in plasma prealbumin (P < 0.05) and γ-glutaminyl transpeptidase levels between infants with biliary atresia and neonatal hepatitis (P < 0.01). Plasma alpha-fetoprotein level was negatively correlated with γ-glutaminyl transpeptidase level (r =-0.516, P < 0.01). A potential diagnosis model was established based on plasma alpha-fetoprotein, prealbumin, γ-glutaminyl transpeptidase levels, age and sex of infant patients, with a sensitivity of 81.82%, specificity of 91.67%, and area under the curve of 0.939. Results suggest that plasma alpha-fetoprotein level increased in infants with biliary atresia. Establishing a diagnosis model based on blood biochemical indicators such as plasma alpha-fetoprotein is of certain reference value for clinical diagnosis of biliary atresia.  Figures and Tables | References | Related Articles | Metrics

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Efficacy of entacapone and pramipexole in treating non-motor symptoms of Parkinson’s disease: a prospective randomized controlled trial  Bei Zheng1, Wen Guoqiang2, Chen Yi1 2019, 23 (31):  5052-5058.  doi: 10.3969/j.issn.2095-4344.1422 Abstract ( 446 )   PDF (26145KB) ( 119 )   Save BACKGROUND: Individuals with Parkinson’s disease exhibit a variety of non-motor symptoms that can negatively impact quality of life. Although both entacapone and pramipexole can be used to treat Parkinson’s disease via modulation of dopamine metabolism, the ways in which these treatments differ in terms of their effects on the non-motor symptoms of Parkinson’s disease is unknown. OBJECTIVE: To compare the differences in treating the non-motor symptoms of Parkinson’s disease of entacapone and pramipexole. METHODS: This prospective, randomized, controlled trial will be conducted in the Geriatric Hospital of Hainan, Haikou, China. A total of 388 patients with idiopathic Parkinson’s disease will be randomly assigned to receive entacapone (n=194) or pramipexole (n=194). This study was approved by the Ethics Committee of the Geriatric Hospital of Hainan, China on August 30, 2013 (approval number: S2013-038-01). Written informed consent regarding the study protocol and surgical procedure will be obtained from all participants. This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1900022534) on April 15, 2019. Protocol version: 1.0. RESULTS AND CONCLUSION: (1) The primary outcome measure will be the rate of improvement of non-motor symptoms 3 weeks after treatment. (2) Secondary outcome measures will be soluble interleukin-2 receptor and homocysteine levels in serum, which reflects inflammation, and adverse events before and 3 weeks after treatment. (3) Our self-controlled pilot study involving 100 patients showed that incidences of autonomic neurological symptoms such as postural hypotension, urinary urgency, urinary frequency, sexual dysfunction, dry mouth, and salivation, psychiatric symptoms such as cognitive dysfunction, hallucination, depression, and anxiety, and sensory abnormalities such as spasm, pain, and restless leg syndrome were remarkably reduced. Meanwhile, levels of serum soluble interleukin-2 receptor and homocysteine had noticeably decreased after treatment with entacapone and pramipexole. (4) This trial will confirm the efficacy of entacapone and pramipexole in the treatment of non-motor symptoms of Parkinson’s disease. We hope that our findings will provide direction for future clinical treatment of non-motor symptoms of Parkinson’s disease, leading to improved patient quality of life. Figures and Tables | References | Related Articles | Metrics

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Current problems and potential treatment options for sports cartilage injury Shi Songyuan1, Peng Zhihui2 2019, 23 (31):  5059-5064.  doi: 10.3969/j.issn.2095-4344.1986 Abstract ( 390 )   PDF (34005KB) ( 100 )   Save BACKGROUND: Articular cartilage damage is very common in exercise and is mainly caused by chronic joint stress or acute traumatic sprain, which often leads to progressive damage of joint function and limits the participation of related exercise and exercise. The existing articular cartilage repair technique can repair articular cartilage damage caused by high impact exercise, but this treatment cannot produce normal articular cartilage, which limits the success rate and durability of cartilage repair. OBJECTIVE: To review the problems and potential treatment progress in the treatment of sports cartilage injury at home and abroad in recent years. METHODS: CNKI, VIP, WanFang, PubMed, Google Scholar, and Web of Science databases were retrieved using the keywords of “cartilage, exercise, review, back pain, treat” in Chinese and English, respectively, focusing on the selection of literature published in the past 5 years. A total of 627 articles were searched, and 44 eligible articles were included based on inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) The goal of treating sports articular cartilage injury is to alleviate pain, improve knee function, and most importantly, to restore athletes to the level of exercise before injury. (2) At present, some surgical techniques have been implemented to achieve variable and durable articular cartilage repair, allowing athletes to return to sports and exercise. However, surgery does not produce completely normal hyaline cartilage. (3) It has been found that cartilage progenitor cells exist in articular cartilage, and have migration behavior, multi-differentiation ability and colony formation ability. Because mechanical injuries with different characteristics and intensities simulate cartilage progenitor cells, so apoptotic cells release inducers, thus differentiating into chondroblasts to repair injured cartilage. (4) Thereafter, bioprinting of specific osteochondral structures rich in cartilage progenitor cells to replace damaged joints remains a potential strategy in the future. Figures and Tables | References | Related Articles | Metrics

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Mechanism of long non-coding RNA in exercise-mediated bone autophagy  Yang Kang1, Chen Xianghe1, Zhao Renqing1, Yu Huilin1, Zhang Xianliang2, Bu Wenqian1 2019, 23 (31):  5065-5071.  doi: 10.3969/j.issn.2095-4344.1442 Abstract ( 361 )   PDF (39506KB) ( 109 )   Save BACKGROUND: Long non-coding RNA has been a hotspot in the field of biomedicine in recent years, and its mechanisms underlying regulating the level of autophagy and the effect of exercise on it have yet to be revealed. OBJECTIVE: To summarize the research progress of long non-coding RNA in regulating the level of autophagy and the effect of exercise on it. METHODS: Foreign language biomedical, biological, and sports journal systems such as CNKI database and PubMed were searched. The keywords were “long chain non-coding RNA, autophagy, bone metabolism, exercise” in Chinese and English, respectively. RESULTS AND CONCLUSION: (1) Autophagy occurs in bone marrow mesenchymal stem cells, osteoblasts, and osteoclasts. (2) Exercise may inhibit the autophagy regulated by mammalian target of rapamycin and post-activate the Akt/mammalian target of rapamycin signal axis through AMPK, regulate steoblast or osteoclast differentiation, and ultimately affect bone metabolism. (3)Long non-coding RNA can up-regulate or down-regulate under exercise condition. As a competitive endogenous RNA, it negatively regulates downstream related miRNAs, and then inhibits downstream Akt/mammalian target of rapamycin signaling pathway through AMPK/ULK1 or AMPK/PPARα signaling axis to initiate autophagy. Figures and Tables | References | Related Articles | Metrics

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Treatment and research progress of adult brachial plexus injury  Mo Fan1, Zhao Jinmin2, Sha Ke2, Yang Yuan1, Huang Weifeng1, Wei Wu1, Xie Qi1 2019, 23 (31):  5072-5078.  doi: 10.3969/j.issn.2095-4344.1474 Abstract ( 378 )   PDF (45234KB) ( 114 )   Save BACKGROUND: There are a large number of patients with brachial plexus injury in clinical practice, and surgical methods are various. The concerning reviews are few. OBJECTIVE: To review the anatomy, surgical methods and surgical history of brachial plexus injury, so as to provide clinical guidance for orthopedic surgeons. METHODS: The first author searched relevant articles in PubMed and CNKI databases from January 1972 to October 2018. The keywords were “brachial plexus, injury, diagnosis, treatment, classification” in English and Chinese, respectively. A total of 478 related articles were retrieved, and 73 articles were eligible for the inclusion criteria. RESULTS AND CONCLUSION: (1) Through the continuous basic researches and clinical practice of domestic and foreign scholars and doctors, the surgical treatment of brachial plexus injury surgery gradually becomes rich and mature, and has achieved great progress. (2) Great progress has been made in the treatment of brachial plexus injury. Due to the complexity of mechanism and anatomical structure of brachial plexus injury, there are still many problems. Although the changes after nerve injury have been described in terms of morphology, electrophysiology and histochemical changes, the essence of muscular atrophy has not been elucidated. The ultimate goal of brachial plexus injury treatment is to reconstruct the internal muscle of the hand, which determines the recovery effect of hand function. (3) Brachial plexus injury is still a worldwide problem in the field of medicine, and is an issue of concern. There are various methods, which have achieved good clinical outcomes, but the irreversible muscle atrophy is difficult to avoid. (4) How to accurately diagnose brachial plexus injury, improve and innovate the nerve displacement method, accelerate the nerve regeneration, and restore hand muscle function is the research focus and direction in the field of hand surgery. A further exploration is needed to provide foundation for further research and clinical practice. Figures and Tables | References | Related Articles | Metrics

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Epidemiology of sports-induced meniscus injury: a systematic review Yang Yuan, Zhang Kaibo, Fu Weili, Li Jian 2019, 23 (31):  5079-5084.  doi: 10.3969/j.issn.2095-4344.1345 Abstract ( 499 )   PDF (20786KB) ( 137 )   Save BACKGROUND: Although many health benefits are related to sports, over the past few years, as the number of people participating in sports has gradually increased, the number of people suffering from meniscus injuries has been on a rise. OBJECTIVE: To systematically review the epidemiological characteristics of meniscus injury in sports injury. METHODS: PubMed, EMbase, WanFang, VIP and CNKI databases were searched to collect studies of the epidemiological characteristics of meniscus injury in sports injury from inception to September 30, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using Stata 12.0 software. RESULTS AND CONCLUSION: (1) Twenty-one studies were included. (2) The results of meta-analysis showed that: the prevalence of meniscus injury in sports injury was 5% [95%CI (0.04, 0.05)]. Five articles included in the literature introduced the incidence of medial and lateral meniscus injury, respectively. The prevalence of lateral meniscus injury in sports injury was 8% [95%CI (0.05, 0.11)] and the prevalence of medial meniscus injury in sports injury was 7% [95%CI (0.04, 0.09)]. (3) The ratio of male to female was 1.5 and male patients were more than female, with the age ranging from 14 to 24 years. (4) Special training was the main cause of sports injuries. (5) Current evidence shows that there is a high prevalence of meniscus injury in sports injury. The incidence of lateral meniscus injury is slightly higher than that of medial side. The main reason of sports injuries is mainly determined by the level of special training. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion. Figures and Tables | References | Related Articles | Metrics