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18 August 2020, Volume 24 Issue 23 Previous Issue    Next Issue

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Recombinant human bone morphogenetic protein-2 combined with autologous bone grafting and fusion in the treatment of thoracolumbar tuberculosis Weng Rui, Ye Linqiang, Huang Xuecheng, Yao Zhensong, Liang De, Jiang Xiaobing, Tang Jingjing, Cai Zhuoyan 2020, 24 (23):  3609-3614.  doi: 10.3969/j.issn.2095-4344.2643 Abstract ( 380 )   PDF (873KB) ( 86 )   Save BACKGROUND: The efficacy and safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with autologous bone grafting for the treatment of spinal degenerative diseases such as lumbar spondylolisthesis, spinal canal stenosis and intervertebral disc herniation have been recognized, but few clinical studies have been conducted on the efficacy and safety in the treatment of spinal infectious diseases such as spinal tuberculosis. OBJECTIVE: To evaluate the clinical efficacy and safety of rhBMP-2 combined with autologous bone grafting for spinal tuberculosis. METHODS: Clinical data of thoracolumbar tuberculosis admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2010 to May 2018 were retrospectively analyzed. All patients underwent posterior pedicle screw fixation plus bone graft for spinal fusion, with (experimental group) or without (control group) the use of rhBMP-2. In the experimental group, 33 patients were treated with posterior pedicle fixation and autologous bone graft for spinal fusion combined with rhBMP-2 (1 mg). In the control group, 35 patients underwent posterior pedicle fixation and autologous bone graft. Visual analogue scale, the American Spinal Injury Association (ASIA), perioperative complications and fusion rate were statistically analyzed. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital, Guangzhou University of Chinese Medicine. Informed consent was obtained from each patient.  RESULTS AND CONCLUSION: All patients were followed up for more than 1 year. During the follow-up period, no fracture or movement of the internal fixation or distinct collapse of the vertebral body were found. There was no significant difference between the two groups in terms of operative time, intraoperative blood loss, length of stay, and proportion of perioperative complications (P > 0.05). There was a significant improvement in visual analogue scale scores and ASIA grades in the two groups at 1 week and 1 year after operation (P < 0.05). However, there were no statistically significant differences between the experimental and control groups (P > 0.05). The fusion rate in the experimental group was significantly higher than that in the control group at 6 months after operation (P < 0.05), but there was no statistically significant difference between the two groups at 1 year after operation (P > 0.05). These findings indicate that rhBMP-2 combined with autologous bone for the treatment of thoracolumbar tuberculosis can accelerate bone fusion with favorable efficacy and safety in a short time. Figures and Tables | References | Related Articles | Metrics

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Screening chronic periodontitis-related genes using whole-genome expression profiling Wu Hui, Xu Nuo, Wang Qian, Shi Chun, Jiang Long 2020, 24 (23):  3615-3620.  doi: 10.3969/j.issn.2095-4344.2723 Abstract ( 542 )   PDF (654KB) ( 75 )   Save BACKGROUND: Whole-genome expression profiling is a technical method for gene expression research, with high sensitivity and specificity. This technique can be used to detect differential genes related to chronic periodontitis in the whole genome, therefore efficiently and quickly finding chronic periodontitis-related factors. OBJECTIVE: To screen genes related to chronic periodontitis by using the whole-genome expression profiling. METHODS: Normal periodontal ligament tissue of 15 patients with orthodontic extraction was selected as control group, and periodontal tissue of 21 patients with chronic periodontitis was selected as experimental group. To screen up-regulated and down-regulated genes. the genome-wide expression profile chips of four chronic periodontitis tissues and four healthy tissues were compared. The expression of the differential gene PI3K-Akt signal pathway was verified by real-time PCR (7 normal cases and 13 cases of chronic periodontitis) and western blot (4 normal cases and 4 cases of chronic periodontitis). The experimental protocol was approved by the Ethics Committee of the First Affiliated Hospital of Hainan Medical University (approval No. HNM20180034) and informed consent was obtained from each patient. RESULTS AND CONCLUSION: Analysis of the whole genome expression profile chip revealed that 1 565 up-regulated genes and 1 849 down-regulated genes were significantly differentially expressed in chronic periodontitis samples. The enrichment analysis revealed that the expression of PI3K-Akt signaling pathway was significantly different in chronic periodontitis (P < 0.001). Real-time PCR and western blot assay results indicated that PI3K and Akt expression was higher in the experimental group than in the control group (P < 0.05). All the findings indicate that the genome-wide expression profile chip is fast and highly sensitive to screen the changes in chronic periodontitis-related genes. Significantly differential expression of PI3K-Akt signal pathway in chronic periodontitis provides an experimental basis for the treatment of chronic periodontitis. Figures and Tables | References | Related Articles | Metrics

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Basic fibroblast growth factors protect chondrocytes by antagonizing extracellular inflammatory factors Yang Fan, Liu Baoyi, Cao Meng, Zhu Xiaoshu, Zhang Yu, Qin Kairong, Zhao Dewei 2020, 24 (23):  3621-3626.  doi: 10.3969/j.issn.2095-4344.2724 Abstract ( 519 )   PDF (841KB) ( 150 )   Save BACKGROUND: Nowadays, there are many studies addressing basic fibroblast growth factor (bFGF) that promotes chondrocyte differentiation and inflammatory factors that damage chondrocyte structure, such as interleukin-1, but there are no reports on the combined effect of the two factors on chondrocytes. OBJECTIVE: To observe the effect of bFGF and inflammatory cytokines on growth characteristics and differentiation potential of chondrocytes. METHODS: Passage 3 chondrocytes from Sprague-Dawley rats cultured in vitro were divided into four groups: a blank control group in which chondrocytes were cultured alone, a negative control group in which chondrocytes were cultured with serum-free DMEM/F12 containing tumor necrosis factor-α, interleukin-1 and interleukin-6, a positive control group in which chondrocytes were cultured with serum-free DMEM/F12 containing bFGF, and an experimental group in which chondrocytes were cultured with serum-free DMEM/F12 containing bFGF, tumor necrosis factor-α, interleukin-1 and interleukin-6. At 3, 5, and 7 days after culture, the proliferative activity of chondrocytes was detected by cell counting kit-8 method; the levels of inflammatory cytokines were determined by ELISA method; and mRNA expression of collagen type II and proteoglycan in chondrocytes was measured by real-time PCR. Protein levels of collagen type II and proteoglycan were assessed by immunofluorescence assay at 7 days after culture. RESULTS AND CONCLUSION: At 3, 5, 7 days after culture, the proliferation of chondrocytes ranked as follows: positive control group > experimental group > blank control group > negative control group. Compared with the blank control group, the expressions of interleukin-1, interleukin-6 and tumor necrosis factor-α were significantly increased in the negative control group. However, compared with the negative control group, the expressions of the above three inflammatory cytokines in the experimental group showed a significant decline (P < 0.05). There was positive expression of collagen type II and proteoglycan in the blank control, positive control and experimental groups, especially in the negative control group. Compared with the blank control group, the expressions of collagen type II and proteoglycan were up-regulated significantly in the positive control and experimental groups. To conclude, the rationale use of bFGF can maintain the phenotype of chondrocytes, inhibit dedifferentiation and promote cell proliferation. Figures and Tables | References | Related Articles | Metrics

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Expression of connexin 43 in cartilage and chondrocyte of osteoarthritis and construction of shRNA lentiviral vector targeting connexin 43 Xue Junjie, Li Jingyu, Zhang Li, Ren Chaochao 2020, 24 (23):  3627-3635.  doi: 10.3969/j.issn.2095-4344.2661 Abstract ( 640 )   PDF (1201KB) ( 242 )   Save BACKGROUND: Connexin 43 (Cx43) plays an important role in occurrence and development of osteoarthritis. However, the specific mechanisms involved remain unclear. OBJECTIVE: To verify the possibility of the dominant position of Cx43 in connexin family in osteoarthritis by detecting the expression of Cx43 in articular cartilage and chondrocyte cell line, and to construct shRNA lentivirus vector of Cx43 gene and establish a stable transfer cell line of chondrocyte (SW1353). METHODS: Animal models of osteoarthritis were established in six C57BL/6 mice by anterior cruciate ligament transection. The differences of Cx43 expression between osteoarthritic and normal knees were investigated by immunohistochemistry. Expression of Cx43 mRNA in chondrocyte (SW1353) was detected by RT-PCR, and the expression levels of Cx37, Cx40, Cx45 and Cx46 in SW1353 cells were detected as control. Cx43 were connected to the lentiviral vector carrying the EGFP gene, to reconstruct the lentiviral vector plasmid. The viral particles were generated by co-transfection of 293T cells with Cx43-shRNA. After transfection of Cx43-shRNA lentiviral vector into chondrocytes (SW1353), the expression level of Cx43 was detected by western blot assay and RT-PCR. The study protocol was approved by the Ethics Committee of State Key Laboratory of Oral Diseases, approved No. SKLODLL2013A172. RESULTS AND CONCLUSION: The expression level of Cx43 was significantly increased in the articular cartilage of osteoarthritic knees. The expression level of Cx43 mRNA was significantly higher than that of Cx37, Cx40, Cx45 and Cx46 in chondrocytes (SW1353). In SW1353 cells, Cx43 occupied the dominant position in connexin family. Cx43 shRNA lentiviral vector could inhibit the expression of Cx43 mRNA in SW1353 cells. The stably transfected SW1353 cell line was screened, laying a foundation for verifying the role of Cx43 in osteoarthritis. Figures and Tables | References | Related Articles | Metrics

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Inokosterone effects on proliferation and differentiation of osteoblasts from neonatal Sprague-Dawley rats Jiang Tao, Shao Min, Chen Qingzhen, Ling Cuimin, Shen Zhen, Wang Gang, Huo Shaochuan, Lin Yanping, Liu Haiquan, Wang Qinsheng, Zeng Zhenming 2020, 24 (23):  3636-3642.  doi: 10.3969/j.issn.2095-4344.2645 Abstract ( 518 )   PDF (983KB) ( 61 )   Save BACKGROUND: It is an effective strategy for the treatment of osteoporosis to promote the proliferation and differentiation of osteoblasts, but the influence of inokosterone on osteoblast proliferation and differentiation is rarely reported. OBJECTIVE: To investigate the effects of inokosterone on the proliferation and differentiation of primary osteoblasts and the underlying molecular mechanism. METHODS: Primary osteoblasts from neonatal Sprague-Dawley rats were isolated via the second enzyme digestion, and the cells were then cultured in osteogenic induction medium and identified. Cell counting kit 8 assay was performed to evaluate the effect of different concentrations of inokosterone (1, 5, 10 mg/L) on cell viability of primary osteoblasts. Early differentiation ability of osteoblasts was evaluated by alkaline phosphatase staining and alkaline phosphatase activity assay. To evaluate the mineralization ability of osteoblasts, alizarin red staining was performed to observe the number of calcium nodules. The expression level of osteogenic genes was detected by RT-qPCR at different time points. Furthermore, MDC staining was also used to observe the number of autophagosomes. RESULTS AND CONCLUSION: Compared with the control group, inokosterone could inhibit the cell viability of primary osteoblast to some degree (P < 0.05) while significantly promoting alkaline phosphatase activity and mineralized nodules formation (P < 0.05). In addition, inokosterone upregulated the expression of osteogenic genes such as Collagen I, osteoprotegerin, osteopontin, osteocalcin and increased the number of autophagosomes. To conclude, inokosterone can promote osteogenic differentiation by upregulating osteogenic genes expression and activating autophagy of primary osteoblasts. Figures and Tables | References | Related Articles | Metrics

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Effect of Bushen Zhuangdu Fang serum on mitochondrial apoptotic pathway of nucleus pulposus cells Zhou Wenming, Lin Yifeng, Zhang Zhen, Chi Liye 2020, 24 (23):  3643-3648.  doi: 10.3969/j.issn.2095-4344.2644 Abstract ( 397 )   PDF (960KB) ( 55 )   Save BACKGROUND: The mitochondrial apoptotic pathway is an important pathway in cell apoptosis. Previous studies have found that Bushen Zhuangdu Fang can improve intervertebral disc degeneration by inhibiting the mitochondrial apoptotic pathway in animal experiments. However, its mechanism of action is to be clarified. OBJECTIVE: To observe the effect of serum containing Bushen Zhuangdu Fang on mitochondrial apoptotic pathway key proteins of human nucleus pulposus cells, and to explore the mechanism by which this drug-containing serum improves intervertebral disc degeneration. METHODS: Thirty-seven male Sprague-Dawley rats were randomly divided into blank group, low-dose Chinese medicine group (0.506 g/kg per day), medium-dose Chinese medicine group (1.012 g/kg per day) and high-dose Chinese medicine group (2.024 g/kg per day). After 2 weeks of continuous administration, drug-containing serum was prepared. Human nucleus pulposus cells were randomly divided into normal group, cell model group, low-dose drug-containing serum group, medium-dose drug-containing serum group, and high-dose drug-containing serum group. The cell model group was treated with 200 μmol/L H2O2 for 6 hours, and the normal group received no treatment. The three drug-containing serum groups were treated with corresponding treatments for 48 hours. The pathological changes of nucleus pulposus cells were observed by transmission electron microscopy. Apoptotic rate of nucleus pulposus cells was detected by flow cytometry and mitochondrial membrane potential was detected by flow cytometry. Apaf1, Bcl-2, Bax and Cytc expressions were detected by real-time quantitative PCR and western blot assay. RESULTS AND CONCLUSION: Compared with the normal group, the apoptotic rate of nucleus pulposus cells with obvious apoptotic morphology was significantly increased (P < 0.05), the expression of Apaf1, Cytc, and Bax were significantly increased at mRNA and protein levels (P < 0.05), and the mitochondrial membrane potential and expression of Bcl-2 mRNA and protein were significantly decreased in the cell model group (P < 0.05). After treatment with drug-containing serum, the apoptotic rate of nucleus pulposus cells decreased significantly (P < 0.05), the expression of Apaf1, Cytc, Bax and their proteins decreased significantly (P < 0.05), and the mitochondrial membrane potential, Bcl-2 and their proteins increased significantly (P < 0.05). Therefore, the serum containing Bushen Zhuangdu Fang can effectively inhibit apoptosis of nucleus pulposus cells in a dose-dependent manner. The drug-containing serum may alleviate intervertebral disc degeneration by reducing the expression of Apaf1, Cytc and Bax and increasing the expression of Bcl-2 at protein and gene levels, and inhibiting the mitochondrial apoptotic pathway. Related Articles | Metrics

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Mechanism by which gypenosides alleviate oxidative stress injury induced by H2O2 in rat osteoblasts Lin Yanping, Huang Jiachun, Chen Tongying, Ma Jiangtao, Guo Haiwei, Wang Yuedong, Yuan Jiayao, Jiang Tao, Huang Hongxing, Huang Hong, Wan Lei 2020, 24 (23):  3649-3653.  doi: 10.3969/j.issn.2095-4344.2725 Abstract ( 686 )   PDF (772KB) ( 188 )   Save BACKGROUND: Gypenosides have antioxidant properties, with beneficial effects such as reducing blood pressure, anti-aging and anti-tumor, but the specific protective mechanism is not clear. It is also unknown whether gypenosides have effect on the proliferation and differentiation of oxidative stress-damaged osteoblasts. OBJECTIVE: To investigate the mechanism by which gypenosides alleviate oxidative stress injury in rat osteoblasts and the effect on the proliferation and differentiation of oxidatively damaged osteoblasts. METHODS: Monolayer cell culture method was used to separate neonatal rat skull cells for the culture of osteoblasts. In this experiment, there were three groups, with normal culture medium as blank group, normal culture medium+oxidative damage as control group, and normal culture medium containing gypenosides and oxidative damage as experimental group. Osteoblasts in the experimental and control groups were cultured in the culture medium containing 150 μmol/L H2O2. After 3 and 5 days of intervention, cell counting kit-8 method was used to detect the effects of gypenosides on oxidative damage of osteoblasts. Alkaline phosphatase staining was used to detect alkaline phosphatase activity on day 7 after induction. Alizarin red staining was used on day 21 of induction to observe osteoblast mineralization. Western blot was used to detect the expression of NOX4, bone morphogenetic protein 2 and Smad4. The experimental protocol was approved by the Animal Ethics Committee of Guangzhou University of Chinese Medicine. RESULTS AND CONCLUSION: Gypenosides could promote the proliferation of oxidatively damaged osteoblasts. The results of alkaline phosphatase staining and alizarin red staining showed that gypenosides could promote the differentiation of oxidatively damaged osteoblasts. Compared with the control group, gypenosides could downregulate the expression of NOX4 protein and upregulate the expression of bone morphogenetic protein 2 and Smad4 protein in the experimental group, with statistically significant results (P < 0.05). All these findings indicate that gypenosides have a protective effect on H2O2-induced oxidative stress injury in osteoblasts, and promote the proliferation and differentiation of damaged osteoblasts. The mechanism may be related to the inhibition of Nox4 protein expression and the activation of bone morphogenetic protein/Smad pathway. Figures and Tables | References | Related Articles | Metrics

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Reasonable choice of occipitocervical angle and posterior occipitocervical angle in basilar invagination patients during occipitocervical fusion  Yang Sheng, Tang Chao, Liao Yehui, Tang Qiang, Ma Fei, He Hongchun, Zhong Dejun 2020, 24 (23):  3654-3661.  doi: 10.3969/j.issn.2095-4344.2730 Abstract ( 475 )   PDF (870KB) ( 76 )   Save BACKGROUND: For patients with basilar invagination under occipitocervical fusion, the unreasonable choice of fixed angle in the occipitocervical region will reduce the clinical efficacy and accelerate the degeneration of subaxial cervical spine OBJECTIVE: To measure the Occipito-C2 angle (OC2A) and the posterior occipitocervical angle (POCA) in healthy subjects, and to analyze the influence of OC2A and POCA selection on the clinical efficacy and the loss of cervical spinal angle (CSA) of subaxial cervical spine in the occipitocervical fusion of basilar invagination. METHODS: 150 healthy subjects (healthy group) were grouped by gender and age, with 75 males and 75 females divided into five age groups ranging from 20 to 69 years old. OC2A and POCA of each healthy subject were measured by three spine surgeons. The intraclass correlation coefficient analysis was performed on the two parameters to prove their consistency. The mean of the two parameters and 95% confidence interval (95% CI) were obtained. Clinical data from 42 patients (malformation group) with basilar invagination who underwent occipitocervical fusion from January 2012 to January 2017 were analyzed retrospectively. These patients were divided into ideal angle subgroup and non-ideal angle subgroup, according to whether their OC2A and POCA immediately after postoperative ambulation were at 95% CI of the healthy group or not. OC2A, POCA, and CSA angles were measured preoperatively, immediately after postoperative ambulation, and at the final follow-up visit. The preoperative and final follow-up visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and the loss of CSA from immediately after postoperative ambulation to the final follow-up (dCSA) were recorded. RESULTS AND CONCLUSION: The values of OC2A and POCA were (14.5±3.7)° and (108.2±8.1)° in the healthy group, respectively, and the respective 95% CI values were 7.2°-21.8° and 92.3°-124.0° as the normal range. There was a negative correlation between OC2A and POCA (r=-0.386, P < 0.001). The preoperative value of OC2A [(5.6±4.3)°] in the malformation group was smaller than that in the healthy group (P < 0.001); however, the preoperative values of POCA [(123.9±10.4)°] and CSA [(25.7±9.5)°] in the malformation group were larger than those in the healthy group (P < 0.001). In the 42 basilar invagination patients, 26 patients (ideal angle subgroup) were fixed in the ideal angle range immediately after postoperative ambulation (95% CI of the healthy group); 16 patients (non-ideal angle subgroup) were not fixed in the 95% CI of the healthy group, of which 14 patients (87.5%) had OC=A lower than 7.2° (lower limit of 95% CI of the healthy group), and 2 patients (12.5%) had POCA higher than 124.0° (upper limit of 95% CI in healthy group). The VAS score, JOA score and NDI of patients in the two subgroups were significantly improved compared with those before operation (P < 0.05). The VAS score and NDI of the ideal angle subgroup were higher than those of the non-ideal angle subgroup, but JOA score was lower than that of the non-ideal angle subgroup (P < 0.05). At the same time, dCSA [(4.0±6.8)°] in the ideal angle subgroup was significantly higher than that in the non-ideal angle subgroup [(-1.6±3.9)°; P < 0.05]. To conclude, the biomechanical balance between the occipitocervical region and subaxial cervical spine in patients with basilar invagination is different from that of normal healthy people. Therefore, it is not recommended to force OC2A and POCA to be fixed in the normal reference range during occipitocervical fusion for basilar invagination. Fixation of OC2A and POCA in the normal reference range will reduce the clinical efficacy of patients and accelerate the dCSA. Figures and Tables | References | Related Articles | Metrics

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Effect of preserving the integrity of peroneal tendon sheath on hindfoot function after calcaneus fracture surgery Zhao Yongjie, Sun Guangchao, Guan Guofeng, Du Rui, Zhu Xiaodong 2020, 24 (23):  3662-3666.  doi: 10.3969/j.issn.2095-4344.2726 Abstract ( 687 )   PDF (679KB) ( 79 )   Save BACKGROUND: Calcaneal fracture is the most common patella fracture. Traditionally, surgical treatment via an enlarged lateral approach is the gold standard method for the treatment of calcaneal fractures. However, this method can lead to joint stiffness and peroneal tendon adhesion to different extents, resulting in postoperative foot pain. OBJECTIVE: To investigate the effect of preserving the integrity of peroneal tendon sheath on hindfoot movement during open reduction and internal fixation of calcaneus fractures. METHODS: A total of 160 patients with displaced intra-articular calcaneus fractures who were admitted to the Department of Foot and Ankle Surgery, Affiliated Hospital of Binzhou Medical University from July 2016 to September 2017 were randomly divided into a control group and an experimental group. The classical lateral “L” incision was used in both groups. In the control group, the calcaneus was exposed by traditional dynamic retraction of the fibular tendon, while the experimental group was treated by static retraction with the preservation of fibular tendon sheath. The trial protocol was approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University on February 18, 2016 with the approval No. 2016-G026-01. RESULTS AND CONCLUSION: There were 156 patients with complete follow-up data, 78 in the control group and 78 in the experimental group. The visual analogue scale scores on the first day, Bohler angle and Gissane angle at the 3rd month, and ankle dorsiflexion and plantar flexion angle at the 6th month of internal fixation were similar in the two groups. Hind foot valgus and varus angles at the 6th month of internal fixation and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores at the 1st year of internal fixation in the experimental group were better than those in the control group. Meanwhile, the excellent and good rate of Maryland hindfoot scoring system in the experimental group was higher than that in the control group at the last follow-up. There were four cases of incision complications in the control group (one case of infection and three cases of necrosis) and two cases of necrosis in the experimental group. These findings indicate that calcaneus fracture surgery with preserving the integrity of peroneal tendon sheath can significantly improve the mobility of the hindfoot, and improve the patient’s satisfaction, and meanwhile do not increase the incidence of incision complications. Figures and Tables | Related Articles | Metrics

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Percutaneous woven modified Kessler suture for a small medial incision of the Achilles tendon in treatment of acute closed Achilles tendon rupture Wang Xiaolong, Han Chaoqian, Hao Zengtao, Yin Chao, Wen Shuzheng, Wang Jihong, Fan Dongsheng, Wang Yongfei, Jiang Dong, Zhang Guorong, Yan Xuedong, Sun Tao, Zhang Zhiyong, Jing Shangfei 2020, 24 (23):  3667-3672.  doi: 10.3969/j.issn.2095-4344.2660 Abstract ( 531 )   PDF (809KB) ( 89 )   Save BACKGROUND: Traditional open suture for the treatment of acute closed Achilles tendon rupture can significantly reduce the risk of gastrocnemius nerve injury and re-rupture of Achilles tendon, but this suture method can increase incision-related complications and result in tissue adhesion. Although the Krackow suture method is more powerful, it is difficult to perform minimally invasive surgery with small incisions, and excessive locks to strengthen the suture may affect the blood supply in the Achilles tendon. The percutaneous woven modified Kessler suture method is not only smooth, flat, and relatively strong, but also has strong tension. This is a minimally invasive method that can achieve good functional recovery of the Achilles tendon. OBJECTIVE: To investigate the clinical effect of percutaneous woven modified Kessler suture of a small medial incision of the Achilles tendon in the treatment of acute closed Achilles tendon rupture in comparison with the open suture method. METHODS: Clinical data of 72 patients with acute closed Achilles tendon rupture diagnosed at Department of Hand and Foot Surgery, the Second Affiliated Hospital of Inner Mongolia Medical University between June 2015 and June 2018 were retrospectively analyzed. All patients were divided into open group and minimally invasive group of medial Achilles tendon (n=36 per group). The operation time, hospitalization time, blood loss, length of incision, wound healing, complications, and clinical efficacy were compared between the two groups. The study was approved by the Ethics Committee of the Second Affiliated Hospital of Inner Mongolia Medical University in China. RESULTS AND CONCLUSION: Compared with the open group, the minimally invasive group of medial Achilles tendon had shorter operation time and hospitalization time, less blood loss, and shorter incision length (P < 0.05). The American Orthopaedic Foot and Ankle Society (AOFAS) and Achilles tendon total rupture (ATRS) scores of the minimally invasive group of medial Achilles tendon were significantly higher than that of the open group at 6 months after surgery (P < 0.05), but there was no significant difference between the two groups in the ATRS score and the AOFAS score at 1 year after surgery (P ˃ 0.05). There was no significant difference in the excellent and good rate between the two groups at 1 year after surgery (P ˃ 0.05). The overall complication rate of the minimally invasive group of medial Achilles tendon was significantly lower than that of the open group (P < 0.05), and incision-related complications were confirmed to be the main postoperative complications. To conclude, compared with the open modified Kessler suture, percutaneous woven modified Kessler suture for the small medial incision of the Achilles tendon has some benefits, including simpler operation, lower price, more prominent perioperative index, lower incidence of postoperative incision-related complications, and better short-term efficacy. Figures and Tables | Related Articles | Metrics

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Surface electromyogram features of the lower limb muscles in cerebral palsy children standing and walking on tiptoes Xu Ping, Liang Leichao, Liang Zhenwen, Cai Ming, Chen Bo, Huang Ping, Zhang Linlin 2020, 24 (23):  3673-3677.  doi: 10.3969/j.issn.2095-4344.2659 Abstract ( 505 )   PDF (699KB) ( 217 )   Save BACKGROUND: Under well-controlled conditions, changes in myoelectric signal activity can largely reflect muscle changes such as muscle function, muscle tension, muscle strength, and multi-muscle coordination, providing objective analysis of the muscle function. OBJECTIVE: To investigate the changes in surface electromyography (SEMG) of the lower limb muscles in cerebral palsy children standing or walking on tiptoes. METHODS: Using TELEMYO 2400R G2 SEMG telemeter produced by NORAXON Company in the United States, surface EMG features of bilateral anterior tibial muscles and medial gastrocnemius muscles were detected in 20 cerebral palsy children standing or walking on unilateral tiptoes. The myoelectric activity of the testicular muscles between the pointed and contralateral side was compared in all the subjects. The study protocol was approved by the Ethics Committee of Shanghai Ruijin Hospital, and all subjects and their guardians signed an informed consent prior to the participation in the study. RESULTS AND CONCLUSION: When the subjects were standing and walking normally, the average SEMG amplitude and average SEMG integral of the medial gastrocnemius at the tiptoe side were significantly lower than those at the contralateral side (P < 0.05); the mean and median frequencies of the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side were significantly higher than those at the contralateral side (P < 0.05). These findings indicate that there are abnormal SEMG signals in the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side in children with cerebral palsy, and the muscle activity of the lower limbs in such children is not balanced. Therefore, SEMG is of practical value in evaluating the functional status of the neuromuscular system in children with cerebral palsy. Figures and Tables | Related Articles | Metrics

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Effects of Pueraria total flavone on inflammatory cytokine and STAT3 expression in brain tissue of exhaustive exercise rats Jiang Yuling, Mo Weibin, Tang Jian, Li Minhua 2020, 24 (23):  3678-3684.  doi: 10.3969/j.issn.2095-4344.2615 Abstract ( 328 )   PDF (808KB) ( 198 )   Save BACKGROUND: The physiological and pathological mechanisms underlying the inflammatory response of rat brain tissue caused by exhaustive exercise are very complicated. Studies have shown that Pueraria total flavonoids have anti-oxidative, neuroprotective, and cardio-cerebrovascular protective effects against brain injury. OBJECTIVE: To investigate the effect of Pueraria total flavone on inflammatory cytokines and signal transducer and activator of transcription-3 (STAT3) expression in rat brain tissue after exhaustive exercise. METHODS: Fifty healthy male Sprague-Dawley rats were randomly divided into a quiet control group, an exercise control group, low, middle, high dose Pueraria total flavone groups. Each training group conducted a 6-week sports training. At the end of 6-week exercise, the rats were confirmed to be exhausted. The rats were intragastrically administered 50, 100 and 200 mg/kg Pueraria total flavone in low, middle and high dose groups, respectively. Administration in each Pueraria total flavone group began at 30 minutes before exercise, once a day, and ended until the completion of the experiment. The activities of tumor necrosis factor-α, interleukin-8, interleukin-1β and interleukin-10 in serum and brain tissue of rats were determined by ELISA. The expression of STAT3 in rat brain tissue was detected by RT-PCR and western blot. The study protocol was approved by the Animal Ethics Committee of Guangxi Normal University (approval No. GXMU201703049). RESULTS AND CONCLUSION: The levels of tumor necrosis factor-α, interleukin-8, interleukin-1β and interleukin-10 in serum and brain tissue of exercise control rats were higher than those in the quiet control group (P < 0.01). The levels of tumor necrosis factor-α and interleukin-10 in serum and brain tissue of rats with middle and high dose of Pueraria total flavone were significantly lower than those in the exercise control group (P < 0.01). The levels of interleukin-8 and interleukin-1β in serum and brain tissue of rats with low, middle and high dose of Pueraria total flavone were significantly lower than those in the exercise control group (P < 0.01 or P < 0.05). The expression levels of STAT3 mRNA and protein in brain tissue of exercise control rats were significantly higher than those in the quiet control group (P < 0.01). The expression levels of STAT3 mRNA and protein in the brain tissue of rats with low, middle and high doses of Pueraria total flavone were significantly higher than those in the quiet control group (P < 0.01). To conclude, exhaustive exercise can cause inflammatory reaction and up-regulate STAT3 expression in rat brain tissue. The total flavonoids of Puerariae can regulate the expression of STAT3 in brain tissues and inhibit the inflammatory response of brain tissue, thus protecting damaged brain tissue. Figures and Tables | Related Articles | Metrics

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Alcohol extract of Eucommia ulmoides Oliv. promotes bone healing in rats with periapical periodontitis Wu Dalei, Zhou Shouheng, Yan Jianwei, Li Bo, Xu Nuo, Shi Chun, Gao Yang 2020, 24 (23):  3685-3689.  doi: 10.3969/j.issn.2095-4344.2727 Abstract ( 492 )   PDF (653KB) ( 91 )   Save BACKGROUND: Current research on Eucommia ulmoides Oliv. mainly focuses on its use in the treatment of osteoarthritis that Eucommia ulmoides Oliv. can enhance the healing ability of bone tissue. However, research on its bone repair ability in periapical periodontitis has not been reported. OBJECTIVE: To study the effect of alcohol extract of Eucommia ulmoides Oliv. on cathepsin K expression in periapical periodontitis rats. METHODS: Twenty-four Sprague-Dawley rats were divided into normal control group (n=4) and apical periodontitis group (n=20). In the periapical periodontitis group, a periapical periodontitis model was established after exposure of the dental pulp in the first molar of the right mandible. The normal control group did not deal with any treatment. After 4 weeks of feeding, four rats from each group were taken for micro-CT detection. Bone destruction was quantified to confirm whether the rat model of periapical periodontitis was successfully constructed. After 5 weeks of feeding, the remaining 16 rats with periapical periodontitis were equally randomized into alcohol extract group (given alcohol extract of Eucommia ulmoides Oliv. via intragastric administration, 5 mL/kg per day) and normal saline group (given the same dose of normal saline via intragastric administration every day). After 4 weeks of gavage, four mice from each group were selected to perform micro-CT examination. The ability of alcohol extract of Eucommia ulmoides Oliv. to repair periapical bone tissue was analyzed. First molars of the right mandible from the other four rats in each group were extracted to detect the expression of cathepsin K in the alveolar bone using immunohistochemical staining. RESULTS AND CONCLUSION: Micro-CT results showed that the rat model of periapical periodontitis was successfully constructed as there was a significant difference in the bone resorption volume between the normal control and apical periodontitis groups [(0.223±0.009) mm3 vs. (0.945±0.037) mm3, P=0.00]. After 4 weeks of gavage, the micro-CT results showed that the alcohol extract of Eucommia ulmoides Oliv. significantly reduced the bone resorption volume in the rat model of periapical periodontitis (P < 0.05). Immunohistochemistry results showed that the alcohol extract of Eucommia ulmoides Oliv. significantly inhibited the expression of cathepsin K, a marker of bone destruction, in the rat model of periapical periodontitis. Therefore, these findings indicate that the alcohol extract of Eucommia ulmoides Oliv. can inhibit the expression of cathepsin K and promote the healing of bone tissue in the rats with periapical periodontitis. Figures and Tables | References | Related Articles | Metrics

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Rabbit knee osteoarthritis model established using polymer bandage and plastic rod Tian Yukui, Hao Yang, Liu Junchang, Sun Yun, Guo Lei, Zhang He, Karemaiti • Abudukeranmu, Zhang Xiaoting 2020, 24 (23):  3690-3695.  doi: 10.3969/j.issn.2095-4344.2592 Abstract ( 398 )   PDF (845KB) ( 270 )   Save BACKGROUND: Various methods have been developed for establishing a rabbit osteoarthritis model worldwide. However, most of modeling methods are cumbersome, and the original gypsum braking method has some defects. OBJECTIVE: To establish the rabbit osteoarthritis model using polymer bandage combined with a plastic rod. METHODS: Sixteen male New Zealand white rabbits were randomly divided into model group and control group. In the model group, the rabbit osteoarthritis model was established through fixed braking using polymer bandage in the flexion position. The control group was normal group. In the model group, the polymer bandage was removed after 8 weeks of fixation. Histological changes of rabbit synovium, cartilage and meniscus were observed using hematoxylin-eosin staining under microscope. Mankin scoring for articular cartilage was performed. The study protocol was approved by the Animal Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (approval No. IACUC-20170222026). RESULTS AND CONCLUSION: Under the light microscope, the number of meniscus chondrocytes and stroma in the model group was increased, with part of chondrocytes increased in size, and clearly visible cartilage pits. A small amount of chronic inflammatory cells in synovial tissue infiltrated, the number of collagen fibers increased, and some collagen fibers were thickened with hyaline degeneration. Villous-nodular hyperplasia was visible in part of synovial tissues. There were slight fissures on part of the cartilage surface, chondrocytes and stroma slightly proliferated, the number of chondrocytes and stroma reduced partially, and collagen fibers arranged disorderly. The pathological results showed that there were typical pathological changes of knee osteoarthritis in the knee. The Mankin score of the model group was significantly higher than that of the control group (P < 0.05). Therefore, the use of polymer bandage combined with plastic rod can successfully establish the rabbit model of knee osteoarthritis, with good local fixation stability, joint angle controllability, and good local permeability. Related Articles | Metrics

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Establishing a rabbit model of yang deficiency and cold coagulation with peppermint oil and climate chamber Guo Lei, Zhang He, Liu Junchang, Sun Yun , Tian Yukui, Hao Yang, Karemaiti•Abudukeranmu, Zhang Xiaoting 2020, 24 (23):  3696-3701.  doi: 10.3969/j.issn.2095-4344.2616 Abstract ( 613 )   PDF (871KB) ( 192 )   Save BACKGROUND: Our preliminary studies have established a rabbit model of knee osteoarthritis using gypsum wire fixation, but the model of traditional Chinese medicine (TCM) syndrome of knee osteoarthritis has not been prepared. OBJECTIVE: To assess the feasibility of establishing a rabbit model of yang deficiency and cold coagulation using peppermint oil and climate chamber, to lay the foundation for future research. METHODS: Thirty-two experimental animals were randomly divided into normal group, model group, yang deficiency group and yang deficiency-cold coagulation group. Except for the normal group, the rabbit knee joints were fixed with plaster fixator brake method for 8 weeks. The yang deficiency group was given daily perfusion of peppermint oil for 2 weeks at the beginning of the 7th week of fixation. In the yang deficiency-cold coagulation group, the rabbits were placed in a climate chamber at 4 °C for 1.5 hours every day, and given daily perfusion of peppermint oil after 6 weeks of braking. After 7 and 14 days of intragastric administration, the serum level of thyrotropin (T4) was detected by ELISA. After 8 weeks of modeling, the articular cartilage, meniscus and synovium were taken for histological scoring. Animal behaviors were observed, and body surface temperature was detected using an infrared thermal imager. The experimental protocol was approved by the Animal Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (approval No. IACUC-20170222026). RESULTS AND CONCLUSION: For behavior observation, the symptoms of yang deficiency-cold coagulation appeared in the yang deficiency-cold coagulation group. The plantar temperature of the yang deficiency-cold coagulation was lower than that of the normal and model groups (P < 0.05). The serum T4 level was lower in the yang deficiency group and yang deficiency-cold coagulation group than the normal group (P < 0.05). The Mankin scores of the knee joints in two yang deficiency groups were both higher than that in the normal group (P < 0.05) but lower than that in the model group (P < 0.05). Hematoxylin-eosin staining of the meniscus and synovial membrane indicated the yang deficiency group and the yang deficiency-cold coagulation group had no significant difference from the model group. Histomorphological findings elucidated that the peppermint oil with climate box contributes to simulating the disease state to a certain extent, which can provide a reference for establishing the rabbit knee osteoarthritis model of yang deficiency-cold coagulation type. Related Articles | Metrics

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Establishment of a VX2 bone tumor model in rabbit tibia Zhao Jingxin, Zhang Meng 2020, 24 (23):  3702-3707.  doi: 10.3969/j.issn.2095-4344.2685 Abstract ( 652 )   PDF (792KB) ( 68 )   Save BACKGROUND: Many methods have been developed to establish a rabbit VX2 tumor model, but the reliability of each method has not been explored. In order to develop a reliable method, we made some improvements based on the existing methods. OBJECTIVE: To investigate the reliability of rabbit VX2 tumor tissue block implantation and cell suspension via modified and traditional implantation to make the rabbit tibia VX2 tumor model. METHODS: Forty healthy adult New Zealand white rabbits were randomly divided into two groups. Group A was treated with tissue block implantation for tibia VX2 tumor modeling, and group B was treated with cell suspension for tibia VX2 tumor modeling. Modified and traditional implantation was performed on the left and right tibia of the experimental animals, respectively. One hour after successful modeling, ultrasound examination of the puncture site was performed to determine whether there is hematoma. All experimental animals were sacrificed at 3 weeks. X-ray examination of the bilateral tibia was performed to confirm the tumor growth range. Tumor tissue and soft tissue around the puncture site were taken for general and pathological observation to compare the size of the tumor and identify whether there is tumor cell metastasis. RESULTS AND CONCLUSION: One rabbit died in the tissue block group, and all the experimental animals in the cell suspension group survived. X-ray examination indicated the tumors in the tissue block group invaded the cortex, but the tumors in the cell suspension group did not invade the cortex. Gross observation revealed that the tumor volume of the tissue block group was greater than that of the cell suspension group. In the tissue block group, there were one and seven cases of hematoma around the puncture site at 1 hour after modified and traditional implantation, respectively. In the cell suspension group, there were two and nine cases of hematoma around the puncture site at 1 hour after modified and traditional implantation, respectively. Pathological examination showed that local tumor invasion was found in 1 and 8 cases in the tissue block group as well as in 2 and 11 cases in the cell suspension group at 3 months after modified and traditional implantation, respectively. Our findings indicate that the tissue block implantation method is easier and more convenient than the cell suspension method for making rabbit VX2 bone tumors, and the tumor invasion rate of the tissue block implantation method is lower than that of the cell suspension method. Improved tissue block implantation can effectively reduce the tumor invasion rate during modeling. Related Articles | Metrics

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High-intensity interval training for treating pathological cardiac hypertrophy in spontaneously hypertensive rats: effects and mechanisms Yuan Guoqiang, Qin Yongsheng, Peng Peng 2020, 24 (23):  3708-3715.  doi: 10.3969/j.issn.2095-4344.2692 Abstract ( 461 )   PDF (837KB) ( 261 )   Save BACKGROUND: Regular exercise training possesses health promotion effect. Low-to-moderate intensity continuous aerobic exercise has been an important strategy for primary and secondary prevention of chronic diseases such as hypertension; however, the effect of high-intensity interval training is still debated. OBJECTIVE: To explore the effects of high-intensity interval training on pathological cardiac hypertrophy and investigate the possible mechanism in spontaneously hypertensive rats. METHODS: Thirty male spontaneously hypertensive rats were randomly assigned into a control group and a training group. Fifteen Wistar-Kyoto rats were used as normotensive group. Rats in the normotensive and control group were housed at rest, while those in the training group were subjected to a high-intensity interval training lasting for 8 weeks. After experiment, blood pressure was detected using a non-invasive blood pressure tester, and cardiac structure and function were measured by echocardiogram. Histopathological detection was performed by hematoxylin-eosin and Masson staining to determine myocardial cross-sectional area. mRNA expression of fetal genes including atrial natriuretic peptide and brain natriuretic peptide were detected by RT-PCR. Protein expression of PI3-K, Akt, CnAβ and NFATc3 was detected using western blot assay. RESULTS AND CONCLUSION: Compared with the normotensive group, the blood pressure level was significantly elevated (P < 0.05), concentric hypertrophy in the left ventricle appeared (including narrowing of the left ventricular cavity, ventricular wall thickening, increasing of myocardial cross-sectional area), cardiac function reduced significantly (P < 0.05), mRNA of brain natriuretic peptide upregulated (P < 0.05), CnAβ protein raised (P < 0.05), p-NFATc3/t-NFATc3 ratio reduced (P < 0.05), and PI3-K(p110α) protein and p-Akt/t-Akt ratio had no significant changes (P > 0.05) in the control group. Compared with the control group, the blood systolic pressure was lowered (P < 0.05), eccentric hypertrophy (cardiac chamber extension) in the left ventricle occurred, cardiac function enhanced (P < 0.05), mRNA of brain natriuretic peptide downregulated (P < 0.05), PI3-K(p110α) protein and p-Akt/t-Akt ratio increased (P < 0.05), while CnAβ protein and p-NFATc3/t-NFATc3 ratio showed no significant difference in the training group (P > 0.05). Therefore, the 8-week high-intensity interval training can induce the transfer from pathological hypertrophy to physiological hypertrophy and enhance heart function in spontaneously hypertensive rats via the activation of PI3-K/Akt signal transduction pathway; however, the Cn/NFAT pathway cannot be inhibited. Related Articles | Metrics

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PI3K/Akt signaling pathway and bone destruction: problems and mechanisms Shi Dongmei, Dong Ming, Lu Ying, Niu Weidong 2020, 24 (23):  3716-3722.  doi: 10.3969/j.issn.2095-4344.2728 Abstract ( 870 )   PDF (878KB) ( 97 )   Save BACKGROUND: In recent years, the PI3K/AKT signaling pathway is closely related to bone destruction-related diseases. Inhibitors targeting this signaling pathway are also undergoing extensive research, which provides new ideas for clinical treatment of bone destruction-related diseases. OBJECTIVE: To review the research of PI3K/AKT signaling pathway in bone destruction. METHODS: WanFang and PubMed databases were searched for relevant articles published from January 1998 to August 2019. The retrieval key words were “PI3K/Akt signaling pathway; osteoclasts; osteoblasts; bone destruction” in Chinese and English, respectively. To exclude duplicate studies by reading the title and abstract, finally 67 articles were included in result analysis. RESULTS AND CONCLUSION: An appropriate balance between osteoblast and osteoclast-mediated osteogenesis and bone resorption is necessary to maintain bone homeostasis, and an imbalance between these two biological processes will result in bone destruction. PI3K/Akt signaling pathway is a signal transduction pathway that regulates cell activities and plays an important role in cell proliferation, apoptosis and differentiation. The PI3K/Akt signaling pathway is involved in the inhibition of osteoporosis by promoting osteoblast proliferation, differentiation and bone formation. These results reveal that further exploration on the inhibitors of the PI3K/Akt signaling pathway related to bone destruction will provide new ideas for drug therapy in clinical practice. Related Articles | Metrics

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The role of OPG/RANKL/RANK signaling pathway in the pathogenesis of giant-cell tumor of bone Liang Chenliang, Zhao Zhenqun, Liu Wanlin 2020, 24 (23):  3723-3729.  doi: 10.3969/j.issn.2095-4344.2694 Abstract ( 906 )   PDF (836KB) ( 98 )   Save BACKGROUND: Studies have shown that osteoprotegerin/receptor activator of nuclear factor κB ligand/nuclear factor κB receptor activator (OPG/RANKL/RANK) signaling pathway has a certain correlation with the pathogenesis of giant-cell tumor. Controlling the OPG/RANKL/RANK signaling pathway to affect the interaction between osteoblasts and osteoclasts can play a certain therapeutic role in giant-cell tumor of bone. OBJECTIVE: Ton introduce the relationship between the OPG/RANKL/RANK signaling pathway and the pathogenesis of giant-cell tumor of bone, and to summarize and discuss the new advances of the OPG/RANKL/RANK signaling pathway in the pathogenesis of giant-cell tumor of bone. METHODS: PubMed, Web of Science, and WanFang databases were searched for relevant articles published from 2001 to 2019 using the keywords of “OPG/RANKL/RANK, giant cell tumor of bone, pathogenesis, signal pathway, bone metabolism" in English and Chinese, respectively. A total of 53 articles were finally included for analysis and discussion after removal of old and repeated literatures. RESULTS AND CONCLUSION: OPG inhibits the proliferation and differentiation of osteoclasts, reduces the activity of mature osteoclasts, and blocks the binding of RANKL to RANK. RANKL binds to RANK on the surface of osteoclast progenitor cells to promote the differentiation and proliferation of osteoclast progenitor cells, thus accelerating osteoclast progression. After binding to RANKL receptor, RANKL activates signal factors such as nuclear factor-κB to promote the proliferation, differentiation and activation of osteoclasts, and to regulate the transcription and expression of related genes. Therefore, the OPG/RANKL/RANK is associated with the pathogenesis of giant-cell tumor. Related Articles | Metrics

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Effect of exercise-induced irisin on myocardial fibrosis Yin Lian, Zhao Jin, Lei Xuemei, Li Miaomiao, Wang Kun, Zhang Tingran, Luo Jiong 2020, 24 (23):  3730-3736.  doi: 10.3969/j.issn.2095-4344.2689 Abstract ( 516 )   PDF (904KB) ( 168 )   Save BACKGROUND: Myocardial fibrosis is an important topic in modern medical research, and its development is closely related to common heart diseases such as arrhythmia and chronic heart failure. Exercise intervention can significantly improve myocardial fibrosis, but there is no systematic and comprehensive understanding of the mechanism by which exercise improves myocardial fibrosis as well as the effects of different types of exercises on myocardial fibrosis. To date, it is still unclear about how exercise triggers the production of irisin against myocardial fibrosis.  OBJECTIVE: To comprehensively review the exercise-induced production of irisin and its effect on myocardial fibrosis, and reveal its myocardial protection, so as to improve heart function and provide fundamental basis for preventing against common heart diseases, such as arrhythmia and chronic heart failure. METHODS: A search of ELSEVIER, Web of Science, CNKI, WanFanga, VIP and Taiwan Academic Literature Database was performed for articles regarding exercise, irisin, and myocardial fibrosis. The deadline for publication was August 2019. According to the inclusion and exclusion criteria, 58 articles were eligible for review. RESULTS AND CONCLUSION: Long-term and single exercise in human experiments has been shown to improve muscular and circulatory irisin levels, which has been better verified in animal experiments. A few experimental results indicate that long-term exercise has no significant effect on blood irisin levels, which may be due to different research subjects, exercise methods, exercise intensity, and exercise frequency. However, the specific mechanism is still unclear. Exercise can improve myocardial fibrosis by acting on myocardial mitochondrial stabilization, energy metabolism, oxidative stress and inflammatory response. The occurrence of myocardial fibrosis results from the regulation of neuroendocrine and oxidative stress and inflammatory responses. Irisin can influence the processes of oxidative stress and inflammation related to the mechanism of myocardial fibrosis, by inhibiting ROS/p38MAPK/NF-κB signaling pathway, endogenous reactive oxygen species and ROS-NLRP3 inflammation signaling pathway, and regulating the expression of uncoupling protein 2 and mitochondrial homeostasis. Therefore, exercise may improve myocardial fibrosis by upregulating the expression of irisin, thus providing myocardial protection. Related Articles | Metrics

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KAASTU training for muscle fitness in the middle-aged and elderly adults: effects and strengths Zhao Jing, Yin Lian, Lei Xuemei, Li Miaomiao, Wang Kun, Zhang Tingran, Luo Jiong 2020, 24 (23):  3737-3743.  doi: 10.3969/j.issn.2095-4344.2690 Abstract ( 443 )   PDF (854KB) ( 200 )   Save BACKGROUND: KAASTU training combined with low-load exercise can achieve the same effect as traditional high intensity resistance exercise. Therefore, it has been widely used in competitive sports, sports fitness, medical rehabilitation and other fields in recent years. However, there are few comments on the effects of KAASTU training on muscle fitness of the middle-aged and elderly adults. OBJECTIVE: To further explain and verify the safety, practicability and convenience of KAASTU training in the middle-aged and elderly adults exercise through a comprehensive review of the muscle fitness of middle-aged and elderly adults, and to provide scientific suggestions for the middle-aged and elderly adults to choose a safe and effective exercise. METHODS: Up to October 2019, Elsevier, PubMed, Springer, VIP, CNKI and Taiwan Academic Literature Database were searched for Chinese and English literature about KAASTU training, blood flow restriction, and muscle. Corresponding selection criteria was established according to the needs of the study, followed by literature screening. RESULTS AND CONCLUSION: KAASTU training combined with low-load exercise can effectively increase the muscle mass of the middle-aged and elderly adults, and has a positive effect on the prevention of muscle atrophy in the middle-aged and elderly adults. KAASTU training combined with low-load exercise can effectively improve the muscle strength of the lower extremities, which is beneficial to reduce exercise injury and improve the quality of life. KAASTU training has positive effects on bone health of the middle-aged and elderly adults, improves osteoporosis and increases bone mineral density of the older adults. Compared with traditional resistance training, KAASTU training is characterized by lower load and better effect. Therefore, KAASTU training is easier to be accepted by the middle-aged and elderly adults. Related Articles | Metrics

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Design principle and biomechanical function of orthopedic insoles Zhang Xinyu, Xing Xinyang, Huo Hongfeng 2020, 24 (23):  3744-3750.  doi: 10.3969/j.issn.2095-4344.2691 Abstract ( 1218 )   PDF (738KB) ( 943 )   Save BACKGROUND: The foot is an important part of the human motor system. Foot diseases and injuries have become a troubling problem. Orthopedic insoles can effectively treat and prevent foot diseases and injuries and reduce the risk of injuries. It has become the main method of physical correction. OBJECTIVE: To clarify the design principles of orthopedic insoles, to classify orthopedic insoles according to the production methods, to sort out the rehabilitation function of orthopedic insoles to human joint-related diseases, children’s hemiplegia, and sports injuries, to explore the current research status and shortcomings of orthopedic insoles, and to make suggestions for future research and development. METHODS: A search of CNKI, WanFang, Baichain, Baidu Library, and PubMed was performed for relevant literature published from 2005 to 2019. Search terms were “Orthopedic insoles,” “valgus hallux, flat feet, high arch, plantar fasciitis,” “knee varus, knee valgus, knee osteoarthritis,” “scoliosis,” “foot and ankle injury,” “gait,” and “abnormal gaits” in Chinese and “Orthopedic insoles, Corrective effect, Motion pattern characteristics” in English. Included articles were screened, summarized and analyzed. RESULTS AND CONCLUSION: The design principles of the insoles include four aspects: adjusting the force bearing point of the vola and dispersing plantar pressure; supporting the arch of the foot, improving cushioning ability; improving the force line of the lower limb, providing a stable support; improving proprioception and foot comfort. Orthopedic insoles can be divided into three types: prefabricated, semi-customized and customized. Orthopedic insoles can play an effective prevention and rehabilitation function in ankle, knee, spinal deformity, hemiplegia-type cerebral palsy in children, and sports injuries. Orthopedic insoles have certain limitations in clinical application and in therapeutic effects. In the development and evaluation of orthopedic insoles, the changes in foot shape and shoe shape during human movement should be considered to reflect the concept of “foot-shoe integration.” Different shapes, materials, and hardness of orthopedic insoles can be used to conduct more in-depth research on the effects of orthopedic insoles to prevent and treat injuries and improve exercise capacity. Related Articles | Metrics

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Vitrification-based cryopreservation of tissues: strengths and existing problems Zhang Yuan, Zeng Min, Zhai Bo 2020, 24 (23):  3751-3755.  doi: 10.3969/j.issn.2095-4344.2693 Abstract ( 689 )   PDF (737KB) ( 247 )   Save BACKGROUND: Vitrification-based cryopreservation is a promising cryopreservation method, which can change the state of the biological materials by using high concentration vitrification reagent to realize active preservation. OBJECTIVE: To review the biological principle of vitrification-based cryopreservation, the classification of cryopreservation reagents, as well as the cryopreservation of ovary skin, cornea and other medical tissue specimens. METHODS: PubMed and WanFang databases were searched for relevant articles published from January 1994 through October 2019. Search terms were “tissue; vitrification; cryopreservation” in English and Chinese, respectively. According to the inclusion and exclusion criteria, 45 articles were finally included in result analysis. RESULTS AND CONCLUSION: The process of vitrification-based cryopreservation can avoid ice crystallization by which the cells are damaged, and effectively preserve the cell’s biological activity and basic functions. Vitrified cryopreservation reagents can be divided into permeable and non-permeable reagents. Their operation is simple and efficient. The only disadvantage is that the high concentration of cryopreservation reagents can cause some toxic injuries to the cells. To reduce the risk of overall tissue damage, a variety of low-toxic cryopreservation reagents can be mixed and used. At present, vitrification-based cryopreservation technology has been successfully applied in a variety of cells. However, the technical problems in the cryopreservation of tissues have not been solved completely. Related Articles | Metrics

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Various acupuncture therapies for lateral epicondylitis: a Bayesian network meta-analysis Shi Yuling, Li Guangyao, Liang Zujian 2020, 24 (23):  3756-3763.  doi: 10.3969/j.issn.2095-4344.2729 Abstract ( 630 )   PDF (927KB) ( 186 )   Save BACKGROUND: Acupuncture therapy plays a very important role in the treatment of lateral epicondylitis. However, due to the diverse characteristics of acupuncture therapy, the current research mostly focuses on a simple comparison between acupuncture therapy and conventional blocking therapy. OBJECTIVE: To compare the efficacy and visual analogue scale score of different acupuncture therapies for lateral epicondylitis using a Bayesian network meta-analysis. METHODS: Randomized controlled trials on acupuncture therapy for lateral epicondylitis included in PubMed, The Cochrane Library, CNKI, VIP, and WanFang were searched. The search time was from inception until October 2019 in each database. Two researchers independently screened and extracted data according to the inclusion criteria, and then evaluated the quality of the literature. Direct meta-analysis and network meta-analysis of data were performed using ADDIS 1.16.8 software. RESULTS AND CONCLUSION: A total of 2 318 lateral epicondylitis patients were included in 32 randomized controlled trials/controlled clinical trials, concerning 6 treatment measures, including warming needle, fire needle, electroacupuncture, filiform needle acupuncture, Fu’s acupuncture, fire needle plus filiform needle. Network meta-analysis results show that: in terms of efficiency, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than warming needles, fire needles are better than electroacupuncture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu’s acupuncture is better than filiform needles, and fire needle plus filiform needle is better than filiform needles alone. In terms of the visual analogue scale score, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than electroacupunture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu's acupuncture is better than filiform needles, fire needle plus filiform needle is better than electroacupuncture. Efficiencies rank from the best to the worst: Fu’s electroacupuncture>fire needle>fire needle plus filiform needle>warming needle>electroacupuncture needle>filiform needles. The visual analogue scale scores rank as follows: Fu’s acupuncture>fire needle+filiform needle>fire needle>warming needle>filiform needle>electroacupuncture. The direct meta-analysis results are highly consistent with the network meta-analysis results, indicating that there is consistency between the direct and indirect comparison, that is, transitive. In the clinical treatment of lateral epicondylitis, Fu’s acupuncture can be preferentially selected, but each acupuncture therapy has advantages and disadvantages. In clinical practice, the appropriate treatment should be selected in accordance with the actual situation and dialectical Chinese medicine. Related Articles | Metrics

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Meta-analysis of muscle strength of exercisers undergoing electrical muscle stimulation training Hou Xiao, Lü Yifan, Liu Jingmin 2020, 24 (23):  3764-3772.  doi: 10.3969/j.issn.2095-4344.2686 Abstract ( 658 )   PDF (1241KB) ( 273 )   Save BACKGROUND: Electrical muscle stimulation can certainly improve muscle protein synthesis and muscle mass growth, but there are also different research results. OBJECTIVE: To analyze the influence of electrical muscle stimulation as a strength training method on the muscle strength of exercisers through meta-analysis, providing advanced method and evidence-based basis for future strength training in sports field. METHODS: Databases such as PubMed, EBSCO host, Web of Science, CNKI, WanFang, and VIP were searched for randomized controlled trials regarding electrical muscle stimulation for improving the muscle strength of exercisers. The literatures were screened by PICOS principles. The subjects were athletes and healthy controls with exercise experience, and they were divided into electrical stimulation group and control group (without any intervention). According to Cochrane criteria we conduct meta-analysis, sensitivity analysis, subgroup analysis, and publication bias evaluation through Stata 15.1 and Review Manager 5.3. RESULTS AND CONCLUSION: Compared with the control group, electrical muscle stimulation significantly increased concentric contraction peak torque in exercise population (combined effect: weighted mean difference=8.23, 95% confidence interval: 6.71-9.76, P < 0.000 1), and the effect was most obvious at the age of 20-22 years. Compared with the control group, electrical muscle stimulation significantly increased eccentric contraction peak torque in exercise population (combined effect: weighted mean difference=5.58, 95% confidence interval: 4.16-7.00, P < 0.000 01). The number of included experiments about isometric contraction peak torque was small and it was not suitable for meta-analysis. To conclude, electrical muscle stimulation training can effectively promote the concentric contraction peak torque and eccentric contraction peak torque of the exercise population, and the effect of electrical muscle stimulation as a training method on the muscle strength of exercisers needs to be explored in terms of indicators, ages and subjects. Related Articles | Metrics