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28 April 2022, Volume 26 Issue 12 Previous Issue   

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Recognition of human lower limb movement intention based on surface electromyography of lower limb corresponding to five gaits Zhao Yiming, Wang Jie, Zhang Gaowei, Sun Jianjun, Yang Peng 2022, 26 (12):  1805-1811.  doi: 10.12307/2022.499 Abstract ( 603 )   PDF (1596KB) ( 72 )   Save BACKGROUND: The lower limb exoskeleton robot is used to recover the basic walking ability of patients. To realize the high coordination between humans and robots and to design robot control strategies, it is necessary to recognize the movement intention of the lower limb which includes gait.   OBJECTIVE: To propose a new classifier to recognize gait using surface electromyography. METHODS:  Firstly, surface electromyography data of lower limbs in five gait patterns were collected. Secondly, the collected signals were denoised and the features were extracted to obtain the data sets of five gait patterns. After that, two of them were combined and 10 groups of data sets were built. Thirdly, the probabilistic neural networks were trained with the AdaBoost algorithm based on each group of data sets. Fourthly, ten strong classifiers were obtained by ensemble of trained probabilistic neural networks. Finally, the testing samples were input into 10 strong classifiers and the categories were judged by voting.   RESULTS AND CONCLUSION: An average recognition rate of 90.2% was achieved in the experiment by improved AdaBoost algorithm to recognize the five gait patterns. Compared with separate probabilistic neural network, the average recognition rate of separate probabilistic neural network was 68.2%, which was lower than that of improved AdaBoost algorithm. When the weak classifier was replaced by support vector machine, BP neural network or decision tree was used to construct strong classifiers for comparison. When a weak classifier was utilized, the average recognition rate of separate support vector machine was higher than that of separate probabilistic neural network. However, but the average recognition rate of strong classifier based on probabilistic neural network was higher than that 84.3% based on support vector machine with improved AdaBoost algorithm. Figures and Tables | References | Related Articles | Metrics

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Effect of zoledronic acid on femoral implant subsidence after hip arthroplasty Chen Yong, Sun Yang 2022, 26 (12):  1812-1815.  doi: 10.12307/2022.500 Abstract ( 449 )   PDF (1092KB) ( 64 )   Save BACKGROUND: Implant subsidence after hip arthroplasty is the main cause of surgical failure. Zoledronic acid has a good effect on improving bone mass and bone density around cementless femoral prosthesis after hip arthroplasty, and it is speculated that zoledronic acid can reduce implant subsidence.   OBJECTIVE: To analyze the effect of zoledronic acid on femoral implant subsidence after hip arthroplasty. METHODS:  Totally 50 female patients with postmenopausal osteoporotic hip fracture who underwent hip arthroplasty in Central Hospital Affiliated to Shenyang Medical College from April 2019 to April 2020 were selected and randomly assigned to two groups. The 25 patients in the trial group received intravenous infusion of zoledronic acid 1 week after total hip arthroplasty, and 25 patients in the control group did not receive zoledronic acid treatment after total hip arthroplasty. At 1 year after arthroplasty, X-ray was used to record the femoral implant subsidence distance. The bone mineral density around the femoral prosthesis was measured using dual energy X-ray bone densitometer. Harris scoring system was used to assess hip joint function.   RESULTS AND CONCLUSION: (1) The femoral implant subsidence distance was less in the trial group than that in the control group at 1 year after arthroplasty (P < 0.05). The average bone mineral density around the femoral prosthesis was higher in the trial group than that in the control group at 1 year after arthroplasty (P < 0.05). (2) Harris hip function score in the two groups was higher at 1 year after arthroplasty than that before arthroplasty (P < 0.05), and there was no significant difference between the two groups (P > 0.05). (3) Eight patients in the trial group developed fever within 3 days, and the symptoms were relieved after oral administration of ibuprofen suspension and drinking plenty of water. (4) It is indicated that zoledronic acid can effectively reduce the loss of bone mineral density around cementless femoral prosthesis and improve the stability of prosthesis after hip arthroplasty. Figures and Tables | References | Related Articles | Metrics

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Effect and mechanism of mechanical factors on intervertebral disc degeneration Yin Xunlu, Jin Zhefeng, Zhu Liguo, Feng Minshan, Yu Jie, Wei Xu, Zhan Jiawen, Gao Chunyu, Yin He, Liang Long, Han Tao, Sun Kai, Xie Rui 2022, 26 (12):  1816-1821.  doi: 10.12307/2022.501 Abstract ( 495 )   PDF (2593KB) ( 62 )   Save BACKGROUND: Our previous study found that mechanical stimulation can affect many key proteins in the Wnt/β-catenin signaling pathway (including β-catenin and GSK-3β protein), but whether it regulates the Wnt/β-catenin signaling pathway in nucleus pulposus cells remains to be clarified.   OBJECTIVE: To clarify the characteristics and effect of continuous loading pressure on intervertebral disc degeneration, and explore the mechanism of mechanical factors-mediated Wnt/β-catenin signaling pathway on intervertebral disc degeneration. METHODS:  Seventy New Zealand white rabbits were selected to establish a rabbit spinal motion segment model, which were randomly divided into blank control group (0 kg), low pressure group (0.5 kg), medium pressure group (1 kg), and high pressure group (3 kg) according to the sustained loading pressure. Others were divided into control group by using optimal sustained loading pressure, activator group and inhibitor group by using Wnt/β-catenin specific activators (SB216763) and inhibitors (ICG001), for 3 consecutive days. Hematoxylin-eosin staining, DAB staining, western blot assay, and RT-PCR were used to observe the function of nucleus pulposus cells. The protocols were approved by Medical Ethics Committee of Wangjing Hospital, China Academy of Chinese Medical Sciences.   RESULTS AND CONCLUSION: (1) The survival rate of nucleus pulposus cells was high under medium pressure (1 kg). Sustained loading pressure could induce intervertebral disc degeneration at 3 days. (2) Compared with the control group, the number of nucleus pulposus cells in the activator group was significantly increased; the cell morphology was regular, and the fibrous tissue and scar in the nucleus pulposus were not obvious. The expression levels of β-catenin and Aggrecan protein were higher and the experssion of GSK-3β protein was significantly decreased (P < 0.05). The expression levels of Aggrecan and Collagen II mRNA were significantly increased (P < 0.05). (3) Compared with the control group, the number of nucleus pulposus cells in the inhibitor group was significantly reduced; the cell morphology was fusiform, and the fibrous tissue and scar in the nucleus pulposus were more obvious; the expression levels of GSK-3β and β-catenin were not significantly different, but the expression of Aggrecan and Collagen II mRNA decreased significantly (P < 0.05). (4) It is concluded that sustained loading force regulates the process of intervertebral disc degeneration in nucleus pulposus cells by mediating Wnt/β-catenin signaling pathway. Figures and Tables | References | Related Articles | Metrics

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Accuracy and precision analysis of optical three-dimensional movement capture system for biomechanical testing Tan Jinghua, Xue Jingbo, Xie Yong, Wang Cheng, Yan Yiguo 2022, 26 (12):  1822-1827.  doi: 10.12307/2022.502 Abstract ( 477 )   PDF (1666KB) ( 65 )   Save BACKGROUND: The optical three-dimensional motion capture system is widely used in physiology or pathology, in vitro or in vivo experiments, medical treatment or life, but there is no objective analysis of the accuracy of the system and its influencing factors.   OBJECTIVE: To establish optical three-dimensional motion capture system to analyze its accuracy and influencing factors for biomechanical testing. METHODS:  First, the optical three-dimensional motion capture system camera was installed to a semi-arc wave position to capture 18 sets of coordinate data of static marker points, each set of 400 coordinate values. The system precision was calculated. The robot arm was used to complete the movement along the coordinate axis X, Y and Z axis, and the obtained coordinate data were processed by MATLAB to calculate the movement distance (measured value). Second, the accuracy of the motion capture system was calculated based on the actual value of the electronic micrometer. Finally, according to the aforementioned precision and accuracy test method, one-way analysis of variance was used to analyze whether there were differences in the precision and accuracy of the system under different motion directions, various coordinate axes, indoor lighting, different camera numbers, different Marker sizes and materials, and different camera position variables.   RESULTS AND CONCLUSION: (1) When the optical three-dimensional motion capture system camera was placed in a semi-arc wave, the X, Y and Z axis coordinate precisions were 5.00, 10.26, and 5.50 μm, respectively, and the accuracies of the movement along the X, Y and Z axes were: 15.58, 20.69, and 12.24 μm. (2) As the camera changed from a single-sided shape to a ring shape, the accuracy gradually increased, and the accuracy was optimal when placed in a ring. (3) The presence or absence of starting lighting in the room had no significant impact on the accuracy of the system. (4) As the number of cameras increased, the precision of the capture system rised, but when the number reached a certain level, the precision would approach its limit. (5) In this system, there was no difference in the precision of the Marker points of plastic rigid 12.7, 14.0, 15.9 mm and rubber material with a diameter of 14.0 mm. (6) Therefore, the number of cameras and the placement position of the optical 3D motion capture system have an impact on the accuracy of the system. The size and material of the Marker, the direction of movement, and the indoor lighting have no significant impact on the accuracy of the system. The precision and accuracy of the system meet the needs of biomechanical testing. Figures and Tables | References | Related Articles | Metrics

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Biomechanical properties of adult biceps and triceps under real-time dynamic stretching Huang Tao, Liu Xiaoyun, Deng Yuping, Li Yanbing, Zhong Shizhen, Huang Wenhua 2022, 26 (12):  1828-1833.  doi: 10.12307/2022.503 Abstract ( 597 )   PDF (1808KB) ( 46 )   Save BACKGROUND: Passive stiffness of muscle is the basic data to guide the research and development of tissue engineering materials, injury transplantation and repair. However, the previous experimental data, such as material research and development, are mostly from animals, and there are few reports on the mechanical properties of human skeletal muscle. By comparing and analyzing the biomechanical properties of adult and pig flexor and extensor muscles, it provides basic human body data for the development of bionic material.   OBJECTIVE: To evaluate the biomechanical properties of adult biceps and triceps muscularis under real-time dynamic stretching, and compare them with pig foreleg flexors and extensors to explore the biomechanical differences between human materials and animal materials. It provides reference for research and development of a bionic material. METHODS:  The test specimens were taken from fresh forelegs of 10 pigs and 6 specimens of human upper limbs, and dissected along the direction of muscle fibers to obtain the largest flexors and extensors of the forelegs of pigs, as well as human biceps and triceps. Samples were sectioned to 10 mm thick, 10 mm wide, 50 mm long and nine black spots were marked on the surface of the sample for the quasi-static tensile testing. The optical non-contact method was adopted to calculate the distance change between the labeled points, measure the strain, and calculate the stress response.   RESULTS AND CONCLUSION: The internal strain of biceps brachii, triceps brachii, flexor muscle and extensor muscle showed uneven distribution during stretching. Triceps brachii, biceps brachii and flexor Cauchy stress-strain showed a nonlinear “S”-type increase. The Cauchy stress-strain of extensor muscle increased linearly. When draw ratio >1.2, under the same strain, the stress of human muscle was much higher than pig muscle. For analysis of variance F=2 870.346, there was statistical significance between pairings of four kinds of muscles (P < 0.001). Under real-time dynamic stretching, there were statistically significant differences in the biomechanical properties of the maximum flexor and extensor muscles of the forelegs of pigs and adult biceps and triceps. The stiffness in descending order was the biceps brachii, triceps brachii, pig flexor, and pig extensor. The flexor stiffness of human rump is greater than that of extensor muscle. Figures and Tables | References | Related Articles | Metrics

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Changes in biomechanical characteristics of children’s lower limbs during visual deprivation and dual tasks Ouyang Yiyi, Peng Jie, Wang Kun, Zhang Tingran, Luo Jiong 2022, 26 (12):  1834-1842.  doi: 10.12307/2022.504 Abstract ( 380 )   PDF (1674KB) ( 66 )   Save BACKGROUND: Human balance and control depend on the coordination of the inner ear vestibular system, proprioceptors and visual system, and the central nervous system. However, when a person is visually deprived or dual cognitive tasks, it will cause changes in neural control and sensory integration, and then change lower limb balance control ability and movement control strategy.   OBJECTIVE: To explore the biomechanical changes of the legs in stair descendent of different visual inputs and cognitive tasks so as to reveal action mechanism, thus preventing and avoiding accidents of children falling off stairs in descending stairs. METHODS:  Twenty students from grades 3-6 of the Primary School Attached to Southwest University were volunteered to participate in the research (n=5 for each grade). The biomechanical parameters of participants in stair descendent of different visual inputs and cognitive tasks were collected with such test tools as JVC9800 high-speed video camera of kinematics, BIOFORCEN dynamic balance training assessment system of dynamics, and JE-TB0810 eight-channel electromyogram tester of surface electromyography.   RESULTS AND CONCLUSION: (1) The angle of the knee joint and the ankle joint with eyes closed and double tasks was obviously larger than that with eyes open and single task (P < 0.05), while the center of gravity was in the lowest level, the angle of the ankle joint with eyes closed and double tasks was obviously larger than that with eyes open and single task (P < 0.05). (2) The lengthways displacement root mean square of center of pressure, transverse displacement root mean square of center of pressure, length of swing trajectory of center of pressure and the enveloping surface of center of pressure with eyes open and double tasks were all smaller than those with eyes closed (P < 0.05). (3) The average electromyogram amplitude standardization parameter and activation length of the biceps femoris, rectus femoris, tibialis anterior and medial head of gastrocnemius with eyes closed and double tasks were significantly smaller than those with eyes open and single task during the first 200 ms prior to touching the steps (P < 0.05); while the average electromyogram amplitude standardization parameter of the tibialis anterior and medial head of gastrocnemius during the buffer period with eyes closed and double tasks were significantly smaller than those with eyes open and single task (P < 0.01). (4) It is concluded that the visual deprivation and double tasks in stair descendent will both block the information transmission of the central nervous system, influence the adjustment of body position and the activation of leg muscles, and further affect children’s balance control and gait steadily and increase their risk of falling off the stairs. However, the influence of visual deprivation to children’s balance control is significantly higher than that of the double tasks. The changes on balance control are caused by visual deprivation. The block of information transmission in the central nervous system will influence children’s cognitive choice, making them pay more attention on walking behaviors instead of cognitive operations. Figures and Tables | References | Related Articles | Metrics

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Biomechanical effects of different placement of femoral prosthesis in unicompartmental knee arthroplasty Ma Pengcheng, Zhang Siping, Sun Rongxin, Chai Hao, Jiang Kan 2022, 26 (12):  1843-1848.  doi: 10.12307/2022.505 Abstract ( 486 )   PDF (2224KB) ( 40 )   Save BACKGROUND: Most of the revision causes of unicompartmental knee arthroplasty are postoperative complications, such as prosthesis loosening, polyethylene wear and progression of uninvolved compartment arthritis, which are linked to the abnormal intra-articular stress caused by the malposition of the prosthesis.   OBJECTIVE: To study the effects of different positions of the femoral prosthesis on the stress magnitude and distribution of polyethylene surface, articular cartilage surface, and cancellous bone surface during unicompartmental knee arthroplasty. METHODS:  The digital image of the knee joint and prosthesis was obtained using radiological technologies and three-dimensional scanning techniques. A normal knee model was developed and validated using mimics and Ansys workbench software. Unicompartmental knee arthroplasty was simulated in Ansys Workbench software. The prosthesis was positioned appropriately and the femoral prosthesis was requisitioned. Nine working conditions were established at the 0°, 3°, 6°, 9°, and 12° of femoral prosthesis varus and valgus to observe the changes in stress and distribution of polyethylene surface, articular cartilage surface and cancellous bone surface in each model.   RESULTS AND CONCLUSION: (1) The stress on the upper surface of polyethylene increased with the increase of the valgus and varus angle in the prosthesis under static load of knee joint extension, and the increase range was large during valgus. The stress distribution on the upper surface of polyethylene shifts was inward during varus and outward during valgus. (2) The stress on the articular cartilage surface increased during varus and decreased during valgus. (3) The stress on the surface of cancellous bone was concentrated in the grooves, and the stress was increased during valgus and varus, and greater during valgus. (4) As move from varus to valgus, the load shifted to the medial side of the knee. (5) Among all the structures, the stress on the upper surface of polyethylene prosthesis was the highest, and the stress value at ≥6° of valgus and valgus of femoral prosthesis was significantly higher than that at the standard position (0° valgus and valgus). Figures and Tables | References | Related Articles | Metrics

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Single-level osteotomy and bone transfer combined with intramedullary nail in the treatment of tibial bone defect Tu Zhenxing, Wang Bin, Lu Aidong, Zhang Dingding, Yang Huanyou, Wang Hui, Wang Wei, Gong Zhongping, Li Ligeng 2022, 26 (12):  1849-1853.  doi: 10.12307/2022.506 Abstract ( 491 )   PDF (1667KB) ( 45 )   Save BACKGROUND: Bone transfer is an effective treatment of bone defect caused by various causes. However, the complications, such as long wearing time of the external fixator, the loss of extended bone length, and bending deformities, restrict its application.   OBJECTIVE: To explore the difference in the efficacy of single-level osteotomy combined with intramedullary nail and single-level osteotomy in the treatment of tibial bone defect. METHODS:  Patients with tibial bone defect were selected from Tangshan Second Hospital from January 2011 to April 2018. Fifteen patients treated with single-level osteotomy and bone transfer combined with intramedullary nail were used as the trial group. Thirty patients treated with single-level osteotomy and bone transfer were used as the control group. After treatment, follow-up was carried out by the combination of outpatient follow-up, phone call and Wechat video. The mineralization time of regeneration area, healing index, external fixation time, external fixation index, joint healing, needle infection, and refracture were compared between the two groups. The scoring standard of Association of Study and Application on Method of Ilizarov was used to evaluate the bone healing and function.   RESULTS AND CONCLUSION: (1) The patients in both groups were followed up for (31.0±7.3) months. The incision had no redness, swelling, or pain, and needle tract infection were controlled after removal of the outer frame. (2) There was no significant difference in mineralization time, healing index, refracture rate, and joint healing between the two groups (P > 0.05). The external fixation index was smaller in the trial group than that in the control group (P < 0.05). Number of patients with bone end cleaning and bone grafting was smaller in the trial group than that in the control group (P < 0.05). The rate of needle tract infection was lower in the trial group than that in the control group (P < 0.05). (3) ASAMI score was better in the trial group than that in the control group (P < 0.05). (4) It is concluded that compared with the single-level osteotomy and bone transfer, single-level osteotomy and bone transfer combined with intramedullary nail in the treatment of tibial bone defect can shorten the fixator time, reduce the probability of postoperative debridement and replantation of bone compression, and avoid needle tract infection. Figures and Tables | References | Related Articles | Metrics

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Patellar suture anchors and semi-tunneling polyetheretherketone suture anchors for double-bundle reconstruction of medial patellofemoral ligament Han Mingzhan, Maihemuti·Yakufu, Chen Hongtao, Liu Jianjiang, Abudusufu·Kuwan, Aierken·Amudong 2022, 26 (12):  1854-1860.  doi: 10.12307/2022.507 Abstract ( 454 )   PDF (1446KB) ( 38 )   Save BACKGROUND: The main treatment methods for recurrent patellar dislocation are medial patellofemoral ligament reconstruction, medial patellofemoral ligament formation, lateral patellofemoral ligament loosening, gluteal muscle contracture loosening, and tibial tubercle displacement surgery. At present, double-bundle anatomical reconstruction of medial patellofemoral ligament is mostly used.   OBJECTIVE: To compare the efficacy of tendon fixation with suture anchors and tendon fixation with semi-tunneling polyetheretherketone suture anchors in the treatment of recurrent patellar dislocation under the condition of double-bundle reconstruction of medial patellofemoral ligament. METHODS:  Totally 57 cases who were diagnosed as recurrent patellar dislocation in Sixth Affiliated Hospital of Xinjiang Medical University from January 2017 to April 2018 received parallel medial patellofemoral ligament revascularization, aged between 16 and 26 patients, including 19 males and 38 females. The graft was autologous semitendinosus muscle. Among them, 26 cases received graft fixation with suture anchors, and 31 cases received graft fixation with semi-tunneling polyetheretherketone suture anchors. After surgery, follow-up was conducted to record patellar redislocation, fracture and other complications, patellar tilt angle, and Kujala score of the affected knee.   RESULTS AND CONCLUSION: (1) During 36-month follow-up, 57 patients did not affect unhealed incision, patellar redislocation, or patellar fracture. In the suture anchor group, four patients experienced pain at femoral insertion point and one patient suffered from persistent pain at ligament and femoral insertion point. In the polyetheretherketone suture anchor group, five patients affected pain at femoral insertion point. No significant difference in the incidence of pain was found between the two groups (P > 0.05). (2) There was no significant difference in Kujala function score of knee joint at 18 and 36 months after operation between the two groups (P > 0.05). (3) Patellar tilt angle was larger in the suture anchor group than that in the polyetheretherketone suture anchor group at postoperative 36 months (P < 0.05). (4) The results suggest that the suture anchor and semi-tunneling polyetheretherketone suture anchor for double-bundle reconstruction of medial patellofemoral ligament can effectively treat recurrent patellar dislocation and improve the function of the affected knee. However, semi-tunneling polyetheretherketone suture anchor improves the patellar tilt angle more significantly. Figures and Tables | References | Related Articles | Metrics

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Screw track in computer navigation-assisted percutaneous hollow pedicle screw placement Yuan Cuihua, Lin Wang, Jiang Yao, Liu Chengzhao 2022, 26 (12):  1861-1865.  doi: 10.12307/2022.508 Abstract ( 474 )   PDF (2387KB) ( 23 )   Save BACKGROUND: Percutaneous minimally invasive pedicle screw placement has limited the use of minimally invasive percutaneous pedicle screw technology, resulting in clinical confusion caused by different reports on the insertion point and angle of the pedicle screw. At present, when percutaneous pedicle screw technique is used in the treatment of thoracolumbar fracture, most of the screws are placed according to experience or the guidance of intraoperative X-ray repeated fluoroscopy. Thus, the patients and the operators suffer great iatrogenic damage.   OBJECTIVE: To study the feasibility of percutaneous pedicle screw orbit design respectively from the angle of body anatomy and imaging under the navigation design of precision of the orbit. METHODS:  (1) Ten bone specimens (T10-L3, a total of 120 vertebral pedicles) were randomly selected, and the preliminary track for pedicle screw was designed based on the best entry points and the best needling angle under computer navigation. The maximum distance from pedicle screw track to the central axis of the vertebral pedicle was measured and recorded. The excellent and good rate of screw placement was counted to analyze the accuracy of the screw track under navigation. (2) Ten spinal bones (T10-L3, a total of 60 vertebral pedicles) were randomly selected. Cases treated with computer navigation-assisted percutaneous pedicle screw placement were set as experimental group. Meanwhile, cases treated with screw placement method under direct vision with naked eyes were set as control group. The excellent and good rate of screw placement among the bone specimens of corpses in both groups was counted and analyzed, separately.   RESULTS AND CONCLUSION: (1) The measurement of 60 vertebral pedicles in the thoracic spine group and the design of pedicle screw track: There were 52 excellent cases, 3 good cases, and 5 poor cases, with an excellent and good rate of 91.67%. The measurement of 60 vertebral pedicles in the lumbar spine group: There were 55 excellent cases, 2 good cases, and 3 poor cases, with an excellent and good rate of 95.00%. No significant difference in the excellent and good rate was detected between thoracic and lumbar spines (P > 0.05). (2) CT scanning was carried out on a total of 30 vertebral pedicles in the navigation experimental group, with an excellent and good rate of screw placement of 96.67%. A total of 30 vertebral pedicles were scanned in the control group, with an excellent and good rate of screw placement of 90.00%. No significant difference in the excellent and good rate was detected between these two groups (P > 0.05). (3) The screw track of computer navigation-assisted percutaneous pedicle screw placement for thoracic and lumbar spines is extremely close to the central axis of the vertebral pedicle or located at the central axis of the vertebral pedicle, and the pedicle screw track designed under navigation is ideal. The excellent and good rate of screw placement among the bone specimens of corpses shows no apparent difference under navigation and direct vision with naked eyes. Therefore, it can be inferred that the pedicle screw track designed with computer navigation-assisted percutaneous placement is feasible. Figures and Tables | References | Related Articles | Metrics

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Three-dimensional finite element analysis of anterior cervical fixation system in children Li Kun, Wang Xing, Li Zhijun, Gao Shang, Sun Hao, Xiong Feng, Wang Peng 2022, 26 (12):  1866-1871.  doi: 10.12307/2022.509 Abstract ( 341 )   PDF (1974KB) ( 72 )   Save BACKGROUND: Occipito-atlanto-axial joint has its own characteristics in morphological development and physiological characteristics, and clinical injuries are common in children. The differences between the biomechanical characteristics of occipito-atlantoaxial internal fixation (a way to maintain the stability of the atlantoaxial spine) and conventional fusion need further study.   OBJECTIVE: To evaluate the biomechanics of a new occipitocervical anterior internal fixation device in children by three-dimensional finite element analysis. METHODS:  The transverse ligament and joint capsule were deleted on the basis of the established three-dimensional finite element model of the normal C0-C2 joint, and the occipitocervical injury model was simulated. A new type of anterior occipitocervical internal fixation device was placed on the model to construct the finite element model of internal fixation. The motion range and stress of each model were compared and analyzed by the finite element method.   RESULTS AND CONCLUSION: Compared with the normal children’s finite element model of occipitocervical titanium plate-screw internal fixation, the occipitocervical and atlantoaxial motion was significantly limited in flexion and extension, lateral flexion and rotation, indicating that this occipitocervical internal fixation system could achieve better stability. During the flexion, extension, lateral flexion and rotation of the occipito-atlantoaxial structure, the stress mainly concentrated on the contact between the titanium plate and the slope, the axial vertebral body, and the contact between the screw and the bone surface. The maximum stress originated from the contact between the screw and the titanium plate, indicating that the stress of the occipitocervical internal fixation system was relatively dispersed, which reduced the risk of screw-titanium plate fracture. Figures and Tables | References | Related Articles | Metrics

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Effect of the match between the medial femoral condyle and tibial plateau on the tear of the posterior root of the medial meniscus evaluated by MRI Tu Youwei, Liu Yunpeng, Wang Xingliang, Peng Chao, Yang Jiaji 2022, 26 (12):  1872-1876.  doi: 10.12307/2022.510 Abstract ( 445 )   PDF (1438KB) ( 112 )   Save BACKGROUND: The anatomical parameters of the femoral condyle and tibial plateau affect the biomechanics of the knee joint. The matching of the medial femoral condyle and the medial tibial plateau may affect the magnitude of the annular stress on the medial meniscus, and thus affect the posterior root tear of medial meniscus.  OBJECTIVE: To evaluate the effect of the match between the medial femoral condyle and the tibial plateau on the tear of the posterior root of the medial meniscus. METHODS:  The data of patients who underwent knee MRI examination at the 904 Hospital of the Joint Service Support Force of Chinese PLA due to knee joint pain from January 2016 to January 2020 were retrospectively analyzed. Finally, 52 patients with medial meniscus posterior root tear were selected as observation group; 40 patients without abnormal bone and soft tissue anatomy were selected as control group. The anatomical parameters of the knee joint were measured on MRI: medial femoral condyle anteroposterior diameter, medial tibial plateau anteroposterior diameter, medial femoral condyle transverse diameter, and the transverse diameter of the medial tibial plateau. The lateral diameter ratio of the medial femoral condyle to the medial tibial plateau and the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau were calculated. At the same time, receiver operating characteristic curve analysis was performed to determine the critical value of risk factors for posterior root tear of the medial meniscus.   RESULTS AND CONCLUSION: (1) The medial femoral condyle transverse diameter and medial femoral condyle anteroposterior diameter were greater in the observation group than those in the control group (P < 0.05). The lateral diameter ratio of the medial femoral condyle to the medial tibial plateau and the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau were greater in the observation group than those in the control group (P < 0.05). There were no significant differences in the transverse diameter of the medial tibial plateau and medial tibial plateau anteroposterior diameter between the two groups (P > 0.05). (2) Receiver operating characteristic curves demonstrated that the best cut-off value of the transverse diameter ratio of the medial femoral condyle to the medial tibial plateau was 0.85, the sensitivity was 57.69%, and the specificity was 97.50%; area under the curve was 0.815. The best cut-off value of the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau was 1.29, and the sensitivity was 61.54%; the specificity was 95.00%; area under the curve was 0.710. (3) These findings suggest that the lateral diameter ratio of the medial femoral condyle to the medial tibial plateau greater than 0.85 and the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau greater than 1.29 may be an important risk factor for the occurrence of posterior root tear of the medial meniscus. The method of measuring the lateral diameter ratio and the anteroposterior diameter ratio of the medial condyle to the plateau in coronal and sagittal MRI views of knee joint has a high sensitivity and detection rate for the diagnosis of posterior root tears of the medial meniscus.  Figures and Tables | References | Related Articles | Metrics

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Visual analysis of patellofemoral pain syndrome research hotspots and content Xu Jie, Zhou Wenqi, Luo Xiaobing 2022, 26 (12):  1877-1887.  doi: 10.12307/2022.511 Abstract ( 564 )   PDF (5188KB) ( 162 )   Save BACKGROUND: Patellofemoral pain syndrome is a common disease in the field of sports injuries. Research in and outside China is increasing year by year, but there is no visual analysis for patellofemoral pain syndrome.   OBJECTIVE: To objectively analyze the literature research on patellofemoral pain syndrome in and outside China in the past 13 years, to summarize the recent research directions in this field and to sort out the knowledge structure in and outside China. METHODS:  Relevant articles on patellofemoral pain syndrome were collected from Web of Science and CNKI. Citespace software was used for visual analysis to show the research hotspots and development trends of this field.   RESULTS AND CONCLUSION: (1) A total of 1 679 articles were finally included in the Web of Science database. The authors with the most articles are De Oliveira Silva D from La Trobe University in Melbourne, Australia and Crossley KM from the University of Melbourne, Australia. Hot keywords are hip, biomechanics, prevention (prognosis), prevalence disease rate, consensus statement, gender differences, electromyographic activity, risk factor, and osteoarthritis. (2) A total of 214 articles were included and analyzed in the CNKI database. The author with the most articles is Miao Ping from the Rehabilitation Department of the Second Affiliated Hospital of Guangzhou Medical University. Hot keywords are arthroscopy, biomechanics, strength training, lateral femoral muscle, surface electromyography, patellofemoral arthritis, and joint replacement. (3) International research hotspots show the biomechanical characteristics of increased knee external rotation, increased hip adduction, and decreased hip internal rotation during patient exercise. Strengthening the hip abductors and external rotators can effectively improve the pain and function of patients. At present, the most appropriate method to treat the disease in the world is a customized multi-modal intervention program, including strengthening of the gluteal muscles and quadriceps, emphasizing education and activity adjustment. (4) The results of major Chinese studies in this field confirm that the use of arthroscopic surgery can improve the pain of patients with patellofemoral pain syndrome, and patellofemoral joint replacement has a certain effect on early severe patellofemoral arthritis in such patients. Rehabilitation training methods are mainly based on hip joint strength training, supplemented by core muscles, lower limb eccentric strength and neuromuscular control training. Compared with foreign countries, the unique research hotspots in China are acupuncture and Chinese medicine. Figures and Tables | References | Related Articles | Metrics

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Inhibition of the proliferation and osteogenic differentiation of MC3T3-E1 cells by targeting prostaglandin-endoperoxide synthase 2 Luo Mingran, Fan Wenhao, Li Xin, Zhou Peng, Wu Zerui, Yuan Feng 2022, 26 (12):  1888-1893.  doi: 10.12307/2022.512 Abstract ( 415 )   PDF (6624KB) ( 60 )   Save BACKGROUND: Osteoporosis can be attributed to an imbalance between osteoblastic bone formation and osteoclastic bone resorption. Osteoblasts are the basis of bone formation and are essential for bone growth and maintenance. Disorders of osteoblast function can lead to dysplasia of bone growth and osteoporosis. However, the key genes involved in osteoblast differentiation are still unknown.   OBJECTIVE: Bioinformatics was used to identify key genes and upstream miRNAs during osteogenic differentiation of MC3T3-E1 cells and verify their effects on osteogenic differentiation and proliferation of MC3T3-E1 cells. METHODS:  The osteogenic induction data of gene expression profile GSE46400 were downloaded from the Gene Expression Omnibus. Differentially expressed genes for osteogenesis differentiation were obtained with limma package. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of differentially expressed genes were analyzed using DAVID database. The STRING website was used to establish a protein-protein interaction network and CytoHubba plug-in was used to screen the key modules in the network to identify the key genes. MC3T3-E1 cells were cultured and transfected with siRNA and miRNA, separately. The change of prostaglandin-endoperoxide synthase 2 (Ptgs2) and ossification-related gene level was detected by real-time quantitative PCR 72 hours after transfection. The change of PTGS2 protein level was detected by western blot assay 72 hours after transfection. Alkaline phosphatase was quantified 14 days after transfection. Alizarin red staining and quantitative detection were performed 21 days after transfection.   RESULTS AND CONCLUSION: (1) 229 differentially expressed genes were screened, of which 114 were up-regulated and 115 were down-regulated. Five genes enriched in the biological process of bone mineralization, including Mmp13, Ibsp, Gpnmb, Ptgs2 and Aspn, were highly expressed. Furthermore, CytoHubba was used to identify that only Ptgs2 was involved in the biological process of bone mineralization, and Ptgs2 was defined as a key gene in the process of osteogenic differentiation. (2) The upstream miRNA of Ptgs2 was predicted by Targetscan, and it was found that mmu-miR-107-3p could regulate Ptgs2 in a targeted way. (3) Knockdown Ptgs2 in MC3T3-e1 cells significantly inhibited cell proliferation and osteogenic differentiation (P < 0.05). After transfection of mmu-miR-107-3p, cell proliferation and osteogenic differentiation were also inhibited. (4) Dual luciferase reporter gene results showed that mmu-miR-107-3p could directly inhibit the transcription of Ptgs2 (P < 0.05). (5) mmu-miR-107-3p can inhibit the proliferation and osteogenic differentiation of MC3T3-E1 cells by targeting Ptgs2. Ptgs2 may be a key gene in the osteogenic differentiation of MC3T3-E1 cells. Figures and Tables | References | Related Articles | Metrics

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Relationship between matrix metalloproteinase-3 gene polymorphism and genetic susceptibility to knee osteoarthritis Guo Wen, Gao Binli, Yang Yong, Wang Jianhua, Li Jiaqi, Wen Shuzheng 2022, 26 (12):  1894-1898.  doi: 10.12307/2022.513 Abstract ( 476 )   PDF (1297KB) ( 34 )   Save BACKGROUND: Although great progress has been made in the etiology, development and treatment of knee osteoarthritis in recent years, its specific etiology and pathogenesis are still unclear. Among the pathogenic factors of knee osteoarthritis, genetic factors account for about 40%-60%, which are closely related to the incidence of knee osteoarthritis. OBJECTIVE: To investigate the relationship between matrix metalloproteinase-3 gene polymorphism and onset of knee osteoarthritis in Han population in north China. METHODS: We recruited 100 male patients with knee osteoarthritis and 197 healthy men admitted at the Affiliated Hospital of Inner Mongolia Medical University between October 2018 and October 2020. All the subjects were from the Han group. We used commercial kits to extract the blood genomic DNAs. Eight single nucleotide polymorphisms of matrix metalloproteinase-3 gene, including rs639752, rs650108, rs520540, rs646910, rs602128, rs679620, rs678815, and rs522616, were genotyped by using the Sequenom MassARRAY RS1000 platform. Unconditional Logistic regression analysis was used to calculate the correlation between single nucleotide polymorphisms and knee osteoarthritis under five genetic models (codominant, dominant, recessive, overdominant and additive models). RESULTS AND CONCLUSION: (1)In the Pearson chi-square test, all loci had no correlation with the risk of knee osteoarthritis under the allelic model. (2)Through the association analysis, we identified that four single nucleotide polymorphisms (rs639752, rs520540, rs602128, and rs679620) in the matrix metalloproteinase-3 gene in the dominant and over-dominant models were associated with the increased risk of knee osteoarthritis. (3)Our study preliminarily revealed that four single nucleotide polymorphisms (rs639752, rs520540, rs602128, and rs679620) in the matrix metalloproteinase-3 gene can increase the incidence of knee osteoarthritis in men of Han ethnics in north China. However, the results we identified here need to be confirmed in further large-scale studies. Figures and Tables | References | Related Articles | Metrics

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Exploring effective components of Guyuling capsule in the treatment of osteoporosis based on bioinformatics analysis Tang Yeling, Liang Pengchen, Shi Junfeng, Sun Miaomiao, Zhou Ziyan, Zhu Lisha, Li Tian, Liang Dongyu, Sha Shuang, Yi Qingqing, Chang Qing 2022, 26 (12):  1899-1906.  doi: 10.12307/2022.514 Abstract ( 783 )   PDF (1989KB) ( 120 )   Save BACKGROUND: Clinical studies have shown that Guyuling capsule is effective in the treatment of osteoporosis, but the mechanism is not clear.   OBJECTIVE: To screen out the active components acting on osteoporosis-related target proteins in Guyuling capsule by molecular docking technique in bioinformatics. METHODS:  The chemical components of Guyuling capsule were screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database (TCMSP) and traditional Chinese medicine comprehensive database (TCMID). The screening conditions were bioavailability ≥ 20% and drug likeness ≥ 0.18. The target protein library related to osteoporosis was constructed according to the literature and database. Drug absorption, distribution, metabolism, excretion and toxicity (ADMET) prediction and molecular docking were carried out by Discovery Studio 2016 software.   RESULTS AND CONCLUSION: (1)In total 130 potential active components with good bioavailability of Guyuling capsule were screened and downloaded from traditional Chinese medicine database. Sixty-three active components with good absorption and low toxicity were screened by ADMET prediction function of Discovery Studio 2016, such as L-α-glycerol palmitate, sesamin and so on. (2)By consulting the literature and database, 17 membrane protein receptors were selected, such as extracellular signal-regulated kinase 1/2, protein kinase, and glycogen synthase kinase-3, which are definitely related to osteoporosis. It is mainly related to mitogen-activated protein kinase signal pathway and bone morphogenetic protein signal pathway, which may promote bone formation by regulating the growth and differentiation of mesenchymal stem cells. (3)The results of molecular docking showed high docking scores between Su-dihydrodehydropineol, (23E)-20, 25-dihydrodama-23-en-3-one, L-α-glycerol palmitate, sesamin, (24S)-20, 24-epoxy-25-hydroxydama resin-3-one and extracellular signal-regulated kinase 1/2, protein kinase, glycogen synthase kinase-3 and other membrane proteins. Osteoporosis may be treated by mainly regulating mitogen-activated protein kinase signaling pathway. (4)The above results confirm that the active components of Guyuling capsule, such as Su-type-dihydrodehydropineol, (23E)-20, 25-dihydroxydama-23-en-3-one, L-α-glycerol palmitate, sesamin, (24S)-20, 24-epoxy-25-hydroxydama resin-3-one, may bind to membrane proteins such as extracellular signal-regulated kinase 1/2, protein kinase and glycogen synthase kinase-3 beta to regulate mitogen-activated protein kinase, bone morphogenetic protein, Wnt, estrogen receptor and other signal pathways, and then play the therapeutic efficacy on osteoporosis, thereby providing big data analysis basis and ideas for further experimental research. Figures and Tables | References | Related Articles | Metrics

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Screening of differentially expressed genes in osteoarthritis by gene chip technique and verification using quantitative real-time PCR Chen Cai, Zeng Ping, Liu Jinfu, Qian Xiaofen, Lu Guanyu, Xiong Bo, Chen Lihua, Huang Yue 2022, 26 (12):  1907-1914.  doi: 10.12307/2022.515 Abstract ( 457 )   PDF (4260KB) ( 112 )   Save BACKGROUND: The incidence of osteoarthritis is increasing as the population ages, and there is still no effective treatment. Gene chip technology has been widely used in the diagnosis and treatment of diseases. OBJECTIVE: To identify the key genes in osteoarthritis by using integrative bioinformatics and weighted gene co-expression network analysis (WGCNA) and to investigate its mechanism.  METHODS: Four original data sets of synovial tissue chips in osteoarthritis patients were downloaded from Gene Expression Omnibus database, and the immune infiltration was analyzed by CIBERSORT algorithm. Differentially expressed genes were screened by R-language software. Gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the selected differentially expressed genes. The text files of these differentially expressed genes were obtained through the online tool STRING (http://string-db.org/) and were imported into the Cytoscape software to edit the visual protein-protein interaction network. R-language software was used to build a bar chart of differentially expressed genes to obtain the top 10 differentially expressed genes in degree values. The four chip data sets were integrated to screen out the genes with the highest correlation of gene co-expression module by WGCNA algorithm, and the intersection genes were screened by Venn analysis method. The synovial tissues of four patients with osteoarthritis and four patients with joint trauma were collected for quantitative real-time PCR verification.   RESULTS AND CONCLUSION: (1)A total of 107 differentially expressed genes were screened out, including 46 up-regulated genes and 61 down-regulated genes. (2)The gene ontology enrichment results showed that differentially expressed genes were mainly involved in biological processes such as positive regulation of ossification and cell adhesion. KEGG pathways were mainly enriched in rheumatoid arthritis pathways, nuclear factor-κB signaling pathways, and receptor protein tyrosine kinase B signaling pathways. Immune infiltration results indicated that the contents of M0 macrophages and M2 macrophages were relatively high in the synovial tissue of patients with osteoarthritis. (3)The obtained intersection genes included matrix metalloproteinase 1, tissue inhibitor of metalloproteinase 4, laminin subunit alpha 3, and follistatin 3. The results of quantitative real-time PCR confirmed that there were significant differences in the expression levels of tissue inhibitor of metalloproteinase 4, laminin subunit alpha 3, and follistatin 3 between the synovial tissue samples from patients with osteoarthritis and those with joint trauma. (4)Therefore, tissue inhibitor of metalloproteinase 4, laminin subunit alpha 3, and follistatin 3 may be therapeutic targets for osteoarthritis. Figures and Tables | References | Related Articles | Metrics

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Sensitivity and specificity of ultrasound in the assessment of posterior ligament complex injury in thoracolumbar fracture Zhao Yuhui, Gao Yue, Xie Yanchun, Gu Hongwen, Li Linyang, Yu Hailong 2022, 26 (12):  1915-1921.  doi: 10.12307/2022.516 Abstract ( 432 )   PDF (2890KB) ( 41 )   Save BACKGROUND: The injury of posterior ligament complex in thoracolumbar fracture is the main consideration in surgical decision. However, X-ray examination and CT examination are often unable to make a definite diagnosis. When MRI examination is not available, the injury of posterior ligament complex cannot be evaluated, and the treatment plan cannot be made further.   OBJECTIVE: To explore the sensitivity and specificity of ultrasonography in the diagnosis of posterior ligament complex injury in thoracolumbar fracture. METHODS:  Totally 45 patients with thoracolumbar fractures treated in the General Hospital of Northern Theater Command from June 2019 to January 2021 were selected. The posterior ligament complexes of 40 patients who met the inclusion criteria were examined by ultrasound and MRI. According to the specific conditions during the operation, the sensitivity and specificity of the two methods in the diagnosis of posterior ligament complex injury of thoracolumbar fracture were compared and evaluated separately.   RESULTS AND CONCLUSION: (1) Totally 23 cases of posterior ligament complex injury and 17 cases of intact thoracolumbar fracture were found during operation. (2) Ultrasonography exhibited 19 cases of posterior ligament complex injury and 21 cases of intact thoracolumbar fracture. Kappa value was 0.801. The sensitivity was 83% (19/23). The specificity was 100% (17/17). The accuracy was 90% (36/40). (3) MRI results displayed 21 cases of posterior ligament complex injury and 19 cases of intact thoracolumbar fracture. Kappa value was 0.899. The sensitivity was 91% (21/ 23). The specificity was 100% (17/17). The accuracy was 95% (38/40). (4) Four cases were false negative in ultrasonography. The reasons were as follows: two patients with body mass index greater than 32 kg/m2, one patient with visual analogue scale score more than 8, and one patient with skin abrasion in the corresponding fracture segment. (5) It is indicated that ultrasound and MRI have their own advantages in the diagnosis of posterior ligament complex injury in thoracolumbar fracture. MRI is the first choice for the diagnosis of posterior ligament complex injury, and its advantage is far greater than that of ultrasound. However, ultrasonic examination has the advantages of safety, practicability, reliability and portability, and has high diagnostic value. Figures and Tables | References | Related Articles | Metrics

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Application of knee joint motion analysis in machanism based on three-dimensional image registration and coordinate transformation Wang Jianping, Zhang Xiaohui, Yu Jinwei, Wei Shaoliang, Zhang Xinmin, Xu Xingxin, Qu Haijun 2022, 26 (12):  1922-1926.  doi: 10.12307/2022.517 Abstract ( 428 )   PDF (1578KB) ( 94 )   Save BACKGROUND: Research on movement process, data, and mechanism of the knee joint is helpful to design and modify a knee joint prosthesis, and improve the knee joint movement function according to its movement characteristics and biomechanical characteristics, so as to avoid sports injuries, improve sports performance and prolong sports life. The movement data of the knee joint are the basis for studying its mechanical properties.   OBJECTIVE: According to the three-dimensional geometric model of the knee joint, to determine the movement data of the tibiofemoral joint and the patellofemoral joint at different flexion angles, thereby providing a new approach and reference for the kinematic analysis of complex spatial mechanisms such as robots and for the mechanical analysis and design of artificial prostheses. METHODS: First, the three-dimensional point cloud of the knee joint at 0°-120° static knee flexion was captured using computed tomography. Secondly, the combination of three-dimensional image registration and coordinate transformation was proposed to accurately analyze the relative motion of the knee joint. Three-dimensional images of the knee joint (including the femur, tibia, patella) in different flexion positions and their coordinates were presented in the same coordinate system. The orthogonal coordinate system of each bone tissue of the knee joint was then established. The movement of the knee joint was studied based on coordinate transformation using the Z-Y-X Euler angle method around the motion coordinate system.   RESULTS AND CONCLUSION: (1)The motion data of the tibiofemoral and patellofemoral joints with 0°-120° of knee flexion were obtained in the five degrees of freedom, which offers a support for studying the mechanical properties of the knee joint and prosthetic design. This method could be used for the motion analysis of kinematics pairs under complex kinematics in mechanism. (2)To conclude, this method is proposed based on multi-static discrete medical images for kinematic measurement and analysis in human body. It can be conducted based on existing computed tomography scanning equipment and existing software, which has low cost and is easily understood. Moreover, this method is characterized by high measurement accuracy and the accuracy error is less than 1 mm. Figures and Tables | References | Related Articles | Metrics

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Biological changes and mechanism of salvianolic acid B in ovariectomized osteoporosis rat models Wang Dong, Ding Hai, Chang Wenju, Wang Jinzi 2022, 26 (12):  1927-1930.  doi: 10.12307/2022.518 Abstract ( 447 )   PDF (1308KB) ( 86 )   Save BACKGROUND: The anti-osteoporotic mechanism of salvianolic acid B is different from traditional anti-bone resorption drugs. It has a multi-target pharmacological effect, which has not yet been fully elucidated.   OBJECTIVE: To study the effect of salvianolic acid B on bone density of femur and lumbar vertebra in rats with osteoporosis, and to explore its anti-osteoporotic mechanism. METHODS:  Totally 36 SPF SD rats aged 6 months were randomly divided into three groups: sham operation group, osteoporosis group, and salvianolic acid B group. Bilateral ovaries were removed and the osteoporosis model was replicated in the osteoporosis group and salvianolic acid B group. In the sham operation group, intact ovaries were kept and part of adipose tissue was removed. At 4 weeks after surgery, 50% salvianolic acid B 25 mg/kg was given by gavage for 6 days per week for 12 consecutive weeks in the salvianolic acid B group. In the other two groups, the same amount of normal saline was given for the same time. At 16 weeks postoperatively, all the rats were sacrificed after anesthesia. The bone density of the right posterior femur and lumbar vertebra was scanned by dual-energy X-ray absorptiometry. The levels of osteoprotegerin and receptor activator of nuclear factor-kB ligand in serum were detected by enzyme-linked immunosorbent assay. The protocols were approved by the Animal Management Committee of Bengbu Medical College (approval No. [2021]255).   RESULTS AND CONCLUSION: (1) The bone mineral density of femur in the osteoporosis group was lower than that in the sham group (P < 0.05). The femoral bone mineral density of salvianolic acid B group was significantly higher than that of osteoporosis group (P > 0.05). The bone mineral density of lumbar vertebrae in osteoporosis group was not significantly different from that in sham operation group (P > 0.05). The lumbar vertebrae bone density of salvianic acid B group was higher than that of osteoporosis group, but the difference was not significant (P > 0.05). (2) Osteoprotegerin level of osteoporosis group was lower than that of sham operation group (P < 0.05). Osteoprotegerin level of salvianolic acid B group was higher than that of osteoporosis group, but the difference was not significant (P > 0.05). The level of receptor activator of nuclear factor-kB ligand of osteoporosis group was significantly higher than that of sham operation group (P < 0.05). The level of receptor activator of nuclear factor-kB ligand of salvianolic acid B group was lower than that of osteoporosis group, but the difference was not significant (P > 0.05). (3) These findings suggest that in the early stage of postmenopausal osteoporosis, bone mineral density of femur decreased significantly, but there was no significant change in bone mineral density of the lumbar spine. At present, it is not believed that salvianolic acid B alone can effectively treat osteoporosis in the short term. Figures and Tables | References | Related Articles | Metrics

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Advantages of micro CT in three-dimensional reconstruction of specimens and its application in animal models of osteoarthritis Du Longlong, Yuan Puwei, Yang Wei, Li Xuefeng, Gao Qimeng 2022, 26 (12):  1931-1936.  doi: 10.12307/2022.519 Abstract ( 560 )   PDF (1265KB) ( 75 )   Save BACKGROUND: There are many factors in the pathological process of osteoarthritis, including synovial inflammation, cartilage loss, subchondral bone damage, bone hyperplasia and so on. The specific mechanism is not yet clear. Micro CT is a non-destructive imaging tool, which can form high-resolution 3D images of samples, and realize the research of related structures and functions of bone and cartilage, quantitative evaluation of disease progression and treatment, and contrast-enhanced soft tissue imaging. Micro CT scanning of osteoarthritis animal model can clarify the pathological changes of joints, articular cartilage, subchondral bone, synovium, blood vessels and other tissues in the course of osteoarthritis, which is conducive to the study of the pathological progress of osteoarthritis. OBJECTIVE: To summarize the imaging methods and research prospects of micro CT in joints, cartilage, subchondral bone, synovium and intraosseous vessels of osteoarthritis animal model, so as to provide a new method for the study of the pathological mechanism of osteoarthritis. METHODS: By searching the databases of CNKI, Web of Science, Embase, PubMed and Wanfang, the Chinese and English keywords were “osteoarthritis, micro CT, pathology”. The qualified articles with strong correlation and relatively new publication years were selected for review.  RESULTS AND CONCLUSION: (1) Micro CT has good imaging performance in joints, cartilage, subchondral bone, and intraosseous vessels. The imaging method is mature, which changes the shortcomings of traditional pathological sections on destroying tissue integrity and cumbersome steps. (2) Micro CT has not been reported in the literature on the imaging of synovium, but it has a good performance in the imaging of soft tissues, such as fat and tumor. The imaging of synovium has a research prospect in the future. (3) Micro CT can carry out three-dimensional reconstruction of specimens, break through the limitations of conventional two-dimensional pathological sections, and provide a new model for the study of the pathological mechanism of osteoarthritis. Figures and Tables | References | Related Articles | Metrics

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The role of extracellular matrix in the occurrence and development of osteoarthritis and its clinical research value Liao Jianzhao, Xia Tian 2022, 26 (12):  1937-1943.  doi: 10.12307/2022.520 Abstract ( 454 )   PDF (2619KB) ( 47 )   Save BACKGROUND: The imbalance of extracellular matrix metabolism affects the structure support and intercellular signal transduction, cell proliferation, differentiation and migration, which plays an important role in the occurrence and development of osteoarthritis. OBJECTIVE: To elucidate the role of extracellular matrix in the occurrence and development of osteoarthritis, and review its application prospects in the diagnosis and treatment of osteoarthritis. METHODS: WanFang, CNKI, PubMed and MEDLINE databases were retrieved respectively with the keywords of “osteoarthritis, cartilage, cartilage cells, extracellular matrix, treatment, signaling pathway, biomarkers, tissue engineering” in Chinese and English, respectively. Articles regarding the role of extracellular matrix in the occurrence and development of osteoarthritis published from 2014 to 2021 were included.  RESULTS AND CONCLUSION: (1)As an important component of articular cartilage, the extracellular matrix provides nutrients to chondrocytes, and forms a complex three-dimensional structure with protective effect and suitable for the growth of chondrocytes. (2)The extracellular matrix is a place for chondrocytes to exchange information with the environment, to feel and respond to external stimuli, and thereby to regulate the proliferation, apoptosis and other behaviors. (3)Extracellular matrix also contains a large number of biomarkers, such as type II collagen carboxy-terminal peptide, type II collagen α1 and matrix metalloproteinase, which can be used for auxiliary diagnosis and differential diagnosis of a variety of diseases including osteoarthritis. (4)In terms of treatment, tissue engineering strategies based on the extracellular matrix have been widely used in a variety of tissue regeneration studies and play an important role in cartilage tissue engineering, such as simple acellular extracellular matrix scaffolds, extracellular matrix scaffolds loaded with stem cells or specific drugs to induce cell behaviors, and composite scaffolds with bionic natural extracellular matrix structure and biological functions. (5)In conclusion, cartilage extracellular matrix has broad research and application prospects in the occurrence, development, diagnosis and treatment of osteoarthritis. However, there are few studies related to cartilage extracellular matrix changes and the occurrence and development of osteoarthritis, and there are much fewer studies related to clinical application. However, how to make full use of the physicochemical properties of extracellular matrix and give full play to the functions of each component in the diagnosis, prevention and treatment of diseases still needs more in-depth research, in order to achieve more accurate diagnosis and staging of osteoarthritis, and provide better treatment means. Figures and Tables | References | Related Articles | Metrics

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Cell sheet technology applied in bone tissue engineering Tan Xianyu, Liao Wenbo 2022, 26 (12):  1944-1949.  doi: 10.12307/2022.521 Abstract ( 458 )   PDF (1057KB) ( 90 )   Save BACKGROUND: Cell sheet technology has broad application prospects in tissue regeneration and repair. What is more, it also has an important role and application value in the field of bone tissue engineering. OBJECTIVE: To review the application and existing problems of cell sheet technology in bone tissue engineering. METHODS: CNKI, PubMed, and Elsevier were searched for relevant articles regarding the application of cell sheet technology in bone tissue engineering published from January 2000 to July 2021. The key words were “cell sheet technology, cell sheet, bone, bone defect, bone repair, tissue engineering, bone tissue engineering” in Chinese and English, respectively. The article types were review, basic and clinical studies.  RESULTS AND CONCLUSION: Cell sheet technology is a new technology for obtaining seed cells, which not only acquires the desired seed cells, but also retains the abundant extracellular matrices and cell-cell connections. Therefore, it has broad application prospects in tissue regeneration and repair. The current technologies for cell sheet preparation mainly include: temperature response systems, mechanical systems, magnetic response systems, light response systems, and pH systems. Various technologies have their own advantages and disadvantages in the preparation of cell sheets. Among them, temperature response systems and magnetic response systems are currently widely used. There are many types of cell sheets, which can be divided into different types of cell sheets according to different cell sources. It can also be divided into single-layer cell sheet, double-layer cell sheet, and multi-layer cell sheet according to the number of sheet layers. In terms of bone tissue engineering, the cell sheet technology can be used alone or combined with various other scaffolds to enhance its mechanical strength in the repair of bone defects. In addition, adding growth factors or small molecular substances into cell sheets provides new ideas for the application of cell sheets. Figures and Tables | References | Related Articles | Metrics

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Role of TRPV5 and TRPV6 calcium channels in bone metabolism Li Chao, Zhang Xian, Shao Jiahao 2022, 26 (12):  1950-1955.  doi: 10.12307/2022.522 Abstract ( 531 )   PDF (1372KB) ( 35 )   Save BACKGROUND: Transient receptor potential (TRP) channels constitute a large and diverse family of cationic channels, which act as cellular sensors to respond to a large number of physical and chemical stimuli in and out of the body. Calcium is an important part of bone tissue, and calcium-related regulatory factors can play a role in bone formation and resorption through changes in Ca2+ concentration. The bone metabolism in the development of osteoporosis is to a large extent the metabolism process of calcium ions, and TRPV5/6 is an important channel of trans-cellular calcium ion transport. The TRP family is highly permeable to Ca2+, so there is a close relationship between epithelial calcium channels and bone metabolism. OBJECTIVE: To review the relationship between bone metabolism and calcium, the characteristics and physiological functions of Ca2+ channels TRPV5/6, and the relationship between Ca2+ channels TRPV5/6 and bone metabolism in the process of osteoporosis, which will provide more sufficient evidence for the research on the specific mechanism of anti-osteoporosis in Chinese medicine. METHODS: The first author searched PubMed, CNKI, and WanFang databases for the literatures related to calcium channel TRPV5/6 and bone metabolism published from January 2000 to April 2021 using the keywords of “calcium channel, TRPV5, TRPV6, bone metabolism, traditional Chinese medicine” in English and Chinese, respectively. Finally, 58 articles were retained for review.  RESULTS AND CONCLUSION: (1)The balance of osteoclasts and osteoblasts plays an important role in normal bone metabolism. The highly expressed calcium channels TRPV5/6 in human epithelial tissue play a very important role in calcium metabolism throughout the body. (2)The Ca2+ channels TRPV5/6 were highly selective and permeable to Ca2+, and played an effect on bone metabolism after phosphorylation, glycosylation, ubiquitination and other translational modifications. They then exert an effect on osteoclasts or osteoblasts, thereby inhibiting osteoclasts, increasing calcium absorption, and promoting osteogenic effects. (3)The anti-osteoporosis effect of traditional Chinese medicine may be to further improve the activity of TRPV5/6 by increasing the expression of TRPV5/6 in the intestines or kidneys in vivo or increasing the opening amount of TRPV5/6 channels, so as to inhibit the bone resorption of osteoclasts and promote the bone formation of osteoblasts, eventually preventing and treating osteoporosis. Figures and Tables | References | Related Articles | Metrics

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Glutathione peroxidase 4 regulates neuronal ferroptosis after spinal cord injury Duan Zhaoyuan, Wu Mingli, Luo Meng, Gao Jing, Li Ruiqing, Feng Xiaodong 2022, 26 (12):  1956-1962.  doi: 10.12307/2022.523 Abstract ( 909 )   PDF (1278KB) ( 80 )   Save BACKGROUND: Ferroptosis, a form of iron ion-dependent cell death characterized by lipid peroxidation, is closely related to the pathophysiological process of spinal cord injury. Glutathione peroxidase 4 is an important regulator of ferroptosis and plays a key role in the regulation of neuronal ferroptosis after spinal cord injury. OBJECTIVE: To review the research progress in the regulatory role of glutathione peroxidase 4 in neuronal ferroptosis after spinal cord injury, to summarize the effect of glutathione peroxidase 4 in the occurrence and development of spinal cord injury and its application prospects as an inhibitor, and to explore new therapeutic strategies for spinal cord injury, providing a theoretical basis for targeting ferroptosis in the treatment of spinal cord injury. METHODS: Databases of PubMed, CNKI, Web of Science and WanFang were searched for relevant literature. The search terms “ferroptosis,” “GPx4,” and “spinal cord injury” were refined using Mesh, and then the search was conducted by subject terms (title/abstract). The search terms were “GPx4, glutathione peroxidase 4, ferroptosis, spinal cord injury, SCI, spinal cord trauma” in English and  “glutathione peroxidase 4, ferroptosis, spinal cord injury” in Chinese. The search period was from the inception of the database to July 2021, and finally 74 papers were included for review.  RESULTS AND CONCLUSION: (1)Ferroptosis, as a newly identified mode of cell death, has been shown to be involved in the pathophysiological process of spinal cord injury, and glutathione peroxidase 4 is considered to be an important regulator of ferroptosis and plays a key role in spinal cord injury. (2)Studies have shown that various inhibitors and drugs can inhibit lipid peroxidation and regulate neuronal ferroptosis after spinal cord injury by restoring glutathione peroxidase 4 activity. Efficay in improving neurological impairment has been shown in several basic studies, but  limitations still exist in clinical trials. (3)Therefore, treatment of spinal cord injury by targeting ferroptosis may be a direction that can be further explored in future studies. Figures and Tables | References | Related Articles | Metrics

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A systematic review of children’s foot type classification methods Tang Yunqi, Zou Lingqiu, Li Yi, Wang Zhikang, Hui Xue, Li Lingjun, Guo Xinyu 2022, 26 (12):  1963-1968.  doi: 10.12307/2022.524 Abstract ( 640 )   PDF (5388KB) ( 64 )   Save OBJECTIVE: The development of abnormal foot will bring adverse effects on the growth and life of children. The early diagnosis of abnormal foot in children is conducive to the timely correction of children’s foot. Here, we review the classification methods of children’s foot types in order to provide valuable references for clinicians in the study of prevention and correction strategies of children’s abnormal foot types.  METHODS: WanFang, VIP, CNKI, the Web of Science, and PubMed were searched for related literatures on the classification of children’s foot, and the methods for the classification of children’s foot types were summarized and systematically reviewed.  RESULTS: (1)A total of 12 articles were finally included. The classification of children’s foot types can be divided into four methods: footprint index, radiological assessment, clinical examination, and anthropometric examination. (2)Each classification method has its own advantages and disadvantages. The footprint method is simple and quick, but the measurement results are one-sided. Radiological assessment method has potential radiation risk, high cost and complicated process. Although clinical examination method is quick and has low cost, it has strong subjectivity. Anthropometric tests are more accurate, but very time-consuming. (3)In the previous studies, the economical and fast foot printing method was selected as the classification method of children’s foot type, and a combination of multiple indicators was also used in some studies to improve the accuracy of children’s foot type classification. (4)The combination of multiple indicators is currently considered to be a accurate classification method.  CONCLUSION: Most of foot type classification methods, which only display the structural characteristics of children’s feet in static state, lack gold standards. Future research needs to establish the relationship between static foot structure and dynamic foot function in order to achieve more accurate and scientific results in the classification of children’ foot types, thereby offering a good strategy for the healthy growth and development of children’s foot until the age of epiphyseal closure. Figures and Tables | References | Related Articles | Metrics