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    18 May 2024, Volume 28 Issue 14 Previous Issue    Next Issue
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    Biomechanical characteristics of orthodontic tooth movement before and after increasing alveolar bone mass with periodontally accelerated osteogenic orthodontics
    Zhao Hexiang, Chen Ziyan, Wang Jing, Ge Zhenlin
    2024, 28 (14):  2133-2139.  doi: 10.12307/2024.233
    Abstract ( 262 )   PDF (1970KB) ( 22 )   Save
    BACKGROUND: There is an increasing demand for orthodontic treatment, and periodontally accelerated osteogenic orthodontics (PAOO) technique can make it possible to move orthodontic teeth that are limited by thin alveolar bone.
    OBJECTIVE: To investigate the biomechanics of orthodontic tooth movement before and after periodontally accelerated osteogenic orthodontics (PAOO) surgery to increase alveolar bone volume using the three-dimensional finite element method. 
    METHODS: A patient undergoing PAOO surgery before orthodontic treatment to increase bone volume on the labial side of the mandibular anterior region was selected. The patient was under invisible orthodontics. Two three-dimensional finite element models were constructed based on the patient’s preoperative and 6-month postoperative cone beam CT data. Both models simulated the movement of tooth 33: experiment I: distal-central movement of 0.25 mm; experiment II: lingual movement of 0.25 mm; and experiment III: intrusion movement of 0.10 mm. The stress distribution and initial displacement trend of tooth 33, periodontal ligament and surrounding alveolar bone under the action of the invisible aligner were analyzed before and after the PAOO procedure.
    RESULTS AND CONCLUSION: Dental stress analysis: In the same orthodontic tooth movement, the maximum Von-Mises stress and overall stress values of tooth 33 were all higher before surgery than after surgery; there were similar distribution areas of maximum equivalent stress and overall distribution trends of Von-Mises stress before and after surgery. Periodontal ligament stress analysis: In the same orthodontic tooth movement, the maximum Von-Mises stress and overall stress values of the periodontal ligament were higher before surgery than after surgery, and there were similar distribution areas of the maximum equivalent stress and overall distribution trends of Von-Mises stress before and after surgery. Alveolar bone stress analysis: In the same orthodontic tooth movement, the maximum Von-Mises stress values of the alveolar bone around tooth 33 were higher before surgery than after surgery, while the equivalent stress distribution showed a gradual decrease from the top of the alveolar ridge to the root. Initial displacement analysis: In the same orthodontic tooth movement, the initial displacements in the main displacement direction for all six observation points of tooth 33 were smaller before surgery than after surgery, and showed a tendency to gradually decrease from the tooth tip to the apex. Therefore, there were differences in the biomechanical characteristics of orthodontic tooth movement before and after the PAOO surgery. With the clear aligner, the postoperative equivalent stress values on the dentition, periodontal ligament, and surrounding alveolar bone were lower than before the surgery, and the initial displacements of the orthodontic teeth after the surgery are larger than before. These findings suggest that PAOO can release the restriction of thin alveolar bone on the movement of orthodontic tooth by increasing alveolar bone thickness, effectively improving the force on the roots, periodontal ligament, and alveolar bone, avoiding the stress concentration on orthodontic tooth in the thin alveolar bone area that can cause complications when moving, and improving the efficiency of tooth movement.
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    Fracture risk analysis and prediction of low bone mass tangential points in middle-aged and elderly women with different chronic diseases
    Chang Feng, Li Yanlong
    2024, 28 (14):  2140-2144.  doi: 10.12307/2024.297
    Abstract ( 272 )   PDF (860KB) ( 53 )   Save
    BACKGROUND: Middle-aged and elderly women have a high risk of osteoporosis, and chronic diseases increase the risk of osteoporosis. Low bone mass is a risk stage before the onset of osteoporosis. There are a small amount of relevant reports on the difference of fracture risk and the tangent value of diagnostic indicators in the population with common chronic diseases.
    OBJECTIVE: Through the analysis of fracture risk of middle-aged and elderly women with different chronic diseases, to investigate the correlation between obesity, hypertension, hyperlipemia, diabetes, arteriosclerosis and bone mineral density and identify the cut-off value of low bone mass index, thereby providing reference for the prevention and treatment of osteoporosis. 
    METHODS: A total of 203 cases of female adults aged 45-70 years were divided into normal group and chronic disease group. The calcaneal bone density was measured by using an ultrasonic bone densitometer. Brachial-ankle pulse wave velocity was tested by using an arteriosclerotic instrument. Blood sugar and blood lipid were tested by using an automatic biochemical analyzer. Body mass index, fat mass and muscle mass were measured by using a body composition analyzer. 
    RESULTS AND CONCLUSION: There were significant differences in body mass index and fracture risk coefficient of women aged 61-70 years and bone strength of women aged 51-60 years and 61-70 years compared with those aged < 50 years (P < 0.05). The fracture risk of diabetes group was significantly higher than that of the other groups, while the fracture risk of arteriosclerosis group was significantly higher than that of normal group and obesity group (P < 0.05). Bone mineral density was negatively correlated with age, left vascular elasticity, right vascular elasticity and triglyceride level, but positively correlated with body mass index (P < 0.05). The area under the receiver operating characteristic curve of body mass density and the above indexes was 0.5-0.7, and the corresponding tangents of low body mass density were 55.5 years old (age), 756.0 cm/s (left vascular elasticity), 789.0 cm/s (right vascular elasticity), 1.115 mmol/L (triglyceride level) and 22.35 kg/m2 (body mass index). To conclude, diabetes and arteriosclerosis increase the risk of fracture in middle-aged and elderly women. Body mass index, vascular elasticity and triglyceride level have a certain early diagnostic value in predicting low bone mass in women.
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    Variation in renal function of type 2 diabetic rats undergoing aerobic exercise
    Wu Yuzhen, Sun Qing, Liu Xia, Zhou Yu, Jin Qiguan
    2024, 28 (14):  2145-2151.  doi: 10.12307/2024.322
    Abstract ( 263 )   PDF (1010KB) ( 110 )   Save
    BACKGROUND: Type 2 diabetes is often accompanied by renal dysfunction. Increasing studies have shown that exercise can alleviate metabolic disorders and renal dysfunction in diabetic patients. However, the specific mechanism underlying the renal protective effect of exercise in patients with type 2 diabetes is rarely reported.
    OBJECTIVE: To investigate whether aerobic exercise can improve renal function in type 2 diabetic rats by inhibiting transforming growth factor β1/Notch1 pathway.
    METHODS: Male Sprague-Dawley rats were randomly divided into normal control group and diabetes model group. After successful modeling, they were randomly divided into diabetes control group and diabetes exercise group. Rats in the diabetes exercise group were subjected to an 8-week aerobic exercise. Samples were collected after exercise, and the relevant indexes of glucose and lipid metabolism and renal function were detected by automatic biochemical analyzer and ELISA. The microscopic structure of renal cortex was observed by electron microscope. ELISA and RT-PCR were used to detect the expression of related proteins and genes in rat kidney tissue.
    RESULTS AND CONCLUSION: Compared with the normal control group, fasting blood glucose, total cholesterol, and triglyceride levels and insulin resistance index were significantly increased in the diabetic control group (P < 0.05). Aerobic exercise could significantly reduce fasting blood glucose and triglyceride levels (P < 0.05). Compared with the normal control group, the diabetic control group had significantly increased contents of urinary microalbumin, serum urea nitrogen and serum creatinine (P < 0.01), thickened renal basement membrane, mesangial matrix hyperplasia, accompanied by a certain degree of foot process fusion, and obvious lesion of the kidney . Aerobic exercise could significantly down-regulate the overexpressions of urinary microalbumin, serum urea nitrogen and serum creatinine in type 2 diabetic rats (P < 0.01), and significantly improve the pathological changes of the kidney in diabetic rats. Compared with the normal control group, the protein and gene expression levels of transforming growth factor β1, Notch1, Jagged1 and Hes1 in rat kidney tissue were significantly increased in the diabetic control group (P < 0.01). Aerobic exercise had a highly significant inhibitory effect on the overexpression of transforming growth factor β1, Notch1 and Jagged1 proteins and genes (P < 0.01) and also significantly inhibited the overexpression of Hes1 protein (P < 0.05). In conclusion, aerobic exercise can protect renal function and delay the pathological progression of the kidney in diabetic rats, which may be achieved by inhibiting the overexpression of transforming growth factor β1/Notch1 signaling pathway.
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    Correlation analysis of circular RNAs involved in liver injury in mice with autoimmune hepatitis
    Hou Yiwen, Liu Ying, Li Zhurong, Chen Chen, Li Zhencheng, Liu Yang
    2024, 28 (14):  2152-2158.  doi: 10.12307/2024.271
    Abstract ( 219 )   PDF (1524KB) ( 22 )   Save
    BACKGROUND: The pathogenesis of autoimmune hepatitis has not been clearly elucidated. Circular RNA (CircRNA) is a research hotspot in the field of RNA and is involved in the pathogenesis of many autoimmune diseases. However, the role of CircRNA in autoimmune hepatitis remains unclear.
    OBJECTIVE: To investigate the relationship between CircRNA (CircRNA) and concanavalin A induced liver injury in mice with autoimmune hepatitis.
    METHODS: Bioinformatics analysis was performed on CircRNA profiles selected by previous microarray technology, including gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, so as to explore the potential biological functions of these differentially expressed genes. Twelve C57BL/6 mice were randomized into normal group and model group (n=6 per group). Autoimmune hepatitis model was established by tail vein injection of concanavalin A in the model group. Mice were killed at 12 hours after modeling to extract mouse liver and peripheral blood. The expression levels of CircRNAs were verified by qRT-PCR. Serum alanine aminotransferase and aspartate aminotransferase levels were detected by colorimetric method. The levels of oxidative stress indexes malondialdehyde and nitric oxide in mouse liver were detected by microplate method. The correlation between oxidative stress level and liver injury index was analyzed. 
    RESULTS AND CONCLUSION: The results of GO analysis showed that the target genes with up-regulated CircRNAs expression were mainly involved in the biological processes of SNARE complex assembly regulation (P=0.004), their molecular functions were mainly metal ion binding (P=0.000 29), and the cell components were mainly enriched in CORVET complex (P=0.075). The biological processes involved in the down-regulated circRNAs target genes were mainly “negative regulation of pancreatic secretion” (P=0.000 42), the molecular functions were mainly “transcriptional activator activity” (P=0.025), and the cell components were mainly enriched in “extracellular components” (P=0.006). KEGG results showed that the target genes with up-regulated CircRNAs expression were mainly enriched in the "base excision-repair" signaling pathways (P=0.026). Compared with the normal group, serum alanine aminotransferase and aspartate aminotransferase levels and the levels of malondialdehyde and nitric oxide in mouse liver in the model group were significantly increased (P < 0.01). Compared with the normal group, the expression of two selected CircRNAs (mmu-circ-0001520 and mmu-circ-0001577) was increased in the model group (P < 0.05). Spearman correlation analysis showed that the expression of mmu-circ-0001520 and mmu-circ-0001577 was positively correlated with alanine aminotransferase, aspartate aminotransferase, malondialdehyde and nitric oxide. To conclude, the differential expression of CircRNAs is correlated with liver injury in autoimmune hepatitis mice. mmu-circ-0001520 and mmu-circ-0001577 are expected to be diagnostic biomarkers and therapeutic targets for autoimmune hepatitis.
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    Identification of differences in N6-methyladenosine-related genes in steroid-induced femoral head necrosis
    Yuan Tianyi, Liu Hongjiang, Yang Zengqiang, Lu Xingbao, Maimaitiyibubaji, Zhou Zhiheng, Cui Yong
    2024, 28 (14):  2159-2165.  doi: 10.12307/2024.329
    Abstract ( 223 )   PDF (2512KB) ( 48 )   Save
    BACKGROUND: It is known that N6-methyladenosine (m6A) plays a role in the pathogenesis of various diseases and studies have suggested its involvement in the pathologic changes of steroid-induced femoral head necrosis (SNFH). However, research on m6A methylation modifications in steroid-induced femoral head necrosis is limited.
    OBJECTIVE: Using bioinformatics methods to identify the differential expression of m6A-related genes in steroid-induced femoral head necrosis and to predict miRNAs associated with these genes to further elucidate the role and mechanism of m6A methylation in steroid-induced femoral head necrosis.
    METHODS: Differential gene expression between steroid-induced femoral head necrosis and control groups was analyzed using GSE123568 gene expression data and identified using the “limma” package in R. Functional enrichment analysis was performed on the differentially expressed genes. Differential analysis of the related genes was carried out using the “ggstatsplot” package in R. The differential genes were cross-validated using the GSE74089 dataset. An mRNA-miRNA regulatory network was constructed, and co-expression analysis was performed on the module genes followed by enrichment analysis. Differences in immune cell infiltration between steroid-induced femoral head necrosis and control groups were quantified using the ssGSEA method.
    RESULTS AND CONCLUSION: Correlation analysis revealed 13 m6A-related genes, and further analysis through the protein-protein interaction network identification and receiver operating characteristic curve analysis showed that YTHDF2 was expected to be a core differential gene as a potential early biomarker. Enrichment analysis indicated that differentially expressed genes were mainly involved in inflammation and immune response and were closely related to osteoclasts. Cross-validation analysis showed that differential gene expression results between the two datasets were consistent. mRNA-miRNA regulatory network analysis revealed that YTHDF2 was negatively correlated with miRNA-27a. Immune infiltration analysis revealed an increase in immune cell infiltration in steroid-induced femoral head necrosis, and YTHDF2 was positively correlated with the infiltration of CD4+T cells. To conclude, m6A-related gene YTHDF2 can serve as a potential biomarker of steroid-induced femoral head necrosis and is valuable for the early clinical diagnosis and treatment of steroid-induced femoral head necrosis. The negative correlation between YTHDF2 and mir-27a and the positive correlation between YTHDF2 and CD4+T cell infiltration provide new insights into the early diagnosis and treatment of steroid-induced femoral head necrosis and shed light on the mechanism of m6A in steroid-induced femoral head necrosis.
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    Bioinformatics analysis and validation of differentially expressed genes and small molecule drug prediction in proliferative scar
    Zuo Jun, Ma Shaolin
    2024, 28 (14):  2166-2172.  doi: 10.12307/2024.332
    Abstract ( 271 )   PDF (2144KB) ( 44 )   Save
    BACKGROUND: Hypertrophic scar is a skin fibrosis disease characterized by excessive proliferation of fibroblasts, epidermal thickening, and stratum corneum dysfunction. At present, the pathogenesis of Hypertrophic scar is still unclear. 
    OBJECTIVE: To screen the core (Hub) genes and important signaling pathways in hypertrophic scar-related datasets based on bioinformatics, and then verify them by cell experiments to predict small molecule drugs that may have therapeutic effects on hypertrophic scar. 
    METHODS: Datasets related to hypertrophic scar were searched from Gene Expression Omnibus (GEO) database, and differentially expressed genes were identified by R software analysis. Gene ontology and KEGG enrichment analyses were performed for differentially expressed genes. Protein-protein interaction network of differentially expressed genes was constructed using String online platform. Then, the key genes and core modules in the protein-protein interaction network were screened by Cytohubba and MCODE plugin-in Cytoscape software respectively, and the Hub genes were obtained by the intersection of the above key genes and the genes that formed the core module. Real-time fluorescent quantitative PCR was used to verify the difference in Hub gene mRNA expression between human hypertrophic scar and normal skin epidermal stem cells. The histological data from the Human Protein Atlas were used to verify the differences in the expression and distribution of Hub gene-encoded proteins in the two kinds of human tissues. Finally, the potential drugs for hypertrophic scar were predicted by the connectivity map database. 
    RESULTS AND CONCLUSION: Among the identified differentially expressed genes, 102 genes were up-regulated and 702 genes were down-regulated. Gene ontology and KEGG analysis showed that the enriched signaling pathways and biological processes were mainly involved in tight junction, arachidonic acid metabolism, extracellular matrix receptor interaction, epidermal development and keratinization. Eight Hub genes were found to be closely related to the mevalonate pathway that regulates cholesterol metabolism, including HMGCS1, DHCR7, MSMO1, FDPS, MVK, HMGCR, MVD and ACAT2. Compared with the normal skin group, the mRNA expression of HMGCS1, DHCR7, MSMO1, FDPS, HMGCR, MVD and ACAT2 in the hypertrophic scar group decreased significantly (P < 0.05), while MVK mRNA expression had no significant change (P > 0.05). Except for MVK, the expression levels of other Hub gene-encoded proteins in normal skin tissue were higher than those in hypertrophic scar tissue (P < 0.05). The top 10 candidate drugs included protein kinase A inhibitor (H-89), serine protease inhibitor (Dabigatran-Etexilate), FLT3 inhibitor (sunitinib), among which resveratrol and β-sitosterol are plant extracts. To conclude, Hub genes closely related to mevalonate metabolism may affect the structure and function of the epidermis by regulating lipid metabolism, which may an important pathogenesis of hypertrophic scar. The small-molecule compounds identified in this study can be used as candidate drugs for the treatment of hypertrophic scar.
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    Establishment of an acute radioactive skin injury model induced by 32P-beta ray radiation and the mechanism of injury
    Wu Xiaodan, Wang Zhiguo, Zhan Ying, Zhang Guoxu
    2024, 28 (14):  2173-2179.  doi: 10.12307/2024.303
    Abstract ( 222 )   PDF (2919KB) ( 38 )   Save
    BACKGROUND: The clinical manifestation of acute radiation skin injury is recurrent necrotic ulcers, and its pathogenesis is still not fully understood. The establishment of a suitable animal model will have important clinical implications for the study of its pathogenesis, prevention and treatment. 
    OBJECTIVE: To establish a model of acute β-ray radiation skin injury and to investigate the mechanism of injury.
    METHODS: Sixty-nine Sprague-Dawley rats were randomly divided into 30, 45, 60 Gy 32P-β-ray groups (n=21 per group) and control group (n=6). A single local irradiation of the back of the rats was performed using 32P radionuclide. The control group was operated in the same way as the irradiated groups except that it was not irradiated. The body mass and skin appearance of the rats were measured at 7, 15, 30, 45, and 60 days after irradiation. Three rats from each group were selected at each observation time point. The skin injury was observed by hematoxylin-eosin staining, Masson staining, transmission electron microscopy, and TUNEL assay. P53, Bcl-2 and Bax protein levels in the skin were measured by immunohistochemistry and western blot assay.
    RESULTS AND CONCLUSION: There was no accidental death after irradiation, and the body mass of rats showed a gradual increase. The rats showed different degrees of epidermal necrosis, inflammatory cell infiltration, reduction of hair follicles and appendages, and collagen fibrillation, which were evident at 60 and 45 Gy. The levels of serum inflammatory factors, interleukin-6 and tumor necrosis factor-α, were significantly increased in a dose-dependent manner. Under the electron microscope, there are varying degrees of mitochondrial reduction, vacuolization and nuclear pyknosis in the cells. The degree of cell apoptosis showed a certain dose-dependence. Immunohistochemistry and western blot results showed an increase in the expression of P53 and Bax proteins and a decrease in the expression of Bcl-2 protein in the skin after irradiation. There were significant differences between the 60 Gy group and the 45 Gy and 30 Gy groups (P < 0.05). To conclude, irradiation with 60 Gy and 45 Gy 32P radionuclide on the back of rats could successfully establish a practically pre-clinical animal model, and the mechanism is related to the up-regulation of P53 and Bax and the down-regulation of Bcl-2. This model can provide a reference for the establishment of animal models for the study of the mechanism of radiation skin injury and its prevention and treatment.
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    Melatonin inhibits hydrogen peroxide-induced injury of human nucleus pulposus cells
    Xie Wenguan, Liu Yutao, Cui Wenbo, Kuang Mingye
    2024, 28 (14):  2180-2185.  doi: 10.12307/2024.296
    Abstract ( 231 )   PDF (1248KB) ( 27 )   Save
    BACKGROUND: Intervertebral disc degeneration is one of the most common underlying factors causing low back pain. Recent studies have shown that melatonin has a positive effect on alleviating intervertebral disc degeneration. However, the underlying mechanism of melatonin remains to be elucidated.
    OBJECTIVE: To explore the biological effect and potential mechanism of melatonin in inhibiting hydrogen peroxide (H2O2)-induced injury of human nucleus pulposus cells.
    METHODS: Human nucleus pulposus cells insolated from degenerative intervertebral disc were cultured in vitro. Cell proliferation and the optimal intervention concentration of melatonin and H2O2 were detected by cell counting kit-8. The Human nucleus pulposus cells treated with H2O2 were used as a model group; the cells treated with H2O2 and intervened with melatonin were used as a melatonin group; the cells cultured in simple medium were used as a control group. The reactive oxygen species levels were detected by 2',7'-dichlorofluorescin diacetate (DCFH-DA), the expression levels of BAX and Caspase3 were detected by immunofluorescence, and the mRNA expression levels of BAX, BCL-2, Casepase3, PI3K and AKT were detected using the real-time fluorescent quantitative reverse transcription PCR. 
    RESULTS AND CONCLUSION: The results of cell counting kit-8 experiment showed that the optimal intervention concentration of H2O2 was 400 µmol/L and the optimal intervention concentration of melatonin was 5 µmol/L. The reactive oxygen species level in the melatonin group was significantly lower than that in the model group. The average fluorescence intensity of BAX and Caspase3 in the melatonin group was significantly lower than that in the model group. The mRNA expressions of BAX and Caspase3 in the melatonin group were lower than those in the model group, while the mRNA expression of Bcl-2 was increased. In addition, the mRNA expressions of PI3K and AKT were also higher in the melatonin group compared with the model group. To conclude, melatonin may protect human nucleus pulposus cells from H2O2-induced oxidative damage through the PI3K/AKT signaling pathway.
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    Electroacupuncture reduces inflammatory factor expression by suppressing Toll-like receptor 4/nuclear factor-kappa B signaling in rats with cerebral ischemia-reperfusion injury
    Luo Fu, Shu Xiangzhong, Liu Danni, Tan Jinqu, Peng Ting, Huang Xiarong, Sun Guanghua, Peng Xinke, Wang Jinling, Zhou Jun
    2024, 28 (14):  2186-2190.  doi: 10.12307/2024.278
    Abstract ( 231 )   PDF (1353KB) ( 34 )   Save
    BACKGROUND: Inflammation is one of the important factors that induce cerebral ischemia-reperfusion injury. Studies have shown that electroacupuncture can effectively reduce inflammation after ischemic stroke and improve the symptoms of neurological deficits, but the mechanism is not clear.
    OBJECTIVE: To observe the effect of electroacupuncture on Toll-like receptor 4/nuclear factor-κB in rats with cerebral ischemia-reperfusion injury.
    METHODS: Forty-eight male Sprague-Dawley rats were randomly divided into sham operation group, model group and electroacupuncture group, with 16 rats in each group. The rat model of cerebral ischemia-reperfusion injury was prepared by middle cerebral artery occlusion. At 24 hours after modeling, the rats in the electroacupuncture group were treated with electroacupuncture, once a day, 20 minutes each time, for a total of 5 days. The sham operation group and the model group did not do any intervention. After 5 days of intervention, Longa method was used to evaluate the degree of neurological injury in rats. Triphenyl tetrazolium chloride staining and hematoxylin-eosin staining were used to measure the volume of cerebral infarction and the pathological changes of brain tissue in rats. Serum interleukin-6, interleukin-18 and tumor necrosis factor-α were detected by ELISA. Expressions of Toll-like receptor 4 and nuclear factor-κB in the cerebral cortex at mRNA and protein levels were detected by fluorescence quantitative PCR and western blot, respectively. 
    Results and conclusion: Compared with the sham operation group, the neurological function scores, serum interleukin-6, interleukin-18, and tumor necrosis factor-α levels, Toll-like receptor 4 and nuclear factor-κB mRNA and protein expression levels were significantly higher in the model group (P < 0.01). Compared with the model group, electroacupuncture significantly reduced the neurological function scores, serum interleukin-6, interleukin-18, and tumor necrosis factor-α levels, Toll-like receptor 4 and nuclear factor-κB mRNA and protein expression levels (P < 0.05, P < 0.01). Compared with the sham operation group, the volume of cerebral infarction in the model group increased significantly (P < 0.01). Compared with the model group, the volume of cerebral infarction in the electroacupuncture group decreased (P < 0.05). In the model group, the arrangement of neurons was disordered, some nerve cells disappeared, nuclei presented with pyknosis and incomplete structure. After electroacupuncture intervention, the degree of neuronal degeneration and neuronal loss in the cerebral cortex of rats were reduced compared with those in the model group. To conclude, electroacupuncture can significantly improve the neurobehavior of rats with cerebral ischemia-reperfusion injury, reduce brain tissue injury, and effectively reduce the level of serum inflammatory factors. The mechanism may be related to the inhibition of Toll-like receptor 4/nuclear factor-κB signaling pathway. 
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    Exploration and clinical validation of the repair mode of the sclerotic zone of steroid-induced osteonecrosis of the femoral head based on Tandem Mass Tags technology
    Zhuang Zhikun, He Mincong, Lin Tianye, Wu Rongkai, Guo Jinhua, Wu Zhaoke, Wei Qiushi
    2024, 28 (14):  2191-2196.  doi: 10.12307/2024.301
    Abstract ( 233 )   PDF (1747KB) ( 16 )   Save
    BACKGROUND: The sclerotic zone in the femoral head is an important imaging feature in the progression of steroid-induced femoral head necrosis, which is associated with disease prognosis. Peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) has been shown to possess biological activities such as osteogenesis, angiogenesis and anti-mitochondrial apoptosis, which may be closely related to bone repair of steroid-induced femoral head necrosis.
    OBJECTIVE: To screen for the differential proteins in the sclerotic zone of steroid-induced osteonecrosis of the femoral head versus the normal zone, to screen for hub proteins in the sclerotic zone, and to verify the differential expression of hub proteins in the femoral head specimens following steroid-induced femoral head necrosis, and to to explore the repair pattern of the sclerotic zone following steroid-induced femoral head necrosis.
    METHODS: Femoral head samples were collected from patients with steroid-induced osteonecrosis of the femoral head receiving total hip arthroplasty. The differentially expressed genes in the sclerotic zone and the normal zone were screened by Tandem Mass Tags and analyzed by GO and KEGG signaling pathways to construct a protein-protein interaction network and screen hub genes. In addition, the expression of hub genes in the sclerotic zone was verified by immunohistochemistry and western blot.
    RESULTS AND CONCLUSION: Quantitative protein profiling by Tandem Mass Tags revealed that 609 proteins were significantly differentially expressed (Log2FC > 1.20, Log2FC < 0.84 and P < 0.05) in the sclerotic zone of the femoral head compared with the normal zone, of which 290 proteins were upregulated and 319 proteins were downregulated. The GO and KEGG pathway enrichment analyses revealed that among the top 10 enriched pathways, Wnt signaling pathway and life-cycle regulatory pathway were closely related to bone repair; in the life-cycle regulatory pathway, PGC-1α was one of the important proteins. In addition, western blot results verified the low expression of PGC-1α and NRF1 in the sclerotic zone and high expression of Cleaved Caspase-3 in the sclerotic zone compared with the normal zone of steroid-induced femoral head necrosis specimens. Light microscopic immunohistochemical results showed the distribution of PGC-1α, NRF1 and Cleaved Caspase-3 positive expression in the sclerotic and normal zones in the femoral head tissue specimens, indicating the presence of their expression in bone trabeculae, osteoblasts and bone marrow. In contrast, the brown area of the sclerotic zone of femoral head necrosis stained darker and showed more obvious expression of Cleaved Caspase-3. To conclude, in the sclerotic zone of steroid-induced femoral head necrosis, biological behaviors including activation of osteogenesis-related pathways such as Wnt and oxidative apoptosis characterized by low expression of PGC-1 are observed. Low expression of PGC-1α in the sclerotic zone of steroid-induced femoral head necrosis may be associated with the activation of oxidative apoptosis. 
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    A cross-sectional survey on the prevalence and risk factors of sarcopenia in the elderly in some areas of the Yunnan-Guizhou Plateau
    Wang Ji, Hu Li, Yang Zhongya, Han Peng
    2024, 28 (14):  2197-2201.  doi: 10.12307/2024.330
    Abstract ( 239 )   PDF (831KB) ( 88 )   Save
    BACKGROUND: Epidemiological research data on sarcopenia in China are concentrated in some provincial capitals and developed areas, while research on sarcopenia in the elderly in the Yunnan-Guizhou Plateau is at the initial stage, and there is still a lack of understanding of the development mechanism, influencing factors and prevention methods of sarcopenia.
    OBJECTIVE: Based on the 2019 Asian Sarcopenia Working Group Standard (AWGS2019), to assess sarcopenia in the elderly in the Yunnan-Guizhou Plateau, while analyzing the prevalence and risk factors of sarcopenia in the elderly. 
    METHODS: A total of 1 327 elderly study subjects (650 males and 677 females) were recruited and their socio-demographic characteristics, clinical data and physical activity levels were collected. The prevalence of sarcopenia was screened using the AWGS2019 criteria. The possible influencing factors for sarcopenia were screened by univariate analysis, including χ2 test for comparing count data and t-test for comparing measurement data, and the indicators through univariate screening were included in the binary logistic regression model to assess the risk factors for sarcopenia, and then the odds ratio (OR) and 95% confidence interval (CI) were calculated. 
    RESULTS AND CONCLUSION: The prevalence of sarcopenia in the elderly in the Yunnan-Guizhou Plateau was 14.62% (12.73% male and 16.49% female). Aging (OR=1.158, 95% CI: 1.133-1.185), female (OR=2.416, 95% CI: 1.629-3.586), fasting blood glucose ≥ 7.0 mmol/L (OR=1.653, 95% CI: 1.071-2.551), smoking (OR=1.595, 95% CI: 1.043-2.438) and a low physical activity level (OR=1.778, 95% CI: 1.154-2.737) were all independent risk factors for sarcopenia, while body mass index was a protective factor for sarcopenia (OR=0.708, 95% CI: 0.583-0.859). These findings indicate that aging, female, fasting glucose ≥ 7.0 mmol/L, smoking and low physical activity levels all increase the risk of sarcopenia, while increased body mass index can decrease the risk of sarcopenia. To conclude, the elderly (especially women) should maintain a healthy lifestyle and slightly higher body mass index levels during the aging process, thus reducing the risk of sarcopenia.
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    Effects of silver needle-thermal conduction therapy on skeletal muscle mitochondria and silent information regulator homolog 3 expression in a rat model of myofascial pain syndrome
    Wang Yue, Zhang Yuhan, Wang Jiayi, Huang Yuanxin, Wo Chunxin, Wang Caixia, Zhou Peiran, Wang Lin
    2024, 28 (14):  2202-2208.  doi: 10.12307/2024.300
    Abstract ( 225 )   PDF (1257KB) ( 43 )   Save
    BACKGROUND:  Clinical studies have found good analgesic effects of silver needle-thermal conduction therapy in patients with myofascial pain syndrome, but the exact mechanism remains unclear.
    OBJECTIVE: To observe the effect of silver needle-thermal conduction therapy on silent information regulator homolog 3 (SIRT3) changes and mitochondrial ultrastructure in a rat model of myofascial pain syndrome.
    METHODS: Twenty rats were randomly selected from 26 Sprague-Dawley rats and were subjected to percussion combined with motor fatigue for replicating the rat model of myofascial pain syndrome. Sixteen rats that were successfully modeled were randomly divided into model group and silver needle-thermal conduction therapy group (treatment group), with eight rats in each group. The remaining rats were used as controls (normal group). The treatment group was treated with silver needle-thermal conduction therapy. Mechanical withdrawal threshold and thermal withdrawal latency of rats were measured at 1 day before modeling, 1 day after modeling and 14 days after treatment. Electromyographic activities of the right medial femoral muscle were measured at 14 days after treatment. The right medial femoral muscle tissue was taken for hematoxylin-eosin staining to observe the local morphology and for transmission electron microscopy to observe the mitochondrial ultrastructure. Western blot assay was performed to detect SIRT3 expression.
    RESULTS AND CONCLUSION: Pain threshold: The mechanical withdrawal threshold and thermal withdrawal latency of the model and treatment groups were significantly decreased compared with those in the normal group and before modeling (P < 0.01). After treatment, the mechanical withdrawal threshold and thermal withdrawal latency of rats were significantly higher in the treatment group compared with the model group (P < 0.01). Electromyography: The rats in the model group showed spontaneous electrical activity in the right medial femur, while the rats in the treatment group showed reduced spontaneous electrical activity, longer time frame (P < 0.01) and lower wave amplitude (P < 0.05) compared with the model group. Hematoxylin-eosin staining: In the normal group, rat muscle fibers arranged closely and regularly. In the model group, the muscle fibers of rats were atrophied, degenerated, and disordered in arrangement. In the treatment group, rat muscle structure disorder improved. Mitochondrial microstructure: Under the transmission electron microscope, mitochondrial structure in the normal group was normal; mitochondrial swelling with broken or disappeared cristae appeared in the model group; mitochondrial swelling in the treatment group was obviously relieved or tended to be normal. SIRT3 expression: SIRT3 expression was significantly downregulated in the model group compared with the normal group, but was significantly upregulated in the treatment group compared with the model group (P < 0.05). To conclude, abnormalities in local muscle mitochondria and downregulation of SIRT3 expression suggest the presence of impaired energy metabolism in the rat model of myofascial pain syndrome. Mitochondrial changes recover and are close to normal after the silver needle-thermal conduction therapy, and the expression of SIRT3 is also upregulated close to the normal group, indicating the silver needle-thermal conduction therapy may play a therapeutic role by promoting mitochondrial repair and improving energy metabolism disorder.
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    Aerobic exercise inhibits neuroinflammation and alleviates cognitive impairment in Alzheimer’s disease model mice
    Deng Longfei, Zhang Yeting, Fu Yan
    2024, 28 (14):  2209-2214.  doi: 10.12307/2024.307
    Abstract ( 294 )   PDF (3202KB) ( 66 )   Save
    BACKGROUND: Patients with Alzheimer’s disease mainly show cognitive and memory dysfunctions. Aerobic exercise can inhibit endoplasmic reticulum stress and improve cognitive function of the patients. However, whether aerobic exercise can inhibit endoplasmic reticulum stress dependent neuroinflammation is still unclear.
    OBJECTIVE: To explore the effect of aerobic exercise on neuroinflammation and cognitive impairment in a mouse model of Alzheimer’s disease. 
    METHODS: Fifty C57BL/6J wild-type male mouse mice were randomly divided into wild-type control and wild-type exercise groups, while another 50 APP/PS1 double transgenic male mice were randomly divided into Alzheimer’s disease group and Alzheimer's disease exercise group, with 25 mice in each group. Mice in the wild-type exercise and Alzheimer's disease exercise groups received aerobic exercise training (treadmill training, 45 min/d, 12 m/min, 5 d/wk, 8 weeks in total). Mice in the wild-type control and Alzheimer’s disease groups were placed on the quiet running platform. Morris water maze test was used to detect the cognitive ability of mice. Hematoxylin-eosin staining and Nissl staining were used to detect hippocampal tissue damage in mice. Thioflavin-S staining was used to detect β-amyloid content in hippocampal tissue. Immunohistochemistry was used to detect β-amyloid and p-Tau levels in hippocampal tissue. Immunofluorescence staining was used to detect the number of positive cells for neuroinflammation-related factors in hippocampal tissue. Western blot was used to detect p-IRE1, IRE1, p-PERK, PERK, ATF6, GRP78, Bip, Caspase-12, Iba-1, and GFAP protein levels. 
    RESULTS AND CONCLUSION: Compared with the wild-type control group, escape latency was increased, the number of times they reached the previous platform and the time they stayed on the platform were decreased, β-amyloid and Tau levels, p-IRE1/IRE1, p-PERK/PERK, ATF6, GRP78, Bip, Caspase-12, Iba-1, 
    and GFAP protein levels, Iba-1+, Iba-1+TNF-α+, Iba-1+IL-6+, Iba-1+IL-1β+, GFAP+, GFAP+TNF-α+, GFAP+IL-6+, GFAP+IL-1β+ positive cells in hippocampal tissue were increased, and Iba-1+IL-4+, Iba-1+IL-10+, GFAP+IL-4+, GFAP+IL-10+ positive cells were decreased in the Alzheimer’s disease group (P < 0.05). Compared with Alzheimer’s disease group, escape latency was decreased, the number of times they reached the previous platform and the time they stayed on the platform were increased, β-amyloid and Tau levels, p-IRE1/IRE1, p-PERK/PERK, ATF6, GRP78, Bip, Caspase-12, Iba-1, GFAP protein levels, Iba-1+, Iba-1+TNF-α+, Iba-1+IL-6+, Iba-1+IL-1β+, GFAP+, GFAP+TNF-α+, GFAP+IL-6+, and GFAP+IL-1β+ positive cells in hippocampal tissue were decreased, and Iba-1+IL-4+, Iba-1+IL-10+, GFAP+IL-4+, GFAP+IL-10+ positive cells were increased in the Alzheimer’s disease exercise group (P < 0.05). To conclude, aerobic exercise can reduce cognitive impairment in Alzheimer’s disease mice by inhibiting endoplasmic reticulum stress and neuroinflammation in hippocampal tissue.
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    Biomechanical characteristics of the lower limbs of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping
    Wang Ling, Jiang Xia, Chen Peng, Zheng Cheng, Xu Jinrong
    2024, 28 (14):  2215-2220.  doi: 10.12307/2024.357
    Abstract ( 200 )   PDF (1028KB) ( 83 )   Save
    BACKGROUND: At present, postoperative timing or subjective criteria by clinicians are commonly employed to determine the return-to-sport timing for patients undergoing anterior cruciate ligament reconstruction. Unfortunately, these criteria do not adequately consider the biomechanical deficits in patients following anterior cruciate ligament reconstruction.
    OBJECTIVE: To explore the lower extremity kinematic and kinetic characteristics of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping.
    METHODS: Twenty athletes undergoing anterior cruciate ligament reconstruction and twenty healthy athletes, aged 20-24 years, were recruited in Wuhan Sports University from December 2021 to December 2022. All the 40 subjects underwent a bilateral vertical jumping test. The kinematic and dynamic characteristics of the lower limbs at propulsion phase, initial landing time and peak vertical ground reaction force moment.
    RESULTS AND CONCLUSION: At the initial landing time, the athletes undergoing anterior cruciate ligament reconstruction showed higher hip flexion angle (P=0.031) and lower ankle plantar flexion angle (P=0.018) on the operated side compared with the healthy athletes. At the peak vertical ground reaction force moment, the athletes undergoing anterior cruciate ligament reconstruction had higher hip flexion angle (P=0.016), lower hip abduction angle (P=0.019), lower knee flexion angle (P=0.025), higher knee external rotation angle (P=0.030), and higher ankle external rotation angle (P=0.042) on the operated side compared with the healthy athletes. At the peak vertical ground reaction force moment, the athletes undergoing anterior cruciate ligament reconstruction showed lower knee extension moment (P=0.036), lower knee internal rotation moment (P=0.016), lower hip abduction moment (P=0.004), higher hip extension moment (P=0.040), and higher hip external rotation moment (P=0.005) on the operated side compared with the healthy athletes. To conclude, the athletes undergoing anterior cruciate ligament reconstruction exhibit a stiff landing pattern, in which the knee load on the operated side tends to shift to the hip joint, and show inadequate control of lower limb rotational stability. Therefore, detection and correction of abnormal biomechanical characteristics should be part of the rehabilitation after anterior cruciate ligament reconstruction.
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    Protective effect of anterior cruciate ligament reconstruction assisted by internal tension-reduction technique on the articular cartilage of southern Yunnan small-ear pigs
    Xiong Bohan, Lu Xiaojun, Xue Wenqiang, Liu Jinrui, Gao Xianling, Yu Hong, Li Yajuan, Liu Haolong, Li Yanlin
    2024, 28 (14):  2221-2226.  doi: 10.12307/2024.336
    Abstract ( 193 )   PDF (1384KB) ( 50 )   Save
    BACKGROUND: Internal tension-reduction technique is to reconstruct the anterior cruciate ligament through high-strength suture system combined with tendon. It can effectively reduce graft relaxation and frets by sharing the internal load of the knee joint, and has achieved good biomechanical results and clinical efficacy. However, whether it can reduce cartilage degeneration after anterior cruciate ligament reconstruction through stress sharing reduction has not been studied.
    OBJECTIVE: To investigate the effect of internal tension-reduction technique on articular cartilage degeneration in southern Yunnan small-ear pigs undergoing anterior cruciate ligament reconstruction.
    METHODS: Ten adult female Yunnan small-ear pigs were selected, and the ipsilateral knee Achilles tendon was taken from the left knee joint for anterior cruciate ligament reconstruction (normal group, n=10), and the ipsilateral knee Achilles tendon from the right knee joint combined with internal tension-reduction and augmentation system for anterior cruciate ligament reconstruction (tension-reduction group, n=10). One year after surgery, the experimental pigs were sacrificed, and the left and right knee cartilage was taken for hematoxylin-eosin staining, Safranin O-fast green staining, Osteoarthritis Research Society International scoring, and immunohistochemistry staining of type II collagen, interleukin-1β, and tumor necrosis factor-alpha in the cartilage.
    RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that in the tension-reduction group, there were mild pathologic changes of osteoarthritis, with a low number of empty bone lacunae and no obvious pathological changes such as fibrosis or cell layer breakage; in the normal group, more severe cartilage damage, with an increased number of empty bone lacunae, loss of chondrocytes near the bone and even the formation of fissures. Safranin O-fast green staining indicated that the tension-reduction group had normal cartilage tissue thickness, flat cartilage surface, a neat cell arrangement in a polar pattern, and no swelling or apoptosis, while in the normal group, the thickness of cartilage tissue was obviously thinner, the cell arrangement was disordered with no polarity, the number of cells was reduced, obvious cartilage fractures and cartilage vacuoles formed, and the absence of cells near the central bone was obvious. The Osteoarthritis Research Society International score was significantly lower in the tension-reduction group than in the normal group (P < 0.05).  Immunohistochemical findings showed that the protein expression of type II collagen in cartilage tissue of the tension-reducing group was higher than that of the normal group (P < 0.05), and the protein expression of interleukin 1β and tumor necrosis factor ɑ in cartilage tissue was lower than that of normal group (P < 0.05). To conclude, internal tension-reduction technique can delay the degeneration of articular cartilage in Yunnan small-eared pigs following anterior cruciate ligament reconstruction.
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    Effect of treadmill exercise on the structure and diversity of intestinal microflora in rats with Parkinson’s disease
    Ma Xinran, Liu Xinhao, Li Yujia, Luo Kailiang, Ma Shujie, Hu Jun
    2024, 28 (14):  2227-2233.  doi: 10.12307/2024.223
    Abstract ( 248 )   PDF (1380KB) ( 41 )   Save
    BACKGROUND: Exercise has a regulatory effect on intestinal flora dysbiosis, which can effectively protect the beneficial flora and improve the intestinal environment. However, the effect of treadmill exercise on the structure and diversity of intestinal microbial community in Parkinson’s disease and the specific mechanism are not clear.
    Objective: Using 16S rDNA technique to analyze the effect of treadmill exercise on the structure and diversity of the intestinal flora of rats with Parkinson’s disease, and to investigate the mechanism of non-pharmacological treadmill exercise to improve Parkinson’s disease.
    METHODS: Twelve of the 18 Sprague-Dawley rats were randomly selected to make animal models of Parkinson’s disease using unilateral 2-point nigrostriatal injection of 6-hydroxydopamine. The remaining six rats were used as sham-operation group, which were injected with the same dose of saline containing 0.2% ascorbic acid using the same positioning and injection method. After successful modeling, 12 rats with Parkinson’s disease were randomly divided into model group and treadmill exercise group (n=6 per group). The treadmill exercise group was subjected to a middle and low intensity tread mill exercise, 10 m/min, 30 minutes per day, 5 days per week for 4 weeks. Fresh feces were collected and stored in liquid nitrogen 24 hour after the last exercise session, and the changes in fecal flora were analyzed by 16S rDNA sequencing technique.
    Results and conclusion: Treadmill exercise significantly improved behavior and nigrostriatal tyrosine hydroxylase-positive cell expression in rats with Parkinson’s disease model and alleviated changes in the structure and diversity of the gut microbial community caused by Parkinson’s disease, increased the number of operational taxonomic units and modulated Alpha and Beta diversity in rats. At the phylum and genus levels, the abundance ratio of Firmicutes/Bacteroidetes in the model group decreased compared with the sham-operated group, while beneficial bacteria such as Prevotella, Bacteroides, and Clostridium_XlV increased significantly after treadmill exercise. To conclude, treadmill exercise has a significant modulating effect on behavioral abnormalities, toxic damage to dopaminergic neurons and gut microbial imbalance caused by Parkinson’s disease, alleviates the symptoms of flora-related diseases, and has a positive effect on the improvement of Parkinson’s disease.
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    Mechanism by which terpenoid herbal monomers prevent osteoporosis by regulating nuclear factor-kappaB signaling pathway
    Pan Chengzhen, Chen Feng, Lin Zonghan, Mo Jian, Zhang Chi, Wei Yuanxun, Wei Zongbo
    2024, 28 (14):  2234-2241.  doi: 10.12307/2024.210
    Abstract ( 283 )   PDF (1279KB) ( 144 )   Save
    BACKGROUND: The nuclear factor-κB signaling pathway plays an important role in the pathogenesis of osteoporosis. In recent years, increasing studies have shown that terpenoid herbal monomer compounds can inhibit the activity of bone resorbing cells and promote the differentiation of bone forming cells via the nuclear factor-κB signaling pathway, thus reducing bone resorption and increasing bone formation, which has certain preventive and therapeutic effects on osteoporosis.
    OBJECTIVE: By analyzing and summarizing the domestic and international literature, to investigate the relationship between nuclear factor-κB signaling pathway and osteoporosis in depth, elucidate the mechanism of terpenoid monomer compounds in regulating the nuclear factor-κB signaling pathway to prevent osteoporosis, and systematically summarize the terpenoid monomer compounds targeting to regulate the nuclear factor-κB signaling pathway to prevent osteoporosis.
    METHODS: According to the proposed inclusion and exclusion criteria, two researchers searched for relevant articles published from database inception to December 2022 in CNKI and PubMed using the search terms “NF-κB, osteoporosis, osteoblasts, osteoclasts, angiogenesis, traditional Chinese medicine, terpenoid” in Chinese and English, respectively. A third researcher summarized and organized the literature and 75 articles were finally included for a systematic review.
    RESULTS AND CONCLUSION: The nuclear factor-κB signaling pathway mediates the onset and progression of osteoporosis by regulating the differentiation and proliferation of osteoblasts and osteoclasts, as well as angiogenesis. Activation of the nuclear factor-κB signaling pathway negatively regulates the proliferation and differentiation of osteoblasts. Activation of the nuclear factor-κB signaling pathway enhances osteoclast activity and inhibits osteoblast growth, thereby inhibiting compensatory bone production to maintain bone homeostasis. However, over-activation of the nuclear factor-κB signaling pathway can lead to osteoporosis. The nuclear factor-κB signaling pathway is involved in the “angiogenesis-osteogenesis” coupling by upregulating the expression levels of cytokines such as angiopoietin-1, platelet-derived growth factor BB and vascular endothelial growth factor, which promote the growth of blood vessels in bone. The terpenoid herbal monomer compounds are used in the field of tissue engineering to promote the proliferation and differentiation of bone cells, thereby promoting the growth and repair of bone tissue. Terpenoid herbal monomer compounds can prevent and treat osteoporosis by inhibiting the degradation of nuclear factor-κB inhibitor, blocking nuclear factor-κB/p65 phosphorylation and nuclear translocation, thereby weakening the nuclear factor-κB signaling pathway, promoting osteoblast differentiation and inhibiting osteoclast formation. Currently, research on the regulation of nuclear factor-κB signaling pathway by monomeric compounds of terpenoids to prevent osteoporosis is mainly based on in vitro cellular experiments and animal models, and there is a lack of research on the complex physiological and pathological processes in humans. In the future, more clinical trials and studies are needed to further clarify the mechanism of action and efficacy of the nuclear factor-κB signaling pathway involved in the intervention of osteoporosis.
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    Mechanism of ferroptosis in osteoarthritis and its traditional Chinese medicine interventions
    Gao Zhengang, Zhang Xiaoyun, Jiang Wen
    2024, 28 (14):  2242-2247.  doi: 10.12307/2024.287
    Abstract ( 277 )   PDF (985KB) ( 125 )   Save
    BACKGROUND: Studies have found that chondrocyte ferroptosis can be used as an important pathogenesis to induce the occurrence and development of osteoarthritis. With the continuous development of Chinese medicine, some scholars have found that some traditional Chinese medicine monomers and traditional Chinese medicine compounds can inhibit chondrocyte ferroptosis through various mechanisms of action, and finally play a role in the treatment of osteoarthritis.
    OBJECTIVE: To explore the relationship between ferroptosis and osteoarthritis and the mechanism by which traditional Chinese medicine deals with ferroptosis in the treatment of osteoarthritis, in order to provide new ideas for the treatment and prevention of osteoarthritis.
    METHODS: With “osteoarthritis, ferroptosis, chondrocytes, lipid metabolism, traditional Chinese medicine, ROS, GPX 4” as the English and Chinese search terms, CNKI, PubMed, WanFang, and VIP databases were searched for relevant articles regarding the relationship between ferroptosis and osteoarthritis and its traditional Chinese medicine intervention until 2022. Then, a systematic analysis was conducted.
    RESULTS AND CONCLUSION: Intracellular iron overload will cause lipid peroxidation, resulting in the accumulation of reactive oxygen species and eventually the occurrence of ferroptosis, while excessive iron will accelerate the apoptosis of chondrocytes and affect chondrocyte homeostasis, thereby inducing the development of osteoarthritis. When amino acid metabolism is abnormal, an imbalance in glutamate and cystine exchange causes the accumulation of glutamate outside the cells, and high extracellular concentration of glutamate will cause the depletion of glutathione, indirectly inhibiting the function of ferroptosis-related factors, and contributing to ferroptosis. When cellular lipid metabolism is abnormal, unsaturated fatty acids, an important component of the cell membrane, lose their diallyl hydrogen atoms, leading to the destruction of cells to induce ferroptosis, while lipid metabolism is closely involved in the progression of osteoarthritis. Traditional Chinese medicine can play a role in the prevention and treatment of osteoarthritis by inducing the occurrence of ferroptosis. The research on iron death is still immature, and further research on its action mechanism is expected to open up new ways for the clinical treatment of osteoarthritis. 
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    Effect of blood flow restriction training on the fitness benefit of upper limb muscles
    Zhang Yue, Guo Yingjie, Cheng Yang, Yang Tingting
    2024, 28 (14):  2248-2253.  doi: 10.12307/2024.292
    Abstract ( 356 )   PDF (913KB) ( 69 )   Save
    BACKGROUND: Blood flow restriction training has broad application prospects in improving limb muscle strength. It has ideal effects on the upper limbs is ideal, and the specific application scheme has high research value.
    OBJECTIVE: To explain the influence of blood flow restriction training on the fitness benefits of upper limb muscles and summarize the specific programs of blood flow restriction training for upper limb, attempting to give suggestions on application programs based on existing studies.
    METHODS: Literature on the application of upper limb blood flow restriction training were searched in CNKI, WanFang, VIP, CBM, PubMed, Embase, EBSCO, Cochrane Library and Web of Science databases. The search terms were “blood flow restriction, blood flow restriction training, pressure training, upper limb, upper arm, forearm, arm, forearm” in Chinese and “blood flow restriction training, blood flow restriction exercise, blood flow restriction therapy, BFR therapy, occlusion training, KAATSU training, BFRT, upper extremity, upper limb, arm, forearm” in English. The relevant articles on the application of blood flow restriction training in the upper limbs included in the database from database inception to December 2022 were selected and screened according to inclusion criteria and exclusion criteria.
    RESULTS AND CONCLUSION: Firstly, blood flow restriction training is mainly applied to healthy people, special athletes and people with upper limb injury. Secondly, the influence of blood flow restriction training on upper limb muscle fitness is mainly reflected in the increase of upper limb circumference, muscle strength, muscle endurance, muscle thickness, muscle cross-sectional area and explosive power of upper limb, followed by the cross migration phenomenon of the upper limbs. Thirdly, blood flow restriction training for the upper limbs mainly uses inflatable blood flow restriction devices: the cuff width was 3-5 cm, the pressure position was 1/3 of the upper arm, the limiting pressure was 40%-60% arterial occlusion pressure or 80-160 mmHg, the training load is 20%-30% 1RM, the training volume is four sessions (30-15-15-15 times), the interval time was 30-60 seconds, and the training frequency was 2 or 3 times per week.
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    The role of reactive oxygen species in periodontitis and periodontal tissue regeneration
    Zhai Haoyan, Zhao Yuan, Fan Dengying, Liu Chunyan
    2024, 28 (14):  2254-2260.  doi: 10.12307/2024.288
    Abstract ( 269 )   PDF (988KB) ( 46 )   Save
    BACKGROUND: Reactive oxygen species is a double-edged sword in the development of periodontitis and the regeneration of periodontal tissue. Low concentration of reactive oxygen species induces the differentiation of periodontal fibroblasts, and excessive reactive oxygen species will cause damage to periodontal tissue. In the process of inflammation, the accumulation of reactive oxygen species in periodontal tissue induces damage to cells and tissues through a variety of signaling pathways or through redox reactions.
    OBJECTIVE: To review the double-edged sword effect of reactive oxygen species in periodontitis and periodontal tissue regeneration, thereby providing potential targets and treatment ideas for the clinical treatment of periodontitis and periodontal tissue regeneration.
    METHODS: Databases of CNKI and PubMed were searched for relevant articles published from April 1990 to April 2023 with the key words of “periodontal tissue engineering, periodontal defect, regeneration of periodontal tissue, chronic periodontitis, reactive oxygen species, oxidative stress, antioxidative stress, oxidative injuries, free radicals, reactive nitrogen species” in Chinese and English, respectively. By reading the titles and abstracts, repetitive studies or irrelevant literatures were excluded. Finally, 77 articles were included for review.
    RESULTS AND CONCLUSION: Reactive oxygen species are a kind of free radicals with high reactivity. When bacteria invade, reactive oxygen species are released in large quantities by the respiratory explosion of neutrophils and play a double-edged sword role in the body through their redox reactions or as pleiotropic physiological signal transmitters. In periodontitis, low concentrations of reactive oxygen species can kill invading pathogenic bacteria, but high concentrations of reactive oxygen species promote the secretion of inflammatory factors through JNK, RANK, Wnt/β-Catenin and other pathways, promote immune damage or directly damage tissues through oxidative reactions or through other ways to aggravate periodontitis. In the process of periodontal tissue regeneration, low concentrations of reactive oxygen species can promote the proliferation and differentiation of periodontal ligament stem cells through Nrf2 and other pathways and can promote the secretion of vascular endothelial growth factor to promote vascular regeneration. This provides seeds and a nutrient environment for periodontal tissue regeneration, which is extremely important for promoting periodontal tissue regeneration. However, high concentrations of reactive oxygen species will reduce the activity of periodontal ligament stem cells and damage endothelial cells, which are not conducive to vascular regeneration. This will inhibit wound healing and periodontal tissue regeneration. Therefore, it is important to explore the role of reactive oxygen species in the development of periodontitis and periodontal tissue regeneration and to discover the potential mechanism of its action and to explore the appropriate concentration for its role in reducing periodontal inflammation and promoting periodontal tissue regeneration for the future treatment of periodontitis and periodontal tissue regeneration in clinical practice. Using reactive oxygen species as a target to explore ways to reduce periodontal inflammation and promote periodontal ligament stem cell activity and vascular regeneration may become a clinically effective method for treating periodontitis and promoting periodontal tissue regeneration.
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    Bone immunity and bone metabolism
    Guo Caopei, Cheng Piaotao, Yang Chengbing, Gong Shouhang, Peng Jiaze, Zhang Lin, Peng Jiachen
    2024, 28 (14):  2261-2266.  doi: 10.12307/2024.289
    Abstract ( 349 )   PDF (906KB) ( 154 )   Save
    BACKGROUND: Osteoporosis is a disease in which bone density and structure are destroyed and fractures are caused by increased bone fragility, leading to high clinical disability and mortality rates.
    OBJECTIVE: To review the research progress in the role of bone immunity in physiological and pathological processes related to bone metabolism, providing ideas for the research and clinical application of bone immunity in bone diseases.
    METHODS: The first author searched PubMed and CNKI databases in November 2022 for relevant literature using the keywords of “osteoimmunology, immuno-skeletal interface, bone metabolism, skeletal metabolism, lymphocyte, immune factor” in English and Chinese, respectively. The time range of retrieval was mainly from January 2010 to November 2022, and a small number of classical long-term literatures were included. After reading the topic and abstract for preliminary screening and excluding repetitive studies, low-quality journals and unrelated literature, 81 documents were finally included for review.
    RESULTS AND CONCLUSION: Osteoimmunology refers to that bone and immune cells share the same microenvironment and interact with each other to jointly perform the “bone immune system,” which includes all cells in the bone marrow. Immuno-skeletal interface has protective effects on bone under physiological conditions, but it may lead to bone destruction under pathological conditions. Osteoprotegerin is mainly derived from B cells and can inhibit osteoclast metabolism. However, when the body is in an inflammatory state, T cells and B cells work together to promote bone resorption. In addition, interleukin-1, interleukin-6 and tumor necrosis factor-α regulate the expression of receptor activator of nuclear factor-κB ligand in vivo and affect bone metabolism. In most clinical diseases (such as rheumatoid arthritis, estrogen deficiency, HIV infection, and hyperparathyroidism), the immuno-skeletal interface interacts with the bone immune system, resulting in the regulation of bone metabolism. In terms of clinical prospect, the interaction between bone immunity and bone metabolism should be studied in order to propose new strategies for therapeutic intervention to reduce the risk of fracture.
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    Long non-coding RNA and periodontitis
    Tong Tong, Liu Chunyan, Liu Bing, Zhao Fei
    2024, 28 (14):  2267-2273.  doi: 10.12307/2024.325
    Abstract ( 235 )   PDF (1196KB) ( 98 )   Save
    BACKGROUND: In recent years, numerous studies have shown that long non-coding RNAs (lncRNAs) have an important role in the pathogenesis of periodontitis, including the immune response process and the biological activity and function of cells (periodontal stem cells and osteoblasts). Researchers attempt to regulate periodontal inflammation and periodontal regeneration by regulating lncRNA expression levels.
    OBJECTIVE: To review the progress of research on lncRNAs in periodontitis, thereby advancing the research of lncRNAs in periodontitis.
    METHODS: The first author searched PubMed, China National Knowledge Infrastructure (CNKI), Web of Science database, and WanFang Database for relevant literature published up to March 2023. “Long non-coding RNA, lncRNA, periodontitis, periodontium, immunity, inflammation, periodontal ligament stem cells, osteoclasts, osteogenic differentiation, bone resorption, bone formation, recurrence, hypoxia, oxidative stress, static mechanical strain”were used as the Chinese search terms. “lncRNA, periodontitis, periodontal, immunity, inflammation, periodontal membrane stem cells, osteoclasts, osteogenic differentiation, bone resorption, bone formation, recurrence, hypoxia, oxidative stress, static mechanical strain” were used as the English search terms. The title and abstract of each paper were read for initial screening, and 87 papers were finally selected for inductive analysis.
    RESULTS AND CONCLUSION: Periodontal pathogens stimulate the body, leading to immune imbalance that triggers inflammatory response and destroy periodontal tissue, and lncRNAs are involved in its regulatory mechanism. LncRNAs are involved in the pro-inflammatory regulation of periodontal ligament cells in an inflammatory environment, and their effects on osteoclast differentiation are regulated through ceRNA mechanism, which provides new clues for exploring the pathogenesis of periodontitis. For B cells and macrophages, lncRNAs can regulate the infiltration, cell activity and function of their subsets in periodontitis. LncRNAs participate in the immune response related to periodontitis mainly through two pattern recognition receptors, Toll-like receptors and NOD-like receptors, and nuclear factor-κB signaling pathway. To investigate whether lncRNAs can be used as a biomarker of periodontitis has great value in the diagnosis and prognosis of periodontitis. Animal experiments have demonstrated that the role of lncRNAs in periodontitis can be reversed by modulating the expression level of lncRNAs and thus lncRNAs act as an anti-inflammatory agent, which is of great value for the study of immunotherapy in periodontitis. The regulation of lncRNAs on periodontal ligament stem cells is mainly realized through endogenous competition mechanism and various signaling pathways, and its effects are influenced by various factors, such as inflammatory environment, mechanical strain, hypoxia and oxidative stress. Research on related mechanisms through these related factors provides new ideas for the treatment of periodontitis.
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    Effects of high-intensity interval training and moderate-intensity continuous training on body composition and glucose metabolism in overweight or obese patients with type 2 diabetes: a Meta-analysis
    Liu Renfan, Lyu Liting, Wu Yi, Wang Lu
    2024, 28 (14):  2274-2281.  doi: 10.12307/2024.290
    Abstract ( 320 )   PDF (1196KB) ( 203 )   Save
    OBJECTIVE: To systematically evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities, thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes.
    METHODS: The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, CBM, WanFang, and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes. The search was conducted from database inception to June 2022. Meta-analysis of outcome indicators was performed using RevMan 5.4.
    RESULTS: (1) A total of 13 randomized controlled trials with 371 subjects were included, and the overall quality of the included studies was relatively high. (2) There was no significant difference in the improvement of body composition between HIIT and MICT [body mass: weighted mean difference (WMD)=2.44, 95% confidence interval (CI): -3.01-7.89, P > 0.05; body mass index: WMD=0.28, 95%CI: -1.21-1.77, P > 0.05; waist circumference: WMD=2.16, 95% CI: -2.04-6.35, P > 0.05; body fat percentage: WMD=0.47, 95%CI: -2.11-3.05, P > 0.05). (3) The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the “training cycle ≥ 12 weeks” subgroup and the “training frequency ≤ 3 times/week” subgroup (training cycle ≥ 12 weeks subgroup: WMD=4.25, 95% CI: 0.90-7.59, P=0.01; WMD=2.71, 95%CI: 1.92-3.51, P < 0.000 01; training frequency ≤ 3 times/week subgroup: WMD=5.14, 95%CI: 1.7-8.57, P=0.003; WMD=1.67, 95% CI: 0.66-2.67, P=0.001). (4) The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups (WMD=2.17, 95% CI: 1.20-3.14, P < 0.000 1), while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups (fasting blood glucose: WMD=0.31, 95% CI: -0.17-0.79, P > 0.05; glycosylated hemoglobin: WMD=0.01, 95% CI: -0.19-0.20, P > 0.05; insulin resistance index: WMD=-0.14, 95%CI: -0.71-0.42, P > 0.05). (5) The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of “training frequency ≤ 3 times/week” (WMD=0.92, 95% CI: 0.25-1.60, P=0.007) and glycosylated hemoglobin was significantly different in the “training frequency > 3 times/week” subgroup (WMD=-0.2, 95% CI: -0.3 to -0.1, P < 0.000 1).
    CONCLUSION: Overall, there is no significant difference between HIIT and MICT in improving body composition such as body mass, body mass index, waist circumference, body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose, glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes. When the training period is ≥ 12 weeks and the training frequency is ≤ 3 times/week, MICT has a better effect on the improvement of body mass as well as body mass index.
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    Effects of high-intensity interval training with different intervention durations on cognitive function in older adults: a Meta-analysis
    Liu Xinxin, Geng Zhizhong, Chen Jian
    2024, 28 (14):  2282-2289.  doi: 10.12307/2024.235
    Abstract ( 293 )   PDF (1813KB) ( 71 )   Save
    OBJECTIVE: With the increasing aging population, the decline of cognitive ability in older adults has received widespread attention. High-intensity interval training (HIIT) has been applied as an emerging exercise intervention to improve cognitive ability in older adults, but its efficacy is still controversial. This study aimed to investigate the effects of HIIT intervention on cognitive ability in older adults, in order to provide a theoretical basis for its application in improving cognitive ability in older adults.
    METHODS: Randomized controlled trials regarding the effect of HIIT on cognitive ability in older adults were retrieved from databases including CNKI, WanFang, PubMed, Embase, and Web of Science, from the database inception to November 2022. The Cochrane Collaboration’s tool for assessing risk of bias in randomized controlled trials was used to evaluate the methodological quality, and RevMan 5.3 software was used for the Meta-analysis of outcome indicators in the included literature.
    RESULTS: A total of 8 randomized controlled trials, including 4 high-quality and 4 low-quality studies with 369 participants, were included in the Meta-analysis. Meta-analysis showed that (1) compared with moderate-intensity continuous training (MICT), HIIT could effectively improve the maximal oxygen uptake of older adults [weighted mean difference (WMD)=3.78, 95% confidence interval (CI): 2.79, 4.77, P < 0.000 01]. Subgroup analysis showed that with long-term intervention (intervention period ≥ 6 weeks), compared with the MICT group, the HIIT group could significantly improve the executive function [standardized mean difference (SMD)=0.36, 95%CI: 0.20-0.52, P < 0.000 1) and its sub-function inhibition ability (SMD=0.35, 95%CI: 0.17-0.52, P < 0.000 1) of older adults. (2) Compared with the control group, the HIIT group could effectively improve the maximal oxygen uptake of older adults (WMD=6.75, 95%CI: 4.20-9.29, P < 0.000 01), memory (SMD=0.20, 95%CI: 0.03-0.37, P=0.02), executive function (SMD=0.87, 95%CI: 0.52-1.22, P < 0.000 01), and its sub-function inhibition ability (SMD=0.89, 95%CI: 0.46-1.33, P < 0.000 1). Subgroup analysis showed that with long-term intervention (intervention period ≥ 6 weeks), compared with the control group, the HIIT group could effectively improve the executive function (SMD=0.75, 95%CI: 0.41-1.09, P < 0.000 1), its sub-function inhibition ability (SMD=0.50, 95%CI: 0.19-0.81, P=0.002), and switching ability (SMD=1.65, 95%CI: 0.86-2.44, P < 0.000 1). (3) With a single intervention, compared with the control group, the HIIT group could effectively improve the executive function (SMD=1.25, 95%CI: 0.39-2.11, P=0.004) and its sub-function inhibition ability (SMD=2.40, 95%CI: 0.87-3.92, P=0.002).
    CONCLUSION: HIIT can effectively improve the executive function and its sub-function inhibition ability of older adults, but has no improvement effect on memory ability. At the same time, long-term HIIT intervention is superior to MICT in improving aerobic capacity and executive function of older adults.
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    Effects of mask-wearing exercise on heart rate, blood oxygen saturation and end-expiratory carbon dioxide: a Meta-analysis
    Dai Xinyu, Yan Jihong, Bi Xuecui, Zheng Xiaohong
    2024, 28 (14):  2290-2296.  doi: 10.12307/2024.279
    Abstract ( 330 )   PDF (1729KB) ( 63 )   Save
    OBJECTIVE: Masks are one of the most important defenses against the virus. However, the impact of wearing masks during daily activities or sports on respiratory and circulatory function remains controversial. A comprehensive quantitative evaluation of the effects of mask-wearing on human heart rate, oxygen saturation and end-expiratory carbon dioxide by Meta-analysis was conducted. The effects of wearing different types of masks at different exercise intensities and time of exercise on the human respiratory and circulatory system were explored. 
    METHODS: By February 2023, with “mask, face mask, N95, training, sports, running, walking, cycling” as the Chinese search terms and “masks, respiratory protective devices, N95 respirators, surgical face masks, exercise, resistance training, explosive training, muscle exercises” as English search terms, the experimental studies addressing the influence of exercise with a mask on hemodynamic indexes were retrieved from CNKI, Web of Science, PubMed, Cochrane Library and WanFang databases. The outcome indicators included three continuous variables - exercise center rate, blood oxygen saturation and end-expiratory carbon dioxide. Stata16.0 software was used to analyze the outcome indicators of the included literature. The PEDro scale was used as a quality assessment tool, and the funnel plot was used to analyze the impact of publication bias.
    RESULTS: Totally 25 articles involving 857 healthy children and adults were included in this Meta-analysis. The overall methodological quality was high, with 22 studies scoring 6 points on the PEDro scale, 2 studies scoring 7 points and 1 study scoring 8 points. The meta-analysis results showed that compared with the control group, exercise with masks had no significant effect on heart rate (SMD=0.02, 95%CI: -0.11 to 0.15, P=0.81), but increased end-expiratory carbon dioxide (SMD=0.60, 95%CI: 0.37 to 0.83, P=0.00), decreased oxygen saturation (SMD=-0.28, 95%CI: -0.47 to -0.09, P=0.03). Intensity and duration were the factors that affected the heterogeneity between studies. Wearing a mask during high-intensity exercise significantly increased heart rate (SMD=-0.20, 95%CI: -0.36 to -0.04, P=0.02). The effect of high-intensity and short-time exercise on blood oxygen saturation was significantly higher than that of other exercises (SMD=-0.40, 95%CI: -0.70 to -0.10; SMD=-0.25, 95%CI: -0.45 to -0.04). For end-expiratory carbon dioxide, maintaining a certain intensity and increasing the exercise time or increasing the intensity further increased the index significantly, reaching a moderate effect size (SMD=0.61, 95%CI: 0.06 to 1.15; SMD=0.58, 95%CI: 0.04 to 1.13).
    CONCLUSION: Existing evidence suggests that exercise with masks may have the adverse effect of increasing end-expiratory carbon dioxide and decreasing blood oxygen saturation. The influence of different exercise test time and intensities on the three outcome indexes was different. Wearing a mask during high-intensity exercise can significantly increase heart rate and decrease blood oxygen saturation. Maintaining moderate intensity for a long period or further increasing the intensity of exercise will lead to increased end-expiratory carbon dioxide levels.
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