Artesunate (ART) is a derivative of artemisinin and has anti-inflammatory, anti-tumor, and anti-angiogenic properties. Although ART has been implicated in osteoarthritis (OA), the mechanism needs to be further dissected. Here, we explored the effects of ART on the development of OA and the underlying mechanism using destabilization of the medial meniscus (DMM) surgical instability model. Mice with OA were developed using DMM and treated with ART. The pathological morphology of knee joint tissues was examined, and the degeneration of joint cartilage was assessed. Mouse knee chondrocytes were isolated and induced with IL-1β, followed by ART treatment. ART alleviates OA in mice by elevating ubiquitin carboxyl-terminal hydrolase 7 (USP7) expression, and USP7 inhibitor (P22077) treatment mitigated the protective effects of ART on chondrocytes. We also showed that USP7 mediated the deubiquitination of forkhead box protein O1 (FoxO1), while FoxO1 alleviated chondrocyte injury. In addition, FoxO1 promoted metastasis-associated protein MTA1 (MTA1) transcription, and downregulation of MTA1 exacerbated chondrocyte injury. Our study identifies that USP7/FoxO1/MTA1 is a key signaling cascade in the treatment of ART on OA.

Objective To investigate the impact of long non-coding RNA (lncRNA) FGD5-AS1 on the osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBM-MSCs) through regulation of the microRNA miR-93-5p/bone morphogenetic protein-2(BMP2) axis. Methods hBM-MSCs in logarithmic growth phase were taken, and the expression levels of lncRNA FGD5-AS1, miR-93-5p and BMP2 mRNA were detected before and after osteogenic differentiation; The cells were transfected or co-transfected with pcDNA FGD5-AS1, miR-93-5p inhibitor, miR-93-5p mimics and corresponding negative controls, respectively, then divided into pcDNA NC group, pcDNA FGD5-AS1 group, inhibitor NC group, miR-93-5p inhibitor group, pcDNA FGD5-AS1+mimics NC group, or pcDNA FGD5-AS1+miR-93-5p mimics group and non-transfected cells were taken as blank group. CCK-8 assay was applied to detect cell proliferation ability of each group; Alkaline phosphatase (ALP) kit was applied to detect its activity; Alizarin red staining was applied to identify cellular mineralized nodule formation; Western blot was applied to detect the levels of BMP2, osteogenesis-related markers-osteocalcin (OCN), osteopontin (OPN), and osterix(OSX); Dual-luciferase experiment was applied to verify the targeting relationship of miR-93-5p with FGD5-AS1 and BMP2, respectively. Results lncRNA FGD5-AS1 and BMP2 were found to be targets of miR-93-5p. After osteogenic differentiation, the expression of FGD5-AS1 and BMP2 was increased and the expression of miR-93-5p was decreased (P＜0.05). Compared with pcDNA NC group, the expression of FGD5-AS1 in pcDNA FGD5-AS1 group was significantly increased(P＜0.05), indicating successful transfection; Mineralized nodules, cell proliferation, ALP activity and the expression of BMP2, OCN, OPN and OSX were obviously higher (P＜0.05) in pcDNA FGD5-AS1 group. Compared with the inhibitor NC group, the expression of miR-93-5p in miR-93-5p inhibitor group was significantly decreased (P＜0.05), indicating successful transfection; Mineralized nodules, cell proliferation, ALP activity and the expression of BMP2, OCN, OPN and OSX were obviously improved (P＜0.05) in miR-93-5p inhibitor group. Over-expression of miR-93-5p inhibited the promoting effect of FGD5-AS1 on the osteogenic differentiation of hBM-MSCs(P＜0.05). Conclusions Up-regulation of FGD-AS1 promotes the osteogenic differentiation of hBM-MSCs, which might be related to the miR-93-5p/BMP2 axis.

目的 探讨芹菜素介导磷酸肌醇3激酶(PI3K)/蛋白激酶(Akt)通路调节绝经后骨质疏松症大鼠骨吸收与骨形成稳态的作用.方法 取60只3月龄雌性SD大鼠随机分为假手术组(n=9)和建模组,后者采用切除双侧卵巢法构建绝经后骨质疏松症模型.建模成功后随机分为模型组(n=9)、雌二醇组(n=10)、芹菜素低剂量组(n=10)、芹菜素中剂量组(n=10)、芹菜素高剂量组(n=10),雌二醇组予以0.18 mg/(kg·d)戊酸雌二醇灌胃,芹菜素低、中、高剂量组分别予以40、80、160mg/(kg·d)芹菜素灌胃,假手术组和模型组仅予以等量生理盐水灌胃,1次/d,给药14周.给药结束24 h后,苏木素伊红(HE)染色观察股骨组织病理变化;计算机微断层扫描仪(Micro-CT)检测股骨组织微结构及计量学指标;抗酒石酸碱性磷酸酶(TRAP)染色观察股骨组织破骨细胞染色情况;碱性磷酸酶(ALP)染色观察股骨组织成骨细胞染色情况;酶联免疫吸附实验(ELISA)检测血清骨源性碱性磷酸酶(BALP)、I型胶原氨基末端前肽(PINP)、Ⅰ型胶原羧基末端肽(CTX-1)、TRAP5b水平;实时-定量聚合酶链反应检测骨组织PI3K、Akt、矮小相关转录因子2(Runx2)、骨钙素(OCN)、骨保护素(OPG)、细胞核因子-κB受体活化因子(RANKL)mRNA 表达;免疫印迹法检测骨组织 PI3K、Akt、Runx2、OCN、OPG、RANKL 蛋白表达及 p-PI3K、p-Akt水平.结果 假手术组大鼠骨小梁分布均匀致密,结构完整,骨髓腔较小;模型组骨小梁断裂,连续性差,骨髓腔明显增大;雌二醇组以及芹菜素低、中、高剂量组骨小梁病理结构逐渐改善;与假手术组比较,模型组大鼠骨组织骨密度(BMD)、骨体积分数(BV/TV)、骨小梁数目(Tb.N)、骨小梁厚度(Tb.Th)降低[(0.11±0.02)g/cm3vs.(0.39± 0.05)g/cm3、(0.14±0.02)％vs.(0.56±0.09)％、(2.67±0.41)mm-1vs.(7.56±1.12)mm-1、(0.04±0.01)mm vs.(0.12±0.02)mm],骨小梁分离度(Tb.Sp)、骨小梁模式因子(Tb.Pf)上升[(0.35±0.06)mm vs.(0.06±0.01)mm、(10.91±1.97)mm-1 vs.(3.72±0.65)mm-1],差异均有统计学意义(P均＜0.05);与模型组比较,雌二醇组以及芹菜素低、中、高剂量组BMD、BV/TV、Tb.N、Tb.Th上升,Tb.Sp、Tb.Pf降低,差异均有统计学意义(P均＜0.05),上述指标在雌二醇组和芹菜素中剂量组间比较差异均无统计学意义(P均＞0.05),芹菜素低、中、高剂量组呈剂量依赖性.与假手术组比较,模型组被染红破骨细胞数量明显增多、成骨细胞ALP染色明显减少;与模型组比较,雌二醇组和芹菜素低、中、高剂量组被染红破骨细胞数量逐渐减少、成骨细胞ALP染色逐渐增加.与假手术组比较,模型组大鼠血清BALP、PINP水平降低[(6.91±1.15)μg/L vs.(18.43±3.08)μg/L、(15.28±2.68)μg/L vs.(32.64±6.11)μg/L],CTX-1、TRAP5b 水平上升[(15.72±2.82)μg/L vs.(6.18±1.05)μg/L、(85.49±16.08)μg/L vs.(23.67±4.43)μg/L],差异均有统计学意义(P均＜0.05);与模型组比较,雌二醇组以及芹菜素低、中、高剂量组大鼠血清BALP、PINP水平上升,CTX-1、TRAP5b水平降低,差异均有统计学意义(P均＜0.05);上述指标在雌二醇组和芹菜素中剂量组间比较差异均无统计学意义(P均＞0.05),芹菜素低、中、高剂量组呈剂量依赖性.与假手术组比较,模型组大鼠骨组织PI3K、Akt、Runx2、OCN、OPG mRNA 以及 p-PI3K、p-PI3K/PI3K、p-Akt、p-Akt/Akt 水平降低[(0.31±0.04)vs.(0.98±0.12)、(0.19±0.03)vs.(1.03± 0.15)、(0.38±0.05)vs.(0.91±0.14)、(0.26±0.04)vs.(0.96±0.14)、(0.23±0.03)vs.(0.95±0.14)、(0.29±0.03)vs.(0.71± 0.11)、(0.27±0.04)vs.(0.68±0.12)、(0.21±0.03)vs.(0.76±0.10)、(0.21±0.03)vs.(0.79±0.12)],RANKL mRNA表达上升[(2.43±0.36)vs.(0.87±0.13)],差异均有统计学意义(P均＜0.05);与模型组比较,雌二醇组以及芹菜素低、中、高剂量组大鼠骨组织PI3K、Akt、Runx2、OCN、OPG mRNA 以及p-PI3K、p-PI3K/PI3K、p-Akt、p-Akt/Akt水平上升,RANKL mRNA表达降低,差异均有统计学意义(P均＜0.05);上述指标在雌二醇组和芹菜素中剂量组间比较差异均无统计学意义(P均＞0.05),芹菜素低、中、高剂量组呈剂量依赖性.与假手术组比较,模型组大鼠骨组织Runx2、OCN、OPG 蛋白表达降低[(0.43±0.06)vs.(1.02±0.15)、(0.33±0.04)vs.(1.06±0.16)、(0.29±0.03)vs.(0.98±0.14)],RANKL蛋白表达上升[(1.62±0.24)vs.(0.68±0.09)],差异均有统计学意义(P均＜0.05);与模型组比较,雌二醇组以及芹菜素低、中、高剂量组大鼠骨组织Runx2、OCN、OPG蛋白表达上升,RANKL蛋白表达降低,差异均有统计学意义(P均＜0.05);上述指标在雌二醇组和芹菜素中剂量组间比较差异均无统计学意义(P均＞0.05),芹菜素低、中、高剂量组呈剂量依赖性.结论 芹菜素可抑制绝经后骨质疏松症骨吸收,促进骨形成,可能与激活PI3K/Akt通路,促进Runx2、OCN、OPG表达,抑制RANKL表达,上调BALP、PINP水平上升,下调CTX-1、TRAP5b水平相关.

目的 基于Wnt信号通路探讨原花青素改善骨质疏松症的作用与分子机制.方法 取50只SD雌性大鼠通过卵巢切除术构建骨质疏松症大鼠模型,将建模成功的大鼠随机分为模型组、阿仑膦酸钠组和原花青素低、中、高剂量组.另取10只SD大鼠记为对照组,对照组仅翻动双侧卵巢不做切除.阿仑膦酸钠组按1 mg/kg灌胃给予阿仑膦酸钠;原花青素低、中、高剂量组分别按15、25、35 mg/kg灌胃给予原花青素;对照组、模型组分别灌胃给予等量生理盐水.酶联免疫测试法(ELISA)测定各组大鼠血清氧化应激相关指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]水平和骨代谢指标[抗酒石酸酸性磷酸酶(TRAP)、Ⅰ型胶原羧基末端肽(PICP)、血清骨钙素(BGP)]含量;骨密度扫描仪扫描检测各组大鼠股骨的骨密度(BMD)值;苏木素-伊红(HE)染色观察各组大鼠骨组织形态学变化;实时荧光定量聚合酶链式反应(RT-PCR)和蛋白免疫印迹法(WB)检测骨组织Wnt、β-连环蛋白(β-catenin)、成骨标志蛋白[Runt相关转录因子2(Runx2)、Osterix]mRNA和蛋白表达.结果 与对照组比较,模型组、阿仑膦酸钠组和原花青素低、中、高剂量组大鼠血清MDA、TRAP升高,SOD、GSH-Px、PICP、BGP降低(P<0.05);与模型组比较,阿仑膦酸钠组和原花青素低、中、高剂量组大鼠股骨血清MDA、TRAP降低,SOD、GSH-Px-PICP、BGP升高(P<0.05).对照组大鼠骨小梁呈网状排列、连接紧密.模型组骨小梁数量降低、排列稀疏紊乱、连续性差.与模型组比较,阿仑膦酸钠组和原花青素低、中、高剂量组骨小梁数量及结构上均存在不同程度的改善.与对照组比较,模型组、阿仑膦酸钠组和原花青素低、中、高剂量组大鼠骨组织Wnt、β-catenin、Runx2、Osterix mRNA及蛋白表达均降低(P<0.05),与模型组比较,阿仑膦酸钠组和原花青素低、中、高剂量组大鼠骨组织Wnt、β-catenin、Runx2、Osterix mRNA及蛋白表达均升高(P<0.05).结论 原花青素能有效改善骨质疏松症大鼠氧化应激和骨代谢指标,发挥治疗骨质疏松症的作用,推测是通过调控Wnt通路抑制过氧化应激反应,促进Wnt、β-catenin及成骨标志蛋白Runx2、Osterix的表达实现此作用的.

目的:探讨积雪草酸对大鼠绝经后骨质疏松症(OP)的治疗作用及相关机制.方法:采用一次性手术摘除双侧卵巢方式构建绝经后 OP大鼠模型,分为模型组(9 只)、雌二醇组(10 只)、积雪草酸低剂量组(10 只)、积雪草酸中剂量组(10 只)和积雪草酸高剂量组(10 只).另取 9 只大鼠作为假手术组.观察骨组织病理改变、骨密度及微结构,以及血清骨代谢指标、骨代谢相关基因及蛋白表达.结果:雌二醇组和积雪草酸低、中、高剂量组均可减轻骨组织病理改变,增加骨密度,改善骨微结构.与假手术组比较,模型组大鼠股骨骨密度(BMD)、骨体积分数(BV/TV)、骨小梁数目(Tb.N)、骨小梁厚度(Tb.Th)下降,结构模式指数(SMI)和骨小梁分离度(Tb.Sp)上升,血清骨碱性磷酸酶(BALP)水平下降,Ⅰ型胶原交联氨基端肽(NTX-Ⅰ)和抗酒石酸酸性磷酸酶(TRAP)水平上升,骨组织音猬因子(SH H)、细胞表面跨膜蛋白Patched1(Ptc1)、7 次跨膜蛋白(Smo)、Gli家族锌指蛋白-1(Gli1)、矮小相关转录因子2(Runx2)、骨保护素(OPG)、成骨细胞特异性转录因子(Osx)mRNA 和蛋白表达下降,细胞核因子-κB受体活化因子(RANKL)mRNA和蛋白表达上升(均P<0.05).与模型组比较,雌二醇组和积雪草酸低、中、高剂量组大鼠股骨BMD、BV/TV、Tb.N、Tb.Th上升,SMI和Tb.Sp下降,血清BALP水平上升,NTX-Ⅰ和TRAP水平下降,骨组织 SHH、Ptc1、Smo、Gli1、Runx2、OPG、Osx mRNA 和蛋白表达上升,RANKL mRNA 和蛋白表达下降(均 P<0.05).雌二醇组和积雪草酸低剂量组上述指标比较差异无统计学意义(均P>0.05).积雪草酸低、中、高剂量组上述指标呈剂量依赖性(均P<0.05).结论:积雪草酸可治疗绝经后 OP,可能与激活 Hedgehog信号通路相关.

目的:探讨柚皮苷通过环磷酸腺苷(cAMP)/蛋白激酶A(PKA)/cAMP反应元件结合蛋白(CREB)通路促进人脂肪间充质干细胞成骨分化的作用.方法:取人脂肪间充质干细胞培养传代,将细胞分为对照组、柚皮苷低、中、高剂量组、cAMP抑制剂(SQ22536)组、成骨分化诱导组(诱导组),柚皮苷低、中、高剂量组分别加12.5μmoL/L、25μmoL/L、50μmoL/L柚皮苷,SQ22536组加100μmoL/L SQ22536,诱导组加10～8moL/L地塞米松、10mmoL/Lβ-甘油磷酸钠和50mg/L抗坏血酸;对照组仅加等体积培养液,每组设置6个复孔.培养48h后,碱性磷酸酶(ALP)染色,磷酸对硝基苯酯(PNPP)法检测各组细胞ALP活性;茜素红S(ARS)染色观察各组细胞钙沉积情况;酶联免疫吸附试验(ELISA)检测各组细胞cAMP水平;实时定量聚合酶链反应(RT-qPCR)检测各组细胞PKA、CREB、矮小相关转录因子2(RUNX2)、骨钙素蛋白(OCN)、骨桥蛋白(OPN)信使核糖核酸(mRNA)表达;蛋白质免疫印迹法(WB)检测各组细胞PKA、CREB、RUNX2、OCN、OPN蛋白表达及p-PKA、p-CREB水平.结果:ALP染色后显示对照组细胞可见少量蓝色沉淀,SQ22536组蓝色沉淀最少,诱导组和柚皮苷3剂量组蓝色沉淀逐渐增多;与对照组比,SQ22536组ALP活性显著下降(P<0.01);与对照组和SQ22536组比,诱导组和柚皮苷3剂量组ALP活性显著上升(P<0.01);对照组存在少量钙沉积,SQ22536组细胞钙沉积显著减少,诱导组和柚皮苷3剂量组钙沉积逐渐增多;与对照组比,SQ22536组细胞cAMP水平、PKA、CREB、RUNX2、OCN、OPN mRNA和蛋白表达及p-PKA、p-CREB水平显著下降(P<0.01);与对照组和SQ22536组比,诱导组和柚皮苷3剂量组cAMP水平、PKA、CREB、RUNX2、OCN、OPN mRNA和蛋白表达及p-PKA、p-CREB水平上升,差异有统计学意义(P<0.05或P<0.01);诱导组和柚皮苷低剂量组上述指标差异无统计学意义(P>0.05);上述指标柚皮苷呈剂量依赖性.结论:柚皮苷可促进人脂肪间充质干细胞成骨分化,可能与激活cAMP/PKA/CREB信号通路,促进RUNX2、OCN、OPN表达,上调ALP活性相关.

In benign squamous lesions and in organotypic epithelial cultures, the human papillomavirus (HPV) E6 and E7 genes are transcriptionally up-regulated in differentiated, spinous keratinocytes. We previously identified sequence elements in the enhancer-promoter regions of HPV types 18 and 11 important for this promoter regulation by using the bacterial LacZ reporter gene in stratified raft cultures of primary human keratinocytes (PHKs) or in submerged, proliferating cultures acutely transduced with recombinant retroviruses. Notably, mutations in the promoter-proximal Sp1, Oct1, and AP1 sites each significantly reduce reporter activity in differentiated cells, indicating that the bound factors are transcription transactivators. In the present study, we performed further mutagenesis on distal motifs in the HPV-11 regulatory region in PHKs in submerged and raft cultures. Mutations in an AP2-like site, three individual NF-1 sites, or five NF-1 sites collectively reduced promoter activity slightly in differentiated cells. A mutation in a putative glucocorticoid response element had no discernable effect in the presence or the absence of dexamethasone. However, mutations in a C/EBP binding site, especially the distal site, strikingly up-regulated reporter gene expression, particularly in basal and lower spinous cells, implicating bound protein as a transcription repressor. Collectively, these results demonstrate that the overall differentiation-dependent papillomaviral gene expression observed in vivo and in vitro involves promoter repression in the lower strata and activation in the upper, differentiated strata.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).This article has been retracted at the request of the Editor-in-Chief.Concerns were raised about the similarities between the background of the Western Blots from Figures 4B and 4D. Also, given the comments of Dr Elisabeth Bik regarding this article "... the Western blot bands in all 400+ papers are all very regularly spaced and have a smooth appearance in the shape of a dumbbell or tadpole, without any of the usual smudges or stains. All bands are placed on similar looking backgrounds, suggesting they were copy/pasted from other sources, or computer generated", the journal requested the authors to provide the raw data. However, the authors were not able to fulfil this request and therefore the Editor-in-Chief decided to retract the article.

目的 探讨自拟补阳还五汤预防全髋关节置换术(THA)后深静脉血栓形成(DVT)的价值.方法 以60例行THA的患者为对象,随机分为观察组(常规治疗+补阳还五汤)与对照组(常规治疗).比较两组下肢DVT发生率.结果 观察组下肢DVT发生率为3.33％,低于对照组23.33％(P<0.04).两组治疗后D二聚体(D?D)水平降低(P<0.05),活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)未见明显变化(P>0.05).两组治疗后股静脉血流峰速度、平均速度加快,观察组高于对照组(P<0.05).观察组并发症发生率为6.67％,低于对照组36.67％(P<0.05).结论 补阳还五汤可有效减少THA术后下肢DVT的发生,促进下肢静脉血液流速,安全性较高.

目的 对比观察手法复位弯角经皮椎体成形术(percutaneous curved vertebroplasty,PCVP)与单侧经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床效果.方法 选取我院2019年1—12月收治的85例OVCF患者,根据治疗方法 的不同分为两组.复合组40例采用手法复位PCVP治疗,常规组45例采用单侧PKP治疗.记录两组手术时间、术中透视次数、骨水泥用量、骨水泥渗漏率、治疗费用、骨水泥分布等级,术前术后后凸Cobb角、伤椎前缘高度(AVH)、疼痛视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(oswestry disability index,ODI)评分.结果 复合组手术时间短于常规组,术中透视次数、治疗费用少于常规组,差异均有统计学意义(P<0.05或P<0.01).复合组骨水泥用量大于常规组,骨水泥分布等级优于常规组,差异均有统计学意义(P<0.05或P<0.01).两组骨水泥渗漏率比较差异无统计学意义(P>0.05).两组术后后凸Cobb角、AVH、VAS评分、ODI评分均较术前改善(P<0.01),但两组组间比较差异均无统计学意义(P>0.05).结论 手法复位PCVP治疗OVCF不仅可达到常规PKP复位伤椎、改善后凸畸形的效果,而且可减少术中透视次数、缩短手术时间和降低治疗费用,但在缓解疼痛、改善脊柱功能方面无明显优势.

Abstract Background Osteoporosis (OP) is a well-known chronic degenerative disease, with impaired mesenchymal stem cells (MSCs) function and suppressed osteogenic differentiation. Total glycosides from Eucommia ulmoides seed (TGEUS) was a Chinese medicine and have rich pharmacological effects. This study was designed to explore the mechanism of TGEUS in promoting osteogenic differentiation and bone formation in ovariectomized (OVX) rats. Methods Adipose‐derived mesenchymal stem cells (ADSCs) were isolated and treated with different concentration of TGEUS. Cell viability was assessed using cell counting kit-8 (CCK-8) assay. Osteogenic capacity was identified by ALP staining and ARS staining. Moreover, RNA sequencing between control and TGEUS treated ADSCs were further performed to reveal the mechanism of TGEUS in promoting osteogenic differentiation. The expression of Jag1, Lfng and Hey1 were measured using quantitative real-time polymerase chain reaction (qRTPCR). Osteogenic markers were further assessed by western blot. DAPT and NICD were further used to identify whether Notch signaling pathway involved into TGEUS promoting osteogenic differentiation of ADSCs. Ovariectomy-induced bone loss rats model was established and divided into three groups: sham, OVX and OVX + TGEUS groups. HE staining and immunohistochemical staining were further performed to identify whether TGEUS could promote bone formation. Results TGEUS treatment significantly enhanced the cell viability and ALP activity than control group, the optimal dose of TGEUS was 5 μM. We selected 5 μM TGEUS for further study. TGEUS significantly enhanced ALP activity and calcium deposition than that of control group. Activation of Notch signaling fully blocked TGEUS-induced osteogenic differentiation of ADSCs. Following TGEUS treatment, the trabecular bone of the rats was significantly increased, thickened, and more connected compared to the OVX group. With the treatment of TGEUS, the expression of Osterix (Osx), Osteocalcin (OCN) and RUNX Family Transcription Factor 2 (RUNX2) increased than OVX group. Conclusion TGEUS enhanced osteogenic differentiation of ADSCs and promoted bone formation in ovariectomy-induced bone loss rats. Our study broadened the understanding of TGEUS as a therapeutic target against osteoporosis.

目的:对比手法复位结合经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗新鲜单节段骨质疏松性椎体压缩骨折(OVCF)的临床疗效.方法:回顾性收集我院收治的63例OVCF患者的临床资料,依采用手法复位结合PVP方法分为观察组32例,采用PKP方法分为对照组31例.记录两组手术时间、骨水泥渗漏例数、住院天数、治疗费用,以及术前术后伤椎前缘高度(AVH)、伤椎后凸Cobb角、疼痛视觉模拟(VAS)评分、Oswestry功能障碍指数(ODI)评分.结果:63例患者均顺利完成手术.观察组手术时间、治疗费用少于对照组,差异均有统计学意义(P<0.05).两组骨水泥渗漏例数、住院天数比较差异均无统计学意义(P>0.05).两组术后AVH、Cobb角、VAS评分、ODI评分对比术前,差异均有统计学意义(P<0.05);但两组间上述指标比较,差异均无统计学意义(P>0.05).结论:手法复位结合PVP与PKP治疗OVCF均可获得满意的临床疗效,但手法复位结合PVP具有手术时间短、治疗费用少的优势.

目的:探讨续断醇提物(RD)对骨关节炎(OA)的治疗作用及相关信号通路的影响.方法:将SD雄性大鼠(220～250 g)48只随机分为假手术组、模型组、RD-L,RD-M,RD-H及阳性对照组,采用右膝关节前交叉韧带切断术复制大鼠骨关节炎模型,评估OA大鼠的关节炎指数和机械性痛阈值;采用苏木精-伊红和TUNEL染色检测OA大鼠滑膜组织的病理变化;采用ELISA和RT-PCR法分别检测OA大鼠血清和滑膜组织中IL-6,IL-1β,TNF-α的含量和表达水平;采用Western Blot法检测OA大鼠滑膜组织中Wnt/β-catenin信号分子蛋白的表达水平.结果:续断醇提物能够减小关节炎指数和增加机械性痛阈值,差异有统计学意义(P＜0.05),同时缓解滑膜炎性细胞浸润和滑膜细胞凋亡,除此之外,还能够降低OA大鼠血清中IL-6,IL-1β,TNF-α的含量和下调滑膜组织中IL-6,IL-1β,TNF-α的表达水平,也能够下调滑膜组织中Wnt和β-catenin的蛋白表达,差异有统计学意义(P＜0.05).结论:续断醇提物对骨关节炎具有潜在的保护作用,同时抑制滑膜组织Wnt/β-catenin信号通路活化.

目的 观察弯角椎体成形术(PCVP)治疗骨质疏松性椎体压缩骨折( OVCF)的临床疗效.方法 收集2018年12月—2019年6月延安大学附属医院骨科收治老年新鲜单节段脊柱胸腰段OVCF患者76例临床资料,依据术中是否采用PCVP分为弯角组36例和常规组40例.弯角组采用PCVP完成手术;常规组采用常规单侧经皮椎体成形术(PVP)完成手术.观察2组手术时间、术中透视次数、骨水泥注入量、骨水泥渗漏率、骨水泥双侧分布率,术前术后疼痛视觉模拟(VAS)评分、Oswestry功能障碍指数( ODI)评分及手术预后情况.结果 2组手术时间、术中透视次数比较,差异均无统计学意义(P＞0. 05).弯角组骨水泥注入量、骨水泥双侧分布率大于常规组,而骨水泥渗漏率小于常规组,差异均有统计学意义(t/P=2. 308/0. 023, Z/P=3. 638/0. 000, χ2/P=4. 395/0. 036). 2组术后VAS评分、ODI评分较术前均降低,差异有统计学意义(t/P=28. 134/0. 000、29. 840/0. 000,11. 979/0. 000、11. 887/0. 000);2组间比较,差异无统计学意义(P＞0. 05). 76例手术均顺利完成,术中未出现血管神经损伤等并发症.结论 与常规PVP比较,采用PCVP治疗新鲜单节段OVCF,在降低骨水泥渗漏风险的同时,有效地增加骨水泥注入量、改善骨水泥双侧分布情况;但在术后疼痛缓解和功能改善方面无明显优势.

目的:探讨内固定技术治疗肱骨大结节撕脱性骨折的临床疗效.方法:选取65例患者,随机两组(接骨板内固定组和锚钉内固定组),分别给予接骨板固定手术和锚钉固定手术.结果:接骨板内固定组有效率86.6％,无复发,无不良反应.锚钉内固定组有效率77.2％,无复发,有2例不良反应.此外,接骨板内固定组和锚钉内固定组患者相比,肩关节疼痛与活动范围均有改善.结论:接骨板内固定手术方法在肱骨大结节撕脱性骨折的治疗上,与锚钉内固定方法相比,具有较高的安全性和显著的疗效.

目的 探讨金天格胶囊联合阿法骨化醇软胶囊治疗绝经后骨质疏松症的临床疗效.方法 选取2016年6月—2018年6月延安大学附属医院收治的124例绝经后骨质疏松症患者为研究对象,运用简单随机数字表法将这124例患者随机分为治疗组和对照组,每组各62例.对照组口服阿法骨化醇软胶囊,2粒/次,1次/d.治疗组在对照组基础上口服金天格胶囊, 3粒/次,3次/d.两组均连续治疗6个月.观察两组的临床疗效,比较两组的症状积分、骨密度(BMD)值、骨转换标志物和炎症因子.结果 治疗后,对照组和治疗组的总有效率分别为 79.0%、91.9%,两组比较差异有统计学意义(P＜0.05).治疗后,两组腰膝酸软、下肢痿弱、腰背疼痛、步履艰难、下肢疼痛积分均显著降低,同组治疗前后比较差异有统计学意义(P＜0.05);且治疗组症状积分明显低于对照组,两组比较差异有统计学意义(P＜0.05).治疗后,两组大转子、股骨颈、Ward三角区、腰椎L1～4的BMD值均显著升高,同组治疗前后比较差异有统计学意义(P＜0.05);且治疗组大转子、股骨颈、Ward三角区、腰椎L1～4的BMD值均明显高于对照组,两组比较差异有统计学意义(P＜0.05).治疗后,两组骨特异性碱性磷酸酶(BALP)、Ⅰ型原胶原N-端前肽(PⅠNP)、抗酒石酸酸性磷酸酶(TRACP)-5b、Ⅰ型胶原C-末端肽交联(CTX)水平均显著降低,同组治疗前后比较差异有统计学意义(P＜0.05);且治疗组 BALP、PⅠNP、TRACP-5b、CTX、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-17 水平明显低于对照组,两组比较差异有统计学意义(P＜0.05).结论 金天格胶囊联合阿法骨化醇软胶囊治疗绝经后骨质疏松症具有较好的临床疗效,可减轻患者骨质疏松的相关症状,提高骨骼质量,减少血中炎症因子水平,具有一定的临床推广应用价值.

目的 探讨G型臂X线机辅助单侧穿刺微创经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的效果.方法 回顾性分析2017年10月至2018年6月在宝鸡市金台医院及渭南市中心医院骨科接受单侧穿刺PKP治疗的80例单节段OVCF患者的临床资料,依据术中PKP穿刺引导仪器的不同将患者分为G臂机组(38例)与C臂机组(42例).比较两组的手术效果.结果 G臂机组手术时间短于C臂机组,术中透视次数少于C臂机组(P<0.05).两组骨水泥渗漏率及末次随访椎体再骨折率比较,差异无统计学意义(P>0.05).术后,两组患者AVH、后凸Cobb角、VAS评分及ODI评分均优于术前(P<0.05).术后,两组患者AVH、后凸Cobb角、VAS评分及ODI评分比较,差异无统计学意义(P>0.05).结论 G型臂和C型臂X线机辅助单侧微创PKP治疗OVCF可取得相似临床效果,但G型臂X线机的使用可有效缩短手术时间,避免无效透视.

目的:探讨青蒿琥酯对膝关节骨性关节炎患者膝关节功能及膝关节液与血清中炎症因子的影响.方法:100例膝关节骨性关节炎患者随机分为两组,每组50例.在常规治疗基础上,对照组给予布洛芬治疗,观察组给予青蒿琥酯治疗.观察两组疗效与安全性,对比两组患者治疗前后膝关节液及血清炎症因子水平以及膝关节功能变化.结果:两组有效率差异无统计学意义(P>0. 05).治疗后两组患者血清及关节腔中炎症因子均较治疗前有明显下降,JKOM明显提高(P<0. 05),且观察组各项指标均优于对照组(P<0. 05).两组患者治疗后不良反应发生率差异无统计学意义(P<0. 05).结论:青蒿琥酯对膝关节骨性关节炎疗效确切安全性高,可明显降低患者血清及关节腔内炎症因子水平、改善膝功能.

目的 探讨腓骨固定在治疗胫腓骨远端复合骨折中的作用.方法 将60例胫腓骨远端复合骨折患者随机分为腓骨固定组和对照组,每组各30例;腓骨固定组行腓骨固定联合胫骨固定术,对照组行单纯胫骨固定术.对获得9个月完整随访的患者在术后1、3、6、9个月通过体检及影像学检查评价踝关节内外翻角度、旋前旋后角度、骨折愈合与否、并发症发生率等指标.结果 55例患者获得随访,腓骨固定组3例失访、对照组2例失访.术后1、3、6、9个月踝关节内外翻、旋前旋后角度腓骨固定组均明显小于对照组(P<0.05).术后6、9个月胫骨骨折愈合率腓骨固定组均优于对照组(P<0.05),术后3、6、9个月的腓骨骨折愈合率腓骨固定组均优于对照组(P<0.05).两组术后感染、神经损伤等并发症发生率比较差异均无统计学意义(P>0.05).结论 腓骨固定联合胫骨固定术治疗胫腓骨远端复合骨折具有重要作用,患者术后的踝关节功能及骨折愈合率良好.