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Objective:To investigate the effect of mechano-growth factor（MGF）on osteoclast activity and its mechanism.Methods:The RAW264.7 precursor osteoclast cell line was cultured with 25 ng/ml macrophage-colony stimulating factor（M-CSF）and 30 ng/ml receptor activator of NF-κB ligand（RANKL），and identified by tartrate resistant acid phosphatase（TRAP）staining after 7 days of culture. Western blot anslysis was used to determine the effect of 45 ng/ml MGF on the phosphoinositide-3-kinase/protein kinase B（PI3K/AKT）signaling pathway in separated osteoclasts，including levels of AKT，phosphorylation（p）-AKT，lactation mammalian target of rapamycin（mTOR），p-mTOR and TRAP at 0，4，8 and 12 hours. Real-time fluorescence quantitative PCR was used to expressions of TRAP in osteoclasts at 0，4，8 and 12 hours. The PI3K/Akt phosphorylation inhibitor LY294002（20 μmol/L）combined with MGF（45 ng/ml）was used to act on osteoclasts，and expression levels of Akt，p-Akt，mTOR，p-mTOR and TRAP were detected by Western blot at 0，4，8 and 12 hours.Results:After culturing RAW264.7 cells with M-CSF and RANKL for 7 days，a large number of osteoclasts with positive TRAP staining can be obtained. Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time（ P>0.05），expression levels of p-Akt and p-mTOR increased continuously from（2.18±0.34）pg/ml and（0.83±0.10）pg/ml at 0 hour to（3.86±0.36）pg/ml and（1.56±0.19）pg/ml at 12 hours（ P<0.05），and expression level of TRAP decreased significantly over time，from（5.66±0.47）pg/ml at 0 hour to（3.76±0.38）pg/ml at 12 hours（ P<0.05）. Real-time fluorescence quantitative PCR analysis of expression of TRAP in osteoclasts showed that MGF inhibited the expression of TRAP in osteoclasts，which decreased from 1.02±0.06 at 0 hour to 0.53±0.11 at 12 hours（ P<0.05）. After acting LY294002 combined with MGF on osteoclasts，Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time（ P>0.05），expression levels of p-AKT and p-mTOR decreased significantly from（3.28±0.18）pg/ml and（3.29±0.22）pg/ml at 0 hour to（2.06±0.34）pg/ml and（2.04±0.20）pg/ml at 12 hours（ P<0.05），and expression level of TRAP had no significant difference over time（ P>0.05）. Conclusions:MGF inhibits osteoclast activity by inhibiting the expression of TRAP in osteoclasts through PI3K/Akt signaling pathway. LY294002 inhibits the expression of PI3K/Akt signaling pathway in osteoclasts，further verifying the mechanism of MGF inhibiting osteoclast activity，and this finding puts forward new ideas for clinical prevention and treatment of osteoporosis.
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Objective:To summarize the age, gender difference, cause, location, time, treatment and prognosis of femoral intertrochanteric fracture complicated with pseudoaneurysm, and analyze the influence of different treatment methods on the occurrence of femoral intertrochanteric fracture complicated with pseudoaneurysm.Methods:Using the method of systematic literature review, a total of 76 literatures were retrieved from multiple databases at home and abroad, and 45 literatures were screened out through the second screening of title, abstract and full text. The patients with intertrochanteric fracture complicated with pseudoaneurysm were selected as the research objects, and the duplicate cases were deleted; the age, gender, onset age, etiology, location, treatment and prognosis of the disease were retrospectively analyzed.Results:A total of 54 cases of femoral intertrochanteric fracture related pseudoaneurysms were selected from 45 literatures, including 25 males and 27 females, and 2 cases had no gender; aged from 43 to 94 years old, and 4 cases were younger than 60 years old, 6 between 61 and 70, 17 between 71 and 80, and 25 between 81 and 90. Forty-five cases occurred in deep femoral artery, 3 cases in superficial femoral artery, 1 case in superior gluteal artery, 1 case of medial circumflex artery, 1 case of lateral circumflex femoral artery, 1 case of femoral artery, and 2 cases of unknown location. The occurrence time of pseudoaneurysm: 17 cases within 1 week after fracture, 8 cases from 1 week to 3 weeks, 19 cases from 3 weeks to 3 months, 2 cases more than 3 months, and 8 cases unknown. The causes of pseudoaneurysm: among the 54 patients, 41 cases had definite causes, including 21 cases of vascular injury caused by fracture block; 20 cases of iatrogenic injury, of which the incidence of direct injury of blood vessels by screw or drill was the highest, accounting for 55% (11/20). Twenty-two cases were treated with vascular embolization, 10 cases with surgical sutures, 8 cases with surgical ligation, 4 cases with resection of pseudoaneurysm, 5 cases with covered stent, and 4 cases with thrombin injection. There were 42 cases who had follow-up data, and no recurrence and other complications were found during the follow-up period.Conclusion:The peak age of femoral intertrochanteric fracture complicated with pseudoaneurysm was 71-90 years old. The incidence of femoral intertrochanteric fracture complicated with pseudoaneurysm was more often within 1 week after fracture and 3 weeks to 3 months after fracture, due to fracture fragments and iatrogenic vascular injury caused by the location of the profundus femoris artery. Treatment options include vascular embolization, surgical ligation, suture or resection of pseudoaneurysm, covered stent and thrombin injection, and the prognosis is generally good.
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Objective@#To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach.@*Methods@#A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics, The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018. They were 5 males and 3 females, aged from 35 to 62 years (average, 43.5 years). According to the Letournel-Judet classification, 3 cases were T-shaped fractures, 4 anterior column plus posterior hemitransverse fractures and one both column fracture. The interval from injury to operation averaged 8 days (from 7 to 17 days). The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws, all through the ilioinguinal approach. The quality of fracture reduction, fracture union time, function of the affected hip and complications were recorded.@*Results@#By the Matta imaging criteria, the quality of fracture reduction was rated as excellent in 7 cases and as fine in one. Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients. This cohort obtained an average follow-up of 8 months (from 6 to 18 months). All fractures united well after an average of 10 weeks (from 8 to 12 weeks). The function of affected hip evaluated by the improved Merle d’Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one. Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification.@*Conclusions@#For patients with complex acetabular fracture involving the posterior column, internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects, because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented. This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor.
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Objective To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach.Methods A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics,The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018.They were 5 males and 3 females,aged from 35 to 62 years (average,43.5 years).According to the Letournel-Judet classification,3 cases were T-shaped fractures,4 anterior column plus posterior hemitransverse fractures and one both column fracture.The interval from injury to operation averaged 8 days (from 7 to 17 days).The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws,all through the ilioinguinal approach.The quality of fracture reduction,fracture union time,function of the affected hip and complications were recorded.Results By the Matta imaging criteria,the quality of fracture reduction was rated as excellent in 7 cases and as fine in one.Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients.This cohort obtained an average follow-up of 8 months (from 6 to 18 months).All fractures united well after an average of 10 weeks (from 8 to 12 weeks).The function of affected hip evaluated by the improved Merle d'Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one.Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification.Conclusions For patients with complex acetabular fracture involving the posterior column,internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects,because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented.This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor.
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Objective To investigate whether Bushen-Huoxue compound adjuvant therapy can be effective on mild cognitive impairment in Parkinson's disease and the influence on plasma phospholipids(PLs) levels. Methods 87 PD patients were recruited and collected for the general information. The patients were evaluated by Unified Parkinson's Disease Rating Scale(UPDRS) Ⅲ and Montreal Cognitive Assessment(MoCA). According to MoCA scores, patients with PD-MCI were divided into a Bushen-Huoxue compound treatment group and a control group(basic L-dopa or dopamine agonist). Reevaluating cognitive function by MoCA and plasma phopholipids levels at posttreatment 12 month and 18 month. Plasma PLs was assayed by measuring its inorganic phosphorus after separation by chromatograph.Results 39 cases in 87 PD patients(44.8%)were with PD-MCI.After 12 months or 18 months treatment period, MoCA scores was significantly higher in Bushen-Huoxue compound treatment group than in controls(P<0.05 or 0.01 respectively). Plasma PLs levels were significantly decreased in Bushen-Huoxue compound treatment group than in controls(P<0.01 or 0.01 respectively). Conclusions Bushen-Huoxue compound could be effective in the adjuvant treatment of PD-MCI, and could delay cognitive rate of decline in patients with PD. Meanwhile, Bushen-Huoxue compound could significantly decrease plasma PLs levels in PD-MCI. The evidence from present study suggested that Bushen-Huoxue compound have neuroprotective effects on patients with PD-MCI.