Early efficacy analysis on arthroscopic autologous osteochondral grafting in the treatment of recurrent anterior shoulder dislocation / 中国骨伤

OBJECTIVE@#To investigate the early efficacy of arthroscopic autologous osteochondral grafting in the treatment of recurrent anterior shoulder dislocation.@*METHODS@#From January 2019 to January 2021, 17 patients with recurrent anterior dislocation of shoulder who underwent arthroscopic autologous osteochondral grafting were selected, including 12 males and 5 females, ranging in age from 17 to 55 years old, with a mean of (32.88±12.33) years old. Rowes rating system for Bankart repair(Rowe), Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test (SST) were compared before operation, 6 months after operation and at the latest follow-up. OSIS and SST used to evaluate shoulder function were recorded before surgery and at the latest follow-up. The shoulder mobility and intraoperative and postoperative complications were also recorded.@*RESULTS@#All 17 patients were followed up, and the duration ranged from 7 to 25 months, with a mean of (18.4±5.4) months. During the follow-up period, there was no re-dislocation, no vascular or nerve injury. Rowe score increased from 26.2±6.0 before operation to 74.4±4.0 and 82.4±3.1 after 6 months and the latest follow-up. There was significant difference in Rowe score between different time points after operation and before operation (P<0.05). The OSIS increased from 37.0±3.6 before operation to 47.4±2.6 and 52.7±2.6 after 6 months and the latest follow-up. There was significant difference in OSIS between different time points after operation and before operation (P<0.05). The SST score increased from 6.8±0.7 before operation to 9.8±0.8, 11.6±2.6 after 6 months and the latest follow-up. There was significant difference in SST score between different time points after operation and before operation (P<0.05). At the latest follow-up, the lateral external rotation and abduction external rotation activities of the patient were significantly improved compared with those before operation.@*CONCLUSION@#This study provides preliminary evidence that arthroscopic autologous osteochondral grafting can achieve satisfactory early clinical outcomes and stability in patients with recurrent anterior shoulder dislocation with glenoid fracture and defect less than <20%, which is a reliable and effective procedure.

Progress on the treatment of recurrent anterior dislocation of shoulder with bone defect / 中国骨伤

Recurrent anterior dislocation of shoulder with bone defect is one of the common diseases of shoulder joint. How to effectively repair glenoid bone defect and reduce recurrence rate of shoulder dislocation is a problem that clinicians focus on. Bone grafting could stimulate bone, promote bone regeneration and bone remodeling, and restore the normal anatomical structure of glenoid. Among them, Bristow-Latarjet procedure is a classic operation for recurrent shoulder dislocation. Latarjet procedure could repair larger glenoid bone defects, but with higher surgical skills for surgeons;autogenous iliac grafting is the first choice for revision once Latarjet procedure failed;osteochondral grafting (autogenous and allogenous) has certain advantages in reconstructing original articular surface and preventing joint degeneration, but autologous osteochondral grafting may cause secondary injury, while immune rejection is difficult to avoid for allogenous osteochondral grafting. With the improvement of composite materials, and the mechanism of bone regeneration and remodeling, as well as the advantages and disadvantages of bone grafting, tissue engineering technology may become an effective method for the treatment of glenoid bone defect in the future.

Suture technique for rotator cuff tears' repair under arthroscopic / 中国骨伤

Shoulder arthroscopic as a conventional method usually is applied to repair rotator cuff tears. In clinical, plenty single-row, double-row and transosseous tunnels suture technique are performed, but the ideal suture technique for rotator cuff repair is not found. Compared with single-row, double-row has better strength in biomechanics property. As the two best suture technique among the single-row, massive cuff stitch and modified Mason-Allen suture have the strongest biomechanics property. Clinical trials indicate that double-row could improve healing rates, but there are no significant difference in clinical outcome functional scores. Transosseous tunnel techniques possess a better bio-mechanic property, which could improve regional micro-environment and induce tendon-bone healing. Transosseous tunnel techniques are better for small to media size rotator cuff tears and osteoporosis patient. The author suggest that optimal rotator cuff repair technique should performed according to skill of performer and individual of patient by analysing bio-mechanic properties, clinical outcome, operative complexity and patient situation. The technique should follow simple opertaion, rapid, less trauma, stable fixation and utility to perform.

Progress on improving tendon-to-bone healing for the enthesis of rotator cuff / 中国骨伤

Rotator cuff repair is a common treatment for rotator cuff tear, which could effectively relieve shoulder pain and improve shoulder movement, and the incidence of rotator cuff retear after rotator cuff repair is still high. The main reason is poor tendon-bone healing in rotator cuff enthesis after rotator cuff repair and could not recover the original histological structure and biomechanical properties. Therefore, the key to solve the problem is how to effectively improve the healing of tendon bone at the end of rotator cuff. With the in-depth study of rotator cuff enthesis, various treatments have made great progress on improving tendon to bone healing of rotator cuff. Our study will discuss the researchprogress on tendon to bone healing of rotator cuff in recent years from three following aspects to provide some guidance for the clinical treatment of rotator cuff tear:the factors affecting the tendon to bone healing of rotator cuff, the recovery of tendon to bone interface promoting the tendon to bone healing of rotator cuff and the application of tissue engineering in tendon to bone healing.

Mechanism of Schisandrae Chinensis Fructus Lignans in Alleviating Learning and Memory Ability in D-galactose Aging Mice / 中国实验方剂学杂志

Objective:To study the effect of Schisandrae Chinensis Fructus lignans (SCL) on learning and memory ability of D-galactose（D-gal）-induced aging model mice. Method:ICR mice were randomly divided into 4 groups: normal group (distilled water, subcutaneous injection with normal saline), model group (distilled water, subcutaneous injection with 200 mg·kg-1D-gal), piracetam group (oral administration with 200 mg·kg-1 piracetam, subcutaneous injection with 200 mg·kg-1D-gal), low-dose SCL group (oral administration with 50 mg·kg-1·d-1 SCL, subcutaneous injection with 200 mg·kg-1·d-1 D-gal), medium-dose SCL group (oral administration with 100 mg·kg-1·d-1 SCL, subcutaneous injection with 200 mg·kg-1·d-1D-gal), high-dose SCL group (oral administration with 200 mg·kg-1·d-1 SCL, subcutaneous injection with 200 mg·kg-1·d-1 D-gal). The drugs were administered continuously for 10 weeks. Dark test and Morris water maze test were performed to observe the effect of SCL on the learning and memory ability of D-gal-induced aging mice. The activities of superoxide dismutase (SOD) and malondialdehyde (MDA) in mouse brain tissue were detected by chemical colorimetry. The expressions of peroxiredoxin-6（Prdx6） and glutathione peroxidase 1（GSH-Px1） mRNA in mouse brain tissue were detected by polymerase chain reaction (PCR). The expressions of Prdx6 and GSH-Px1 protein in mouse tissues were detected by Western blot. Result:In behavioral experiments, compared with normal group, the number of dark avoidance errors in model group significantly increased (P<0.05), the latency was significantly reduced (P<0.01), and the number of mouse passes and the target quadrant residence time were significantly reduced (P<0.01), which can be used as an indicator of successful modeling. Compared with the model group, the number of errors in the piracetam group, and medium and high-dose SCL groups was significantly reduced (P<0.05，P<0.01), and the latency was significantly prolonged (P<0.05，P<0.01). At the same time, the number of water maze passes and the target quadrant retention time in the high-dose SCL group increased significantly (P<0.01). The results of biochemical indicators showed that compared with normal group, the SOD activity in brain tissue of model group mice was significantly reduced (P<0.01), while the MDA content was increased (P<0.05). Compared with the model group, SOD activity in the brain tissues of piracetam group, and low, medium and high-dose piracetam groups was significantly increased (P<0.05), whereas the level of MDA was reduced (P<0.05). The expressions of Prdx6 and GSH-Px1 were significantly increased (P<0.05，P<0.01), indicating that the SCL administration group was dose-dependent. Conclusion:SCL can improve the learning and memory ability of D-gal-induced aging mice, which may be related to the anti-oxidation ability of SCL and the up-regulation of Prdx6 and GSH-Px1 expressions in mouse brain tissue.

Research advance in surface modification of titanium alloys with chitosan / 中国骨伤

Titanium alloy has good biological properties and is commonly used in orthopedics, but its bone integrity and antibacterial properties are poor, so surface modification is needed to make up for its shortcomings. Chitosan has good biocompatibility and film forming ability, and can be used as a carrier to introduce the target drug to the surface of titanium alloy, which can effectively improve the biological properties of titanium alloy materials and increase its application range. In this paper, the related research of chitosan surface modified titanium alloy materials in recent years is summarized. The modification methods of chitosan coating, the improvement of osteogenesisand antibacterial properties of titanium alloy materials are discussed in order to provide guidance for the clinical application of coating modification of titanium alloy materials.

Progress on effect of osteoporosis on rotator cuff repair / 中国骨伤

The rate of rotator cuff injury repair and retear is high in elderly patients due to the combination of different degrees of osteoporosis. To solve this problem, many surgeons try to reduce retear rate of rotator cuff injuries in these patients by increasing the initial fixation strength of anchors and changing local bone conditions. The rapid advances of tissue engineering have made it possible to use growth factors as an aid. However, repair of rotator cuff injury with osteoporosis is still a great challenge for clinical workers. How to better increase anchor fixation strength, improve micro-environment of tendon and bone healing, reduce the rotator cuff retear rate have become the research focus in recent years. The paper reviewed literatures on the relationshipbetween osteoporosis and rotator cuff injury, effect of osteoporosis in rotator cuff tendon healing, methods of reducing osteoporosis on rotator cuff tendon healing, in order to guide clinical treatment, improve operative effect and postoperative satisfaction.

Advances in Research on Mechanism of Salvianolic Acid B Against Oxidative Stress / 中国实验方剂学杂志

Salvia miltiorrhiza Bge was first published in Shennong Bencaojing. Salviae Miltiorrhizae Radix et Rhizoma has the effect of promoting blood circulation, cooling blood and eliminating phlegm. Modern pharmacological studies have found that Salviae Miltiorrhizae Radix et Rhizoma has strong heart, improve microcirculation and antithrombotic effects. The decoction of Salviae Miltiorrhizae Radix et Rhizoma is commonly used in clinical practice. The dissolved component of Salviae Miltiorrhizae Radix et Rhizoma is mainly salvianolic acid. Among them, salvianolic acid B is one of the water-soluble components of Salviae Miltiorrhizae Radix et Rhizoma. It has strong physiology. Activity, salvianolic acid B is the strongest antioxidant activity of salvianolic acids. Salvianolic acid B regulates nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, decoupled endothelial nitric oxide synthase (eNOS) in vivo, and regulates Janus protein tyrosine kinase 2/signal transducer and transcriptional activation 3/vascular endothelial growth factor (JAK2/STAT3/VEGF) and tumor suppressor(p53), B cell lymphoma-2(Bcl-2), Bcl-2-related X protein (Bax), Caspase-3 anti-apoptotic pathway, inhibition of extracellular signal-regulated kinase/mitogen-activated protein kinase (ERK/MAPK), c-Jun N-terminal kinase/mitogen-activated protein kinase (JNK/MAPK), mitogen-activated protein kinase p38 (p38MAPK) and estrogen receptor alpha/phosphatidylinositol 3-kinase/serine-threonine protein kinase/nuclear transcription factor kappa B (ERα/PI3K/Akt/NF-κB) anti-inflammatory pathway, silencing information regulator 2 related enzyme 1/nuclear factor E2 related factor 2/Kelch-like ECH combined protein 1-antioxidant response element (SIRT1/Nrf2/Keap1-ARE) and NAD-dependent deacetylase sirtuin Forkhead transcription factor 1/superoxide dismutase on-3/β cells (NAD-dependent deace tylase sirtuin-3, SIRT3/FOXO1/SOD2) antioxidant pathway and autophagy pathway inhibit oxidative stress and protect tissues and organs from oxidative damage. Based on the study of the pathway of salvianolic acid B against oxidative stress injury, this paper reviews the related research published in domestic and foreign journals in the past five years, and provides new ideas for expanding the clinical application range of salvianolic acid B.

Follow-up study on autogenous osteochondral transplantation for cartilage defect of knee joint / 中国骨伤

OBJECTIVE@#To evaluate clinical effect of autologous osteochondral transplantation in treating localized knee cartilage defects.@*METHODS@#Fifteen patients with knee cartilage defects were treated by autologous osteochondral transplantation from January 2007 to January 2008, including 8 females and 7 males, aged from 23 to 45 years old. Preoperative and postoperative KSS score at 10 years were compared.@*RESULTS@#All patients were followed up for 10.0 to 10.7 years, with an average of(10.2±0.3) years. Clinical score of KSS was improved from 38.86±4.09 to 85.07±2.19 at 10 years after operation(0.05). All patients had no other complications.@*CONCLUSIONS@#Through long-term follow-up of patients with cartilage defect in knee treated by autologous bone cartilage transplantation showed that this method could effectively improve function of knee joint and alleviate pain. So it is an effective method for repair of osteochondral defect.

Effect of deer bone polypeptides on bone microarchitecture of dexamethasone-induced osteoporosis rats / 中草药

Objective: To investigate the effect of deer bone polypeptides on bone microarchitecture of dexamethasone-induced osteoporosis (GIOP) rats. Methods: The rats were im given dexamethasone for establishing a rat GIOP model. The rats were ig given deer bone polypeptide with different doses for 75 d. The serum biochemical indexes were classic detection. The three-dimensional analysis of the trabecular structure of proximal tibia was conducted by microCT method; The pathological changes in the morphology of distal femur were observed by hematoxylin. Results: Deer bone polypeptides could increase serum Ca2+ and bone-gla-protein (BGP), decrease serum P3+, alkaline phorphatase (ALP), and parathyroid (PTH) in rats with GIOP. Deer bone polypeptide showed a tendency to reduce the serum CT in rats with GIOP, but the decreasing tendency was not statistically significant compared with the blank control group. The trabecula was thin and ruptured, its free ends increased, its number decreased, its spaces were widened, and the destructed space structures increased in rats with GIOP, while the intervention with deer bone polypeptides could significantly improve the above indexes to evaluate the bone microstructure. Conclusion: Deer bone polypeptides can inhibit the glucocorticoids-induced metabolism imbalance of calcium and phosphorus, reduce the serum ALP, increase the serum BGP, and inhibit the bone resorption and bone formation in rats with GIOP. Moreover, deer bone polypeptides can improve pathological changes in the microstructure and protect osteoporosis rats.

Reconstruction of complex proximal tibial defects using the long-stem tibial component combined with metallic wedge / 中国骨伤

<p><b>OBJECTIVE</b>To investigate results of total knee arthroplasty using the long-stem tibial component combined with metallic wedge of knee prosthesis for the treatment of proximal defects.</p><p><b>METHODS</b>From January 2011 to May 2013, 10 patients (11 knees) were treated with total knee arthroplasties using the long-stem tibial component with metallic tibial wedge of knee prosthesis. All the patients were female and the average age was 67 years old (ranged, 60 to 77 years old). All the patients were osteoarthritis. All the patients were classified as T2A style. The patients were evaluated according to knee score system (KSS).</p><p><b>RESULTS</b>All the patients were followed up for 12 months on average (ranged 3 to 29 months). The clinical outcome was assessed using KSS score, including knee pain score, knee stability score, knee range of motion score and knee walking score, knee stairs score. There were significantly differences at 6 weeks, 3 months, 6 months and 12 months between pre-and postoperative KSS score.</p><p><b>CONCLUSION</b>The mechanical stability of tibial fixation in primary TKA is significantly increased by using the long-stem tibial component with metallic wedge of knee prosthesis, even in the presence of poor proximal bone.</p>

Investigation of a compound, compatibility of Rhodiola crenulata, Cordyceps militaris, and Rheum palmatum on metabolic syndrome treatment III--controlling blood glucose / 中国中药杂志

Base on the improvement of compound FF16, compatibility of Rhodiola crenulata, Cordyceps militaris, and Rheum palmatum, on both insulin resistance and obesity, its effects on type 2 diabetes (T2DM ) was investigated here. The results showed that the levels of fasting and no-fasting blood glucose were controlled in the spontaneous type 2 diabetes KKAy mice; the impaired glucose tolerance (IGT)was improved by decreasing significantly the values of the glucose peaks and the area under the blood glucose-time curve (AUC ) after glucose-loading in glucose tolerance test (OGTT) in both high-fat-diet-induced pre-diabetes IRF mice and KKAy mice, respectively. The pancreatic histopathological analysis showed that the increased islet amount, the enlarged islet area, and the lipid accumulation in the pancreas were reversed by FF16 treatment in both IRF mice and KKAy mice. In the palmitate-induced RINm5f cell model, FF16 could effectively reduce the apoptosis and enhance the glucose-stimulated insulin secretion, respectively. In conclusion, FF16 could improve the T2DM by protecting the pancreatic beta-cells.

Treatment of tibial intercondylar eminence fracture under arthroscopy through patellofemoral joint space / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical outcome of arthroscopy techniques for the treatment of tibial intercondylar eminence fractures through patellofemoral joint space.</p><p><b>METHODS</b>From September 2008 to September 2012,45 patients (32 males, 13 females; ranging in age from 15 to 22 years old) with intercondylar eminence fractures (29 left knees and 16 right knees) were treated with reduction and fixation through patellofemoral joint space under arthroscopy. All fractures were fresh fracture and were treated within 10 days after trauma. The fractures were confirmed by X-ray. According to Meyers and McKeever classification, 27 patients had fractures with type III and 18 patients had fractures with type II. After operation, X-ray films were taken to evaluate fracture heal,and Lysholm criteria was used to evaluate therapeutic effects.</p><p><b>RESULTS</b>All the patients were followed up, and all fractures healed at 3 months after operation. During the follow-up period, all the patients had excellent or good results,without complications such as nonunion, limit extension caused by intercondyloid fossa knocking of knee joint, strengthening pain and anterior instability of knee joint. The mean Lysholm score was 92 (ranged, 85 to 96) of patients with type II fractures,and 93 (ranged, 83 to 96) of patients with type II fractures.</p><p><b>CONCLUSION</b>Treatment of tibial intercondylar eminence fractures under arthroscopy through patellofemoral joint space has follow advantages: simple reduction and fixation, easy operation and good clinical outcome.</p>