Clinical observation of modified Shenqi Decoction in the treatment for patients with early-to-middle stage nontraumatic osteonecrosis of femoral head / 中成药

AIM To investigate the clinical therapeutic effects of modified Shenqi Decoction in treating earlyto-middle stage nontraumatic osteonecrosis of femoral head (NONFH) due to kindey deficiency and blood stasis syndrome,and its impacts on serum TNF-α,CRP,NO,SOD as well.METHODS Totally,104 cases of eligible patients were randomly divided into traditional Chinese medicine (TCM) group,chemical medicine group and TCM combined with chemical medicine group,38 cases in each group,for a three-month course of treatment.The TCM group was dosed with modified Shenqi Decoction,the chemical medicine group with sodium alendronate,and the TCM combined with chemical medicine group with both modified Shenqi Decoction and sodium alendronate.The Harris SF-36,SF-36,FPS-R and TCM symptoms assessment were applied to estimating the efficacy of three groups before and after the treatment.So were the check of the serum TNF-α,CRP,NO,SOD levels,and rates of efficiency after treatments and six-month follow-ups,and incidence of adverse reactions during the treatment among all the three groups.RESULTS The efficiency rates were found to be in the following sequence:the chemical medicine group (76.5％) ＜ the TCM group (83.8％) ＜ the TCM combined with chemical medicine group (97.2％) (P ＜ 0.05).The TCM combined with chemical medicine group had its post-treatment scores of Harris SF-36,FPS-R,FPS-R,TCM symptom and the serum TNF-α,CRP,NO,SOD levels significantly improved as compared with other two groups (P ＜ 0.05).And the revealed incidence of adverse reactions was ranked as the TCM group (2.7％) ＜ the TCM combined with chemical group (30.6％) ＜ the chemical medicine group (70.6％) (P ＜ 0.05).CONCLUSION Modified Shenqi Decoction is superior to sodium alendronate in the treatment of NONFH due to kidney deficiency and blood stasis syndrome for its better performance in both the efficacy and the incidence of adverse reactions,and its synergistic effect with use of sodium alendronate may associate with its capability in offsetting the adverse reactions of sodium alendronate.

Study on Polymorphism of Nontraumatic Osteonecrosis of Femoral Head in Blood Stasis / 中国中医药信息杂志

Objective To study the correlation between nontraumatic osteonecrosis of femoral head (NONFH) and ApoA1 polymorphism of blood stasis type.Methods Totally 93 cases of NONFH were selected as the case group, and 83 healthy volunteers were randomly selected as the control group. With TCM constitution questionnaire survey, the case group was screened out 32 cases of blood stasis NONFH type and 61 cases of non blood stasis NONFH type. In the case group and control group, the subjects took blood samples 2 mL, extracted DNA for PCR amplification, PCR products for DNA sequencing. G994T PAF-AH and rs9658282 gene NOS1 site polymorphism were detected for tatistical analysis.Results -75G/A gene AA ApoA1 genotype (OR: 2.578; 95%CI: 1.174-5.663;P=0.018) and A allele (OR: 1.726; 95%CI: 1.121-2.658;P=0.013) may be one of the risk factors of NONFH.Conclusion -75G/A gene ApoA1 may be related to the pathogenesis of NONFH. There was no correlation between the ApoA1 gene polymorphism of -75G/A gene and the pathogenesis of blood stasis NONFH. There was no correlation between the ApoA1 gene polymorphism of +83C/T gene and the pathogenesis of blood stasis NONFH.

The expression of Ezrin and its correlation in nontraumatic osteonecrosis of femoral head / 安徽医科大学学报

Objective To investigate the expression level of Ezrin and its clinical significance in nontraumatic os-teonecrosis of femoral head. Methods Expression level of Ezrin in 38 patients with nontraumatic osteonecrosis of femoral head ( experimental group) and 16 patients with femoral neck fractures ( control group) were detected by immunohistochemistry and RT-PCR analysis. Results The expression level of Ezrin was significantly lower in ex-perimental group than that in control group (P<0. 05). It was correlated with the Ficat Stage, and had no rela-tionship with gender, age, BMI, profession and etiological factor. Conclusion Ezrin may involve in the develop-ment of nontraumatic osteonecrosis of femoral head, and play an important role in regulation.

Expression of bFGF and BMP-2mRNA of the local femoral head in nontraumatic osteonecrosis of femoral head / 中国矫形外科杂志

[Objective]To explore the change and its significance of the expression of basic fibroblastic growth factor(bFGF) and bone morphogenetic protein-2(BMP-2) of the local femoral head in nontraumatic osteonecrosis(NONFH). [Methods]Thirty samples of femoral heads of NONFH were collected as the experimental group and 10 fresh samples of femoral heads of femoral neck fracture as control group.The specimens were collected at the time of total articular replacement arthroplasty.The bone tissues from necrosis area and healthy area were made into general sections after immobility and decalcification.Pathological changes were exexamined by optical microscopy and the expression of bFGF and BMP-2 in femoral head was determined with in-situ hybridization technique.[Results]The organization structure of experimental group was disorganized,cracked,and the bone trabecula was rarefactive and non-intact.There were a great number of empty lacune in bone trabecula.The intensity and area of positive expression of bFGF and BMP-2 in femoral head of the experimental group were obviously lower than that of control group.The result had statistical significance(P

Experimental study of expression of BMP-2 and VEGFmRNA in local femoral head of nontraumatic osteonecrosis of femoral head / 中国矫形外科杂志

[Objective]To explore the change and its significance of the expression of vascular endothelial growth factor(VEGF) messenger RNA and bone morphogenic protein-2(BMP-2) of the local femoral head in the nontraumatic osteonecrosis of femoral head(NONFH).[Method]Sixteen samples of femoral heads of NONFH were collected as the experimental group and fresh 10 samples of femoral heads of femoral neck fracture as control group,overall examples were collected from total articular replacement arthroplasty.The samples were splitted in coronal plane and get one bone block from necrosis area and another one from healthy area,make them into microtome section after the process of immobility and decalcification.Their pathological change was observed by using optical microscope and electron microscope and detect the expression of BMP-2 and VEGFmRNA in femoral head through making use of immunohistochemistry and in-situ hybridization technique.[Result]The organization structure of experimental group was disorganized,cracked and the bone trabecula was rarefactive and non-intact and there was a great number of empty lacuna in bone trabecula.While there was the reverse situation in the control group.The intensity and area of positive expression of BMP-2 and VEGFmRNA in femoral head of the experimental group were lower than that of control group obviously.The result showed statistical significance(P