Salvianolic acid A contributes to cartilage endplate cell restoration by regulating miR-940 and miR-576-5p / 中国骨伤

OBJECTIVE@#To investigate whether Salvianolic acid A (SAA) can restore cartilage endplate cell degeneration of intervertebral discs and to identify the mechanism via regulation of micro-RNA.@*METHODS@#Cartilage endplate cells were isolated from lumbar intervertebral disc surgical samples and were treated with serum containing a series of concentrations of SAA (2, 5, and 10 ?M) for 24, 48, and 72 h to identify a proper dose and treatment time of SAA. The effect SAA on interlenkin-1β (IL-1β)-induced extracellular matrix degradation of cartilage endplate cells were analyzed by Alcian blue staining and assessment of the expression levels of ADAMTS-5, MMP3 and Col2a1. Further, the potential target miRNAs were preliminarily screened by micro-RNA sequencing combining qRT-PCR and Western blot, and then, the miRNAs mimics and inhibitors were used to verify the regulatory effect of SAA on potential target miRNAs.@*RESULTS@#The 10 μM SAA treatment for 48 h significantly enhanced the viability of cartilage endplate cells, and increased Col2a1 expression and glycosaminoglycan accumulation that were repressed by IL-1β, and reduced the effect of IL-1β on ADAMTS-5, and MMP3. Screening analysis based on micro-RNA sequencing and Venny analysis identified the downstream micro-RNAs, including miR-940 and miR-576-5p. Then, the miR-940-mimic or miR-576-5p-mimic were transfected into CEPCs. Compared with the SAA group, the expression of ADAMTS-5 and MMP3 increased significantly and the expression of COL2A1 obviously decreased after overexpression of miR-940 or miR-576-5p in CEPCs.@*CONCLUSION@#Salvianolic acid A attenuated the IL-1β-induced extracellular matrix degradation of cartilage endplate cells by targeting regulate the miR-940 and the miR-576-5p.

Systemic review of Jintiange Capsules in treatment of postmenopausal osteoporosis / 中国中药杂志

To systemically evaluate the efficacy and safety of Jintiange Capsules in the treatment of postmenopausal osteoporosis(PMOP).Seven literature databases were retrieved systematically,and two reviewers independently searched and screened studies,extracted data,and included all the randomized controlled trials on Jintiange Capsules in the treatment of PMOP.Interventions included comparison of Jintiange Capsules with placebo and routine treatment,and the studies on Jintiange Capsules combined with routine treatment versus conventional treatment were also included.The evaluation indicators of the study included at least one of the followings:fracture,quality of life,daily living ability,clinical symptoms,death,adverse events/adverse reactions,bone density,and bone metabolism indexes.The original study quality evaluation was conducted by following the Cochrane Handbook standard and statistical analysis was performed by using Rev Man 5.2.A total of 7 randomized controlled trials were included and the study quality was low.Meta-analysis showed that as compared with conventional treatment alone,Jintiange Capsules combined with conventional treatment showed more obvious effects in pain relief(MD=-0.98,95% CI[-1.55,-0.41],P=0.000 8),increasing blood calcium levels(MD=0.05,95% CI[0.02,0.09],P=0.003) and lowering serum alkaline phosphatase levels(MD=-12.92,95% CI[-24.09,-1.75],P=0.02).In addition,the Chinese patent medicine alone or in combination with conventional treatment was relatively safe.In conclusion,Jintiange Capsules has a certain effect in treating PMOP,but the quality of evidence is low.It is necessary to conduct well designed randomized controlled trials and select recognized evaluation indicators,especially the end outcomes in order to further improve the clinical evidence.

Effect of serum of Bushen Huoxue prescription on rabbit with intervertebral disc motion segments in vitro culture / 中国骨伤

<p><b>OBJECTIVE</b>To compare effect of serum of Bushen Huoxue prescription on rabbit with intervertebral disc motion segments in vitro culture.</p><p><b>METHODS</b>Twenty-four New Zealand white rabbits aged from 4 to 6 months and weighted from 2.5 to 3 kg were divided into medicated group and control group, 7 in each group. Rabbits were excuted under condition of asepsis, 28 spinal motion segments were taken out in each group, and segments were loaded in spinal motion segments in vitro and cultured in culture apparatus. Nutrient solution of medicated group contain 10% serum of Bushen Huoxue prescription, and 10% blank serum in control group. Seven discs between two groups were taken out and observed by histomorphology, proteoglycan PAS/AB stining, collagen II immunohistochemical staining, AGG, Col2aI by PCR test before culture and on the 3th, 7th and 14th day after culture.</p><p><b>RESULTS</b>Histomorphology results showed the formation of medicated group was better than that of control group at 1 week after culture. PAB/AB test results showed content of poteoglycan between two groups were decreased. Imunohistochemical results showed content of collagen II in medicated group were obviously increased than that of control group at 3 days, but decreased obviously at 1 week than that of control group. PCR results showed expression of Agg in medicated group was obviously decreased than that of control group, but no statistical significance between two groups on the 7 th and 14 th day. Expression of Col2aI between two groups at 3 days were increased, and medicated group increased obviously more, while there were no significant difference between two groups.</p><p><b>CONCLUSIONS</b>Serum of Bushen Huoxue prescription could delay intervertebral disc degeneration at short time for it is relate with improving circulation, inhibiting inflammatory, regulating extracellular matrix, so the prescription plays an important role in early prevention and treatment for intervertebral disc degeneration.</p>

Case-control study on clinical effects of squeezing and clapping manipulation for treating the postpartum pubic symphysis separation / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical effect of squeezing and clapping bone setting manipulation in treating the postpartum pubis symphysis separation.</p><p><b>METHODS</b>From June 2015 to March 2017, 80 patients with postpartum pubic symphysis separation were randomly divided into treatment group and control group, 40 patients in each group. In treatment group, the patients' reproductive age ranged from 26 to 40 years old with an average of (30.61±5.94) years old and the neonatal weight ranged from 3.2 to 4.52 kg with an average of (3.59±0.13) kg. In control group, patients' reproductive age ranged from 22 to 37 years old with an average age of (27.51±4.57) years old and the neonatal weight ranged from 3 to 5.8 kg with an average of (3.81±0.63) kg. The patients in the treatment group were treated with the squeezing and clapping manipulation, once a week for 3 weeks. The patients in the control group were treated with pelvic bandage immobilization, and the immobilization of the pelvis was not less than 8 hours per day, 3 weeks for 1 course. The VAS pain score, Oswestry dysfunction index (ODI) and separation distance of pubis were clinical observed and evaluated on the first day of treatment, 1, 2, 3 weeks and 1 months after treatment.</p><p><b>RESULTS</b>The pubic symphysis VAS score was compared with that before treatment, in the treatment group, the difference was statistically significant at 1 week(0.013); the difference was statistically significant in the control group for 1 month (0.042). The two groups were less than those of the control group after treatment (<0.05). The ODI score was compared with that before the treatment, in the treatment group, the difference was statistically significant at 1 week (0.009), the difference was statistically significant in the control group for 1 month(0.013), the two groups were less than those before treatment(<0.05). The pubic symphysis distance was compared with that before treatment, the treatment group decreased significantly after treatment (<0.05), there was no significant difference in the control group after treatment (>0.05), the two groups were compared, the difference was statistically significant at first weeks(0.042) and third weeks (0.005).</p><p><b>CONCLUSIONS</b>The "squeezing and clapping" manipulation can quickly restore the distance between pubic symphysis separation, relieve local pain and improve lumbosacral function, and is better than pelvic bandage fixation treatment.</p>

Research on the stability of teaching robots of rotation-traction manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the stability of teaching robot of rotation-traction manipulation.</p><p><b>METHODS</b>Operators were required to get the hang of rotation-traction manipulation and had clinical experience for over 5 years. The examination and data processing of the ten operators in our research were collected by the teaching robot of rotation-traction manipulation. Traction, pulling force, maximum force, pulling time, rotational amplitude and pitch range were recorded and compared for five times(G1, G2, G3, G4 and G5). The qualification rates were analyzed to evaluate the stability of teaching robot of rotation-traction manipulation.</p><p><b>RESULTS</b>Nonconforming items were found in G1 and G2, for instance, pulling force(=0.074), maximum force(=0.264) and rotational amplitude (=0.531). There was no statistically difference. None nonconforming item was found in G3, G4 and G5. All data were processed by SPSS and One-way ANOVA was used to analysis. Pulling force was found statistically different in G1, compared with G4 and G5(=0.015,=0.006). Maximum force was found statistically different in G1, compared with G4 and G5 (=0.021,=0.012). None differences were found in other comparisons (>0.05).</p><p><b>CONCLUSIONS</b>The teaching robot of rotation-traction manipulation used in our research could provide objective and quantitative indices and was considered to be an effective tool of assessing the rotation-traction manipulation.</p>

Clinical effects of rehabilitation exercise in the treatment of knee osteoarthritis based on the theory of "treating muscle for bone" / 中国骨伤

<p><b>OBJECTIVE</b>To study the efficacy and safety of voluntary rehabilitation exercise in the treatment of knee osteoarthritis, based on the traditional Chinese medicine theory of "treating muscle for bone".</p><p><b>METHODS</b>Ninety participants with early knee osteoarthritis were randomly divided into experimental group (=45) and control group (=45). Patients in experimental group were treated with voluntary rehabilitation exercise combined with isometric extension of quadriceps femoris. Patients in control group were treated with apparatus training combined with isometric extension of quadriceps femoris. The treatment course lasted for two weeks. Visual analogue scale (VAS), Lysholm score and total therapeutic effect were evaluated before and after treatments.</p><p><b>RESULTS</b>After two weeks of treatment, cure-remarkable-effective rate in experimental group (86.67%) was higher than that in control group (71.11%). The VAS scores and Lysholm scores were significantly improved in both two groups (<0.05). The results were significantly better in experimental group those in control group (<0.05). There were no serious adverse events.</p><p><b>CONCLUSIONS</b>Voluntary rehabilitation exercise combined with isometric extension of quadriceps femoris was effective and safe in the treatment of early knee osteoarthritis.</p>

Application of shear wave elastography in the evaluation of neck-shoulder myofascial pain syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical value of shear wave elastography (SWE) in the evaluation of neck-shoulder myofascial pain syndrome.</p><p><b>METHODS</b>From December 2013 to July 2014,30 patients diagnosed as neck-shoulder myofascial pain syndrome were in the treatment group,including 17 males and 13 females, with an average age of (44 ± 3) years old. Thirty healthy people were in the control group, including 22 males and 8 females, with a mean age of (37 ± 5) years old. The patients in the treatment group were treated with manipulation, once every other day, total 7 times. The SWE was used to detect tension part of trapezius muscle of patients in the treatment group before and after treatment, as well as to detect muscle belly at the descending part of trapezius muscle in the control group. The tissue elasticity and Yang's modulus value were recorded and compared.</p><p><b>RESULTS</b>The tissue elasticity chart of patients in the treatment group before treatment was mainly greenish blue with the score of 3.70 ± 1.53, and the Yang's modulus was (43.4 ± 15.6) kPa. The tissue elasticity figure after treatment was mainly blue with the score of 2.40 ± 0.87, and the Yang's modulus was (29.0 ± 5.9) kPa. Whereas in the control group, the tissue elasticity figure was mainly blue with the score of 1.60 ± 0.72, and the Yang's modulus was (24.0 ± 7.6) kPa. These were statistical differences between the two groups (P = 0.000).</p><p><b>CONCLUSION</b>SWE can be used as an evaluation method of manipulation treatment for neck-shoulder myofascial pain syndrome, which is an objective and sensitive detection method.</p>

Effect of removing dampness and promoting diuresis method on IgG, IgM and IL-1beta, IL-8 in serum of rats with autoimmunity induced by nucleus pulposus / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effects of removing dampness and promoting diuresis method on autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats, in order to provide the basis for the treatment of lumbar disc herniation with Chinese medical immunotherapy.</p><p><b>METHODS</b>Forty male Wistar rats were divided into 4 groups randomly according to body weight layer:sham operation group (group A), model contrast group (group B), colchicine tablets group (group C), modified Qingyao decoction group (group D). There were 10 rats in each group. Nucleus pulposus of coccygeal vertebra was transplanted to the gluteal muscle by operation in groups B, C, D, which can lead to autoimmune and immuno-inflammatory response of rats; the rats of group A were only treated with sham operation. At the 3rd day after operation, the rats were fed through intragastric administration, the group A and B with distilled water (10 ml/kg), the group C and D respectively with suspension of colchicine tablets (10 ml/kg, 0.01 mg/ml) and water-decocted liquid of modified Qingyao decoction (10 ml/kg,1.035 g/ml), once a day and continuous medication for 18 days. All rats were killed at the 21th day after operation. The immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-1beta (IL-1beta), interleukin-8 (IL-8) level in serum of different groups were detected by ELISA method. At the same time, surrounding tissues of the transplanted nucleus pulposus were observed by pathological section.</p><p><b>RESULTS</b>The level of IgG, IgM, IL-1beta, IL-8 in serum of group B was significantly higher than that of group A (P < 0.01), while the level of IgG, IgM, IL-1beta, IL-8 in serum of group C, D was significantly lower than that of group B (P < 0.05 or P < 0.01). Moreover, pathological section indicated that immuno-inflammatory response was hardly found in surgical site of group A, while local immuno-inflammatory response of surrounding tissues of the transplanted nucleus pulposus of group C and D was much lighter than that of group B.</p><p><b>CONCLUSION</b>Removing dampness and promoting diuresis method could inhibit autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats.</p>

Clinical observation on improvement of motion range of cervical spine of patients with cervical spondylotic radiculopathy treated with rotation-traction manipulation and neck pain particles and cervical neck pain rehabilitation exercises / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of two different therapies on patients whose cervical function were restricted due to cervical spondylotic radiculopathy.</p><p><b>METHODS</b>Form April 2008 to October 2009, 71 cases with cervical spondylotic radiculopathy were divided into group A (36 cases) and group B (35 cases). Among them, 22 cases were male and 49 cases were female, ranging in age form 45 to 65 years with an average of 52.27 years, course of disease was from 3 days to 5 years. The patients in group A were treated with rotation-traction manipulation, neck pain particles and cervical rehabilitation exercises; and the patients in group B were treated with cervical traction, Diclofenac sodium sustained release tablets and wearing neck collar. Theapeutic time was two weeks. The cervical anteflexion, extension, left and right lateral bending, left and right rotative activity were measured by helmet-style activities instrument before and after treatment (at the 1, 3, 5, 7, 9, 11, 13 days and 1 month after treatment respectively).</p><p><b>RESULTS</b>There were no difference between two groups in cervical activity in all directions before treatment (P > 0.05). Compared with the beginning, cervical anteflexion and extension showed significant difference at the 5th day after treatment in group A (P < 0.01). In group B, cervical anteflexion showed significant difference at the 13th day after treatment (P < 0.05), but at the 1 month after treatment, the significant difference disappeared (P > 0.05); cervical extension showed significant difference at the 7th day after treatment compared with the beginning (P < 0.05). Compared with the beginning,left lateral bending showed significant difference at the 1st day after treatment in group A (P < 0.05) and at the 5th day after treatment in group B (P < 0.01). Both in group A or B, right lateral bending, left and right rotative activity showed significant difference at the same time after treatment, either the 3rd day (P < 0.05) or the 5th day (P < 0.05). Compared between groups, cervical anteflexion, left and right lateral bending, left and right rotative activity showed significant difference at the 1 month after treatment (P < 0.05).</p><p><b>CONCLUSION</b>The rotation-traction manipulation and neck pain particles and cervical rehabilitation exercises in treating cervicalspondylotic radiculopathy have quick effect to improve the activities of cervical anteflexion, extension, left lateral bending, and have durable effect to improve the activities of cervical spine in all directions.</p>

Changes in serum interleukin-1 beta,interleukin-6,and tumor necrosis factor alpha in patients with lumbar disc herniation after Shenshi Tongluo therapy:Randomized controlled study / 中国组织工程研究

AIM:To observe the changes in serum cytokines in patients with lumbar disc herniation(LDH) following Shenshi Tongluo therapy(discharging damp and dredging collaterals).METHODS:①Forty-three patients with LDH(cold-damp arthralgia type) were selected from Wangjing Hospital,China Academy of Chinese Medical Sciences from February to December 2005,and randomly divided into experimental group(n =22) and control group(n =21).The informed consent was obtained from all subjects.Meanwhile,30 healthy volunteers were selected as controls.②The patients in the experimental group orally took modified Semen Coicis decoction(Semen Coicis,eucommia bark,Radix dipsaci,cocculi,Chinese clematis root,caulis millettiae,angelica root,achyranthis,and paeoniae radix) according to Shenshi Tongluo therapy,one dose daily for 4 weeks.The patients in control group took Yaotong Ning capsule,4 pills per day,once daily for 4 weeks.③ Contents of serum interleukin-1 ?(IL-1?),IL-6,tumor necrosis factor-?(TNF-?) in patients were detected using radioimmunoassay before and after treatment.Clinical outcome was evaluated using visual analog scale(VAS) and assessment criteria for low lumbar pain of Japanese Orthopedic Association(JOA).RESULTS:①Contents of serum IL-1?,IL-6,and TNF-? in patients were higher than healthy people(P