Lifelong bound feet in China: a quantitative ultrasound and lifestyle questionnaire study in postmenopausal women.

OBJECTIVE: The phenomenon of foot binding, also known as 'lotus feet', has an enduring and influential history in China. To achieve a man-made smaller foot size, lifelong foot binding may have had adverse effects on the skeleton. We investigated bone properties in postmenopausal women with bound feet, which may provide new information for developing countermeasures for prevention of fragility fractures. DESIGN: Population-based cohort study. PARTICIPANTS: This study involved 254 postmenopausal women aged 65-80, including 172 with bound feet and 82 age- and gender-matched control subjects, living in a remote region of China. OUTCOMES: Anthropometric, SF-36 Lifestyle Questionnaire and heel quantitative ultrasound (QUS) data were collected for the whole study population. A small subset of two cases was also invited for assessment of bone mineral density and microarchitecture at the distal tibia using high-resolution peripheral quantitative CT (HR-pQCT) and gait and balance tests. RESULTS: Women with bound feet had significantly lower QUS values than age-matched women with normal feet; this was supported by HR-pQCT data. However, SF-36 Questionnaire results did not reveal any statistically significant differences in any categorical responses, including physical functioning, general health vitality and physical component summary score, and number of previous fractures. No impairment of body balance was found in the small subset. CONCLUSIONS: The man-made changes caused by foot binding led to reduced physical activity, making the subjects prone to osteoporosis. Women with bound feet and osteoporosis did not have a higher incidence of fragility fractures than controls. This might be explained by compensation in physical activity to improve body balance, implying the importance of improving or maintaining body balance in overall prevention strategies against fragility fractures.

Tissue levels of leukemia inhibitory factor vary by osteoarthritis grade.

The objective of this study was to observe the expression of leukemia inhibitory factor (LIF) in animals and in different clinical grades of patient osteoarthritic tissues. Thirty-five rabbits were used in a Colombo model of experimental osteoarthritis (OA). Five rabbits each were sacrificed on postoperative days 3, 7, 14, 28, 42, 56, and 84. Immunohistochemistry analysis for LIF expression and distribution in the cartilage and synovium of animals was performed at these times. Sixty-seven samples of human articular tissue were obtained from patients with different grades of OA according to symptoms and radiographic inspection. The mRNA expression of LIF was determined by reverse transcription polymerase chain reaction, and LIF protein was determined by enzyme-linked immunosorbent assay (ELISA). The results showed a slight expression of LIF in normal cartilage tissue but less in synovium tissue; however, the expression of LIF was marked in synovial lining cells and superficial and middle-layer cartilage in animal OA (P<.05). Leukemia inhibitory factor mRNA was expressed at the highest level in moderate degrading subchondral bone, and LIF was expressed at the highest level in seriously degrading articular cartilage tissue. These results were similar to those found with ELISA. This study suggests that LIF in OA articular tissues varies by clinical symptoms and grade. It plays an important role in the pathogenesis of OA.

Related Biological Research in the Interface between Bone Cement and Bone after Percutaneous Vertebroplasty.

Percutaneous vertebroplasty (PVP) is widely used in the treatment of painful osteoporotic vertebral compression fractures with the injection of PMMA cement, and the controversy for PMMA damage to the osteoporotic bone tissue and to affect the fractures repairing never stops. 72 old female rabbits, each age 3.0~3.5 y, rabbits were assigned randomly to two groups of thirty-six each; PMMA cement were injected into vertebral body in rabbits via mimic PVP, sacrificed at 1 h, 24 h, 3 d, 7 d, 4 w, and 12 w. The expression VEGF and collagen type I, the tissue response, and repair reaction in the interface between PMMA and bone tissue were observed dynamically with RT-PCR and western blot technique; the osteocalcin expression were studied by immunohistochemistry. Compared with the control group, the expression of collagen I increased at 1 hour and was higher from 24 h to 3 d. From 4 weeks to 12 weeks after injection of PMMA. The expression of VEGF decreased at 1 hour and 24 hours, significantly increased at 3 days, decreased once again at 7 days, then increased significantly at 4-12 weeks. The osteocalcin expression continued to increase during 4 to 12 week. PMMA would not cause local bone permanent necrosis, and interface injury repairing cycle could be prolonged in a vertebroplasty.