Lei's formula attenuates osteoarthritis mediated by suppression of chondrocyte senescence via the mTOR axis: in vitro and in vivo experiments.

Lei's formula (LSF), a traditional Chinese herbal remedy, is recognized for its remarkable clinical effectiveness in treating osteoarthritis (OA). Despite its therapeutic potential, the exact molecular mechanisms underlying LSF's action in OA have remained enigmatic. Existing research has shed light on the role of the mTOR signaling pathway in promoting chondrocyte senescence, a central factor in OA-related cartilage degeneration. Consequently, targeting mTOR to mitigate chondrocyte senescence presents a promising avenue for OA treatment. The primary objective of this study is to establish LSF's chondroprotective potential and confirm its anti-osteoarthritic efficacy through mTOR inhibition. In vivo assessments using an OA mouse model reveal substantial articular cartilage degeneration. However, LSF serves as an effective guardian of articular cartilage, evidenced by reduced subchondral osteosclerosis, increased cartilage thickness, improved surface smoothness, decreased OARSI scores, elevated expression of cartilage anabolic markers (Col2 and Aggrecan), reduced expression of catabolic markers (Adamts5 and MMP13), increased expression of the chondrocyte hypertrophy marker (Col10), and decreased expression of chondrocyte senescence markers (P16 and P21). In vitro findings demonstrate that LSF shields chondrocytes from H2O2-induced apoptosis, inhibits senescence, enhances chondrocyte differentiation, promotes the synthesis of type II collagen and proteoglycans, and reduces cartilage degradation. Mechanistically, LSF suppresses chondrocyte senescence through the mTOR axis, orchestrating the equilibrium between chondrocyte anabolism and catabolism, ultimately leading to reduced apoptosis and decelerated OA cartilage degradation. LSF holds significant promise as a therapeutic approach for OA treatment, offering new insights into potential treatments for this prevalent age-related condition.

Reference values of gait parameters in healthy Chinese university students: A cross-sectional observational study.

BACKGROUND: Gait is influenced by race, age, and diseases type. Reference values for gait are closely related to numerous health outcomes. To gain a comprehensive understanding of gait patterns, particularly in relation to race-related pathologies and disorders, it is crucial to establish reference values for gait in daily life considering sex and age. Therefore, our objective was to present sex and age-based reference values for gait in daily life, providing a valuable foundation for further research and clinical applications. AIM: To establish reference values for lower extremity joint kinematics and kinetics during gait in asymptomatic adult women and men. METHODS: Spatiotemporal, kinematics and kinetics parameters were measured in 171 healthy adults (70 males and 101 females) using the computer-aided soft tissue foot model. Full curve statistical parametric mapping was performed using independent and paired-samples t-tests. RESULTS: Compared with females, males required more time (cycle time, double-limb support time, stance time, swing time, and stride time), and the differences were statistically significant. In addition, the step and stride lengths of males were longer. Compared to males, female cadence was faster, and statures-per-second and stride-per-minute were higher. There were no statistical differences in speed and stride width between the two groups. After adjusting for height, it was observed that women walked significantly faster than men, and they also had a higher cadence. However, in terms of step length, stride length, and stride width, both genders exhibited similarities. CONCLUSION: We established reference values for gait speed and spatiotemporal gait parameters in Chinese university students. This contributes to a valuable database for gait assessment and evaluation of preventive or rehabilitative programs.

[Clinical experience on postoperative balance of hemostasis and antithrombus for patients with hemophilic arthritis after arthroplasty].

OBJECTIVE: To observe the clinical significance of postoperative personalized antithrombotic therapy for patients with hemophilic arthritis (HA) patients after arthroplasty. METHODS: From September 2005 to October 2013, 11 cases of arthroplasty for hemophilic arthritis in hip and knee total operation 14 times,including 1 case of double knees (calculated as one operation), operation in left knees 6 times, operation in right knees 5 times, 2 in hip. All the patients were male and the age ranged from 23 to 57 years old,with an average of (36.1 ± 11.0) years old; the average weight was (64.1 ± 8.9) kg. All the patients were preoperatively diagnosed and classified as hemophilic arthritis with the radiological images and laboratory tests. According to the function of joints, the risk of postoperative venous thromboembolism (VTE), and dynamic observation of Factor VIII:C (FVIII:C) activity, patients were treated with personalized antithrombus by adjusting the dosage of recombinant human coagulation factor VIII (Kogenate FS). All the patients were orderly divided into postoperatively distal joints moving group and none-moving group to observe the coagulation function. RESULTS: The enrolled patients had no postoperative complication of VTE and pulmonary embolism (PE). The APTT and D-2 were different between two groups in the postoperative early stage. Length of hospital day was shorter in the moving group than none-moving group. CONCLUSION: Because of the self-coagulation disorder, patients with HA tended to bleed. However it doesn't mean that there is no risk of postoperative thrombosis. Therefore,it's important to determine how to control the balance between postoperative antithrombus, hemostasis,and coagulation factor replacement therapy after arthroplasty for HA. Postoperative moving has proved helpful for HA, especially in reducing the risk of hemostasis and shortening the time in hospital.

[Correlation research on the MRI quantity of lumbar modic changes and low back pain].

OBJECTIVE: To analyzed the relationship between lumbar endplate Modic area changes rate and low back pain by measuring MRI T2 sagittal image of lumbar endplate Modic area changes rate. METHODS: From December 2011 to June 2012,70 patients with low back pain in operation were evaluated on pain by VAS and function by JOA,and examined by MRI including 39 males and 31 females with an average age of (51.00 +/- 11.89) years ranging from 29 to 72 years old. Among them, 54 cases had lumbar endplate Modic changes involving 15 cases in types Modic I ,21 cases in type Modic II, 11 cases in type Modic III ,mixed type Modic in 7 cases (eliminated for too few cases). Modic area changes and corresponding vertebral area were measured on MRI T2 median sagittal. The areas of two ways were compared to yield the rate of changes for Modic, for multisegmental Modic changes to calculate the total ratios. A correlation was observed among JOA, VAS and the rate of Modic changes. RESULTS: The correlation coefficient of change rate of Modic I with JOA score was r = -0.308, P = 0.048 < 0.05, there was a negative correlation;the correlation coefficient of change rate of Modic I with VAS scores was r = 0.428,P = 0.021 < 0.05, there was a positive correlation. The correlation coefficient of change rate of Modic II with JOA score was r = -0.375, P = 0.043 < 0.05, there was a negative correlation;the correlation coefficient of change rate of Modic II with VAS score was r = 0.352, P = 0.041 < 0.05, there was a positive correlation. The area change rate of Modic III had no significant correlation with low back pain degree (P > 0.05). CONCLUSION: Modic I and II area changes rate of of patients with low back pain is closely related to the degree of pain low back pain, Modic III area changes rate is not significant correlated to the degree of lower back pain.

[Analysis of concurrent intravertebral vacuum sign in thoracolumbar fractures after posterior internal fixation].

OBJECTIVE: To investigate the importance of TLICS classification to surgical options of thoracolumbar fractures by analyzing the cause of intravertebral vacuum sign, vertebral collapse and vertebral pseudarthrosis. METHODS: From January 2006 to December 2010, the clinical data about 15 patients with postoperative complications by thoracolumbar fracture after posterior internal fixation were retrospectively analyzed. There were 9 males and 6 females, ranging in age from 18 to 75 years, with an average of 54.6 years. Of them, fracture site in T12 was 7 cases, L1 was 5 cases, L2 was 3 cases; compression fractures was in 12 cases and burst fracture was in 3 cases; according to classification of TLICS, 12 cases were of type I ,3 cases of type III. And the causes of complications after posterior fixation were analyzed according clinical manifestation and imaging finding combined with review literatures. RESULTS: After 10 to 20 months following-up (with average of 15 months), loss of vertebral height found in 9 cases (4 cases existed vertebral collapse, as well as 3 cases occurred screw loosening) and Intravertebral Vacuum Sign appeared in 6 cases. CONCLUSION: In order to avoid the vertebral vacuum and fixation failure, the clinical data of patients should be roundly and carefully evaluated, surgical indications should be strictly controlled and the surgical approach should be selected according to correct classification. Particularly, the reconstruction of the stability of former spinal column shoud be paid more attention.