BACKGROUND:Previous studies have demonstrated that total saponins of panax notoginseng can inhibit the ethanol-induced adipogenic differentiation of rabbit bone marrow stromal cells and confirmed that total saponins of panax notoginseng promoted the proliferation and differentiation of rabbit osteoblasts, and improved the osteoprotegerin mRNA relative expression in osteoblasts so as to inhibit receptor activator of nuclear factor kappa B ligand mRNA expression.
OBJECTIVE:To observe effects of total saponins of panax notoginseng on the ultrastructure of the rabbit models of alcoholic avascular necrosis of the femoral head.
METHODS:New Zealand rabbit models of alcohol-induced avascular necrosis of the femoral head were established by gavage of spirit. Successful rabbit models were separately injected with saline, compound bone peptide and total saponins of panax notoginseng group, 0.1 mL/kg, once a day, for 4 consecutive weeks. The ultrastructure of each group were observed by transmission electron microscope.
RESULTS AND CONCLUSON:Transmission electron microscopy showed that osteocytes after alcoholic avascular necrosis of the femoral head presented mitochondrial swel ing and fuzzy crista structure, and degranulation of polysomes on rough endoplasmic reticulum. Lipid droplets were seen in osteocytes. Compared with saline group, mitochondria swel ing subsided, cristae appeared, the number of polysomes increased on rough endoplasmic reticulum, but the number of lipid droplet decreased in total saponins of panax notoginseng group. Morphological changes in ultrastructure were similar between compound bone peptide group and total saponins of panax notoginseng group. Morphological changes in ultrastructure were more significant in the total saponins of panax notoginseng and compound bone peptide groups compared with saline group (P<0.05). Results verified that total saponins of panax notoginseng could effectively restore ultrastructure of osteocytes of rabbit models of alcoholic avascular necrosis of the femoral head in the early stage.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.