BACKGROUND: Preliminary study has prepared three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin. OBJECTIVE: To investigate the role of three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin in the repair of rabbit models of osteonecrosis of the femoral head. METHODS: New Zealand white rabbits (provided by Qinglongshan Laboratory Animal Center of Nanjing) were selected to establish the steroid-induced osteonecrosis of the femoral head. The 27 model rabbits underwent core decompression and debridement, were randomly divided into three groups, and then implanted with autologous bone, β-tricalcium phosphate scaffold, three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin (composite scaffold group) , respectively. The micro-CT scanning and pathological observation were performed at 4, 8, and 12 weeks after implantation. RESULTS AND CONCLUSION: (1) Micro-CT showed that at 4 weeks after implantation, trabecular bone was observed around and in implants in each group. In the autologous bone group, there were a large number of trabecular bones in the grafting area at 8 weeks, and the trabecular bone structure was dense at 12 weeks after implantation. In the tricalcium phosphate and composite scaffold groups, the scaffolds were well integrated with the bone interface. At 4 weeks after implantation, there was a certain amount of trabecular bone surrounding the scaffold, and trabecular grew into the scaffold until 8 weeks in the composite scaffold group. At 4 weeks after implantation, few thin trabecular bone was visible, and extensive trabecular bone formation was observed around the scaffold at 8 weeks in the tricalcium phosphate group. (2) Hematoxylin-eosin staining results showed that there were many mature osteoblasts, and few cartilage matrix, newly born bones integrated well to the implants at 12 weeks in the autologous bone and tricalcium phosphate groups. In the composite scaffold group, there were many cartilage matrixes, and newly born bones integrated poorly to the implants. (3) Masson staining showed that at 12 weeks after implantation, the osteogenic capacity in the composite scaffold group was lower than that in the autologous bone group (P < 0.05) , but higher than that in the tricalcium phosphate group (P < 0.05) . (4) TRAP staining results at 12 weeks after implantation revealed that the amount of osteoclast in composite scaffold group was less than that in the tricalcium phosphate group (P < 0.05) , and was not significantly different from the autologous bone group (P> 0.05) . (5) Immunohistochemical staining at 12 weeks after implantation revealed that the positive rate of vascular endothelial growth factor in the composite scaffold group was higher than that in the tricalcium phosphate group (P < 0.05) , and lower than that in the autologous bone group (P < 0.05) . (6) In summary, three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin implanted into the rabbit model of osteonecrosis of the femoral head can promote the proliferation and differentiation of osteoblasts, inhibit the viability of osteoclasts, promote the angiogenesis, and contribute to the repair of osteonecrosis of the femoral head in rabbits.

Objective To analyse the risk factors for postoperative infection in traumatic tibial plateau fractures and to construct a Nomogram prediction model.Methods One hundred and forty-eight patients with traumatic tibial plateau fractures who underwent surgery in our hospital from October 2019 to August 2021 were selected for the study,and were divided into an infected group(n=20)and an uninfected group(n=128)according to whether they developed infection after surgery.The general data of the two groups were compared;the predictive value of statistically significant continuous variables was analysed using the ROC experiment;the risk factors affecting postoperative infection in traumatic tibial plateau fractures were analysed using the logistic regression experiment;and the clinical efficacy of the Nomogram model was verified using internal data.Results In the comparison of general data such as age and gender between the two groups,the differences were not statistically significant(P＞0.05).Compared with the uninfected group,patients in the infected group had a higher percentage of diabetes mellitus,open fracture type,and osteofascial compartment syndrome,and longer operative time and hospital stay(P＜0.05);diabetes(yes),fracture type(open),osteofascial compartment syndrome(yes),and operative time(＞3 h)were risk factors affecting postoperative infection in traumatic tibial plateau fractures.The AUCs for operative time and hospital stay were not 0.792 and 0.651;the optimal stage values were not 3 h and 13 d(P＜0.05);the Nomogram model predicted a C-index of 0.744(0.651-0.807)for the risk of postoperative infection in traumatic tibial plateau fractures.The model predicted the risk of infection after traumatic tibial plateau fracture at a threshold of＞0.09.Conclusion Diabetes mellitus(yes),fracture type(open),osteofascial compartment syndrome(yes),and operative time(＞3 h)were risk factors affecting postoperative infection in traumatic tibial plateau fractures,and the Nomogram model constructed based on the above variables had good predictive value.

OBJECTIVE To study the effects and mechanisms of serum containing Wenjing Tongluo Decoction on interleukin-1β(IL-1β)-induced mouse primary chondrocyte injury.METHODS The IL-1β-induced primary chondrocyte injury model was estab-lished,and the mRNA expression of inflammatory factors IL-1β,IL-6,TNF-α,cartilage degradation-related proteases matrix metal-loproteinase 3(MMP3),MMP9,MMP13,ADAM metallopeptidase containing thrombospondin 1 motif 4(ADAMTS4),and glycoly-sis-related enzymes lactate dehydrogenase A(LDHA),M2 pyruvate kinase(PKM2),reduced coenzyme Ⅱ oxidase 2(NOX2)and re-duced coenzyme Ⅱ oxidase 4(NOX4)in the cells was detected;the intracellular MMP3,MMP13,P65,IκB-ζ,hypoxia-inducible factor 1α(HIF-1α)and LDHA protein expression levels were determined;the concentrations of nitric oxide(NO),malondialdehyde(MDA)and lactic acid in the cell supernatant were further detected,and the ratio of the reduced state(NADH)and oxidized state(NAD+)of intracellular coenzyme Ⅰ(NAD),as well as intracellular reactive oxygen species(ROS)levels were assayed.RESULTS Serum containing Wenjing Tongluo Decoction significantly inhibited the mRNA expression of IL-1β,IL-6,and TNF-α in IL-1β chondrocytes(P＜0.01),reduced the NO concentration in the cell supernatant(P＜0.05,P＜0.01),and downregulated the protein ex-pression of IκB-ζ(P＜0.05)and P65(P＜0.05,P＜0.01).Serum containing Wenjing Tongluo Decoction significantly downregulated the mRNA expression of MMP3,MMP9,MMP13 and ADAMTS4(P＜0.01),and inhibited the protein expression of MMP13(P＜0.05,P＜0.01)and MMP3(P＜0.05).In terms of oxidative stress,it significantly suppressed the production of ROS in chondrocytes,increased the NADH/NAD+ratio,reduced the MDA concentration in the supernatant,and downregulated the expression of HIF-1α protein(P＜0.01).The serum containing Wenjing Tongluo Decoction significantly reduced the lactic acid concentration,downregulated the expression of LDHA,PKM2,NOX2 and NOX4,and reduced the level of intracellular glycolysis(P＜0.05,P＜0.01).CONCLU-SION The serum containing Wenjing Tongluo Decoction can alleviate IL-1β-induced mouse primary chondrocyte injury by inhibiting inflammation,cartilage degradation,oxidative stress and glycolysis,which may be related to the regulation of IκB-ζ/HIF-1α/LDHA axis.