1.Research progress of metabolism and physiological functions of the lacunar-canalicular system
Lijun SHI ; Fuqiang GAO ; Wei SUN
Chinese Journal of Tissue Engineering Research 2016;20(42):6363-6370
BACKGROUND:Interstitial fluid flow around the osteocytes caused by a series of physiological activities plays an important role in the osteocyte metabolism and signal transduction.
OBJECTIVE:To review and summarize the research progress of bone structures and physiological functions, then further il ustrate how the mechanical loads make an impact on bone tissue.
METHODS:A computer-based search was conducted in PubMed database for articles related to the bone microstructure, metabolism and osteocyte signal transduction published from January 2009 to December 2015. The keywords were“osteocyte, mechanical load, permeability, lacunar-canalicular system, interstitial fluid flow, mechanotransduction, signaling pathways”in English. Data were screened firstly, dated articles or literatures with wrong research methods were excluded, and total y 40 eligible articles were enrol ed.
RESULTS AND CONCLUSION:Bone tissue can quickly adapt to the change of mechanical environment to guarantee enough osteocytes in the functional bone area indicating that osteocytes regulate the bone absorption and formation by responding to stress, which is closely related to osteocyte physiological characters. Osteocytes exist in mineralized matrix, and the special microstructures make it possible to receive mechanical loads and transform the mechanical signals into chemical signals aimed at regulating the bone absorption or formation.So the interstitial fluid flow in the lacuna-canalicular system occures, namely load-induced fluid flow, when the mechanical load is distributed on the bone. This fluid flow affects the bone tissue through two mechanisms:regulating osteocyte metabolism and participating in the mechanotransduction. In conclusion, the mechanical load plays a vital role in maintaining health bone and regulating bone adaptation.
2.A study on the executive function and working memory ability in patients with social phobia
Yanjie GAO ; Hongru QU ; Fuqiang MAO
Chinese Journal of Behavioral Medicine and Brain Science 2011;20(6):513-515
Objective To explore the executive function and working memory ability of patients with social phobia. Methods The study included 42 social phobia patients whose age, sex, and level of education were matched with those of a healthy control group. Wisconsin Card Sorting Test and Digit Span, Spatial Span, Multiple-Objects-Spatial span were used to study the executive function and working memory. Results Patients with social phobia scored higher than the control group in terms of the number of non perseverative errors on the Wisconsin Card Sorting Test ( 18. 75 ± 6. 20, 8. 89 ± 3. 22 respectively ). No differences were observed in perseverative errors and other scores between the patient and control group. Patients with social phobia scored lower than the control group in terms of Digit Span(7.25 ±1.35,8.03 ±2. 30 respectively) ,Spatial Span(6. 11±1.85,8.61 ±2.87 respectively) and Multiple-Objects-Spatial span(4.03 ± 1. 39 ,5. 18 ± 1.07 respectively). Conclusion Working memory ability in the social phobia patients is impaired, and this may cause the poor performance in patients with the social phobia in academic and social working.
3.Increased expression and activity of MMP-9 in C-reactive protein- induced human THP-1 mononuclear cells is related to activation of nuclear factor kappa-B.
Fuqiang, SHENG ; Longxian, CHENG ; Qiutang, ZENG ; Wen, GAO
Journal of Huazhong University of Science and Technology (Medical Sciences) 2009;29(4):399-403
The relation between the expression and activity of MMP-9 in C-reactive protein (CRP)-induced human THP-1 mononuclear cells and the activation of nuclear factor kappa-B (NF-kappaB) was studied to investigate the possible role of CRP in plaque destabilization. Human THP-1 cells were incubated in the presence of CRP at 0 (control group), 25, 50 and 100 mug/mL (CRP groups) for 24 h. In PDTC (a specific NF-kappaB inhibitor) group, the cells were pre-treated with PDTC at 10 mumol/L and then with 100 mug/mL CRP. The conditioned media (CM) and human THP-1 cells in different groups were harvested. MMP-9 expression in CM and human THP-1 cells was measured by ELISA and Western blotting. MMP-9 activity was assessed by fluorogenic substrates. The expression of NF-kappaB inhibitor alpha (IkappaB-alpha) and NF-kappaB P(65) was detected by Western blotting and ELISA respectively. The results showed that CRP increased the expression and activity of MMP-9 in a dose-dependent manner in the human THP-1 cells. Western blotting revealed that IkappaB-alpha expression was decreased in the cells with the concentrations of CRP and ELISA demonstrated that NF-kappaB P65 expression in the CRP-induced cells was increased. After pre-treatment of the cells with PDTC at 10 mumol/L, the decrease in IkappaB-alpha expression and the increase in NF-kappaB P(65) expression in the CRP-induced cells were inhibited, and the expression and activity of MMP-9 were lowered too. It is concluded that increased expression and activity of MMP-9 in CRP-induced human THP-1 cells may be associated with activation of NF-kappaB. Down-regulation of the expression and activity of MMP-9 may be a new treatment alternative for plaque stabilization by inhibiting the NF-kappaB activation.
4.Clinical application of intra-articular injection drugs in orthopedics:features and value
Jinhui MA ; Wei SUN ; Fuqiang GAO ; Yunting WANG ; Zirong LI
Chinese Journal of Tissue Engineering Research 2014;(31):5068-5074
BACKGROUND:As a more common method in the orthopedic field, the method of intra-articular injection drugs has distinct curative effects, but there are some complications. In a certain extent, this method caters to the psychological fear of surgery, and can serve as a kind of conservative treatment. But some experts believed that because of the limit of sterile conditions, intra-articular injection of drugs wil increase the risk of intra-articular infection and they opposed this method.
OBJECTIVE:To review the efficacy and adverse reactions of intra-articular injection drugs in recent years, and explain clinical applications of intra-articular injection drugs in orthopedics.
METHODS:A computer-based search was conducted in PubMed and Wanfang database for articles related to the application of intra-articular injection drugs in orthopedics published between January 2007 and December 2013. The English and Chinese key words were“intra-articular, injection, orthopaedics, tranexamic acid, hyaluronic acid, corticosteroid, drugs”. Data were checked in the first trial, old articles and repetitive studies were excluded. The relevant 43 articles accorded with inclusion criteria were reviewed.
RESULTS AND CONCLUSION:In orthopedics, the method of intra-articular injection drugs is simple, economic and effective, but at the same time, there are some side effects. Tranexamic acid by intra-articular injection can significantly reduce blood loss after total joint replacement, is safety and economic. Intra-articular injection joint lubricant can reduce internal friction of joints and improve the adhesion of joint cavity, can be used as a good conservative treatment for osteoarthritis. Intra-articular injection hormone drugs can treat inflammatory arthritis, and short-term curative effect is obvious, but due to large long-term side effects, the method is not recommended now. Intra-articular injection of analgesic drugs and other drugs have both advantages complications. The efficacy of intra-articular injection drugs in orthopedics is obvious;meanwhile, this method has some complications. Orthopedic surgeons should select related drugs by indications. We stil need to further make reasonable regimen with intra-articular injection drugs in future large-scale study.
5.Blood loss and limb circumference changes in patients undergoing unilateral total knee arthroplasty after intra-articular injection of tranexamic acid:a randomized controlled trial
Jinhui MA ; Wei SUN ; Fuqiang GAO ; Yunting WANG ; Zirong LI
Chinese Journal of Tissue Engineering Research 2014;(35):5577-5582
BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE:To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty. METHODS:From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3%tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P>0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood test was reviewed after the surgery. RESULTS AND CONCLUSION:There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P>0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P<0.05). These data suggested that the intra-articular injection of tranexamic acid intraoperatively in patients receiving total knee arthroplasty could significantly reduce the amounts of postoperative hidden blood loss, and did not affect the postoperative limb circumference changes.
6.Correlation of 24 h microalbuminuria and cerebral microbleeds in patients with small artery occlusion: a retrospective case series study
Haixian ZHU ; Min ZHANG ; Fuqiang ZHONG ; Lei ZHAO ; Xianlin GAO
International Journal of Cerebrovascular Diseases 2013;(1):19-22
Objective To investigate the risk factors for cerebral microbleeds (CMBs) and its correlation with the 24 h microalbuminuria (mALB) in patients with small artery occlusion (SAO).Methods The patients with SAO were enrolled.CMBs were detected with susceptibility-weighted imaging.The demographic and clinical characteristics and 24 h mALB of the patients were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CMB in patients with SAO.Spearman correlation analysis was used to investigate the correlation between the 24 h mALB and the degree of CMBs.Results A total of 90 patients with SAO were enrolled and 35 patients (38.89%) had CMBs.CMBs mainly distributed in basal ganglia/thalamus and infratentorial (62%) regions.The Age (70.8 ± 5.4 vs.67.3 ± 8.1; t =2.461,P =0.016),proportion of hypertension (80.0% vs.52.7% ;x2 =6.851,P =0.009),and 24 h mALB levels (16.257 ± 6.031 mg/24 h vs.11.910 ±5.458 mg/24 h; t =3.536,P =0.001) in the CBM group were significantly higher than those in the non-CMB group.Spearman rank correlation analysis showed that the 24 h mALB and the severity of CMB in patients with SAO showed a significant positive correlation (rs =0.795,P =0.000).The higher the 24 h mALB level was,the more severe the CMB degree would be.Multivariate logistic regression analysis showed that only 24 h mALB was the only independent risk factor for CMBs in patients with SAO (odds ratio,1.100,95% confidence interval 1.031-1.176; P =0.002).Conclusions The 24 h mALB is an independent risk factor for CMB in patients with SAO.The 24 h mALB level is positively correlated with the severity of CMB,and it may be used as a marker for small vascular injury.
7.Clinical outcomes and impact factors of hip preserving surgery for osteonecrosis of the femoral head based on China-Japan Friendship Hospital classification
Lihua LIU ; Wei SUN ; Fuqiang GAO ; Liming CHENG ; Zirong LI ; Jiangning WANG
Chinese Journal of Orthopaedics 2021;41(5):271-279
Objective:To evaluate the risk factors related to the mid-term outcomes of hip preserving surgery for early stages osteonecrosis of the femoral head (ONFH) basing on China-Japan Friendship Hospital (CJFH) classification system.Methods:From June 2012 to September 2016, there were consecutive 325 patients (432 hips) were enrolled and divided into different preserving surgery groups, namely core decompression (CD) group 141 hips and "lightbulb" operation (LB) group 291 hips, respectively. Harris hip score (HHS) was used to evaluate the clinical outcomes. The progression of ONFH was observed by radiography. Clinical failure was defined as worsen of HHS and/or radiographic evaluation. Clinical endpoint events were marked as significant hip pain (HHS<70), and/or collapse of the femoral head requiring further interventions. Potential risk factors, including sex, age, etiology, the duration from symptom onset to treatment, preoperative CJFH type, ARCO stage and HHS, were analyzed using univariate risk analysis and Cox regression multivariate risk model.Results:The rate of hip failure was 47.5% (67/141) in CD group, including type C+M 13.0% (3/23), L1 38.1% (24/63), L2 82.4% (14/17) and L3 68.4% (26/38), respectively. There was significant difference in age (χ 2=3.887, P=0.049), type of CJFH (χ 2=40.943, P=0.000) in CD group. The Cox regression analysis revealed that age≥40 ( HR=2.325, 95% CI 1.398, 3.866, P=0.000), pre-HHS 70-80 ( HR=2.163, 95% CI 1.140, 4.105, P=0.018) and <70 ( HR=2.597, 95% CI 1.173, 5.749, P=0.019), type L2 ( HR=35.052, 95% CI 7.721, 159.133, P=0.000) and L3 ( HR=13.242, 95% CI 3.104, 56.491, P=0.000) were associated with failure of core decompression. The rate of hip failure was 36.4%(106/291) in LB group, including type C+M 33.3% (1/3), L1 31.3% (41/131), L2 84.6% (22/26) and L3 32.1% (42/131), respectively. There were significant differences in age (χ 2=8.437, P=0.004), pre-HHS (χ 2=19.737, P=0.000) and type of CJFH (χ 2=29.265, P=0.000) in LB group. The Cox regression analysis showed that poor pre-HHS ( HR=5.102, 95% CI 2.339, 11.129, P=0.000), type L2 ( HR=32.761, 95% CI 6.165, 43.507, P=0.000) were associated with failure of "lightbulb" preserving surgery. Conclusion:The results of hip preserving surgery for ONFH are associated with age, preoperative HHS and CJFH typing. The prognosis depends on the severity of symptoms, the residual of weight-bearing joint surface and lateral pillar of the femoral head.
8.Impact of extracorporeal shock waves on physiological function of bone microvascular endothelial cells
Wei ZUO ; Fuqiang GAO ; Peiyao LI ; Wei SUN ; Zirong LI ; Lingjun SHI
Chinese Journal of Tissue Engineering Research 2016;20(37):5504-5510
BACKGROUND:Extracorporeal shock wave has been shown to influence the physiological function of endothelial cel s via the activation of mechanoreceptors and specific signal transduction system, and gene expression regulation.
OBJECTIVE:To explore the impact of different energy flow densities and numbers of shots of extracorporeal shock waves on the new vessel formation ability, migration capability and apoptosis of bone microvascular endothelial cel s.
METHODS:Bone microvascular endothelial cel s isolated from the femoral head of patients undergoing arthroplasty were subcultured in vitro, and then were immunofluorescently evaluated with endothelial cel marker antibodies to CD31 and von Wil ebrand factor (vWF), and grouped according to different energy flow densities (low, 0.03 mJ/mm2;high, 0.11 mJ/mm2) and numbers of shots (400 and 800). Capil ary-like tube formation, migration capability and apoptosis of bone microvascular endothelial cel s were determined by 3-D culture in vitro, scratch test, and flow cytometry, respectively.
RESULTS AND CONCLUSION:vWF and CD31 were positively expressed in approximately 100%of bone microvascular endothelial cel s, which indicates the cultured cel s had characterization of microvascular endothelial cel s. Extracorporeal shock wave enhanced angiogenesis and migration capability of bone microvascular endothelial cel s derived from the femoral head, and especial y low-energy flow density of extracorporeal shock wave exerted more superior effects. Angiogenesis of bone microvascular endothelial cel s was decreased with the increased shot number in the low-energy flow density group. In addition, extracorporeal shock wave inhibited bone microvascular endothelial cel apoptosis induced by steroids. Our results suggest that energy flow density and number of shots of extracorporeal shock waves impact the physiological function of bone microvascular endothelial cel s derived from the femoral head.
9.Cocktail therapy reduces hidden blood loss after total knee arthroplasty
Lijun SHI ; Fuqiang GAO ; Wei SUN ; Weiguo WANG ; Liming CHENG ; Wanshou GUO
Chinese Journal of Tissue Engineering Research 2017;21(3):329-334
BACKGROUND:Blood loss after total knee arthroplasty is a common problem that wil affect the clinical effects. As a kind of hemostatic medicine, tranexamic acid has been more and more used in reducing bleeding after joint replacement. However, there are few studies concerning the combined use of tranexamic acid with other hemostatic drugs. OBJECTIVE:To evaluate the efficacy and safety of intra-articular administration of cocktail wine (tranexamic acid plus diluted-epinephrine) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty. METHODS:From July 2013 to October 2015, 113 patients scheduled to undergo total knee arthroplasty were randomized into two groups. Cocktail wine group (57 patients) received intra-articular cocktail wine (3 g tranexamic acid plus 0.25 mg diluted-epinephrine;1:200 000). Tranexamic acid group (56 patients) received 3 g topical tranexamic acid alone. Al patients were not drain inserted after the operation. During perioperative period, intraoperative blood loss, postoperative dominant blood loss, occult blood loss and al ogeneic blood transfusion were observed. Within postoperative 90 days, the incidences of symptomatic deep venous thrombosis and pulmonary embolism were observed. RESULTS AND CONCLUSION:(1) The topical administration of cocktail wine significantly reduced total blood loss (P=0.007), hidden blood loss (P=0.000) and transfusion rate (0%vs. 5.4%), without increasing the risk of thromboembolic and hemodynamic complications (P>0.05). (2) Therefore, the hemostatic effect of topical tranexamic acid plus diluted-epinephrine was better than tranexamic acid alone. Their combination does not produce severe adverse reactions, and can be used as an important method to reduce blood loss after total knee arthroplasty.
10.A study on the oxytocin levels and the relationship of symptoms severity with clinical symptoms
Yonghui ZHANG ; Hongru QU ; Yanjie GAO ; Yuhui CHEN ; Hongjun TIAN ; Fuqiang MAO
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(3):244-246
Objective To explore the difference of the oxytocin levels between social phobia patients and normal controls,and the relationship of symptoms severity of social phobia with the oxytocin levels and the relationship of drug effects with oxytocin levels.Methods Twenty seven 16-26 years old social phobia patients and thirty one normal controls were tested by an enzyme-linked immunosorbent assay to evaluate the oxytocin levels,and the Liebowitz Social Anxiety Scale was used to evaluate the symptoms severity of social phobia in patient group.Paroxetine was used to treat the patients with the drugs of 20mg per day,the Clinical Global Impression Scale were used to evaluate the drug effects after 4 weeks treatment.Results Mann-Whitney test showed there were significantly differences in oxytocin level between patients and controls ( (202.93 ± 145.06) pg/ml vs ( 152.29 ± 101.89 ) pg/ml,Z =- 1.307,P=0.030).Multiple liner regression analyses showed that the level of oxytocin was an impact factor of the severity of social phobia symptom (adjusted R2 =0.158,F=5.888,P=0.023 ).Logistic regression analyses showed that the level of oxytocin was an impact factor of the effective of drug treatment( OR=3.132,P =0.029 ).Conclusion This study indicate that the value of plasma oxytocin maybe significantly differences between social phobia and normal controls and the plasma oxytocin level maybe a factor which influence the symptoms severity and the effective of drug treatment in social phobia patients.