BACKGROUND:At present, there are many methods to treat cartilage defects, but none radical y repairs the articular cartilage defects.
OBJECTIVE:To histological y verify the effect of naringin combined with tissue engineering cartilage on the repair of rabbit articular cartilage defects.
METHODS:Rabbit bone marrow mesenchymal stem cells fol owing in vitro proliferation were compounded onto acellular dermal matrix, which was then implanted into rabbit knee cartilage defects. Naringin was also given by lavage. Hematoxylin-eosin staining, Masson trichrome staining, toluidine blue dyeing, type II col agen staining and type X col agen staining were performed in the repaired tissue.
RESULTS AND CONCLUSION:After 8 weeks post-surgery, the defects repaired with the naringin and stem cells composite were turned into milky-white and transparent smooth tissue. The defective tissue which was repaired, was very similar to normal cartilage tissue, with smooth surface. After the histology research, we found that the defect tissue was fil ed with new cartilage tissue. Results indicated that naringin combined with tissue engineering cartilage can promote the repair of articular cartilage defects in rabbits.

Objective To compare the short-term efficacy and occurrence of complication of en-doscopic laminar fenestration(Endo-LOVE)and percutaneous endoscopic transforaminal decompres-sion(PETD)in patients with degenerative lumbar lateral recess stenosis(LSLRS).Methods A to-tal of 160 patients with LSLRS were enrolled as study objects,and were randomly assigned to control group(treated with PETD)and observation group(treated with Endo-LOVE),with 80 patients in each group.Surgical indicators,occurrence of complications,and therapeutic effects were observed and compared between the two groups.Bone lateral recess angle,soft lateral recess angle,Oswestry Disability Index(ODI)score,pain score,and Japanese Orthopaedic Association(JOA)score were compared before and after surgery.Results The observation group had less intraoperative blood loss,and shorter operative and hospital stays than the control group(P＜0.05).There were no sta-tistically significant differences in the incidence of complications such as lower limb numbness,fever,and postoperative low back pain between the two groups(P＞0.05).There were no statistically significant differences in preoperative bone lateral recess angle or soft lateral recess angle between the two groups(P＞0.05).At 72 hours postoperatively,both angles increased in both groups compared with preoperative values,and the observation group had larger angles than the control group(P＜0.05).There were no statistically significant differences in preoperative pain score,ODI score,or JOA score between the two groups(P＞0.05).At 3 months postoperatively,JOA scores increased and pain scores as well as ODI scores decreased in both groups compared with preoperative values,with the observation group having higher JOA scores and lower pain scores as well as ODI scores than the control group(P＜0.05).The excellent and good rate was 96.25％(77/80)in the observation group,which was higher than 87.50％(70/80)in the control group(P＜0.05).Conclusion Com-pared with the PETD approach,the Endo-LOVE approach for the treatment of LSLRS offers shorter operative time,less intraoperative blood loss,and better short-term efficacy.

Objective To compare the short-term efficacy and occurrence of complication of en-doscopic laminar fenestration(Endo-LOVE)and percutaneous endoscopic transforaminal decompres-sion(PETD)in patients with degenerative lumbar lateral recess stenosis(LSLRS).Methods A to-tal of 160 patients with LSLRS were enrolled as study objects,and were randomly assigned to control group(treated with PETD)and observation group(treated with Endo-LOVE),with 80 patients in each group.Surgical indicators,occurrence of complications,and therapeutic effects were observed and compared between the two groups.Bone lateral recess angle,soft lateral recess angle,Oswestry Disability Index(ODI)score,pain score,and Japanese Orthopaedic Association(JOA)score were compared before and after surgery.Results The observation group had less intraoperative blood loss,and shorter operative and hospital stays than the control group(P＜0.05).There were no sta-tistically significant differences in the incidence of complications such as lower limb numbness,fever,and postoperative low back pain between the two groups(P＞0.05).There were no statistically significant differences in preoperative bone lateral recess angle or soft lateral recess angle between the two groups(P＞0.05).At 72 hours postoperatively,both angles increased in both groups compared with preoperative values,and the observation group had larger angles than the control group(P＜0.05).There were no statistically significant differences in preoperative pain score,ODI score,or JOA score between the two groups(P＞0.05).At 3 months postoperatively,JOA scores increased and pain scores as well as ODI scores decreased in both groups compared with preoperative values,with the observation group having higher JOA scores and lower pain scores as well as ODI scores than the control group(P＜0.05).The excellent and good rate was 96.25％(77/80)in the observation group,which was higher than 87.50％(70/80)in the control group(P＜0.05).Conclusion Com-pared with the PETD approach,the Endo-LOVE approach for the treatment of LSLRS offers shorter operative time,less intraoperative blood loss,and better short-term efficacy.

Objective To investigate the differences in efficacy and safety in the treatment of patients with cerebral palsy at different grades of the Gross Motor Function Classification System(GMFCS)by selective posterior rhizotomy(SPR).Methods Relevant literatures on SPR treatment for cerebral palsy were retrieved from Pubmed,Embase,Web of Science,China Biology Medicine disc,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database.Clinical trials on SPR treatment for cerebral palsy were included for Meta-analysis.At least two re-searchers independently screened the literatures,extracted data,and assessed the quality of the liter-atures.Data analysis was performed by Review Manager 5.4 software.Results A total of 2,726 lit-eratures were retrieved,and 8 literatures were finally included after screening.The results of the Me-ta-analysis showed that the gross motor function and self-care ability of patients with cerebral palsy at all GMFCS grades improved significantly after surgery,and muscle tone decreased significantly after surgery(P＜0.05).In comparison of the improvement in gross motor function before and after SPR,patients with grades Ⅱ and Ⅲ of GMFCS benefited the most,followed by those with grade Ⅰ,and those with grades Ⅳ and Ⅴ benefited less.In terms of improving self-care ability,patients with grade Ⅰbenefited the most,followed by those with grade Ⅲ,and those with grades Ⅱ and Ⅳ benefited less.No significant adverse reactions were reported in previous literatures.Conclusion SPR is a relatively safe and effective treatment option for patients with cerebral palsy.Patients at grades Ⅱand Ⅲ of GMFCS benefit the most from SPR,and patients at grades Ⅳ and V with poor preoperative physical status can also benefit from SPR.

BACKGROUND:Most scholars now believe that children with cerebral palsy who have severe spinal deformities in early childhood(<15 years of age)may have a higher risk of progression of spinal deformities,which may result from imbalances in movement due to pelvic tilt,pain,etc. OBJECTIVE:To investigate the relationship between lumbar spine development and hip joint development in children with spastic cerebral palsy. METHODS:A retrospective analysis was performed in 102 children with spastic cerebral palsy admitted at Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from January 2014 to December 2021.All admitted children had X-rays of the pelvic position and the lumbar lateral position.Anteroposterior X-ray of the pelvis was performed to measure femoral head migration percentage,central edge angle,neck-shaft angle,and acetabular index.The sagittal Cobb angle,sacral slope,arch-top distance,and lumbar lordosis index were measured by the lateral X-ray of the lumbar spine.Correlation of the two sets of indicators was further analyzed.All children were divided into normal group,risk group,hip subluxation group and total hip dislocation group according to their femoral head migration percentage,and the differences in lumbar spine indexes between groups were evaluated. RESULTS AND CONCLUSION:Pearson correlation analysis showed that the femoral head migration percentage was moderately positively correlated with sagittal Cobb angle and arch-top distance,and weakly positively correlated with lumbar lordosis index;the central edge angle was moderately negatively correlated with the arch-top distance and weakly negatively correlated with the sagittal Cobb angle;the neck-shaft angle was weakly positively correlated or not correlated with the sagittal Cobb angle and lumbar lordosis index;and the acetabular index was weakly positively correlated with the sagittal Cobb angle and arch-top distance.No statistically significant correlation was found between the remaining indicators.According to the femoral head migration percentage,the children were divided into four groups,including 25 cases in the normal group,41 cases in the risk group,27 cases in the hip subluxation group,and 9 cases in the total hip dislocation group.The sagittal Cobb angle was significantly increased in the risk group,the hip subluxation group and the total hip dislocation group compared with the normal group,showing an increasing trend group by group,and there were significant differences between groups(P<0.05).Compared with the normal group,the lumbar lordosis index in the risk group and the hip subluxation group increased significantly,and there were significant differences between groups(P<0.05).There was an increase trend in the lumbar lordosis index of the total hip dislocation group compared with the normal group.Compared with the normal group,the arch-top distance in the hip subluxation group and the total hip dislocation group increased significantly(P<0.05),and there was a stepwise increasing trend.There was no significant difference in sacral slope between groups.To conclude,the development of the lumbar spine in children with cerebral palsy is closely related to the development of the pelvic hip joint,and the most obvious relationship is between lumbar lordosis and hip dislocation.

BACKGROUND:Shujin Jiannao Prescription is an empirical formula for the treatment of cerebral palsy in Dongzhimen Hospital,Beijing University of Chinese Medicine,with clear clinical efficacy,but the specific mechanism needs to be elucidated. OBJECTIVE:To explore the possible mechanism of Shujin Jiannao Prescription in treating cerebral palsy. METHODS:Sixty-four 7-day-old Sprague-Dawley rats were randomly divided into a normal group(n=12)and a model group(n=52).An animal model was established by the Rice-Vannucci method.After successful modeling,52 model rats were randomly divided into control model group(n=12),minocycline group,and the low-,medium-,and high-dose groups of the Shujin Jiannao Prescription(n=10 per group).Rats in the minocycline group were given 40 mg/kg·d minocycline by gavage;rats in the low-,medium,and high-dose groups were given 4,8,and 16 g/kg·d Shujin Jiannao Prescription granules by gavage,respectively;and rats in the normal group and control model group were given an equal dose of normal saline by gavage.Medication in each group was given once a day for 1 week.The rats in each group were evaluated behaviorally using suspension test,abnormal involuntary movement score,and Bederson score.The pathological changes of the cerebral cortex were observed by hematoxylin-eosin staining.The levels of tumor necrosis factor α,interleukin 1β,and interleukin 10 in the cerebral cortex were determined using ELISA.The positive expressions of Janus kinase 2(JAK2),phosphorylated Janus kinase 2(p-JAK2),phosphorylated signal transducer and activator of transcription 3(p-STAT3)in the cerebral cortex were detected using immunohistochemistry.The protein expression levels of JAK2,p-JAK2,and p-STAT3 were detected using western blot. RESULTS AND CONCLUSION:Compared with the normal group,the suspension test score and involuntary movement score were decreased in the control model group(P＜0.01 or P＜0.05).The pathological results showed structural disruption of nerve cells,formation of large numbers of vacuoles,cell swelling,and increased intercellular space in the control model group.In addition,the expressions of tumor necrosis factor α and interleukin 1β in the cerebral cortex were significantly increased(P＜0.01),the expression of interleukin 10 was decreased(P＜0.05),and the protein expressions of JAK2,p-JAK2,and p-STAT3 in the cerebral cortex were significantly increased(P＜0.01)in the control model group compared with the normal group.Compared with the model group,minocycline and Shujin Jiannao Prescription at each dose could improve the behavioral indexes of rats(P＜0.01 or P＜0.05)and ischemic-hypoxic pathological changes were attenuated,with only a small amount of necrotic nerve cells and a few vacuoles,and reduced intercellular space.Moreover,the expressions of tumor necrosis factor α and interleukin 1β in the cerebral cortex were decreased in each drug group compared with the control model group(P＜0.05),while the protein expressions of JAK2,p-JAK2,and p-STAT3 in the cerebral cortex were significantly decreased(P＜0.01).The most obvious improvement was observed in the high-dose Shujin Jiannao Prescription group.To conclude,Shujin Jiannao Prescription can inhibit inflammation in the cerebral cortex of rats with hypoxic-ischemic brain injury.The mechanism may be related to the regulation of the JAK2/STAT3 signaling pathway.

BACKGROUND:Studies have shown that there is a close association between spinal cord injury and ferroptosis,and that tetramethylpyrazine has the function of regulating redox reactions. OBJECTIVE:To investigate the regulatory effect of tetramethylpyrazine on ferroptosis in rats with spinal cord injury and its mechanism. METHODS:Thirty-six female specific pathogen-free Sprague-Dawley rats were randomly divided into sham-operated group,model group and tetramethylpyrazine group,with 12 rats in each group.Animal models of spinal cord injury were established using the modified Allen's method in the latter two groups.No treatment was given in the sham-operated group,while rats in the model and tetramethylpyrazine groups were given intraperitoneal injection of normal saline and tetramethylpyrazine solution,once a day,for 28 days. RESULTS AND CONCLUSION:The Basso,Beattie&Bresnahan Locomotor Rating Scale score in the tetramethylpyrazine group was lower than that in the sham-operated group but higher than that in the model group after 14,21,and 28 days of treatment(P＜0.05).After 28 days of treatment,hematoxylin-eosin staining showed that in the model group,the spinal cord tissue of rats showed cavity formation,necrotic tissue and inflammatory infiltration with fibrous tissue formation;in the tetramethylpyrazine group,the area of spinal cord tissue defects was smaller,and inflammatory infiltration and fibrous tissue formation were less than those in the model group.After 28 days of treatment,Prussian blue staining showed that a large amount of iron deposition was seen in the spinal cord tissue of rats in the model group,and less iron deposition was seen in the spinal cord tissue of rats in the tetramethylpyrazine group than in the model group.After 28 days of treatment,the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were decreased(P＜0.05)and the level of malondialdehyde was increased in the model group compared with the sham-operated group(P＜0.05);the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were increased(P＜0.05)and the level of malondialdehyde was decreased in the tetramethylpyrazine group compared with the model group(P＜0.05).After 28 days of treatment,qRT-PCR and western blot assay showed that the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the model group were decreased compared with those in the sham-operated group(P＜0.05),while the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the tetramethylpyrazine group were increased compared with those in the model group(P＜0.05).Immunofluorescence staining showed that after 28 days of treatment,the neuronal nuclei positive staining in the spinal cord of rats was the most in the sham-operated group and the least in the model group.To conclude,tetramethylpyrazine can improve motor function and play a neuroprotective role in rats with spinal cord injury by regulating ferroptosis.

BACKGROUND:Perinatal hypoxic-ischemic brain injury is one of the most common causes of cerebral palsy.Shujin Jiannao Prescription is an experienced formula for treating cerebral palsy and improving blood supply to the brain developed by the Dongzhimen Hospital,Beijing University of Chinese Medicine. OBJECTIVE:To explore the possible mechanism of Shujin Jiannao Prescription in treating hypoxic-ischemic cerebral palsy. METHODS:Sixty-four 7-day-old Sprague-Dawley rats were randomly divided into six groups.There were 12 rats in each of the control and model groups as well as 10 animals in each of the minocycline group,and the low-,medium-,and high-dose groups of Shujin Jiannao Prescription.The neonatal rat ischemic-hypoxic cerebral palsy model was established in all groups except for the control group.After successful modeling,rats in each drug group were respectively gavaged with minocycline and Shujin Jiannao Prescription at a dose of 4,8,and 16 g/kg per day for 1 week.Body mass of rats was measured and behavioral changes were detected before and after drug administration.Hematoxylin-eosin staining was used to observe the histomorphology of hippocampal CA1 region of rat brain tissue,and immunohistochemistry and western blot were used to detect the expression levels of Bcl-2,Bax,and Caspase-3 in the brain tissue of rats. RESULTS AND CONCLUSION:Compared with the model group,medium-and high-dose Shujin Jiannao Prescription significantly increased the body mass of rats(P<0.05).Compared with the model group,minocycline effectively prolonged the suspension time of ischemic-hypoxic cerebral palsy rats(P<0.05),while medium-and high-dose Shujin Jiannao Prescription significantly prolonged the suspension time,shortened the inclined plane test time,and increased the Longa score of rats(P<0.05).The pathological results showed that after drug intervention,only a small number of neuronal cells in the brain tissue of rats were necrotic,the cells were more neatly arranged,the cell structure was more complete,and only part of the cell nuclei became smaller.Compared with the model group,minocycline and medium-and high-dose Shujin Jiannao Prescription reduced the expression of Bax Caspase-3(P<0.05),medium-and high-dose Shujin Jiannao Prescription increased the expression of Bcl-2(P<0.05),and Bcl-2/Bax protein expression was increased in minocycline and three Shujin Jiannao Prescription groups(P<0.05).In addition,the protein expression was increased in a dose-dependent manner after intervention with Shujin Jiannao Prescription,and there was no significant difference between the minocycline and three Shujin Jiannao Prescription groups(P>0.05).To conclude,the mechanism by which Shujin Jiannao Prescription treats ischemic-hypoxic cerebral palsy in rats may be to enhance the expression of anti-apoptotic protein Bcl-2,inhibit the expression of pro-apoptotic protein Bax,and reduce the expression of Caspase-3,ultimately inhibiting the apoptosis of hippocampal neuronal cells in rats with cerebral palsy.Within a certain range,the higher dose of Shujin Jiannao Prescription indicates the better therapeutic effect,and the high-dose Shujin Jiannao Prescription is as effective as minocycline.

Objective To investigate the differences in efficacy and safety in the treatment of patients with cerebral palsy at different grades of the Gross Motor Function Classification System(GMFCS)by selective posterior rhizotomy(SPR).Methods Relevant literatures on SPR treatment for cerebral palsy were retrieved from Pubmed,Embase,Web of Science,China Biology Medicine disc,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database.Clinical trials on SPR treatment for cerebral palsy were included for Meta-analysis.At least two re-searchers independently screened the literatures,extracted data,and assessed the quality of the liter-atures.Data analysis was performed by Review Manager 5.4 software.Results A total of 2,726 lit-eratures were retrieved,and 8 literatures were finally included after screening.The results of the Me-ta-analysis showed that the gross motor function and self-care ability of patients with cerebral palsy at all GMFCS grades improved significantly after surgery,and muscle tone decreased significantly after surgery(P＜0.05).In comparison of the improvement in gross motor function before and after SPR,patients with grades Ⅱ and Ⅲ of GMFCS benefited the most,followed by those with grade Ⅰ,and those with grades Ⅳ and Ⅴ benefited less.In terms of improving self-care ability,patients with grade Ⅰbenefited the most,followed by those with grade Ⅲ,and those with grades Ⅱ and Ⅳ benefited less.No significant adverse reactions were reported in previous literatures.Conclusion SPR is a relatively safe and effective treatment option for patients with cerebral palsy.Patients at grades Ⅱand Ⅲ of GMFCS benefit the most from SPR,and patients at grades Ⅳ and V with poor preoperative physical status can also benefit from SPR.