Wnt signaling pathway has a critical role in differentiation, proliferation, supersession and metabolism of osteocyte. Although the principal components are relatively simple, however, the numerous components consisted of Wnt signaling participate in the reaction, including several LRPs ( low density lipoprotein receptor-related protein,LRP) , 19 different Wnt proteins and 19 different FZDs( frizzled receptor, FZD) , and non-canonical Wnt signaling and multiple inhibitors of Wnt signaling.The Wnts linked to mem-brane coreceptor and activated downstream of canonical Wnt signaling or non-canonical Wnt signaling, In addition, different Wnts had different roles in differentiation, bone formation and bone absorption of osteocyte.This review aims to understand the relationship be-tween Wnt signaling and osteocyte metabolism and bone diseases, by analyzing a variety of factors and the process of Wnt protein and Wnt signaling pathway in activity of osteocyte.

Objective To investigate the presence of radial displacement of the meniscus in knee joint, and discuses its clinical significance. Methods From January 2000 to February, 398 cases underwent MRI because of different symptoms, and were analyzed retrospectively. Of them, 312 were recruited to the study, whose age was more than 18 years without knee operation, serious deformity, bone destruction, fracture, dislocation and tumor. Non-weight-bearing magnetic resonance images (MRI) of 312 patients with symptoms, including 125 males and 187 females aging from 19 to 85 years, were used to evaluate retrospectively for the radial displacement of the meniscus in knees by Kenny's method. The macroscopic observation for menisci were noted separately during total knee replacement(TKR) and knee arthroscopy in 21 and 35 patients respectively. Results In the 312 cases, MRI examinations demonstrated that 52 patients were found with the radial displacement of the meniscus(16.7%),including 47 medial menisci and 6 lateral menisci. There was a statistically difference among each age group (?2=10.18,P

Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis.Methods A total of 150 cases of senile knee osteoarthritis(182 knee joints) was selected for total knee replacement.Their X-ray examination results were gathered for recording the impairment of the articular surface,the joint space narrowing,and the location and amount of osteophytes.An MRI examination was performed in some of the cases for recording changes of fibrocartilage and locations of meniscus.Results Out of the 150 cases,there were 108 cases of genu varum(mean inversion angle,12.5?;range,0?~25?),21 cases of genu valgum(mean eversion angle,18.3?;range,15?~25?),and 21 cases of flexion contracture (mean angle,15.3?;range,0?~40?).The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases,and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases(152 joints).MRI examinations were performed in 11 cases(15 joints),in which discontinuous,cystoid,and worn-out fibrocartilages were seen.Radial displacement of the meniscus was found.Intraoperative findings proved that the fibrocartilage on the articular surface on the side with joint space narrowing was severely worn away,the collateral ligaments were contracted,the osteophytes were seen at the posterior part of the tibia and the femur,and abrasion or radial displacement of the meniscus on the side with joint space narrowing.Conclusions Joint space narrowing,varus or valgus deformity,osteophytes,and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.

OBJECTIVE:To discuss the working method for clinical pharmacists in the use of antibacterials in retinopathy surgical department. METHODS:The utilization of antibacterials in surgical department and the experience of the author in the use of antibacterials were analyzed. RESULTS & CONCLUSION:Clinical pharmacists can play an important role in the rational use antibacterials by participating in the perioperative use of antibacterials,treatment of infection cases,and sample collection etc in surgical department.

BACKGROUND:Lithium chloridecan promote the proliferation and osteogenic capacity of bone marrow mesenchymal stem cels in the necrotic region after avascular necrosis of the femoral head, which has become an issue of concern. OBJECTIVE:To compare the advantages and disadvantages of bone marrow stem cel transplantation combined with lithium chloride in the treatment of rabbit femoral head necrosis. METHODS: Passage 2 bone marrow mesenchymal stem cels from 1-week-old New Zealand rabbits were cultured in 0, 5, 10, 20, 40 mmol/L lithium chloride. Forty-eight healthy adult New Zealand rabbits were selected to make femoral head necrosis models in the right femoral head using liquid nitrogen freezing method and then randomized into four groups: model group with no implantation; lithium chloride group given lithium chloride treatment at 3 days after modeling; cel transplantation group given gelatin sponge implantation and bone marrow mesenchymal stem cel suspension injection into the femoral head after modeling; combined group given bone marrow mesenchymal stem cel suspension injection and lithium chloride treatment. Intraperitoneal injection of lithium chloride (45.2 mg/kg) was given daily beginning at the postoperative 3rdday, and the treatment duration was 4 weeks. RESULTS AND CONCLUSION:Lithium chloride at 10 mmol/L had the maximum effect on the proliferation of rabbit bone marrow mesenchymal stem cels, and if the concentration of lithium chloride was > 10 mmol/L, the promotion role of lithium chloride began to decline. After combined treatment, the morphology of the femoral head was restored a little, with increased bone density and thickened trabecular bone; the level of β-catenin in the femoral head was significantly increased in the combined group compared with the cel transplantation group or the lithium chloride group. These findings show that bone marrow stem cel transplantation combined with lithium chloride treatment can promote the recovery from femoral head necrosis by increasing bone mass of the trabecular bone and bone density of the femoral head in the necrotic region.

Objective With the development of minimally invasion and the popularization of arthroscopy the technology of ar-throscopy has been widely applied for the treatment of acute and the safety of this has been validated.To analyze the clinical effect of ar-throscopically assisted double Endobutton plate reconstruction of coracoclavicular ligament in the treatment of acute acromioclavicular joint dislocation. Methods From November 2013 to December 2014, a total of 23 patients with Rockwood type III,Ⅳ,Ⅴshoulder joint dis-location were included, all cases was treated by arthroscopic double Endobutton fixaton technique.Patients were followed up for 6 to 18 months.The changes of shoulder joint forward elevation and external rotation, Japanese Orthopaedic Association score(JOA), and Visual Analogue score( VAS) of acromioclavicular joint in both perioperative and postoperative were recorded. Results The mean follow-up time was (9.3 ±2.4) months ( range from 6 to 18 months),and mean time from injury to surgery was(10.1 ±3.2)days.The therapeutic effects were achieved in all patients after the arthroscopically assisted double Endobutton plate reconstruction.All the measurements, in-cluding the mean forward elevation JOA scores before and after fixation (71.0 ±5.4 vs 93.5 ±3.6), and mean VAS scores (4.6 ±1.0 vs 1.9 ±0.9), mean forward elevation [(102.5 ±8.6) degrees vs (144.3 ±6.3) degrees], and mean external rotation[(107.1 ±6.2) de-grees vs (149.6 ±7.5) degrees] improved significantly (P<0.05) after the treatment. Conclusion Arthroscopic double Endobutton fixaton technique could provide an effective immobilization of shoulder and acromioclavicular joint, thus improving the function of the joint and achieving an excellent effect in the treatment of acute acromiocla-vicular joint dislocation.

BACKGROUND:Previous therapies for diabetic foot are not ideal with large cost, and moreover, amputation is often required. OBJECTIVE: To perform the Ilizarov bone transport in the treatment of patients with diabetic foot (Wanger grades 3-4), and to observe the limb salvage conditions. METHODS: Eighteen patients with diabetic foot, Wanger grades 3-4, admitted in the Department of Bone and Joint Surgery, First Affiliated Hospital of Guangxi Medical University from December 2013 to June 2015 were enroled in this trial. Al of patients were subjected to Ilizarov bone transport. RESULTS AND CONCLUSION: Al the 18 patients were folowed up for 3 to 20 months, and presented with ulcer healing. Scores on ankle-brachial index and 10-g nylon line test were both increased significantly in the patients after treatment, but the visual analog scale scores were reduced. These findings indicate that the Ilizarov bone transport is an effective method for treating ulcer of diabetic foot at Wanger grades 3-4.

Objective:To evaluate the clinical efficacy of the modified biplane Chevron osteotomy and autogenous osteochondral transplantation for the treatment of talar cartilage injury with bone cyst.Methods:From February 2016 to February 2019, 26 patients with talar cartilage injury and bone cyst were treated at Department of Orthopaedics, The First Affiliated Hospital to Guangxi Medical University. They were 16 males and 10 females, aged from 22 to 50 years (average, 36.2 years). According to the Hepple classification, there were 5 cases of type Ⅳ and 21 cases of type Ⅴ. The extent and range of talar cartilage injury were evaluated by arthroscopy, the modified biplane Chevron osteotomy of medial malleolus was performed to expose cartilage defects medial to the talus, unstable cartilage was removed thoroughly, sclerotic wall of the bone cyst was freshly treated, and an osteochondral column taken from the non-weight-bearing area of the ipsilateral femoral medial condyle was implanted into the injured area of talar cartilage. The clinical efficacy was evaluated by comparing the ankle-hindfoot scores of American Orthopedic Foot and Ankle Society (AOFAS), Karlsson ankle scores, visual analogue scale (VAS) and Lysholm ankle scores between preoperation and one year post-operation.Results:All the 26 patients were followed up for an average of 20.6 months (from 12 to 30 months). Follow-up did not observe any postoperative complications like incision infection, cyst recurrence or malunion, or any obvious pain or movement limitation at the donor knee joint. The AOFAS ankle-hindfoot scores were significantly increased from preoperative 64.3±3.9 to 89.5±5.1 one year postoperation, the Karlsson scores were significantly increased from preoperative 60.5±5.5 to 85.2±6.9 one year postoperation, and the VAS scores were significantly decreased from preoperative 6.2±1.1 to 1.8±0.9 one year post-operation (all P<0.05). The Lysholm ankle scores before and after operation were 94.7±1.9 and 94.1±1.8, respectively, showing no significant difference ( P>0.05). Conclusion:In the treatment of talar osteochondral injury and bone cyst, the modified biplane Chevron osteotomy of medial malleolus and autogenous transplantation of osteochondral column can effectively relieve ankle pain and improve ankle function, leading to satisfactory clinical efficacy.

OBJECTIVETo analyze the effect of endophytic fungi on expression amount of key enzyme genes SS (squalene synthase gene), SE (squalene epoxidase gene) and bAS (beta-amyrin synthase gene) in saponin biosynthesis and saponins content in Eleutherococcus senticosus.

METHODWound method was used for back meeting the endophytic fungi to E. senticosus. With GAPDH as internal control gene, the expression of key enzyme genes was detected by real time PCR method. E. senticosus saponins content was measured by spectrophotometry method.

RESULTWhen wound method back meeting P116-1a and P116-1b after 30 d, the expression content of SS improved significantly (P < 0.05), however the back meeting of P109-4 and P312-1 didnt change the expression of SS. After that SS expression showed reduction-equality-reduction varying trend. Thirty days after back meeting P312-1, the expression content of SE improved significantly (P < 0.05). Ninty days after back meeting P116-1b and P312-1, the expression content of SE improved significantly to 130%,161%, respectively (P < 0.05). After 120 d, back meeting four endophytic fungi, the expression of SE were significantly higher than the control (P < 0.05). Back meeting four endophytic fungi form 60 d to 120 d, the expression of bAS was significantly higher than the control (P < 0.05). The back meeting four endophytic fungi improved E. senticosus saponins content significantly (P < 0.05).

CONCLUSIONEndophytic fungi P116-1a, P116-1b, P1094 and P312-1 significantly effected the expression of key enzyme genes SS, SE and bAS and then affected E. senticosus saponins content. Among the genes, bAS was key target gene.

Eleutherococcus ; chemistry ; metabolism ; microbiology ; Endophytes ; physiology ; Farnesyl-Diphosphate Farnesyltransferase ; genetics ; Fungi ; physiology ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Plant ; Intramolecular Transferases ; genetics ; Saponins ; analysis ; biosynthesis ; Squalene Monooxygenase ; genetics

BACKGROUNDPain has a substantial impact on patients' activities and overall quality of life, but current conventional drugs have debilitating side effects, including gastrointestinal disorders. Thus there is a pressing need for new therapies with fewer side effects to alleviate cancer pain. We recently developed a topical herbal formula Xiaotan Tongluo analgesic gel (XTTL gel) based on the principles of traditional Chinese herbalism, and we have received positive feedback from bone cancer pain patients. The aim of this study was to determine the analgesic effects and explore the mechanisms of XTTL gel in a rat model of bone cancer pain.

METHODSThe rat model of bone cancer pain was established by inoculating Walker-256 rat carcinoma cells directly into the right tibial medullary cavity of Wistar rats. The rats were randomly assigned to three groups (n = 10 per group): (1) sham bone cancer control (sham group): vehicle (PBS) inoculation without carcinoma cells plus topical administration of blank gel; (2) Sham treatment control (vehicle group): Walker-256 cell inoculation plus topical administration of blank gel; (3) XTTL gel treatment (treatment group): Walker-256 cell inoculation plus topical administration of XTTL gel. XTTL gel treatments were applied daily for 7 days starting on day 14 following inoculation. Outcomes were assessed 21 days after inoculation by mechanical allodynia, histological staining, and by measuring concentrations of type I collagen carboxy-terminal telopeptide (ICTP) and bone-specific alkaline phosphatase (BAP) in serum.

RESULTSFourteen days after cancer cell incubation, significant mechanical allodynia in the ipsilateral hind paw and tumor growth in proximal end of the tibia were observed in the vehicle and treatment groups but not in the sham group. At day 21, mechanical withdrawal thresholds in treatment group rats were significantly higher ((4.8557 +/- 0.8336) g) compared with those of the vehicle group ((1.8630 +/- 1.4369) g, P < 0.05). ICTP and BAP levels increased significantly in vehicle group rats ((101.5176+/- 11.0694) U/L and (370.7838 +/- 12.8273) U/L, respectively) compared with those of the sham group ((11.7553 +/- 1.1885) U/L and (185.7338 +/- 3.6761) U/L, respectively; P < 0.05). XTTL gel decreased the level of blood serum ICTP ((41.8998 +/- 6.4970) U/L, P < 0.05) but had little effect on blood serum BAP ((365.5338 +/- 18.5361) U/L, P > 0.05).

CONCLUSIONTopical use of XTTL gel may have an analgesic effect on bone cancer pain, an effect mediated by lowering of ICTP levels and inhibiting bone resorption.

Alkaline Phosphatase ; metabolism ; Animals ; Body Weight ; Bone Neoplasms ; complications ; Cell Line, Tumor ; Collagen Type I ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Pain ; drug therapy ; etiology ; Peptide Fragments ; blood ; Peptides ; Procollagen ; blood ; Random Allocation ; Rats ; Rats, Wistar