BACKGROUND:The OPG-RANKL-RANK transport system plays a crucial role in bone resorption mechanism of osteoclasts. OBJECTIVE:To observe the expression of OPG-RANKL-RANK signaling system in osteoclasts, osteoporosis, and the targeted therapy of OPG-RANKL-RANK signaling system. METHODS:We retrieved related literatures in the periodicals database with the key words of“osteoprotegerin, RANKL, RANK, osteoclasts, osteoporosis”in English and Chinese. According to the inclusion criteria, the literatures were included in this study after the evaluation of quality. RESULTS AND CONCLUSION:The mature of osteoclasts is mediated via OPG-RANKL-RANK signaling system and its associated signaling pathways. This signal pathway leads to the mechanism of osteoporosis. At the genetic and molecular levels, the targeted therapy of osteoporosis has become the focus. OPG-RANKL-RANK signaling system can provide a research platform for targeted treatment of osteoporosis, and OPG-RANKL-RANK signaling system is an important way to the regulation of osteoclasts and osteoporosis.

AIM:To investigate the protective effect of Huoxue-Dingxuan capsule-medicated serum on mouse brain microvascular endothelial cell line bEnd .3 with hypoxic injury .METHODS:The Wistar rats were randomly divided into control group and Huoxue-Dingxuan capsule group .The serum was collected at the 7th day after drug administration . The bEnd.3 cells were divided into normal group , hypoxia serum model group and Huoxue-Dingxuan capsule serum group . After administration of the medicated serum , bEnd.3 cell were treated with hypoxia for 6 h.The cell morphology was ob-served under microscope , the apoptosis rate and cell cycle were detected by flow cytometry , and the activity of superoxide dismutase ( SOD) and the content of malondialdehyde ( MDA) were detected by ELISA .RESULTS:Compared with other groups, Huoxue-Dingxuan capsule-medicated serum significantly resisted the injury caused by hypoxia , obviously improved the morphology of bEnd .3 cells, significantly reduced the number of apoptotic cells induced by hypoxia , and effectively in-hibited the occurrence of hypoxia-induced G1/S phase arrest in the bEnd.3 cells.At the same time, the medicated serum inhibited MDA production , and increased SOD activity .CONCLUSION: Huoxue-Dingxuan capsule attenuates hypoxia-induced bEnd .3 cell damage by enhancing the antioxidant capacity of cells and inhibiting cell apoptosis .

Objective To compare and evaluate the methods of building model of cervical spondylosis of vertebral artery type (CSA)rats by measuring the learning and memory ability,anxiety and depression,and degree of nervous tension of three kinds of CSA model rats.Methods We randomly divided 120 rats into mixed modeling group,bone graft compression modeling group,mechanical balance disorder modeling group,and blank control group with 30 rats in each.Morris water maze,elevated plus maze test and open field test were used to detect and compare the rats’abilities of learning and memory,anxiety and depression,and degree of nervous tension.We then evaluated the three CSA rat models.Results Compared with those in the blank group,the learning and memory abilities in the mixed modeling, bone graft compression and mechanical balance disorder modeling rats were significantly decreased,the anxiety and depression and degree of nervous tension were significantly increased (P<0.05).Compared with bone graft compression and mechanical balance disorder modeling groups,the mixed modeling group could restore the characteristics of CSA.Conclusion The three kinds of modeling methods can successfully reproduce the CSA animal model;the mixed modeling is superior and thus worthy of promotion.

Objective To determine the curative effect of stabilizing unstable pelvic ring fracture using the anterior subcutaneous internal fixator (INFIX).Methods From July 2013 to June 2014,15 cases who suffered from anterior pelvic ring fracture were treated with the device.There were 11 males and 4 females,with mean age of 38.5 years (range,23-65 years).Eight cases sustained fracture in traffic accidents,4 in high falls,and 3 in crush injury.According to the Young-Burgess and AO/OTA classification systems,type APC2 or 61-B1 was noted in one case,LC1 or 61-B2.1 in 4 cases,LC2 or 61-B2.2/61-B2.3 in 6 cases,and VS or 61-C1/61-C2 in 4 cases.Basic method in anterior ring fixation was one pedicle screw was respectively inserted into the area between the anterior superior iliac spine and anterior inferior iliac spine of both sides.The precontoured rod was then tunneled subcutaneously from one screw to the other.For the stable posterior injury in pelvic ring fracture,the anterior pelvic ring was stabilized only using the technique.For the unstable posterior injury in pelvic ring fracture,the anterior and posterior ring were both fixed using the technique.During follow-up visits,patients' tolerance to the device,wound infection,myositis ossificans,internal fixation lessening,and lateral femoral cutaneous nerve injury were evaluated.Results Follow-up ranged from 6-12 months (mean,7.5 months).The device was well tolerated by the patients for comfort.None had surgical site infection and internal fixation loosening.Injuries healed without loss of reduction at the 3-month follow-up.Injury of the lateral femoral cutaneous nerve at the both side was reported in 4 cases and at one side in 2 cases,but all restored 3 month after operation.Conclusion The reported technique is minimally invasive with few complications and reliable results,hinting an ideal method to stabilize the anterior pelvic ring fracture.

Objective To investigate the tissue remodeling and cell alignment of TDBM scaffolds seeded with rabbit tenocytes under the cycle dynamic tensile force or static tension-free culture in vitro. Methods TDBM were made by ourselves, and uniaxial cyclic tendon stretching device was designed and manufactured on our own. Primary tenocytes were isolated from the Achilles tendon of three-day-old New Zealand white rabbits and seeded into scaffolds, and were cultured collectively in DMEM in vitro. Samples were divided into two groups:dynamic tension-loaded group, and static tension-free group. Fresh natural tendons were used to be positive control. The experiment's time was six weeks. The scaffold-cell complexes were harvested at 3 and 7 days of culture for Inverted microscope and scanning electron micrograph (SEM) analysis. The morphological characters of the samples, including the general view, HE and Masson's dyeing, were observed at 2, 4 and 6 weeks. In addition, the gene expression of the I-type collagen and III-type collagen of the samples was detected by using Real time PCR at every week. Set fresh natural tendon as control. Results The inverted microscope and SEM showed that it was nice compatible condition between the tendon cells and TD-BM scaffold. In addition, the tendon of tension-loaded group revealed a structure of longitudinally aligned collagen fi bers and dense structure of collagen fibers arranged in orderly form a unique corrugated structure. Tenocytes layer located between the col-lagen fibers and aligned longitudinally along the force axis, with increased matrix deposition after the 3th week showed by RT-PCR. The cell/matrix ratio decreases. When cultured to 6 weeks, the tissue structure was very similar to that of fresh natural ten-don pattern. By contrast, HE and Masson's staining revealed the collagen fibro-tissue structure in tension-free groups with disorga-nized matrix structure and randomly distributed cells. Collagen fibers were gradually degraded with time. In tension-loaded group, Real-time PCR showed that gene expression of I-type collagen and III-type collagen gradually increase, but in tension-free group, the relative gene expression of I-type collagen and III-type collagen was highest at 3rd week, and from that time the relative expres-sion gradually decrease. Conclusion Under the dynamic stress, the TDBM scaffolds seeded with rabbit tenocytes can promote extra-cellular matrix biosynthesis and tendon structure remodeling, which is a promising method for tendon tissue engineering.

BACKGROUND:The V-ATPase a3 transport system plays a crucial role on bone resorption mechanism of the osteoclasts.
OBJECTIVE:To observe the expression of V-ATPase a3 transport system in fracture repair and the effect of V-ATPase a3 transport system inhibitor on fracture healing.
METHODS:We retrieved related literatures in the periodicals database with the key words, and screen them according to the inclusion criteria. The literatures were included in this study after the evaluation of quality.
RESULTS AND CONCLUSION:V-ATPase a3 transport system widely exists in the cytoplasm membrane and organel e membrane of eukaryotic cells. V-ATPase a3 has two structural domains:V0 and V1. V0 structural domain is the proton transport channel, V1 structural domain is mainly the hydrolysis of ATP. V-ATPase a3 transport system focuses on the fril ed edge of osteoclasts, H+is transported to form a high concentration, dissolves inorganic minerals and provides the acidic environment for hydrolytic enzymes, thus being involved in bone resorption. So V-ATPase a3 transport system is selected as the research target in the fracture repair and reshape.

Objective To study the chemical components from Dryopteris fragrans and their biological activities.Methods By means of HPLC and other column chromatography,the chemical components were isolated from D.fragrans and their chemical structures were identified by spectral and chemical tests in accordance with their physicochemical characteristics.Furthermore,the cytotoxicity of the chemical components for Bel-7402,HCT-8,and A-549 cells was measured by MTT method.Results Four compounds,geniposide(Ⅰ),3S,5R,6R,7E,9S-megastigman-7-ene-3,5,6,9-tetrol-3-O-?-D-glucopyranoside(Ⅱ),(6S,9R)-3-oxo-?-ionol-9-O-?-D-glucopyranoside(Ⅲ),and fragranoside a(Ⅳ) were iso-lated and identified.Conclusion Compound Ⅳ is a new compound.And all the other three compounds Ⅰ-Ⅲ are found in plants of Dryopteris Adanson for the first time.The results of pharmacological experiments indicate that compounds Ⅰ and Ⅲ show strong cytotoxicity.

AIM:To investigate the effect of rhein on bleomycin-induced pulmonary fibrosis and the expression of microRNA-21 (miR-21) and transforming growth factor-β1 (TGF-β1)/Smad signaling molecules in rats.METHODS:A single dose of bleomycin was intratracheal injected into the SD rats to induce pulmonary fibrosis .After injection of bleo-mycin, the rats were randomly divided into low-, medium-and high-dose rhein treatment groups and model group .The rats that were instilled with normal saline intratracheally served as control group .After the treatment for 28 d, the pulmonary pathologic changes were observed under microscope with hematoxylin-eosin staining .The lung coefficient and hydroxypro-line content were also measured .The expression of miR-21 and the mRNA levels of TGF-β1 and Smad7 in the lung tissues were detected by real-time PCR.The protein levels of TGF-β1 and Smad7 were determined by Western blot .RESULTS:Rhein significantly attenuated the experimental alveolitis , pulmonary fibrosis , lung coefficient and hydroxyproline contents in the rats.Rhein obviously decreased the expression of miR-21,and the mRNA and protein levels of TGF-β1, but signifi-cantly increased the mRNA and protein levels of Smad 7 in the lung tissues .CONCLUSION: Rhein effectively prevents bleomycin-induced pulmonary fibrosis by inhibiting the expression of miR-21 and promoting the expression of Smad 7, thus regulating the TGF/Smad signaling pathway to decrease extracellular matrix deposition .

Objective To explore the clinical efficacy of rectangle advancement flaps used in the reconstruction of skin defects around the Achilles tendon in children.Methods From May 2014 to June 2015,7 children with skin defects around the Achilles tendon were admitted to our trauma center.The areas of skin defect ranged from 3.4 cm × 2.7 cm to 5.5 cm × 4.0 cm.The integrity of Achilles tendon was preserved in 6 cases but the tendon insertion was partly disrupted in one case.The skin defects were reconstructed with self-designed rectangle advancement flaps after debridement.In the one case with the Achilles tendon partly disrupted,the contaminated tendon ends were excised before wound closure.The injured ankles were immobilized in plantar flexion with one 1.5 mm K-wire and plaster splint to decrease the postoperative tension of the flap.Results All the flaps survived completely by primary intention but local infection occurred in 2 wounds which was cured by second intention of dressing change.The follow-up periods ranged from 8 to 12 months (average,11.5 months).The scar around the flap was remarkable in 2 cases,but the flaps in the other cases appeared normal in terms of color and texture.The ankle function was satisfactorily normal in all the cases.Conclusion Our self-designed rectangle advancement flaps provide a simple,safe and reliable way to repair skin defects around the Achilles tendon in children.

Objective To introduce the competing risk model into outcome prediction of mild cognitive impairment (MCI) of seniors and to explore influencing factors for the prognosis of MCI to Alzheimer' s disease (AD).Methods Data were collected from six follow-up visits to 600 seniors from communities in Taiyuan city,which were conducted at an interval of six months from October 2010 to May 2013.MCI state was defined as the transient state,AD and death before AD as two absorbing states (death before AD in which was regarded as a competing risk event),building the competing risk model to identify the model parameters,and to explore influencing factors on MCI prognosis to AD.In the meantime,the 3-year MCI-AD transition probability was estimated based on the multi-state Markov model.Results Based on screening with the multivariate competing risk model analysis,factors such as higher age (estimate HR=1.56,95％CI:1.01-2.39),female gender (HR=1.72,95％CI:1.02-2.92),higher education(HR=0.64,95％CI:0.41-1.00),reading frequently (HR=0.57,95％CI:0.32-0.99),hypertension (HR=3.43,95％CI:1.08-10.85) and high SBP(HR=1.67,95％CI:1.04-2.66),were statistically significant for transition from MCI to AD in three years.3-year MCI-AD transition probability was 10.7％(95％CI:8.6％-13.2％).Conclusion Age,gender,education,reading and blood pressure were the influencing factors for the prognosis of MCI to AD.Competing risk model was advantageous in studying longitudinal data with multiple potential outcomes.