1.Application of c-- reactive protein in diagnosis and treatment of nosocomial pneumonia with coal workers' pneumoconiosis.
Jun-he DAI ; Pei-yue LIU ; Ling-wen KONG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2005;23(5):325-325
Aged
;
Aged, 80 and over
;
Anthracosis
;
blood
;
C-Reactive Protein
;
analysis
;
metabolism
;
Cross Infection
;
diagnosis
;
therapy
;
Humans
;
Male
;
Middle Aged
;
Pneumonia
;
blood
;
Serum
;
chemistry
2.Peripheral natural killer cell counting and its clinical significance blood in patients with bronchial asthma.
Fang LIU ; Ya-ling LUO ; Yue-xian WU ; Qing-yu KONG
Journal of Southern Medical University 2008;28(5):780-782
OBJECTIVETo investigate the changes in natural killer (NK) cell count in the peripheral blood of asthmatic patients.
METHODSThe number of NK cells in the peripheral blood was determined with flow cytometry in 63 asthmatic patients with acute episodes, 65 patients with stable asthma and 62 healthy nonatopic subjects.
RESULTSA significant decrease in NK cell number was noted in asthmatic patients during acute exacerbation [(13.9-/+9.4) %] in comparison with patients with stable asthma [(22.5-/+12.3) %] and healthy subjects [(19.6-/+10.1)%] (P<0.05), and the NK cell number showed no significant difference between the latter two groups (P>0.05).
CONCLUSIONNK cell number is reduced in acute exacerbation of asthma, suggesting its important role in the asthmatic process.
Adult ; Asthma ; blood ; immunology ; Cell Count ; methods ; Female ; Flow Cytometry ; Humans ; Killer Cells, Natural ; cytology ; immunology ; Male ; Middle Aged
3.Establishment of a complex alcoholic liver fibrosis mouse model and investigation of OPN and TGF-beta1 hepatic expression.
Ling-bo KONG ; Wei-guang REN ; Hong-mei MI ; Su-xian ZHAO ; Yu-guo ZHANG ; Yue-min NAN
Chinese Journal of Hepatology 2013;21(3):207-212
OBJECTIVETo create a convenient method to establish an alcoholic liver fibrosis model in mice and use it to explore the putative pathogenic mechanisms involving the immunomodulatory proteins osteopontin (OPN) and transforming growth factor-betal (TGF-beta1).
METHODSForty C57BLI6J mice were fed the Lieber-DeCarli 4% ethanol-containing liquid diet for four weeks, followed by an additional four weeks of the 4% ethanol diet combined with intraperitoneal injection of carbon tetrachloride (CC14 5% solution in olive oil; 2ml/ kg body weight, 2 times/week) to induce alcoholic liver fibrosis. Control groups (n = 6 each) included: normal diet; normal diet plus CCl4 injections; ethanol diet alone; ethanol diet plus solvent (olive oil) injections. Model establishment was monitored by sacrificing six mice at model inception (week 0), and weeks 4, 5, 6, 7, and 8 of modeling to collect liver tissues and blood for histological and biochemical analyses. Extent of hepatic steatosis, inflammation, and fibrosis was assessed by hematoxylin-eosin and Masson staining. Liver function markers, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, were tested by automated enzymatic assays. Alpha-smooth muscle actin (alpha-SMA) expression was detected by immunohistochemistry. The mRNA and protein expression of OPN and TGF-beta1 was detected by real-time quantitative reverse transcription-PCR and western blotting, respectively. Significance of differences between multiple groups was assessed by one-way ANOVA analysis followed by least significant difference t-test or Kruskal-Wallis H test followed by the Mann-Whitney U test.
RESULTSCompared to the control groups, the group of mice administrated ethanol and CCl4 developed mild to moderate hepatic steatosis at week 4 of modeling, progressive necroinflammation and perisinusoidal and portal fibrosis from weeks 5-8, and irregular necrosis and bridging fibrosis at week 8. In addition, the model group showed progressive up-regulation of a-SMA expression in the activated hepatic stellate cells (HSCs) and fibrotic areas from weeks 5-8. Both hepatic OPN and TGF-beta1 showed significantly increasing trends in mRNA and protein expressions from weeks 5-8 (OPN mRNA: 1.83 +/- 0.25, 2.94 +/- 0.19, 3.45 +/- 0.31, and 5.99 +/- 0.17 (F= 476.27, P < 0.001); OPN protein: 0.52 +/- 0.06, 1.02 +/- 0.10, 1.52 +/- 0.11 and 1.50 +/- 0.08 (F= 298.03, P< 0.001); TGF-beta1 mRNA: 13.19 +/- 0.40, 3.31 +/- 0.28, 1.58 +/- 0.18 and 2.08 +/- 0.26 (F= 85.55, P < 0.001); TGF-P31 protein: 1.26 +/- 0.16, 0.96 +/- 0.12, 1.09 +/- 0.25 and 1.10 +/- 0.20 (F = 43.64, P < 0.001).
CONCLUSIONFeeding C57BL/6J mice the Lieber-DeCarli ethanol-containing liquid diet combined with CCl4 intraperitoneal injection is a convenient method to establish a model of alcoholic liver fibrosis within a relatively short amount of time (eight weeks). Progression of alcoholic liver fibrosis is accompanied by increased hepatic expression of OPN and TGF-beta1, which may contribute to the pathogenic mechanism of this disease and may be targets of future molecular therapies.
Actins ; metabolism ; Animals ; Disease Models, Animal ; Liver ; metabolism ; Liver Cirrhosis, Alcoholic ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Osteopontin ; metabolism ; Transforming Growth Factor beta1 ; metabolism
4.Activation of Fas/FasL and its downstream signaling pathway promotes development of alcoholic steatohepatitis and liver fibrosis in mice.
Wei-guang REN ; Ling-bo KONG ; Hong-mei MI ; Su-xian ZHAO ; Yu-guo ZHANG ; Rong-qi WANG ; Yue-min NAN
Chinese Journal of Hepatology 2013;21(2):129-133
OBJECTIVETo explore the role and mechanism of the Fas/Fas ligand (FasL) system and its downstream signaling pathway related to the progression of alcoholic steatohepatitis and liver fibrosis.
METHODSEighteen C57BL/6J mice were randomly divided into three groups: controls; alcoholic steatohepatitis model, given four-weeks of a 4% ethanol-containing Lieber-DeCarli liquid diet; alcoholic steatohepatitis and liver fibrosis model, given the four-week alcohol diet followed by twice weekly intraperitoneal injections of carbon tetrachloride (5% olive oil solution; 2 mL/kg dose) during the fifth to eighth weeks. Mice in the model groups were sacrificed at the end of week 4 and 8, respectively, along with control mice for comparative analyses. Liver tissue sections were evaluated for hepatocellular apoptosis by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. The mRNA expression of Fas, FasL, cysteine aspartate-specific proteases 3 (caspase 3), and cytochrome P450 2E1 (CYP 2E1) in liver tissues was detected by reverse transcription (RT)-PCR, visualized by ethidium bromide staining, and normalized to the gray-value of GAPDH expression. The protein expression of Fas and caspase 3 were detected by western blotting (b-actin normalized), and of FasL and CYP 2E1 by immunohistochemistry staining. Intergroup differences and statistical significance were evaluated by single factor analysis of variance and the least squares difference-t test or the Kruskal-Wallis H test and the Mann-Whitney U test.
RESULTSThe number of apoptotic cells in the liver sections was significantly higher in both model groups with alcoholic steatohepatitis (vs. controls) and the amount in the alcoholic steatohepatitis plus liver fibrosis model was significantly higher than that in the model with only alcoholic steatohepatitis. In addition, activation of Fas, FasL and its downstream signaling pathway showed an increasing trend with extent of liver injury. The hepatic mRNA (by RT-PCR) and protein (by western blotting) normalized expression levels in the controls, alcoholic steatohepatitis models, and alcoholic steatohepatitis plus liver fibrosis models were, respectively: Fas mRNA: 0.50+/-0.05, 0.61+/-0.10, 0.76+/-0.03 (H=12.137, P less than 0.05), protein: 0.52+/-0.14, 0.86+/-0.10, 0.99+/-0.09 (F=12.758, P less than 0.01); FasL mRNA: 0.31+/-0.03, 0.53+/-0.02, 1.02+/-0.04 (F=153.260, P less than 0.01); caspase 3 mRNA: 0.86+/-0.11, 0.85+/-0.05, 1.33+/-0.16 (F=8.740, P less than 0.01), protein: 0.40+/-0.03, 0.69+/-0.06, 1.02+/-0.10 (F=90.785, P less than 0.01); CYP 2E1 mRNA: 0.72+/-0.14, 1.00+/-0.15, 1.30+/-0.20 (H=4.713, P less than 0.01). The changes in hepatic FasL and CYP 2E1 expression detected by immunohistochemistry were consistent with the mRNA expression.
CONCLUSIONActivation of Fas/FasL and its downstream signaling pathway, which induces hepatocellular apoptosis, contributes to the development of alcoholic steatohepatitis and liver fibrosis.
Animals ; Apoptosis ; Cytochrome P-450 CYP2E1 ; metabolism ; Fas Ligand Protein ; metabolism ; Fatty Liver, Alcoholic ; metabolism ; pathology ; Liver Cirrhosis ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Signal Transduction ; fas Receptor ; metabolism
5.The role of Fas mutation on non-alcoholic steatohepatitis in mice.
Shan-shan SU ; Fang HAN ; Rong-qi WANG ; Wei-guang REN ; Wen-juan WU ; Ling-bo KONG ; Su-xian ZHAO ; Yue-min NAN
Chinese Journal of Hepatology 2011;19(9):653-657
OBJECTIVEOur previous study indicated that the death receptor Fas played a key role on hepatocyte apoptosis in nutritional steatohepatitis in mice. This study aimed to explore whether Fas mutation accelerated hepatic steatosis and inflammatory infiltration in methionine-choline deficient (MCD) diet feeding mice.
METHODSMice homozygous for the lymphoproliferation spontaneous mutation (C57BL/6J-Faslpr) and wild type C57BL/6J mice were fed with MCD diet for three weeks to induce non-alcoholic steatohepatitis (NASH). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG) and total cholesterol (TC) levels were detected by an Olympus AU5400 automatic chemical analyzer. The role of Fas gene mutation on NASH was assessed by comparing the severity of hepatic steatosis and inflammation in the liver sections, the mRNA and protein expressions of hepatic inflammatory and fibrogenesis related factors, proliferating cell nuclear antigen (PCNA) and transforming growth factor beta 1 (TGFb1).
RESULTSThe serum ALT levels of the wild type and Faslpr mice fed with MCD were significant higher than that of the control mice (126.33+/-10.50 U/L vs (25.00+/-10.14) U/L, (160.33+/-48.29) U/L vs (18.33+/-9.08) U/L, with the LSD-t value 12.02, 5.08 respectively, the P value<0.001, 0.007 respectively. The serum ALT levels showed no significant difference between the Faslpr and wild type mice fed with MCD, with the LSD-t value 1.19, the P value 0.229. The serum AST, TG and TC levels showed neithere significant difference among the four groups. MCD diet induced hepatic steatosis and inflammatory infiltration in both of the wild type and Faslpr mice. Especially, severer hepatic injury was observed in Faslpr mice as compared with wild type mice. The mRNA expression levels of cell proliferation factor PCNA and fibrogenesis growth factor TGF b1 in wild type mice fed with MCD were significantly higher than that of the control mice (2.84+/-0.73, 2.77+/-0.54 vs 1.31+/-0.18, 0.89+/-0.18), with the LSD-t value 4.99, 8.08 respectively, the P value 0.001, <0.001 respectively. The mRNA expression levels of PCNA and TGFb1 in Faslpr mice fed with MCD were significantly higher than that of the Faslpr control mice and the wild type mice fed with MCD (5.57+/-1.13, 5.73+/-0.89 vs 1.04+/-0.16, 0.85+/-0.11 and 2.84+/-0.73, 2.77+/-0.54), with the LSD-t value 10.15, 13.19 and 5.33, 6.91 respectively, the P value<0.001. The protein expressions levels of PCNA and TGFb1 were concordant with the mRNA.
CONCLUSIONSFaslpr promoted hepatic steatosis and inflammatory infiltration in mice fed with MCD diet, which might associated with excessive release of cell proliferative, inflammatory and fibrogenesis factors.
Animals ; Fatty Liver ; chemically induced ; genetics ; Male ; Mice ; Mice, Inbred C57BL ; Mutation ; Non-alcoholic Fatty Liver Disease ; Proliferating Cell Nuclear Antigen ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; fas Receptor ; genetics
6.Peroxisome proliferator activated receptor gamma activation and overexpression prevent hepatocellular apoptosis of nutritional fibrotic steatohepatitis in mice.
Yue-min NAN ; Fang HAN ; Ling-bo KONG ; Ya LI ; Rong-qi WANG ; Su-xian ZHAO
Chinese Journal of Hepatology 2011;19(7):521-526
OBJECTIVETo elucidate the effect of targeted gene modulation of peroxisome proliferator activated receptor gamma (PPARg) on hepatocellular apoptosis in nutritional fibrotic steatohepatitis in mice. C57BL/6J mice were fed with high fat, methionine-choline deficient (MCD) diet for 8 weeks to induce fibrotic steatohepatitis. Mice fed the MCD diet were treated with adenovirus carrying PPARg (Ad-PPARg), adenovirus-beta-galactosidase (Ad-LacZ), Ad-PPARg plus PPARg agonist rosiglitazone, or PPARg antagonist 2-chloro-5-nitro- benzanilide (GW9662), respectively. H and E stain was performed for observation of hepatocellular apoptosis, hepatic steatosis, inflammation and fibrosis in the liver sections. The expression levels of mRNA and protein of PPARg and apoptosis related genes, Fas, Fas Ligand (FasL), B cell lymphoma/leukemia-2 (Bcl-2), Bcl-2 associated X protein (Bax) and cysteine-containing aspartate-specific proteases-3 (caspase-3) were detected by real-time RT-PCR and Western blot assay, respectively.
RESULTSMice fed with MCD diet for 8 weeks showed severe hepatic injury including steatosis, hepatocellular apoptosis, inflammatory infiltration and fibrosis, concomitancy with enhanced expression of pro-apoptosis genes, Fas, FasL, Bax and caspase-3 and increased expression of anti-apoptosis gene Bcl-2, by comparing with the control group. The mRNA expression levels of these genes were 3.59+/-0.35 vs 1.11+/-0.37, 4.37+/-1.03 vs 1.09+/-0.33, 4.27+/-0.48 vs 1.03+/-0.10, 4.93+/-0.67 vs 1.12+/-0.24 and 3.95+/-0.34 vs 1.20+/-0.19, and LSD-t values were 2.49, 3.28, 3.25, 3.80 and 2.75, as compared with the control group, P is less than 0.01; the protein expression levels were 1.96+/-0.07 vs 0.45+/-0.07, 0.53+/-0.07 vs 0.22+/-0.02, 1.32+/-0.06 vs 0.59+/-0.03, 1.51+/-0.23 vs 0.36+/-0.09 and 0.57+/-0.01 vs 0.29+/-0.01, and LSD-t values were 1.51, 0.31, 0.73, 1.14 and 0.28, P is less than 0.01. Administration of PPARg agonist rosiglitazone and/or Ad-PPARg significantly ameliorated hepatic steatosis, hepatocellular apoptosis, necro inflammation and fibrosis. These effects were associated with repressed expression of pro-apoptosis genes and up-regulated expression of anti-apoptosis gene. After rosiglitazone treatment, the mRNA expression levels were 3.78+/-0.58, 3.66+/-0.83, 3.04+/-0.37, 2.54+/-0.62 and 4.42+/-0.42, and LSD-t values were 0.18, 0.71, 1.23, 2.39 and 0.46, as compared with MCD group, the P values were 0.627, 0.241, less than 0.01, less than 0.01 and 0.278, the protein expression levels were 1.06+/-0.03, 0.30+/-0.01, 0.70+/-0.05, 1.19+/-0.30 and 0.90+/-0.01, and LSD-t values were 0.90, 0.23, 0.62, 0.31 and 0.34, the P values were less than 0.01, less than 0.01, less than 0.01, 0.122, less than 0.01. After Ad-PPARg treatment, the mRNA expression levels were 2.31+/-0.16, 2.71+/-0.23, 2.52+/-0.27, 1.79+/-0.32 and 5.97+/-0.72, and LSD-t values were 1.28, 1.66, 1.75, 3.13 and 2.02, as compared with MCD group, P is less than 0.05; the protein expression levels were 1.73+/-0.07, 0.43+/-0.04, 1.01+/-0.08, 1.31+/-0.10 and 1.56+/-0.04, and LSD-t values were 0.23, 0.10, 0.30, 0.20 and 0.99, with P values equal 0.009, 0.01, less than 0.01, 0.322 and less than 0.01.
CONCLUSIONSThis study provided evidences for the protective role of activation and overexpression of PPARg in ameliorating hepatocellular apoptosis in mice with hepatic fibrosing steatohepatitis.
Animals ; Apoptosis ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; PPAR gamma ; metabolism
7.A case of Leigh syndrome associated with respiratory chain complex I deficiency due to mitochondrial gene 13513G>A mutation.
Xiao-Qiong WEI ; Qing-Peng KONG ; Yao ZHANG ; Yan-Ling YANG ; Xing-Zhi CHANG ; Yu QI ; Zhao-Yue QI ; Jiang-Xi XIAO ; Jiong QIN ; Xi-Ru WU
Chinese Journal of Contemporary Pediatrics 2009;11(5):333-336
Leigh syndrome is a genetically heterogeneous disease caused by defects in enzymes involved in aerobic energy metabolism and the Krebs', cycle. Mitonchondrial complex I deficiency is a main cause of Leigh syndrome. In this study, a Chinese child with Leigh syndrome caused by 13513G>A mutation was reported. The proband was the first child of his parents. The previously healthy boy presented with generalized epilepsy at 12 years of age. When he visited Peking University First Hospital at 13 years of age, he had subacute loss of vision in two eyes and temporal defect of visual field in the left eye. He walked with a spastic gait. His blood lactate and pyruvate levels were elevated. Muscle biopsy showed mild lipid accumulation in muscle fiber. An electrocardiogram showed incomplete right bundle branch block. Brain magnetic resonance imaging showed bilateral, symmetrical lesions in the basal ganglia, supporting the diagnosis of Leigh syndrome. 13513G>A mutation was identified by gene analysis in the patient, which led to mitochondrial respiratory chain complex I deficiency. Multivitamins and L-carnitine were administered. At present, the patient is 16 years old and has progressive deterioration with significant muscle weakness and body weight loss. He is absent from school. He has no obvious retardation in intelligence. 13513G>A mutation was first identified by gene analysis in Chinese population with Leigh syndrome. This may be helpful in genetic counseling.
Adolescent
;
DNA, Mitochondrial
;
genetics
;
Electron Transport Complex I
;
deficiency
;
Humans
;
Leigh Disease
;
genetics
;
Male
;
Mutation
8.A Whole-Tumor Histogram Analysis of Apparent Diffusion Coefficient Maps for Differentiating Thymic Carcinoma from Lymphoma.
Wei ZHANG ; Yue ZHOU ; Xiao Quan XU ; Ling Yan KONG ; Hai XU ; Tong Fu YU ; Hai Bin SHI ; Qing FENG
Korean Journal of Radiology 2018;19(2):358-365
OBJECTIVE: To assess the performance of a whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating thymic carcinoma from lymphoma, and compare it with that of a commonly used hot-spot region-of-interest (ROI)-based ADC measurement. MATERIALS AND METHODS: Diffusion weighted imaging data of 15 patients with thymic carcinoma and 13 patients with lymphoma were retrospectively collected and processed with a mono-exponential model. ADC measurements were performed by using a histogram-based and hot-spot-ROI-based approach. In the histogram-based approach, the following parameters were generated: mean ADC (ADCmean), median ADC (ADCmedian), 10th and 90th percentile of ADC (ADC10 and ADC90), kurtosis, and skewness. The difference in ADCs between thymic carcinoma and lymphoma was compared using a t test. Receiver operating characteristic analyses were conducted to determine and compare the differentiating performance of ADCs. RESULTS: Lymphoma demonstrated significantly lower ADCmean, ADCmedian, ADC10, ADC90, and hot-spot-ROI-based mean ADC than those found in thymic carcinoma (all p values < 0.05). There were no differences found in the kurtosis (p = 0.412) and skewness (p = 0.273). The ADC10 demonstrated optimal differentiating performance (cut-off value, 0.403 × 10−3 mm2/s; area under the receiver operating characteristic curve [AUC], 0.977; sensitivity, 92.3%; specificity, 93.3%), followed by the ADCmean, ADCmedian, ADC90, and hot-spot-ROI-based mean ADC. The AUC of ADC10 was significantly higher than that of the hot spot ROI based ADC (0.977 vs. 0.797, p = 0.036). CONCLUSION: Compared with the commonly used hot spot ROI based ADC measurement, a histogram analysis of ADC maps can improve the differentiating performance between thymic carcinoma and lymphoma.
Area Under Curve
;
Diffusion*
;
Humans
;
Lymphoma*
;
Retrospective Studies
;
ROC Curve
;
Sensitivity and Specificity
;
Thymoma*
9.Regulatory effects of moxibustion on ubiquitin and NLRP3 proteins in colon of ulcerative colitis rats
Xi-Ying LI ; Guang YANG ; Li-Jie WU ; Jue HONG ; Yue ZHAO ; Jie LIU ; Xie-He KONG ; Xiao-Qing DONG ; Fang-Yuan ZHI ; Xiao-Peng MA ; Ling YANG ; Dan ZHANG ; Yan-Ping YANG
Journal of Acupuncture and Tuina Science 2020;18(2):96-104
Objective: To observe the effects of moxibustion on colonic inflammation, and the expressions of ubiquitin and nucleotide-binding oligomerization domain (Nod)-like receptor protein 3 (NLRP3) proteins in rats with ulcerative colitis (UC), and to explore the anti-inflammatory mechanism of moxibustion in the UC treatment. Methods: Clean grade male Sprague-Dawley (SD) rats were randomly divided into a normal group (NG), a model group (MG), a moxa-stick moxibustion group (MSMG) and a Western medicine group (WMG). UC model was prepared by freely drinking 35 g/L dextran sulfate sodium (DSS) solution. Bilateral Tianshu (ST 25) were selected for mild moxibustion treatment in the MSMG; mesalazine solution was intragastrically administrated in the WMG. Rats in the NG and MG were only grasped and fixed as in the MSMG without any treatment. After treatment, hematoxylin-eosin (HE) staining was performed to observe and score the colonic pathological damage under light microscope; immunofluorescence method was used to determine the expression of colonic ubiquitin protein; immunohistochemical method was used to detect the expressions of colonic interleukin (IL)-1β and NLRP3 proteins. Results: The colon tissue was severely injured, and the pathological score was significantly increased in the MG than in the NG (P<0.01), and the protein expressions of ubiquitin, NLRP3 and IL-1β in the colon were significantly increased (all P<0.01). Compared with the MG, the colonic damage was repaired, the inflammation and pathological scores were reduced, and the ubiquitin, NLRP3 and IL-1β protein expressions were decreased in the MSMG and WMG (all P<0.01). Correlation analysis revealed that the ubiquitin protein expression was correlated with the colonic pathological score and the NLRP3 protein expression (r=0.677, P<0.01; r=0.536, P<0.05). Conclusion: Moxibustion can down-regulate the protein expressions of ubiquitin, NLRP3 and IL-1β in the colon of UC rats, which may be one of the mechanisms to promote the repair of colonic inflammatory lesions and exert anti-inflammatory effects.
10.Implication of Dickkopf-1 and cell apoptosis in steroid-induced avascular necrosis of the femoral head
yue Ling KONG ; lin Wan LIU ; zhong Yi REN
Chinese Journal of Tissue Engineering Research 2017;21(28):4436-4441
BACKGROUND:The roles of osteocyte and osteoblast apoptosis in steroid-induced avascular necrosis of the femoral head (ANFH) have arouse much attention,and its pathogenesis has been understood gradually.But there is a lack of knowledge about the mechanisms underlying osteocyte and osteoblast apoptosis.Meanwhile,hormones have been shown to enhance the Dickkopf-1 expression in Wnt signaling pathway.OBJECTIVE:To investigate the roles of Dickkopf-1 and cell apoptosis in steroid-induced ANFH,and to understand their correlations with steroid-induced ANFH.METHODS:Necrotic femoral head samples were removed from 14 patients with steroid-induced ANFH after total hip arthroplasty (experimental group),and normal femoral heads were from 8 patients with femoral neck fracture (control group).The cellular morphology was observed using transmission electron microscope;the number of empty lacunae was counted through hematoxylin-eosin staining;the cell apoptosis was detected by TUNEL assay;the expression level of Dickkopf-1 was detected by immunohistochemistry.Moreover,the correlation between the Dickkopf-1 positive rate and apoptosis index of osteocytes was analyzed by Spearman rank correlation analysis.RESULTS AND CONCLUSION:The number of empty lacunae,expression level of Dickkopf-1,and apoptosis index of osteocytes in the experimental group were significantly higher than those in the control group (P < 0.05).In the experimental group,the Dickkopf-1 positive rate was positively correlated to the apoptosis index of osteocytes (r=0.623).These results indicate that Dickkopf-1 and osteocyte apoptosis both play key roles in steroid-induced ANFH,and increased Dickkopf-1 level may promote the development of ANFH.