OBJECTIVE To investigate the protective effect of 2-dodecyl-6-methoxy-2，5-diene-1，4-cyclohexanedione （DMDD）， an active component from Averrhoa carambola root， on myocardial injury in diabetic mice based on the nuclear receptor coactivator 4/ferritin heavy chain 1/autophagy-related protein 8 （NCOA4/FTH1/ATG8） axis. METHODS The successfully modeled diabetic mice were randomly divided into model group and DMDD low-， medium-， and high-dose （12.5， 25， 50 mg/kg） groups， while an additional non-modeled control group was established， with 6 mice in each group. Each group received the corresponding drug solution or an equal volume of normal saline intragastically once daily for 21 consecutive days. After the administration， the levels of fasting blood glucose （FBG）， serum lactate dehydrogenase （LDH）， and creatine kinase isoenzyme MB （CK-MB） were measured. Myocardial pathological changes， degree of fibrosis， and myocardial cell ultrastructure were observed. Myocardial cell death index and NCOA4 protein positive index were detected. The protein expression levels of NCOA4， FTH1， ATG8， solute carrier family 7 member 11 （SLC7A11）， and glutathione peroxidase 4 （GPX4） in cardiac tissue were measured. RESULTS Compared with model group， each DMDD group showed significant alleviation of cardiac pathological injury and varying degrees of improvement in the myocardial cell ultrastructure. The FBG and serum LDH and CK-MB levels， the myocardial cell death index and NCOA4 protein positive index，the protein expression levels of NCOA4， FTH1， and ATG8 in cardiac tissue were significantly decreased （ P ＜0.001）， while the protein expression levels of SLC7A11 and GPX4 were significantly increased （ P ＜0.001）. CONCLUSIONS DMDD can reduce blood glucose levels， alleviate myocardial histopathological injury， and inhibit cell death in diabetic mice. The mechanism is associated with inhibiting excessive activation of the NCOA4/FTH1/ATG8 axis and reducing ferritinophagy.

Objective:To examine the clinical effect of autologous osteochondral transplantation via biplanar osteotomy for osteochondral lesions of the talus combined with subchondral cysts.Methods:A retrospective analysis of 25 patients who underwent autogenous osteochondral transplantation via biplanar osteotomy for treatment of talus osteochondral injury combined with subchondral cysts at Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University from December 2015 to December 2018 were conducted.There were 21 males and 4 females, aged 35.5 years(range: 21 to 47 years).The extent and depth of cartilage damage of patients were evaluated under arthroscopy.The Outerbridge classification of patients were stage Ⅱ-Ⅳ. Through the anterior and medial incision of the medial malleolus, bilateral osteotomy of the medial malleolus was performed. The osteotomy block was turned down to reveal the cartilage damage site. The abnormal cartilage was completely removed and the sclerotic wall of cyst was completely removed with a spatula.Then the healthy cartilage from the same knee joint was transplanted to the talus cartilage damage area. The preoperative and postoperative visual analogue scale(VAS), American Orthopedic Foot Andankle Society-Ankle Hindfoot Scale (AOFAS-AH) and Karlsson-Peterson score and Lysholm score of knee joint were recorded. Data were analyzed by paired-samples t-test.Results:All of patients were followed up for 25.6 months (range: 12 to 48 months) .The VAS decreased from 6.5±1.3 to 1.9±1.3 ( t=8.13, P=0.00) .AOFAS-AH increased from 62.4±3.3 to 88.0±2.4 ( t=-31.51, P=0.00) .Karlsson-Peterson scores increased from 59.8±2.7 to 85.2±3.5 ( t=-25.50, P=0.00) . While there was no statistical different in Lysholm score of knee joint (92.5±1.3 vs. 92.0±1.3, t=1.93, P=0.065) . No complications like infection, translated cartilage necrosis, cycst residual, nonunion, persistent pain in donor site. Conclusion:Autologous osteochondral transplantation via biplanar osteotomy has satisfactory effect for patients with osteochondral lesions of the talus combined with subchondral cysts.

Objective:To examine the clinical effect of autologous osteochondral transplantation via biplanar osteotomy for osteochondral lesions of the talus combined with subchondral cysts.Methods:A retrospective analysis of 25 patients who underwent autogenous osteochondral transplantation via biplanar osteotomy for treatment of talus osteochondral injury combined with subchondral cysts at Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University from December 2015 to December 2018 were conducted.There were 21 males and 4 females, aged 35.5 years(range: 21 to 47 years).The extent and depth of cartilage damage of patients were evaluated under arthroscopy.The Outerbridge classification of patients were stage Ⅱ-Ⅳ. Through the anterior and medial incision of the medial malleolus, bilateral osteotomy of the medial malleolus was performed. The osteotomy block was turned down to reveal the cartilage damage site. The abnormal cartilage was completely removed and the sclerotic wall of cyst was completely removed with a spatula.Then the healthy cartilage from the same knee joint was transplanted to the talus cartilage damage area. The preoperative and postoperative visual analogue scale(VAS), American Orthopedic Foot Andankle Society-Ankle Hindfoot Scale (AOFAS-AH) and Karlsson-Peterson score and Lysholm score of knee joint were recorded. Data were analyzed by paired-samples t-test.Results:All of patients were followed up for 25.6 months (range: 12 to 48 months) .The VAS decreased from 6.5±1.3 to 1.9±1.3 ( t=8.13, P=0.00) .AOFAS-AH increased from 62.4±3.3 to 88.0±2.4 ( t=-31.51, P=0.00) .Karlsson-Peterson scores increased from 59.8±2.7 to 85.2±3.5 ( t=-25.50, P=0.00) . While there was no statistical different in Lysholm score of knee joint (92.5±1.3 vs. 92.0±1.3, t=1.93, P=0.065) . No complications like infection, translated cartilage necrosis, cycst residual, nonunion, persistent pain in donor site. Conclusion:Autologous osteochondral transplantation via biplanar osteotomy has satisfactory effect for patients with osteochondral lesions of the talus combined with subchondral cysts.