BACKGROUND:Steroid-induced avascular necrosis of the femoral head is a common progressive,crippling and high incidence of non-traumatic osteonecrosis of the femoral head,but its exact pathogenesis is not clear.Internal heat acupuncture therapy has a good clinical effect in the treatment of steroid-induced avascular necrosis of the femoral head,but its specific mechanism is not clear.OBJECTIVE:To investigate the effect of internal heat acupuncture on osteoblast apoptosis and expression of Bcl-2-associated X protein(Bax)and B lymphocytoma-2(Bcl-2)in steroid-induced avascular necrosis of the femoral head in rabbits.METHODS:Totally 24 male New Zealand rabbits were randomly divided into blank group,model group,and internal heat acupuncture group(n=8).The rabbit model of steroid-induced avascular necrosis of the femoral head was made in the last two groups by methylprednisolone sodium succinate combined with Escherichia coli endotoxin.After successful model establishment for 4 weeks,the rabbits in the internal heat acupuncture group received internal heat acupuncture intervention on the buttocks of rabbits,once a week for 20 minutes each time,while the other two groups did not receive any intervention.After 4 weeks of treatment,samples were harvested.Morphological changes of femoral head and osteoblast apoptosis were observed by hematoxylin-eosin staining and TUNEL assay.Protein expression of Bcl-2 and Bax in rabbit femoral head tissue was detected by immunohistochemistry and western blot assay.RESULTS AND CONCLUSION:(1)In the blank group,there were abundant hematopoietic cells in the bone marrow cavity,clear and orderly trabecular structure,few adipocytes and few empty bone lacunae.In the model group,the number of adipocytes in the bone marrow cavity increased significantly,accompanied by hyperplasia,steatosis of some osteocytes and more empty bone lacunae.After the intervention of internal heat acupuncture,the number of adipocytes and hollow bone lacunae was less than that in the model group,but more obvious than that in the blank group.(2)Compared with the blank group,the apoptosis of osteoblasts in the model group was significantly increased,the expression of Bax was significantly increased(P＜0.001),and the expression of Bcl-2 was significantly decreased(P＜0.001).After the intervention of internal heat acupuncture,the apoptosis of osteoblasts was significantly decreased,the expression of Bax was significantly decreased(P＜0.001),and the expression of Bcl-2 was significantly increased(P＜0.001).(3)The results show that internal heat acupuncture can alleviate steroid-induced avascular necrosis of the femoral head by inhibiting osteoblast apoptosis in the femoral head.

BACKGROUND:Steroid-induced avascular necrosis of the femoral head is a common progressive,crippling and high incidence of non-traumatic osteonecrosis of the femoral head,but its exact pathogenesis is not clear.Internal heat acupuncture therapy has a good clinical effect in the treatment of steroid-induced avascular necrosis of the femoral head,but its specific mechanism is not clear.OBJECTIVE:To investigate the effect of internal heat acupuncture on osteoblast apoptosis and expression of Bcl-2-associated X protein(Bax)and B lymphocytoma-2(Bcl-2)in steroid-induced avascular necrosis of the femoral head in rabbits.METHODS:Totally 24 male New Zealand rabbits were randomly divided into blank group,model group,and internal heat acupuncture group(n=8).The rabbit model of steroid-induced avascular necrosis of the femoral head was made in the last two groups by methylprednisolone sodium succinate combined with Escherichia coli endotoxin.After successful model establishment for 4 weeks,the rabbits in the internal heat acupuncture group received internal heat acupuncture intervention on the buttocks of rabbits,once a week for 20 minutes each time,while the other two groups did not receive any intervention.After 4 weeks of treatment,samples were harvested.Morphological changes of femoral head and osteoblast apoptosis were observed by hematoxylin-eosin staining and TUNEL assay.Protein expression of Bcl-2 and Bax in rabbit femoral head tissue was detected by immunohistochemistry and western blot assay.RESULTS AND CONCLUSION:(1)In the blank group,there were abundant hematopoietic cells in the bone marrow cavity,clear and orderly trabecular structure,few adipocytes and few empty bone lacunae.In the model group,the number of adipocytes in the bone marrow cavity increased significantly,accompanied by hyperplasia,steatosis of some osteocytes and more empty bone lacunae.After the intervention of internal heat acupuncture,the number of adipocytes and hollow bone lacunae was less than that in the model group,but more obvious than that in the blank group.(2)Compared with the blank group,the apoptosis of osteoblasts in the model group was significantly increased,the expression of Bax was significantly increased(P＜0.001),and the expression of Bcl-2 was significantly decreased(P＜0.001).After the intervention of internal heat acupuncture,the apoptosis of osteoblasts was significantly decreased,the expression of Bax was significantly decreased(P＜0.001),and the expression of Bcl-2 was significantly increased(P＜0.001).(3)The results show that internal heat acupuncture can alleviate steroid-induced avascular necrosis of the femoral head by inhibiting osteoblast apoptosis in the femoral head.

BACKGROUND:Internal heat-type acupuncture therapy is a new treatment technique that combines acupuncture therapy with hyperthermia.It has good clinical effects on steroid-induced osteonecrosis of the femoral head,but the mechanism of action is still not fully clear. OBJECTIVE:To explore the possible mechanism of internal heat-type acupuncture therapy in treating steroid-induced osteonecrosis of the femoral head in rabbits. METHODS:Thirty-two New Zealand rabbits were randomly divided into blank group,model group,internal heat-type acupuncture group and shock wave group using a random number table method,with 8 rabbits in each group.The model group,internal heat-type acupuncture group and shock wave group were modeled using methylprednisolone sodium succinate combined with Escherichia coli endotoxin.The internal heat-type acupuncture group received an internal heat-type acupuncture intervention on the buttocks of rabbits,once a week,for 20 minutes each time.The shock wave group received shock wave intervention on the buttocks of rabbits,once a week,with 2 000 beats per session.The blank group and model group were not given any treatment.After 4 weeks of intervention,blood samples and bilateral femoral head samples were collected from experimental rabbits.The levels of tumor necrosis factor-α and interleukin-6 in serum were detected by ELISA;the histomorphology of the femoral head was observed using hematoxylin-eosin staining and the rate of empty lacunae was calculated;the protein expressions of matrix metalloproteinase 2,matrix metalloproteinase 9,matrix metalloproteinase tissue inhibitor 1,and matrix metalloproteinase tissue inhibitor 2 were detected by immunohistochemistry and western blot. RESULTS AND CONCLUSION:Compared with the blank group,the model rabbits showed reduced food intake,mental fatigue,and decreased activity;compared with the model group,the above performance of the experimental rabbits was significantly improved after internal heat-type acupuncture and shock wave treatment.Compared with the blank group,the histomorphology of the femoral head in the model group deteriorated significantly and the rate of empty bone lacuna increased(P<0.001),while the histomorphology of the femoral head in the internal heat-type acupuncture group and shock wave group was significantly improved compared with the model group,and the rate of empty bone lacuna was reduced(P<0.001).The serum levels of tumor necrosis factor-α and interleukin-6 in the model group were significantly higher than those in the blank group(P<0.05),while the serum levels of tumor necrosis factor-α and interleukin-6 in the internal heat-type acupuncture group and the shock wave group were significantly lower than those in the model group(P<0.05).Compared with the blank group,the expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in the femoral head of the model group were significantly increased,while the expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly decreased(P<0.001);compared with the model group,the protein expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 were significantly decreased,while the protein expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly increased in the internal heat-type acupuncture group and the shock wave group(P<0.001).Overall,these findings indicate that internal heat-type acupuncture may promote the repair of the necrotic femoral head by regulating the levels of matrix metalloproteinases/matrix metalloproteinase tissue inhibitors and serum inflammatory factors,thus treating early steroid-induced osteonecrosis of the femoral head.

In order to understand the evolution of the diagnosis and treatment plans of corona virus disease 2019 (COVID-19), and provide convenience for medical staff in actual diagnosis and treatment, this paper uses the 9 diagnosis and treatment plans of COVID-19 issued by the National Health Commission during the period from January 26, 2020 to August 19, 2020 as research data to perform comparative analysis and visual analysis. Based on text mining, this paper obtained the text similarity and summarized its evolution law by expressing and measuring the similarity of the overall diagnosis and treatment plans of COVID-19 and the same modules, which provides reference for clinical diagnosis and treatment practice and other diagnosis and treatment plan formulation.
COVID-19 ; Data Mining ; Humans ; SARS-CoV-2