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Mechanism of acupuncture in attenuating cerebral ischaemia-reperfusion injury based on nuclear receptor coactivator 4 mediated ferritinophagy

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Journal of Traditional Chinese Medicine 2024年第2期44卷 345-352页

作者： ZHANG Xinchang HUANG Zheng HUANG Peiyan YANG Mengning ZHANG Zhihui NI Guangxia college of acupuncture-Moxibustion and Tuina Nanjing University of Chinese MedicineNanjing 210023China Key Laboratory of acupuncture and Medicine Research of Ministry of Education Nanjing University of Chinese MedicineNanjing 210023China

OBJECTIVE:To explore the effect of acupuncture treatment on cerebral ischaemia-reperfusion injury(CIRI)and reveal the underlying mechanism of the effect based on nuclear receptor coactivator 4(NCOA4)mediated ferritinophagy.METHODS:Sprague-Dawley male rats were divided into four groups:the sham group,model group,acupuncture group,and sham acupuncture group.After 2 h of middle cerebral artery occlusion(MCAO),reperfusion was performed for 24 h to induce CIRI.The rats were treated with acupuncture at the Neiguan(PC6)and Shuigou(GV26)acupoints.Their neurological function was evaluated by taking their Bederson scores at 2 h after ischaemia and 24 h after reperfusion.Triphenyltetrazolium chloride staining was applied to assess the cerebral infarct volume at 24 h after reperfusion.The malondialdehyde(MDA)and ferrous iron(Fe^(2+))levels were observed after 24 h of reperfusion using an assay kit.Western blotting was performed to detect the expression of NCOA4 and ferritin heavy chain 1(FTH1)at 24 h after reperfusion.Moreover,the colocalization of ferritin with neurons,NCOA4 with microtubule-associated protein 1 light chain 3(LC3),and NCOA4 with ferritin was visualized using immunofluorescence staining.RESULTS:acupuncture significantly improved neurological function and decreased cerebral infarct volume in the acupuncture group.Following CIRI,the expression of NCOA4,LC3 and FTH1 was increased,which enhanced ferritinophagy and induced an inappropriate accumulation of Fe^(2+)and MDA in the ischaemic brain.However,acupuncture dramatically downregulated the expression of NCOA4,LC3 and FTH1,inhibited the overactivation of ferritinophagy,and decreased the levels of MDA and Fe^(2+).CONCLUSIONS:acupuncture can inhibit NCOA4-mediated ferritinophagy and protect neurons against CIRI in a rat model.

关键词： acupuncture ferritinophagy ferroptosis ferritin nuclear receptor coactivator 4 cerebral ischaemia-reperfusion injury

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Management of proximal tibial stress fracture associated with advanced knee osteoarthritis:A systematic review

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Chinese Journal of Traumatology 2024年第3期27卷 147-152页

作者： Mukesh Kumar Saini Mahendra Singh Devendra Singh Prem Manohar Seervi Pera Jayavardhan Reddy Neelam Ramana Reddy Department of orthopaedics Dr SN Medical CollegeJodhpur342011India Department of orthopaedics Star HospitalsB Block Banjara HillsHyderabad500034India

Purpose:Tibial stress fracture associated with knee osteoarthritis is an unusual and difficult clinical scenario.There is no clear existing treatment guideline for this uncommon clinical disease.The aim of this study is to review the impact of various treatment options for patients with advanced knee osteoarthritis associated with proximal tibial stress fracture.Methods:The study was performed using the databases of PubMed and Scopus.Methodological index for non-randomized studies score was used to evaluate the included studies’bias.The concluded data included the treatment approach,reported outcome measure,and time to fracture union.The literature search was started in December 2021 and accomplished in January 2022.A narrative description of the different methods and comparison of their results were done.Results:Out of total assessed 69 studies,9 studies were included in our review.The commonest treatment approach used was total knee arthroplasty by long tibial stem extension.The mean preoperative knee society score and knee functional score were 30.62 and 23.17,respectively.The mean postoperative knee society knee score was 86.87,while the functional score was 83.52.The average reported time to achieve fracture union was 4 months(a range of 2.07-5.50 months).Conclusion:The optimal clinical outcome for treating either acute or mobile tibial stress fracture in patients with advanced knee osteoarthritis can be achieved with long stem total knee arthroplasty.However,due to heterogeneity of data,comparison of different treatment options for chronic proximal tibial stress fracture mal-union/non-union coexisting with knee osteoarthritic and such inferences need to be judged cautiously.

关键词： Tibial stress fracture Knee osteoarthritis Total knee arthroplasty

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Acupotomy alleviates knee osteoarthritis in rabbit by regulating chondrocyte mitophagy via Pink1-Parkin pathway

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Journal of Traditional Chinese Medicine 2024年第3期44卷 468-477页

作者： ZHU Wenting GUO Changqing DU Mei MA Yunxuan CUI Yongqi CHEN Xilin GUO Changqing the Third Affiliated Hospital of Beijing University of Chinese Medicine School of acupuncture-Moxibustion and Tuina Beijing University of Chinese Medicine Department of Medical Technology Shijiazhuang Medical College

OBJECTIVE: To investigate the effect of acupotomy, on mitophagy and the Pink1-Parkin pathway in chondrocytes from rabbits with knee osteoarthritis(KOA).METHODS: A KOA model was established via the modified Videman method. Rabbits were randomly divided into a control group(CON), KOA group and KOA + acupotomy group(Acu). Rabbits in the acupotomy group were subjected to acupotomy for 4 weeks after model establishment. The behavior of the rabbits before and after intervention was recorded. Cartilage degeneration was evaluated by optical microscopy and fluorescence microscopy. The level of mitophagy was evaluated by transmission electron microscopy,immunofluorescence and enzyme-linked immunosorbent assay(ELISA). The expression of phosphatase and tensin homolog(PTEN)-induced kinase 1(Pink1)-Parkin mitophagy pathway components was evaluated by immunofluorescence, Western blotting and real-time polymerase chain reaction.RESULTS: In rabbits with KOA, joint pain, mobility disorders and cartilage degeneration were observed, the Mankin score was increased, collagen type Ⅱ(Col-Ⅱ)expression was significantly decreased, mitophagy was inhibited, mitochondrial function was impaired, and factors associated with the Pink1-Parkin pathway were inhibited. Acupotomy regulated the expression of Pink1-Parkin pathway-related proteins, the mitophagy-related protein microtubule-associated protein-1 light chain-3,the translocase of the outer membrane, and the inner mitochondrial membrane 23; increased the colocalization of mitochondria and autophagosomes; promoted the removal of damaged mitochondria;restored mitochondrial adenosine-triphosphate(ATP) production;and alleviated cartilage degeneration in rabbits with KOA.CONCLUSIONS: Acupotomy played a role in alleviating KOA in rabbits by activating mitophagy in chondrocytes via the regulation of proteins that are related to the Pink1-Parkin pathway.

关键词： PTEN phosphohydrolase acupuncture therapy cartilage mitophagy osteoarthritis, knee

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Lateral clavicle fracture-plating options and considerations

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World Journal of Clinical Cases 2024年第6期12卷 1039-1044页

作者： Sathish Muthu Saravanan Annamalai Velmurugan Kandasamy Department of orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Biotechnology Karpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of orthopaedics Government Karur Medical CollegeKarur 639004Tamil NaduIndia Department of orthopaedics Government Thiruvallur Medical CollegeThiruvallur 631203Tamil NaduIndia Department of orthopaedics Government Kilpauk Medical CollegeChennai 600010Tamil NaduIndia

Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.

关键词： Clavicle fracture Surgical management Distal clavicle plating Superior plating Anterior plating

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Effect of moxibustion on expression profile of miRNAs in Tripterygium glycoside-induced decreased ovarian reserve

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Journal of Traditional Chinese Medicine 2024年第4期 745-752页

作者： SHEN Jie YIN Yaoli LI Hongxiao LU Ge ZHU Yaoyao QIN Yantong JIN Xun CHENG Jie SHEN Meihong college of acupuncture and Tuina Nanjing University of Chinese Medicine

OBJECTIVE: To explore the possible regulatory mechanism of microRNA(miRNA) in moxibustion treatment for decreased ovarian reserve(DOR). METHODS: The DOR model was constructed by intragastrical Tripterygium glycoside suspension administration, and moxibustion therapy was simultaneously given. The morphological ovarian changes were observed by hematoxylin and eosin staining. The miRNA expression profile was detected by RNA sequencing, and bioinformatics analysis was performed. Cytoscape software 3.6.1 was used to establish a regulatory network and differentially expressed miRNAs were verified by reverse transcription quantitative polymerase chain reaction(RT-qPCR). RESULTS: Decreased number of mature follicles, increased atresia follicles, and abnormal granulosa cell morphology were observed in the model group compared with the control group. The moxibustion group demonstrated increased mature follicles, decreased atretic follicles, and significantly decreased abnormal morphology of granulosa cells compared with the model group. Additionally, RNA sequencing results manifested significantly up-regulated miRNA expressions(miR-92b-3p, miR-26-5p＿R + 1＿1ss10TC, miR-206-3p, miR-9993b-3p＿1ss6GA, miR-7857-3p＿R-1, miR-219a-2-3p＿1ss10GC, miR-3968-p5＿1ss10AT, and PC-5p-6478＿1795) and down-regulated miR-664-2-5p＿R + 1 in the model group, compared with the control group, and the moxibustion group reversed abnormal disorder levels of these miRNAs. Moreover, these differentially expressed miRNAs were mainly involved in the phosphatidylinositol-3-kinase/protein kinase B signaling pathway and nuclear factor erythropoietin-2-related factor 2/heme oxygenase 1 signaling pathway. Finally, network and RT-qPCR verification revealed miR-9993b-3p＿1ss6GA as the most critical miRNA. CONCLUSION: This experiment proved the effectiveness of moxibustion in improving the ovarian reserve of rats by regulating miRNA expression, especially miR-9993b-3p＿1ss6GA.

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Clinical outcomes of triceps reflecting anconeus pedicle and olecranon osteotomy approach for distal humerus intercondylar fractures

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World Journal of Orthopedics 2024年第6期15卷 570-577页

作者： Rohit Ailani Sanjeev Kumar Bhuyan Brejesh Kumar Prasad Amit Kumar Namrata Dawani Department of orthopaedics Lovee Shubh HospitalLucknowUttar Pradesh 226002India Department of orthopaedics Gauhati Medical CollegeGuahati 781032India Department of orthopaedics ESIC Medical College and HospitalFaridabadHaryana 121001India Department of orthopaedics All India Institute of Medical SciencesKalyaniWest Bengal 741245India Department of Obstetric and Gynecology Kannauj Medical CollegeKannaujUttar Pradesh 209732India

BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.

关键词： Elbow joint Humeral fracture Osteotomy Internal Fracture fixation

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Tenosynovitis of hand: Causes and complications

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World Journal of Clinical Cases 2024年第4期12卷 671-676页

作者： Sathish Muthu Saravanan Annamalai Velmurugan Kandasamy Department of orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia Orthopaedic Research Group Coimbatore 641045Tamil NaduIndia Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of orthopaedics Government Thiruvallur Medical CollegeThiruvallur 631203Tamil NaduIndia Department of orthopaedics Government Kilpauk Medical CollegeChennai 600010Tamil NaduIndia

Tenosynovitis represents a common clinical condition characterized by inflam-mation of the synovium that encases the tendon sheath.Although tenosynovities may be noted in any tendon in the body,extremities such as hand,and foot remain the sites of high predilection to acquire this condition.The predominant cause of this predilection rests in the intricate tendon arrangements in these extremities that permit fine motor actions.This editorial explores the common causes and the complications associated with this condition to improve the understanding of the readers of this common condition encountered in our everyday clinical practice.

关键词： Tenosynovitis Gout Hand Complications Infection

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Isorhamnetin Downregulates MMP2 and MMP9 to Inhibit Development of Rheumatoid Arthritis through SRC/ERK/CREB Pathway

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Chinese Journal of Integrative Medicine 2024年第4期30卷 299-310页

作者： LIU Xiao-rong LI Shuo-fu MEI Wen-ya LIU Xiang-dan ZHOU Ri-bao college of Pharmacy Hunan University of Chinese MedicineChangsha(410208)China Department of orthopaedics The First Hospital of Hunan University of Chinese MedicineChangsha(410007)China

Objective To investigate the effect of isorhamnetin on the pathology of rheumatoid arthritis(RA).Methods Tumor necrosis factor(TNF)-α-induced fibroblast-like synoviocytes(FLS)was exposed to additional isorhamnetin(10,20 and 40µmol/L).Overexpression vectors for matrix metalloproteinase-2(MMP2)or MMP9 or SRC were transfected to explore their roles in isorhamnetin-mediated RA-FLS function.RA-FLS viability,migration,and invasion were evaluated.Moreover,a collagen-induced arthritis(CIA)rat model was established.Rats were randomly divided to sham,CIA,low-,medium-,and high-dosage groups using a random number table(n=5 in each group)and administed with normal saline or additional isorhamnetin[2,10,and 20 mg/(kg·day)]for 4 weeks,respectively.Arthritis index was calculated and synovial tissue inflammation was determined in CIA rats.The levels of MMP2,MMP9,TNF-α,interleukin-6(IL-6),and IL-1β,as well as the phosphorylation levels of SRC,extracellular regulated kinase(ERK),and cyclic adenosine monophosphate response element-binding(CREB),were detected in RA-FLS and synovial tissue.Molecular docking was also used to analyze the binding of isorhamnetin to SRC.Results In in vitro studies,isorhamnetin inhibited RA-FLS viability,migration and invasion(P<0.05).Isorhamnetin downregulated the levels of MMP2,MMP9,TNF-α,IL-6,and IL-1βin RA-FLS(P<0.05).The overexpression of either MMP2 or MMP9 reversed isorhamnetin-inhibited RA-FLS migration and invasion,as well as the levels of TNF-α,IL-6,and IL-1β(P<0.05).Furthermore,isorhamnetin bound to SRC and reduced the phosphorylation of SRC,ERK,and CREB(P<0.05).SRC overexpression reversed the inhibitory effect of isorhamnetin on RA-FLS viability,migration and invasion,as well as the negative regulation of MMP2 and MMP9(P<0.05).In in vivo studies,isorhamnetin decreased arthritis index scores(P<0.05)and alleviated synovial inflammation.Isorhamnetin reduced the levels of MMP2,MMP9,TNF-α,IL-6,and IL-1β,as well as the phosphorylation of SRC,ERK,and CREB in synovial tissue(P<0.05).Notably,the inhibit

关键词： rheumatoid arthritis isorhamnetin SRC/ERK/CREB matrix metalloproteinase

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Efficacy of stromal vascular fraction for knee osteoarthritis:A prospective,single-centre,non-randomized study with 2 years follow-up

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World Journal of Orthopedics 2024年第5期15卷 457-468页

作者： Madhan Jeyaraman Naveen Jeyaraman Tarun Jayakumar Swaminathan Ramasubramanian Rajni Ranjan Saurabh Kumar Jha Ashim Gupta Department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennaiTamil Nadu 600077India Department of Biotechnology School of Engineering and TechnologySharda UniversityGreater NoidaUttar Pradesh 201310India Department of orthopaedics and Regenerative Medicine South Texas Orthopaedic Research InstituteLaredoTX 78045United States Department of orthopaedics KIMS-Sunshine HospitalHyderabadTelangana 500032India Department of orthopaedics Government Medical CollegeOmandurar Government EstateChennaiTamil Nadu 600002India Department of orthopaedics School of Medical Sciences and ResearchSharda UniversityGreater NoidaUttar Pradesh 201306India Department of Zoology Kalindi CollegeUniversity of DelhiNew Delhi 110008India Department of orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301Uttar PradeshIndia Department of orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States Department of orthopaedics and Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States

BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease process.In regenerative medicine,current treatments have limitations.In regenerative medicine,more research is needed for intra-articular stromal vascular fraction(SVF)injections in OA,including dosage optimization,long-term efficacy,safety,comparisons with other treatments,and mechanism exploration.AIM To compare the efficacy of intra-articular SVF with corticosteroid(ICS)injections in patients with primary knee OA.METHODS The study included 50 patients with Kellgren-Lawrence grades II and III OA.Patients were randomly assigned(1:1)to receive either a single intra-articular SVF injection(group A)or a single intra-articular ICS(triamcinolone)(group B)injection.Patients were followed up at 1,3,6,12,and 24 months.Visual analog score(VAS)and International Knee Documentation Committee(IKDC)scores were administered before the procedure and at all followups.The safety of SVF in terms of adverse and severe adverse events was recorded.Statistical analysis was performed with SPSS Version 26.0,IBM Corp,Chicago,IL,United States.RESULTS Both groups had similar demographics and baseline clinical characteristics.Follow-up showed minor patient loss,resulting in 23 and 24 in groups A and B respectively.Group A experienced a notable reduction in pain,with VAS scores decreasing from 7.7 to 2.4 over 24 months,compared to a minor reduction from 7.8 to 6.2 in Group B.This difference in pain reduction in group A was statistically significant from the third month onwards.Additionally,Group A showed significant improvements in knee functionality,with IKDC scores rising from 33.4 to 83.10,whereas Group B saw a modest increase from 36.7 to 45.16.The improvement in Group A was statistically significant from 6 months and maintained through 24 months.CONCLUSION Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA.More adequately powe

关键词： Knee osteoarthritis Adipose tissue Stromal vascular fraction Regenerative medicine Orthobiologics

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Brain mechanism of acupuncture for children with anisometropic amblyopia: a resting functional magnetic resonance imaging study based on voxel-mirrored homotopic connectivity

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 339-347页

作者： Jue Wang Jing Jia Yan Sun Chong-Bing Ma Yu-Zhu Chen An-Guo Liu Xing-Ke Yan college of acupuncture-Moxibustion and Tuina Gansu University of Chinese MedicineLanzhou 730101Gansu ProvinceChina Department of Ophthalmology Lanzhou Purui Ophthalmology HospitalLanzhou 730050Gansu ProvinceChina

AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)technology based on clinical effectiveness.METHODS:Eighty children with anisometropic monocular amblyopia were randomly divided into two groups:control(40 cases,1 case of shedding)and acupuncture(40 cases,1 case of shedding)groups.The control group was treated with glasses,red flash,grating,and visual stimulations,with each procedure conducted for 5min per time.Based on routine treatment,the acupuncture group underwent acupuncture of“regulating qi and unblocking meridians to bright eyes”,Jingming(BL1),Cuanzhu(BL2),Guangming(GB37),Fengchi(GB20)acupoints were taken on both sides,with the needle kept for 30min each time.Both groups were treated once every other day,three times per week,for a total of 4wk.After the treatment,the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted.At the same time,nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rsfMRI before and after treatment.The differences in the brain regions between the two groups were compared and analyzed with VMHC.RESULTS:Chi-square test showed a notable difference in the total efficiency rate between the acupuncture(94.87%)and control groups(79.49%).Regarding the P100 wave latency and amplitude,the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group.Moreover,the VMHC values of the bilateral temporal lobe,superior temporal gyrus,and middle temporal gyrus were notably increased in the acupuncture group after treatment.CONCLUSION:acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia.Compared with the conventional treatment,the regulation

关键词： resting functional magnetic resonance imaging voxel-mirror homotopy connection anisometropic amblyopia acupuncture

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