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Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The early stage of avascular necrosis of the femoral head is difficult to find, easy to be ignored and misdiagnosed. Due to the relatively poor medical conditions in some areas, the treatment is often delayed, resulting in a high rate of late disability. OBJECTIVE: To summarize the related literature in and outside China, and the research on the pathogenesis of hormonal osteonecrosis of the femoral head and related signal pathway so as to understand the pathogenesis. METHODS: The databases of CNKI, Wanfang and VIP were retrieved in Chinese with the key words of “necrosis of femoral head, glucocorticoid, pathogenesis, apoptosis, signal pathway, lipid metabolism disorder, BMSCs, Wnt/β-catenin”. PubMed and MEDLINE databases were retrieved in English with the key words of “ANFH, glucocortioids, pathogenesis, cell apoptosis, signal path, lipid metabolism disorder, BMSCs, Wnt/β-catenin”. The articles regarding the pathogenesis of hormonal osteonecrosis of the femoral head were collected. Finally, 57 articles were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) The pathogenesis of steroid-induced femoral head necrosis is the result of a combination of multiple mechanisms and factors. Currently, the accepted theories mainly include intravascular coagulation, lipid metabolism disorder, osteoporosis and cell apoptosis. However, the pathological process has not yet been fully elucidated and further in-depth research is needed. (2) At present steroid-induced femoral head necrosis has not been completely cured because its pathogenesis has not been clearly identified. The reason for this difficulty may be that animal models in a large number of experiments at present cannot satisfactorily simulate the complex pathological changes and mechanisms of human femoral head necrosis. It is hoped that animal models of femoral head necrosis can be further improved in future experiments on steroid-induced femoral head necrosis. (3) On the basis of fully understanding the pathogenesis of steroid-induced femoral head necrosis, rational clinical use of glucocorticoids and preventive and intervention measures may be the key to prevent femoral head necrosis. In addition, speeding up the research on relevant signal pathways will help investigators find targets for the prevention and treatment of steroid-induced femoral head necrosis, and hopefully find more effective therapeutic schemes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bone nonunion is a common complication after fracture, which brings great distress to patients. With the continuous development of exosomal technology, exosomes gradually show their advantages in the treatment of nonunion, which has become a new research direction in medical work. OBJECTIVE: To summarize the researches in and outside China and explore the role of exosomes in the treatment of nonunion. METHODS: The authors retrieved related Chinese articles published from 2003 to 2019 in Wanfang database, CNKI and VIP database with the key words of “exosomes, nonunion, bone remodeling, bone regeneration, vascular injury, osteoblasts, osteoclasts” and related English articles published from 2003 to 2019 in PubMed with the key words of “exosomes, nonunion, bone remodeling”. Totally 50 articles were selected based on inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) In recent years, more and more attention has been paid to the study of exosomes on bone nonunion. MiRNAs and proteins in exosomes can affect bone nonunion by affecting the differentiation of osteocytes. (2) Studies have found that exosomes can treat bone nonunion by regulating bone remodeling, promoting vascular repair, and improving systemic diseases. (3) However, the current research on exosomes is still in the experimental stage. The specific method of how to better apply it to clinical treatment needs further exploration. [ABSTRACT FROM AUTHOR]