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Purpose To use three-dimensional (3D) virtual models to study how the parameters and insertion rates of the infra-acetabular corridor (IAC) change under different fluoroscopic angles. Methods The pelvis computed tomography data of 187 patients are imported into Mimics software in DICOM format to generate a 3D model. The anterior pelvis plane is used as the reference plane to measure the diameter of the optimum IAC when the pelvis model is tilted forward by 5°, 15°, 25°, 35° and 45°. The diameter of at least 3.5 mm is defined as the cutoff for placing a 3.5 mm screw, the rate of infra-acetabular screw (IAS) insertion is calculated, and the mean length of the IAC and the mean tilt of the corridor axis in relation to the sagittal midline plane (SMP) are measured. Results The similar diameters of the IAC can be found under fluoroscopy at 5°–35°, with the largest diameter of 4.08 ± 1.84 mm and the highest screw insertion rate of 60.42% at 15° and 25°, whereas the diameter and insertion rate are lowest at 45°. The corridor length increases with increasing fluoroscopic angle, and the angle of the corridor axis to the SMP decreases gradually. Conclusion The conventional fluoroscopic angle of the pelvic inlet is not suitable for the IAS insertion. The parameters of the IAC vary according to a certain rule under different fluoroscopic angles, so a surgeon can select the appropriate fluoroscopic angle in accordance with the type of fracture and the fracture line angle.

Aim To explore the difference in the efficacy of intraperitoneal injection of exogenous melatonin of daytime or nighttime in the treatment of postmenopausal osteoporosis. Methods In this study, 40 rats were randomly divided into four groups: sham operation group (Sham), ovariectomy (OVX), and daytime melatonin injection group (OVX + DMLT, 9:00, 30mg/ kg/d) and nighttime injection of melatonin (OVX + NMLT, 22:00, 30 mg/kg/d). During the period, we measured the concentration of melatonin in the blood of each group 1 hour after the injection of melatonin. After three months of treatment, the rats were sacrificed. The distal femur, blood and femoral marrow cavity contents were saved. The rest of the samples were tested by Micro-CT, histology, biomechanics and molecular biology. Blood was used for bone metabolism marker measurements. Results Compared with the nighttime injection, the bone mass of the rats was significantly increased after the daytime injection treatment. All morphometric parameters increased, only Tb.Sp decreased. Histologically, the bone microarchitecture was also better. In the biomechanical experiment, the femur samples of the day treatment group were able to withstand greater loads and deformation. In molecular biology experiments, bone formation-related molecules increased, while bone resorption-related molecules decreased. After treatment with melatonin injection at night, the expression of MT2 was significantly decreased. Conclusion Daytime injection of melatonin is more effective in preventing bone loss.

The purpose is to observe whether local administration with selenium (Se) can enhance the efficacy of calcium phosphate cement (CPC) in the treatment of osteoporotic bone defects. Thirty ovariectomized (OVX) rats with two defects were generated and randomly allocated into the following graft study groups: (1) OVX group (n = 10), (2) CPC group (n = 10); and (3) Se-CPC group (n = 10). Then, these selenium-modified calcium phosphate cement (Se-CPC) scaffolds were implanted into the femoral epiphysis bone defect model of OVX rats for 12 weeks. Micro-CT, history, western blot and reverse transcription–quantitative polymerase chain reaction (RT-qPCR) analysis were used to observe the therapeutic effect and to explore the possible mechanism. Micro-CT and histological analysis evaluation showed that the Se-CPC group presented the strongest effect on bone regeneration and bone mineralization when compared with the CPC group and the OVX group. Protein expressions showed that the oxidative stress protein expressions, such as SOD2 and GPX1 of the Se-CPC group, are significantly higher than those of the OVX group and the CPC group, while Se-CPC remarkably reduced the expression of CAT. RT-qPCR analysis showed that the Se-CPC group displayed more OPG than the OVX and CPC groups (p

Objective The present work was aimed to evaluate the effect of valproic acid (VPA)，Parathyroid hormone (1–34) (PTH)+VPA on Ti rods osseointegration in ovariectomized rats and further investigation of the possible mechanism. Methods The MC3T3-E1 cells were co-cultured with VPA，PTH ​+ ​VPA and induced to osteogenesis, and the cell viability，mineralization ability were observed by MTT and ALP staining，Alizarin Red staining and Western blotting. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group OVX and VPA，PTH ​+ ​VPA, and all the rats received Ti implants and animals belong to group VPA，PTH ​+ ​VPA received valproic acid (300 ​mg/day), valproic acid (300 ​mg/day) plus Parathyroid hormone (1–34) every 3 days (60 ​μg/kg), respectively, treatment until death at 12 weeks. Micro-CT, histology, biomechanical testing, bone metabolism index and Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis were used to observe the therapeutic effect and explore the possible mechanism. Results Results shown that VPA decreased new bone formation around the surface of titanium rods and push-out force other than group OVX. Histology, Micro-CT and biochemical analysis results showed combined application of systemic VPA showed harmful effects than OVX group on bone formation in osteopenia rats, with the worse effects on CTX-1, P1NP and microarchitecture as well as biomechanical parameters by down-regulated gene expression of Runx2, OCN, Smad1, BMP-2 and OPG, while up-regulated RANKL. However, after PTH treatment, the above indicators were significantly improved. Conclusions The present study suggests that systemic use of VPA may bring harm to the stability of titanium implants in osteoporosis, PTH can reverse the negative effect of VPA on the osseointegration of titanium rods in ovariectomized rats. Translational potential of this article According to our research, when patients with epilepsy have osteoporotic fractures, after joint replacement or internal fixation, continue to use sodium valproate for anti-epileptic therapy, the possibility of postoperative loosening increases, again on the basis of It can be reversed with the anti-osteoporosis drug parathyroid hormone (1-34).

Previous studies have demonstrated the beneficial effect of melatonin (MEL) on bone tissue and bone metabolism. Rapamycin (RAP) promotes osteoblast proliferation and inhibits osteoclast proliferation, and positively affects bone regeneration; however, reports about effects of RAP on bone loss for aged female rats with MEL administration are limited. This study investigated the impact of treatment with RAP on bone loss for aged female rats with MEL administration. Female Sprague-Dawley rats weighing approximately 520 g were randomly divided into 3 groups of 10: group CON, group MEL and group MEL + RAP and received saline, MEL, RAP plus MEL treatment until death at 12 weeks, respectively. The results of maintaining bone mass and bone strength with RAP plus MEL administration were evaluated by histology, microcomputerized tomography (Micro-CT), gene expression analysis and biomechanical testing. Results from this study indicated that MEL + RAP had stronger effects on the prevention and treatment of osteoporosis than MEL administration. Administration of MEL + RAP produced the strongest effects on bone parameters and strength for distal femurs and regulation of OPG/RANKL signalling pathway-related gene expression. These results seemed to indicate that RAP could increase the effects of MEL on age-dependent bone loss.

Despite advances in the pathogenesis of Tauroursodeoxycholic acid (TUDCA) on bone, the understanding of the effects and mechanisms of bone osseointegration in TUDCA-associated Hydroxyapatite (HA)-coated titanium implants remains poor. Therefore, the present work was aimed to evaluate the effect of local administration with TUDCA on HA-coated titanium implants osseointegration in ovariectomized(OVX) rats and further investigation of the possible mechanism. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into three groups: sham operation(Sham) group, OVX group and TUDCA group, and all the rats from Sham group and OVX group received HA implants and animals belonging to group TUDCA received TUDCA-HA implants until death at 12 weeks. The bilateral femurs of rats were harvested for evaluation. TUDCA increased new bone formation around the surface of titanium rods and push-out force other than group OVX. Histology, Micro-CT and biochemical analysis results showed systemic TUDCA showed positive effects than OVX group on bone formation in osteopenic rats, with beneficial effect on via activation OPG/RANKL pathway and BMP-2/Smad1 pathway and microarchitecture as well as by reducing protein expression of TNF-α and IFN-γ. The present study suggests that local use of TUDCA may bring benefits to the osseointegration of HA-coated titanium implants in patients with osteoporosis, and this effect may be related to the inhibition of inflammatory reaction and promotion of osteogenesis.

The aim of this study was to confirm the effect of the systemic administration of melatonin on hydroxyapatite-coated titanium (HA-Ti) implants in senile osteopenic rats. For this study 24-month-old female Sprague-Dawley rats were used. The animals were randomly divided into two groups: a control group and a melatonin group and the bilateral femurs of all the rats received HA-Ti implants. Animals in the melatonin group received treatment with melatonin (30 mg/kg day). After a 12-week healing period, rats in the melatonin group revealed improved osseointegration compared to the control group, with the bone area ratio (BAR) and bone to implant contact (BIC) increased by 1.87-fold and 1.65-fold in histomorphometry, the quantitative results of implant osseointegration and peri-implant trabeculae, such as a higher bone volume per total volume (BV/TV), trabecular number (Tb.N), the mean connective density (Conn.D), trabecular thickness (Tb.Th), and a lower trabecular spacing (Tb.Sp) in micro-computed tomography (CT) evaluation and the maximum push-out force by 1.75-fold in push out tests. Additionally, compared with the control group, melatonin could significantly up-regulate the expression of the runt-related transcription factor 2 (Runx2), osteocalcin (OC) and osteoprotegerin (OPG) genes and down-regulate the expression of the RANKL gene. These findings suggest that systemic administration with melatonin is useful to improve the fixation of HA-coated implants even in osteopenic rats through promoting Runx2, OC and OPG gene expression and inhibiting RANKL gene expression.

Previous studies have demonstrated the damaging effect of alcohol (ALH) consumption on bone tissue and bone metabolism. Resveratrol (RES) promotes osteoblast proliferation and inhibits osteoclast proliferation and positively affects bone regeneration; however, reports about effects of RES on osseointegration in aged female rats with ALH consumption are limited. This study was designed to investigate the impact of treatment with RES on osseointegration for aged female rats with ALH consumption. This study included 30 female Sprague-Dawley rats (22 months old), weighing approximately 520 g. All animals were randomly divided into 3 groups of 10: a control group (CON) receiving saline, a group receiving ALH and a group receiving ALH + RES until death after 12 weeks. The results of enhanced osseointegration in senile female rats with RES consumption were evaluated by histology, microcomputerized tomography (micro-CT), gene expression analysis and a biomechanical test. The results of this study indicated that ALH + RES showed stronger effects on the improvement of osseointegration in senile female rats with ALH consumption. The ALH + RES produced stronger effects on bone volume per total volume (BV/TV), mean trabecular thickness (Tb.Th), mean trabecular number (Tb.N) and mean trabecular separation (Tb.Sp), connective tissue density (Conn.D) and maximum push-out force for implants, and regulation of osteogenesis and bone resorption-related gene expression. These results seem to indicate that RES intervention reverses the negative effect of alcohol on hydroxyapatite-coated implant osseointegration in senile female rats with ALH consumption.

As hydroxyapatite has good osteoconductive properties, it is used as coating material for the implants in cementless arthroplasty. However, its effect is not sufficient for osteoporotic bone. Silym...

The objectives of the present study were to determine whether simvastatin (SIM) could reverse the harmful effects on titanium rod osseointegration in ovariectomized rats fed high-fat diet (HFD). Ovariectomized female Sprague–Dawley rats were randomly allocated to three groups and received SIM treatment plus HFD for 12 weeks. We then evaluated the microstructure parameters, histological parameters, biomechanical parameters, bone turnover, and blood lipid level. After 12 weeks of treatment, SIM can significantly improve bone formation around the titanium rod and osseointegration including higher values of maximum push-out force, bone area ratio (BAR), bone-to-implant contact (BIC), bone mineral density (BMD), bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), mean connective density (Conn.D) when compared with the HFD group. In addition, system administration of SIM showed positive effects on collagen type 1 cross-linked C-telopeptide (CTX-1), procollagen I N-terminal propeptide (PINP), total cholesterol (TC), triglycerides (TGL), low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. Compared with the HFD group, lower values of CTX-1, P1NP, TC, TGL and LDL were observed in the SIM+HFD group (P

To measure the maximum corridor parameters of the infra acetabular screw and evaluate the feasibility of screw insertion through digital analysis of the acetabular structure.The pelvic CT data of 100 patients who received plain pelvic CT scan from April 2013 to June 2015 were retrospectively analyzed. There were 50 males, aged 20 to 84 years, with an average age of (48.42±17.48) years, and 50 females, aged 18 to 87 years, with an average age of (55.02±19.54) years. Patients with acetabular fractures, hip dysplasia, and metal implants in the acetabulum were excluded. Import CT data into Mimics software in DICOM format to generate a three-dimensional model, and find the axialprojection of the infra-acetabular corridor in the middle of the pubis ramus in the inlet view. A virtual screw was placed in the infra-acetabular space and measure the parameters including the diameter and the length of the maximum corridor, the distance from the insertion point to the pubic symphysis, to the anterosuperior iliac spine and to the medial edge of the pelvis. Then import the pelvic model into 3- matic software, establish the pelvic model anterior pelvic plane and median sagittal plane, and measure the angle between the screw axis and the two planes. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5 mm screw, and calculate the screw insertion rate.In 100 cases, 49% of patients had a infra acetabular corridor with a diameter ≥5 mm, and the rate of screw placement in men was significantly higher than that in women. The average diameter of the maximum corridor of infra-acetabular screw was (4.86±1.72) mm, the average length was (94.04±8.29) mm, the average distance from the insertion point to the pubic symphysis was (60.92±4.84) mm, to the anterosuperior iliac spine was (85.15± 6.85) mm, and to the medial edge of the pelvis was (6.12±3.32) mm. The mean angle between the axis of the screw and the median sagittal plane was (-1.38±4.74)°, and the mean angle between the axis of the screw and the anterior pelvic plane was (56.77±7.93)°. There are significant differences between male and female measured parameters, except for the angle between the screw axis and the anterior pelvic plane. There was no statistically significant difference in the maximum corridor parameters of infra-acetabular screw on both sides of the pelvis.This study shows that the insertion rate of infra-acetabular screws is low in local patients, and the feasibility of screw insertion should be fully evaluated before surgery.

Local application of lithium or aspirin with biological scaffold has been identified as a potent means to improve bone formation. In this study, lithium and aspirin modified calcium phosphate cement (Asp-Li/CPC) was prepared, and the feasibility of this biological scaffold in the treatment of osteoporotic bone defect was observed in vivo and in vitro. In vitro experiments confirmed that Asp-Li/CPC had better ability to promote MC3T3-E1 cells differentiation into osteoblasts, osteoblast mineralization and viability, and promote cell expression of ALP, OP, RUNX-2, OC and COL-1 protein than simple CPC or lithium modified CPC by MTT, Alizarin red staining and Western blot evaluation. In vivo experiments confirmed that Asp-Li/CPC presented the strongest effect on bone regeneration and bone mineralization through the comparison with CPC group and Li/CPC group with X-ray images, Micro-CT and Histological evaluation. RT-qPCR analysis showed that Asp-Li/CPC, Li/CPC group and CPC group demonstrated increased BMP2, Smad1, OPG than the OVX group (P

The purpose was to observe whether local administration Strontium (Sr) and Aspirin (Asp) can enhance the efficacy of β-Tricalcium phosphate(β-TCP) in the treatment of osteoporotic bone defect. The MC3T3-E1 cells were co-cultured with β-TCP, Sr/β-TCP, Asp-Sr/β-TCP scaffold and induced to osteogenesis, and the cell viability, mineralization ability were observed by MTT, Alizarin Red staining(ARS) and Western blotting(WB). Then this scaffolds were implanted into the femoral epiphysis bone defect model of ovariectomized(OVX) rats for 8 weeks. X-ray, Micro-CT, histology and Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis were used to observe the therapeutic effect and explore the possible mechanism. MTT, ARS results show that the cell mineralization and viability of Asp-Sr/β-TCP group is significantly higher than Control group, β-TCP group and Sr/β-TCP group. Protein expression show that the osteogenic protein expression such as ALP、OP、RUNX-2、OC and COL-1 of Asp-Sr/β-TCP group is significantly higher than Control group, β-TCP group and Sr/β-TCP group. X-ray images, Micro-CT and Histological analysis evaluation show that, group Asp-Sr/β-TCP presented the strongest effect on bone regeneration and bone mineralization, when compared with β-TCP group and Sr/β-TCP group. RT-qPCR analysis show that Asp-Sr/β-TCP, β-TCP group and Sr/β-TCP group showed increased BMP2, Smad1, OPG than the OVX group(p < 0.05), while Asp-Sr/β-TCP exhibited decreased TNF-α、IFN-γ and RANKL than the OVX group(p < 0.05). Our current study demonstrated that Asp-Sr/ β-TCP is a scheme for rapid repair of femoral condylar defects, and these effects may be achieved by inhibiting local inflammation and through BMP-2/Smad1 and OPG/RANKL signaling pathway.

To investigate the influencing factors of hidden blood loss (HBL) during the treatment of percutaneous vertebroplasty (PVP).The clinical data of 125 patients with osteoporotic vertebral compression fractures (OVCFs) treated with percutaneous vertebroplasty from March 2016 to December 2017 were retrospectively analyzed. All patients underwent X rays of the AP and lateral lumbar spine, double oblique, and dynamic positions. Lumbar spine CT, MRI, and dual energy X ray bone densitometer (DXA) were used to confirm the diagnosis. There were 55 males and 70 females, 10 cases of thoracic vertebrae, 89 cases of thoracolumbar vertebrae, 26 cases of lumbar vertebrae, 87 cases with single segment, 29 cases with double segment,and 9 cases with 3 segments. The vertebral compression height ratios of 67 patients were less than 1 / 3, and the ratios for 41 patients were from 1 / 3 to 2 / 3,for 17 patients were more than 2 / 3. Blood routine examination were performed before and 3 days after surgery to analyze hidden blood loss and to explore its risk factors.The average hidden blood loss was (317±156) ml in 125 patients. Multiple linear regression analysis revealed a history of diabetes(Patients with OVCFs have a large amount of hidden blood loss after PVP treatment, which needs attention. At the same time, the history of diabetes, surgical segments, number of segments, bone cement leakage rate, vertebral height loss rate and vertebral height recovery rate are the risk factors for hidden blood loss.

To explore the effect of suture anchor combined with transverse drilling of patella to repair the fracture of the joint of bone and tendon of quadriceps femoris tendon.From April 2016 to January 2018, 6 patients (8 knees) with complete rupture of the joint of the tendon and bone tendon of the quadriceps femoris were treated with the combination of anchor with wire and transverse drilling of the patella, including 5 males (7 knees) and 1 female, aged from 43 to 74 years with an average age of 53 years old. All the patients had pain in knee joint and could not extend the knee actively after trauma. X-ray, CT and MRI were performed on the knee joints, and it was clear that the joint of bone and tendon of quadriceps femoris tendon was completely broken. The X-ray of knee joint was reviewed regularly after operation, and Lysholm score was used to evaluate the function of knee joint.The average operation time of all patients was 60 minutes. Tourniquets were used during the operation, no drainage was placed after the operation, and no blood transfusion was performed in all patients. Six patients were followed up for 15 to 36 months with an average of 26 months. Lysholm score of 6 patients (8 knees) was 79 to 95 in the last follow-up with an average of 89 points. One of the patients with mandatory spondylitis developed infection and healed after 2 debridements.The suture structure of the joint of bone and tendon of quadriceps femoris tendon repaired with suture anchor and lateral drilling of patella is simple, reliable and effective.

Osteoporosis-induced impaired bone regeneration would result in compromised osseointegration of hydroxyapatite-coated titanium and high rate of implant failure. Local administration of aspirin prom...

Chitosan Oligosaccharide (COS) has been widely used for the systemic treatment of clinical diseases such as bone tissue engineering. However, its influence on osteoclast formation, which plays a critical role in bone homeostasis, has never been investigated. The aim of this study was to investigate the effect of chitosan oligosaccharide on differentiation of osteoclast. Using cell counting kit-8, tartrate-resistant acid phosphatase staining, reverse transcription‑quantitative polymerase chain reaction assay and western blot analysis, we demonstrated that chitosan oligosaccharide cannot inhibit RANKL-induced osteoclast precursor proliferation but does promote osteoclast differentiation by stimulating the activation of p38/mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase (JNK)/MAPK, extracellular signal-regulated kinase (ERK)/MAPK and protein kinase B (AKT) without affecting nuclear factor kappaB (NF-kB) signaling pathways. Based on the promoting effect of chitosan oligosaccharide on osteoclast differentiation, we suggest that this property of chitosan oligosaccharide may have potential detrimental effect on bone homeostasis.

Recently, the use of the pharmacological agents strontium ranelate (SR), parathyroid hormone (1-34, PTH) and zoledronic acid (ZA) has come to prominence for the treatment of osteoporosis due to their ability to prevent bone loss in osteoporotic patients. Although much emphasis has been placed on using pharmacological agents for the prevention of disease, much less attention has been placed on which one is more effective. There is still no direct comparative study on these three drugs. The aim of the present study was to investigate the effect of SR, PTH, ZA on preventing ovariectomy-induced osteoporosis in rats. After bilateral ovariectomy the rats randomly received vehicle, SR (500 mg/kg body weight/day, orally), PTH (20 μg/kg/day, subcutaneously) or a single injection of ZA (0.1 mg/kg, i.v.) until death at 12 weeks. The distal femurs were harvested for evaluation of bone metabolism. The rats treated with ZA demonstrated the highest levels of new bone formation as assessed by microcomputed tomography (CT), biomechanical strength, histological analysis and bone metabolism. Furthermore, PTH and SR showed a stronger effect on improving trabecular bone mass at 12 weeks. The results from the present study demonstrate that systemic administration of PTH, SR and ZA could prevent bone loss, while a single dose of ZA has a better effect on preventing ovariectomy-induced osteoporosis than either PTH or SR.

Parathyroid hormone (1-34, PTH) combined β-tricalcium phosphate (β-TCP) achieves stable bone regeneration without cell transplantation in previous studies. Recently, with the development of tissue engineering slow release technology, PTH used locally to promote bone defect healing become possible. This study by virtue of collagen with a combination of drugs and has a slow release properties, and investigated bone regeneration by β-TCP/collagen (β-TCP/COL) with the single local administration of PTH. After the creation of a rodent critical-sized femoral metaphyseal bone defect, β-TCP/COL was prepared by mixing sieved granules of β-TCP and atelocollagen for medical use, then β-TCP/COL with dripped PTH solution (1.0 µg) was implanted into the defect of OVX rats until death at 4 and 8 weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that single-dose local administration of PTH combined local usage of β-TCP/COL can increase the healing of defects in OVX rats. Furthermore, treatments with single-dose local administration of PTH and β-TCP/COL showed a stronger effect on accelerating the local bone formation than β-TCP/COL used alone. The results from our study demonstrate that combination of single-dose local administration of PTH and β-TCP/COL had an additive effect on local bone formation in osteoporosis rats.

The present work was aimed to evaluate the effect of different administration modes of sodium valproate (VPA) on bone strength, bone mass and bone mineral density in ovariectomized (OVX) rats and further investigation of the possible mechanism. 60 female SD rats were randomly divided into 4 groups: Sham group (Sham, n = 15), OVX group (OVX, n = 15), OVX rats received intermittent VPA treatment group (IVPA, n = 15) and OVX rats received daily VPA treatment group (EVPA, n = 15). After 12 weeks of treatment, the rats were sacrificed, and serum and femur samples were harvested. DEXA, Micro-CT, history, biomechanical testing, biochemical index and western blot analysis were used to observe the therapeutic effect and explore the possible mechanism. Micro-CT and DEXA analysis of bones revealed better BMD and higher BV/TV, Tb. Th, Tb. N, Conn. D and lower Tb. Sp at femoral metaphysis evaluated in IVPA when compared with OVX and EVPA group (P 0.05). Histological, fluorescent analysis and biological strength revealed more trabecular bone and higher relative mineral apposition rate, maximal load, elastic modulus and energy at break with evaluated in IVPA when compared with OVX and EVPA group (P 0.05). The levels of P1NP, estrogen, CTX, TRAP-5b and RANKL of the IVPA group showed a significant increase when compared with the OVX and EVPA group (P 0.05). We confirm adverse effects on protein expressions including Notch1, Jagged1, HEY1, Wnt 1, β-catenin and RUNX2 following daily VPA treatment in OVX female rats. Our current study demonstrated that intermittent administration of sodium valproate has a protective effect on bone health in OVX rats and these effects may be achieved by activating Notch/Wnt/β-catenin/RUNX2 signal axis.

The effects of both alendronate (ALN) and Drynaria rhizome extracts (DRE) alone could promote bone healing in osteoporotic fractures but there are no reports about the combined use of ALN and DRE for promotion of bone healing of fractures in osteoporotic settings. This study investigated the effects of ALN plus DRE on fractures in osteopenic rats. Osteopenic rats underwent unilateral transverse osteotomy on the femur fixed by a sterilized Kirschner wire 2 weeks after intragastric administration of retinoic acid (80 mg/kg body weight/day). Subsequently, the animals were randomly divided into four groups: control, ALN, DRE and ALN + DRE. All rats from groups ALN, DRE and ALN + DRE received ALN (40 mg/kg, weekly), DRE (90 mg/kg/day), or both for 2, 4 and 6 weeks. The results of our study indicated that all treatment promoted fracture healing and callus formation compared to controls but ALN + DRE treatment showed significantly stronger effects than ALN or DRE alone in histological, X‑ray and biomechanical tests. These results seem to indicate that combined treatment with ALN and DRE has an additive effect on fracture healing and callus formation in osteoporotic rats.

Surface modification techniques have been applied to generate titanium implant surfaces that promote osseointegration for the implants in cementless arthroplasty. However, its effect is not sufficient for osteoporotic bone. Strontium (Sr) promotes osteoblast proliferation and inhibits osteoclast proliferation and positively affects bone regeneration. The aim of this study was to confirm the effects of strontium-substituted hydroxyapatite (Sr-HA) coating via electrochemical deposition on implant's osseointegration in the osteoporotic condition. Female Sprague Dawley rats were used for this study. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group HA; group 5 % Sr-HA; group 10 % Sr-HA; and group 20 % Sr-HA. Afterward, all rats from groups HA, 5 % Sr-HA, 10 % Sr-HA, and 20 % Sr-HA received implants with hydroxyapatite coating containing 0, 5, 10, and 20 % Sr. Implants were inserted bilaterally in all animals until death at 12 weeks. The bilateral femurs of rats were harvested for evaluation. All treatment groups increased new bone formation around the surface of titanium rods and push-out force; group 20 % Sr-HA showed the strongest effects on new bone formation and biomechanical strength. Additionally, these are significant differences in bone formation and push-out force was observed between groups 5 % Sr-HA and 10 % Sr-HA. This finding suggests that Sr-HA coating can improve implant osseointegration, and the 20 % Sr coating exhibited the best properties for implant osseointegration among the tested coatings in osteoporosis rats.

The objective of this study was to evaluate the effect of following combined treatment with parathyroid hormone (1-34) (PTH) and β-tricalcium phosphate (β-TCP) on local bone formation in a rat 3-mm critical-sized defect at the distal femur. Fourteen weeks were allowed to pass before defect surgery for the establishment of osteopenic animal models chronically fed a low-protein diet. All animals were randomly divided into four groups: group PTH; group β-TCP, group PTH + β-TCP, and a control group. All rats then underwent a surgical procedure to create bone defects in the bilateral distal femurs, and β-TCP was implanted into critical-sized defects for the groups designated as β-TCP and group PTH + β-TCP. After the defect operation, all animals from group PTH and group PTH + β-TCP received following subcutaneous injections with PTH (60 μg/kg, three times per week) until euthanasia at 4 and 8 weeks. The distal femurs and blood were collected for evaluation. The results of study showed the strongest effect on accelerating the local bone formation with treatment β-TCP and PTH at 4 weeks and 8 weeks. The results from our study demonstrate that a combination of PTH and β-TCP had an additive effect on local bone formation in osteopenic rats chronically fed a low-protein diet.

The effect of human parathyroid hormone 1-34 (PTH) and simvastatin (SIM) alone could promote bone healing in osteoporotic osseous integration of the implant, but there are no reports about the combined use of PTH and SIM for promotion of bone healing around implant in osteoporotic settings still limited. This study aims to investigate effects of PTH+SIM on osseous integration of the implant in OVX rats. Female Sprague-Dawley rats were used for this study. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group control; group SIM; group PTH and group PTH+SIM. Afterwards, all OVX rats received hydroxyapatite (HA)-coated titanium rods (external diameter and length are 1.5mm and 20mm) in the femoral medullary canal. Subsequently, the animals from group SIM, group PTH and group PTH+SIM received human parathyroid hormone 1-34 (60μg/kg, three times a week), SIM (5mg/kg daily), or both for 12 weeks. Implants were inserted bilaterally in all animals until death at 12 weeks. The bilateral femurs of rats were harvested for evaluation. All groups increased new bone formation around the surface of titanium rods and push-out force; group PTH+SIM showed the strongest effects on new bone formation and biomechanical strength. Additionally, these are significant difference observed in bone formation and push-out force between groups SIM and PTH. This finding suggests that intermittent administration of PTH or SIM alone has an effect to increase new bone formation on the surface of HA-coated implants in the osteoporotic condition, and the additive effects of combination PTH and SIM on osseous integration of the implant in OVX rats.

To discuss the clinical effects of the different pedicle screw fixation methods for the treatment of thoracolumbar fractures.The clinical data of 55 patients with single thoracolumbar fractures treated between January 2013 and December 2016 were retrospectively analyzed. There were 32 males and 23 females, aged from 20 to 55 years with an average of 35.6 years old. All the fractures were located on a single segment, 8 cases of T₁₁, 18 cases of T₁₂, 19 cases of L₁, 10 cases of L₂. According to the classification of AO, 10 cases were type A1, 17 cases were type A2, 18 cases were type A3, 7 cases were type B2, 2 cases were type B3, 1 case was type C1. The patients were divided into three groups according to the different fixation methods, among them, 20 cases treated by traditional short-segment 4 pedicle screws fixation were control group, 22 cases treated by intermediate bilateral pedicle screws fixation (6 pedicle screws fixation) were bilateral group, 13 cases treated by intermediate unilateral pedicle screw fixation (5 pedicle screws fixation) were unilateral group. The three groups were compared by operation time, intraoperative blood loss, hospitalization cost, VAS and ODI scores, the correction of the fractured vertebrae height and kyphosis angle postoperatively and the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up and so on.All the patients were followed up from 12 to 20 months with an average of 15.2 months. No complications such as loosening of internal fixation and breakage were found after operation. There was no significant difference in operation time and intraoperative blood loss among three groups(All the three different pedicle screw fixation methods are suitable for the treatment of thoracolumbar fractures and the short-term clinical effects are consistent. Compared with traditional short-segment 4 pedicle screws fixation, intermediate bilateral or unilateral pedicle screw fixation were more effective in maintaining the height of the injuried vertebrae and preventing the occurrence of kyphosis. The intermediate unilateral pedicle screw fixation was comparable to that of bilateral fixation at clinical outcomes, but the unilateral fixed hospitalization cost was lower, which was worthy of clinical promotion.

To explore the effect of cinnamaldehyde on the distal femur in ovariectomized rats and its influence on osteoblast in vitro. Female Sprague–Dawley rats which underwent either bilateral ovariectomy or sham operation were divided into five groups randomly: group OVX (OVX, N = 10) and group sham (SHAM, N = 10) received normal saline (NS) by gavage at a dose of 50 ml/kg·d; group low dose, group middle dose and group high dose received cinnamaldehyde by gavage at a dose of 25 mg/kg·d (OLD, N = 10), 50 mg/kg·d (OMD, N = 10), and 75 mg/kg·d (OHD, N = 10) respectively. Distal femurs were harvested for hematoxylin and eosin (HE) staining, micro-ct scanning and immunohistochemical analysis. Murine mesenchymal stem cells were cultured and dealt with the presence of either cinnamaldehyde at a dose of 15ug/ml (OLD), 30ug/ml (OMD), 60ug/ml (OHD) or vehicle. ALP staining and western blot were performed to observe the influence of cinnamaldehyde on the differentiation of osteoblast. HE and micro-ct results indicated that osteogenesis were promoted with the treatment of cinnamaldehyde. Immunohistochemical results showed that cinnamaldehyde increased the number of osteoblast and decreased the number of osteoclast. In vitro studies indicated that cinnamaldehyde promoted expression of alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), osteocalcin (OCN) and collagen type Iɑ1 (COL1ɑ1). The treatment effect behaved as dose-dependently. Thus, cinnamaldehyde inhibits osteoclastogenesis and promotes osteoblastogenesis, and may plays an important role in the treatment of osteoporosis clinically. Keywords: Cinnamaldehyde, Anti-Osteoporosis, Bone morphology, Osteoblast, Osteoclast

The objective of the present study was to incorporate strontium into calcium phosphate cement combined with a lower single-dose local administration of bone morphogenetic protein-2 to enhance its in vivo biodegradation and bone tissue growth. After the creation of a rodent critical-sized femoral metaphyseal bone defect, strontium-modified calcium phosphate cement was prepared by mixing sieved granules of calcium phosphate cement and 5% SrCO3 for medical use, and then strontium-modified calcium phosphate cement with dripped bone morphogenetic protein-2 solution (5 µg) was implanted into the defect of OVX rats until death at eight weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that a lower single-dose local administration of bone morphogenetic protein-2 combined local usage of strontium-modified calcium phosphate cement can increase the healing of defects in OVX rats. Furthermore, treatments with single-dose local administration of bone morphogenetic protein-2 and strontium-modified calcium phosphate cement showed a stronger effect on accelerating the local bone formation than calcium phosphate cement and strontium-modified calcium phosphate cement used alone. The results from our study demonstrate that combination of a lower single-dose local administration of bone morphogenetic protein-2 and strontium-modified calcium phosphate cement had an additive effect on local bone formation in osteoporosis rats.

Previous studies have demonstrated the effect of human parathyroid hormone (1–34) (PTH) or strontium-doped hydroxyapatite coating (Sr-HA) on osteoporotic bone implantation. However, reports about effects of PTH plus Sr-HA on bone osseointegration of titanium implants in a state of osteoporosis were limited. This study was designed to investigate the effects of intermittent administration of human parathyroid hormone (1–34) on strontium-doped hydroxyapatite coating (Sr-HA) implant fixation in ovariectomized (OVX) rats. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups including control group, Sr group, PTH group and PTH+Sr group. Forty OVX rats accepted implant insertion in the distal femurs, control group, and PTH group with HA implants and the Sr group and PTH+Sr group with Sr-HA implants. Animals from PTH group and PTH+Sr group then randomly received PTH (60 µg/kg, 3 times a week) until death at 12 weeks. After 12-week healing period, implants from group PTH+Sr revealed improved osseointegration compared with other treatment groups, which is manifested by the exceeding increase of bone area ratio and bone-to-implant contact, the trabecular microarchitecture and the maximal push-out force displayed by tests like histomorphometry, micro-CT, and biomechanics evaluation. These results demonstrated that PTH+ Sr-HA coatings could enhance implant osseointegration in OVX rats, and suggested the feasibility of using this method to improve implant fixation in osteoporotic bone.

The aim of this study was to develop a novel method for observing the morphology of the blood vessels in the rabbit endplate. Twenty 6-month-old rabbits were used in this study. The blood vessels in the L5 endplate in Group A were injected with iohexol and Group B with barium sulfate. Group C was the control group with saline. To optimize the study, Group B was divided into two subgroups: Group B-1 was injected with 100% (w/v) barium sulfate and Group B-2 with 50% (w/v). After injection, the L4–L5 vertebral body was excised and the cranial endplate of L5 was scanned using a micro-CT scanner. Models of the vertebral endplate and vessels were reconstructed using the 3D reconstruction software (Mimics 16.0) by calculating a bone threshold value, and then merged these two models to create a superimposed model. The 3D vessel models could not be created in Groups A and C, but they were clearly visualized in Group B. In the 3D model, the blood vessels extended from the subchondral bone to the endplate, and the density of the blood vessels in the area of the nucleus pulposus (NP) was higher than in the annulus fibrosus. The results of this study suggest that the blood vessels in the rabbit endplate can be clearly observed by the method described using barium sulfate [the 50% (w/v) gave better results compared with the 100% (w/v)]. The information from the 3D vessel structure could provide essential data to help us understand the nutrient pathways within the vertebral endplate.

Surface modification techniques have been applied to generate titanium implant surfaces that promote osseointegration for the implants in cementless arthroplasty. However, its effect is not sufficient for osteoporotic bone. Zinc (Zn), magnesium (Mg), and strontium (Sr) present a beneficial effect on bone growth, and positively affect bone regeneration. The aim of this study was to confirm the different effects of the fixation strength of Zn, Mg, Sr-substituted hydroxyapatite-coated (Zn-HA-coated, Mg-HA-coated, Sr-HA-coated) titanium implants via electrochemical deposition in the osteoporotic condition. Female Sprague-Dawley rats were used for this study. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group HA; group Zn-HA; group Mg-HA and group Sr-HA. Afterwards, all rats from groups HA, Zn-HA, Mg-HA and Sr-HA received implants with hydroxyapatite containing 0%, 10% Zn ions, 10% Mg ions, and 10% Sr ions. Implants were inserted bilaterally in all animals until death at 12 weeks. The bilateral femurs of rats were harvested for evaluation. All treatment groups increased new bone formation around the surface of titanium rods and push-out force; group Sr-HA showed the strongest effects on new bone formation and biomechanical strength. Additionally, there are significant differences in bone formation and push-out force was observed between groups Zn-HA and Mg-HA. This finding suggests that Zn, Mg, Sr-substituted hydroxyapatite coatings can improve implant osseointegration, and the 10% Sr coating exhibited the best properties for implant osseointegration among the tested coatings in osteoporosis rats.

The objective of this study was to evaluate the effect of following combined treatment with parathyroid hormone (1-34) (PTH) and beta-tricalcium phosphate (β-TCP) on local bone formation in a rat 3-mm critical-size defect at distal femur. Twelve weeks after bilateral ovariectomy (OVX) and sham operation (sham), all animals were randomly divided into four groups: group OVX, group OVX + β-TCP, group sham, and group sham + β-TCP, then all rats underwent bone defect in the bilateral distal femurs, and β-TCP were implanted into critical-sized defects for group OVX + β-TCP and group sham + β-TCP. After defect operation, all animals were received following subcutaneous injections with PTH (60 μg/kg, three times a week) until death at 4 and 8 weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that systemic usage of PTH or local usage of β-TCP can increase the healing of defects in OVX or sham rats. Furthermore, treatments with PTH and β-TCP showed a stronger effect on accelerating the local bone formation than used alone. Osteoporosis can limit the function of PTH and/or β-TCP. The results from our study demonstrate that combination of PTH and β-TCP had an additive effect on local bone formation in non-osteoporosis and/or osteoporosis rats.

In this study, we tested the effect of Teriparatide (PTH) in combination with β-tricalcium phosphate (β-TCP) as a bone void filler in an ovariectomised rat distal femoral metaphysis model.β-TCP is a completely resorbable synthetic calcium phosphate and the Teriparatide is a drug that can promote bone formation in the condition of osteoporosis. A critical size defect of 3mm in diameter, a through-hole bone defect, was drilled into each distal femur of the ovariectomised rats. The hole was filled with β-TCP and the rat was injected PTH Teriparatide (30μg/kg) in peritoneum 5 times per week. After 4and 8 weeks the animals were killed and the degree of bone healing analysed. In total, 60 animals were investigated. When the β-TCP and PTH were used, histological, biochemistry and histomor-phometric evaluations revealed significantly better bone healing in terms of quantity and quality of the newly formed bone. The Ovariectomised rats which suffer from femur metaphysis defect are cured by embedding β-tricalcuim phosphate and intermittently cured by parathyroid hormone (PTH).

This study aimed to investigate the effect exerted by teriparatide on the repair of femoral metaphyseal defect in ovariectomized rats. Female Sprague–Dawley rats were ovariectomized and after 3 months a critically sized defect of 3 mm in diameter—a through-hole bone defect—was drilled into each distal femur of the ovariectomized rats. The rats were injected with teriparatide (30 μg/kg) parathyroid hormone (PTH) in the peritoneum three times per week. After 4 and 8 weeks the animals were killed and the blood and bilateral femora were harvested for biochemical analysis, histopathological observation, and micro-computed tomography (CT) examination. The PTH group and control group were compared 4 and 8 weeks after surgery. PTH increased bone formation in the defect area. Moreover, PTH showed the strongest effects on bone volume per total volume, trabecular number, trabecular thickness, trabecular separation, and total fluorescence-marked new bone area. Additionally, the PTH treatment group showed inhibited serum concentrations of C-terminal telopeptide of type I collagen and enhanced expression of calcium, phosphorus, and bone alkaline phosphatase. Our findings suggest a positive effect of PTH on defect healing in ovariectomized rats.