Nanchang Hongdu Hospital of Traditional Chinese Medicine

Nanchang, China

Nanchang Hongdu Hospital of Traditional Chinese Medicine

Nanchang, China

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Chen X.-F.,Shanghai JiaoTong University | Huang H.-M.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Li X.-L.,Shanghai JiaoTong University | Liu G.-J.,Shanghai JiaoTong University | Zhang H.,Shanghai JiaoTong University
International Journal of Clinical and Experimental Medicine | Year: 2015

Slightly focused high-energy shockwave (HESW) therapy is characterized by a wide focal area, a large therapy zone, easy positioning and less pain during treatment. The objective of this study was to perform for the first time an in vivo test of the slightly focused HESWs for osteoporotic fractures. Bilateral proximal tibial osteotomies were made in 30 ovariectomized (OVX) Sprague-Dawley rats and secured with internal fixation. The osteotomy site in the left tibia was subsequently treated with slightly focused HESWs with the energy flux density of 0.26 mj/mm2, shock repetition frequency of 1 Hz and 2000 shocks (OVX + HESW group). The contralateral right tibia was not treated and served as the control (OVX group). Roentgenographic examination 2, 4, 6, and 8 weeks after osteotomy showed that HESW treatment accelerated tibia fracture healing in osteoporotic rats. Histological examination 2, 4, and 8 weeks after HESW treatment showed a greater inflammatory reaction in the OVX + HESW group, with more mature collagen and trabeculae than in the OVX group. Micro computer tomography (Micro-CT) scanning after 4 and 8 weeks showed that bone volume (BV), bone volume/tissue volume (BV/TV), mean trabecular thickness (Tb.Th), and mean trabecular number (Tb.N) were about 45.0% and 33.1%, 18.4% and 20.1%, 38.2% and 20.9%, 26.7% and 28.4%, respectively, higher in the treatment group than in the control group (P < 0.05); and the mean trabecular separation (Tb.Sp) was about 16.7% and 27.3% lower in the treatment group (P < 0.05). Four and eight weeks after HESW treatment, the maximum compressive callus endurance was about 72.3% and 25.5%, respectively, higher in the treatment group than in the control group (P < 0.05). These results show that slightly focused HESW therapy has a beneficial effect on osteoporotic tibial fracture healing. Slightly focused HESWs could increase callus endurance, induce bone formation, and improve trabecular bone microarchitecture and biomechanical properties. © 2015, E-Century Publishing Corporation. All rights reserved.


Huang H.-M.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Li X.-L.,Shanghai JiaoTong University | Tu S.-Q.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Chen X.-F.,Shanghai JiaoTong University | And 2 more authors.
Chinese Medical Journal | Year: 2016

Background: Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area,a large therapy zone,easy positioning,and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats. Methods: Seventy-two female Sprague-Dawley (SD) rats,3 months old,were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66). Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation. The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2,60 doses/min,and 2000 pact quantities. The contralateral right tibia was left untreated and served as a control. Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry,real-time polymerase chain reaction (PCR),and Western blotting analysis. Results: Bone mineral density (BMD) at the proximal tibia,femur,and L5 spine was significantly reduced after ovariectomy. BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group. Meanwhile,bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals. Three months after bilateral oophorectomy,BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P < 0.001). These data showed that the SD rats became a suitable model of osteoporosis,3 months after they were OVX. Immunohistochemical analysis showed higher levels of BMP-2 and OPG expression in the treatment group than those in the control group. Compared with the contralateral controls,decreased expression of OPG and BMP-2 at 3 days after roughly focused ESWT,followed by a later increase at 7 days,was indicated by real-time PCR and Western blotting analysis. The OPG messenger RNA (mRNA) expression levels peaked at 6 weeks after the shock wave treatment,paired with a much earlier (at 4 weeks) increase of BMP-2,and declined close to normal at 8 weeks. Conclusions: Roughly focused ESWT may promote the expression of OPG and BMP-2 in the osteoporotic fracture area in rats. BMP-2 and OPG may act synergistically and may lead to a significant enhancement of bone formation and remodeling. © 2016 Chinese Medical Journal.


PubMed | Kunshan First Peoples Hospital, Nanchang Hongdu Hospital of Traditional Chinese Medicine and Shanghai JiaoTong University
Type: Journal Article | Journal: Chinese medical journal | Year: 2016

Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area, a large therapy zone, easy positioning, and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats.Seventy-two female Sprague-Dawley (SD) rats, 3 months old, were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66). Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation. The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2, 60 doses/min, and 2000 pact quantities. The contralateral right tibia was left untreated and served as a control. Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry, real-time polymerase chain reaction (PCR), and Western blotting analysis.Bone mineral density (BMD) at the proximal tibia, femur, and L5 spine was significantly reduced after ovariectomy. BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group. Meanwhile, bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals. Three months after bilateral oophorectomy, BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P < 0.001). These data showed that the SD rats became a suitable model of osteoporosis, 3 months after they were OVX. Immunohistochemical analysis showed higher levels of BMP-2 and OPG expression in the treatment group than those in the control group. Compared with the contralateral controls, decreased expression of OPG and BMP-2 at 3 days after roughly focused ESWT, followed by a later increase at 7 days, was indicated by real-time PCR and Western blotting analysis. The OPG messenger RNA (mRNA) expression levels peaked at 6 weeks after the shock wave treatment, paired with a much earlier (at 4 weeks) increase of BMP-2, and declined close to normal at 8 weeks.Roughly focused ESWT may promote the expression of OPG and BMP-2 in the osteoporotic fracture area in rats. BMP-2 and OPG may act synergistically and may lead to a significant enhancement of bone formation and remodeling.


Ma Z.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Li Y.,Shanxi Province Peoples Hospital | Zhou M.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Huang K.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | And 3 more authors.
PLoS ONE | Year: 2016

Background Aim of the present study was to identify the predictors of ibandronate efficacy in subjects with osteoporosis or decreased bone mineral density (BMD). Method Several electronic databases were searched by using specific keywords for the acquisition of research articles reporting the efficacy of ibandronate in subjects with osteoporosis or decreased BMD. Metaregression analyses were carried out by using changes in the BMD of lumbar spine and total hip following ibandronate treatment as dependent (outcome) variables against several independent (explanatory) variables. Results Data were extracted from 34 studies (11,090 ibandronate treated subjects) which fulfilled eligibility criteria. A history of previous fracture/s was reported by 46% of these subjects. In overall population, longer treatment duration from 1 to 5 years, increasing age, history of previous fractures, lower baseline T score, and higher baseline levels of C-terminal telopeptide of type 1 collagen (CTX) predicted higher ibandronate efficacy in improving BMD of the lumbar spine as well as of the total hip. Lower baseline levels of vitamin D and higher baseline levels of bone specific alkaline phosphatase (BSAP) predicted higher efficacy of ibandronate for lumbar spine only. In postmenopausal women with osteoporosis or decreased BMD, in addition to above-mentioned predictors, better efficacy of ibandronate was also associated with increasing time since menopause for both lumbar spine and total hip and lower body weight for lumbar spine only. Conclusion Longer treatment duration from 1 to 5 years, increasing age, lower baseline T scores, and higher serum CTX levels are identified as the predictors of better efficacy of ibandronate in the study subjects with osteoporosis or decreased BMD. © 2016 Ma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Li B.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Zhang B.,Nanchang University | Ding Z.,Nanchang Hongdu Hospital of Traditional Chinese Medicine | Liu Y.,Nanchang University | Dai M.,Nanchang University
International Surgery | Year: 2015

This cadaveric study was designed to clarify the anatomic basis of using an anterolateral intermuscular approach to repair type A2 intertrochanteric fractures (ITF). The conventional lateral approach to surgery that is used for ITF has several disadvantages that can result in both intraoperative and postoperative complications, especially for type A2 ITF. Previous studies have suggested using minimally-invasive total hip arthroplasty (THA) with an anterolateral approach. The legs of 10 formalin-fixed Asian cadavers were dissected, simulating an anterolateral surgical approach. The distances from the superior gluteal nerve and the lateral femoral circumflex artery branches to the lateral protrusive point of the greater trochanter were measured. The anterolateral intermuscular approach provided excellent exposure of the GT, the lesser trochanter and the femoral neck. The gluteus medius branch of the ascending branch of the lateral femoral circumflex artery (GMB-LFCA) and the most inferior branch of the superior gluteal nerve (MIB-SGN) were found to cross the spatium intermusculare between the gluteus medius and the tensor fasciae latae. The distance from the GMB-LFCA, in the intermuscular plane, to the lateral protrusive point of the GTwas (4.04 ± 1.00 cm, range 2.96-6.62 cm); and the distance from the MIB-SGN to the lateral protrusive point of the GT was (5.47 ± 1.61 cm, range 3.68-9.56 cm). The anterolateral intermuscular approach is relatively safe, provides excellent exposure, and causes less soft-tissue damage than the traditional approach, and it represents a promising new method to surgically treat type A2 ITF.


PubMed | Nanchang Hongdu Hospital of Traditional Chinese Medicine
Type: Journal Article | Journal: International surgery | Year: 2015

This cadaveric study was designed to clarify the anatomic basis of using an anterolateral intermuscular approach to repair type A2 intertrochanteric fractures (ITF). The conventional lateral approach to surgery that is used for ITF has several disadvantages that can result in both intraoperative and postoperative complications, especially for type A2 ITF. Previous studies have suggested using minimally-invasive total hip arthroplasty (THA) with an anterolateral approach. The legs of 10 formalin-fixed Asian cadavers were dissected, simulating an anterolateral surgical approach. The distances from the superior gluteal nerve and the lateral femoral circumflex artery branches to the lateral protrusive point of the greater trochanter were measured. The anterolateral intermuscular approach provided excellent exposure of the GT, the lesser trochanter and the femoral neck. The gluteus medius branch of the ascending branch of the lateral femoral circumflex artery (GMB-LFCA) and the most inferior branch of the superior gluteal nerve (MIB-SGN) were found to cross the spatium intermusculare between the gluteus medius and the tensor fasciae latae. The distance from the GMB-LFCA, in the intermuscular plane, to the lateral protrusive point of the GT was (4.04 1.00 cm, range 2.96-6.62 cm); and the distance from the MIB-SGN to the lateral protrusive point of the GT was (5.47 1.61 cm, range 3.68-9.56 cm). The anterolateral intermuscular approach is relatively safe, provides excellent exposure, and causes less soft-tissue damage than the traditional approach, and it represents a promising new method to surgically treat type A2 ITF.

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